NSW Health has progressed in identifying and addressing key R&D issues in a complex and difficult environment. The Infrastructure Grants Program (IGP) is an innovative program and reflects a commitment by Government to support research infrastructure. The IGP has as its aims the provision of significant funding accompanied by clear research objectives and criteria for accountability and introduces a rational basis for the allocation of infrastructure grants.

While NSW Health has progressed, there is an opportunity to make the IGP more efficient and effective. These opportunities are in the areas of addressing longer term planning issues in health, streamlining and clarifying eligibility and selection criteria, improving decision-making structures and processes and improving accountability.

Parliamentary reference - Report number #56 - released 25 November 1998

The Audit Office is of the view that:

• there is no system wide plan for the location of emergency departments. This function is undertaken by each Area Health Service

• coordination between the Department and the NSW Ambulance Service could be improved in aspects such as the collocation of facilities and direct communications between ambulances and emergency departments

• there is no policy framework that recognises the increasing role and impact of private providers

• the Department’s guidelines do not take into account demographic factors, the number of patients treated or the acuity of presentations as criteria for determining the size of an emergency department or the level and scope of emergency services that should be available at that location.

• the Department has introduced a range of initiatives over a period of time to improve the performance of emergency departments such as the establishment of the Integrated Bed Management Committee. Some have been quite effective, whilst others have had mixed success. There has been an overall improvement in emergency department waiting times for urgent cases. However, there has been little improvement in waiting times for less urgent cases and a decline in performance for access block (the time taken to be admitted to a hospital ward from the emergency department after a decision has been made that this is required).

Parliamentary reference - Report number #54 - released 21 October 1998

Land tax has a significantly higher cost to collection ratio than other State taxes. In part this is because of its design. But there are opportunities to reduce collection costs within current policy constraints. The Office of State Revenue (OSR) has been actively pursuing better practice initiatives for some time and a substantial range of improvements has been made. OSR is continuing these efforts. However, inadequate systems and continued difficulties with the quality of land information remains as an impediment to efforts to increase efficiency and effectiveness and reduce collection costs.

Improvements canvassed in this Report (a number of which OSR had already been addressing before the audit commenced) would provide reduced collection costs (through greater efficiency) and improved collection results (through better education of taxpayers and better use of penalties and incentives). Notwithstanding these improvements, the long standing issues of land information standards and land ownership data compatibility between NSW agencies (largely outside OSR’s control) remain to be satisfactorily resolved.

Parliamentary reference - Report number #51 - released 5 August 1998