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

Hospitals, schools, public housing, roads, bridges, buses and trains are just some of the assets used by government in providing services to citizens.

The NSW Government’s asset base is impressive in size - with a value of around $167 billion and with government plans to spend around $8 billion acquiring or replacing assets in the current year. Another $2 billion is spent each year on maintenance.

Good asset management is very important to government; even a small efficiency gain in this area can provide significant returns. Good practice by those responsible for managing assets can improve reliability, extend asset life, save on maintenance costs and aid in identifying and disposing of unnecessary or non-performing assets.

Improving the NSW public sector’s approach to asset management has been on the reform agenda for at least a decade. Changes in practice have been accelerated more recently by integrating asset management policy with the budget process.

In this audit we examined NSW Treasury’s efforts to improve asset management practices in the public sector and the progress made by 3 agencies - the Department of Corrective Services, NSW Fire Brigades and the Powerhouse Museum - towards better managing their asset portfolios.

This report informs Parliament and the community on progress to date and what more needs to be done to ensure that agencies manage assets effectively and achieve best value.

Parliamentary reference - Report number #143 - released 12 October 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

In 1998 NSW Health developed Waste Management Guidelines to promote continuous improvement in waste management across the public health sector. Systematic implementation of the Guidelines was impeded in 1999- 2000 by resistance from the waste industry and transport workers. Since then, NSW Health has not actively promoted waste management in public hospitals. As a consequence Area Health Services (AHSs) and hospitals have developed separate and individual responses to waste management. This has resulted in inconsistent management of waste by public hospitals, inappropriate segregation of waste and additional costs of waste disposal.

Parliamentary reference - Report number #105 - released 10 December 2002

In our view, the agencies we studied cannot be sure that the grants they allocate align with their corporate objectives, and that program outcomes are achieved. This is mainly due to problems with grant selection and the evaluation of results. It was good to see that most of the grants programs had funding objectives which were fairly clear. But we found problems across most programs which could affect the fair and equitable selection of grants, such as, often no procedures for assessing applications, no assessment guidelines for advisory committees, often no clear rationale for assessments and poor documentation of the reasons for decisions.

Parliamentary reference - Report number #104 - released 4 December 2002

Reform of procurement in the NSW public health system is a huge, complex and difficult task. Much thought has been given to this reform. An immense amount of planning and preparatory work is required, and is apparent. In our opinion, at this time, the NSW public health system is making only limited progress towards achieving the economies in purchasing that its size and market dominance could deliver. While millions of dollars in savings are potentially available, much needs to be done to realise this. It is critical that all those involved, at all levels, ensure that reform is given priority, and driven through to fruition.

Parliamentary reference - Report number #102 - released 25 September 2002