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Inquiry Into the NSW Ambulance Service: Readiness to Respond

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Inquiry Into the NSW Ambulance Service: Readiness to Respond LEGISLATIVE ASSEMBLY NSW Public Accounts Committee Inquiry into the NSW Ambulance Service: Readiness to Respond Report No. 3/53 (146) – June 2004 New South Wales Parliamentary Library cataloguing-in-publication data: New South Wales. Parliament. Public Accounts Committee Inquiry into the NSW Ambulance Service: readiness to respond / NSW Public Accounts Committee. [Sydney, N.S.W.] : The Committee, 2004. – xvii, 96 p. ; 30 cm. (Report no. 146 / Public Accounts Committee) ([Parliamentary paper] ; no. 3/53) At head of title: Legislative Assembly. “June 2004”. Chair: Matt Brown. ISBN 0734766289 1. New South Wales. Ambulance Service. 2. Ambulance service—New South Wales. I. Brown, Matt. II. Title III. Series: New South Wales. Parliament. Public Accounts Committee. Report; no. 146 IV. Series: Parliamentary paper (New South Wales. Parliament); no. 53/3 DDC 362.188 Inquiry into the NSW Ambulance Service: Readiness to Respond Table of Contents Table of Contents........................................................................................ i Membership & Staff .................................................................................. iii Charter of the Committee............................................................................ v Terms of Reference ....................................................................................vi Chairman’s Foreword.................................................................................vii Executive summary ..................................................................................viii List of Recommendations .......................................................................... xv Chapter One - Introduction ......................................................................... 1 Chapter Two - Recommendation 1: Enhance the accountability framework for the Service................................................................................................ 7 Chapter Three - Recommendation 2: Enhance Public Performance Reporting 23 Chapter Four - Recommendation 3: Work towards a “whole of health” delivery of ambulance services .............................................................................. 29 Chapter Five - Recommendation 4: Further develop management information capabilities to support decision making...................................................... 45 Chapter Six - Recommendation 5: Identify and remove barriers to flexibility of resource deployment. ............................................................................... 53 Chapter Seven - Recommendation 6: Enhance consultation with external stakeholders ............................................................................................ 57 Chapter Eight - Recommendation 7: Review Recruitment and development strategies ................................................................................................ 61 Chapter Nine - Recommendation 8: Continue to place a high priority on addressing issues relating to culture and ethics .......................................... 73 Chapter Ten - The value of the audit report, in terms of accountability and in improving the performance of government. ................................................. 77 Appendix One - Submissions and documents received by the Committee ...... 83 Appendix Two – List of witnesses at Hearing............................................... 84 Appendix Three - Organisational Structure for the NSW Ambulance Service... 85 Appendix Four – Hospital diversion verification form ................................... 86 Appendix Five – Minutes of Proceedings .................................................... 87 Report No. 146 – June 2004 i Inquiry into the NSW Ambulance Service: Readiness to Respond Membership & Staff Chairman Matthew Brown MP, Member for Kiama Vice Chairman Paul McLeay MP, Member for Heathcote Members Steve Whan MP, Member for Monaro Gladys Berejiklian MP, Member for Willoughby John Turner MP, Member for Myall Lakes Richard Torbay MP, Member for Northern Tablelands Staff Mr David Monk, Committee Manager (until March 2004) Ms Vicki Buchbach, Project Officer (Committee Manager from March 2004) Ms Christine Lloyd, Committee Officer (until March 2004) Ms Stephanie Hesford, Committee Officer (from March 2004) Ms Mohini Mehta, Assistant Committee Officer Contact Details NSW Public Accounts Committee Legislative Assembly Parliament House Macquarie Street Sydney NSW 2000 Telephone 02 9230 2631 Facsimile 02 9230 2831 E-mail [email protected] URL www.parliament.nsw.gov.au Report No. 146 – June 2004 iii Inquiry into the NSW Ambulance Service: Readiness to Respond Charter of the Committee The Public Accounts Committee has responsibilities under Part 4 of the Public Finance and Audit Act 1983 to inquire into and report on activities of Government that are reported in the Total State Sector Accounts and the accounts of the State’s authorities. The Committee, which was first established in 1902, scrutinises the actions of the Executive Branch of Government on behalf of the Legislative Assembly. The Committee recommends improvements to the efficiency and effectiveness of government activities. A key part of committee activity is following up aspects of the Auditor-General’s reports to Parliament. The Committee may also receive referrals from Ministers to undertake inquiries. Evidence is gathered primarily through public hearings and submissions. As the Committee is an extension of the Legislative Assembly, its proceedings and reports are subject to Parliamentary privilege. Report No. 146 – June 2004 v Inquiry into the NSW Ambulance Service: Readiness to Respond Terms of Reference At its meeting of 2 July 2003, the Committee resolved to conduct a follow-up inquiry on the Auditor-General’s report titled Ambulance Service of NSW: Readiness to Respond. The Terms of Reference were: 1. Implementation of the report’s recommendations; and 2. The value of the audit report, in terms of accountability and in improving the performance of government. Report No. 146 – June 2004 vi Inquiry into the NSW Ambulance Service: Readiness to Respond Chairman’s Foreword In March 2001 the Auditor-General published a performance audit report into ambulance response times. The report noted that response times in the Sydney Metropolitan Area were considerably higher than those in other states. The report made eight recommendations, which included 27 sub recommendations. The key areas for the Service to address were: • the further collection and analysis of operational data through the computer aided dispatch system (CAD), which will better align staffing and rostering to workload; and • the Service’s relationship with the Health system, which affects how long it takes the Service to handle each patient. This follow-up report examines the progress of the Service’s attempt to address the Auditor-General’s concerns. The Committee was pleased to note that in most areas progress has been made to implement the recommendations. It must be stressed however, that the Auditor-General’s report is still relevant to the Service as there is still much to be done to achieve the Service’s goal of being Australia’s best. I would like to thank the Service, NSW Health and the Health Services Union for their assistance throughout this inquiry. I would also like to thank David Monk and Christine Lloyd for their efforts in drafting this report. Matt Brown MP Chairman Report No. 146 – June 2004 vii Public Accounts Committee Recommendations Executive summary Introduction This report is a follow-up inquiry into the Auditor-General’s report Ambulance Service of NSW: Readiness to Respond. It reviews the extent to which the Service has implemented the recommendations of the Audit Office and makes further recommendations to support future implementation. The Committee’s terms of reference for the inquiry were to establish the extent to which the Service had implemented the audit report’s recommendations and the value of the audit report in terms of accountability and performance of government. The discussion in relation to each recommendation is divided into three sections. Section one briefly describes the Auditor-General’s findings, which generated each recommendation. Section two covers the action taken by the Service to address the recommendation and section three discusses the extent of progress and where and whether further progress is required. The Auditor-General chose to undertake the first performance audit of the Ambulance Service because of performance concerns with ambulance response times and allegations of waste and corruption made to the Independent Commission Against Corruption. During the audit, the terms of reference were extended to include interactions between the Department of Health and the Service, as this also impacted on the Service’s ability to respond effectively. The final audit was not favourable to the Service. It indicated that the Service had considerable work to do to address ineffective and inefficient management structures and procedures. These problems reduced the Service’s ability to meet workload demands and improve response times. The Service responded to the report by acknowledging there was scope for improvement and made an undertaking to implement most of the recommendations. However, the Service noted that it did not support the audit report’s recommendation in relation to governance. It argued that the governance structure of the Service must be considered in the context of the broader health
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