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

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

Notwithstanding the considerable effort, it is not apparent that the Government's vision can be fully achieved without increased efforts. Based on the current position, to ensure that the Government's vision can be achieved the Audit Office is of the view that the following key issues need to be urgently addressed: 

• more robust mechanisms are needed to monitor, review and report publicly on progress and benefits

• a greater emphasis should be placed on central coordination to ensure that agencies act in a more uniform and integrated manner  

• the achievement of significant reform of business processes will require a substantial strengthening of accountability mechanisms and more comprehensive, rigorous and systematic approaches to e-government project and risk management. 

• despite an array of guidance material and support provided by central agencies, line agency needs for assistance do not seem to be being met to sufficiently advance matters across the sector at the pace and scope desired

• the Government’s e-government aspirations and funding are not always effectively harmonised. Agencies typically have limited resources available to trial or experience new technologies, and display an aversion to the associated risks.

Parliamentary reference - Report number #87 - released 19 September 2001

This performance audit indicates that the Service has considerable work to do to reach its aspirations of being recognised amongst leading examples of best practice services. The commitment of the Service to serving the community and the professionalism of the Service's officers is not in question. It is, however, apparent that a number of barriers to performance will need to be overcome for the Service to perform as well as it would wish.

Parliamentary reference - Report number #80 - released 7 March 2001

This Report, Volume Two: Corporate Governance in Practice reports upon how actual corporate governance practices by NSW public sector boards compare with “better practice”.

It found criteria and processes for appointing directors to boards are not always transparent. It also found a more systematic and rigorous approach to the range of corporate governance issues is required across the public sector if it is to approach "better practice", there is a lack of accountability for board decision making and board performance and where boards are to serve a governance role, then a basic framework needs to be created to ensure they can operate efficiently and effectively.

Parliamentary reference - Report number #39 - released 17 June 1997

A Supplement to Volume Two: Survey Findings has also been prepared, presenting The Audit Office’s survey findings in detail. This may serve as a useful benchmark for governance in the NSW public sector.

It found that, supporting/enabling legislation, governance structures and boards creation processes should facilitate better governance practice. It also found boards and management should understand their roles, responsibilities and duties and that these should be clearly articulated in legislation, board directors should possess appropriate qualifications and expertise to fulfil their responsibilities, boards need to ensure that adequate systems are in place to be able to oversight on the activity of the agency and boards must be accountable to those whose interests they represent.

Parliamentary reference - Report number #39 - released 17 June 1997