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

About one in every twelve Sydney people travels by train each weekday.

Unplanned disruptions to services are inevitable, even on the best-run railways.

Because of the complexities of Sydney’s rail network, a single event can disrupt many services.

From a passenger’s perspective, three issues are important –

• how quickly the disruption is fixed (“When will my train arrive?”)
• the accuracy of information provided about the disruption (“Should I change my travel/meeting/other arrangements?”)
• how often the disruptions occur (“Should I give up on rail travel?”).

In this audit, we looked at how well RailCorp responds when there are routine disruptions to its CityRail passenger services. We focused on how RailCorp manages passenger journeys and informs passengers.

This report informs Parliament and the community about the limitations of the current system, and what more needs to be done in order to minimise the impact of disruptions on passengers.

It should also help passengers judge the extent to which they can rely on the information they receive, and to better understand some of the obstacles faced by staff.

Parliamentary reference - Report number #139 - released 22 June 2005

Periodically we review the extent to which agencies have implemented the recommendations they accepted from our earlier 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 May 2002 report on how well the:

• State Transit Authority maintained its buses
• Ministry of Transport administered contracts for the provision of regular passenger bus services.

Parliamentary reference - Report number #138 - released 14 June 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

Reliably supplying water to our State’s principal city, Sydney, is a major responsibility for the Government.

The community has been made keenly aware in recent years that inflows have been decreasing, and that Sydney has been using more water than is available. In April 2005 the water in Sydney’s storages dropped to 41.5 per cent of their capacity – the lowest level since the construction of Warragamba dam in 1960.

As Sydney continues to develop, it is expected that the demand for water will increase. The way that we use it will need to be sustainable, as it has a direct impact on our economy, our lifestyle and our environment.

In planning for the future the State’s water agencies face a range of uncertainties. But the task is vital.

This report informs Parliament and the community on the progress made - and what remains to be done - to ensure a reliable water supply for Sydney.

Parliamentary reference - Report number #135 - released 4 May 2005

Periodically we review the extent to which agencies have implemented the recommendations they accept from our earlier 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 April 2002 report on how well the State Debt Recovery Office (under the Office of State Revenue) was collecting outstanding fines and penalties.

Parliamentary reference - Report number #132 - released 17 March 2005

Periodically we review the extent to which agencies have implemented the recommendations they accepted from our earlier audits. This gives Parliament and the public an update on the extent of progress made.

Major development and infrastructure projects may have significant environmental, social and quality-of-life impacts. The purpose of environmental impact assessment is to ensure that major projects are environmentally and socially sustainable and integrated with State, regional and local planning.

The Department of Infrastructure, Planning and Natural Resources (DIPNR) manages the assessment of major infrastructure proposals and coordinates whole of Government involvement. In November 2001 we audited this process, then undertaken by the Department of Urban and Regional Planning. (In July 2003 the new Department of Infrastructure, Planning and Natural Resources assumed responsibility.)

In this follow-up audit, we examine DIPNR’s implementation of the recommendations of the 2001 audit.

Parliamentary reference - Report number #129 - released 1 February 2005

We recognise that Home and Community Care Services (HCS) operates in an increasingly difficult and changing environment. However, HCS does not have the capacity to meet these needs. Currently at least 50 per cent of those eligible to receive a service will miss out. Under the current system, there are inequities in service delivery. The ability to receive a service depends on when the applicant calls, where they live and if this coincides with service hours becoming available at the local HCS branch. In addition, applicants who miss out on a service may not automatically be referred to another provider. HCS needs to better manage both demand and expectations regarding access to the services it provides.

Parliamentary reference - Report number #127 - released 13 October 2004

This audit follows our earlier studies on ambulance response times, on waiting times for elective (i.e. non-urgent) surgery and on the ‘Code Red’ status of hospital emergency departments. Those audits indicated that matching resources to the ever-increasing numbers of people seeking emergency treatment was certainly an issue, but not the only issue. We found that problems were also occurring at the ‘interface’ between different parts of the health system – when patients arrive in ambulances at emergency departments or when they need to be admitted from emergency departments to hospital wards.

Parliamentary reference - Report number #125 - released 28 July 2004

All three hospitals followed the Department of Health’s guidelines for judging capacity and had systems in place to notify hospital staff and ambulance crews of changes in status. We found discrepancies in the records kept by all three hospitals when compared to the records maintained by the Department of Health. Our view however, is that these records do not need to be a perfect match for the intended purpose, which is to guide ambulance crews to the shortest queue.

Parliamentary reference - Report number #121 - released 15 December 2003