C.4 Legislative Assembly Inquiries and Reports

Committee Report Title Date Tabled
Standing Committee on Health, Ageing, Community and Social Services Report 3 - Annual and Financial Report 2012 - 2013 April 2014
Report purpose
To inquire into and report on matters related to the ACT Health Annual Report 2012-13.
Recommendations
The following recommendations related to ACT Health:
Recommendation 11 - The Committee recommends that the ACT Government's Immunisation Strategy includes data on a varied range of target groups to ensure high rates of immunization for all sectors of the community.
Recommendation 12 - The Committee recommends that the ACT Health continue efforts in the area of preventative health and in particular programs such as Towards Zero Growth.
Government response
Recommendation 11 - Agreed. The ACT Immunisation Strategy 2012-2016 includes the collection of data for numerous targeted groups in the community. This data collection is ongoing and progress for the targeted groups is monitored and evaluated on a regular basis. Evaluation of the specific datasets collected and recommendations for future data to be collected will be undertaken with the review of the strategy.
Recommendation 12 - Agreed. The Healthy Weight Action Plan was completed and launched in October 2013. Implementation is progressing, with a focus on community engagement.
Implementation
Recommendation 11 - Implementation is ongoing.
Recommendation 12 - On 14 October 2013 the Chief Minister launched the Towards Zero Growth Healthy Weight Action Plan, which sets the goal of zero growth in rates of obesity in the ACT. Towards Zero Growth focuses on strategies that will make active and healthy lifestyle choices easier. The Government has adopted a whole-of-government Healthy Weight Initiative governance model, managed by Chief Minister, Treasury and Economic Development Directorate.

 

 

Committee Report Title Date Tabled
Select Committee on Estimates 2013-2014 Inquiry into Appropriation Bill 2013-2014 and the Appropriation (Office of the Legislative Assembly) Bill 2013-2014 6 August 2013
Report purpose
To examine the expenditure proposals contained in the Appropriation Bill 2013-2014, the Appropriation (Office of the Legislative Assembly) Bill 2013-2014 and any revenue estimates proposed by the Government in the 2013-2014 Budget and prepare a report to the Parliament.
Recommendations
The following recommendations related to ACT Health:
Recommendation 53 - The Committee recommends that the ACT Government consider reporting Health and Community Care and ACT Local Hospital Network accountability indicators together in future budgets.
Recommendation 55 - The Committee recommends that the ACT Government advise the Assembly on why the ACT is the worst or near worst performing jurisdiction in elective surgery achievements.
Recommendation 56 - The Committee recommends that the ACT Government advise the Assembly about when the ACT will achieve national average or better than the national average in elective surgery performance.
Recommendation 57 - The Committee recommends that the ACT Government advise the Assembly why the ACT has the longest emergency department waiting times in the country and why ACT waiting times have deteriorated so significantly.
Recommendation 58 - The Committee recommends that the ACT Government provide details to the Assembly on the key lessons learnt from Western Australia's successful implementation of the emergency department four-hour length of stay rule.
Recommendation 59 - The Committee recommends that the ACT Government advise the Assembly of the outcomes from the action plan that was developed in response to the ACT Auditor-General's 2012 report into Emergency Department Performance Information and the PricewaterhouseCoopers report into the integrity of Emergency Department records and processes at the Canberra Hospital.
Recommendation 60 - The Committee recommends that the ACT Government advise the Assembly why it has taken so long to backfill the Executive Director for Critical Care position.
Recommendation 61 - The Committee recommends that the ACT Government develop strategies to educate older Canberrans on the dangers of alcohol use in relation to the risk of falls and subsequent injuries.
Recommendation 62 - The Committee recommends that the ACT Government provide a quarterly report to the Assembly outlining the progress, scope and budget and delivery date of the Aboriginal and Torres Strait Islander Alcohol and other Drug Rehabilitation centre.
Recommendation 63 - The Committee commends the staff of the QEII for providing a wonderful service over the last 50 years.

 

 

Committee Report Report Title Date Tabled
Select Committee on Estimates 2013-14 Inquiry into Appropriation Bill 2013-14 and the Appropriation (office of the Legislative Assembly) Bill 2013-2014 6 August 2013
Government response
Recommendation 53 - Not Agreed. It is a requirement of the Financial Management Act, 1996 (section 12) that all Directorates have accountability indicators.
Recommendation 55 - Not Agreed. The ACT was the only jurisdiction to meet its targets under the National Elective Surgery Target (NEST) in 2012. Over the last three years the Government has provided additional funding which has resulted in record levels of access to Elective Surgery in the ACT over the past three years.
Until there is a nationally consistent approach for elective surgery categorisation it is not possible to measure jurisdictions against jurisdictions or national averages. In a report published in July 2013, The Australian Institute of Health and Welfare (AIHW) and the Royal Australian College of Surgeons (RACS) provided evidence about the inability to measure performance between jurisdictions due to considerable variations in classifications of elective surgery patients. The report found that 49 percent of ACT elective surgery patients are classified as category two patients, against the NSW figure of 32 percent.
This identifies major variations between jurisdictions, and as such it is not possible to judge the relative performance of states and territories in meeting elective surgery waiting times.The AIHW and RACCS propose a national approach for elective surgery categorisation to provide for more simple definitions for each category rather than the current national definitions. Also all jurisdictions should have the same end target to ensure that all elective surgery patients are admitted within established timeframes.
Recommendation 56 - Not agreed. Until all jurisdictions adopt the same methodology for elective surgery categorisation it is not possible to compare against the same targets.
Recommendation 57 - Noted. The ACT Government tabled in March 2013 its Emergency Access Plan for 2013–2017 which detailed actions to be implemented over the next four years to improve waiting and treatment times within our public hospital emergency departments. The plan recognises that improvements to emergency department times must include changes to the way the whole hospital works and improved partnerships between hospitals and community services.
Recommendation 58 - Agreed. Key lessons learnt from Western Australia include:
  • The key objective should be on quality of patient care to drive whole of hospital change and not target focused. This is imperative to engage clinician support;
  • Executive leadership, support and accountability is vital;
  • Dedicated resources in the area of Clinical Service Redesign (CSR), together with proven redesign methodologies imperative;
  • 3 years of hard work and commitment to progress changes using a sound change management approach;
  • Improvement solutions based on true root causes supported by robust data;
  • Ongoing training and education provided to Executives and project teams to ensure change management and leadership are sustained;
  • Ongoing evaluation of redesign projects; and
  • Key organisational changes to ensure ongoing evaluation and strategy development to meet KPIs.
  • ACT Health continues to address quality of patient care initiatives including:
    • Through the Patient Flow Steering Committee to provide advice and oversight the patient flow project;
    • Senior clinicians and other staff have visited Western Australia to gather knowledge;
    • The Chief Minister is planning to visit Queensland Health in the near future to see at firsthand how they have managed big improvements in a short amount of time; and
    • Embedding staff with redesign skills within the hospital and health service areas to bring them closer to clinical areas.

    Recommendation 59 - Agreed. A Progress report was provided to the ACT Legislative Assembly.
    Recommendation 60 - Agreed. An unsuccessful recruitment round was held in February 2013. A second round of recruitment is currently underway.
    Recommendation 61 - Agreed in Principle. ACT Health will examine more closely the degree to which alcohol may be a contributing factor in relation to falls injuries and, if required, how current efforts in the area of falls prevention and early intervention may be strengthened.
    Recommendation 62 - Not Agreed. In addition to responding to questions at the select committee hearings and to questions on notice, the ACT Government also publishes a quarterly report on capital works projects which includes information on the Aboriginal and Torres Strait Islander Alcohol and other Drug Rehabilitation Centre. In addition, the Government reports on progress of capital works projects in the annual midyear review.
    Recommendation 63 - Noted.

 

 

Committee Report Title Date Tabled
Select Committee on Estimates 2013-2014 Inquiry into Appropriation Bill 2013-2014 and the Appropriation (Office of the Legislative Assembly) Bill 2013-2014 6 August 2013
Implementation
Recommendation 53 - No further action required.
Recommendation 55 - No further action required.
Recommendation 56 - No further action required.
Recommendation 57 - No further action required.
Recommendation 58 - In March 2013, the Government tabled the Emergency Access Plan for 2013-2017, which detailed actions to be implemented over the next four years to improve waiting and treatment times within our public hospital emergency departments.
There has been an improvement in ED NEAT performance (59 per cent for the 2013 calendar year) since the Emergency Access Plan was tabled.
Some of the initiatives to be undertaken over the next four years include:
  • the development of streams for acute and ambulatory patients who present to the ED, that will enable streamlined triage and admission processes
  • the development of an expanded paediatric area that will enable streamlined triage and admission processes, as well as enhancing the patient experience through more a appropriate child - and family-friendly environment
  • employing new doctors and nurses within our emergency departments to manage increasing demand, including four new specialist senior emergency physicians
  • increasing the focus on improved and coordinated discharges to enable patients to leave the hospital in the most efficient manner, with all their discharge needs catered for thereby enhancing patient flow and allowing access to ward beds for ED patients who require admission
  • ensuring both public hospitals continue to plan effectively for seasonal changes in demand patterns, such as the annual establishment of a winter strategy which provides for changes in the way hospitals operate during peak periods and how hospitals and community services can work better in high-demand periods.
    • The Chief Minister visited the Princess Alexandra and Royal Brisbane Women's Hospital on 23 September 2013 to look at different ways of responding to increasing demand for emergency care.
      The visit confirmed that improved Emergency Department access is a whole-of hospital issue.
      A new streaming approach introduced in October 2013 at Canberra Hospital is also very similar to the approach at Royal Brisbane.

  • Recommendation 59 - In July 2014 the Chief Minister provided a final update to the Standing Committee on Public Health for each of the recommendations in the Auditor-General's Report No 6: Emergency Department Information Progress Report which also included the PricewaterhouseCoopers report. The majority of recommendations have been completed and the remainder should be completed by the end of 2014.
    Recommendation 60 - National and international advertising for the second round of recruitment for this position occurred in September 2013 under contract with Hardy Group International. The first ranked candidate for the position was unable to take up the position due to problems experienced in relation to obtaining a visa that could not be overcome. The second ranked candidate has been offered the position and is due to commence in the role in September 2014.
    Recommendation 61 - Currently there is limited data available to determine the extent to which alcohol may contribute to falls in the elderly in the ACT.
    It is known that falls are increasingly over-represented in permanent residents of aged care facilities, that less than 5 per cent of the ACT population resides in these facilities, and that they and are unlikely to have access to alcohol.
    ACT Health is unable to reliably determine the underlying cause of falls based on diagnoses from Admitted Patient Care data. Emergency Department data is also limited. However, these data sources could be investigated further. New methods of data collection and surveillance may have to be costed and implemented before it is possible to determine whether alcohol as a cause of falls is a significant public health issue across the elderly population.
    If it is determined that this is a significant issue at the population level, strategies will be implemented to incorporate the risks of alcohol and falls in educational materials and health promotion activities related to falls.
    If appropriate, alcohol use and its risk in relation to falls will be incorporated in the assessment of individuals reviewed at the falls prevention program.
    As part of the assessment in the Falls and Falls Injury Prevention Clinic, information is obtained in relation to the consumption of alcohol and whether this has been a contributing factor to a person's fall.
    If appropriate, information is then provided from the 'Reduce Your Risk' document published by the Australian Government Department of Health on the national recommendation for alcohol consumption and fact sheets from the Department of Human Services, Victoria on Alcohol intake.
    Recommendation 62 - No further action required.Recommendation 63 - No further action required.

 

 

Committee Report Title Date Tabled
Select Committee on Estimates 2014-2015 Inquiry into Appropriation Bill 2014-2015 and the Appropriation (Office of the Legislative Assembly) Bill 2014-2015 Ongoing as at 30 June 2014
Report purpose
To examine the expenditure proposals contained in the Appropriation Bill 2014-2015, the Appropriation (Office of the LegislativeAssembly) Bill 2014-2015 and any revenue estimates proposed by the Government in the 2014-2015 Budget and prepare a report to the Assembly.
Recommendations
As at 30 June 2014 the inquiry was ongoing.
Government response
Not applicable.
Implementation
Not applicable

 

 

Committee Report Title Date Tabled
Standing Committee on Public Accounts Auditor-General's Report No. 4 of 2014: Gastroenterology and Hepatology Unit, Canberra Hospital Presented 6 June 2014
Report purpose
This report presents the results of a performance audit on the effectiveness of administrative and triaging practices of outpatient services provided by the Gastroenterology and Hepatology Unit (GEHU) at Canberra Hospital. .
Recommendations
The Auditor-General recommended ACT Health should improve the governance of the GEHU and develop and implement an action plan to reduce the GEHU outpatient waiting list and guide GEHU in providing the best possible patient care.
As at 30 June 2014 the report was under consideration by the Standing Committee on Public Accounts.
Government response
Not applicable.
Implementation
Not applicable.

 

 

Committee Report Title Date Tabled
Standing Committee on Public Accounts Auditor-General's Report No 5 of 2014: Capital Works Reporting Presented 27 June 2014
Report purpose
This report presents the results of a performance audit of reporting on the capital works program.
Recommendations
The audit made eight recommendations to address the audit finding in this report. Recommendation 6 relates to Health - All Directorates should quality control information to be included in capital works reports to the Chief Minister and Treasury Directorate and the Budget Committee of Cabinet, and have documented quality control procedures.
As at 30 June 2014 the report was under consideration by the Standing Committee on Public Accounts.
Government response
Not applicable.
Implementation
Not applicable.