There have been notable changes in the provision of emergency department services over the last decade, principally by increasing the number, seniority and training of staff and upgrading facilities. More recently, programs have focussed on achieving improvements in emergency department waiting times (the time taken to see a doctor) and access block (delay in accessing a hospital bed). However, these programs have had limited effect. Although waiting times for seriously ill patients have decreased, waiting times for around 95% of emergency department patients have increased or remain unchanged and performance against benchmarks for access block has declined each year.

Although The Audit Office identified opportunities to improve patient flow in the emergency department, benefits will be limited by access block and the congestion caused by being unable to move patients to a ward. Only a better balance of resources between inpatient access programs (that is booked and emergency department patients) will bring about improvements in access block.

Parliamentary reference - Report number #72 - released 15 March 2000

Improving immunisation levels has been a policy priority for NSW and Commonwealth governments since the early 1990s. Along with other States they are pursuing a range of initiatives aimed at reaching immunisation target levels above 95% by the year 2000. At such levels, the occurrence of vaccine preventable diseases is minimised and their spread prevented.

There is considerable support for this policy from the public, the medical profession and all levels of government. However, like much in public health, it depends for its success on effective cooperation between many participants, both nationally and locally, with competing demands on their time and resources.

Parliamentary reference - Report number #38 - released 12 June 1997

Following a request from the NSW Legislative Council in September 1996, a performance audit into various matters affecting the operation of the New South Wales Department of Agriculture was undertaken by The Audit Office.

Among the recommendations from this report, the Audit Office found that:

• An economic appraisal should be undertaken before all major developments, including rationalisation plans, are implemented. It should include details of anticipated benefits from the changes planned, so that their achievement can be evaluated after implementation.

• Government policies should be made explicit or else established by directives in writing. Planning Infrastructure and human resources should be planned to maximise efficiency and effectiveness. If Government chooses alternatives that have higher costs or lower benefits for the Department, then these should be explicitly funded.

• The Department should strengthen its system of internal control by strengthening the role of the Board of Management as a means of management control, directing an overhaul of the Charter of the Internal Audit Committee and using it to drive the Department’s internal audit function and ensuring implementation of an effective financial management information system.

Parliamentary reference - Report number #36 - released 27 March 1997