It is estimated that one in five people will be affected at some stage by a mental health problem or illness. The increasing prevalence of mental illness means that at some point in time most of us will either be affected or we will know of someone who is.

Although most people with mental illness can be treated in the community, at times some may require emergency treatment or admission to hospital for shortterm intensive therapy.

Not only are more mental health patients presenting to an emergency department for treatment than ever before, they are reportedly sicker and a greater number require admission to a hospital bed for further treatment. And, because of its very nature, those suffering from acute mental illness may not understand what is wrong or be able to communicate their problems clearly.

This makes access to emergency mental health services a significant issue for government that requires continuing attention.

The focus of this report is on the provision of 24-hour crisis services to adults. Emergency mental health services play a vital role in providing timely and appropriate care. Without proper treatment the severity of the illness may escalate, increasing the risk of self-harm or harm to others.

There have been many changes to mental health services over the last decade to deal with increasing demand. Much has been done to improve access to, and the quality of emergency services through significant increases in funding, the opening of new beds and the employment of more mental health staff.

Yet recent reviews have highlighted problems with accessing mental health beds and inadequate levels of psychiatric support in rural areas.

I believe that our report will provide valuable assistance to area health services on alternative models of emergency mental health care that better manage patient risk and further improve service quality.

Parliamentary reference - Report number #136 - released 26 May 2005

This audit follows our earlier studies on ambulance response times, on waiting times for elective (i.e. non-urgent) surgery and on the ‘Code Red’ status of hospital emergency departments. Those audits indicated that matching resources to the ever-increasing numbers of people seeking emergency treatment was certainly an issue, but not the only issue. We found that problems were also occurring at the ‘interface’ between different parts of the health system – when patients arrive in ambulances at emergency departments or when they need to be admitted from emergency departments to hospital wards.

Parliamentary reference - Report number #125 - released 28 July 2004

All three hospitals followed the Department of Health’s guidelines for judging capacity and had systems in place to notify hospital staff and ambulance crews of changes in status. We found discrepancies in the records kept by all three hospitals when compared to the records maintained by the Department of Health. Our view however, is that these records do not need to be a perfect match for the intended purpose, which is to guide ambulance crews to the shortest queue.

Parliamentary reference - Report number #121 - released 15 December 2003

We recognise that managing waiting times is a difficult and complex task. Waiting times are influenced by many factors, some of which are outside the control of NSW Health. There are, however, steps which NSW Health could, and should, take to ensure that the processes to manage waiting times are efficient and effective. By all measures used by NSW Health, patients are waiting longer for elective treatment today than six or seven years ago. In March 2003 patients admitted to elective medical or surgical treatment had waited, on average, 1.8 months, whereas in March 1997 they would have waited on average 1.1 months.

Parliamentary reference - Report number #116 - released 18 September 2003

Freedom of Information (FOI) Coordinators and their staff were supportive of the legislation. However, the agencies examined can do considerably more to fully achieve the intentions of the Act. On the positive side, all three agencies had processes in place to handle requests and had made a number of changes to improve the effectiveness of the FOI process. Fees and charges had also been kept to a minimum. No processing fees were requested in the majority of cases, and if charged, were not unreasonable.

Parliamentary reference - Report number #114 - released 28 August 2003

State Rail has made significant improvements since the purchase of the Tangara. It improved measures necessary for handling contracts dealing with technically complex and innovative projects, although some other problems have been encountered, with new lessons to learn. The design and manufacture of new trains requires a significant investment in both time and cost. The Millennium Train has come at a considerably higher price than originally expected. And it is very late compared to the Government’s original announcements, as the development/design took longer than planned.

Parliamentary reference - Report number #112 - released 17 June 2003

A staged, systematic and careful approach and extensive business re-engineering effort underpinned the Roads and Traffic Authority's (RTA) steady progress in providing customers with a range of reliable and secure online registration services. The RTA’s consistent and disciplined pursuit of new and challenging e-business opportunities is commendable.

Parliamentary reference - Report number #111 - released 11 June 2003

StateRail has invested significantly over the last five years in passenger safety and security. Security guards on trains from 7.00 pm were introduced in 1998. More recently, additional lighting, 5,700 closed circuit television cameras (CCTV) and emergency help points have been installed on CityRail stations. In addition, CityRail has employed some 100 transit officers to patrol its network and intends to employ another 200 transit officers in 2003. While substantial steps have been taken to reduce crime and improve passenger safety and security, the results have been mixed. Overall, the risk of a passenger becoming a victim of a crime on CityRail has increased.

Parliamentary reference - Report number #106 - released 12 February 2003

The Audit Office is of the opinion that, while agencies are aware of the need to manage risk, their risk management falls short of better practice. Many agencies do not consider their risk management to be adequate. The survey suggests that some agencies, mainly those in the Public Trading Enterprise Sector have approached risk management in a systematic way and in accordance with the principles of better practice standards. Others, mainly departments not subject to commercial imperatives, have yet to progress the management of risk beyond the traditional response of insuring against the more common types of risk. Thus there is a danger that with a number of agencies, risk may not be managed adequately, especially in the General Government Sector.

Parliamentary reference - Report number #98 - released 19 June 2002

State Transit has developed fleet management plans and maintenance standards that meet its regulatory and contractual obligations as a bus operator and are consistent with vehicle manufacturers’ standards and best practice. However, assumptions used in fleet management plans to forecast fleet growth may not result in the most efficient and effective outcome for State Transit. Forecasts fail to take account of opportunities to redesign or reduce services where they exceed contract requirements and are difficult to justify on a commercial basis. Of greater concern are the consequences arising from bus maintenance practices not meeting State Transit’s own standards.

Parliamentary reference - Report number #97 - released 29 May 2002