The Ambulance Service of New South Wales has substantially implemented the 28 recommendations of the 2001 audit report that it accepted. It has also introduced significant new initiatives to improve performance that were not part of the 2001 recommendations. It has made substantial changes to its organisation and operations to implement these changes. Many of the changes are still proceeding. The Service has addressed a key finding of the 2001 audit report - that it did not have adequate, relevant or credible management data for decision making. The Service now has five years of operational data from the Computer Aided Dispatch (CAD) system.

Parliamentary reference - Report number #167 - released 6 June 2007

Many projects, both Partnership Against Homelessness and by individual agencies, have shown good results or led to improvements. One example is helping mental health patients maintain stable housing. Another is providing street outreach services to homeless people in inner Sydney. Despite these efforts, we were unable to determine how well the government is responding to homelessness statewide. This is because there are no statewide performance measures or targets on homelessness. Also there is limited benchmarking, and no formal means of spreading information on homelessness initiatives and projects.

Parliamentary reference - Report number #165 - released 2 May 2007

Assessment processes for older people needing to go to an Residential Aged Care Facility (RACF) vary depending on the processes of the Aged Care Assessement Teams (ACAT) they see and whether or not they are in hospital. The data collected on ACAT performance was significantly revised during 2004 making comparisons with subsequent years problematic. ACATs have more responsibilities than assessing older people for residential care. It is not clear whether they have sufficient resources for this additional workload.

Parliamentary reference - Report number #160 - released 5 December 2006

NSW Health is working to increase its preparedness to respond to a major infectious disease outbreak. It is also contributing to the development of national policies, strategies and capabilities, which affect its level of preparedness. We found however little evidence that other jurisdictions were significantly further advanced than NSW in preparation and testing of plans for a pandemic. In our view NSW Health needs to balance the costs of over-preparedness and additional capacity that may never be used, against the very significant consequences of under-preparation. It needs to identify the desired level of preparedness for its Area Health Services, set measurable goals and identify key gaps between those goals and current capabilities. It needs to set clear plans for closing those gaps and then sustaining desired levels of preparedness.

Parliamentary reference - Report number #159 - released 22 November 2006

The Roads and Traffic Authority (RTA) has improved the overall surface condition of State Roads in the last decade. Country road surfaces are now generally much better. Ride quality has improved and cracking has been reduced. The RTA has also achieved a substantial reduction in the number of structurally deficient bridges over the same period. 

Despite a significant increase in the State’s contribution to maintenance since 1999-2000, the RTA has deferred road rebuilding projects. The RTA is rebuilding at less than half its long term target, and has not met this target at any time this decade. The RTA has not identified how it will address deferred rebuilding, although it advises it is developing a new road network management plan which will address this.

Parliamentary reference - Report number #157 - released 16 August 2006

In our opinion the Government’s ‘no net cost to government’ requirement was a legitimate (but not the only possible) basis for the tunnel bid process. The Government was entitled to decide that tunnel users meet the tunnel costs. Structuring the bid process on the basis of an upfront reimbursement of costs incurred (or to be incurred) by the Roads and Traffic Authority (RTA) was therefore appropriate.

In our opinion, however, the Government, Treasury and the RTA did not sufficiently consider the implications of an upfront payment involving more than simple project cost reimbursement (i.e. the ‘Business Consideration Fee’ component). In addition, the RTA was wrong to change the toll escalation factor late in 2002 to compensate the tunnel operator, Cross City Motorway Pty Ltd, for additional costs.

Parliamentary reference - Report number #152 - released 31 May 2006

In the cases we examined, we found that agencies working together can improve services or results. However, the changes were not always as great as anticipated or had not reached maximum potential. Establishing the right governance framework and accountability requirements between partners at the start of the project is critical to success. And joint responsibility requires new funding and reporting arrangements to be developed.

Parliamentary reference - Report number #149 - released 22 March 2006

In our view the contracts in the New Schools Privately Financed Project were established and let in a way that greatly assists their potential for delivering value for money. The contracts in the New Schools Privately Financed Project are at an early stage of their 30 year lives and the savings and other benefits are not guaranteed. The contracts will need to be carefully managed over the 30 year period to ensure that benefits are realised and that costs do not escalate beyond expectations.

Parliamentary reference - Report number #148 - released 8 March 2006

Several of my recent audits have identified a need to improve our public transport system – both for the benefit of travellers and to assist in achieving better air quality.

Bus Transitways can provide a good public transport solution for lower density population areas, potentially at a relatively low capital cost. This audit examines the transitway running between Liverpool and Parramatta, the first of several planned for Sydney. This audit should contribute to a better understanding of the lessons learnt from this first project, and so to future transitways providing better value for money.

But this audit also raises broader issues.

It highlights the importance of accurately projecting the total cost of major infrastructure projects before governments lock in their decisions. It also highlights the need for sound decision-making processes when government agencies compete with the private sector. The principles and recommendations flowing from these issues are ones I would draw to the attention of all agencies, and to the Government.

Parliamentary reference - Report number #146 - released 5 December 2005

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