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

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

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

The Audit Office recognises that TAFE NSW has undergone significant change in the last decade in order to improve service delivery. Whilst the focus of change has been TAFE NSW's core educational role, administration has also benefited. The Quality Management Systems introduced by the Institutes are an example.

The Audit Office is of the opinion that TAFE NSW needs a means by which the efficiency and effectiveness of administrative functions can be assessed notwithstanding initiatives by certain Institutes to introduce monitoring, benchmarking and reporting of administration. In the interests of accountability, TAFE NSW requires the establishment of a common performance reporting framework for administration in each Institute and across Institutes. Along with other key result areas of TAFE NSW’s operations, a reporting framework would better able the TAFE Commission Board (the Board) to inform the Minister for Education, in compliance with the Act, of the efficiency and effectiveness of the administrative functions.

Parliamentary reference - Report number #79 - released 6 February 2001

The Audit Office is of the opinion that cost of administration at the University of Western Sydney is unnecessarily high and could be reduced. In addition, its approach to administration can place barriers in the way of potential students and other users of the University. To its credit, the University has recognised that administrative costs are high and is developing plans to reduce those costs. The Audit Office considers that there is now an urgent need to accelerate those activities and to move from planning to implementation. Further delays will be costly and will affect the service the University provides to its customers, the students and other users.

Parliamentary reference - Report number #67 - released 17 November 1999