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.

This audit focuses on the M4 handback. It looks at whether the road will be in good condition when the State gets it back, and whether it will cope with the extra traffic after the toll is removed. These are critical issues for taxpayers and motorists. Taxpayers don’t want to be responsible for a large repair bill and motorists don’t want to be stuck in traffic jams.

To ensure that future private sector partnerships (PPP) deal adequately with handback, we recommend that the Roads and Traffic Authority (RTA):

• ensure deeds spell out an appropriate inspection and testing program to determine repairs required to bring roads up to a satisfactory condition at handback (p.11)
• ensure deeds link condition standards and maintenance approaches to changing industry standards and approaches over the life of the PPP (p.11)
• consider including in deeds a requirement that operators provide a performance bond or similar security over the cost of handback repairs (p.11)
• review the lessons learnt from the M4 tollway handback and determine whether it should seek to negotiate changes to existing tollway deeds to better deal with handback, by June 2010 (p.11)

Parliamentary reference - Report number #193 - released 27 October 2009

Overall radiotherapy services are managed in a reasonably efficient and effective manner. Much is being done to further improve efficiency and effectiveness, and more can be done. While New South Wales has a number of well-established radiotherapy treatment centres, the high capital cost limits their availability in all hospitals. Some patients need to travel long distances and be away from their homes for up to seven weeks. The projected growth in demand for radiotherapy services will further challenge NSW Health and it needs to more clearly demonstrate how it will have the right facilities in the right place at the right time.

Parliamentary reference - Report number #188 - released 23 June 2009

We found no significant difference in the funding of government and opposition electorates. However, more money was given to electorates that were safely held by the major parties. These seats received $1.29 for every dollar given to marginal and independent seats with government marginals getting the least. Electorates also receive different levels of funding according to which region they are in. Such variations may reflect valid agency objectives such as meeting State Plan targets or addressing socio-economic disadvantage.

But while agencies publish who gets what, they do not adequately evaluate or explain what grant programs have achieved. As a result, there is a risk that New South Wales may not get the best value for its spending. We recommend that agencies regularly evaluate their grant programs and publish the results.

Parliamentary reference - Report number #186 - released 6 May 2009

We see considerable potential for the Ministry of Transport to plan and manage interchanges more effectively, so as to make better use of our public transport network. We believe that the Ministry now needs to focus more on multi-modal transport planning and interchange performance. It needs to assign responsibility for the coordination and oversight of inter-modal operations to an entity resourced for the purpose. Without this it will continue to be very difficult to identify and address unmet needs, seek and secure stakeholder funding, and monitor and evaluate system performance.

Parliamentary reference - Report number #168 - released 6 June 2007

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

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