Melbourne Health Annual Report 2007/08
1BTTJPOGPS $BSJOH"DIJFWJOH UIF&YUSBPSEJOBSZ PROFILE
Prof Graham Brown
There was none more deserving of the 2007 Melbourne Health Chairman’s Award than Prof Graham Brown.
Prof Brown, an acclaimed infectious diseases physician, researcher and teacher, is passionate about public health and is highly regarded by colleagues for his outstanding leadership, intellect and ethical standards.
Prof Brown this year took up the role of Foundation Director of the Nossal Institute for Global Health and Foundation Chair in Global Health at the University of Melbourne.
Prof Brown’s association with Melbourne Health began as a medical student at RMH, then as a resident, medical registrar, consultant and ultimately, as the James Stewart Professor of Medicine. In 1996, he established the hospital’s renowned Victorian Infectious Diseases Service, taking responsibility for the many services transferred from the former Fairfi eld Infectious Diseases Hospital.
“It was almost by chance that I ended up in Medical School, and incredible good fortune to be trained in the environment of RMH that valued academic- based medicine with strong links to Melbourne University. The mentorship, the collegiality, the pursuit of excellence, the challenging students, the superb nursing and allied health staff, and above all, the concern and care for every patient, set very high standards and a benchmark for my career in medicine.” CONTENT
43 Financial Statements 44 Operating Statement 45 Balance Sheet Contents 46 Cash Flow Statement 2 Chairman’s Report 47 Statement of Changes in Equity 3 Chief Executive’s Report 48 Notes to the Financial Statements 4 Melbourne Health at a Glance 86 Independent Audit Report 8 The Royal Melbourne Hospital 14 NorthWestern Mental Health 18 North West Dialysis Service 21 Victorian Infectious Diseases Reference Laboratory 22 Facilities Management 24 Staff Development 28 Research 31 Community Support 32 Corporate Governance 37 Appendices - General Information - Donors - Senior Staff - Organisational Structure - Disclosure Index
The Melbourne Health Annual Report 2007/08 is also available at www.mh.org.au
Melbourne Health Annual Report 1 Chairman’s Report
In accordance with the Financial In August 2008, the Commonwealth These are not just wall posters but Management Act 1994, I am pleased to Government announced $7.3 million the way we work together throughout present the Report of Operations for funding to enhance our perioperative Melbourne Health. Melbourne Health for the year ending services, which will further improve 30 June 2008. patient access. I would also like to acknowledge our Chief Executive, Ms Linda Sorrell, who was I have just completed my first year as Construction of new facilities for the WHO the winner of the 2007 Telstra Victorian Chairman of Melbourne Health and I Collaborating Centre for Reference and Business Woman of the Year and the am delighted to report that 2007/08 has Research on Influenza – one of only four National and Victorian winner of the IBM been a year of significant improvement in the world – is nearly complete and is Community and Government category. in patient access, clinical and corporate expected to open in late December 2008. This is an outstanding achievement and a governance, organisational culture and testament to Linda’s professional standing In June 2008, we welcomed to the financial performance. On a personal note, and stature in the business community. I am tremendously proud to be associated Precinct the Royal Women’s Hospital, with an organisation such as Melbourne an iconic institution with a proud history. During the past year two major Health. The strength of our organisation We look forward to working closely with hospital wide projects were undertaken. is our people who bring care, skill and the Women’s Board to explore areas of The Australian Council on Healthcare dedication to our crucial community mutual benefit without compromising Standards (ACHS) Accreditation involved service. the independence of either organisation. every aspect of the hospital operation A combined Breast Service has been and required enormous effort from staff. During 2008, The Royal Melbourne operating successfully for some time; This work resulted in the organisation Hospital has celebrated its 160th year now the hospitals’ libraries have joined achieving four-year accreditation status of operation which makes it one of the as one unit, and the chaplaincy and receiving outstanding achievement most venerable and iconic Melbourne and pastoral care services are sharing ratings in Research and Contracts. institutions. Opening on 15 March 1848, a new sacred space. We are further Secondly the Nexus Disaster exercise, the hospital treated four outpatients connected to the Women’s by the new a statewide emergency and security and two inpatients on its first day. This shared retail precinct which has created a management exercise, affected a wide financial year, we treated nearly 300,000 lively ground floor link. The finishing touch cross section of the staff. Both of these outpatients and more than 100,000 will be the new front entrance for RMH projrcts demonstrated that teamwork inpatients, doing so as one of the state’s and the unveiling of the RMH Tapestry, and professionalism at Melbourne outstanding teaching, research and Healing Threads, in late 2008. Health is second to none. clinical hospitals. The $56 million RMH Emergency Finally I would like to thank retired Board This has been a busy and productive year Department redevelopment is member Dr Patricia Molloy for her valued of building and planning for our future. continuing and is due to open at the contribution over the past three years, end of 2009, to meet the expanding and welcome new Board member The Royal Melbourne Hospital (RMH) demand for emergency and trauma Mr Michael Gorton to Melbourne Health. Service Plan has been completed, services. This is a huge project, which as the first stage in planning a major has included substantial preparatory I would also like to acknowledge the redevelopment of the hospital. Detailed works and the creation of a temporary tireless and cooperative work of the planning has also started on the emergency facility which will open in Board and Executive over what has Melbourne Comprehensive Cancer Centre, early September 2008, allowing vital been a busy and challenging year but in conjunction with the State Government services to continue during the next a most successful year of achievement (which has provided $5 million funding construction phase. for Melbourne Health. for this stage), Peter MacCallum Cancer Centre and the Ludwig Institute for Cancer These capital projects have seen Research. Partnerships within the Parkville unprecedented construction activity Precinct continue to strengthen across in and around RMH (including the clinical, education and research initiatives. brick rectification works which are now complete). I wish to thank our patients, As part of its long-term vision for the Robert Doyle staff and visitors for their patience during Precinct, the Board has given in principle Chairman periods of disruption. endorsement of the Peter Doherty Melbourne Health Institute for Infection and Immunity During this year we have also had 18 August 2008 (PDI3). The PDI3 will integrate teaching, industrial action and while this is always training, research and public health difficult for all parties, one of the major activities in human infectious diseases at positive results was that staff worked The University of Melbourne and RMH, together in trying circumstances and offers opportunities in the areas of according to our Values – Caring, infectious diseases and immunity. Unity, Respect, Integrity and Discovery.
2 Melbourne Health Annual Report Chief Executive’s Report
It has been an exciting and dynamic In particular, clinical divisions’ innovation Finally, I would also like to acknowledge year at Melbourne Health. The and quality of care; the culture of quality the contribution of Assoc Prof Christine implementation of a comprehensive improvement; care planning and pathway Kilpatrick, Executive Director – The Royal improvement program has been development; staff fire training compliance Melbourne Hospital, a highly respected underpinned by strong clinical at 95 per cent; commitment to nursing clinician and administrator at RMH for 25 governance, improved financial postgraduate education; commitment to years. Chris was appointed Chief Executive management, increased patient access clinical research; and contract management Officer of the Royal Children’s Hospital and service delivery, robust consumer (the latter two received Outstanding in August 2008, and we wish her every participation, and open and Achievement ratings). success in her new role. inclusive communication. During the year, Melbourne Health Patient access has been significantly completed two major projects as part improved through an organisation- of the Victorian Government’s multi- wide Access Improvement Plan, with million dollar HealthSMART initiative to 19 improvement teams producing upgrade technology across all public excellent results, for example: hospitals. The FMIS Oracle system for Linda Sorrell purchase orders and expense claims Chief Executive > overall elective surgery waiting lists came online in July 2007, replacing the Melbourne Health reduced by 21 per cent paper system and providing staff with 18 August 2008 > no patients waiting more than a faster, easier and more accurate system. Melbourne Health Chief Executive Linda Sorrell 24 hours in Emergency for a bed In December 2007, a digital electronic was awarded the 2007 Victorian Telstra Business on a ward system to collate, store and view patients’ Woman of the Year and the National and diagnostic images was launched. State Telstra Awards for the Community and > waiting times for a hip replacement Government Sector category. improving by 63 per cent, and knee The Picture Archiving Communications replacement by 55 per cent System (PACS) enables clinicians to access patients’ x-rays from any computer across Alongside this work, Melbourne Health Melbourne Health. A third initiative, the has extensively reviewed corporate and Patient and Client Management System clinical governance structures during (P&CMS) project, will see the replacement the year. This has led to an improved of the ageing HOMER patient record Risk Management Framework, Clinical system with i.Patient Manager (iPM) Indicators, Workforce Planning Framework, by October 2009. Leadership Model and Development Capability Framework. The Melbourne Health Values – Caring, Respect, Integrity, Unity and Discovery Service-wide initiatives have achieved – developed by staff in late 2006, have a significant turnaround in our financial become embedded in the fabric of position, from a consolidated operating the organisation. The values feature deficit of $13,328,000 in 2006/07 to a in all recruitment advertising, position $641,000 deficit by 30 June 2008. We descriptions and employment interviews, are well placed to build further financial as well as in staff orientation, managers’ stability in the coming year and beyond. induction and Code of Conduct, as well as Melbourne Health publications, Melbourne Health achieved excellent correspondence and websites. results in the Australian Council on The values and associated behaviours Healthcare Standards survey, undertaken figure prominently in performance in December 2007. We were awarded reviews and training programs. four-year accreditation, a reflection of our commitment to providing quality clinical I am delighted to report Melbourne services. The surveyors commended Health initiatives won one Premier’s Melbourne Health for its many continuous Award, three Minister’s Awards, and one improvement projects and excellence in Gold and one Silver award at the 2008 education, training, and research. Victorian Public Healthcare Awards. Congratulations to the staff behind these outstanding efforts.
Melbourne Health Annual Report 3 Melbourne Health at a Glance
Melbourne Health is Melbourne Health was established 2008 Victorian Public Victoria’s second largest in July 2000 under the Health Services Healthcare Awards Act 1988 (Victoria) and comprises: health service, providing The expertise and achievements of comprehensive acute, > The Royal Melbourne Hospital (RMH) Melbourne Health staff were recognised sub-acute and community- City and Royal Park Campuses at the 2008 Victorian Public Healthcare based health care programs > NorthWestern Mental Health (NWMH) Awards, with departments and individuals winning four awards and winning a gold > North West Dialysis Service (NWDS) to more than one million and silver in category awards. people living in north- > Victorian Infectious Diseases Reference Laboratory (VIDRL) western metropolitan Premier’s Award Melbourne, as well as > Facilities Management The Premier’s Award is for initiatives at general and specialist the forefront of health improvement in the services to regional Statement of Purpose priority areas identified by the Premier and rural Victorians. Securing the health of our communities of Victoria. Through RMH, the State’s through research and innovation, to deliver effective services and educate The Royal Melbourne Hospital and second Adult Trauma future generations. Royal Women’s Hospital Combined Centre, Melbourne Health Breast Service won the award for excellence for improving cancer care also offers emergency Goals and trauma services to in Victoria, while the Jack Brockhoff Health care. We will deliver services Reconstructive Plastic Surgery Unit all Victorians. Melbourne that meet the current and changing RMH/The University of Melbourne, Health’s operating budget needs of our communities and collaborate were highly commended. is $676 million; it employs with our strategic partners so that we are more than 7800 staff; at the forefront of innovations in practice. Ministers’ Awards manages more than 1000 Quality and safety. We will provide The Ministers’ Awards are for exceptional beds; annually sees 55,000 a safe, appropriate and effective health dedication to delivering the best possible patients in the Emergency care experience, every time. care for consumers and communities. Department and provides Research. We will foster research that Prof Stephen Davis, Divisional Director over 700,000 occasions enhances patient care, challenges clinical Neurosciences, won the Health Minister’s of service. practice and promotes innovative health award for outstanding achievement by an service delivery. individual, particularly for his contribution to neurology, while the RMH ABO Education. We will invest in the Incompatible Renal Transplant Team, quality of our communities’ current won the outstanding achievment by a and future health by facilitating lifelong team category. multidisciplinary learning. Former NWMH Clinical Director Prof Bruce Organisational improvement. Singh won the Minister for Mental Health’s We will develop and maintain a dynamic award for outstanding achievement by an and sustainable organisation that provides individual in mental health care. our staff with a constructive working environment and achieves the goals of our organisation. Category Awards NWMH’s Psychiatric Assessment and Values Planning Unit won Gold in the providing timely and accessible health services Respect for the dignity, beliefs and category through its initiative to dramatically abilities of every individual improve Emergency Department waiting Caring and compassion times for mental health patients. 1BTTJPOGPS Integrity by being open, honest and fair Melbourne Health’s Improvement $BSJOH"DIJFWJOH Program was awarded Silver in the UIF&YUSBPSEJOBSZ Unity as a team and in embracing our communities providing sustainable, well managed and efficient health services category, which Discovery through passion for innovation recognises initiatives that lead to more sustainable healthcare services through innovative practices.
4 Melbourne Health Annual Report MELBOURNE HEALTH AT A GLANCE
Activity Performance
Admitted Patients Acute Subacute Mental Health Total
Separations
Sameday 76,978 5 - 76,983
Multiday 27,640 1,548 4,366 33,554
Total Separations 104,618 1,553 4,366 110,537
Emergency 27,595 1 4,366 31,962
Elective 77,023 1,552 - 78,575
Other inc Maternity - - - -
Total Separations 104,618 1,553 4,366 110,537
Total WIES 66,097
Total Bed days 222,177 43,799 150,323 416,299
Non- Admitted Patients Acute Subacute Mental Health Total
Emergency Department Presentations 55,423 55,423
Outpatient Services - occasions of service 201,931 29,969 428,687 660,587 (VACS and Non- VACS clinics)
Total occasions of service 257,354 29,969 428,687 716,010
Victorian Ambulatory Classification System 137,609 137,609 (Number of Weighted Encounters)
Financial Summary
2008 2007 2006 2005 2004 $’000 $’000 $’000 $’000 $’000 Total Revenue 723,016 672,891 651,423 627,365 572,138
Total Expenses 704,537 684,301 647,470 613,398 573,742
Loss Attributable to Minority Interest 422 633 259 0 0
Net Result Surplus / (Deficit) 18,901 (10,777) 4,212 13,967 (1,604)
Retained Surplus / (Deficit) (42,531) (61,057) (42,737) (39,759) (45,674)
Total Assets 618,926 546,134 525,841 460,227 398,846
Total Liabilities 164,760 178,651 160,916 159,737 136,357
Net Assets 454,166 367,483 364,925 300,490 262,489
Total Equity 454,166 367,483 364,925 300,490 262,489
Melbourne Health Annual Report 5 MELBOURNE HEALTH AT A GLANCE
Financial Analysis
Parent Entity Parent Entity Consolidated Consolidated
2008 2007 2008 2007 $ ‘000 $ ‘000 $ ‘000 $ ‘000
Services Supported by Health Services Agreement
Government Grants 521,481 488,979 521,481 488,979
Private Practice Fees 16,484 7,941 16,484 7,941
Indirect Contributions by Dept of Human Services 10,417 11,684 10,417 11,684
Patient and Resident Fees 14,847 11,395 14,847 11,395
Recoupment from Private Practice for use of Hospital Facilities 79 107 79 107
Research 205 446 205 446
Donations & Bequests 1 1 1 1
Interest 2,460 2,255 2,460 2,255
Dividends 3333
Property Income 66 78 66 78
Other Revenue 54,249 50,305 54,249 50,305
620,291 573,194 620,291 573,194
Services Supported by Hospital and Community Initiatives Government Grants 10,373 9,270 10,373 9,270
Private Practice Fees 4,234 4,109 4,234 4,109
Patient and Resident Fees 131 88 131 88
Research 12,051 7,457 12,051 7,457
Donations and Bequests 4,685 2,410 4,683 2,410
Interest 229 338 260 434
Dividend 515 204 605 219
Property Income 2,563 2,279 2,563 2,279
Other Revenue 19,832 51,654 21,404 51,169
54,612 77,809 56,304 77,435
674,903 651,003 676,595 650,629
EXPENSES Services Supported by Health Services Agreement Employee Entitlements 439,241 405,475 439,304 405,475
Non- Salary Labour Costs 13,718 16,637 13,718 16,637
Supplies and Consumables 117,187 110,027 117,187 110,027
Other Expenses 64,861 64,051 64,861 64,051
635,007 596,191 635,070 596,190
6 Melbourne Health Annual Report MELBOURNE HEALTH AT A GLANCE
Financial Analysis continued
Parent Entity Parent Entity Consolidated Consolidated
2008 2007 2008 2007 $ ‘000 $ ‘000 $ ‘000 $ ‘000
Services Supported by Hospital and Community Initiatives
Employee Entitlements 22,532 22,803 22,532 23,094
Non- Salary Labour Costs 1,824 1,840 1,824 1,840
Supplies and Consumables 4,535 27,708 4,535 27,708
Other Expenses 11,672 14,106 13,275 15,123
40,563 66,457 42,166 67,766
675,570 662,648 677,236 663,957
Surplus/(Deficit) for the year before Capital Purpose Income, Depreciation, Amortisation and Specific Revenuesand Expenses
Capital Purpose Income 46,421 22,262 46,421 22,262
Depreciation and Amortisation (26,527) (19,199) (26,527) (19,220)
Finance Costs (178) (151) (178) (152)
Expenditure using Capital Purpose Income (604) (973) (596) (973)
19,112 1,939 19,120 1,918
Net Result from Continuing Operations 18,445 (9,706) 18,479 (11,410)
Loss Attributable to Minority Interest 0 0 422 633
Net Surplus/(Deficit) 18,445 (9,706) 18,901 (10,777)
Melbourne Health Annual Report 7 The Royal Melbourne Hospital
The Royal Melbourne In 2007/2008, the hospital exceeded Over the last 12 months, their initiatives Hospital is offi cially the that level, with more than 106,000 have created major improvements. admissions, alongside 300,000 outpatient Overall elective surgery waiting lists busiest hospital in Australia. appointments and 55,000 Emergency have been reduced by 21 per cent, and In the Commonwealth Department presentations. turnaround times for radiology test results Government’s The State have improved from 71 per cent within The hospital is a tertiary referral hospital, of Our Public Hospitals 24 hours to 95 per cent in the same operating from two campuses. RMH period. The Orthopaedics team has 2008 report, the RMH City Campus provides specialist acute reduced the average waiting time for City Campus headed clinical services across all specialties, plus a hip replacement from 170 days to the list with 100,476 a designated State Adult Trauma Service 63 days, a 63 per cent improvement on admissions in 2006/07. and the statewide Victorian Infectious the previous year, and knee replacement Diseases Service. RMH Royal Park from 252 days to 113 days, a 55 per cent Campus provides sub-acute, aged and improvement. rehabilitation services, and coordinates residential care facilities. These improvements happened in a period of increased demand: during Access improvement 2007/08 episodes of care rose 3.5 per cent, Emergency Department attendances In 2007, a whole-of-organisation were up 2.4 per cent and trauma cases strategy was developed to improve increased by 4.2 per cent. The number patient access to all services – a key of complex patients presenting to priority area for Melbourne Health. Emergency Department also increased, The Access Improvement Plan set out by 11.1 per cent. These complex cases to achieve sustainable, systemic changes made up more than half of all emergency across outpatient, emergency and patients. elective services, sub-acute and community based care. The Access Improvement Plan will continue in 2008/09, and further streams Nineteen improvement teams have been added to ensure Melbourne were established across a number Health provides timely, effective health of areas including the RMH Emergency care to patients. Department, Operating Theatre and Elective Surgery, Orthopaedics, Outpatients and Length of Stay area, to look at processes, communication and better ways of doing things.
Access
1. Elective Surgery Performance 2007/08 2006/07
Category 1 proportion waiting less than 30 days 100.00% 100.00%
Category 2 proportion waiting less than 90 days 60.00% 53.00%
Category 3 proportion waiting less than 365 days 83.60% 67.00%
2. Emergency Performance
2a. Percentage of Triage Category 1 emergency 100.00% 100.00% patients seen immediately
2b. Percentage of emergency patients admitted 62.00% 58.00% to an inpatient bed within 8 hours
2c. Percentage of operating time on hospital bypass 4.02% 2.88%
2d. Percentage of non-admitted emergency patients 69.00% 71.00% with a length of stay of less than 4 hours
2e. Number of patients with an emergency department 0512 length of stay greater than 24 hours
Note: these results were achieved during a significant increase in demand.
8 Melbourne Health Annual Report PROFILE
Prof James Tatoulis Cardiac Surgeon
When Prof James Tatoulis left the devastation of post-War Greece as a young boy with his family in 1954 to seek opportunities in Australia, he dreamt of being a physicist or astronomer. Instead, somehow he found himself at medical school and today, is the Divisional Director of Cardiac Services at RMH, which encompasses the largest cardiac surgery and cardiology services in Victoria as well as a rapidly expanding Department of Respiratory and Sleep Medicine.
For Prof Tatoulis, cardiac surgery offers the excitement and challenge of reconstructing arteries, valves, damaged muscle, and a host of other problems in the heart in a highly sophisticated technological setting.
“I am the benefi ciary of a good education system and an egalitarian society that allows achievement through merit. I came to the RMH as a 4th year medical student in 1969 and graduated in 1972. In 1975 I was made an offer I couldn’t refuse and embarked on a career as a cardiac surgeon, training at the RMH, St Vincent’s as well as in the USA, returning to the RMH in 1981.
“The scope of medical student life is unlimited. So much to learn, experience and evolve. Even seemingly ordinary things can become fascinating if you show interest and delve below the surface.
“The power of medicine is not only in its capacity to heal, but also in its ability to immerse you into education, research, ethics, expanding knowledge and advances, and importantly a wonderful collegiality.”
Melbourne Health Annual Report 9 THE ROYAL MELBOURNE HOSPITAL
Capital Works Funding was provided under the Elective 160th Anniversary Surgery Waiting List Reduction Plan. The RMH City Campus has undergone Celebrations significant physical changes in the past 12 In June 2008, a new retail precinct The Royal Melbourne Hospital – Victoria’s months, with several major capital works linking RMH with the new Royal Women’s oldest hospital – celebrated 160 years of projects to enhance access and services. Hospital opened, providing staff, patients caring for Victorians in 2008. and visitors with access to a range of Work is continuing on the $56 million commercial businesses and services. On 15 March 1848, the then Melbourne State Government-funded redevelopment This precinct is also home to a new shared Hospital in Lonsdale Street opened its of the Emergency Department. Due Sacred Space, for patients and staff from doors to the public for the first time, and for completion in late 2009, the new both hospitals. treated two inpatients and four outpatients. department will allow growth as demand All were male, with the first two female increases, provide improved high-tech As part of this development, a new patients treated on 22 March. The hospital imaging facilities, including a computer hospital entrance and foyer is under had 10 beds, and treated 89 inpatients and at every bedside to assist with patient construction and is due to be completed 98 outpatients in its first year. registration and test results, larger and by late 2008. The foyer’s centrepiece will more private cubicles, and dedicated be the Healing Threads tapestry created The hospital was rebuilt on the same site education and research areas for staff. by the Victorian Tapestry Workshop. but chronic overcrowding and inadequate A temporary Emergency Department The tapestry was designed by Merrin facilities led to a new hospital being built opened in early September 2008, allowing Eirth following a three-month artist in Grattan Street, Parkville. The relocation vital services to continue during the next in-residence program, and was made was deferred for two years, when the construction phase. possible by support from Baillieu and building was “occupied” by the US Army’s Sarah Myer, Barbara Haynes, the Tapestry 4th General Hospital, to treat US soldiers Patients will also benefit from $7.3 million Foundation of Victoria, Helen Macpherson fighting in the Pacific during World War Commonwealth Government funding Smith Trust and Victoria College of the II. Finally, The Royal Melbourne Hospital to enhance perioperative services, Arts. patients and staff were able to move to including a new 23-hour bed area and their new home in December 1944. redevelopment of the Day Procedure Unit, Pre-Admission, Day of Surgery Admission Unit and Sterile Processing Service areas.
10 Melbourne Health Annual Report THE ROYAL MELBOURNE HOSPITAL
The RMH Royal Park Campus is renowned for its high-quality and specialist aged care and rehabilitation services. As well as inpatient services, the campus provides assessment and outpatient programs, community outreach programs and residential care.
160th anniversary celebrations this Highlights patients could be treated closer to home. year have included: the reopening of A physiotherapist assessed patients, and Guidance DS, a computerised the Merlyn Myer Historical Room; the those who did not require joint surgery drug prescribing approval system – inaugural RMH Oration given by Prof were diverted to conservative treatments developed over 10 years by a team in Rob Moodie; a visit by six World War such as physiotherapy and exercise. the Victorian infectious Diseases Service II US veterans; the US Consul General Previously patients would have waited – has effectively reduced inappropriate presentation of a letter of congratulations for an assessment by an orthopaedic prescribing of restricted antibiotic and from US President George Bush (the surgeon, and received no intervention in other antimicrobial drugs, and helped hospital also received letters from the interim. Feedback from patients, GPs tackle “superbug” drug resistance in the Governor-General, Prime Minister, and surgeons has been excellent, and hospitals. The Guidance DS software Victorian Premier, Federal and State Health the model of care is now being rolled is in operation at RMH, The Alfred and Ministers, and Melbourne Lord Mayor); out across all Victorian hospitals. Barwon Health, and its success has an International Nurses’ Day presentation attracted DHS funding to roll out to other on the history of nursing at RMH; The new Picture Archiving and public hospitals across Victoria. It has also church services; historic displays and Communication System (PACS) was been awarded the statewide licence for a special website. launched in December 2007. It displays Tasmania, where it will be introduced in x-rays on a computer screen, which In September, the RMH will hold an 2009. International interest is also growing. eliminates the need to process thousands historic exhibition about the women of x-ray films each year. Clinicians can The Orthopaedic Waiting List project, of the hospital, ‘The ladies have come access images quickly and easily, from led by RMH in collaboration with the to stay’, at the Queen Victoria Women’s almost any computer within the hospital. DHS and The University of Melbourne, Centre – the site of the former Melbourne has successfully piloted a tool to Hospital. This will be followed in late prioritise patients waiting for hip or knee 2008 by the unveiling of the RMH Healing replacements. The tool is the first in the Threads Tapestry, as part of the launch of world to prioritise patients using physical, the new front entrance. social economic and carer perspectives. The tool was piloted at four sites (RMH and three community health services) so that
Melbourne Health Annual Report 11 PROFILE
Jenni Wegener, Pastoral Care and Chaplaincy Coordinator
For Jenni Wegener, being part of a patient’s care, or providing support to their families and carers, is a unique, personal and privileged responsibility. Jenni, along with her team, attend to the spiritual, emotional and psychological care of individuals, regardless of their spiritual beliefs or faith.
“For me the greatest wonder is found in the emergence of the resilient human spirit within vulnerability. I am moved by the willingness of people to invite me to companion them into their deepest fears and losses and by the courage of many who continue life’s journey with trust and passion.”
Jenni’s passion for supporting others extends to the training of pastoral carers and supervisors within the fi eld. As Director of the Centre for Clinical Pastoral Education, she oversees the training of up to 18 people a year who want to be, or are already, pastoral carers and chaplaincy ministers.
“As an educator and supervisor these characteristics are evident as trainees seek to learn. I am challenged and stimulated in discovering with them the key to their learning style and my greatest satisfaction comes in watching the integration of new awareness and the resulting blossoming of capabilities.”
12 Melbourne Health Annual Report THE ROYAL MELBOURNE HOSPITAL
RMH has developed a test to identify Prof Finlay Macrae, Head of Colorectal A new model of care has been patients at high risk of contracting Medicine and Genetics, is coordinating introduced on the rehabilitation ward meningitis or meningococcal a new volunteer program to provide at RMH Royal Park Campus. It provides septicaemia, which is quicker and gastroenterology training to the patient with more opportunities to cheaper than existing methods. undergraduate and postgraduate take an active role in their rehabilitation The test screens for a genetic disposition students in Fiji, while three RMH Oncology program. The contact person or primary to meningitis or meningococcal, which and Pharmacy staff visited Nauru to nurse meets with the patient regularly means patients and their families can help review cancer services and make to understand what their needs are receive a vaccination to protect them from recommendations to Nauru’s Minister and acts as an advocate on their behalf. the illnesses, begin antibiotic treatment, of Health. Nursing, allied health and medical staff and receive urgent treatment if they teams facilitate improved communication A rare and special moment in the present with any symptoms. Results take between the disciplines, and work Intensive Care Unit was the birth of a four weeks, and cost about $20, compared together in solving complex problems to baby, when a woman went into labour with three months when tests were help patients regain as much function as at 27 weeks while having life-threatening previously sent to NSW, at a cost of $300. possible. Staff also work to goals that assist seizures. Louise Bevan gave birth to son RMH is the first accredited site in Victoria patient discharge, when they are able to Harrison on 8 February 2008. for adults to receive this test. continue their rehabilitation program as an outpatient, allowing them to be close Three years after it was launched, the Prof Stephen Davis, Divisional Director to family and friends in the comfort of multidisciplinary Diabetic Foot Unit of Neurosciences, was the only Australian their own home. The rehab unit will also (DFU) is maintaining more than a 50 per representative invited to the Vatican to undergo refurbishment later this year, cent reduction in lower limb amputations attend a select meeting requested by with a new patient sitting area, removal for patients with diabetes-related foot the Pope, of the Pontifical Academy of of carpet and fresh paint, and a larger problems. The unit uses an evidenced- Sciences, which considered “The Signs communal dining area. based protocol that focuses on timely of Death.” and appropriate assessment, investigation Gold medal-winning Australian and management. The DFU is undertaking triathlete Emma Snowsill was among VCAT hearings on campus a quality project to look at wound healing a group of Olympic athletes who A review at RMH Royal Park Campus rates across the acute and community undertook asthma screening at the found that one of the major causes of sectors with its Community Diabetic Foot Department of Respiratory and Sleep delays for patients seeking residential Program. It is also helping other health Disorders Medicine prior to the Beijing aged care, was the time taken to obtain services set up their own DFU, and is Games. Many athletes have underlying administration and/or guardianship developing a tele-health component to asthma or exercise-related asthma but orders through the Victorian Civil and provide specialist clinical assessment and are not aware of its presence. Snowsill Administration Tribunal (VCAT). Accessing management utilising local expertise for had been plagued by illness in 2007 but hearing times following the lodgement its patients outside the catchment area. couldn’t pinpoint the cause, and feared of an application ranged from 14 to The Transition Care Program (TCP) she had chronic fatigue syndrome. 59 days. Some patients had difficulty received Commonwealth Government The test revealed that she had asthma, attending VCAT hearings in King Street, funding for an additional 14 beds, and Snowsill was able to take medication Melbourne, due to their frailty, and it was increasing the total to 29 community- for the condition and successfully also difficult for medical and nursing based places, and will support more compete at the Olympics. staff to attend. than 100 patients each year. TCP provides A book edited and largely authored RMH Ambulatory and Continuing short-term care to older people at the end by RMH anaesthetists, the Pocket Care Director Felicity Topp met with of a hospital stay, who require more time Guide to Perioperative and Critical the Chief Executive Officer of VCAT and and support to complete their restorative Care Echocardiography, published by DHS representatives in April 2008, and process. The care can be delivered in McGraw-Hill Australia, was the number successfully proposed that VCAT hold a bed-based residential setting or in a one selling book for McGraw-Hill at some hearings on site at RMH Royal Park patient’s home. The aim is to improve the medical conferences in Europe in 2007. Campus as a pilot project. The pilot began patient’s capacity to live independently or Approximately 100 books were sold in June 2008, and in the first three months, to optimise their functioning while long- each month. VCAT held five hearing days, and dealt term care is arranged. with 21 cases. In one case, the hearing RMH staff have formed a choir, as part Staff have been involved in a number officer was able to visit a patient on the of the Making Music. Being Well national ward. Early results show improved access of projects to support their colleagues initiative to highlight the link between in the Asia Pacific region. Several RMH for patients and clinicians, and reduced music-making and wellbeing. length of stay. experts joined 14 neurologists from The Working Voices Choir aims to Asia at a special Epilepsy School to help ‘care for the carers’ and helps to reduce delegates set up more comprehensive stress, as well as being fun. services in their countries.
Melbourne Health Annual Report 13 NorthWestern Mental Health
NorthWestern Mental One of the most significant events of Northern and North West adult and Health (NWMH) is one of the year was the retirement of Prof aged persons’ services underwent an Bruce Singh AM, stepping down as Cato ACHS periodic review, and South Stone the largest public mental Professor and the Head of University of Lodge completed accreditation under health services in Australia, Melbourne Department of Psychiatry Commonwealth Nursing Home Standards. with an annual budget of and NWMH Deputy Director (Clinical The NWMH Access Improvement $135 million and more Governance), after 17 years. Prof Singh has made an outstanding contribution Project has achieved remarkable results, than 1700 staff providing to the development of mental health including a significant reduction in psychiatric care to youth, services locally, across Australia and waiting times in Emergency Departments adult and aged clients in internationally. He will continue to be at the Royal Melbourne, Northern and involved at NWMH as Co-ordinator, Sunshine Hospitals for patients requiring a catchment of 1.2 million a psychiatric bed. This was achieved in people in the north and Registrar Training, as well as his new role as Deputy Dean of the University’s conjunction with a 33 per cent increase west of Melbourne. Faculty of Medicine and Health Sciences. in admissions across NWMH and an It has a national reputation NWMH welcomed Dr Peter Burnett who increased capacity to accommodate for innovation in service commenced as Deputy Director (Clinical patients from outside NWMH when Governance) in March 2008. necessary. The focus of access delivery and workforce improvement has now broadened training, and an outstanding It has been a big year for NWMH services to include community mental international reputation for for accreditation, with Inner West Area health services. research. In the last year, Mental Health Service (AMHS), ORYGEN Youth Health, Mid West AMHS, Western more than 13,400 clients Aged Persons’ Mental Health achieving received 430,000 occasions positive results in the Australian Council of service. Of these, 47 per on Healthcare Standards (ACHS) in-depth cent were new to NWMH. mental health survey during 2007.
14 Melbourne Health Annual Report NORTHWESTERN MENTAL HEALTH
The four-bed short stay Psychiatric A Consumer and Carer Advisory their physical and mental heath Assessment and Planning Unit Group has been set up to maximise concerns, in an environment where (PAPU) in the Adult Acute Mental Health opportunities for participation at all levels. the young people feel comfortable. Inpatient Unit at RMH continues to be Already a project utilising Experienced Seven schools are participating in the an outstanding collaboration between Based Design methodology has been program and NWMH hopes to expand Inner West AMHS-RMH and the RMH successfully piloted in the Mid West this to 10 schools by the end of 2008. Emergency Department. PAPU has AMHS acute unit at Sunshine Hospital. dramatically improved access for mental Consumers, carers and staff worked Families where a parent has a mental health clients to acute psychiatric beds together, using their own experiences illness (FaPMI) have been identified by and thereby reducing their waiting time and stories, to identify ways to modify the government as a priority for service in Emergency. Since PAPU became fully practices and processes to make the development. The Northern AMHS was operational in January 2007, there has experience for all involved more positive, one of only two metropolitan services been only one incident of a patient therapeutic and rewarding. This project to receive funding for a FaPMI coordinator staying longer than 24 hours in the will be implemented in other NWMH position to enhance the capacity of Emergency Department – down from programs in 2008/09. the service and partner community 125 annually. organisations to respond to the needs The Shared Care Team at North West of these families. A 12-week client discharge preparation AMHS and North West Melbourne program has helped patients move back Division of General Practice, with funding Over the next 12 months, a number into the community or to other services from the Norm Anderson Young People’s of major capital and service development with the aim of living satisfying lives. Trust, have launched the innovative Docs projects will be undertaken, including Patient feedback has been positive and in Schools program. Research shows construction of an additional 25-bed participants’ readmissions into the Acute that young people, especially males, are psychiatric ward at The Northern Inpatient Unit have reduced. less likely to visit a GP than the rest of the Hospital, beginning in August 2008. population. GPs visit secondary schools fortnightly to provide an opportunity for young people to speak to a doctor about
The Psychiatric Assessment and Planning Unit won Gold at the 2008 Victorian Public HealthCare Awards for reducing waiting times for mental health beds. Since January 2007, only one patient has waited longer than 24 hours in the Emergency Department for a bed.
Melbourne Health Annual Report 15 NORTHWESTERN MENTAL HEALTH
In 2009, three Prevention and Recovery The ABC TV program Enough Rope The Substance Use and Mental Illness Care Services (PARCS) will be opened: presented a special show in April titled Treatment Team (SUMITT) has developed Burnside PARCS in Mid West AMHS, in a ‘Angels and Demons’ about people an online competency based training redeveloped former nursing home, and who live with mental illness. package for mental health clinicians, Victoria’s first purpose-built PARCS in Host Andrew Denton visited ORYGEN which is the first of its kind in Australia. Broadmeadows and Preston. PARCS are Youth Health and spoke to six young The NWMH Senior Nurse Advisory Group ‘step up - step down’ facilities, with 10 participants of the Platform Team, has also developed and piloted an online beds, and maximum stay of four weeks, who shared their personal experiences medication knowledge test for nurses, for adults being discharged from an acute and hopes for the future. which will be implemented across hospital, or for those requiring increased the service. support and treatment to prevent a The Aged Persons’ Mental Health hospital admission. They provide support, Program in October 2007 set up a Dr John Farhall, La Trobe University supervision, respite and time centralised triage service to improve Senior Lecturer and clinical psychologist for convalescence/recovery. The access to mental health services, which in the Northern AMHS), received national PARCS will be run in partnership with has benefited clients and their carers acclaim from the Carrick Institute, an a Psychiatric Disability Rehabilitation as well as primary health providers, and independent body that promotes Support Service (PDRSS). provided a consistent approach to their excellence in higher education. Dr Farhall needs. The service is based at the Aged received a citation for ‘outstanding Patients from the Eating Disorders Psychiatry Assessment and Treatment contribution to student learning’. Day Patient Program are benefiting Team (APATT) office at Sunshine Hospital. from a groundbreaking pilot program In 2008, NWMH accepted the full compliment of seven first-year trainees which uses circus skills to improve their Education and Training wellbeing. The collaboration between to its Royal Australian and New Zealand NWMH and the Women’s Circus aims to The Aged Person’s Mental Health Program, College of Psychiatry Training Program. build trust and encourage patients with in collaboration with Victoria University, For the second year, the trainees have eating disorders to reconnect with their has developed a Division 2 Graduate been involved in a buddy program and bodies, and develop a healthier attitude program in mental health nursing. This matched to senior RANZCP trainees. to exercising. Learning performance skills innovative and popular program involves NWMH also welcomed 22 new graduate – acrobalance, aerials, juggling and hula recruiting Division 2 Nurses into previously psychiatric nurses, and one based at hoops – help people build trust and difficult-to-fill vacancies in NWMH Aged the Royal Children’s Hospital, who learn positive risk taking. Care residential facilities, and supporting will complete three rotations in their them through the graduate program. first year.
NWMH received funding to develop a training and orientation package tailored to the needs of international medical graduates, to better assist them in adapting to the Australian healthcare system.
16 Melbourne Health Annual Report PROFILE
Prof Bruce Singh
Prof Bruce Singh AM has been dedicated to the development of psychiatric services for more than 30 years; fi rst in Sydney, then New York and London before moving to Melbourne in the 1980s.
In his 17 years with the organisation, Prof Singh has seen the RMH psychiatric service grow from a small 20-bed general hospital unit into NorthWestern Mental Health Service, one of the largest services in Australia with 1700 staff providing care to more than 1 million people in Melbourne’s north and west.
“As well as a large service system, NWMH has a reputation as one of the most innovative in the country with a national reputation for training the mental health workforce, and an international reputation for research, particularly in the fi elds of youth mental health, neuropsychiatry, psychiatric epidemiology and health services research and, clinical trials,” Prof Singh said.
This year, Prof Singh retired as the Cato Professor and head of the Department of Psychiatry to take up the position of Deputy Dean of the Faculty of Medicine, Dentistry and Health Sciences at Melbourne University. His association with NWMH continues as coordinator of postgraduate training.
Prof Singh was awarded the Minister for Mental Health’s Award for outstanding achievement by an individual in mental health care at the 2008 Victorian Public Healthcare Awards.
Melbourne Health Annual Report 17 North West Dialysis Service
North West Dialysis NWDS coordinates a network of Service initiatives services, including six metropolitan Service (NWDS) is Australia’s In conjunction with Northern Health, and 23 regional satellite dialysis centres, NWDS opened an inpatient dialysis largest provider of renal which enable patients to stay in their service at The Northern Hospital in replacement therapies, communities for life-sustaining dialysis September 2007. The new service enables caring for and promoting treatment. These services are linked to people with kidney failure who live in the the central hub at RMH City Campus. the best quality of life for area to have routine medical or surgical For those who prefer to manage their treatment as an inpatient closer to home. pre-dialysis and dialysis own care at home, NWDS offers home Previously, these people either travelled patients across north-west haemodialysis and peritoneal dialysis longer distances to their parent hospitals metropolitan Melbourne, education and training at RMH Royal for care or presented to The Northern Park Campus. NWDS also provides country Victoria and Hospital Emergency Department and extensive pre-dialysis and pre-transplant southern New South Wales. had to be transferred. NWDS continues education, promoting informed choice to work closely with The Northern and appropriate support to patients Hospital to ensure that service and families. development continues to meet patient needs.
In line with a Department of Human Services decision to develop Western Health to Level 3 Hub status, NWDS supported the transition of the Sunshine Dialysis Unit to Western Health, effective from 1 July 2008. About one third of the dialysis patients decided to continue their inpatient care with NWDS.
18 Melbourne Health Annual Report NORTH WEST DIALYSIS SERVICE
A breakthrough by the ABO Incompatible Renal Transplant Team has allowed many people to successfully receive a kidney transplant, ending a lifetime of dialysis. The team won the Minister’s Outstanding Achievement Award at the 2008 Victorian Public Heathcare Awards.
Melbourne Health will continue to Health Care Award at the 2007 Another support group, NephFriends, provide Level 4 Hub services, which Melbourne Health Best of Health Awards, has decided to wind up after nine years includes transplantation, cardiac surgery and an outstanding achievement award of wonderful support to patients and and neurosurgery. at the 2008 Public Healthcare Awards. staff. Our special thanks go to kidney NWDS in July 2008 reached agreement recipient Jeanette Belcher and husband NWDS experienced a plateau in demand with Djerriwarrh Health Services to Mark, who started the group, and have for dialysis services in 2007/08, largely provide renal dialysis training for raised more than $20,000 annually to buy due to a significant breakthrough by regional nurses from northern and equipment, as well as providing invaluable Melbourne Health in its kidney transplant western Victoria at Melton Health. peer support to dialysis patients and those program. With the introduction of new This will prepare nurses to work at preparing for a kidney transplant. technologies and protocols supported by any of the 23 regional dialysis sites. a dedicated team of physicians, surgeons, dialysis and nursing staff, pathologists, haematologists and laboratory scientists, NWDS Supporters Melbourne Health pioneered ABO Anita Narduzzo, President of the RMH incompatible kidney transplantation Dialysis Support Group, was awarded in Australia in December 2005. the Order of Australia medal (OAM) in This program has enabled a rapidly the 2008 Australia Day Honours, for growing number of patients to receive a service to community health. Anita, successful kidney transplant from a living her husband John and extended family donor with an incompatible blood group, established the support group in 2000 where previously this would not have after she and brother-in-law Joe Urbino been possible. Without this breakthrough, received kidney transplants within a few many of these patients would have months of each other, ending many years remained dialysis dependent for life. of dependence on dialysis. The group The impact of this program and the run a number of events each year to raise dedication and collaboration of multiple funds to provide patients with comfort teams was acknowledged with the during long hours on dialysis.
Melbourne Health Annual Report 19 PROFILE
Dr Karin Leder – Travel & Immigrant Health
There are increasing numbers of international travellers to exotic destinations and tens of thousand of immigrants coming to Victoria each year. This means that specialised health services to support GPs in managing health problems that occur among these patients are critically important.
“Travellers and immigrants often have health issues that are unfamiliar to many health care professionals, and they often have many things to deal with when arriving in a new country: the emotional and physical stresses of resettling, medical conditions requiring ongoing treatment, cultural expectations, or language diffi culties,” said Dr Karin Leder, head of Travel Medicine and Immigrant Health at RMH.
“The Travel and Immigrant Health Service has been invaluable in supporting patient care of these groups. We have developed protocols with GPs for shared-care services for refugees, while research involving international colleagues and community organisations has facilitated insight into many new issues. This collaboration has already helped us to learn that travellers going home to visit friends and relatives are at high risk of acquiring many travel-related infections, while our work among immigrants has identifi ed a link between tuberculosis and vitamin D defi ciency. Ongoing research is necessary to help identify the most practical ways of managing these health issues for those at risk.”
20 Melbourne Health Annual Report Victorian Infectious Diseases Reference Laboratory
The Victorian Infectious As national poliovirus reference laboratory, World Health Diseases Reference VIDRL played a key role in responding Organisation activities to a national public health emergency Laboratory (VIDRL) is this year: Australia’s first case of polio Construction of new facilities for the the State’s largest public in 20 years, in a returned traveller from WHO Collaborating Centre for Reference health reference laboratory Pakistan. VIDRL undertook extensive and Research on Influenza has continued and home to the WHO testing of serial specimens from the through the year. This complex project Collaborating Centre for person, other member’s of the person’s entails refitting approximately one-third household, a GP surgery, hospital staff of VIDRL’s total floor space, over three of Reference and Research and passengers on the same aircraft. the building’s four floors, as well as works on Infl uenza, one of only to the building fabric, façade and support four such centres in Research and Training infrastructure. The facilities will be complete and the Centre staff will relocate from their the world. The AusAID-funded Laboratory existing laboratories in Parkville by late Twinning project with the Nha December 2008. The WHO Influenza Centre Trang Pasteur Institute in Vietnam, hosted a two-day influenza symposium at in its second year, involved training the Australian National University attended two groups of Vietnamese scientists by national and international experts. at VIDRL, supervisory visits to Vietnam, In addition, Professor Anne Kelso, Director and implementation of new nucleic acid at the Centre, was an invited participant robotics and testing equipment in Nha in the Health stream of the Australian Trang. The scoping phase of a WHO- Government 2020 Summit. sponsored Laboratory Twinning project with Fiji’s public health laboratory was VIDRL was designated as a WHO also completed this year, as was a UNICEF- Collaborating Centre in Mycobacterium funded parasitology training initiative. ulcerans this year, the seventh formal Professor Sang-Han Ahn of Yonsei WHO laboratory designation for the University College of Medicine, Seoul, organisation. South Korea, joined the Research Division at VIDRL for a 12-month sabbatical Visitors studying the hepatitis B precore protein. Distinguished visitors to VIDRL during Doris Chibo, deputy head of the HIV the year included Dr David Heymann, Characterisation laboratory, was awarded WHO Deputy Director General of her PhD this year for her thesis “Molecular Communicable Diseases; Senator Joe evolution and diversity of viruses of Ludwig, Federal Minister for Human public health importance” and Dr Alex Services; Professor John Horvath, Thompson of the Research Division Commonwealth Chief Medical Officer; submitted his PhD thesis “Studies on Professor Richard Tedder, Health the innate immune response in Protection Agency, UK; and Professor chronic hepatitis B”. Peter Doherty, Nobel Laureate. Publications VIDRL’s co-discovery of a new virus in the course of the public health investigation into the deaths of Victorian transplant patients was published in the prestigious New England Journal of Medicine along with an accompanying editorial. A training DVD was also published by VIDRL’s WHO Biosafety Collaborating Centre: “Working Safely in a Class II Biological Safety Cabinet: a training resource for Australasian laboratories”.
Melbourne Health Annual Report 21 Facilities Management
Facilities Management Melbourne Health participated in the The installation of controlled water flow can be described as the national Earthhour event held in March, tap ware in wash basins, showers and where power and lighting was reduced to toilets in some wards has helped save engine room to the health a minimum. The success of this exercise up to 110,000 litres of water annually. service, co-ordinating the has influenced the planning of a regular An independent water audit of the RMH many core background event called GreenFriday to begin in City and Royal Park Campuses is nearing activities, enabling our 2008/09, which will endeavour to raise completion and will help establish water awareness about electricity consumption saving strategies in 2008/09. clinical services to function and behaviour. Power will be turned effectively. Sustainability off for one hour in non-critical areas, Engineering Services responded and environmental initiatives enabling the regular measurement and to 77,000 work requests in 2007/08. benchmarking of kilowatt outputs. The recently implemented electronic have continued to be the work order management system focus during the year. Minimising waste and promoting correct (WOMS) provided a more efficient waste disposal remains an important tool to manage maintenance jobs practice within Melbourne Health. The and received a commendation by the “Know Before You Throw” campaign ACHS Surveyors. Clinical Engineering held in September 2007 successfully maintained an extra 1,000 items – taking promoted waste segregation procedures its maintenance register to 7,000 assets. and recycling opportunities. Ongoing initiatives such as reducing the number The removal of two thirds of RMH cooling of rubbish bins in office areas, introducing towers and installation of environmentally- dual connecting bins for clinical and friendly 3C Coolers has minimised most general waste and the introduction of risks associated with Legionnaires’ disease. colour coded bin lids have all helped These coolers expend less energy, use to improve waste segregation and about 80 per cent less water than typical reduce landfill waste. cooling towers, and do not require chemical treatments. Melbourne Health follows In addition, an increase in service activity stringent Legionella testing procedures and hence supplies, also increased the for the remaining cooling towers and tepid amount of paper and cardboard recycled water systems, and no presentations were during the year. reported this past year.
Facilities Management uses an onsite compacting machine to recycle all cardboard packaging, which primarily comes from goods and supplies.
Waste Management: RMH City Campus
2007/08 2006/07 2006/05
Clinical Waste 391.518 tonnes 372.84 tonnes 354.73 tonnes
General Waste 588.850 tonnes 569.66 tonnes 585.04 tonnes
Recycling
- Commingled 14 tonnes 26.15 tonnes 21.78 tonnes
- Cardboard 132 tonnes 32.27 tonnes 51.44 tonnes
- Mixed Paper 87 tonnes 101.98 tonnes 74.68 tonnes
- Confidential 88.5 tonnes 45.00 tonnes 69.24 tonnes
22 Melbourne Health Annual Report FACILITIES MANAGEMENT
Transport Services managed a Environmental Services exceeded total of 364 vehicles, which travelled the Victorian healthcare cleaning a combined total of 4.3 million kilometres benchmark standard (85%) with both during 2007/08, (or an average of the RMH City and Royal Park Campuses 11,800km each) utilising almost 500,000 satisfying internal and external audits. litres of fuel. The Service is progressively Melbourne Health is also represented on replacing all fleet vehicles to 4-cylinder the DHS Steering Group in formulating models to help reduce carbon emissions. cleaning standards across health services state-wide. The Supply and Logistics Department replaced the manual paper requisitioning process with an electronic ordering and RMH approval system, improving workflow Royal efficiencies for both Supply staff and RMH City Park its customers. In May, Supply relocated Campus Campus offsite to a custom-built warehouse in 2007/08: % % Tullamarine. Supply continues to provide External Audit 89.6 95.5 a highly successful service to 12 health organisations statewide. Internal Audit 92.5 97.0
Food Services produced and delivered Security officers at Melbourne Health’s 900,000 meals to Melbourne Health two main sites – RMH City and Royal Park patients this year and a further 1.5 million Campuses are on duty 24 hours a day, to other health services. 7 days a week. They are responsible for The service met the Department of protecting patients, staff, visitors, property Human Services’ (DHS) patient audit and facilities. The Security Department benchmark and Victorian Government received a commendation by the ACHS Nutrition Standards. It had 29 successful Equip Surveyors for its comprehensive food safety audits by external auditors approach to staff training on the and regularly sought feedback from the management of clinical aggression. Melbourne Health Community Advisory The RMH Telephone and Committee on taste testing and menu Communications Department review. This year, the service became managed 2,076,686 incoming external and an accredited provider of halal meals. internal calls and announced some 4,400 Emergency Response codes - an internal system designed to ensure an immediate response. Such situations range from patients or visitors needing unexpected urgent medical assistance, detection of smoke or fire and threatening situations (see Security section above) to preparing for external critical emergencies such as the Kerang rail disaster or the Burnley Tunnel incident.
Melbourne Health Annual Report 23 Staff Development
Melbourne Health has a Workforce Data large workforce of more than 7850 staff across a 2007/2008 2006/2007 EFT Headcount EFT Headcount wide range of clinical and Administration/Clerical 893.81 1151 903.12 1165 non-clinical professions. In the past year, the Hotel/Allied 449.02 627 432.01 593 organisation welcomed Nursing 2051.63 3285 2011.36 3296 more than 1000 new staff HMOs 505.62 577 492.63 553
in full time, part time, Sessional Clinical 143.07 442 137.61 423 casual, volunteer, honorary Allied Health 507.07 669 555.25 728 and (nurse) bank positions. Medical 130.38 132 119.96 122
Medical Support 772.71 974 769.93 965
Total 5453.31 7857 5421.87 7845
Human Resources of Victoria Police, as guest speakers. Customer service training for 280 Melbourne Health undertook a major frontline clerical and administrative staff review of its Human Resources area, will begin in August 2008, facilitated by to look at all aspects of its functions, the Australian Institute of Management. and enhance its role and effectiveness in supporting and developing the The Building Positive Attendance organisation’s workforce. The result has initiative aims to improve attendance been a strategic framework to strengthen and minimise unplanned absence within coordination of areas such as workforce the workplace. An expert consultant, planning, performance management, and in conjunction with Human Resources, leadership and development training. has developed a skills development and training program for managers and staff, Forecasting Melbourne Health’s future which will be implemented in 2008/09. workforce needs is a complex and important responsibility for Human The organisation was proud to acknowledge Resources. A comprehensive Workforce Plan 192 RMH City Campus staff and 27 has been devised, giving an overarching RMH Royal Park Campus staff who have framework for all occupational categories. contributed between 10 and 40 years’ continuous service at the Annual RMH Recruitment using web-based Length of Service Awards, and together technologies is being expanded. have contributed over 3440 years of service. Melbourne Health will next year use an integrated e-recruitment system, The Medical Workforce Unit (MWU) held which will streamline processes, improve a very successful RMH Open Day on 1 June efficiency, reduce the time to fill vacancies 2008, attracting more than 400 prospective and lower costs. Melbourne Health interns and hospital medical officers has also introduced an electronic visa (HMOs). The visitors had the opportunity application system for overseas applicants, to meet directors of training, heads of units, which has reduced processing times by medical education representatives and up to eight weeks and helped increase the HMO Society; 20 junior RMH doctors recruitment of overseas trained staff also took groups on tours through the and medical graduates by 47 per cent. hospital. From 569 intern applications, Melbourne Health currently has 199 staff the unit was successful in matching all (98 doctors and 101 nurses) on ’457’ visas. 52 positions available in 2009, including a newly funded position for a Psychiatric A Women in Leadership Program was Intern. GP rotations in Melbourne and the launched in early 2007 to provide female Northern Territory have been added to the managers with a quarterly networking HMO program next year, and the unit is “lunch and learn forum”, featuring internal exploring the possibility of joint rotations and external women leaders, such as with the Royal Women’s Hospital. Christine Nixon, Chief Commissioner
24 Melbourne Health Annual Report PROFILE
Nursing Rewards
Nurses are the health professionals patients see the most often.
At Melbourne Health, nurses make up just under half of the total workforce, and this year to recognise their contributions, Melbourne Health joined with NorthWestern Mental Health to present annual Nursing Awards for Excellence.
Emergency clinical nurse specialist Suzi Wong (left) was named the inaugural Melbourne Health Nurse of the Year Award, while Assistant Nurse Unit Manager at the Northern Acute Inpatient Unit Clare Neale (right) received the NorthWestern Mental Health Nurse of the Year prize. Kelly Leiper (centre) was named the Australian Graduate Nurse of the Year at an industry- wide event in May.
“It’s the unpredictable and constantly changing nature of emergency medicine that has kept me in the fi eld for 25 years,” said Suzi.
For Kelly, nursing older people is where she believes she can make a difference to patients and their families, to the nursing profession and to the wider community.
“As a young nurse in aged care, the sky is the limit. You can move further faster and make a difference which infl uences the care an individual receives for the remainder of their life,” Kelly said.
Clare’s interest in mental health nursing stemmed from a fascination of watching individuals interacting with each other and the world.
In psychiatry, no two days are the same. “Each day brings different challenges and puts us in contact with people from all walks of life,” she said.
Melbourne Health Annual Report 25 STAFF DEVELOPMENT
Education and Training beyond. Clinical Librarian Terence Harrison for RMH staff and clinicians from says Evidence Direct has the widest range around Australia. The program was Human Resources has a established a of EBM resources available in Australia, originally developed inthe UK and is Capability Development Framework including guidelines (local, national and now taught across Europe. Dr Peter to promote and support the growth international), evidence databases/sources Morley, RMH Intensivist and Deputy of Melbourne Health as a learning and and evidence appraisal. It also features Chair of the Australian Resuscitation knowledge-based organisation, in specialist search facilities, e-learning and Council, helped revise the ALS manual accordance with the new Melbourne teaching resources. The initiative received and curriculum to reflect current best Health Education Strategy. The framework Melbourne Health’s 2007 Best of Health practice in resuscitation in Australia. will be implemented in 2008/09. Achieving Excellence – Education award, RMH has also helped to establish the After several years of planning, the RMH and led to an Evidence Week successfully ALS program at the NSW Ambulance Health Sciences Library and Royal being staged in 2007, which will become Service. RMH Director of Anaesthesia, Women’s Hospital library merger an annual event. Assoc Prof Daryl Williams, is the course took place in June 2008, just prior to the director and coordinator of the In August 2007, the Clinical Skills Women’s move to Parkville. Staff from both Victorian course. Centre opened on the ground floor at hospitals now have access to a larger, more RMH, bringing together training and An Allied Health Education and comprehensive journal and book collection, education facilities for medical, nursing Service Development Unit has been in addition to extensive online services such and allied health disciplines. Educators established to support and facilitate as journals and databases. Of particular interest from the Women’s collection is are also based in the centre. service development and innovation in Allied Health, implement evidence material from the specialist disciplines of: The centre was used to deliver eastern obstetrics and midwifery; gynaecology; based practice, embed the principles of Australia’s first internationally accredited quality and safety in all aspects of service neonatology; perinatology; reproductive Advanced Life Support (ALS) course to medicine; and women’s health. The RMH provision and service evaluation, provide 20 critical care staff in January 2008. The clinical education programs, and to foster Library already houses the Victorian Mental intensive 2-day course uses high-tech Health Library collection. a culture of continuous improvement. mannequins to create a variety of medical Allied Health representatives are involved The RMH Library has developed Evidence emergencies, which the instructor can on the Melbourne Comprehensive Cancer Direct, a ‘one-stop shop’ for Evidence change at the press of a button. Several Centre Education and Training working Based Medicine (EBM) resources online, RMH Anaesthetists were trained as ALS party and the Statewide Allied Health which is benefiting clinicians at RMH and instructors in Perth, and now run courses Workforce Education program.
26 Melbourne Health Annual Report STAFF DEVELOPMENT
Clinical Librarian Terence Harrison has developed Evidence Direct, an online evidence- based resource, which offers clinicians the most up-to-date information about treatment options through access to local, national and international guidelines, databases and evidence appraisals.
Allied Health has also received a $35,000 Occupational Health In April 2008, Melbourne Health DHS grant to develop Allied Health and Safety completed a three-year, WorkSafe Assistants Certificate IV workplace learning Victoria-funded Aggression Prevention programs. The number of WorkCover claims for and Management Project to examine Melbourne Health has consistently fallen the issue of occupational violence and The Graduate Nurse Program (GNP) in recent years. Over the past five years, aggression in relation to policies and and Graduate Certificate in Clinical total claims have reduced by 32.5 per cent procedures, staff training and workplace Nursing continue to be very successful and standard claims by 17.65 per cent. design. programs at RMH. The GNP received more A standard claim is defined as those than 700 applications for the 2008 program, claims over the statutory employer excess. The project, a joint venture between which employed 125 graduates across a All claims are reported to WorkSafe Victoria Melbourne Health and Northeast wide variety of clinical areas. The Graduate during the financial year. Health - Wangaratta, has resulted in Certificate was set up by RMH in conjunction the development of a toolkit, which will with the Australian Catholic University three Occupational Health and Safety Claims be released as WorkSafe Victoria guidance years ago and currently has 90 students. Total Standard material for both within and beyond the This postgraduate initiative was Claims Claims health sector. commended by the ACHS surveyors in 2003/04 286 153 the December 2007 review. Peer Support assisted more than 270 2004/05 244 125 staff across Melbourne Health during The RMH Nursing Education Services Short 2005/06 195 112 the year. Staff contacted Peer Support Course Program continues to grow and for assistance with a wide range of 2006/07 195 102 flourish. It attracts a large number and variety issues, including critical incident stress, of nurses from both Melbourne Health and 2007/08 193 126 bereavement, work related and personal regional and metropolitan organisations. Work Cover Total Claims issues. Peer Support continues to provide 300 286 a responsive and confidential service to Staff from across NWMH attended Defusing 244 250 all staff in Melbourne Health. and Debriefing training at the Harvester 195 195 193 200 Clinic in Sunshine. The 18 staff who attended 150 will join 23 trained staff currently on the 100 debriefing team - almost doubling the 50 0 number of debriefers available across NWMH. 2003-04 2004-05 2005-06 2006-07 2007-08
Melbourne Health Annual Report 27 Research
Melbourne Health is Melbourne Health’s research strategy Research highlights aims to encourage and support health committed to providing There were many significant research workers to participate in research highlights during the year. Among them research outcomes that activity, optimise translation of research was receiving an “OA” – outstanding benefi t all Victorians. into clinical practice and health policy, achievement – for research by the As a teaching hospital promote Melbourne Health and the surveyors during Melbourne Health’s Parkville Precinct as a leading centre and provider of tertiary accreditation process. and specialist services, for research, and foster collaborative relationships to optimise opportunities The annual Research Week was again most work is translational for research. a success. The Governor of Victoria, and research. Up to 600 distinguished researcher, Prof David de research projects are Offi ce of Research Kretser, opened the week, which attracted a record 197 abstracts showcasing the conducted across the Lead by Prof Ingrid Winship, Melbourne organisation at any organisation’s many outstanding research Health’s Office of Research (formerly projects, both internal and in collaboration one time. Research Directorate) coordinates the with Parkville Precinct partners. administration of research activities, particularly research and ethics The fight against type 1 diabetes was committees, and coordinates staff whose boosted with a $10 million, five-year salaries are funded by research grants. National Health and Medical Research Council (NHMRC) grant to a team of The Office of Research has two Australian researchers headed by RMH’s human research and ethics committees. Prof Len Harrison and Prof Peter Colman, The Human Research and Ethics to work towards the prevention and cure Committee reviews human research in all of this disease. clinical disciplines where projects involve staff or patients from Melbourne and/ The Australian Cancer Research or Western Health and other affiliated Foundation awarded a $5 million grant staff with these two organisations, to the Centre for Therapeutic Target including associated University of Discovery, a consortium of Melbourne Melbourne departments, Walter and cancer research institutes, of which Eliza Hall Institute of Medical Research, RMH is a member. The group is creating Ludwig Institute for Cancer Research an Australian-first collaborative and and Howard Florey Institute. The Mental integrated cancer research centre where Health Research and Ethics Committee clinicians who diagnose and treat cancer reviews human research in the fields of patients will work closely with scientists behavioural, psychosocial, psychological researching the disease. The consortium and psychiatric research involving staff will initially focus on bowel and breast and patients from NorthWestern Mental cancers and cancers of the blood. Health. BioGrid Australia (formerly Bio21:MMIM), the informatics model which links researchers to multiple clinical databases across Australia, received $11 million in State Government funding to develop the third phase of the system – an Australian cancer grid research platform. Melbourne Health will lead the development of the Victorian arm of this platform.
28 Melbourne Health Annual Report RESEARCH
Awards Rheumatology Director Prof Ian Wicks was awarded the Parr Prize by the Many Melbourne Health staff received Australian Rheumatology Association, recognition for their endeavours awarded every three years for outstanding throughout the year, from conference achievement in research. Prof Wicks’ presentation prizes, to receipt of research has focused on rheumatoid fellowships and grants, to name a few. arthritis and inflammatory diseases. Award winners included: Anatomical Pathology’s David Williams Neurologist Sandra Petty was this year’s received the Kanematsu/Kitamura Cleveland Young Investigator’s Award Memorial Award in March. The award winner. Dr Petty is completing her PhD provides $10,000 towards research costs with the Department of Medicine, RMH, for final year pathology trainees who are where she is examining the association undertaking either an MD or PhD. of epilepsy and anti-epileptic medication with fractures, falls and changes in body Jenny Beavis won the 2007 Amgen composition. The Cleveland award is International Travel Grant, in recognition for original research, and acknowledges of her work as North West Dialysis RMH’s link with the hospitals of Cleveland, Service’s Bone Vascular Syndrome Ohio, USA. Many of the medical and Coordinator. The grant is awarded to one nursing staff recruited to the 4th General Australian nephrology nurse each year. Hospital of the US Army, which occupied the RMH for two years during the Second More information about the Office of World War, were from Cleveland. Research and research activities can be found in the Melbourne Health Research Dr Geoff Lindeman was awarded the Report 2007. Royal Australasian College of Physicians’ prestigious Eric Susman Prize. The annual award is for a Fellow of the RACP who published the most outstanding medical research in the preceding two years. Dr Lindeman, who has a joint appointment with RMH and WEHI, received the prize for his discoveries in the field of breast cancer and stem cell biology, and for his contributions as a clinician-scientist to translational research efforts in clinical oncology.
Dr Lindeman and RMH/WEHI colleague Dr Jane Visvader were also presented with the GlaxoSmithKline Award for Research Excellence for their outstanding contribution to breast cancer research.
Prof Bruce Singh received the title of Honorary Fellow of the UK College of Psychiatrists for his extensive contribution to psychiatry – only the third Australian to receive the title.
Melbourne Health Annual Report 29 PROFILE
Lesley Stevenson, hospital volunteer
This year, Melbourne Health said farewell to the RMH Kiosk Auxiliary, which closed its doors after running the hospital’s Kiosk for more than 80 years and raising more than $3 million for the organisation.
With a roster of 47 volunteers, including four aged over 90, the Kiosk was open every day of the year. And, as well as selling magazines, toiletries, confectionery and fl owers, the volunteers often gave cups of tea and comfort to people distressed about their loved one’s diagnosis or condition.
Lesley, the Kiosk Auxiliary President, and a volunteer for 35 years, said every day was rewarding: to be there to help someone or just to have a chat.
“Without a doubt meeting people was the most rewarding part of being a Kiosk volunteer – be it patients, staff or visitors. All of the volunteers have been absolutely fantastic, and it was just magnifi cent to work with them. We had lots of goodwill with people and still hear from a lady whose husband was a patient 10 years ago.” The mother of Dutch backpacker Paul De Waard, who was shot in Melbourne in 2007, also keeps in contact with Lesley.
The end of an era has not meant the end of these volunteers’ association with the hospital. Lesley and many of her peers will continue to be familiar faces around the organisation, taking up new volunteer activities within Melbourne Health.
30 Melbourne Health Annual Report Community Support
Community supporters, Community Supporters And Melbourne Health staff also did their bit during the year. As well as supporting be they volunteers, Melbourne Health is grateful to the and promoting a range of health support groups and auxiliaries who donors, former patients awareness campaigns such as Diabetes support staff and patients across RMH, or corporations, are an Week, Heart Week, World AIDS Day and NWMH and NWDS. During the year, integral part of Melbourne Movember for prostate cancer, these groups raised a combined total a team of staff members competed Health, ensuring we remain of $270,000. connected to the community in the annual Murray to Moyne 520 km The RMH Community Council, bicycle relay. The team’s efforts helped we serve and adding another chaired by Mrs Judy Adam AM, fund a Peer Support Coordinator dimension to the care and continued to be an important forum position for LifeMoves, an RMH Royal treatment of our patients. in which auxiliaries, support groups, Park Campus-based community therapy volunteers and prominent members program for people who have suffered of RMH and wider community learned neurological damage. of each other’s activities as well as those Events Sadly, Melbourne Health said goodbye of Melbourne Health, harnessing broader The RMH Foundation’s annual RMH to the RMH Kiosk Auxiliary, which support and ideas for their individual Golf Classic, Opera in the Market closed its doors in June 2008 after 86 initiatives. and RMH Home Lottery were among years’ service to the hospital. The Kiosk the major events staged during the Melbourne Health also acknowledges raised more than $3 million over the year, raising both awareness and more the many individuals who have initiated years, and was open every day of the than $1.5 million to aid patient care and fundraising activities in order to help year to serve patients, visitors and staff. research. The inaugural RMH Oration, others. For example, former cancer Some members had been part of the featuring Prof Rob Moodie talking on patient Craig Connelly raised more auxiliary for more than 30 years. Their work-life balance, and the Chairman than $15,000 through his Exercise for Life link with the organisation will not be lost, and Chief Executive’s Luncheon, with swimming and running events, while however, with many members taking up Federal Finance Minister Lindsay Tanner Justin Nelson, Derek Borg, Jason Hill and volunteering duties in other areas as speaker, were held as part of the Mark Powell cycled from Sydney to RMH of Melbourne Health. hospital’s 160th anniversary celebrations. to raise funds for leukaemia research. The hospital has also farewelled These have now joined the Foundation’s NephFriends (see North West Dialysis annual calendar of events. Philanthropic trusts and foundations continue to support the endeavours Service report) and the RMH Cancer Melbourne City Motors in Parkville, with of Melbourne Health. State Trustees Support Group, which has decided to the help of Fox FM presenter Matt Tilly, provided NWMH’s McLellan House – wind up after six years supporting the auctioned a new Nissan Micra in March a residential care facility – with almost work of Oncology. Originally called the 2008, with all proceeds going to the RMH. $5,000 to build a ‘men’s shed’ at its Jacana Bombers Cancer Support Group, it held The company suggested the auction as site. The shed helps provide therapeutic regular fundraising events such as the a neighbourly gesture and a way in which activities for residents, as well improving Peter Thomson Golf Day and annual it could give something back to the staff awareness of, and access to, activities gala cabaret. local community. that promote the dignity and quality of life for residents in their care. The Friends of RMH Neurosciences In Memoriam and Bequests Foundation annual ball continued to be The ANZ Western Gate branches Each year, the RMH receives memorial a highlight on the fundraising calendar. raised $27,000 to support a new studio gifts from families who have chosen to Now in its 15th year, the event raised and therapy space for patients as part make a very personal donation. These $400,000 for research into neurological of RMH’s Music Therapy program. gifts, along with legacies and bequests, disorders. Special guest was Rasheda Ail, The Music Therapy Opera project AVATAR raised more than $625,000 directly daughter of boxing great Muhammad has also received nearly $50,000 support supporting departments and services Ali, who is an advocate for people from the Cancer Council Victoria and as nominated by donors. touched by Parkinson’s Disease. philanthropist Betty Amsden OAM. A second Music Therapist position for For a full list of our major supporters, Corpus Medicorum, a chamber cancer patients was created this year, please go to page 39. ensemble comprising musicians from thanks to $30,000 funding from Barbara the medical fraternity formed by RMH Haynes via the Caroline Clifford surgeon Phillip Antippa, continued to Memorial Trust, set up in memory delight audiences with its concerts which of a young RMH cancer patient who raise funds for the hospital. Mr Antippa died in 2005. also performed at the Opera in the Market event.
Melbourne Health Annual Report 31 Corporate Governance
The Board of Melbourne The Board is accountable to the Minister > Developing and effectively Health consists of for Health for the conduct, performance participating in active communication and culture of Melbourne Health. with stakeholders, in particular the independent non-executive Minister and the Department; directors. The Directors have The role of the Board is to exercise good > Setting and measuring the no personal relationship with governance in the achievement of Melbourne Health’s stated objectives. effectiveness of internal controls to Melbourne Health other than This necessarily includes all of the manage significant identifiable risks; their position as a Director. following: > Monitoring compliance with The number of directors established policies, laws and > Determining a reasoned and regulations; and is set at nine by the Minister achievable strategic direction; > Appointing and reviewing the for Health. > Approving strategic and business plans; performance of the Chief Executive. > Establishing policies to support corporate governance processes which facilitate the achievement of the business plan; > Approving delegations where necessary and appropriate; > Monitoring the performance of Melbourne Health and senior management against the business plan and in accordance with the established goals;
32 Melbourne Health Annual Report CORPORATE GOVERNANCE
The Directors for Ms Marilyn Beaumont Ms Kate Redwood 2007/08 were: Appointed 1 July 2000 to 30 June Appointed 1 July 2003 to 30 June 2003. Reappointed to 30 June 2006 2006. Reappointed to 30 June 2009. and again to 30 June 2009. Mr Robert Doyle – Chairman Ms Redwood has held a number of senior Appointed 1 July 2007 to 30 June 2010. Ms Beaumont has extensive experience management positions including CEO of across a number of States and at the the Australian Physiotherapy Association, Mr Doyle is a Principal with The Nous national level in nursing, management Executive Director of Australian Red Group, a management consultancy firm and administration, health policy Cross Victoria, and Executive Director with offices in Melbourne, Sydney and development and analysis, women’s of the Victorian Council of Social Service. Canberra. He is also a Council Member, health and health consumer rights. A former Councillor for the City of Policy and Economics Council, for the Since 1995, she has been the Executive Melbourne, Ms Redwood has chaired a Gerson Lehrman Group. Mr Doyle was a Director, Women’s Health Victoria, number of standing committees as well Member of the Victorian Parliament from a statewide women’s health information as the Yarra/Melbourne Regional Library 1992-2006. His political career includes and advocacy service. Between 1987 Board, the Melbourne Disability Advisory serving as Leader of the Opposition and 1995, Ms Beaumont was the Federal Committee and for many years was and Leader of the Liberal Party, Shadow Secretary of the Australian Nursing President of the Carlton Senior Citizens Minister for Health and Parliamentary Federation and prior to that, State Centre. Ms Redwood is the chair of Secretary for Health. Mr Doyle is also an Secretary, South Australian branch. the Community Advisory Committee, Ambassador for Odyssey House. He holds Between 1995 and 2000, she was a a member of the Remuneration a Bachelor of Arts, Bachelor of Education part-time commissioner with the Committee and represents Melbourne and a Master of Letters. Health Insurance Commission. Health on the ORYGEN Research Foundation Board. Ms Beaumont is a founding member of the Melbourne Health Board and has been the chair of its Safety and Service Improvement Committee since June 2002.
Melbourne Health is Victoria’s second largest public health service, serving more than 1 million people living in Melbourne’s northern and western communities as well as providing specialist and referral medical and surgical services for rural and regional Victorians.
Melbourne Health Annual Report 33 CORPORATE GOVERNANCE
Professor James Angus Mr Bill Mountford Dr Patricia Molloy Appointed 23 March 2004 to 30 June Appointed 1 July 2007 to 30 June 2010. Appointed 1 July 2005 to 2006. Reappointed to 30 June 2007, 30 June 2008. again to 30 June 2008 and again to Mr Mountford is Executive Chairman of 30 June 2009. Primecarers Pty Ltd, a community aged Dr Molloy is a general practitioner in the care provider; a Director of McEwan Melbourne suburb of Footscray. She holds Professor Angus is the Dean, Faculty Mountford Pty Ltd, a consulting and a clinical governance position at Box Hill of Medicine, Dentistry and Health venture company; and a Director of Colin Hospital. She is a former member of the Sciences, at The University of Melbourne. Carter and Associates, board advisors. Medical Practitioners Board of Victoria, a Previously the Chair of Pharmacology, Previously, Mr Mountford has served as current member of the Victorian Civil and Professor Angus has an extensive research CEO of the Victorian Workcover Authority, Administrative Tribunal and a tutor for the record in cardiovascular and analytical was a Partner of Arthur Anderson, Monash University medical law program. pharmacology and is one of the most Director of Australian Consulting Her interests lie in the areas of professional cited researchers in Australia. Professor Partners, Executive Director of Australian regulation, clinical governance and health Angus was President of the Academic Manufacturing Council and a consultant administration. Dr Molloy’s appointment Board and has served on the council for the Boston Consulting Group. He holds ended on 30 June 2008. of The University and Council of The a Master of Philosophy in Economics, a Australian Academy of Science. He also Bachelor of Economics and has attended Changes to the Board serves on the Boards of a number of the Advanced Management Program at research institutes. Professor Angus was Harvard Business School. since 30 June 2008 awarded the Gottschalk Medal from Mr Michael Gorton AM the Australian Academy of Science Ms Penelope Hutchinson Appointed 1 July 2008 to 30 June 2011. (1984) and the Centenary Medal for Appointed 1 July 2007 to 30 June 2010. services to Pharmacology and the Mr Gorton is a Partner in a Melbourne law community (2003). Ms Hutchinson has been the Director of firm, Russell Kennedy Solicitors. He has Arts Victoria since 2000 and prior to this had government roles, including President was a partner with BDO Nelson Parkhill, Ms Leanne Planck of the Health Services Review Council, Chartered Accountants. Ms Hutchinson Appointed 1 July 2006 to Chair of the Biotechnology Ethics Advisory currently serves on the Monash University 30 June 2009. Committee and is currently Deputy Chair Council and the board of Tourism Victoria. of the Infertility Treatment Authority. Ms Planck is a consultant with her own She previously served on the Federal He has also been a member of the company that specialises in improving Airports Corporation board, chaired the Advisory Board of the Monash Institute finance processes, systems and functions board of the Victorian Rehabilitation for Medical Research; National President for major organisations. She was a Director Centre, and was on the board of of Greening Australia and inaugural of the Metropolitan Ambulance Service, Medibank Private. She holds a Master Co-Chair of Reconciliation Victoria Inc. Chair of their Finance Committee and of Public Policy, a Bachelor of Arts, and He was Victoria’s first permanent male member of their Audit Committee. is a Fellow of the Institute of Chartered Equal Opportunity Commissioner. She is a Director and Chair of the Audit Accountants Australia and an Associate Michael advises many of the Australasian Committee for the Legal Practitioners’ of the Institute of Chartered Accountants medical colleges, and for his work was Liability Committee, which provides in England and Wales. awarded Honorary Fellowships with professional indemnity insurance and risk Royal Australasian College of Surgeons management services for Victorian legal Professor David Hayward and Australian & New Zealand College of practitioners and national law firms. Appointed 1 July 2007 to 30 June 2010. Anaesthetists and was made a Member Ms Planck has previously worked for the in the Order of Australia in 2004 for his Royal Dutch Shell Group, was a Director Professor Hayward is the Dean, Faculty community contribution. of Ernst & Young and originally started her of Business and Enterprise, at Swinburne career with Price Waterhouse. Ms Planck University of Technology, and the former is a Fellow of the Institute of Chartered foundation Executive Director and then Accountants and the Australian Institute Director of the Institute of Social Research of Company Directors. at Swinburne. Professor Hayward has published widely on social economics, state government finances and housing policy. He is a member of the Australian Institute of Public Administration and the Australian Institute of Company Directors.
34 Melbourne Health Annual Report PROFILE
Guiding clinicians’ prescription choices
Treating patients who have developed drug-resistant “superbugs” is one of the great challenges healthcare professionals face, but thanks to an RMH team, that may be about to change.
Led by infectious diseases physician Dr Karin Thursky, the team, which included physicians, epidemiologists, pharmacists, psychologists and software specialists, has created Guidance DS. A computerised drug prescribing approval system to counter inappropriate and excessive prescribing of antibiotics - two factors that play a big part in the development of the superbugs.
As a result, RMH now has some of the lowest usage of several classes of antimicrobials among hospitals of similar size, and public hospitals across Victoria and Tasmania are embracing the Guidance DS system.
Dr Thursky said studies had found that about 40 per cent of hospital patients are given antimicrobials, half of which are inappropriately prescribed. Since the introduction of Guidance DS at RMH in January 2005, there has been a demonstrable reduction in antimicrobial prescribing levels, improved choice of antimicrobial and reduced drug costs, as well as reduced resistance to drugs.
The system received a Commonwealth Biotechnology Innovation Fund grant in 2002, won the Victorian Public Healthcare Award for IT innovation in 2006 and the pilot project received a Quality Award at the Royal Australian College of Physicians’ Annual Scientifi c Meeting in 2004.
Melbourne Health Annual Report 35 CORPORATE GOVERNANCE
Board Meetings and Access Directors’ Attendance the aim of improving the health outcomes to Management Mr Robert Doyle 10/10 of the communities in Melbourne Health The Directors contribute to the Prof James Angus 4/10 catchments. Membership includes senior staff and representatives from community governance of Melbourne Health Ms Marilyn Beaumont 9/10 collectively as a Board through partners in Melbourne Health’s catchment Prof David Hayward 9/10 attendance at meetings. Individual area, including local government, Ms Penelope Hutchinson 8/10 contribution occurs through participation community health centres, general in, or chairmanship of, the various Dr Patricia Molloy 8/10 practitioners, Royal District Nursing Service committees of the Board, and they are Mr Bill Mountford 8/10 and The University of Melbourne Centre for often approached to assist management Ms Kate Redwood 10/10 Health and School of Population Health. in the performance of their functions. Ms Leanne Planck 8/10 Directors also give their time to attend Audit Committee significant functions and Ministerial Board Committees Board membership: Ms Penelope events across Melbourne Health. The Board has established a number Hutchinson (Chair), Ms Leanne Planck, of sub-committees and advisory Prof David Hayward. Meetings held Members of the Melbourne Health committees, which are also attended bi-monthly. Executive who regularly attend Board by members of the Melbourne Health meetings are the Chief Executive and the Executive. The Chairman is an ex-officio Finance Committee Executive Director Finance. In addition, of each committee. Board membership: Ms Leanne Planck other members of the Executive present (Chair), Prof David Hayward, Mr Bill to the Board on specific issues. Community Advisory Committee Mountford. Meetings held monthly. The Board meets on average monthly, Board Membership: Ms Kate Redwood with 10 meetings held in the year (Chair), Mr Robert Doyle. Meetings Safety and Service Improvement 1 July 2007 to 30 June 2008. held monthly. Committee (Quality Committee) Board membership: Ms Marilyn Beaumont As Melbourne Health comprises several The Community Advisory Committee (Chair), Dr Patricia Molloy, Prof James Angus, campuses, the Directors are encouraged is required by the Health Services Act 1988 Mr Bill Mountford. Meetings held monthly. to undertake site visits in order to view to provide direction and leadership in first-hand the activities and services relation to the integration of consumer, provided at hospitals and services other carer and community views into all than RMH City Campus, which hosts the levels of Melbourne Health’s operations, majority of meetings of the Board. planning and policy development. Members of the Committee representing the community in which Melbourne Health operates, are: Mr Richard Chua, Mrs Diana Frew, Mr Moreno Grison, Mrs Lisa Wotton, Mrs Florence Kingsley- Matthews and Ms Janney Wales.
Primary Care and Population Health Advisory Committee Board membership: Dr Patricia Molloy (Chair), Ms Penelope Hutchinson, one vacancy. Meetings held quarterly.
The Primary Care and Population Health Advisory Committee is required by the Health Services Act 1988 to advise the Melbourne Health Board on strategic issues and approaches to population health and service planning issues, with
36 Melbourne Health Annual Report Appendices
General Information Merit and Equity Principles > Leighton Contractors Merit and equity principles are > Baulderstone Hornibrook Melbourne Health Privacy Policy encompassed in all employment and > MAW Building and Maintenance Melbourne Health is committed to diversity management activities protecting the privacy of its patients and throughout Melbourne Health. > Melbec Construction Group clients. The organisation is required by > Acton Lodge law to protect personal and confidential Competitive Neutrality > Johnstaff information such as information about Melbourne Health continues to comply an individual’s health and other personal with the Victorian Government’s In order to maintain buildings in a safe details. Melbourne Health complies with Competitive Neutrality Policy. In addition, and serviceable condition, routine all applicable Victorian legislation relating the Victorian Government’s Competitive inspections were undertaken. Where to confidentiality and privacy including, Neutrality pricing principles for all relevant required, Melbourne Health proceeded where relevant, the Health Services Act business activities has been applied by to implement the highest priority 1988 and the Health Records Act 2001. The Melbourne Health from 1 July 2000. recommendations arising out of those Melbourne Health Privacy Policy is available inspections through planned rectification in hardcopy and online at www.mh.org.au. Victorian Industry and maintenance works. Participation Policy Freedom of Information Melbourne Health complies with the Building certifi ed for approved All applications were processed in intent of the Victorian Industry Participation design phase – under construction accordance with the provision of the Policy Act 2003, which requires wherever RMH City Campus Freedom of Information Act 1982 which possible local industry participation > Emergency Department provides a legally enforceable right of in supplies, taking into consideration Redevelopment access to information held by government the principle of value for money and > WHO Collaborating Centre for agencies. All Melbourne Health clinical transparent tendering processes. During Reference and Research on Influenza services provide a report on these requests 2007/08, Melbourne Health commenced to the Victorian Department of Justice. one contract totalling more than > Infrastructure 2007/08 Upgrade $17 million in value to which the VIPP > The Royal Melbourne Hospital > Perioperative applied. The commitments by contractors received 1306 requests, of which > Biplane Angiography installation under VIPP included an overall level of 1053 were completed, 3 were local content of 100% of the total value > 3 West – Alterations to procedure withdrawn, 2 had no documentation of the contracts. The following benefits room 3 for ophthalmic microscope and 228 are in progress. to the Victorian economy in terms of skills > 7 West – Building works for medical > Melbourne Health received 7 and technology transfer increases include day stay treatment area requests directly, of which 4 were promoting a model that encourages completed, 1 was not proceeded with, competition between retail service > Balcony rectification 1 was not able to be answered by providers; ensuring services are available RMH Royal Park Campus Melbourne Health and 1 is in progress. at reasonable prices; and delivering Melbourne Health also received 7 an appropriate range and volume of > Robert Campbell Building other requests from other authorities services that meet staff and public air conditioning upgrade wishing to disclose information / needs whilst generating a positive > Robert Campbell Building toilet documents referring to Melbourne commercial outcome. exhaust upgrade Health - all 7 were competed. > Environmental improvements to Building Act 1993 > NorthWestern Mental Health received aged care facilities 201 requests, of which 188 were Melbourne Health has obtained Building completed, 5 were withdrawn, 126 Permits for new projects and Certificates NWMH had access granted in full, 46 had of Occupancy or Certificates of Final > Building 5 office fitout at RMH access granted in part, 4 had access Inspection for all completed projects. Royal Park Campus denied, 5 were transferred to other Registered Building Practitioners have > 263 Bell Street office fitout services, and 17 are in progress. been involved with all new building > Car Park works – St. Albans CCU Whistleblowers Protection Act 2001 works projects and were supervised by > 1 North office reconfiguration Melbourne Health has a policy and either the relevant Construction Manager procedure in compliance with Part 6 of in liaison with Melbourne Health or > Travencore PARC Melbourne Health Capital Projects. the Whistleblowers Protection Act 2001. The > PARCS (Preston/Broadmeadows) policy and procedure are available to all Each building practitioner has supplied staff on the Melbourne Health Intranet the required Building Registration site. In accordance with the provisions Number. Building contractors include: of Section 104 of the Act, no disclosures were received during the year.
Melbourne Health Annual Report 37 APPENDICES
Certifi ed/fi nal inspection Consultancies RMH City Campus Total Fees Consultant Details > Brick removal - façade rectification - $’000 Stage 2 Syris Consulting Clinical Benchmarking 108 > Brick removal - Stage 1 Kalmor Consulting Human Resource Strategy 109 > 2005/06 Energy Infrastructure Services Upgrade ¬Central Energy plant; So Asher Consultants Pty Ltd Fundraising 295 > Emergency Department William Buck Process Solutions Pty Ltd Accounting Services 482 Redevelopment – Stage 1 Other (under $100,000 comprised 1,121 of 138 engagements) > MRI installation Total Consultancies 2,115 > Cardiac Catheter Laboratory installation
> Ground Floor - West Wing main block Attestation on Compliance (c) Details of publications produced by the refurbishment with Australian/New Zealand department about the activities of the > Chiller Upgrade 2005/06 Risk Management Standard entity and where they can be obtained. I, Robert Doyle, certify that Melbourne > Infrastructure 2006/07 Upgrade (d) Details of changes in prices, fees, Health has risk management processes charges, rates and levies charged by > 9 East (Stage 1 & 2) Infectious diseases in place consistent with the Australian/ the entity. response unit New Zealand Risk Management Standard and an internal control system is in place RMH Royal Park Campus (e) Details of any major external reviews that enables the executive to understand, carried out on the entity. > Parkville Hostel - Balcony structural manage and satisfactorily control risk upgrade exposures. The Audit Committee verifies (f) Details of major research and > Park House - Electrical supply upgrade this assurance and that the risk profile development activities undertaken of Melbourne Health has been critically by the entity that are not otherwise NWMH reviewed within the last 12 months. covered either in the Report of > 363 Bell Street office fitout Operations or in a document that contains the financial report and > Car Park works – St Albans CCU Report of Operations.
(g) Details of overseas visits undertaken including a summary of the objectives Robert Doyle and outcomes of each visit. Chairman (h) Details of major promotional, public Melbourne Health relations and marketing activities 1 September 2008 undertaken by the entity to develop community awareness of the entity Additional information and its services.
The following information, where it (i) Details of assessments and relates to Melbourne Health is relevant measures undertaken to improve to the financial year 2007/08 is available the occupational health and safety upon request by relevant Ministers, of employees. members of Parliament and the public: (j) General statement on industrial (a) A statement of pecuniary interest relations within the entity and details has been completed. of time lost through industrial (b) Details of shares held by senior officers accidents and disputes, which is not as nominee or held beneficially. otherwise detailed in the Report of Operations.
(k) A list of major committees sponsored by the entity, the purposes of each committee and the extent to which the purposes have been achieved.
38 Melbourne Health Annual Report APPENDICES
Thank you to Travis Gatt Support Group Macquarie Bank Foundation Baulderstone Hornibrook Pty Ltd St. Aloysius College Michael and Andrew Buxton Big Fish Evolution Pty Ltd our Supporters Academy of Mary Immaculate Foundation Bilfinger Berger Concessions Genezzano College Perpetual Trustees Billard Leece Partnership Pty Ltd RMH Auxiliaries and Support Melbourne Grammar Pierce Armstrong Trust BOC Medical ltd Groups Melbourne High School Shepherd Foundation Cadalong Pty Ltd Birthday League Trinity Grammar Syd and Ann Wellard Perpetual Trust Century Plus Pty Ltd Cancer Support Group Xavier College State Trustees City of Melbourne Christmas Card Group Presbyterian Ladies’ College - Tattersall’s Foundation Ltd Clifford Hallam Healthcare Diabetes Support Group Burwood The Hugh D T Williamson Foundation Combined Christmas Charity Shop Dialysis Support Group Overnewton Anglican Community The Myer Foundation Dentoh and Associates Friends of RMH College The Sarah and Baillieu Myer Des Nixon and Associates Graduate Nurses’ Association Family Foundation Eliptus Private Benefactors Greek Fund for Arthritis Research The William Angliss (Victoria) Esso Australia Mr Robert Abrahams Charitable Fund Kiosk Auxiliary Fuji Xerox Australia Ms Betty Amsden OAM Neph Friends Goldman Sachs JB Were Mrs Margaret Blandford Estates and Bequests Pacemakers Patients Auxiliary Grollo Australia Pty Ltd Miss Margaret Bowman AHW Dehnert Estate Guidant Australia Pty Ltd Mr Frank Callaway AL Blannin Estate RMH Volunteers Hassell Architects Mrs Liz Clifford Anna Benallack Estate RMH City Campus - Volunteer Services ImRAC PTY Ltd Mr Ian Conrad Catherine Myra Markham Estate > Volunteer Centre Industrial Workforce Mrs June Danks Diane Margaret Waters Estate > Ward Visitors ISPT community Fund Mr John Evans Dorothy W Dike Estate > Library Service Lcubed Ms Susanne Gabor Emily Vera Winder Estate > Guide Service Medtronic Australasia Pty Ltd Mrs Neilma B Gantner Ernest Buxton Estate > Justices of the Peace Melbourne City Motors Mr Peter Goodrich George H Ievers Estate > Newspaper Trolley Melbourne Pathology Services Pty Ltd Mr Kevin Green Gladys Doreen Morris Estate > Craft Volunteers Myer Pty Ltd Mrs Barbara Haynes Glendon Park Trust > Assisting with events, Novartis Pharmaceuticals Irene Daisy Dike Estate stalls or raffles Ms Monica Ho Australia Pty Ltd John and Thirza Daley > Delta Dog Pet Partners Mr Bernie and Mrs Gerry Lamers Olympic Hotel Charitable Bequest Program (external) Mr Phuong D Lay Patrick Stevedores John Anderson Estate Mrs Seow Loon Lay Queen Victoria Market Pty Ltd RMH Royal Park Campus - Mr Roderick & Mrs Margaret John Lambrick Trust Volunteer Services Roche Products Pty Ltd Macdonald John McIntyre Johnston > LifeMoves Peer Support Program Schiavello Pty Ltd Mr Andrew Macfarlane Joseph and Kate Levi Charitable Trust > Rehabilitation Activities Group Siemens Limited Mrs Joan McVeigh Joseph Herman Estate > Parkville Hostel Activities Group Smith & Nephew Pty Ltd Mr Joshua Mills Keith Anderson Strickland Estate > Delta Dog Pet Partners Program Spacerack (Lenrael Pty Ltd) Mr Chi Bui and Mrs Sook Chi Ng Lillian Maud Kees Estate (external) SO Asher Pty Ltd Mr Tony Peake Louisa Henty Estate > Italian Socialisation Group St Jude Medical Australia Pty Ltd Mr Ian Pietzsch McKean and Park Lawyers > Ward Visitors Stud Park Medical Centre Lady Southey AC Miss Ethel Margaret Bulmer Estate > Clinical Centre Visitors The Slade Group Mr Bin Thai Morley, Naughton, Pearn and Cook 3AW Mr Tom Tootell Muriel Berenice Beattie Community Support Groups Telco Services Australia Pty Ltd Mr Ken & Mrs Rose Truong Nancy Fuller Bequest Banyule Support and Information Tolhurst Noall Pty Ltd Mr Thieu Vo Olga Zobula Estate Centre Wilson Parking Australia Pty Ltd Robert Maurice Jacka Estate Box Hill Lions Christmas Card Shop Ms Doris Yip Sarah Jill Hollyer Estate Berwick Opportunity Shop Mr Peter Zwar The Grant Bequest Camberwell Charity Christmas Card Shop Charitable Trusts The JRG and E McKenzie Bequest Cancer Council of Victoria AMP Foundation Charitable Trust Corporate Supporters Chinese Masonic Society ANZ Trustees Coeliac Society of Australia The Percy Baxter Charitable Trust 101 Collins St Pty Ltd Coeliac Society of New Zealand Bell Charitable Fund AR Capital Management Pty Ltd Combined Charities Christmas Shop Bone Marrow Donor Institute Ltd Australian Tallow Producers Melbourne Boston Sister City Colonial Foundation Ltd Abeles Pty Ltd Committee Equity Trustees Australian Consolidated Press Rotary Club District 9790 Fitzgerald Foundation ADCO Constructions Rotary Club of Yarrawonga/Mulwala The Marian and E H Flack Trust ANZ Bank (Western Gate Local Walking Tall Support Group Galante Charities Trust Market Branches) George and Edith Ramsay AstraZeneca Charitable Trust B Braun Australia Limited George Hicks Foundation Bassett Guthrie Family Charitable Trust H and L Hecht Trust Helen Macpherson Smith Trust Lord Mayor’s Charitable Fund
Melbourne Health Annual Report 39 APPENDICES
Senior Staff Senior Staff NorthWestern Mental Health Deputy Director (Clinical Governance) Director Allied Health Executive Prof Bruce Singh (to December 2007) Ms Elizabeth Cashill (to July 2008) Chief Executive Assoc Prof Peter Burnett (from April 2008) Ms Genevieve Juj (Acting from July 2008) Ms Linda Sorrell Director Diagnostic Imaging Deputy Director (Operations) Executive Director Access and Prof Patricia Desmond Ms Robyn Humphries (Acting) Organisational Improvement Mr Lee Martin Director Facilities Management Nursing Director Mr Michael McCambridge Mr Brian Jackson Executive Director Business Development and Corporate Secretary Director Pathology Surgery and Perioperative Services Mrs Sally Campbell Dr Vincent Sinickas Divisional Director Assoc Prof Rodney Judson Executive Director Clinical Governance Director Pharmacy and Medical Services Mr David Ford Dr Tony Snell (Acting to June 2008) Divisional Director Nursing and Operations Dr Peter Bradford (from July 2008) Ms Rhonda Beattie-Manning Clinical Divisions Executive Director Communications Medical Director Perioperative Services and Community Relations Ambulatory and Continuing Dr Daryl Williams Ms Trudy Habner Care Service Director Intensive Care Unit Executive Director Finance Ms Felicity Topp Director Mr Colin Holland Prof Jack Cade (to Dec 2007) Medical Director Dr Nerina Harley (from Jan 2008) Executive Director Human Resources Dr Tom Hale and Workplace Development Divisional Director Nursing and Operations Ms Christine Fitzherbert Nursing Director Mr Colin Dawson Doris Vella Executive Director NorthWestern Melbourne Comprehensive Mental Health Cardiac Services Cancer Centre Assoc Prof Alex Cockram (to July 2008) Divisional Director Director Mr Peter Kelly (Acting) Assoc Prof James Tatoulis Prof Andrew Kaye Executive Director Nursing Services Divisional Director Nursing and Operations North West Dialysis Service Assoc Prof Denise Heinjus Mr Colin Dawson Director Executive Director Research Medicine and Emergency Services Ms Jenny Soding Prof Ingrid Winship Divisional Director Victorian Infectious Diseases Prof Mark Rosenthal Reference Laboratory Executive Director The Royal (Acting Dec 2007-June 2008) Melbourne Hospital Director Assoc Prof Christine Kilpatrick Dr Tony Snell Dr Mike Catton (to July 2008) Assoc Prof Alex Cockram (Acting) Divisional Director Nursing and Operations Ms Linda Davidson
Neurosciences Divisional Director Prof Stephen Davis
Divisional Director Nursing and Operations Mr Colin Dawson
40 Melbourne Health Annual Report APPENDICES
Organisational Structure
Melbourne Health Board
Chief Executive Internal Auditors
Executive Director Bed management Hospital In the Home Preadmissions Access & Organisational Clinical coding Outpatients Department Theatre schedules Improvement Health Information Services Performance Measurement Unit Waiting List coordinators
Executive Director Business Development Facilities Management Legal Counsel Business Development & Capital Works Health Sciences Library VIDRL Corporate Secretary Contracts Management Information Technology VICNISS
Executive Director Allied Health Medical Services Safety & Quality Unit Clinical Governance & Clinical Epidemiology & Health North West Dialysis Service Strategy & Planning Medical Services Services Evaluation Pathology
Executive Director Archives Media Relations Communications & Community Engagement Medical Illustration Community Relations Fundraising & Philanthropy Public Affairs
Executive Director Finance Budget Controller Business Managers Payroll
Executive Director Employee Relations Recruitment Human Resources & Employee Services Staff Support Services Workplace Development Occupational Health & Safety
Executive Director Inner West AMHS North West AMHS NorthWestern Mental Health Mid West AMHS Aged Persons’ MHP Northern AMHS ORYGEN Youth Health
Executive Director Back Attack Emergency Management Nursing Workforce Unit Nursing Services Clinical Aggression Coordinator Planning Nurse Education Clinical Policy & Procedure Nurse Bank Professor of Nursing Nurse Education Professional Nursing
Executive Director Research Ethics Committees Research Grants
Executive Director Ambulatory & Imaging Neurosciences The Royal Melbourne Hospital Continuing Care Intensive Care Surgery & Perioperative Cardiac Services Medicine Emergency Services
Melbourne Health Annual Report 41 APPENDICES
Disclosure Index The Annual Report of Melbourne Health Service is prepared in accordance with all relevant Victorian legislation. This index has been prepared to facilitate identification of the Department’s compliance with statutory disclosure requirements.
Legislation Requirement Page Ref
Ministerial Directions
Report of Operations – FRD Guidance
Charter and purpose
FRD 22B Manner of establishment and the relevant Ministers 4 FRD 22B Objectives, functions, powers and duties 4 FRD 22B Nature and range of services provided 4
Management and Structure
FRD 22B Organisational structure 41
Financial and other Information
SD 4.2(j) Accountable officer, signed of report of operations 2 SD 4.5.5 Risk Management Compliance 38 FRD 22B Operational and budgetary objectives and performance against objectives 8 FRD 22B Statement of merit and equity 37 FRD 22B Workforce Data Disclosures 24 FRD 22B Occupational health and safety 27 FRD 22B Summary of the financial results for the year 5 FRD 22B Significant changes in financial position during the year N/A FRD 22B Major changes or factors affecting performance N/A FRD 22B Subsequent events 85 FRD 22B Application and operation of Freedom of Information Act 1982 37 FRD 22B Compliance with building and maintenance provisions of Building Act 1993 37 FRD 25 Victorian Industry Participation Policy disclosures 37 FRD 22B Statement on National Competition Policy 37 FRD 22B Application and operation of the Whistleblowers Protection Act 2001 37 FRD 22B Details of consultancies over $100,000 38 FRD 22B Details of consultancies under $100,000 38 FRD 22B Statement of availability of other information 38 FRD 10 Disclosure index 42 FRD 11 Disclosure of ex-gratia payments N/A FRD 21A Responsible person and executive officer disclosures 84
Financial Statements – FRD Guidance
Financial statements required under Part 7 of the FMA
SD 4.2(b) Operating Statement 44 SD 4.2(b) Balance Sheet 45 SD 4.2(b) Statement of Changes in Equity 47 SD 4.2(b) Cash Flow Statement 46 SD 4.2(c) Accountable officer’s declaration 44 SD 4.8(c) Compliance with Australian accounting standards and other authoritative pronouncements 86 SD 4.2(c) Compliance with Ministerial Directions 44 SD 4.2(d) Rounding of amounts 48
Legislation
Freedom of Information Act 1982 Whistleblowers Protection Act 2001 Victorian Industry Protection Act 2003 Building Act 1993 Financial Management Act 1994 Audit Act 1994
42 Melbourne Health Annual Report Melbourne Health Financial Report
Financial Report for the Year Ended 30 June 2008
Contents 44 Operating Statement 45 Balance Sheet 46 Cash Flow Statement 47 Statement of Changes in Equity 48 Notes to the Financial Statements 86 Independent Audit Report
Melbourne Health Annual Report 43 Board Members’, Accountable Offi cer’s and Chief Finance & Accounting Offi cer’s declaration
We certify that the attached financial report for Melbourne Health has been prepared in accordance with Standing Direction 4.2 of the Financial Management Act 1994, applicable Financial Reporting Directions, Australian Accounting Standards, Interpretations and other mandatory professional reporting requirements. We further state, that in our opinion, the information set out in the Operating Statement, Balance Sheet, Statement of Changes in Equity, Cash Flow Statement and notes forming part of the financial report, presents fairly the financial transactions during the year ended 30 June 2008 and financial position of Melbourne Health at 30 June 2008.
We are not aware of any circumstance which would render any particulars included in the financial report to be misleading or inaccurate.
We authorise the attached financial report for issue on this day.
Chairperson Chairperson, Chief Executive Executive Director Audit Committee Finance
“On behalf of the Board, “On behalf of the Board, Ms Linda Sorrell Mr Colin Holland Mr Robert Doyle” Ms Penelope Hutchinson”
Melbourne Dated this 18th day of August, 2008
Melbourne Health Operating Statement For the year ended 30 June 2008
Note Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 Revenue from Operating Activities 2 668,997 645,683 670,568 645,197 Revenue from Non-Operating Activities 2 5,906 5,320 6,027 5,432 Employee Benefits 3 (461,773) (428,278) (461,836) (428,569) Non-Salary Labour Costs 3 (15,542) (18,478) (15,542) (18,478) Supplies & Consumables 3 (121,723) (137,736) (121,723) (137,736) Other Expenses from Continuing Operations 3 (76,532) (78,157) (78,135) (79,174)
Net Result Before Capital & Specific Items (667) (11,645) (641) (13,328)
Capital Purpose Income 2 46,421 22,262 46,421 22,262 Depreciation and Amortisation 4 (26,527) (19,199) (26,527) (19,220) Finance Costs 5 (178) (151) (178) (152) Expenditure using Capital Purpose Income 3 (604) (973) (596) (973)
NET RESULT FROM CONTINUING OPERATIONS 18,445 (9,706) 18,479 (11,410)
Loss Attributable to Minority Interest - - 422 633 Net Result for the Period 18,445 (9,706) 18,901 (10,777) This Statement should be read in conjunction with the accompanying notes.
44 Melbourne Health Annual Report Melbourne Health Balance Sheet As at 30 June 2008
Note Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 Current Assets Cash and Cash Equivalents 6 32,685 26,988 33,197 27,305 Receivables 7 41,551 36,886 41,067 36,609 Inventories 9 7,696 7,830 7,697 7,830 Other Current Assets 10 852 971 852 1,016 Total Current Assets 82,784 72,675 82,813 72,760
Non-Current Assets Receivables 7 5,132 7,216 5,132 7,216 Other Financial Assets 8 9,454 8,699 7,131 5,588 Property, Plant & Equipment 11 515,655 454,124 515,696 454,150 Intangible Assets 12 6,645 5,133 7,679 5,945 Investment Properties 13 475 475 475 475 Total Non-Current Assets 537,361 475,648 536,113 473,374 TOTAL ASSETS 620,145 548,322 618,926 546,134
Current Liabilities Payables 14 44,461 71,995 46,301 72,520 Provisions 15 103,914 91,448 103,914 91,448 Other Liabilities 16 1,669 1,298 1,669 1,298 Total Current Liabilities 150,044 164,741 151,884 165,266
Non-Current Liabilities Provisions 15 12,876 13,385 12,876 13,385 Total Non-Current Liabilities 12,876 13,385 12,876 13,385 TOTAL LIABILITIES 162,920 178,125 164,760 178,651 NET ASSETS 457,225 370,197 454,166 367,483
EQUITY Asset Revaluation Reserve 17a 154,789 87,950 154,789 87,950 Available for Sale Revaluation Reserve 17a 684 - 606 - Restricted Specific Purpose Reserve 17a 30,081 29,406 35,325 34,950 Contributed Capital 17b 304,713 303,953 304,713 303,953 Accumulated Surpluses/(Deficits) 17c (33,042) (51,112) (42,531) (61,057) Minority Interest 17d 1,264 1,687 TOTAL EQUITY 17d 457,225 370,197 454,166 367,483
This Statement should be read in conjunction with the accompanying notes.
Melbourne Health Annual Report 45 Melbourne Health Cash Flow Statement For the Year Ended 30 June 2008
Note Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 CASH FLOWS FROM OPERATING ACTIVITIES Operating Grants from Government 535,288 551,148 535,288 551,148 Patient and Resident Fees Received 10,488 9,243 10,488 9,243 Private Practice Fees Received 20,718 12,050 20,718 12,050 Donations and Bequests Received 4,685 2,411 4,684 2,411 GST Received from/(paid to) ATO 14,679 (43,528) 16,828 (46,028) Recoupment from private practice for 408 469 408 469 use of hospital facilities Interest Received 2,638 2,568 2,670 2,665 Dividend Received 518 206 607 221 Other Receipts 100,978 136,575 99,559 135,604 Employee Benefits Paid (449,833) (422,406) (449,896) (422,697) Non- Salary Labour Costs (15,542) (18,478) (15,542) (18,478) Payments for Supplies & Consumables (175,466) (151,509) (174,178) (151,509) Finance Costs (178) (151) (178) (152) Other Payments (68,857) (70,991) (69,920) (68,427) Cash Generated from Operations (19,476) 7,607 (18,464) 6,519
Capital Grants from Government 46,120 24,839 46,120 24,839 Capital Donations and Bequests Received 369 - 369 -
NET CASH INFLOW/(OUTFLOW) FROM 18 27,013 32,446 28,025 31,358 OPERATING ACTIVITIES
CASH FLOWS FROM INVESTING ACTIVITIES Purchase of Property, Plant & Equipment (50,210) (51,840) (50,176) (52,097) Proceeds from Sale of Property, Plant & Equipment 153 90 153 90 Purchase of Investments - (529) (850) (1,728) Proceeds from Sale of Investments 109 - 109 - NET CASH INFLOW/(OUTFLOW) FROM (49,948) (52,278) (50,764) (53,734) INVESTING ACTIVITIES
CASH FLOWS FROM FINANCING ACTIVITIES Contributed Capital from Government 28,260 11,304 28,260 11,304 NET CASH INFLOW/(OUTFLOW) FROM 28,260 11,304 28,260 11,304 FINANCING ACTIVITIES NET INCREASE/(DECREASE) IN CASH HELD 5,325 (8,528) 5,521 (11,072) CASH AND CASH EQUIVALENTS AT 25,691 34,219 26,007 37,079 BEGINNING OF PERIOD CASH AND CASH EQUIVALENTS AT 6a 31,016 25,691 31,528 26,007 END OF PERIOD
This Statement should be read in conjunction with the accompanying notes
46 Melbourne Health Annual Report Melbourne Health Statement of Changes in Equity For the Year Ended 30 June 2008
Note Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 Total equity at beginning of financial year 370,197 365,935 367,483 364,925 Transfer to/from reserves: Accumulated Surpluses/(Deficits) 17c 675 - 375 - Restated total equity at beginning 370,872 365,935 367,858 364,925 of financial year Gain on Asset Revaluation 17a 66,839 - 66,838 - Available-for-sale investments: Gain taken to equity 17a 684 - 606 - NET INCOME RECOGNISED DIRECTLY 67,523 - 67,444 - IN EQUITY Net result for the year 18,445 (9,706) 18,901 (10,777) Transfer to and from reserves 17c (375) - (375) - Minority Interest - - (422) (633) TOTAL RECOGNISED INCOME AND EXPENSE 85,593 (9,706) 85,548 (11,410) FOR THE YEAR Transactions with the State in its capacity 17b 760 13,967 760 13,967 as owner Total Equity at the end of the financial year 457,225 370,196 454,166 367,483
This Statement should be read in conjunction with the accompanying notes.
Melbourne Health Annual Report 47 Notes to the Financial Statements Note 1: Statement of Signifi cant Accounting Policies
This consolidated general-purpose Financial (a) Reporting Entity (g) Other Financial Assets Report of Melbourne Health (the ‘Service’) and The financial report includes all the controlled activities Other financial assets are recognised and de- the economic entity has been prepared on an of the Service. The entity is a not-for-profit entity recognised on trade date where the puchase or sale accrual basis in accordance with the provisions and therefore applies the additional Aus paragraphs of an investment is under a contract whose terms of the Financial Management Act 1994, applicable applicable to “not-for-profit” entities under the AASs. require delivery of the investment within the time Australian Accounting Standards (AAS), which frame established by the market concerned, and are includes the Australian accounting standards (b) Rounding of Amounts initially measured at fair value, net of transaction costs. issued by the Australian Accounting Standards All amounts shown in the financial statements The Service classifies its other investments Board (AASB), Interpretations and other mandatory are expressed to the nearest one thousand dollars ($’000). as available for sale. This classification depends on the professional requirements. purpose for which the investments were acquired. The financial statements were authorised (c) Principles of Consolidation Management determines the classification of its for issue by the Board of Melbourne Health The assets, liabilities, incomes and expenses investments at initial recognition. (the ‘Service’) on 18 August, 2008. of all controlled entities of the Service have been included at the values shown in their audited Annual The Service assesses at each balance date whether a Financial Reports. Subsidiaries are entities controlled financial asset or group of financial assets is impaired. Basis of preparation by Service, control exists when the Service has the Other investments held by the Service are classified power to govern the financial and operating policies of The financial report is prepared in accordance with the as being available-for-sale and are stated at fair value. an entity so as to obtain benefits from its activities. In historical cost convention, except for the revaluation of Gains and losses arising from changes in fair value are assessing control, potential voting rights that presently certain non-current assets and financial instruments, recognised directly in equity, until the investment is are exercisable are taken into account. Any inter-entity as noted. Cost is based on the fair values of the disposed of or is determined to be impaired, at which transactions have been eliminated on consolidation. consideration given in exchange for assets. time the cumulative gain or loss previously recognised The consolidated financial statements include the in equity is included in profit or loss for the period. In the application of AASs management is audited financial statements of the controlled entities Fair value is determined in the manner described required to make judgements, estimates and listed in note 25. in Note 19. assumptions about carrying values of assets and (d) Cash and Cash Equivalents liabilities that are not readily apparent from other Dividend revenue is recognised on a receivable basis. sources. The estimates and associated assumptions Cash and cash equivalents comprise cash on hand Interest revenue is recognised on a time proportionate are based on historical experience and various other and cash at bank, deposits on call and highly liquid basis that takes into account the effective yield on the factors that are believed to be reasonable under investments with an original maturity of 3 months or financial asset. the circumstance, the results of which form the basis less, which are readily convertible to known amounts of making the judgements. Actual results may differ of cash and are subject to insignificant risk of changes (h) Intangible Assets from estimates. in value. Intangible assets represent identifiable non-monetary assets without physical substance such as patents, The estimates and underlying assumptions are (e) Receivables computer software and development costs. reviewed on an ongoing basis. Revisions to accounting Trade and patient debtors are carried at nominal estimates are recognised in the period in which the amounts due and are due for settlement within Intangible assets are recognised at cost. estimate is revised if the revision affects only that 30 days from the date of recognition. Collectability Costs incurred subsequent to initial acquisition are period, or in the period of the revision, and future of debts is reviewed on an ongoing basis, and debts capitalised when it is expected that additional future periods if the revision affects both current and which are known to be uncollectible are written off. economic benefits will flow to the Service. future periods. General provisions for doubtful debts are raised in accordance with Service policy, and specific provisions Amortisation is allocated to intangible assets with Accounting policies are selected and applied in a are raised where doubt as to collection finite useful lives on a systematic basis over the asset’s manner which ensures that the resulting financial of a specific debt exists. Bad debts are written useful life. Amortisation begins when the asset is information satisfies the concepts of relevance and off when identified. available for use, that is, when it is in the location and reliability, thereby ensuring that the substance of the condition necessary for it to be capable of operating underlying transactions or other events is reported. (f) Inventories in the manner intended by management. The Inventories include goods and other property held amortisation period and the amortisation method for The accounting policies set out below have been either for sale or for distribution at no or nominal cost in an intangible asset with a finite useful life are reviewed applied in preparing the financial statements for the ordinary course of business operations. at least at the end of each annual reporting period. the year ended 30 June 2008, and the comparative In addition, an assessment is made at each reporting information presented in these financial statements Inventories held for distribution are measured at date to determine whether there are indicators that the for the year ended 30 June 2007. the lower of cost and current replacement cost. intangible asset concerned is impaired. If so, the assets All other inventories are measured at the lower concerned are tested as to whether their carrying of cost and net realisable value. value exceeds their recoverable amount.
Cost for all other inventory is measured on the basis of weighted average cost.
48 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Intangible assets with indefinite useful lives are not 2008 2007 amortised. The useful life of intangible assets that are not being amortised are reviewed each period to Buildings Up to 40 Years Up to 40 Years determine whether events and circumstances continue Plant & Equipment Up to 10 Years Up to 10 Years to support an indefinite useful life assessment for Furniture & Fittings Up to 10 Years Up to 10 Years that asset. In addition, the Service tests all intangible Motor Vehicles Up to 4 Years Up to 4 Years assets with indefinite useful lives for impairment by comparing its recoverable amount with its Computers Equipments Up to 3 Years Up to 3 Years carrying amount: > annually, and > whenever there is an indication that the intangible Revaluation increases and revaluation decreases (m) Impairment of Assets asset may be impaired relating to individual assets within an asset class Intangible assets with indefinite useful lives are offset against one another within that class are tested annually as to whether their carrying value Any excess of the carrying amount over but are not offset in respect of assets in different exceeds their recoverable amount. All other assets the recoverable amount is recognised as an classes. Revaluation reserves are not transferred are assessed annually for indications of impairment, impairment loss. to accumulated funds on derecognition of the except for: relevant asset. (i) Property, Plant and Equipment > inventories; Freehold and Crown Land is measured at fair (k) Investment Property > assets arising from construction contracts; value with regard to the property’s highest and Investment properties represent properties held > assets arising from employee benefits; best use after due consideration is made for any legal to earn rentals or for capital appreciation or both. > financial instrument assets; and or constructive restrictions imposed on the land, public Investment properties exclude properties held to meet > investment property that is measured announcements or commitments made in relation to service delivery objectives of the State of Victoria. at fair value. the intended use of the land. Theoretical opportunities that may be available in relation to the asset(s) are not Investment properties are initially recognised at If there is an indication of impairment, the assets taken into account until it is virtually certain that any cost. Costs incurred subsequent to initial acquisition concerned are tested as to whether their carrying restrictions will no longer apply are capitalised when it is probable that future value exceeds their recoverable amount. Where economic benefits in excess of the originally assessed an asset’s carrying value exceeds its recoverable Buildings are initially measured at cost and performance of the asset will flow to the Service. amount, the difference is written-off by a charge subsequently measured at fair value less accumulated to the operating statement except to the extent depreciation and impairment. Subsequent to initial recognition at cost, investment that the write-down can be debited to an asset properties are re-valued to fair value with changes in revaluation reserve amount applicable to that Plant, Equipment and Vehicles are measured at cost the fair value recognised as revenue or expenses in class of asset. less accumulated depreciation and impairment. the period that they arise. The properties are not depreciated. The recoverable amount for most assets is measured (j) Revaluations of Non- Current at the higher of depreciated replacement cost and Physical Assets Rental revenue from the leasing of investment fair value less costs to sell. Recoverable amount for Non-current physical assets measured at fair properties is recognised in the Operating Statement in assets held primarily to generate net cash inflows is value are revalued in accordance with FRD103C. This the periods in which it is receivable, as this represents measured at the higher of the present value of future revaluation process normally occurs every five years, the pattern of service rendered through the provision cash flows expected to be obtained from the asset as dictated by timelines in FRD103C which sets the of the properties. and fair value less costs to sell. It is deemed that, in next revaluation to occur on June 30, 2009, or earlier the event of the loss of an asset, the future economic (l) Depreciation should there be an indication that fair values are benefits arising from the use of the asset will be materially different from the carrying value. Revaluation Assets with a cost in excess of $1,000 (2006-7 replaced unless a specific decision to the contrary increments or decrements arise from differences and 2007-8) are capitalised and depreciation has been has been made. between an asset’s carrying value and fair value. provided on depreciable assets so as to allocate their cost or valuation over their estimated useful lives using (n) Payables Revaluation increments are credited directly to the the straight-line method. Estimates of the remaining These amounts represent liabilities for goods asset revaluation reserve, except that, to the extent useful lives and depreciation method for all assets are and services provided prior to the end of the financial that an increment reverses a revaluation decrement in reviewed at least annually. This depreciation charge is year and which are unpaid. The normal credit terms respect of that class of asset previously recognised at not funded by the Department of Human Services. are usually Nett 30 days. an expense in net result, the increment is recognised as income in the net result. The following table indicates the expected useful (o) Provisions lives of non- current assets on which the depreciation Provisions are recognised when the Service has a Revaluation decrements are recognised immediately charges are based. present obligation, the future sacrifice of economic as expenses in the net result, except that, to the extent benefits is probable, and the amount of the provision that a credit balance exists in the asset revaluation can be measured reliably. reserve in respect of the same class of assets, they are debited directly to the asset revaluation reserve.
Melbourne Health Annual Report 49 Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
The amount recognised as a provision is the best Those liabilities that the health service does not The Service does not recognise any defined benefit estimate of the consideration required to settle the expect to settle within 12 months are recognised liability in respect of the superannuation plans present obligation at reporting date, taking into in the provision for employee benefits as current because the Service has no legal or constructive account the risks and uncertainties surrounding the liabilities, measured at present value of the amounts obligation to pay future benefits relating to obligation. Where a provision is measured using the expected to be paid when the liabilities are settled its employees; its only obligation is to pay cashflows estimated to settle the present obligation, using the remuneration rate expected to apply superannuation contributions as they fall due. The its carrying amount is the present value of at the time of settlement. Department of Treasury and Finance administers and those cashflows. discloses the State’s defined benefit liabilities in its Long Service Leave financial report. (p) Resources Provided and Received Free of Current Liability – unconditional LSL (representing Charge or for Nominal Consideration 10 or more years of continuous service) is disclosed On-Costs Resources provided or received free of charge or as a current liability regardless of whether the Service Employee benefit on-costs are recognised and for nominal consideration are recognised at their does not expect to settle the liability within 12 included in employee benefit liabilities and costs fair value. Contributions in the form of services are months as it does not have the unconditional right when the employee benefits to which they relate only recognised when a fair value can be reliably to defer the settlement of the entitlement should are recognised as liabilities. determined and the services would have been an employee take leave. purchased if not donated. (t) Finance Costs The components of this current LSL liability are Finance costs are recognised as expenses in the (q) Functional and Presentation Currency measured at: period in which they are incurred. present value – component that the Service does The presentation currency of the Service is the not expect to settle within 12 months; and Finance costs include: Australian dollar, which has also been identified as nominal value – component that the Service > interest on bank overdrafts and short-term and the functional currency of the Service. expects to settle within 12 months. long-term borrowings; (r) Goods and Services Tax Non-Current Liability – conditional LSL (representing > interest on bank overdrafts and short-term and long-term borrowings; bank fees and charges Income, expenses and assets are recognised less than 10 years of continuous service) is disclosed as a non-current liability. There is an unconditional net of the amount of associated GST, unless the (u) Intersegment Transactions GST incurred is not recoverable from the taxation right to defer the settlement of the entitlement Transactions between segments within the Service authority. In this case it is recognised as part of until 10 years of service has been completed by have been eliminated to reflect the extent of the the cost of acquisition of the asset or as part of an employee. Conditional LSL is required to be Service’s operations as a group. the expense. measured at present value. (v) Leases Receivables and payables are stated inclusive Consideration is given to expected future wage and of the amount of GST receivable or payable. The net salary levels, experience of employee departures Operating lease payments, including any contingent amount of GST recoverable from, or payable to, the and periods of service. Expected future payments rentals, are recognised as an expense in the taxation authority is included with other receivables are discounted using interest rates of national operating statement on a straight line basis over the or payables in the balance sheet. Government guaranteed securities in Australia. lease term, except where another systematic basis is more representative of the time pattern of the Cash flows are presented on a gross basis. The GST Superannuation benefits derived from the use of the leased asset. components of cash flows arising from investing or Defined contribution plans (w) Revenue Recognition financing activities which are recoverable from, or Contributions to defined contribution payable to the taxation authority, are presented superannuation plans are expenses when incurred. Revenue is recognised in accordance with AASB as operating cash flow. 118 Revenue and is recognised as to the extent it Defined benefit plans is earned. Unearned income at reporting date is (s) Employee Benefits The amount charged to the Operating Statement reported as income received in advance. Wages and Salaries, Annual Leave, Sick Leave in respect of defined benefit superannuation plans Amounts disclosed as revenue are, where applicable, and Accrued Days Off represents the contributions made by the Service to net of returns, allowances and duties and taxes. Liabilities for wages and salaries, including non- the superannuation plan in respect of the services of monetary benefits, annual leave and accrued days current Service staff. Superannuation contributions off expected to be settled within 12 months of are made to the plans based on the relevant rules of the reporting date are recognised in the provision each plan. for employee benefits in respect of employee’s services up to the reporting date, classified as current Employees of the Service are entitled to receive liabilities and measured at nominal values. superannuation benefits and the Service contributes to both the defined benefit and defined contribution plans. The defined benefit plan(s) provide benefits based on years of service and final average salary.
The Service made contributions to the following major superannuation plans during the year:
Employee Superannuation: Health Super Defined contribution plans: HESTA
50 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Government Grants (z) Comparative Information ii) Specific income/expense, comprises the Grants are recognised as income when the Service There have been no changes to previous year’s following items, where material: gains control of the underlying assets in accordance figures. > Voluntary departure packages with AASB 1004 Contributions. Where grants are > Write-down of inventories (aa) Asset Revaluation Reserve reciprocal, revenue is recognised as performance > Non-current asset revaluation increments/ occurs under the grant. Non-reciprocal grants are The asset revaluation reserve is used to record decrements recognised as income when the grant is received or increments and decrements on the revaluation > Diminution in investments receivable. Conditional grants may be reciprocal or of non-current assets (Note 1j). non-reciprocal depending on the terms of the grant. > Restructuring of operations (disaggregation/ (ab) Specific Restricted Purpose Reserve aggregation of health services) Indirect Contributions A specific restricted purpose reserve is established > Litigation settlements Insurance is recognised as revenue following advice where the Health Service has possession or title to > Non-current assets lost or found from the Department of Human Services. the funds but has no discretion to amend or vary the > Forgiveness of loans restriction and/or condition underlying the funds > Reversals of provisions Long Service Leave (LSL) – Revenue is recognised received. upon finalisation of movements in LSL liability in line > Voluntary changes in accounting with the arrangements set out in the Acute Health (ac) Contributed Capital policies (which are not required by an accounting standard or other authoritative Division Hospital Circular 13/2008. Consistent with UIG Interpretation 1038 pronouncement of the Australian Accounting Contributions by Owners Made to Wholly-Owned Standards Board) Patient and Resident Fees Public Sector Entities and FRD 2A Contributions by Patient fees are recognised as revenue at the time Owners, appropriations for additions to the net asset iii) Impairment of non- current assets, includes invoices are raised. base have been designated as contributed capital. all impairment losses (and reversal of previous Other transfers that are in the nature of contributions Private Practice Fees impairment losses), related to non- current assets or distributions, that have been designated as only which have been recognised in accordance Private practice fees are recognised as revenue at the contributed capital are also treated as contributed with note 1 (m). time invoices are raised. capital. iv) Depreciation and amortisation, as described in Donations and Other Bequests (ad) Net Result Before Capital note 1 (h) and (l). Donations and bequests are recognised as revenue & Specific Items when received. If donations are for a special purpose, The sub-total entitled ‘Net result Before Capital & v) Assets provided or received free of charge, as they may be appropriated to a reserve, such as Specific Items’ is included in the Operating Statement described in note 1 (p). specific restricted purpose reserve. to enhance the understanding of the financial performance of the Service. This sub-total reports the vi) Expenditure using capital purpose income, (x) Fund Accounting result excluding items such as capital grants, assets comprises expenditure which either falls below The Service operates on a fund accounting received or provided free of charge, depreciation, the asset capitalisation threshold (note 1 (h) and basis and maintains three funds: Operating, Specific and items of unusual nature and amount such as (i)), or doesn’t meet asset recognition criteria and Purpose and Capital Funds. The Service’s Capital specific revenues and expenses. The exclusion therefore does not result in the recognition of an and Specific Purpose Funds include unspent capital of these items are made to enhance matching asset in the balance sheet, where funding for that donations and receipts from fund-raising activities of income and expenses so as to facilitate the expenditure is from capital purpose income conducted solely in respect of these funds. comparability and consistency of results between (ae) Category Groups years and Victorian Public Health Services. The Net (y) Services Supported By Health Services result Before Capital & Specific Items is used by the The Service has used the following category groups Agreement and Services Supported By management of the Service, the Department of for reporting purposes for the current and previous Hospital And Community Initiatives Human Services and the Victorian Government to financial years. Activities classified as Services Supported by measure the ongoing result of Health Services in Admitted Patient Services (Admitted Patients) Health Services Agreement (HSA) are substantially operating hospital services. funded by the Department of Human Services and comprises all recurrent health revenue/expenditure on includes Residential Aged Care Services (RACS) Capital and specific items, which are excluded from admitted patient services, where services are delivered and are also funded from other sources such as this sub-total, comprise: in public hospitals, or free standing day hospital the Commonwealth, patients and residents, while facilities, or palliative care facilities, or rehabilitation Services Supported by Hospital and Community i) Capital purpose income, which comprises all tied facilities, or alcohol and drug treatment units or Initiatives (Non- HSA) are funded by the Health grants, donations and bequests received for the hospitals specialising in dental services, hearing and Service’s own activities or local initiatives and/or purpose of acquiring non-current assets, such as ophthalmic aids. the Commonwealth. capital works, plant and equipment or intangible assets. It also includes donations of plant and equipment (refer note 1 (p)). Consequently the recognition of revenue as capital purpose income is based on the intention of the provider of the revenue at the time the revenue is provided.
Melbourne Health Annual Report 51 Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Mental Health Services (Mental Health) comprises all Off Campus, Ambulatory Services (Ambulatory) recurrent health revenue/expenditure on specialised comprises all recurrent health revenue/expenditure mental health services (child and adolescent, general on public hospital type services, provided under the and adult, community and forensic) managed or following agreements: Services that are provided or funded by the state or territory health administrations, received by hospitals (or area health services) but are and includes: Admitted patient services (including delivered/received outside a hospital campus, services forensic mental health), outpatient services, emergency which have moved from a hospital to a community department services (where it is possible to separate setting since June 1998, services which fall within the emergency department mental health services), agreed scope of inclusions under the new system, community-based services, residential and ambulatory which have been delivered within hospital’s i.e. in services. rural/remote areas.
Outpatient Services (Outpatients) comprises all Residential Aged Care including Mental Health (RAC, recurrent health revenue/expenditure on public including Mental Health) referred to in the past as hospital type outpatient services, where services psychogeriatric residential services, comprises those are delivered in public hospital outpatient clinics, or Commonwealth-licensed residential aged care services free standing day hospital facilities, or rehabilitation in receipt of supplementary funding from DHS under facilities, or alcohol and drug treatment units, or the mental health program. It excludes all other outpatient clinics specialising in ophthalmic aids residential services funded under the mental health or palliative care. program, such as mental health-funded community care units (CCUs) and secure extended care units (SECs). Emergency Department Services (EDS) comprises all recurrent health revenue/expenditure on emergency Other Services excluded from Australian Health Care department services that are available free of charge Agreement comprise of revenue/expenditure for to public patients. services not separately classified above, including: Public health services including Laboratory testing, Aged Care comprises revenue/expenditure from Blood Borne Viruses / Sexually Transmitted Infections Home and Community Care (HACC) programs, clinical services, immunisation and screening services, Allied Health, Aged Care Assessment and Drugs services including drug withdrawal, counselling support services. and the needle and syringe program, Disability services including aids and equipment and flexible support Primary Health comprises revenue/expenditure for packages to people with a disability, Community Community Health Services including Care programs including sexual assault support, early health promotion and counselling, physiotherapy, parenting services, parenting assessment and skills speech therapy, podiatry and occupational therapy. development, and various support services. Health and Community Initiatives also falls in this category group.
52 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
(af) New Accounting Standards and Interpretations Certain new accounting standards and interpretations have been published that are not mandatory for 30 June 2008 reporting period. As at 30 June 2008, the following standards and interpretations had been issued but were not mandatory for financial years ending 30 June 2008. The Service has not and does not intend to adopt these standards early.
Australian Interpretations Beginning on or after Interpretation 13 Customer Loyalty Programmes 1-Jul-08 Interpretation 14 AASB 119 – The Limit on a Defined Benefit Asset, Minimum Funding Requirements and their Interaction 1-Jan-08 Interpretation 113 Jointly Controlled Entities – Non-Monetary Contributions by Venturers 1-Jul-07 Interpretation 1038 Contributions by Owners Made to Wholly-Owned Public Sector Entities 1-Jul-08 Interpretation 2007-8 Amendments to Australian Accounting Standards arising from AASB 101 1-Jan-09
AASB Accounting Standards Beginning on or after AASB 101 Presentation of Financial Statements 1-Jan-09 AASB 107 Cash Flow Statements 1-Jul-07 AASB 121 The Effects of Changes in Foreign Exchange Rates 1-Jul-07 AASB 127 Consolidated and Separate Financial Statements 1-Jul-09 AASB 1004 Contributions 1-Jul-08 AASB 1048 Interpretation and Application of Standards 30-Sep-07 AASB 1049 Whole of Government and General Government Sector Financial Reporting 1-Jul-08 AASB 1050 Administered Items 1-Jul-08 AASB 1051 Land Under Roads 1-Jul-08 AASB 1052 Disaggregated Disclosures 1-Jul-08 AASB 2007-8 Amendments to Australian Accounting Standards arising from AASB 101 1-Jan-09 AASB 2007-9 Amendments to Australian Accounting Standards arising from the Review of AASs 27, 29 and 31 1-Jul-08 [AASB 3, AASB 5, AASB 8, AASB 101, AASB 114, AASB 116, AASB 127 & AASB 137] Amendments to Australian Accounting Standard - Share-based Payments: Vesting Conditions AASB 2008-1 1-Jan-09 and Cancellations [AASB 2] Amendments to Australian Accounting Standards – Puttable Financial Instruments AASB 2008-2 1-Jan-09 and Obligations arising on Liquidation [AASB 7, AASB 101, AASB 132, AASB 139 & Interpretation 2] Amendments to Australian Accounting Standards arising from AASB 3 and AASB 127 [AASBs 1, 2, 4, 5, 7, 101, AASB 2008-3 1-Jul-09 107, 112, 114, 116, 121, 128, 131, 132, 133, 134, 136, 137, 138 & 139 and Interpretations 9 & 107]
Exposure Drafts ED 157 Joint Arrangements Proposed Amendments to AASB 139 Financial Instrument Recognition and Measurement ED 158 – Exposures Qualifying for Hedge Accounting ED 159 Proposed Improvements to Australian Accounting Standards Proposed Amendments to AASB 1 First-time Adoption of Australian Equivalents to International Financial ED 160 Reporting Standards and AASB 127 Consolidated and Separate Financial Statements – Cost of an Investment in a Subsidiary, Jointly Controlled Entity or Associate Proposed Amendments to AASB 2 Share-based Payment and AASB Interpretation 11 AASB 2 ED 161 – Group and Treasury Share Transactions – Group Cash-Settled Share-based Payment Transactions
Melbourne Health Annual Report 53 Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 2: Revenue
PARENT HSA HSA Non- HSA Non- HSA Total Total 2008 2007 2008 2007 2008 2007 $’000 $’000 $’000 $’000 $’000 $’000 Revenue from Operating Activities Government Grants Department of Human Services 505,997 473,967 470 3,344 506,466 477,311 - Equipment and Infrastructure Maintenance 2,545 2,464 - - 2,545 2,464 Commonwealth Government - Residential Aged Care Subsidy 5,300 5,229 - - 5,300 5,229 - Other 7,639 7,320 9,903 5,926 17,543 13,246 Total Government Grants 521,481 488,980 10,373 9,270 531,853 498,250 Indirect Contributions by Department of Human Services Insurance 7,139 8,714 - 7,457 7,139 11,684 Long Service Leave 3,278 2,970 - - 3,278 - Total Indirect Contributions by Department 10,417 11,684 - 7,457 10,417 11,684 of Human Services Patient and Resident Fees Patient and Resident Fees (refer note 2b) 14,847 11,395 131 88 14,978 11,483 Total Patient & Resident Fees 14,847 11,395 131 88 14,978 11,483 Business Units & Specific Purpose Funds Private Practice and Other Patient Activities Fees 16,484 7,941 4,234 4,109 20,718 12,050 Research 205 446 12,051 12,256 ; 7,903 Total Business Units & Specific Purpose Funds 16,689 8,387 16,285 4,109 32,974 19,953 Donations & Bequests 1 1 4,685 2,410 4,685 2,411 Recoupment from Private Practice for Use of 79 107 329 362 408 469 Hospital Facilities Other Revenue from Operating Activities External Supply Agreements - - 2,586 24,646 2,586 24,646 Salary & Wages Recoveries 6,882 5,235 3,924 4,825 10,807 10,060 Shared Income - Pathology 10,408 - - 10,213 10,408 10,213 Others 36,959 45,071 12,923 11,444 49,881 56,515 Sub-Total Revenue from Operating Activities 617,762 570,860 51,236 74,824 668,997 645,683 Revenue from Non-Operating Activities Interest 2,460 2,255 229 338 2,689 2,593 Dividends 3 3 515 204 518 206 Property Income 66 78 2,563 2,279 2,630 2,357 Other Revenue from Non-Operating Activities - - 70 164 70 164 Sub-Total Revenue from Non-Operating Activities 2,529 2,335 3,377 2,985 5,906 5,320 Total Revenue from Operating & 620,291 573,194 54,612 77,809 674,903 651,003 Non- Operating Activities
PARENT HSA HSA Non- HSA Non- HSA Total Total 2008 2007 2008 2007 2008 2007 $’000 $’000 $’000 $’000 $’000 $’000 Revenue from Capital Purpose Income State Government Capital Grants Targeted Capital Works and Equipment - - 26,770 19,124 26,770 19,124 Other - - 8,788 3,457 8,788 3,457 Commonwealth Government Capital Grants - - 10,562 - 10,562 - Net Gain/(Loss) on Disposal of Non-Current Assets - - (68) (319) (68) (319) (refer note 2c) Donations & Bequests - - 369 - 369 - Total Revenue (refer to note 2a) 620,291 573,194 101,033 100,071 721,324 673,265
54 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
CONSOLIDATED HSA HSA Non- HSA Non- HSA Total Total 2008 2007 2008 2007 2008 2007 $’000 $’000 $’000 $’000 $’000 $’000
505,997 473,967 470 3,344 506,466 477,311 2,545 2,464 - - 2,545 2,464
5,300 5,229 - - 5,300 5,229 7,639 7,320 9,903 5,926 17,543 13,246 521,481 488,980 10,373 9,270 531,853 498,250
7,139 11,684 - - 7,139 11,684 3,278 - - - 3,278 - 10,417 11,684 - 10,417 11,684
14,847 11,395 131 88 14,978 11,483 14,847 11,395 131 88 14,978 11,483
16,484 7,941 4,234 4,109 20,718 12,050 205 446 12,051 7,457 12,256 7,903 16,689 8,387 16,285 11,566 32,974 19,953 1 1 4,683 2,410 4,684 2,411
79 107 329 362 408 469
- - 2,586 24,646 2,586 24,646 6,882 5,235 3,924 4,825 10,807 10,060 10,408 - 10,213 10,408 10,213 36,959 45,071 14,495 10,959 51,453 56,029 617,762 570,858 52,806 74,339 670,568 645,197
2,460 2,255 260 434 2,720 2,689 3 3 605 219 607 221 66 78 2,563 2,279 2,630 2,357 - - 70 164 70 164 2,529 2,335 3,498 3,096 6,027 5,432 620,291 573,194 56,304 77,435 676,595 650,629
CONSOLIDATED HSA HSA Non- HSA Non- HSA Total Total 2008 2007 2008 2007 2008 2007 $’000 $’000 $’000 $’000 $’000 $’000
- - 26,770 19,124 26,770 19,124 - - 8,788 3,457 8,788 3,457 - - 10,562 - 10,562 -
- - (68) (319) (68) (319)
- - 369 369 - 620,291 573,196 102,725 99,697 723,016 672,891
Melbourne Health Annual Report 55 Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 2a: Analysis of Revenue by Source 2008
Admitted Out- EDS Ambula- Mental RAC incl. Aged Care Primary Other Total Patients patients tory Health Mental Health
Health 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 Revenue from Services Supported by Health Services Agreement Government Grants Department of Human Services 340,076 - 4 37,582 120,576 - 5,009 - 8,573 511,819 State Government - Other - - Equipment and Infrastructure ------Maintenance Commonwealth Government - - Residential Aged Care Subsidy 122 - - - 6,197 5,300 1,320 - - 12,939 - Other - Indirect contributions by Department of - Human Services Insurance 7,139 ------7,139 Long Service Leave - Patient & Resident Fees (refer note 2b) 9,311 134 - 1,129 2,186 2,044 43 - - 14,847 Private Practice Fees 16,331 - 147 - 6 - - - - 16,484 Donations & Bequests (non- capital) 1 ------1 Recoupment from Private Practice 41 - 38 ------79 for Use of Hospital Facilities Research - Other Revenue from Operating Activities 40,190 42 426 1,359 4,380 871 102 - 7,151 54,521 Interest & Dividends 2,463 ------2,463 Property Income - Sub-Total Revenue from Services 415,673 175 614 40,071 133,345 8,215 6,474 - 15,724 620,291 Supported by Health Services Agreement
Revenue from Services Supported by Hospital and Community Initiatives Melbourne Private Hospital Contracts ------1,561 1,561 Freemasons Supply Agreement ------396 396 Royal Children’s Supply Agreement ------Royal Women’s Supply Agreement ------529 529 Adesse Supply Agreement ------100 100 Melbourne Neuropsych Centre ------400 400 Medical Trusts ------441 441 Forensic Care ------Cafeteria & Functions ------3,649 3,649 Car Park ------3,930 3,930 Fundraising ------Mammography Service ------2,990 2,990 Nursing Homes ------1,128 1,128 Neuro Foundation ------1,679 1,679 VIDRL ------778 778 VICNISS ------1,095 1,095 MMIM ------Post Office ------445 445 Private Practice and other Patient ------5,116 5,116 Activities Orygen Research Centre ------1,695 1,695 Retail Food-Northern Health ------846 846 RMH Home Lottery ------Cancer Trials Australia ------(253) (253) Other ------76,132 76,132 Capital Purpose Income (refer note 2) 68 68 Sub-Total Revenue from Services ------102,725 102,725 Supported by Hospital and Community Initiatives Total Revenue 415,673 175 614 40,071 133,345 8,215 6,474 - 118,448 723,016
56 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 2a: Analysis of Revenue by Source 2007
Admitted Out- EDS Ambula- Mental RAC incl. Aged Care Primary Other Total Patients patients tory Health Mental Health Health 2007 2007 2007 2007 2007 2007 2007 2007 2007 2007 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 Revenue from Services Supported by Health Services Agreement Government Grants Department of Human Services 306,257 2,419 2 35,222 116,744 223 4,857 - 8,242 473,967 Other State Government 2,464 ------2,464 Commonwealth Government - Residential Aged Care Subsidy - - - - - 5,229 - - - 5,229 - Other 181 - - - 5,721 - 1,418 - - 7,320 Research 446 ------446 Indirect contributions by Department of Human Services Insurance 8,714 ------8,714 Long Service Leave 2,970 ------2,970 Patient and Resident Fees (refer note 2c) 6,523 135 - 843 1,898 1,914 81 - (0) 11,395 Recoupment from Private Practice for 40 - 68 ------107 Use of Hospital Facilities Interest and Dividends 2,258 ------2,258 Property Income 78 ------78 Donations & Bequests (non- capital) - 1 ------1 Other 46,039 46 275 793 3,919 279 269 - 6,626 58,246 Sub-Total Revenue from Services 375,970 2,600 344 36,858 128,283 7,645 6,626 - 14,868 573,194 Supported by Health Services Agreement Revenue from Services Supported by Hospital and Community Initiatives Internal and Restricted Specific Purpose Fund Melbourne Private Hospital Contracts ------8,380 8,380 Freemasons Supply Agreement ------5,785 5,785 Royal Children’s Supply Agreement ------7,140 7,140 Royal Women’s Supply Agreement ------3,094 3,094 Adesse Supply Agreement ------715 715 Melbourne Neuropsych Centre ------420 420 Medical Trusts ------2,912 2,912 Cafeteria and Functions ------3,997 3,997 Car Park ------3,415 3,415 Fundraising ------2,445 2,445 Mammography Service ------2,164 2,164 Nursing Homes ------1,260 1,260 Neuro Foundation ------1,449 1,449 VIDRL ------872 872 VICNISS ------1,445 1,445 MMIM ------1,352 1,352 Post Office ------489 489 Private Practice and Other ------4,891 4,891 Patient Activities Orygen Research Centre ------1,353 1,353 Retail Food-Northern Health ------752 752 RMH Home Lottery ------80 80 Cancer Trials Australia ------685 685 Property Income ------472 472 Research ------5,736 5,736 Capital Purpose Income (refer note 2) ------22,237 22,237 Donations & Bequests (non-capital) ------708 708 Others ------15,449 15,449 Sub-Total Revenue from Services ------99,697 99,697 Supported by Hospital and Community Initiatives Total Revenue 375,970 2,600 344 36,858 128,283 7,645 6,626 - 114,565 672,891
Melbourne Health Annual Report 57 Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 2b: Patient and Resident Fees
Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 Patient and Resident Fees Raised Recurrent: Acute - Inpatients 9,251 6,523 9,251 6,523 - Outpatients 134 135 134 135 - Other 191 843 191 843 Residential Aged Care - - - - - Generic 3,174 1,694 3,174 1,694 - Mental Health 95 220 95 220 Mental Health 2,091 1,898 2,091 1,898 Other 43 155 43 155 Total Recurrent 14,978 11,469 14,978 11,469
Capital Purpose: Residential Accommodation Payments - 14 - 14 Total Capital - 14 - 14
58 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 2c: Net Gain/(Loss) on Disposal of Non-Current Assets
Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 Proceeds from Disposals of Non-Current Assets Motor Vehicles 153 91 153 91 Total Proceeds from Disposal of Non-Current Assets 153 91 153 91
Less: Written Down Value of Non-Current Assets Sold Plant and Equipment 6 13 6 13 Medical Equipment 176 182 176 382 Motor Vehicles 39 6 39 6 Total Written Down Value of Non-Current Assets Sold 221 400 221 400 Net gains/(losses) on Disposal of Non-Current Assets (68) (309) (68) (309)
Melbourne Health Annual Report 59 Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 3: Expenses
PARENT HSA HSA Non- HSA Non- HSA Total Total 2008 2007 2008 2007 2008 2007 $’000 $’000 $’000 $’000 $’000 $’000 Employee Benefits Salaries & Wages 388,465 359,083 20,474 20,482 408,939 379,565 WorkCover Premium 5,549 4,933 1 32 5,551 4,965 Departure Packages 1,306 780 38 14 1,343 795 Long Service Leave 9,006 7,703 441 568 9,447 8,271 Superannuation 34,915 32,975 1,578 1,706 36,493 34,681 Total Employee Benefits 439,241 405,475 22,532 22,803 461,773 428,278 Non-Salary Labour Costs Fees for Visiting Medical Officers 1,757 1,811 18 8 1,774 1,819 Agency Costs - Nursing 5,880 6,699 - - 5,880 6,699 Agency Costs - Other 6,081 8,127 1,806 1,833 7,887 9,959 Total Non-Salary Labour Costs 13,718 16,637 1,824 1,840 15,542 18,478 Supplies & Consumables Drug Supplies 23,534 20,648 94 617 23,629 21,265 S100 Drugs 15,233 14,916 - - 15,233 14,916 Medical, Surgical Supplies and Prosthesis 59,021 56,670 598 23,323 59,619 79,993 Pathology Supplies 12,528 11,156 1,805 1,503 14,333 12,660 Food Supplies 6,871 6,636 2,038 2,265 8,909 8,901 Total Supplies & Consumables 117,187 110,027 4,535 27,708 121,723 137,736 Other Expenses from Continuing Operations Domestic Services & Supplies 5,409 5,534 77 1,112 5,486 6,646 Fuel, Light, Power and Water 7,476 6,049 194 177 7,670 6,226 Insurance costs funded by DHS 7,139 8,714 - - 7,139 8,714 Motor Vehicle Expenses 834 902 24 32 858 933 Repairs & Maintenance 4,778 5,176 781 569 5,559 5,745 Maintenance Contracts 7,286 6,797 149 722 7,435 7,519 Patient Transport 2,008 2,287 5 2 2,013 2,289 Bad & Doubtful Debts 1,189 378 (7) 138 1,182 516 Lease Expenses 5,497 4,826 944 2,088 6,441 6,914 Other Administrative Expenses 22,905 22,971 9,497 9,388 32,822 32,359 Audit Fees VAGO - Audit of Financial Statements 200 295 8 2 248 296 Other 140 - - - 140 - Total Expenses from Continuing Operations 635,008 596,067 40,563 66,582 675,570 662,653
HSA HSA Non- HSA Non- HSA Total Total 2008 2007 2008 2007 2008 2007 $’000 $’000 $’000 $’000 $’000 $’000 Expenditure using Capital Purpose Income Employee Benefits Salaries & Wages 604 495 604 495 Total Employee Benefits - - 604 495 604 495 Other Expenses Domestic Services & Supplies 478 - 478 Total Other Expenses - - - 478 - 478 Total Expenditure using Capital Purpose Income - - 604 973 604 973
Depreciation & Amortisation - - 26,527 19,199 26,527 19,199 Finance Costs 167 124 11 27 178 151 Total 167 124 26,538 19,226 26,704 19,350 Total Expenses (refer 3a) 635,175 596,191 67,704 86,780 702,879 682,971
60 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
CONSOLIDATED HSA HSA Non- HSA Non- HSA Total Total 2008 2007 2008 2007 2008 2007 $’000 $’000 $’000 $’000 $’000 $’000
388,528 359,083 20,474 20,773 409,002 379,856 5,549 4,933 1 32 5,551 4,965 1,306 780 38 14 1,343 795 9,006 7,703 441 568 9,447 8,271 34,915 32,975 1,578 1,706 36,493 34,681 439,304 405,475 22,532 23,094 461,836 428,569
1,757 1,811 18 8 1,774 1,819 5,880 6,699 - - 5,880 6,699 6,081 8,127 1,806 1,833 7,887 9,959 13,718 16,637 1,824 1,840 15,542 18,478
23,534 20,648 94 617 23,629 21,265 15,233 14,916 - - 15,233 14,916 59,021 56,670 598 23,323 59,619 79,993 12,528 11,156 1,805 1,503 14,333 12,660 6,871 6,636 2,038 2,265 8,909 8,901 117,187 110,027 4,535 27,708 121,723 137,736
5,409 5,534 77 1,112 5,486 6,646 7,476 6,049 194 177 7,670 6,226 7,139 8,714 - - 7,139 8,714 834 902 24 32 858 933 4,778 5,176 781 569 5,559 5,745 7,286 6,797 149 722 7,435 7,519 2,008 2,287 5 2 2,013 2,289 1,189 378 (7) 138 1,182 516 5,497 4,826 944 2,115 6,441 6,940 22,905 22,971 11,100 10,357 34,005 33,329
200 295 8 23 208 318 140 - 140 - 635,070 596,068 42,166 67,890 677,236 663,956
HSA HSA Non- HSA Non- HSA Total Total 2008 2007 2008 2007 2008 2007 $’000 $’000 $’000 $’000 $’000 $’000
- 595 495 596 495 - - 595 495 596 495
- - 478 - 478 - - - 478 - 478 - - - 973 596 973 - - - 26,527 19,220 26,527 19,220 167 124 11 28 178 152 167 124 26,538 19,247 26,704 19,371 635,238 196,191 69,299 88,110 704,537 684,301
Melbourne Health Annual Report 61 Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 3a: Analysis of Expenses by Source 2008
Admitted Out- EDS Ambula- Mental RAC incl. Aged Care Primary Other Total Patients patients tory Health Mental Health Health 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 Services Supported by Health Services Agreement Employee Benefits Salaries & Wages 253,267 1,079 11,071 24,590 67,244 19,094 2,564 - 9,556 388,465 WorkCover Premium 3,490 58 158 351 1,018 301 37 - 137 5,550 Departure Packages 821 14 37 83 240 71 9 - 32 1,306 Long Service Leave 5,663 95 257 570 1,652 489 59 - 222 9,006 Superannuation 21,954 367 995 2,210 6,403 1,896 230 - 859 34,915 Non-Salary Labour Costs ------Fees for Visiting Medical Officers 1,105 18 50 111 322 95 12 - 43 1,757 Agency Costs - Nursing 3,698 62 168 372 1,078 319 39 - 145 5,880 Agency Costs - Other 3,823 64 173 385 1,115 330 40 - 150 6,081 Supplies & Consumables ------Drug Supplies 24,053 402 1,090 2,421 7,016 2,077 252 - 941 38,253 Medical, Surgical Supplies and 37,113 620 1,682 3,736 10,825 3,205 390 - 1,452 59,022 Prosthesis Pathology Supplies 7,878 132 357 793 2,298 680 83 - 308 12,528 Food Supplies 4,321 72 196 435 1,260 373 45 - 169 6,872 Other Expenses ------Domestic Services & Supplies 4,690 78 213 472 1,368 405 49 - 183 7,458 Fuel, Light, Power and Water 4,701 78 213 473 1,371 406 49 - 184 7,476 Insurance costs funded by DHS 4,489 75 203 452 1,309 388 47 - 176 7,139 Motor Vehicle Expenses 743 12 34 75 217 64 8 - 29 1,182 Repairs & Maintenance 3,005 50 136 302 876 259 32 - 118 4,778 Maintenance Contracts 3,610 60 164 363 1,053 312 38 - 141 5,742 Patient Transport 1,263 21 57 127 368 109 13 - 49 2,008 Bad & Doubtful Debts 748 12 34 75 218 65 8 - 29 1,189 Lease Expenses 3,457 58 157 348 1,008 299 36 - 135 5,498 Other Administrative Expenses 14,403 241 653 1,450 4,201 1,244 151 - 563 22,905 Sub-Total Expenses from Services 408,294 3,668 18,098 40,196 112,461 32,481 4,191 - 15,621 635,008 Supported by Health Services Agreement Services Supported by Hospital and Community Initiatives Employee Benefits ------14,651 14,651 Non-Salary Labour Costs ------9,706 9,706 Supplies & Consumables ------119 119 Other Expenses from Continuing ------17,586 17,586 Operations Impairment of Physical Assets ------(refer note 3) Impairment of Financial Assets ------(refer note 3) Depreciation & Amortisation ------26,694 26,694 (refer note 4) Specific Expenses (refer note 3c) ------Finance Costs (refer note 5) ------178 178 Sub-Total Expense from Services Supported by Hospital and Community ------68,934 68,934 Initiatives Services Supported by Capital - Sources Employee Benefits ------595 595 Non-Salary Labour Costs ------Other Expenses ------Sub-Total Expenses from Services ------595 595 Supported by Capital Resources Total Expenses 408,294 3,668 18,098 40,196 112,461 32,481 4,191 - 85,150 704,537
62 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 3a: Analysis of Expenses by Source 2007
Admitted Out- EDS Ambula- Mental RAC incl. Aged Care Primary Other Total Patients patients tory Health Mental Health Health 2007 2007 2007 2007 2007 2007 2007 2007 2007 2007 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 h $’000 $’000 Services Supported by Health Services Agreement Employee Benefits Salaries & Wages 216,331 2,827 12,859 19,797 74,493 23,916 2,393 - 6,466 359,083 WorkCover Premium 3,636 7 33 5 1,324 7 (57) - (21) 4,933 Departure Packages 668 1 13 36 36 21 2 - 4 780 Long Service Leave 4,703 66 244 432 1,593 451 57 - 156 7,703 Superannuation 20,060 285 1,164 1,865 6,583 2,096 209 - 714 32,975 Non-Salary Labour Costs Fees for Visiting Medical Officers 1,805 - - 0 0 - - - 6 1,811 Agency Costs - Nursing 3,558 9 302 445 1,362 1,024 1 - - 6,699 Agency Costs - Other 3,215 0 60 3,197 1,303 177 80 - 95 8,127 Supplies & Consumables Drug Supplies 17,303 289 512 631 1,755 154 0 - 3 20,648 S100 Drugs 9,898 2,419 2 12 2,364 222 - - - 14,916 Medical, Surgical Supplies and 50,228 167 954 2,115 1,822 353 417 - 615 56,670 Prosthesis Pathology Supplies 5,896 22 5 15 328 4 - - 4,887 11,156 Food Supplies 3,024 6 18 82 1,754 1,696 44 - 13 6,636 Other Expenses Domestic Services & Supplies 3,598 22 351 291 530 642 5 - 95 5,534 Fuel, Light, Power and Water 5,171 1 - 1 303 356 - - 216 6,049 Insurance costs funded by DHS 8,714 ------8,714 Motor Vehicle Expenses 282 - 1 40 483 58 41 - (3) 902 Repairs & Maintenance 2,736 6 41 835 1,010 200 24 - 325 5,176 Maintenance Contracts 6,133 6 0 49 141 157 0 - 312 6,797 Patient Transport 1,144 8 109 598 280 13 135 - - 2,287 Bad & Doubtful Debts 372 - 1 - 4 1 0 - - 378 Lease Expenses 2,764 - 60 342 1,572 69 11 - 6 4,826 Other Administrative Expenses 3,387 136 256 6,916 10,214 763 559 - 739 22,971 Sub-Total Expenses from Services 374,624 6,276 16,985 37,703 109,257 32,378 3,922 - 14,628 595,772 Supported by Health Services Agreement Services Supported by Hospital and Community Initiatives Employee Benefits Salaries & Wages ------20,773 20,773 WorkCover Premium ------32 32 Departure Packages ------14 14 Long Service Leave ------568 568 Superannuation ------1,706 1,706 Non-Salary Labour Costs Fees for Visiting Medical Officers ------8 8 Agency Costs - Other ------1,833 1,833 Supplies & Consumables Drug Supplies ------617 617 Medical, Surgical Supplies and ------23,323 23,323 Prosthesis Pathology Supplies ------1,503 1,503 Food Supplies ------2,265 2,265 Other Expenses Domestic Services & Supplies ------1,112 1,112 Fuel, Light, Power and Water ------177 177 Motor Vehicle Expenses ------32 32 Repairs & Maintenance ------569 569 Maintenance Contracts ------722 722 Patient Transport ------2 2 Bad & Doubtful Debts ------138 138
Melbourne Health Annual Report 63 Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 3a: Analysis of Expenses by Source 2007 continued
Admitted Out- EDS Ambula- Mental RAC incl. Aged Care Primary Other Total Patients patients tory Health Mental Health Health 2007 2007 2007 2007 2007 2007 2007 2007 2007 2007 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 h $’000 $’000 Lease Expenses ------2,115 2,115 Other Administrative Expenses ------10,358 10,358 Specific Expenses (refer note 2h) - - Other (List) - - Sub-Total Expense from Services Supported by Hospital and Community ------67,867 67,867 Initiatives
Services Supported by Capital Sources Employee Benefits Salaries and Wages ------455 455 Workcover Premium ------7 7 Superannuation ------39 39 Long Service Leave ------(10) (10) Motor Vehicle Expenses ------17 17 Administrative Expenses ------(67) (67) Other ------531 531 Sub-Total Expenses from Services ------973 973 Supported by Capital Resources Depreciation and Amortisation ------19,220 19,220 (refer note 3) Audit Fees Auditor-General’s (refer note 23) 294 ------2 296 Other ------22 22 Finance Costs (refer note 4) 123 ------28 151 Total Expenses 375,041 6,276 16,985 37,703 109,257 32,378 3,922 - 102,739 684,301
Note 3b: Analysis of Expenses by Internal and Restricted Specifi c Purpose Funds for Services Supported by Hospital and Community Initiatives
Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 Supply Agreements 871 22,886 871 22,886 Private Practice 4,891 3,984 4,891 3,984 Orygen Research Centre 1,634 1,319 1,634 1,319 Mammography Screening Program 2,695 2,343 2,695 2,343 Neurology Foundation 1,674 1,461 1,674 1,461 WHO Reference & Research on Influenza 2,518 1,510 2,518 1,510 RMH Research Directorate 717 597 717 597 Medical Oncology 923 661 923 661 BioGrid Australia 1,285 247 1,285 247 VICNISS 917 1,017 917 1,017 Fundraising and Community Support 2,421 668 2,421 668 Cafetaria (Parkville & Royal Park) 2,971 2,985 2,971 2,985 Car Parking 1,858 1,687 1,858 1,687 Other 17,217 21,461 17,217 21,461 TOTAL 42,592 62,826 42,592 62,826
64 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 4: Depreciation and Amortisation
Parent Entity Consolidated Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 Depreciation Buildings at valuation 15,980 9,302 15,980 9,302 Plant and Equipment 1,414 1,658 1,414 1,678 Medical Equipment 5,527 4,076 5,527 4,076 Computers & Communication 1,990 2,044 1,990 2,044 Furniture & Fittings 130 96 130 96 Motor Vehicles 550 562 550 562 Total Depreciation 25,591 17,737 25,591 17,757 Amortisation Intangible Assets 936 1,463 936 1,463 Total Amortisation 936 1,463 936 1,463 Total Depreciation & Amortisation 26,527 19,199 26,527 19,220
Note 5: Finance Costs
Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 Bank Charges 178 151 178 152 TOTAL 178 151 178 152
Note 6: Cash and Cash Equivalents
Parent Entity Parent Entity Consolidated Consolidated Note 2008 2007 2008 2007 $’000 $’000 $’000 $’000 Cash on Hand 26 31 26 31 Cash at Bank 30,990 25,660 31,502 25,976 Patient Trust Monies 1,669 1,298 1,669 1,298 TOTAL 32,685 26,988 33,197 27,305
(a) Represented by: Cash for Health Service Operations 6a 31,016 25,691 31,528 26,007 (as per Cash Flow Statement) Cash for Monies Held in Trust - Cash at Bank 1,669 1,298 1,669 1,298 TOTAL 32,685 26,988 33,197 27,305
Melbourne Health Annual Report 65 Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 7: Receivables
Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 CURRENT Inter Hospital Debtors 7,004 7,769 6,822 7,769 Trade Debtors 14,906 8,895 14,649 8,569 Patient Fees 12,203 8,895 12,203 8,895 Accrued Investment Income 230 179 230 179 Accrued Revenue - DHS 2,483 556 2,483 556 Accrued Revenue - Other 3,761 8,292 3,716 8,292 GST Receivable 3,212 4,070 3,212 4,120 TOTAL 43,799 38,656 43,315 38,379 LESS Allowance for Doubtful Debts Trade Debtors 912 621 912 621 Patient Fees 1,336 1,149 1,336 1,149 TOTAL CURRENT RECEIVABLES 41,551 36,886 41,067 36,609 NON-CURRENT DHS – Long Service Leave 5,132 7,216 5,132 7,216 TOTAL 5,132 7,216 5,132 7,216 TOTAL NON-CURRENT RECEIVABLES 5,132 7,216 5,132 7,216 TOTAL RECEIVABLES 46,683 44,101 46,199 43,825
(a) Movement in the Allowance for Doubtful Debts Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 Balance at beginning of year 1,770 1,709 1,770 1,709 Amounts written off during the year (1,092) (628) (1,092) (628) Increase/(decrease) in allowance recognised in profit or loss 1,570 689 1,570 689 Balance at end of year 2,248 1,770 2,248 1,770
(b) Ageing analysis of receivables Please refer to note 19(c) for the ageing analysis of receivables.
(c) Nature and extent of risk arising from receivables Please refer to note 19(c) for the nature and extent of credit risk arising from receivables.
(d) Investment Category (19b) Consolidated Consolidated Receivables are stated at nominal value and for the purposes of AASB7 Financial 2008 2007 Instruments reporting in note 19 exclude GST receivable and accrued revenue DHS. 35,372 31,934
(e) Impairment (1e) General provisions for doubtful debt have been raised in line with Service policy for the categories trade receivables and patient fees. Specific provisions for doubtful debt have been raised for individual debts where collectability is known to be at risk.
66 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 8: Other Financial Assets
Operating Fund Specific Purpose Fund Capital Fund Parent Entity Consolidated 2008 2007 2008 2007 2008 2007 2008 2007 2008 2007 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 NON-CURRENT Available-for-Sale Financial Assets Shares 5,090 4,335 25 25 5,115 4,360 6,337 5,559 Aust. Dollar Term Deposits (at call) ------765 - Investment in Evivar Medical P/L 4,310 4,310 - - - - 4,310 4,310 - - Investment in Australian Technology Fund P/L 29 29 - - - - 29 29 29 29 Total Non- Current 4,339 4,339 5,090 4,335 25 25 9,454 8,699 7,131 5,588 TOTAL 4,339 4,339 5,090 4,335 25 25 9,454 8,699 7,131 5,588 Represented by: Health Service Investments 4,339 4,339 5,090 4,335 25 25 9,454 8,699 7,131 5,588 TOTAL 4,339 4,339 5,090 4,335 25 25 9,454 8,699 7,131 5,588
(b) Ageing analysis of other financial assets Please refer to note 19(c) for the ageing analysis of other financial assets.
(c) Nature and extent of risk arising from other financial assets Please refer to note 19(c) for the nature and extent of credit risk arising from other financial assets. Parent Consolidated (d) Investment Category (19b) - 765 Term Deposits that are not designated as ‘held to maturity’ 5,115 6,337 Equity Instruments quoted in the market place (Australian Stock Exchange) Stated at fair value (market value) and increments recognised directly in equity. 4,339 29 9,454 7,131 Equity Instruments not quoted in the market place. Stated at cost as these do not have a quoted market price in an active market and whose fair value cannot be reliably measured.
(e) Impairment (1e) Service Management have conducted impairment testing on the above financial assets. There is no indication that the carrying value exceeds their recoverable amount except for Investment in Evivar Medical P/L (refer Note 12)
Melbourne Health Annual Report 67 Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 9: Inventories
Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 Pharmaceuticals At cost 2,232 2,136 2,232 2,136 Supply Store At cost 2,357 2,284 2,357 2,284 Aids & Appliances At cost 75 75 75 75 Medical and Surgical Lines At cost 2,176 2,398 2,176 2,398 Post Office At cost - 50 - 50 Pathology At cost 750 137 750 137 Food At cost 106 749 106 749 TOTAL INVENTORIES 7,696 7,830 7,696 7,830
Inventories are valued at the lower of Cost and Net Realisable Value. There has not been any oss of service potential identified as at 30 June 2008.
Note 10: Other Current Assets
Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 Prepayments 852 971 852 1,016 CURRENT 852 971 852 1,016 TOTAL 852 971 852 1,016
68 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 11: Property, Plant & Equipment
Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 Land Land at Valuation 112,234 72,895 112,234 72,895 Total Land 112,234 72,895 112,234 72,895
Buildings Buildings Under Construction 46,166 45,368 46,166 45,368 Buildings at Valuation 349,654 320,048 349,654 320,048 Less Accumulated Depreciation 35,714 24,358 35,714 24,358 Total Buildings 360,106 341,058 360,106 341,058
Plant and Equipment at Cost Plant and Equipment 15,958 12,493 16,024 12,539 Less Accumulated Depreciation 6,118 4,720 6,142 4,740 Total Plant and Equipment 9,840 7,773 9,882 7,799
Medical Equipment at Cost Medical Equipment 56,697 51,696 56,697 51,696 Less Accumulated Depreciation 28,578 23,545 28,578 23,545 Total Medical Equipment 28,119 28,151 28,119 28,151
Computers at Cost Computers 14,164 11,020 14,164 11,020 Less Accumulated Depreciation 10,801 9,044 10,801 9,044 Total Computers and Communications 3,363 1,977 3,363 1,977
Furniture and Fittings at Cost Furniture and Fittings 1,319 1,112 1,319 1,112 Less Accumulated Depreciation 373 244 373 244 Total Furniture and Fittings 946 868 946 868
Motor Vehicles at cost Motor Vehicles 4,436 5,113 4,436 5,113 Less Accumulated Depreciation 3,389 3,711 3,389 3,711 Total Motor Vehicles 1,047 1,402 1,047 1,402 TOTAL 515,655 454,124 515,696 454,150
Melbourne Health Annual Report 69 Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 11: Property, Plant & Equipment continued
Reconciliations of the carrying amounts of each class of asset for the consolidated entity at the beginning and end of the previous and current financial year is set out below.
CONSOLIDATED Land Buildings Buildings Plant & Medical Computer Fixture Motor Total WIP Equipment Equipment Equipment & Fittings Vehicle $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 Balance at 1 July 2006 72,895 254,636 66,758 4,831 22,302 1,974 614 804 424,814 Additions - 170 30,326 1,910 11,703 1,667 393 1,174 47,343 Assets transferred as capital contributions ------Disposals - - - (8) (383) (3) - (14) (408) Revaluation increments/(decrements) ------Net Transfers between classes - 50,186 (50,616) 1,462 (1,394) 382 (43) (562) 158 Depreciation and Amortisation (note 4) - (9,302) - (1,678) (4,076) (2,044) (96) - (17,757) Balance at 1 July 2007 72,895 295,690 46,468 6,698 28,152 1,976 869 1,402 454,150 Additions - - 34,196 4,377 5,572 3,148 207 233 47,733 Assets transferred as capital contributions1 (27,500) - 284 - - - - - (27,216) Disposals - - - (6) (176) - - (38) (220) Revaluation increments/(decrements)2 66,839 ------66,839 Net Transfers between classes - 34,229 (34,782) 226 98 229 - - - Fair Value adjustments to depreciation - useful - (5,010) ------(5,010) life review (note 4) Depreciation and amortisation (note 4) - (10,969) - (1,414) (5,527) (1,990) (130) (550) (20,580) Balance at 30 June 2008 112,234 313,940 46,166 9,881 28,119 3,363 946 1,047 515,696
PARENT Land Buildings Buildings Plant & Medical Computer Fixture Motor Total WIP Equipment Equipment Equipment & Fittings Vehicle $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 Balance at 1 July 2006 72,895 254,636 66,758 4,809 22,302 1,974 614 804 424,793 Additions - 170 30,326 1,886 11,703 1,667 393 1,174 47,319 Assets transferred as capital contributions ------Disposals - - - (8) (383) (3) - (14) (408) Revaluation increments/(decrements) ------Net Transfers between classes - 50,186 (50,616) 1,642 (1,394) 382 (43) - 158 Fair Value Adjustments to depreciation ------useful life review (note 4) Depreciation and Amortisation (note 4) - (9,302) - (1,658) (4,076) (2,044) (96) (562) (17,737) Balance at 1 July 2007 72,895 295,690 46,468 6,673 28,152 1,976 869 1,402 454,125 Additions - - 34,196 4,336 5,572 3,148 207 233 47,692 Assets transferred as capital contributions1 (27,500) - 284 - - - - - (27,216) Disposals - - - (6) (176) - - (38) (220) Revaluation increments/(decrements)2 66,839 ------66,839 Net Transfers between classes - 34,229 (34,782) 226 98 229 - - - Fair Value adjustments to depreciation - useful - (5,010) ------(5,010) life review (note 4) Depreciation and amortisation (note 4) - (10,969) - (1,414) (5,527) (1,990) (130) (550) (20,580) Balance at 30 June 2008 112,234 313,940 46,166 9,840 28,119 3,363 946 1,047 515,655
Land and buildings carried at valuation
1. Assets Transferred as Capital Contributions
Transfer of land to Royal Women’s Hospital The new Royal Women’s Hospital was constructed on a site belonging to Melbourne Health. Melbourne Health has surrendered this site to the Crown, who has provided Royal Women’s Hospital with a 99 Year Crown Lease over the site.
Subdivision of the land was effected 13 May 2008, and the transfer was designated as a contributed capital transfer as per the requirements under Financial Reporting Direction 2A ‘Contributed Capital’ by the Minister on 20 June 2008.
The Valuer General’s valuation reported the fair value of the existing Flemington Road land site as follows:
Royal Women’s Hospital Site $27.5m, Royal Melbourne Hospital Site $54.9m, which resulted in a $52.4m increment to the land revaluation reserve. The Royal Women’s Hospital Site portion of the revaluation increment is not required to be transferred to accumulated funds upon disposal of the site.
70 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Brick Rectification Project Stage 2 The Royal Melbourne Hospital Brickwork Recitification - Stage 2 project was designated to be funded from Contributed Capital from Government (rather than capital grants) in 2007/2008. There were $280k of assets transferred into this project in addition to funding cashflow in 2007/2008.
2. Revaluation Increments The Infrastructure building is scheduled to be demolished in September 2008. This has resulted in the useful life of the building to be revised from 28 years to 2 months and an additional depreciation charge of $1.5m expensed to the Operating Statement as at 30 June 2008.
After reviewing the future maintenance requirements of the following buildings: Main Block (including East and West wings); Clinical Services building; Centre for Medical Research; Anatomical, Pathology and Bone Marrow Research building; Materials Handling building, Management has revised the useful life from 28 years to 17 years. To reflect this change, an additional depreciation charge of $3.5m has been expensed to the Operating Statement as at 30 June 2008.
3. Fair Value Assessment - Land and Buildings In accordance with FRD103C Non-Current Physical Assets, a fair value assessment of land and building values was conducted as at 30 June 2008.
Land: A material difference to the carrying values reported at 30 June 2007 of $14.4m was transferred as an increment to the Land Revaluation Reserve. The valuation was carried out by managerial valuation applying April 08 indices supplied by the Valuer General. All land sites with the exception of the Flemington Road site were revalued using this method.
Buildings: There was neither an exceptional material movement since last valuation, nor a material difference to the carrying values, therefore no revaluation increment was recorded.
4. Independent Valuation Independent valuations for the Service’s land and buildings by the Valuer General or his representative agent are conducted on a 5 year cycle. The next scheduled valuation is during the 2008/2009 year.
Note 12: Intangible Assets
Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 Capitalised Costs 6,264 4,563 7,330 4,563 Less Accumulated Depreciation 1,244 1,215 1,277 1,215 5,020 3,348 6,053 3,348 Post Office Licence 70 70 70 70 70 70 70 70 Software Development Costs Capitalised 6,505 5,758 6,505 6,570 Less Accumulated Amortistation 4,950 4,043 4,950 4,043 1,555 1,715 1,555 2,527 Total Written Down Value 6,645 5,133 7,679 5,945
Reconciliation of the carrying amounts of Intangible Assets at the beginning and end of the previous and current financial year:
Capitalised Software Post Office Total Costs Development Licence $’000 $’000 $’000 $’000 Balance at 1 July 2006 1,383 2,382 70 3,835 Additions 2,596 978 - 3,574 Amortisation (note 4) (813) (650) - (1,463) Balance at 1 July 2007 3,166 2,710 70 5,946 Additions 2,669 2,669 Disposals (62) (874) (936) Balance at 30 June 2008 5,773 1,836 70 7,679
Impairment Test Intangible assets with indefinite useful lives and intangible assets not yet available for use are tested annually for impairment.
An independent valuation of Evivar Medical Pty Ltd confirms the carrying value and as such no impairment adjustment is required.
Melbourne Health Annual Report 71 Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 13: Investment Properties
Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 Balance at Beginning of Period 475 475 475 475 Balance at End of Period 475 475 475 475
Note 14: Payables
Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 CURRENT Trade Creditors 25,471 49,728 27,219 50,232 Accrued Expenses 14,765 10,026 14,857 10,026 GST Payable 475 4,436 475 4,436 Salary Packaging 2,044 2,061 2,044 2,061 Inter Hospital Creditors - 962 - 962 Income in Advance 557 276 557 276 Other Creditors 1,149 4,506 1,149 4,527 TOTAL CURRENT 44,461 71,995 46,301 72,520 TOTAL 44,461 71,995 46,301 72,520
(a) Maturity analysis of Payables Please refer to note 19d for the ageing analysis of payables.
(b) Nature and extent of risk arising from Payables Please refer to note 19d for the nature and extent of risks arising from payables.
Investment Category Other liabilities, classifed as payables, are inititally recognised at fair value, then subsequently carried at amortised cost. Statutory Payables (GST) and Salary Packaging are not classifed as payables for the purposes of AASB7 Financial Instruments reporting at note 19.
Consolidated Consolidated 2008 2007 Note 19b 43,782 66,023
72 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 15: Provisions
Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 CURRENT Employee Benefits (Note 15a) • unconditional and expected to be settled 57,941 47,712 57,941 47,712 within 12 months • unconditional and expected to be settled 45,973 43,736 45,973 43,736 after 12 months TOTAL 103,914 91,448 103,914 91,448 NON-CURRENT Employee Benefits (Note 15a) 12,876 13,385 12,876 13,385 TOTAL 12,876 13,385 12,876 13,385
Leave Provisions Total & Accruals Movements in Provisions $’000 $’000
Carrying amount at start of year 104,833 104,833 Additional provisions recognised 69,508 69,508 Amounts incurred during the year (including estimates) (57,551) (57,551) Carrying amount at end of year 116,790 116,790
Melbourne Health Annual Report 73 Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 15a: Employee Benefi ts
Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 CURRENT (refer note 1s) Unconditional long service leave entitlements 47,190 43,285 47,190 43,285 Annual leave entitlements 36,405 35,976 36,405 35,976 Accrued Wages and Salaries 17,297 9,346 17,297 9,346 Subsitution Leave 703 652 703 652 Accrued Days Off 2,133 2,036 2,133 2,036 Four Clear Days 186 154 186 154 TOTAL 103,914 91,448 103,914 91,448
Current Employee benefits: Expected to be utilised within 12 months 57,941 47,712 57,941 47,712 (nominal value) Expected to be utilised after 12 months (present value) 45,973 43,736 45,973 43,736 103,914 91,448 103,914 91,448
NON-CURRENT (refer note 1s) Conditional long service leave entitlements 12,876 13,385 12,876 13,385 (present value)
TOTAL 12,876 13,385 12,876 13,385
Movement in Long Service Leave: Balance at start of year 56,670 53,699 56,670 53,699 Provision made during the year 9,496 8,175 9,496 8,175 Settlement made during the year (6,099) (5,205) (6,099) (5,205) Balance at end of year 60,067 56,669 60,067 56,669
Note 16: Other Liabilities
Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 CURRENT Monies Held in Trust • Patient Monies Held in Trust 393 410 393 410 • Accommodation Bonds (Refundable Entrance Fees) 1,276 887 1,276 887 Total Current 1,669 1,298 1,669 1,298
Total Other Liabilities 1,669 1,298 1,669 1,298 Total Monies Held in Trust Represented by the following assets: Cash Assets (refer to note 6) 1,669 1,298 1,669 1,298 TOTAL 1,669 1,298 1,669 1,298
74 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 17: Equity & Reserves
Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 (a) Reserves Land and Buildings Asset Revaluation Reserve Balance at the beginning of the reporting period 87,950 87,950 87,950 87,950 Revaluation Increment Land 66,839 - 66,839 - Balance at the end of the reporting period 154,789 87,950 154,789 87,950 Represented by: Land 110,921 44,082 110,921 44,082 Buildings 43,868 43,868 43,868 43,868 154,789 87,950 154,789 87,950 Financial Assets Available-for-Sale Revaluation Reserve Valuation gain recognised 684 - 606 - Balance at end of the reporting period 684 - 606 -
(1) The land and buildings assets revaluation reserve arises on the revaluation of land and buildings (refer note 11).
(2) The financial assets available-for-sale revaluation reserve arises on the revaluation of available-for-sale financial assets. Where a revalued financial asset is sold, that portion of the reserve which relates to the financial asset, and is effectively realised, is recognised in the profit and loss. Where a revalued financial asset is impaired that portion of the reserve which relates to that financial asset is recognised in profit and loss.
Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 Restricted Specific Purpose Reserve Balance at the beginning of the reporting period 29,406 21,845 34,950 27,406 Transfers to and from Reserve 675 7,561 375 7,544 Balance at the end of the reporting period 30,081 29,406 35,325 34,950 Total Reserves 185,554 117,356 190,720 122,900 (b) Contributed Capital Balance at the beginning of the reporting period 303,953 289,986 303,953 289,986 Capital contribution received from Victorian Government3 28,260 13,967 28,260 13,967 Capital repayments4 (note 11) (27,500) - (27,500) - Balance at the end of the reporting period 304,713 303,953 304,713 303,953 (c) Accumulated Surpluses/(Deficits) Balance at the beginning of the reporting period (51,112) (33,846) (61,057) (42,737) Net Result for the Year 18,445 (9,706) 18,901 (10,777) Transfers to and from Reserve (375) (7,561) (375) (7,544) Balance at the end of the reporting period (33,042) (51,112) (42,531) (61,057) Minority Interest (d) - - 1,264 1,687 Total Equity at end of financial year 457,225 370,197 454,166 367,483
(3) Capital contribution received from Victorian Government:
The Royal Melbourne Hospital Brickwork Rectification - Stage 2 project was designated to be funded from Contributed Capital from Government in 2007/2008; $9.3m;
Financial sustainability grant $14m and GST supplementation grant $4.9m.
(4) The new Royal Women’s Hospital was constructed on a site belonging to Melbourne Health. Melbourne Health has surrendered this site to the Crown, who has provided Royal Women’s Hospital with a 99 Year Crown Lease over the site.
Subdivision of the land was effected 13 May 2008, and the transfer was designated as a contributed capital transfer as per the requirements under Financial Reporting Direction 2A ‘Contributed Capital’ by the Minister on 20 June 2008.
Melbourne Health Annual Report 75 Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 18: Reconciliation of Net Result for the Year to Net Cash Infl ow/(Outfl ow) from Operating Activities
Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 Net Result for the Period 18,445 (9,706) 18,479 (11,410)
Depreciation & Amortisation 26,527 19,199 26,527 19,220 Provision for Doubtful Debts 478 61 478 61 Change in Inventories 134 128 134 128 Net (Gain)/Loss from Sale of Plant and Equipment 68 319 68 319 (Increase)/Decrease in Receivables (3,827) 698 (4,114) 1,020 (Increase)/Decrease in Prepayments (119) 489 (164) 443 Increase/(Decrease) in Payables (27,159) 15,387 (25,848) 15,706 Increase/(Decrease) in Employee Benefits 12,466 5,871 12,466 5,871 NET CASH INFLOW/(OUTFLOW) 27,013 32,446 28,025 31,358 FROM OPERATING ACTIVITIES
Note 19: Financial Instruments
(a) Significant accounting policies Available for sale financial assets are stated at fair value with reference to the quoted price on the Australian Stock Exchange at the relevant reporting date. Financial Liabilities are measured at amortised cost if the maturity is greater than 1 year, otherwise measured at nominal value (Note 1g).
(b) Categorisation of financial instruments Carrying Amount Carrying Amount Note Category 2008 2007 $’000 $’000 Financial Assets Cash and cash equivalents 6 N/A 31,016 26,007 Receivables 7 Loans and Receivables 35,372 31,934 Other financial assets 8 Available for sale financial assets (at fair value) 7,131 5,588 Term Deposits that are not designated as ‘held to maturity’ Term Deposit 765 - (fixed interest) Equity Instruments quoted in the market place Shares 5,115 4,360 (Australian Stock Exchange) Equity Instruments quoted in the market place Hybrid Securities 1,222 1,199 (Australian Stock Exchange) Investment in ATF Equity Instruments not quoted in the market place 29 29
Financial Liabilities Payables 14 Financial liabilities measured at amortised cost 43,782 66,023 Accommodation Bonds 16 Financial liabilities measured at amortised cost 1,276 887 Other Liabilities 16 Financial liabilities measured at amortised cost 393 410
76 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 19: Financial Instruments continued
(c) Credit Risk Credit risk arises from the financial assets of the Service, which comprise cash and cash equivalents, trade, patient and other receivables and available for sale financial assets.
Trade and Patient Debtors: The Services exposure to credit risk arises from the potential default of counter parties on their contractual obligations resulting in financial loss to the Service. Credit risk is monitored on a regular basis. Minimisation of risk occurs through conducting credit checks before contracting with trade debtors, and the internal controls around the integrity of patient billing debtor data prior to billing insurance companies, medicare, TAC and other such entities. Trade and Patient debtors are shown net of general provisions for doubtful debt which are caluclated in line with Service policy. Specific provisions for doubtful debt are treated as impaired.
Inter hospital and other accrued revenue: The Service’s exposure to credit risk is minimal.
Cash & Cash Equivalents & Other Financial Assets: The Service minimises exposure to credit risk by only investing with ASX200 companies, and major financial institutions.
The Service’s exposure to credit risk and effective weighted average interest rate by ageing periods is set out in the following table. For interest rates applicable to each class of asset refer to individual notes to the financial statements.
Interest rate exposure and ageing analysis of financial asset as at 30 June 2008
Interest Rate Exposure Past Due But Not Impaired Weighted Consol’d Fixed Variable Non Not Past Less than 1-3 3 months 1-5 Years Over 5 Impaired Average Carrying Interest Interest Interest due & not 1 Month Months - 1 Year years Financial Effective Amount Rate Rate Bearing Impaired Assets Interest 2008 Rates (%) $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 Financial Assets Cash and Cash Equivalents 6.89% 31,016 - 31,016 - 31,016 ------Receivables: Trade Debtors - 13,737 - - 13,737 - 8,008 4,433 1,113 - - 183 Patient Debtors - 10,868 - - 10,868 - 3,334 4,832 2,650 - - 53 Inter Hospital Debtors - 6,822 - - 6,822 - 6,822 - - - - - Other Accrued Revenue - 3,945 - - 3,945 - 3,945 - - - - - Other financial assets Term Deposit 7.81% 765 765 - - 765 ------Shares - 5,115 - - 5,115 5,115 ------Hybrid Securities - 1,222 - - 1,222 1,222 ------Investment in ATF - 29 - - 29 29 ------Total Financial Assets 73,518 765 31,016 41,738 38,146 22,109 9,265 3,762 - - 236
2007 Financial Assets Cash and Cash Equivalents 26,007 - 26,007 - 26,007 ------Receivables 31,934 - - 31,934 - 20,521 4,892 5,912 - 609 Other financial assets 5,588 - - 5,588 5,588 ------Total Financial Assets 63,529 - 26,007 37,522 31,595 20,521 4,892 5,912 - - 609
The ageing analysis of financial assets excludes GST and DHS debtors.
Melbourne Health Annual Report 77 Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note19: Financial Instruments continued
(d) Liquidity Risk Liquidity risk arises when the Service is unable to meet its financial obligations as they fall due. The Service operates under the Government fair payments policy of settling financial obligations within 30 days and in the event of a dispute, make payments within 30 days from the date of resolution. It also continuously manages risk through monitoring future cash flows and maturities planning to ensure adequate holding of highly liquid assets and managing timely collection of debt owed to the Service (refer note 19 Credit Risk).
Melbourne Health has a historical exposure to liquidity risk which has been and is continued to be tightly monitored. During 2007/2008 a $15m cash advance from the Department of Human Services to support Melbourne Health in meeting its operational cash requirements was received. This was repaid in June 2008.
The following table discloses the contractual maturity analysis for the Service’s financial liabilities.
Interest rate exposure and maturity analysis of financial liabilities as at 30/06/2008
Interest Rate Exposure Maturity Dates Carrying Fixed Variable Non- *Weighted Contractual Less than 1-3 3 months 1-5 Years Over 5 Amount Interest Interest Interest Average Cash Flows 1 Month Months - 1 Year years Rate Rate Bearing Effective Interest Rates 2008 $’000 $’000 $’000 $’000 (%) $’000 $’000 $’000 $’000 $’000 $’000 Payables: Trade Creditors 27,219 - - 27,219 - 27,219 10,129 17,090 - - - Other Accruals 16,563 16,563 - - - 16,563 - - - Accommodation Bonds 1,276 - - 1,276 - 1,276 - - - 1,276 - Other Financial Liabilities 393 - - 393 - 393 393 - - - - Total Financial Liabilities 45,451 - - 45,451 - 28,888 10,522 33,653 - 1,276 -
2007 Payables: Trade creditors and 66,023 - - 66,023 - - 56,909 9,114 - - - accruals Accommodation Bonds 887 - - 887 - - - - - 887 - Other Financial Liabilities 410 - - 410 - - 410 - - - - Total Financial Liabilities 67,320 - - 67,320 - - 57,319 9,114 - 887 -
*Weighted average or effective interest rates for each class of assets Ageing analysis of financial liabilities excludes types of statutory financial liabilities (GST payable) and salary packaging payable.
(e) Market Risk The Service’s exposures to market risk are primarily through equity price risk and interest rate risk. There is some insignificant exposure to foreign currency risk
Equity Price Risk The Service is exposed to equity price risk arising from its portfolio of shares ($5.1m) and hybrid securities ($1.2m) which are used as cash backing for Special Purpose Funds and other external liabilities such as long service leave. Minimisation of risk is reflected in investment strategies as follows: Share Portfolio: Investing within Investment Committee approved asset classes with the total investment portfolio risk profile not being higher than the ASX200. Hybrid Securities: To ensure regular income streams and low equity volatility by and investing in high credit quality security backed equities.
Interest Rate Risk Exposure to interest rate risk arises primarily through the the Service’s cash and cash equivalents which have a floating interest rate (profit impact), and its term depost which has a fixed interest rate (equity impact). Minimisation of risk is achieved by mainly undertaking fixed rate short term term deposts when cash flow allows. Melbourne Health does not have any interest bearing liabilities.
Currency Risk The Service is exposed to insignificant foreign currency risk through its payables relating to purchases of supplies and consumables from overseas and from its receivables from its VIDRL operations ($1.3m total debtor balance as at 30 June 2008).
Sensitivity Disclosure Analysis Taking into account past performance, future expectations, economic forecasts, and management’s knowledge and experience of the financial markets, the Service believes the following movements are ‘reasonably possible’ over the next 12 months (Base rates for interest rates risk sourced from the Reserve Bank of Australia. Base rates for equity price risk based on Standard & Poors equity indexes for ASX200 as at 31 Dec 2007).
A parallel shift of +1% and -1% in market interest rates (AUD) from year-end rates of 7.25%;
A parallel shift of 9.38% reflecting the 3 years Std Dev risk profile of ASX200 companies per the Standard & Poors ASX200 index 31 Dec 2007.
78 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 19: Financial Instruments continued
The following table discloses the impact on net operating result and equity for each category of financial instrument held by Melbourne Health at year end.
Carrying Interest Rate Risk Equity Price Risk Amount -1% +1% -9.38% +9.38% Profit Equity Profit Equity Profit Equity Profit Equity 2008 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 Financial Assets Cash and Cash Equivalents 31,016 (310) - 310 - - - - - Receivables 35,372 ------Other financial assets Term Deposits that are not designated as 765 - (8) - 8 (72) (72) 72 72 ‘held to maturity’ (fixed interest) Equity Instruments quoted in the market 5,116 - - - - (480) (480) 480 480 place (Australian Stock Exchange) Equity Instruments quoted in the market 1,222 - - - - (115) (115) 115 115 place (Australian Stock Exchange) Equity Instruments not quoted in the 29 - - - - (3) (3) 3 3 market place
Financial Liabilities Trade creditors and accruals 43,782 ------Accommodation Bonds 1,276 (13) - 13 - - - - - Other Liabilities 393 ------
Note 19: Financial Instruments continued
Carrying Interest Rate Risk Other Price Risk Amount -1% +1% -9.38% +9.38% Profit Equity Profit Equity Profit Equity Profit Equity 2007 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 Financial Assets Cash and Cash Equivalents 26,007 (260) - 260 - - - - - Receivables 31,934 ------Other financial assets 5,588 - - - - (524) (524) 524 524 Financial Liabilities Trade creditors and accruals 66,023 ------Accommodation Bonds 887 (9) - (9) - - - - - Other Liabilities 410 ------
Melbourne Health Annual Report 79 Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 20: Commitments for Expenditure
Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 Capital Expenditure Commitments Payable: Land and Buildings 77,921 25,518 77,921 25,518 Total Capital Commitments 77,921 25,518 77,921 25,518
Land and Buildings Not later than one year 74,618 25,518 74,618 25,518 Later than 1 year and not later than 5 years 3,303 3,303 Total 77,921 25,518 77,921 25,518
Lease Commitments Commitments in relation to leases contracted for at the reporting date: Operating Leases 9,430 8,483 9,430 8,483 Total Lease Commitments 9,430 8,483 9,430 8,483
Operating Leases Non-cancellable Not later than one year 3,143 3,907 3,143 3,907 Later than 1 year and not later than 5 years 5,253 4,576 5,253 4,576 Later than 5 years 1,034 1,034 Sub Total 9,430 8,483 9,430 8,483 TOTAL 9,430 8,483 9,430 8,483
Total Commitments for expenditure (inclusive of GST) 87,351 34,001 87,351 34,001 Less GST recoverable from the Australian Tax Office (7,941) (1,568) (7,941) (1,568) Total commitments for expenditure (exclusive of GST) 79,410 32,433 79,410 32,433
Note 21: Contingent Assets and Contingent Liabilities
There have not been any contingent assets of liabilities, other than that referred to in the financial statements or notes thereto, as at or that has arisen since the end of the financial year, that has significantly affected, or may significantly affect, the operations of the Service, the results of those operations, or the state of affairs of the Service in the future financial years.
80 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 22: Segment Reporting
2008 Acute Mental RAC RAC Mental Aged Care Other HSA Hospital Unallocated Consolidated Health Health Commmunity Initiatives 2008 2008 2008 2008 2008 2008 2008 2008 2008 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 REVENUE External Segment Revenue 446,775 128,752 20,581 583 7,875 15,724 33,731 33,366 687,387 Total Revenue 446,775 128,752 20,581 583 7,875 15,724 33,731 33,366 687,387 EXPENSES External Segment Expenses (474,483) (109,343) (15,106) (13,512) (7,315) (15,462) (26,085) (15,810) (677,116) Total Expenses (474,483) (109,343) (15,106) (13,512) (7,315) (15,462) (26,085) (15,810) (677,116) Net Result from ordinary (27,708) 19,409 5,475 (12,929) 560 262 7,646 17,556 10,271 activities Interest Expense - - - - - (178) (178) Interest Income - - - - - 2,720 2,720 Net Result for Year (27,708) 19,409 5,475 (12,929) 560 262 7,646 20,098 12,813 OTHER INFORMATION Segment Assets 332,146 100,501 7,507 1,279 5,207 5,119 81,354 80,146 613,260 Total Assets 332,146 100,501 7,507 1,279 5,207 5,119 81,354 80,146 613,260 Segment Liabilities 79,539 20,275 1,924 4,603 1,940 1,226 6,664 48,588 164,760 Total Liabilities 79,539 20,275 1,924 4,603 1,940 1,226 6,664 48,588 164,760 Acquisition of property, plant and equipment and intangible 30,089 9,639 552 61 488 464 6,736 2,935 50,526 assets Depreciation & amortisation 19,181 6,142 355 39 309 296 4,290 1,581 32,193 expense
2007 Acute Mental RAC RAC Mental Aged Care Other HSA Hospital Unallocated Consolidated Health Health Commmunity Initiatives 2007 2007 2007 2007 2007 2007 2007 2007 2007 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 REVENUE External Segment Revenue 413,526 128,550 7,176 480 6,649 14,868 76,677 22,276 670,202 Total Revenue 413,526 128,550 7,176 480 6,649 14,868 76,677 22,276 670,202 EXPENSES External Segment Expenses (435,882) (109,257) (12,110) (20,269) (3,922) (14,628) (67,910) (20,172) (684,149) Total Expenses (435,882) (109,257) (12,110) (20,269) (3,922) (14,628) (67,910) (20,172) (684,149) Net Result from ordinary (22,356) 19,293 (4,934) (19,789) 2,727 240 8,767 2,104 (13,948) activities Interest Expense - - - - - (152) (152) Interest Income - - - - - 2,690 2,690 Net Result for Year (22,356) 19,293 (4,934) (19,789) 2,727 240 8,767 4,642 (11,410) OTHER INFORMATION Segment Assets 285,882 89,501 6,685 1,139 4,637 9,908 72,449 75,933 546,134 Total Assets 285,882 89,501 6,685 1,139 4,637 9,908 72,449 75,933 546,134 Segment Liabilities 83,356 21,984 2,086 4,992 2,104 2,889 7,226 54,014 178,651 Total Liabilities 83,356 21,984 2,086 4,992 2,104 2,889 7,226 54,014 178,651 Acquisition of property, plant and equipment and intangible 29,322 9,718 557 61 492 1,016 6,792 2,959 50,917 assets Depreciation & amortisation 11,068 3,669 210 24 186 384 2,564 1,115 19,220 expense
Melbourne Health Annual Report 81 Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 22: Segment Reporting continued
The major products/services from which the above Emergency Department Services (EDS) RAC Mental Health segments derive revenue are: comprises all recurrent health revenue/ RAC Mental Health, referred to in the past as expenditure on emergency department services psychogeriatric residential services, comprises Acute that are available free of charge to public patients. those Commonwealth-licensed residential aged Admitted Patient Services (Admitted care services in receipt of supplementary funding Patients) comprises all recurrent health revenue/ - This category includes recurrent health from DHS under the mental health program. It expenditure on admitted patient services, where expenditure/revenue for patient transport, excludes all other residential services funded services are delivered in: training, research and telemedicine where it under the mental health program, such as mental relates to emergency department services. health-funded community care units (CCUs) and - Public hospitals secure extended care units (SECUs). - Free standing day hospital facilities Off Campus, Ambulatory Services (Ambulatory) comprises all recurrent health - Palliative care facilities revenue/expenditure on public hospital Aged Care - Rehabilitation facilities type services, provided under the following Aged Care comprises revenue/expenditure for - Alcohol and drug treatment units agreements: Home and Community Care (HACC) programs, - Hospitals specialising in dental services, - Services that are provided or received by Allied Health, Aged Care Assessment and support hearing and ophthalmic aids hospitals (or area health services) but are services. delivered/received outside a hospital campus This category also includes recurrent health Other HSA - Services which have moved from a hospital to revenue/expenditure on admitted patient services Other HSA comprises revenue/expenditure a community setting since June 1998 where service delivery is contracted to private for services not separately classified above, - Services which fall within the agreed scope of hospitals or treatment facilities, as well as recurrent including: funds for patient transport, training, research and inclusions under the new system, which have telemedicine where it relates to admitted never been delivered within hospitals i.e. in rural/ - Public Health Services including Laboratory patient services. remote regions testing, Blood Borne Viruses/ Sexually Transmitted Infections clinical services, Koori This category includes recurrent health revenue/ Outpatient Services (Outpatients) comprises all Health liaison officers, immunisation and expenditure for patient transport, training, research recurrent health revenue/expenditure on public screening services. and telemedicine where it relates to off-campus, hospital type outpatient services, where services - Drugs Services including drug withdrawal, ambulatory services. are delivered in: counselling and the needle and syringe program. - Public hospital outpatient clinics Mental Health - Disability Services including aids and equipment and flexible support packages to people with - Free standing day hospital facilities Mental Health Services (Mental Health) comprises all recurrent health revenue/ a disability. - Rehabilitation facilities expenditure on specialised mental health - Community Care programs including sexual - Alcohol and drug treatment units services (child and adolescent, general and assault support, early parenting services, - Outpatient clinics specialising in ophthalmic aids adult, community and forensic) managed parenting assessment and skills development, or palliative care or funded by the state or territory health and various support services. administrations, and includes: This category includes recurrent health revenue/ Hospital & Community Intitiatives expenditure for patient transport, training, research - Admitted patient services Health and Community Initiatives. and telemedicine where it relates to outpatient (including forensic mental health) services. - Outpatient services Unallocated - Emergency department services (where Clinical support, infrastructure and corporate it is possible to separate emergency department Business Units; Diagnostics laboratory and mental health services) medical imaging services. - Community-based services - Residential and ambulatory services Geographical Segment Melbourne Health operates predominantly in This category includes recurrent health expenditure for Melbourne, Victoria. More than 90% of revenue, net patient transport, training, research and telemedicine surplus from ordinary activities and segment assets where it relates to mental health services. relate to operations in Melbourne, Victoria. RAC RAC comprises of residential high care and low care facilities.
82 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 23: Responsible Persons & Executive Offi cer Disclosures
Note 23a: Responsible Persons Disclosures In accordance with the Ministerial Directions issued by the Minister for Finance under the Financial Management Act 1994, the following disclosures are made regarding responsible persons for the reporting period.
Period Responsible Ministers: The Honourable Bronwyn Pike, MLA, Minister for Health 1/07/2007 - 3/08/2007 The Honourable Daniel Andrews, MLA, Minister for Health 3/08/2007 - 30/06/2008 Governing Boards Mr Robert Doyle Chair 1/07/2007 - 30/06/2008 Ms Marilyn Beaumont Board Member 1/07/2007 - 30/06/2008 Prof David Hayward Board Member 1/07/2007 - 30/06/2008 Mr William Mountford Board Member 1/07/2007 - 30/06/2008 Ms Kate Redwood Board Member 1/07/2007 - 30/06/2008 Ms Penelope Hutchinson Board Member 1/07/2007 - 30/06/2008 Dr Patricia Molloy Board Member 1/07/2007 - 30/06/2008 Ms Leanne Planck Board Member 1/07/2007 - 30/06/2008 Prof James Angus Board Member 1/07/2007 - 30/06/2008 Accountable Officers
Ms Linda Sorrell Chief Executive 1/07/2007 - 30/06/2008
Remuneration of Responsible Persons The number of Responsible Persons are shown in their relevant income bands;
Parent Parent Consolidated Consolidated 2008 2007 2008 2007 Income Band No. No. No. No. $0 - $ 9,999 11136 $20,000 - $ 29,999 -7-- $30,000 - $ 39,999 7-77 $50,000 - $ 59,999 -1-1 $60,000 - $ 69,999 1-11 $80,000 - $ 89,999 -1-- $240,000 - $249,999 -1-1 $390,000 - $399,999 1-1-
Total Numbers 10 11 22 16
Total remuneration received or due and receivable $667,793 $553,267 $707,793 $603,267 by Responsible Persons from the reporting entity amounted to:
Related Party Transactions There have not been any related party transactions requiring disclosure under the Directions of the Minister for Finance during the reporting period.
Melbourne Health Annual Report 83 Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 23b: Executive Offi cer Disclosures
Executive Officers’ Remuneration The numbers of executive officers, other than Ministers and Accountable Officers, and their total remuneration during the reporting period are shown in the first two columns in the table below in their relevant income bands. The base remuneration of executive officers is shown in the third and fourth columns. Base remuneration is exclusive of bonus payments, long-service leave payments, redundancy payments and retirement benefits.
PARENT CONSOLIDATED Total Remuneration Base Remuneration Total Remuneration Base Remuneration 2008 2007 2008 2007 2008 2007 2008 2007 No. No. No. No. $70,000 - $79,999 1 - 1 - 1 - 1 - $110,000 - $119,999 - 1 - 1 - 1 - 1 $130,000 - $139,999 - 1 1 2 - 1 1 2 $140,000 - $149,999 1 1 - - 1 1 - - $150,000 - $159,999 - - 1 - - - 1 - $160,000 - $169,999 1 - 1 - 1 - 1 - $170,000 - $179,999 1 - 1 - 1 - 1 - $180,000 - $189,999 1 - - 2 1 - - 2 $190,000 - $199,999 - 1 - 1 - 1 - 1 $200,000 - $209,999 - - 1 - - - 1 - $210,000 - $219,999 1 1 - 1 1 1 - 1 $220,000 - $229,999 - 1 - - - 1 - - $250,000 - $259,999 - 1 - - - 1 - - $260,000 - $269,999 - 1 1 - - 1 1 - $270,000 - $279,999 1 - 1 - 1 - 1 - $290,000 - $299,999 1 - - - 1 - - - $300,000 - $309,999 - - 2 1 - - 2 1 $320,000 - $329,999 2 1 - - 2 1 - - $350,000 - $359,999 - 1 - - - 1 - - 10 10 10 8 10 10 10 8 $2,171,500 $2,217,085 $2,047,509 $1,596,353 $2,171,500 $2,217,085 $2,047,508 $1,596,353
Note 24: Remuneration of Auditors
Parent Entity Parent Entity Consolidated Consolidated 2008 2007 2008 2007 $’000 $’000 $’000 $’000 Audit fees paid or payable to the Victorian Auditor-General’s 200 170 200 170 Office for audit of the Service’s current financial report Total Paid and Payable 200 170 200 170
84 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Note 25: Events Occurring after the Balance Sheet Date
No Events have occurrred since reporting date and the date of certification of this report which will have a material effect on the information contained in the financial report.
Note 26: Controlled Entities
Name of entity Country of Incorporation Class of Shares Equity Holding Evivar Medical Pty Ltd Australia Ordinary 63% Royal Melbourne Hospital Foundation Ltd Australia Limited by guarantee 100%
Note 27: Going Concern
The Consolidated financial statements have been prepared on a going concern basis as at 30 June 2008.
Melbourne Health Management is committed to the continued review of its financial and operating peformance with a view to identifying further cost saving initiatives and revenue generating opportunities and providing the most effective and efficient service delivery model without compromising patient care and quality.
An ongoing budget strategy has been identified by management of the Service which includes a number of business initiatives designed to more effectively manage the available financial resources. The strategy adopted by the service includes assurances by the Department of Human Services to support the ongoing operations and financial requirements of the Service and to provide to the Service adequate cash flow support to enable it to meet its current and future obligations as and when they fall due, for a period up to September 2009, should this be required.
Note 28: Revision of estimates
Revision of estimates Useful life review of buildings
The Infrastructure Building is scheduled to be demolished in September 2008. This has resulted in the useful life of the building to be revised from 28 years to 2 months and an additional depreciation charge of $1.5m expensed to the Operating Statement as at 30 June 2008.
After reviewing the future maintenance requirements of the following buildings: Main Block (including East and West wings); Clinical Services building; Centre for Medical Research; Anatomical Pathology and Bone Marrow Research building; Materials Handling building, Management has revised the useful life from 28years to 17 years. To reflect this change, an additional depreciation charge of $3.5m has been expensed to the Operating Statement as at 30 June 2008.
Melbourne Health Annual Report 85 Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
86 Melbourne Health Annual Report Notes to and forming part of the Financial Statements Melbourne Health Annual Report 2007/2008
Melbourne Health Annual Report 87 88 Melbourne Health Annual Report c/o The Royal Melbourne Hospital Grattan Street, Parkville 3050 Victoria Australia Phone: 61 3 9342 7000 www.mh.org.au [email protected]
Melbourne Health Annual Report 2007/08 Production: Melbourne Health Communications and Community Relations Design: Ckaos Ink Pty Ltd Photography: Mark Munro 1BTTJPOGPS $BSJOH"DIJFWJOH UIF&YUSBPSEJOBSZ