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

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

Reliably supplying water to our State’s principal city, Sydney, is a major responsibility for the Government.

The community has been made keenly aware in recent years that inflows have been decreasing, and that Sydney has been using more water than is available. In April 2005 the water in Sydney’s storages dropped to 41.5 per cent of their capacity – the lowest level since the construction of Warragamba dam in 1960.

As Sydney continues to develop, it is expected that the demand for water will increase. The way that we use it will need to be sustainable, as it has a direct impact on our economy, our lifestyle and our environment.

In planning for the future the State’s water agencies face a range of uncertainties. But the task is vital.

This report informs Parliament and the community on the progress made - and what remains to be done - to ensure a reliable water supply for Sydney.

Parliamentary reference - Report number #135 - released 4 May 2005

Air is fundamental to our existence.

The quality of our air is a key issue for everyone. It directly affects our health. It also affects our environment, and can even affect our economy.

And air pollution does not respect geo-political boundaries. Pollution produced locally may have regional and global implications.

The substances which may pollute our air can interact in complex ways, which even the best scientists do not fully understand. Strategies that reduce some types of air pollution can make others worse.

All this points to the need for a well-planned and coordinated approach with effective monitoring, review and reporting.

The Government’s plans to address air quality issues place particular emphasis on pollution from road transport as a major contributor to air pollution. Managing these emissions is a critical issue facing governments everywhere, and is an important part of a broader challenge of developing sustainable cities.

This performance audit examines the New South Wales Government’s approach to managing air quality. It is also one of several by my Office in recent times with an environmental focus.

These audits contribute to an understanding of complex issues in public administration and to public debate on issues that affect us all.

Parliamentary reference - Report number #134 - released 6 April 2005

Periodically we review the extent to which agencies have implemented the recommendations they accept from our earlier audits. This gives Parliament
and the public an update on the extent of progress made.

Intellectual property (IP) can have value to the agency concerned and may have the potential for wider commercial use. Poor management of IP can impose risks, including the risk of lost opportunities. Because it is not ‘tangible’ like a building or plant and equipment, the need for properly managing IP may be overlooked.

In this follow-up audit, we examine changes following our October 2001 report on how well public sector agencies were managing intellectual property.

Parliamentary reference - Report number #133 - released 30 March 2005

Periodically we review the extent to which agencies have implemented the recommendations they accept from our earlier audits. This gives Parliament and the public an update on the extent of progress made.

Given the size of the NSW public sector, the potential for fraud could run into billions of dollars if not properly managed. It is an area of risk that warrants close and ongoing attention. Over the last decade, we have responded by issuing three performance audits and a comprehensive guide to better practice on this topic.

In conducting my financial audits, there is now an Auditing Standard that requires me to seek annual assurances from every agency concerning the adequacy of their arrangements for fraud control. This latest performance audit provides a further report card on the extent to which the NSW public sector is managing its fraud risks.

This Report also provides updated guidance on improving arrangements for fraud control both at a whole-of-government level and at the agency level.

I commend the Report for close and careful attention by every agency.

Parliamentary reference - Report number #130 - released 9 February 2005

Periodically we review the extent to which agencies have implemented the recommendations they accepted from our earlier audits. This gives Parliament and the public an update on the extent of progress made.

Major development and infrastructure projects may have significant environmental, social and quality-of-life impacts. The purpose of environmental impact assessment is to ensure that major projects are environmentally and socially sustainable and integrated with State, regional and local planning.

The Department of Infrastructure, Planning and Natural Resources (DIPNR) manages the assessment of major infrastructure proposals and coordinates whole of Government involvement. In November 2001 we audited this process, then undertaken by the Department of Urban and Regional Planning. (In July 2003 the new Department of Infrastructure, Planning and Natural Resources assumed responsibility.)

In this follow-up audit, we examine DIPNR’s implementation of the recommendations of the 2001 audit.

Parliamentary reference - Report number #129 - released 1 February 2005

The Audit Office has recently completed a performance audit of the information published in the annual reports of eight public sector agencies. Although there is much guidance material on preparing annual reports, the performance audit found that the quality of published performance information in annual reports often falls short of what is considered best practice.

The aim of this Guide is to assist agencies to prepare annual reports that provide performance information that demonstrates accountability for the expenditure of public monies.

Parliamentary reference - Report number #77 - released 29 November 2000

Agencies have made some notable attempts to nominate objectives and define measures of performance and report against them each year. However, the quality of the performance information varies and in most cases falls short of what is accepted as best practice. The result is diminished accountability, transparency and openness.

Agencies still have problems reporting outcomes and results and frequently regress to reporting activities and plans. Few annual reports discussed setbacks and failures (particularly in the same detail as successes) or compared performance to goals or targets. And none of the agencies benchmarked their achievements against the results of operators in other jurisdictions or the private sector.

Parliamentary reference - Report number #76 - released 29 November 2000

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