Area Health Services and hospitals have developed programs which can provide clinical outcomes as good for patients as in-hospital care and can reduce the time they spend in hospital. They have operated for several years and show considerable potential. Ageing of the population, increasing costs and higher expectations of health care will continue to challenge health systems. Sometimes, unfortunately, the system struggles to cope. 

Parliamentary reference - Report number #182 - released 24 September 2008

The Better Practice Guide (BPG) aims to provide guidance for those implementing an amalgamation. It provides a series of questions identifying what needs to be done to achieve a successful amalgamation following the formal announcement of the amalgamation and the Administrative Orders for the new arrangements being finalised. The BPG’s aim is to alert those managing an amalgamation to actions that should be considered. How the Guide is applied will depend on circumstances. A lot will depend on how clear the expectations of the amalgamation are and on how complex it is.

Parliamentary reference - Report number #176 - released 5 March 2008

Both Commerce and DPI substantially achieved their stated amalgamation savings objectives as set by government. The departments are expected to achieve savings targets of about $150 million and $190 million respectively over their first four years. Our analysis indicates that there are two key factors in successful amalgamations. The first is effective early planning by departments based on clear objectives, supported by quick action. Second, significant synergies in service delivery can be achieved when departments with similar services and customers are amalgamated. The Department of Primary Industries is an example.

Parliamentary reference - Report number #175 - released 5 March 2008

The department has done well to attract and retain nurses. Between 2001-02 and 2005-06 the average number of nurses employed increased to 39,804 with the annual resignation rate falling from 16 to 14 per cent. Overall, the public health sector gained 5,588 nurses, representing an average annual increase of four per cent. Despite the gains, there are indicators that there may still not be enough nurses.

Parliamentary reference - Report number #162 - released 12 December 2006

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 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

Decisions to relocate government agencies to non-metropolitan areas are not made purely for cost reasons. They can also serve government policy objectives, such as promoting regional economic development.

Regardless of the policy objectives that may exist, I would expect that decisions on individual agency relocations would be based on sound business cases. Those business cases would show how the relocation achieves any relevant government objectives, what costs (or savings) would be involved, logistical considerations such as obtaining appropriate accommodation and staff, and any impacts on levels service to the public.

In my view, the existence of government policy objectives does not remove the need for individual decisions to be made in a transparent, rational and accountable manner. Responsible public servants should provide the appropriate information to government to allow it to judge how best to implement its policies.

Parliamentary reference - Report number #147 - released 14 December 2005

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