We found that the two NSW Health campaigns had followed the required approval processes and were appropriate. We had some concerns with the two Department of Premier and Cabinet (DPC) campaigns. The revised Guidelines, which incorporate recommendations from earlier audit reports, are a positive step towards reducing the risk that publicly funded advertising could be used inappropriately. But there are still parts of the Guidelines that require a subjective judgement and therefore do little to help manage this risk. While we did not have any concerns with the two NSW Health campaigns, the two DPC campaigns highlighted these risks.

Parliamentary reference - Report number #194 - released 9 December 2009

The Magistrates Early Referral into Treatment program (MERIT) diverts adult defendants with drug problems from the local court into a drug treatment program. Recent studies of MERIT outcomes indicate that MERIT is a highly appropriate intervention program for Aboriginal defendants. It has improved the health of participants, including significant reduction in drug use and significant improvement in mental health. Better justice outcomes include lower rates of imprisonment and reduced rates of reoffending.

Overall, the ability to identify MERIT clients, the eligibility criteria, the location and the ability of MERIT teams to engage with Aboriginal defendants are key factors that limit MERIT’s capacity to treat Aboriginal defendants. MERIT needs to overcome these barriers. If MERIT is to be a truly mainstream program, it must adapt to meet the needs of all who should participate.

Parliamentary reference - Report number #189 - released 5 August 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

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

Issues of corporate governance have long been a matter for concern in the private sector. Following recent corporate collapses and scandals, legislators and regulators in a number of countries have focused on strengthening governance in publicly traded corporations. Considerable attention has been given to setting clear expectations for the performance of boards and for the disclosure of information to various stakeholders.

Good governance is no less important in the public sector.

Indeed issues of oversight and accountability may be more complex in the public sector, particularly in government businesses. There are more stakeholders involved (portfolio Ministers, shareholder Ministers, Parliament and central agencies) and there are competing – and potentially conflicting - objectives (financial, social, environmental, etc).

Because of these potential conflicts, it is important that Boards understand what government expects of them. Some of these expectations reflect the government’s regulatory role in areas such as safety, pricing and ensuring consumers receive essential services. Some expectations reflect the government’s role as a business owner.

Having a clear separation of regulatory expectations from ownership expectations is essential if boards are to be accountable for their performance on both aspects. To assist in this separation, New South Wales (like many other jurisdictions) has adopted the concept of ‘shareholder Ministers’ – as distinct from the portfolio Minister – to exercise the ownership function.

This report looks more closely at a particular area - how the State conducts itself as the owner of the State owned electricity corporations. This is an important issue as the State’s (ie taxpayers’) equity in these businesses is worth over $9 billion. Managing the risks associated with continuing ownership of these businesses is an essential aspect of good governance.

Although the audit focuses on the State’s holdings in the electricity sector, its findings and recommendations have relevance for all State owned corporations.

Parliamentary reference - Report number #144 - released 19 October 2005

Hospitals, schools, public housing, roads, bridges, buses and trains are just some of the assets used by government in providing services to citizens.

The NSW Government’s asset base is impressive in size - with a value of around $167 billion and with government plans to spend around $8 billion acquiring or replacing assets in the current year. Another $2 billion is spent each year on maintenance.

Good asset management is very important to government; even a small efficiency gain in this area can provide significant returns. Good practice by those responsible for managing assets can improve reliability, extend asset life, save on maintenance costs and aid in identifying and disposing of unnecessary or non-performing assets.

Improving the NSW public sector’s approach to asset management has been on the reform agenda for at least a decade. Changes in practice have been accelerated more recently by integrating asset management policy with the budget process.

In this audit we examined NSW Treasury’s efforts to improve asset management practices in the public sector and the progress made by 3 agencies - the Department of Corrective Services, NSW Fire Brigades and the Powerhouse Museum - towards better managing their asset portfolios.

This report informs Parliament and the community on progress to date and what more needs to be done to ensure that agencies manage assets effectively and achieve best value.

Parliamentary reference - Report number #143 - released 12 October 2005

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

Both the University of New South Wales' Internal Audit and HR reports identified serious deficiencies in the operation and management of the Education Training Centre (ETC). This performance audit verified those findings where appropriate, and they are referred to or incorporated within this report. In addition, we identified other weaknesses that are also presented here. All the findings point to a serious lack of management controls, proper accountability and management practices within ETC.

The Audit Office has a concern whether other activities within the University, or indeed within any other university, could be functioning with similar lack of corporate governance and accountability arrangements. The Audit Office considers that there is an urgent need for the University, and for other universities, to review their corporate governance and accountability framework.

Parliamentary reference - Report number #91 - released 21 November 2001