This report includes comments on financial audits of government agencies in the Health sector. In 2010-11, Ambulance Officers spent an extra 77,200 hours waiting at emergency departments for patients to transfer to hospital care. In 2010-11, only 66 per cent of patients were moved from the emergency department to an inpatient bed within eight hours of their arrival. This is significantly down on last year’s 73 per cent and well below the 80 per cent target.

We found that hospitals are generally able to deploy their VMOs and staff specialists to be at the place and time required. However, a hospital’s ability to manage supply and demand at a local level is limited. This limitation will become more critical with the current national health reforms when public hospital funding will depend on their ability to set and meet activity targets and priorities. NSW Health cannot be sure that all payments made to VMOs are for agreed and delivered services. Across the hospitals visited we found limited checking of VMO claims for payment, limited quality information on staff specialist activities and limited hospital-level analysis of trends or inconsistencies in activities and treatments.

Parliamentary reference - Report number #219 - released 14 December 2011

The report includes comments on financial audits of government agencies in the Transport and Ports sectors. The audit of corporations’ financial statements for the year ended 30 June 2011 resulted in unmodified audit opinions within the Independent Auditor’s Reports. A key recommendation from the report is that Sydney Ports Corporation should continue working with other government authorities and industry stakeholders to improve the effectiveness of program initiatives for increasing container freight movements by rail. The Corporation should review the underlying causes hindering growth in the rail mode and develop and implement strategies to address the unfavourable trend.

The audits of the New South Wales Government controlled superannuation entities financial statements for the year ended 30 June 2011 resulted in unmodified audit opinions within the Independent Auditor’s Reports. Findings show that Treasury should review the structure and number of public sector superannuation funds and consider whether efficiencies and cost savings could be achieved through consolidation.

There have been tangible improvements in the time it takes NSW Government agencies to engage consultants through the Government’s Prequalification Scheme. The Scheme was introduced in February 2008 to improve agencies’ procurement of consultants. More than 300 service providers have been prequalified and over $300 million worth of consultancy services have been provided. Ideally agencies should know what assignments each consultant has won, for what services, what their rates are and how well they have performed. Agencies should then be free to contact other agencies before engaging a consultant.

Parliamentary reference - Report number #216 - released 28 September 2011

The level of non compliance with the requirements of this Premier’s Memorandum is concerning, particularly considering the NSW Procurement Reforms were effective since 2006. The implementation strategy for procurement reform was announced as early as 2001. We recommend the governing bodies of agencies and management review, not only the processes their agencies have in place to comply with procurement reforms and requirements, but also more broadly how agencies identify and comply with laws, regulations, Treasury policy pronouncements, Premier’s memoranda and other obligations. 

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

There have been notable changes in the provision of emergency department services over the last decade, principally by increasing the number, seniority and training of staff and upgrading facilities. More recently, programs have focussed on achieving improvements in emergency department waiting times (the time taken to see a doctor) and access block (delay in accessing a hospital bed). However, these programs have had limited effect. Although waiting times for seriously ill patients have decreased, waiting times for around 95% of emergency department patients have increased or remain unchanged and performance against benchmarks for access block has declined each year.

Although The Audit Office identified opportunities to improve patient flow in the emergency department, benefits will be limited by access block and the congestion caused by being unable to move patients to a ward. Only a better balance of resources between inpatient access programs (that is booked and emergency department patients) will bring about improvements in access block.

Parliamentary reference - Report number #72 - released 15 March 2000