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Published

Actions for Purchasing Hospital Supplies: Follow-up of 2002 Performance Audit

Purchasing Hospital Supplies: Follow-up of 2002 Performance Audit

Health
Asset valuation
Financial reporting
Management and administration
Procurement
Service delivery

Periodically we review the extent to which agencies have changed their practices as a result of our audits. This gives Parliament and the public an update on the extent of progress made.

In this follow-up audit, we examine changes following our September 2002 report, to assess whether NSW Health has improved its buying of hospital supplies using electronic systems.

NSW Health spends over $1.3 billion on hospital supplies. It is the largest expenditure area after employee costs. Reform of this area has the potential to make significant savings that could be redirected to frontline services.

As part of our series of audits in the area of e-government, our previous audit looked closely at the extent to which technology was being used to deliver potentially major savings in purchasing hospital supplies. This is a key area of so-called “process re-engineering” in the “e” field, and NSW Health provided an ideal case study.

Whilst implementing large-scale e-procurement has many technical aspects, it is not chiefly a technical issue. The key requirements for success reside in effective change management, in particular being clear as to who has the authority to make change decisions and be held accountable.

This audit looks at NSW Health’s successes to date, and its frustrations and challenges in making further progress in this field. Many of the issues raised in this report may provide lessons for any agency that is seeking to drive a significant change program.

 

Parliamentary reference - Report number #145 - released 23 November 2005

Published

Actions for Implementing Asset Management Reforms

Implementing Asset Management Reforms

Justice
Planning
Finance
Treasury
Asset valuation
Financial reporting
Infrastructure
Internal controls and governance
Management and administration
Project management

Hospitals, schools, public housing, roads, bridges, buses and trains are just some of the assets used by government in providing services to citizens.

The NSW Government’s asset base is impressive in size - with a value of around $167 billion and with government plans to spend around $8 billion acquiring or replacing assets in the current year. Another $2 billion is spent each year on maintenance.

Good asset management is very important to government; even a small efficiency gain in this area can provide significant returns. Good practice by those responsible for managing assets can improve reliability, extend asset life, save on maintenance costs and aid in identifying and disposing of unnecessary or non-performing assets.

Improving the NSW public sector’s approach to asset management has been on the reform agenda for at least a decade. Changes in practice have been accelerated more recently by integrating asset management policy with the budget process.

In this audit we examined NSW Treasury’s efforts to improve asset management practices in the public sector and the progress made by 3 agencies - the Department of Corrective Services, NSW Fire Brigades and the Powerhouse Museum - towards better managing their asset portfolios.

This report informs Parliament and the community on progress to date and what more needs to be done to ensure that agencies manage assets effectively and achieve best value.

 

Parliamentary reference - Report number #143 - released 12 October 2005

Published

Actions for In-year Monitoring of the State Budget

In-year Monitoring of the State Budget

Finance
Premier and Cabinet
Compliance
Financial reporting
Internal controls and governance
Management and administration

The annual Budget is one of the most important and visible statements about a government’s financial intentions.

Once a Budget is released, it is important to monitor variations from the projections it contains. This is done for two reasons -

  • first, to ensure that individual agencies are properly managing their budget allocations and that any genuine emerging need for additional funding is met.
  • second, to ensure that any changes to the State’s overall financial position are understood and corrective action is undertaken.

This audit dealt primarily with the second of these objectives.

Budget monitoring involves both agencies and Treasury working together to quickly identify factors that might impact the budget, to clearly understand the implications for their budget position and to take any remedial action needed.

Poor monitoring may reduce the confidence that stakeholders have in the government’s financial management. It may mean that government decisions made in- year or for the following budget (for example on tax measures or spending increases/savings) are based on an incorrect understanding of the State’s true financial position.

I hope that this Report provides some useful insights that will assist in better monitoring.

 

Parliamentary reference - Report number #141 - released 28 July 2005

Published

Actions for Emergency Mental Health Services

Emergency Mental Health Services

Health
Management and administration
Service delivery
Shared services and collaboration
Workforce and capability

It is estimated that one in five people will be affected at some stage by a mental health problem or illness. The increasing prevalence of mental illness means that at some point in time most of us will either be affected or we will know of someone who is.

Although most people with mental illness can be treated in the community, at times some may require emergency treatment or admission to hospital for shortterm intensive therapy.

Not only are more mental health patients presenting to an emergency department for treatment than ever before, they are reportedly sicker and a greater number require admission to a hospital bed for further treatment. And, because of its very nature, those suffering from acute mental illness may not understand what is wrong or be able to communicate their problems clearly.

This makes access to emergency mental health services a significant issue for government that requires continuing attention.

The focus of this report is on the provision of 24-hour crisis services to adults. Emergency mental health services play a vital role in providing timely and appropriate care. Without proper treatment the severity of the illness may escalate, increasing the risk of self-harm or harm to others.

There have been many changes to mental health services over the last decade to deal with increasing demand. Much has been done to improve access to, and the quality of emergency services through significant increases in funding, the opening of new beds and the employment of more mental health staff.

Yet recent reviews have highlighted problems with accessing mental health beds and inadequate levels of psychiatric support in rural areas.

I believe that our report will provide valuable assistance to area health services on alternative models of emergency mental health care that better manage patient risk and further improve service quality.

 

Parliamentary reference - Report number #136 - released 26 May 2005

Published

Actions for Planning for Sydney's Water Needs

Planning for Sydney's Water Needs

Planning
Environment
Infrastructure
Internal controls and governance
Management and administration
Procurement
Project management
Service delivery

Reliably supplying water to our State’s principal city, Sydney, is a major responsibility for the Government.

The community has been made keenly aware in recent years that inflows have been decreasing, and that Sydney has been using more water than is available. In April 2005 the water in Sydney’s storages dropped to 41.5 per cent of their capacity – the lowest level since the construction of Warragamba dam in 1960.

As Sydney continues to develop, it is expected that the demand for water will increase. The way that we use it will need to be sustainable, as it has a direct impact on our economy, our lifestyle and our environment.

In planning for the future the State’s water agencies face a range of uncertainties. But the task is vital.

This report informs Parliament and the community on the progress made - and what remains to be done - to ensure a reliable water supply for Sydney.

 

Parliamentary reference - Report number #135 - released 4 May 2005

Published

Actions for Follow-up of Performance Audit: Collecting Outstanding Fines and Penalties

Follow-up of Performance Audit: Collecting Outstanding Fines and Penalties

Finance
Internal controls and governance
Management and administration
Service delivery

Periodically we review the extent to which agencies have implemented the recommendations they accept from our earlier audits. This gives Parliament and the public an update on the extent of progress made.

In this follow-up audit, we examine changes following our April 2002 report on how well the State Debt Recovery Office (under the Office of State Revenue) was collecting outstanding fines and penalties.

 

Parliamentary reference - Report number #132 - released 17 March 2005

Published

Actions for Educational Testing Centre

Educational Testing Centre

Universities
Internal controls and governance
Management and administration
Risk

Both the University of New South Wales' Internal Audit and HR reports identified serious deficiencies in the operation and management of the Education Training Centre (ETC). This performance audit verified those findings where appropriate, and they are referred to or incorporated within this report. In addition, we identified other weaknesses that are also presented here. All the findings point to a serious lack of management controls, proper accountability and management practices within ETC.

The Audit Office has a concern whether other activities within the University, or indeed within any other university, could be functioning with similar lack of corporate governance and accountability arrangements. The Audit Office considers that there is an urgent need for the University, and for other universities, to review their corporate governance and accountability framework.

 

Parliamentary reference - Report number #91 - released 21 November 2001

Published

Actions for Follow-up audits: Police response to calls for assistance, The levying and collection of Land Tax and Coordination of bushfire fighting activities

Follow-up audits: Police response to calls for assistance, The levying and collection of Land Tax and Coordination of bushfire fighting activities

Justice
Finance
Management and administration
Service delivery

The acceptance of audit recommendations by agencies in the current review was high and represented 96 per cent of the recommendations made. In addition, half of the recommendations in the 1998 audits have been adequately addressed and for over 70 per cent of recommendations there has been some measurable change in practices or performance.

But overall, most of these improvements have been incremental. And, for nearly one third of the recommendations, changes have not yet taken effect and there is a risk that the issue or problem contained in the original reports may persist. There is also a danger that current reporting arrangements may not provide Parliament sufficient assurance as to the extent accepted recommendations have been implemented and improvements have been achieved. 

To provide greater transparency and accountability, agencies, following a performance audit, should establish arrangements, such as an audit committee, to follow up on the progress of implementation of the recommendations and report on the progress of the implementation of recommendations in their annual report to Parliament.

 

Parliamentary reference - Report number #84 - released 21 June 2001

Published

Actions for Controlling and reducing pollution from industry

Controlling and reducing pollution from industry

Planning
Environment
Compliance
Management and administration
Regulation

The regulatory framework introduced under the Protection of the Environment Operations Act 1997, along with other initiatives progressively being implemented by the Environment Protection Authority (EPA), should enhance the overall effectiveness of environment protection in NSW. The Audit Office is of the opinion that the framework is consistent with best practice and once fully implemented, should contribute to the achievement of further improvements in the environmental performance of industry.

However while the legislative framework supports best practice in regulation and enforcement, there are a number of issues which limit the effectiveness of the reforms. Some of the problems, such as the quality of licences and the effectiveness of compliance activities, have been identified by the EPA and may be addressed through recent initiatives.

 

Parliamentary reference - Report number #82 - released 18 April 2001

Published

Actions for Ambulance Service of NSW: Readiness to respond

Ambulance Service of NSW: Readiness to respond

Health
Internal controls and governance
Management and administration
Shared services and collaboration
Workforce and capability

This performance audit indicates that the Service has considerable work to do to reach its aspirations of being recognised amongst leading examples of best practice services. The commitment of the Service to serving the community and the professionalism of the Service's officers is not in question. It is, however, apparent that a number of barriers to performance will need to be overcome for the Service to perform as well as it would wish.

 

Parliamentary reference - Report number #80 - released 7 March 2001