2019-20 Annual Report Acknowledgement of Country
Acknowledgement of Country Disclaimer Cover image Monash Health acknowledges the Traditional Custodians of the land, the Some images featured in this report Medical Director of Infection Wurundjeri and Boonwurrung peoples, and we pay our respects to them, their were taken before COVID-19 infection Prevention, Professor culture and their Elders past, present and future. In this document, ‘Aboriginal’ prevention precautions - such as Rhonda Stuart, meeting the refers to both Aboriginal and Torres Strait Islander people. ‘Indigenous’ or ‘Koori/ physical distancing and the increased challenge of COVID-19 Koorie’ is retained when part of the title of a report, program or quotation. use of PPE - were put in place. with her team.
Monash Health Annual Report. 2019-20 3 Contents
Acknowledgement of Country 2 Report of Chair of Board and Chief Executive 5 The year in review 6 Care and fortitude in a time of COVID 7 Aged Care 36 Monash Health Foundation 38 Jessie McPherson Private Hospital 40 Report of Operations 42 Who we are 45 Our tertiary health services 46 Our campuses 47 Our Board of Directors 52 Our executive team 60 Our workforce 64 Occupational health and safety 66 Clinical Governance Report 67 Environmental Sustainability Report 67 Financial information 69 Consultancies information 70 Disclosures required under legislation 71 Attestations 74 Statement of Priorities 2019-20 76 Disclosures Index 87 Our supporters 89 Financial Statements 90
Disclaimer Cover image Some images featured in this report Medical Director of Infection were taken before COVID-19 infection Prevention, Professor prevention precautions - such as Rhonda Stuart, meeting the physical distancing and the increased challenge of COVID-19 use of PPE - were put in place. with her team.
Monash Health Annual Report. 2019-20 3 TheWelcome year in review
Report of Chair of Board and Chief Executive
Welcome to the Monash Health Our strategic intent Annual Report 2019-20
his year has been one of Dipak Sanghvi Andrew Stripp the most challenging in Chair of Board Chief Executive We are relentless Tour 170-year history as we prepared for and responded to the COVID-19 pandemic. Our people’s dedication to caring Hospital expansion with new Acknowledgements for our community and each other theatre operating suites, intensive Our thanks go to our Board in our pursuit of led to an exceptional response. care unit, high dependency members and executive As a leading teaching and unit, pharmacy, and increased team for their guidance, research health service of pandemic response capacity support, and stewardship of international standing, much is the Monash Health vision. expected of Monash Health, • the new Distribution Service Thank you to all Monash Health excellence and much is asked of our Centre which has increased employees for delivering on people, and they delivered. supply chain capacity and that vision with every consumer They adapted, remained agile, streamlined our procurement interaction. To our community, “ Exceptional care comes down to exceptional people and always put the care and service, while assisting a we thank you for entrusting us coming together across our organisation, and uniting for a safety of our consumers, patients, statewide program to ensure with the privilege of caring for you families, and their colleagues essential pandemic supplies and for sharing your feedback, common cause - the pursuit of excellence in healthcare.” at the core of each action. enabling continuous improvement. In the following pages, you will fi nd • our world-class clinical and We recognise considerable Andrew Stripp, highlights and case studies illustrating translational research, with input from partners, including Chief Executive our strategic guiding principles. over 280 new and 1,500 400 Monash Health volunteers, The substantive achievements patient-focused research and around 350 volunteers from are due to the collective actions projects underway organisations like the Starlight of our teams, culminating in Children’s Foundation, Ronald organisational success. • the largest Go-Live of an McDonald House Charities, The While some accomplishments can Electronic Medical Record Humour Foundation, and Radio be quantifi ed, it’s the many daily acts in Australia for our inpatient Lollipop. Generous donations from of compassion and kindness that services, with eight sites moving the broader community helped contributed to immeasurable positive to the new way of working ensure we could deliver the very outcomes for our community. best care, and we thank the The stand-outs include: • the launch of the Monash many individuals, businesses, and Health Aboriginal Reconciliation organisations for their support. • our response to COVID-19, Action Plan in partnership Acknowledgment and protecting and supporting with the Aboriginal community thanks go to the Victorian our employees while enabling supported ‘Closing the Gap’ Government, Department of Monash Health to respond Health and Human Services, to the need of our patients • Family Violence Unit and Federal Government, for and the wider community continued to address the their role in partnering with us Royal Commission into Family to deliver positive outcomes • opening the $135 million Casey Violence recommendations. for our diverse community.
Monash Health Annual Report. 2019-20 4 Monash Health Annual Report. 2019-20 5 TheWelcome year in review
Report of Chair of Board and Chief Executive Report of Chair of Board and Chief Executive
Welcome to the Monash Health Annual Report 2019-20
his year has been one of Dipak Sanghvi Andrew Stripp the most challenging in Chair of Board Chief Executive Tour 170-year history as we prepared for and responded to the COVID-19 pandemic. Our people’s dedication to caring Hospital expansion with new Acknowledgements for our community and each other theatre operating suites, intensive Our thanks go to our Board led to an exceptional response. care unit, high dependency members and executive As a leading teaching and unit, pharmacy, and increased team for their guidance, research health service of pandemic response capacity support, and stewardship of international standing, much is the Monash Health vision. expected of Monash Health, • the new Distribution Service Thank you to all Monash Health and much is asked of our Centre which has increased employees for delivering on people, and they delivered. supply chain capacity and that vision with every consumer They adapted, remained agile, streamlined our procurement interaction. To our community, and always put the care and service, while assisting a we thank you for entrusting us safety of our consumers, patients, statewide program to ensure with the privilege of caring for you families, and their colleagues essential pandemic supplies and for sharing your feedback, at the core of each action. enabling continuous improvement. In the following pages, you will fi nd • our world-class clinical and We recognise considerable highlights and case studies illustrating translational research, with input from partners, including our strategic guiding principles. over 280 new and 1,500 400 Monash Health volunteers, The substantive achievements patient-focused research and around 350 volunteers from are due to the collective actions projects underway organisations like the Starlight of our teams, culminating in Children’s Foundation, Ronald organisational success. • the largest Go-Live of an McDonald House Charities, The While some accomplishments can Electronic Medical Record Humour Foundation, and Radio be quantifi ed, it’s the many daily acts in Australia for our inpatient Lollipop. Generous donations from of compassion and kindness that services, with eight sites moving the broader community helped contributed to immeasurable positive to the new way of working ensure we could deliver the very outcomes for our community. best care, and we thank the The stand-outs include: • the launch of the Monash many individuals, businesses, and Health Aboriginal Reconciliation organisations for their support. • our response to COVID-19, Action Plan in partnership Acknowledgment and protecting and supporting with the Aboriginal community thanks go to the Victorian our employees while enabling supported ‘Closing the Gap’ Government, Department of Monash Health to respond Health and Human Services, to the need of our patients • Family Violence Unit and Federal Government, for and the wider community continued to address the their role in partnering with us Royal Commission into Family to deliver positive outcomes • opening the $135 million Casey Violence recommendations. for our diverse community.
Monash Health Annual Report. 2019-20 5 The year in review The year in review
The year in review COVID-19 Care and fortitude in a time of COVID Over 18,000 Monash Health employees met the challenges of COVID-19 with grit, and a united front, illustrating exemplary teamwork and unwavering commitment to our community.
January to February: 18,000 employees. One of our and communication met daily in the stormfront arrives immediate actions was to create working groups, covering areas reliable online sources of information such as critical care, pharmacy, n 24 January 2020, for our employees and our aged care, site, and ward Monash Health began communities and use regular and logistics, and pathology to ensure Ocaring for Australia’s fi rst frequent online forums to update nothing was left to chance. COVID-19 positive patient. While our teams rapidly. In this new To assist in the critical role of we were confi dent we could socially-distanced world, the use identifying, tracking, and tracing diagnose, manage and isolate of technology in communication transmission in the community, patients with the virus, it was also would prove paramount. we established off-site COVID-19 the beginning of a time that would During this initial period, screening clinics adjacent to challenge and transform every presentations from suspected Monash Medical Centre, Casey aspect of our health service. As our COVID-19 patients remained low. Hospital, and Dandenong Hospital. understanding of the virus evolved, Despite having only one verifi ed These clinics immediately fi lled with its impact on our communities positive patient, new procedures people seeking tests, illustrating grew, receded, and re-emerged were established to provide our community’s concern. in a series of ‘waves’ that brought guidance when caring for patients Determined to protect unique and urgent challenges. suspected of having COVID-19. patients and employees, our Our tight-knit teams collaborated As case numbers outside China teams began planning for a wide across our health service to steadily increased, we continued to range of potential scenarios. problem-solve, design, and prepare, working closely with our We knew as Victoria’s largest implement changes that would in-house experts, the Department health service provider, we would typically take months or years, of Health and Human Services be relied upon to take action in just days and weeks. (DHHS), and other agencies. to slow the spread of the virus, During this time, COVID-19 to respond to outbreaks, and numbers declined, but the expert March 2020: facing the assist our community recover. advice from our top infection fi rst wave head-on Suitable spaces were identifi ed and virology teams was clear: Following the incidence of and prepared at Dandenong, this was only the beginning. community-acquired disease Casey, Monash Medical Centre, and Our commitment to in other states, we established Monash Children’s Hospital to admit communicating, training, securing an Incident Command Team to people requiring inpatient care due supplies, and consolidating changes guide Monash Health through this to infection. Additional capacity was to our clinical and non-clinical emerging crisis. Meeting daily, this also fast-tracked at Casey Hospital. workfl ows continued, knowing team oversaw and coordinated our Our rapid action saw outpatient future waves were imminent. preparation and management of the clinics streamlined, reducing the We realised that our decisions, potential pandemic as a State of number of people attending, Screening clinics were at the frontline based on the latest credible Emergency was called in Victoria. and limiting visitors to our sites. of our fi ght against COVID-19. information, should be shared Our experts in infection prevention, Understanding that the supply quickly and accurately with our operations, logistics, planning, chain for Personal Protective
Monash Health Annual Report. 2019-20 6 Monash Health Annual Report. 2019-20 7 The year in review
Care and fortitude in a time of COVID COVID-19 Care and fortitude in a time of COVID Over 18,000 Monash Health employees met the challenges of COVID-19 with grit, and a united front, illustrating exemplary teamwork and unwavering commitment to our community.
January to February: 18,000 employees. One of our and communication met daily in the stormfront arrives immediate actions was to create working groups, covering areas reliable online sources of information such as critical care, pharmacy, n 24 January 2020, for our employees and our aged care, site, and ward Monash Health began communities and use regular and logistics, and pathology to ensure Ocaring for Australia’s fi rst frequent online forums to update nothing was left to chance. COVID-19 positive patient. While our teams rapidly. In this new To assist in the critical role of we were confi dent we could socially-distanced world, the use identifying, tracking, and tracing diagnose, manage and isolate of technology in communication transmission in the community, patients with the virus, it was also would prove paramount. we established off-site COVID-19 the beginning of a time that would During this initial period, screening clinics adjacent to challenge and transform every presentations from suspected Monash Medical Centre, Casey aspect of our health service. As our COVID-19 patients remained low. Hospital, and Dandenong Hospital. understanding of the virus evolved, Despite having only one verifi ed These clinics immediately fi lled with its impact on our communities positive patient, new procedures people seeking tests, illustrating grew, receded, and re-emerged were established to provide our community’s concern. in a series of ‘waves’ that brought guidance when caring for patients Determined to protect unique and urgent challenges. suspected of having COVID-19. patients and employees, our Our tight-knit teams collaborated As case numbers outside China teams began planning for a wide across our health service to steadily increased, we continued to range of potential scenarios. problem-solve, design, and prepare, working closely with our We knew as Victoria’s largest implement changes that would in-house experts, the Department health service provider, we would typically take months or years, of Health and Human Services be relied upon to take action in just days and weeks. (DHHS), and other agencies. to slow the spread of the virus, During this time, COVID-19 to respond to outbreaks, and numbers declined, but the expert March 2020: facing the assist our community recover. advice from our top infection fi rst wave head-on Suitable spaces were identifi ed and virology teams was clear: Following the incidence of and prepared at Dandenong, this was only the beginning. community-acquired disease Casey, Monash Medical Centre, and Our commitment to in other states, we established Monash Children’s Hospital to admit communicating, training, securing an Incident Command Team to people requiring inpatient care due supplies, and consolidating changes guide Monash Health through this to infection. Additional capacity was to our clinical and non-clinical emerging crisis. Meeting daily, this also fast-tracked at Casey Hospital. workfl ows continued, knowing team oversaw and coordinated our Our rapid action saw outpatient future waves were imminent. preparation and management of the clinics streamlined, reducing the We realised that our decisions, potential pandemic as a State of number of people attending, based on the latest credible Emergency was called in Victoria. and limiting visitors to our sites. information, should be shared Our experts in infection prevention, Understanding that the supply quickly and accurately with our operations, logistics, planning, chain for Personal Protective
Monash Health Annual Report. 2019-20 7 StrapThe line year xxxxx in review xx
COVID-19
converted the Acute Assessment Within a matter of days, Level 3 at Unit at Dandenong Hospital into Jessie McPherson Private Hospital Equipment and essential supplies a COVID-19 intensive care unit, was converted to a COVID-19 would be critical, our team while planning for the potential Admission Ward for suspected worked to secure delivery. to add 200 Intensive Care Unit positive patients awaiting test results. Employees worked from home beds across Monash Health. Meanwhile, the State Government where possible and elective surgery By late April, the State testing blitz continued, with a new was reduced to increase capacity Government announced a goal of 150,000 additional tests and reduce risk. We established COVID-19 screening blitz to build by the end of May announced a Workforce Mobilisation Team an accurate picture of how and by the Premier. Monash Health to help meet the demands of the where the infection had spread. continued to support this COVID-19 response, and we built Monash Health was at the important public health activity. an expanded team of nurses, forefront of this effort to test 100,000 Supporting our employees midwives, allied health, and other people through its COVID-19 was crucial, and the Workforce health professionals. Two hundred screening clinics. At the same Mobilisation Team found new employees who were clinically time, voluntary employee screening Above: Medical Director temporary roles for team trained but not currently working in commenced across our sites. of Infection Prevention, members whose work areas a clinical role registered their interest The success of our Distribution Professor Rhonda Stuart. slowed or were placed on hold to support workforce planning. Service Centre operations led to it because of the pandemic. As the number of people in becoming a Victorian hub for the By the end of May, the Premier the community infected with distribution of medical supplies to supporting the pathology team had announced a further easing of COVID-19 increased, screening healthcare workers on the front- to scale up their response. restrictions throughout the State, was introduced for visitors at major line of the coronavirus pandemic. By mid-May, our Nurse Educators which, coupled with a return to sites, visitor limits imposed, and This proved to be a vital part of had trained more than 7,000 school for some students, saw us visiting hours further reduced. admissions team was installed in specially-designed ‘cubes’ receiving the ‘life-blood’ of critical employees in the correct use of enter a new phase in our response On 22 March, the Victorian assembled and deployed. located adjacent to the Emergency supplies for many healthcare Personal Protective Equipment. to the COVID-19 pandemic. Government announced a shutdown The number of COVID-19 Department. All employees were providers across the State. At this time, we had not had a As people mobilised and of all non-essential services positive patients being treated asked to complete a profi le to COVID-19 positive patient admitted interacted, we saw the possibility within 48 hours. While the spread at Monash Health remained identify those with additional skills, May to June 2020: preparing for some weeks but remained acutely of a rise in cases and recognised of the virus slowed, our teams low as our community followed qualifi cations, and specialties for a possible second wave aware that if viral transmissions we needed to use this time to continued to remain vigilant and the State Government’s ‘stay that could be used to support The screening blitz continued rose within the community, continue to prepare effectively. prepared for what might come. at home’ directions. our response to COVID-19. with Monash Health rapidly we had to be ready to act. Given greater community During this time, Monash Health While infection rates across establishing new screening clinics Following the screening blitz, the movement and interaction, the April 2020: remaining vigilant sadly recorded its fi rst patient Victoria were low at that stage, at Kingston, Springvale, and Premier again announced a gradual possibility of a second wave in the eye of the storm death resulting from COVID-19. Premier Daniel Andrews extended Pakenham, adding to those already easing of restrictions, including for remained, and Monash Health In April, our fi rst employee tested Our readiness continued, with the State of Emergency for another operating at Clayton, Dandenong, visitors, which was crucial given continued to prepare and evolve positive for COVID-19. This was the installation of 10 thermal four weeks until 11 May, highlighting Berwick, and Cranbourne. the vital role loved ones play in its response to the pandemic. a stark reminder of the need for scanners across Monash Health, the pandemic was far from over. Within two days, we had consumer welfare and recovery. The Nursing and Midwifery ongoing vigilance and keeping checking all people entering our During this period, as COVID-19 further bolstered screening Our Incident Command Team, with Education and Strategy team worked employees safe with evidence- sites for elevated temperature. cases continued to decline, we began activity within Monash Health, support from DHHS, commissioned with our Critical Care team to ensure based practice and meticulous With the support of DHHS funding, to plan for a potential reintroduction opening the new locations, fi lling the opening of the new clinical our Intensive Care Units were ready attention to infection prevention. we further strengthened Monash of elective procedures and were able rosters, training employees, areas at Casey Hospital, enabling to meet an increase in nursing Recognising that a second Medical Centre’s resuscitation to ease some visiting restrictions. establishing administrative and a rapid response for any increase demand, engaging with more than wave was possible, a COVID-19 unit capacity with six patient bays Given the risks of escalation, we also communication protocols, and in demand for intensive care. 300 employees to return or upskill.
24 January 1 March 16 March 22 March 26 April 11 May
Monash Australia State of Stage 2 restrictions Screening blitz Restrictions Health begins records fi rst Emergency introduced, non- announced, begin easing treating the fatality, a in Victoria essential services targeting on social fi rst COVID-19 78-year-old fi rst declared closing, social 100,000 tests interactions positive patient Perth man distancing rules and in two weeks in Australia transition to remote learning and work
Monash Health Annual Report. 2019-20 8 Monash Health Annual Report. 2019-20 9 converted the Acute Assessment Within a matter of days, Level 3 at Unit at Dandenong Hospital into Jessie McPherson Private Hospital a COVID-19 intensive care unit, was converted to a COVID-19 while planning for the potential Admission Ward for suspected to add 200 Intensive Care Unit positive patients awaiting test results. beds across Monash Health. Meanwhile, the State Government By late April, the State testing blitz continued, with a new Government announced a goal of 150,000 additional tests COVID-19 screening blitz to build by the end of May announced an accurate picture of how and by the Premier. Monash Health where the infection had spread. continued to support this Monash Health was at the important public health activity. forefront of this effort to test 100,000 Supporting our employees people through its COVID-19 was crucial, and the Workforce screening clinics. At the same Mobilisation Team found new time, voluntary employee screening Above: Medical Director temporary roles for team commenced across our sites. of Infection Prevention, members whose work areas The success of our Distribution Professor Rhonda Stuart. slowed or were placed on hold Service Centre operations led to it because of the pandemic. becoming a Victorian hub for the By the end of May, the Premier distribution of medical supplies to supporting the pathology team had announced a further easing of healthcare workers on the front- to scale up their response. restrictions throughout the State, line of the coronavirus pandemic. By mid-May, our Nurse Educators which, coupled with a return to This proved to be a vital part of had trained more than 7,000 school for some students, saw us receiving the ‘life-blood’ of critical employees in the correct use of enter a new phase in our response supplies for many healthcare Personal Protective Equipment. to the COVID-19 pandemic. providers across the State. At this time, we had not had a As people mobilised and COVID-19 positive patient admitted interacted, we saw the possibility May to June 2020: preparing for some weeks but remained acutely of a rise in cases and recognised for a possible second wave aware that if viral transmissions we needed to use this time to The screening blitz continued rose within the community, continue to prepare effectively. with Monash Health rapidly we had to be ready to act. Given greater community establishing new screening clinics Following the screening blitz, the movement and interaction, the at Kingston, Springvale, and Premier again announced a gradual possibility of a second wave Pakenham, adding to those already easing of restrictions, including for remained, and Monash Health operating at Clayton, Dandenong, visitors, which was crucial given continued to prepare and evolve Berwick, and Cranbourne. the vital role loved ones play in its response to the pandemic. Within two days, we had consumer welfare and recovery. The Nursing and Midwifery further bolstered screening Our Incident Command Team, with Education and Strategy team worked activity within Monash Health, support from DHHS, commissioned with our Critical Care team to ensure opening the new locations, fi lling the opening of the new clinical our Intensive Care Units were ready rosters, training employees, areas at Casey Hospital, enabling to meet an increase in nursing establishing administrative and a rapid response for any increase demand, engaging with more than communication protocols, and in demand for intensive care. 300 employees to return or upskill.
22 March 26 April 11 May
Stage 2 restrictions Screening blitz Restrictions introduced, non- announced, begin easing essential services targeting on social closing, social 100,000 tests interactions distancing rules and in two weeks transition to remote learning and work
Monash Health Annual Report. 2019-20 9 The year in review
COVID-19
The Facts With the State of Emergency a return to ‘Stage 3 stay-at-home continuing and the COVID-19 restrictions’. As cases increased pandemic evolving, safety in locally, all Monash Health employees workplaces, our community, and for involved in outreach work in affected 174,334 employees remained at the forefront. ‘hot spot’ suburbs were required to Safety is both physical and wear Personal Protective Equipment. Total number of psychological, and Monash Health This affected Hospital in the screening tests. provided expert advice, training, Home employees, Rehabilitation 01 and resources to support overall in the Home, and community health and wellbeing of employees and mental health programs. and the broader community. A new drive-through screening 12,329 Monash Health worked with clinic opened at Casey Fields, DHHS to build a COVID-19 resilient replacing the Cranbourne clinic Total employees service into the future, with local and increasing capacity. PPE trained. solutions to enable early detection We established Outbreak We consistently and swift public health response, to Management Teams to respond to reduce community transmission. potential exposures, to understand Part of this involved testing in the risks and oversee the contact 6 areas where cases were most tracing and quarantining of Number of screening likely, where testing had been employees and patients. provide safe, clinics established. low, or equity of access is an The rapid onset and unknowns issue for vulnerable groups. of COVID-19 have meant we have To provide greater fl exibility and relied on the resilience and agility increase testing rates in the City of of our workforce more than ever 75 Greater Dandenong, we opened a before in our history, trusting them high quality and Employees deployed daily drive-through clinic in Dandenong to continue putting their safety and at screening clinics. to complement existing clinics. the wellbeing of our community fi rst. We had our fi rst COVID-19 At every phase of this pandemic, admission for over a month and an the scale and impact to our health timely care increase in people infected through service has been rapidly-evolving. 25 untraceable community transmission. Nonetheless, our highly skilled While early June saw new cases workforce has united to overcome Total number of COVID-19 across the State hovering in single the challenges of COVID-19 “The Electronic Medical Record means our people are patients admitted. fi gures, the number began to grow, while delivering outstanding supported to take full advantage of the power of data to and by the last day of the month, the levels of care to our community innovate and pursue excellence in a safe, timely and high State had reported 76 new cases – and each other, every day. quality manner.” its highest increase since 30 March. Without this commitment to 22 Victorians became increasingly community and each other, the Jane Ross, Total number of patients aware of the trajectory of outcomes for the areas we serve EMR Director, Advancing Care recovered from COVID-19. COVID-19 in the State and we may have been so very different. understood our community While this COVID-19 would need us more than ever. journey continues, to every The increase in numbers saw employee, we say thank you.
26 May 1 June 30 June
Night Duty Hospitality 10 metropolitan- Manager, the restrictions Melbourne fi rst from begin easing postcodes a Victorian re-enter Stage quarantine hotel, 3 stay-at-home diagnosed with restrictions COVID-19
Monash Health Annual Report. 2019-20 10 Monash Health Annual Report. 2019-20 11 01 We consistently provide safe, high quality and timely care
“The Electronic Medical Record means our people are supported to take full advantage of the power of data to innovate and pursue excellence in a safe, timely and high quality manner.”
Jane Ross, EMR Director, Advancing Care
Monash Health Annual Report. 2019-20 11 The yearThe year in review in review The year in review
Martin Keogh, Chief Operating Offi cer, watches on as Sue Kerwin and Ignatious Abraham ‘Go-Live’ with the Electronic Medical Record at Cranbourne Integrated Care Centre in August.
Monash Health Annual Report. 2019-20 12 The year in review
The Electronic Medical Record: a foundation improvement for Monash Health
Delivering the single largest Go-Live of an Electronic Medical Record in Australia required meticulous planning, teamwork, and overcoming many challenges to transform our care into the future.
Laying the groundwork: The build-up: setting the the case for change scene for success To be successful, it was imperative ntroducing the Electronic to bring together the right team Medical Record (EMR) and resources at the right time. Ifor our inpatient services The EMR Program Team combined went beyond transferring talent from across Monash Health paper records onto a digital along with valued vendor partners. platform. It offered far-reaching With a strong belief in the power benefi ts to our consumers, our of the EMR to transform care, organisation and the advancement the team focused on a multi-year, of community health. multi-phased plan. It required Through reliable integration of meticulous adherence to a complex information across systems and critical pathway involving input from clinical areas, the EMR ensures our every discipline and level, including interdisciplinary healthcare teams Emilio Pozo, Executive Director consumers and vendors. The choice can securely access accurate, Digital Health spearheaded of solution partner, Cerner, was just up-to-date, and legible information the EMR program. the beginning. Many moving parts about patients at the point of came together so that nothing was care. This includes history, clinical left to chance before Go-Live. notes, diagnoses, test results, processes, and terminologies An EMR Implementation and allergies, all accessible in one result in less variation in the Committee worked alongside sub- location. Real-time information manner in which we deliver care. committees to ensure governance, means easier collaboration and With data entered at the point risk, issues, operational and project a seamless continuum of care of care, collation, processing, timelines were supported. between our departments and and analysis of trends simplifi ed Consultation with clinicians, sites and other care partners. our ability to satisfy governance, subject matter experts, and The technology supports reporting, and accreditation, and consumers informed the system improvements to patient care advance research and teaching. design and build. Continuous through decision support Translational clinical and refi nement through user feedback, capabilities, enhanced outcomes-based research testing, and issue resolution medication management, and and education could also be ensured a robust and reliable alerts quickly fl agging patient disseminated via the EMR to inform system, with safety, patient, and deterioration, leading to fewer improvements and innovations employee experience at its core. errors. Standardised workfl ows, in clinical practice rapidly. The many thousands of
Monash Health Annual Report. 2019-20 13 The year in review
Note: Images were taken pre COVID-19.
devices to access the EMR Super Users, Champions, and were sourced, confi gured, Cerner partner coaches providing tested, and delivered effi ciently. immediate assistance on the fl oor. This occurred concurrently with system and electrical Embedding the new: upgrades to accommodate the gaining altitude in the new platform and devices. face of a pandemic Comprehensive training The successful launch of the and engagement programs for EMR at such a scale was a our employees were crucial signifi cant milestone for Monash to a successful rollout. Health, our consumers, and Patients, consumers, the Victorian community. visitors and employees A testament to the strength of were kept informed via an our employees was their willingness extensive communications to educate themselves on how and support program. to use the EMR, embrace it, and The Go-Live success was a integrate it into their daily work. result of teamwork, collaboration, Their application during the consultation, and the pursuit pressures of the COVID-19 pandemic of excellence in patient care. to support clinical care and our operational needs was outstanding. Take off: all systems Go-Live They continue to impress Staggered over three events in with their responsiveness and August, October, and November continuous improvements to the of 2019 across eight sites, one system to ensure the EMR fulfi ls ward or clinical area transitioned the intended benefi ts for safe at a time. Daily operational and and timely care to our patients. governance meetings coordinated the schedule to ensure a smooth and safe transition to “ We are an integral part of our community and troubleshoot arising issues. Clinical Transition Teams aspire for our actions to support the delivery comprising a pharmacist, doctor, of safe, high quality, and timely care. The EMR and nurse, carefully transcribed will assist our world-leading teams in their existing inpatient information clinical decision making every day.” from paper to the EMR. Signifi cant support was Emilio Pozo, Executive Director Digital Health available on-site for every ward, including a Command Centre providing 24-hour support, supernumerary EMR
Monash Health Annual Report. 2019-20 14 EMR Go-Live snapshot 6,255 EMR devices 8 * including WOWs hospitals went live across three EMR Go-Live events and tablets deployed during Go-Live. in a planned and controlled transition. * Work station on wheels. 13,500 employees trained in using the EMR
within a tailored face-to-face and online familiarisation and learning package.
918 1,195 inpatient Super Users records securely supported a transitioned safe and timely onto the EMR. Go-Live by providing ‘at the elbow’ support to their peers.
Monash Health Annual Report. 2019-20 15 The year in review
02 We provide In April, John was one of the fi rst patients admitted to experiences the new tower facilities at that exceed Casey Hospital. expectations A new era for care in the southeast “I just feel so overwhelmed that the employees at Monash Children’s Hospital were able to take this Construction of the $135 million Casey Hospital expansion is complete tiny, fragile, 600 gram baby and get her to where and delivering above and beyond our community’s expectations. she is now. I couldn’t possibly express how much I appreciate what they’ve done.” he construction phase of the services they need closer to home. The fi rst ICU for Casey Brendan O’Brien, father of premature baby Willow, Casey Hospital expansion Commencing in September 2017, Martin Keogh, Monash Health’s who spent 140 days in our care Tis now complete, signifying the phased construction and opening Chief Operating Offi cer, said that a step-change in care for patients of facilities underlined the additional the Intensive Care Unit (ICU), and the community. Casey Hospital challenges of hospital construction. which opened on 18 May 2020, opens many possibilities across the A broad range of critical was a fi rst for Casey and an Monash Health network and beyond infrastructure and performance important milestone for the rapidly and will provide a signifi cant boost requirements were successfully expanding Casey catchment. for healthcare in the wider South balanced with uninterrupted In particular, the ICU increases Eastern region, relieving pressure provision of care. Casey’s ability to care for critically ill on several nearby hospitals. Casey Hospital can now patients without the need to transfer attract and retain the best them to alternate facilities. Casey Far-reaching benefi ts medical and administrative now joins Monash Medical Centre, The new and expanded facilities employees and enhance our Dandenong Hospital, and Monash mean less need to transfer patients, teaching capabilities to improve Children’s Hospital, with their provision as there is ready access to the the patient experience further. of care featuring a fully-equipped ICU.
Monash Health Annual Report. 2019-20 16 Monash Health Annual Report. 2019-20 17 The year in review
In April, John was one of the fi rst patients admitted to the new tower facilities at Casey Hospital. A new era for care in the southeast
Construction of the $135 million Casey Hospital expansion is complete and delivering above and beyond our community’s expectations.
he construction phase of the services they need closer to home. The fi rst ICU for Casey Casey Hospital expansion Commencing in September 2017, Martin Keogh, Monash Health’s Tis now complete, signifying the phased construction and opening Chief Operating Offi cer, said that a step-change in care for patients of facilities underlined the additional the Intensive Care Unit (ICU), and the community. Casey Hospital challenges of hospital construction. which opened on 18 May 2020, opens many possibilities across the A broad range of critical was a fi rst for Casey and an Monash Health network and beyond infrastructure and performance important milestone for the rapidly and will provide a signifi cant boost requirements were successfully expanding Casey catchment. for healthcare in the wider South balanced with uninterrupted In particular, the ICU increases Eastern region, relieving pressure provision of care. Casey’s ability to care for critically ill on several nearby hospitals. Casey Hospital can now patients without the need to transfer attract and retain the best them to alternate facilities. Casey Far-reaching benefi ts medical and administrative now joins Monash Medical Centre, The new and expanded facilities employees and enhance our Dandenong Hospital, and Monash mean less need to transfer patients, teaching capabilities to improve Children’s Hospital, with their provision as there is ready access to the the patient experience further. of care featuring a fully-equipped ICU.
Monash Health Annual Report. 2019-20 17 The year in review
“Opening our new ICU is such an important milestone for Monash Health in terms of serving the local Casey community and our ability to provide timely care for critically ill patients,” Mr Keogh said.
Improving access to specialty care The expansion has also broadened the range of specialist care in the region and included the opening of new theatre operating suites and pandemic response capacity within the Casey Hospital. Andrew Perta, General Manager Casey Hospital, explained, “We’ve added several new sub-specialties to the Casey site, including on-site gastroenterology, renal, respiratory, and infectious disease, and expanded our pathology department. A new pharmacy space features more advanced refrigeration, security features, additional storage, work stations, and collaborative meeting spaces for employees — and students. So now, we can provide a more wide-ranging clinical service to our general patients and keep critically ill patients here. It’s not just about the ICU; it’s all the One of the clinical services that we provide at new procedure Casey that will bring benefi ts.” rooms at Casey Hospital. Acknowledging every part of the experience While the new clinical areas contain the state-of-the-art technology “The redevelopment includes expected at a new facility, the design unexpected touches, big and small, and construction team has also paid to help us continue to give 100% to signifi cant attention to aesthetics. our community and make people feel Calm, clean spaces abound that special and cared for.” will help to ease the minds of anxious patients and families. Andrew Perta, General Manager, Casey Hospital The expansion included a spacious and welcoming revamped main entranceway, new Terrace Café, and Education Hub. “It’s got a SmartPak foodservice model meal, including more options for light, airy feel, so it doesn’t look recognised during Monash Health’s those with dietary restrictions. too clinical when you fi rst walk in. Innovation Awards in 2017, delivering With all this attention to detail “There’s visibility to the outside more menu choices for patients. and care that has gone into that will benefi t employees, The SmartPak technology allows function, aesthetics, and focus patients, and families. It’s a meals to be specially prepared on consumers’ needs, Casey beautiful facility,” Mr Keogh said. to retain freshness and colour, Hospital will now undoubtedly ring A lot of work went into changing allow for easier and faster delivery in a new era for Monash Health to the perception of hospital food, to the wards and give as many deliver experiences that exceed too, with the introduction of the as 19 different options for each our community’s expectations.
Monash Health Annual Report. 2019-20 18 The year in review
“Opening our new ICU is such an important milestone for Monash Health in terms of serving the local Casey community and our ability to provide timely care for critically Snapshot of expanded capacity to care ill patients,” Mr Keogh said.
Improving access to specialty care fully-equipped temporary The expansion has also broadened resuscitation bays constructed the range of specialist care in the region and included the opening on demountable units adjacent of new theatre operating suites to Monash Medical Centre and pandemic response capacity within the Casey Hospital. Emergency Department, built in Andrew Perta, General Manager 6 just six weeks Casey Hospital, explained, “We’ve added several new sub-specialties to support our ongoing response to COVID-19. to the Casey site, including on-site gastroenterology, renal, respiratory, and infectious disease, and expanded our pathology department. A new pharmacy space features more advanced refrigeration, security features, additional storage, work stations, and collaborative meeting spaces for employees — and students. So now, we can brand new beds provide a more wide-ranging clinical service to our general patients and opened in the keep critically ill patients here. It’s treatment 40 not just about the ICU; it’s all the One of the bays opened new Casey clinical services that we provide at new procedure 20 in the new Casey that will bring benefi ts.” rooms at Casey Medical Hospital tower Hospital. Infusion Unit Acknowledging every at Monash facility. part of the experience Medical Centre. While the new clinical areas contain the state-of-the-art technology “The redevelopment includes expected at a new facility, the design unexpected touches, big and small, and construction team has also paid to help us continue to give 100% to signifi cant attention to aesthetics. our community and make people feel bed Intensive Calm, clean spaces abound that special and cared for.” Care Unit will help to ease the minds of anxious patients and families. Andrew Perta, General Manager, Casey Hospital opened at The expansion included a spacious Casey Hospital, and welcoming revamped main 5 the fi rst for the entranceway, new Terrace Café, and Education Hub. “It’s got a SmartPak foodservice model meal, including more options for region. light, airy feel, so it doesn’t look recognised during Monash Health’s those with dietary restrictions. too clinical when you fi rst walk in. Innovation Awards in 2017, delivering With all this attention to detail $22m “There’s visibility to the outside more menu choices for patients. and care that has gone into that will benefi t employees, The SmartPak technology allows function, aesthetics, and focus spent to upgrade Monash patients, and families. It’s a meals to be specially prepared on consumers’ needs, Casey Medical Centre’s electrical beautiful facility,” Mr Keogh said. to retain freshness and colour, Hospital will now undoubtedly ring A lot of work went into changing allow for easier and faster delivery in a new era for Monash Health to infrastructure. the perception of hospital food, to the wards and give as many deliver experiences that exceed *Excludes surgical operations, total hospital admissions, too, with the introduction of the as 19 different options for each our community’s expectations. births ambulance arrivals and paediatric admissions.
Monash Health Annual Report. 2019-20 18 Monash Health Annual Report. 2019-20 19 03 0x We work with humility, respect, kindness, and compassion in high-performing teams
“Working through challenges with empathy, the team came together, not just as a team, but as somewhat of a family.”
Fairley Wijesinghe, Food Services Manager, Casey Hospital
Monash Health Annual Report. 2019-20 20 The year in review
0x
Working together in high- performing teams is a key to our success. (Images were taken pre COVID-19.) The A-team brings its A-game for COVID The Support Services team is a diverse and dedicated force.
s COVID-19 increased had each other’s backs during Illustrating the capabilities of demand for their services, a challenging time. This ensured this high-performing unit are their Aour ‘no-fuss’ heroes delivered they could work rapidly and considerable effort and empathetic excellence through teamwork. fl exibly to maintain exceptional approach to our consumers and their Our Support Services team care every step of the way. colleagues during the pandemic. partnered across Monash Health “Our dedicated and passionate There was considerable care put into departments to augment our clinical leaders are all about delivering protecting all employees with personal services with the very best supportive services whilst ensuring safety protective equipment (PPE) training care. Director of Support Services, measures, systems, processes, and safety measures put in place. Sharon McNulty, recognised the skill of and the work environment are all Workforce and business her team and the teamwork required improved. They consistently support contingency planning ensured by every member of the program. their team members as individuals the services so critical to the “We believe we can go further when on both a professional and personal function of our health service we combine our talents toward a level. They lead from the front, would not be interrupted. shared goal, which was highlighted and with sleeves decidedly rolled The team understood that patient in our pandemic response. up. It’s why their teams give their safety and care, and quality of service “The team worked as one and best, always,” said Ms McNulty. should not be compromised.
Monash Health Annual Report. 2019-20 21 The year in review
Securing meals, winning Every team awards, all in a day’s work member is proud Securing patient meal supply and to deliver high- ensuring the safe delivery of meals quality care that met nutritional standards and from the heart. non-negotiable dietary provision was vital. Monash Health has Victoria’s largest public health food production kitchen, servicing “The mark of an exceptional team both internal and external clients. lies in their ability to empathise Ordinarily, the team produces over deeply with those in their care and 8,500 meals per day, including each other. That’s the Support specialised and multiculturally Services team to a tee.” sensitive meals. Their reserves were drawn upon to answer the state’s David Ballantyne, call for help to ensure the provision Executive Director, Capital Infrastructure of meals during the pandemic. Not only did the Food Services Team maintain a reliable food supply for all Monash Health patients The 24/7 heroes: cleaning, into the existing weekly schedule. and external customers, but they waste, environmental This included developing new partnered with the Department and linen services and tailored cleaning solutions for of Health and Human Services When it came to fi ghting Coronavirus, over 12 newly created areas. and Health Purchasing Victoria as our cleaning, waste, environmental With additional PPE part of the statewide COVID-19 and linen service teams proved requirements comes additional food services plan. The team themselves to be our humble heroes. waste and linen requirements. provisioned an additional 50,000 They continued to ensure the The waste and environmental frozen meals able to be heated via day-to-day operational services services teams kept up with microwave or oven at any hospital, were maintained during this the substantial demand for aged care, meals on wheels, or time and adapted quickly to clinical waste services across home care facility in the state in implement additional services all our sites, including the new the event of major preparation and solutions specifi c to the screening clinics. Our linen kitchens becoming unavailable. issues raised by COVID-19. services went into overdrive and Amid the pandemic, the Central The cleaning team rolled out an maintained excellent service. Production Kitchen team won entire interim system for clinical The remarkable drive for the 2020 Australian Institute of cleaning during the pandemic to customer service and exemplary Food Science and Technology ensure compliance with COVID-19 teamwork meant our Support Allergen Bureau ‘Julie Newlands’ cleaning requirements until a longer- Services team not only kept up Award, acknowledging the team’s term solution was implemented. with the challenges of COVID-19 science-based approach to Additional workforce and but excelled in every aspect of food allergen risk assessment, resources delivered in excess of compassionate, kind, high-quality management, and communication. 3,500 hours of additional cleaning care, delivered from the heart.
Monash Health Annual Report. 2019-20 22 Recognising excellence
Tania Green Nurse of the Year HESTA Nursing and Midwifery Awards 2020
Tania Green is an exceptional nurse, devoted to improving the lives of cleft-affected babies. The HESTA Nurse of the Year is clinic nurse coordinator of our Cleft and Craniofacial Unit, and was recognised for her career-long 7 commitment to outstanding patient care, and of our team and community members delivering fantastic outcomes. were recognised in the 2020 Australia Day Honours.
Congratulations to: Dr Jane Tracy • Prof Diana Egerton- Lifetime Achievement Honour Roll, Warburton OAM Victorian Disability Awards 2019
• Dr Michael Leung AM Dr Jane Tracy has committed her career to caring for people with disability. • Mr Naim Melhem OAM As Director of our Centre for Disability Health • Prof Pauline Nugent AM Victoria she has been instrumental in ensuring mainstream health services better understand, • Dr Sabar Rustomjee AM care for and support people with intellectual disability and complex needs. • Mr Patrick Tessier OAM Her pioneering work has now been recognised with her elevation to the Lifetime Achievement • Dr Desiree Yap AM Honour Roll.
Dr Hashrul Rashid Trainee of the Year Award, Royal Australasian College of Physicians 2020
Dr Hashrul Rashid was awarded the prestigious award upon completion of his advanced training in cardiology. This award, bestowed by the RAC Fellowship Committee, recognises the highest achieving trainee who has shown signifi cant leadership, and contributions to education and training. Dr Rashid’s thesis investigated the diagnosis, impact and predictors of leafl et thrombosis following transcatheter aortic valve replacement.
Monash Health Annual Report. 2019-20 23 The year in review
04 We integrate teaching, research and innovation to continuously learn and improve
“The radical changes necessitated by COVID-19 were possible through iconoclastic innovation with support from the executive team, and the team’s ‘can-do’ attitude.”
Scott Donnellan, Director, Urology
Monash Health Annual Report. 2019-20 24 The year in review
Jomole John, enjoying quality time with her newborn daughter, Jianna, thanks to the NEOS calculator.
Keeping mothers and babies together In recognition of the importance of continuous learning and improvement, Monash Health was the fi rst Victorian service to implement the Neonatal Early Onset Sepsis calculator.
onducted on a smartphone, been used for many years to 200 times higher than the the Neonatal Early Onset to assist clinicians caring for actual incidence of EOS. CSepsis (NEOS) calculator babies to determine a baby’s allows us to keep more well babies risk of developing sepsis. Pathway to improved with their mothers rather than Those babies judged to be at high outcomes exposing them to unnecessary risk are then assessed through blood When combined with universal blood tests, antibiotic therapy, and tests, with intravenous antibiotics screening for Group B Streptococcus admission to the neonatal unit. given for suspected infection. (GBS) in pregnant women, the This means babies are calculator provided a more Challenging the norm admitted to the nursery and individualised and specifi c Early Onset Sepsis (EOS) is separated from their mothers. risk assessment that reduced an uncommon but severe However, traditional risk antibiotic treatment and separation bacterial bloodstream infection in assessment algorithms resulted rates in well newborn babies, newborn babies that can cause in high rates of antibiotic without increased risk of missing critical illness or death if not exposure for well babies, and genuine cases of sepsis. detected and treated early. the number of newborn infants Since we began using the Risk-factor algorithms have treated with antibiotics was up calculator, Monash Health
Monash Health Annual Report. 2019-20 25 The year in review
Award winners Charles “We are curious and drawn to learning Barfi eld, Alice Stewart, and and researching new things, and harness Ryan Hodges with Chief this curiosity to drive innovation and Executive, Andrew Stripp and improvement in all that we do.” Board Chair, Dipak Sanghvi.
Associate Professor Ryan Hodges, Program Director, Monash Women’s and Newborn
neonatal sites have shown clear Associate Professor Ryan improvement in the ways they identify Hodges, Program Director of Monash Mothers and babies united EOS, with no cases of missed or Women’s and Newborn, said, “The Director of Monash Newborn, delayed treatment for EOS. NEOS was a culmination of our Dr Alice Stewart, was delighted This positive impact on the team asking the question ‘what if?’ with the results and proud of quality of care was only achieved to develop alternative approaches the team’s achievements. with effective program leadership, and drive positive outcomes. “The message of ‘keeping collaboration, and engagement “It’s how we endeavour to mothers and babies together’ with all key stakeholders. solve problems for the benefi t of united our clinicians from The ‘keeping mothers and our mothers and babies and the across disciplines and had a babies together’ initiative represents broader community. The results signifi cant impact on mothers’ the integration of best evidence, have been striking – fewer babies experiences and outcomes for innovation, and team engagement had antibiotics, and fewer babies them and their babies,” she to improve the quality and safety of were separated from their mothers.” said. “More well babies were care that Monash Health provides spared unnecessary medical to babies and their mothers. Maintaining the precious bond interventions and stayed with their The newborn sepsis calculator The initiative means more mums mothers after birth, which, in turn, has been applauded in the like Jomole John (pictured on enabled stronger bonding and healthcare industry, winning the previous page) who gave birth to her breastfeeding establishment.” award for Excellence in Women’s second daughter Jianna at Monash The thoughtful care that Health at the 2019 Victorian Health, are enjoying additional went into implementing the Public Health Care Awards. quality time with their newborns NEOS means an excellent Associate Professor Ryan during those critical fi rst few days. outcome that will benefi t our Hodges, Dr Alice Stewart, and “I know if she’s taken to the community into the future. Associate Professor Charles nursery, she’s in good hands, but It’s just one example of many Barfi eld received the award from the as her mother, there is always a of our teams at Monash Health Victorian Minister for Health, Jenny bit of anxiety if you are separated. leading healthcare outcomes Mikakos, who recognised their Now I can feed her whenever with evidence-based research pivotal role in the health outcomes she needs and have that special and learning to drive innovation for mothers and their babies. bonding time,” Jomole said. and improvements in care.
Monash Health Annual Report. 2019-20 26 Research at Monash Health $63m awarded for commercially sponsored research. 1530 active research projects, spanning trials for drug 55 and devices, clinical currently held clinical research Fellowships research and quality at Monash Health. improvement. 240 Graduate research students in the School of Clinical $23m Sciences at awarded for research Monash Health. Fellowships.
Monash Health Annual Report. 2019-20 27 05 We orientate care towards our community to optimise access, independence, and wellbeing
“To see a client achieve a goal they previously believed was out of reach, and subsequently see their perception of what they are capable of gradually change, is incredibly rewarding.”
Lauren Alley, Speech Pathologist, Youth and Family Team
Monash Health Annual Report. 2019-20 28 TheThe yearyear inin reviewreview
Djirri Djirri dancers performed at our National Reconciliation Week celebrations. (Images were taken pre COVID-19.) Caring for our diverse communities Monash Health launched our Innovate Reconciliation Action Plan 2020-2022 in partnership with the Aboriginal community to support ‘Closing the Gap’.
he Innovate Reconciliation and wellbeing for every member peoples and other Australians Action Plan (RAP) for of our diverse communities. There to create an environment of T2020–2022, launched in are more than 20,000 Aboriginal collaboration, respect, and support. February 2020, is an essential and Torres Strait Islander peoples “Monash Health is committed step toward ‘Closing the Gap’ across the local government areas to creating a culturally safe between healthcare outcomes of Glen Eira, Kingston, Monash, environment and ensuring that for Aboriginal and Torres Strait Greater Dandenong, Casey, and everyone has equal healthcare Islanders and other Australians. Cardinia, where many of our patients opportunities. This plan presents and healthcare workers live. our reconciliation journey and our An action plan for change Board Chair Dipak Sanghvi said relationship with the Aboriginal Monash Health is an integral part that the RAP outlines the vision community,” Mr Sanghvi said. of the local communities we care for a Monash Health community “I believe this plan clearly for, and we place a high priority on that welcomes unity between sets out our commitment to this optimising access, independence, Aboriginal and Torres Strait Islander journey and establishes a clear
Monash Health Annual Report. 2019-20 29 The year in review
history and health, including, “What Australian history meant Care in our community for Aboriginal people and how that impacted on health.”
Inspiring future generations Dr Barunga said her ‘end goal’ is to return to her community in the Kimberley. 240 “If I wasn’t going to be a doctor, I 9,631 Dr Vinka Barunga don’t know what I would be. There residential aged care facilities, people received care at are so many people in the community supported residential services, that support me and look up to disability group homes and hostels home via our Hospital in the me, and I couldn’t let them down. provided with acute medical Home service, the largest in “Working in a hospital is and nursing assistance via our exciting, it’s challenging, it’s not Australia. really a feeling I get anywhere Residential In-Reach program. else in my life,” she said. We are very proud that Vinka is a part of our team and honoured to be a part of her journey to enact positive and lasting change.
A journey of mutual respect and shared goals Monash Health believes that Aboriginal Health is everyone’s business. Reconciliation relies on 386,793 both Aboriginal and non-Aboriginal people working together to create “Everyone can be an ally for reconciliation and opportunities, build respect, and community health champion change moving forward. It takes simple nurture relationships. The RAP is part acts such as coming to Aboriginal events, asking all of a pledge to create an inclusive appointments provided. patients if they identify as Aboriginal or Torres Strait environment and experience for all. Islander, or ordering catering from an Aboriginal A critical step has been the development of bespoke Monash business.” Health Aboriginal Cultural Awareness Daniel Carter, modules launched in June 2020 proud Ngarrindjeri/Wergaia man, Director of Aboriginal Health to complement the RAP. Project Lead for Aboriginal Health, Isabelle Howard, and People and Culture’s Kitty Chandler, had deep involvement path to achieving greater equality in the SBS Insight NAIDOC Week in the development of the online 71,934 in healthcare for our Aboriginal special ‘Deadly Future’ while working training. Since then, the rapid 85 patients. We want to lead the way at Monash Health in July 2019. adoption means Monash Health is on clients supported appointments in ‘Closing the Gap’ between health Dr Barunga is the fi rst Aboriginal track to have all employees embrace held via Telehealth as part of new outcomes for Aboriginal people doctor in her hometown of Derby, this essential cultural education. or telephone, and other Australians,” he said. Western Australia, and hopes Monash Health will continue its NDIS support increasing access to give back to her community reconciliation journey, built on a coordination Proud Worrorra doctor and inspire the next generation strong foundation of mutual respect, to important leads the way of Aboriginal women. cultural learning, and supportive service support and Dr Vinka Barunga, proud Worrorra Dr Barunga said that leadership, helping us to orientate 67 clients supported with NDIS allied health services. care. woman and Critical Care doctor, conversations with teachers and care towards our community to added her perspective when featured mentors during high school stoked optimise access, independence, as one of the First Nation trailblazers her interest in the link between and wellbeing for everyone.
Monash Health Annual Report. 2019-20 30 Monash Health Annual Report. 2019-20 31 Care in our community
240 9,631 residential aged care facilities, people received care at supported residential services, disability group homes and hostels home via our Hospital in the provided with acute medical Home service, the largest in and nursing assistance via our Australia. Residential In-Reach program. 386,793 community health appointments provided.
85 71,934 clients supported appointments held via Telehealth as part of new or telephone, NDIS support increasing access coordination to important service support and 67 clients supported with NDIS allied health services. care.
Monash Health Annual Report. 2019-20 31 TheThe year year in inreview review
The Distribution Service Centre, a key part of streamlining our processes.
06 We manage our resources wisely and sustainably to provide value for Essential resources for excellence in care our community To provide excellent care while maintaining value for our community, Monash Health’s extensive network of services and facilities requires a procurement and supply chain like no other. “The state-of-the-art Distribution Service Centre consolidates our procurement and supply chain operations, increasing the range of options and streamlining the end-to-end process. We can source, ur new Distribution Service and function working smoothly. Neil to the new Distribution Service track and deliver maximum value for our community.” Centre helps us to procure, Sigamoney, Director Procurement Centre,” Mr Sigamoney said. Omanage, and distribute and Supply Chain, says this wasn’t “In consultation with our clinicians, Neil Sigamoney, the constant fl ow of products, merely an exercise to increase clinical support employees, Director, Procurement and Supply Chain services, and equipment required capacity. Using our resources consumers, and industry partners, to maintain an excellent provision of wisely means a sophisticated we work to ensure we procure care and value for our community. and highly complex operation. the best value products and The 8,000m² warehouse space services without compromising is 25 times larger than the previous Transforming our on the delivery of excellent patient capacity at Monash Medical Centre resource provision care and experience,” he said. in Clayton. The sheer size of the “We reviewed and transformed our Mr Sigamoney said the new facility means we can increase the clinical and non-clinical products and facility capability was felt throughout items we hold and handle them more services, procurement practices, the supply chain, as well as effi ciently with improved response and processes across Monash assisting in the State’s response times to keep every department Health as part of the transition to the COVID-19 pandemic.
Monash Health Annual Report. 2019-20 32 Monash Health Annual Report. 2019-20 33 TheThe year year in inreview review
The Distribution Service Centre, a key part of streamlining our processes.
Essential resources for excellence in care To provide excellent care while maintaining value for our community, Monash Health’s extensive network of services and facilities requires a procurement and supply chain like no other.
ur new Distribution Service and function working smoothly. Neil to the new Distribution Service Centre helps us to procure, Sigamoney, Director Procurement Centre,” Mr Sigamoney said. Omanage, and distribute and Supply Chain, says this wasn’t “In consultation with our clinicians, the constant fl ow of products, merely an exercise to increase clinical support employees, services, and equipment required capacity. Using our resources consumers, and industry partners, to maintain an excellent provision of wisely means a sophisticated we work to ensure we procure care and value for our community. and highly complex operation. the best value products and The 8,000m² warehouse space services without compromising is 25 times larger than the previous Transforming our on the delivery of excellent patient capacity at Monash Medical Centre resource provision care and experience,” he said. in Clayton. The sheer size of the “We reviewed and transformed our Mr Sigamoney said the new facility means we can increase the clinical and non-clinical products and facility capability was felt throughout items we hold and handle them more services, procurement practices, the supply chain, as well as effi ciently with improved response and processes across Monash assisting in the State’s response times to keep every department Health as part of the transition to the COVID-19 pandemic.
Monash Health Annual Report. 2019-20 33 The year in review
Distribution services
900 58,000 tonnes of single-use plastics replaced recyclables diverted with reusable lids and containers by the Food from landfi ll. Services Team at Moorabbin.
“We acknowledge we have fi nite resources and make every dollar count toward enabling our employees to care for our community to the fullest of their capabilities.” Neil Sigamoney, Director, Procurement and Supply Chain Wise resourcing for better care 78,000 Neil Sigamoney said that improvements made to the supply plastic bags replaced with satchels and paper chain and the effi ciencies they bags for dispensing medications, as part of “Our new centre consolidated not instrumental in the storing and create would benefi t healthcare only our warehousing but also our supply of essential supplies for workers, patients, and their families. the Monash Medical Centre Pharmacy Project, Procurement and Supply Chain and state healthcare providers. “We need to ensure that every Finance functions. Bringing everyone A great deal of media dollar counts toward caring for our reducing landfi ll and our carbon footprint. together in the one place boosted attention was paid to the patients and our employees. Every our tight-knit teams’ collaboration possibility of a shortage of time we create effi ciency without and ability to fast-track response personal protective equipment compromising care, we increase times during this challenging in Victoria, as healthcare and our ability to serve our community period,” Mr Sigamoney said. other industry organisations with value-adding healthcare “There were new processes instituted higher levels of activity,” Mr Sigamoney said. that enhanced and streamlined vigilance for employee safety. “At Monash Health, we are the sourcing of the best value, In April 2020, Victorian Minister always looking for ways to improve 3,364 most sustainable products and for Health Jenny Mikakos spoke our practices and processes so services, shortened the supply about the State’s centralised that we can manage our resources types of items, including chain, increased the capacity and approach to the storage and wisely and sustainably to provide 970 medication, personal range and made a big difference distribution of personal protective value for our community. We are protective equipment and to Monash Health and the State’s equipment and the critical role the all about managing the multiple different health sites across medical equipment, pandemic response,” he said. Monash Health Distribution Service moving parts to source and move Victoria that supplies were Centre played securing a vital resources to the people that need stored at our Stepping up for the State pandemic response supply chain. them, where they are needed, distributed to in support of Distribution With the nation mobilising to “We thank Monash Health and avoiding waste,” he said. the COVID-19 response. Centre. respond to the challenges posed for the critical role that they Within a short timeframe, the new by the COVID-19 pandemic, are playing, making sure that Distribution Service Centre and the Monash Health stepped up to our health services can secure team have already delivered value assist with supply chain issues, the vital equipment that they to the broader community and will with the Distribution Service Centre need,” Minister Mikakos said. continue to do so for years to come.
Monash Health Annual Report. 2019-20 34 Monash Health Annual Report. 2019-20 35 Distribution services
900 58,000 tonnes of single-use plastics replaced recyclables diverted with reusable lids and containers by the Food from landfi ll. Services Team at Moorabbin. 78,000 plastic bags replaced with satchels and paper bags for dispensing medications, as part of the Monash Medical Centre Pharmacy Project, reducing landfi ll and our carbon footprint. 3,364 types of items, including 970 medication, personal protective equipment and different health sites across medical equipment, Victoria that supplies were stored at our distributed to in support of Distribution the COVID-19 response. Centre.
Monash Health Annual Report. 2019-20 35 The year in review
Aged Care
Care delivered from the heart At Monash Health, excellence in aged care means going the extra mile to ensure every care recipient feels at home.
hether working in one of Monash Health’s “Aged care is so much more than tending to Wresidential aged care physical and medical needs. We want our care facilities, in the community or recipients and their families to feel inclusive of onsite, our employees go above a community. Every one of our actions is about and beyond to deliver excellence creating a sense of belonging to home, a loving in aged care. Our dedicated community, and a neighbourhood.” and diverse teams are always looking for ways to improve the Juliet Adams, experience of our aged care Deputy Director of Nursing/Operations Manager, Residential Services recipients and their families.
We are a family There’s a special bond that We are a neighbourhood homes initiated this wellness program develops between our teams Exceptional medical and personal to engender a feeling of belonging. and their residential aged care caregiving is second nature to our The name MACEY used the fi rst community, where we interact team of aged care employees, but letter of each home, Mooraleigh, with our care recipients and they delight in teaming with care Allambee, Chestnut Gardens, their family and friends daily recipients to build a community Eastwood, and Yarraman. The and over several years. experience. A fi tting example is MACEY Games ‘baton’ was Work goes into ensuring a the ‘MACEY Games’, held for decorated and passed through homely, nurturing experience the second time in December each home, building up excitement including everyone as an individual 2019. Following the spirit of the before ending at Chestnut Gardens, and fi nding out about their life Commonwealth Games, the fi ve the location of the games. and what is meaningful to them. Monash Health residential aged care The care recipients came
Monash Health Annual Report. 2019-20 36 Bringing aged care into the community
he Monash Health Community TSupport Options (CSO) Team deliver Home Care Packages to older Victorians in the comfort of their own home. Award-winning care The CSO Team’s focus is facilitating empathetic, compassionate, and Ruth Peters, EEN, 2020 Taiwan International accountable service delivery every made a heartfelt submission Nursing Conference and day of the year. Our services to the Victorian Healthcare Australian Association of gained essential status during Association’s ‘Celebrating Gerontology Conference. the very isolating lockdowns for aged care – why I love my job’ aged and vulnerable Victorians. campaign. Ruth’s submission Fiona McAlinden, Jacinta The team takes pride on ‘returning won a workplace morning tea Re, Justine Little and thanks’ to the wonderful Victorians for her and her workmates. Jaye Toulson won the whose immeasurable contributions Excellence in Public Sector have built our great state. Ruby Pipson, ANUM, Aged Care Award for their won the Monash Health Guardianship in Hospitals: Monash Health Community 2020 Emerging Researcher A Health Services/ Support Options: Fellowship Grant and will OPA Pilot Program. conduct a duplicate ‘Nurse Since its introduction, • encompassed 371 Home Care Empowerment and Engagement the time vulnerable Packages and support in residential aged mental health Victorians spent waiting in and dementia care’ project. hospital for guardianship • programs have continued to be Her abstract was accepted allocation decreased from delivered at 100% throughout the for oral presentation at the 46.5 to 16.2 days. COVID-19 lockdowns in Victoria
• ensured zero COVID-19 community together as one neighbourhood, messages of support to transmissions, due to the focus with games modifi ed to allow all ‘inundate our care recipients on safety precautions and high members to compete. Events with kindness and hope’ standards of care delivery included target shooting, quoits, during the challenging time. and a hand-held bean bag toss, The idea snowballed with • acquired six new clients for with Mooraleigh the 2019 victors! drawings, paintings, videos, their packages due to the The vibrancy, competitiveness, collages, and entertaining reputation for safe delivery of and sense of achievement were stories pouring in. care throughout the pandemic. terrifi c. With the medal ceremony Receiving the messages concluding the games, the of support from the What clients had to say about ‘neighbours’ went back to their community provided an our Support Options Team: homes with stories to tell, pride, additional boost to morale. and a sense of belonging. Dr Jakqui Barnfi eld, “Commendation to all for doing the Operations Director, Residential job with such love and affection.” We are a community Services, emphasised the When the COVID-19 threat pride within the team. “Our “Excellent service!” meant visitation restrictions, team is all about celebrating the team discussed how to and highlighting the many “Lovely people.” maintain connections and positive aspects there are to quickly mobilised technology working in aged care. I’m so “From Kingston Centre to the to facilitate virtual visitation. grateful for the supportive Community Support Options, They wanted to help lift everyone’s people we have who focus he has such a lot of caring spirits further and put out a call on our care recipients’ health people doing everything to via Facebook for drawings and and wellbeing, every day.” make things easier for him.”
Monash Health Annual Report. 2019-20 37 The year in review
Monash Health Foundation In-kind Monash Health support Foundation: Special thanks to the following for their generous in-kind advancing donations to support Monash Health’s patients and front line world class care healthcare workers.
The Monash Community fundraising events Fibrosis (CF) event raises funds Health Foundation The COVID-19 response in 2020 to support CF research and $150,000 affected the community’s ability clinical improvements. The worth of products by L’Oréal. exists to generate to hold face-to-face fundraising March 2020 event was cancelled philanthropic events for Monash Health, due to COVID-19, however, including the postponement of registrants walked in their own support for the the Dandelion Wishes Gala. communities, raising $78,000 $20,000 important work of The earlier part of the fi nancial year included many terrifi c events. Special thanks to Richard Lim for his worth of products by Winc Monash Health. support throughout 2019-20. Richard offi ce supplies. • The My Room Telethon, hosted hosted various events and activities by Channel Nine, contributed that brought together the Cambodian, n 2019-20 the Foundation more than $1.25 million in support Vietnamese and Chinese communities worked with individuals, of the MCH Cancer Centre to raise funds for Monash Health. $19,000 Icompanies and communities worth of products by to raise funds towards: “On behalf of all who benefi t from • The inaugural Monash Health Employee giving (iGive) Novartis Pharmaceuticals. your generous donations, I would Pyjama Fun Run raised more Many Monash Health employees • new and additional equipment like to thank you for helping make a than $70,000 towards generously choose to make a difference in so many lives.” specialised equipment fortnightly donation through their • medical research, including and sleep health research salary. As at 30 June 2020 there $15,000 translational research in Monash Health’s Lung were 824 employees participating in Ron Fairchild, worth of PJ bears for MCH Director, Monash Health Foundation and Sleep Department the iGive program, who collectively and Emergency Department • initiatives focused on donated more than $93,000. patients from Lorraine Lea Linen patients and their families • In November 2019, the Rotary Club of Emerald hosted their Gifts in-kind • additional specialised very generous contribution by the Major contributions annual ‘Kids Fun Run with Businesses and individuals often employee positions Freemasons Foundation Victoria. The Foundation has received Thomas’ and donated $50,000 give in-kind donations of products The appeal broke Foundation wonderful support from a number towards the MCH Cancer Centre for patients and employees. During $5,000 • scholarships and professional records for community appeals, of major donors including Max COVID-19 the Foundation has worth of homeware gifts from development training raising more than $470,000. and Judith Bennetts, who • The Teo Chew Chinese experienced a signifi cant increase Koh Living. opportunities for employees July 2019 saw the launch of made a generous donation in Association hosted a New of in-kind gifts supporting frontline an exciting new national initiative recognition of the care received Year celebration, raising workers. More than $210,000 For a list of supporters in • capital projects such - Curing Homesickness. The joint by their late daughter, to support $75,000 for the new Children’s in products was donated to 2019-20 see page 86. as new facilities. fundraising initiative brings children’s the Oncology Department. Emergency Department help those fi ghting the virus. hospitals and paediatric services Patrick Tessier continued his The Foundation responded to the from across Australia together. support with a major contribution to • In early March 2020, more Thank you urgent need around COVID-19 This fi nancial year the the Monash Children’s Hospital (MCH) than 2000 people attended the Thank you to those who have raised To contact the Monash with a community appeal, raising initiative’s major partnership Cancer Centre, through Bailey’s Day. 2020 Walk for MCH, raising funds in celebration of a special Health Foundation: funds for research into treatments with Coles contributed more The event has made a $175,000 for the new Children’s occasion or have given a gift in for people with Coronavirus. The than $150,000 towards the signifi cant difference to patient Emergency Department memory of a loved one. Special T: (03) 9594 2700 appeal was strongly supported new Children’s Emergency care over the past 17 years, thanks also to auxiliary members for E: [email protected] by the community, including a Department at the Clayton site. raising more than $3.3 million. • The annual 65km for Cystic their commitment and contribution.
Monash Health Annual Report. 2019-20 38 Monash Health Annual Report. 2019-20 39 In-kind support
Special thanks to the following for their generous in-kind donations to support Monash Health’s patients and front line healthcare workers.
Community fundraising events Fibrosis (CF) event raises funds The COVID-19 response in 2020 to support CF research and $150,000 affected the community’s ability clinical improvements. The worth of products by L’Oréal. to hold face-to-face fundraising March 2020 event was cancelled events for Monash Health, due to COVID-19, however, including the postponement of registrants walked in their own the Dandelion Wishes Gala. communities, raising $78,000 $20,000 The earlier part of the fi nancial year included many terrifi c events. Special thanks to Richard Lim for his worth of products by Winc support throughout 2019-20. Richard offi ce supplies. • The My Room Telethon, hosted hosted various events and activities by Channel Nine, contributed that brought together the Cambodian, more than $1.25 million in support Vietnamese and Chinese communities of the MCH Cancer Centre to raise funds for Monash Health. $19,000 worth of products by • The inaugural Monash Health Employee giving (iGive) Novartis Pharmaceuticals. Pyjama Fun Run raised more Many Monash Health employees than $70,000 towards generously choose to make a specialised equipment fortnightly donation through their and sleep health research salary. As at 30 June 2020 there $15,000 in Monash Health’s Lung were 824 employees participating in worth of PJ bears for MCH and Sleep Department the iGive program, who collectively and Emergency Department donated more than $93,000. patients from Lorraine Lea Linen • In November 2019, the Rotary Club of Emerald hosted their Gifts in-kind annual ‘Kids Fun Run with Businesses and individuals often Thomas’ and donated $50,000 give in-kind donations of products towards the MCH Cancer Centre for patients and employees. During $5,000 COVID-19 the Foundation has worth of homeware gifts from • The Teo Chew Chinese experienced a signifi cant increase Koh Living. Association hosted a New of in-kind gifts supporting frontline Year celebration, raising workers. More than $210,000 For a list of supporters in $75,000 for the new Children’s in products was donated to 2019-20 see page 86. Emergency Department help those fi ghting the virus.
• In early March 2020, more Thank you than 2000 people attended the Thank you to those who have raised To contact the Monash 2020 Walk for MCH, raising funds in celebration of a special Health Foundation: $175,000 for the new Children’s occasion or have given a gift in Emergency Department memory of a loved one. Special T: (03) 9594 2700 thanks also to auxiliary members for E: [email protected] • The annual 65km for Cystic their commitment and contribution.
Monash Health Annual Report. 2019-20 39 The year in review The year in review
Jessie McPherson Private Hospital Choosing Jessie McPherson Private Hospital When discussing booking in at Jessie McPherson Jessie McPherson for her births, Bonnie explained it came down to the high level of care. “As a nurse, I understand the importance of access to neonatal Private Hospital intensive care services, theatre, and anaesthetics 24/7. Jessie McPherson offers all this with the Jessie McPherson Private Hospital is a private tertiary hospital benefi ts of a private stay. I could co-located at Monash Medical Centre in Clayton. have chosen a private hospital closer to home, but the level of care and peace of mind made Jessie e are proud of our tight- McPherson an obvious choice.” knit team of highly skilled W and dedicated employees, equipped with some of the best Birth experience and medical facilities in Victoria. postnatal care Our 103-bed hospital offers COVID-19 meant Bonnie was specialist services, including able to make some interesting cardiology, cardiothoracic comparisons to her fi rst stay. surgery, neurosciences, vascular, Bonnie’s Story: “While the personal protective gastrosciences, general medicine equipment and precautions may and respiratory, maternity, Giving birth during the be confronting for some, it meant and neonatal services. less traffi c in and out of the room, The co-location of the hospital COVID-19 pandemic which resulted in the birth suite with Monash Medical Centre provides being quiet, peaceful, and calm. I consumers with confi dence they have still had a beautiful birth, with no access to a wide range of services onnie, a Monash Health Theatre COVID-19 impact from COVID-19. It’s clear and facilities, including pharmacy, BNurse, shares her experience By March 2020, the COVID-19 that to all the employees, you are pathology, and diagnostic imaging. of staying at Jessie McPherson pandemic was having an impact their priority, not the pandemic.” This affi liation also provides Private Hospital and giving birth on the lives of Australians, with On her postnatal stay, Bonnie consumers with the benefi t of during the extraordinary time restrictions and social distancing said, “I felt extremely well cared specialist services and state-of- of the COVID-19 pandemic. rules imposed nationally. for and enjoyed the uninterrupted the-art teaching and research that Like many pregnant attention of the midwives due to Monash Health has to offer. “Our employees’ commitment to Pregnancy women, Bonnie experienced visitor restrictions. While my care was The tertiary level status, with excellent outcomes remained steadfast, After the excellent care they received some variations to the usual excellent the fi rst time, I found that 24/7 support from Monash Health, even during the most challenging times in 2018 for the birth of their fi rst pregnancy care. “My antenatal this time as the employees didn’t provides consumers with the of the COVID-19 pandemic.” child Jed, Bonnie and Tom had no appointments were impacted, have to work around visitors, I spent assurance that Jessie McPherson doubts about booking into Jessie as I had to go on my own to more time asking questions and Private Hospital is one of the safest, Thinesh Chandraratne, McPherson for a second time, under scans, and call from the carpark talking to the midwives. For me, this highest-quality private hospitals Chief Executive Offi cer, the care of Dr Shavi Fernando. to announce my arrival.” added to the level of care I received. in which to receive care. Jessie McPherson Private Hospital During her fi rst pregnancy As a healthcare professional, While disappointed about Jed not Our ‘Point of Care Goals’, in 2018, Bonnie experienced Bonnie had insight into the being able to meet his brother, I developed following input from complications, including high blood pandemic, “I worked up loved the quality one-on-one time employees and consumers, refl ect pressure and preeclampsia. until 36 weeks in early April. I had with Beau. We completely consumers’ values and how they relate Thank you, Anne Howe After experiencing high blood Working in a hospital during understand why the restrictions are to healthcare access and delivery, pressure during her second this time meant I knew in place and found that it did make We would like to extend our sincere thanks to Anne which in turn, translate into exceptional pregnancy, Bonnie was closely what was going on behind us feel safer, like being in a protected Howe, Chief Executive Offi cer, Jessie McPherson care for every patient, every time. monitored, and the pregnancy went the scenes with pandemic bubble from the outside world.” Private Hospital (2015 to 2020) for her tireless efforts in Our dedication to our consumers smoothly with all complications planning. So, although the “While the world felt like a crazy guiding the organisation and ensuring the best possible and each other is illustrated rapidly and expertly managed. changes to appointments and place, I felt very safe in the hands outcomes for all our consumers and employees. in Bonnie’s story – the perfect Bonnie was induced at 38 weeks, precautions around social of the team at Jessie McPherson. Following a long career of service to the health industry, example of continued highly- and baby Beau was welcomed distancing felt very strange, Thank you to Dr Fernando and Anne resigned in March 2020 and we wish her the very specialised obstetric and neonatal into a somewhat altered world I completely understood the wonderful midwives for their best as she embarks on the next chapter of her life. services during the pandemic. on ANZAC Day, Saturday 25 it was for our safety.” amazing care of all of us.” April 2020, weighing 3.4kgs.
Monash Health Annual Report. 2019-20 40 Jessie McPherson Private Hospital 41 The year in review
Choosing Jessie McPherson Private Hospital When discussing booking in at Jessie McPherson for her births, Bonnie explained it came down to the high level of care. “As a nurse, I understand the importance of access to neonatal intensive care services, theatre, and anaesthetics 24/7. Jessie McPherson offers all this with the benefi ts of a private stay. I could have chosen a private hospital closer to home, but the level of care and peace of mind made Jessie McPherson an obvious choice.”
Birth experience and postnatal care COVID-19 meant Bonnie was able to make some interesting comparisons to her fi rst stay. Bonnie’s Story: “While the personal protective equipment and precautions may Giving birth during the be confronting for some, it meant less traffi c in and out of the room, COVID-19 pandemic which resulted in the birth suite being quiet, peaceful, and calm. I still had a beautiful birth, with no onnie, a Monash Health Theatre COVID-19 impact from COVID-19. It’s clear BNurse, shares her experience By March 2020, the COVID-19 that to all the employees, you are of staying at Jessie McPherson pandemic was having an impact their priority, not the pandemic.” Private Hospital and giving birth on the lives of Australians, with On her postnatal stay, Bonnie during the extraordinary time restrictions and social distancing said, “I felt extremely well cared of the COVID-19 pandemic. rules imposed nationally. for and enjoyed the uninterrupted Like many pregnant attention of the midwives due to Pregnancy women, Bonnie experienced visitor restrictions. While my care was After the excellent care they received some variations to the usual excellent the fi rst time, I found that in 2018 for the birth of their fi rst pregnancy care. “My antenatal this time as the employees didn’t child Jed, Bonnie and Tom had no appointments were impacted, have to work around visitors, I spent doubts about booking into Jessie as I had to go on my own to more time asking questions and McPherson for a second time, under scans, and call from the carpark talking to the midwives. For me, this the care of Dr Shavi Fernando. to announce my arrival.” added to the level of care I received. During her fi rst pregnancy As a healthcare professional, While disappointed about Jed not in 2018, Bonnie experienced Bonnie had insight into the being able to meet his brother, I complications, including high blood pandemic, “I worked up loved the quality one-on-one time pressure and preeclampsia. until 36 weeks in early April. I had with Beau. We completely After experiencing high blood Working in a hospital during understand why the restrictions are pressure during her second this time meant I knew in place and found that it did make pregnancy, Bonnie was closely what was going on behind us feel safer, like being in a protected monitored, and the pregnancy went the scenes with pandemic bubble from the outside world.” smoothly with all complications planning. So, although the “While the world felt like a crazy rapidly and expertly managed. changes to appointments and place, I felt very safe in the hands Bonnie was induced at 38 weeks, precautions around social of the team at Jessie McPherson. and baby Beau was welcomed distancing felt very strange, Thank you to Dr Fernando and into a somewhat altered world I completely understood the wonderful midwives for their on ANZAC Day, Saturday 25 it was for our safety.” amazing care of all of us.” April 2020, weighing 3.4kgs.
Jessie McPherson Private Hospital 41 Report of Operations
Report of Operations
About Report of Monash Health
Operations or almost 170 years, Monash and inclusion for those with whom Health and its predecessors we work. Our commitment to Fhave provided safe, high- our community and each other is quality healthcare for people at distilled into our strategic intent, Responsible bodies declaration every life stage. We work to support purpose, and guiding principles. healthy communities, partnering with In accordance with the Financial Management Act 1994, all levels of Government, with not-for- I am pleased to present the report of operations for profi t and local organisations to help Strategic intent Monash Health for the year ending 30 June 2020. individuals achieve their health goals. We are relentless in our At every step we place our pursuit of excellence. patients and clients at the centre of what we do, striving to make our Purpose services responsive to the changing To deliver quality, patient-centred needs of our communities. healthcare and services that meet Today, we are proud to be the needs of our diverse community. recognised as a leading teaching and research health service of Our guiding principles international standing. We will • We consistently provide safe, continue to embrace our role at high quality and timely care Dipak Sanghvi the forefront of the Victorian health Chair, Board of Directors system, addressing community • We provide experiences Melbourne needs, advances in health science that exceed expectations and technology, and supporting 6 October 2020 employee aspirations. • We work with humility, respect, • We orientate care towards our While maintaining the core of who kindness, and compassion community to optimise access, we are, we continue to raise our in high performing teams independence, and wellbeing expectations, pursuing excellence in care for those in need, excellence • We integrate teaching, • We manage our resources wisely in teaching and research, and research and innovation to and sustainably to provide providing a place of opportunity continuously learn and improve value for our community
Monash Health Annual Report. 2019-20 42 Monash Health Annual Report. 2019-20 43 Report of Operations
About Monash Health
or almost 170 years, Monash and inclusion for those with whom Health and its predecessors we work. Our commitment to Fhave provided safe, high- our community and each other is quality healthcare for people at distilled into our strategic intent, every life stage. We work to support purpose, and guiding principles. healthy communities, partnering with all levels of Government, with not-for- profi t and local organisations to help Strategic intent individuals achieve their health goals. We are relentless in our At every step we place our pursuit of excellence. patients and clients at the centre of what we do, striving to make our Purpose services responsive to the changing To deliver quality, patient-centred needs of our communities. healthcare and services that meet Today, we are proud to be the needs of our diverse community. recognised as a leading teaching and research health service of Our guiding principles international standing. We will • We consistently provide safe, continue to embrace our role at high quality and timely care the forefront of the Victorian health system, addressing community • We provide experiences needs, advances in health science that exceed expectations and technology, and supporting employee aspirations. • We work with humility, respect, • We orientate care towards our While maintaining the core of who kindness, and compassion community to optimise access, we are, we continue to raise our in high performing teams independence, and wellbeing expectations, pursuing excellence in care for those in need, excellence • We integrate teaching, • We manage our resources wisely in teaching and research, and research and innovation to and sustainably to provide providing a place of opportunity continuously learn and improve value for our community
Monash Health Annual Report. 2019-20 43 Report of Operations
Our care at a glance 3.2m 48,023 procedures total episodes performed. of care.*
(2018-19: 46,812) (2018-19: 4.1m)
64,546 258,592 emergency total hospital department ambulance admissions. arrivals.
(2018-19: 63,133) (2018-19: 265,027) 36,184 366,540 Who we are 1.63m mental health client Monash Health is Victoria’s largest and most comprehensive health paediatric outpatient consumer contacts. admissions. service. Our size, scope and quality are comparable with any services. healthcare service in the world. (2018-19: 41,203) (2018-19: 1.55m) (2018-19: 335,428)
ith more than 18,000 • prevention and early • hospital and community-based employees, we provide intervention programs mental health services W care to south eastern metropolitan Melbourne and rural • community and home-based • comprehensive sub-acute 216,871 10,097 Victoria from over 40 locations, treatment and rehabilitation and aged care programs via telehealth, and in people’s emergency department births. (2018-19: 10,357) communities and homes. • specialised surgical, medical • palliative care attendances across Monash Health cares for people diagnosis, treatment and across the full lifespan, from monitoring services, at primary, • research our three campuses. pre-birth to end-of-life, providing secondary, tertiary, and some integrated, comprehensive, and quaternary level care • teaching the next generation of (2018-19: 231,856) 36.8m often highly complex care. healthcare professionals through pathology tests. We improve people’s health • a specialist referral role for undergraduate, postgraduate, * Excludes surgical operations, total hospital admissions, and experiences through: many specialties serving greater vocational, and specialist programs, births, ambulance arrivals and paediatric admissions. (2018-19: 34.3m) Melbourne, Victoria and interstate simulation, and telehealth.
Monash Health Annual Report. 2019-20 44 Monash Health Annual Report. 2019-20 45
Kate Nolan con rming exact number of employees and locations Report of Operations
Who we are
Who we are Monash Health is Victoria’s largest and most comprehensive health service. Our size, scope and quality are comparable with any healthcare service in the world.
ith more than 18,000 • prevention and early • hospital and community-based employees, we provide intervention programs mental health services W care to south eastern metropolitan Melbourne and rural • community and home-based • comprehensive sub-acute Victoria from over 40 locations, treatment and rehabilitation and aged care programs via telehealth, and in people’s communities and homes. • specialised surgical, medical • palliative care Monash Health cares for people diagnosis, treatment and across the full lifespan, from monitoring services, at primary, • research pre-birth to end-of-life, providing secondary, tertiary, and some integrated, comprehensive, and quaternary level care • teaching the next generation of often highly complex care. healthcare professionals through We improve people’s health • a specialist referral role for undergraduate, postgraduate, and experiences through: many specialties serving greater vocational, and specialist programs, Melbourne, Victoria and interstate simulation, and telehealth.
Monash Health Annual Report. 2019-20 45
Kate Nolan con rming exact number of employees and locations Report of Operations Report of Operations
Our tertiary health services Our campuses Our The services we provide at each of our sites are constantly evolving to ensure we continue to meet the changing needs tertiary and expectations of our community, adopt the latest advances in health science and technology, and provide consistently health safe and high-quality care across each of our sites. services Monash Health provides medical and surgical tertiary health services for children, adolescents and adults Australia wide. Monash Monash Casey his includes the provision of neurosurgery, cardiac Medical Children’s Hospital Tcare and paediatric sleep Centre Hospital medicine for regional and rural communities, and partnering with health services in regional and rural Monash Medical Centre is Monash Health provides the Casey Hospital serves one of locations in the provision of care a major tertiary, teaching third busiest paediatric service the fastest growing areas in for their communities, including via and research hospital providing in the country, caring for more Melbourne’s south east and provides the use of telehealth technology. a comprehensive range of than 100,000 children every year. emergency, general medical, mental We are one of only two services specialist surgical, medical, Monash Children’s Hospital (MCH) health, rehabilitation, surgical and in Australia that provides combined allied health, mental health is a network of paediatric healthcare ambulatory, maternity and special kidney and pancreas transplants, and palliative care services. services across three sites in care nursery services. The hospital and one of only two centres in Monash Medical Centre has one Clayton, Dandenong and Casey. is a provider of paediatric services Victoria with an acute stroke unit of the state’s busiest emergency MCH is a comprehensive tertiary, for Monash Children’s Hospital and that provides an endovascular departments, is the primary site for teaching and research healthcare leading cardiovascular services. clot retrieval service. We are the our world-renowned cardiovascular service providing more than 30 Casey Hospital expansion dedicated statewide provider care, provides one of Victoria’s specialist services and programs, includes an intensive care unit and of thalassaemia care, and in largest women’s health services including Early in Life Mental Health more operating theatres, which partnership with other tertiary - uniquely offering maternity and Service (ELMHS) co-located with will provide the rapidly growing health services, we provide newborn services including a the statewide Child Inpatient Unit, local community with easier statewide paediatric services in Neonatal Intensive Care Unit and Victoria’s largest Neonatal ICU, access to higher acuity care. intensive care, cancer services, Special Care Unit on the one leading Paediatric services in cardiac care, surgery, rehabilitation, site, is a statewide provider of rehabilitation, Oncology, Paediatric sleep disorders, forensic thalassemia treatment and is a Intensive Care, and Palliative Care. medicine and palliative care. designated national provider of MCH is also a statewide provider The breadth of Monash renal and pancreatic transplants. of children’s cancer services and Health’s tertiary services makes the Victorian Referral Centre for us the employer of choice many low-volume and highly for highly talented healthcare complex cases. We uniquely link professionals, enabling us to paediatric and adult services to provide the best possible care and create positive, safe, and high- experience for the community. quality transitions of care.
Monash Health Annual Report. 2019-20 46 Monash Health Annual Report. 2019-20 47 Report of Operations
Our campuses Our campuses The services we provide at each of our sites are constantly evolving to ensure we continue to meet the changing needs and expectations of our community, adopt the latest advances in health science and technology, and provide consistently safe and high-quality care across each of our sites.
Monash Monash Casey Medical Children’s Hospital Centre Hospital
Monash Medical Centre is Monash Health provides the Casey Hospital serves one of a major tertiary, teaching third busiest paediatric service the fastest growing areas in and research hospital providing in the country, caring for more Melbourne’s south east and provides a comprehensive range of than 100,000 children every year. emergency, general medical, mental specialist surgical, medical, Monash Children’s Hospital (MCH) health, rehabilitation, surgical and allied health, mental health is a network of paediatric healthcare ambulatory, maternity and special and palliative care services. services across three sites in care nursery services. The hospital Monash Medical Centre has one Clayton, Dandenong and Casey. is a provider of paediatric services of the state’s busiest emergency MCH is a comprehensive tertiary, for Monash Children’s Hospital and departments, is the primary site for teaching and research healthcare leading cardiovascular services. our world-renowned cardiovascular service providing more than 30 Casey Hospital expansion care, provides one of Victoria’s specialist services and programs, includes an intensive care unit and largest women’s health services including Early in Life Mental Health more operating theatres, which - uniquely offering maternity and Service (ELMHS) co-located with will provide the rapidly growing newborn services including a the statewide Child Inpatient Unit, local community with easier Neonatal Intensive Care Unit and Victoria’s largest Neonatal ICU, access to higher acuity care. Special Care Unit on the one leading Paediatric services in site, is a statewide provider of rehabilitation, Oncology, Paediatric thalassemia treatment and is a Intensive Care, and Palliative Care. designated national provider of MCH is also a statewide provider renal and pancreatic transplants. of children’s cancer services and the Victorian Referral Centre for many low-volume and highly complex cases. We uniquely link paediatric and adult services to create positive, safe, and high- quality transitions of care.
Monash Health Annual Report. 2019-20 47 Report of Operations
Cranbourne Dandenong Jessie Kingston Moorabbin Community Mental Aged Integrated Hospital McPherson Centre Hospital Health Health Care Care Centre Private Facilities Facilities Facilities Hospital
Cranbourne Centre Dandenong Hospital A tertiary level private Kingston Centre is a Moorabbin Hospital Monash Health’s Monash Health Monash Health provides a range is a large acute hospital co-located at large sub-acute facility incorporates Monash community program operates eight mental provides a range of of same-day acute and hospital providing several Monash Medical Centre, specialising in high-quality Cancer Centre, one of operates across 21 sites health facilities including aged care services across sub-acute services general and specialist Jessie McPherson Private rehabilitation and functional Victoria’s leading cancer and supports our local inpatient, residential, Melbourne’s south east, including surgery, renal services to the community Hospital offers a range restoration, including the treatment centres, hosts community to improve, community care and drug including low-level care dialysis, specialist of Dandenong and its of specialist services for full range of allied health the Southern Melbourne maintain and manage and alcohol facilities. The in hostels, high-level care consulting, regional surrounding areas. These people in Melbourne, services for adults of all Integrated Cancer Service, health, independence and comprehensive range of in nursing homes, respite ophthalmology, mental services include an regional Victoria, interstate ages, transitional care, and provides elective wellbeing by providing or mental health services care, dementia-specifi c health, and community emergency department, and overseas. Further and aged mental health. surgery and dialysis. Home connecting with integrated, provided to adults and care and specialised health services general medical and information on Jessie The centre provides to Victoria’s fi rst Patient multidisciplinary care. children include alcohol aged mental health care. and a community surgical, intensive McPherson Private specialist services for Simulation Centre, the The aim is to support and and drug care; telephone A story on our aged care rehabilitation centre. care, maternity care, Hospital is on Page 40. older people including hospital plays a major prepare consumers to psychiatric triage; crisis services appears on pages special care nursery, aged care assessment, role in the education and self-manage their health assessment and treatment; 36 and 37 of this report. paediatrics, outpatients, cognitive dementia and training of undergraduate and health care. Monash consultation liaison day chemotherapy, home memory services, a Falls and postgraduate medical Health Community delivers psychiatry; mobile support haemodialysis, mental and Balance Clinic, Pain students, nurses and allied services to people of all and treatment; acute health and allied health Clinic, clinical gait analysis health professionals. The ages, supporting them inpatient care; extended services. Dandenong and continence service. hospital is a centre for through all stages of inpatient care; perinatal Hospital also provides Kingston Centre research, and in particular, their care and delivering and infant care; eating specialist services is at the forefront of a major contributor to an integrated pathway disorders care; gender including orthopaedic, research into movement cancer-related research. from acute and subacute dysphoria; prevention plastic, vascular and gait disorders, care to the community. and recovery care; and facio-maxillary aged mental health and community residential and surgery, gynaecology, geriatric medicine. rehabilitation services; respiratory medicine and agile psychological infectious diseases. medicine outpatient assessments; and Police, Ambulance and Clinical Early Response (PACER) response.
Our campuses 48 Our campuses 49 Moorabbin Community Mental Aged Hospital Health Health Care Facilities Facilities Facilities
Moorabbin Hospital Monash Health’s Monash Health Monash Health incorporates Monash community program operates eight mental provides a range of Cancer Centre, one of operates across 21 sites health facilities including aged care services across Victoria’s leading cancer and supports our local inpatient, residential, Melbourne’s south east, treatment centres, hosts community to improve, community care and drug including low-level care the Southern Melbourne maintain and manage and alcohol facilities. The in hostels, high-level care Integrated Cancer Service, health, independence and comprehensive range of in nursing homes, respite and provides elective wellbeing by providing or mental health services care, dementia-specifi c surgery and dialysis. Home connecting with integrated, provided to adults and care and specialised to Victoria’s fi rst Patient multidisciplinary care. children include alcohol aged mental health care. Simulation Centre, the The aim is to support and and drug care; telephone A story on our aged care hospital plays a major prepare consumers to psychiatric triage; crisis services appears on pages role in the education and self-manage their health assessment and treatment; 36 and 37 of this report. training of undergraduate and health care. Monash consultation liaison and postgraduate medical Health Community delivers psychiatry; mobile support students, nurses and allied services to people of all and treatment; acute health professionals. The ages, supporting them inpatient care; extended hospital is a centre for through all stages of inpatient care; perinatal research, and in particular, their care and delivering and infant care; eating a major contributor to an integrated pathway disorders care; gender cancer-related research. from acute and subacute dysphoria; prevention care to the community. and recovery care; community residential and rehabilitation services; agile psychological medicine outpatient assessments; and Police, Ambulance and Clinical Early Response (PACER) response.
Our campuses 49 Report of Operations Report of Operations VICTORIA Moorabbin Monash Dandenong Hospital Medical Hospital Centre and Monash Children’s Hospital Doveton Cockatoo
Dandenong CLAYTON Community MOORABBIN Health
Springvale DANDENONG
Berwick
Pakenham Kingston Cranbourne Centre
OFFICER
Cranbourne Casey Centre Hospital Our community Monash Health is privileged to be an integral part of the local communities we care for across our primary catchment area.
Our people are from local Ageing populations More illness government areas including Glen The north west of our primary There is a higher prevalence of Eira, Kingston, Monash, Greater catchment area has signifi cantly cancer and neurological conditions, Dandenong, Casey and Cardinia. higher rates of older persons chronic diseases, including than the state average. diabetes, heart disease and The demographic characteristics asthma, and risk factors such as of these rapidly evolving Multicultural diversity obesity and high blood pressure. communities include: Approximately 20,000 residents Monash Health’s reach also extends are Aboriginal and/or Torres Strait across Victoria and Australia, for Rapid growth Islander peoples, over a third of some of our specialist services. The south east growth corridor of residents were born overseas, and The local government areas Casey and Cardinia is one of the we have the largest refugee and that comprise our secondary fastest growing regions in the state. migrant community in Victoria. catchments are Bayside, Frankston, Knox and the High birth rates Inequity Mornington Peninsula. The south east of our primary Many of our local communities Our tertiary catchment area catchment area has a younger experience socioeconomic includes Bass Coast, Baw Baw, population and higher birth disadvantage and high East Gippsland, Latrobe, South rates than the state average. rates of unemployment. Gippsland and Wellington.
Monash Health Annual Report. 2019-20 50 Monash Health Annual Report. 2019-20 51 Report of Operations
Moorabbin Monash Dandenong Hospital Medical Hospital Centre and Monash Children’s Hospital Doveton Cockatoo
Dandenong CLAYTON Community MOORABBIN Health
Springvale DANDENONG
Berwick
Pakenham Kingston Cranbourne Centre
OFFICER
Cranbourne Casey Centre Hospital
Monash Health Annual Report. 2019-20 51 Report of Operations Report of Operations
Our Board of Directors Board Chair Dipak Sanghvi leads a committed and talented group of Directors.
Our Board of Directors
Manner of Establishment The function of the Board is to:
onash Health is a • monitor the performance • ensure any problems public health service; of Monash Health identifi ed with the quality Ma body corporate or effectiveness of the established under Section 65P • appoint and determine health services provided of the Health Services Act 1988, the terms and conditions are addressed in a timely as amended in 2005 and listed (including remuneration) manner and that Monash in Schedule 5 of that Act. of the Chief Executive Health continuously strives The Board of Directors of Monash to improve the quality of the Health is appointed by the Governor • monitor the management health services it provides in Council on the recommendation of of Monash Health and and to foster innovation the Minister for Health in accordance performance of the Chief with the Health Services Act 1988. Executive of Monash Health • develop arrangements with other agencies and health The Ministers for Health • develop statements of priorities service providers to enable and Mental Health and strategic plans for the effective and effi cient service during 2019–20 were: operation of Monash Health delivery and continuity of care and to monitor compliance The Honourable Jenny Mikakos • establish the organisational Minister for Health • develop fi nancial and business structure, including the Minister for Ambulance Services plans, strategies and budgets management structure, to ensure the accountable and of Monash Health The Honourable Martin Foley effi cient provision of health Minister for Mental Health services by Monash Health • ensure that the Minister and the Secretary are advised Our people’s • ensure that Monash Health about signifi cant board operates within its budget and decisions and are informed dedication to caring that its systems accurately in a timely manner of any for our community refl ect its fi nancial position issues of public concern ‘‘ and long-term viability or risks that affect or may and each other affect Monash Health • ensure effective and accountable shone through.” systems are in place to monitor • establish a Finance and improve the quality and Committee, an Audit Dipak Sanghvi, effectiveness of health services Committee and a Quality Chair of Board, provided by Monash Health and Safety Committee. Monash Health
Monash Health Annual Report. 2019-20 52 Monash Health Annual Report. 2019-20 53 Report of Operations
Board Chair Dipak Sanghvi leads a committed and talented group of Directors.
Our people’s dedication to caring ‘‘for our community and each other shone through.”
Dipak Sanghvi, Chair of Board, Monash Health
Monash Health Annual Report. 2019-20 53 Report of Operations
Mr Dipak Sanghvi Ms Aurélia Balpe Mrs Jane Bell Mr Tony Brain Ms Helen Brunt Mr Charles Gillies BSc Pharm (UK), FAICD, MBA, GAICD, GradDip BEc, LLB, LLM (Lond), BCom, CA, FAIST, GAICD BA (Hons), GAICD BA, BSc, MBA MrFAIPM Dipak Sanghvi Demog, BEc MrFAICD Dipak Sanghvi
• Chair of the Monash • Chair of the Primary Care • Chair of the Audit Committee • Member of the Finance • Member of the Finance • Chair of the Finance Committee Health Board and Population Health Committee Committee Advisory Committee • Director of Kitaya • Member of the Remuneration • Chair of the Remuneration Holdings Pty Ltd* • Member of the Audit Committee Term of appointment: Committee (as Chair - Committee • Chair of the Community July 2019 – current Finance Committee) Advisory Committee • Member of the Audit Committee Term of appointment: • Member of the Finance Kitaya Holdings Pty Ltd* July 2019 – current Ms Brunt is a senior governance Term of appointment: Committee • Member of the Quality and technology delivery executive July 2011 – June 2020 Committee Term of appointment: Mr Brain is a Chartered Accountant who brings extensive experience • Aboriginal Health Strategic July 2018 – current with over 30 years’ experience in in digital technology and large- Mr Gillies is the co-founder of Partnership: Monash Health Term of appointment: governance, assurance, fi nance scale transformation in complex Jolimont Global Mining Systems, and Dandenong and District July 2018 – current Mrs Bell is a banking and fi nance and regulatory oversight. business environments including which specialises in investing in Aborigines Co-operative Ltd lawyer and non-executive director His executive leadership Wesfarmers and Westpac. mining technology companies. Ms Balpe is an international with more than 30 years’ experience experience includes 12 years She is skilled in developing These companies compete in Term of appointment: humanitarian leader with experience in leading law fi rms, fi nancial services, as Partner at Deloitte and nearly strategies to leverage technology fast-moving, highly competitive December 2015 – current in the non-profi t and for-profi t corporate treasury operations three years as Head of Risk to support business strategy. global technology markets. sectors in Asia, the Pacifi c, the and governance gained living in Management at AustralianSuper. Ms Brunt is passionate about As an active investor himself, his Mr Sanghvi is a pharmacist who Americas, Africa and Europe. Melbourne, London, Toronto, In addition to Monash Health, diversity and the use of approach has been to work closely owns fi ve pharmacies in Victoria. Ms Balpe has worked with boards San Francisco and Brisbane. his current non-executive director technology to transform customer with management to develop a He is currently Chair of Member and senior executive teams on the Mrs Bell has been a non-executive experience includes three years and employees experience plan to create economic value. Benefi ts Australia Pty Ltd. development of strategy and policy, director since 2002, serving on 11 at the Australian Scholarships and previously served as an He has been Director and Previous positions held include legal compliance, risk management, boards including eight health sector Group Friendly Society Pty Ltd associate board member for Chairman of a number of technology President of the Pharmacy Guild organisational performance and the and medical research institute and nearly one year at AMP the VIC ICT for Women in IT. and investment companies and Victoria Branch from 2006 to 2011, resolution of integrity issues. Ms Balpe boards. Mrs Bell currently serves as Superannuation Limited where She has previously served has worked closely with CEOs and Chair of Gold Cross Products and has had oversight of multinational Deputy Chair of Biomedical Research he is currently Interim Chair. as an elected Member Director management teams in developing Services Pty Ltd, Chair of Return programs in organisational Victoria, Director of UCA Funds Mr Brain also sits on Board of the Wesfarmers Super strategies and setting objectives of Unwanted Medicines, Board development, disaster response and Management Limited and as Chair Committees for Victoria University, Trust Policy Committee. and performance targets. member of Guild Insurance and law, water and sanitation and health. of the Community Advisory Group Barwon Health, Magistrates Superannuation and of Meridian Ms Balpe has been a strategic advisor of the Melbourne Genomics Health Court Victoria and the Alannah Lawyers, as well as several other to governments, United Nations Alliance. Mrs Bell is a Member of and Madeline Foundation. board positions in the community agencies, regional organisations the Administrative Appeals Tribunal. He is a current member and pharmaceutical industry. and corporations on humanitarian She is a former Board member of of the Companies Auditor He is also currently Chair of action and coordination. Ms Balpe Melbourne Health (Royal Melbourne Disciplinary Board. Musculoskeletal Australia. currently serves as a member of Hospital), WorkSafe Victoria, Hudson the Australian Red Cross Divisional Institute of Medical Research-Monash Advisory Board. In 2015 she was Institute of Medical Research-Prince awarded the Vanuatu Red Cross Henry’s Institute of Medical Research, medal for her contribution to the Queensland Institute of Medical Tropical Cyclone Pam Relief Operation. Research Trust, Victorian Women’s In 2017 she was the recipient of the Housing Association, Australian Monash University Top Achievement Red Cross (Qld) and Deputy Chair and Dean’s Awards for her MBA. of Westernport Water Corporation. *Kitaya Holdings Pty Ltd operates Ms Balpe is currently undertaking a Jessie McPherson Private Hospital Graduate Diploma in Psychology. Our Board of Directors 54 Our Board of Directors 55 Mr Tony Brain Ms Helen Brunt Mr Charles Gillies BCom, CA, FAIST, GAICD BA (Hons), GAICD BA, BSc, MBA
• Member of the Finance • Member of the Finance • Chair of the Finance Committee Committee Committee • Member of the Remuneration • Member of the Audit Committee Term of appointment: Committee (as Chair - July 2019 – current Finance Committee) Term of appointment: July 2019 – current Ms Brunt is a senior governance Term of appointment: and technology delivery executive July 2011 – June 2020 Mr Brain is a Chartered Accountant who brings extensive experience with over 30 years’ experience in in digital technology and large- Mr Gillies is the co-founder of governance, assurance, fi nance scale transformation in complex Jolimont Global Mining Systems, and regulatory oversight. business environments including which specialises in investing in His executive leadership Wesfarmers and Westpac. mining technology companies. experience includes 12 years She is skilled in developing These companies compete in as Partner at Deloitte and nearly strategies to leverage technology fast-moving, highly competitive three years as Head of Risk to support business strategy. global technology markets. Management at AustralianSuper. Ms Brunt is passionate about As an active investor himself, his In addition to Monash Health, diversity and the use of approach has been to work closely his current non-executive director technology to transform customer with management to develop a experience includes three years and employees experience plan to create economic value. at the Australian Scholarships and previously served as an He has been Director and Group Friendly Society Pty Ltd associate board member for Chairman of a number of technology and nearly one year at AMP the VIC ICT for Women in IT. and investment companies and Superannuation Limited where She has previously served has worked closely with CEOs and he is currently Interim Chair. as an elected Member Director management teams in developing Mr Brain also sits on Board of the Wesfarmers Super strategies and setting objectives Committees for Victoria University, Trust Policy Committee. and performance targets. Barwon Health, Magistrates Court Victoria and the Alannah and Madeline Foundation. He is a current member of the Companies Auditor Disciplinary Board.
Our Board of Directors 55 Report of Operations
Board Committees
Associate Professor Ms Robyn McLeod Emeritus Professor These committees support the functions of the Board of Directors Misty Jenkins BA, BEd, GAICD Hatem Salem AM BSc (Hons), PhD, MB, ChB (Mosul, Iraq), MAICD FRACP, FRCPA, MRCP, MD Quality Committee Remuneration Committee Aboriginal Health Strategic (Monash), LRCP, MRCS Partnership Committee The purpose of the Quality The principal role of the Committee is to support the Board’s Remuneration Committee is to The purpose of the Aboriginal Health • Member of the Quality • Member of the Audit Committee • Chair of the Quality Committee function of providing strategic advise the Board of Directors on Strategic Partnership Committee is Committee leadership in relation to the clinical matters relating to the organisation’s to ensure a collaborative partnership • Member of the Community • Member of the governance of quality and safety at remuneration policies and practice between the Dandenong and • Aboriginal Health Strategic Advisory Committee Remuneration Committee Monash Health. It serves to ensure, In addition, the Remuneration District Aborigines Co-operative Partnership: Monash Health (as Chair - Quality Committee) on behalf of the Board, that the Committee provides oversight Limited and Monash Health. and Dandenong and District • Member of the Primary following objectives are fulfi lled: with respect to succession The Committee ensures respectful Aborigines Co-operative Ltd Care and Population Health Term of appointment: planning for the Chief Executive and collaborative relationships Advisory Committee May 2017 – current • Effective and accountable and senior executive positions. between Monash Health and the Term of appointment: systems are in place to monitor Aboriginal and Torres Strait Islander November 2016 – current Term of appointment: Professor Salem is an Emeritus and improve the quality and Finance Committee community. The Committee also July 2019 – current Professor at Monash University. effectiveness of health services oversees the implementation of the Ms Jenkins is an NHMRC Prior to this, Professor Salem provided by Monash Health The role of the Finance Committee is Monash Health Reconciliation Action fellow, biomedical scientist and Ms McLeod is a governance and was the Head of the Academic to advise the Board of Directors on Plan and Employment Plan, identifi es laboratory head at Walter and public policy expert who currently Department of Clinical • Any problems identifi ed with fi nancial matters and to assist in the shared strategic opportunities and Eliza Hall Institute for Medical serves on the Boards of Melbourne Haematology at Monash the quality or effectiveness of oversight of fi nancial performance. projects and also monitors the Research, where she researches Water and VicWater, and previously University and the Head of Clinical the health services provided are The Finance Committee reviews Monash Health Aboriginal Health cellular immunology and new served as a member of the Haematology at the Alfred Hospital. addressed in a timely manner and makes recommendations Data Report and relevant data immunotherapies for cancer. Governance working group of He served as President of the to the Board regarding fi nancial from the Dandenong and District Ms Jenkins has previously the Board of Good Shepherd Asia Pacifi c Society of Thrombosis • Monash Health continuously strategy, fi nancial policies, annual Aborigines Co-operative Limited. held postdoctoral positions at the Australia and New Zealand. and Haemostasis and past strives to improve the quality of operating and capital budgets, cash Universities of Cambridge and Her previous positions President and Executive Director the health services it provides fl ow and business plans to ensure Primary Care and Population Oxford, and The Peter MacCallum include director of the Australian of the Australasian Society of and to foster innovation alignment with key strategic priorities Health Advisory Committee Cancer Centre in Melbourne. Centre for Social Innovation, Thrombosis and Hemostasis. and performance objectives. Ms Jenkins was awarded the Independent Commissioner for He is a senior Counsellor of the Audit Committee The Primary Care and Population L’Oreal for Women in Science Water Security in South Australia, International Society of Thrombosis Community Advisory Health Advisory Committee provides Fellowship (2013), was Tall National Director of Water for and Haemostasis. In 2005, his The role of the Audit Committee Committee strategic advice to the Board of Poppy of the Year (2015) and KPMG, Executive Director of vision and ability to develop is to advise the Board of Directors on matters specifi c to won the Westpac/Australian Major Projects Water with the leading clinical and research Directors on audit matters The Community Advisory Committee the primary care and population Financial Review 100 Women Department of Sustainability and programs was recognised by the relating to fi nancial accounting works to increase consumer, carer health of our local community. of Infl uence award (2016). Environment, Victoria and Chief Victorian Government’s Public and legislative compliance and and community participation in all The Committee focuses on In addition to her research of Staff to the Victorian Energy Healthcare Award, where he the operational effectiveness and facets of Monash Health’s operations improving the health status of our career, Ms Jenkins brings Resources and Ports Minister. was the recipient of the Health effi ciency of Monash Health. in partnership with the Board of community in areas such as the experience in governance as a Minister’s Award for Outstanding The Committee also advises the Directors. The roles of the committee hospital primary care interface, Director and Deputy Chair of The Individual Achievement. Board on the level of business risk or are to provide leadership in relation mental health and wellbeing, health National Centre for Indigenous In 2010, Professor Salem exposure to which Monash Health to the integration of consumer, promotion, population health, health Genomics at ANU, as a former was awarded a Member of might be subject and oversight of carer and community views into independence programs, research, Director of the Aurora Education the Order of Australia (AM) internal and external audit activities. all levels of strategy, operations, and education. In addition, there is Foundation, Ambassador for the for service to medicine in planning and policy development, a focus on the health and wellbeing Poche Centre for Indigenous the fi eld of haematology as and to provide advice on priority of vulnerable groups such as Health and Chair of NHMRC a clinician, educator and areas and issues from a consumer, refugees, Aboriginal and Torres Strait Project Grant Review Panels. researcher and also through the carer and community perspective. Islander peoples and culturally and establishment of the Australian linguistically diverse communities. Centre for Blood Diseases.
Our Board of Directors 56 Monash Health Annual Report. 2019-20 57 Report of Operations
Board Committees These committees support the functions of the Board of Directors
Quality Committee Remuneration Committee Aboriginal Health Strategic Partnership Committee The purpose of the Quality The principal role of the Committee is to support the Board’s Remuneration Committee is to The purpose of the Aboriginal Health function of providing strategic advise the Board of Directors on Strategic Partnership Committee is leadership in relation to the clinical matters relating to the organisation’s to ensure a collaborative partnership governance of quality and safety at remuneration policies and practice between the Dandenong and Monash Health. It serves to ensure, In addition, the Remuneration District Aborigines Co-operative on behalf of the Board, that the Committee provides oversight Limited and Monash Health. following objectives are fulfi lled: with respect to succession The Committee ensures respectful planning for the Chief Executive and collaborative relationships • Effective and accountable and senior executive positions. between Monash Health and the systems are in place to monitor Aboriginal and Torres Strait Islander and improve the quality and Finance Committee community. The Committee also effectiveness of health services oversees the implementation of the provided by Monash Health The role of the Finance Committee is Monash Health Reconciliation Action to advise the Board of Directors on Plan and Employment Plan, identifi es • Any problems identifi ed with fi nancial matters and to assist in the shared strategic opportunities and the quality or effectiveness of oversight of fi nancial performance. projects and also monitors the the health services provided are The Finance Committee reviews Monash Health Aboriginal Health addressed in a timely manner and makes recommendations Data Report and relevant data to the Board regarding fi nancial from the Dandenong and District • Monash Health continuously strategy, fi nancial policies, annual Aborigines Co-operative Limited. strives to improve the quality of operating and capital budgets, cash the health services it provides fl ow and business plans to ensure Primary Care and Population and to foster innovation alignment with key strategic priorities Health Advisory Committee and performance objectives. Audit Committee The Primary Care and Population Community Advisory Health Advisory Committee provides The role of the Audit Committee Committee strategic advice to the Board of is to advise the Board of Directors on matters specifi c to Directors on audit matters The Community Advisory Committee the primary care and population relating to fi nancial accounting works to increase consumer, carer health of our local community. and legislative compliance and and community participation in all The Committee focuses on the operational effectiveness and facets of Monash Health’s operations improving the health status of our effi ciency of Monash Health. in partnership with the Board of community in areas such as the The Committee also advises the Directors. The roles of the committee hospital primary care interface, Board on the level of business risk or are to provide leadership in relation mental health and wellbeing, health exposure to which Monash Health to the integration of consumer, promotion, population health, health might be subject and oversight of carer and community views into independence programs, research, internal and external audit activities. all levels of strategy, operations, and education. In addition, there is planning and policy development, a focus on the health and wellbeing and to provide advice on priority of vulnerable groups such as areas and issues from a consumer, refugees, Aboriginal and Torres Strait carer and community perspective. Islander peoples and culturally and linguistically diverse communities.
Monash Health Annual Report. 2019-20 57 Report of Operations
Organisational Structure
Research Chief Executive Offi ce of the Chief Executive Director, Monash Health Foundation: Ron Fairchild Head of Organisational Transformation: Barry Bloch Clinical Trials; Monash Health Translation Precinct (MHTP); Andrew Stripp Director, Legal Services/ Director, Enterprise Strategy & Development: Research Governance; Research Strategy Chief Legal Offi cer: Peter Ryan Angus Henderson
Chief Executive Executive Executive Executive Executive Executive Executive Executive Operating Director, Director, Director, Director, Director, Director, Director, Director, Offi cer Medical Residential Quality & Financial Digital People & Capital & Public Affairs & Services/ Care & Support Safety Services/ Health Culture Infrastructure Communication Chief Medical Services/ Chief Financial Offi cer Chief Nursing Offi cer & Midwifery Offi cer
Martin Anjali Katrina Carlos Stuart Emilio Karen David Louise Keogh Dhulia Nankervis* Scheinkestel Donaldson Pozo Lowe Ballantyne Kanis
Clinical Programs Clinical Programs Clinical Programs • Quality & Safety • Audit • Information • Diversity & • Biomedical • Public relations • Acute Medicine • Pharmacy • Residential Care • Risk • Budget Technology Inclusion Engineering • Media relations • Subacute & • Radiology • Infection Prevention • Clinical Costing Services • Employee • Capital • Internal & corporate Community Campuses • Monash Business • Finance • Electronic Development • Engineering communications • Allied Health & Other • Hostels & Intelligence • Payroll Medical Record • Employee Health • Infrastructure • Project Patient Flow • Medical Workforce Nursing Homes • Procurement & Wellbeing • Property communications • Children’s – Appointment • Revenue • Employee Relations • Major Projects • Brand • Mental Health – Credentialing Other • People & Culture • Web and digital • Specialty • Medical Education • Monash Bureau • Recruitment communications Medicine, Cancer – Library • Nursing & & Retention • Government & Critical Care – Simulation Centre Midwifery • Occupational and community • Surgery & • Chief Allied Education & Health & Safety relations Interventional Health Offi cer Workforce • Pathology Services • Patient Experience • Security • Women’s & • Food Services Newborn • Cleaning Services • Emergency Campuses Management & • Casey Hospital Business Continuity • Community Sites *Acting • Cranbourne Integrated Care Centre • Dandenong Hospital • Kingston Centre • Monash Medical Centre & Monash Children’s Hospital • Moorabbin Hospital
Other • Health Information Services Monash Health Annual Report. 2019-20 58 Organisational Structure 59 Offi ce of the Chief Executive Director, Monash Health Foundation: Ron Fairchild Head of Organisational Transformation: Barry Bloch Director, Legal Services/ Director, Enterprise Strategy & Development: Chief Legal Offi cer: Peter Ryan Angus Henderson
Executive Executive Executive Executive Director, Director, Director, Director, Digital People & Capital & Public Affairs & Health Culture Infrastructure Communication
Emilio Karen David Louise Pozo Lowe Ballantyne Kanis
• Information • Diversity & • Biomedical • Public relations Technology Inclusion Engineering • Media relations Services • Employee • Capital • Internal & corporate • Electronic Development • Engineering communications Medical Record • Employee Health • Infrastructure • Project & Wellbeing • Property communications • Employee Relations • Major Projects • Brand • People & Culture • Web and digital • Recruitment communications & Retention • Government • Occupational and community Health & Safety relations • Pathology
Organisational Structure 59 Report of Operations
Our executive team Our executive team
Mr Andrew Stripp Mr David Ballantyne Dr Anjali Dhulia Mr Stuart Donaldson Ms Louise Kanis Mr Martin Keogh Chief Executive Executive Director, Chief Medical Offi cer, Chief Financial Offi cer, Executive Director, Chief Operating Offi cer Capital & Infrastructure Executive Director, Executive Director, Public Affairs & Medical Services Financial Services Communication
Andrew Stripp has extensive David Ballantyne brings to Anjali Dhulia started her medical Stuart Donaldson joined Monash Louise Kanis joined Monash Health Martin Keogh joined Monash experience in executive roles Monash Health 20 years’ career in the Indian Army where Health in January 2017. in February 2018. In a career Health as Chief Operating Offi cer in a variety of hospitals and experience gained in Australia she served for eight years. Stuart is an experienced spanning more than 20 years, after many years of clinical healthcare settings, within and the United Kingdom in major She completed her post-graduate senior fi nance executive with a Louise has headed corporate and management experience the State Government’s infrastructure projects, across all training in paediatrics and practised strong record of achievement affairs for a major Melbourne in a variety of roles within Department of Health and phases of the asset life cycle. in paediatric intensive care before and a wealth of experience within transport consortium, established acute healthcare settings. Human Services as the He has a development migrating to Australia. She worked several multinational organisations. the communications and marketing This has enabled him to develop Director for the State’s mental background across health, rail and as a Fellow in Neonatology at the His track record demonstrates function for a multinational a broad level of knowledge, health system, as Regional aviation industries and a strong Women’s and Children’s Hospital excellent fi nancial acumen and fi nancial services fi rm, driven the skill and understanding of Director for Health, Housing understanding of both public and in Adelaide, the Royal Women’s strategic thinking combined communications for a university the contemporary drivers for and Community Services and private sectors. His qualifi cations and Royal Children’s Hospital in with commercial know-how. He undergoing major change and health service performance as Director of Strategy. include Bachelor of Engineering Melbourne and also with the Neonatal recognises the importance of built her own agency servicing and the need for continual Prior to joining Monash (Civil), Masters of Business Emergency Transport Service (NETS). partnering to deliver excellent marquee external clients across organisational improvement. Health, he was the Deputy Chief Administration (Executive) and She switched to a career in outcomes aligned to the overall a diverse range of industries. Before joining Monash Health Executive and Chief Operating he is a Member of the Australian medical administration in 2008 and strategy of an organisation. Louise has served on Australian Martin was acting Chief Operating Offi cer at Alfred Health. Institute of Company Directors. completed a Fellowship of the Royal Stuart’s previous role was executive management groups, Offi cer of Alfred Health. Having With a passion for leading Australasian College of Medical Chief Financial Offi cer at RMIT an international marketing and originally trained as a registered teams and ongoing innovation, Administrators and has worked in University since 2010. Stuart has communications executive team, nurse, Martin practised in the David is focused on embracing various medical management roles. also worked in senior fi nance a crisis management executive, areas of emergency and cardiology technological change Her professional interests and roles with multinational fast- as a director of a charitable before fi nally specialising and developing hospitals expertise include medical workforce moving consumable goods, foundation and as the co-owner in intensive care nursing. equipped for the future. management, healthcare safety, including Cadbury Schweppes, and director of her own company. Subsequently, he embarked Prior to joining Monash Health quality and patient experience Kraft Foods, Nestle and Pacifi c on a management career. he was Executive Director of and engagement and wellbeing Dunlop. As Chief Financial Offi cer, Martin has a proven track record Development and Innovation of medical employees. Stuart has responsibility for in identifying and implementing and Asset Management at She has completed a Master Procurement, Logistics, Internal improvements to enhance patient Health Infrastructure in NSW. of Public Health and a Master Audit, and Financial Services as safety, access and, enhancing the During that time he held a of Applied Positive Psychology. well as being a Board member overall experience of patients. number of senior roles and was She has led the development and of Kitaya Holdings Pty Ltd. He has a strong interest in a signifi cant contributor to the implementation of Monash Care patient safety and quality of development of over $10 billion (Mental Health and Wellbeing Strategy care initiatives, incorporating in capital projects across NSW. for Monash Doctors) and is co- evidence-based practice. lead in implementing the Women in Medicine Program at Monash Health.
Monash Health Annual Report. 2019-20 60 Our executive team 61 Mr Stuart Donaldson Ms Louise Kanis Mr Martin Keogh Chief Financial Offi cer, Executive Director, Chief Operating Offi cer Executive Director, Public Affairs & Financial Services Communication
Stuart Donaldson joined Monash Louise Kanis joined Monash Health Martin Keogh joined Monash Health in January 2017. in February 2018. In a career Health as Chief Operating Offi cer Stuart is an experienced spanning more than 20 years, after many years of clinical senior fi nance executive with a Louise has headed corporate and management experience strong record of achievement affairs for a major Melbourne in a variety of roles within and a wealth of experience within transport consortium, established acute healthcare settings. several multinational organisations. the communications and marketing This has enabled him to develop His track record demonstrates function for a multinational a broad level of knowledge, excellent fi nancial acumen and fi nancial services fi rm, driven the skill and understanding of strategic thinking combined communications for a university the contemporary drivers for with commercial know-how. He undergoing major change and health service performance recognises the importance of built her own agency servicing and the need for continual partnering to deliver excellent marquee external clients across organisational improvement. outcomes aligned to the overall a diverse range of industries. Before joining Monash Health strategy of an organisation. Louise has served on Australian Martin was acting Chief Operating Stuart’s previous role was executive management groups, Offi cer of Alfred Health. Having Chief Financial Offi cer at RMIT an international marketing and originally trained as a registered University since 2010. Stuart has communications executive team, nurse, Martin practised in the also worked in senior fi nance a crisis management executive, areas of emergency and cardiology roles with multinational fast- as a director of a charitable before fi nally specialising moving consumable goods, foundation and as the co-owner in intensive care nursing. including Cadbury Schweppes, and director of her own company. Subsequently, he embarked Kraft Foods, Nestle and Pacifi c on a management career. Dunlop. As Chief Financial Offi cer, Martin has a proven track record Stuart has responsibility for in identifying and implementing Procurement, Logistics, Internal improvements to enhance patient Audit, and Financial Services as safety, access and, enhancing the well as being a Board member overall experience of patients. of Kitaya Holdings Pty Ltd. He has a strong interest in patient safety and quality of care initiatives, incorporating evidence-based practice.
Our executive team 61 Report of Operations
Ms Karen Lowe Adjunct Professor Mr Emilio Pozo Professor Carlos MrExecutive Dipak Director, Sanghvi Katrina Nankervis Executive Director, Scheinkestel People & Culture Chief Nursing & Midwifery Offi cer, Digital Health Executive Director, Executive Director, Residential Quality & Safety Care & Support Services (Acting)
Karen Lowe joined Monash With over 20 years’ within Victoria’s Emilio Pozo has more than 20 Carlos Scheinkestel’s remit is to Health as Executive Director public health system, Katrina years’ experience in Information drive and support the organisation People and Culture in September Nankervis brings to Monash Health Technology having undertaken in the delivery of reliably safe, 2016 with a broad range of extensive experience in strategic appointments in a number of high-quality care that consistently experience across many industries workforce planning, professional global enterprise organisations meets or exceeds best practice including chartered accounting, and clinical practice and education. across various industries, standards and expectations. utilities, steel, professional She is a Registered Nurse, enabling Emilio to develop the His track record includes leading services and banking. holds a Master’s of Nursing skills necessary to successfully a large and complex department She has developed her passion Science and has a keen interest manage complex and major to achieve international recognition for people through a variety of in healthcare policy, initially business transformation projects. as a centre of excellence in roles including shared services, developed as an undergraduate Emilio has worked as an patient outcomes, research fi nance, human resources and student of politics and economics Executive Director at a tertiary and education and winning general management roles. at the University of Melbourne. health service, has led Electronic four Victorian Public Healthcare Karen’s most recent role was Katrina has worked within Medical Record (EMR) related Awards, the AHRI Wayne Cascio Head of Human Resources – the public, private, government programs and developed Award for organisational change Branch Banking for NatWest, and higher education sectors. solutions in acute, subacute and and development, an Australian Royal Bank of Scotland and She is a passionate advocate community health settings. Business Award for Service Ulster Bank based in Scotland. for the exemplary delivery As Executive Director Digital Excellence, an Australian Mobile of fundamental care and is Health, Emilio has executive and App Design Award, The Best particularly focused on enhancing accountability for leading a multi- of the Best International Nutrition outcomes and experience for million dollar, multi-year hospital- Competition four times and an employees and consumers. wide EMR program as well as ELSO Centre of Excellence twice. having operational accountability He has served on government for Information Technology committees, has a number of across the entire health service. publications, received an NHMRC The EMR program is a digital research grant, and given many version of the patient record that invited presentations, both has transformed the way in which nationally and internationally. Monash Health delivers high- He is an adjunct clinical quality healthcare to its patients. professor with Monash University and has completed studies focusing on leadership in disruptive times, obtaining a Specialist Certifi cate in Executive Leadership at the Melbourne Business School.
Our executive team 62 Our executive team 63 Professor Carlos Scheinkestel Executive Director, Quality & Safety
Carlos Scheinkestel’s remit is to drive and support the organisation in the delivery of reliably safe, high-quality care that consistently meets or exceeds best practice standards and expectations. His track record includes leading a large and complex department to achieve international recognition as a centre of excellence in patient outcomes, research and education and winning four Victorian Public Healthcare Awards, the AHRI Wayne Cascio Award for organisational change and development, an Australian Business Award for Service Excellence, an Australian Mobile and App Design Award, The Best of the Best International Nutrition Competition four times and an ELSO Centre of Excellence twice. He has served on government committees, has a number of publications, received an NHMRC research grant, and given many invited presentations, both nationally and internationally. He is an adjunct clinical professor with Monash University and has completed studies focusing on leadership in disruptive times, obtaining a Specialist Certifi cate in Executive Leadership at the Melbourne Business School.
Our executive team 63 Report of Operations Report of Operations
Our workforce
Recognition
2019 Victorian Public Healthcare Awards
Seven of our major Winners initiatives were Monash Health Monash Health recognised by the Victorian Public Healthcare Awards in November. Congratulations to the teams involved. Our workforce
s an equal opportunity We are committed to the innovation, quality and Excellence in women’s health Improving integration of care employer, Monash Health ongoing development of our professionalism. This year, we have Keeping mothers and babies for patients with chronic and A is committed to a fair and people and provide a wide range of continued our commitment to our together: a better way of complex conditions non-discriminatory workplace that professional development activities, Equity and Inclusion Strategy 2018- assessing sepsis risk. Early Neurodevelopment Clinic Team. maximises talent, potential and supported by strong leadership 2021 covering fi ve priority areas contribution of all employees. and management capability. including Gender, Aboriginal and We act with fairness, dignity We value honesty, openness Torres Strait Islander Health and and empathy for each other and taking responsibility for our Employment, LGBTI, Disability and Finalists and for our consumers. performance by recognising Cultural and Linguistic Diversity. Monash Health Monash Health Monash Health Monash Health The Royal Melbourne Austin Health. Alfred Health, Minister for Mental Hospital labour category June current month FTE* Average monthly FTE** Hospital and Eastern Health, Northern Improving Health’s Award The University of Health, Western Health, healthcare for excellence in 2019 2020 2019 2020 Melbourne. Monash University, through clinical supporting the Nursing 5,301 5,646 5,411 5,494 Offi ce of the Public Improving healthcare research mental health Advocate (Victoria). Administration and Clerical 1,768 1,841 1,807 1,828 through clinical Improving the and wellbeing of research management Minister for Victorians Medical Support 1,230 1,322 1,250 1,288 EXTEND: a game changer of paracetamol Disability, Ageing Promoting recovery Hotel and Allied Services 1,062 1,165 1,062 1,106 for ischemic stroke overdose. and Carers Award and trauma Medical Offi cers 195 219 208 209 treatment worldwide. for excellence in treatment in public sector aged public Hospital Medical Offi cers 1,118 1,206 1,155 1,180 care health. Sessional Clinicians 378 410 397 404 Monash Health Guardianship in Ancillary Staff (Allied Health) 1,053 1,102 1,078 1,074 Safer Care Victoria compassionate care award Hospitals: a health services/OPA Total 12,105 12,911 12,368 12,583 Delivering a better quality of life to patients pilot program. with malignant ascites with in-home paracentesis via an indwelling drain. *Excludes surgical operations, total hospital admissions, *Full time equivalent (FTE) employees at Monash Health and Jessie McPherson Private Hospital as at 30 June 2019. births ambulance arrivals and paediatric admissions. **Average monthly FTE for fi nancial year.
Monash Health Annual Report. 2019-20 64 Monash Health Annual Report. 2019-20 65 Report of Operations
Our workforce
s an equal opportunity We are committed to the innovation, quality and employer, Monash Health ongoing development of our professionalism. This year, we have A is committed to a fair and people and provide a wide range of continued our commitment to our non-discriminatory workplace that professional development activities, Equity and Inclusion Strategy 2018- maximises talent, potential and supported by strong leadership 2021 covering fi ve priority areas contribution of all employees. and management capability. including Gender, Aboriginal and We act with fairness, dignity We value honesty, openness Torres Strait Islander Health and and empathy for each other and taking responsibility for our Employment, LGBTI, Disability and and for our consumers. performance by recognising Cultural and Linguistic Diversity.
Hospital labour category June current month FTE* Average monthly FTE**
2019 2020 2019 2020 Nursing 5,301 5,646 5,411 5,494
Administration and Clerical 1,768 1,841 1,807 1,828
Medical Support 1,230 1,322 1,250 1,288
Hotel and Allied Services 1,062 1,165 1,062 1,106
Medical Offi cers 195 219 208 209
Hospital Medical Offi cers 1,118 1,206 1,155 1,180
Sessional Clinicians 378 410 397 404
Ancillary Staff (Allied Health) 1,053 1,102 1,078 1,074
Total 12,105 12,911 12,368 12,583
*Full time equivalent (FTE) employees at Monash Health and Jessie McPherson Private Hospital as at 30 June 2019. **Average monthly FTE for fi nancial year.
Monash Health Annual Report. 2019-20 65 Report of Operations
Occupational health and safety Occupational health and safety
he physical health, Occupational health safety and overall and safety statistics 2017-18 2018-19 2019-20 Twellbeing of our employees is of paramount The number of reported hazards/incidents 32.44 30.83 29.08 importance. We are committed for the year per 100 FTE employees to providing a workplace that promotes and facilitates The number of 'lost time' standard claims 1.50 1.63 1.53 for the year per 100 FTE employees employee wellbeing and safety to ensure they return The average cost per claim for the year $61,722 $ 52,495 $53,952 each day safe and well. We have been committed to working towards our goals in the Occupational Health and Safety Strategy 2018-2023 and Occupational violence 2019-20 have focused on supporting our WorkCover accepted claims with an 0.25 people in the workplace by: occupational violence cause per 100 FTE
• developing safety leadership Number of accepted WorkCover claims with 1.72 through development lost time injury with an occupational violence and implementation of cause per 1,000,000 hours worked eLearning modules, guidance material and tools Number of occupational violence incidents reported 1,330
• actively engaging Number of occupational violence 10.72 incidents reported per 100 FTE people in their health, safety and wellbeing Percentage of occupational violence incidents 7% resulting in employee injury, illness or condition • having the right processes and systems in place to monitor our performance and enable continuous improvement. Defi nitions
In 2019-20 our lost time injury Occupational violence Accepted WorkCover frequency rate reduced by 4%. Any incident where an employee is claims Some 81% of employees abused, threatened or assaulted in Accepted WorkCover claims completed mandatory circumstances arising out of, or in that were lodged in 2018-19. Occupational Violence and the course of their employment. Aggression and Occupational Lost time Health and Safety training. Incidents Defi ned as greater than We continue to work An event or circumstance that one day. collaboratively to care for the could have resulted in, or did physical and psychological result in, harm to an employee. Injury, illness or condition health, safety and overall Incidents of all severity rating must This includes all reported harm wellbeing of our people. be included. Code Grey reporting is as a result of the incident, not included, however, if an incident regardless of whether the occurs during the course of a employee required time off planned or unplanned Code Grey, work or submitted a claim. the incident must be included.
Monash Health Annual Report. 2019-20 66 Clinical Governance Report ExcellenceClinical Governance is our standard. Report
ur Clinical Governance Clinical Governance needs indicators is tracked and Framework outlines the to permeate through the entire reported monthly to Monash Ostructures, processes, organisation, to all employees at Health’s Executive and Board. leadership and culture required all levels, to ensure continuous New initiatives in 2019-20 include Environmental Sustainability Report to provide safe, effi cient patient- improvement in care, safety the Quality Newsletter, a monthly centred care. It is aligned to the and patient experience. update including a summary of an Victorian Clinical Governance Our key quality indicators are adverse event, which is circulated Framework (June 2017) and available on dashboards customised to facilitate a culture of learning, the National Model Clinical for each ward, unit and program and employee forums held via Governance Framework so that employees can see how web conference, which showcase - Australian Commission we are performing and play a role the work of clinical teams and on Safety and Quality in in continuous improvement. allow employees to ask questions Healthcare, (December 2017). Performance against these directly of the Executive.
Environmental Sustainability Report Monash Health is committed to reducing our ecological footprint with sustainability being one of our strategic principles.
e aim to engage, following extensive stakeholder across all our sites and our Eco educate and empower engagement across our Champions group has grown to W our employees to create organisation and will continue to include over 110 representatives. an environmentally sustainable guide Monash Health in improving workplace and demonstrate this our environmental performance. • Our membership in the Victorian across our six sustainability themes. Green Hospitals Round Table • Climate change has been Group enables us to meet with Environmental Citizenship added to the Monash Health Sustainability Representatives Establish accountabilities and Risk Register, enabling all across metropolitan Melbourne responsibilities for employees departments to consider climate to discuss innovative ideas, across Monash Health to improve mitigation and adaptation remain transparent in our our environmental impact and in day-to-day processes. activities and ensure our actions build a culture where we act are guided by best practice. and participate in society as • The ever-expanding Monash agents of positive change. Health Eco Champions • Monash Health was the recipient Committee communicate of two grants from the Victorian Achievements: regularly to explore, discuss, Health and Human Services • The new Monash Health prioritise and implement Building Authority which enabled Environmental Sustainability sustainability efforts organisation us to improve environmental Strategy and Action Plan 2020- wide. In 2019/2020, ten new behaviours of employees in the 2024 has been developed Green Teams have been formed Clayton Operating Theatres.
Monash Health Annual Report. 2019-20 67 Report of Operations
Green Procurement our Kingston Centre Food • Replaced incandescent & halogen Incorporate sustainable Services, saving 24.3 tonnes lights with LEDs at all sites procurement in Monash Health’s of CO2 emissions. products and services as part • Installed LED technology at of any tendering processes. • Monash Health are exploring strategic locations to obtain setting up soft plastics recycling, maximum energy saving. For Achievements: beginning with a pilot at our example – MMCC loading • Compostable paper medicine procurement warehouse and dock, streetlights, etc. cups have been introduced pharmacy department at Clayton site-wide, replacing the plastic • Monash Health plans to cups that were used previously Sustainable Travel and implement mandatory ecological Active Transport sustainable design principles • Moorabbin Hospital’s kitchen Reduce greenhouse gas emissions and energy effi ciency initiatives services team have replaced from Monash Health’s fl eet car in new builds and major retrofi ts/ their single-use dessert and soup service, and encourage the use of refurbishments in accordance containers with reusable ones car-pooling and active transport with the relevant sections of the National Construction Code • Monash Health Pharmacy Achievements: Departments at Clayton • Monash Health has increased Energy Effi ciency have transitioned away from the use of teleconferencing and Emissions using single-use plastic bags technology across all sites Support the Victorian Government’s to reusable or paper bags, which has drastically reduced climate change framework for eliminating close to 5000 the amount of travel to and from emissions reduction (net zero plastic bags in one month. work as well as between sites greenhouse gas emissions by Pharmacy departments at 2050 and renewable energy Casey, Monash Children’s • We have a Bicycle Users Group, generation targets of 25% by Hospital and the Monash and bike facilities across our 2020 and 40% by 2025) Health Translation Precinct have sites promoting and enabling the also begun this transition. use of active bike transport Achievements: • Emissions from the Monash Waste Management • We are a part of Hospital Health Fleet Service have Encourage the avoidance, reduction, Car Share, an organisation decreased by 74% compared re-use and recycling of resources, enabling workers to carpool to 2018/19 fi gures, resulting in and increase diversion of resources to and from work (temporarily a saving of 618 tonnes of CO2 from landfi ll. The infection prevention suspended due to COVID-19) measures required to combat • Overall energy portfolio has COVID-19 have necessitated an • Our fl eet car service operations recorded a commendable increase in the use of single use are purchasing smaller, more reduction when comparing items, however, when it is safe to fuel-effi cient vehicles for Monash validated NGER data for 2017/18 do so, the re-use and recycling Health with these being the default to 2018/19 consumptions of resources is encouraged. and are exploring the purchasing of hybrid vehicles where possible • Total energy consumed Achievements: has reduced by 0.4% Through various recycling streams Sustainable Buildings we have diverted the following this Improve environmental standards for • This has resulted in fi nancial year from landfi ll: new and retrofi t building projects corresponding reductions in Scope 1 & 2 combined • Almost 900 tonnes of recyclables Achievements: GHG emissions by 2.27% • Replacement of critical • Almost 1.6 tonnes of Polyvinyl infrastructure assets with energy Chloride (PVC) products effi cient plant under MEEIRP since 2012 to date. For example – Note: while the percentage reductions • Almost 16 tonnes of electronics steam boilers, chillers, condensing above may appear very small, this boilers, cooling towers, medical represents a substantial reduction when • Over 1.5 tonnes of single- air compressors, medical considering Monash Health’s overall use metal instruments vacuum plant, HVAC systems, energy portfolio (466,344 GJ in 2018/19). electrical switchboards, etc. For detailed information refer to page 73. • 12.8 tonnes of food from
Monash Health Annual Report. 2019-20 68 Report of Operations
Financial information
Green Procurement our Kingston Centre Food • Replaced incandescent & halogen Incorporate sustainable Services, saving 24.3 tonnes lights with LEDs at all sites Financial information procurement in Monash Health’s of CO2 emissions. products and services as part • Installed LED technology at of any tendering processes. • Monash Health are exploring strategic locations to obtain setting up soft plastics recycling, maximum energy saving. For Summary Achievements: beginning with a pilot at our example – MMCC loading 2020 2019 2018 2017 2016 • Compostable paper medicine procurement warehouse and dock, streetlights, etc. Operating result $’000 $’000 $’000 $’000 $’000 cups have been introduced pharmacy department at Clayton site-wide, replacing the plastic • Monash Health plans to Total revenue 2,295,881 2,066,252 1,882,075 1,850,723 1,751,511 cups that were used previously Sustainable Travel and implement mandatory ecological Total expenses 2,258,195 2,046,513 1,877,401 1,754,104 1,647,800 Active Transport sustainable design principles • Moorabbin Hospital’s kitchen Reduce greenhouse gas emissions and energy effi ciency initiatives Net result from transactions 37,687 19,740 4,674 96,619 103,711 services team have replaced from Monash Health’s fl eet car in new builds and major retrofi ts/ Total other economic fl ows -11,094 -24,820 -4,659 10,838 184 their single-use dessert and soup service, and encourage the use of refurbishments in accordance containers with reusable ones car-pooling and active transport with the relevant sections of the Net result 25,782 -5,080 15 107,457 103,895 National Construction Code • Monash Health Pharmacy Achievements: Total assets 2,754,032 2,252,249 1,818,761 1,715,387 1,591,476 Departments at Clayton • Monash Health has increased Energy Effi ciency Total liabilities 1,119,049 677,135 589,603 522,107 505,698 have transitioned away from the use of teleconferencing and Emissions using single-use plastic bags technology across all sites Support the Victorian Government’s Net assets/Total equity 1,634,980 1,575,113 1,229,158 1,193,280 1,085,778 to reusable or paper bags, which has drastically reduced climate change framework for eliminating close to 5000 the amount of travel to and from emissions reduction (net zero There are no signifi cant changes or any subsequent events to balance date. plastic bags in one month. work as well as between sites greenhouse gas emissions by Pharmacy departments at 2050 and renewable energy Reconciliation between the Net result from transactions Casey, Monash Children’s • We have a Bicycle Users Group, generation targets of 25% by Hospital and the Monash and bike facilities across our 2020 and 40% by 2025) 2020 2019 2018 2017 2016 Health Translation Precinct have sites promoting and enabling the $’000 $’000 $’000 $’000 $’000 also begun this transition. use of active bike transport Achievements: Net operating result i 442 -10,690 39 1,294 2,393 • Emissions from the Monash Waste Management • We are a part of Hospital Health Fleet Service have Capital and specifi c items Encourage the avoidance, reduction, Car Share, an organisation decreased by 74% compared re-use and recycling of resources, enabling workers to carpool to 2018/19 fi gures, resulting in Capital purpose income 183,255 127,422 101,699 180,160 193,492 and increase diversion of resources to and from work (temporarily a saving of 618 tonnes of CO2 Share of net profi t of associates -117 -29 -87 -147 -184 from landfi ll. The infection prevention suspended due to COVID-19) in other economic fl ows measures required to combat • Overall energy portfolio has COVID-19 have necessitated an • Our fl eet car service operations recorded a commendable Specifi c expenses -1,049 -5,328 -372 -667 -5,741 increase in the use of single use are purchasing smaller, more reduction when comparing COVID-19 State supply arrangements 3,280 - - - - items, however, when it is safe to fuel-effi cient vehicles for Monash validated NGER data for 2017/18 - products received free of charge do so, the re-use and recycling Health with these being the default to 2018/19 consumptions of resources is encouraged. and are exploring the purchasing COVID-19 State supply items -3,280 - - - - of hybrid vehicles where possible • Total energy consumed consumed up to 30 June 2020 Achievements: has reduced by 0.4% Assets provided free of charge - - - - - Through various recycling streams Sustainable Buildings Assets received free of charge 259 - - - - we have diverted the following this Improve environmental standards for • This has resulted in fi nancial year from landfi ll: new and retrofi t building projects corresponding reductions Expenditure for capital purpose -14,428 -10,094 -11,349 -10,226 -8,503 in Scope 1 & 2 combined Depreciation and amortisation -118,846 -73,129 -77,310 -67,063 -70,184 • Almost 900 tonnes of recyclables Achievements: GHG emissions by 2.27% • Replacement of critical Impairment of non-fi nancial assets - - - - - Almost 1.6 tonnes of Polyvinyl infrastructure assets with energy • Bad and doubtful debt expense ii -3,845 -3,618 -2,729 -1,259 -1,887 Chloride (PVC) products effi cient plant under MEEIRP since 2012 to date. For example – Note: while the percentage reductions Finance costs - other -7,984 -4,794 -5,217 -5,473 -5,675 • Almost 16 tonnes of electronics steam boilers, chillers, condensing above may appear very small, this Net assets/Total equity 37,687 19,739 4,674 96,619 103,711 boilers, cooling towers, medical represents a substantial reduction when • Over 1.5 tonnes of single- air compressors, medical considering Monash Health’s overall use metal instruments vacuum plant, HVAC systems, energy portfolio (466,344 GJ in 2018/19). Net result before capital and specifi c items, i.e. the result which the health service is monitored against in the Statement of Priorities. electrical switchboards, etc. For detailed information refer to page 73. i: Note: Restated Share of Net Profi t of Associates is in Other Economic fl ows as of 2019, prior years restated. ii: Note: Restated Net Operating Result to exclude Bad and Doubtful Debts Expense in 2016 & 2017. • 12.8 tonnes of food from
Monash Health Annual Report. 2019-20 68 Report of Operations 69 Report of Operations
Consultancies information
Consultancies information Details of Information and Communication Technology The total ICT expenditure incurred during 2019-20 is $92.4million (excluding GST).
$'000
BAU ICT Expenditure Non-BAU ICT Expenditure Operational Expenditure Capital Expenditure Total (excluding GST) Total = A+B (Excluding GST) A (Excluding GST) B (Excluding GST)
53,725 38,669 638 37,986
2019-20 Disclosure of Consultancy Expenditure Details of consultancies (under $10,000) In 2019-20, there were 84 consultancies where the total fees payable to the consultants were less than $10,000. The total expenditure incurred during 2019-20 in relation to these consultancies is $192,257 (excluding GST).
Details of consultancies (valued at $10,000 or greater) In 2019-20, there were 18 consultancies where the total fees payable to the consultants were $10,000 or greater. The total expenditure incurred during 2018-19 in relation to these consultancies is $8,398,839 (excluding GST). Details of these consultancies are listed below.
Consultants
2020 2019 2018 2017 2016
Consultants’ cost ($) 8,591,096 3,251,980 1,587,973 1,228,225 996,437
Total number of consultants 102 121 51 107 140
Consultancies Details
Consultant Purpose of Consultancy Start date End date Total Expenditure approved 2019-2020 project fee ($'000) ($'000)
McKinsey & Company Improvement in Financial Viability 1/07/19 30/06/20 7,397 7,397
Ernst & Young Internal Audit and FBT Services 1/07/19 30/06/20 436 436
Madison Cross Australia Pty Ltd Organisational Growth and Development 1/07/19 30/06/20 180 180
Olive Branch Group Pty Ltd Information Technology Consulting 1/07/19 30/06/20 83 83
Dnaco Construction Pty Ltd Asset Management Consulting 1/07/19 30/06/20 35 35
Black Dog Institute Workplace Health Consulting 1/07/19 30/06/20 33 33
Cogent Advisory Pty Ltd Organisational Growth and Development 1/07/19 30/06/20 32 32
Open Advisory Pty Ltd Organisational Growth and Development 1/07/19 30/06/20 31 31
Fundraising Force Organisational Growth and Development 1/07/19 30/06/20 23 23
Canyon Pty Ltd Design Consultation 1/07/19 30/06/20 20 20
Paxton Consulting Pty Ltd Improvement in Financial Viability 1/07/19 30/06/20 20 20
Fortitude Digital Organisational Growth and Development 1/07/19 30/06/20 36 36
Monash Health Annual Report. 2019-20 70 Disclosures required under legislation
Consultancies Details continued
Consultant Purpose of Consultancy Start date End date Total Expenditure approved 2017-2018 project fee ($'000) ($'000)
Safety Australia Group Pty Ltd Workplace Safety Review 1/07/19 30/06/20 19 19
Alcidion Aus Pty Ltd Information Technology Consulting 1/07/19 30/06/20 18 18
SenateSHJ EMR Communications Consultation 1/07/19 30/06/20 15 15
Spratt Phillip Maxwell Cardiothoracic Consulting 1/07/19 30/06/20 13 13
Miller Network Group Organisational Growth 1/07/19 30/06/20 12 12 and Development
LW Corporate Services Improvement of Financial Viability 1/07/19 30/06/20 11 11
Disclosures required under legislation
Freedom of Information Outcomes of Requests Freedom of Information Act 1982 Received in the Period 1 Fees and charges: July 2019 to 30 June 2020: • Application fees collected $40,256.00 Rights of the public under the • Access granted in full: 1551 • Application fees waived $11,544.00 Freedom of Information Act 1982 • Access granted in part: 65 • Copy charges collected $68,542.00 are published on our website • Access denied in full: 0 • Copy charges waived $3,680.00 at monashhealth.org. These • Other (no documents found) 21 include contact details for the • Other (not proceeded with) 38 Initial decision makers: freedom of information team • Not yet fi nalised 75 • Hayley Capiron (Release of and guidance on how to make a • Exemptions cited – a total of 105 Information Manager) freedom of information request. • Frances Rogers (FOI Decision Maker) A request for documents must be Clause: • Elaine Elliott (Health in writing and include suffi cient detail • s.30(1) was used in 11 request(s) Information Manager) to identify the correct medical record. • s.32(1) was used in 2 request(s) • Maija Dimits (Health Contact details of our FOI team • s.33(1) was used in 35 request(s) Information Manager) are through to [email protected] • s.33(4) was used in 2 request(s) • Carrie Harris (FOI Offi cer) • s.35(1)(b) was used in 36 request(s) • s.38 was used in 19 request(s) Summary of requests received under the Act from 1 July Outcomes of Requests 2019 to 30 June 2020 Outstanding from 2018-19 • Total number of requests • Total number of requests received: 1750 outstanding: 110 • Number of requests transferred • Access granted in full: 105 to another agency: 0 • Access granted in part: 3 • Access denied in full: 1 • Other (no documents): 1
Report of Operations 71 Report of Operations
Building Act 1993 that all ESM are operational at persons in care relationships. the required level of performance The Monash Health Consumer, Local Jobs First-Victorian Industry Participation Policy Monash Health sites and facilities for the safety of these facilities. Carer and Community Partnerships Projects Type Number of Estimated Value VIPP/LIDP Plan Completed In Progress are managed through site Framework provides an organisation- Projects Required inspections, risk assessments Risk assessment wide structure describing our Standard >$3M 3 $16,300,000 3 2 1 and audits. We have contracts Victorian Managed Insurance approach to embedding relationship in place to maintain Essential Authority (VMIA) conducts Site centred care and partnerships Strategic >$50M N/A N/A N/A N/A N/A Safety Measures and annual Risk Surveys (SRS) at Monash in our culture, recognising that compliance audits by independent Medical Centre, Moorabbin everyone in the organisation has Registered Building Surveyors. Hospital, Kingston Centre an impact on patient, family, and Dandenong Hospital. carer and consumer experience. Local Jobs First Act 2003 found on pages 67 and 68. reviews carried out on Building standards and Risk treatment options generated Patient Experience education is the Health Service condition assessments from the SRS are monitored through mandatory for all new Monash Monash Health complies with the Greenhouse gas action plans until they are completed. Health employees, both clinical and intent of the Local Jobs First Act emissions (CO2-e) • Details of major research The condition of our buildings are non-clinical and Partnering with 2003 which requires, wherever • Scope 1: 11,895 and development activities assessed through site inspections Protected Disclosure Consumers education is provided for possible, local industry participation • Scope 2: 65,381 undertaken by the Health and condition audits by architects Act 2012 managers and leaders. Our learning in supplies; taking into consideration • Total (tonnes CO2-e): 77,276 Service that are not otherwise and consultant engineers on an tools draw particular attention to the principle of value for money and covered either in the report of Water consumption as-needed basis. Fire audits and Monash Health has a procedure for the needs of carers and families. transparent tendering processes. operations or in a document that • Class A recycled water: 0 risk assessments are undertaken protected disclosures and matters Monash Health reports on how contains the fi nancial statements • Potable water: 485,685 by consultant fi re engineers to of this nature are referred to the we engage with our consumers, Safe Patient Act 2015 and report of operations comply with the Department of Independent Broad-based Anti- their families and carers in the • Reclaimed water: 0 Health and Human Services Fire Risk Corruption Commission. Information annual Quality of Care Report. That Monash Health have no matters to • Total (kL): 485,685 • Details of overseas visits Management Guidelines Series 7. is included in the ‘Patient & Visitors/ report is available on our website: report in relation to its obligations Energy consumption undertaken including a Recommendations from fi re Concerns and Compliments’ section https://monashhealth.org/about/ under Section 40 of the Safe • Total (GJ): 519,617 summary of the objectives audits are actioned through a of the Monash Health Internet site publications/quality-account/ Patient Care Act 2015. Waste generated and outcomes of each visit series of projects developed in for external parties and on our There are no disclosures • Total (kg): 5,094,578 consultation with the Victorian Health intranet for internal employees to required to be made under the Car Parking Fees • Details of major promotional, & Human Services Building Authority view policies and procedures. Carers Recognition Act 2012. public relations and marketing (VHHSBA) Fire Risk Management Monash Health complies with the Additional information activities undertaken by the Branch to maintain a high degree National Competition DataVic Access Department of Health and Human available on request Health Service to develop of fi re safety. All bed-based facilities Policy Policy Services hospital circular on car community awareness of the are audited on a fi ve-yearly cycle. parking fees and details of car Details in respect of the items Health Service and its services Monash Health continued to comply Consistent with the DataVic Access parking fees and concession benefi ts listed below have been retained Fire safety audits with the Victorian Government’s Policy issued by the Victorian can be viewed at https://www2. by the health service and are • Details of assessments and The last fi ve yearly fi re safety audit Competitive Neutrality Policy. Government in 2012, Monash health.vic.gov.au/about/news-and- available to the relevant Ministers, measures undertaken to of Monash Health’s 12 bed based In addition, the Victorian Health data sets are available events/hospitalcirculars/circ0515 Members of Parliament and improve the occupational health facilities was completed in 2018. Government’s Neutrality Pricing on the DataVic website in 2019- Monash Health’s car parking fees the public on request (subject and safety of employees The next audit will be undertaken Principles for all relevant business 20. The information included in and concession benefi ts can be to the Freedom of Information and completed in 2023. activities have been applied by this Annual Report will also be found at www.monashhealth.org requirements, if applicable): • A general statement on industrial Monash Health since 1 July 1988. available at www.data.vic.gov.au relations within the Health Service Essential safety measures in an electronic readable format. Environmental performance • Declarations of pecuniary and details of time lost through maintenance Carers Recognition interests have been duly industrial accidents and disputes, Contracts are in place to maintain Act 2012 Monash Health remains committed completed by all relevant offi cers which are not otherwise detailed all Essential Safety Measures (ESM) to environmental sustainability by in the report of operations at sites owned by Monash Health. Monash Health is committed to continuing to develop initiatives that • Details of shares held by Audits are performed at these sites partnering with and empowering improve effi ciencies and reduce senior offi cers as nominee • A list of major committees by Building Surveyors to ensure our consumers. We understand its environmental footprint. or held benefi cially sponsored by the Health Service, compliance with ESM Maintenance that our consumers, their families The environmental data management the purposes of each committee regulations. Action plans to rectify and carers need to play an active system (EDMS) records our • Details of publications produced and the extent to which those defects identifi ed during the audits role in their own healthcare and in environmental performance data. by the entity about itself, and purposes have been achieved are currently in place. In accordance helping us improve the quality and The EDMS generates reports how these can be obtained with regulatory requirements, safety of our services. We take all related to our greenhouse gas • Details of all consultancies and service and maintenance, records practicable measures to ensure emissions, waste generation, and • Details of changes in prices, contractors including consultants/ are kept to enable the completion our employees and agents refl ect energy and water consumption. fees, charges, rates and levies contractors engaged, services of an annual ESM Report for all the care relationship principles in Further details and initiatives about charged by the Health Service provided, and expenditure properties owned by Monash developing, providing or evaluating Monash Health’s Environmental committed for each engagement. Health. This provides confi rmation support and assistance for Sustainability 2019-20 can be • Details of any major external
Monash Health Annual Report. 2019-20 72 Report of Operations 73 Local Jobs First-Victorian Industry Participation Policy
Projects Type Number of Estimated Value VIPP/LIDP Plan Completed In Progress Projects Required
Standard >$3M 3 $16,300,000 3 2 1
Strategic >$50M N/A N/A N/A N/A N/A
Local Jobs First Act 2003 found on pages 67 and 68. reviews carried out on the Health Service Monash Health complies with the Greenhouse gas intent of the Local Jobs First Act emissions (CO2-e) • Details of major research 2003 which requires, wherever • Scope 1: 11,895 and development activities possible, local industry participation • Scope 2: 65,381 undertaken by the Health in supplies; taking into consideration • Total (tonnes CO2-e): 77,276 Service that are not otherwise the principle of value for money and covered either in the report of Water consumption transparent tendering processes. operations or in a document that • Class A recycled water: 0 contains the fi nancial statements • Potable water: 485,685 Safe Patient Act 2015 and report of operations • Reclaimed water: 0 Monash Health have no matters to • Total (kL): 485,685 • Details of overseas visits report in relation to its obligations Energy consumption undertaken including a under Section 40 of the Safe • Total (GJ): 519,617 summary of the objectives Patient Care Act 2015. Waste generated and outcomes of each visit • Total (kg): 5,094,578 Car Parking Fees • Details of major promotional, public relations and marketing Monash Health complies with the Additional information activities undertaken by the Department of Health and Human available on request Health Service to develop Services hospital circular on car community awareness of the parking fees and details of car Details in respect of the items Health Service and its services parking fees and concession benefi ts listed below have been retained can be viewed at https://www2. by the health service and are • Details of assessments and health.vic.gov.au/about/news-and- available to the relevant Ministers, measures undertaken to events/hospitalcirculars/circ0515 Members of Parliament and improve the occupational health Monash Health’s car parking fees the public on request (subject and safety of employees and concession benefi ts can be to the Freedom of Information found at www.monashhealth.org requirements, if applicable): • A general statement on industrial relations within the Health Service Environmental performance • Declarations of pecuniary and details of time lost through interests have been duly industrial accidents and disputes, Monash Health remains committed completed by all relevant offi cers which are not otherwise detailed to environmental sustainability by in the report of operations continuing to develop initiatives that • Details of shares held by improve effi ciencies and reduce senior offi cers as nominee • A list of major committees its environmental footprint. or held benefi cially sponsored by the Health Service, The environmental data management the purposes of each committee system (EDMS) records our • Details of publications produced and the extent to which those environmental performance data. by the entity about itself, and purposes have been achieved The EDMS generates reports how these can be obtained related to our greenhouse gas • Details of all consultancies and emissions, waste generation, and • Details of changes in prices, contractors including consultants/ energy and water consumption. fees, charges, rates and levies contractors engaged, services Further details and initiatives about charged by the Health Service provided, and expenditure Monash Health’s Environmental committed for each engagement. Sustainability 2019-20 can be • Details of any major external
Report of Operations 73 Report of Operations
Attestations Attestations
Financial Management Data Integrity Compliance attestation I, Dipak Sanghvi, on behalf of the Monash I, Andrew Stripp, certify that Monash Health has put Health Board, certify that Monash Health has in place appropriate internal controls and processes complied with the applicable Standing Directions to ensure that reported data accurately refl ects actual of the Minister for Finance under the Financial performance. Monash Health has critically reviewed Management Act 1994 and Instructions. these controls and processes during the year.
Dipak Sanghvi Andrew Stripp Chair, Board of Directors Chief Executive Melbourne Melbourne
6 October 2020 6 October 2020
Confl ict of Interest Integrity, Fraud and Corruption
I, Andrew Stripp, certify that Monash Health has put I, Andrew Stripp, certify that Monash Health in place appropriate internal controls and processes has put in place appropriate internal controls to ensure that it has complied with the requirements and processes to ensure that integrity, fraud of hospital circular 07/2017 Compliance reporting in and corruption risks have been reviewed and health portfolio entities (revised) and has implemented a addressed at Monash Health during the year. ‘Confl ict of Interest’ policy consistent with the minimum accountabilities required by the VPSC. Declaration of private interest forms have been completed by all executive employees within Monash Health and members of the Board, and all declared confl icts have been addressed and are being managed. Confl ict of interest is a standard agenda item for declaration and documenting at each executive board meeting.
Andrew Stripp Andrew Stripp Chief Executive Chief Executive Melbourne Melbourne
6 October 2020 6 October 2020
Monash Health Annual Report. 2019-20 74 Report of Operations 75 Report of Operations
Statement of Priorities 2019-20 Reporting of outcomes from Statement of Priorities 2019-20 Part A
Goals Strategies Health Service Outcome Deliverables
Better Health Better Health Develop a model of care In Progress • A system geared • Reduce Statewide and implementation plan • The Community Assessment to prevention Risks. to strengthen the role of and Response Team community services in as much as • Build Healthy (CART) model of care was treatment. supporting patient’s transition developed and deployed. Neighbourhoods. out of hospital, reducing • Everyone • Help people to avoidable emergency • This initiative will be further understands stay healthy. department presentations developed in 20-21. their own health • Target health gaps. and hospital admissions, and risks. and preventing acute and • Illness is chronic conditions from detected and worsening in the community. managed early. • Healthy neighbourhoods Continue working with the In Progress and communities regional chronic disease • Delayed due to COVID-19 encourage coalition to deliver the Chronic preparations. Has been healthy lifestyles. Disease Strategy Action Plan carried forward until 20-21. for 2019-20 with priority work streams in Oral Health, Diabetes and Palliative Care.
Continue delivery of an In Progress improved maternity model of • A Telehealth model of pregnancy care, including implementation care was introduced in March of a Fetal Surveillance 2020 was shown to deliver Unit at Casey Hospital. high quality care, improved access and overall increased patient satisfaction. • The implementation of the Fetal Surveillance Unit at Casey Hospital has been delayed due to COVID-19 preparations. This initiative has been carried forward until 20-21.
Better Access Better Access Together with Monash In Progress • Care is always • Plan and invest. University and the Department • Victorian Heart Hospital of Health and Human Services, there when • Unlock innovation. build on track. people need it. progress the planning for • Provide easier the Victorian Heart Hospital • Governance framework • More access to access. according to the project plan. delayed due to COVID-19 care in the home preparations. Has been Ensure fair access to and community. • carried forward to 20-21. full range of care and support they need. • There is equal access to care.
Monash Health Annual Report. 2019-20 76 Health Service Outcome Goals Strategies Deliverables
• People are Work towards improved In Progress connected to access for our community and • Construction has commenced the full range of consumers by commencing but has been delayed due care and support construction of our Emergency to COVID-19. Has been they need. Department at Monash carried forward until 20-21. Medical Centre, Clayton. • There is equal access to care. Commence the service and In Progress facility master plan for Monash • Delayed due to COVID-19 Medical Centre, Clayton. preparations. Has been carried forward until 20-21.
Complete the full business In Progress case for services and • The business case for the facilities at Pakenham Health Pakenham Health Centre Centre and Kingston Centre has been completed. for consideration by the Overarching feasibility analysis Victorian Government. • and planning for the Kingston Centre has been completed. Business case development will continue subject to Department of Health and Human Services’ directions.
Complete the overarching In Progress Monash Health Strategic • Overarching feasibility plans have Service Plan to allow been completed. Master planning improved access to the efforts continue to be informed range of healthcare services by Department of Health and provided by Monash Health. Human Services’ directions.
Finalise the work plans for In Progress implementation of site service • The Dandenong Hospital and plans at Dandenong Hospital, Casey Hospital Emergency Casey Hospital Emergency Department service plans Department, Cranbourne have been drafted. and Pakenham Community Development of the Casey Hospitals, and implement the • Hospital Emergency Department Casey Hospital Expansion Expansion Service Plan is Year One Operational at functional brief stage. and Workforce Plan. • Cranbourne and Pakenham Community Hospitals have been delayed due to COVID-19 preparations. This initiative has been carried forward until 20-21. • The Casey Hospital Expansion Year One Operational and Workforce Plan achieved through commissioning and progressive operationalisation of the Casey Hospital Expansion in May 2020. Workforce recruitment continues into FY20-21 aligned with service growth and clinical demand requirements.
Report of Operations 77 Report of Operations
Goals Strategies Health Service Outcome Deliverables Ensure fair access for people In Progress who require community services • Delayed due to COVID-19 by redesigning the access to preparations. Has been service approach to effi ciently carried forward until 20-21. and effectively support the needs of our community.
Better Care Better Care Improve digital to clinical Achieved workfl ows, effi ciency • Target zero • Put quality fi rst. • Implementation of the fi rst and patient safety by phase of the Monash Health avoidable harm. Join up care. • implementing an Electronic Electronic Medical Record Healthcare that • • Partner with patients. Medical Record across all system was completed in focusses on • Strengthen the Monash Health campuses. December 2019. This achieved a outcomes. workforce. safe and controlled introduction • Patients and • Embed evidence. of standardised digital clinical carers are active workfl ows across all campuses partners in care. • Ensure equal care. providing inpatient care. • Care fi ts together around people’s needs. Develop a real time patient Achieved experience survey to improve • A real-time Patient Experience the way consumer feedback is Survey based on questions from collected and new opportunities VHES survey is available to all for improvement are identifi ed. clinical areas using Power BI.
Improve consumer experience In Progress of discharge management • Initial reforms did not achieve through implementation performance targets. A of initiatives for access, revised access and fl ow discharge criteria and ward model was implemented governance procedures. because of COVID-19. • Optimisation of same-day and multi-day planned medical admissions across the health service remains on track.
Implementation of the Clean Achieved Slate initiative to improve • Monash Health transitioned hygiene and cleanliness towards a new contracted across the organisation. cleaning agent across all inpatient and residential sites between July to December 2019. • The cleaning agent is fully compliant with the DHHS and Worksafe cleaning requirements.
Implement revised food In Progress services delivery model • A revised food service delivery across the organisation. model was implemented at Monash Medical Centre, Kingston Centre and Moorabbin Hospital. The new model involves the delivery of food directly to the bedside by our Food Services Assistants.
Monash Health Annual Report. 2019-20 78 Goals Strategies Health Service Outcome Deliverables • This change has enabled our Patient Services Assistants to spend more time undertaking environmental cleaning on the wards. • The implementation of the Dandenong Hospital revised food delivery model was delayed due to COVID-19 preparations. This model has been carried forward until 20-21.
Increasing organisational In Progress capability to ensure sustainable • Delayed due to COVID-19 improvement at Monash preparations. Has been Health through development carried forward until 20-21. of workforce strategies for pharmacy, pathology, diagnostic imaging and nursing and midwifery.
Work with Safer Care Achieved Victoria and the Institute for • Worked with Safer Care Healthcare Improvement to Victoria to provide training for engage and build consumer Program Directors, Deputy capability for improvement. Program Directors and Quality and Safety Unit employees in RCA methodology.
Specifi c Supporting the Mental Improve access to mental Achieved Health System 2019-20 health services through • The Emergency Department Priorities optimising the access to acute Mental Health & Alcohol and community treatment and Other Drug (AOD) pathways for our communities. Response Model went live. • The model is supported by a multi-disciplinary team involving mental health and AOD nurses, consumer and carer peer workers and a social worker who support patients presenting to the Emergency Department. • The team also provides community outreach for up to 28 days post presentation for people who have not been linked in to specialist mental health services.
Addressing Implement initiatives to improve In Progress Occupational Violence the workplace environment • Delivery of the OVA Strategy was and minimise occupational Foster an organisational impacted by COVID-19. violence and aggression in wide occupational Of 69 actions, 44 are complete, line with the department’s health and safety 25 are underway. Delayed security training principles. risk management actions have been carried approach, including forward until 20-21. identifying security risks and implementing controls, with a focus on prevention and improved reporting and consultation. Implement the department’s security training principles to address identifi ed security risks.
Report of Operations 79 Report of Operations
Goals Strategies Health Service Outcome Deliverables
Addressing Bullying Implement initiatives to In Progress and Harassment promote equity and inclusion • The framework has been largely Actively promote positive in the workplace. implemented with minor delays workplace behaviours, due to COVID-19 preparations. encourage reporting • Ongoing training is in place for all and action on all employees, including mandatory reports. Implement the annual refresher training. department’s Framework for promoting a • All claims of bullying and positive workplace harassment were investigated culture: preventing and de-identifi ed outcomes bullying, harassment communicated to all employees. and discrimination and Workplace culture and bullying, harassment and discrimination training: guiding principles for Victorian health services.
Implement a series of Achieved tools to assist employees and management with • Implemented new resources to support employee mental greater psychological wellbeing, including ongoing safety in the workplace. wellbeing presentations at all employee forums, peer support networks, a Call a Psychologist service, and resource hubs.
Supporting Optimise access to community Achieved Vulnerable Patients services and deliver initiatives • The Monash Health Aboriginal Partner with patients to improve acute and subacute Health team delivered the to develop strategies services to vulnerable Healthy Koori Kids (HKK) that build capability people in our community. program. The program offers within the organisation a multidisciplinary clinic for to address the health Aboriginal and Torres Strait needs of communities Islander children in or at and consumers at risk of out of home care. risk of poor access • During COVID-19 the service to healthcare. transitioned to a Telehealth model of care to ensure high-risk clients can still access health services.
Supporting Aboriginal Implement 2019-20 work In Progress Cultural Safety program for the Innovate • The Monash Health Innovate Reconciliation Action Plan Improve the health Reconciliation Action Plan (RAP) (Innovate 2019-2023). outcomes of Aboriginal was launched in February 2020. and Torres Strait Islander • The RAP was developed in people by establishing consultation with our Aboriginal culturally safe practices and Torres Strait Islander across the entire community, Monash Health organisation to recognise employees, and Aboriginal and and respect Aboriginal Torres Strait Islander community culture and deliver organisations across the region. services that meet the • Since its launch, over 11,000 needs, expectations Monash Health staff have and rights of Aboriginal completed online Aboriginal patients, their families, and Torres Strait Islander and Aboriginal staff. Cultural Awareness training. • Celebrations and activities have been held to acknowledge National
Monash Health Annual Report. 2019-20 80 Goals Strategies Health Service Outcome Deliverables
Reconciliation Week and this year’s postponed NAIDOC Week. • Some actions in the RAP have been delayed due to COVID-19 preparations. These have been carried forward until 20-21.
Continue to implement and In Progress strengthen outcomes achieved • Delayed due to COVID-19 through the Monash Health’s preparations. Has been Aboriginal Employment Plan. carried forward until 20-21.
Addressing Family Develop a plan for In Progress Violence implementation of the Multi- • Delayed due to COVID-19 Strengthen responses Agency Risk Assessment preparations. Has been to family violence in line and Management Framework carried forward until 20-21. with the Multiagency in the context of Monash Risk Assessment and Health and its community. Risk Management Continue to develop the Framework (MARAM) and In Progress Monash Health workforce with assist the government • Delayed due to COVID-19 appropriate skills to ensure that in understanding preparations. Has been the risk of family violence is workforce capabilities by carried forward until 20-21 effectively identifi ed, assessed championing participation and managed, and participate in the census of in the census of workforces. workforces that intersect with family violence.
Implementing Implement the 2019-20 work In Progress Disability Action Plan program for the Monash • Delayed due to COVID-19 Continue to build upon Health Disability Action preparations. Has been last year’s action by Plan, including workforce carried forward until 20-21. ensuring implementation resourcing to ensure delivery. and embedding of a Disability Action Plan which seeks to reduce barriers, promote inclusion and change attitudes and practices to improve the quality of care and employment opportunities for people with disability.
Supporting Develop and approve an Achieved Environmental Environmental Sustainability • Our Monash Health Sustainability Sustainability Strategy for Monash Health that Strategy for 2020-2024 has been Contribute to improving aligns with the DHHS Building developed and approved by the environmental Authority’s Environmental Monash Health Board of Directors. Sustainability Strategy 2018- sustainability of the health An action plan has now been 2023. The Strategy will be • system by identifying and developed to support the developed through consultation implementing projects strategy. This plan includes key with Monash Health engineering, and/or processes to performance indicators for a staff and relevant community reduce carbon emissions. number of areas including core groups, and will be aimed at emissions and landfi ll reduction. addressing key performance indicators to measure our carbon footprint including core emissions, water, waste, paper usage and procurement.
Report of Operations 81 Report of Operations
Part B: Performance Priorities
High quality and safe care Target Result Accreditation
Compliance with the Commonwealth’s Aged Care Accreditation Standards Accredited Accredited
Infection prevention and control
Compliance with Hand Hygiene Australia program 83% 81.9% Healthcare worker immunisation 84% 84%
Patient experience
Victorian Healthcare Experience Survey – data submission Full Compliance Full Compliance Victorian Healthcare Experience Survey - Percentage of positive >=95% 86% patient experience responses Quarter 1 Victorian Healthcare Experience Survey - Percentage of >=95% 85% positive patient experience responses Quarter 2 Victorian Healthcare Experience Survey - Percentage of positive >=95% 87% patient experience responses Quarter 3 Victorian Healthcare Experience Survey - Percentage of positive >= 75% 69% responses to questions on discharge care Quarter 1 Victorian Healthcare Experience Survey - Percentage of positive >= 75% 70% responses to questions on discharge care Quarter 2 Victorian Healthcare Experience Survey - Percentage of positive >= 75% 71% responses to questions on discharge care Quarter 3 Victorian Healthcare Experience Survey – Patients’ perception of >= 70% 56% cleanliness Quarter 1 Victorian Healthcare Experience Survey – Patients’ perception of >= 70% 58% cleanliness Quarter 2 Victorian Healthcare Experience Survey – Patients’ perception of >= 70% 62% cleanliness Quarter 3
Healthcare associated infections (HAI’s)
Number of patients with surgical site infection No outliers Not met Number of patients with ICU central-line-associated bloodstream Nil 1.3 infection (CLABSI) Rate of patients with SAB1 per occupied bed day ≤ 1 0.7
Adverse events
Unplanned readmission hip replacement Annual rate ≤ 2.5% 3.2% Sentinel events – root cause analysis (RCA) reporting All RCA reports 100% of RCA reports submitted within 30 submitted within 30 business days business days
Mental Health
Percentage of adult acute mental health inpatients who are <=14% 17% readmitted within 28 days of discharge Rate of seclusion events relating to a child and adolescent acute <=15/1000 15 mental health admission Rate of seclusion events relating to an adult acute mental health <=15/1000 5 admission Rate of seclusion events relating to an aged acute mental health <=15/1000 0 admission
"Percentage of child and adolescent acute mental health inpatients >=80% 96% who have a post-discharge follow-up within seven days"
Monash Health Annual Report. 2019-20 82 Target Result "Percentage of adult acute mental health inpatients who have a >=80% 97% post-discharge follow-up within seven days" "Percentage of aged acute mental health inpatients who have a >=80% 91% post-discharge follow-up within seven days"
Continuing care
"Functional independence gain from an episode of rehabilitation ≥ 0.645 0.82 admission to discharge relative to length of stay"
Maternity and newborn Baby’s wellbeing at birth (Apgar score)
Casey Hospital <= 1.4% 1.58% Dandenong Hospital <= 1.4% 1.36% Monash Medical Centre <= 1.4% 1.70% Severe fetal growth restriction born at 40 or more weeks gestation (FGR rate)
Casey Hospital <=28.6% 24.1% Dandenong Hospital <=28.6% 16.7% Monash Medical Centre <=28.6% 16.5%
Proportion of urgent maternity patients referred for obstetric care to a level 4, 5 or 6 maternity service who were booked for a specialist clinic appointment within 30 days of accepted referral Casey Hospital 100% 100% Dandenong Hospital 100% 100% Monash Medical Centre 100% 97.1%
Strong governance, leadership and culture Target Result* Organisational Culture (*2018-19 results - People Matter survey was not held in 2020 due to COVID-19)
People matter survey - Employees with an overall positive response to safety culture question >=80% 91% People matter survey - I am encouraged by my colleagues to >=80% 96% report any patient safety concerns I may have
People matter survey - Patient care errors are handled appropriately in my work area >=80% 95% People matter survey - My suggestions about patient safety would >=80% 93% be acted upon if I expressed them to my manager People matter survey - The culture in my work area makes >=80% 90% it easy to learn from the errors of others People matter survey - Management is driving us to be a safety-centred organisation >=80% 93% People matter survey - This health service does a good job of >=80% 83% training new and existing employees People matter survey - Trainees in my discipline are adequately >=80% 87% supervised" People matter survey - I would recommend a friend or relative to >=80% 92% be treated as a patient here
Timely access to care Target Result
Emergency Care
Emergency - Casey Hospital Percentage of ambulance patients transferred within 40 minutes >=90% 67.7% Percentage of Triage Category 1 emergency patients seen immediately 100% 100% Percentage of Triage Categories 1-5 emergency patients >=80% 48.1% seen within clinical recommended times
Report of Operations 83 Report of Operations
Percentage of emergency patients with length of stay less than 4 hours >=81% 61.6% Number of patients with a length of stay in the emergency department greater than 24 hours 0 109
Emergency - Dandenong Hospital Percentage of ambulance patients transferred within 40 minutes >=90% 69.0% Percentage of Triage Category 1 emergency patients seen immediately 100% 100.0% Percentage of Triage Categories 1-5 emergency patients >=80% 54.5% seen within clinical recommended times Percentage of emergency patients with length of stay less than 4 hours >=81% 50.0% Number of patients with a length of stay in the emergency department greater than 24 hours 0 66
Emergency - Monash Medical Centre Percentage of ambulance patients transferred within 40 minutes >=90% 63.7% Percentage of Triage Category 1 emergency patients seen immediately 100% 100% Percentage of Triage Categories 1-5 emergency patients seen >=80% 49.8% within clinical recommended times Percentage of emergency patients with length of stay less than 4 hours >=81% 55.2%
Number of patients with a length of stay in the emergency 0 87 department greater than 24 hours
Elective Surgery
Percentage of Urgency Category 1 elective patients removed within 30 days 100% 100% Percentage of Urgency Category 1, 2 and 3 elective patients >=94% 82.4% admitted within clinically recommended timeframes Reduce long waiting elective surgery patients <=5% 21.2% Number of patients on the elective surgery waiting list (end of June 2020) 7,545 9,150 Number of Hospital Initiated postponements per 100 scheduled admissions <=7% 8.8%
Number of patients admitted from the elective surgery waiting list – annual total 29,275 25,359
Specialist clinics Percentage of urgent patients referred by a GP or external specialist 100% 59% who attended a fi rst appointment within 30 days Percentage of routine patients referred by GP or external specialist 90% 92% who attended a fi rst appointment within 365 days
Effective fi nancial management Target Result
Finance
Operating Result ($m) $0.00 $0.44 Average number of days to paying trade creditors <60 days 64 days Average number of days to receiving patient fee debtors <60 days 40 days Public and Private WIES2 activity performance to target 100% 94% Adjusted Current Asset Ratio 0.7 or 3% 1.0 improvement from health service base target Actual number of days available cash, measured on the last day of each month. 14 days Not met Variance between forecast and actual Net result from transactions Variance $37.5 (M) (NRFT) for the current fi nancial year ending 30 June. >= $250,000 Forecast number of days available cash (based on end of year forecast) 14 days 73 days
Monash Health Annual Report. 2019-20 84 Part C: Activity and Funding
Acute Admitted 2019-20 Activity Achievement
WIES Public 158,513 WIES Private 16,239 WIES Public and Private 174,753 WIES DVA 513 WIES TAC 459 WIES TOTAL 175,723
Acute Non-Admitted 2019-20 Activity Achievement
Home Enteral Nutrition 4,734 Home Renal Dialysis - Home ABF 180 Specialist Clinics 322,337 Home Perinatal Nutrition 151
Sub-acute and Non-Acute Admitted 2019-20 Activity Achievement
Subacute WIES - Rehabilitation Public 2,137 Subacute WIES - Rehabilitation Private/TAC/WorkCover 420 Subacute WIES - GEM Public 2,252 Subacute WIES - GEM Private/TAC/WorkCover 304 Subacute WIES - Palliative Care Public 419 Subacute WIES - Palliative Care Private 44 Subacute WIES - DVA 51 Transition Care - Occupied Bed days 16,649 Transition Care - Home day 9,931
Sub-acute Non-Admitted 2019-20 Activity Achievement Health Independent Program - Public 174,263
Aged Care 2019-20 Activity Achievement Residential Aged Care 29,474
HACC - Service Time Hours 41,617
Report of Operations 85 Report of Operations
Mental Health (Occupied Bed days) and Drug Services 2019-20 Activity Achievement Mental Health Ambulatory 198,434 Mental Health Inpatient - Available bed days 58,729 Mental Health Inpatient - Secure Unit 16,818 Mental Health Residential 44,026 Mental Health Subacute 12,959 Mental Health Drug services 1,991
Primary Health 2019-20 Activity Achievement Community Health/Primary Care Program -Service Time Hours 91,852 Community Health Other 2,436
Other 2019-20 Activity Achievement NFC- Pancreas Transplants 8 Total Funding ($’000) 1,558,868
Monash Health Annual Report. 2019-20 86 Disclosures Index
Disclosures Index The annual report of Monash Health is prepared in accordance with all relevant Victorian legislation. This index has been prepared to facilitate identifi cation of the Department’s compliance with statutory disclosure requirements.
Charter and Purpose
Legislation Requirement Page Reference
FRD 22H Manner of establishment and the relevant Ministers 52 FRD 22H Purpose, functions, powers and duties 43 FRD 22H Nature and range of services provided 47 FRD 22H Activities, programs and achievements for the reporting period 11 FRD 22H Signifi cant changes in key initiatives and expectations for the future 4
Management and Structure
Legislation Requirement Page Reference
FRD 22H Organisational structure 58 FRD 22H Workforce data, employment and conduct principles 65 FRD 22H Occupational Health and Safety 66
Financial Information
Legislation Requirement Page Reference
FRD 22H Summary of the fi nancial results for the year 69 FRD 11A Disclosure of ex-gratia expenses N/A FRD 22H Signifi cant changes in fi nancial position during the year 69 FRD 22H Operational and budgetary objectives and performance against objectives 69 FRD 22H Subsequent events 69 FRD 22H Details of consultancies under $10,000 70 FRD 22H Details of consultancies over $10,000 70 FRD 22H Disclosure of ICT expenditure 70
Report of Operations 87 Report of Operations
Legislation
Legislation Requirement Page Reference
FRD 22H Application and operation of Freedom of Information Act 1982 71 FRD 22H Compliance with building and maintenance provisions of Building Act 1993 72 FRD 22H Application and operation of Protected Disclosure 2012 72 FRD 22H Statement on National Competition Policy 72 FRD 22H Application and operation of Carers Recognition Act 2012 72 FRD 22H Summary of the entity’s environmental performance 72 FRD 22H Additional information available on request 73 FRD 25C Reporting of outcomes from Statement of Priorities 2019–20 76-86 Occupational Violence reporting 66 Reporting obligations under the Safe Patient Care Act 2015 73 Reporting of compliance regarding Car Parking Fees 73 FRD 25D Local Jobs First Act 2003 disclosures 73 DataVic Access Policy 72
Attestations
Legislation Requirement Page Reference
Data Integrity 74 Managing Confl icts of Interest 74 Integrity, fraud and corruption 74 SD 5.1.4 Financial Management Compliance attestation 74 SD 5.2.3 Declaration in Report of Operations 42
Monash Health Annual Report. 2019-20 88 Our supporters
Thank you to our supporters
• 13CABS • Estate of the late Martin • Pfi zer Australia Pty Ltd • 65k for Cystic Fybrosis and Isabel McLoughlin • Pyjama Fun Run • Andrew and Patsy Pinxt • Estate of the late Mary MacGregor • Redkite • Anthea Kane • Estate of the late Michael Barr • Rhinomed • Australasian College for • Estate of the late Phyliss • Richard Lim Emergency Medicine Nerelle Turner • Ricky Taylor Foundation • Australian Communities Foundation • Estate of the late Vasiliki Gidis • Rita Murgana • Australian Philanthropic • Estate of the late Werge Batters • Rotary Club of Bentleigh Services Foundation • Estate of the late William and Mary Moorabbin Central • Avant Insurance Limited Ievers & Sons Maintenance Fund • Rotary Club of Emerald District • Bailey’s Day • Estate of the late William Macrow • Rotary Club of Mount Waverley • BankVic • Estate of the late William Marshall • Schacht Family • Bauer Media Pty Ltd • Field & Hall Contractors Pty Ltd • Scleroderma Victoria Inc. • B Kunz • Fisher & Paykel • SomnoMed • Bentleigh RSL • Freemasons Foundation Victoria • Stephen Nethercote • Berwick Montuna Ladies Golf Club • Friends of the Children Foundation • Supertee • Berwick Opportunity Shop • Healesville Football & Netball Clubs • Symbion Hospital Services • Biggest Playdate • Hesta Superfund • Taing Family • Brainlab Australia Pty Ltd • Horne Family • Tan Hung Supermarket • Brightest Star • Hospital Promotions Victoria • Te Investment Family Trust • Bunnings Warehouse Keysborough • Hudson Institute of Medical Research • Team Plastics • Camp Quality • Humpty Dumpty Foundation • The Biggest Playdate • Casey Fields Woodworkers • J K Mortgage Consultancy Pty Ltd • The Country Women’s Association Group - Lifestyle Communities • Jack Nguyen MA • The Garnett Passe and Rodney • Cathy Fraser • Jeannette Ting Williams Memorial Foundation • Children’s Cancer Foundation • KARL STORZ Endoscopy • The Knit Studio • Child’s Play Charity Australia Pty Ltd • The Public Brewery • Collier Charitable Fund • Kim Minett • The Teo Chew Chinese • CPAP Victoria • Lifestyle Communities Association of Vic • Curing Homesickness • Lim Mey Investments Pty Ltd • The Walk for Monash • Cystic Fibrosis Community Care • Lim’s Pharmacy Children’s Hospital • Dandelion Wishes Gala • Lions Club of Moorabbin Inc • The Walt Disney Company • Delight Solar Pty Ltd • L’Oreal Australia • Tien Le • Dr M Murname AM • Lorraine Lea Simply Home • Tran Tan Pty Ltd • Dry July Foundation • M and H Packaging Pl • Triple A Global Group • Eliza and James Hoppe • Macari Consulting Pty Ltd • Triston’s Headshave • Estate of the late Abner Del Castillo • Mallinckrodt Pharmaceuticals • Turner Institute for Brain • Estate of the late Amelia Batten • Matthew Sutcliffe and Mental Health • Estate of the late Arthur • Max and Judith Bennetts • Van Dan Nguyen (Thi Diep Liem) Lindhurst Blannin • Maxxia • Victoria Police Blue Ribbon • Estate of the late Charlotte Marshall • McGrath Foundation Ltd Foundation Inc • Estate of the late Digby Looker • Medical Indemnity Protection • Watpac Construction Pty Ltd • Estate of the late EC Blackwood Society (MIPS) • Westall Free Range Charcoal • Estate of the late Gregory • Medical.com.au Chicken Joseph and Zig Dickson Trust • Medtronic Australasia Pty Ltd • Winc Australia Pty Ltd • Estate of the late Heather Sybil Smith • Megan Paterson • Yan Wo Tong Chinese • Estate of the late James • Melbourne Gujarati Mahila Medicine Centre McConnell Kerr Satsang Group • Zee Cheng Khor • Estate of the late John • Michael and Nereda Hanion Frederick Wright • Michael Lo • Estate of the late John Lambrick • MIGA • Estate of the late Lindsay • Monash Cystic Fibrosis Foundation James Baldy • Monash Kids Support Group • Estate of the late Lois Srepacholis • Mutual Trust Foundation • Estate of the late Louise • My Room and Lesley Nelken • Nine News • Estate of the late Marlee Viero • Novartis Pharmaceuticals Pty Ltd
Monash Health Annual Report. 2019-20 89 Financial Statements
0x
Financial Statements 2019-2020
Monash Health Annual Report. 2019-20 90 Contents
Board member’s, accountable officer’s 92 Note 5.2 Inventories 121 and chief finance & accounting Note 5.3 Payables 121 officer’s declaration Note 5.4 Other liabilities 123 Independent Auditor’s Report 94 Note 6 How we finance our operations 124 Comprehensive Operating Statement 96 Note 6.1 Borrowings 124 Balance Sheet as at 30 June 2020 97 Note 6.2 Cash and cash equivalents 127 Statement of Changes in Equity 98 Note 6.3 Commitments for expenditure 128 XxxxCash Flow Statement xxxx99 Note 7 xxxRisks, contingencies and valuationx 131 uncertainties Notes to the Financial Statements 100 Note 7.1 Financial instruments 131 Basis of preparation Note 8 Other disclosures 135 xxxxxxxxNote 1 Summary of Significant Accounting 100 Notexxxx 8.1 Reconciliation of net result for the 135 Policies year to net cash inflow / (outflow) from operating activities Note 2 Funding delivery of our services 101 Note 8.2 Responsible persons disclosures 136 Note 2.1 Income from transactions 101 xxxxxx xxxxNote 8.3 Remuneration of executives 137 Note 3 The cost of delivering our services 103 Note 8.4 Related parties 138 Note 3.1 Expenses from transactions 104 Note 8.5 Remuneration of auditors 139 Note 3.2 Other economic flows 105 Note 8.6 Events occurring after the balance 140 Note 3.3 Analysis of expense and revenue by 106 sheet date internally managed and restricted specific purpose funds Note 8.7 Controlled entities 140 Note 3.4 Specific expenses 107 Note 8.8 Investments accounted for using 140 the equity method Note 3.5 Employee benefits in the balance 108 sheet Note 8.9 Economic dependency 141 Note 3.6 Superannuation 109 Note 8.10 Changes in accounting policy 142 Note 4 Key assets to support service 110 Note 8.11 AASBs Issued that are not yet 143 delivery Effective
Note 4.1 Property, plant and equipment 110 Note 8.12 Glossary of terms and style 144 conventions Note 4.2 Intangible assets 117 Note 4.3 Depreciation and amortisation 118 Note 5 Other assets and liabilities 119 Note 5.1 Receivables 119
How this report is structured Monash Health has presented its audited general purpose financial statements for the financial year ended 30 June 2019 in the following structure to provide users with the information about Monash Health’s stewardship of resources entrusted to it.
Monash Health AnnualFinancial Report. Statements 2019-20 91 Financial Statements
Board member’s, accountaable officer’s and chief finance & accounting officer’s declaration
Financial Year ended 30 June 2020 Board Member’s, Accountable Offi cer’s and Chief Financial and Accounting Offi cer’s declaration.
he attached fi nancial statements balance sheet, statement of changes for Monash Health and its in equity, cash fl ow statement and T consolidated entity have been accompanying notes presents fairly the prepared in accordance with Direction fi nancial transactions during the year 5.2 of the Standing Directions of the ended 30 June 2020, and the fi nancial position of Monash Health and its Assistant Treasurer under the Financial consolidated entity at 30 June 2020. Management Act 1994, applicable At the time of signing, we are Financial Reporting Directions, Australian not aware of any circumstance Accounting Standards including which would render any particulars Interpretations, and other mandatory included in the fi nancial statements professional reporting requirements. to be misleading or inaccurate. We further state that, in our We authorise the attached opinion, the information set out in the fi nancial statements for issue comprehensive operating statement, on 11 September, 2020.
Dipak Sanghvi Andrew Stripp Stuart Donaldson Chair, Board of Directors Chief Executive Chief Financial Offi cer Melbourne Melbourne Melbourne
11 September 2020 11 September 2020 11 September 2020
Monash Health Annual Report. 2019-20 92 Chief Financial Offi cer’s Summary The 2019-2020 fi nancial year was substantially impacted by the COVID-19 global pandemic from March 2020 onwards, but prior to that saw continued growth in demand for services across Monash Health
he key fi nancial performance specifi c items, was a surplus of Inlier Equivalent Separations) increased measure monitored by Monash $51.4 million in 2019–2020 compared by 3.4 percent over the previous year. THealth management and the to a surplus of $345.0 million in Monash Health’s operating cash Department of Health & Human Services 2018-2019. Included in the 2019- as at 30 June 2020 was $487.9 is the ‘Net Result Before Capital and 2020 ‘Comprehensive Result’ was million compared with $97.6 Specifi c Items’ and in 2019-2020 Monash the Revaluation of Land increment million as at 30 June 2019. Health achieved a surplus result of $0.44 of $25.5m compared to a Land & The reason for the increase in cash million compared with the reported defi cit Buildings increment of $349.0 million holding was mainly attributable to result of $10.69 million in 2018-2019. in 2018-19 from the Valuer General $259.6m provided by the Department In addition to the usual health Victoria independent assessment. of Health and Human Services to funding provided by the Department of Total revenue from operations for purchase and supply COVID-19 Health & Human Services, additional the 2019-2020 fi nancial year was products to Victorian Health Services funding was provided for the impact $2,113.3 million which is an increase across the state and additional of Covid19 on Monash Health for the of $177.8 million or 9.1 per cent advanced funding for Monash Health period March 2020 to June 2020. compared with the previous year. to deal with the COVID-19 pandemic Monash Health’s ‘Comprehensive Despite the overall increase in revenue; into the 2020/21 fi nancial year. Result’, which includes capital and our main measure of activity (Weighted
Stuart Donaldson Chief Financial Offi cer Melbourne
11 September 2020
Financial Statements 93 Financial Statements
Independent Auditor’s Report Independent Auditor’s Report
Monash Health Annual Report. 2019-20 94 For the Financial Year Ended 30 June 2020
Financial Statements 95 Financial Statements
Comprehensive Operating Statement Comprehensive Operating Statement For the Financial Year Ended 30 June 2020 Consolidated Consolidated 2020 2019 Income from Transactions Note $'000 $'000 Operating Activities 2.1 2,293,826 2,062,805
Non-operating Activities 2.1 2,055 3,447
Total Income from Transactions 2,295,881 2,066,252
Expenses from Transactions Employee Expenses 3.1 -1,652,844 -1,510,534
Supplies and consumables 3.1 -301,592 -290,975
Finance costs 3.1 -7,984 -4,908
PPE Operating expenses 3.1 -9,315
Other Operating Expenses 3.1 -157,553 -148,042
Other Non-operating Expenses 3.1 -10,060 -18,926
Depreciation and Amortisation 3.1, 4.3 -118,846 -73,129
Total Expenses from Transactions -2,258,195 -2,046,514
Net Result from Transactions - Net Operating Balance 37,687 19,740
Other Economic Flows included in Net Result Losses from Other Economic Flows 3.2 -11,904 -24,820
Total Other Economic Flows included in Net Result -11,904 -24,820
Net Result for the year 25,782 -5,080
Other Comprehensive Income
Items that will not be reclassifi ed to Net Result Changes in Property, Plant and Equipment Revaluation Surplus 4.1(b) 25,551 349,623
Total Other Comprehensive Income 25,551 349,623
Comprehensive result for the year 51,333 344,543
This statement should be read in conjunction with the accompanying notes.
Monash Health Annual Report. 2019-20 96 Balance Sheet as at 30 June 2020 Balance Sheet As at 30 June 2020 Consolidated Consolidated 2020 2019 Current Assets Note $'000 $'000 Cash and Cash Equivalents 6.2 501,059 111,749
Receivables 5.1 55,082 66,987
Inventories 5.2 24,956 18,528
Other Financial Assets 4,673 4,595
Total Current Assets 585,770 201,859
Non-Current Assets Receivables 5.1 125,978 113,467
Investments using the equity method 8.8 4,246 4,129
Property, Plant and Equipment 4.1(a) 1,954,329 1,868,135
Intangible Assets 4.2 83,709 64,657
Total Non-Current Assets 2,168,262 2,050,388
Total Assets 2,754,032 2,252,247
Current Liabilities Payables 5.3 248,208 126,946
Borrowings 6.1 64,546 8,602
Provisions 3.5 378,301 335,292
Other Liabilities 5.4 207,909 27,052
Total Current Liabilities 898,963 497,892
Non-Current Liabilities Borrowings 6.1 127,931 98,525
Provisions 3.5 92,155 80,719
Total Non-Current Liabilities 220,086 179,244
Total liabilities 1,119,049 677,136
Net assets 1,634,980 1,575,113
Equity Property, Plant and Equipment Revaluation Surplus 4.1(f) 1,051,719 1,026,168
Restricted Specifi c Purpose Surplus 26,412 23,901
Contributed Capital 413,064 404,530
Accumulated Surpluses 143,786 120,514
Total equity 1,634,980 1,575,113
This statement should be read in conjunction with the accompanying notes.
Financial Statements 97 Financial Statements
Statement of Changes in Equity Statement of Changes in Equity For the Financial Year Ended 30 June 2020
Property, Plant Restricted and Equipment Specifi c Revaluation Purpose Contributed Accumulated Surplus Surplus Capital Surpluses Total Consolidated Note $’000 $’000 $’000 $’000 $’000 Balance at 30 June 2018 676,545 20,715 403,920 127,978 1,229,158
Net result for the year - - - -5,080 -5,080
Other comprehensive income for the year 4.1(f) 349,623 - - - 349,623
Opening balance adjustment on adoption of AASB 9 - - - 802 802
Transfer (from)/to accumulated surpluses - 3,186 - -3,186 -
Contributed capital - - 610 - 610
Balance at 30 June 2019 1,026,168 23,901 404,530 120,514 1,575,113
Effect of adoption of AASB 15, 16 and 1058 8.10 - - - - -
Net result for the year - - - 25,782 25,782
Other comprehensive income for the year 4.1(f) 25,551 - - - 25,551
Transfer (from)/to accumulated surpluses - 2,511 - -2,511 -
Contributed capital - - 8,533 - 8,533
Balance at 30 June 2020 1,051,718 26,412 413,064 143,786 1,634,980
This statement should be read in conjunction with the accompanying notes.
Monash Health Annual Report. 2019-20 98 Cash Flow Statement Cash Flow Statement For the Financial Year Ended 30 June 2020 Consolidated Consolidated 2020 2019 Cash Flows from Operating Activities Note $'000 $'000 Operating Grants from Government - State 2,647,745 1,515,885
Operating Grants from Government - Commonwealth 126,979 120,885
Capital Grants from Government 52,145 72,210
Commercial Activities, Patient and Hospital Fees Received 170,047 187,823
Donations and Bequests Received 3,466 4,626
GST Received from/(paid to) ATO 67,879 38,392
Interest and Investment Income Received 2,055 3,447
Other Receipts 113,797 92,778
Total Receipts 3,184,112 2,036,046
Employee Expenses Paid -1,623,471 -1,484,541
Payments for Supplies and Consumables -969,353 -315,155
Finance Costs -2,585 -5,165
Cash outfl ow for leases -3,194 -
Other Payment -163,870 -177,627
Total Payments -2,762,473 -1,982,487
Net Cash Flows from Operating Activities 8.1 421,639 53,558
Cash Flows from Investing Activities Purchase of Intangible Assets, Property, Plant and Equipment -87,563 -96,480
Net Cash Flows used in Investing Activities -87,563 -96,480
Cash Flows from Financing Activities Contributed Capital 8,533 -
Cash Advance from DHHS 52,240 -
Repayment of Borrowings -4,418 -5,380
Receipt of Accommodation Deposits 4,322 3,634
Repayment of Accommodation Deposits -5,442 -4,516
Net Cash Flows used in Financing Activities 55,235 -6,262
Net Increase / (Deacrease) in Cash and Cash Equivalents Held 389,314 -49,183 Cash and Cash Equivalents at Beginning of Year 111,749 160,932
Cash and Cash Equivalents at End of Year 6.2 501,059 111,749
This statement should be read in conjunction with the accompanying notes.
Financial Statements 99 Financial Statements Notes to the Financial Statements Notes to the Financial Statements For the Financial Year Ended 30 June 2020
Basis of preparation purpose fi nancial statements which Monash Health operates on a fund These fi nancial statements are in have been prepared in accordance accounting basis and maintains three Australian dollars and the historical cost with the Financial Management Act funds: Operating, Specifi c Purpose convention is used unless a different 1994 and applicable AASBs, which and Capital Funds. Monash Health’s measurement basis is specifi cally include interpretations issued by the Capital and Specifi c Purpose Funds disclosed in the note associated with Australian Accounting Standards Board include unspent donations and receipts the item measured on a different basis. (AASB). They are presented in a manner from fundraising activities conducted The accrual basis of accounting consistent with the requirements of AASB solely in respect of these funds. has been applied in preparing these 101 Presentation of Financial Statements. The fi nancial statements, except fi nancial statements, whereby assets, The fi nancial statements also comply for cash fl ow information, have been liabilities, equity, income and expenses with relevant Financial Reporting prepared using the accrual basis of are recognised in the reporting period Directions (FRDs) issued by the accounting. Under the accrual basis, to which they relate, regardless of Department of Treasury and Finance, items are recognised as assets, when cash is received or paid. and relevant Standing Directions (SDs) liabilities, equity, income or expenses authorised by the Assistant Treasurer. when they satisfy the defi nitions and Impact of COVID-19 Monash Health is a not-for-profi t recognition criteria for those items, that A state of emergency was declared in entity and therefore applies the additional is, they are recognised in the reporting Victoria on 16 March 2020 due to the AUS paragraphs applicable to ‘not-for- period to which they relate, regardless global coronavirus pandemic, known profi t’ Health Service under the AASBs. of when cash is received or paid. as COVID-19. A state of disaster was Judgements, estimates and subsequently declared on 2 August 2020. (b) Reporting Entity assumptions are required to be made To contain the spread of the virus and The fi nancial statements include all the about the carrying values of assets and to prioritise the health and safety of our controlled activities of Monash Health. liabilities that are not readily apparent communities various restrictions have Its principal address is: from other sources. The estimates and been announced and implemented by 246 Clayton Road underlying assumptions are reviewed the state government, which in turn has Clayton, Victoria 3168 on an ongoing basis. The estimates and impacted the manner in which businesses associated assumptions are based on operate, including Monash Health. A description of the nature of Monash professional judgements derived from In response, Monash Health placed Health’s operations and its principal historical experience and various other restrictions on non-essential visitors, activities is included in the report factors that are believed to be reasonable implemented reduced visitor hours, of operations, which does not form under the circumstances. Actual results deferred elective surgery and reduced part of these fi nancial statements. may differ from these estimates. activity, performed COVID-19 testing Revisions to accounting estimates and implemented work from home (c) Basis of Accounting are recognised in the period in arrangements where appropriate. Preparation and Measurement which the estimate is revised and In addition, Monash Health has Accounting policies are selected and in future periods that are affected entered an agreement with Department applied in a manner which ensures by the revision. Judgements and of Health and Human Services (DHHS) that the resulting fi nancial information assumptions made by management to act as an agent for the department satisfi es the concepts of relevance in the application of AASBs that have Notein paying, 1: Summary warehousing, of Significant and distributing Accounting Policiesand reliability, thereby ensuring that signifi cant effects on the fi nancial products and equipment for Victorian the substance of the underlying statements and estimates relate to: public health services and other entities transactions or other events is reported. during the COVID-19 pandemic. The accounting policies have been • The fair value of land, buildings and For further details refer to Note 2.1 applied in preparing the fi nancial plant and equipment (refer to Note Funding delivery of our services and Note statements for the year ended 30 June 4.1 Property, Plant and Equipment); 4.1 Property, plant and equipment. 2020, and the comparative information presented in these fi nancial statements • Employee benefi t provisions Note 1: Summary of for the year ended 30 June 2019. are based on likely tenure of Signifi cant Accounting Policies The fi nancial statements are prepared existing employees, patterns These annual fi nancial statements on a going concern basis (refer to of leave claims, future salary represent the audited general-purpose Note 8.9 Economic Dependency). movements and future discount fi nancial statements for Monash These fi nancial statements are rates (refer to Note 3.5 Employee Health and its controlled entities for presented in Australian dollars, the Benefi ts in the Balance Sheet). the year ended 30 June 2020. The functional and presentation currency of report provides users with information Monash Health. All amounts shown in the Goods and Services Tax (GST) about Monash Health’s stewardship fi nancial statements have been rounded Income, expenses and assets are of resources entrusted to it. to the nearest thousand dollars, unless recognised net of the amount of otherwise stated. Minor discrepancies associated GST, unless the GST (a) Statement of Compliance in tables between totals and sum of incurred is not recoverable from the These fi nancial statements are general components are due to rounding. Australian Taxation Offi ce (ATO). In this
Monash Health Annual Report. 2019-20 100 case the GST payable is recognised listed in Note 8.7 Controlled Entities. Transfers of net liabilities arising as part of the cost of acquisition of The parent entity is not shown from administrative restructurings are the asset or as part of the expense. separately in the notes. treated as distributions to owners. Receivables and payables are stated Where control of an entity is obtained Other transfers that are in the nature of inclusive of the amount of GST receivable during the fi nancial period, its results contributions or distributions or that have or payable. The net amount of GST are included in the Comprehensive been designated as contributed capital recoverable from, or payable to, the Operating Statement from the date are also treated as contributed capital. ATO is included with other receivables on which control commenced. Where or payables in the Balance Sheet. control ceases during a fi nancial period, Specifi c Restricted Purpose Surplus Cash fl ows are presented on a the entity’s results are included for The Specifi c Restricted Purpose gross basis. The GST components of that part of the period in which control Surplus is established where Monash cash fl ows arising from investing or existed. Where entities adopt dissimilar Health has possession or title to the fi nancing activities which are recoverable accounting policies and their effect is funds but has no discretion to amend from, or payable to the ATO, are considered material, adjustments are or vary the restriction and/or condition presented as operating cash fl ow. made to ensure consistent policies are underlying the funds received. Commitments and contingent adopted in these fi nancial statements. assets and liabilities are (f) Comparatives presented on a gross basis. Intersegment Transactions Where applicable, the comparative Transactions between segments within fi gures have been restated to align with (d) Principles of Consolidation Monash Health have been eliminated the presentation in the current year. These statements are presented on to refl ect the extent of Monash Figures have been restated at Notes 2.1. a consolidated basis in accordance Health’s operations as a group. with AASB 10 Consolidated Note 2: Funding delivery Financial Statements. (e) Equity of our services NoteThe 2: consolidatedFunding delivery fi nancial of our services Monash Health’s overall objective statements of Monash Health includes Contributed Capital is to deliver programs and services all reporting entities controlled by Consistent with the requirements of that support and enhance the Monash Health as at 30 June 2020. AASB 1004 Contributions, contributions wellbeing of its patients. Control exists when Monash Health by owners (that is, contributed capital Monash Health is predominantly has the power to govern the fi nancial and and its repayment) are treated as funded by accrual-based grant operating policies of an organisation so equity transactions and, therefore, funding for the provision of as to obtain benefi ts from its activities. In do not form part of the income and outputs and also receives income assessing control, potential voting rights expenses of Monash Health. from the supply of services. that presently are exercisable are taken Transfers of net assets arising into account. The consolidated fi nancial from administrative restructurings Structure statements include the audited fi nancial are treated as distributions to or • 2.1 Income from Transactions statements of the controlled entities contributions by owners. Note 2.1: Income from Transactions
Note 2.1: Income from Transactions Consolidated Consolidated 2020 2019 $'000 $'000 Government grants (State) - Operatingi 1,741,108 1,531,397 Government grants (Commonwealth) - Operating 126,979 120,885 Government grants (State) - Capital 139,903 119,021 Other Capital purpose income 38,112 6,243 Capital Donations 5,224 2,079 Patient and Resident Fees 36,597 51,078 Private Practice Fees 10,140 11,085 Commercial Activitiesii 121,837 131,935 Assets received free of charge 3,539 - Other Revenue from Operating Activities 70,388 89,082 Total Income from Operating Activities 2,293,826 2,062,805 Other Interest 2,055 3,447 Total Income from Non-Operating Activities 2,055 3,447 Total Income from Transactions 2,295,881 2,066,252
i. Government Grant (State) – Operating includes funding of $116.02m which was spent due to the impacts of COVID-19. ii. Commercial activities represent business activities which Monash Health enters into to support its operations.
Financial Statements 101 Financial Statements
Impact of COVID-19 on whereas grant revenue in relation to the approximately equal value in return. While revenue and income construction of capital assets which grants may result in the provision of some As indicated at Note 1, Monash Health the health service controls has been goods or services to the transferring response to the pandemic included the recognised in accordance with AASB party, they do not provide a claim to deferral of elective surgeries and reduced 1058 and recognised as deferred receive benefi ts directly of approximately activity. The Department of Health and grant revenue (refer note 5.3). equal value (and are termed ‘non- Human Services provided funding to If the grant revenue was accounted reciprocal’ transfers). Receipt and compensate for the lost revenue with for under the previous accounting sacrifi ce of approximately equal value certain direct and indirect COVID-19 standard AASB 1004 in 2018-19, the may occur, but only by coincidence. costs also reimbursed. Monash Health total grant revenue received would Some grants are reciprocal in also received essential personal have been recognised in full. nature (i.e. equal value is given back protective equipment free of charge by the recipient of the grant to the under the state supply arrangement. Performance obligations provider). Monash Health Service The types of government grants recognises income when it has Government Grants recognised under AASB 15 Revenue from satisfi ed its performance obligations Income from grants to construct a project Contracts with Customers includes: under the terms of the grant. is recognised when (or as) Monash For non-reciprocal grants, Monash Health satisfi es its obligations under • Activity Based Funding (ABF) Health Service recognises revenue the transfer. This aligns with Monash paid as Weighted Inlier Equivalent when the grant is received. Health’s obligation to construct the Separation casemix Grants can be received as general asset. The progressive percentage costs purpose grants, which refers to grants incurred is used to recognise income • National Weighted Activity which are not subject to conditions because this most closely refl ects the Unit (NWAU) funding regarding their use. Alternatively, they construction’s progress as costs are may be received as specifi c purpose incurred as the works are done. • other one-off grants if funding grants, which are paid for a particular Income from grants that are conditions contain enforceable purpose and/or have conditions enforceable and with suffi ciently specifi c and suffi ciently specifi c attached regarding their use. performance obligations are accounted performance obligations. for under AASB 15 as revenue from contracts with customers, with revenue The performance obligations for ABF Non-cash contributions from recognised as these performance and WIES revenue is recognised as the the Department of Health obligations are met. Income from number and mix of patients admitted and Human Services grants without any suffi ciently specifi c to hospital (casemix) in accordance The Department of Health and Human performance obligations, or that are not with levels of activity agreed to Services makes certain payments enforceable, is recognised when Monash with the Department of Health and on behalf of Monash Health. These Health has an unconditional right to Human Services (DHHS) in the annual amounts have been brought to account receive the cash which usually coincides Statement of Priorities (SoP). Revenue as grants in determining the operating with receipt of cash. On initial recognition is recognised in accordance with the result for the year by recording them of the asset, Monash Health Service WIES activity for each separation. The as revenue. These payments include: recognises any related contributions by performance obligations have been owners, increases in liabilities, decreases selected as they align with funding • The Victorian Managed Insurance in assets, and revenue in accordance with conditions set out in the Policy and Authority non-medical indemnity other Australian Accounting Standards. funding guidelines issued by the DHHS. insurance payments are Related amounts may take the form of: NWAU revenue is recognised as recognised as revenue following levels of NWAU are satisfi ed and advice from the Department of a) contributions by owners, in completed inaccordance with levels of Health and Human Services accordance with AASB 1004; activity agreed to with the Department b) revenue or a contract liability arising of Health and Human Services (DHHS) • Long Service Leave (LSL) revenue from a contract with a customer, in the annual Statement of Priorities is recognised upon fi nalisation in accordance with AASB 15; (SoP). The performance obligations have of movements in LSL liability in c) a lease liability in accordance been selected as they align with funding line with the long service leave with AASB 16; conditions set out in the Policy and funding arrangements set out in the d) a fi nancial instrument, in funding guidelines issued by the DHHS. relevant Department of Health and accordance with AASB 9; or For other grants with performance Human Services Hospital Circular e) a provision, in accordance with obligations Monash Health exercises AASB 137 Provisions, Contingent judgement over whether the • Public Private Partnership (PPP) Liabilities and Contingent Assets. performance obligations have been lease and service payments are met, on a grant by grant basis. paid directly to the PPP consortium. As a result of the transitional impacts Revenue and the matching expense of adopting AASB 15 and AASB 1058, Previous accounting policy are recognised in accordance a portion of the grant revenue has for 30 June 2019 with the nature and timing of been deferred. If the grant income is Grant income arises from transactions the monthly or quarterly service accounted for in accordance with AASB in which a party provides goods or payments made by the Department 15, the deferred grant revenue has assets (or extinguishes a liability) to of Health and Human Services. been recognised in contract liabilities Monash Health Service without receiving
Monash Health Annual Report. 2019-20 102 Performance obligations and have been selected as they align with property,facilities or services. These revenue recognition policies the terms and conditions of the performance obligations have been Revenue is measured based on providing services. Revenue is recognised selected as they align with the terms the consideration specifi ed in the as these performance obligations are and conditions per the contract with the contract with the customer. Monash met which is at the point in time provider of the commercial activities. Health recognises revenue when when the services are provided. Revenue is recognised at the time the it transfers control of a good or Resident fees are recognised usage or service is provided. The types service to the customer i.e. revenue as revenue over time as Monash of revenue include car park revenue, is recognised when, or as, the Health provides accommodation. property rental income and commercial performance obligations for the services laboratory medicine revenue. to the customer are satisfi ed. Private Practice Fees The performance obligations related Other Income • Revenue from the rendering of to Private Practice Fees are the Other income includes recoveries for services is recognised at a point providing of Medical procedures and salaries and wages, non-property in time when the performance services. These performance obligations rental, external services provided, and obligation is satisfi ed when the have been selected as they align with donations and bequests. If donations service is completed; and over time the terms and conditions agreed are for a specifi c purpose, they may be when the customer simultaneously with the private provider. Revenue is appropriated to a surplus, such as the receives and consumes the recognised at the time the services are specifi c restricted purpose surplus. services as it is provided. provided and include recoupments from the private practice for the Interest Income Patient and Resident Fees use of hospital facilities. Interest revenue is recognised on a The performance obligations related time proportionate basis that takes to Patient fees revenue are the Commercial Activities into account the effective yield of providing of Medical procedures and The performance obligations related the fi nancial asset, which allocates services. These performance obligations to commercial activities are the use of interest over the relevant period.
Note 2.1(b): Fair value of assets and services received free of charge or for nominal consideration
Note 2.1(b) Fair value of assets and services received 2020 2019 free of charge or for nominal consideration $’000 $’000 Assets received free of charge under State supply arrangements 3,539 -
Total fair value of assets and services received free of charge or for nominal consideration 3,539 -
In order to meet the State of Victoria’s or conditions are imposed over Structure health network supply needs during the the use of the contributions. COVID-19 pandemic, arrangements The exception to this would be • 3.1 Expenses from Transactions were put in place to centralise the when the resource is received from purchasing of essential personal another government department • 3.2 Other Economic Flows protective equipment and essential (or agency) as a consequence of capital items such as ventilators. a restructuring of administrative • 3.3 Analysis of expenses and The general principles of the State arrangements, in which case such revenue by internally managed and Supply Arrangement were that Health a transfer will be recognised at its’ restricted specifi c purpose funds Purchasing Victoria sourced, secured carrying value in the transferring and agreed terms for the purchase of department or agency as a • 3.4 Specifi c Expenses the products, funded by the department, capital contribution transfer. while Monash Health and the department • 3.5 Employee benefi ts in took delivery, and distributed the Note 3: The cost of the Balance Sheet products to health services as delivering our services resources provided free of charge. This section provides an account of • 3.6 Superannuation Contributions of resources the expenses incurred by the hospital provided free of charge or for nominal in delivering services and outputs. In consideration are recognised at Section 2, the funds that enable the their fair value when the recipient provision of services were disclosed obtains control over the resources, and in this note the cost associated irrespective of whether restrictions with provision of services are recorded.
Financial Statements 103 Financial Statements
Note 3.1: Expenses from Transactions Consolidated Consolidated 2020 2019 Note 3.1: Expenses from Transactions $'000 $'000 Salaries and Wages 1,435,148 1,304,126
On-costs 173,396 169,667
WorkCover Premium 22,036 14,767
Agency Expenses 22,264 21,974
Total Employee Expenses 1,652,844 1,510,534
Drug Supplies 112,444 106,782
Medical and Surgical Supplies (including Prostheses) 132,820 130,106
Diagnostic and Radiology Supplies 22,331 19,204
Other Supplies and Consumables 33,996 34,884
Total Supplies and Consumables 301,592 290,976
Finance Costs 2,585 1,601
Finance Costs - PPP Arrangements 5,399 3,307
Total Finance Costs 7,984 4,908
Public private partnership operating expenses 9,315 7,175
Total PPP Operating Expenses 9,315 7,175
Fuel, Light, Power and Water 20,112 17,681
Repairs and Maintenance 24,459 23,201
Medical Indemnity Insurance 28,470 27,343
Expenses related to short term leases 1,486 -
Expenses related to leases of low value assets 7,330 -
Other Administrative Expenses 75,696 79,817
Total Other Operating Expenses 157,553 148,042
Total Operating Expense 2,129,288 1,961,633
Depreciation and Amortisation (refer Note 4.3) 118,846 73,129
Total Depreciation and Amortisation 118,846 73,129
Expenditure for Capital Purposes 5,166 2,805
Bad and Doubtful Debt Expense 3,845 3,618
Specifi c Expense 1,049 5,328
Total Other Non-Operating Expenses 10,060 11,750
Total Non-Operating Expense 128,907 84,879
Total Expenses from Transactions 2,258,195 2,046,513
Expenses are recognised as they are incurred and reported in the fi nancial year to which they relate.
Monash Health Annual Report. 2019-20 104 Impact of COVID-19 on expenses • Amortisation of discounts or Operating lease payments As indicated at Note 1, Monash Health premiums relating to borrowings; Operating lease payments up until daily activities were impacted by the 30 June 2019 (including contingent pandemic. This resulted in direct and • Finance charges in respect of fi nance rentals) were recognised on a straight indirect costs being incurred, such as leases which are recognised in line basis over the lease term, increased employee expenses, medical accordance with AASB 16 Leases. except where another systematic consumables and cleaning costs. basis is more representative of the Other Operating Expenses time pattern of the benefi ts derived Employee Expenses Other operating expenses generally from the use of the leased asset. Employee expenses include: represent the day-to-day running From 1 July 2019, the following costs incurred in normal operations lease payments are recognised • Salaries and wages (including fringe and include such things as: on a straight-line basis: benefi ts tax, leave entitlements, termination payments); • Fuel, light and power; • Short-term leases – leases with a term less than 12 months; and • On-costs; • Repairs and maintenance; • Low value leases – leases with • Agency expenses; • Other administrative expenses; the underlying asset’s fair value (when new, regardless of the • Fee for service medical • Expenditure for capital purposes age of the asset being leased) offi cer expenses; represents expenditure related to is no more than $10,000. the purchase of assets that are • WorkCover premium. below the capitalisation threshold. Variable lease payments not included in the measurement of the lease liability Supplies and consumables The Department of Health and Human (i.e. variable lease payments that do Supplies and consumables - Supplies Services also makes certain payments on not depend on an index or a rate, and services costs which are behalf of Monash Health. These amounts initially measured using the index or recognised as an expense in the have been brought to account as grants rate as at the commencement date). reporting period in which they are in determining the operating result for These payments are recognised in the incurred. The carrying amounts of the year by recording them as revenue period in which the event or condition any inventories held for distribution and also recording the related expense. that triggers those payments occur. are expensed when distributed. Non-operating expenses Finance costs Other non-operating expenses Finance costs include: generally represent expenditure outside the normal operations such • Interest on long-term borrowings, as depreciation and amortisation, and interest expense is recognised in assets and services provided free of the period in which it is incurred; charge or for nominal consideration.
Note 3.2: Other Economic Flows
Note 3.2: Other Economic Flows Consolidated Consolidated 2020 2019 $’000 $’000 Net gain/(loss) on disposal of property plant and equipment 589 -760
Total net gain/(loss) on non-fi nancial assets 589 -760
Share of net profi ts of associates 117 29
Total Share of other economic fl ows from Joint Operations 117 29
Net loss arising from revaluation of long service liability -12,611 -24,089
Total other losses from other economic fl ows -12,611 -24,089
Total other losses from economic fl ows -11,904 -24,820
Financial Statements 105 Financial Statements
Other economic fl ows are changes in the on disposal of non-fi nancial assets. rate movements and the impact of volume or value of an asset or liability that Any gain or loss on the disposal of changes in probability factors; and do not result from transactions. Other non-fi nancial assets is recognised gains/ (losses) from other economic at the date of disposal. • transfer of amounts from the fl ows include the gains or losses from reserves to accumulated surplus the revaluation of the present value of Other gains/ (losses) from or net result due to disposal or the long service leave liability due to other economic fl ows derecognition or reclassifi cation. changes in the bond interest rates. Other gains/ (losses) include:
Net gain/ (loss) on • the revaluation of the present non-fi nancial assets value of the long service leave Net gain/ (loss) on non-fi nancial assets liability due to changes in the Noteand liabilities 3.3: Analysis includes of expense net gain/ and (loss) revenue by internallybond managedrate movements, and infl ation restricted specific purpose funds
Note 3.3: Analysis of expense and revenue by internally managed and restricted specifi c purpose funds
Expenses Revenue Consolidated Consolidated Consolidated Consolidated 2020 2019 2020 2019 Commercial Activities $’000 $’000 $’000 $’000 Private Practice and Other Patient Activities 2,266 14,984 25,432 24,907
Laboratory Medicine 2,118 2,099 1,767 2,089
Diagnostic Imaging 0 8,558 12,992 12,755
Other Bequests and donations 3,323 1,611 3,598 2,632
Breast screen service 5,288 5,483 6,011 6,442
Cardiology 8,122 8,888 10,613 10,928
Other special purpose funds 8,915 8,552 13,359 12,160
Property 0 0 122
Total Commercial Activities 30,032 50,175 73,772 72,035
Other Activities Fundraising and Community Support -666 43 111 107
Research and Scholarship 12,714 10,158 13,019 10,529
Other 2,744 2,176 2,328 2,173
Total Other Activities 14,792 12,377 15,458 12,809
Total 44,824 62,552 89,230 84,844
Monash Health Annual Report. 2019-20 106 NoteNote 3.4: 3.4: Specific Specifi Expenses c expenses Consolidated Consolidated 2020 2019 $’000 $’000 Prior year adjustment - 3,220
Voluntary Departure Packages 953 1,419
Discount interest expense on fi nancial instruments 96 689
Total Specifi c Expenses 1,049 5,328 Note 3.5: Employee benefits in the balance sheet
Note 3.5: Employee benefi ts in the balance sheet Consolidated Consolidated 2020 2019 Current provisions $’000 $’000 Employee Benefi ts i
Accrued Days Off Unconditional and expected to be settled wholly within 12 months ii 5,356 4,732
Annual leave Unconditional and expected to be settled wholly within 12 months ii 102,314 89,475
Unconditional and expected to be settled wholly after 12 months iii 17,503 15,070
Long Service Leave Unconditional and expected to be settled wholly within 12 months ii 23,822 22,431
Unconditional and expected to be settled wholly after 12 months iii 192,467 170,913
341,462 302,620
Provisions related to Employee Benefi t On-Costs Unconditional and expected to be settled wholly within 12 months ii 13,838 12,298
Unconditional and expected to be settled wholly after 12 months iii 23,001 20,373
36,839 32,671
Total current provisions 378,301 335,292
Non-current provisions Conditional Long Service Leave iii 83,060 72,753
Provisions related to Employee Benefi t On-Costs 9,095 7,966
Total non-current provisions 92,155 80,719
Total provisions 470,456 416,011 i. Employee benefi ts consist of amounts for accrued days off, annual leave and long service leave accrued by employees, not including on-costs. ii. The amounts disclosed are nominal amounts. iii. The amounts disclosed are discounted to present values.
Financial Statements 107 Note 3.5(a): Employee Benefits and Related On-Costs Financial Statements
Note 3.5 (a): Employee Benefi ts and Related On-Costs Consolidated Consolidated 2020 2019 Current Employee Benefi ts and Related On-Costs $’000 $’000 Unconditional long service leave entitlements 239,973 214,515
Annual leave entitlements 132,971 116,045
Accrued days off 5,356 4,732
Non-Current Employee Benefi ts and Related On-Costs Conditional long service leave entitlements 92,155 80,719
Total employee benefi ts and related on-costs 470,456 416,011
Note 3.5(b): Movement in On-Costs Provision Note 3.5 (b): Movement in On-Costs Provision Consolidated Consolidated 2020 2019 $’000 $’000
Balance at start of year 32,671 27,047 Additional provisions recognised 6,881 7,423
Unwinding of discount and effect of changes in the discount rate -253 243
Reduction due to transfer out -2,460 -2,042
Balance at end of year 36,839 32,671
Employee Benefi t Recognition • nominal value – if Monash Conditional LSL is disclosed as a non- Provision is made for benefi ts accruing Health expects to wholly current liability. Any gain or loss following to employees in respect of accrued settle within 12 months; or a revaluation of the present value of days off, annual leave and long service non-current LSL liability is recognised as leave for services rendered to the • present value – if Monash Health a transaction, except to the extent that reporting date as an expense during does not expect to wholly a gain or loss arises due to changes in the period the services are delivered. settle within 12 months. estimations e.g. bond rate movements, infl ation rate movements and changes Provisions Long Service Leave in probability factors which are then Provisions are recognised when Monash The liability for long service leave recognised as other economic fl ows. Health has a present obligation, the (LSL) is recognised in the provision future sacrifi ce of economic benefi ts for employee benefi ts. Termination Benefi ts is probable, and the amount of the Unconditional LSL is disclosed in Termination benefi ts are payable provision can be measured reliably. the notes to the fi nancial statements as when employment is terminated The amount recognised as a a current liability even where Monash before the normal retirement date or liability is the best estimate of the Health does not expect to settle the when an employee decides to accept consideration required to settle the liability within 12 months because it an offer of benefi ts in exchange for present obligation at reporting date, will not have the unconditional right to the termination of employment. taking into account the risks and defer the settlement of the entitlement uncertainties surrounding the obligation. should an employee take leave within On-Costs Related to 12 months. An unconditional right Employee Benefi ts Annual Leave and Accrued Days Off arises after a qualifying period. Provision for on-costs such as workers’ Liabilities for annual leave and accrued The components of this current compensation and superannuation days off are recognised in the provision LSL liability are measured at: are recognised separately from for employee benefi ts as ‘current provisions for employee benefi ts. liabilities’ because Monash Health • nominal value – if Monash does not have an unconditional right to Health expects to wholly defer settlements of these liabilities. settle within 12 months; or Depending on the expectation of the timing of settlement, liabilities • present value – if Monash Health for annual leave and accrued does not expect to wholly days off are measured at: settle within 12 months.
Monash Health Annual Report. 2019-20 108 NoteNote 3.6: 3.6: Superannuation Superannuation Paid Contribution Contribution Outstanding for the Year at Year End Consolidated Consolidated Consolidated Consolidated 2020 2019 2020 2019 Defi ned Benefi t Plans i $’000 $’000 $’000 $’000 State Superannuation Fund 475 469 39 38
First State Super 2,358 2,826 392 223
Unisuper 863 608 188 66
Defi ned Contribution Plans First State Super 47,892 50,921 8,678 4,418
Hesta 45,495 45,906 8,662 4,060
VicSuper and Other 10,654 7,755 2,341 821
Total 107,737 108,485 20,300 9,626
i. The basis for determining the level of contributions is determined by the various actuaries of the defi ned benefi t superannuation plans.
Employees of Monash Health are entitled based on the relevant rules of each plan The name, details and amounts that to receive superannuation benefi ts and it and are based upon actuarial advice. have been expensed in relation to the contributes to both defi ned benefi t and Monash Health does not recognise major employee superannuation funds defi ned contribution plans. The defi ned any unfunded defi ned benefi t liability in and contributions made by Monash benefi t plan provides benefi ts based on respect of the plans because Monash Health Service are disclosed above. years of service and fi nal average salary. Health has no legal or constructive obligation to pay future benefi ts relating Defi ned Contribution Defi ned Benefi t to its employees; its only obligation is Superannuation Plans Superannuation Plans to pay superannuation contributions In relation to defi ned contribution (i.e. The amount charged to the as they fall due. The Department of accumulation) superannuation plans, Comprehensive Operating Statement in Treasury and Finance discloses the the associated expense is simply the respect of defi ned benefi t superannuation State’s defi ned benefi ts liabilities in its employer contributions that are paid or plans represents the contributions made disclosure for administered items. payable in respect of employees who by Monash Health to the superannuation However superannuation contributions are members of these plans during plans in respect of the services of paid or payable for the reporting period the reporting period. Contributions to current Monash Health’s staff during are included as part of employee defi ned contribution superannuation the reporting period. Superannuation benefi ts in the Comprehensive Operating plans are expensed when incurred. contributions are made to the plans Statement of Monash Health.
Financial Statements 109 Financial Statements
Note 4: Key Assets to support service delivery at the lease commencement date. The expense in net result, the increment is right-of-use asset is initially measured at recognised as income in the net result. Monash Health controls infrastructure cost which comprises the initial amount Revaluation decrements are and other investments that are of the lease liability adjusted for: recognised in ‘Other Comprehensive utilised in fulfi lling its objectives and Income’ to the extent that a credit conducting its activities. They represent • any lease payments made at or balance exists in the asset revaluation the key resources that have been before the commencement date; plus surplus in respect of the same class entrusted to Monash Health to be of property, plant and equipment. utilised for delivery of those outputs. • any initial direct costs incurred; and Revaluation increases and revaluation decreases relating to Structure • an estimate of costs to dismantle individual assets within an asset class and remove the underlying asset are offset against one another within • 4.1 Property, plant & equipment or to restore the underlying asset that class but are not offset in respect or the site on which it is located, of assets in different classes. • 4.2 Intangible assets less any lease incentive received. Revaluation surplus is not transferred to accumulated funds • 4.3 Depreciation and amortisation Right-of-use asset – on de-recognition of the relevant Subsequent measurement asset, except where an asset is Note 4.1: Property, Monash Health Service depreciates the transferred via contributed capital. plant and equipment right-of-use assets on a straight line In accordance with FRD 103H, Note 4.1: Property plant and equipment basis from the lease commencement Monash Health’s non-current physical Initial Recognition date to the earlier of the end of the assets were assessed to determine Items of property, plant and equipment useful life of the right-of-use asset or the whether a revaluation of the non- are measured initially at cost and end of the lease term. The estimated current physical assets was required. subsequently revalued at fair value useful life of the right-of-use assets less accumulated depreciation and are determined on the same basis as Fair value measurement impairment loss. Where an asset is property, plant and equipment, other Fair value is the price that would acquired for no or nominal cost, the than where the lease term is lower than be received to sell an asset or paid cost is its fair value at the date of the otherwise assigned useful life. The to transfer a liability in an orderly acquisition. Assets transferred as part of right-of-use assets are also subject to transaction between market participants a change in government departments are revaluation as required by FRD 103H, at the measurement date. transferred at their carrying amounts. however as at 30 June 2020 right-of- For the purpose of fair value The cost of a leasehold improvement use assets have not been revalued. disclosures, Monash Health has is capitalised as an asset and depreciated In addition, the right-of-use asset determined classes of assets on the over the shorter of the remaining is periodically reduced by impairment basis of the nature, characteristics and term of the lease or the estimated losses, if any and adjusted for certain risks of the asset and the level of the useful life of the improvements. remeasurements of the lease liability. fair value hierarchy. In addition, Monash The initial cost for non-fi nancial Health determines whether transfers have physical assets under fi nance lease (refer Revaluations of Non- occurred between levels in the hierarchy to Note 6.1) is measured at amounts Current Physical Assets by reassessing categorisation (based on equal to the fair value of the leased Non-current physical assets are the lowest level input that is signifi cant to asset or, if lower, the present value of measured at fair value and are the fair value measurement as a whole) the minimum lease payments, each revalued in accordance with FRD 103H at the end of each reporting period. determined at the inception of the lease. Non- Current Physical Assets. This The Valuer-General Victoria Theoretical opportunities that may revaluation process normally occurs (VGV) is Monash Health’s be available in relation to the assets every fi ve years, based upon the asset’s independent valuation agency. are not taken into account until it is Government Purpose Classifi cation, The estimates and underlying virtually certain that any restrictions but may occur more frequently if fair assumptions are reviewed will no longer apply. Therefore, unless value assessments indicate material on an ongoing basis. otherwise disclosed, the current use changes in values. Independent valuers of these non-fi nancial physical assets are used to conduct these scheduled will be their highest and best uses. revaluations and any interim revaluations Land and buildings are are determined in accordance with recognised initially at cost and the requirements of the FRDs. subsequently measured at fair value Revaluation increments or decrements less accumulated depreciation and arise from differences between an accumulated impairment loss. asset’s carrying value and fair value. Revaluation increments are recognised Right-of-use asset acquired in ‘Other Comprehensive Income’ and are by lessees (Under AASB 16 credited directly to the asset revaluation – Leases from 1 July 2019) surplus, except that, to the extent that – Initial measurement an increment reverses a revaluation Monash Health Service recognises a decrement in respect of that same class right-of-use asset and a lease liability of asset previously recognised as an
Monash Health Annual Report. 2019-20 110 Valuation hierarchy Non-Specialised Land and measurement, and takes into account the In determining fair values a number of Non- Specialised Buildings use of the asset that is physically possible, inputs are used. To increase consistency Non-specialised land and non-specialised legally permissible and fi nancially feasible. and comparability in the fi nancial buildings are valued using the market As adjustments of CSO are considered as statements, these inputs are categorised approach. Under this valuation method, signifi cant unobservable inputs, specialised into three levels, also known as the fair the assets are compared to recent land would be classifi ed as Level 3 assets. value hierarchy. The levels are as follows: comparable sales or sales of comparable For Monash Health, the depreciated assets which are considered to have replacement cost method is used for the • Level 1 – quoted (unadjusted) nominal or no added improvement value. majority of specialised buildings, adjusting market prices in active markets For non-specialised land and for the associated depreciation. As for identical assets or liabilities; nonspecialised buildings, an depreciation adjustments are considered independent valuation was performed as signifi cant and unobservable inputs in • Level 2 – valuation techniques by the Valuer- General Victoria to nature, specialised buildings are classifi ed for which the lowest level input determine the fair value using the as Level 3 for fair value measurements. that is signifi cant to the fair market approach. Valuation of the An independent valuation of Monash value measurement is directly assets was determined by analysing Health’s specialised land and specialised or indirectly observable; and comparable sales and allowing for buildings was performed by the Valuer- share, size, topography, location and General Victoria. The valuation was • Level 3 – valuation techniques other relevant factors specifi c to the performed using the market approach for which the lowest level input asset being valued. An appropriate rate adjusted for CSO. The effective date that is signifi cant to the fair value per square metre has been applied to of the valuation is 30 June 2019. As measurement is unobservable. the subject asset. The effective date depreciation adjustments are considered of the valuation is 30 June 2019. as signifi cant and unobservable inputs in Identifying unobservable inputs nature, specialised buildings are classifi ed (Level 3) fair value measurements Specialised Land and as Level 3 for fair value measurements. Level 3 fair value inputs are unobservable Specialised Buildings valuation inputs for an asset or liability. Specialised land includes Crown Land Vehicles These inputs require signifi cant judgement which is measured at fair value with Monash Health acquires new vehicles and assumptions in deriving fair value for regard to the property’s highest and best and at times disposes of them before both fi nancial and nonfi nancial assets. use after due consideration is made for completion of their economic life. The Unobservable inputs are used to any legal or physical restrictions imposed process of acquisition, use and disposal measure fair value to the extent that on the asset, public announcements or in the market is managed by Monash relevant observable inputs are not commitments made in relation to the Health who set relevant depreciation rates available, thereby allowing for situations intended use of the asset. Theoretical during use to refl ect the consumption of in which there is little, if any, market opportunities that may be available in the vehicles. As a result, the fair value of activity for the asset or liability at the relation to the assets are not taken into vehicles does not differ materially from measurement date. However, the fair account until it is virtually certain that any the carrying amount (depreciated cost). value measurement objective remains restrictions will no longer apply. Therefore, the same, i.e., an exit price at the unless otherwise disclosed, the current Plant and Equipment measurement date from the perspective use of these non-fi nancial physical assets Plant and equipment (including of a market participant that holds the will be their highest and best use. medical equipment, computers and asset or owes the liability. Therefore, During the reporting period, Monash communication equipment and unobservable inputs shall refl ect the Health held Crown Land. The nature furniture and fi ttings) are held at assumptions that market participants of this asset means that there are carrying amount (depreciated cost). would use when pricing the asset or certain limitations and restrictions When plant and equipment is liability, including assumptions about risk imposed on its use and/or disposal specialised in use, such that it is rarely that may impact their fair value. sold other than as part of a going Consideration of highest The market approach is also used concern, the depreciated replacement and best use (HBU) for non- for specialised land and specialised cost is used to estimate the fair value. fi nancial physical assets buildings although it is adjusted for the Unless there is market evidence that Judgements about highest and community service obligation (CSO) current replacement costs are signifi cantly best use must take into account the to refl ect the specialised nature of different from the original acquisition cost, characteristics of the assets concerned, the assets being valued. Specialised it is considered unlikely that depreciated including restrictions on the use and assets contain signifi cant, unobservable replacement cost will be materially different disposal of assets arising from the asset’s adjustments; therefore these assets are from the existing carrying amount. physical nature and any applicable classifi ed as Level 3 under the market There were no changes in legislative/contractual arrangements. based direct comparison approach. valuation techniques throughout In accordance with paragraph AASB The CSO adjustment is a refl ection of the period to 30 June 2020 13.29, Monash Health has assumed the the valuer’s assessment of the impact of For all assets measured at fair current use of a non-fi nancial physical restrictions associated with an asset to value, the current use is considered asset is its HBU unless market or the extent that is also equally applicable the highest and best use. other factors suggest that a different to market participants. This approach use by market participants would is in light of the highest and best use Cultural Assets maximise the value of the asset. consideration required for fair value Cultural assets are stated at their fair value.
Financial Statements 111 Financial Statements
Note 4.1 (a): Gross carrying amount and accumulated depreciation Consolidated Consolidated 2020 2019 $'000 $'000 Land Land at Fair Value 264,512 238,961
Total Land 264,512 238,961
Buildings Buildings at Fair Value 1,190,954 1,190,954
Less Accumulated Depreciation -75,226 -206
Sub-total Buildings at Fair Value 1,115,728 1,190,748 Buildings at Cost 94,282 5,026
Less Accumulated Depreciation -1,126 -86
Sub-total Buildings at Cost 93,156 4,940 Building Work in Progress at Cost 130,303 158,435
Total Buildings 1,339,187 1,354,123
Plant and Equipment Plant and Equipment at Fair Value 66,027 62,920
Less Accumulated Depreciation -33,852 -28,659
Sub-total Plant and Equipment 32,176 34,261
Motor Vehicles Motor Vehicles at Fair Value 1,588 1,771
Less Accumulated Depreciation -1,588 -1,771
Sub-total Motor Vehicles 0 0
Medical Equipment Medical Equipment at Fair Value 188,049 166,211
Less Accumulated Depreciation -113,320 -101,665
Sub-total Medical Equipment 74,729 64,546
Computers and Communication Equipment Computers and Communication Equipment at Fair Value 26,956 20,900
Less Accumulated Depreciation -20,644 -18,544
Sub-total Computers and Communication Equipment 6,312 2,356
Furniture and Fittings Furniture and Fittings at Fair Value 46,571 12,406
Less Accumulated Depreciation -5,930 -3,891
Sub-total Furniture and Fittings 40,641 8,515
Cultural Assets Cultural Assets at Fair Value 2,792 2,792
Sub-total Cultural Assets 2,792 2,792
Monash Health Annual Report. 2019-20 112 Note 4.1 (a) continued Consolidated Consolidated 2020 2019 $’000 $’000 Other Assets Under Construction at Cost PPP Right of Use (ROU) Buildings at Fair Value 159,533 159,533
Less Accumulated Depreciation -7,293 -20
Sub-total PPP - ROU Buildings at Fair Value 152,240 159,513
PPP ROU Improvements at Valuation 893 893
Less Accumulated Depreciation -712 -584
Sub-total PPP - ROU Improvements at Valuation 182 309
Buildings - ROU at Fair Value 38,593 -
Less accumulated depreciation -3,577 -
Sub-total ROU Buildings at Fair Value 35,015 -
Leasehold Improvements ROU at Fair value 273 -
Less Accumulated Depreciation -12 -
Sub-total ROU Leasehold Improvements at Fair Value 261 -
Plant, Equipment, Motor Vehicles, Medical Equipment ROU at Fair Value 15,487 13,174
Less Accumulated Depreciation -12,848 -11,777
Sub-total ROU Plant, Equipment, Motor Vehicles, Medical Equipment at Fair Value 2,640 1,397
Total Right of Use Assets 190,337 161,219
Total property, plant and equipment 1,954,329 1,868,135
*Included in Leased Buildings at Fair associated interest bearing liabilities (note Value is Casey Hospital. Casey Hospital 6.1). The State of Victoria is obligated commenced operation during the year to fund quarterly service payments due to ended 30 June 2005. Construction and the Project Agreement for the life of that fi t out of Casey Hospital was funded agreement, a period of up to 25 years. as a Public Private Partnership under During the year ended 30 June 2020, the Project Agreement between the the Casey Hospital Expansion Project State of Victoria and Plenary Health was completed The project is funded Pty Ltd (formerly Progress Health Pty as a Public Private Partnership under a Ltd). Monash Health is responsible Project arrangement between the State for operating Casey Hospital and of Victoria and Plenary Health Pty Ltd. has recognised the leased asset and
Financial Statements 113 Financial Statements
Note 4.1 (b): Reconciliations of the carrying amounts of each class of asset
Computers Assets Plant & Medical & Comm Furniture Cultural Right of Under Motor Land Buildings Equipment Equipment Equipment Fittings Assets Use Assets Construction Vehicles Total Consolidated $’000 $’000 $’000 $’000 $’000 $’000 $’0000 $’000 $’000 $’000 $’000
Balance at 1 July 2018 222,022 1,020,440 33,745 65,987 3,408 9,017 2,792 99,005 3,316 6 1,459,738
Additions - 117,912 1,583 9,615 863 251 - 148 1,042 - 131,416
Disposals - -79 -33 -562 - -22 - -61 - - -757
Revaluation increments/ (decrements) 16,939 262,007 - - - - - 70,678 - - 349,623
Net Transfers between classes - -5,251 4,350 1,984 364 459 - - -2,995 - -1,089
Depreciation (refer Note 4.3) - -40,907 -5,384 -12,478 -2,279 -1,189 - -8,551 - -6 -70,794
Balance at 1 July 2019 238,961 1,354,122 34,261 64,547 2,356 8,516 2,792 161,219 1,363 - 1,868,137
Additions - 112,983 2,935 8,763 -822 496 - 2,293 3,519 - 130,166
Disposals - - -21 -81 0 -7 - - - - -109
Revaluation increments/ (decrements) 25,551 ------25,551
Net Transfers between classes - -51,859 362 15,579 7,478 33,702 - 165 -1,239 - 4,189
Recognition of right-of-use assets on initial application of AASB16 ------39,160 - - 39,160
Depreciation (refer Note 4.3) - -76,060 -5,362 -14,077 -2,700 -2,065 - -12,500 - 190,337
Balance at 30 June 2020 264,512 1,339,186 32,175 74,729 6,313 40,642 2,792 190,337 3,644 0 1,954,330
Land and Buildings and Leased facilitate this, management obtained managerial revaluation was required for Assets Carried at Valuation from the Department of Treasury Buildings as the accumulated movement A full revaluation of Monash Health and Finance the VGV indices for the was less than 10% for this asset class. Land and Buildings was performed by fi nancial year ended 30 June 2020. The land and building balances are the Valuer-General of Victoria (VGV) in The VGV indices, which are considered to be sensitive to market accordance with the requirements of based on data to March 2020, conditions. To trigger a further managerial Financial Reporting Direction (FRD) 103H indicate an average increase of revaluation a decrease in the land indice Non-Financial Physical Assets. The 10.69% across all land parcels and of 10% and a decrease in the building valuation, which conforms to Australian a 2.01% increase in buildings. indice of 12% would be required. Valuation Standards, was determined Management regards the VGV Department of Health and Human by reference to the amounts for which indices to be a reliable and relevant Services approved a managerial assets could be exchanged between data set to form the basis of their revaluation of the land asset class knowledgeable willing parties in an estimates. Whilst these indices are of $25.6m. There was no material arm’s length transaction. The effective applicable at 30 June 2020, the fair fi nancial impact on change in fair value date of the valuation for both land value of land and buildings will continue of buildings and leased buildings. and buildings was 30 June 2019. to be subjected to the impacts of In compliance with FRD 103H, in the COVID-19 in future accounting periods. year ended 30 June 2020, management As the accumulative movement for conducted an annual assessment of Land was more than 10% a managerial the fair value of land and buildings. To revaluation was performed, however no
Monash Health Annual Report. 2019-20 114 Note 4.1 (c) Fair value measurement Fair value measurement at end hierarchy for assets of reporting period using: Consolidated Carrying Amount Level 1 i Level 2 i Level 3 i Balance at 30 June 2020 $'000 $'000 $'000 $'000 Land at Fair Value Non-Specialised Land 16,176 0 16,176 0
Specialised Land 248,335 0 0 248,335
Total Land at Fair Value 264,512 0 16,176 248,335
Buildings at Fair Value Non-Specialised Building 2,685 0 2,685 0
Specialised Buildings 1,113,043 0 0 1,113,043
Total Building at Fair Value 1,115,728 0 2,685 1,113,043
Plant and Equipment at Fair Value 32,175 0 0 32,175
Medical Equipment at Fair Value 74,728 0 0 74,728
Computers and Communication Equipment at Fair Value 6,313 0 0 6,313
Furniture and Fittings at Fair Value 40,640 0 0 40,640
Cultural Assets at Fair Value 2,793 0 2,793
Motor Vehicles at Fair Value - - - -
Total Other Property, Plant and Equipment 1,536,889 0 21,654 1,515,234 i. Classifi ed in accordance with the fair value hierarchy. There have been no transfers between levels during the current year. There was transfers between levels during the prior year as per the full Land & Buildings revaluation as at 30 June 2019.
Fair value measurement at end of reporting period using: Balance at 30 June 2019 Consolidated Carrying Amount Level 1 i Level 2 i Level 3 i $'000 $'000 $'000 $'000
Land at Fair Value Non-Specialised Land 14,084 0 14,084 0
Specialised Land 224,877 0 0 224,877
Total Land at Fair Value 238,961 0 14,084 224,877
Buildings at Fair Value Non-Specialised Building 3,216 0 3,216 0
Specialised Buildings 1,187,532 0 0 1,187,532
Total Building at Fair Value 1,190,748 0 3,216 1,187,532
Plant and Equipment at Fair Value 34,261 0 0 34,261
Motor vehicles at Fair Value 64,546 0 0 64,546
Computers and Communication Equipment at Fair Value 2,356 0 0 2,356
Furniture and Fittings at Fair Value 8,515 0 0 8,515
Cultural Assets at Fair Value 2,792 0 2,792 0
Total Property, Plant and Equipment 1,542,179 0 20,092 1,522,087 i. Classifi ed in accordance with the fair value hierarchy. There have been no transfers between levels during the current year. There was transfers between levels during the prior year as per the full Land & Buildings revaluation as at 30 June 2019.
Financial Statements 115 Financial Statements
Note 4.1 (d): Reconciliation of Level 3 Fair Value Measurement*
Computer Plant & Medical & Comm Furniture & Land Buildings Equipment Motor Vehicles Equipment Equipment Fittings
Consolidated $’000 $’000 $’000 $’000 $’000 $’000 $’000
Balance at 1 July 2018 174,937 555,635 33,745 6 65,987 3,408 9,016
Additions/(Disposals) 0 -79 5,900 0 11,037 1,228 688
Net Transfers between classes 0 0 0 0 0 0 0
Gains/(Losses) recognised in Net Result
- Depreciation and Amortisation 0 -40,678 -5,384 -6 -12,478 -2,279 -1,189
Reclassifi cation on Valuation 414,000
Reclassifi cation in/(out) level 3 36,101 -2,305
- Revaluation 13,839 260,960 0 - - - -
Balance at 30 June 2019 224,877 1,187,532 34,261 0 64,546 2,357 8,515
Additions/(Disposals) 3,276 24,260 6,656 34,191
Gains/(Losses) recognised in Net Result
- Depreciation and Amortisation -74,490 -5,362 -14,077 -2,700 -2,065
Reclassifi cation on Valuation
Reclassifi cation in/(out) level 3
- Revaluation 23,458
Balance at 30 June 2020 248,335 1,113,042 32,175 0 74,728 6,313 40,641
Note 4.1 (e): Property, Plant and Equipment (Fair value determination) Asset Class Likely valuation approach Signifi cant inputs (Level 3 only) i
Non-specialised land Market approach Not applicable Specialised land Market approach Community Service Obligations Adjustments i Non-specialised buildings Market approach Not applicable Specialised buildings Depreciated replacement cost approach Cost per square metre Useful life Vehicles Depreciated replacement cost approach Cost per square metre Useful life Plant and equipment Depreciated replacement cost approach Cost per square metre Useful life Medical equipment Depreciated replacement cost approach Cost per square metre Useful life Computers and Communication Depreciated replacement cost approach Cost per square metre Equipment Useful life Furniture and Fittings Depreciated replacement cost approach Cost per square metre Useful life Cultural assets Market approach Not applicable i. A community Service Obligation (CSO) of 20% was applied to the health services specialised land Classifi ed in accordance with the fair value hierarchy.
Monash Health Annual Report. 2019-20 116 Note 4.1 (f): Property, Plant and Equipment Revaluation Surplus Consolidated Consolidated 2020 2019 Property, Plant and Equipment Revaluation Surplus $’000 $’000 Balance at the beginning of the reporting period 1,026,168 676,545
Revaluation Increment Land (refer Note 4.1(b)) 25,551 16,939
Buildings - 262,007
Leased Building - 70,678
Balance at the end of the reporting period* 1,051,719 1,026,168
*Represented by: Land 201,353 175,802
Buildings 778,924 778,924
Leased Building 70,678 70,678
Cultural Assets 447 447
Motor Vehicles 317 317
1,051,719 1,026,168
Note 4.2 (a) Intangible assets - Consolidated Consolidated Gross carrying amount and accumulated amortisation 2020 2019 $’000 $’000 Intangible Produced Assets - Software 116,359 40,034
Less Accumulated Amortisation -38,541 -32,458
Intangible Work in Progress at Cost 5,892 57,081
Total intangible assets 83,709 64,657
Reconciliation of the carrying amounts of intangible assets at the beginning and end of the previous and current fi nancial year:
Consolidated Total $'000 Balance at 1 July 2018 35,182
Additions 30,721
Net Transfers between classes -1,089
Amortisation (Note 4.3) -2,335
Balance at 1 July 2019 64,657
Additions 29,324
Net Transfers between classes -4,189
Amortisation (Note 4.3) -6,083
Balance at 30 June 2020 83,709
Financial Statements 117 Financial Statements
Intangible assets represent identifi able criteria in AASB 138 Intangible Assets a. the technical feasibility of completing non-monetary assets without physical is met, internally generated intangible the intangible asset so that it will substance such as computer software. assets are recognised at cost. be available for use or sale; Intangible assets are initially Subsequently, intangible assets with b. an intention to complete the recognised at cost. Subsequently, fi nite useful lives are carried at cost intangible asset and use or sell it; intangible assets with fi nite useful lives less accumulated amortisation and c. the ability to use or sell are carried at cost less accumulated accumulated impairment losses. the intangible asset; amortisation and accumulated Depreciation and amortisation d. the intangible asset will generate impairment losses. Costs incurred begins when the asset is available probable future economic benefi ts; subsequent to initial acquisition are for use, that is, when it is in the e. the availability of adequate technical, capitalised when it is expected that location and condition necessary for fi nancial and other resources to additional future economic benefi ts it to be capable of operating in the complete the development and to will fl ow to Monash Health. manner intended by management. use or sell the intangible asset; and Expenditure on research activities An internally generated intangible f. the ability to measure reliably is recognised as an expense in the asset arising from development (or from the expenditure attributable period on which it is incurred. the development phase of an internal to the intangible asset Purchased intangible assets are initially project) is recognised if, and only if, all during its development. recognised at cost. When the recognition of the following are demonstrated:
Note 4.3: Depreciation and amortisation Consolidated Consolidated 2020 2019 Buildings $’000 $’000 Buildings 76,060 40,907
Plant and Equipment 5,362 5,384
Motor Vehicles - 6
Medical Equipment 14,077 12,478
Computers and Communication Equipment 2,700 2,279
Furniture and Fittings 2,065 1,189
Cultural Assets - - Leased Assets 8,674 8,551
Right of use assets
- Right of use buildings 3,577 -
- Right of use plant, equipment and vehicles 248 - Total depreciation 112,763 70,794 Amortisation Intangible Assets 6,083 2,335
Total Amortisation 6,083 2,335
Total Depreciation and Amortisation 118,846 73,129
Depreciation value over its estimated useful life. Amortisation All infrastructure assets, buildings, Right-of use assets are depreciated Amortisation is the systematic plant and equipment and other non- over the shorter of the asset’s allocation of the depreciable amount fi nancial physical assets (excluding useful life and the lease term. of an asset over its useful life. items under operating leases, assets Where Monash Health obtains held for sale, land and investment ownership of the underlying leased The following table indicates the properties) that have fi nite useful asset or if the cost of the right-of- expected useful lives of noncurrent lives are depreciated. Depreciation is use asset refl ects that the entity assets on which the depreciation and generally calculated on a straight-line will exercise a purchase option, amortisation charges are based. basis at rates that allocate the asset’s the entity depreciates the right-of- value, less any estimated residual use asset overs its useful life.
Monash Health Annual Report. 2019-20 118 Note 4.3 (a): useful life of non-current assets Buildings 2020 2019 - Structure Shell Building Fabric 45 to 70 years 45 to 70 years - Site Engineering Services and Central Plant 22 to 30 years 22 to 30 years Central Plant - Fit Out 22 to 30 years 22 to 30 years - Trunk Reticulated Building System 22 to 30 years 22 to 30 years Plant and equipment 3 to 10 years 3 to 10 years Medical Equipment 3 to 10 years 3 to 10 years Computers and Communication 3 years 3 years Furniture and Fitting 10 years 10 years Motor Vehicles 4 years 4 years Leased Buildings 45 Years 45 Years Intangible Assets 5 years 5 years
As part of the building valuation, building values are separated into components and each component assessed for its useful life which is represented above.
Note 5: Other assets and liabilities
This section sets out those assets Structure and liabilities that arose from • 5.1 Receivables and contract assets Monash Health's operations. • 5.2 Inventories • 5.3 Payables and contract liabilities • 5.4 Other liabilities
Note 5.1 (a): Receivables Consolidated Consolidated 2020 2019 Current $’000 $’000 Contractual Inter-Hospital Debtors 2,201 1,952 Trade Debtors 11,259 7,282 Patient Fees 14,443 26,461 Contract Assets AABS15 20,110 - Accrued Revenue - 13,793 Amounts Receivable from Governments and Agencies 1,778 18,126 Less Allowance for Impairment losses of contractual receivables Trade Debtors -1,131 (234) Patient Fees -3,194 (3,638) 45,468 63,742 Statutory GST Receivable 9,614 3,246 9,614 3,246 Total current receivables 55,082 67,610
Non-current Statutory Long Service Leave - Department of Health and Human Services 125,978 113,467 125,978 113,467 Total non-current receivables 125,978 113,467 Total receivables 181,060 180,455
As at 30 June 2020, Monash Health Service has contract assets of $20.1m. There is no expected credit losses from these contract assets. Financial Statements 119 Financial Statements
Note 5.1 (b): Movement in the Allowance for Consolidated Consolidated impairment losses of contractual receivables 2020 2019 $’000 $’000 Balance at beginning of year 3,872 3,289
Opening retained earnings adjustment on adoption of AASB 9 - -802
Reversal of provision of receivables written off during the year as uncollectable -3,392 -2,233
Increase in provision recognised in the net result 3,845 3,618
Balance at end of year 4,326 3,872
Receivables recognition input tax credits recoverable. averages and other computational Receivables consist of: Statutory receivables do not arise methods in accordance with AASB from contracts and are recognised 136 Impairment of Assets. • Contractual receivables, which and measured similarly to contractual .Monash Health is not exposed consists of debtors in relation receivables (except for impairment), to any signifi cant credit risk exposure to goods and services. These but are not classifi ed as fi nancial to any single counterparty or any receivables are classifi ed as fi nancial instruments for disclosure purposes. group of counterparties having similar instruments and categorised as Monash Health applies AASB 9 for characteristics. Trade receivables consist ‘fi nancial assets at amortised costs’. initial measurement of the statutory of a large number of customers in They are initially recognised at fair receivables and as a result statutory various geographical areas. Based on value plus any directly attributable receivables are initially recognised historical information about customer transaction costs. Monash Health at fair value plus any directly default rates, management consider the holds the contractual receivables attributable transaction cost. credit quality of trade receivables that are with the objective to collect the not past due or impaired to be good. contractual cash fl ows and therefore Trade debtors are carried at subsequently measured at amortised nominal amounts due and are cost using the effective interest due for settlement within 30 days Impairment losses of method, less any impairment. from the date of recognition. contractual receivables In assessing impairment of statutory Refer to Note 7.1 (c) Contractual • Statutory receivables, which (non-contractual) fi nancial assets, receivables at amortised costs predominantly includes amounts which are not fi nancial instruments, for Monash Health’s contractual owing from the Victorian Government professional judgement is applied in impairment losses. and Goods and Services Tax (GST) assessing materiality using estimates,
Note 5.1 (c): Contract assets Consolidated 2020 (a) $’000
Opening balance brought forward from 30 June 2019 adjusted for AASB 15 (a) 19,367
Add: Additional costs incurred that are recoverable from the customer 297,779
Less: Transfer to trade receivable or cash at bank -297,036
Less: impairment allowance -
Total contract assets 20,110 Represented by
Current contract assets 20,110
Non-current contract assets 0
(a) As AASB 15 was fi rst applied from 1 July 2019, there is no comparative information to display.
Contract assets relate to Monash June 2020 was impacted by timing of Health Service’s right to consideration the works completed by contractors in exchange for goods transferred to and is new compared to last year as it customers for works completed, but is not billable at this stage. The works not yet billed at the reporting date. The are expected to be completed and balance of the contract assets at 30 recovered early next fi nancial year.
Monash Health Annual Report. 2019-20 120 Note 5.2: Inventories Consolidated Consolidated 2020 2019 $'000 $'000 Medical and surgical consumables: 8,940 8,163 Pharmacy supplies: 10,779 8,192
Pathology supplies: 1,569 1,569
General Stores: 3,669 605
Total inventories at cost 24,956 18,528
Inventories include goods and functional obsolescence. Cost is assigned of service potential for inventories other property held either for sale, to high value, low volume inventory items held for distribution include current consumption or for distribution at on a specifi c identifi cation of cost basis. replacement cost and technical no or nominal cost in the ordinary Inventories held for distribution or functional obsolescence. course of business operations. It are measured at cost, adjusted for Technical obsolescence occurs when excludes depreciable assets. any loss of service potential. All other an item still functions for some or all the Inventories acquired at no cost or inventories are measured at the lower tasks it was originally acquired to do, but for nominal consideration are measured of cost and net realisable value. no longer matches existing technologies. at current replacement cost at the Inventories acquired for no Functional obsolescence occurs date of acquisition. The bases used in cost or nominal considerations are when an item no longer functions the assessing loss of service potential for measured at current replacement way it did when it was fi rst acquired. inventories held for distribution include cost at the date of acquisition. current replacement cost and technical or The basis used in assessing loss
Note 5.3: Payables and Contract Liabilities Consolidated Consolidated 2020 2019 $'000 $'000 Current Contractual Trade Creditors 10,315 30,385
Accrued Salaries and Wages 75,832 51,294
Accrued Expenses 98,909 34,575
Deferred grant revenue. Refer to note 5.3 (a). 7,421 -
Contract Liabilities - income received in advance. Refer to note 5.4 (b). 45,957 -
Other 9,775 10,692
Total payables 248,208 126,946
Payables Recognition Payables consist of: • Payables include $65m for goods • contractual payables, classifi ed as received that remain unpaid as at 30 fi nancial instruments and measured June 2020 relating to the state health at amortised cost. Accounts payable product supply (refer Note 6.2). and salaries and wages payable represent liabilities for goods and The normal credit terms for accounts services provided to the Monash payable are usually Nett 60 days. Health prior to the end of the fi nancial year that are unpaid
• statutory payables, that are recognised and measured similarly to contractual payables, but are not classifi ed as fi nancial instruments and not included in the category of fi nancial liabilities at amortised cost, because they do not arise from contracts.
Financial Statements 121 Financial Statements
Note 5.3 (a): Deferred grant revenue Consolidated 2020 $'000 Grant considerations for capital works recognised that was included in the deferred - grant liability balance (adjusted AASB 1058) at the beginning of the year Grant consideration for capital works received during the year 147,324
Grant revenue for capital works recognised consistent with the capital works undertaken during the year -139,903
Closing balance of deferred grant consideration received for capital works 7,421
Revenue recognised from performance obligations satisfi ed in previous periods - Transaction price allocated to the remaining performance obligations - from contracts with customers to be recognised in: Not longer than one year 7,421
Longer than one year but not longer than fi ve years -
Longer than fi ve years -
Total 7,421
Grant revenue is recognised progressively constructed. The progressive percentage note 2.1) As a result, Monash Health as the asset is constructed, since this is costs incurred is used to recognise has deferred recognition of a portion of the time when Monash Health satisfi es income because this most closely refl ects the grant consideration received as a its obligations under the transfer by the progress to completion as costs are liability for the outstanding obligations. controlling the asset as and when it is incurred as the works are done. (see
Note 5.3 (b): Contract liabilities Consolidated 2020 $'000 Opening balance brought forward from 30 June 2019 adjusted for AASB 15 11,021 Add: Payments received for performance obligations yet to be completed during the period 214,119
Add: Grant consideration for suffi ciently specifi c performance obligations received during the year 1,474,696
Less: Revenue recognised in the reporting period for the completion of a performance obligation -214,119
Less: Grant revenue for suffi ciently specifi c performance obligations works recognised -1,439,761 consistent with the performance obligations met during the year Total contract liabilities 45,957
Represented by
Current contract liabilities 45,957 Non-current contract liabilities -
Contract liabilities include consideration in support of Monash Health Services. recognised when the service obligations received in advance from customers. Grant income is recognised as service are delivered in the following year. Invoices are raised once the goods obligations are met. Differences in the and services are delivered/provided. number of some services provided may Maturity analysis of payables In addition, grant consideration was also be adjusted in the funding provided Please refer to Note 7.1(b) for the received from the State Government annually. The remaining grant revenue is ageing analysis of payables.
Monash Health Annual Report. 2019-20 122 Note 5.4: Other Liabilities Consolidated Consolidated 2020 2019 $'000 $'000 Current Unearned income - 12,889 Monies Held in Trust*
- Patient Monies Held in Trust* 230 219
- Accommodation Deposits (Refundable Entrance Fees)* 12,813 13,945
- Government COVID19 Victorian Health Services Product funds* 194,866 -
Total Current 207,909 27,052
* Total Monies Held in Trust Represented by the following assets:
Cash Assets 207,909 14,163
Total Payables 207,909 14,163
Refundable accommodation deposits (RAD) are paid by residents upon admission to Monash Health’s aged care facilities in accordance with the Aged Care Act - 1997.
As at 30 June 2020 Monash Health have recorded a liability of $195m for amounts received from DHHS but unspent in acquiring health services products on their behalf (refer Note 6.2).
Financial Statements 123 Financial Statements
Note 6: How we fi nance our operations
This section provides information on the Note 7.1 provides additional, specifi c sources of fi nance utilised by Monash fi nancial instrument disclosures. Health during its operations, along with interest expenses (the cost of Structure borrowings) and other information related • 6.1 Borrowings to fi nancing activities of Monash Health. • 6.2 Cash and cash equivalents This section includes disclosures of • 6.3 Commitments for expenditure balances that are fi nancial instruments • 6.4 Non-cash fi nancing (such as borrowings and cash balances). and investing activities
Note 6.1: Borrowings Consolidated Consolidated 2020 2019 $'000 $'000 Current
– Public Private Partnership (PPP) related Lease Liabilities i 3,840 5,700 – Non PPP Related Lease Liabilities (2019: Finance Lease) 4,827 -
– TCV Loan ii 1,331 1,254
– Advances from government iii 53,240 1,000
– Other Financial Liability iv 1,308 648
Total Current Borrowings 64,546 8,602
Non Current – Public Private Partnership (PPP) related Lease Liabilities i 42,972 47,375 – Non PPP Related Lease Liabilities (2019: Finance Lease) 35,712 -
– TCV Loan ii 23,423 24,754
– Advances from government iii 6,630 7,534
– Other Financial Liability iv 19,194 18,862
Total Non Current Borrowings 127,931 98,525
Total Borrowings 192,477 107,127
i. During the year ended 30 June Corporation of Victoria to fund and Human Services granted a cash 2005, Casey Hospital commenced $19.6m improvements required to advance of $52.4m to meet early July operations. Construction and fi t out the car park at the Clayton site. The Payments. The amount is repayable of Casey Hospital was funded as loan is repayable over 22 years with early in the 20/21 fi nancial year. a public private partnership under repayments made quarterly. In the a project agreement between the 2014 fi nancial year, Monash Health iv. During the year ended 30 June 2020, State of Victoria and Plenary Health made a further drawdown under the the Casey Hospital Expansion Project Pty Ltd (formerly Progress Health Pty existing loan arrangement with the was completed. The project was Ltd). Monash Health is responsible Treasury Corporation of Victoria to funded as a Public Private Partnership for operating Casey Hospital and fund $13.5m improvements required under an agreement between the has recognised the leased asset to the car park at the Clayton site. The State of Victoria and Plenary Health (Note 4.1) and associated interest loan is repayable over 22 years with Pty Ltd. Monash Health is responsible bearing liabilities. The State of repayments being made quarterly. for operating Casey Hospital and has Victoria is obligated to fund quarterly recognised the asset (Note 4.1) and service payments due under the iii. During the year ended 30 June 2018, associated interest bearing liabilities. Project Agreement for the life of that the Department of Health and Human The State of Victoria is obligated agreement, a period of up to 25 years. Services granted an interest free to fund quarterly service payments loan of $10m to Monash Health. The due under the Project Agreement ii. During the year ended 30 June loan is repayable over 10 years with for the life of that agreement, a 2010 Monash Health entered into repayments being made annually. In period of up to 2030 in line with the a loan agreement with the Treasury June 2020, the Department of Health original Casey Hospital Liability.
Monash Health Annual Report. 2019-20 124 Maturity analysis of borrowings Defaults and breaches Lease Liabilities Please refer to Note 7.1(b) for the During the current and prior Repayments in relation to leases ageing analysis of borrowings. year, there were no defaults and are payable as follows: breaches of any of the loans.
Repayments in relation to leases Minimum future lease Present value of minimum are payable as follows payments (i) future lease payments
2020 2019 2020 2019 $'000 $'000 $'000 $'000
Casey Hospital and VicFleet
Casey Hospital Public Private Partnership Lease Repayments in relation to fi nance leases are payable as follows:
Not later than one year 6,592 6,592 3,840 3,613 Later than. One year but not later than 5 years 26,370 26,370 17,928 16,868
Later than fi ve years 28,567 35,160 25,044 29,944
VicFleet lease liabilities payable i Not later than one year 1,722 2,119 1,653 2,087
Later than. One year but not later than 5 years 1,940 577 1,864 564
Minimum lease payments ii 65,192 70,819 50,329 53,075 Less future fi nance charges -14,864 -17,744
Total 50,329 53,075 50,329 53,075
Included in the fi nancial statements as:
Current borrowings lease liabilities 5,493 5,700
Non-current borrowing lease liabilities 44,836 47,375
50,329 53,075
The interest rate implicit in the leases is 4.73% (2019: 6.07%).
Leases as ‘a contract, or part of a contract, • Monash Health has the right to obtain A lease is a right to use an asset for an that conveys the right to use an asset substantially all of the economic agreed period of time in exchange for (the underlying asset) for a period of benefi ts from use of the identifi ed payment. All leases are recognised on the time in exchange for consideration’. asset throughout the period of use, balance sheet, with the exception of low To apply this defi nition Monash considering its rights within the value leases (less than $10,000 AUD) and Health Service assesses whether defi ned scope of the contract and short term leases of less than 12 months. the contract meets three key Monash Health Service has the right evaluations which are whether: to direct the use of the identifi ed asset Monash Health Service’s throughout the period of use; and leasing activities • the contract contains an identifi ed Monash Health Service has asset, which is either explicitly • Monash Health has the right to entered into leases related to identifi ed in the contract or implicitly make decisions in respect of ‘how property, plant and equipment. specifi ed by being identifi ed and for what purpose’ the asset is For any new contracts entered into at the time the asset is made used throughout the period of use. on or after 1 July 2019, Monash Health available to Monash Health and for Service considers whether a contract is, which the supplier does not have This policy is applied to contracts entered or contains a lease. A lease is defi ned substantive substitution rights; into, or changed, on or after 1 July 2019.
Financial Statements 125 Financial Statements
Separation of lease and Short-term leases and leases the estimated useful life of the asset or non-lease components of low value assets the term of the lease. Minimum fi nance At inception or on reassessment Monash Health has elected to account for lease payments were apportioned of a contract that contains a lease short-term leases and leases of low value between the reduction of the outstanding component, the lessee is required to assets using the practical expedients. lease liability and the periodic fi nance separate out and account separately for Instead of recognising a right of use expense, which is calculated using the non-lease components within a lease asset and lease liability, the payments interest rate implicit in the lease and contract and exclude these amounts in relation to these are recognised charged directly to the consolidated when determining the lease liability as an expense in profi t or loss on a Comprehensive Operating Statement. and right-of-use asset amount. straight line basis over the lease term. Assets held under other leases were classifi ed as operating leases Recognition and measurement Below market/Peppercorn lease and were not recognised in Monash of leases as a lessee (under Right-of-use assets under leases at Health’s balance sheet. Operating AASB 16 from 1 July 2019) Lease signifi cantly below-market terms and lease payments were recognised as an Liability – initial measurement conditions that are entered into principally operating expense in the Statement of The lease liability is initially measured to enable Monash Health Service to Comprehensive Income on a straight- at the present value of the lease further its objectives, are initially and line basis over the lease term. payments unpaid at the commencement subsequently measured at cost. date, discounted using the interest These right-of-use assets are Operating lease payments rate implicit in the lease if that rate is depreciated on a straight line basis over up until 30 June 2019 readily determinable or Monash Health the shorter of the lease term and the These are recognised on a straight incremental borrowing rate. Lease estimated useful lives of the assets. line basis over the lease term, payments included in the measurement of except where another systematic the lease liability comprise the following: Presentation of right-of-use basis is more representative of the assets and lease liabilities time pattern of the benefi ts derived • fi xed payments (including in- Monash Health presents right-of- from the use of the leased asset. substance fi xed payments) less use assets as ‘property plant and any lease incentive receivable; equipment’ unless they meet the From 1 July 2019, the following defi nition of investment property, in lease payments are recognised • variable payments based on an which case they are disclosed as on a straight-line basis: index or rate, initially measured ‘investment property’ in the balance using the index or rate as at sheet. Lease liabilities are presented • short-term leases – leases with a the commencement date; as ‘borrowings’ in the balance sheet. term less than 12 months; and
• amounts expected to be payable Recognition and measurement • low value leases – leases with under a residual value guarantee; and of leases (under AASB 117 the underlying asset’s fair value until 30 June 2019) (when new, regardless of the • payments arising from purchase In the comparative period, leases age of the asset being leased) and termination options reasonably of property, plant and equipment is no more than $10,000. certain to be exercised. were classifi ed as either fi nance lease or operating leases. Variable lease payments not included in the measurement of the lease liability Lease Liability – subsequent Monash Health determined whether (i.e. variable lease payments that do measurement an arrangement was or contained not depend on an index or a rate, Subsequent to initial measurement, the a lease based on the substance of initially measured using the index or liability will be reduced for payments the arrangement and required an rate as at the commencement date). made and increased for interest. It is assessment of whether fulfi llment of the These payments are recognised in the remeasured to refl ect any reassessment arrangement is dependent on the use of period in which the event or condition or modifi cation, or if there are changes the specifi c asset(s); and the arrangement that triggers those payments occur. in-substance fi xed payments. conveyed a right to use the asset(s). When the lease liability is remeasured, Leases of property, plant and Commissioned public private the corresponding adjustment is equipment where Monash Health as partnerships (PPP): refl ected in the right-of-use asset, a lessee had substantially all of the Monash Health Service entered into a or profi t and loss if the right of use risks and rewards of ownership were Public Private Partnership agreement asset is already reduced to zero. classifi ed as fi nance leases. Finance between the State of Victoria and Plenary leases were initially recognised as Health Pty Ltd. Under the arrangement, assets and liabilities at amounts the portion of total payments to Plenary equal to the fair value of the leased Health that relates to Monash Health’s property or, if lower, the present value right to use the assets is accounted of the minimum lease payment, each for as a fi nance lease liability. determined at the inception of the lease. The leased asset was accounted for as a non-fi nancial physical asset and depreciated over the shorter of
Monash Health Annual Report. 2019-20 126 Note 6.2: Cash and Cash Equivalents Consolidated Consolidated 2020 2019 $'000 $'000 Cash and Cash Equivalents
Cash on hand (excluding monies held in trust) 73 64
Cash on Hand (Monies held in trust) - 10
Cash at Bank (monies held in trust) - 2,000
Cash at Bank - CBS (excluding monies held in trust) 228,322 97,511
Cash at Bank - CBS (monies held in trust) 272,664 12,163
Total cash and cash equivalents 501,059 111,748
Cash and cash equivalents recognised and equipment for Victorian public health of DHHS of $260m. Liabilities of $260m on the balance sheet comprise cash services and other entities during the have also been recognised comprising on hand and in banks, deposits at call COVID-19 pandemic. These items are payables of $65m for items goods and highly liquid investments (with an distributed at cost, and Monash received that remain unpaid (refer Note original maturity date of three months or Health receives no commission on 5.3) and other liabilities of $195m for less), which are held for the purpose of the transactions. As Monash Health amounts received from DHHS but meeting short term cash commitments would only record the amount of unspent in acquiring goods on their rather than for investment purposes, any fee or commission to which it behalf as at year-end (refer Note 5.4). which are readily convertible to known expects to be entitled in exchange for For the year ended 30 June amounts of cash and are subject to arranging these distributions, and this 2020 Monash Health received insignifi cant risk of changes in value. amount is zero, there was no impact funding of $850m and made Monash Health entered into an on the Comprehensive Operating payments of $590m acting agreement with the DHHS to act as Statement from this relationship. as agent for DHHS. an agent for the department in paying, As at 30 June 2020 the cash assets warehousing, and distributing products balance includes funds held on behalf
Financial Statements 127 Financial Statements
Note 6.3: Commitments for expenditure Consolidated Consolidated 2020 2019 $'000 $'000 Capital Expenditure Commitments
Less than 1 year 5,906 28,612
Longer than 1 year but not longer than 5 years 11,825 1,286
5 years or more -
Total Capital Expenditure Commitments 17,730 29,898
Operating Expenditure Commitments
Less than 1 year 59,565 62,872
Longer than 1 year but not longer than 5 years 95,947 104,966
5 years or more 22,708 18,358
Total Operating Expenditure Commitments 178,221 186,195
Non-cancellable Short Term and Low Value Lease Commitments
Less than 1 year 2,852 5,821
Longer than 1 year but not longer than 5 years 3,869 15,742
5 years or more - 18,037
Total Non-cancellable Lease Commitments 6,721 39,599
Public Private Partnership Commitments (commissioned)
Less than 1 year 24,385 17,838
Longer than 1 year but not longer than 5 years 123,905 77,201
5 years or more 137,910 114,031
Total Public Private Partnership Commitments 286,200 209,070
Public Private Partnership Commitments (uncommissioned)
Less than 1 Year - 5,069
Longer than 1 year but not longer than 5 years - 32,340
5 years or more - 55,245
5 years or more
Total Public Private Partnership Commitments - 92,654
Total Commitments for Expenditure (inclusive of GST) 488,872 574,481
Less GST recoverable from the Australian Tax Offi ce -44,443 -50,674
Total Commitments for Expenditure (exclusive of GST) 444,429 523,807
Future lease payments are recognised on the balance sheet, refer to Note 6.1 Borrowings.
Monash Health Annual Report. 2019-20 128 PPPs commitments (a) (b) (e) 2020 2019
Minimum Other Total Minimum Other Total lease Commitments Commitments lease Commitments Commitments payments payments
Present value Present value Nominal value Present value Present value Nominal value $'000 $'000 $'000 $'000 $'000 $'000
Commissioned PPPs
Casey Hospital Public Private 69,224 54,007 180,448 73,174 54,853 190,063 Partnership Lease
Casey Hospital Public Private 27,444 36,498 79,734 Partnership Expansion
Sub-total 96,668 90,505 260,182 73,174 54,853 190,063
Uncommissioned PPPs (f)(g)(h)
Casey Hospital Public Private - - - 28,249 37,192 84,231 Partnership Expansion
Sub-total - - - 28,249 37,192 84,231
Total commitments for PPPs (c)(d) 96,668 90,505 260,182 101,423 92,045 274,294 a. The present values of the minimum lease payments for commissioned PPPs are recognised on the balance sheet (not disclosed as commitments). b. The discounted values of the minimum lease payments for uncommissioned PPPs have been discounted to the expected dates of commissioning and the present values of other commitments have been discounted to 30 June of the respective fi nancial years. After adjusting for GST, the discounted values of minimum lease payments refl ect the expected impact on the balance sheet when the PPPs are commissioned. c. The year on year reduction in the nominal amounts of the other commitments refl ects the payments made. d. The year on year reduction in the present values of other commitments refl ects payments, offset by the impact of one fewer year used for discounting. e. The table discloses only other operating and maintenance commitments for the Casey Hospital. f. The total commitments will not equal the sum of the minimum lease payments and other commitments because they are at present value, whereas total commitments are at nominal value. g. The minimum lease payments of uncommissioned PPPs include the government capital contributions. If the government capital contributions are made upfront, the amount represents the nominal value of the payments that will be made when the project is commissioned. h. The nominal amounts are exclusive of GST.
Financial Statements 129 Financial Statements
Commitments Service concession Commitments for future expenditure arrangements (SCA) include operating and capital Monash Health is party to a Service Pursuant to the agreement for the commitments arising from contracts. Concession Arrangement (SCA), which project, the state contributed to the These commitments are disclosed is an arrangement entered into with constructions costs of the project at their nominal value and are private sector participants to design during the construction phase. The inclusive of the GST payable. and construct or upgrade assets Department of Health and Human In addition, where it is considered used to provide public services. Services made capital contributions to appropriate and provides additional These arrangements are typically Monash Health to fund these payments. relevant information to users, the net complex and usually include the provision Monash Health recognises a present values of signifi cant projects of operational and maintenance services leased asset and corresponding lease are stated. These future expenditures for a specifi ed period of time. These liability in respect of the arrangement cease to be disclosed as commitments arrangements are also referred to as in accordance with the State’s stated once the related liabilities are public private partnerships (PPP). accounting policy for such arrangements. recognised on the Balance Sheet. With these arrangements, the Quarterly service payments will Monash Health has entered into Department of Health and Human be made to Monash Health. commercial leases on certain medical Services pays the operator over the Each payment includes an allowance equipment, computer equipment and period of the arrangement subject to for the remaining capital cost of the property where it is not in the interest of specifi ed performance criteria being met. facility, the facilities maintenance Monash Health to purchase these assets. At the date of commitment to the and ancillary services to be delivered These leases have an average life of principal provisions of the arrangement, by Monash Health over the 25 year between 1 and 20 years with renewal these estimated periodic payments operating phase, interest rate service terms included in the contracts. Renewals are allocated between a component payments and equity return. are at the option of Monash Health. related to the design and construction or Pass through payments in relation There are no restrictions placed upon upgrading of the asset and components to Monash Health utilities, medical the lessee by entering into these leases. related to the ongoing operation and laboratory gases and waste Lease commitments in 2019 includes and maintenance of the asset. disposal services are not included future payments for operating leases The former component is accounted in PPP commitments as they are not included on the balance sheet. With for as a lease payment in accordance contingent on future amounts AASB 117 Leases being superseded with the lease policy. The remaining utilised in operating the hospital. by AASB 16 Leases from 1 July 2019, components are accounted for as Monash Health is not a grantor in a these obligations are now recorded on commitments for operating costs which service concession arrangement and the balance sheet as lease liabilities. are expensed in the comprehensive therefore has no arrangements that operating statement as they are incurred. are within the scope of AASB 1059 Pursuant to the requirements of the Service Concession Arrangements. Operating Deed between the State and Monash Health, the Department of Health and Human Services agrees to meet all payments (including leasing and operating) for which the State is liable and which are associated with the project. Monash Health has agreed to record and report all of the obligations of the state refl ecting Monash Health’s position as the government agency that controls the assets.
Monash Health Annual Report. 2019-20 130 Financial Statements
Note 7: Risks, contingencies Note 7.1: Financial and valuation uncertainties instruments Monash Health is exposed to risk from Financial instruments arise out of Commitments Service concession its activities and outside factors. In contractual agreements that give rise Commitments for future expenditure arrangements (SCA) addition, it is often necessary to make to a fi nancial asset of one entity and include operating and capital Monash Health is party to a Service Pursuant to the agreement for the judgements and estimates associated a fi nancial liability or equity instrument commitments arising from contracts. Concession Arrangement (SCA), which project, the state contributed to the with recognition and measurement of of another entity. Due to the nature These commitments are disclosed is an arrangement entered into with constructions costs of the project items in the fi nancial statements. This of Monash Health’s activities, certain at their nominal value and are private sector participants to design during the construction phase. The section sets out fi nancial instrument fi nancial assets and fi nancial liabilities inclusive of the GST payable. and construct or upgrade assets Department of Health and Human specifi c information, including exposures arise under statute rather than a contract. In addition, where it is considered used to provide public services. Services made capital contributions to to fi nancial risks, as well as those items Such fi nancial assets and fi nancial appropriate and provides additional These arrangements are typically Monash Health to fund these payments. that are contingent in nature or require a liabilities do not meet the defi nition relevant information to users, the net complex and usually include the provision Monash Health recognises a higher level of judgement to be applied of fi nancial instruments in AASB 132 present values of signifi cant projects of operational and maintenance services leased asset and corresponding lease which, for Monash Health, is related Financial Instruments: Presentation. are stated. These future expenditures for a specifi ed period of time. These liability in respect of the arrangement mainly to fair value determination. cease to be disclosed as commitments arrangements are also referred to as in accordance with the State’s stated once the related liabilities are public private partnerships (PPP). accounting policy for such arrangements. Structure recognised on the Balance Sheet. With these arrangements, the Quarterly service payments will • 7.1 Financial Instruments Monash Health has entered into Department of Health and Human be made to Monash Health. commercial leases on certain medical Services pays the operator over the Each payment includes an allowance equipment, computer equipment and period of the arrangement subject to for the remaining capital cost of the property where it is not in the interest of specifi ed performance criteria being met. facility, the facilities maintenance Note 7.1 (a): Categorisation of fi nancial instruments Monash Health to purchase these assets. At the date of commitment to the and ancillary services to be delivered Financial Financial Total These leases have an average life of principal provisions of the arrangement, by Monash Health over the 25 year Assets at Liabilities at between 1 and 20 years with renewal these estimated periodic payments operating phase, interest rate service Consolidated Amortised Cost Amortised Cost terms included in the contracts. Renewals are allocated between a component payments and equity return. are at the option of Monash Health. related to the design and construction or Pass through payments in relation 2020 $'000 $'000 $'000 There are no restrictions placed upon upgrading of the asset and components to Monash Health utilities, medical the lessee by entering into these leases. related to the ongoing operation and laboratory gases and waste Contractual Financial Assets Lease commitments in 2019 includes and maintenance of the asset. disposal services are not included future payments for operating leases The former component is accounted in PPP commitments as they are Cash and Cash Equivalents 6.2 501,059 - 501,059 not included on the balance sheet. With for as a lease payment in accordance contingent on future amounts Receivables AASB 117 Leases being superseded with the lease policy. The remaining utilised in operating the hospital. by AASB 16 Leases from 1 July 2019, components are accounted for as Monash Health is not a grantor in a - Trade Debtors 5.1 10,129 - 10,129 these obligations are now recorded on commitments for operating costs which service concession arrangement and - Other Receivables 5.1 15,551 - 15,551 the balance sheet as lease liabilities. are expensed in the comprehensive therefore has no arrangements that operating statement as they are incurred. are within the scope of AASB 1059 Total Financial Assets i 526,738 - 526,738 Pursuant to the requirements of the Service Concession Arrangements. Operating Deed between the State and Monash Health, the Department of Financial Liabilities Health and Human Services agrees to meet all payments (including leasing and Payables 5.3 - 194,830 194,830 operating) for which the State is liable and Borrowings 6.1 - 192,477 192,477 which are associated with the project. Monash Health has agreed to Other Financial Liabilities 5.4 - record and report all of the obligations of the state refl ecting Monash - Accommodation bonds - 12,813 12,813 Health’s position as the government - Government COVID-19 Victorian 194,866 194,866 agency that controls the assets. Health Services Product funds
- Other - 230 230
Total Financial Liabilities i - 595,216 595,216
As at 30 June 2020 Monash Health have recorded an other liability of $195m for amounts received from DHHS but unspent in acquiring health services products on their behalf (refer Note 6.2).
Monash Health Annual Report. 2019-20 130 Financial Statements 131 Financial Statements
Financial Financial Total Assets at Liabilities at Consolidated Amortised Cost Amortised Cost
2019 $'000 $'000 $'000 Contractual Financial Assets
Cash and Cash Equivalents 6.2 111,749 - 111,749
Receivables
- Trade Debtors 5.1 7,048 - 7,048
- Other Receivables 5.1 56,694 - 56,694
Total Financial Assets i 175,491 - 175,491
Financial Liabilities
Payables - 126,946 126,946
Borrowings 6.1 - 107,126 107,126
Other Financial Liabilities 5.4
- Accommodation bonds - 13,945 13,945
- Other - 219 219
Total Financial Liabilities i - 248,236 248,236
i. The carrying amount excludes statutory receivables (i.e. GST receivable and DHHS receivable and statutory payables (i.e. Revenue in Advance and DHHS payable). Monash Health applies AASB 9 and classifi es all of its fi nancial assets based on the business model for managing the assets and the asset’s contractual terms.
Categories of fi nancial assets
Financial assets at amortised cost Loans and receivables and cash are method. Monash Health recognises Financial assets are measured fi nancial instrument assets with fi xed the following liabilities in this category: at amortised costs if both of the and determinable payments that following criteria are met and the are not quoted on an active market. • payables (excluding assets are not designated as These assets and liabilities are initially statutory payables); and fair value through net result: recognised at fair value plus any • the assets are held by directly attributable transaction costs. • borrowings (including Monash Health to collect the Subsequent to initial measurement, fi nance lease liabilities). contractual cash fl ows, and loans and receivables are measured at amortised cost using the Derecognition of fi nancial assets: • the assets’ contractual terms give effective interest method (and for A fi nancial asset (or, where applicable, rise to cash fl ows that are solely assets, less any impairment). a part of a fi nancial asset or part of payments of principal and interests. a group of similar fi nancial assets) is Categories of fi nancial liabilities derecognised when the rights to receive These assets are initially recognised Financial liabilities at amortised cost are cash fl ows from the asset have expired. at fair value plus any directly initially recognised on the date they are Derecognition of fi nancial liabilities: attributable transaction costs and originated. They are initially measured A fi nancial liability is derecognised subsequently measured at amortised at fair value plus any directly attributable when the obligation under the liability cost using the effective interest transaction costs. Subsequent to initial is discharged, cancelled or expires. method less any impairment. recognition, these fi nancial instruments Monash Health recognises the are measured at amortised cost with following assets in this category: any difference between the initial recognised amount and the redemption • cash and deposits; and value being recognised in profi t and loss over the period of the interest bearing • receivables (excluding liability, using the effective interest rate statutory receivables);
Monash Health Annual Report. 2019-20 132 Note 7.1 (b): Maturity analysis of Financial Liabilities as at 30 June 2020 The following table discloses the contractual maturity analysis for Monash Health’s fi nancial liabilities. For interest rates applicable to each class of liability refer to individual notes to the fi nancial statements.
Maturity Dates
Note Carrying Nominal Less 1-3 3 1-5 Over 5 Amount Amount than 1 Months months Years Years Month - 1 Year
2020 $'000 $'000 $'000 $'000 $'000 $'000 $'000
Financial Liabilities
At amortised cost
Payables 5.3 194,830 194,830 180,988 4,589 4,365 4,888
Borrowings 6.1 192,477 192,477 53,519 3,521 7,505 48,191 79,740
Other Financial Liabilities i
- Accommodation Deposits 5.4 12,813 12,813 - 577 12,236
- Government COVID19 Deposit 5.4 194,866 194,866 194,866 - -
- Other 5.4 230 230 230 - -
Total Financial Liabilities 595,216 595,216 429,603 8,687 24,106 53,079 79,740
2019
Financial Liabilities
At amortised cost
Payables 5.3 126,947 126,947 102,206 15,256 4,139 5,346 -
Borrowings 6.1 107,126 107,126 1,553 3,221 5,166 38,747 58,440
Other Financial Liabilities i
- Accommodation Deposits 5.4 13,945 13,945 - 628 13,317 - -
- Other 5.4 219 219 219 - - - -
Total Financial Liabilities 248,236 248,236 103,978 19,104 22,622 44,093 58,440 i. Maturity analysis of fi nancial liabilities excludes statutory fi nancial liabilities (i.e. GST payable).
Note 7.1 (c): Contractual receivables at amortised costs Note Current Less than 1–3 3 months 1–5 Total 1-Jul-19 1 month months –1 year years
Expected loss rate 0.9% 7.0% 28.4% 37.0% 0.0% 5.7%
Gross carrying amount of 5.1 53,091 5,458 4,096 4,968 - 67,613 contractual receivables
Loss allowance -492 -380 -1,163 -1,838 - -3,873
Current Less than 1–3 3 months 1–5 Total 30-Jun-20 1 month months –1 year years
Expected loss rate 2.7% 7.5% 42.7% 18.8% 0.0% 8.7%
Gross carrying amount of 5.1 31,619 3,995 2,423 11,433 - 49,470 contractual receivables
Loss allowance -848 -298 -1,034 -2,146 - -4,326
Financial Statements 133 Financial Statements
Impairment of fi nancial assets under or designated at fair value through net of default and expected loss rates. AASB 9 Financial Instruments result are not subject to impairment Monash Health has grouped Monash Health records the allowance assessment under AASB 9. contractual receivables on shared credit for expected credit loss for the relevant While cash and cash equivalents risk characteristics and days past due fi nancial instruments, in accordance are also subject to the impairment and select the expected credit loss with AASB 9 Financial Instruments requirements of AASB 9, the identifi ed rate based on Monash Health’s past ‘Expected Credit Loss’ approach. impairment loss was immaterial. history, existing market conditions, Subject to AASB 9 impairment as well as forward looking estimates assessment include the Monash Contractual receivables at the end of the fi nancial year. Health’s contractual receivables, at amortised cost On this basis, Monash Health statutory receivables and its Monash Health applies AASB 9 simplifi ed determines the opening loss allowance investment in debt instruments. approach for all contractual receivables and the closing loss allowance at end of Equity instruments are not subject to measure expected credit losses the fi nancial year as disclosed above. to impairment under AASB 9. Other using a lifetime expected loss allowance fi nancial assets mandatorily measured based on the assumptions about risk
Reconciliation of the movement in the loss 2020 2019 allowance for contractual receivables $'000 $'000
Balance at beginning of the year 3,872 3,289
Opening retained earnings adjustment on adoption of AASB 9 - -802
Opening Loss Allowance 5.1 3,872 2,488
Increase in provision recognised in the net result 3.1 3,845 3,618
Reversal of provision of receivables written off during the year as uncollectable -3,392 -2,233
Balance at end of the year 5.1 4,326 3,872
Credit loss allowance is classifi ed off when identifi ed. A provision is made nevertheless recognised and as other economic fl ows in the net for estimated irrecoverable amounts from measured in accordance with result. Contractual receivables are the sale of goods when there is objective AASB 9 requirements as if those written off when there is no reasonable evidence that an individual receivable receivables are fi nancial instruments. expectation of recovery and impairment is impaired. Bad debts considered Statutory receivables are considered losses are classifi ed as a transaction as written off by mutual consent. to have low credit risk, taking into expense. Subsequent recoveries of account the counter party’s credit amounts previously written off are Statutory receivables and debt rating, risk of default and capacity to credited against the same line item. investments at amortised cost meet contractual cash fl ow obligations In prior years, a provision for doubtful Monash Health’s non-contractual in the near term. As a result, the loss debts is recognised when there is receivables arising from statutory allowance recognised for these fi nancial objective evidence that the debts may not requirements are not fi nancial assets during the period was limited be collected and bad debts are written instruments. However, they are to 12 months expected losses.
Monash Health Annual Report. 2019-20 134 Note 8: Other disclosures
This section includes additional material disclosures required by accounting standards or otherwise, for the understanding of this fi nancial report.
Structure • 8.1 Reconciliation of Net Result for the Year to Net Cash Flow from Operating Activities • 8.2 Responsible Persons Disclosures • 8.3 Remuneration of Executives • 8.4 Related Parties • 8.5 Remuneration of Auditors • 8.6 Events Occurring after the Balance Sheet Date • 8.7 Controlled Entities • 8.8 Investments accounted for using the Equity Method • 8.9 Economic Dependency • 8.10 Changes in Accounting Policy • 8.11 AASBs Issued that are not yet Effective • 8.12 Glossary
Note 8.1: Reconciliation of Net Result for the Consolidated Consolidated Year to Net Cash Flow from Operating Activities 2020 2019 Note $'000 $'000
Net Result for the Year 25,782 (5,080)
Non-cash movements:
Depreciation and amortisation 4.3 118,846 73,129
Provision for doubtful debts 5.1 (a) 454 1,384
Share of net results in associates 3.2 -117 -29
Net movement in Finance Lease Liability and Borrowings -14,392 18,239
Government Non Cash Funding for Hospital Expansion -73,366 -65,050
Discount (interest)/ expense on Loan 96 690
Movements included in investing and fi nancing activities
Net gain / -loss from Sale of Plant and Equipment -589 760
Movements in assets and liabilities:
Statement of changes in equity – changes for AASB 1059 and AASB 15 adoption
For the fi nancial year ended 30 June 2020
(Increase)/Decrease in Receivables -1,058 -41,633
(Increase)/Decrease in Other Assets -78 -2,509
Increase/(Decrease) in Payables 82,754 5,211
Increase/(Decrease) in Other Liabilities 235,155 72,633
Increase/(Decrease) in Provisions 54,495 -2,978
(Increase)/Decrease in Inventories -6,428 -1,208
Net cash infl ow/(outfl ow) from operating activities 421,639 53,558
Financial Statements 135 Financial Statements
Note 8.2: Responsible persons disclosures
In accordance with the Ministerial Directions issued by the Assistant Treasurer under the Financial Management Act 1994, the following disclosures are made regarding responsible persons for the reporting period.
Responsible Ministers Period
The Honourable Jenny Mikakos, Minister for Health and Minister for Ambulance Services 01/07/2019 - 30/06/2020
The Honourable Martin Foley, Minister for Mental Health 01/07/2019 - 30/06/2020
The Honourable Luke Donnellan, Minister for Child Protection, 01/07/2019 - 30/06/2020 Minister for Disability, Ageing and Carers
Governing Boards
Mr Dipak Sanghvi – Chair 01/07/2019 - 30/06/2020
Ms Aurélia Balpe 01/07/2019 - 30/06/2020
Mr Charles Gillies 01/07/2019 - 30/06/2020
Prof. Hatem Salem AM 01/07/2019 - 30/06/2020
Ms Helen Brunt 01/07/2019 - 30/06/2020
Mrs Jane Bell 01/07/2019 - 30/06/2020
Associate Professor Misty Jenkins 01/07/2019 - 30/06/2020
Ms Robyn McLeod 01/07/2019 - 30/06/2020
Mr Tony Brain 01/07/2019 - 30/06/2020
Accountable Offi cers Mr Andrew Stripp (Chief Executive) 01/07/2019- 30/06/2020
Remuneration of Responsible Persons The number of Responsible Persons are shown in their relevant income bands. Kitaya Holding Pty Ltd is Monash Health’s controlled entity. Amounts relating to Kitaya Holding Pty Ltd’s Governing Board Members and Accountable Offi cer are disclosed in its fi nancial statements. Amounts relating to Responsible Ministers are reported within the Department of Parliamentary Services’ Financial Report.
Consolidated Consolidated 2020 2019 Income Band No. No.
$50,000 - $59,999 7 8
$60,000 - $69,999 1 -
$100,000 - $109,999 1 1
$530,000 - $539,999 1 1
Total Numbers 10 10
2020 2019 $'000 $'000
Total remuneration received or due and receivable by Responsible $1,105 $1,079 Persons from the reporting entity amounted to:
Monash Health Annual Report. 2019-20 136 Note 8.3: Remuneration of Executives
The number of executive offi cers, other than Ministers and Accountable Offi cers, and their total remuneration during the reporting period are shown in the table below. Total annualised employee equivalent provides a measure of full time equivalent executive offi cers over the reporting period. Consolidated Total Remuneration
2020 2019 Remuneration of Executive Offi cers $'000 $'000 Short-term Benefi ts 2,974 3,041
Post-employment Benefi ts 174 233
Other Long-term Benefi ts 257 207
Total Remuneration i 3,405 3,481
Total Number of Executives 10 11
Total Annualised Employee Equivalent ii 10 11 i. The total number of executive offi cers includes persons who meet the defi nition of Key Management Personnel (KMP) of Monash Health under AASB 124 Related Party Disclosures and are also reported within Note 8.4 Related Parties. ii. Annualised employee equivalent is based on working 38 ordinary hours per week over the reporting period.
Total remuneration payable to executives Short-term Employee Benefi ts during the year included additional Salaries and wages, annual leave or sick executive offi cers and a number leave that are usually paid or payable on of executives who received bonus a regular basis, as well as non-monetary payments during the year. These benefi ts such as allowances and free bonus payments depend on the terms or subsidised goods or services. of individual employment contracts. Remuneration comprises employee Post-employment Benefi ts benefi ts in all forms of consideration Pensions and other retirement benefi ts paid, payable or provided in exchange paid or payable on a discrete basis for services rendered, and is disclosed when employment has ceased. in the following categories: Other Long-term Benefi ts Long service leave, other long-service benefi t or deferred compensation.
Financial Statements 137 Financial Statements
Note 8.4: Related parties Monash Health is a wholly owned and controlled entity of the State of Victoria. Related parties of Monash Health include:
• All Key Management Personnel (KMP) and their close family members;
• Cabinet ministers (where applicable) and their close family members;
• Controlled Entity – Kitaya Holdings Pty Ltd; and
• All hospitals and public sector entities that are controlled and consolidated into the State of Victoria fi nancial statements.
KMPs are those people with the authority and responsibility for planning, directing and controlling the activities of the Monash Health and its controlled entities, directly or indirectly. The Board of Directors and the Chief Executive of Monash Health and its controlled entities are deemed to be KMPs.
Key Management Position Title Compensation - KMPs Consolidated Consolidated personnel of 2020 2019 Monash Health $’000 $’000 Mr Dipak Sanghvi Chair of the Board Short-term Employee Benefi tsi 993 956
Ms Aurélia Balpe Board Member Post-employment Benefi ts 79 76
Ms Jane Bell Board Member Other Long-term Benefi ts 33 47
Mr Tony Brain Board Member Total ii 1,105 1,079
Ms Helen Brunt Board Member i. Total remuneration paid to KMPs employed as a contractor Mr Charles Gillies Board Member during the reporting period through accounts payable has been reported under short-term employee benefi ts. Assoc. Prof. Misty Jenkins Board Member ii. KMPs are also reported in Note 8.2 Responsible Persons or Note 8.3 Remuneration of Executives. Ms Robyn McLeod Board Member
Prof. Hatem Salem Board Member
Mr Andrew Stripp Chief Executive Offi cer
Kitaya Holdings Pty Ltd’s KMPs are disclosed in the company’s fi nancial statements. The compensation detailed below excludes the salaries and benefi ts the Portfolio Ministers receive. The Minister’s remuneration and allowances is set by the Parliamentary Salaries and Superannuation Act 1968, and is reported within the Department of Parliamentary Services’ Financial Report.
Monash Health Annual Report. 2019-20 138 Signifi cant Transactions with Transactions with KMPs and Controlled Entities Related Government Related Entities Other Related Parties Party Transactions Monash Health received funding from Given the breadth and depth of State the Department of Health and Human government activities, related parties Kitaya Holdings Pty Ltd Services (DHHS) of $1,783m (2019: transactions with the Victorian public $1,541m) and indirect contributions sector occur in a manner consistent • Ms Jane Bell is a member of both of $13.7m (2019: $23.6m). with other members of the public. the Monash Health Board and the Monash Health also received further Further, employment of processes within Kitaya Holdings Pty Ltd Board. funds from the DHHS of $850m to the Victorian public sector occur on • Mr Andrew Stripp is Chief Executive act as an agent for the Department in terms and conditions consistent with of Monash Health and a member of paying, warehousing and distributing the Public Administration Act 2004 the Kitaya Holdings Pty Ltd Board. products for Victorian health services and Codes of Conduct and Standards • Mr Stuart Donaldson is Chief and other entities during the COVID-19 issued by the Victorian Public Sector Financial Offi cer of Monash pandemic. As at 30 June 2020 Monash Commission. Procurement processes Health and a member of the Health have recorded a current occur on terms and conditions Kitaya Holdings Pty Ltd Board. liability of $195m for the remaining consistent with the Victorian Government balance owed to the department for Procurement Board requirements. Kitaya Holdings Pty Ltd operates amounts received but unspent. Outside of normal citizen type Jessie McPherson Private Hospital. The DHHS granted an interest free transactions with Monash Health, there Monash Health is reimbursed by its loan of $10m to Monash Health in 2018. were no related party transactions that controlled entity, Kitaya Holdings Pty Ltd, The loan is repayable over 10 years with involved key management personnel, for the provision of goods and services repayments made annually. At 30 June their close family members and their required to run the private hospital. 2020, the total amount due to DHHS in personal business interests. No The fee includes charges for labour, relation to this loan was $7.6m (2019: provision has been required, nor any power, food, cleaning and other services. $8.5m). In June 2020, the Department expense recognised, for impairment of All transactions are conducted on normal of Health and Human Services granted receivables from related parties. There commercial terms and conditions. a cash advance of $52.4m to meet early were no related party transactions The aggregate amounts brought July Payments. The amount is repayable with Cabinet Ministers required to to account in respect of the following early in the 20/21 fi nancial year. be disclosed in 2020 (2019 Nil). types of transactions were: Monash Health has two loan There were no related party agreements with Treasury Corporation transactions required to be disclosed for of Victoria (TCV) for $19.6m and $13.3m the Monash Health Board of Directors with amounts borrowed repayable and the Chief Executive Offi cer in 2020. over 22 and 20 years respectively. Related party transactions required At 30 June 2020, the total amount to be disclosed for Kitaya Holding Pty due to TCV in relation to these loans Ltd’s Board of Directors in 2020 are was $24.7m (2019: $26.0m) disclosed in its fi nancial statements. Expenses incurred by Monash Health in delivering services and outputs are in accordance with Health Purchasing 2020 2019 Victoria requirements. Goods and $'000 $'000 services including procurement, diagnostics, patient meals and multi- Rental income received from 1,183 1,166 site operational support are provided its controlled entity by other Victorian Health Service Contracted goods and services Providers on commercial terms. 17,438 22,935 provided to its controlled entity Professional medical indemnity insurance and other insurance products Amount owing to controlled 15,586 11,479 are obtained from the Victorian entity at balance date Managed Insurance Authority. The Standing Directions of the Assistant Treasurer require Monash Consolidated Health to hold cash (in excess of working capital) in accordance with the State’s 2020 2019 centralised banking arrangements. 8.5 Remuneration of Auditors $'000 $'000 All borrowings are required to be Victorian Auditor-General’s Offi ce sourced from Treasury Corporation Victorian unless an exemption has been Audit of the Financial Statements 337 336 approved by the Minister for Health and Total Remuneration of Auditors 337 336 Human Services and the Treasurer.
Financial Statements 139 Financial Statements
Note 8.6: Events occurring after the balance sheet date
The COVID-19 pandemic has created it is diffi cult to reliably estimate with any state of disaster still in place. unprecedented economic uncertainty. degree of certainty the potential impact No other matters or circumstances have Actual economic events and of the pandemic after the reporting date arisen since the end of the fi nancial year conditions in the future may be materially on Monash Health, its operations, its which signifi cantly affected or may affect the different from those estimated by future results and fi nancial position. operations of Monash Health, the results Monash Health at the reporting date. The state of emergency in Victoria of the operations or the state of affairs of As responses by government continue was extended on 16 August 2020 Monash Health in the future fi nancial years. to evolve, management recognises that until 13 September 2020 and the
Note 8.7: Controlled entities Monash Health’s interest in the jointly controlled operations are detailed below. The amounts are included in the consolidated fi nancial statements under their respective categories:
Name of Entity Country of Incorporation Ownership Interest % Equity Holding
Kitaya Holdings Pty Ltd Australia 100 100% (trading as Jessie McPherson Private Hospital)
Monash Health’s interest in revenues and expenses resulting from this is detailed below:
Controlled entities contribution to the consolidated results
2020 2019 Net result for the year $'000 $'000
Kitaya Holdings Pty Ltd -2,151 -2,872
Note 8.8: Investments accounted for using the equity method Principal Country of Activity Incorporation Ownership Interest Published Fair Value
2020 2019 2020 2019 Name of Entity % % $'000 $'000
Associates
Monash Health Research Property Australia 20.33 20.33 4,246 4,129 Precinct Pty Ltd (a)(b) Investment
(a) As at 30 June 2020, the fair value of Monash Health’s interest in Monash Health Research Precinct Pty Ltd was based on its share of the company’s net assets which is a level 3 input in terms of AASB 13 Fair Value Measurement.
(b) The fi nancial year end date in Monash Health Research Precinct Pty Ltd is 31 December. This was the reporting date established when that company was incorporated. For the purpose of applying the equity method of accounting, the fi nancial statements of Monash Health Research Precinct Pty Ltd have been used, and appropriate adjustment have been made for the effects of signifi cant transactions between that date and 30 June 2020.
Note 8.9: Economic The Department of Health and Human prepared on a going concern basis. dependency Services has provided confi rmation Monash Health’s current asset ratio Monash Health is wholly dependent that it will continue to provide Monash continues to be below an adequate on the continued fi nancial support Health adequate cash fl ow support to short term position (2020: 0.65 and of the State Government and meet its current and future obligations 2019: 0.41) while cash generated from in particular, the Department of as and when they fall due. On that basis, operations has increased from a $54m Health and Human Services. the fi nancial statements have been surplus in 2019 to a $422m surplus in
Monash Health Annual Report. 2019-20 140 2020 this was mainly due to $850m Contracts that were not identifi ed • Adjusted the right-of-use assets grant received for state health product as leases under AASB 117 and by the amount of AASB 137 supply for the COVID-19 pandemic Interpretation 4 were not reassessed onerous contracts provision response and $590m paid for supplies for whether there is a lease. immediately before the date of and consumables for the COVID-19 Therefore, the defi nition of a initial application, as an alternative response. Cash reserves have moved lease under AASB 16 was applied to an impairment review; from $112m in 2019 to $501m ($241m to contracts entered into or excluding COVID19 Victorian Health changed on or after 1 July 2019. • Applied the exemption not to Services Product funds) in 2020. A letter recognise right-of-use assets confi rming adequate cash fl ow was also Leases classifi ed as operating and liabilities for leases with less provided in the previous fi nancial year. leases under AASB 117 than 12 months of lease term; As a lessee, Monash Health previously Note 8.10: Changes in classifi ed leases as operating or fi nance • Excluded initial direct costs from accounting policy leases based on its assessment of measuring the right-of-use asset at whether the lease transferred signifi cantly the date of initial application; and Leases all of the risks and rewards incidental This note explains the impact of the to ownership of the underlying asset • Used hindsight when determining adoption of AASB 16 Leases on to Monash Health. Under AASB 16, the lease term if the contract Monash Health fi nancial statements. Monash Health Service recognises contains options to extend Monash Health has applied AASB right-of-use assets and lease or terminate the lease. 16 with a date of initial application of 1 liabilities for all leases except where July 2019. Monash Health has elected exemption is availed in respect of For leases that were classifi ed as to apply AASB 16 using the modifi ed short-term and low value leases. fi nance leases under AASB 117, retrospective approach, as per the On adoption of AASB 16, Monash the carrying amount of the right- transitional provisions of AASB 16 for Health recognised lease liabilities of-use asset and lease liability at 1 all leases for which it is a lessee. in relation to leases which had July 2019 are determined as the The cumulative effect of initial previously been classifi ed as operating carrying amount of the lease asset application is recognised in retained leases under the principles of AASB and lease liability under AASB 117 earnings as at 1 July 2019. Accordingly, 117 Leases. These liabilities were immediately before that date. the comparative information presented measured at the present value of the is not restated and is reported under remaining lease payments, discounted Leases as a Lessor AASB 117 and related interpretations. using Monash Health’s incremental Monash Health is not required to make Previously, Monash Health determined borrowing rate as of 1 July 2019. any adjustments on transition to AASB at contract inception whether an On transition, right-of-use assets are 16 for leases in which it acts as a arrangement is or contains a lease measured at the amount equal to the lessor. Monash Health accounted for under AASB 117 and Interpretation lease liability, adjusted by the amount of its leases in accordance with AASB 4 – ‘Determining whether an any prepaid or accrued lease payments 16 from the date of initial application. arrangement contains a Lease’. Under relating to that lease recognised in the AASB 16, Monash Health assesses balance sheet as at 30 June 2019. Impacts on fi nancial statements whether a contract is or contains a Monash Health has elected On transition to AASB 16, Monash lease based on the defi nition of a to apply the following practical Health recognised $92,234,872 lease as explained in note 6.1. expedients when applying AASB of right-of-use assets and On transition to AASB 16, Monash 16 to leases previously classifi ed as $92,234,872 of lease liabilities. Health has elected to apply the practical operating leases under AASB 117: When measuring lease liabilities, expedient to grandfather the assessment Monash Health discounted lease of which transactions are leases. • Applied a single discount rate payments using its incremental It applied AASB 16 only to contracts to a portfolio of leases with borrowing rate at 1 July 2019. The that were previously identifi ed as leases. similar characteristics; weighted average rate applied is 6.05%.
1 July 2019 $’000
Total Operating lease commitments disclosed at 30 June 2019 35,999
Discounted using the incremental borrowing rate at 1 July 2019 35,151
Finance lease liabilities as at 30 June 2019 53,075
Recognition exemption for:
Short-term leases -263
Leases of low-value assets -608
Extension and termination options reasonably certain to be exercised 4,880
Lease liabilities recognised at 1 July 2019 92,235
Financial Statements 141 Financial Statements
Revenue from Contracts Income of Not-for-Profi t Entities Transition impact on with Customers In accordance with FRD 122 fi nancial statements. In accordance with FRD 121 requirements, Monash Health has This note explains the impact requirements, Monash Health has applied applied the transitional provision of AASB of the adoption of the following the transitional provision of AASB 15, 1058, under modifi ed retrospective new accounting standards for the under modifi ed retrospective method with method with the cumulative effect of fi rst time, from 1 July 2019: the cumulative effect of initially applying initially applying this standard against this standard against the opening the opening retained earnings at 1 July • AASB 15 Revenue from retained earnings at 1 July 2019. Under 2019. Under this transition method, Contracts with Customers; this transition method, Monash Health Monash Health applied this standard applied this standard retrospectively only retrospectively only to contracts and • AASB 1058 Income of Not- to contracts that are not ‘completed transactions that are not completed for-Profi t Entities; and contracts’ at the date of initial application. contracts at the date of initial application. Monash Health has not applied the fair Comparative information • AASB 16 Leases. value measurement requirements for has not been restated. right-of-use assets arising from leases Note 2.1 – Grants includes details Impact on Balance Sheet due to the with signifi cantly below-market terms about the transitional application of adoption of AASB 15, AASB 1058 and conditions principally to enable the AASB 1058 and how the standard has and AASB 16 is illustrated with the entity to further its objectives as allowed been applied to revenue transactions. following reconciliation between the under temporary option under AASB The adoption of AASB 1058 did not restated carrying amounts at 30 June 16 and as mandated by FRD 122. have an impact on Other comprehensive 2019 and the balances reported under Comparative information income and the Statement of Cash the new accounting standards (AASB has not been restated. fl ows for the fi nancial year. 15 and AASB 16) at 1 July 2019: Note 2.1 – Sales of goods and services includes details about the transitional application of AASB 15 and how the standard has been applied to revenue transactions.
Note 8.10: Changes in accounting policy Before new Impact of new After new accounting accounting accounting standards standards - standards Opening 1 AASB 16, 15 Opening 1 July 2019 & 1058 July 2019 Balance sheet Notes $’000 $’000 $’000
Property, Plant and Equipment 4.1 1,868,135 39,160 1,907,295
Total non-fi nancial assets 1,932,792 39,160 1,971,952
Total Assets 2,252,248 39,160 2,291,408
Borrowings 6.1 107,127 39,160 146,287
Total Liabilities 677,135 39,160 716,295
Accumulated surplus/(defi cit) 120,514 120,514
Physical Revaluation Surplus 1,026,168 1,026,168
Other items in equity 428,431 428,431
Total Equity 1,575,113 1,575,113
Monash Health Annual Report. 2019-20 142 Note 8.11: AASBs Issued that are not yet Effective
Certain new Australian accounting of their applicability and early reporting periods commencing after standards have been published that adoption where applicable. the stated operative dates as detailed are not mandatory for the 30 June As at 30 June 2020, the following in the table below. Monash Health 2020 reporting period. Department standards and interpretations had Service has not and does not intend of Treasury and Finance assesses been issued by the AASB but were not to adopt these standards early. the impact of all these new standards yet effective. They become effective and advises Monash Health Service for the fi rst fi nancial statements for
Standard/ Summary Applicable for annual reporting Impact on public sector Interpretation periods beginning on entity fi nancial statements.
AASB 17 The new Australian standard 1 Jan 2021 The assessment has indicated Insurance eliminates inconsistencies and that there will be no signifi cant Contracts weaknesses in existing practices impact for the public sector. by providing a single principle based framework to account for all types of insurance contracts, including reissuance contract that an insurer holds. It also provides requirements for presentation and disclosure to enhance comparability between entities. This standard currently does not apply to the not-for-profi t public sector entities
AASB 2018-7 This Standard principally 1 Jan 2020 The standard is not expected Amendments amends AASB 101 Presentation to have a signifi cant impact to Australian of Financial Statements and on the public sector. Accounting AASB 108 Accounting Policies, Standards – Changes in Accounting Estimates Defi nition of and Errors. The amendments Material refi ne and clarify the defi nition of material in AASB 101 and its application by improving the wording and aligning the defi nition across AASB Standards and other publications. The amendments also include some supporting requirements in AASB 101 in the defi nition to give it more prominence and clarify the explanation accompanying the defi nition of material.
Financial Statements 143 Financial Statements
Note 8.12: Glossary of terms and style conventions
Actuarial gains or losses on Effective interest method superannuation defi ned benefi t plans The effective interest method is used Financial instrument Actuarial gains or losses are changes in to calculate the amortized cost of a A fi nancial instrument is any contract the present value of the superannuation fi nancial asset or liability and of allocating that gives rise to a fi nancial asset of one defi ned benefi t liability resulting from: interest income over the relevant period. entity and a fi nancial liability or equity The effective interest rate is the rate instrument of another entity. Financial • experience adjustments (the effects that exactly discounts estimated future assets or liabilities that are not contractual of differences between the previous cash receipts through the expected (such as statutory receivables or actuarial assumptions and what life of the fi nancial instrument, or, payables that arise as a result of statutory has actually occurred); and where appropriate, a shorter period. requirements imposed by governments) are not fi nancial instruments. • the effects of changes in Employee benefi ts expenses actuarial assumptions. Employee benefi ts expenses include Financial liability all costs related to employment A fi nancial liability is any liability that is: Amortisation including wages and salaries, fringe Amortizations is the expense which benefi ts tax, leave entitlements, • A contractual obligation: results from the consumption, extraction redundancy payments, defi ned benefi ts or use over time of a non-produced superannuation plans, and defi ned – to deliver cash or another fi nancial physical or intangible asset. contribution superannuation plans. asset to another entity; or – to exchange fi nancial assets or Associates Ex gratia expenses fi nancial liabilities with another Associates are all entities over which Ex gratia expenses mean the voluntary entity under conditions that are an entity has signifi cant infl uence but payment of money or other non-monetary potentially unfavorable to the entity; not control, generally accompanying benefi t (e.g. a write off) that is not made or a shareholding and voting rights of either to acquire goods, services or other between 20 per cent and 50 per cent. benefi ts for the entity or to meet a legal • A contract that will or may liability, or to settle or resolve a possible be settled in the entity’s own Comprehensive result legal liability, or claim against the entity. equity instruments and is: The net result of all items of income and expense recognized for the period. Financial asset – a non-derivative for which the entity It is the aggregate of operating result A fi nancial asset is any asset that is: is or may be obliged to deliver a and other comprehensive income. variable number of the entity’s own • cash; equity instruments; or Commitments Commitments include those • an equity instrument of another entity; – a derivative that will or may be operating, capital and other settled other than by the exchange outsourcing commitments arising • a contractual or statutory right: of a fi xed amount of cash or from non-cancellable contractual another fi nancial asset for a fi xed or statutory sources. – to receive cash or another fi nancial number of the entity’s own equity asset from another entity; or instruments. For this purpose the Current grants – to exchange fi nancial assets or entity’s own equity instruments Amounts payable or receivable fi nancial liabilities with another do not include instruments that for current purposes for which no entity under conditions that are are themselves contracts for the economic benefi ts of equal value are potentially favorable to the entity; future receipt or delivery of the receivable or payable in return. or entity’s own equity instruments.
Depreciation • a contract that will or may Depreciation is an expense that be settled in the entity’s own arises from the consumption through equity instruments and is: wear or time of a produced physical or intangible asset. This expense – a non-derivative for which the reduces the ‘net result for the year’. entity is or may be obliged to receive a variable number of the entity’s own equity instruments; or
– a derivative that will or may be settled other than by the exchange of a fi xed amount of cash or another fi nancial asset for a fi xed number of the entity’s own equity instruments.
Monash Health Annual Report. 2019-20 144 Financial statements General government sector Liabilities A complete set of fi nancial statements The general government sector Liabilities refers to interest-bearing comprises: comprises all government liabilities mainly raised from public departments, offi ces and other bodies liabilities raised through the Treasury • Balance sheet as at the engaged in providing services free Corporation of Victoria, fi nance leases end of the period; of charge or at prices signifi cantly and other interest-bearing arrangements. below their cost of production. Liabilities also include non-interest- • Comprehensive operating General government services include bearing advances from government statement for the period; those which are mainly non-market that are acquired for policy purposes. in nature, those which are largely • A statement of changes in for collective consumption by the Net acquisition of non-fi nancial equity for the period; community and those which involve assets (from transactions) the transfer or redistribution of income. Purchases (and other acquisitions) • Cash fl ow statement for the period; These services are fi nanced mainly of non-fi nancial assets less sales (or through taxes, or other compulsory disposals) of non-fi nancial assets less • Notes, comprising a summary of levies and user charges. depreciation plus changes in inventories signifi cant accounting policies and Intangible produced assets and other movements in non-fi nancial other explanatory information; Refer to produced assets assets. It includes only those increases in this glossary. or decreases in non-fi nancial assets • Comparative information in resulting from transactions and therefore respect of the preceding period Intangible non-produced assets excludes write-offs, impairment as specifi ed in paragraph 38 Refer to non-produced write-downs and revaluations. of AASB 101 Presentation of asset in this glossary. Financial Statements; and Net result Interest expense Net result is a measure of fi nancial • A statement of fi nancial position Costs incurred in connection with the performance of the operations for the at the beginning of the preceding borrowing of funds includes interest period. It is the net result of items of period when an entity applies an on bank overdrafts and short-term income, gains and expenses (including accounting policy retrospectively or and long-term liabilities, amortization losses) recognized for the period, makes a retrospective restatement of discounts or premiums relating to excluding those that are classifi ed of items in its fi nancial statements, liabilities, interest component of fi nance as ‘other comprehensive income’. or when it reclassifi es items in its leases repayments, and the increase Net result from transactions/ fi nancial statements in accordance in fi nancial liabilities and non-employee net operating balance, Net result with paragraphs 41 of AASB 101. provisions due to the unwinding of from transactions or net operating discounts to refl ect the passage of time. balance is a key fi scal aggregate and Grants and other transfers is income from transactions minus Transactions in which one unit provides Interest income expenses from transactions. goods, services, assets (or extinguishes Interest income includes unwinding It is a summary measure of the a liability) or labor to another unit over time of discounts on fi nancial ongoing sustainability of operations. without receiving approximately equal assets and interest received on bank It excludes gains and losses resulting value in return. Grants can either term deposits and other investments. from changes in price levels and other be operating or capital in nature. changes in the volume of assets. While grants to governments may Investment properties result in the provision of some goods or Investment properties represent Net worth services to the transferor, they do not give properties held to earn rentals or Assets less liabilities, which is an the transferor a claim to receive directly for capital appreciation or both. economic measure of wealth. benefi ts of approximately equal value. Investment properties exclude For this reason, grants are referred properties held to meet service delivery Non-fi nancial assets to by the AASB as involuntary transfers objectives of the State of Victoria. Non-fi nancial assets are all assets that and are termed non-reciprocal transfers. are not ‘fi nancial assets’. It includes Receipt and sacrifi ce of Joint Arrangements inventories, land, buildings, infrastructure, approximately equal value may occur, A joint arrangement is an arrangement and road networks, land under roads, but only by coincidence. For example, of which two or more parties have joint plant and equipment, investment governments are not obliged to provide control. A joint arrangement has the properties, cultural and heritage assets, commensurate benefi ts, in the form following characteristics: intangible and biological assets. of goods or services, to particular taxpayers in return for their taxes. • The parties are bound by a Grants can be paid as general contractual arrangement. purpose grants which refer to grants that are not subject to • The contractual arrangement gives conditions regarding their use. two or more of those parties joint Alternatively, they may be paid as control of the arrangement specifi c purpose grants which are paid for a particular purpose and/or have A joint arrangement is either a joint conditions attached regarding their use. operation or a joint venture.
Financial Statements 145 Non-produced assets Sales of goods and services Transactions Non-produced assets are assets Refers to income from the direct Revised Transactions are those needed for production that have not provision of goods and services and economic fl ows that are considered themselves been produced. They includes fees and charges for services to arise as a result of policy decisions, include land, subsoil assets, and certain rendered, sales of goods and services, usually an interaction between two intangible assets. Non-produced fees from regulatory services and entities by mutual agreement. intangibles are intangible assets work done as an agent for private They also include fl ows in an entity needed for production that have not enterprises. It also includes rental such as depreciation where the owner is themselves been produced. They include income under operating leases and on simultaneously acting as the owner of the constructs of society such as patents. produced assets such as buildings and depreciating asset and as the consumer entertainment, but excludes rent income of the service provided by the asset. Non-profi t institution from the use of non-produced assets Taxation is regarded as mutually A legal or social entity that is created such as land. User charges includes agreed interactions between the for the purpose of producing or sale of goods and services income. government and taxpayers. distributing goods and services but is Transactions can be in kind (e.g. not permitted to be a source of income, Supplies and services assets provided/given free of charge profi t or other fi nancial gain for the units Supplies and services generally or for nominal consideration) or where that establish, control or fi nance it. represent cost of goods sold and the the fi nal consideration is cash. day-to-day running costs, including Payables maintenance costs, incurred in the Style conventions Includes short and long term trade normal operations of Monash Health. Figures in the tables and in the text debt and accounts payable, grants, Supplies and services are recognised have been rounded. Discrepancies taxes and interest payable. as an expense in the reporting period in tables between totals and sums of in which they are incurred. The components refl ect rounding. Percentage Produced assets carrying amounts of any inventories variations in all tables are based on Produced assets include buildings, plant held for distribution are expensed the underlying unrounded amounts. and equipment, inventories, cultivated when the inventories are distributed. The notation used in the assets and certain intangible assets. tables is as follows: Intangible produced assets may include Taxation income computer software, motion picture fi lms, Taxation income represents income • zero, or rounded to zero and research and development costs received from the State’s taxpayers and (which does not include the startup includes: • - , negative numbers costs associated with capital projects). • payroll tax; land tax; duties levied Public fi nancial corporation sector principally on conveyances Public fi nancial corporations (PFCs) and land transfers; are bodies primarily engaged in the provision of fi nancial intermediation • gambling taxes levied mainly services or auxiliary fi nancial services. on private lotteries, electronic They are able to incur fi nancial gaming machines, casino liabilities on their own account (e.g. operations and racing; taking deposits, issuing securities or providing insurance services). • insurance duty relating to compulsory Estimates are not published for the third party, life and non-life policies; public fi nancial corporation sector. • insurance company contributions Public non-fi nancial to fi re brigades; corporation sector The public non-fi nancial corporation • motor vehicle taxes, including (PNFC) sector comprises bodies mainly registration fees and duty on engaged in the production of goods and registrations and transfers; services (of a non-fi nancial nature) for sale in the market place at prices that aim to • levies (including the environmental recover most of the costs involved (e.g. levy) on statutory corporations in water and port authorities). In general, other sectors of government; and PNFCs are legally distinguishable from the governments which own them. • other taxes, including landfi ll levies, license and concession fees. Receivables Includes amounts owing from government through appropriation receivable, short and long term trade credit and accounts receivable, accrued investment income, grants, taxes and interest receivable.
Monash Health Annual Report. 2019-20 146
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