Nearly 11,000 rescues are carried out each year in New South Wales, the majority involving motor vehicle accidents.

In metropolitan areas we have three emergency services providing general land rescue - NSW Police, the Ambulance Service and the NSW Fire Brigades. The two volunteer services, the State Emergency Service and the Volunteer Rescue Association, generally cover the remainder of the State.

Rescue arrangements in NSW are different to all other mainland states. Elsewhere, the trend in metropolitan areas has been towards consolidation with only one provider of rescue services.

The State Rescue Board of NSW was set up in 1989. Its primary role is to ensure efficient and effective rescue services are maintained throughout the State.

In this audit we examined how well placed the Board was to provide assurance to Parliament and the community that the organisation of rescue services in NSW best serves those in need of rescuing.

NSW deserves a clear and unequivocal answer on such an important issue. However, the issues are complex, often strongly argued, and generally there is insufficient relevant information upon which to make judgements about performance and value. This report outlines a way forward.

Parliamentary reference - Report number #140 - released 20 July 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