Department of Health and Community Services
Annual Report 2001/2002
Government Printer of the Northern Territory Darwin
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www.health.nt.gov.au
© Northern Territory Government This work is copyright, such copyright belonging to the Northern Territory of Australia and subject to conditions of the Copyright Act 1968 and the Northern Territory Copyright policy.
ISSN 1327-6301
Publication Number 2058/06/02 Published by the Department of Health and Community Services (DHCS), 2002-09-16 Printed by Government Printer of the Northern Territory Cover Designed by Sprout Creative (NT) Pty Ltd PO Box 40596 CASUARINA Northern Territory 0811 Australia www.health.nt.gov.au
The Honourable Jane Aagaard MLA Minister for Health and Community Services Minister Assisting the Chief Minister on Women’s Policy Parliament House DARWIN NT 0801
Dear Minister,
In accordance with the provision of Section 28 of the Public Sector Employment and Management Act, it gives me pleasure to submit the Annual Report on the activities and operations of the Department of Health and Community Services (DHCS) for the year ending 30 June 2002.
I advise that, in respect of my duties as an Accountable Officer, and to the best of my knowledge and belief: a) proper records of all transactions affecting the Agency were kept and employees under my control observed the provisions of the Financial Management Act, the Financial Management Regulations and Treasurer’s Directions. Proper records were kept of transactions undertaken by the Department of Corporate and Information Services (DCIS) on behalf of DHCS b) procedures within DHCS afforded proper internal control, and a current description of these procedures, which were prepared in accordance with the Financial Management Act, can be found in the accounting and property manual c) no indication of fraud, malpractice, major breach of legislation or delegation, major error in or omission from the accounts and records existed d) in accordance with the requirements of Section 15 of the Financial Management Act, the internal audit capacity available to the Agency was adequate, and the result of internal audits were reported to the Chief Executive Officer e) financial statements included in the annual report were prepared from proper accounts and records and were in accordance with Part 2, Section 5 of the Treasurer's Directions where appropriate. All financial statements prepared by DCIS on behalf of DHCS were prepared from proper accounts and records f) all Employment Instructions issued by the Commissioner for Public Employment were complied with.
Yours sincerely,
GRAHAM SYMONS Acting Chief Executive Officer
30 September 2002
Central Office Darwin Urban Darwin Rural Tel +61 8 8999 2400 Fax +61 8 8999 2700 Tel +61 8 8922 7499 Fax +61 8 8922 7482 Tel +61 8 8922 8317 Fax +61 8 8922 8940 Table of Contents
CEO’s Foreword ...... 6
Performance Highlights 2001/02...... 8 Primary Health Care Access Program PHCAP 8 Nursing Recruitment and Retention 11 LifeNet NT 13 Learning Through The Senses 15
Health and Community Services at a Glance...... 16 History 16 Corporate Plan 19 Strategy 21 – Directions 2005 21 DHCS Service Outlet Locations 22 Organisational Structure 23 DHCS Staffing 24 Expenditure 27 Complaints Handling 30
New Government Policy Initiatives ...... 33
Output Performance Reporting ...... 36
Aboriginal Health...... 37
Hospital Services ...... 47 Royal Darwin Hospital 57 Katherine Hospital 61 Gove District Hospital 64 Alice Springs Hospital 66 Tennant Creek Hospital 71
Community Health...... 75
Family and Children’s Services ...... 86
Aged, Disability and Community Care ...... 94
Mental Health Services...... 101
Environmental Health ...... 109
Page 4 Disease Control...... 118
Health Promotion...... 130
Alcohol and Other Drugs ...... 133
Top End Service Network ...... 138
Central Australian Service Network...... 142
Services Development Division ...... 147
Menzies School of Health Research...... 152
DHCS Corporate Governance...... 153 Executive Standing Committees 156 Legislative Responsibilities 157 Leadership (Executive Bios) 158 Performance Management 161 Program Evaluation / Reviews 162 Internal / External Audits 163
Human Resources ...... 165 Strategic Workforce Services 165 Human Resource Accountability 169 Occupational Health and Safety (OHS) 173 Industrial Relations 180
Financial Statements ...... 181
Senior Contact Officers...... 196
List of Acronyms ...... 199
Figures and Tables Index...... 201
Subject Index ...... 204
Appendix...... 205 Non Government Service Provision 205
Page 5 CEO’s Foreword
CEO’s Foreword
2001/02 has been an eventful year with significant changes in the environment in which staff operate, including: ♦ a change in Government in August 2001 and the consequent changes in policies, priorities and style ♦ significant changes in the public service ♦ a number of senior management changes in the Department ♦ the commencement of a major review of departmental operations.
Major initiatives progressed by the Department in accordance with the new Government’s policies and election commitments included: ♦ planning for the establishment of a renal dialysis service in Tennant Creek, which became operational in August 2002 ♦ support for the Minister’s Task Force on Illicit Drugs which reported through the Minister to government in August 2002 ♦ additional ambulance services for the residents of Darwin and Palmerston and a volunteer ambulance service for Humpty Doo ♦ planning for the development of youth programs identified in Government’s election commitments ♦ implementation of the Enterprise Bargaining Agreement for nursing staff including work towards a new career structure and additional undergraduate and postgraduate scholarships ♦ public consultations on protection from tobacco smoking with a view to legislation being introduced to Parliament in September 2002.
Together with the above, the department embarked upon a significant reform agenda including:
♦ the Hospitals Improvement Project, which aims to improve quality of patient care and efficiency of service delivery across the Territory’s network of 5 public hospitals, with initial priority given to Alice Springs Hospital. It is of note that Katherine Hospital was successful in achieving accreditation during the year ♦ continued planning with our partners in the NT Aboriginal Health Forum for the roll out of Aboriginal community controlled Health Zones across the NT. Two more zones were approved for the Top End together with an additional coordinated care trial for Katherine East
Page 6 CEO’s Foreword
♦ participating with the non government sector in forums auspiced by NTCOSS with a particular focus on service viability issues and working collaboratively towards a more sustainable sector.
Staff have maintained the delivery of essential health and community services to Territorians as well as taking in their stride the discontinuities and disruptions that often come with change.
The achievements of 2001/02 have been a reflection of the dedication and professionalism of staff in the Department as well as to the tireless efforts of our partners in the non- government sector.
I also take this opportunity to thank Paul Bartholomew, who was Chief Executive Officer during 2001/02 for his contribution to the Department.
Key priorities for Health and Community Services in the coming year will be: ♦ further enhancing the quality of services delivered through the Northern Territory hospital network ♦ boosting indigenous health through increased resourcing, strengthening indigenous decision making and enhancing child health programs ♦ improving community service through increased support for children services, greater resourcing of disability services and child protection and further development of mental health services ♦ supporting the health and community service workforce through programs to boost recruitment, provide development opportunities and enhance the working environment ♦ strengthening the capacity of the Department to deliver on Government priorities through implementation of outcomes of the Departmental Review.
GRAHAM SYMONS ACTING CHIEF EXECUTIVE OFFICER
30 September 2002
Page 7 Performance Highlights
Performance Highlights 2001/02
Primary Health Care Access Program PHCAP
In response to the poor health status of Aboriginal and Torres Strait Islander people, the Federal Government announced the Primary Health Care Access Program (PHCAP) in its 1999/00 budget. PHCAP is based on a model of Regional Health Planning processes to be conducted in each State and Territory. In the NT, Aboriginal health planning studies have been completed for both Central Australia and the Top End.
The planning studies have proposed 21 zones across the NT, 10 in the Top End and 11 in Central Australia, as outlined on the map on page 10. PHCAP is to roll out zone by zone, with flexible boundaries between zones.
The Northern Territory Aboriginal Health Forum is central to the success of PHCAP and is providing assistance and advice in the development and implementation of this program.
The Northern Territory Government is working closely with the Commonwealth, the Aboriginal Medical Services Alliance of the Northern Territory (AMSANT) and the Aboriginal and Torres Strait Islander Commission (ATSIC) to ensure that health services provided to Aboriginal and Torres Strait Islander people in the NT continue to improve.
New PHCAP funding for a zone will be pooled with existing Territory resources for primary health care in that zone. The pooled funds will be managed under a single funding agreement between the Commonwealth, NT Government and the zonal community controlled health organisation, once established. Interim arrangements may be developed until that time.
The NT Aboriginal Health Forum makes recommendations to the Commonwealth Government on priority areas for implementation. In making these recommendations, the forum takes into account the relative needs of Aboriginal and Torres Strait Islander people in a health zone, as well as the current capacity of zones to implement new arrangements.
Page 8 Performance Highlights
To date, the following 5 health zones have been chosen in the Central Australia region: ♦ Anmatjerre ♦ Eastern Arrernte ♦ Luritja-Pintubi ♦ Northern Barkly ♦ Warlpiri
In the Top End, the former Aboriginal Coordinated Care Trial site at Katherine West and the Tiwi Islands have received funding under this program. 2 new health zones have also been selected for funding: ♦ South East Top End ♦ Darwin
Over the next few years, health zones will be implemented in a number of areas across the Northern Territory.
PHCAP will operate through a strategic community planning approach. This will be implemented collaboratively involving all Aboriginal communities and individuals in a zone and will be funded by the Office for Aboriginal and Torres Strait Islander Health (OATSIH).
It is expected that planning will accommodate the diversity of local circumstances and differing capacity in achieving effective, integrated primary health care services.
Health Zones are groups of communities and health services working together for better health.
Page 9 Performance Highlights
Source: TOP END ABORIGINAL HEALTH PLANNING STUDY April 2000, PlanHealth Pty Ltd, Ben Bartlett and Pip Duncan.
CENTRAL AUSTRALIAN HEALTH PLANNING STUDY July 1997, PlanHealth Pty Ltd, Ben Bartlett, Pip Duncan, David Alexander, and Jill Hardwick.
Page 10 Performance Highlights
Nursing Recruitment and Retention
The Department of Health and Community Services (DHCS) has identified the need to recruit and retain a skilled work force in the nursing stream.
In October 2000, DHCS Executive Group commissioned a task force for Recruitment and Retention of Nurses. The task force found there was an urgent need to improve work force planning and strategies to enhance recruitment and retention of nurses in the Northern Territory.
A Project Officer was employed with the aim of developing an action plan that would allow for department wide implementation of recommendations made by the task force. In November 2001, DHCS Executive Group endorsed the following recommendations made by the task force:
♦ improved marketing and promotion of employment opportunities with DHCS
♦ management training
♦ professional development
♦ improved information gathering
♦ improved recruitment processes
♦ enhanced human resource management
♦ occupational health and safety
♦ accommodation issues
♦ inappropriate behaviours in the workplace
Page 11 Performance Highlights
Dedicated nursing staff at Royal Darwin Hospital
Implementation has included the following: ♦ professional development allowance established in the Nursing Certified Agreement ♦ establishment of postgraduate nursing course scholarships in mental health, peri- operative and critical care ♦ establishment of undergraduate nursing degree scholarships ♦ establishment of a paid re-entry program for nurses ♦ creation and establishment of additional Clinical Nurse Educator positions ♦ through the Public Affairs Unit, a strong focus on marketing nursing as a career
Further strategy implementation is expected with the project steering committee overseeing the process.
Page 12 Performance Highlights
LifeNet NT
Demystifying the Organ Donation Process
Organ transplantation is the ultimate treatment for people with end stage renal failure. For many people with diseased vital organs, transplantation is the promise of living a normal, healthy life.
At present all transplants are done interstate with only retrieval of organs being carried out at Royal Darwin Hospital (RDH) and Alice Springs Hospital (ASH) . As both hospitals continue to expand and incorporate new services, the Department of Health and Community Services (DHCS) aims to have kidney transplants performed within the NT.
Table 1: Number of Donors From Each Hospital 1989 to 2001 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 Total ASH 0 0 0 0 0 1 1 1 0 1 1 2 0 7 RDH 2 1 2 0 3 0 0 2 4 2 2 0 2 20 Total 2 1 2 0 3 1 1 3 4 3 3 2 2 27
In November 2001 the Northern Territory launched LifeNet NT, formerly known as the Northern Territory Organ Donation Agency. This has enabled the establishment of the Territory’s first Organ Donor Coordinator. The position was developed to allow contact with families during the organ donation process and follow up support after the organ donation has occurred. Prior to this all donations were facilitated through the South Australian Organ Donation Agency (SAODA).
After organ transplantation, patients often fear leaving the security of the transplant unit to return to the NT. LifeNet NT is able to give support to recipients and their families once they arrive home.
As well as coordinating donations and counselling families, LifeNet NT works to increase numbers of intending donors. Education, aimed at demystifying stories that have prevented people from making informed decisions about organ donation, is a priority, and the goal is to reach across the whole population spectrum.
Page 13 Performance Highlights
Surveys have shown that, although the percentage of Australians willing to donate is high, most people never formalise their decision by registering or informing their families of their choice. This has resulted in a very low organ donation rate in Australia.
Figure 1: Organ Donors Selected Countries
35
30
25
20
15
10 Number of Donors per Million Population 5
0 Spain USA Portugal France Germany Italy UK New Zealand Australia
Country
Source: Council of Europe Newsletter Transplant 2002 – Provisional data May 2002
Page 14 Performance Highlights
Learning Through The Senses
Learning Through The Senses (LTTS) is a resource manual for teachers and therapists developed by the School Therapy Services (STS) team, Darwin.
The concept of the manual grew from a need to provide teachers with practical and effective classroom strategies to assist students with learning difficulties and/or disruptive behaviours.
In early 1999 the STS Occupational Therapy team embarked on a project that 2 years later resulted in the production of this 200 page manual.
LTTS assists teachers to develop an understanding of sensory processing and its impact on a child’s learning and behaviour in the classroom. It is designed to assist children to develop skills and is a guide for teachers to implement strategies to assist children in gaining the maximum from the learning environment.
The manual is structured around information gained from an assessment instrument called the ‘Sensory Profile Questionnaire’. The questionnaire was developed by Dr Dunn, an occupational therapist at Kansas University who has been researching the field of sensory processing for over 8 years.
Dr Dunn has been very supportive of the STS team throughout the process of developing the manual. She was impressed when she received a copy of the manual and commended the STS team on the work they had achieved.
The manual was officially launched on the 13th February 2002 at Bakewell Primary School by the Minister for Health and Community Services and the Minister for Education.
Since the launch of the manual, 322 teachers and support staff in over 20 schools in Darwin and Nhulunbuy have been inserviced on sensory processing and use of the manual, which has been distributed in hard copy and electronically.
Page 15 DHCS at a Glance
Health and Community Services at a Glance
History
Understanding the past is important for individual identity, no less so for an organisation such as the Department of Health and Community Services. A strong commitment to improving the wellbeing of Territorians is evident in the following brief history.
DHCS Stretch Goal – ‘Develop a Robust Health and Community Services Sector in the NT’
Significant Developments and Achievements
1991 ♦ Living with Alcohol Program commenced ♦ Magnetic Resonance Imaging (MRI) became available ♦ A Women’s Health Advisor was appointed
1992 ♦ The Strong Women, Strong Babies, Strong Culture project commenced
1993 ♦ Community Care Centres were established collocating community services and primary health care ♦ The Food and Nutrition Unit was set up to improve the nutritional status of Territorians ♦ A new Adoption Act was introduced enabling link up services to be provided to adopted people and their birth families
1994 ♦ A new mental health facility opened on RDH campus ♦ A specialist rehabilitation service was established on RDH campus
1995 ♦ The name of the department changed to Territory Health Services (THS) to reflect the changed corporate approach which moved beyond service provider into a partnership with non government service providers ♦ A Territory wide palliative care service came into existence
Page 16 DHCS at a Glance
1996 ♦ The NT Clinical School for teaching undergraduate medical students was initiated through a formal agreement with Flinders University ♦ The Remote Area Well Women’s program commenced ♦ The Aboriginal Health Strategy Unit was established. A new Aboriginal Health Policy was approved by the NT Government
1997 ♦ On site cardiology services commenced at RDH ♦ An agreement was reached with an international technology group for the design and development of the Community Care Information System (CCIS), the first information system in Australia to cover the full scope of community services ♦ The Commonwealth and NT Governments agreed to the development of 2 Coordinated Care Trials, Katherine West and Tiwi, with Health Boards established for each area ♦ Specialist Outreach Program commenced in the Top End ♦ A 5-year strategic plan for Disability Services was approved
1998 ♦ The Strong Women, Strong Babies, Strong Culture Program was extended into a further 20 communities. An additional sum of $568 000 was granted to the program to ensure that it continues in the first 10 communities ♦ The NT participated in the first stage of a national campaign to eliminate measles from Australia in line with the World Health Organisation plan for global eradication. 15 362 children were vaccinated in schools and 642 at community or mobile clinics ♦ Executive undertook a comprehensive consultative process in the establishment of a new strategic plan. This was ultimately named Strategy 21, and covered the period 1999 to 2003 ♦ Responsibility for primary health care services at Milikapiti and Pirlangimpi was transferred to the Tiwi Health Board ♦ A child care centre opened at Royal Darwin Hospital
1999 ♦ Preventable Chronic Diseases Strategy (diabetes, high blood pressure, obstructive airways disease, heart disease, kidney disease) was launched ♦ NT Seniors Card was introduced allowing seniors to purchase goods and services at reduced cost. This service was introduced as a strategy to support Territorians to remain actively involved in the community and to lead lifestyles of their choice
Page 17 DHCS at a Glance
2000 ♦ The Public Health Bush Book was launched. It is written in plain English and supported by case studies, diagrams and illustrations. It is also used as a practical guide for all health care providers ♦ Mental Health Services advanced the establishment of a Community Visitors Program and Quality Assurance Committee to safeguard the rights of people with mental illness ♦ Northern Territory Disability Advisory Board (NTDAB) was established to inform and advise the NT Government on broad disability issues
2001 ♦ In conjunction with other departments a ‘Hunting for Health’ program was launched aimed at improving the nutritional and physical activity status of school aged children ♦ The Palmerston Health Precinct began delivering services ♦ To emphasise the diverse range of services provided by the agency, the title ‘Territory Health Services’ was replaced by ‘The Department of Health and Community Services’ ♦ In consultation with internal and external stakeholders, Strategy 21 was reviewed to ensure its continued relevance. Additional stretch goals were added and the strategy now extends to 2005 ♦ The department endorsed a Quality and Performance Framework which includes a Strategic Action Plan allocating $1.8M over a 2 year period. The aim is to achieve good governance, effective information, partnerships with consumers and quality improvement for all services
2002 ♦ The ‘Choose Yourself’ alcohol and other drugs promotion was launched ♦ The Women’s Health Strategy Unit produced the ‘Women’s Business’ antenatal book in 5 Aboriginal Languages with a generic English language version ♦ The first National Youth Tobacco Free Day was launched in conjunction with National Youth Week. The theme was ‘Tobacco companies … the truth will make you mad’ ♦ Sixteen communities throughout the NT received funds through the Women's Cancer Prevention Program for the promotion of Well Women's cancer screening ♦ Royal Darwin Hospital won the Federal/State Government Post Disaster Category of the Australian Safer Communities Awards for its emergency procedures manual ♦ Childcare subsidy increased and additional funding provided to the assist the development of child care centres across the Territory ♦ Government decides to increase the number of Hospital nurses by 75 over the next 2 years, and to increase regional Health Care Teams by 25 child health specialists ♦ Taskforce on Illicit Drugs established ♦ Provision of Renal Dialysis services commenced in Tennant Creek
Page 18 DHCS at a Glance
Corporate Plan
The strategic intent of the Department of Health and Community Services (DHCS) is to provide a Territory wide network of services that delivers continuing improvement in the health status and wellbeing of all Territorians. How this is to be accomplished is outlined in our Corporate Plan, Strategy 21 – Directions 2005 which came into effect on 25 July 2001. This plan is an extension of the original Strategy 21 corporate plan which was reviewed, with staff and external stakeholder consultation, after 2 years of operation. The review led to the addition of 2 new stretch goals: ‘enhance our organisational capacity’ and ‘be a major contributor to the Northern Territory’s economic and social development’.
Figure 2: Health and Community Services Strategy 21 - Directions 2005
To create and enhance a Territory wide network of services which delivers continuing improvements in the health status and wellbeing of all Territorians.
STRATEGIC DIRECTIONS CORE BUSINESS FOCUS STRETCH GOAL AREAS
Building on and sharpening New emphasis in Health and Achieving 5 practical and our core directions x Community Services’ role = challenging goals
♦ Organisational Support ♦ Policy leader in health for ♦ Strengthen community capacity Territorians ♦ Develop a robust health and ♦ Hospital Services community services sector in (Acute Care) ♦ Funder/purchaser of the Northern Territory government approved health services ♦ Community Health ♦ Significantly increase Aboriginal involvement in the Health and (Primary Level Health) ♦ A core Northern Territory Community Service workforce provider of non commercial ♦ Community Services health services ♦ Be a major contributor to the - Aged Care and Disability Northern Territory’s economic - Family and Children and social development - Mental Health ♦ A catalyst for total health solutions, achieved ♦ Enhance our organisational ♦ Public Health intersectorally capability - Environmental Health - Disease Control - Health Promotion - Alcohol and Other Drugs - Health Research
Page 19 DHCS at a Glance
The Department’s Intended Outcomes (listed in Budget paper No 2, Strategy 21, etc.) for each Output or Service Area as listed in Strategy 21 - Directions 2005, are outlined below:
OUTPUT (SERVICE AREA) INTENDED OUTCOME Corporate and Strategic Increase number of hospital nurses by 75 and increase nurses pay Workforce Services by 15% over next 4 years. Allow greater flexibility in remuneration for specialist staff and clinicians. Increase funding Support
Organisational for professional development to 1.2% of personnel budget.
Acute and Specialist Care Commit $25m annually to be spent on upgrading facilities and equipment. Increase Emergency Department Staff at Royal Darwin Hospital. Hospital Services
Primary Level Health Increase remote area health care teams by 25 child health specialists. Improve school health programs and conduct a pilot
Health nutrition program. Establish Renal Dialysis services in Tennant
Community Creek. Provide extra ambulance officers in the Darwin area.
Aged and Disability Services Implement new framework for allocation of Unmet Need funding. Establish Seniors Advisory Comittee. Family and Children’s Services Increase the NT Childcare subsidy by $7.50 per week and provide an additional $300,000 to assist the development Child Care Centres across the Territory. Mental Health Services Establish quality improvement plans including a commitment to Community Services be fully accredited by 2003.
Environmental Health Services Improve the monitoring, supervision and control of Schedule 8 drugs prescription and dispensing. Disease Control Services Exceed immunisation levels of 87% and 80% for fully immunised children at age 12 months and 2 years respectively. Health Promotion Support 27 community initiated health promotion projects and involve 129 participants in accredited health promotion training. Public Health
Alcohol and Other Drugs Establish a Task Force on Illicit Drugs. Provide $560,000 additional asistance for improved Drug Rehabilitation Services.
Page 20 Strategy 21 – Directions 2005
Implementation of initiatives under Strategy 21 - Directions 2005 is now well underway. This includes 6 initiatives which aim to enhance a Territory wide network of services to deliver continuing improvement in the health and wellbeing of all Territorians. Partnerships with the community and other organisations, as well as consultation with internal and external stakeholders, are crucial to their success.
Primary Health Care Access Program Information Systems Development Hospital Improvement Strategy Aim: Increase access to primary health care in remote Aim: Effective use of information to plan and manage the Aim: Improve patient outcomes and quality of care in NT Aboriginal communities. provision of services to clients in urban centres and remote hospitals, and stronger links and networks between hospitals. Status: Funding now approved for 5 health zones in Barkly and Aboriginal Health Clinics. Status: Working groups formed to investigate delivery of safe the Centre and 4 in the Top End. Status: Fully operational in all urban clinics. Commencing and quality services. Newly formed Clinical Services Advisory implementation of new Primary Care Information System into Group consisting of Senior Medical, Nursing and Allied Health remote clinics. representatives.
STRATEGY 21 in action
Development of Health and Community Services Disability Unmet Need Funding Workforce Development and Organisational Capability Sector Aim: Address unmet need for services in the disability area. Aim: Develop a skilled and competent workforce. Aim: Strong and sustainable network of providers across the NT Status: $100 000 provided in 2001/02 to service providers for Status: Endorsed new Nursing Career Structure. Nursing with realistic matching of services and resources for best health Respite Care for children under 12 years. Up to $200 000 on a Career, Recruitment and Retention Project completed. gains. one off basis to develop innovative projects in the disability field Aboriginal Workforce Development Strategy and initiatives Status: Service Agreements implemented across the sector, and $40 000 one off equipment/resource grants for early ongoing. Completed first course of Leadership Development funding provided to support strategies for sector development childhood intervention services. Program. Commenced Health Professionals Recruitment and through NTCOSS. Retention Project. DHCS at a Glance
DHCS Service Outlet Locations
Page 22 Organisational Structure
ACTING SECRETARY / CEO Graham Symons Public Affairs Ministerial Liaison Vera Whitehouse Jan Evans Deputy Secretary Service Provision Chief Health Officer Assistant Secretary A/Assistant Secretary Principal Medical Graham Symons Shirley Hendy Strategic Review Business and Operational Support Consultant and Information Services Joanne Schilling Len Notaras Stephen Moo Centre for Disease Control – Vicki Krause Strategic Review and Evaluation – John Montz Finance and General Services – Brian Slatter Medical Entomology – Peter Whelan Quality Improvement – Lorraine Porter Information Technology Services – Francis Kong Service Provision Strategy Unit Hospital Information Services – Jan Robbins Strategic Workforce Services – Steve Marshall Rosemary Warden Community Information Services – Peter Kerr Health Professions Licensing – Carolyn Wilson Principal Nursing Consultant Corporate Information Services – Julie Searle Legal Services – Susan Paltridge Ged Williams Primary Care and Public Health Info.Services – Margie McLean Library Services – Ann Alderslade Director of Community Partnership Health Information Privacy Project – Robyn Cooke Office Services – June Tomlinson Dayalan Devanesen
Assistant Secretary Assistant Secretary Regional Director Health Development and Community Services Development Top End Service Network Services Rose Rhodes David Ashbridge Shirley Hendy Purchaser of Government and Non Government Services Darwin Rural District – Lesley Kemmis Health Development Health Gain Planning Unit – Steve Gutheridge Darwin Urban District – Meribeth Fletcher Katherine Hospital and District – Robin Smith SOEWELL – Cheryl Furner East Arnhem District and Gove District Hospital – Environmental Health – Xavier Schobben Community Services Mark Watson Community Services – Jenny Scott Aged Care and Disability Services – Damien Conley Family and Children’s Services – Anthony Burton Regional Director Central Australian Service Network Community Health Development – Jill MacAndrew Sue Korner Assistant Secretary Community Health, Aboriginal Health Alice Springs Hospital – Roger Weckert Alice Springs District – Ian Crundall and Hospital Services Hospital Services – Allison Grierson Barkly Health Service and Tennant Creek Hospital Jenny Cleary – John Heslop
A/Executive Director Community Health – Noelene Swanson Royal Darwin Hospital Gary Lum Hospital Services – Allison Grierson
F U N D E R P U R C H A S E R P R O V I D E R DHCS at a Glance
DHCS Staffing
Overview
With its widely dispersed population, the Northern Territory faces critical health issues in rural and remote areas. Recruiting and retaining health professionals is a major concern in a department which employs more than a quarter of the NT’s public sector work force. The department’s staffing strategies have continued to focus on better health outcomes for Territorians.
Figure 3: Staffing as a Percentage of Total Full Time Equivalent Employees in NT Public Sector
16,000
14604 14669 14491 14624 14430 14,000
12,000
10,000
8,000
6,000 Average FTE Staffing
4,000
2,000 26.2% 25.6% 25.7% 25.3% 26.5
0 1997/98 1998/99 1999/00 2000/01 2001/02
Financial Year
DHCS Total NT Public Sector
Page 24 DHCS at a Glance
Figure 4: Full Time Equivalent Staffing Trends over a 3 Year Period.
1600
37% 1400 36% 35%
1200 Female
1000 25% Male 23% 24%
800
600 13% 13% 12% 11% 11% 11% 400 FTE Staffing End of Financial Year 8 % 7% 7% 5% 5% 4% 200 3% 3% 3% 1% 2% 1% 0 1999/00 2000/01 2001/02 1999/00 2000/01 2001/02 1999/00 2000/01 2001/02 1999/00 2000/01 2001/02 1999/00 2000/01 2001/02 1999/00 2000/01 2001/02 1999/00 2000/01 2001/02 1999/00 2000/01 2001/02
NursingAdministration Physical Professional Medical Technical Aboriginal Executive (inc Dental) Health Worker
Classification
Note: Staffing by classification as a percentage of total staffing.
♦ Gender balance has remained stable with approximately ¾ of staff being female.
♦ The actual number of nurses (2001/02) increased from the previous year. The relative percentage of the agency's total workforce represented by nursing reduced as a result of an increase in the total DHCS workforce.
♦ An increase in medical officers and professional category staff is attributed to improved recruitment and retention strategies.
♦ The number of non-management staff in the administrative stream continues to increase. This is a result of small increases in staff over a large number of areas.
The technical stream has remained stable over the last 3 years and remains the most stable of all classifications. 86% of technical staff employed in June 2001 were still employed in the department 1 year later.
Page 25 DHCS at a Glance
Figure 5: Program Staff as Percent of Total Agency Staff
Hospitals
Health Promotion
Mental Health
Disease Control
Community Health
Program Environmental Health
Family and Children
Alcolol and Other Drugs
Aged and Disability
Corporate
0% 10% 20% 30% 40% 50% 60% Percent of Total Agency Staff
Page 26 DHCS at a Glance
Expenditure
Figure 6: DHCS Expenditure as a Percentage of Total NT Public Sector
$4,000
$3,500
$3,000
$2,500
$2,000 Expenditure $M $1,500 $2 866 $2 935 $3 082 $3 401 $3 350
$1,000
$500
13.8% 13.7% 14.1% 13.2% 14.6% $0 1997/98 1998/99 1999/00 2000/01 2001/02
Financial Year Total NT Public Sector Health & Community Services
Figure 7: Health and Community Services Expenditure by Source of Funding
$500 $490m 5% $447m $450 $434m 5% DHCS 4% Revenue $395m $400 22% $378m 5% 22% 5% 22% Commonwealth $350 Tied Funds
27% $300 29% NT Government $250
Expenditure $M $200
74% 73% 73% $150 68% 67%
$100
$50
$0 1997/98 1998/99 1999/00 2000/01 2001/02 Financial Year
Page 27 DHCS at a Glance
Figure 8: Health and Community Services Expenditure by Source of Funding and Activity
$240 DHCS Revenue $220
$200
$180
$160 Commonwealth $140 Tied Funds $120
Expenditure $M $100
$80 NT Governemnt $60
$40
$20
$0 1998/99 1999/00 2000/01 2001/02 1998/99 1999/00 2000/01 2001/02 1998/99 1999/00 2000/01 2001/02 1998/99 1999/00 2000/01 2001/02 1998/99 1999/00 2000/01 2001/02 Organisational Health Development Community Community Health Hospital Services Support (Public Health) Services (Primary Health Care) (Acute Care)
Activity
Figure 9: Breakdown of Actual Expenditure for all Hospitals
150
125
100
75
Actual Expenditure $M 50
25
0 Royal Darwin Hospital Alice Springs Hospital Katherine Hospital Gove District Hospital Tennant Creek Hospital
1999/00 2000/01 2001/02
Note: Cross border patient charges are included in Royal Darwin Hospital and Alice Springs Hospital expenditure
Page 28 DHCS at a Glance
Figure 10: DHCS Expenditure by Activity
$500 5% Organisational Support $450 5% 8% 5% 9% Public Health (Health $400 5% Development) 6% 10% 16% 11% $350 11% 17% Community Services 17% 15% $300 16% 20% Primary Health Care 21% (Community Health) $250 22% 21% 22% Acute and other Acute $200 (Hospital Services)
Actual Expenditure $M $150 51% $100 48% 45% 47% 47%
$50
$0 1997/98 1998/99 1999/00 2000/01 2001/02 Financial Year
Expenditure trends across the Agency’s main activities have been reasonably consistent over the past five years. The most significant impact on Financial Year 2001/02 was the unusually large increase in expenditure for Acute Care (Hospitals). This increase changed the relative proportion of expenditure across programs. In absolute terms Public Health and Primary Health Care expenditure increased from 2000/01 to 2001/02, however, as a percent of total expenditure they decreased from 9% to 8% and 21% to 20% respectively. Community Services did experience a small decrease in actual expenditure.
Page 29 DHCS at a Glance
Complaints Handling
The enactment of the Health and Community Services Complaints Act of 1998 resulted in the formation of the Health and Community Services Complaints Commission. A requirement of the Act is for both public and private health providers to furnish a statistical return on an annual basis. As the major health provider in the Northern Territory, the Department of Health and Community Services is required to submit a return to the Commissioner.
The Department of Health and Community Services recorded 485 complaints in 2001/02, which was a decrease of 124 or 20.9% from the previous year where 613 complaints were recorded.
A comparison of complaints recorded in 2000/01 and 2001/02 by region revealed that: − Royal Darwin Hospital, being the largest hospital in the Northern Territory, recorded a decrease of 22% − Top End Service Network (TESN) recorded a decrease of 26.5% − Central Australia Service Network (CASN) recorded a decrease of 60.9% − Alice Springs Hospital recorded an increase of 3.8% − Barkly Region recorded an increase of 25%
The number of complaints recorded has decreased, especially at Royal Darwin Hospital, because members of staff are becoming more pro-active in resolving issues at the point of service so that complaints are not made. In Alice Springs Hospital, the increase has been due to the redevelopment works.
Table 2: Number of Complaints Received by Service
Service 1999/00 2000/01 2001/02 Percentage of Growth 2000/01 – 2001/02 Royal Darwin Hospital 453 495 386 -22.0% Alice Springs Hospital 54 53 55 3.8% Barkly 10 8 10 25.0% Top End Service 17 34 25 -26.5% Central Australian Service 21 23 9 -60.9% Total 555 613 485 -20.9%
Page 30 DHCS at a Glance
In 2001/02, 15% of complaints recorded at Royal Darwin Hospital were from persons of Aboriginal descent, compared to 25% at Alice Springs Hospital and 80% within the Top End Service Network.
Table 3: Nature of the Complaints
Category 1999/00 Percent 2000/01 Percent 2001/02 Percent
Access to Services 192 35 185 30.2% 149 30.7% Privacy 81 15 120 19.6% 94 19.4% Other 85 15 102 16.6% 68 14.0% Quality of Treatment 107 19 86 14.0% 83 17.1% Communication 65 12 76 12.4% 53 10.9% Standards 11 2 17 2.8% 8 1.6% Decision Making 8 1 12 2.0% 18 3.7% Costs 3 0.5 7 1.1% 9 1.9% Grievances 3 0.5 8 1.3% 3 0.6% Total 555 100% 613 100% 485 100%
Complaints relating to ‘decision making’ increased by 1.7% in 2001/02 whilst complaints relating to ‘communication’ decreased by 1.5%. ‘Quality of treatment’ rose from 14.1% in 2000/01 to 17% in 2001/02.
The decrease in ‘other’ complaints of 2.6% in 2001/02 relates to a reduced number of complaints about the Patients Assistance Travel Scheme, as a result of improvements to processes following 2001 consumer survey. In Alice Springs Hospital the reduction of complaints in relation to ‘standards’ is due to the completion of the redevelopment.
Page 31 DHCS at a Glance
Table 4: Complaint Outcomes 2001/02
Outcomes July 01 to Oct 01 to Jan 02 to Apr 02 to Total Sept 01 Dec 01 Mar 02 Jun 02 Apology provided 12 21 14 13 60 Compensation paid 0 0 0 0 0 Concern registered 9 12 13 12 46 Counselling / Mediation 2 3 0 9 14 Refund provided 0 2 0 1 3 Disciplinary action taken 1 0 1 2 4 Explanation provided 68 49 31 32 180 Procedure changed 4 1 2 1 8 Policy changed / developed 2 3 1 1 7 Service obtained 35 24 26 24 109 Conciliation 1 0 0 3 4 Other – pending 13 7 7 8 35 Other – unresolved 5 1 2 1 9 Unknown 3 2 3 2 10 Total 155 125 100 109 489
Table 5: Length of time to complete complaint investigation and outcome process
Area Shortest Number Longest Number Average Number of days of days of days Royal Darwin Hospital 0 101 10.31 Alice Springs Hospital 10 63 27 Barkly Region 2 150 28
Page 32 New Government Policy Initiatives
New Government Policy Initiatives
The Northern Territory had a change of government on 18 August 2001, with Labor taking office on 27 August 2001. This led to a change in name for the department, from Territory Health Services (THS) to the Department of Health and Community Services (DHCS), as well as the introduction of a number of new policy initiatives. 22 new initiatives were outlined in Labor’s Financial Statement and included in the November 2001 Mini Budget with corresponding expenditures outlined in Mini Budget Paper No 3. Detailed below are highlights from health related commitments in Labor’s Financial Statement with corresponding departmental activity during the year.
Policy Initiative Commit $25M annually from Capital Works Program to be spent on hospital facilities and equipment. Budget Allocation 2001/02 Mini Budget: $25M Departmental Activity The Hospital Improvement Project will result in better coordination of planning across the Agency’s 5 hospitals and a more systematic upgrade of facilities and equipment. Similarly, the determination of priorities for upgrading remote area clinics will be better informed as a result of information provided by the Remote Area Health Centre Infrastructure Standards Project.
Policy Initiative Establish an Oncology and Radiotherapy Unit for Royal Darwin Hospital. Budget Allocation 2002/03 Mini budget: $2M, 2003/04 $12.47M, 2004/05 $0.96M Departmental Activity The department is analysing relevant patient activity data, related cross border charges, and capital and recurrent operational funding requirements. This initiative will be addressed in the development of capital works programs for 2002/03 and beyond.
Page 33 New Government Policy Initiatives
Policy Initiative Renal Dialysis provision in Tennant Creek. Budget Allocation 2002/03 Mini Budget: $0.41M Departmental Activity DHCS staff held meetings with all key stakeholders in Tennant Creek to develop a holistic renal dialysis service model which will provide haemodialysis services for 8 to 10 patients in the Barkly region. The service will be available to patients in the Barkly region by the end of 2002.
Policy Initiative Increase the number of hospital nurses by 75 and increase nurses’ pay by 15% over the government’s first term. Budget Allocation 2001/02 Mini Budget: $2.76M Departmental Activity A variety of activities are underway including: funding for a re-entry program to nursing; development of a targeted advertising and marketing campaign at a national level and representation at national Nursing Careers Expos. The NT Public Sector Nurses 2001 to 2003 Certified Agreement provided an 11% salary increase over 2 years. The remaining 4% to be considered during March 2003 EBA negotiations.
Policy Initiative Increased staff for Royal Darwin Hospital Emergency Department. Budget Allocation 2002/03 Mini budget: $0.51M, 2003/04 $0.53M and 2004/05 $0.54M Departmental Activity The government will commit $0.5M a year from 1 July 2002 to overcome staff shortages and employ sufficient specialist staff for accreditation. Clinical Implementation Groups are being established.
Policy Initiative Implement 3 point plan to tackle the illicit drug problem in the Northern Territory. Budget Allocation This is to be achieved within existing resources Departmental Activity Establishment of a task force on Illicit Drugs in November 2001.
Page 34 New Government Policy Initiatives
Policy Initiative Increase regional Health Care Teams by 25 personnel, with specialist skills in child health, to visit remote area clinics and provide relief staffing arrangements in communities. Budget Allocation 2001/02 Mini Budget: $0.22M Departmental Activity Additional 25 nurses to be employed by end of 2002/03.
Policy Initiative School health programs, including a pilot nutrition program. Budget Allocation 2002/03 Mini Budget: $0.31M Departmental Activity Most programs to be met within existing resources. In 2002/03, the department will introduce a pilot nutrition program for 500 students in remote areas. The aim of the program will be to provide healthy breakfasts.
Policy Initiative Funding for quality improvement in childcare and an increase the NT child care subsidy by $7.50 per week. Budget Allocation 2002/03 Mini budget: $0.91M Departmental Activity To be implemented from 1 July 2002.
Page 35 Output Performance Reporting
Output Performance Reporting
OUTPUT GROUP/ Number of Refer to Output Measures Page
HOSPITAL SERVICES 12 47 Acute In-Patient Services 8 48 Non Admitted Patient Services 4 54
COMMUNITY HEALTH 7 74 Community Health Education and Development 7 79 Prevention and Early Intervention - - Primary Care - - Continuing Care / Complex Care - -
FAMILY AND CHILDREN’S SERVICES 11 86 Community Development and Skill Enhancement - - Child Care and Development 4 88 Crisis Support 3 90 Child Protection Care 4 90
AGED AND DISABILITY SERVICES 8 93 Community Support Services for Frail Aged People 4 95 and People with a Disability Support for Senior Territorians 4 97
MENTAL HEALTH SERVICES 4 101 Community Programs - - Collaborative Partnerships in Program - - and Service Development
ENVIRONMENTAL HEALTH 7 109 Surveillance Services 3 111 Community Education 4 114
DISEASE CONTROL 9 118 Expertise, Risk Management 4 119 and Surveillance Services Clinical Services and Intervention 5 121
HEALTH PROMOTION 3 130 Community Development 2 130 and Health Education Professional Health Promotion Training 1 131 and Development
ALCOHOL AND OTHER DRUGS 5 133 Community Education 3 134 Treatment, Care and Intervention Services 2 134
MENZIES SCHOOL OF HEALTH RESEARCH 2 152
Page 36 Aboriginal Health
Aboriginal Health
Overview
Improving Indigenous health outcomes is a high priority for the department. Indigenous people comprise 28% of the Northern Territory population with the majority living in remote communities. The poor health status of Indigenous people is highlighted in their mortality and hospitalisation rates.
Figure 11: Indigenous Death Rate for all Causes
18
16
14
12
10
8
6 Deaths per 1,000 population
4
2
0 1991 1992 1993 1994 1995 1996 1997 1998 1999
WA,SA and NT Indigenous Population ALL Australians
Indigenous death rates greatly exceed the corresponding Australian death rates at all ages. The overall death rate for the Indigenous population is more than twice that for the total Australian population. The greatest differences occur in the middle age group of 25 to 54 years. In 2000 the leading causes of death among the Indigenous population were diseases of the circulatory system, external causes of injuries and poisoning and malignant neoplasms. These accounted for 26%, 14% and 14% of Indigenous death respectively.
Cardiovascular disease (CVD) is the leading cause of death among Indigenous people, and occurs at up to twice the rate among Australians. However, CVD accounts for a lower proportion of Indigenous deaths due to the greater relative importance of other causes of
Page 37 Aboriginal Health
death. In 2000, a significantly higher proportion of Indigenous males than Indigenous females died from ischaemic heart disease.
Figure 12: Indigenous Death Rate for Cardiovascular Disease
700
600
500
400
300
Deaths per 1,000 population 200
100
0 1991 1992 1993 1994 1995 1996 1997 1998 1999
WA,SA and NT Indigenous Population ALL Australians
Life expectancy at birth is the number of years that a newborn child can expect to live if the current pattern of death rates in each age group remains the same throughout the child’s life. It is a useful measure of the health status of a population and provides an indication of changes over time between Indigenous and non Indigenous people in the Territory.
There has been an improvement in life expectancy of both Indigenous and non Indigenous Territorians over the last 15 years. The difference between the 2 groups reduced from 19.1 to 16.3 years for males and from 26.1 to 16.7 years for females. It is premature adult death and not excess infant death that accounts for the reduced life expectancy of Indigenous people.
Table 6: Life Expectancy at Birth in Years in the Northern Territory
Male Female Years Aboriginal non Aboriginal Difference Aboriginal non Aboriginal Difference 1986-1990 55.0 74.1 19.1 60.7 86.8 26.1 1991-1995 57.7 74.6 16.9 62.2 83.8 21.6 1996-1999 60.3 76.6 16.3 66.4 83.1 16.7
Source: DHCS Epidemiology Branch
Page 38 Aboriginal Health
Figure 13: Age Adjusted Years of Life Lost (YLLs) Per Thousand Population Northern Territory 1989 to1998
300
250
200
150
100
Years Life Lost per 1000 population 50
0 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999
Indigenous Non-Indigenous Source: Health Gains Planning, DHCS
An additional way of presenting information on health status is years of life lost. This is measured as the difference between average life expectancy for an individual of a specific age, and the age at which that individual actually dies. This is a useful measure to emphasise the effect of diseases or conditions that cause death at an early age.
There has been a reduction in years of life lost, indicating health gains, for the Aboriginal population of the NT. The difference in years of life lost between the Indigenous and non Indigenous population is narrowing, mainly as a result of the improving indigenous infant mortality rate.
Page 39 Aboriginal Health
Figure 14: NT Infant Mortality Rates 1981-1984 to 1997-2000
35.0
30.0
25.0
20.0 Aboriginal Non Aboriginal 15.0
Deaths per 1000 live births 10.0
5.0
0.0 1981-1984 1985-1988 1989-1992 1993-1996 1997-2000 Years
Source: ABS mortality data ABS Births, Australia cat no 3301.0
Table 7: NT Infant Mortality Rates 1980 to 1999
Aboriginal Non-Aboriginal Year of registration Neonatal Postnatal Infant Neonatal Postnatal Infant 1981-1984 13.7 17.6 31.3 9.4 4.0 13.4 1985-1988 15.8 14.7 30.5 5.8 4.2 10.0 1989-1992 14.5 12.7 27.2 5.9 2.6 8.5 1993-1996 13.7 8.3 22.0 5.9 2.0 7.9 1997-2000 10.0 6.9 16.9 3.2 1.1 4.3
Note: Rates are expressed as number of deaths per 1 000 live births ‘Year of registration’ refers to the year that the birth or death was registered with Births, Deaths and Marriages Source: ABS mortality data ABS Births, Australia cat no 3301.0
♦ Infant mortality refers to deaths in the first year of life. The rate of infant mortality is defined as the number of infant deaths within the first year of life per 1 000 live births. Infant mortality is composed of 2 rates: − the rate of deaths in the neonatal period (the first 4 weeks of life)
Page 40 Aboriginal Health
− the rate of death in the post neonatal period (4 to 51 weeks of life) Both rates are important indicators of health status with the neonatal rate reflective of the effectiveness of health services and the post neonatal rate reflective of the prevailing social conditions.
♦ In the NT, Indigenous infant mortality has declined substantially since the early 1980s. In 1981 to 1983 there were 31.3 infant deaths per 1 000 live births and in 1997 to 2000 the rate reduced to 16.9. There are many reasons for this fall in Indigenous infant mortality rates. The main reason is increased access and better resourcing of primary health care services. There is, however, still great disparity between the rates for Indigenous and non Indigenous infants with the Indigenous infant mortality rate almost 4 times the non Indigenous rate. The 35 Indigenous infant deaths recorded in the NT in 2000 comprised 81% of total infant deaths.
Figure 15: Hospital Separation Rates per Thousand Population 1995/96 and 1998/99
Indigenous 700 Non-Indigenous
600
500
400
300
200 Separation rate per 1,000 population 100
0 NT Australia NT Australia 1995/96 1998/99
Source: AIHW Report, Australia’s Health 2000
The hospitalisation rate for the Northern Territory’s Indigenous population is approximately triple that of the non Indigenous population. The most common causes of hospitalisation for Indigenous people included circulatory, respiratory, genito urinary and endocrine diseases and injuries.
For Indigenous people hospitalisation rates increased between 1995/96 and 1998/99 by 22% in the NT and 16% nationally, compared with just a 4% increase for the non Indigenous
Page 41 Aboriginal Health
population in both NT and Australia as a whole. This suggests that Indigenous patients have a higher cost per episode and higher cost per bed day due to a higher degree of complexity and morbidity.
There is widespread recognition and commitment to improve the health status of Indigenous people in the NT. The National Aboriginal Health Strategy 1989 and the NT Aboriginal Health Policy 1996 were developed to tackle longstanding issues in Indigenous health. The Aboriginal Health Forum also plays an important role under Strategy 21 – Directions 2005. This department is committed to:
♦ involving Aboriginal people in planning, administration and delivery of their services
♦ improving access to primary health care
♦ delivering specialist services to remote communities
♦ building partnership with Aboriginal communities
♦ increasing Aboriginal participation in the health work force
♦ collaborating with other agencies involved in education, housing, employment and the environment
♦ developing culturally appropriate health promotion messages and information
♦ delivering greater resources
Page 42 Aboriginal Health
Figure 16: Indigenous / Non Indigenous Admissions 1999 to 2002 NT Government Hospitals
50000
45000
40000
35000
30000
25000
20000
Number of Admissions 15000
10000
5000
0 1998/99 1999/00 2000/01 2001/02 Financial Year Indigenous Total Non Indigenous Total Indigenous Renal Non Indigenous Renal
Expenditure on Indigenous Health
♦ Total provisional expenditure by the department during 2001/02 was $490M. Of this amount, $283M or 57.7% was attributed to the provision of services for Territorians who identified as Aboriginal or Torres Strait Islander. Per capita expenditure for Aboriginal and Torres Strait Islander people was estimated $4 936 per person compared with $1 433 per person for the rest of the population.
Page 43 Aboriginal Health
Figure 17: Health Expenditure per Person
6,000
4,936 5,000
4,378 4,443 4,066 4,000
3,000
2,000 1,433 1,315 1,363 1,380
1,000
- 1998/99 1999/00 2000/01 2001/02
Aboriginal Expenditure Non-Aboriginal Expenditure
Source: Health Gains Planning, DHCS
A comparison between expenditures for 1998/99 and 2001/02 reveals increased per capita expenditure of $871 for the NT Aboriginal and Torres Strait Islander population. The high costs are a combination of the provision of health services to remote locations and a population with a high prevalence of complex health problems. Increased expenditure for hospital services is particularly significant.
Achievements and Health Gains
♦ Work has commenced on the development of 5 Health Zones in Central Australia and 2 Health Zones in the Top End. Refer to page 10.
♦ There are currently 70 communities participating in the Growth Assessment and Action (GAA) program. In Central Australia, there has been a 24% reduction in the numbers of underweight children and a 42% reduction in the rates of stunting between 1999 and 2001
♦ An economic analysis of the GAA program showed that participating children aged 0 to 4 years program were less likely to be admitted to hospital than children from communities not participating in the program
Page 44 Aboriginal Health
♦ Immunisation with the new pneumococcal vaccine of all Aboriginal infants and children up to 5 years in Central Australia, and up to 2 years in the Top End, began on 1 June 2001. Uptake of this vaccine has been high, with 98% of Aboriginal children in remote Aboriginal communities receiving this vaccine with their other routine immunisations. This vaccine should significantly reduce the rate of invasive pneumococcal disease (pneumonia, meningitis and blood infection caused by the pneumococcal bacteria), as well as potentially reducing pneumonia and ear infections
♦ Male Healthy Lifestyle grants of $15 000 each were given to 5 communities across the Northern Territory
♦ Male Health Places were opened at Yarralin and Pirlangimpi
♦ 14 communities were funded to employ Strong Women, Strong Baby, Strong Culture workers
♦ The Central Australian community of Santa Teresa developed a flexible and culturally appropriate case management, support and respite service for community members with disabilities and their carers. Funding has also been allocated for remote service delivery in the East Arnhem region
♦ In 2001/02, 31% of clients accessing Home and Community Care (HACC) services were Indigenous people living in remote communities. An additional 6 remote communities were funded for new HACC services
♦ There was an increase from 4 to 10 places in the department’s Indigenous Cadetship Program
♦ Due to the success of the DHCS Septic Tank Upgrade projects, Aboriginal and Torres Straight Islander Commission (ATSIC) approved the Environmental Health Program to act as grantee of a water supply upgrade involving outstations in Jabiru, East Arnhem and Katherine Regions. 47 remote Aboriginal communities have been identified as a priority to benefit from the project, at a cost of $3.05M
♦ In conjunction with the National Aboriginal Health Strategy Environmental Health Program’ upgrading of septic tank systems was completed at Titjikala, Laramba, and Attitjere Communities and Irrelirre Outstation in Central Australia
♦ In conjunction with the Human Services Training Advisory Council, a pilot scheme was developed offering an apprenticeship on award wages for Aboriginal Environmental
Page 45 Aboriginal Health
Health Worker Trainees in Certificate II. The program takes into account cultural issues and aims at building community capacity
♦ The ‘Safe Food is Good Food’ video research package was produced to assist implementation of National Food Safety Standards in remote community stores. The project was funded by the Commonwealth and is available for use Australia wide
♦ An Early Intervention Against Domestic Violence Project was established in 2 Aboriginal communities. It increased knowledge and awareness of family and domestic violence, increased skills in conflict resolution and provided opportunities for young people to talk about these issues
♦ There is a strong Aboriginal participation in the Pallitative Care Inpatient Unit Building Working Group to oversee the design and construction of a culturally appropriate facility
♦ Aboriginal Health Promotion Incentive Funds assisted a number of community projects across the Northern Territory
♦ The Top End Mental Health Service, Top End Division of General Practice, Batchelor Institute of Indigenous Tertiary Education and the Northern Territory University have developed a partnership agreement to ensure Aboriginal Mental Health Workers receive the training and support they need to carry out their work in remote communities
♦ ATSIC approved the Environmental Health Program to act as a grantee for the $3.05M National Aboriginal Health Strategy – Environmental Health Program (NAHS-EHP) Water Supply Upgrade Project. This project provides a targeted approach to improve water supplies to 47 outstations in the Jabiru, East Arnhem and Katherine regions
♦ ATSIC approved the Environmental Health program to act as a grantee for the $1.65M NAHS-EHP Septic Tank Upgrade Project – Round 2. This project involves the upgrade of septic tanks to required standards in 4 remote communities in Central Australia
Page 46 Hospital Services
Hospital Services
2001/2002 Budget Outcome
Improved local access and culturally effective acute care services.
Overview
The Department of Health and Community Services operates five public hospitals located in the major population centres with a combined total of 569 beds. The hospitals form a network of general and specialist medical services providing primary screening, prevention, acute and chronic care services.
Demands on the public hospital system in the Territory differ markedly from most other parts of Australia due to a combination of factors, including remoteness, small and scattered population and the absence of alternative health care providers.
As a result, public hospitals in the Territory provide a range of acute and non acute services that would not usually be provided in other states. In addition, where specialised treatments and services are not available locally, referrals are arranged for patients between NT based hospitals or to interstate hospitals. These factors, as well as relatively higher costs for transport, fuel, labour and consumables add to the cost of providing hospital services when compared to those accessed by other Australians.
♦ Royal Darwin Hospital Expenditure: $125 777 000
♦ Katherine Hospital Expenditure: $16 409 000
♦ Gove District Hospital (Nhulunbuy) Expenditure: $12 261 000
♦ Alice Springs Hospital Expenditure: $65 282 000
♦ Tennant Creek Hospital Expenditure: $6 303 000
♦ Payment for Territorians treated interstate Expenditure: $21 850 000
Page 47 Hospital Services
Performance Reporting
Output 1 – Acute Admitted Patient Services Target Actual
Quantity HFM weighted inlier equivalent separations (WIES) 43 800 40 509 Quality Beds accredited by the Australian Council on Health Care Standards 60% 62% (National Indicator). Timeliness Elective Surgery waiting times (National indicator) Category 1 admission within 30 days 87% 66% Category 2 admission within 90 days 83% 58% Cost Average variable cost per WIES Alice Springs Hospital $928 Royal Darwin Hospital $1066 Katherine Hospital $863 Gove District Hospital $1 601 Tennant Creek Hospital $1149
Weighted Inlier Equivalent Separations (WIES) is a measure of admitted inpatient activity that varies according to diagnosis and length of hospital stay. The measurement is important as it gives a value to a workload of the hospital rather than simply counting the number of people admitted. The method of calculating WEIS is reviewed annually and revised to reflect any changes in technologies or inefficiencies that may affect hospital costs/workloads.
Table 8: Acute Inpatient Activity – WIES by NT Hospital
1999/00 2000/01 2001/02 1 % Growth 2000/01 – 2001/02 2
Royal Darwin Hospital 21 777 21 775 21 792 0.08% Alice Springs Hospital 10 626 11 438 12 490 9.20% Katherine Hospital 3 207 3 088 3 514 13.80% Tennant Creek Hospital 1 059 845 999 18.17% Gove District Hospital 1 796 1 678 1 712 2.01% Total 38 466 38 827 40 509 4.33% 1 Uncoded records for RDH (727), ASH (666) and KDH (344) are multiplied by 1.08 to approximate the WIES which eventuates once the records are coded. 2 Growth for 2001/02 calculated using WIES 2000/01 and comparing with WIES (inc. uncoded factor) of 2001/02.
Page 48 Hospital Services
The greatest variation in acute inpatient workload measured by WIES occurred in Tennant Creek hospital. WIES increased by 18% but was accompanied by an 11% decrease in the actual WIES cost when comparing this financial year to last year. At Katherine Hospital there was also a significant increase in WIES activity of 14% while the WIES cost increased 3% compared to last year. There was an insignificant variation in WIES activity and WIES costs at Gove District Hospital. Refer to figure 18 below.
Royal Darwin and Alice Springs hospitals recorded growth in WIES activity of 0.08% and 9.2%, respectively, while WIES costs increased by 13% and 8% over last year. Refer to table 8 on page 48.
Factors that contribute to variations in WIES costs include economies of scale, length of hospital stay, complexity of cases, accuracy of coding, recruitment and retention of staff, rostering and overtime arrangements, sick leave and utilisation of agency staff.
Figure 18: Acute Inpatient Activity - WIES by Indigenous Status
14000
12000
10000
8000
6000
4000 Weighted Inlier Equivalent Separations 2000
0 Royal Darwin Alice Springs Tennant Creek Katherine Hospital Gove District Hospital Hospital Hospital Hospital
Indigenous Non-Indigenous
Note: Acute inpatient refers to Hospital Funding Model Generation 6 patient classifications which receive a WIES payment
Page 49 Hospital Services
WIES activity in all Northern Territory hospitals, except Royal Darwin, is proportionately greater for Indigenous patients than for non Indigenous patients. The activity reflects the higher proportion of Indigenous clients in the rural and remote catchment areas of district hospitals compared to the urbanised population profile of the greater Darwin area, which has a higher proportion of non Indigenous residents. Refer to figure 18.
Figure 19: Major Diagnostic Categories 2001/02 – Non Indigenous
4000 25
3500
20 3000
2500 15
2000 WIES
10 1500 Average Length of Stay
1000 5
500
0 0 Pregnancy & Childbirth Musculoskeletal System Digestive System Circulatory System Respiratory System Major Diagnostic Category
WIES 2000/01 WIES 2001/02 ALOS 2000/01 ALOS 2001/02 Figures 19 and 20 show a marked variation in the incidence of hospitalisation for diseases of the respiratory system with WIES activity for Indigenous patients being more than twice that of non Indigenous patients. The respiratory system major diagnostic category (MDC) includes respiratory infections, chronic obstructive airways disease, whooping cough and bronchitis.
Pregnancy and childbirth WIES activity is high for both the Indigenous and non Indigenous groups. Transport arrangements for Indigenous clients from and to remote locations contributes to a greater length of stay as does retention in hospital to give babies a better start on return to their home community.
While the newborns and other neonates MDC category does not appear in the top five MDCs for non Indigenous patients, it is significant for the Indigenous population. Abnormal lengths of stay, of up to 20 days, indicate the seriousness of conditions affecting Indigenous newborns and neonates.
Page 50 Hospital Services
Figure 20: Major Diagnostic Categories 2001/02 – Indigenous
4000 25
3500
20 3000
2500 15
2000 WIES
10 1500 Average Length of Stay
1000 5
500
0 0 Respiratory System Pregnancy & Childbirth Digestive System Newborns & Other Musculoskeletal System Neonates Major Diagnostic Category
WIES 2000/01 WIES 2001/02 ALOS 2000/01 ALOS 2001/02
Figure 21: Same Day Renal Treatment
25000 $14
$12 20000
$10
15000 $8
$6 10000 Total Cost $M Number of Separations $4
5000 $2
0 $0 1992/93 1993/94 1994/95 1995/96 1996/97 1997/98 1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 Financial Year
NT Indigenous NT Non Indigenous Renal Cost Linear (Renal Cost)
Page 51 Hospital Services
The number of renal dialysis treatments continues to grow. The rate of growth accelerated to 19% in 2001/02 compared to 1% in the previous year. Numbers of Indigenous clients continue to escalate at a disproportionate rate.
Figure 22: Average Length of Stay (ALOS) 2001/02 Excluding Same Day
9
8
7 Australian Average
6 Northern Territory Average
5
4 Number of Days 3
2
1
0 Royal Darwin Hospital Katherine Hospital Gove District Hospital Alice Springs Hospital Tennant Creek Hospital
Indigenous Non-Indigenous
Figure 22 demonstrates the relatively longer period of time that Indigenous patients stay in Northern Territory public hospitals compared to non Indigenous patients. It also highlights longer lengths of stay at the Royal Darwin and Alice Springs hospitals. This is primarily due to the complexity and severity of conditions that are treated at the tertiary level hospitals. The graph also shows that the average length of stay in Northern Territory public hospitals is generally below the Australian average.
Page 52 Hospital Services
Figure 23: Hospitals Expenditure 1999 to 2002 WIES/Outpatients/Emergency Attendances
60,000
$248 $250 50,000 $213 $203 $200 $188 40,000
$150 30,000
$100 20,000 Weighted Inlier Separations (WIES) 10,000 $50 Combined Five DHCS Hospitals Expenditure ($M)
0 $0 1998/99 1999/00 2000/01 2001/02
WIES Outpatients Emergency Attendances
Note: Outpatients data not available prior to 2000/01
Hospital costs continued to escalate in the Northern Territory with an average increase of 10.1% in the last financial year. However, public hospital costs in the NT increased by an average 6.1% between the 1998/99 and 2001/02 financial years. This is consistent with a 6.1% average increase in expenditure for hospitals across Australia for the same period, as reported by the Australian Institute for Health and Welfare (AIHW).
The Australian Council on Health Care Standards (ACHS), the leading Australian enterprise in Hospital accreditation, is providing a scheduled independent assessment of quality care provision at each of the NT public hospitals.
At this stage, Royal Darwin Hospital and Katherine Hospital (62% of total beds) have been accredited and within the next financial year the remaining three hospitals will undergo the accreditation assessment.
Page 53 Hospital Services
Output 2 – Non Admitted Patient Services Target Actual Quantity Non Admitted Specialist Clinic occasions of service 131 000 132 684
Emergency Department attendances 99 000 95 403
Provision of 24 hour emergency department access in the five 5 5 hospitals Timeliness Emergency department waiting times (national indicator) Category 1 attended to immediately 100% 100% Category 2 attended to within 10 minutes 70% 67% Category 3 attended to within 30 minutes 70% 69%
All five public hospitals in the Northern Territory maintained 24 hour emergency department access.
Table 9: Percentage of Patients Treated in Emergency Department 2001/02 Royal Darwin Hospital
Triage Proposed Within Time Outside Time Total Patients Percent Treated Category Target Treated within 2001/02 Timeframe Resuscitation 100% 623 623 100.00% Emergency 70% 1 739 626 2 365 73.53% Urgent 70% 8 780 2 102 10 882 80.68% Semi-urgent 15 239 6 626 21 865 69.70% Non-urgent 1 039 169 1 208 86.01% Total 27 420 9 523 36 943 74.22%
Table 10: Percentage of Patients Treated in Emergency Department 2001/02 Alice Springs Hospital
Triage Proposed Within Time Outside Time Total Patients Percent Treated Category Target Treated within 2001/02 Timeframe Resuscitation 100% 100 100 100.00% Emergency 70% 994 663 1 657 59.99% Urgent 70% 5 448 3 608 9 056 60.16% Semi-urgent 9 282 7 159 16 441 56.46% Non-urgent 1 184 192 1 376 86.05% Total 17 008 11 622 28 630 59.41%
Page 54 Hospital Services
Table 11: Percentage of Patients Treated in Emergency Department 2001/02 Katherine District Hospital
Triage Proposed Within Time Outside Time Total Patients Percent Treated Category Target Treated within 2001/02 Timeframe Resuscitation 100% 21 0 21 100.00% Emergency 70% 88 103 191 46.07% Urgent 70% 913 1 047 1 960 46.58% Semi-urgent 4 416 4 107 8 523 51.81% Non-urgent 2 118 625 2 743 77.21% Total 7 556 5 882 13 438 56.23%
Table 12: Percentage of Patients Treated in Emergency Department 2001/02 Tennant Creek Hospital
Triage Proposed Within Time Outside Time Total Patients Percent Treated Category Target Treated within 2001/02 Timeframe Resuscitation 100% 23 0 23 100.00% Emergency 70% 50 29 79 63.29% Urgent 70% 400 213 613 65.25% Semi-urgent 1 954 732 2 686 72.75% Non-urgent 4 183 485 4 668 89.61% Total 6 610 1 459 8 069 81.92%
Table 13: Percentage of Patients Treated in Emergency Department 2001/02 Gove District Hospital
Triage Proposed Within Time Outside Time Total Patients Percent Treated Category Target Treated within 2001/02 Timeframe Resuscitation 100% 11 0 11 100.00% Emergency 70% 41 10 51 80.39% Urgent 70% 359 73 432 83.10% Semi-urgent 1 575 159 1 734 90.83% Non-urgent 5 915 177 6 092 97.09% Total 7 901 419 8 320 94.96%
The target for category 1 patients (all patients to be attended to immediately) was achieved across the five public hospitals.
The target for category 2 patients (70% of patients to be attended to within 10 minutes) was not met on a Territory wide basis with only 67% attended to within the allocated time. Royal Darwin and Gove District hospitals exceeded the target with results of 74% and 80%, respectively. At Tennant Creek Hospital 63% were attended to within the allocated time while Alice Springs and Katherine hospitals achieved 60% and 46%, respectively.
Page 55 Hospital Services
The target for category 3 patients (70% of patients to be attended to within 30 minutes) was not met on a Territory wide basis with only 69% attended to within the allocated time.
Royal Darwin and Gove District hospitals exceeded the target with results of 81% and 83% respectively. At Tennant Creek Hospital 65% were attended to within the allocated time while Alice Springs and Katherine hospitals achieved 60% and 47% respectively.
Achievements
♦ The Northern Territory Government is committed to providing best practice medical care in our hospitals. To achieve this, the Hospital Services Branch and NT Hospitals are working together within a hospital improvement framework to ensure that Territorians have access to safe and appropriate acute care services. ♦ Under the Commonwealth Advanced Specialist Training Posts in Remote Area program, 3 posts are funded to support recruitment and retention of medical specialists in rural and remote areas of Australia. ♦ An arrangement between the Commonwealth of Australia, the Repatriation Commission and the Northern Territory (NT) was introduced to improve the quality of services for the veteran community. ♦ Arrangements were introduced to enable remote area Aboriginal health services to participate in the supply of pharmaceuticals under the Commonwealth Pharmaceutical Benefits Scheme. This led to an increase in funding of approximately $2.5M through reimbursements to DHCS and was subsequently applied to chronic disease prevention and quality use of medicines initiatives. ♦ Review and evaluation of medication policy in the Northern Territory resulted in the development of guidelines for medication management in DHCS remote health centres and increased frequency of pharmacist visits to the centres for the purpose of pharmacy audit and education. ♦ A hospital information management group was established to improve the quality of hospital data. ♦ A special project to develop a standard medication management and reporting system led to increased reporting of medication incidents and will better inform development of system analysis and improvements. ♦ An evaluation of the 12 month trial of AIMS resulted in the development of an evaluation tool which was used as a basis for a national review of AIMS by the Australian Patient Safety Foundation. This led to the development of subsequent improvement versions of AIMS, and the implementation of AIMS in all NT public hospitals.
Page 56 Hospital Services
Royal Darwin Hospital
Overview
Royal Darwin Hospital (RDH) is a 295 bed facility, including 25 mental health beds as part of Top End Mental Health. RDH services the vast area of the Darwin, rural and remote regions.
A major activity for RDH has been continued work on redevelopment. This will result in a new and improved Emergency Department, Intensive Care Unit, Coronary Care Unit and Operating Theatres. The redevelopment will also house a new High Dependency Unit, a service not previously offered at RDH.
Construction has progressed steadily. A project team, consisting of representatives of RDH, the construction firm Sitzler Barclay Mowlem Joint Venture and the Department of Infrastructure, Planning and Environment, meets regularly to oversee progress.
RDH worked diligently to meet the departmental goal of increasing the Aboriginal work force. RDH has a proud record of employing Aboriginal Health Workers and Aboriginal Liaison Officers. The Aboriginal Interpreter Service was continued during the year and 5 Aboriginal trainees were employed.
Construction continues at RDH
Page 57 Hospital Services
Outputs
Services provided include: ♦ a major teaching and reference hospital for northern Australia and South East Asia including rural and remote training placements for doctors
♦ delivery of services through staff or visiting specialists in the areas of cardiology, dermatology, emergency medicine, ear nose and throat, endocrinology, forensic pathology, gastroenterology, infectious diseases, intensive care, general medicine, hyperbaric medicine, microbiology, neurology, neurosurgery, oro-maxillo facial surgery, obstetrics and gynaecology, oncology, ophthalmology, orthopaedics/trauma, paediatrics, paediatric respiratory, pain, plastic reconstructive surgery, psychiatry, radiology (including nuclear medicine, CT scan and MRI), rehabilitation services, renal, reproductive medicine, adult respiratory medicine, rheumatology, sleep studies, spinal, anatomical pathology, general surgical and urological and anaesthetics
♦ allied health services including prosthetics and orthotics, physiotherapy, occupational therapy, speech pathology, social work, Aboriginal liaison, audiology, nutrition/dietetics, ECG/EEG, hospital chaplaincy, interpreter services and Seating, Equipment and Technical (SEAT)
♦ delivery of outreach services in a range of specialty and allied health areas through the Palmerston Health Precinct
♦ hospital in the home services
♦ support services including food services, linen services and sterilising
♦ pharmaceutical services that cover not just RDH but also surrounding community areas.
♦ special outreach services in conjunction with the Commonwealth Government
♦ volunteer participation in delivery of services to patients
Page 58 Hospital Services
Achievements
♦ Royal Darwin Hospital’s Emergency Procedures Manual was announced as the winner of the Federal/State Government Post Disaster Category in the Australian Safer Communities Awards. RDH’s manual was described as a model for other organisations. Judges suggested that other Australian hospitals could adopt the same approach.
♦ In February 2002, RDH staged an inaugural Safety Week, highlighting occupational health and safety requirements and issues to staff. The week included poster competitions, information sessions and awards. This resulted in an increased awareness of OH & S issues.
♦ An educational video entitled Operation Story was produced to help broach cultural and communication barriers between Indigenous patients and staff. The video involved cooperation between the Department of Anaesthesia, the Aboriginal Liaison Service and the Territory’s Aboriginal Interpreter Service. A steady stream of orders and inquiries has been received from around the country.
♦ LifeNet NT was launched in November 2001. This is the first time there has been a dedicated service for organ donation in the Territory. The service includes the appointment of a coordinator based at RDH. Refer to page 13.
♦ The Department of Emergency Medicine was reaccredited for advanced emergency physician training. The department lost accreditation in May 2000 and has worked tirelessly to improve performance, increase medical staff and reengineer the processes necessary to regain accreditation.
♦ The Paediatric Department had its accreditation upgraded to 2 years for basic paediatric training.
♦ RDH was also accredited for a 2 year period as a general teaching hospital by the Royal Australasian College of Physicians’ Committee for Physician Training.
♦ The RDH Management Board sponsored the production of the inaugural RDH Year In Review, a comprehensive report of the hospital’s achievements. The publication was launched by the Minister for Health and Community Services, the Hon. Jane Aagaard, in December 2001.
♦ The RDH Auxiliary celebrated its 20th birthday with an event sponsored by the Hospital Management Board. The auxiliary has raised thousands of dollars to purchase a range of equipment and furnishings to improve the comfort of patients during their stay in hospital.
Page 59 Hospital Services
♦ A Patient Educator was appointed to help people from East Arnhem take advantage of the health services they receive in the hospital.
♦ RDH was awarded a research grant from the Royal College of Pathologists of Australasia (to Dr Ronan Murray, Microbiology Registrar) to examine the factors behind the emergence of Staphylococcus aureus in the Top End of the NT.
The grant will allow further research into the treatment of septic shock patients with a product called G-CSF, which has reduced the fatality rate of patients, particularly those suffering melioidosis or meningococcal. In the 10 years prior to the introduction of G-CSF, only 1 of 21 patients survived melioidosis septic shock. Since the start of the trial, 16 out of 18 patients have survived.
♦ A second intensive care specialist was appointed in June 2002.
♦ A hospital based police officer was introduced to assist and provide advice on a range of issues including criminal and associated problems affecting delivery of service.
♦ An inaugural Burns Awareness Week was staged in conjunction with NT Fire Service, St John Ambulance and KidSafe representatives.
♦ A zero tolerance policy was formulated in relation to aggression within the hospital. This included public awareness signage, staff inservicing on aggression management and installation of additional duress alarms for clinical areas.
♦ Policy and training guidelines were developed for RDH volunteers.
♦ Pamphlets were produced for maternity patients to improve communication and create better understanding of care options.
♦ Donations from the ‘Bluey Day’ appeal were used to purchase equipment to create an adaptable transportation unit for neonatal retrieval and transfer.
♦ Fire safety training was provided to more than 1200 staff.
♦ Occupational therapy services were provided to Palmerston Health Precinct for patients living in Palmerston and the rural area.
♦ Development of the cleft lip and palate clinic continued to increase the number of patients seen.
Page 60 Hospital Services
Katherine Hospital
Overview
Katherine Hospital is a 60 bed facility servicing the Katherine Region, which covers approximately 340 000 kilometres between the Western Australian and Queensland borders extending as far as Dunmarra in the south and Pine Creek in the north. The area has a population of approximately 19 000 with an annual tourist presence in excess of 500 000 visitor nights.
Katherine Hospital management liaises closely with Wurli Wurlinjang Aboriginal Health Service to ensure collaboration, continuity of services for clients and a reduction in service duplication. Hospital management also has regular contact with Katherine West Health Board and cooperates with the new Sunrise Coordinated Care Trial.
Outputs
Services provided: ♦ general medical, diagnostic and treatment services ♦ general surgery, paediatrics, medicine, gynaecology, ophthalmology, ear nose and throat, orthopaedics, cardiology and paediatric cardiology specialist services ♦ a 4 chair renal dialysis unit ♦ participation in the Royal Australian College of General Practitioners training program and the training program for overseas doctors ♦ placement for nursing and allied health students from various universities
Page 61 Hospital Services
Achievements
♦ Katherine Hospital received 4 year accreditation through the Australian Council on Healthcare Standards (ACHS). Accreditation demonstrates to staff, clients and the community that Katherine Hospital is committed to safety and quality of services within available resources. ♦ The midwifery ward achieved accreditation as a Baby Friendly Hospital through the Australian Council of Midwives. ♦ The Pathology Department received full National Association of Testing Authorities (NATA) and ISO 17 025 accreditation. ♦ The Renal Unit increased the number of daily dialysis episodes from 4 per day to 8 per day while operating 6 days a week. ♦ The Palliative Care Unit has been upgraded and refurbished to provide more comfortable accommodation for clients and their families. ♦ Cultural and ethical issues were promoted through the employment of Aboriginal Health Workers and Aboriginal Liaison Officers. Issues addressed included: − encouragement for mothers or carers of babies admitted to hospital to board with them during their stay − recognition of men’s health issues for Aboriginal men in hospital. ♦ Visiting specialist appointments have been maintained. This has resulted in: − continued client access to specialist appointments − limited need for patients to travel to Darwin for appointments. ♦ Episodes of acute care increased from the previous financial year. ♦ Average length of stay decreased from the previous financial year which: − lowered cost per episode of care − decreased the chance for hospital acquired infection.
Page 62 Hospital Services
Figure 24: Episodes of Acute Care - Katherine Hospital
600
500
400
300
200
100
0
Oct Dec Jan Feb July Aug Sept Nov April May June March
1999/2000 2000/2001 2001/2002
Note: Discharge Episodes of Care (excluding boarders/including renal dialysis day patients)
Figure 25: Average Length of Stay - Katherine Hospital
4.5
4
3.5
3
2.5
2 Number of Days 1.5
1
0.5
0
July April May June August March October January February September November December Month 1999/00 2000/01 2001/02
Page 63 Hospital Services
Gove District Hospital
Overview
Gove District Hospital (GDH) is a 30 bed facility located in Nhulunbuy, servicing the East Arnhem District. Approximately 14 000 people live in 12 main communities as well as numerous smaller Aboriginal homelands located on the mainland and adjacent islands. As part of the Top End Service Network, the GDH business plan and Hospital objectives are in line with the directions of Strategy 21 – Directions 2005. Outputs
Services offered by the Hospital include:
♦ a 24 hour accident and emergency service
♦ general surgical, medical and paediatric care
♦ elective and emergency surgery
♦ gynaecological and obstetric services
♦ routine medical visits to various remote communities and assistance with emergency evacuations of clients from those communities
♦ support services including radiography, pharmacy, physiotherapy, pathology, occupational therapy and dietetics
GDH supports a number of visiting specialists including:
physicians surgeons paediatricians ear nose and throat specialists gynaecologists psychiatrists ophthalmologists
Page 64 Hospital Services
Achievements
♦ Gove District Hospital has undertaken the process of accreditation and is progressing well towards achieving accreditation when assessed in November 2002. ♦ A consistent level of patient activity was maintained as shown in the figure below. ♦ Hospital facilities have been upgraded to meet current cyclone standards. ♦ A new analyser was installed in the pathology department. ♦ Improvements were made to imaging services with recruitment of a radiographer/ sonographer. ♦ New patient menus were introduced to improve the selection of traditional foods being offered. ♦ Gove Hospital maintained full staffing levels, bringing total medical staff to 9 doctors and 40 nurses.
Figure 26: Number of patients treated – Gove District Hospital
1800
1600
1400
1200
1000
800 Number of of patients Number 600
400
200
0 1998/99 1999/00 2000/01 2001/02
Indigenous Non-Indigenous
Summary
GDH continues to support and strengthen surrounding communities through the supply of hospital services in Nhulunbuy and visiting services to the communities of Arnhem Land.
Page 65 Hospital Services
Alice Springs Hospital
Overview
Alice Springs Hospital (ASH) is a 164 bed teaching hospital servicing the Central Australia Region, and is the primary referral centre for the Tennant Creek Hospital. The catchment area covered is approximately 1 000 000 square kilometres between the Western Australia, Queensland and South Australia borders and extending north to Elliott. The area has a population of approximately 42 500 people with an average of 4 200 tourists receiving medical assistance each year. The closest major referral centres are Darwin and Adelaide, both over 1 500 kilometres from Alice Springs.
In addition to hospital beds, ASH manages the Renal Dialysis Unit at the Community Health Centre, Flynn Drive. This has the capacity for 26 haemodialysis chairs, provides outreach services for patients receiving peritoneal dialysis and coordinates renal transplantation services.
Construction for hospital redevelopment began in July 2000 and was completed in April 2002. Hospital services were maintained during construction and work was completed approximately 5 months ahead of schedule. A private patient wing of 15 beds was completed in the redevelopment and awaits the confirmation of a provider.
A nursing station in Alice Springs Hospital
Page 66 Hospital Services
Stage 4 of the redevelopment of Alice Springs Hospital is now complete. Stage 5 will include upgrades to: − pathology − Central Sterilizing Department − Emergency Department − Radiology − staff accommodation − basement and administration − a step down facility − lecture theatre − office space and stores − GP services − library services − hydrotherapy pool
Outputs
Services provided are: ♦ general allied health, diagnostic and treatment services ♦ general surgery, paediatrics, medicine, obstetrics and gynaecology, ophthalmology, ear nose and throat, orthopaedics, emergency medicine, anaesthetics and intensive care ♦ visiting medical officer service providing neurology, neurosurgery, oncology, rheumatology, urology, cardiology, respiratory, pain service, gastroenterology, plastic surgery, sleep studies, allergy service, dermatology, rehabilitation medicine, endocrinology ♦ renal services including haemodialysis for 78 patients and outreach services for peritoneal dialysis patients ♦ the only 24 hour emergency service available to Central Australians, fulfilling a retrieval and interhospital transfer role in conjunction with district medical officers and the Royal Flying Doctor Service ♦ outreach services to rural communities for eye clinics, ear nose and throat clinics, paediatric services, and orthopaedic clinics ♦ continuation of the Structured Training and Employment Program (STEP) for Aboriginal people and the School Leavers Training Program for the Business and Administration Certificate
Page 67 Hospital Services
Achievements
♦ Opening newly redeveloped services, including: − Operating Theatres − Day Procedure Unit − Intensive Care Unit and High Dependency Unit − Outpatients and Main Entry − Chapel − Pharmacy − Medical Records − Surgical Ward − Medical Imaging − Paediatric Ward, Outpatients and Administrative Area.
♦ Upgrade of patient related areas including: − all wards − expansion of physiotherapy and rehabilitation − Aboriginal liaison − main entry − cafeteria − additions to radiology and emergency.
♦ Ward clerk coverage in all patient ward areas improved.
♦ Change to the organisational structure, including increased executive membership to the executive meeting and introduction of key management committees to review the budget, clinical practices and quality.
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♦ 2001/02 inpatient activity as a measure of Weighted Inlier Equivalent Separations (WIES) of 9.2%
Figure 27: Weighted Separations - Alice Springs Hospital
1400
1200
1000
800
600
400 Number of Weighted Separations
200
0
July April May June August March October January February September November December
Indigenous Non-Indigenous Total
♦ Stage 4 of the Hospital redevelopment was completed under budget. Of a total budget allocation of $30M, actual expenditure was approximately $29.1M, resulting in a saving of approximately $900 000.
Page 69 Hospital Services
Figure 28: Average Length of Stay - Alice Springs Hospital
7
6
5
4
3 Number of Days
2
1
0
July May April June March August October January February November December September
Indigenous Non-Indigenous Average
♦ Average length of stay increased from 3.48 to 3.86 days. Aboriginal patients occupied 77% of available beds.
♦ The average waiting period for elective surgery increased due to urgent admission requirements and a shortage of theatre nursing staff.
♦ Additional patient service assistant positions were established for emergency, night duty adult wards, x-ray, operating theatre, outpatients and paediatrics to alleviate expanding workloads previously covered by nursing staff.
Page 70 Hospital Services
Tennant Creek Hospital
Overview
Tennant Creek Hospital is a 20 bed facility servicing the 6 000 residents of Tennant Creek and the Barkly Region. The region covers 250 000 square kilometres from just north of Ti Tree in the south to Elliott in the north, and east to the Queensland border.
The Tennant Creek campus houses the hospital, community care, health development, family and children’s services, and general practitioner and dental surgeries, providing a wide range of services at a single point. This integrated approach facilitates the provision of support services to the hospital, including: ♦ radiology ♦ pharmacy ♦ pathology ♦ physiotherapy ♦ speech and occupational therapy ♦ disease control and dietetics
Outputs
Services provided are: ♦ Accident and Emergency services ♦ Aerial medical retrieval and inter hospital transfer service ♦ Medical, surgical, midwifery and paediatric inpatient services ♦ Diagnostic services ♦ Visiting specialist services – Orthopaedic Surgeon, General Surgeon, Ear Nose and Throat Surgeon, Ophthalmologist, Paediatrician, Gynaecologist ♦ Day Surgery and minor procedures
Page 71 Hospital Services
Achievements
♦ Significantly, both ear nose and throat (ENT) and ophthalmic surgery commenced in Tennant Creek in November 2001, reducing the need for patients to travel. This was supported by the purchase of additional equipment and related staff training. ENT outpatients consultations increased by 96% over the year.
♦ Funding for a Tennant Creek renal dialysis unit saw construction of a 3 chair interim dialysis unit commence in April, with treatments expected to commence in August 2002. This unit is located within the existing hospital building. The establishment of a Community Renal Management Board that includes other health care providers, social services providers, and community and client representatives demonstrates commitment to community involvement. The interim unit is capable of treating 8 to 10 clients, and will mean the return of dialysis patients to Tennant Creek.
♦ Increased surgical services have reduced patient travel and related costs.
♦ Additional support is obtained from Family and Children’s Services (FACS), a full time Aboriginal Liaison Officer and 2 full time Aboriginal Health Workers. The Aboriginal Interpreter Service is used regularly at the hospital, particularly in the day surgery setting. This support ensures that services are provided in a culturally appropriate manner.
♦ The Tennant Creek Hospital commenced the process of accreditation in February 2002 with the Australian Council on Healthcare Standards (ACHS). This is supported by the employment of a full time Accreditation Coordinator and a joint Quality Manager/Nursing Director. To date, widespread consultation with staff and management has led to successful completion of workbooks required by ACHS. The hospital’s accreditation survey is scheduled for December 2002.
♦ An increase of 25.5% in total bed days was recorded for the year 2001/02.
Page 72 Hospital Services
Figure 29: Total Bed Days - Tennant Creek Hospital
500
450
400
350
300
250
200
150
100
50
0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun
2000/01 2001/02 ♦ An overall increase in Day Surgery discharges from 32 (2001) to 55 (2002), representing a 71% increase.
Figure 30: Day Surgery Unit Discharges - Tennant Creek Hospital
12
10
8
6
Number of Discharges 4
2
0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Months
2000/01 2001/02
Page 73 Hospital Services
♦ An increase in most specialist outpatients was recorded, with an overall increase of 27% from the previous financial year.
Figure 31: Specialist Outpatients Attendances - Tennant Creek Hospital
350
300
250
200
150 Number of Attendances 100
50
0 Gynaecologist Surgical Orthopaedic Ear Nose & Throat Opthal. Specialist
2000/01 2001/02 ♦ Outpatient attendances for specialist services increased in most categories.
Page 74 Community Health
Community Health
2001/2002 Budget Outcome
The burden of ill health in the community and the need for hospitalisation will be reduced by increasing the capacity of individuals and families to improve and maintain their health.
Overview
Community Health builds the capacity of the community to maintain and improve health through education, development, prevention and early intervention activities. It also ensures access to culturally appropriate assessment, treatment and support services in the community.
Community Health Services (CHS) develops solutions to health issues in partnership with the community. It aims to reduce the burden of ill health in the community and the need for hospitalisation.
Outputs
CHS encompasses services such as: ♦ general practice ♦ hospital emergency departments and pharmacies ♦ community based care to support people in their own homes ♦ illness prevention and early detection, through maternal and child health, nutrition and population health programs
Services are delivered via a network of government, non government and Aboriginal medical services and private providers across urban, rural and remote communities. Program objectives are similar but modes of service delivery differ to address the individual needs and available community resources. Some community health services may be provided in people’s homes.
Page 75 Community Health
The community health workforce is distributed across the Northern Territory and comprises:
♦ allied health professionals ♦ district medical officers ♦ community nurses ♦ Aboriginal health workers ♦ general practitioners in private practices, ♦ dentists or as salaried staff of community controlled Aboriginal health services.
To achieve community health objectives, CHS collaborates with other program areas within DHCS. It also incorporates relevant aspects of Departmental Strategies.
The Community Health Program is comprised of several key services: Primary care Primary care provides prevention, early intervention and treatment services in community health centres and general practices. Primary care at the community level offers a more effective and culturally appropriate approach to health issues than hospital care.
Policy and strategic planning The focus is on community health, physical activity, nutrition, primary health care and male health. Working in partnership with other government and non government primary health care providers, the Community Health Program explores new and innovative ways to improve access to primary care services in rural and remote areas.
Primary Health Care Access Program (PHCAP) In a national first, the department is working with the NT Aboriginal Health Forum to develop health zones. The health zones concept supports groups of remote Aboriginal communities to take greater control of the health care services they receive. Zones establish their own health boards, which advise and make decisions on health priorities and services for their communities. Refer to page 10.
Page 76 Community Health
Nutrition Services are delivered by community nutritionists, Aboriginal nutrition workers and Aboriginal health workers. The priority focus areas are:
− maternal and child health − food and nutrition monitoring − nutrition education in schools − community nutrition worker program − growth assessment and action (GAA) program − food supply and healthy lifestyle through the remote stores projects
Oral health Services are provided to primary school children, high school children and disadvantaged people. Figure 32: Services delivered by dentists and dental therapists
mobile dental clinics
remote dental clinics
school dental clinics Type of Dental Clinic
dental clinics
0 5 10 15 20 25 30 35 40 45 50 Number of Dental Clinics
Maternal and child health Services delivered emphasise the following: − disease prevention − early identification and management of health problems − immunisation − health promotion − health education, provided by multidisciplinary health teams.
Page 77 Community Health
Palliative Care Palliative Care is coordinated by a team of medical, nursing, allied health and volunteer workers.
Domiciliary Care Domiciliary care aims to support people in their homes according to assessed need. Services are provided in the home by a team of nursing and allied health professionals. Through treatment, education, specialist support and coordinated care people are supported to achieve health and independence in a safe, familiar environment.
Hearing services Audiological and audiometric care and Hearing Health Training is provided by audiologists and nurse audiometrists from district based Hearing Centres and Remote Health Centres.
Emergency and retrieval services Emergency and retrieval services comprise:
− NT Aerial Medical Service (Top End) − Royal Flying Doctor Service (Central Australia) − outsourced aviation (Barkly) − accident and trauma services − St John Ambulance − Hospital Emergency Departments.
Patient being transferred by NT Aerial Medical Service
Page 78 Community Health
Performance Reporting
Output 1 – Community Health Education and Development Target Actual
Quantity NGOs Funded 53 53
Total value of NGOs funded 16 600 000 16 603 000
Community Health Service Hours – Urban 426 500 426 560
Community Health Service Hours – Rural 934 000 934 230
Community Health Events – Urban 149 500 149 600
Costs Average cost per Service hour – Urban 37.00 37.10 Average cost per Service hour - Remote 31.00 31.90
Some non government organisations received first quarter payments at the end of the previous financial year.
The National Heart Foundation received a grant to partly fund an Indigenous Male Health Promotion officer to support the implementation of healthy lifestyle programs in selected communities.
An Aboriginal Nutrition Workshop was held at Springvale Homestead to explore nutrition issues that affect Aboriginal people. The workshop was attended by approximately 200 people representing 40 communities and organisations from across the NT.
Page 79 Community Health
A grant of $80 000 was provided to Menzies School of Health Research to evaluate the Growth Assessment and Action (GAA) program and collect baseline data on child health.
Biannual reports were distributed to approximately 70 communities. These reports contain community level data on growth status of the 0-5 year population as part of the Growth Assessment and Action (GAA) Program. Since 1999, the prevalence of malnutrition has fallen by 25% and the rate of anaemia has fallen by over 20% in Central Australian remote communities.
Figure 33: Growth rate of children 0-4years in Alice Springs Rural District
10
9
8
7
6
5
4
3 Percent of Children
2
1
0 Underweight Wasted Stunted
1999 2000 2001
Male Healthy Lifestyle grants of $15 000 each were given to 5 communities throughout the Northern Territory.
An advisory committee was formed to develop an NT wide program to encourage greater participation in physical activity. Representation on this committee includes: National Heart Foundation, Department of Community Development Sport and Cultural Affairs, Local Government Association of the Northern Territory, Menzies School of Health Research, Life Be in it, Division of General Practice, Diabetes Australia and ATSIC.
An NT Indigenous Ear Health and Hearing Strategic Plan is being developed in collaboration with AMSANT, the Commonwealth, ATSIC, the Department of Education, Employment and Training (DEET), Batchelor Institute of Tertiary Education and Australian Hearing.
Page 80 Community Health
5 health zones in Central Australia are soon to select a consultant. Each consultant will work with their steering committee to develop a strategic plan, which will encompass service delivery and community control aspects of their health service.
2 funded health zones have been announced for the Top End.
A market basket survey of 54 remote community stores has been completed to monitor the cost, availability and quality of foods. A Territory wide report was produced and distributed.
Resource and policy guidelines for nutrition have been developed for remote community takeaway food premises. A recipe book for takeaway workers was also distributed.
The Good Food Store Project was launched. This is a joint project between DHCS, Unilever and Arnhem Land Progress Association to promote healthy recipes and healthy food on communities.
7 communities received grants to employ local Aboriginal people to run nutrition programs.
In collaboration with the Department of Education, a nutrition resource for primary schools, the NT Hunting for Health Challenge has been developed and launched. In 2001, 40 schools, 104 teams and approximately 2600 children participated in the challenge.
The National Health and Medical Research Council (NHMRC) funded a 3 year community based model of health promotion at Yuendumu. A total of $77 000 will be granted over the 3 year period.
Page 81 Community Health
Output 2 - Prevention and Early Intervention Northern Territory Hospital pharmacies distributed 98 909 vaccines in 2001/02.
14 communities received grants to employ local Aboriginal women to run the Strong Women, Strong Babies, Strong Culture program (SWSBSC).
Strong Women, Strong Babies, Strong Culture Program Figure 34: Birth weights of children born within communities with a Strong Women, Strong Babies, Strong Culture Program
3200
3150
3100
3050
3000 Average birthweightin grams 2950
2900
2850 1988-89 1990-91 1992-93 1994-95 1996-97 1998-99 2000-01
Group 1 Group 2 Controls Note: Group 1 – Communities, with below average birth weights, that initiated the SWSBSC program in 1993 Group 2 – Communities, with below average birth weights, that joined the program in 1996 and1997 Control group – Communities without the Strong Women Strong Babies Strong Culture program Source: Health Gains Planning Unit
Page 82 Community Health
Output 3 - Primary Care
6 Community Care/Health Centres provide primary care services in urban locations throughout the NT. 3 annexes in Darwin focus specifically on maternal and child health. In areas outside the major centres, DHCS provides primary care services from 63 health centres and purchases additional primary care services from local health boards or local councils in a further 30 community locations.
Memoranda of understanding between DHCS and employers of 5 general practitioners resident in remote communities were signed. Communities include: ♦ Alyangula ♦ Galiwinku ♦ Ntaria ♦ Numbulwar ♦ Gunbalunya
5 137 medical flight evacuations were funded by DHCS.
2 male health centres opened at Yarralin and Pirlangimpi.
The main oral health service delivery outlet will be relocated from Darwin CBD to Casuarina. This aims to improve access as the majority of clientele live in this area.
Figure 35: Number of Dental Visits
40000
35000
30000
25000
20000
Number of Visits 15000
10000
5000
0 1992/93 1993/94 1994/95 1995/96 1996/97 1997/98 1998/99 1999/00 2000/01 2001/02 Financial Year
NT Aboriginal NT Non Aboriginal Male Female
Page 83 Community Health
Output 4 - Continuing/Complex Care
The following graph demonstrates an increase of gynaecology specialist outreach services to remote clients. Increased remote consultations have led to a reduction in gynaecology referrals to the Outpatients department at RDH.
Figure 36: Impact of Remote Area Outreach on RDH Gynaecological Consultations
1800
1600
1400
1200
1000
800
600 Number of referals patients 400
200
0 1995 1996 1997 1998 1999 2000 2001
RDH Outpatients Department Remote Outreach
Page 84 Community Health
Figure 37: Place of Death 1998/99 to 2001/02 by Region
160
140
120 Other Home 100 Hospital
80
60 Number of Deaths
40
20
0 1998/99 1999/2000 2000/2001 2001/2002 1998/99 1999/2000 2000/2001 2001/2002
Top End Service Network Central Australian Service Network
229 clients received palliative care. This does not include bereaved clients.
The delivery of accredited palliative care education was outsourced to the Northern Territory University, resulting in access by a wider range of health professionals. Palliative care is now available as an undergraduate unit for nursing and allied health students and as a postgraduate unit within a general science degree. In the first semester, 20 internal and 42 external students enrolled in the units.
Page 85 Family & Children’s Services
Family and Children’s Services
2001/2002 Budget Outcome
Individuals, families and communities are supported to maintain social independence, overcome crisis and protect children from harm.
Overview
The Family and Children’s Services Program administers NT and Commonwealth funds to provide services for the protection and care of children and the improvement of individual and family wellbeing. Some services are available to all families in the NT. Others are targeted to meeting the needs of specific groups of people including children and young people whose families are unable to safely care for them.
Objectives are to: ♦ promote responsibility and growth in family and community life ♦ ensure families, children and individuals grow in safe, supportive and culturally appropriate communities ♦ encourage families, children and individuals to reach their full potential.
The Family and Children’s Services Program has 3 strategic directions to guide future action. These directions are consistent with Strategy 21 – Directions 2005 and aim to strengthen community capacity by supporting families and individuals to grow and participate fully in community life. The key directions are: ♦ individuals, families and communities are supported to be independent and develop capacity to improve their own well being ♦ individuals and families are supported through crisis ♦ children are protected from harm and their future wellbeing is enhanced.
A client focused approach is taken across a continuum of services including: ♦ support for children’s care and development, and assistance for parents ♦ prevention of child maltreatment ♦ crisis and medium term accommodation for adults and young people who are homeless ♦ counselling and family support assistance to people in crisis including survivors of domestic violence and sexual assault ♦ provision of substitute care for children unable to live with their families.
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Performance Reporting
Output 1 - Community Development and Skill Enhancement
The family is one of the fundamental building blocks of society. Supporting families and communities is a major way for the government to help improve the health and wellbeing of all Territorians.
Individuals, families and communities are supported to maintain independence through community education, information and skill enhancement.
In 2001/02, Family and Children’s Services: ♦ worked with the Commonwealth to ensure its initiatives, particularly the Strengthening Families and Communities Strategy, coincide with NT priorities
♦ conducted 5 regional forums with non government service providers to plan services for families and children
♦ strengthened advisory mechanisms under the Supported Accommodation Assistance Program (SAAP) Agreement to ensure more community input into government decision making
♦ provided grants to 17 organisations to develop staff skills to improve services to clients
♦ arranged the 'Jannawi Kids' Territory tour which provided training to 230 people who work with children who have experienced family violence
♦ improved access to a range of parenting information and support services for families with dependent children by:
− training 20 organisations in the adolescent Triple P-Positive Parenting Program so they can support parents with teenage children − providing 200 parents with adolescent Triple P-Positive Parenting Program information and training.
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Output 2 - Childcare and Development Target Actual
Quantity Licensed child care centre places 2 512 2 556
Early childhood development and parent support services 28 29
Quality Substantiated complaints against child care centres 0 5
Accreditation status of child care centres1: 48 46 accredited 0 2 not accredited or not yet assessed
Services delivering this output provide children’s day care for: working parents and parents participating in other activities; early childhood learning and development activities and parenting information and education. Services funded by the NT Government include child care centres, kindergartens, toy libraries, mobile services and positive parenting programs.
Childcare – providing opportunity for social interaction
1 There were 54 licensed child care centres as at 30 June 2002 while 48 centres were required to participate in the accreditation process.
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Figure 38: Access to licensed Child Care Places
6000
5000
4000 child care centre places
projected population 0-4 years, 2002 3000
2000
1000 Total NT Population aged 0 - 4 years, 2002
0 Darwin Palmerston & Rural Alice Springs Regional Urban Remote Centres
Note: Access to child care centre places is based on the number of licensed child care places (excluding 3 year old Kindergartens) and projected 2001 population data from Australian Bureau of Statistics. This data differs from previous years in that it is based on the total 0 – 4 year old population, rather than children whose parents are in the work force or training.
Accreditation is an additional quality assurance measure, managed by a Commonwealth Government and industry funded accreditation council. During 2001/02, the National Childcare Accreditation Council (NCAC) changed the accreditation system from allocating 1, 2 or 3 years status to an accredited/not accredited status. Due to this change, previously reported data on accreditation status are not comparable with this year. Not all child care centres are required to be accredited with the council. Data for this report were sourced from the NCAC web site.
Page 89 Family & Children’s Services
Output 3 - Crisis Support Target Actual
Quantity Clients accessing crisis support services 3 050 3 050
Number of support periods 4 700 5 200
Quality Clients with an agreed case plan 63% 65.2%
Note: each individual client can receive support on more than 1 occasion
Data derived from: Australian Institute of Health and Welfare, Supported Accommodation Assistance Program (SAAP) National Data Collection Annual Report 2000/01 Northern Territory Supplementary Tables.
Families and individuals in crisis are supported to minimise further harm, strengthen capacity and achieve wellbeing and independence. Services include support for victims of family, domestic and sexual assault and violence, people who are homeless or at risk of homelessness, and families in financial crises.
The increase of 2.5% in clients with an agreed support plan indicates an increasingly comprehensive service response.
Output 4 - Child Protection Target Actual Quantity Child protection reports investigated 767 539
Number of children in care at 30th June 208 226
Quality Aboriginal children placed in accordance with the Aboriginal child 71% 74.8% placement principle Timeliness Investigations completed within 28 days 80% 69.7%
The child protection reports investigated were 30% less than expected due to fluctuations in the number of reports received and hence the number of cases needing to be investigated. These fluctuations are outside the control of the DHCS and cannot be predicted.
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The aim of Child Protection is to protect and minimise harm to children. Services provided include investigation of reports of abuse, protective assessments and placement of children in care of the minister where they are no longer safe to stay with their families. Other services include: family reunification and reconnection, permanent placement, services for children leaving care and support for young people who have left care.
Any person who believes a child is being or has been abused is required by law to report that belief to the minister or to the police. Not all reports result in a child protection investigation.
At 30 June 2002, 226 children were in the care of the minister and of those children 59% were of Aboriginal or Torres Strait Islander descent.
The Aboriginal Child Protection Principle (ACPP) requires that where possible Aboriginal children who cannot live with their parents be placed with carers of appropriate kin relationship. If that cannot be arranged, the child must be placed in accordance with customary law or, after consultation with the child’s family, with other Aboriginal carers. If no suitable Aboriginal carers are available, a child may be placed with non Aboriginal carers. In some cases, for example where a child has a severe disability, placement with non Aboriginal carers is often the only feasible option.
The 2001/02 target for Aboriginal children placed in accordance with ACPP was 71%. The actual rate was 74.8%.
One measurement of the quality of service provided is the timeliness with which investigations are completed. The target set for 2001/02 was to have 80% of investigations complete within 28 days. The actual completion rate was 69.7%. A shortfall of 10.3% is due to the increasing complexity of cases which required more time to investigate thoroughly.
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Achievements
♦ For people who requested assistance to obtain independent housing, there was a marked change in before and after support. Accommodation in public or community housing and private rental almost doubled while service users were less likely to be living in a car, in a tent, on the street or squatting after assistance was provided.
Table 39: Persons Living in Independent Accommodation After Leaving a Crisis Service
Type of Accommodation Before Support After Support SAAP or other emergency housing 16.3% 13.6% Living rent free in house or flat 12.9% 8.2% Private rental 13.7% 26.6% Public or community housing 15.3% 26.0% Rooming house/hostel/hotel/caravan 5.8% 9.2% Boarding in private home 15.0% 5.3% Own home 3.6% 3.7% Living in car/tent/park/street/squat 11.4% 3.5% Institutional 3.7% 2.1% Other 2.3% 2.0% Total 100% 100.2%
♦ For the first time, data are available on support provided to children accompanying an adult to SAAP services. In the 6 months from January to June 2001, 800 children, 52% of whom were under 5 years of age, received 1 100 periods of support.
♦ Greater levels of community consultation compared to earlier years were realised through forums held in the 5 regional centres.
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Summary
♦ The program is placing a stronger focus on the needs of children and all families. Funding was provided for 2 children’s workers in crisis services. Community consultation was undertaken on a children’s care, development and learning framework to promote collaboration with other agencies and programs.
♦ Reflecting this focus, changes were made during 2001/02 in the mix of services to better meet the needs of families and individuals. These included: the closure of 2 services, the opening of a support service for young pregnant women in Alice Springs and a new transitional housing support program for people moving from treatment to public housing.
♦ A review by DHCS of intercountry adoption arrangements was completed. When the Hague Convention on Intercountry Adoption came into effect 4 years ago, service provision was outsourced to the Australians Aiding Children Adoption Agency, based in Adelaide. The review concluded that the new service was superior, more popular with clients and faster. The average wait time from application to child placement is 15 months. The agency is being reaccredited for a further 4 year term, with Lithuania and Taiwan expected to be added to the programs available to adoptive couples. 8 intercountry and 3 local adoptions were finalised during the year.
♦ Family and Children’s Services supports the Northern Territory Government’s Domestic and Family Violence Strategies and provides policy advice, work force development and funding to services in both the government and non-government sector to address domestic and family violence. Services include counselling, supported housing assistance and other support for women and children experiencing domestic violence. As well, other programs initiated by Indigenous communities are funded under the Aboriginal Family Violence Strategy.
Page 93 Aged, Disability and Community Care
Aged, Disability and Community Care
2001/2002 Budget Outcome
People with a disability and senior Territorians, particularly those who are frail, are supported to maintain independence in, and contact with, their community and family.
Overview
Older people and people with disabilities are valued and contributing members of our community. In accordance with Strategy 21 – Directions 2005, Aged, Disability and Community Care provides services which support the capacity of older people and people with a disability to participate fully in community life, and encourages the development of the non government sector as the primary providers of services to such people.
Aged, Disability and Community Care provides services for older people and people with disabilities supporting them to enjoy optimum health, independence and wellbeing.
The program aims to: ♦ Develop positive attitudes and create accessible services in communities that support the involvement of older people and people with disabilities in community, work force, education and leisure activities. ♦ Promote necessary supports and services to older people, people with a disability and their carers to meet individual needs with the view of fostering their long term independence in the community. For people where in home support is no longer feasible, residential aged care and supported accommodation services are provided.
The Aged and Disability Services and Community Care Policy and Program Development Unit: − sources funding − allocates resources − undertakes research and − develops policies and programs. Funds are allocated to the Community Services Development Division to identify and monitor the most appropriate mix of services for older people, their carers and people with disabilities throughout the Northern Territory.
Page 94 Aged, Disability and Community Care
Performance Reporting
Output 1 - Community Support Services for Frail Aged and People with a Disability Target Actual Quantity CSDA and HACC projects 140 140 Clients accessing support services 3 795 3 795
Quality Number of service providers that meet requirements of service 100% 100% agreements or licensing standards. HACC urban services reviewed against service standards (Previous 30% 30% measures number of service providers assessed against service standards and number of service providers that meet service standards.)
Some specialist Aged and Disability services are provided by the DHCS Top End and Central Australian Service Networks. Aged, Disability and Community Care spent 61% of its budget to purchase quality specialised disabled services from community based and private sectors.
Assessment services are provided to the frail aged through Aged Care Assessment Teams (ACATs). This ensures that they receive community care services most appropriate to their needs and facilitates access to residential aged care when required. 760 ACAT Assessments were completed in 2001/02.
Table 14: ACAT Assessments by Region
Darwin Barkly East Arnhem Katherine Alice Springs Number of Assessments 407 33 59 41 220
The transitional Care Project (TCP) provides intensive coordination and support services for up to 8 weeks after discharge from hospital. 43 clients received these intensive care packages during the year.
Taxi Subsidy Scheme vouchers were distributed to eligible frail aged persons and people with disabilities unable to use public transport.
Table 15: Taxi Subsidy Scheme
1998/99 1999/00 2000/01 2001/02 Number of Clients 642 720 860 893 Expenditure $219 000 $274 000 $340 000 $426 848
In recognition of the contribution of the Territory Independence and Mobility Equipment (TIME) Scheme to enhance the safety and independence of people with disabilities and to
Page 95 Aged, Disability and Community Care
assist with participation at home, work and the community, an additional allocation of $148 000 was provided in 2001/02.
Table 16: Territory Independence and Mobility Equipment Scheme Expenditure
1999/00 $828 000 2000/01 $824 000 2001/02 $829 000
Customised mobility and seating equipment were supplied to people with disabilities through the Seating and Equipment Assessment Team (SEAT).
Adult Guardianship services involving court orders were provided to adults with disabilities who require support to make daily living decisions.
During 2001/02, 64 new guardianship orders were made and 38 reviews of orders were conducted. 82 new applications were received and, as at June 2002, there were 63 applications on the waiting list for investigation and court hearings.
Figure 40: Adult Guardianship Waiting List and Orders Made 1991 to June 2002
400
350
300
250
200 Individuals 150
100
50
0 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 Year
Guardianship Caseload Waiting List Orders Made (Community and Public Guardians)
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Output 2 - Support for Senior Territorians and Pensioner Concessions Target Actual Quantity Number of Seniors Card holders. 9 500 8 286 Number of Pensioner Concession recipients 15 000 16 252 Quality Participating businesses in the Seniors Card Program 230 350 Timeliness Applicants able to access concessions and discounts within 14 days 90% 90% (previous measure - length of card approval process)
Seniors Cards are provided to Territorians 60 years and older to support them to maintain financial independence, health, fitness and community participation.
A range of concessions on local government and NT Government service charges are provided to pensioners and senior citizens who are residents of the Northern Territory. The scheme aims to assist with the cost of living and to encourage seniors to stay in the Northern Territory past retirement.
As shown in the table below, registration of senior card members and business participation in Senior’s Card continued to grow.
Table 17: Number of Senior Card registrations and business participants
1998/99 1999/00 2000/01 2001/02 Senior Card registrations 4 029 5 829 7 502 9 090 Business Participants 187 225 298 350
The NT Pensioner Concession Scheme provides concessions to eligible members on electricity, water, sewerage, property rates, garbage charges, motor vehicle registration drivers licence, urban bus travel, spectacles and interstate travel. As at June 2002, 16 252 NT residents had access to the scheme. 889 new memberships were received during the year.
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Achievements
♦ Ongoing funding of Home and Community Care Services (HACC) occurred throughout the Northern Territory. Support to frail aged people and people with disabilities and their carers to prevent premature admission to long term residential care was provided. In 2001/02, $517 000 was allocated for expanded HACC services and an additional 6 remote communities were funded for new HACC services.
♦ 31% of clients accessing HACC services were Indigenous people living in remote communities.
♦ The Terrace Gardens facility, incorporating the Chan Park Nursing Home, was redesigned and rebuilt within the Palmerston Health Precinct. The new facility incorporates an innovative tropical design adapted for Territory conditions. It provides an additional 16 residential aged care places, increasing available beds from 40 to 56 in the Darwin area. Terrace Gardens was officially opened on 22 April 2002.
♦ Health and Community Care (HACC) providers were invited to participate in planning forums to identify, prioritise and advise on planning issues in the delivery of community care to frail aged people and younger people with disabilities. In addition, the forums provided a valuable opportunity for networking, collaboration and shared problem solving, particularly in remote areas.
♦ The Taxi Subsidy Scheme was expanded to allow people with disabilities in Nhulunbuy to access the scheme. This ensures consumer entitlements keep pace with increases in taxi fares and enables people in residential aged care to have access to transport.
♦ $313 000 in ongoing funding was provided to enhance intervention and support services in schools. Children with disabilities are provided support services by school therapists.
♦ On the request of people with disabilities to control and manage their own services, an innovative model of consumer focussed funding for people with disabilities has been implemented.
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♦ In 2001/02 the Commonwealth and Northern Territory Government jointly made available $1.2M for people with disabilities. This funding was allocated following community forums in Darwin and Alice Springs which were attended by consumers, service providers, peak bodies and advocates. Both forums prioritised areas of unmet need and the following priorities were funded:
− A Review of the Post School Options Program (PSOP) and identification of models of service delivery for school leavers with high support needs was undertaken. Pending finalisation of the review, $32 000 was allocated to families in Darwin for post school opportunities for young people. In Alice Springs, $50 000 in ongoing funding was allocated to Bindi Community to expand the Day Options Program for young people with high support needs − A Small Grants Program was established to provide funds to community based organisations, enabling them to purchase specialised equipment and resources for children with special needs − Individual community support packages were provided to people with disabilities across the Northern Territory. Packages are tailored to suit individual circumstances and have been prioritised for people whose support networks are at risk of breakdown − 2 remote area services were funded to enable the coordination and delivery of local care and support options for people with disabilities. A Central Australian community has developed a case management, support and respite service for community members with disabilities and their carers. Funding has also been allocated for remote service delivery in the East Arnhem region − Funds have been allocated for Innovative Projects Grants to assist organisations in developing new projects and services for people with disabilities, their families and carers. The Northern Territory Disability Advisory Group worked in partnership with consumers and DHCS to develop ideas and allocate the grants.
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♦ Service system reforms progressed through the Aged, Disability and Community Care Branch include:
− implementation of the Commonwealth State and Territory Disability Agreement (CSDA) − procedures for collecting National Minimum Data Set − implementation of the Early Childhood Intervention Review.
Table 18: Disability Services Total Expenditure
1997/98 1998/99 1999/00 2000/01 2001/02
Northern Territory $11 253 179 $10 341 373 $10 644 602 $13 439 556 $14 617 985 Commonwealth $3 193 802 $3 400 501 $4 806 747 $5 156 897 $6 215 925 Total $14 446 981 $13 741 874 $15 451 349 $18 596 453 $20 833 910
Note: These figures show the total expenditure on Disability Services for Department of Health and Community Services being a combination of CSDA, equipment services and the full cost of administration.
Page 100 Mental Health Services
Mental Health Services
2001/2002 Budget Outcome
The emotional and social wellbeing of the Territory community is promoted and strengthened, and where possible, the development of mental disorders is prevented or the impact reduced.
Overview
The Northern Territory Government has a commitment to creating and enhancing services that deliver continuing improvement in the mental health and wellbeing of individuals, families and the community. This is reflected in the Government’s endorsement of the Second National Mental Health Plan 1998 to 2003 and the renewal of the National Mental Health Strategy. The strategy provides a national framework for future activity in mental health reform, and comprises: ♦ the Mental Health Statement of Rights and Responsibilities 1991 ♦ the National Mental Health Policy 1992 ♦ the Second National Mental Health Plan ♦ Schedule B of the Australian Health Care Agreement 1998.
The Mental Health Program Plan has been developed to address both national and Territory priorities in the delivery of social and emotional wellness services.
The strategic directions of the program are to: ♦ build the capacity of the Northern Territory community to promote emotional and social wellbeing ♦ support individuals, families and communities to effectively manage mental health problems and mental disorders ♦ build the capacity of Aboriginal and Torres Strait Islander communities, families and individuals to effectively manage emotional and social wellbeing issues ♦ work collaboratively to create and strengthen partnerships with consumer, carer and community involvement and build integrated service systems ♦ develop systems to support positive consumer outcomes across the lifespan
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Services provided include: ♦ inpatient facilities (Darwin and Alice Springs) ♦ specialist child, adolescent and youth services ♦ community based adult mental health and forensic services ♦ education and training programs ♦ consultation liaison services to the Royal Darwin and Alice Springs Hospitals ♦ rural and remote services ♦ partnerships in service reform involving consumers, carers, service providers and other community partners ♦ community outreach services ♦ support services
Performance Reporting Target Actual
Quantity Inpatient separations from designated services (national indicator). 880 872
Occupied bed days by designated services (national indicator). 7 000 7 352
Individuals receiving community-based mental health services 4 520 4 784 (national indicator). Quality Public mental health services working toward accreditation in line 100% 100% with QIC.
The predicted number of occupied bed days was exceeded while inpatient separations were slightly less than predicted. This is due to a combination of factors including population growth, clinical severity/complexity and cultural influences.
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Figure 41: Mental Health In patient Activity 2001/02
450 Non Aboriginal 400 Aboriginal
350
300
250
200
150
100 Number Mental Health Inpatient Separations 50
0 Male Female Male Female
Top End Region and Gender Central Australian Mental Health Services Mental Health Services
Note: Figures are from specialised Mental Health inpatient units in Darwin & Alice Springs only.
Table 19: Mental Health Inpatient Separations by Diagnostic Group.
Diagnostic Category (ICD10-AM) CAMHS TEMHS Total F00-09 Organic Disorders 2 20 22 F10-19 Disorder due to psycho-active substance use 23 103 126 F20-29 Delusional Disorders 65 185 250 F30-39 Mood Disorders 24 115 139 F40-49 Neurotic Disorders 24 91 115 F50-59 Disorders Assoc with Physical Factors 2 1 3 F60-69 Adult Personality Disorders 7 3 10 F70-79 Mental Retardation 0 0 0 F80-89 Disorders of psychological development 0 1 1 F90-98 Childhood associated disorders 0 1 1 Other Conditions 46 57 103 Not Stated 11 91 102 Total 204 668 872
Note: Figures from Central Australian Mental Health Services (CAMHS) and Top End Mental Health Services (TEMHS) inpatient units only
The diagnostic attributes of inpatient clients indicate the types of disorder that were the focus of care and treatment. The distribution of disorders remains consistent and reflects the general incidence experienced by other state/territory public mental health inpatient populations.
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Table 20: NT Mental Health Consumer Population by Gender and Indigenous Status
Indigenous Status Male Female Not Stated Total Aboriginal 838 482 3 1323 Non Aboriginal 1 405 955 1 2361 Not Stated 103 73 41 217 Total 2 346 1 510 45 3 901
This year Mental Health Services attended 6% more clients than the previous year, in both inpatient and community settings.
Growth is largely due to increased participation of Aboriginal consumers (17% increase from previous year).
Table 21: Community Mental Health Consumers by Age and Service Location
Age group (10 years) Region 0 - 09 10-19 20 - 29 30 – 39 40 - 49 50 - 59 60+ Total Barkly 0 10 26 30 22 8 3 99 Central Urban 0 34 78 45 26 17 8 208 Central Remote 28 135 235 199 76 26 21 720 Darwin Urban 0 26 57 26 18 5 0 132 Darwin Rural 143 567 784 643 376 178 63 2 754 East Arnhem 3 43 81 63 33 7 1 231 Katherine 2 21 69 62 36 19 6 215 Total 176 836 1 330 1068 587 260 102 4 359
Note: Some consumers are seen in more than 1 service location and some may be in more than 1 age group.
34% of all consumers seen were in the 0 to 24 year age group (refer to table above). This level of participation has remained relatively constant over recent years.
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Table 22: Number of people receiving community Mental Health Services by Indigenous Status and Location
Location Indigenous Non Indigenous Not Stated Total Barkly 49 72 2 123 Central Remote 185 40 1 226 Central Urban 289 483 11 783 Darwin Rural 125 20 2 147 Darwin Urban 660 2258 178 2996 East Arnhem 187 65 2 254 Katherine 113 135 7 255 Total 1608 2973 203 4784
Note: Some consumers are seen in more than 1 service location
Table 23: Number of people receiving Community Mental Health Services by Gender and Location
Location Male Female Not Stated Total
Barkly 75 48 10 133 Central Remote 128 98 0 226 Central Urban 498 285 4 787 Darwin Rural 100 47 0 147 Darwin Urban 1 879 1 113 38 3 030 East Arnhem 144 110 1 255 Katherine 138 117 5 260 Total 2 962 1 818 58 4 838
Note: Some consumers are seen in more than 1 service location
Table 24: Community Mental Health Service Contacts by Location
Location Total Barkly 1 290 Central Remote 643 Central Urban 5 896 Darwin Rural 853 Darwin Urban 31 159 East Arnhem 1 686 Katherine 1 992 Total 43 519
Note: Contacts are defined as being of a clinically significant nature and involve an entry to the consumer’s health record
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Summary
Strengthen Community Capacity The Northern Territory Community Advisory Group (NTCAG) on Mental Health continues to meet regularly to provide advice to the Minister for Health and Community Services.
Top End Mental Health Service involves consumers/carers in:
− collaborative Planning and Implementation of Services Committee − Quality Committees on Service Development, Inpatient Services and Community Services − staff recruitment and selection panels − service restructure planning groups
Central Australian Mental Health Services involves local Consumer Advisory Group representation in:
− staff recruitment and selection panels
Other mechanisms for increasing consumer/carer involvement are being actively explored.
Develop a robust Health and Community Service Sector in the NT Mental Health Services have established quality improvement plans that include a commitment to be fully accredited by 2003.
Service development occurs under the Collaborative Planning and Purchasing framework. It is producing better definition of agreements and targeting and monitoring of services purchased from a range of providers of mental health services.
Significantly increase Aboriginal involvement in the Health and Community Service Workforce Mental Health Services actively support the development and utilisation of an Aboriginal Mental Health Worker (AMHW) work force. AMHW staff placement is increasing throughout the Territory both within and outside the public health workforce. This program provides cultural support and increased relevance to mainstream mental health service providers. This aims to lessen the impact of acute interventions and ensure better outcomes for Aboriginal people.
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Be a major contributor to NT economic and social development The Mental Health Program established partnerships with government, non government and private sector agencies. A Memorandum of Understanding with NT Police has been implemented and an agreement with Correctional Services is being developed. Meetings with community and private sector organisations support the advancement of suicide prevention and other mental health related initiatives.
Enhance our Organisational Capability DHCS is undertaking a project to implement standard outcome measures that will enhance the quantity and quality of mental health data collections. Information developed from the data will contribute to the planning and delivery of mental health services throughout the Territory. The development of program and service performance indicators will be enhanced by further development of mental health information collection.
Page 107 Environmental Health
Page 108 Environmental Health
Environmental Health
2001/2002 Budget Outcome
Improved health and wellbeing of Territorians, particularly client groups of poor health, through the development and delivery of appropriate environmental health standards and environmental health promotion activities.
Overview
Environmental Health is encompassed within the broader area of public health. It is distinct from environmental protection, but the two do overlap in some areas. Environmental health practice covers the assessment, correction, control, and prevention of environmental factors adversely affecting human health. Environmental health practice provides opportunities for improved health outcomes and working towards health promoting environments.
Objectives of Environmental Health are to:
♦ develop, implement and enforce environmental health and food safety legislation ♦ monitor, audit, inspect and risk assess all premises including takeaway food shops, markets, restaurants, boarding houses and ear and body piercing establishments ♦ work with other DHCS programs and with other agencies to improve environmental health outcomes and support at risk groups in conjunction with communities and key stakeholders ♦ assist in the development of large scale housing and environmental health infrastructure projects under both the National Aboriginal Health Strategy – Environmental Health Program (NAHS-EHP) and the Indigenous Housing Authority of the Northern Territory (IHANT) ♦ develop a flexible funding strategy enabling communities to train and employ their own environmental health workers ♦ strengthen health promotion practice at the community level ♦ conduct environmental health research and development
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Environmental Health is comprised of several discrete services:
♦ Aboriginal and community environmental health ♦ environmental health standards ♦ environmental planning, sanitation and waste management ♦ food safety ♦ radiation health ♦ poisons control
A small Policy Unit is responsible for legislative and policy development activities for all Environmental Health services including advice to other agencies.
Operational Environmental Health Units are located in all regional centres. These provide services for the enhancement of environmental health standards in urban, rural areas and remote Aboriginal communities. This includes food safety, environmental planning, sanitation and waste management.
Radiation health services are provided to minimise detrimental health impacts of radiation. These services ensure that radioactive materials and radiation emitting devices are used in a responsible manner according to scientific practice and appropriate controls.
Poisons control services are provided by a small unit located in Darwin and supported by hospital based pharmacists in regional centres. These services include advising, undertaking investigations and controlling the supply and use of therapeutic drugs and devices, as well as industrial, agricultural and veterinary chemicals.
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Performance Reporting
Output 1 - Surveillance Services Target Actual Quantity Regulatory Compliance Activities 8 500 71522 number of: system audits (equipment inspections, water quality activities, septic 712 systems, sampling, etc.) premises monitoring 1 302 complaint investigations 561 food and therapeutic drugs and devices recalls 807 licences, registrations and authorisations 3 3603 land use planning activities 410 Quality Premises achieving a satisfactory standard of compliance with EH 95% 95% legislation over 1 calendar year, ie without receiving any significant adverse notes. Timeliness Proportion of EH, food and food borne illness and complaints 90% 95% investigations initiated within 1 working day of notification
Environmental Health:
− issued 464 registrations for food premises under the Food Act − issued 560 registrations for premises under the Public Health Act − issued 81 approvals for septic tank installations under the Public Health Act − carried out 1302 premises inspections required by the public health legislation (the Food Act and the Public Health Act) − responded to 553 complaints relating to environmental health issues, all of which were investigated fully to the satisfaction of the complainants − provided policy and operational support for the Alice Springs to Darwin rail project, managed by AdRail Provided environmental health comments on:
− the draft guidelines for a Public Environmental Report, proposed expansion to the Wickham Point Liquefied Natural Gas (LNG) plant − the environmental management plan for the Shoal Bay waste disposal site − the draft guidelines for an environmental impact statement, Darwin to Moomba gas pipeline
2 The actual total achieved for Surveillance Services (84% of the target) was largely due to a major emphasis on community education activities (Refer Output 2 – Community Education) 3 Licences, registrations and authorisations comprise 464 food premises registrations, 560 health premises registrations, 11 irradiating apparatus registrations, 47 poisons registrations, 473 temporary food premises licences, 142 radiation licences, 1 324 poisons authorisations and 339 poisons licences.
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Radiation Health:
− issued 142 licences under the Radiation (Safety Control) Act
− registered 11 new irradiating apparatus items
− carried out compliance inspections on 231 (92%) of a total of 251 irradiating apparatus registered, located at 105 premises
− carried out 19 other statutory audits, including 3 businesses possessing radioactive substances
− contributed to the implementation of the National Competition Policy review of Radiation Protection Legislation
− contributed to the Commonwealth/State national uniformity implementation panel (radiation control) aimed at achieving nationwide uniformity of radiation protection practices and legislation
− represented DHCS on the standing radiation health committee of Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) and the Commonwealth/State consultative committees on nuclear codes and the management of radioactive wastes
− continued proceedings related to the intended revision of the Radiation (Safety Control) Act
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Poisons Control − conducted 105 compliance inspections on: pharmacies, health professionals, medical kit holders, pest control operators, primary producers and manufacturers, wholesalers, retailers of scheduled drugs and poisons
− assisted DHCS hospitals with accreditation requirements ensuring continuation of funding for highly specialised drugs to the NT by the Commonwealth
− issued 339 licences, 47 registrations and 1 324 authorisations to supply and use scheduled drugs and poisons under the provisions of the Poisons and Dangerous Drugs Act
− dealt with 8 complaints related to poisons and scheduled substances
− actioned 687 national recalls and safety alerts for unsafe therapeutic drugs and devices. Recalls have increased in number as the national recall scheme has been expanded to include recalls of complementary medicines, blood products and implanted products
− assisted with the national assessment of preparedness for dealing with terrorism using anthrax or other threat requiring the use of certain drugs for prophylaxis or treatment
− amended schedules to the Poisons and Dangerous Drugs Act maintaining national uniformity. Most significant was to reschedule hydrofluoric acid to schedule 7 (dangerous poison) removing it from domestic use
− rescheduling changes of terbutaline (bricanylr) turbuhaler from a prescription only (S4) to a pharmacist only (S3) medicine. This enables easier access by asthmatics, and corrects the scheduling of nitrous oxide. All inhalation products are now prescription only (S4)
− assisted with drafting new S29 notices under the Poisons and Dangerous Drugs Act. This included a new notice for staff at Territory palliative care facilities and updates of notices for staff at remote health clinics and urban community care centres
− assisted Asthma NT with the introduction of Asthma Friendly Schools Program aimed at improving awareness and management skills
− worked with the Education Department and school councils on pest control management in schools and school grounds
Page 113 Environmental Health
Output 2 – Community Education Target Actual Quantity Number of Aboriginal Environmental Health Workers employed by 12 12 DHCS Other Environmental Health Activities comprising: 500 3 631 environmental health surveys 986 health promotion and health protection activities 2432 supporting health infrastructure priority projects/national 117 Aboriginal Health Strategy – Environmental Health Program projects, 96 legislation and policy development Number of environmental health surveys. 986 Quality Food safe premises accredited 1
Aboriginal Environmental Health Workers (AEHWs) play an important part in assisting the community to prevent illness and break the disease cycle.
DHCS funds the following 12 communities to employ AEHWs: − Alekarenge − Bulla/Timber Creek − Bulman − Elliot − Galiwinku − Maningrida − Milingimbi − Nguiu − Ngukurr − Numbulwar − Ramingining − Wadeye
Roles and responsibilities of AEHWs are varied, depending on the needs of the community and include the following: − housing maintenance surveys − health education − pest control − mosquito surveys − water sampling − dog control programs − solid/liquid waste issues − food store surveys − organise or undertake repairs to − maintaining partnerships with damaged infrastructure such as other health, local government and houses, water or sewerage systems environmental health workers.
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Production of a video completed in collaboration with Western Australia Health Department illustrating the roles and responsibilities of AEHWs on communities in WA and the NT. Copies were forwarded to all key stakeholders in government and non government agencies associated with this area.
Delivery of apprentice training in remote communities was coordinated by the Aboriginal Environmental Health Worker program. This was done in collaboration with the Human Services Training Advisory Council.
A 6 day disaster management training course for all environmental health officers was conducted in the Northern Territory. The Minister of Infrastructure, Planning and Environment, on behalf of the Minister for Health and Community Services, opened the course for health and community services.
A video resource package designed to assist in the implementation of National Food Safety Standards in remote communities was produced. The Commonwealth Department of Health and Ageing funded the project. The resource will be available for use Australia wide.
Achievements
♦ The department is currently working with Parliamentary Counsel on the drafting of 2 substantial Bills, expected to be tabled in the Legislative Assembly in late 2002. The Food Bill and the Public and Environmental Health Bill address many common areas and are being drafted concurrently.
♦ A code of practice is currently being developed for visitor accommodation premises in the NT in collaboration with industry and government agencies. The code of practice will identify classes of accommodation not covered by existing regulation. Once accepted by industry, the code will become a regulation under the new Public Health Act.
♦ The Environmental Health Program developed an NT wide database for all environmental health issues, which will greatly assist the program in data collection and identification of priority issues.
Page 115 Environmental Health
♦ An NT wide Clinical Waste Management Policy is being developed as per the 1999 National Health and Medical Research Council (NHMRC) National Guidelines for Waste Management in the health care industry. This will assist in the review of the 1996 DHCS interim policy for disposal of departmental clinical and medical waste.
♦ 45 notifications of nationwide food recalls of unsafe or potentially unsafe food were actioned. Products recalled included a range of soy sauces with elevated levels of chloropropanols and mini jelly cups, which posed a choking hazard to young children due to the illegal food additive konjac.
♦ Poisons control monitored 21 622 prescriptions for schedule 8 (S8) drugs to control prescription drug abuse. 6 prescription forgeries were dealt with. Data was used to identify people who visit several doctors to obtain multiple prescriptions in excess of their current therapeutic needs. These persons are encouraged to sign a contract with 1 prescriber. The prescriber may then notify poisons control of the contract details. This voluntary notification system for S8 contracts began in February 1999 and is proving an effective tool for medication management. 198 new contracts were registered during the year.
Figure 42: Schedule 8 Drug Prescriptions and Patient Contracts in the NT
35000 1000
900 30000 800
25000 700
600 20000
500
15000 400
10000 300 Number of Patient Contracts Number of S8 Drug Prescriptions 200 5000 100
0 0 1992/93 1993/94 1994/95 1995/96 1996/97 1997/98 1998/99 1999/00 2000/01 2001/02 Financial Year Number of Prescriptions Patient Contracts
Page 116 Environmental Health
♦ The department developed a memorandum of understanding (MOU) with the Department of Infrastructure, Planning and Environment in relation to approval and licensing of future landfill sites in the NT. While landfill is primarily a planning and environment issue, public health considerations need to be identified as part of the environmental management plans.
♦ An MOU was developed between the department and the PowerWater Corporation (PWC) in relation to water quality monitoring and reporting triggers in major communities in the NT. PWC is a licensee under the Water Supply and Sewerage Act. DHCS is the regulator for water quality under the same Act.
♦ Following a water contamination incident at Tennant Creek, a joint agency protocol on counter terrorism issues was agreed by PWC and NT Police.. The protocol identifies measures to be taken by each agency to counter a contamination incident.
Page 117 Disease Control
Disease Control
2001/2002 Budget Outcome
Improved health and wellbeing of Territorians, particularly for groups with poor health, through the development of disease prevention strategies and appropriate interventions
Overview
Disease Control provides services to prevent, monitor and control communicable and non- communicable diseases in the Northern Territory. Activities are coordinated through Centre for Disease Control (CDC) units in each health district.
Disease Control activities include: policy development; surveillance activities for selected communicable and non communicable diseases and endemic and exotic mosquito vectors; outbreak investigation; appropriate control measures; development, coordination, promotion and monitoring of preventive programs; and involvement in research, education and health promotion activities. Screening and clinical services are provided for tuberculosis (TB), leprosy, sexually transmissible infections (STIs) including HIV and hepatitis, and Australian bat lyssavirus immunisation.
Following an internal review, and in line with the collaborative service model being developed in DHCS, responsibility for policy development in Women's Cancer Prevention was transferred to Women's Health Strategy Unit in 2001, with operational staff transferred to direct management under Top End Services Network.
89% of children aged at 12 months are fully immunised
Page 118 Disease Control
Performance Reporting
Output 1 Expertise, Risk Management and Surveillance services Target Actual Quantity Mosquito samples analysed 1 800 1 811 Hectares treated by mosquito control program 700 740
Timeliness Larval control operations in Darwin Urban that take place, within 95% 100% guidelines-specified time frame of trigger (tides, rain, mosquito numbers) Cost Average cost per hectare treated for mosquito control $135 $157
Good control of mosquitoes in Darwin and low rainfall resulted in a reduction in numbers by half in the prime Ross River virus months of December and January when compared to last year. Ross River virus cases decreased in the Darwin region from 106 to 41, a record low.
Figure 43: Number of Salt Marsh Mosquitoes Ochlerotatus vigilax per Month Caught Using Weekly Mosquito Traps at Eleven Darwin Monitoring Sites
4000
3500
3000
2500
2000
1500
1000
500 Total Number of Female Ochlerotatus Vigilax
0
July April May June August March October January February September November December Month
Oc. Vigilax 2000/01 Oc. Vigilax 2001/02
Page 119 Disease Control
4 importations of exotic mosquitoes (compared with 18 the previous year) including 1 high risk of Aedes Albopictus, a dengue mosquito from the Philippines/Timor area. Eradication measures have maintained the NT free of the mosquito vectors of dengue.
Identification of exotic mosquitoes
The Ilparpa swamp drainage in Alice Springs was completed in March 2002. While temporary pumping measures were carried out over summer, a helicopter program applied a long lasting pellet insecticide to the flooded swamp reducing Common Banded mosquito numbers.
8 sentinel chicken flocks were bled a total of 84 times for virus antibody testing. Evidence of Murray Valley encephalitis virus shown from February to May resulted in 11 press releases to alert the public.
Page 120 Disease Control
Output 2 Clinical Services and Intervention Target Actual
Quantity Vaccines distributed 94 000 98 909
Quality Children fully immunised at age 12 months 87% 89% at age 2 years 80% 84% Male clients with symptoms of gonorrhoea/chlamydia treated on 95% 100% presentation at Clinic 34 in Darwin People completing treatment for tuberculosis 95% 97%4
Timeliness Public health response investigated, within guidelines and specified 95% 100% time frame, from time of disease outbreak notification
The Immunisation section provides: vaccine provider and community education and advice on all aspects of child and adult immunisation. This section also collects childhood immunisation data for the Australian Childhood Immunisation Register (ACIR), maintains the Pneumococcal Vaccination Register and coordinates vaccine funding, procurement and distribution throughout the NT.
Figure 44: Percentage of Children Aged 12 <15 Months Fully Immunised for Age
95.00%
90.00%
Target 87%
85.00% Percent Fully Immunised
80.00% Sep-01 Dec-01 Mar-02 Jun-02 Assessment Date
NT Australia Source: Australian Childhood Immunisation Register
4 For the period 01/01/2001-31/12/2001
Page 121 Disease Control
Figure 45: Percentage of Children Aged 24 <27 Months Fully immunised for Age
95%
90%
85%
Percent FulIy Immunised Target 80% 80%
75% Sep-01 Dec-01 Mar-02 Jun-02 Assessment Date
NT Australia
Source: Australian Childhood Immunisation Register
As shown in figures above, the Northern Territory immunisation rates as measured by the ACIR continued to improve and move closer to the rate for Australia overall. Much of the improvement in NT ACIR coverage rates relates to improvements in data quality.
Increased cases of chlamydia, gonorrhoea and syphilis are due to better case management, ascertainment resulting from increased testing of priority groups, improved follow up and notification of syphilis. Figures reflect an increase in disease rates as a result of unprotected sex, limited STI screening and access to health services, including education. Refer to table on page 127.
In response to cases diagnosed since November 2001, an entire Katherine community with a population of 1100 was screened for TB. As of June 2002, 13 cases of active TB were identified and under appropriate management.
Page 122 Disease Control
Achievements
♦ The Northern Territory was the first jurisdiction to introduce the 7-valent conjugate pneumococcal vaccine. Vaccination of eligible infants began on 1 June 2001, and a catch up program for older eligible children began on 1 September 2002. Uptake has been high and is shown in the figure below. Enhanced surveillance of invasive pneumococcal disease is currently being undertaken.
Figure 46: Percentage of Eligible Children who have had at least 1 dose of 7vPCV as at 25/05/2002
100% 236 / 256 196 / 214 376 / 402 90% 349 / 390 247 / 289 625 / 790 80%
70% 121 / 183
1692 / 2873 60% 221 / 391
50% 121 / 253
40%
30%
20% Percentage of eligible children vacinated
10%
0% Alice Springs Darwin Rural Darwin Urban East Arnhem Katherine Regions
Born after 1/4/2001 Born before 1/4/01
♦ 886 people were registered on the rheumatic fever/rheumatic heart disease database for follow up in the Top End.
♦ CDC Darwin provided placement for 2 full time Master of Applied Epidemiology and medical students. In 2002, training placements for rural and urban general practitioners (GPs) expanded to 1 half time GP registrar.
Page 123 Disease Control
Summary
♦ The Non Communicable Diseases and Injury section has strategic input into the implementation of the NT Preventable Chronic Disease Strategy. The chronic diseases network links an intersectoral group of stakeholders with interests in chronic disease. The section also delivers specialist clinical services in internal medicine and coordinates delivery to all major communities in the Top End.
♦ The Community Paediatric Program develops and evaluates policies for paediatric communicable and non communicable diseases with a particular focus on prevention and early detection. Specialist paediatric services are provided to and coordinated through Top End communities. Input into disease control policies and programs as well as paediatric expertise in education, training and research for CDC is also provided.
♦ The Rheumatic Heart Disease Program assists in coordinating the clinical care of people with Rheumatic Heart Disease (RHD) in remote areas, provides staff education and promotes the standardisation of treatment.
♦ District CDC Units work with primary health care services to provide clinical services, immunisation, contact tracing, community screening and professional education
♦ Surveillance programs monitored include enhanced surveillance of invasive Haemophilus influenzae type b (Hib), meningococcal disease, enteric disease, measles, malaria, TB, influenza, invasive pneumococcal disease, hepatitis C, antibiotic resistant gonorrhoea, rheumatic fever and rheumatic heart disease and adverse reactions following immunisation and vaccine use
Page 124 Disease Control
♦ The AIDS/STD program aims to decrease the rates of sexually transmittible infections, blood borne viruses and associated complications.
♦ Clinic 34 offers specialised clinical services in the following urban areas: Darwin, Katherine, Nhulunbuy, Tennant Creek and Alice Springs. Sexual health staff support primary care providers to undertake community prevention and education programs in urban and remote/rural areas.
♦ The number of HIV notifications in NT residents, including Indigenous cases, remains stable. This does not include cases diagnosed in non residents, which have accounted for more than half of the notifications (11 out of 19) since September 1999. Approximately 25% of all HIV infections in NT residents were transmitted through heterosexual contact.
Figure 47. HIV Notifications in the Northern Territory 1985–2001 by Indigenous Status
18 NT Indigenous 16 NT Non Indigenous unknown non resident 14
12
10
8
Number of notifications 6
4
2
0 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 Year
Page 125 Disease Control
♦ The TB/Leprosy Control Unit screens at risk groups and provides free curative treatment of all cases and increased treatment of latent TB.
♦ Medical Entomology reduces the impact of biting insects through mosquito borne disease awareness, surveillance and control programs, provision of advice on biting insects, a public inquiry service and incidental research.
Figure 48: Notification Rates of TB in the Northern Territory 1991-2001
80
70
60
50
40
30 Rate per 100,000
20
10
0 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
Year
NT Indigenous Overseas born NT Non Indigenous
Note: The figures in this graph differ slightly from those presented in the previous annual report as they include clients transferred from other states.
Page 126 Disease Control
Table 25: Northern Territory Notifiable Diseases 1997 – 2001 (Total Number Of Cases)
1997 1998 1999 2000 2001 Vaccine Preventable Diseases Diphtheria 0 0 0 0 1 Haemophilus influenzae type b (invasive) 4 0 3 2 3 Invasive Pneumococcal Disease 86 72 77 67 96 Measles 11 1 10 0 0 Pertussis 24 23 2 6 147 Tetanus 0 0 0 0 0
Mosquito Borne Diseases Murray Valley Encephalitis 0 0 0 7 3 Barmah Forest Virus 42 21 21 9 39 Dengue Fever (imported) 7 8 15 111 43 Kunjin Virus 2 0 1 2 2 Malaria (imported) 38 27 62 86 58 Ross River Virus 223 121 142 153 235
Blood Borne Viruses AIDS 3 4 2 3 1 Hepatitis B (incident cases) 19 18 16 10 3 Hepatitis C (unspecified cases) 296 224 196 183 213 HIV 11 11 8 9 7 HTLV-1 33 29 33 25 39
Sexually Transmitted Diseases Chlamydia 655 783 855 994 1245 Gonorrhoea 1031 1184 1137 1159 1435 Syphilis 271 335 339 280 400 Trichomonas NN NN 869 1215 926
Enteric Diseases Campylobacter 206 196 242 188 283 Hepatitis A 92 47 85 50 37 Rotavirus 259 183 405 264 592 Salmonella 347 411 367 322 383 Shigella 169 98 116 115 106
Other Acute Rheumatic Fever 45 46 45 27 36 Adverse Vaccine Reactions 16 19 11 28 30 Acute Post-Streptococcal Glomerulonephritis 15 17 7 54 20 Leprosy 2 0 0 1 0 Meningococcal infection 15 17 8 10 13 Tuberculosis 34 32 40 60 34
Note: NN = not notifiable Dengue and malaria are not endemic in the NT. All cases were acquired elsewhere. Due to late notifications and data cleaning the number of cases for some diseases for the year 2000 will vary slightly from that reported for 2000 in the last annual report. These data are presented by the ‘reporting period’ for each year. This differs from national reporting which is based on the year of the ‘onset date’ of the disease. To be consistent with national figures NT data will be reported by ‘onset date’ from 2002. There was a national outbreak of Pertussis in 2001.
Page 127 Disease Control
♦ In 2000 there was an outbreak of post streptococcal glomerulonephritis in several Top End communities. An outbreak of tuberculosis accounted for 14 cases in 1 Top End community, as well as an increase in cases from unauthorised entrants. Starting in May 2001 there was a large rotavirus outbreak that began in Alice Springs and spread throughout the NT.
Figure 49: Northern Territory Notifiable Diseases 2000 to 2001
Gonorrhoea Chlamydia Trichomonas Rotavirus Salmonella Syphilis Campylobacter
Cryptosporidium Hepatitis C (prevalence)
Ross River Virus
Shigella
Influenza
Invasive Pneumococcal Dis
Dengue
Malaria
Chlamydia conjunctivitis
Tuberculosis Hepatitis A Glomerulonephritis Melioidos is 2001 HTLV-1 2000 Acute Rheumatic Fever Adverse Vaccine Reaction Barmah Forest Virus
0 100 200 300 400 500 600 700 800 Rate per 100 000
Source: NT estimated residential population 2000 – 195 469; 2001 – 198 943 Supplied by Health Gains Planning and Statistics Branch, DHCS
Page 128 Disease Control
Table 26: Notified Cases of Vaccine Preventable Diseases in the Northern Territory by report date 1999, 2000 and 2001
Total Cases Cases among children aged 0 – 5 Diseases 1999 2000 2001 1999 2000 2001 Congenital rubella syndrome 0 0 0 0 0 0 Diphtheria 0 0 1 0 0 0 Haemophilus influenzae type b 3 2 3 2 0 3 Hepatitis B 16 10 3 0 0 0 Measles 10 0 0 3 0 0 Mumps 3 4 1 1 1 0 Pertussis 2 6 147 1 2 39 Poliomyelitis, paralytic 0 0 0 0 0 0 Rubella 3 1 0 0 1 0 Tetanus 0 0 0 0 0 0
Note: Cases among children aged 0 – 5 (2001) - 2 children completely vaccinated 1 partially vaccinated
Mumps as a clinical notification tends to be under reported
There was a national outbreak of Pertussis in 2001
Page 129 Health Promotion
Health Promotion
2001/2002 Budget Outcome
Communities and their members take action to solve local health problems.
Overview
The Health Promotion Program supports approaches and practices that strengthen the capacity of individuals and communities to take greater control of their health. The program supports the following core approaches: health action by communities; professional support and development; and the development of frameworks, guidelines and standards.
The Wellness Promotion Section in the Social and Emotional Wellness (SOEWELL) Branch undertook responsibility for progressing mental health promotion and youth development within the program.
Performance Reporting
Output 1 - Community Development and Health Education 2000/01 2001/02 Quantity Number of community initiated health promotion projects 27 20 supported by incentive funds. Value of incentive funds supporting community initiated health $36 848 $37 894 promotion projects.
Health action in communities, in particular rural and remote Aboriginal communities, is supported through community development processes. These include health promotion skills for community members and Aboriginal Health Promotion Incentive Funds (AHPIF) of up to $5 000 for community initiated projects.
This year, 20 projects were funded as opposed to 27 in the previous year. Individual projects received higher amounts than last year.
Page 130 Health Promotion
Output 2 – Professional Health Promotion Training and Development 2000/01 2001/02 Quantity Number of participants in accredited training 129 184
Health Promotion Training Coordinators and Officers, many of whom are Aboriginal Health Promotion Officers, provide training, advice and consultancy services to health and community services staff. Accredited health promotion training offered includes: ♦ the Health Promotion Principles and Practice program ♦ the Certificate IV in Health Promotion Principles and Practice ♦ 2 additional units of competency. This year 184 participants completed at least 1 module of this training.
A wide range of other training and development services were provided, including: health promotion in strategic planning; health promoting schools; orientation for health and community services staff, including use of The Public Health Bush Book; and health promotion components in other accredited and non-accredited training.
Due to consistent demand, the standard DHCS text The Public Health Bush Book was reprinted and, in a sample month, received the fourth highest number of hits on the DHCS website.
Achievements
♦ ‘Celebrating Health Promotion!’ showcased 33 initiatives across the community, government and non government sectors. The successful outcomes of this inaugural symposium were reported in the national newsletter, ‘Auseinetter’.
♦ Since the AHPIF commenced 7 years ago, 144 projects have been supported by $330 331. An evaluation of the 97 projects funded through June 2001 found that: 80% of project managers sampled reported an increase in their health promotion skills; where communities identified the need, 81% of projects were assisted; and most projects (78%) were successful in achieving their purpose. The evaluation concluded that these projects strengthen community capacity and that ‘small amounts of money get big things done’.
Page 131 Health Promotion
♦ Over 40 representatives including community government, consumer and carer groups participated in NT forums. The forums met to assess the implementation of the National Action Plan for Promotion, Prevention and Early Intervention for Mental Health. Issues raised will guide future work in mental health promotion in the NT.
♦ AHPIF supported community health promotion at Bonya in Central Australia. A women’s health project focused on healthy cooking led to the creation of a community vegetable garden. The bumper crop of vegetables and watermelons was used in the healthy cooking program and shared by community members. Program staff worked with the school and clinic to develop a Healthy Lifestyles week, and the women are now establishing a healthy school lunch program. The project continues with tree planting and other community gardens at outstations in a cooperative project involving the Health Promotion team and Tangentyere Land Care Project.
Summary
Program staff supported people in communities to address health issues of concern to them. Other health and community services staff were supported to increase their health promotion skills through training, use of The Public Health Bush Book, consultancy and advice. Infrastructure for health promotion was strengthened through inclusion of health promotion approaches in partnerships and policies, programs, planning and agreements. Through its core business, the program contributed significantly to achieving Strategy 21 – Directions 2005 first stretch goal, ‘Strengthen Community Capacity’.
Page 132 Alcohol and Other Drugs
Alcohol and Other Drugs
2001/02 Budget Outcome
Reduced alcohol, tobacco and other substance-related harm across the Northern Territory. Overview
The Alcohol and Other Drugs Program (AODP) develops and coordinates strategies to minimise the incidence and harm of substance misuse. Reducing the harm caused by substances contributes directly to health and well being responsibilities as outlined in Strategy 21 – Directions 2005.
The program builds on intersectoral collaboration adopting a ‘whole of government and community’ approach to achieve its goals. It has strong linkages and partnerships with a range of stakeholders including consumers, government, non government and private sector providers.
The program aims to: ♦ minimise the incidence and prevalence of substance misuse
♦ minimise the rates of antisocial behaviour, social disorder and offences related to alcohol and other substance use
♦ minimise rates of premature death, diseases and injuries resulting from alcohol, tobacco and other substance use
♦ increase capacity among individuals, families, communities and services to respond to and cope with substance issues.
AODP incorporates the Tobacco Action Project, Public Behaviour Program, National Drug Strategy and activities previously recorded under Living With Alcohol.
Page 133 Alcohol and Other Drugs
Performance Reporting
Output 1 – Community Education Target Actual
Quantity Community education and community development activities. 60 75
Frontline workers participating in training to improve their 130 287 knowledge and skills in alcohol and other drugs issues. Quality Percent of training courses delivered or facilitated that meet 90% 80% national accreditation
75 education sessions on a range of substances, particularly cannabis, alcohol, inhalants and tobacco were undertaken by government providers during July to December 2001.
The training of frontline workers increased the capacity of the work force and the organisation to respond to alcohol and other drugs issues.
Accredited alcohol and other drugs training was undertaken with 78 units being completed and 209 students continuing in 2001.
Output 2 – Treatment, Care in Intervention Services Target Actual Quantity Admissions in sobering-up shelters. 18 500 20 360 Clients accessing support services5 2 370 2 634
The Public Behaviour Program (PBP) provides funds that seek to prevent the incidence of antisocial behaviour in public places that is related to alcohol and other drug use. Funds are applied for through a Reserve Pool, which addresses government and public health priorities and ‘hot spots’. The aim is to provide support to frontline workers such as Night Patrol Services, Warden Schemes and Sobering up Shelters.
There was a strong community response to the ‘You should have been there’ campaign resulting in a significant increase in calls to the Quitline. The campaign portrayed the consequences of smoking on quality of life and the impact on the family. This is a shift from the disease consequences portrayed in the ‘Every cigarette is doing you damage’ material to date. Achievements
♦ A proposal to amend the Tobacco Act was forwarded to Cabinet for consideration. Proposals are: to protect people from exposure to environmental tobacco smoke; to
5 Comprising client registrations for assessment, counselling or referral, receiving residential treatment services or receiving alcohol or other drugs detoxification services during 2001 .
Page 134 Alcohol and Other Drugs
discourage children from beginning to smoke through advertising and retailing restrictions; and to licence tobacco retailers.
♦ The task force on Illicit Drugs was announced in November 2001. The focus was: ‘What can be done to minimise the harm caused by drug use to the individual who is using, their families, and the community?’ Task force findings and recommendations were documented in a report submitted to the Minister on 31 May 2002.
♦ The percentage of alcohol related road accidents continues to decline, decreasing alcohol related road trauma by 12.8% since 1991.6
Figure 50: Percentage of Northern Territory Road Accidents related to Alcohol
25%
20%
15%
10% Percentage of Road Accidents 5%
0% 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 Year
Source: NT Department of Infrastructure, Planning and Environment.
6 ‘alcohol related' refers to an accident where an operator, pedestrian or other person who contributed to the accident records a Blood Alcohol Content (BAC ) >= 0.03 or where other evidence indicates obvious alcohol impairment.
Page 135 Alcohol and Other Drugs
♦ The percentage of fatal road accidents illustrates the variability in the percentage of NT related road fatalities. Since 1996, road fatalities have fallen around 26%.
Figure 51: Percentage of Fatal Road Accidents Related to Alcohol – Northern Territory and Australia
70% Northern Territory
60% Australia
50%
40%
30% Percentage of Fatalities 20%
10%
0% 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 Year
Note: Many states have not contributed data collections since 1997. An Australian benchmark is therefore not available from that date. Source: NT Department of Infrastructure, Planning and Environment
Page 136 Alcohol and Other Drugs
Figure 52: Consumption of Alcohol Per Capita - Northern Territory and Australia
20
18
16 Northern Territory
14
12
10 Australia 8 Consumption (litres) 6
4
2
0 1990/91 1991/92 1992/93 1993/94 1994/95 1995/96 1996/97 1997/98 1998/99 1999/00 2000/01 Financial Year
Note: Per capita alcohol consumption for the 1999/00 financial year has changed following revised figures on alcohol sales from the Liquor Commission. The figures are based on NT estimated resident population aged 15 years and over. Australia wide data not collected since 1997
♦ Per capita consumption of alcohol from 1992/93 to 2000/01 remains relatively stable. Pure alcohol consumption averages around 15 litres per person during this period.
Summary
♦ AODP coordinates activities of the NT Illicit Drug Pre Court Diversion program in partnership with other government, non government and private sector providers. The aim is to offer first time drug offenders in possession of a non trafficable quantity of illicit drugs an opportunity to participate in assessment, treatment and/or education. This aims to expiate the offence and to minimise the rate of premature death, disease and injury resulting from illicit substance misuse.
♦ Community education and resources such as the Pregnancy, Tobacco, Alcohol and Cannabis flip charts have been developed for remote use. The aim is to reduce the incidence and harm of substance misuse on individuals, families and communities in the NT.
♦ Support continues for community initiatives that contribute to minimising the rates of antisocial behaviour, social disorder and offences related to alcohol and other substance use.
Page 137 Top End Service Network
Top End Service Network
Clinics
LEGEND
+ Hospital O DHCS Funded
W Resident General Practitioner + DHCS/Commonwealth Funded
Q DHCS Staffed V Other Community Service Outlet
Page 138 Top End Service Network
Clinics in the Top End Service Network
Darwin Rural & Remote Area: Gunyangara (Marngarr) +O Royal Darwin Hospital Phone: 89873800, Fax: 89873582 Darwin +WQOV+ Laynhapuy (Layna) +O Phone: 8922 8888 Phone: 89871242, Fax: 89871109 Adelaide River WQ Milingimbi QVO Phone: 89767027, Fax: 89767093 Phone: 89879903, Fax: 89879940 Bagot O Numbulwar QO+ Phone: 89483166, Fax: 89483044 Phone: 89754670, Fax: 89754671 Batchelor Q Ramingining & homelands QVO Phone: 89760011, Fax: 89760105 Phone: 89797923, Fax: 89797930 Belyuen (Delissaville) V+O Umbakumba QVO+ Phone: 89785023, Fax: 89785009 Phone: 89876772, Fax: 89876779 Casuarina Community Care Centre OQ Yirrkala QVO Phone: 89227301, Fax 89227477 Phone: 89870367, Fax: 89870366 Darwin Community Care Centre OQ Katherine Area Phone: 89992876, Fax 89992882 Katherine Hospital Gagadju WOV+ Katherine +WQV+ Phone: 89792018, Fax: 89792041 Phone: 8973 9211 Jabiru WQV Phone: 89738570, Fax: 89738620 Phone: 89792018, Fax: 89792041 Amanbidji (Kildurk)Q Kunbarllanjnja Phone: 091-678842/89750748 T/C (Oenpelli/ Gunbalanya) WOV+ Fax: 89750748 Phone: 89790178, Fax: 89790159 Barunga (Bamyili) QVO Maningrida WQVO Phone: 89754501/4509, Fax: 89754602 Phone: 89795930, Fax: 89795933 Binjari O+ Milikapiti (Snake Bay) QVO Phone: 89710823, Fax: 89710813 Phone: 89783950, Fax: 89783902 Borroloola WQV Minjilang (Croker Island)O Phone: 89758757, Fax: 89758718 Phone: 89790229, Fax: 89790207 Bulla Camp Q Nauiyu Nambiyu (Daly River) WOV+ Phone: 091-687303, Fax: 89 750 748 Phone: 89782435, Fax: 89782416 Daguragu (Wattie Creek) QVO Nganmarriyanga (Palumpa) O Phone: 89750891, Fax 89750748 Phone: 89782369, Fax: 89782369 Gulin Gulin (Bulman) QVO+ Nguiu (Bathurst Island) WOV Phone: 89754712/4350, Fax: 89754829 Phone: 89783984, Fax: 89783906 Jilkminggan (Duck Creek) QV Palmerston Community Care Centre OQ Phone: 89754741, Fax: 89754621 Phone: 89993344, Fax 89993333 Kalkarindji (Wave Hill) QV Peppimenarti O Phone: 89750785, Fax: 89750792 Phone: 89782369, Fax: 89782369 Lajamanu (Hooker Creek) QV+ Pirlangimpi (Garden Point) Q Phone: 89750782, Fax: 89750903 Phone: 89783953, Fax: 89783932 Mataranka Q Wadeye (Port Keats) QV Phone: 89754547, Fax: 89754621 Phone: 89782360, Fax: 89782555 Manyallaluk (Eva Valley) Q Warruwi (Goulburn Island) OV+ Phone: 89710823, Fax: 89710813 Phone: 89790230, Fax: 89790227 Minyerri (Hodgson Downs) Q Woodykupildiya OQ Phone: 89759959, Fax: 89759809 Phone: 89782661, Fax: 89782661 Ngukurr (Roper River) QV East Arnhem Area Phone: 89754688, Fax: 89754689 Gove District Hospital Pine Creek QV+ Nhulunbuy +WQV+ Phone: 89761268, Fax: 89761325 Phone: 8987 0211 Robinson River Q Alyangula WQV Phone: 89759985, Fax: 89 750 748 Phone: 89876255, Fax: 89876116 Timber Creek QV Angurugu QV+ Phone: 89750727, Fax: 89750748 Phone: 89876311, Fax: 89876632 Urapunga Q Bickerton Island (Milyakburra) Phone: 89754688, Fax: 89754689 Phone: 89876269, Wugularr (Beswick) QV+ Galiwinku (Elcho Island) WOV+ Phone: 89754527, Fax: 89754820 Phone: 89879031, Fax: 89879061 Wurli Wurlinjang V+O Gapuwiyak (Lake Evella) & homelands + Phone: 89710044, Fax: 89722376 Phone: 89879150, Fax: 89879121 Yarralin QV Phone: 89750893, Fax: 89750911
Page 139 Top End Service Network
Overview
Top End Service Network (TESN) provides community and health services across the Top End of the Northern Territory as well as public hospital services in Katherine and Nhulunbuy. The Top End has a population in excess of 154 000 across 61 400 square kilometres.
TESN comes under the leadership of a Regional Director who reports directly to the Deputy Secretary, Service Provision. A Regional Executive Team, comprised of general managers, meets fortnightly to ensure that TESN services are aligned with corporate strategic directions and agreed service plans to ensure all services are accountable for both expenditure incurred and outcomes achieved.
Expenditure $106.2M Employing 1,050 (excluding Royal Darwin Hospital)
Output
As a provider of health services, TESN delivers the following services:
♦ Workforce support ♦ Hospital Services ♦ Community Health rural ♦ Community Health urban ♦ Oral Health Services ♦ Mental Health Services ♦ Family and Children’s Services ♦ Aged and Disability Services ♦ Public Health including Alcohol and Other ♦ Primary Health Care Drugs and Tobacco Act project
Achievements
♦ A partnership agreement was implemented between Top End Division of General Practice, Bachelor Institute, NT University and Top End Mental Health Service (TEMHS). The agreement aims to support Aboriginal Mental Health Workers, GPs and visiting mental health teams addressing mental health needs in remote communities.
Page 140 Top End Service Network
♦ The Preventable Chronic Disease Strategy has progressed in remote communities. Achievements include: − effective use of client recall systems has increased from 50% to 88% of health centres − 60% of clients now have a comprehensive care plan − 2 regional and 7 community workshops have been provided for health teams focusing on clinical aspects, ethical approaches and promotion of self care in chronic disease management − improved service delivery for men, including workplace visits, outreach service and dedicated men’s clinics − coordinating multidisciplinary diabetic clinics in communities − facilitation of community food suppliers to improve access to foods that promote healthy diets ♦ Katherine Hospital gained accreditation with the Australian Council of Health Care Standards (ACHCS). ♦ A new multidisciplinary orientation program commenced for all Top End Service Network (TESN) employees.
Summary
TESN aims to: ♦ incorporate the principles of primary health care and health promotion in the planning and delivery of services ♦ establish and sustain services that provide the community with quality care options ♦ improve health services to remote Aboriginal communities ♦ ensure recruitment and retention practices and outcomes meet organisational goals and customer needs ♦ provide leadership, direction and support in the design and implementation of continuous improvement throughout TESN ♦ develop, implement and evaluate sustainable quality programs.
Page 141 Central Australian Service Network
Central Australian Service Network
Clinics
LEGEND
+ Hospital O DHCS Funded
W Resident General Practitioner + DHCS/Commonwealth Funded
Q DHCS Staffed V Other Community Service Outlet
Serviced by DHCS Mobile Staff Community Controlled Health Boards
Page 142 Central Australian Service Network
Clinics in Central Australian Service Network
Titjikala (Maryvale) Q Alice Springs Remote Area Phone: 8956 0906 Fax: 8956 0742 Alice Springs Hospital UkakaQ Alice Springs +WQV+ Phone: 8956 7828 Phone: 8951 7777 Fax: 8951 7988 Urapuntja (Utopia) W+V Aherrenge (Ampilatwatja) W+V Phone: 8956 9846 Fax: 8956 9863 Phone: 8956 9942 Fax: 8956 9971 Utju (Areyonga) QV Alpurrurulam (Lake Nash) QV Phone: 8956 7308 Fax: 8956 7308 Phone: 07 4748 3111 Fax: 07 4748 4874 Wallace Rockhole Q Amunturrngu (Mt Liebig) QV Phone: 8956 7763 Fax: 8956 7763 Phone: 8956 8595 Fax: 8956 8984 Walungurru (Kintore/Pintupi Aputula (Finke) OV Homelands) W+V Phone: 8956 0961 Fax: 8956 0778 Phone: 8956 8593 Fax: 8956 8582 Atitjere (Harts Range) Q Watarrka (Kings Canyon) Q Phone: 8956 9778 Fax: 8956 9947 Phone: 8956 7807/997 Fax: 8956 7183 Bonya Q Wilora (Stirling) Q Phone: 8956 6300 Fax: 8566 390 Phone: 8956 9950 Fax: 8956 9850 Engawala (Alcoota) Q Wirliyatjarrayi (Willowra) QV Phone: 8956 9944 Fax: 8956 9944 Phone: 8956 8788 Fax: 8956 8979 Ikuntji (Haasts Bluff) QV Yulara WOV Phone: 8956 8472 Fax: 8956 8547 Phone: 8956 2286 Fax: 8956 2373 Imanpa (Mt Ebenezer) +V Yuelamu (Mt Allan) QV Phone: 8956 7484 Fax: 8956 7826 Phone: 8956 8747 Fax: 8956 8847 Kaltukatjarra (Docker River) QV Yuendumu QV Phone: 8956 7342 Fax: 8956 7741 Phone: 8956 4030 Fax: 8956 4051 QV Laramba (Napperby) Barkly Phone: 8956 8792 Fax: 8956 8432 Tennant Creak Hospital Ltyentye Apurte(Santa Teresa) OV+ Tennant Creek +WQV+ Phone: 8956 0911 Fax: 8956 0910 Phone: 8962 4399 Fax: 8962 4207 Mutijulu (Ayers Rock) +VW Ali-Curung (Murray Downs) QV Phone: 8956 2353 Fax: 8956 2031 Phone: 8964 1954 Fax: 8964 1971 Ntaria (Hermannsburg) QV Barkly Mobile Phone: 8956 7433 Fax: 8956 7473 Phone: 8962 4399 Fax: 8962 4207 Nturiya (Ti Tree Station) QVW Canteen Creek (Orwaitilla) QV Phone: 8956 9820 Fax: 8956 9820 Phone: 8964 1510 Nyrripi QV Elliott QV Phone: 8956 8835 Fax: 8956 8840 Phone: 8969 2060 Fax: 8969 2070 Papunya QV Epenarra (Wutunurrgurru) QV Phone: 8956 03/5 Fax: 8956 8512 Phone: 8964 1559 Pmara Jutunta (6 Mile) QV McLaren Creek (Mungkarta) Q Phone: 8956 9847 Phone: 8962 2385 Fax: 8964 1961 Tara (Neutral Junction) Q Marlinja O Phone: 8956 9789 Fax: 8956 8979 Phone: 8964 4590 Ti-Tree QV Phone: 8956 9736 Fax: 8956 9829
Page 143 Central Australian Service Network
Overview
The Central Region covers an area in excess of 1.1M square kilometres extending from the borders of South Australia, Western Australia and Queensland and as far north as Elliott.
Central Australian Services Network (CASN) provides or supports the delivery of services to approximately 42 500 residents including an Aboriginal population of 15 000. Emergency services are provided to 4 000 people who live adjacent to but outside of the Northern Territory border in Western Australia and South Australia. An average of 4 200 tourists receive medical assistance annually.
This year has focused on service improvement through both departmental and regional projects. This includes the Hospital Improvement Project, Strategy 21 - Directions 2005, Primary Health Care Access Program (PHCAP) and the Alice in 10 Quality of Life Project.
CASN Strategies are to: ♦ advance remote health services and improve Aboriginal access to services ♦ focus regional activities on health priorities and outcomes ♦ create a supportive environment for all staff.
Expenditure $ 101.1 M Employing 1 100
CASN includes: ♦ CASN Executive made up of Regional Director and Senior Managers ♦ Alice Springs Hospital and Renal Unit ♦ Alice Springs District consisting of health development, community services and community health services for urban and rural areas ♦ Barkly Health Services and Tennant Creek Hospital comprising health development, community services, community health, and acute services ♦ Regional professional and business support services including Quality Improvement, Director of Allied Health, Business Support, and Human Resource Services.
Page 144 Central Australian Service Network
Achievements
♦ Redevelopment of the Alice Springs Hospital was completed. The Chief Minister officially opened on 4 July 2002. All redeveloped ward areas have been commissioned and are operational, with the exception of the High Dependency Unit.
♦ As part of the Alice in 10 Quality of Life Project, the Indigenous Employment Challenge, an Indigenous Employment Strategy has been developed. The challenge is to employ one hundred young people in the first year of operation.
♦ The framework for Action in Central Australia was endorsed as a way of working in remote health centres. This continues to operate as part of an ongoing service improvement plan.
♦ In preparation for the implementation of the Primary Health Care Access Program (PHCAP), interim steering committees were formed and supported in 5 health zones. This was undertaken in collaboration with the Commonwealth, ATSIC and AMSANT. An Internal Strategic Operational Group was formed to guide the Departmental processes in Central Australia.
♦ Collaboration between DHCS, Northern Territory University, Flinders University and the Centre for Remote Health, resulted in the opening of a Clinical Training Laboratory at Alice Springs Hospital.
♦ A specialist general physician was recruited to provide increased access to specialist services in remote areas.
♦ Through the Quality Improvement Council, accreditation was achieved for a second 3 year period at Community Health Urban and Aged and Disability Services.
♦ Aboriginal Health Worker (AHW) Development Coordinator position was developed to further professional and career issues. Continued support of the Central Australian Remote Health Development Services to be a sustainable AHW training resource.
♦ Revised government arrangements were developed at ASH with a focus on clinical governance, best practice, budget management, and quality improvement, including accreditation.
Page 145 Central Australian Service Network
♦ Regional Provider Support Unit within FACS focusing on improving the level of training and support to staff and that Aboriginal child protection issues are managed appropriately.
♦ Regional Action Plan to implement the Central Australian Regional Substance Misuse Strategic Plan was distributed. Focus is on the implementation of strategies to address the first fifteen priority areas identified in the Strategic Plan.
♦ 7 non Government community sector employees graduated in Certificate IV in Community Services (Alcohol and Other Drugs).
♦ An interim renal service commenced in Tennant Creek supporting 3 haemodialysis chairs. This service has been developed pending the arrangement of a long term renal service at Tennant Creek Hospital.
♦ Partnerships were formed with non Government sectors and other departments through a number of forums, including the Central Australian Indigenous Health Planning Forum and Alice in 10.
Page 146 Central Australian Service Network
Services Development Division
Overview
The Services Development Division (SDD) ensures the delivery of services that maximise the health of all Territorians.
The division negotiates and enters into agreements with all service providers receiving funds through DHCS. Agreements detail the performance requirements including specified standards. By building relationships with providers and monitoring performance standards and processes, the accountability of service provision is increased.
Outputs
Service Development output activities include: ♦ Completion of an external review of Palmerston Precinct, After Hours GP Services ♦ Completion of a Territory wide review of the Strong Women, Strong Baby, Strong Culture Program ♦ A cost effectiveness study of the Growth, Assessment and Action (GAA) Program in Central Australia ♦ Investigation of health service requirements for permanent residents of Dundee Beach and health needs assessment planning in Litchfield Shire to determine future service development needs in these areas ♦ Conduct of several community forums to inform service providers and consumers on departmental planning processes. These included: − Disability Unmet Needs − Home and Community Care (HACC) − Supported Accommodation Assistance Program (SAAP)
Page 147 Services Development
Funding
For a comprehensive list of organisations that received funding through DHCS, see Appendix on page 205. ♦ 182 organisations received funding to provide services ♦ 61 child care centres received NT child day care subsidies and /or licence related upgrade grant funding. this included innovative remote child care centres and 3 year old Kindies ♦ 311 new or renegotiated services or small grants took effect ♦ 142 service plans were negotiated for agreements signed between the internal service providers, Top End Service and Central Australian Service Network
Figure 53: Total payments for Non Government Agencies 2001/02
Mental Health Services 2%
Family & Childrens Aged & Disability Services Services 23% 28%
Environmental Health 1%
Alcohol & Other Drugs 12%
Disease Control Community Health 1% 33%
♦ Public tenders were sought for the following services: − Katherine Pharmacy Services − Health Strategies for People who Inject Drugs Projects − Hepatitis C and Blood Borne Virus Education and Coordination − Cardiac and Diabetes Rehabilitation, Education and Information Services in Central Australia − Cardiac Rehabilitation and Prevention Services in the Top End
Page 148 Services Development
♦ In additions public proposals were sought for services and small grants funding including:
− SAAP Skills Development Projects − Health Promoting Youth Projects − Health Promoting Schools Projects − HACC services − Remote Area Aboriginal Alcohol and Other Substance Strategy (RAAASS) − Petrol Brokerage (National Illicit Drugs) − CSDA Disability Innovative projects − CSDA Early Childhood Intervention Equipment/Resource grants − Licence Related Upgrade Grants to Child Care Centres
Achievements
♦ In October 2001, the Health Gains Planning Unit was transferred to the division. This has emphasised strategic planning to address priority health issues and determine where investments are to be best placed to achieve health gains for Territorians. ♦ Service agreements were signed with departmental program areas and all internal service providers comprising: − hospitals − Top End Service Network − Central Australian Service Network
♦ For the first time, Services Development Division received performance reports from all internal and external service providers. This information has been analysed and collated to comprise the divisions’ first output based performance report to all departmental program areas within DHCS.
Page 149 Services Development
♦ Support and monitoring of services by SDD resulted in successful readjustment of some services by providers to enable achievement of agreed service outcomes − A staged approach to increase ambulance services is underway. The aim is to improve response time to emergencies in Darwin and surrounding areas − In March 2001, the Licensing Commission determined restrictions on the supply of alcohol to be trialed in Alice Springs. The trial was a broad based approach that included a number of supportive measures based on harm reduction, prevention, referral, treatment and care strategies. In January 2002, the NT Government approved funding of $182 000 to support these measures. Negotiation then commenced with the Alcohol Education and Rehabilitation Foundation for a policy partnership proposal
♦ A Territory wide population health survey for non Indigenous Territorians was completed. Areas covered were mental health or injury occurring in the last 12 months and excess weight
Table 27: Health and Wellbeing Survey – NT Non-Indigenous
Urban Rural Remote NT At least 1 mental health problem 11.4 9.8 9.2 10.7 Injury requiring medical treatment 22.4 22.9 24.8 22.8 Overweight or obese 44.0 51.1 45.1 46.7
Page 150 Services Development
Figure 54 Non Government Service Provision Funds Allocated as Percent of Program Budget 2001/02
Hospitals
Health Promotion 0.0%
Mental Health
Disease Control
Community Health Program Environmental Health
Family and Children
Alcolol and Other Drugs
Aged and Disability
0% 10% 20% 30% 40% 50% 60% Percent of Each Program Budget Provided for Non Government Service Provision
Note: Funds for Health Promotion activities are provided from the appropriate program budget
Page 151 Menzies School of Health Research
Menzies School of Health Research
2001/2002 Budget Outcome
Improved health of people of Northern and Central Australia and regions to the near north through multidisciplinary research and education.
Overview
Menzies School of Health Research (MSHR) was established in 1985 and is located on the grounds of the Royal Darwin Hospital.
MSHR has a multidisciplinary research program that spans non communicable and communicable diseases, the social and environmental determinants of health, health systems and information systems.
Performance Reporting
Target Actual
Quantity Value of Menzies School of Health Research grant. $3 228 00 $3 264 000
Timeliness Grant payment made within stipulated timeframe 100% 100%
DHCS provides MSHR with a grant to support core operations. In addition to DHCS funding, MSHR attracts external research and training grants for activities relevant to health policies and practices in the Northern Territory.
Collaboration between MSHR and DHCS is evident in their range of shared activities on research issues of common interest.
Joint appointments are held in the areas of infectious diseases, tropical diseases, research management and education, and a number of DHCS staff are engaged in MSHR research projects. MSHR provides Post Graduate training in Public Health, engaging a number of DHCS staff as lecturers, tutors and students.
Page 152 DHCS Corporate Governance
NORTHERN TERRITORY GOVERNMENT Hon Jane Aagaard, Minister for Health and Community Services
Building a Better Northern Territory A/CHIEF EXECUTIVE OFFICER Territory Graham Symons Legislation
EXECUTIVE GROUP Graham SYMONS, Shirley HENDY, Jenny CLEARY, Rose RHODES, David ASHBRIDGE , Sue KORNER, Stephen MOO, Len NOTARAS, Joanne SCHILLING
Workforce Quality Program Finance Information Internal Advisory Improvement & Development Graham Symons (Chair Management Audit Joanne Schilling (Chair) Best Practice Jenny Cleary (Chair) Joanne Schilling Graham Symons (Chair Graham Symons (Chair) David Ashbridge Rose Rhodes Shirley Hendy Graham Symons (Chair) Joanne Schilling Joanne Schilling Sue Korner Stephen Moo Jenny Cleary Len Notaras Shirly Hendy John Montz Len Notaras Steve Guthridge David Ashbridge Lorraine Porter Jenny Cleary Leigh Eldridge Bruce March Anthony Burton Sue Korner Joyce Bowden Stephen Moo Peter Hill Dayalan Devanesen Damien Conley Rose Rhodes Jenny Scott Steve Guthridge Noelene Swanson Cheryl Furner Len Notaras Karin Mulligan Francis Kong Jill Macandrew Xavier Schobben Brian Slatter Mary Grace Bingham Vera Whitehouse Ged Williams Vicki Krause Samantha Byrne Janice Wheldon Greg Moo Steve Marshall Jill Macandrew Chris Burrows Jenny Scott Noelene Swanson Allison Grierson
- Propose Annual Budget Strategy (identifying major policy initiatives, program outcomes and outputs for approval by Legislative Assembly) - Monitor Performance of Corporate Strategy 21, Output/Outcome Indicators, Client Feedback, Program Evaluations, Agreements, Expenditure - Analyse Demand, Emerging Service Pressures, Program Cost/Effectiveness, Community Capacity, Potential Risk and Critical Success Factors - Develop Strategies to Improve Health Status, Wellbeing and Community Capacity, Strategies to Improve Cost Effectiveness, Resource Allocation - Report Annual Outcome Indicators, Program Effectiveness/Efficiency, Financial Statements, and Compliance with Government Policy Corporate Governance
Executive Standing Committees
Workforce Advisory Standing Committee (WASC) Achievements − Endorsed guidelines for setting work priorities for strategic workforce services and distributed to senior managers − Endorsed leave without pay guidelines − Endorsed conditions of employment booklet
Quality Improvement and Best Practice Standing Committee (QUIBP) Achievements − Endorsed governance and business rules − Applications for 2001/02 quality improvement and enhanced funding approved. − Developed complaints handling policy − Finalised quality performance framework and strategic plan − Developed quality action plan to be used as a working document for QuIBP to monitor the progress of DHCS quality activities − Developed informal sub committee structure − A master plan for accreditation of all DHCS services, including time lines, now forms part of the quality action plan
Program Development Standing Committee (PDSC) Achievements − Process for collecting and reporting output group performance measures developed and endorsed
Finance Standing Committee (FSC) Achievements − Developed template and process to review the YTD and projected end of year expenditure versus budget each month − Endorsed terms of reference for the works sub committee − Endorsed guidelines for proposals for the minor new works program and made available to staff via the Intranet site − Endorsed 2002/03 capital works design list and forward estimates − Endorsed 2002/03 minor new works program
Strategic Information Management Standing Committee (SIMSC) Achievements − Completed committee structure charts for the SIMSC sub committees and the national health information management committees
Page 154 Corporate Governance
Legislative Responsibilities
The Minister for Health and Community Services and the Department of Health and Community Services (DHCS) is responsible for administering the areas of government relating to: social welfare, community grants for health related organisations, health including hospitals and medical services, human quarantine, food standards, alcohol and other drug dependence, aged and disability services, children’s services and mental health services.
The Minister is also responsible for Senior Territorians. DHCS provides administrative support to this Ministerial portfolio in the absence of a specifically nominated agency.
The portfolio of Minister for Health and Community Services is through supporting agencies responsible for the following Acts: ♦ Health and Community Services Complaints Act ♦ Menzies School of Health Research Act
The Minister administers the following Acts:
♦ Adoption of Children Act ♦ Adult Guardianship Act ♦ Cancer Registration Act ♦ Community Welfare Act ♦ Dental Act ♦ Disability Services Act ♦ Emergency Medical Operations Act ♦ Food Act ♦ Guardianship of Infants Act ♦ Health Practitioners and Allied Professionals Registration Act ♦ Hospital Management Boards Act ♦ Human Tissue Transplant Act ♦ Medical Act ♦ Medical Services Act ♦ Mental Health and Related Services Act ♦ Natural Death Act ♦ Notifiable Diseases Act ♦ Nursing Act ♦ Optometrists Act ♦ Pharmacy Act ♦ Poisons and Dangerous Drugs Act ♦ Private Hospitals and Nursing Homes Act ♦ Public Health Act ♦ Radiation (Safety Control) Act ♦ Radiographers Act ♦ Therapeutic Goods and Cosmetics Act ♦ Tobacco Act ♦ Transfer of Powers (Health) Act.
Page 155 Corporate Governance
Leadership (Executive Bios)
Graham Symons, Acting Chief Executive Officer / Deputy Secretary, Service Provision Graham returned to the department as Deputy Secretary in June 2002. Previous roles in the public service include 7 months as acting CEO Department of Community Development, Sport and Cultural Affairs, 2 ½ years as CEO Territory Housing and 10 ½ years with DHCS, including 2 years as Deputy CEO. Graham has degrees in Science and Social Administration and postgraduate qualifications in Management.
Dr Shirley Hendy, Assistant Secretary, Health Development and Community Services and Chief Health Officer Shirley has been an Assistant Secretary and Chief Health Officer since January 1996. She came to the NT in 1976 as Senior Registrar in Paediatrics on rotation from Sydney’s Prince of Wales Children’s Hospital and chose to stay. She has worked as a District Medical Officer, in general practice, and as director of NT programs such as Health Promotion, Sexually Transmitted and Blood-borne Infections, Alcohol and Other Drugs, and Living with Alcohol. Shirley represents the NT on the National Public Health Partnership and is a Fellow of the Faculty of Public Health Medicine of the Royal Australasian College of Physicians.
Jenny Cleary, Assistant Secretary, Community Health, Aboriginal Health and Hospital Services Jenny commenced her career as a Clinical Dietician and Public Health Nutritionist. She was the project manager for the Tiwi and Katherine West Coordinated Care Trials in the formative years. Jenny moved into Regional Services management with TESN prior to taking up the position of Assistant Secretary in 1999. She joined the NT DHCS in 1987. Jenny has a Bachelor of Applied Science, Graduate Diploma Dietetics and Master of Public Health. She is Chairperson for DHCS Program Development Standing Committee and represents DHCS on the National Health Priorities Action Council.
Page 156 Corporate Governance
Rose Rhodes, Assistant Secretary, Services Development Rose had 17 years working in Acute Public Hospitals in South Australia and the United Kingdom. She joined the Department of Health and Community Services in 1985 and has held various senior management positions. Rose is a Registered Nurse, Registered Midwife and holds a Diploma in Hospital Nursing and Management, Bachelor of Health Administration and a Graduate Diploma in Executive Management. She is a Member of the Royal College of Nursing Australia and the Australian College of Health Services Administrators.
Joanne Schilling, Acting Assistant Secretary, Business and Operational Support Joanne commenced her public sector career in NT Treasury Budgets Division in 1990. She joined NT DHCS in 1994, and was Director Finance and General Services for 6 years. Joanne is Chairperson of the DHCS Workforce Advisory Standing Committee, and the NTPS Nursing Career Structure Review Executive Steering Committee. Joanne has a Bachelor of Business, a Bachelor of Economics, and a Master of Public Policy and Management.
Stephen Moo, Assistant Secretary, Strategic Review and Information Services Stephen has been employed by the Department of Health and Community Services for in excess of 20 years and has held a variety of management positions. Stephen was appointed as the Assistant Secretary of Strategic Review and Information Services Division in April 2002 after having served as the Director of Business Information Management since 1995. Stephen has a Batchelor of Accounting from the Northern Territory University and is a member of CPA Australia.
Dr David Ashbridge, Regional Director, Top End Service Network David commenced as Regional Director, Top End Service Network in February 2001. Prior to this David was the Senior Medical Adviser and Assistant Secretary for Health Strategies and Workforce for the Commonwealth Department of Health and Aged Care in Canberra. David has worked with the Northern Territory Department of Health and Community Services since 1988, initially as a District Medical Officer. He has also held positions such as General Manager Darwin Rural District, Deputy Regional Director Operations North, Acting Secretary for Aboriginal and Community Health Policy and is a Specialist in Public Health Medicine.
Page 157 Corporate Governance
Sue Korner, Regional Director, Central Australian Service Network Sue has over 30 years experience in Central Australia and has held senior positions in the Department of Transport and Works, Community Development and Health and Community Services. She has broad public sector management experience and has a Graduate Diploma in Public Sector Management. Sue is also the Chair of the Alice in 10 Quality of Life Committee.
Dr Gary Lum, Acting Executive Director, Royal Darwin Hospital Gary commenced at RDH as Director of Microbiology in 1996. He became Director of Pathology at RDH in1997, which also involved being the Supervising Pathologist for NATA/RCPA accredited medical laboratories within DHCS. In May 2002, Gary took on the role of Acting Executive Director of RDH. He Represents RDH and DHCS on a number of national government committees relating to pathology. Gary Graduated in Medical Science and Medicine/Surgery from the University of Queensland in 1989. He completed Postgraduate Medical Specialist training in Pathology [Microbiology] through the Royal College of Pathologists of Australasia in 1995.
Dr Len Notaras, Principal Medical Consultant Dr Len Notaras was recruited to Royal Darwin Hospital as Medical Superintendent in 1994, and since that time has worked in a range of positions. Len is currently the NTs Principal Medical Consultant, as well as hospital medical Superintendent. He has degrees in Law, Arts [History], Commerce, and Medicine, and has had a diverse career since the late 1960s spanning the law, military, private enterprise and medicine.
Page 158 Corporate Governance
Performance Management
Overview
Organisational goals and performance improvement were enhanced through: ♦ Implementation of corporate Strategy 21 - Directions 2005 ♦ Health Gains Planning and strategic investment of resources ♦ Program plans and service agreements ♦ Strategic information management and systems development ♦ Risk assessment and management ♦ Strategic research focus on Indigenous and tropical health ♦ Evaluations, reviews and audits ♦ Workforce recruitment and retention strategies ♦ Leadership development program within the agency
Strategy 21, the department’s corporate plan for 1999 to 2003 was reviewed in consultation with major internal and external stakeholders including staff from across the organisation. Strategy 21 was extended to 2005, and additional stretch goals were identified for special focus during the coming 5 years. Refer to page 19.
DHCS utilises a Corporate Governance structure which expands the Departmental Executive to include 6 standing committees which focus on Information Management, Quality Improvement, Program Development, Finance, Workforce, and Internal Audit. Refer to page 153.
The agency uses an overall planning and purchasing framework with a clear separation of the functions of funder, purchaser and provider. This effective separation is enhanced by the use of formal agreements with both internal and external service providers. These agreements include clear outcomes and measures of effectiveness.
DHCS undertakes extensive program performance monitoring and reporting of business activity information to agency managers. Performance reports are also provided for numerous external bodies including: NT Treasury, National Report on Government Service Provision, Australian Institute of Health and Welfare, and the Australian Bureau of Statistics.
Health gains planning is utilised within a strategic investment framework to inform resource allocation decisions and to integrate strategic planning processes with annual resource allocation and budgeting.
Page 159 Corporate Governance
Program Evaluation / Reviews
A number of evaluations and reviews were undertaken by the agency during 2001/02. The outcomes of these and the implementation of key recommendations are monitored by the Executive and relevant executive standing committees. Outcomes from key evaluations are reported as follows and where appropriate in the relevant program sections of this report.
Program evaluations commenced or completed during 2001/02 included:
Aboriginal Incentive (TAP) Grants (Menzies) Preliminary results indicate the scheme is meeting its objectives, areas for improvement identified Aboriginal Incentive (TAP) Grants DHCS Improvements identified and are being implemented administration (DHCS) Detoxification Unit (Darwin) Operational Model Restructure of services endorsed Review (C Watson) Family Violence Scheme, Aboriginal Communities Recommendations received, strategies to improve (P Morrison) scheme under development Information Privacy (DHCS) Consultations completed, agency requirements identified, health information bill to be drafted Inter-country Adoption Agreement Effectiveness Agreement with SA agency performing well, to be (DHCS) continued Legislation Review, National Competition Policy Reforms in respect of 14 of the Agency’s 23 Acts are being undertaken. Mental Health and Related Services Act (DHCS) Issues identified, discussion paper for community comment to be circulated Mental Health Services review of compliance with Areas for improvement identified, achievement national standards accreditation before end of 2002 strategies implemented
Nursing Career Structure Review (DHCS) New career structure proposed for nurses, ballot to be sent to all nurses in NT Nursing Staff Utilisation in Hospitals (R Olly) Recommendations accepted in part, a more extensive review to be undertaken Policy Review (DHCS) Due for completion December 2002 Strategic Business Risk Assessment (Risk Risk Management Plan developed and endorsed by Management Services DCM) DHCS Executive Tobacco Act (DHCS) Issues identified, amendments proposed being considered for further development TIME Scheme Review (DHCS) New guidelines developed/implemented, issues identified for future program development Remote Area Well Women’s Screening (DHCS) Supports program continuation, review to be considered in future program planning
Page 160 Corporate Governance
Internal / External Audits
Internal Audit
The Department of Health and Community Services worked with Risk Management Services within the Department of the Chief Minister to identify and manage strategic business risks and arrange internal audits.
The Agency’s Internal Audit Committee met 8 times during the 2001/02 financial year. The Internal Audit Committee comprised representatives from DHCS senior management, Risk Management Services (Department of the Chief Minister) and a private accounting firm. The committee scheduled and coordinated audits, considered the findings, recommendations and outcomes of both internal and external audits conducted within the agency or where DHCS was part of a broader whole of government audit.
Internal audit activities were undertaken to ensure that risks were being monitored and managed appropriately to improve performance and to provide assurance that the organisation’s management, systems, and internal controls are operating satisfactorily.
During 2001/02 audits were undertaken in the following areas:
Internal Audit Date Completed Result Strategic Risk Assessment September 2001 DHCS strategic risks identified for determining audit / monitoring priorities
Primary Health Care Funding October 2001 Audit issues identified and improvements to Peppimenarti implemented with support from DHCS’s Services Development staff
Legal Services in DHCS October 2001 Recommendations not seen as feasible in light of changes planned for the Department of Justice’s provision of legal services
Debt Management for DHCS June 2002 Indicated scope of problem and need for substantial development work with staff in both DHCS and DCIS
Taxi Subsidy Scheme June 2002 Problems identified, plan of correction being developed by the program
Page 161 Corporate Governance
External Audit
Agency Compliance Audits arranged by the Auditor General for 2001/02 were:
Agency Compliance Audits Date Completed End of Year Compliance 2000/01 October 2001 Agency Compliance Audit 2001/02 May 2002 Patient Travel Scheme, Alice Springs Administration March 2002
Performance Management Audits undertaken by the Auditor General during 2001/02 included:
Performance Management Audits Date Completed
Systems to Measure Performance Information April 2002
Page 162 Human Resources
Human Resources
Strategic Workforce Services
Overview
Strategic Workforce Services (SWS) enhances the health and wellbeing of people in the NT through the promotion of a learning culture and development of best practice strategies to ensure a skilled workforce.
Strategic Workforce Services consists of: ♦ Aboriginal Workforce Development ♦ Darwin Human Resource Services ♦ Workforce Improvement ♦ Workforce Relations and Planning.
Achievements
Aboriginal Workforce Development Aboriginal Workforce Development Unit (AWDU) focuses on enhancing Aboriginal employment, career development and participation in the DHCS workforce.
During 2001/02 AWDU: ♦ updated the DHCS Aboriginal Career Information Kit ♦ recruited 7 Indigenous cadets. 4 Indigenous cadets are continuing studies ♦ operated Structured Training and Employment Projects (STEP) in Central Australian Service Network (CASN) in partnership with: Tangentyere Council, Arrente Council and the Commonwealth Department of Employment and Workplace Relations (DEWR) ♦ operated a STEP program in Top End Service Network (TESN) in partnership with Royal Darwin Hospital (RDH) and Darwin regional Community Development Employment Program (CDEP)
Page 163 Human Resources
Table 28: STEP Trainees in Central Australia Services Network (CASN) and Top End Services Network (TESN).
Year Number of Trainees Location Number of Employees Post STEP 2000 12 Alice Springs Hospital 5 2001 11 Alice Springs Hospital N/A 2001 5 Royal Darwin Hospital 5
♦ developed guidelines and procedures for the Indigenous Mentorship program. Mentor training is being delivered in TESN and CASN ♦ recruited 2 trainees in the fields of Men’s Health and Aboriginal Community Health ♦ continued development of the Aboriginal Health Worker Training and Assessment Framework. The framework has 4 components: − NT Aboriginal Health Worker Career Structure − NT Aboriginal Health Worker Competency Standards − NT Aboriginal Health Worker Qualifications Framework − Auspicing Agreement between DHCS and Batchelor Institute of Indigenous Tertiary Education ♦ developed an AHW Internship Program component of the AHW Career Structure. The aim of the Program is to promote the transition of beginning practitioners from ‘vocational training’ to ‘confident, independent practitioner’
Workforce Improvement ♦ initiated a Leadership Development Program for DHCS senior managers in September 2001. The final of 5 modules was completed in April 2002. Project presentations will be undertaken in October 2002 prior to participants graduating the Program. $230 000 was allocated for this inaugural Program ♦ developed partnership initiatives to upgrade skills of remote area staff. Training pathways in CASN are currently being evaluated. Training pathways in TESN continue to be developed ♦ delivered Community Based and Acute Care Programs. There is a demand for programs such as High Dependency Nursing and Pain Management. Programs such as Neonatal Care and Hyperbaric Care have been added ♦ conducted RDH New Graduate Program and the DHCS Introduction to Child Protection Course ♦ implemented new Undergraduate Nursing Grant and Postgraduate Nursing Grant initiatives which provide studies assistance support to people gaining qualifications in respective fields of study. $29 750 was spent on Undergraduate Nursing Grants and $2 500 on Postgraduate Nursing Grants
Page 164 Human Resources
♦ spent $137 899 on Studies Assistance grants and allocated $77 619 for new grants
Table 29: Studies Assistance Grants 2000/01 & 2001/02
Category New Recipients 2000/01 New Recipients 2001/02 DHCS Employees 70 58 Non DHCS Employees 38 78
Table 30: Undergraduate Nursing Grants 2001/02
Category New Recipients 2001/02 DHCS Employees 6 Non DHCS Employees 17
Table 31: Postgraduate Nursing Grants 2001/02
Category New Recipients 2001/02 DHCS Employees 12
Table 32: Studies Assistance Recipients by Professional Affiliation
Position Title New Continuing Total Staff Nursing 68 4 72 Allied Health 24 0 24 Medicine 24 7 31 Community Services 7 3 10 Public Health 7 2 9 Social Work 4 1 5 Children's Services 3 0 3 Management 3 0 3 Other 7 2 9 Total 147 19 166
Workforce Relations and Planning: ♦ provided quarterly employee profile reports to Executive and senior managers ♦ managed the Nursing Career Structure Review and the Recruitment and Retention Projects for Nursing and Professional streams ♦ provided on call human resource advisory service to all DHCS employees ♦ developed the Criminal Record Check processes ♦ established the Strategic Workforce Services intranet site ♦ provided ongoing revision of Employment Relations policies and guidelines ♦ implemented a targeted management leadership program, ‘Prevention is Better Than Cure’
Page 165 Human Resources
♦ recruited 27 graduates (since 1996) through the Graduate Development Program. The program has been a successful workforce initiative with 56% of graduates continuing employment within DHCS
Table 33: Profile of DHCS Graduate Development Program 1996 to 2002
Year Employed Retained in DHCS as Retained in NTPS as at 1 July 2002 at 1 July 2002 1996 6 3 6 1997 3 2 3 1998 4 2 2 1999 4 1 1 2000 3 3 3 2001 7 4 5 Total 27 15 20
Summary
SWS has developed new approaches to attract and retain a skilled workforce, as demonstrated by the Nursing and Aboriginal Health Structure Reviews, Recruitment and Retention initiatives and renewed focus on the departments professional development activities. These approaches strategies have helped to strengthen Aboriginal involvement in the departmental workforce.
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Human Resource Accountability
As required by Sections 18 and 28 of the Public Sector Employment and Management Act, the following information is provided in relation to Human Resource Management.
Section 28 Public Sector Employment and Management Act
♦ (f) equal opportunity management programs and other initiatives designed to ensure that employees employed in the Agency have equal employment opportunities
Strategic Workforce Services developed and conducted an Equal Employment Opportunity (EEO) survey on a representative sample of DHCS staff to provide information on workplace diversity. An improved version of this survey will be utilised to survey all DHCS staff.
DHCS have also conducted various information sessions on EEO throughout the agency. An Equity and Diversity session, presented by the Anti Discrimination Commission, is included in the ‘Prevention is Better Than Cure’ course and dedicated information has been presented to CASN and TESN Regional Executives by DHCS Human Resource Officers.
Other EEO initiatives designed to ensure that employees have equal employment opportunities include:
− an Inappropriate Workplace Behaviour survey to be conducted with all hospital based staff by August 2002 − the availability of Harassment Contact Officers at RDH − all DHCS employees and their families having access to services provided by Employee Assistance Scheme EAS
♦ (g) management training and staff development programs in the agency
A range of training and development programs have been conducted. The first Leadership Development Program will be finalised in October with 18 participants expected to complete it.
In February 2002 the ‘Prevention is Better Than Cure’ course was implemented throughout the agency. Courses have been conducted in all locations and to 30 June 2002, 129 staff had attended. An Aboriginal Mentoring Program has also been developed and implemented throughout the agency.
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The DHCS Indigenous Cadetship and Graduate Development Program continue to be successful. The department currently has 10 Indigenous Cadets and 4 administration stream graduates.
Section 18 Public Sector Employment and Management Act
♦ (2)(b) measures taken to improve human resource management in the agency
Information sessions were held throughout the year to increase awareness in regard to probation, selection panels, Job Evaluation, Establishment and Recruitment Protocols, and performance management. The Strategic Workforce Services intranet site was launched in May 2002. The site allows employees access to employment relations policies and forms, employment conditions, support services, workforce planning information, studies assistance information, Aboriginal workforce development information, contacts, links to relevant human resource sites and the latest information regarding human resource issues. Query and feedback, audit and evaluation mechanisms are also incorporated into the site. DHCS’ Personnel Integrated Payroll System (PIPS) security was improved as a result of audit reports.
DHCS participated in the NTPS Redeployment task force and agency policies and guidelines such as the Outside Employment guidelines have recently been reviewed. A leave without pay guideline has also been implemented to improve the provision of such arrangements.
♦ Employment Instruction 1 – Advertising, Selection and Appointment
Managers within DHCS continue to refer to the Job Evaluation, Establishment and Recruitment Protocols. Since their implementation in February 2001, the protocols have been an effective communication tool enabling managers to become more familiar with the processes. In addition, selection panel information sessions are conducted within the ‘Prevention is Better Than Cure’ course.
The DHCS Criminal Record Check project is in developmental stages. The project aims to develop processes to screen employees in positions that have regular, direct contact with clients. This process will be integrated into the current recruitment process to ensure employees do not commence with the department without a criminal history check clearance. This will ensure the department employs the most suitable and appropriate people for positions.
♦ Employment Instruction 2 – Probation
Probation guidelines and reporting mechanisms are available to all department managers. The guidelines provide a step by step approach to the fundamentals of effective management of supervisors and probationers.
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♦ Employment Instruction 4 – Performance Management
DHCS endorsed a new Performance Management system in October 2001. All managers are required to conduct performance management with their staff. The performance management system provides best practice information enabling managers and staff to apply a well established system.
♦ Employment Instruction 6 – Inability to Discharge Duties
Managers have sought human resource advice on inability issues and have accessed EI 6 information from the DHCS Strategic Workforce Services intranet site. Draft guidelines are to be finalised by August 2002.
♦ Employment Instruction 7 – Discipline
Managers continued to use EI 7 and the DHCS Strategic Workforce Services intranet site. 2 formal discipline cases occurred during this reporting year.
♦ Employment Instruction 8 – Management of Grievances
Managers in DHCS continue to refer to EI 8 and information on the Strategic Workforce Services intranet site. Managers and staff were assisted by DHCS Human Resource Officers and through the Employee Assistance Program.
♦ Employment Instruction 10 – Employee Records
All employee records were kept in strict adherence to EI 10 and legislative requirements. Security and confidentiality was maintained with systems in place regarding authorised access to employee information.
♦ Employment Instruction 11 – Equal Opportunity Management Plan
Various elements of DHCS Equal Opportunity Management Plan (EOMP) were actioned. These elements include the Equal Employment Opportunity survey and continued progress towards implementing a DHCS wide Harassment Contact Officer network.
♦ Employment Instruction 12 – Occupational Health and Safety Plan
The Occupational Health and Safety Management System (OHSMS) continues to be used by DHCS managers. As part of the revised Strategic Workforce Services intranet site, all electronic OHS information was simplified. DHCS continues to work closely with DCIS to provide a valuable service to managers.
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♦ Employment Instruction 13 – Code of Conduct
All DHCS employees receive a copy of the Code of Conduct on commencement with the department. The booklet is also available on the Strategic Workforce Services intranet site and is prominently displayed as an icon. Accompanying the electronic link is a practical explanation of the Principles and Code of Conduct highlighting the fact that all employees are bound by the content.
♦ Employment Instruction 14 – Part Time Employment
The DHCS Flexible Employment Guidelines were endorsed by Executive in July 2001. Permanent part time hours, temporary work, working from home and job sharing are being used as employment options for DHCS staff. 14% of DHCS work force was employed on a part time employment basis.
♦ (2)(c) Extent to which disciplinary, redeployment and inability procedures were invoked.
Table 34: Summary of Human Resource Activity by Area
Formal Inability Summary Dismissal Disciplinary Darwin area Nil 1 1 Gove Nil Nil Nil Katherine Nil Nil 1 Tennant Creek Nil Nil Nil Alice Springs region 1 1 Nil Total 1 2 2
Page 170 Human Resources
Occupational Health and Safety (OHS)
Overview
The Department of Corporate and Information Services (DCIS) manages OHS and Workers Compensation and Rehabilitation for DHCS under a service agreement which includes performance targets.
In May 2000 DHCS approved the Occupational Health and Safety Management System (OHSMS) and a Managers Hands On Guide for self assessment of the workplace. Over the past 2 years these strategies have become the keystone of the DHCS OHS Management Plan.
2001/02 Performance Goals
1. To reduce the number and severity of individual claims by 5%.
2. To maintain the claims costs at or below the benchmark.
3. To reduce the number and severity of manual handling injuries by 3%.
4. To target designations at risk and implement strategies to reduce the risk.
5. To reduce the number of incidents of aggression.
6. To reduce the number and cost of injuries to nursing staff by 5%.
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1. To reduce the number and severity of individual claims by 5%.
The figure below shows that the performance target was met. There has been a 0.6% decrease in the number and a 15% decrease in the cost of new claims. The performance goal for 2002/03 is to continue the early intervention program to further reduce the number of stress related claims and associated costs by 5%.
Figure 55: DHCS New Stress Claims by Number/Cost
$900 70
$800 60
$700 50 $600
$500 40
$400 30 Number of Claims $300 Cost of Claims $000 20 $200
10 $100
$0 0 1997/98 1998/99 1999/00 2000/01 2001/02
Financial Year Cost of Stress Claims Number of Stress Claims
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2. To maintain the claims costs at or below the benchmark.
The figure below shows the costs of compensation injuries as a percentage of gross salary. A benchmark of 1.8% is based on national health industry performance figures for 1992. With the exception of the current year, performance remained close to or below the benchmark. The increase in 2001/02 was influenced in part by an assertive strategy to reduce the number of long term claims and lower DHCS unfunded liabilities. There is an expectation that performance in future years will reflect this initiative and the target for 2002/03 is a reduction to 1.7% gross salary.
Figure 56: Workers Compensation as a Percentage of Salary
3.0
OHS Performance Target
2.0
Percentage of Salary 1.0
0.0 1997/98 1998/99 1999/00 2000/01 2001/02 Financial Year
Page 173 Human Resources
3. To reduce the number and severity of manual handling injuries by 3%.
An increase in the number and cost of manual handling injuries across DHCS indicates a failure to enthusiastically embrace the manual handling strategy. In 2002/03 the Back Care Manual Handling program will be revised, with a new focus on training at all levels, together with early intervention and rehabilitation strategies. The performance target for 2002/03 is a reduction by 10% in the number and costs of injuries.
Figure 57: Number and Severity of Manual Handling Injuries
350000 70
300000 60
250000 50
200000 40
150000 30 Number of Claims $ Cost of Claims 100000 20
50000 10
0 0 1996/97 1997/98 1998/99 1999/00 2000/01 2001/02 Financial Year
Cost of Claims Number of Claims
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4. To target designations at risk and implement strategies to reduce the risk.
There has been an increase in costs in all designations, reflecting legacy costs from injuries in previous years together with significant payments to resolve long term claims. Performance goal for 2002/03 is to identify ‘at risk’ designations and, through early intervention and preventative strategies, to reduce the number of claims by 10%.
Figure 58: Cost of Stress Claims by Designation
275
250
225
200
175
150
125
100 Cost of Claims $000 75
50
25
0 AHW Remote Hospital Nurses Urban Nurses AO5 to Prof Phys to AO4 Community Nurses Occupation 1997/98 1998/99 1999/00 2000/01 2001/02
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5. Reduce the number of incidents of aggression.
The figure below shows a reduction in the number of claims for incidents of aggression. However, a significant increase in costs indicates higher incident severity and increased lost time. (These injuries are mostly stress related.) Performance goals for 2002/03 are: − continue the early intervention program with the objective of minimising the effects of stress related injuries where critical incidents are the cause − maintain the training and support of aggression response teams throughout all DHCS hospitals − improve the availability of training for staff in remote locations.
Figure 59: Claims as a result of physical and non physical aggression
$250 45
40
$200 35
30
$150 25
20 $100 Number of Claims Cost of Claims $000 15
10 $50
5
$0 0 1997/98 1998/99 1999/00 2000/01 2001/02 Financial Year Total Cost of Claims Total Number of Claims
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6. Reduce the number and cost of injuries to nursing staff by 5%.
There has been a marginal reduction in the number of claims involving nursing staff. However an increase of 20% in days lost is an indicator of injury severity. Performance goals for 2002/03: − continued reduction in number of injuries to nurses − focus on early intervention, rehabilitation and return to work programs − facilitate a 10% decrease in days lost
Figure 60: Number and Cost of Claims Involving Nursing Staff
120 2500
100 2000
80 1500
60
1000 Number of Claims
40 Number of Days Lost
500 20
0 0 1995/96 1996/97 1997/98 1998/99 1999/00 2000/01
Financial Year
Total Number of Claims Total Days Lost
Page 177 Human Resources
Industrial Relations
Overview
A harmonious work environment is an important factor in allowing DHCS to fulfil its strategic directions. The Office of the Commissioner for Public Employment provides industrial relations advice to DHCS. In addition, the agency’s Strategic Workforce Services (SWS) provides industrial relations support to managers, implements certified agreements and makes a range of industrial relations information available to all staff.
Achievements
Negotiation and implementation of the 2001 to 2003 Nurses Certified Agreement. This includes: − professional development allowance, − specialised studies assistance for nurses − Nursing Re Entry Program. − an 11% salary increase over 2 years. Union involvement in projects such as the Nursing Career Structure Review and Inappropriate Behaviour Working Parties.
Joint Consultative Council (JCC) meetings were conducted every 4 months. The JCC comprises representatives from the following relevant unions: − Australian Nursing Federation (ANF) − Community and Public Sector Union (CPSU) − Australian Liquor, Hospitality & Miscellaneous Workers Union (LHMU) − 8 members of the DHCS Executive − DHCS Director Strategic Workforce Services
Summary
During the 2001/02 financial year there was a focus on nursing industrial relations. In conjunction with DHCS workforce initiatives, this will enable the department to enhance its future organisational capability. In addition, Industrial Relations: ♦ maintained appropriate working relationships with relevant Unions ♦ delivered timely and accurate industrial relations advice to Executive and senior management ♦ provided staff with advice on conditions of service. ♦
Page 178 Financial Statements
Financial Statements
In the opinion of Management, the Financial Statements of Department of Health and Community Services as set out, provide a true and fair account of the results of agency operations for the year ended 30 June 2002.
The Financial Statements are presented in accordance with Part 2 Section 5 of the Treasurer’s Direction, and records have been kept as required by the Financial Management Act.
GRAHAM SYMONS JOANNE SCHILLING Acting Chief Executive Officer Acting Assistant Secretary Business and Operational Support
The following tables detail the statements as indicated.
Table 1 2001/02 Expenditure by Functional Area Table 2 2001/02 Expenditure by Standard Classification Table 3 2001/02 Receipts by Account Table 4 Accountable Officers Trust Account Transactions for the Year Ended 30 June 2002 Table 5 Write Offs, Postponements and Waivers for the Year Ended 30 June 2002
Table 6 Debtors as at 30 June 2002 Table 7 Creditors and Accruals as at 30 June 2002 Table 8 Employee Entitlements Outstanding as at 30 June 2002 Table 9 Lease Liabilities as at 30 June 2002
Department of Health and Community Services Notes to and Forming Part of the Financial Statements for the Year Ended 30 June 2002.
Page 179 Financial Statements
Financial Table 1
2001/2002 Expenditure by Functional Area
Functional Area Staffing Final Actual Actual Allocation 2001/2002 2000/2001 $000 $000 $000
Organisational Support 153 24 877 22 091 Executive and Support 21 2 441 2 549 Corporate Services 132 22 436 19 542
Acute Care 1 317 137 584 119 076 Royal Darwin Hospital 1 317 137 584 119 076
Other Acute Care 1 016 110 298 93 817 Katherine Hospital 181 16 409 14 579 Gove District Hospital 109 12 261 11 930 Tennant Creek Hospital 56 6 303 6 162 Alice Springs Hospital 670 75 325 61 146
Public Health 314 41 122 38 420 Public Health Services 186 20 529 19 837 Dental Services 72 5 971 5 786 Alcohol and Other Drugs 56 11 358 10 341 Menzies School of Health Research 3 264 2 456
Community Services 414 75 906 77 882 Mental Health Services 141 14 715 13 939 Family, Aged and Disability Services 273 59 056 61 051 Community Service Obligations 2 135 2 892
Primary Health Care 638 100 136 95 954 Program Development 75 11 667 10 051 Primary Health Care - Urban 203 24 661 23 678 Primary Health Care - Rural 360 63 808 62 225
TOTAL 3 852 494 7907 489 923 447 240
7 Allocation was changed to a single line appropriation in the November Mini Budget. The Department lapsed allocation of $4.630M to allow for a carry forward into 2002/03.
Page 180 Financial Statements
Explanations to Table 1:
Variations between 2000/01 and 2001/02 Expenditures
ORGANISATIONAL SUPPORT expenditure increased by $2.8M, due to additional legal cases settled, and additional IT costs.
ACUTE CARE (Royal Darwin Hospital) expenditure increased by $18.5M. Cross Border payments relating to the previous year totalled $6.7M. Increased costs were also incurred in providing Angiography services and the doubling of Intensive Care Unit ventilated days, together with a 20% increase in throughput in the Neonatal Intensive Care Unit.
OTHER ACUTE CARE (all other Hospitals) expenditure increased overall by $16.5M. Increases were due to inpatient activity growth of approximately 18% at Tennant Creek Hospital, 13.8% at Katherine Hospital, and 9.2% at the Alice Springs Hospital. Cross Border payments also increased expenditure by $6M.
PUBLIC HEALTH expenditure increased by $2.7M. This was due to additional spending on Commonwealth funding programs such as the Public Health Outcomes Funding Agreement (PHOFA), Rheumatic Heart Disease Program and Immunisation programs. Additional grant funding was also provided to the Menzies School of Health Research.
COMMUNITY SERVICES overall expenditure decreased by $1.9M. Additional Mental Health Services increased costs by $0.8M. A reduction in expenditure in the Family, Aged and Disability Services program from 2000-01 resulted from the cessation of Commonwealth funding under the National Childcare strategy agreement in 2000/01, and other one off expenditures in 2000/01. Community Service Obligations are a reflection of Power and Water billing to DHCS for pensioner concessions.
PRIMARY HEALTH CARE expenditure increased overall by $4.2M. Major increases are in the areas of Patient Assistance Travel and Client Medical Evacuations. Increased expenditure on the chronic disease prevention and quality use of medicine initiative was funded through reimbursement from the Commonwealth under the Pharmaceutical Benefits Scheme (Section 100).
Page 181 Financial Statements
Financial Table 2
2001/2002 Expenditure by Standard Classification
Category of Cost/Standard Classification Actual Expenditure $000
PERSONNEL COSTS 197 879 Salaries 177 439 Payroll Tax 4 277 Fringe Benefits Tax 1 104 Superannuation 15 059
OTHER PERSONNEL COSTS 59 879 Higher Duties Allowance 2 593 Leave Loading 1 358 Northern Territory Allowance 962 Other Allowances 4 768 Other Benefits paid by Employer 6 043 Overtime 14 373 Penalty Payments 16 072 Perishable Freight Subsidy 16 Recreation Leave Fares 1 945 Salary Advances 38 Termination Payments 6 190 Workers Compensation 5 521
OPERATIONAL EXPENSES/EXPENDITURE 17 680 Repairs and Maintenance 2 117 Property Maintenance 3 082 General Property Management 3 061 Power 8 584 Water & Sewerage 836
OTHER OPERATIONAL COSTS 133 832 Advertising 139 Audit Fees 4 Client Travel 14 397 Clothing 262 Communications 4 817 Consultants' Fees 7 211 Consumables/General Expenses (including Stores) 2 020 Cross Border Patient Charges 21 853
Page 182 Financial Statements
Document Production 598 Entertainment 4 Food 2 357 Freight 804 Furniture and Fittings 944 Information Technology Services 17 602 Insurance Premiums 26 Laboratory Expenses 3 376 Legal Expenses 4 846 Library Services 859 Marketing and Promotion 424 Medical/Dental Supplies 33 959 Memberships and Subscriptions 99 Mobile Plant 69 Motor Vehicles (excl. Insurance) 5 538 Office Requisites and Stationery 1 681 Official Duty Fares 2 070 Other Plant and Equipment 1 169 Recruitment Expenses 2 800 Registration & Advisory Boards/Committees 273 Relocation Expenses 270 Training and Study Expenses 1 713 Travelling Allowance 1 634 Bank Charges 14
INTRASECTOR PAYMENTS 79 Payments to the Northern Territory Government 79
CAPITAL EXPENDITURE 3 611 Construction (works in progress) 166 Purchase of Capital Assets 3 445
GRANTS AND SUBSIDIES 76 181 Grants 65 873 Subsidies 10 308
INTEREST 94 Interest Expenses 94
ADVANCES 688 Repayment of Advances 688
TOTAL EXPENDITURE 489 923
Page 183 Financial Statements
Financial Table 3
2001/2002 Receipts by Account
Consolidated Revenue Account Estimated Actual Receipts Receipts $000 $000
Taxes, Fees and Fines 404 590 Miscellaneous Receipts 0 313
Total Consolidated Revenue Account: 404 903
Operating Account Estimated Actual Receipts Receipts $000 $000
Charges for Goods and Services 17 836 19 263 Sale of Other Assets 45 34 Miscellaneous Revenue/Receipts 4 176 4 746 Commonwealth Payments 108 390 106 529 Other Intrasector Revenue/Receipts 221 199 Interest Received 0 0 Advances Received 0 0
Total Operating Account Receipts 130 668 130 771
Transfer from Consolidated Revenue Account 366 787 366 787
Total Receipts to Agency Operating Account 497 455 497 558
Page 184 Financial Statements
Explanations to Table 3: 2001/02 Receipts by Account
The Department of Health and Community Services (DHCS) contribution to the Consolidated Revenue Account (CRA) includes public health inspections and licensing, and registration fees for health professionals such as medical practitioners and nurses. These are legislated fees and as a result are directed to Consolidated Revenue and do not impact on the Agency Operating Account
The agency receives revenue primarily from Commonwealth Grants and charges for goods and services.
DHCS has exceeded the 2001/02 revenue target for goods and services charges by $1.4M. This variation is attributed to an increase inpatient charging of $1.4M and Cross Border Charging of $1.0M. These were partially offset by minor reductions to other charges.
The Department receives funding from the Commonwealth for a number of programs and projects. These include the Australian Health Care Agreement, the Commonwealth State Disability Agreement, the Public Health Outcomes Funding Agreement and the Home and Community Care arrangements. These are an important source of funds to the Department and in 2001/02 Commonwealth grants made up 81% of the Agency Operating Account revenue.
The agency’s revenue is insufficient to meet the cost of delivering health care services to the Northern Territory. The shortfall between the agency’s budgeted revenue and expenditure is funded by the NT Government through transfers from the Consolidated Revenue Account. In 2001/02 $366.8M was transferred to the Agency’s Operating Account.
Page 185 Financial Statements
Financial Table 4
Accountable Officers Trust Account Transactions for the Year Ended 30 June 2002
Opening Balance Closing Balance Nature of Trust Money 1 July 2001 Receipts Payments 30 June 2002 $000 $000 $000 $000
Accommodation Bonds 136 178 160 154
Adoption Previous Subsidy Scheme 3 4 7 0
Electricity Security Deposits 5 0 0 5
Keys Security Deposits 14 19 16 17
Nursing Airfares 42 1 11 32
Overseas Adoptions (2) 81 64 15
Sessional Medical Officers Superannuation 6 0 0 6
Unclaimed Monies 12093
RDH Key Deposit 0 2 0 2
Community Donation 4 0 0 4
TOTAL 220 285 267 238
Page 186 Financial Statements
Financial Table 5
Write Offs, Postponements And Waivers For The Year Ending 30 June 2002
Category $
WRITE OFFS, POSTPONEMENTS AND WAIVERS UNDER THE ACT Amounts written off or waived by Delegated Officers Irrecoverable money written off 94 480 Losses or deficiencies of monies written off 0 Value of public property written off 43 692 Waiver of right to receive or recover money 0
Amounts written off, postponed or waived by the Treasurer Irrecoverable money written off 10 679 Losses or deficiencies of monies written off 0 Value of public property written off 0 Postponement of money owing 449 127 Waiver of right to receive or recover money 0
WRITE OFFS, POSTPONEMENTS AND WAIVERS AUTHORISED UNDER OTHER LEGISLATION Amounts written off or waived by Delegated Officers Losses or deficiencies of monies written off 223 643
TOTAL 821 621
Page 187 Financial Statements
Financial Table 6
Debtors As At 30 June 2002
External Intrasector Charges Other Total Charges Other CSO Total TOTAL $000 $000 $000 $000 $000 $000 $000 $000
GROSS DEBTORS 3 032 4 712 7 744 37 48 85 7 829 Less: Provision for (1 050) (1 183) (2 233) (2 233) Doubtful Debts
NET DEBTORS 1 982 3 529 5 511 37 48 0 85 5 596
Classified as: Current 1 982 3 529 5 511 37 48 85 5 596 Non Current 0 0 0 0 0 0 0
NET DEBTORS 1 982 3 529 5 511 37 48 0 85 5 596
Page 188 Financial Statements
Financial Table 7
Creditors And Accruals As At 30 June 2002
External Intrasector Creditors Accruals Total Creditors Accruals Total TOTAL $000 $000 $000 $000 $000 $000 $000
CREDITORS & 7 057 6 595 13 652 277 755 1 032 14 684 ACCRUALS Classified As: Current 7 057 6 595 13 652 277 755 1 032 14 684 Non Current 0 0 0 0 0 0 0
TOTAL 7 057 6 595 13 652 277 755 1 032 14 684
Creditors are amounts owing to external suppliers and include invoices dated 30 June 2002 and before but unpaid as at 30 June 2002.
Accruals are the value of goods/services relating to the 2001/02 financial year incurred by the Department of Health and Community Services but unpaid until after 30 June 2002. Items include staff salaries, superannuation, payroll and fringe benefits tax, electricity and telephone accounts.
Page 189 Financial Statements
Financial Table 8
Employee Entitlements Outstanding as at 30 June 2002
Entitlement $000
Current Recreation Leave 24 381 Recreation Leave Fares 1 945 Leave Loading 3 560 Long Service Leave 17 110
Non Current Long Service Leave 5 345
TOTAL 52 341
METHODOLOGY
1Recreation Leave
The value of recreation leave entitlements are calculated by PIPS based on employees' actual salaries and entitlements at 30 June 2002.
2 Recreation Leave Fares
Recreation Leave Fares entitlements are calculated based on 2001/02 actuals.
3 Leave Loading
The value of leave loading entitlements are calculated by PIPS based on employees' actual salaries and entitlements at 30 June 2002.
4Long Service Leave
Long Service entitlement is calculated in accordance with Australian Accounting Standard AAS 30. The calculation takes into account the probability of employees reaching 10 years of service, the future increases in salary costs and discount rates to achieve the net present value of the future liability.
Page 190 Financial Statements
Financial Table 9
Lease Liabilities as at 30 June 2002
Lease Commitments/ Information Technology Furniture Other Plant Liability Hardware Software & Fittings & Equipment Total $000 $000 $000 $000 $000 Not later than 1 year 111 377 488 Later than 1 year but not later than 2 years 64 0 64 Later than 2 years but not later than 5 years 32 0 32 Later than 5 years -
Minimum lease payments 207 377 584 Less: future financing charges ( 22) ( 60) ( 82)
TOTAL 185 317 - - 502
Classified as: Current 99 317 416 Non Current 86 86
TOTAL 185 317 - - 502
Page 191 Financial Statements
Department of Health and Community Services Notes To and Forming Part of the Financial Statements for the Year Ending 30 June 2002
Note 1: Significant Financial and Account Policies
(a) Department of Health and Community Services as an Agency Department of Health and Community Services is an Agency of the Northern Territory Government as defined by the Financial Management Act. The accompanying financial statements are prepared in accordance with Section 11 of the Financial Management Act and Part 2 Section 5 of the Treasurer’s Directions which define the requirements of financial reporting by Northern Territory Government Agencies. These financial statements are included in this Annual Report in accordance with Section 12 of the Financial Management Act.
(b) Basis of Account Department of Health and Community Services’ financial records are kept on a cash basis, and recognise events on receipt of monies or payment of monies and are reported within the financial accounting period concerned. No accrual entries (recognition of revenues as they are earned and expenses as they are incurred) are recorded in the General Ledger. There is no requirement for the Department of Health and Community Services to prepare a Balance Sheet for the year ending 30 June 2002.
(c) Reporting The allocation in Output Groups and Outputs for 2001/02 in the November Mini Budget was the first presentation of the budget in line with the new Working for Outcomes framework. The Department will commence Output reporting in 2002/03. Expenditure for 2001/02 is presented by Activity and Program, which is the same basis as the previous financial year.
Note 2: Investments Department of Health and Community Services had no investments held in corporation, trust, joint ventures or similar entities as at 30 June 2002.
Note 3: Contingent Liabilities Details of all contingent liabilities have been provided to Northern Territory Treasury in accordance with Treasurer’s Directions Part 2 Section 4 for consideration in global reporting in the Treasurer’s Annual Financial Statement.
Note 4: Accountable Officer’s Trust Account The Accountable Officer’s Trust Account is established in accordance with Section 7 of the Financial Management Act of the receipt and payment of monies held in trust on behalf of third parties where it is not intended that Department of Health and Community Services will be a beneficiary, eg. conditional accommodation bonds paid by employees where it is intended to refund those monies.
Page 192 Senior Contact Officers
Senior Contact Officers
Executive Group
Principal Medical Consultant Acting Chief Executive Officer / Dr Len Notaras Deputy Secretary, Service Provision Telephone: (08) 89228156 Graham Symons Telephone: (08) 89992416 Executive Director, Royal Darwin Hospital Dr Len Notaras Acting Assistant Secretary, Business and Telephone: (08) 89228156 Operational Support Joanne Schilling Executive Director, Alice Springs Hospital Telephone: (08) 89992416 Jeff Byrne Telephone: (08) 89517992 Assistant Secretary, Strategic Review & Information Services Executive Support Stephen Moo Telephone: (08) 89992847 Ministerial Liaison Director, Jan Evans Assistant Secretary, Health Development & Telephone: (08) 89992886 Community Services and Chief Health Officer Dr Shirley Hendy Public Affairs Telephone: (08) 89992768 Director, Vera Whitehouse Telephone: (08) 89992743 Assistant Secretary, Community Health, Aboriginal Health & Hospital Services To p E n d S e r v i c e N e t w o r k Jenny Cleary Darwin Urban District Telephone: (08) 89992752 General Manager, Meribeth Fletcher Assistant Secretary, Services Development Telephone: (08) 89227242 Rose Rhodes Darwin Rural District Telephone: (08) 89227237 General Manager, Lesley Kemmis Regional Director, Top End Service Network Telephone: (08) 89228086 David Ashbridge East Arnhem District Telephone: (08) 89227149 General Manager, Mark Watson Regional Director, Central Australian Service Telephone: (08) 89870302 Network Katherine District Sue Korner General Manager, Robin Smith Telephone: (08) 89515111 Telephone: (08) 89739034
Page 193 Senior Contact Officers
Oral Health Strategic Operations General Manager, Noni Bickerstaff Manager, Vacant Telephone: (08) 89244484 Telephone: (08) 89515844
Mental Health Community Health Services Urban General Manger, Vic Rowe General Manager, Del Hird Telephone: (08) 89994900 Telephone: (08) 89516708 Central Australian Health Development & Service Network Community Services
Alice Springs District Social and Emotional Wellness General Manager, Ian Crundall Director, Cheryl Furner Telephone: (08) 89515157 Telephone: (08) 89992916
Barkly Health Services Centre for Disease Control General Manager, John Heslop Director, Vicki Krause Telephone: (08) 89624266 Telephone: (08) 89228510
Health Development Environmental Health (including Radiation Manager, Penny Fielding Health and Poisons) Telephone: (08) 89516916 Director, Xavier Schobben Telephone: (08) 89992714 Community Service – Family and Children’s / Aged and Disabilities Medical Entomology Manager, Jenny Mills Director, Peter Whelan Telephone: (08) 89515365 Telephone: (08) 89228333
Community Services – Mental Health Women’s Cancer Prevention Manager, Vicki Stanton Program Manager, Karen Finch Telephone: (08) 89517716 Telephone: (08) 89992837
Community Services – Alcohol and Other Family and Children’s Services Drugs Director, Anthony Burton Manager, Brycen Brook Telephone: (08) 89992723 Telephone: (08) 89517582 Aged care and Disability Services Oral Health Director, Damien Conley Manager, Bruce Symmons Telephone: (08) 89992831 Telephone: (08) 89576722 Community Health Community Health Services Remote Manager, Joanne Harkin Primary Health and Coordinated Care Telephone: (08) 89517800 Director, Noelene Swanson Telephone: (08) 89992831
Page 194 Senior Contact Officers
Aboriginal Health Professional Boards Senior Policy Officer, Trish Jones Acting Director, Carolyn Wilson Telephone: (08) 89992642 Telephone: (08) 89994194
Women’s Health Strategy Unit Director, Jenne Roberts Workforce Development Telephone: (08) 89992932 Director, Dr. Rosy Warden Hospital Services Telephone: (08) 89228227
Workforce Relations and Planning Hospital Services Director, Steve Marshall Director, Allison Grierson Telephone: (08) 89992920 Telephone: (08) 89992659 Legal Services Alice Springs Hospital Manager, Susan Paltridge Executive Director, Jeff Byrne Telephone: (08) 89992810 Telephone: (08) 89517992
Katherine Hospital Strategic Review and Information Services General Manager, Robin Smith Telephone: (08) 89739034 Strategic Review and Evaluation Gove Hospital Director, John Montz General Manager, Mark Watson Telephone: (08) 89992633 Telephone: (08) 89870302 Quality Improvement Unit Royal Darwin Hospital Director, Lorraine Porter Executive Director, Gary Lum Telephone: (08) 89992406 Telephone: (08) 89228156 Services Development Tennant Creek Hospital General Manager, John Heslop Health Gains Planning Telephone: (08) 89624266 Program Director, Steve Guthridge Telephone: (08) 89227232 Business and Operational Support Community Health Development Finance and General Services Program Director, Jill MacAndrew Acting Director, Brian Slatter Telephone: (08) 89227093 Telephone: (08) 89992808 Community Services Information Technology Services Program Director, Jenny Scott Director, Ian Allan Telephone: (08) 89227080 Telephone: (08) 89992783
Page 195 List of Acronyms
List of Acronyms
AAS Australian Accounting Standard ACAT Aged Care Assessment Teams AHCS Australian Health Care Standards ACIR Australian Childhood Immunisation Register ACPP Aboriginal Child Protection Principle AEHW Aboriginal Environmental Health Worker AHPIF Aboriginal Health Promotion Incentive Fund AHW Aboriginal Health Worker AIDS Acquired Immune Deficiency Syndrome AIMS Australian Incident Monitoring System ALOS Average Length of Stay AMHW Aboriginal Mental Health Worker AMSANT Aboriginal Medical Services Alliance Northern Territory ANF Australian Nursing Federation AODP Alcohol and Other Drug Program ARPANSA Australian Radiation Protection and Nuclear Safety Agency ASH Alice Springs Hospital ATSIC Aboriginal and Torres Strait Islander Commission AWDU Aboriginal Workforce Development Unit CAMHS Central Australian Mental Health Services CASN Central Australian Service Network CBD Central Business District CCIS Community Care Information System CDC Centre for Disease Control CDEP Community Development Employment Program CHS Community Health Services CPSU Community and Public Sector Union CSDA Commonwealth/State Disability Agreement CT Computed Tomography DCM Department of Chief Minister DEET Department of Employment Education and Training DEWR Department of Employment and Workplace Relations DHCS Department of Health and Community Services EAS Employee Assistance Service EBA Enterprise Bargaining Agreement ECG/EEG Electro Cardio Graph /Electro Encephalo Graph EEO Equal Employment Opportunity EHP Environmental Health Program EH Environmental Health ENT Ear, Nose and Throat EOMP Equal Opportunity Management Plan FACS Family and Children's Services FTE Full Time Equivalent GAA Growth Assessment and Action GDH Gove District Hospital GP General Practitioner HACC Home and Community Care HIV Human Immunodeficiency Virus
Page 196 List of Acronyms
IHANT Indigenous Housing Authority of the Northern Territory ISO Industry Search and Opportunity JCC Joint Consultative Council KDH Katherine District Hospital LHMU Australian Liquor Hospitality & Miscellaneous Workers Union LNG Liquefied Natural Gas MOU Memo of Understanding MRI Magnetic Resonance Imaging MSHR Menzies School of Health and Research NAHS National Aboriginal Health Strategy NCAC National Childcare Accreditation Council NGO Non Government Organisation NHMRC National Health and Medical Research Council NTCAG Northern Territory Community Advisory Group NTCOSS Northern Territory Council of Social Services NTDAB Northern Territory Disability Advisory Board OATSIH Office for Aboriginal and Torres Strait Islander Health OHS Occupational Health and Safety OHSMS Occupational Health and Safety Management System PATS Patients Assisted Travel Scheme PBP Public Behaviour Program PBS Pharmaceutical Benefits Scheme PHCAP Primary Health Care Access Program PIPS Personnel Integrated Payroll System PWC Power Water Corporation QIC Quality Improvement Committee RDH Royal Darwin Hospital RHD Rheumatic Heart Disease SAAP Supported Accommodation Assistance Program SAODA South Australian Organ Donation Agency SDD Service Development Division SEAT Seating and Equipment Assessment Team SOEWELL Social and Emotional Wellness STD Sexually Transmitted Diseases STEP Structured Training and Employment Program STI Sexually Transmitted Infections SWS Strategic Workforce Services TB Tuberculosis TCP Transitional Care Project TEMHS Top End Mental Health Service TESN Top End Service Network THS Territory Health Service TIME Territory Independence and Mobility Equipment Scheme WEIS Weighted Inlier Equivalent Separations WHO World Health Organisation
Page 197 Figures and Tables Index
Figures and Tables Index
Performance Highlights Table 1: Number of Donors From Each Hospital 1989 to 2001...... 13 Figure 1: Organ Donors Selected Countries...... 14 Health and Community Services at a Glance Figure 2: Health and Community Services Strategy 21 - Directions 2005...... 19 Figure 3: Staffing as a Percentage of Total Full Time Equivalent Employees in NT Public Sector ...... 24 Figure 4: Full Time Equivalent Staffing Trends over a 3 Year Period...... 25 Figure 5: Program Staff as Percent of Total Acengy Staff ...... 26 Figure 6: DHCS Expenditure as a Percentage of Total NT Public Sector...... 27 Figure 7: Health and Community Services Expenditure by Source of Funding ...... 27 Figure 8: Health and Community Services Expenditure by Source of Funding and Activity ...... 28 Figure 9: Breakdown of Actual Expenditure for all Hospitals...... 28 Figure 10: DHCS Expenditure by Activity...... 29 Table 2: Number of Complaints Received by Service ...... 30 Table 3: Nature of the Complaints ...... 31 Table 4: Complaint Outcomes 2001/02...... 32 Table 5: Length of time to complete complaint investigation and outcome process...... 32 Aboriginal Health Figure 11: Indigenous Death Rate for all Causes...... 37 Figure 12: Indigenous Death Rate for Cardiovascular Disease ...... 38 Table 6: Life Expectancy at Birth in Years in the Northern Territory...... 38 Figure 13: Age Adjusted Years of Life Lost (YLLs) Per Thousand Population Northern Territory 1989 to1998 39 Figure 14: NT Infant Mortality Rates 1981-1984 to 1997-2000...... 40 Table 7: NT Infant Mortality Rates 1980 to 1999...... 40 Figure 15: Hospital Separation Rates per Thousand Population 1995/96 and 1998/99...... 41 Figure 16: Indigenous / Non Indigenous Admissions 1999 to 2002 NT Government Hospitals ...... 43 Figure 17: Health Expenditure per Person ...... 44 Hospital Services Table 8: Acute Inpatient Activity – WIES by NT Hospital...... 48 Figure 18: Acute Inpatient Activity - WIES by Indigenous Status...... 49 Figure 19: Major Diagnostic Categories 2001/02 – Non Indigenous ...... 50 Figure 20: Major Diagnostic Categories 2001/02 – Indigenous...... 51 Figure 21: Same Day Renal Treatment ...... 51 Figure 22: Average Length of Stay (ALOS) 2001/02 Excluding Same Day ...... 52 Figure 23: Hospitals Expenditure 1999 to 2002 WIES/Outpatients/Emergency Attendances ...... 53 Table 9: Percentage of Patients Treated in Emergency Department 2001/02 Royal Darwin Hospital...... 54 Table 10: Percentage of Patients Treated in Emergency Department 2001/02 Alice Springs Hospital...... 54 Table 11: Percentage of Patients Treated in Emergency Department 2001/02 Katherine District Hospital...... 55 Table 12: Percentage of Patients Treated in Emergency Department 2001/02 Tennant Creek Hospital ...... 55 Table 13: Percentage of Patients Treated in Emergency Department 2001/02 Gove District Hospital ...... 55 Figure 24: Episodes of Acute Care - Katherine Hospital...... 63 Figure 25: Average Length of Stay - Katherine Hospital ...... 63 Figure 26: Number of patients treated – Gove District Hospital ...... 65 Figure 27: Weighted Separations - Alice Springs Hospital ...... 69 Figure 28: Average Length of Stay - Alice Springs Hospital...... 70
Page 198 Figures and Tables Index
Figure 29: Total Bed Days - Tennant Creek Hospital...... 73 Figure 30: Day Surgery Unit Discharges - Tennant Creek Hospital...... 73 Figure 31: Specialist Outpatients Attendances - Tennant Creek Hospital ...... 74 Community Health Figure 32: Services delivered by dentists and dental therapists...... 77 Figure 33: Growth rate of children 0-4years in Alice Springs Rural District ...... 80 Figure 34: Birth weights of children born within communities with a Strong Women’s Program ...... 82 Figure 35: Number of Dental Visits ...... 83 Figure 36: Impact of Remote Area Outreach on RDH Gynaecological Consultations...... 84 Figure 37: Place of Death 1998/99 to 2001/02 by Region ...... 85 Family and Children's Services Figure 38: Access to licensed Child Care Places ...... 89 Table 39: Persons Living in Independent Accommodation After Leaving a Crisis Service...... 92 Aged, Disability and Community Care Table 14: ACAT Assessments by Region...... 95 Table 15: Taxi Subsidy Scheme ...... 95 Table 16: Territory Independence and Mobility Equipment Scheme Expenditure...... 96 Figure 40: Adult Guardianship Waiting List and Orders Made 1991 to June 2002...... 96 Table 17: Number of Senior Card registrations and business participants...... 97 Table 18: Disability Services Total Expenditure ...... 100 Mental Health Services Figure 41: Mental Health In patient Activity 2001/02 ...... 103 Table 19: Mental Health Inpatient Separations by Diagnostic Group...... 103 Table 20: NT Mental Health Consumer Population by Gender and Indigenous Status...... 104 Table 21: Community Mental Health Consumers by Age and Service Location...... 104 Table 22: Number of people receiving community Mental Health Services by Indigenous Status and Location105 Table 23: Number of people receiving Community Mental Health Services by Gender and Location...... 105 Table 24: Community Mental Health Service Contacts by Location...... 105 Environmental Health Figure 42: Schedule 8 Drug Prescriptions and Patient Contracts in the NT...... 116 Disease Control Figure 43: Number of Salt Marsh Mosquitoes Ochlerotatus vigilax per Month Caught Using Weekly Mosquito Traps at Eleven Darwin Monitoring Sites ...... 119 Figure 44: Percentage of Children Aged 12 <15 Months Fully Immunised for Age ...... 121 Figure 45: Percentage of Children Aged 24 <27 Months Fully immunised for Age...... 122 Figure 46: Percentage of Eligible Children who have had at least 1 dose of 7vPCV as at 25/05/2002 ...... 123 Figure 47. HIV Notifications in the Northern Territory 1985–2001 by Indigenous Status ...... 125 Figure 48: Notification Rates of TB in the Northern Territory 1991-2001 ...... 126 Table 25: Northern Territory Notifiable Diseases 1997 – 2001 (Total Number Of Cases) ...... 127 Figure 49: Northern Territory Notifiable Diseases 2000 to 2001...... 128 Table 26: Notified Cases of Vaccine Preventable Diseases in the Northern Territory by report date 1999, 2000 and 2001...... 129 Alcohol and Other Drugs Figure 50: Percentage of Northern Territory Road Accidents related to Alcohol ...... 135 Figure 51: Percentage of Fatal Road Accidents Related to Alcohol – Northern Territory and Australia...... 136 Figure 52: Consumption of Alcohol Per Capita - Northern Territory and Australia ...... 137 Services Development Figure 53: Total payments for Non Government Agencies 2001/02 ...... 148 Table 27: Health and Wellbeing Survey – NT Non-Indigenous...... 150
Page 199 Figures and Tables Index
Figure 54 Non Government Service Provision Funds Allocated as Percent of Program Budget...... 151 Human Resources Table 28: STEP Trainees in Central Australia Services Network (CASN) and Top End Services Network (TESN)...... 166 Table 29: Studies Assistance Grants 2000/01 & 2001/02 ...... 167 Table 30: Undergraduate Nursing Grants 2001/02 ...... 167 Table 31: Postgraduate Nursing Grants 2001/02...... 167 Table 32: Studies Assistance Recipients by Professional Affiliation ...... 167 Table 33: Profile of DHCS Graduate Development Program 1996 to 2002...... 168 Table 34: Summary of Human Resource Activity by Area ...... 172 Figure 55: DHCS New Stress Claims by Number/Cost...... 174 Figure 56: Workers Compensation as a Percentage of Salary ...... 175 Figure 57: Number and Severity of Manual Handling Injuries ...... 176 Figure 58: Cost of Stress Claims by Designation ...... 177 Figure 59: Claims as a result of physical and non physical aggression...... 178 Figure 60: Number and Cost of Claims Involving Nursing Staff...... 179
Financial Statements Financial Table 1...... 182 Financial Table 2...... 184 Financial Table 3...... 186 Financial Table 4...... 188 Financial Table 5...... 189 Financial Table 6...... 190 Financial Table 7...... 191 Financial Table 8...... 192 Financial Table 9...... 193
Page 200 Subject Index
Subject Index
Aboriginal Health ...... 9, 37, 56, 76 Hospital Services ...... 20, 44, 47, 65, 66, 140 Aboriginal Health Forum...... 8, 42, 76 Immunisation...... 45, 77, 118, 121, 122, 124 Aboriginal Health Promotion ...... 46 Infant Mortality ...... 39, 40, 41 Aboriginal Health Workers ...... 57, 62, 72, 77, 145, 164 Legislative Responsibilities ...... 155 Aboriginal Interpreter Service ...... 57, 59, 72 Life Expectancy...... 38, 39 Aboriginal Medical Service...... 8, 75, 130 LifeNet...... 13, 59 Aboriginal Mental Health Worker ...... 46, 106, 140 Living with Alcohol...... 16, 133 Acute Care ...... 20, 29, 47, 164 Malaria...... 124 Aged and Disability Services...... 20, 145, 155 Malnutrition ...... 80 Aged, Disability and Community Care...... 94 Medical Entomology...... 126 AIDS/HIV...... 118, 125 Men’s Health ...... 62, 164 Alcohol and Other Drugs ...... 18, 20, 133, 146 Mental Health12, 16, 18, 20, 46, 57, 101, 130, 132, 150, Asthma...... 113 155 ATSIC...... 8, 45, 46, 80, 145 Menzies School of Health Research...... 80, 152 Audit ...... 56, 109, 112, 159, 161, 162, 168 Mosquito...... 118, 119, 120 Australian Council on Health Care Standards...... 53, 91 National Heart Foundation...... 79, 80 Barkly Health Services...... 144 NGO – Alcohol and Other Drugs...... 210 Budget ...... 8, 33, 69, 95, 145, 154 NGO - Family, Aged and Disability Services...... 202 Cardiology ...... 17 NGO – Hospital Services ...... 213 Central Australian Service Network95, 142, 148, 149, 163 NGO – Mental Health ...... 214 Child Care ...... 20, 88, 149 NGO – Primary Health Care...... 212 Child Protection...... 90, 164 NGO – Public Health Services...... 214 Children’s Services...... 155, 165 Northern Territory University...... 145 Clinics...... 17, 67, 113, 138, 142 NT Clinical School...... 17 Code of Practice ...... 115 Nurses ...... 11, 18, 25, 76, 78, 177, 178 Community Care...... 16, 83, 94, 95 Occupational Health and Safety ...... 59, 169, 171 Community Health ...... 75 Oral Health...... 77, 83 Community Services ...... 94, 106, 165 Organ Donation...... 13, 59 Complaints ...... 30, 111, 113, 154 Organisational Structure ...... 23 Crisis Support...... 90 Orientation ...... 131, 141 Death Rates...... 37, 38 Palliative Care...... 16, 62, 77, 85 Diabetes...... 80, 148 Palmerston Health Precinct ...... 18, 58, 60, 98 Diagnostic Categories...... 50 Patient Travel ...... 72 Disability...... 91, 94, 147 Performance Management...... 159, 162, 168, 169 Disease Control...... 20, 71, 118 Pharmaceutical ...... 56, 58 Domestic Violence...... 46, 86, 93 PHCAP...... 8, 76, 144 Education94, 102, 113, 114, 118, 121, 122, 124, 125, 130, Pneumococcal...... 44, 45, 121, 123, 124 134, 137, 148, 150, 152, 164, 196 Poisons and Dangerous Drugs Act...... 113 Elective Surgery...... 70 Positive Parenting Program ...... 87, 88 Environmental Health ...... 20, 109 Preventable Chronic Disease Strategy ...... 17, 124, 141 Executive...... 156 Primary Health...... 20 Family and Children’s Services ...... 20, 71, 72, 86 Primary Health Care29, 41, 42, 76, 124, 140, 141, 144, Family Violence...... 87 145 Flinders University ...... 17 Public Health Act...... 111, 115 Food Act...... 111 Purchasing...... 106, 159 Food and Nutrition ...... 16, 77 Quality18, 31, 53, 56, 62, 68, 72, 81, 89, 91, 95, 106, 107, Food Recall...... 116 117, 122, 134, 141, 144, 145, 154 General Practitioner GP...... 61, 71, 76, 83, 123 Radiation...... 110, 112 Growth Assessment and Action (GAA) .... 44, 77, 80, 147 Radiology ...... 67, 68, 71 Guardianship ...... 96 Renal Dialysis...... 13, 18, 52, 61, 62, 66, 67, 72, 144, 146 Health Development...... 144, 145 Research...... 81, 94, 109, 116, 118, 126, 152 Health Promotion ...... 20, 42, 77, 79, 81, 109, 118, 130 Residential Care...... 98 Health Zones...... 9, 44, 76, 81, 145 Rheumatic Heart Disease...... 123, 124 Hearing ...... 78, 80 Risk Management...... 119, 161 Hepatitis ...... 118, 124, 148 School Therapy Services ...... 15 Home and Community Care (HACC) ...... 45, 98, 147 Screening - Cancer ...... 18 Hospital - Alice Springs .. 13, 30, 31, 47, 66, 102, 144, 145 Seating and Equipment Assessment Team ...... 96 Hospital - Gove ...... 47, 64 Seniors Cards ...... 17, 97 Hospital - Katherine...... 47, 61, 141 Sexual Assault ...... 86, 90 Hospital - Royal Darwin13, 30, 31, 47, 57, 102, 152, 163, Sexually Transmitted Disease...... 118, 125 174 Smoking ...... 134 Hospital - Tennant Creek...... 47, 71, 144, 146 Social Services ...... 72 Hospital Improvement ...... 56 Top End Service Network ...... 138, 148, 149, 163
Page 201 Appendix
Appendix
Non Government Service Provision
The following lists a summary of payments made during 2001/02 for service provision by non government providers. The amounts paid to organisations for each service are not included as most of these payments were determined by formal negotiation or tender processes and are subject to similar future processes.
Summary of Payments by Program $000 Family, Aged and Disability 24 782 Alcohol and Other Drugs 6 092 Primary Health Care Urban 8 911 Primary Health Care Rural 13 399 Hospital Services 1 838 Public Health Services 1 552 Mental Health Services 1 121 Total 57 695
Summary of Services Funded by Program 2001/02
Program - Family, Aged and Disability Services REGION – TOP END ORGANISATION SERVICE A new start towards independence inc. Supported accommodation Aboriginal resource and development services inc. Community Options Program Aboriginal resource and development services inc. Consulting and Referral Service Aboriginal resource and development services inc. Understanding Disabilities ACROD NT Division Making a difference ACROD NT division Administrative support Alawa Aboriginal Corporation Minyerri Home Care Project Ali Curung Council Assoc. Workshop for Kurduju Committee Alice Springs Family Day Care Inc. Extended Service Hours Alzheimer's Disease and Related Disorders Association NT Counselling and support service Inc. Anglicare Top End Respite services Anglicare Top End Chaplaincy Service Anglicare Top End Financial counselling Anglicare Top End Respite Care Service 0-12 Anglicare Top End MJD Project Anglicare Top End Darwin medium term youth accommodation and advocacy Anglicare Top End Katherine community accommodation and support Anglicare Top End Health Connections for Youth
Page 202 Appendix
Program - Family, Aged and Disability Services - continued REGION – TOP END ORGANISATION SERVICE Anglicare Top End Youth Housing Program Anglicare Top End Substitute Care Emergency Accommodation and Support Services (SCEASS) Angurugu Community Government Council Meals on wheels and home help service Australian Breastfeeding Association Education programs Australian Early Childhood Association Relief Staff Scheme Australian Early Childhood Association Disability Innovative Grant Australian Early Childhood Association Children's Week Australian Red Cross - Northern Territory Division Darwin Home Help Australian Red Cross - Northern Territory Division Administration cost support - delivered meals Australian Red Cross - Northern Territory Division Aged care hostel Australian Red Cross - Northern Territory Division Community based therapy Australian Red Cross - Northern Territory Division Home care service Australian Red Cross - Northern Territory Division Training courses - casual carers Australian Red Cross - Northern Territory Division Individual Support Autism Support Group of Central Australia Inc. Dr.Tony Attwood presentation Bagot Community Incorporated Bagot Women's Safe House Barunga Manyallaluk Community Government Council Home care service Bawinanga Aboriginal Corporation Capital to set up HACC Service Bawinanga Aboriginal Corporation Aboriginal Community Worker Project Belyuen Community Government Council Women and Children support service Belyuen Community Government Council Imabulk Centre - Aged and Disability Service Bindi inc Early Childhood Intervention Grant Binjari Community Government Council Binjari Home Care Service Carpentaria Disability Services Inc. Lifestyle Options Carpentaria Disability Services Inc. Supported Living Carpentaria Disability Services Inc. Flexi Respite Carpentaria Disability Services Inc. Early Intervention Services Carpentaria Disability Services Inc. Connections (Respite) Carpentaria Disability Services Inc. Home Away From Home (Respite) Carpentaria Disability Services Inc. Lifestyle Options Carpentaria Disability Services Inc. Disability Innovative Grant Carpentaria Disability Services Inc. Early Intervention Services Carpentaria Disability Services Inc. Supported Living Casuarina ChildCare Centre Inc. Minor Capital Works Catholic Church of the Diocese of Darwin Property Trust Licence Related Upgrade Centacare NT Pregnancy Help Centacare NT Katherine Family Network. Centacare NT Sexual Assault Counselling Service Centacare NT Katherine Family Link Infrastructure Centacare NT Domestic violence intervention worker (Katherine) Centacare NT Rural and Remote Domestic Violence Initiative. Central Australia Supported Accommodation Disability Innovative Grant Central Australian Community Toy Library Early Childhood Intervention Grant Coomalie Community Govt Council Purchase of mobile toilet Council for Aboriginal Alcohol Program Services Inc. Indigenous Family Violence Offender Program Council for Aboriginal Alcohol Program Services Inc. Training Program in Behaviour Change Council for Aboriginal Alcohol Program Services Inc. Community base outreach and referral project Council On The Ageing (NT) Inc. Administration support Council On The Ageing (NT) Inc. Linkcare Community Options
Page 203 Appendix
Program - Family, Aged and Disability Services - continued REGION – TOP END ORGANISATION SERVICE Council On The Ageing (NT) Inc. Counselling and Support Service Council On The Ageing (NT) Inc. To assist COTA to meet 01/02 shortfall Country Women's Association - Nhulunbuy Branch Lorelei House Country Women's Association - Nhulunbuy Branch Meals On Wheels Country Women's Association of the NT Inc. Annual General Meeting Create Foundation NT Services and programs to children and young people in care in the NT Crisis Accommodation Gove (Inc.) Skills Development Grant Crisis Accommodation Gove (Inc.) Crisis Accommodation Service Crisis Accommodation Gove (Inc.) After hours access to Crisis Accommodation Crisis Line Inc. Counselling Service Daguragu Community Government Council Daguragu HACC Service Darwin Aboriginal and Islander Women's Shelter Inc. Supported Accommodation Darwin Christian Outreach Centre Ministries NT Supported accommodation Darwin Christian Outreach Centre Ministries NT Skills Development Grant Darwin Christian Outreach Centre Ministries NT Children's Case Manager Darwin Church of Christ Child Care Centre Inc. Minor Capital Works Darwin City Council Fun Bus Service Darwin City Council Youth Networks Project Darwin Community Legal Service Advocacy Services Darwin Pensioners and Senior Citizens Association Inc. Tracy Aged Care Hostel Darwin Toy Library Inc. Toy lending service Darwin Toy Library Inc. Early Childhood Intervention Grant Darwin Youth Support Group Inc. Advocacy and support service Dawn House Inc. Women's Shelter Dawn House Inc. DV Counselling Service Dawn House Inc. Community development and training Deafness Association of the NT Inc. Hearing Services Deafness Association of the NT Inc. Tinnitus Retraining Therapy Disability in the Arts, Disadvantage in Arts Australia Cross Sector Partnership Djabulukgu Association Inc. Kakadu Aged Care Service Down Syndrome Association of the Northern Territory Inc. Support service Down Syndrome Association of the Northern Territory Inc. Better understanding of Down Syndrome Dripstone Children's Centre Incorporated Minor Capital Works Family Day Care - Darwin Region Inc. Extended Service Hours Family Day Care - Darwin Region Inc. Family Education Officer Family Planning Welfare Association of NT Inc. Sexuality Needs and Rights Galiwinku Community Inc. Community Worker and Youth Services Galiwinku Community Inc. Meals On Wheels Service Galiwinku Community Inc. Replacement of Kitchen Equipment Gap Youth Centre Access and Equity on line Gapuwiyak Community Inc. Meals On Wheels Service Gray Child Care Centre Major Capital works Guide Dogs Association of SA and NT Inc. NT Vision Resources Gulin Gulin and Weemol Aboriginal Corporation Meals and home help service Community Council Inc. HK Training and Consultancy HACC General Training and Data Collection Training. HMAS Coonawarra 3 Year Old Kindy Sessional Child Care Centre HPA Incorporated Darwin Accommodation Services. Human Services Training Advisory Council Inc. Childrens Services Workplace Assessment Resource Project
Page 204 Appendix
Program - Family, Aged and Disability Services - continued REGION – TOP END ORGANISATION SERVICE Humpty Doo Community and ChildCare Centre Inc. Major Capital works Integrated Disability Action Inc. Peak consumer body Kalano Community Association Inc. HACC service Kardu Numida Council Inc. Home help service Karu Aboriginal and Islander Child Care Agency Foster care recruitment, training and support Katherine East Child Care Centre Inc. Minor Capital Works Katherine Regional Family Child Care Early Childhood Intervention Grant Katherine Women’s Crisis Centre Inc. Katherine Women's Crisis Centre Kentish Family Day Care Minor Capital Works Kunbarllanjnja Community Government Council Home Help Services Lajamanu Community Government Council Support service Lajamanu Community Government Council Establishment of Women's Safe House Little Gecko's Child Care Centre Minor Capital Works Mabunji Aboriginal Resource Assoc Inc. Wunala Creche Mabunji Aboriginal Resource Assoc Inc. Malandari Care Centre Mabunji Aboriginal Resource Assoc Inc. Borroloola Night Patrol Consultancy Mataranka Community Council Meals service Minjilang Community Inc. Home and Community Care 1off payment Mission Australia Medical Transport Service Mitchell St Child Care Centre Minor Capital Works Moulden Park Primary School Council Comprehensive Children's Service - Operational Nauiyu Nambiyu Community Government Council Women's centre - staff Nauiyu Nambiyu Community Government Council Meals on Wheels Ngaruwanajirri (Nguiu) Life skills training Nhulunbuy Community Toy Library Early Childhood Intervention Grant Nhulunbuy Community Toy Library Toy Library Service Nhulunbuy Over Threes Association Incorporated Minor Capital Works Nightcliff Primary School Council Extended Service Hours Northern Territory Council of Social Service Industry Development Project NT Carers Association Inc. Counselling and Support Service NT Carers Association Inc. Respite Care Service 0-12 NT Carers Association Inc. Foster carers Conference NT Carers Association Inc. Music Therapy Service NT Friendship and Support Incorporated Darwin Respite and Social Support Service. NT Friendship and Support Incorporated Family support service NT Friendship and Support Incorporated Est costs for Respite Care 0-12 NT Friendship and Support Incorporated Respite Care Service 0-12 Katherine NT Friendship and Support Incorporated Respite Care Services NT Friendship and Support Incorporated Respite Care - disabled Aboriginal children NT Friendship and Support Incorporated Bush Kids Respite NT University Child Care Centre Minor Capital Works Ntaria Council Early Childhood Intervention Grant Numbulwar Numburindi Community Government Council FACS Community Project Numbulwar Numburindi Community Government Council Challenging Behaviour Support Numbulwar Numburindi Community Government Council Numbulwar Respite Service Palmerston City Council Joy Anderson Centre Palmerston City Council Community Development Program Palmerston City Council Palmerston and Rural Area Seniors Week Papulu-Apparr-Kari Aboriginal Corp Early Childhood Intervention Grant Pensioners' Workshop Association Inc. Workshop and activity centre Peppimenarti Community Council Inc. Meals on Wheels Pine Creek Community Government Council Transport service. Ramingining Community Incorporated Purchase of 4WD
Page 205 Appendix
Program - Family, Aged and Disability Services - continued REGION – TOP END ORGANISATION SERVICE Riding for the Disabled NT inc Establish a pilot hypotherapy program Ruby Gaea House - Darwin Centre Against Rape Counselling, support and education service Ruby Gaea House - Darwin Centre Against Rape Skills Development Grant Society of St Vincent de Paul Bakhita Centre Darwin Society of St Vincent de Paul Ozanam House Darwin Society of St Vincent de Paul Ormonde House Katherine Somerville Community Services Inc. Disability Services Somerville Community Services Inc. Family Services Somerville Community Services Inc. Palmerston Community Accommodation Service Somerville Community Services Inc. Youth and Family Services - Katherine Somerville Community Services Inc. Challenging Behaviour St. Andrew Lutheran Child Care Centre Minor Capital Works Step Out Community Access Service Inc. Community Access Step Out Community Access Service Inc. Respite Care Stuart Park Neighbourhood Child Care Centre Minor Capital Works Tennant Creek Women’s Refuge Early Childhood Intervention Grant Territory Housing Katherine IHAS contribution The Totally and Permanently Incapacitated Soldiers Assoc National conference of the NT inc. The Salvation Army - Northern Territory Region Catherine Booth - code 001 846. The Salvation Army - Northern Territory Region Sunrise Centre - code 001 861. The Salvation Army (NT) Property Trust Towards Independence Development Project The Uniting Church - Frontier Services Rocky Ridge Nursing Home The Uniting Church - Frontier Services Tracey Aged Care Consultancy The Uniting Church - Frontier Services Territory Older Persons Support Services Tiwi Health Pty Ltd Nutritional Program Tiwi Health Pty Ltd Manager of Social Services Top End Association For Mental Health Inc. Transitional accommodation - Manse Top End Association For Mental Health Inc. Identify number of people with psychiatric disability Top End Association For Mental Health Inc. Mental Health Resource Worker Top End Women's Legal Service Kunbarllanjnja Women's Crisis Centre Total Recreation Sport and Recreation Total Recreation Support for 8 clients - 3 months Umbakumba Community Council Inc. FACS Community Worker Umbakumba Community Council Inc. Meals on wheels Service Vietnam Veterans Association of Australia NT Branch Coral House Walangeri Ngumpinku Community Government Council Karuwulijawu playgroup Warruwi Community Inc. Meals on Wheels Watiyawanu Community Government Council Remote innovative Services for the provision of financial assistance to Child Care Centres Wugularr Community Government Council Beswick Creche Wugularr Community Government Council Beswick Aged Care Yirrkala Dhanbul Community Association Inc. Meals on Wheels Young Women's Christian Association Inc. Big Sister/Little Sister Program. Young Women's Christian Association Inc. Dr Helen Phillipps Cottages. Young Women's Christian Association Inc. Palmerston Family Crisis Accommodation and Support Service Young Women's Christian Association Inc. Community Placement Program Young Women's Christian Association Inc. Casy House Young Women's Christian Association Inc. Oakley House Young Women's Christian Association Inc. Stanley House Yuendumu Community Government Council Remote innovative Services for the provision of financial assistance to Child Care Centres
Page 206 Appendix
Program - Family, Aged and Disability Services - continued REGION – CENTRAL AUSTRALIA ORGANISATION SERVICE Aherrenge Women's Centre Meals and home help program for the frail, aged and younger people with disabilities Ali Curung Council Association Inc Homemaker service Ali Curung Council Association Inc Supported accommodation assistance program Ali Curung Council Association Inc Meals and home help program for frail, aged and younger people with disabilities Alice Springs Child Care Centre Licence related upgrade Alice Springs Senior Citizens Home maintenance / Modifications Alice Springs Town Council Licence related upgrade Alice Springs Women's Shelter Inc Crisis accommodation, counselling, advocacy and outreach services for women and their children Alice Springs Women's Shelter Inc Domestic violence trainer Alice Springs Youth Accommodation And Support Services Accomm and Advocacy - Crisis and Medium term Inc. Accommodation Alice Springs Youth Accommodation And Support Services Co-Ordin and Advocacy - Crisis and Medium term Inc. Accommodation Alice Springs Youth Accommodation And Support Services Alice house supported accommodation assistance program Inc. Alpurrurulum Community Govt Council Meals and home help program for the frail, aged and younger people with disabilities Alzheimer's Disease and Related Disorders Association NT Counselling and support Incorporated Anglicare Central Australia Residential care service in Alice Springs for 12 adults who have medium to high diability support needs Anglicare Central Australia MD - to cover establishment costs and care needs Anglicare Central Australia ADMIN/WELFARE (Forrest) - Residential Out of Home Care for 8 children Anglicare Central Australia Chaplaincy Anglicare Central Australia MC - Attendant care/personal care for client M.C. Anglicare Central Australia CHILDRENS SERVICES (GREY) - residential care service in Alice Springs for 6 children who have medium to high disability support needs Anglicare Central Australia Adult Services - residential care service in Alice Springs for 12 adults who have medium to high disability support needs Anglicare Central Australia Challenging behaviour Anglicare Central Australia ENCLAVE - transitional housing program (bill braitling) Animparrinpi Yutlitju Women's Aboriginal Corp. (Mt Meals program for HACC eligible clients/One off purchase of Liebig) vehicle Anyinginyi Congress Employ a community worker, an Advocacy and referral service to assist aboriginal people Aputula Housing Association Inc Meals and home help program for the frail, aged and younger people with disabilities Areyonga Community Meals and home help program for the frail, aged and younger people with disabilities Arrernte Council Meals and Homehelp program for the frail, aged and younger people with disabilities living in Alice Springs Atitjere Homelands Aboriginal Corporation Vehicle and facility requirements to provide HACC services Australian Red Cross (NT Division) Meals and Homehelp program for the frail, aged and younger people with disabilities living in Alice Springs Autism Support Group Of Central Australia Inc Dr Tony Attwood to provide two days of talks in Alice Springs
Page 207 Appendix
Program - Family, Aged and Disability Services - continued REGION – CENTRAL AUSTRALIA ORGANISATION SERVICE Barkly Region Alcohol And Drug Abuse Advisory Group Provision of a non-residential Domestic violence counselling, Inc. crisis intervention and supports service Barkly Region Alcohol And Drug Abuse Advisory Group Provide community development, education and training Inc. addressing domestic violence Bindi Incorporated (ex DSCA) Output Group 3.3 - Community Access and Day Programs to be provided for a group of medium to high needs disability clients. Bindi Incorporated (UNMET NEEDS) Output Group 3.3 - Community Access and Day Programs to be provided for a group of medium to high needs disability clients for a period of nine weeks Bindi Incorporated To purchase vehicle for social support services Braitling Neighbourhood Centre Licence related upgrade Central Australian Aboriginal Congress Child Care Agency ARANDA HOUSE - Short term supported residential Places for young people Central Australian Aboriginal Congress Incorporated Under fives program Central Australian Aboriginal Congress Incorporated Licence related upgrade Central Australian Community Toy Library Licence related upgrade Central Australian Supported Accommodation Care and support for client LJ Central Australian Supported Accommodation To support clients in Independent Living Central Australian Supported Accommodation Attendant care for client DR Central Australian Supported Accommodation Attendant care for client MA Central Australian Supported Accommodation Provide long term supported accommodation service for adults with intellectual disability Central Australian Ymca Child Care Licence related upgrade Childbirth Education Association, Alice Springs Inc Childbirth education programs Children's Services Support Program (Central Australia Resource, counselling and advisory service Inc.) Children's Services Support Program (Central Australia Additional Support to Barkly and Yulara Child Care Centres Inc.) Disability Advocacy Service Provide advocacy and referral service for disabled clients with medium to high support needs in Alice Springs Disability Advocacy Service Facilitate training and independent living skills for persons with disabilities and provide respite for clients with challenging behaviour Eastside Neighbourhood Centre Licence related upgrade Elliott District Community Government Council Meals and home help program for frail, aged and younger people with disabilities Gap Community Child Care Comprehensive service pilot project Gap Community Child Care Licence related upgrade Ikuntji Community Council Inc. (Women's Centre) Children's program Ikuntji Community Council Inc. (Women's Centre) To upgrade community building including kitchen for the provision of meals. Imanpa Community Incorporated Homemaker program Imanpa Community Incorporated Meals program Julalikari Council Aboriginal Corporation Residential care service in Tennant Creek for clients who have medium to high disability support needs Julalikari Council Aboriginal Corporation Supported accommodation Julalikari Council Aboriginal Corporation Meals and home help program for frail, aged and younger people with disabilities Kaltukatjara C/C (Docker Rvr) Meals program for the frail, aged and younger people with disabilities Ltyentye Apurte Arelhe-Ingkerrenyekekenhe Corporation Disability Support Service, Unmet needs remote services (Santa Teresa Women's Centre
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Program - Family, Aged and Disability Services - continued REGION – CENTRAL AUSTRALIA ORGANISATION SERVICE Ltyentye Apurte Community Government Council Health Youth Development program Centre (Santa Teresa) Ltyentye Apurte Ingkerrenyekekenhe Apmere Aboriginal Meals and home help program for the frail, aged and younger Corporation (Santa Teresa Women's Centre)S people with disabilities Mampu Mininja Kurlangu Jarlu Patu Aku (Yuendumu) Meals and Homehelp program for the frail, aged and younger people with disabilities/ Production of Old People's video Mutitjulu Community Operate a disability respite facility in Mututjulu Mutitjulu Community Meals and Homehelp program for the frail, aged and younger people with disabilities living in Alice Springs Mutitjulu Community Health Service To Promote the Physical Growth and Wellbeing of Children 0-5 Yrs through a program fo health promotion and Education on Healthy feeding and parenting N.P.Y. Tristate Establishment and development of appropriate disability services in remote areas in Central Australia Ngintaka Women's Centre Meals program for the frail, aged and younger people with disabilities Nyirripi Community Council Incorporated Meals program for the frail, aged and younger people with disabilities Papunya Community Council Inc. Youth community culture program Relationships Australia Relationship/marriage counselling service Royal Flying Doctor Service YULARA RSC Community counselling Service at Yularra Salvation Army (NT) Property Trust Part time Welfare Officer Salvation Army (NT) Property Trust Towards Independent Development project St Vincent De Paul Women Crisis Support for Women In Crisis Tangentyere Council Incorporated Irrkerlantye learning centre - innovative health education programs Tangentyere Council Incorporated Support multigernerational learning centre - yarrenyty arltere Tangentyere Council Incorporated Homemaker and old peoples service (HOPS) in the town camps of Alice Springs Tennant Creek Children Services T/A Barkly Bumble Beez Licence related upgrade Tennant Creek Children Services T/A Barkly Bumble Beez Project office to be employed to support the development of a viable and quality childcare service Tennant Creek Town Council Home and community care services for frail, aged and younger people with disabilities - adult day care Tennant Creek Women's Refuge Incorporated Accommodation for women in crisis Tennant Creek Women's Refuge Incorporated Outreach and Children's service Uniting Church OLD TIMERS - To assist with the recurrent shortfall in the operation of Flynn Lodge (nursing home) - Alice Springs Uniting Church Tennant Creek nursing home Uniting Church Carer Respite Centre - To enhance quality of life experiences for children Uniting Church Carer Respite Centre - Undertake developmental project focusing on community / culturally appropriate respite Waltja Tjutangku Palyapayi Aboriginal Corporation Disability brokerage family support - remote Waltja Tjutangku Palyapayi Aboriginal Corporation Disability brokerage Yuelamu Community Inc Meals and home help program for the frail, aged and younger people with disabilities Yuendumu Child Care - Kurdu Kurdu Kurlangu Upgrade buildings to comply with 9b of the building code Yuendumu Women's Centre Aboriginal Corporation Family support / Homemaker service Yulara Child Care Centre Incorporated Licence related upgrade TOTAL PAYMENTS 24 782
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Program – Alcohol and Other Drugs REGION – TOP END ORGANISATION SERVICE Aboriginal and Islander Alcohol Awareness and Family Alcohol and other drug residential program Recovery Aboriginal and Islander Alcohol Awareness and Family Community based support program Recovery Aherrenge Assoc Inc. Health Promoting Youth Grants Alice Springs Youth Accommodation and Youth Support Health Promoting Youth Grants Services inc. Amity Community Services Non residential assessment counselling and referral service Amity Community Services Drink driver education co-ordination Anglicare Top End Administration costs for Ms Sheila Miller-model of car for those with alcohol related problems Anglicare Top End Dillinga Katherine - Residential alcohol therapeutic facility Angurugu Comm Govt Council Health Promoting Youth Grants Anyinginyi Congress Aboriginal Corp Health Promoting Youth Grants Anzac Hill High School Health Promoting Youth Grants Australian Hotels Association - Northern Territory Branch Operation Drinksense Australian Red Cross - Northern Territory Division Health Promoting Youth Grants Binjari Community Government Council Night Patrol Catholic Church of the Diocese of Darwin Property Trust Non residential counselling and support service Council for Aboriginal Alcohol Program Services Inc. Residential Treatment Service Employee Assistance Service NT Inc Katherine assessment, intervention and referral service F.O.R.W.A.A.R.D. Residential/non residential Rehabilitation Service Forster Foundation - Banyan House Residential treatment program Gap Youth Centre Health Promoting Youth Grants Gapuwiyak Community Inc. Cultural Healing for Petrol Sniffers Healthy Lifestyle Committee Health Promoting Youth Grants Institute for Aboriginal Development Petrol sniffing program Jabiru Town Council Petrol sniffing program Kalano Community Association Inc. Alcohol and other Drugs Program Kalano Community Association Inc. Community Patrol. Katherine BMX club Health Promoting Youth Grants Milingimbi Community Inc. Each One, Teach One Mission Australia Darwin Sobering Up Shelter Mission Australia Katherine Sobering Up Shelter Mission Australia Night Patrol Mission Australia Youth Outreach Worker Project Nauiyu Nambiyu Community Government Cncl Health Promoting Youth Grants Nauiyu Nambiyu Community Government Cncl Night Patrol Numbulwar Numburindi Community Council Substance Misuse Project Palmerston City Council Youth Project Specialised to Life Oriented Ministries Inc ARMTOUR of Central Australia Taminmin High School Health Promoting Youth Grants Tangentyere Council Inc. Petrol sniffing program Tennant Creek Amateur Swimming Club Health Promoting Youth Grants Tennant Creek High School Health Promoting Youth Grants Tennant Creek Town Council Health Promoting Youth Grants The Salvation Army - Northern Territory Region Bridge Program - code 001 833. Umbakumba Community Council Inc. Diversionary Project YMCA Darwin and District Youth Services Health Promoting Youth Grants
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Program – Alcohol and Other Drugs – continued REGION – CENTRAL AUSTRALIA ORGANISATION SERVICE Anyinginyi Congress Female Counselling Anyinginyi Congress Innovative Health Service Homeless Youth Anyinginyi Congress Community Development Unit - IHSHY Aputula Housing Association Inc Night Patrol Arltarlpilta Community Government Council Night Patrol Barkly Region Alcohol And Drug Abuse Advisory Group Sobering Up Shelter Inc. Barkly Region Alcohol And Drug Abuse Advisory Group Supported Accommodation and Treatment Inc. Barkly Region Alcohol And Drug Abuse Advisory Group Sobering Up Shelter - Additional 15 bed service Inc. Central Australian Aboriginal Alcohol Program Unit Mens Counselling Program Central Australian Aboriginal Alcohol Program Unit Residential Treatment Drug and Alcohol Services Association Sobering Up Shelter Drug and Alcohol Services Association Education / Counsellor Holyoake Recovery Counsellor Holyoake Receptionist / Child Counsellor Holyoake Adolescent Counsellor Ikuntji Community Council Inc. (Women's Centre) Night Patrol Imanpa Community Incorporated Camping program for children for Xmas holidays and weekends/Night Patrol Intjartnama Aboriginal Corp Treatment and Care Julalikari Council Aboriginal Corporation Night Patrol Julalikari Council Aboriginal Corporation RAAASS - Occupational Health and safety project Keringke Arts Aboriginal Corporation Music Can Make It Program Laramba Community Incorporated Night Patrol Ltyentye Apurte Community Government Council Health Purchase of uniforms, fuel and torches for Night Patrol Centre (Santa Teresa) Marle Ingkeherekenhe Arndaritjika Aboriginal Corporation Purchase of uniforms and radio equipment Mutitjulu Community Equipment Purchase Mutitjulu Community Night Patrol uniforms/ Cultural exchange program N.P.Y. Tristate Kaltukatjara Youth festival 9-11 April 2002 Papunya Community Council Inc. George Rrurrumbu and Bomba-Nerbu Message Man Tour/ meal vouchers to night patrol staff Specialised Life-Oriented Ministries Incorporated Role Modelling Health Life-Styles project and Athletes as role models (Armtour) Tangentyere Council Incorporated Warden Scheme Program Tangentyere Council Incorporated Night Patrol Tangentyere Council Incorporated Trial of the Century/ Lightning Carnival Support Tangentyere Council Incorporated Community Patrol and outreach referral service Urapuntja Health Service Aboriginal Corporation Oneoff Night Patrol Waltja Tjutangku Palyapayi Aboriginal Corporation Western Desert Substance misuse meeting Yuelamu Community Inc Night patrol Yuendumu Women's Centre Aboriginal Corporation Night Patrol TOTAL PAYMENTS 6 092
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Program – Primary Health Care Urban REGION – TOP END ORGANISATION SERVICE A New Start Towards Independence Inc. Medical support (Supported Accommodation) Aboriginal Resource and Development Services Inc. Health promotion and preventative intervention Anglicare Top End Palliative Care Worker Arthritis Foundation of the Northern Territory Inc. Community education and support service Asthma Foundation of the NT Inc. Community education and support service Australian Red Cross Blood Service - NT Blood Transfusion Service - Operational Australian Red Cross Blood Service - NT Blood Transfusion Service - Capital Australian Red Cross Blood Service - NT Capital balance for 00/01 for Progesa and IS Bagot Community Incorporated Bagot Health clinic Cancer Council of the NT Inc. Community education and support services. Cancer Council of the NT Inc. Breast Cancer Support Cancer Council of the NT Inc. Ostomy Service Childbirth Education Association Darwin Incorporated Education, information and support service Danila Dilba Biluru Butji Binnilutlum Health Service Danila Dilba Health Service Aboriginal Corporation Diabetes Australia Northern Territory Cardiac Rehabilitation and Secondary Prevention Service Family Planning Welfare Association of NT Inc. Family Planning Services Family Planning Welfare Association of NT Inc. Work with funding bodies to resolve funding difficulties Farrar Medical Pty Ltd 6-10pm Service Farrar Medical Pty Ltd 10pm-8am Service Farrar Medical Pty Ltd Incentive Funding to offset overhead costs Kidsafe Child Accident Prevention Foundation of Australia Child Accident Prevention Services - NT Division Mission Australia Medical Transport Service Natural Family Planning Council NT Inc. Family planning and support services. St. John Ambulance Aust. NT Inc. Ambulance Service St. John Ambulance Aust. NT Inc. Additional funding to increase services at Parap REGION – CENTRAL AUSTRALIA Australian Red Cross (NT Division) Palliative care volunteer service
Central Australian Aboriginal Congress Health Worker Education Childbirth Education Association, Alice Springs Inc Provide Childbirth Education Programs in Alice Springs TOTAL PAYMENTS 8 911
Program – Primary Health Care Rural REGION – TOP END ORGANISATION SERVICE Belyuen Community Government Council Belyuen Health Service Belyuen Community Government Council Reimbursement for S100 medication expenditure Binjari Community Government Council Binjari Health Service Djabulukgu Association Inc. Kakadu Health Services Galiwinku Community Inc. Ngalkanbuy Health Service Galiwinku Community Inc. Reimbursement for S100 medication expenditure Galiwinku Community Inc. Strong Women, Strong Babies, Strong Culture Program Gap Youth Aboriginal Corporation Men's Health Pilot Prog Gapuwiyak Community Inc. Strong Women, Strong Babies, Strong Culture Program Hodgson River Station Health Care Agent Program. Kardu Numida Council Inc. Men's Health Pilot Prog Katherine West Health Board Minyerri Health Service Laynhapuy Homeland Association Inc. Laynhapuy Homelands Health Service Ltyentye Apurte Community Government Council Reimbursement for S100 medication expenditure Mabunji Aboriginal Resource Assoc Inc. SWSB Worker Program Marngarr Community Government Council Marngarr Community Health service Milingimbi Community Inc. Sexual Health and Family Violence Program for Indigenous Males
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Program – Primary Health Care Rural - continued REGION – TOP END ORGANISATION SERVICE Minjilang Community Inc. Minjilang Health Service Minjilang Community Inc. Reimbursement for S100 medication expenditure National Heart Foundation Indigenous Male Healthy Lifestyle Program Nauiyu Nambiyu Community Government Council Health Service Nauiyu Nambiyu Community Government Council Reimbursement for S100 medication expenditure NT Aboriginal Hearing Program Coordinating Committee Hearing Program Inc. Numbulwar Numburindi Community Government Council Numbulwar Community Health Service Peppimenarti Association Health Service Peppimenarti Association Reimbursement for S100 medication expenditure Ramingining Homelands Resource Centre Aboriginal Aboriginal Health Worker Project Corporation Ramingining Homelands Resource Centre Aboriginal SWSB Strong Culture Program Corporation Tiwi Health Pty Ltd Men's Health Pilot Program Tiwi Health Pty Ltd Strong Women, Strong Babies, Strong Culture Program. Waltja Tjutangku Pallyapayi Abor Corp. Men's Health Forums Warruwi Community Inc. Health Service Warruwi Community Inc. Reimbursement for S100 medication expenditure Wurli Wurlingjang Aboriginal Corporation Health Service Yirrkala Dhanbul Community Association Inc. Strong Women, Strong Babies, Strong Culture Program REGION – CENTRAL AUSTRALIA Alexandria Station Health Care Agents Subsidy Anyinginyi Congress Health Centre - AHW'S - Employ trained aboriginal health workers Aputula Housing Association Inc Health Centre Aputula Housing Association Inc Build healthy individuals, families and communities to maintain good health Canteen Creek Owairtilla SWSB Central Australian Remote Health Training Unit IAD -CARTHU Centralian Support Services Inc Operation of ante-natal hostel Centralian Support Services Inc Lease of ante-natal hostel Ltyentye Apurte Community Government Council Health Health Centre Centre (Santa Teresa) Ltyentye Apurte Ingkerrenyekekenhe Apmere Aboriginal Build healthy individuals, families and communities to Corporation (Santa Teresa Women's Centre) maintain good health Nyirripi Community Council Incorporated Build healthy individuals, families and communities to maintain good health Royal Flying Doctor Service Aeromedical Service Royal Flying Doctor Service Yulara Health and Ambulance Service Urapuntja Health Service Aboriginal Corporation Build healthy individuals, families and communities to maintain good health Waltja Tjutangku Palyapayi Aboriginal Corporation To build the capacity of healthy individuals, families and communities to maintain good health TOTAL PAYMENTS 13 399
Program – Hospital Services REGION – TOP END ORGANISATION SERVICE REPROMED Reproductive medicine services for public patients NT Medical Imaging Capital Funding Anglicare Top End Provision of Chaplaincy Services at RDH Flinders University of SA NT Clinical School ARDS Inc Provision of Education to Aboriginal inpatients TOTAL PAYMENTS 1 838
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Program – Public Health Services REGION – TOP END ORGANISATION SERVICE Amity Community Services Education and Co-ordination Project Bawinanga Aboriginal Corporation Nutrition Program Bawinanga Aboriginal Corporation Weaning Program Diabetes Australia Northern Territory Community education and support services Diabetes Australia Northern Territory Free needle and syringe program Environmental Health Workshop Various charges for Environmental Health W/Shops Galiwinku Community Inc. Environmental Health Worker Gapuwiyak Community Inc. Improving child growth in the NT. Gulin Gulin and Weemol Aboriginal Corporation Environmental Health Project Community Council Inc. Human Services Training Advisory Council Inc. Indigenous Environmental Health Worker Program Kardu Numida Council Inc. Environmental Health Project Kunbarllanjnja Community Government Council Nutritional Outreach Program National Heart Foundation Indigenous Male Healthy Lifestyle Program Ngaliwurru-Wuli Association Environmental Health Project Northern Territory AIDS Council Inc. Community education and support services. Northern Territory AIDS Council Inc. Sex Worker Outreach Program Umbakumba Community Council Inc. Environmental Health Worker Wurli Wurlingjang Aboriginal Corporation Nutrition Service Yugul Mangi Community Government Council Environmental Health Project Yugul Mangi Community Government Council Community Nutrition Project REGION – CENTRAL AUSTRALIA Ali Curung Council Association Inc Environmental Health Worker Position Alice Springs Town Council Health Surveyor Service Gurungu Council Aboriginal Corporation Environmental Health Worker Position Life Choices Education, needle exchange and support program Waltja Tjutangku Palyapayi Aboriginal Corporation GAA video TOTAL PAYMENTS 1 552
Program – Mental Health Service REGION – TOP END ORGANISATION SERVICE GROW (NT) Mental Health Support Service Nauiyu Nambiyu Community Government Council Aboriginal Family and School Support Worker project NT Association of Relatives and Friends of the Mentally ill Support and community education services. Inc Top End Association For Mental Health Inc. Long term supported accommodation service Top End Association For Mental Health Inc. Outreach Program Top End Association For Mental Health Inc. Coordination of Team Health Services Top End Association For Mental Health Inc. Community training project Top End Association For Mental Health Inc. Addressing the Stigma Associated with Mental Illness Project REGION – CENTRAL AUSTRALIA Anglicare Central Australia Mental Health supported accommodation Anglicare Central Australia Transitional Accommodation Service Central Australian Aboriginal Congress Incorporated Aboriginal Mental Health Program Ltyentye Apurte Community Govt Council Health Centre Aboriginal Community Mental Health Worker (Santa Teresa) Mental Health Association Of Central Australia Inc. Rehabilitation Mental Health Association Of Central Australia Inc. Consumer Coordination and Carer Initiatives Mental Health Association Of Central Australia Inc. Life Promotion / Suicide Prevention Yuendumu Community Government Council Aboriginal Community mental Health Workers for support and intervention TOTAL PAYMENTS 1 121
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