NSW Health has progressed in identifying and addressing key R&D issues in a complex and difficult environment. The Infrastructure Grants Program (IGP) is an innovative program and reflects a commitment by Government to support research infrastructure. The IGP has as its aims the provision of significant funding accompanied by clear research objectives and criteria for accountability and introduces a rational basis for the allocation of infrastructure grants.

While NSW Health has progressed, there is an opportunity to make the IGP more efficient and effective. These opportunities are in the areas of addressing longer term planning issues in health, streamlining and clarifying eligibility and selection criteria, improving decision-making structures and processes and improving accountability.

Parliamentary reference - Report number #56 - released 25 November 1998

The Audit Office is of the view that:

• there is no system wide plan for the location of emergency departments. This function is undertaken by each Area Health Service

• coordination between the Department and the NSW Ambulance Service could be improved in aspects such as the collocation of facilities and direct communications between ambulances and emergency departments

• there is no policy framework that recognises the increasing role and impact of private providers

• the Department’s guidelines do not take into account demographic factors, the number of patients treated or the acuity of presentations as criteria for determining the size of an emergency department or the level and scope of emergency services that should be available at that location.

• the Department has introduced a range of initiatives over a period of time to improve the performance of emergency departments such as the establishment of the Integrated Bed Management Committee. Some have been quite effective, whilst others have had mixed success. There has been an overall improvement in emergency department waiting times for urgent cases. However, there has been little improvement in waiting times for less urgent cases and a decline in performance for access block (the time taken to be admitted to a hospital ward from the emergency department after a decision has been made that this is required).

Parliamentary reference - Report number #54 - released 21 October 1998

This audit was initiated following concerns expressed by the Department of Agriculture about the Police’s handling of a suspected fraud that it had first reported in 1996. The Department’s main concern related to the long delays before a full Police investigation took place.

Nevertheless, the current review highlighted a number of areas that, in the opinion of The Audit Office, require closer examination and resolution by the Police Service in implementing their changes. This report highlights those areas and provides recommendations for the Police to consider in its implementation of its reforms. Key areas requiring attention include: service standards are not clearly defined for the police response to fraud, without which it is difficult to ensure that police objectives and public expectations are met; restrictive employment arrangements which limit management’s ability to obtain the appropriate mix of people with skills to investigate fraud and inadequate information systems to support operational, tactical and strategic decision-making.

Parliamentary reference - Report number #53 - released 14 October 1998

While central communications units are responsible for broadcasting calls from the public for assistance to police cars; these units have no authority over those police cars. And while local police commands are responsible for police deployment, they have no ready capability to communicate with their police cars. The report also found that Local police management have limited contemporaneous knowledge of what their response resources are doing, and little useful management information that can tell them what they have done over prior periods. Current systems of response fail to distinguish adequately between calls of various types. All tend to be allocated for response by a police car, even where the caller’s needs may be equally well met by alternatives which are less resource intensive.

The NSW Police Service has begun to address these limitations. But it understands that more needs to be done before the service can realise improvements in response performance, and evidence levels of efficiency and effectiveness. In particular, the NSW Police Service should: formulate a strategy for improving response overall, before it commits itself to major new investments in this area and, as part of this strategy it should clarify accountabilities throughout the response “system” and develop a framework of indicators and standards to help it (and the public) monitor response performance.

Parliamentary reference - Report number #47 - released 10 March 1998