Reports
Actions for Helping Aboriginal Defendants through MERIT
Helping Aboriginal Defendants through MERIT
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
Actions for Tackling Cancer with Radiotherapy
Tackling Cancer with Radiotherapy
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
Actions for Grants Administration
Grants Administration
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
Actions for Sustaining Native Forest Operations
Sustaining Native Forest Operations
We found that Forests NSW has adequate estimates of how much timber is available from native forests, now and into the future. It uses an industry accepted process to develop estimates, but more could be done to improve reliability. For instance, yield estimates for the South coast, Eden and Tumut are well overdue for review.
We also found that Forests NSW should have sufficient timber to meet its wood supply commitments which are fixed for periods up to 2023 using both native and plantation hardwood. However, the cost and difficulty of harvesting and hauling this timber is likely to increase over time. This presents a significant challenge for Forests NSW to manage.
Parliamentary reference - Report number #185 - released 29 April 2009
Actions for Purchasing Hospital Supplies: Follow-up of 2002 Performance Audit
Purchasing Hospital Supplies: Follow-up of 2002 Performance Audit
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
Actions for Emergency Mental Health Services
Emergency Mental Health Services
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