DoH 2011-2012 Annual Report.pdf - NT Health Digital Library ...

DEPARTMENT OF HEALTHAnnual Report2011–2012

AcknowledgementThe authors are grateful to the many people throughout the Department who have assisted inthe production of this report.(Cover photographs are courtesy of Interactive Communication and Development.)© Northern Territory Government 2012.This publication is copyright. The information in this report may be freely copied and distributedfor non-profit purposes such as study, research, health service management and publicinformation subject to the inclusion of an acknowledgment of the source. Reproduction for otherpurposes requires the written permission of the Chief Executive of the Department of Health,Northern Territory.Printed by the Government Printer of the Northern Territory, 2012.An electronic version is available at: http://health.nt.gov.au/Publications/Corporate_Publications/index.aspxGeneral enquiries about this publication should be directed to:Executive Director, System Performance and Aboriginal PolicyDepartment of HealthPO Box 40596, Casuarina, NT 0811Telephone: (08) 8999 2871Fax: (08) 8999 2568

DEPARTMENT OF HEALTH – Annual Report 2011-12Table of ContentsPurpose of Report .................................................................................................... 4Chief Executive’s Overview ...................................................................................... 6Organisational Chart ................................................................................................ 9Our Department ..................................................................................................... 10Our Executive ........................................................................................................ 11The Department at a Glance .................................................................................. 16Key Achievements ................................................................................................. 18Overview ................................................................................................................ 20Chief Health Officer’s Report .................................................................................. 27Aboriginal Health Report ........................................................................................ 30Regional Achievements and Services Map ............................................................. 33Hospital Services Output Group ............................................................................. 43Health and Wellbeing Services Output Group ......................................................... 62Public Health Services Output Group ..................................................................... 75Corporate Plan ....................................................................................................... 92Promoting and Protecting Health and Wellbeing and Preventing Injury ............ 93Healthy Children and Young People in Safe and Strong Families .................... 97Targeting Smoking, Alcohol and Substance Abuse ........................................ 100Connecting Care ............................................................................................ 102Safety, Quality and Accountability .................................................................. 105Attract, Develop and Retain a Workforce for the Future ................................. 109Strategic Projects ................................................................................................. 113Our People ........................................................................................................... 114Corporate Governance ......................................................................................... 126Our Money ........................................................................................................... 141Certification of the Financial Statements ........................................................ 147Appendix 1: Employment Instructions ................................................................... 186Appendix 2: Councils, Committees, Groups.......................................................... 192Appendix 3: External Funding .............................................................................. 202Appendix 4: Capital and Minor Works ................................................................... 208Appendix 5: Legislative Responsibilities ............................................................... 215Appendix 6: Acronyms ......................................................................................... 2171

DEPARTMENT OF HEALTH – Annual Report 2011-12TablesTable 1 : Age-adjusted smoking prevalence, per cent of total population, by sex andAboriginal status, Northern Territory and Australia: 2004-05 and 2007-08 ... 26Table 2 : Summary of Health Harms and impacts from Tobacco in the NorthernTerritory 2005-06* ......................................................................................... 28Table 3 : Weighted Separations by Hospital ................................................................ 51Table 4 : Total Number of Elective and Emergency Surgery Admissions by PublicHospital 2009-12 ........................................................................................... 55Table 5 : Number of Patient Travel Requests, 2006-07 to 2011-12 ............................. 56Table 6 : Number of Patient Travel Requests, by Program, 2006-07 to 201-12 .......... 57Table 7 : Number of Patient Travel Escorts 2006-07 to 2011-12 ................................. 57Table 8 : Total Emergency Department Attendances 2007-08 to 2010-12 .................. 59Table 9 : Proportion of Patients seen within Standard Waiting Times – TriageCategories 1 to 5 .......................................................................................... 60Table 10 : Northern Territory immunisation rates (From Australian ChildhoodImmunisation Register calculated at 30 June 2012) ...................................... 82Table 11 : Selected notifiable diseases in the Northern Territory 2006-2011 (calculatedby calendar year) ....................................................................................... 83Table 12 : Number of Closed Episodes of Treatment Services by Principal Drug ofConcern ......................................................................................................... 87Table 13 : Student Numbers ........................................................................................ 113Table 14 : Equal Employment Opportunity Statistics based on myHR EEO data ........ 116Table 15 : National Indigenous Cadetships 2011-12 ................................................... 117Table 16 : Cases dealt with by HR Unit ........................................................................ 118Table 17 : Workers Compensation Incidents and Claims 1 July 2011 - 30 June 2012 120Table 18 : Aggression by Physical/Verbal Type – 1 July 2011 to 30 June 2012 .......... 120Table 19 : Student Work Placements ........................................................................... 122Table 20 : 2011-12 Apprentices ................................................................................... 122Table 21 : Orientation Attendance for 2011–12 ........................................................... 123Table 22 : Training Grants Issued/Received ................................................................ 123Table 23 : Training Program Attendance ..................................................................... 124Table 24 : Clinical Learning Programs and Attendance ............................................... 125Table 25 : Self-insurance claims cost 2009-10 to 2011-12 .......................................... 135Table 26 : Complaints by Types ................................................................................... 137Table 27 : Complaints by Outcomes ............................................................................ 138Table 28 : Application outcomes under the Information Act (NT)................................. 139Table 29 : Operating Statement Summary ................................................................... 141Table 30 : Operating Revenue ..................................................................................... 141Table 31 : Expenses ..................................................................................................... 143Table 32 : Balance Sheet Summary ............................................................................. 145Table 33 : Cash Flow Statement Summary .................................................................. 145Table 34 : Budget Target Summary ............................................................................. 1462

DEPARTMENT OF HEALTH – Annual Report 2011-12FiguresFigure 1 : 2011 Estimated Resident Population by Age, Northern Territory ................. 20Figure 2 : 2006 Estimated Resident Population, Remoteness Areas, Northern Territoryby Aboriginal Status ...................................................................................... 21Figure 3 : Life expectancy at birth, Northern Territory and Australia, 1967 to 2006 ..... 22Figure 4 : Ratio of the Northern Territory and Australian age-specific death rates, bysex and Aboriginal status, 1967 to 1971 and 2002 to 2006 ......................... 23Figure 5 : All causes separations per 1000 population, including renal dialysis, 1992-93to 2007-08 .................................................................................................... 24Figure 6 : Trends of notifications of invasive pneumococcal disease among childrenaged 0–23 months, Northern Territory 1999 to 2011 ................................... 25Figure 7 : Inpatient Separations and Weighted Separations, 2007-08 to 2011-12 ....... 50Figure 8 : Weighted Separations by Aboriginal status, by hospital, %, 2011-12 .......... 51Figure 9 : Northern Territory Hospitals Inpatient Separations - Top Five MDCs byAboriginal status, 2011-12 ............................................................................ 52Figure 10 : Average Length of Stay Excluding Same Day by Hospital, 2011-12 ............ 53Figure 11 : Renal Dialysis Treatments 2007-08 to 2011-12 ........................................... 53Figure 12 : Renal Dialysis Treatment Separations by Hospital and Aboriginal Status2007-08 to 2011-12 ...................................................................................... 54Figure 13 : Non-admitted Specialist Clinic Occasions of Service (with Radiology) – allNorthern Territory Hospitals 2006-07 to 2011-12 ......................................... 59Figure 14 : ED Attendances – all Northern Territory Hospitals 2007-08 to 2011-12 ...... 60Figure 15: Environmental Health regulatory and other activities 2009-10 to 2011-12 ... 76Figure 16 : Northern Territory Schedule 8 drug prescription and patient contracts 1992-93 to 2010-12 ............................................................................................... 79Figure 17 : Full Time Equivalent Staffing Trends including percentage of total in eachcategory ...................................................................................................... 115Figure 18 : Sources of Revenue 2011-12 ..................................................................... 142Figure 19 : Expenses compared - 2011-12 with 2010-11 ............................................. 1433

DEPARTMENT OF HEALTH – Annual Report 2011-12Purpose of ReportWelcome to the Department of Health’s Annual Report for 2011-12.This Annual Report aims to:• outline services we provide, our vision, mission, values, core business objectivesand how we measure our performance;• fulfil our obligation to the Parliament and Territorians to provide an account forour actions against budget;• highlight the key achievements for our organisation, services and people for theprevious financial year; and• provide insight and information relating to the Department’s direction, strategicpriorities and planning.This Annual Report has been produced in accordance with Section 28 of the PublicSector Employment and Management Act and Section 12 of the FinancialManagement Act.Target AudienceOur Department works in partnership with other government and non-governmentorganisations to ensure the wellbeing of all Territorians. We work collaboratively withpeople in communities to ensure that we can deliver an outcome to our clients,patients and consumers.This Annual Report provides a summary of our agency’s achievements andhighlights the important role all employees and our partner organisations take inbringing together and delivering services in every part of our jurisdiction.This is a high level accountability report, therefore the primary audience is theParliament and the public. It is also an important tool to communicate with otherinterested parties such as potential employees, students and our service partnerswho may use the report when seeking specific information.If the information you are looking for is not contained within this report pleasecontact us on (08) 8999 2400 or access our website at: http://health.nt.gov.au.Please note that wherever this report refers to Aboriginal people this should also betaken to include Torres Strait Islanders and also to mean Aboriginal and TorresStrait Islander peoples.4

DEPARTMENT OF HEALTH – Annual Report 2011-12The Honourable David Tollner MLAMinister for HealthParliament HouseDARWIN NT 0800Dear MinisterI am pleased to present you with the Annual Report for the Department of Health forthe financial year 1 July 2011 to 30 June 2012.The report describes activities and performance outcomes against the Department’sCorporate Plan and key achievements of the output areas.With regard to my duties as the Accountable Officer pursuant to Section 13 of theFinancial Management Act, I advise to the best of my knowledge and belief that:• proper records of all transactions affecting the agency and its employees werekept under my control by the Department of Business and Employment (DBE) onbehalf of the Department, observing the provisions of Section 28 of the PublicSector Employment and Management Act and Section 12 of the FinancialManagement Act, the Financial Management Regulations and applicableTreasurer’s Directions;• procedures within the agency afforded proper internal control. A currentdescription of these can be found in the Department’s Accounting and PropertyManual which is continuously updated in accordance with the FinancialManagement Act;• no indication of malpractice, major breach of legislation or delegation, majorerror in or omission from the accounts and records exists;• in accordance with the requirements of Section 15 of the Financial ManagementAct, the internal audit capacity available to the agency was adequate and theresults of all internal audits were reported to the Audit Committee and the ChiefExecutive;• all Employment Instructions issued by the Commissioner for Public Employmenthave been satisfied; and• procedures within the agency complied with the requirements of the InformationAct.In conclusion, I believe the Department has been able to provide an acceptablebalance of health services for Territorians considering the demands for service andthe resources available.Yours faithfullyJeffrey Moffet28 September 20125

DEPARTMENT OF HEALTH – Annual Report 2011-12Chief Executive’s OverviewJeffrey MoffetChief Executive OfficerThe past year has been a busy time for our Department, ourstaff and our partners. The demand for services continued togrow, consistent with national and international trends. In theNorthern Territory we are also meeting the challenge ofdelivering health services over great distances and to peoplein dispersed communities, many of whom have significant health concerns.Our services provided care to more than 258 000 Territorians and visitors across theTerritory in a range of settings, including remote health centres, our five hospitals;and through lifelong care relationships such as with clients receiving disabilityservices. I am very proud of the fantastic work that our staff do every day of theyear, and in service to the community. Our clients and patients are our priority.People lie at the heart of our health system - both the patients and clients whom wehelp and the dedicated staff who provide the medical care and other services. Theperformance of our staff is recognised not only by me, but by many members of thebroader community.There has been a range of significant improvements in Territorians’ health outcomesover time, including:• a four and a half year improvement in life expectancy for Aboriginal womenbetween 1996-2000 and 2006;• a 35% drop in the Aboriginal infant mortality rate between 1997 and 2005;• a significant decrease in anaemia rates for Aboriginal children from 29% in 2004to 22% in 2010;• a 44% reduction in cervical cancer rates between 1991 and 2008;• a dramatic decline in mortality from cervical cancer between 1991 and 2006 forboth Aboriginal and non-Aboriginal women of 87% and 84% respectively; and• survival rates for patients on renal dialysis equivalent to the rest of Australia.However, there is still much work to do. A continued focus on increased employmentof Aboriginal people in the health system remains a priority. This year has seen thegraduation of a record 12 Indigenous Employment Program (IEP) participants, in theareas of Administration and Community Services. This is an important step along theway to improving employment opportunities for Aboriginal people across theDepartment.6

DEPARTMENT OF HEALTH – Annual Report 2011-12IEP Participants; backrow from left: AngelaFarmer, RumeldaO’Donnell, LenaThorne, Jackie Barbaand Nicole Curtis.Front row from left: LilyHampton, MelanieMurakami, KeishaOber, Kaitlin Cardona,Priscilla Kingi andPenny Fielding,Executive DirectorStrategy and ReformDivision.There has been a notable expansion and upgrading of health facilities in 2011-12:• the building of a new $24M Emergency Department at Alice Springs Hospital,due to open in late 2012;• the continuation of major upgrades at Royal Darwin Hospital which increasedbed numbers in the Emergency Department (ED) and the Short Stay Unit andbuilding of two additional operating theatres and a 100 bed patientaccommodation complex;• new works or upgrades were also completed at Gove District Hospital (ED andstaff accommodation), Katherine Hospital (ED) and Tennant Creek Hospital(Renal Unit); and• a 16 bed group home was constructed in both Darwin and Alice Springs toprovide specialised, secure care and support for adults and young people withcomplex care needs who require comprehensive therapeutic assessment andintensive intervention.Clinical service planning has been a key area of focus for 2011-12. This work,designed to build an evidence based plan of future clinical service needs, has beenundertaken for the Greater Darwin Region. Clinical staff have actively participated indiscussions about the future needs for hospital and other community based services,critical to meeting demand to 2020 and beyond. The combination of evidence fromhealth data, staff expertise about models of care and the way we do our businesshas been critical in finalising a plan outlining the clinical needs for the GreaterDarwin Region. This work will be expanded in the coming year to include a focus onthe Central Australian Region and an overarching Territory wide framework. Inaddition, we are committed to a continued focus on clinical governance and clinicalleadership in 2012-13, through service critical issues such as clinical redesign.On behalf of the Executive team, I wish to thank those serving on the HospitalBoards, Advisory Councils and the Committees that provide valuable input andassist us in the planning and delivery of services. My sincere appreciation also goesto the many volunteers from the community who have supported our hospitals and7

DEPARTMENT OF HEALTH – Annual Report 2011-12other services. This is particularly the case for members of the Territory’s HospitalBoards. Members of our five Hospital Boards generously gave up their time tocommit to support the transition from five Boards to two Hospital Network GoverningCouncils. Members debated issues as diverse as regional representation, how bestto increase community engagement in our health system and the role of GoverningCouncils in pursuing safety and quality outcomes along the pathways of our patients.This resulted in a strong framework for the new Top End and Central AustralianGoverning Councils and confirms the Department’s desire to collaborate with theGoverning Councils.In addition, the Department will continue working with the non-government sector,our regulators and other key partners. The finalisation of our StakeholderEngagement Strategy and approaches to consumer participation will formalise ourcommitment to being an outward looking agency that is focused on the consumerswe serve. This is critical for the ongoing strength of our organisation and to thequality of services we provide for Territorians every day.Jeffrey Moffet - Chief Executive8

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012Our DepartmentOur VisionHealthy Territorians living in Healthy Communities.Our MissionWe promote, protect and improve the health and wellbeing of all Territorians inpartnerships with individuals, families and the community.Our Values• Respect and cooperation• Responsibility to society• Pride in our work• We are here for our clientsOur RoleTo improve the health and wellbeing of all Territorians and their families by:• providing individual, family and community health and wellbeing services;• ensuring timely access to emergency and acute hospital care;• working with communities in the planning, development, delivery and evaluationof health and family services;• changing attitudes and behaviours harmful to health and wellbeing;• promoting independence and self-sufficiency; and• providing advice and support to advance the interests of senior Territorians andAboriginal people.10

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012DEPARTMENT OF HEALTH – Annual Report 2011-12Our ExecutiveThe Executive Leadership Team (ELT) provides strategic management and leadership to the agency.From left: Jill Macandrew, Mike Melino, Liz Stackhouse, Stephen Moo, Jenny Cleary, Jeffrey Moffet, Wendy Ah Chin, Barbara Paterson, Jan Currie,Penny Fielding, Nikki Walford and Ian Pollock.11

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012Jeffrey Moffet, Chief ExecutiveJeff commenced with the Departmentin September 2010 after six years ofsenior leadership roles in the WesternAustralia Country Health Service, thelargest country health service inAustralia.Jeff is a highly experienced healthadministrator who has occupied seniorleadership and management roles inthe rural and remote health sector forthe past decade. Jeff has extensivemanagement experience and also helda clinical position as a physiotherapistin Darwin in the early 1990s.Jeff represents the Territory on theAustralian Health Ministers’ AdvisoryCouncil (AHMAC), chairs the HealthWorkforce Principal Committeereporting to AHMAC and is a boardmember of the National eHealthTransition Authority and MenziesSchool of Health Research.Penny Fielding, ExecutiveDirector Strategy and ReformPenny has worked in various areas ofhealth for more than 15 years andholds a Masters in Primary HealthCare. Following a number of positionsacross public health and primaryhealth care in Central Australia, Pennymoved to Darwin in 2007 to lead Agedand Disability Services. During thisperiod she led the implementation ofthe Disability Services Review.In January 2011 she commenced hercurrent role of Executive DirectorStrategy and Reform. The roleencompasses leading theDepartment’s response to reform inthe Northern Territory, includingNational Health Reform. This providesan opportunity for health systemreform with a focus on enhancedclinical leadership, safety and qualityand system performance. TheStrategy and Reform Division alsoincludes Clinical Planning, Policy,Service Development, Activity BasedFunding, Major Projects and SystemPerformance.Dr Barbara Paterson - ChiefHealth Officer and ExecutiveDirector, Health ProtectionDivisionBarbara is a medical graduate andPublic Health Physician. She has over20 years’ experience in the NorthernTerritory in Aboriginal health, includingexperience as a District MedicalOfficer for remote Aboriginalcommunities, research and serviceprovision with the Sexual Health andBlood Borne Virus Program of theCentre for Disease Control and childhealth policy and programdevelopment.She became a Fellow of theAustralasian Faculty of Public HealthMedicine in 1995. Barbara began hercurrent roles in August 2008.As Program Director, Maternal, Childand Youth Health, Barbara had aTerritory-wide role in development andmonitoring of evidence based policy,strategies and programs, contributingto national policy directions.12

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012DEPARTMENT OF HEALTH – Annual Report 2011-12Jenny Cleary, Executive Director,Top End Hospital NetworkJenny worked in the Northern Territoryin various areas of public health for 25years before taking up the role ofActing Executive Director, Top EndHospital Network, in September 2011.This position brings the Royal Darwin,Katherine and Gove District Hospitalsunder the banner of a single LocalHospital Network.Prior to that time, Jenny spent fiveyears as the Executive Director,Health Services, heading up primarycare, mental health and a number ofpublic health programs and communityservices across the Territory.In earlier roles in the Department ofHealth Jenny worked in health systemreform, policy and public healthsystems management. She played akey role in the Northern Territory’ssuccessful remote IndigenousCoordinated Care Trials. Jenny’sprofessional background is in dieteticsand public health nutrition. She has aMasters in Public Health.Mike Melino, A/ExecutiveDirector, Central AustralianHospital NetworkMike Melino was appointed GeneralManager of the Alice Springs Hospitalin September 2010 and more recentlyhas taken on the role as ActingExecutive Director of the CentralAustralian Hospital network.From 2007 to 2010 Mike was theExecutive Director, Mental HealthServices for Country Health in SouthAustralia. In this role he wasresponsible for significant reform ofmental health services for CountrySouth Australia, including thedevelopment of a new model of careand the implementation of a single,integrated service delivery system formental health in Country SouthAustralia.Mike has held a number of othersenior executive positions in ruralhealth as a Chief Executive of CountryHospitals and Area Health Manager inCountry Health South Australia.Stephen Moo, Chief InformationOfficerStephen has been employed in thehealth sector for over 30 years. Duringthe last 12 years he has had directresponsibility for the design,development, implementation and ongoingsystem management for majorcorporate client and clinicalinformation systems and informationcommunications infrastructure.Stephen has been Director of eHealthNT for the past seven years and is theprincipal architect and sponsor for thedevelopment and implementation of acomprehensive and well regardedeHealth program.Stephen was the Chair of the NationalHealth Chief Information OfficerForums for the past four years. Heplayed a key role in the developmentof the National eHealth Strategy andthe development of national eHealthfoundation services and standards bythe National eHealth TransitionalAuthority.13

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012Wendy Ah Chin, ExecutiveDirector Aboriginal Policy andStakeholder EngagementDivisionOriginally from Mt. Isa, and adescendant from the Wannyi people inNorth West Queensland, Wendy grewup in the Territory. Wendy commencedwith the Department of Health inFebruary 2012 in the role as ExecutiveDirector, Aboriginal Policy andStakeholder Engagement. Wendy hasa health science degree and agraduate certificate in public sectormanagement. She has worked inAboriginal affairs across the health,education and employment portfoliosfor over 20 years in both thecommunity and government sector.Wendy has held senior positions invarious community organisations andgovernment at a Territory and federallevel, including working as the CEO forthe Yothu Yindi Foundation and asDeputy CEO with the CooperativeResearch Centre for Aboriginal Health.Jan Currie, Senior Director,Office of the Chief ExecutiveJan Currie has been in the NorthernTerritory Public Service in seniormanagement positions since 1989.She was with the Department ofJustice for 10 years before transferringto the Department of Health andFamilies in 1998. Since joining theDepartment Jan has held seniorExecutive positions with responsibilityfor Executive Services, MinisterialLiaison, Media, Legal Services, PublicRelations and CorporateCommunications, Audit Services,Corporate Services, HumanResources, Industrial Relations andWorkforce.Jan was Deputy General Manager atRoyal Darwin Hospital and acted asGeneral Manager for periods of timethroughout 2009 and 2010. In June2010, she took on the role of DeputyChief Executive, Acute Care for ninemonths leading up to the departmentalchanges relating to national healthreform.Liz Stackhouse, ExecutiveDirector, Capital andInfrastructureLiz has had a long career in theAustralian health system in hospitalmanagement as well as for AustralianGovernment, state and TerritoryDepartments of Health and spent twoyears working for the National Healthand Hospitals Reform CommissionShe is a Fellow of the Institute ofChartered Accountants and prior toher career in the Australian healthsystem worked with Deloitte andCoopers and Lybrand.Jill Macandrew, A/SeniorDirector, People and ServicesJill commenced with the Department in1977 as a Dental Therapist and wenton to manage the School DentalService. Other positions she has heldwithin the Department include:Director, Community and PublicHealth; Top End Coordinator; ActingDirector, Aged and Disability; ActingChief Operations Officer; and SeniorDirector, Office of the Chief Executive.Jill has played a key role in two majordepartmental restructures. She holdsqualifications in Dental Therapy,Teaching and Health Promotion; andis a Public Sector ManagementGraduate. Jill has held the position ofSenior Director, People and Servicessince April 2011.14

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012DEPARTMENT OF HEALTH – Annual Report 2011-12Ian Pollock, A/Chief FinanceOfficerIan commenced as Chief FinanceOfficer in July 2010. He started withthe Department in 1998 as a BusinessManager at the Royal Darwin Hospital,before moving to work as theManager, Performance and Contractsin Acute Care. In 2007 he wasemployed as the Director ofInformation Services in theDepartment of Education and Trainingand returned to the Department ofHealth in 2008, as the Director, AcuteCare Systems Performance.Ian has a Masters in Health ServiceManagement, a Graduate Diplomafrom the Institute of CompanyDirectors and a Bachelor of Business.He has worked in a number of keyservice development portfoliosincluding renal and radiation oncologyservices and has also managed theNorthern Territory Hospital Cost DataCollection.Nikki Walford, A/ExecutiveDirector, Health ServicesNikki is a long term Territorian withnearly twenty years’ experience in theNorthern Territory Public Sectoracross Treasury and Health and hascompleted a Business Degree atCharles Darwin University and aGraduate Diploma of International andCommunity Development from DeakinUniversity.A Northern Territory Treasurygraduate, she commenced with theDepartment of Health after leavingTreasury as the Director of BudgetPolicy. She has gained experience insenior health service deliverymanagement positions across urbanand remote Territory settings,including as Director for CommunityHealth.Nikki has been acting in the position ofExecutive Director, Health ServicesDivision since January 2012. This rolemanages many government servicesoutside the hospital environmentincluding aged and disability, mentalhealth, oral and remote and urbanprimary health care as well as healthprogram development.15

DEPARTMENT OF HEALTH – Annual Report 2011-12The Department at a GlanceA Month in the Life of the DepartmentOn a typical month during the last financial year the Department provided, deliveredor dealt with around:• 270 babies born in our hospitals;• 10 420 hospital admissions;• 14 950 specialist clinic consultations;• 12 070 emergency department attendances;• 3770 oral health occasions of service;• 1995 Healthy Under 5 Kids Checks;• 5770 services to our clients in Aged and Disability services;• 3690 remote health centre service events;• 3100 services to Mental Health patients and clients;• 2080 alcohol and other drugs service interventions;• 820 environmental health compliance checks; andThis cost • about haemodialysis $104M in op for 36 patients in their home or community.This cost about $104M in operational expenses each month.(Control click on the underlined sections above to jump to more information.)16

DEPARTMENT OF HEALTH – Annual Report 2011-1217

DEPARTMENT OF HEALTH – Annual Report 2011-12Key AchievementsFor more details on achievements please follow the hyperlinks given.• Northern Territory hospitals have successfully managed an 8.2% increase inseparations in 2011-12, following an annual average 4% increase in separationsbetween 2006 and 2011.• A significant decline was experienced in pneumococcal disease among childrenbetween 1999 and 2011 due to immunisation.• There was a downward trend in trachoma prevalence in all regions of theNorthern Territory during 2011-12, down to 7% from 12% in 2010-11.• 54 000 people were signed up to My eHealth Record, a way of securely storingand sharing health information with our clients’ consent, including an estimated75% of the targeted Aboriginal and Torres Strait Islander rural and remotepopulation.• Major upgrades at Royal Darwin Hospital increased capacity in the EmergencyDepartment (ED) and Short Stay Unit.• With the establishment of the Red Lily Health Board in the West Arnhem Regionand the transition of the Department’s community health centre at Yirrkala toMiwatj Health Services, regionalised remote health service planning and deliverywas progressed.• A nursing service was established in the Police watch houses in Darwin,Katherine and Alice Springs.• Child and adolescent mental health services in Darwin and Alice Springsreceived funding of $1M, enabling expansion of services to rural and remotecommunities and improved access to specialist assessment in Darwin and AliceSprings.• Two secure care residential facilities have been constructed, one each in Darwinand Alice Springs, providing a safe therapeutic environment for people with asevere intellectual disability impacting on harm to self and others.• Three Northern Territory Alcohol and Other Drugs services became nationallyaccredited for the first time.• Workforce information available to managers was significantly enhanced throughthe development of a suite of human resources data reports.• The Quitline Enhancement program has led to a significant increase in the use ofthe smoking Quitline by Aboriginal people; in 2011-12 approximately 16% ofcallers were identified as Aboriginal and/or Torres Strait Islander, double the 8%for the previous year and triple the 5% recorded in 2009-10.18

DEPARTMENT OF HEALTH – Annual Report 2011-12• Hospital Network Governing Councils were established in both the Top End andin Central Australia following consultation with community stakeholders andhospital board members about the role and function of Governing Councils.• With the Aboriginal Medical Services Alliance Northern Territory (AMSANT) andthe General Practice Network Northern Territory (GPNNT), the Departmentdeveloped a framework for the first Northern Territory Medicare Local.• The Stakeholder Engagement Framework was developed in order to lead acoordinated approach to stakeholder engagement activities across theDepartment.• Tennant Creek opened a new purpose built Renal Unit with eight renal chairs.As we move into 2013 and the final implementation of the National Health Reforms,the Department will be developing a service plan for 2013 and beyond.19

DEPARTMENT OF HEALTH – Annual Report 2011-12OverviewThe Northern Territory Health ContextThe Northern Territory faces unique challenges in delivering equitable access tocore health services due to its demographic and geographic landscape.Recent Census data demonstrates differences between the Territory population andthe rest of Australia in size, gender, age, Aboriginal status and distribution. All ofthese factors impact on patterns of health service need and provision. The 2011Census preliminary rebased estimated resident population (ERP) of the NorthernTerritory, as at 30 June 2011, was 231 330 persons, representing just 1.0% of thetotal Australian population.The average annual Northern Territory growth rate for the five year period from 30June 2006 to 2011 was 1.9%, compared to a national average growth rate of 1.5% inthe same period. Over the last five years the Northern Territory population increasedby 20 700 persons (9.8%), from 210 630 in 2006 to 231 330 in 2011. In 2011, theTerritory recorded a much younger population than the rest of Australia, with amedian age of 31.4 years. Males outnumbered females, with 110.6 males for every100 females (Figure 1).Figure 1 :2011 Estimated Resident Population by Age, Northern Territory(Source:Australian Bureau of Statistics (ABS), 2012. Australian Demographic Statistics,December 2011. ABS. Cat. No. 3101.0 Canberra)The major issue for the provision of health services in the Territory is that 30.4% ofour population is Aboriginal and most of that group (74%) lives in very remote areas20

DEPARTMENT OF HEALTH – Annual Report 2011-12making access to core health services a constant challenge for the Department(Figure 2).Figure 2 :2006 Estimated Resident Population, Remoteness Areas, Northern Territory byAboriginal Status(Source:ABS Experimental Estimates of Aboriginal and Torres Strait Islander Australians,June 2006 (Cat. No. 3238.0))This figure is based on the last 2006 Census as reliable figures on our Aboriginalpopulation are not yet available from the 2011 Census.21

DEPARTMENT OF HEALTH – Annual Report 2011-12Health statusLife expectancyLife expectancy has improved significantly over the past 40 years, both in theNorthern Territory and in Australia; however a considerable gap in life expectancystill exists between Aboriginal and non-Aboriginal populations (Figure 3). Closingthis gap in life expectancy is a major focus for both the Department and its local andnational partners.Figure 3 : Life expectancy at birth, Northern Territory and Australia, 1967 to 2006(Source:Health Gains Planning Branch, Health Protection Division)There have been improvements in the life expectancy of Aboriginal people living inthe Territory during the last 40 years. This was more evident for Aboriginal femaleswith an improvement of 16 years compared to an eight year increase for Aboriginalmales. The increase in life expectancy of non-Aboriginal males and females wasgreater, being 16.5 years and 12.4 years respectively, resulting in a widening of thedifference in life expectancy between the two populations. Vigorous effort is requiredto reduce this gap by addressing not only health problems, but also the socialdeterminants of health.22

DEPARTMENT OF HEALTH – Annual Report 2011-12Mortality RatesThe substantial shift in Aboriginal age-specific mortality rates in the NorthernTerritory over the last 40 years is shown by comparing the five year period of 1967to 1971 and 2002 to 2006 (Figure 4). The age-specific death rate ratio provides acomparison of death rates between Northern Territory Aboriginal or non-Aboriginalmales and females, and Australian males and females respectively.Figure 4 :Ratio of the Northern Territory and Australian age-specific death rates, by sexand Aboriginal status, 1967 to 1971 and 2002 to 2006(Source:Trends in Mortality Report, (upcoming), Health Gains Planning Branch, HealthProtection Division)23

DEPARTMENT OF HEALTH – Annual Report 2011-12Comparing the first five years (1967-1971) and the last five years (2002-2006), thefollowing observations can be made.• There were no substantial differences in death rates between Territory andAustralian non-Aboriginal females. There was a persisting small excess in deathrates for Northern Territory non-Aboriginal males in most age groups.• Between the two time periods, the death rate ratios for most age groups in theAboriginal population increased as the result of the slower rates of improvementsin this population. For example, the death rate ratio for Aboriginal males andfemales in the 35-39 years age group was around 5-6 times Australian ratesduring the early years and around 10-11 times in the last five years. Thisincrease was consistent across all age groups from 10-14 years through to olderadults.• The death rate ratio for Aboriginal children aged 0 to 4 years has improvedmarkedly from 5.3 and 6.9 times the Australian rates, for males and femalesrespectively, to around 3 times in recent years.• During both periods, the death rate ratio between Territory Aboriginal andAustralian populations gradually increased from the younger ages to peak atages 35-39 before declining again in the older age groups. This highlights thatthe greatest excess in Aboriginal mortality occurs in mid-adulthood.Admissions to hospitalThere has been a substantial rise in hospital admissions rates which reflects theageing of the Aboriginal population, the emergence of chronic diseases andincreasing renal dialysis (Figure 5).Figure 5 :All causes separations per 1000 population, including renal dialysis, 1992-93 to2007-08(Source:Trends in Hospital Admissions Report, (2012), Health Gains Planning Branch,Health Protection Division)24

DEPARTMENT OF HEALTH – Annual Report 2011-12Disease preventionThere has been demonstrable success in translating health service efforts intoimproved health outcomes as shown in the significant decline in pneumococcaldisease among children between 1999 and 2011 due to immunisation programs(Figure 6). Pneumococcal disease can cause:• meningitis (infection of the membranes that enclose the brain and spinal cord);• pneumonia (lung infection);• septicaemia/bacteraemia (blood system infection); and• middle ear and sinus infections.Figure 6 :Trends of notifications of invasive pneumococcal disease among children aged0–23 months, Northern Territory 1999 to 2011(Source:Infancy to Young Adulthood (upcoming publication) Health Gains Planning Branch,Health Protection Division)Tobacco use in the Territory is high:• in 2004-05, 35.3% of people in the Northern Territory smoked tobacco comparedto 22% of all Australians; and• in 2007-08, 33.4% of Territorians smoked tobacco compared to 21% ofAustralians (Table 1).While the age-adjusted prevalence of smoking shows higher use of tobaccoamongst Aboriginal people and Territorians when compared with non-Aboriginalpeople and Australians, respectively. The reduction in smoking prevalence has beenhigher in these high use groups between 2004-05 and 2007-08.25

DEPARTMENT OF HEALTH – Annual Report 2011-12Table 1 :Age-adjusted smoking prevalence, per cent of total population, by sex andAboriginal status, Northern Territory and Australia: 2004-05 and 2007-08Aboriginal status2004-05Male%Female%Persons%Aboriginal Territorians 62.1 44.0 52.4Non-Aboriginal Territorians 31.8 29.3 30.2Northern Territory Persons 37.6 33.4 35.3Australia Persons 24.1 20.0 22.02007-08Aboriginal Territorians 54.6 45.5 49.8Non-Aboriginal Territorians 30.5 24.5 27.8Northern Territory Persons 36.0 30.3 33.4Australia Persons 22.9 19.0 21.0(Source:Estimated by Health Gains Planning, Department of Health – multiple sources)The Northern Territory Government has been working to reduce tobacco relatedharm through action in the areas of policy and legislation, health care, andcommunity interventions as outlined in the Northern Territory Tobacco Action Plan2010-2013 framework. The key partner organisations in this work are the HeartFoundation NT, Cancer Council NT, Menzies School of Health Research, and theAboriginal Medical Services Alliance Northern Territory.In 2011-12, a total of $1.38M was allocated to tobacco control. This included $1.06Min funding from the Australian Government under the Closing the Gap NationalPartnership Agreement. This funded a multifaceted tobacco control strategy with anemphasis on reducing harm for Aboriginal people by reducing the supply of tobaccoproducts, placing restrictions on smoking in public venues, supporting individuals toquit smoking, and conducting health education campaigns.Emergency DepartmentRoyal Darwin Hospital26

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012Chief Health Officer’s ReportDr Barbara PatersonMBChB, DCH, DGM, DRCOG, MRCGP, MPH, FAFPHMThe focus of public health is to improve health and quality oflife through prevention and promotion of health lifestyles.Access to quality health services is fundamental andexpected by the community and the demand for acutetreatment services continues to be driven by the epidemic ofchronic disease and high burden of injuries. However,continued improvements in health outcomes will only beachieved through a broader approach encompassing early detection andintervention. This will be achieved through evidence based screening programs,quality primary health care, community education and promotion of healthy lifestylesand addressing the upstream determinants of health.The value of screening programsThe upcoming report Women’s cancers and cancer screening in the NorthernTerritory illustrates the importance of evidence based screening programs. Between1991-1995 and 2001-2008, the incidence of cervical cancer decreased by more than50% for Aboriginal women and 40% for non-Aboriginal women. In the same timeperiod, mortality decreased by about 75% for all women. This significantimprovement in cervical cancer detection and survival demonstrates theeffectiveness of screening in improving health outcomes.Addressing major causes of chronic diseaseThe report on the Burden of Disease and Injury in the Northern Territory showed usthat tobacco, overweight and obesity and physical inactivity contributed 8%, 11%and 11% respectively of the attribution of the total burden of disease. These arefactors which are amenable to change through focussed programs in contrast to lowsocio-economic status, which was reported to contribute 26.8% of the total burden.Reducing the harm from tobaccoFor the first time, we have a stark analysis of the significant impact of tobacco on theTerritory community through a commissioned report: the Harms from and Cost ofTobacco Consumption in the Northern Territory. It shows that the total social cost oftobacco to the Northern Territory in 2005-06 was $764M, a cost $5 150 per personaged over 14 years. This is more than double the corresponding cost per personacross Australia as a whole, which was $2345 in 2004-05. Costs arising fromtobacco-related illnesses and deaths included direct health care costs, lost27

DEPARTMENT OF HEALTH – Annual Report 2011-12workforce output and household labour, as well as the economic costs of pain andsuffering related to premature death.The health harms and impacts from tobacco in the Northern Territory in 2005-06 aresummarised in the table below.Table 2 : Summary of Health Harms and Impacts from Tobacco in the NorthernTerritory 2005-06*169 deaths were caused by tobacco use.Lung cancer, chronic obstructive pulmonary disease (COPD) and ischaemic heart disease (IHD)accounted for 25%, 25% and 20% of deaths respectively.72% of these deaths were in males and 48% in Aboriginal people.1880 tobacco-attributable hospitalisations occurred comprising 6.5 per cent of all hospital beddays.56% of people hospitalised were males and 59% were Aboriginal.COPD, lower respiratory tract infections and IHD accounted for 23%, 17% and 15% ofhospitalisations respectively.* Harms from and Costs of Tobacco Consumption in the Northern Territory, the SouthAustralian Centre for Economic Studies (April 2012). Northern Territory-specific tobaccoattributablefractions were calculated by the Health Gains Planning Branch, Department ofHealth, based on epidemiological studies and smoking surveys for both Northern TerritoryAboriginal and non-Aboriginal people.The study estimates that achieving the goals of the Northern Territory TobaccoAction Plan to reduce smoking prevalence by 5% among non-Aboriginal people and10% among Aboriginal people over a five year period could reduce these costs by$59 million. Due to the lag time in health benefit, this would take several years to befully realised.This year saw the release of the first Northern Territory Tobacco Control AdvisoryCommittee annual report which highlighted the progress being made across allgovernment, non-government, health and other sectors against the Tobacco ActonPlan 2010 to 2013. The report commended the Department on implementation ofnew legislative and smoke-free area initiatives as well as an increase in programs toreduce the harm smoking causes in the remote Aboriginal population.Preventing obesity and overweightIn Australia and worldwide, the prevalence of obesity has increased markedly overthe last 20 to 30 years and has become a major public health challenge. In Australia,approximately two-thirds of adults and one-quarter of children are overweight orobese. Our more sedentary lifestyle and high energy food intake predispose thepopulation to obesity and the development of chronic disease.Over the past three decades, it has become abundantly clear from the evidence thatthe nutritional environment of pregnancy and the early years of life strongly influencethe future risk of many chronic conditions in adulthood. Children with low birthweight, or significant growth impairment during infancy, remain biologically differentthroughout their lives with double the risk of coronary artery disease, a six-foldincrease in the risk of non-insulin dependent diabetes and an eighteen-fold increase28

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012in their risk of developing metabolic syndrome, while also being significantly morelikely to develop higher blood pressure. More recently, research has revealed thatoverweight or obesity in childhood significantly predicts obesity and risk ofcardiovascular disease in adults. Importantly it has also now been shown that rapidweight gain and higher body mass in the first years of life of at-risk children play amajor role in setting an increased risk of obesity and chronic disease in adulthood.In 2011 in the Northern Territory, 8.4% of non-Aboriginal children entering schoolwere overweight and a further 3.9% were recorded as obese. There was a slightlyhigher proportion of overweight and obese urban Aboriginal children (14.5%), whileamong Aboriginal children in remote communities there was a complicated blendwith 5.5% overweight and obese and 7.9% underweight.The Department is working with the South Australian Government and the City ofPalmerston to pilot an obesity prevention initiative in the Palmerston communitycalled Childhood Obesity Prevention and Lifestyle (COPAL). COPAL, funded by theAustralian Government, aims to promote healthy eating and increases children’sparticipation in physical activity with the long term goal of reducing rates ofchildhood obesity.There are efforts at national, Territory and community levels to address chronicdisease risk factors, including the prevention of smoking, reduction in overweightand obesity and an increase in physical activity. Initiatives, such as the NationalPartnership Agreement on Preventative Health and the National Preventive HealthTaskforce have a clear focus on improving not only how long we live, but also thequality of that longer life.There is much that can be done. For chronic diseases, the solutions are not simplyimproved health services, but also to prevent and delay the development of thesediseases by individuals making healthy lifestyle choices within a health promotingsociety.Tennant Creek Hospital29

DEPARTMENT OF HEALTH – Annual Report 2011-12Aboriginal Health ReportWendy Ah ChinExecutive Director, Aboriginal Policy andStakeholder EngagementAboriginal Territorians’ social determinants ofhealthThe Northern Territory has the highest proportion ofAboriginal people (26.8% compared to 2.5% Australiawide). The Territory also has the highest burden of diseaseof all jurisdictions in Australia. Most of the extra burden of disease experienced byAboriginal people occurs in chronic conditions with modifiable risk factors such asischaemic heart disease, diabetes, chronic kidney disease and chronic airwaysdisease. Aboriginal people have a higher prevalence of some of the risk factors thatcontribute to chronic conditions e.g. 55% of Northern Territory Aboriginal peoplesmoke, 28% are overweight and 29% obese.It is important to view this disparity in the broader context of the social determinantsof health and the socio cultural disruptions experienced by Aboriginal people,including the effect of racism on health, education, housing and employment. Lowsocio-economic status contributes 26.8% to the total burden of disease and injury inthe Territory which is a major issue for Aboriginal people.Evidence indicates that improvements in health status require strategies thataddress structural issues such as Aboriginal community control of and reliableaccess to comprehensive primary health care (including health promotion andprevention) as well as addressing the social determinants that underlie poor healthoutcomes.An effective and appropriate service systemProviding services for Aboriginal people is a major part of the Department’s serviceeffort. 60% of hospital overnight patients and 71% of government managed remotehealth care centre patients are Aboriginal. For this reason, it is important that wehave a strong focus on developing our services to be more effective and efficient forAboriginal Territorians. To assist with this the Department has also establishedcultural leave entitlement provisions for its Aboriginal staff. These provisions enableAboriginal staff to access cultural leave for events of cultural significance.In relation to community control, the Department, Aboriginal Medical ServicesAlliance of the Northern Territory and the Australian Government continues to workin partnership with a focus on improved community engagement and clinicallysustainable services on the ground.30

DEPARTMENT OF HEALTH – Annual Report 2011-12Assuring cultural security in service deliveryImplementation of the Cultural Security Policy is a priority for the Department. Anaudit was undertaken in 2012 on the implementation of the Cultural Security Policyand the outcomes will be used to inform the next phase of cultural security initiativesacross the Department.Under the Cultural Security Policy platform the Department has implemented arange of initiatives, including the cultural competency self-assessment and audittool. This tool allows the gathering of baseline data to assess how culturallycompetent the Department is at the staff/individual, systemic and organisationallevels.The Department has identified four trial sites within a remote community healthsetting and the hospitals. Further rollouts of this tool will continue across theDepartment to measure and ultimately improve the cultural competency of theDepartment and its workforce, ensuring health services and programs reflect thecultural needs and values of Aboriginal people.Working in partnershipThe Northern Territory Trachoma Strategy has continued to expand, developingfurther partnerships with the Indigenous Eye Health Unit at Melbourne Universityand the Fred Hollows Foundation. In 2011-12, there was a downward trend intrachoma prevalence in all regions of the Northern Territory. The overall prevalenceof active trachoma in children in the 65 communities screened was 7% (down from12% in 2010-11), with no trachoma found in 34% of communities (21 of 65).The Department also developed its Aboriginal Interpreter and Translator Policy in2012 and has engaged with key stakeholders for feedback.Another exciting initiative being driven by the Department is My eHealth Record,which provides clients with a way of securely storing and sharing health informationwith their consent. This information can be easily and quickly accessed byparticipating healthcare providers when needed for ongoing client health care.My eHealth Record is having a significant positive effect on the way services aredelivered to Aboriginal people in rural and remote locations throughout the Territorywhere it has effectively 100% coverage of healthcare providers involved in their care(all Aboriginal community controlled health services, Department of Health remotehealth centres and Northern Territory public hospitals). Consumer registrationsexceed 80% in most communities in rural and remote locations (average is 75%).31

DEPARTMENT OF HEALTH – Annual Report 2011-12Growing our Aboriginal workforceAboriginal employment is a key priority for the Department. Recruiting and retainingAboriginal staff is vital to that effort. Currently 8% of our employees are Aboriginaland we aim to increase this in the future.The Aboriginal and Torres Strait Islander Professional Development Program,Stepping UP , is part of a broader commitment to continued investment in growing ourown workforce.The Stepping UP program is an accelerated development program that provides anopportunity for Aboriginal and Torres Strait Islander staff to develop and enhanceskills and competencies to open up career pathways within the Department and theNorthern Territory Government. The Stepping UP program has had 25 participantsover a three year period. The third Stepping UP program intake is currently finishingand the Department will recruit for a fourth intake in 2013.Aboriginal Liaison Officers atAlice Springs Hospital32

DEPARTMENT OF HEALTH – Annual Report 2011-12Regional Achievements andServices MapOverviewCoordination of health and wellbeing services across the vast and varied NorthernTerritory landscape is complex. Getting the most from our services and supportingthe coordinated implementation of government policies is a responsibility that falls tothe Top End and Central Australian Coordination Units.The Top End and Central Australian Coordination Units aim to foster cooperationand collaboration across Department of Health programs and endeavour to maintainstrong working relationships with communities, government and non-governmentorganisations. The units are responsible for developing, in conjunction with relevantprogram areas, Department of Health Regional Plans. The plans are reviewedregularly to ensure that priorities and objectives progress through to implementationand that ongoing and emerging issues are addressed. These plans provide aneffective platform for promoting and delivering cross-program outcomes.Royal Flying DoctorService.33

34DEPARTMENT OF HEALTH – Annual Report 2011-12

DEPARTMENT OF HEALTH – Annual Report 2011-12Performance Highlights by Region 2011-12East Arnhem RegionHealth education was again a priority in the Gove area withapproximately 50 Department of Health staff working side by sidewith staff from the Department of Children and Families to delivereducation and employment options to the 3000 participants at thefour day Garma Festival in August 2011.The Department also participated in health education at the GovePeninsula Festival in 2011. Health promotion characters were usedto deliver specific health messages to 2000 attendees over the day.Health promotion characters at the Gove Peninsula FestivalBreast screen Northern Territory held screenings at Miwatj Health facilities in August2011.All East Arnhem Health Centre staff members were trained in the new NorthernTerritory alcohol reforms by September 2011.Alcohol and Other Drugs (AOD) assisted in the development of Volatile SubstanceManagement Plans (VSMPs) for Millingimbi, Gapuwiyak and Yirrkala in consultationwith other government departments and community members. Galiwinku’s VSMPwas completed and signed off in February 2012.35

DEPARTMENT OF HEALTH – Annual Report 2011-12The Environmental Health Branch, in conjunction with the East Arnhem HealthDevelopment Team, conducted the Healthy Homes, Healthy Skin campaigns inMillingimbi, Ramingining and Gapuwiyak communities. The project received supportfrom the East Arnhem Shire.The Top End Coordination Unit continues to be involved in Emergency Managementand Disaster Coordination through Medical and Environmental Health Planning withthe incorporation of WebEOC (a web based incident management system) trainingand counter disaster exercise participation.A router was installed for the East Arnhem Health Library allowing Wi-Fi access inand around the district office, library and staff quarters.The Centre for Disease Control (CDC) in Nhulunbuy developed an immunisationprogram and register for the Gove District Hospital to meet hospital accreditationrequirements. CDC Nhulunbuy has also been involved with the Charles DarwinUniversity Ralpa program. Ralpa is a training program focusing on ensuring thatYolngu youth have a meaningful pathway to employment.Katherine RegionIn February, 60 participants attended the Indigenous Risk ImpactScreen (IRIS) and Brief Intervention Program. The programprovides a culturally secure and validated screening instrument andbrief intervention designed to meet the specific needs of Aboriginaland Torres Strait Islander communities. The course is funded bythe Australian Government and is aimed at frontline workers andwill be rolled out across Australia. Alcohol and Other Drugs (AOD)program staff were trained and certified to deliver the trainingacross the Northern Territory.The Indigenous Risk Impact Screen (IRIS) and Brief Intervention Program providesa culturally secure and validated screening instrument and brief interventiondesigned to meet the specific needs of Aboriginal and Torres Strait Islandercommunities.A number of significant improvements and renovations were made to KatherineHospital. These included:• an additional three cubicles and a flight deck view for staff, to enable improvedworkflow and conditions at the Emergency Department;• a new office and patient waiting room within the Radiology Department to provideimproved privacy and better function of the area; film prints are now being usedinstead of electronic images; and• a Breast Screening Clinic was held with over 300 women attending. Amongthese, ten women from Borroloola were sponsored to travel for the screening byMcArthur River Mining.36

DEPARTMENT OF HEALTH – Annual Report 2011-12Staff from the Katherine Alcohol and Other Drugs (AOD) program conductedAuthorised Persons Volatile Substance Abuse Prevention Act training. The teamalso facilitated the development and gazettal of a Management Area and Plan underthe Volatile Substance Abuse Prevention Act (VSAPA) for Yarralin, Pigeon Hole andtwo outstations, located near Katherine. A public meeting was held at Yarralin wherecommunity members unanimously supported the plan, which has now beenimplemented.Katherine AOD staff also facilitated the development of a Management Plan underthe VSAPA for Beswick. A public meeting was held at Beswick and communitymembers unanimously supported the plan. The plan has not yet been gazetted.AOD staff are supporting the Australian Government and BP Australia staff in theOpal Road Show to gain public support for the roll out of Opal fuel in the region.Training in the Katherine region for the year included the About Giving VaccinesWorkshop attended by six Aboriginal Health Workers.A new program, funded by the Australian Government through Specialist OutreachNorthern Territory and the Medical Specialist Outreach Assistance Program,Maternal Services, was introduced in March 2012. This has enabled midwives fromKatherine Hospital to visit four remote communities each month to work with womenand local staff to improve continuity of antenatal information and care and prenataloutcomes.The Katherine Environmental Health Program provided support to remotecommunities through mentoring programs for the Aboriginal Environmental HealthOfficers based at Ngukurr and the Sunrise Aboriginal Health Board.The Adolescent Sexuality Education Project commenced in November 2011.Positions are based in Katherine, although training is provided through the YoungWomen’s Community Health Education Program and the Young Men’s CommunityHealth Education Program throughout the greater Katherine region.In May 2012, the Katherine Hospital hosted a day of disaster managementexercises. These included a multi-agency table top exercise in the morning and ahospital practical exercise in the afternoon. The exercise, Emergo Train, involvedstaff from Katherine Hospital, Northern Territory Police, Northern TerritoryEmergency Services, St John Ambulance, Sunrise Aboriginal Health Services,Katherine West Health Board, RAAF Base Tindal Health Centre, the Department ofChildren and Families, Gorge Health Services and the Kintore Health Clinic.More than 100 staff members were recognised for their years of service in a specialceremony held in September 2011 with awards presented by the Minister for Healthand Ms Jenny Cleary, as the departmental executive representative.37

DEPARTMENT OF HEALTH – Annual Report 2011-12Katherine based midwife, Ms Kimberly Window was awarded Midwife of the Year atthe 2012 Nursing and Midwifery Excellence Awards, held at Parliament House on 11May 2012.Central AustraliaImproving health in the general community and implementingpreventative programs was again a major focus for health workers inCentral Australia.The Eat Better Move More (EBMM) program was delivered withtraining to staff members who provide services to, or work in, remotecommunities. These included Epenarra, Amoonguna, Kintore,Papunya, Canteen Creek, Elliott, Engawala, Bonya, Ti Tree, DockerRiver, Nyrippi, and Yuendumu.At the same time Child Health Hearing Nurses have been working with other hearingstaff to provide support and education to 13 Central Australian remote communities.One of the most significant projects to be developed in Central Australia was in thearea of men’s health. There are now three Male Health Coordinators in CentralAustralia focusing on the development of a male health stakeholder group andhealth promotion in remote communities. The stakeholders involved includedTangentyere Council, Central Australian Aboriginal Congress, Remote Health,Mental Health, the Department of Employment and Training, Anyinginyi, Braddagg,Drug and Alcohol Services Association, STePS, Barkly Shire, McDonnell Shire,Central Desert Shire, Family as First Teachers, Health Development staff and thedepartmental Men’s Health program for Male Safe Places.The aim of the program was to encourage men to take up male health checks. Thecommunities which were targeted included Bonya, Harts Range, Engawala, Tara,Wilora, Mutitjulu, Imanpa, Ti Tree, Canteen Creek, Docker River, Elliott, TennantCreek, Ikuntji and Mt Liebig. Staff were also involved in a project with Tangentyere,known as the Men’s Engagement/Wellbeing Pilot Project. Women and childrencontinue to be supported through the Strong Women Strong Babies Program whichis implemented in five Central Australia Communities. These include Papunya,Docker River, Canteen Creek, Ali Curung, Elliott and Ntaria.Early childhood pathways were developed between the Department, the Departmentof Education and non-government organisations to provide better integration ofservices for children and families.Other improvements in service integration are taking place in Ntaria with a ChildHealth Care worker based in the Women’s Health and Aged Care premises.In the area of Mental Health, a joint project was developed with Remote Health toimprove recording of suicide attempt data, which led to improved sharing ofinformation. Mental Health worked closely with the Mental Health Association ofCentral Australia to coordinate responses to suicide attempts.38

DEPARTMENT OF HEALTH – Annual Report 2011-12There was a stronger focus on building relationships with other agencies andsupporting staff with better lifestyle choices. The 10 000 Steps Program involvingstaff and clients provided assistance with Nicotine Replacement Therapy to stopsmoking and encouraged staff to walk to work and nominate themselves for the2012 Masters Games.The Alice Springs Hospital Tobacco and Alcohol project continued, providing over600 referrals including 246 referrals to community based AOD services and NicotineReplacement Therapy for 83 clients. The Alice Springs Hospital EnhancedWithdrawal Pathway program was also established.The Oral Health team provided health prevention education sessions to childcarecentres, preschools, primary schools, health and wellbeing expos and career expos.The team also delivered the Enhanced Parental Participation Program in schools, aswell as a mouthguard promotion and distribution campaign.Oral Health examinationIn June 2012, the Territory’s first Telehealth Outpatient Clinic was conductedbetween specialists at the Alice Springs Hospital and patients located at the TennantCreek Hospital. The service enabled patients to receive follow up treatment in theirhome town rather than travel to Alice Springs. The service continues to operate on amonthly basis.To improve staff retention in Remote Health, annual staff satisfaction surveys weredeveloped. Some housing shortfalls were addressed with new houses erected andupgrades completed in relevant communities. Several flexible workplacearrangements were also approved and implemented.The Environmental Health team undertook a number of projects, including anEnvironmental Health risk assessment which identified priority action items withinCentral Australian growth towns. From this, projects around water supply and solidwaste management were undertaken.Environmental Health was also on the Northern Territory Waste ManagementStrategy Steering Committee and provided information for the strategy on waste inremote areas. In collaboration with Central Australian shires, Environmental Health39

DEPARTMENT OF HEALTH – Annual Report 2011-12developed and implemented Food Safety Plans in child care and aged care facilitiesto meet the standard 3.3.1 Food Safety Programs for Service to Vulnerable Groups.Other projects supported by Environmental Health included the Healthy Skin Projectdeveloped in remote communities utilising the No Germs on Me campaign and theBarkly Shire Council’s Animal Health Program which won the 2012 National Awardsfor Local Government in the Small Council category.Environmental Health continues to work with remote communities to undertake smallurban renewal projects that build on the strengths of the community.A Memorandum of Understanding (MOU) for access to library services andresources was signed between the library and Anyinginyi Health in Tennant Creek.The majority of practising health professionals and Aboriginal Health Workers in theCentral and Barkly regions now has library access with MOUs in place betweenAnyinginyi Health, Central Australian Aboriginal Congress, General Practice NetworkNorthern Territory, General Practice Northern Territory Education (GPNTE) andRoyal Flying Doctors Service Central Operations.The Regional Librarian delivered a poster presentation at the GPNTE’s HealthProfessionals Teaching and Learning Conference 2012.The presentation, Accessing health information - anywhere, anytime, promotedlibrary services and resources to non-government health professionals andAboriginal Health Workers.The Child and Family Health Service developed an innovative approach toincreasing the involvement of fathers in the parenting of their newborn children. Theservice offers the Territory Parents Support Program as a post natal support group.These programs run for six weeks and are aimed at new mothers with changes tothe program working towards including the involvement of fathers. The last sessionof the program is now known as Dad’s Day and involves new fathers through a40

DEPARTMENT OF HEALTH – Annual Report 2011-12forum for discussion and support. Relationships Australia deliver a session on theimportance of the role of being a father, the need for fathers to support mothers toshare in baby care and the importance of the parents’ relationship. It is hoped theflow on effects around this program will see fathers become more supportive parentsand form support networks.The Centre for Disease Control continues to roll out the Adolescent SexualityEducation Project with a male and female position commencing in Alice Springs.These positions provide training through the Young Women’s Community HealthEducation Program and the Young Men’s Community Health Education Programthroughout the Central Australian region.The sexual health clinic, Clinic 34, completed building renovations this year,improving efficiency and privacy. Clinic 34 also commenced a weekly late openingevening clinic to improve access for clients.What’s coming up in the Regions 2012-13Top EndIn Katherine, the Beswick Management Area and Management Plan, developedunder the Volatile Substance Abuse Act, is expected to be gazetted after communityagreement earlier this year.Community nurses will implement training to assist people working in health,education, family or children’s services to better develop father inclusive strategieswithin their programs.New mother, LorettaFrancis with baby Mathewand Nurse Lucy Higgins atthe Alice Springs Hospital.41

DEPARTMENT OF HEALTH – Annual Report 2011-12Central AustraliaThe Tennant Creek Hospital Emergency Department upgrade is due for completionin 2013. The upgrade will provide seven treatment bays, two resuscitation bays, asecure pharmacy, a secure mental health facility, three separate waiting areas forcultural security and the expansion of the morgue from six to 12 bays.Telehealth infrastructure will allow for specialist outreach clinics to be delivered toremote health centres in the Central Australian growth towns, as well as a number ofother remote communities. These include Yuendumu, Papunya, Ali Curung, Elliott,Ntaria, Ti Tree and Borroloola.Central Australia Oral Health will have a position for a Graduate Dentist, beginningin January 2013, as part of the Voluntary Dental Internship Program funded overfour years.Under an agreement with Health Workforce Australia and James Cook University,four final year dental students will be supervised in Central Australia commencing inJanuary 2013. Students will be in Alice Springs’ urban and remote areas for 17 weekblocks twice a year; a total of eight students will take part. These programs willprovide dental graduates with enhanced practice and professional developmentopportunities, whilst improving workforce and service delivery capacity, particularlyin the public sector.42

DEPARTMENT OF HEALTH – Annual Report 2011-12Hospital Services Output GroupOutcomeThe intended outcome of the provision of hospital services is improved health andwellbeing of those in the Northern Territory community who require acute orspecialist care.Implementation of the National Health ReformSignificant work was undertaken during 2011-12 to achieve Northern Territoryreform priorities as part of the implementation of the National Health ReformAgreement. This included planning for the establishment of Local Hospital Networksin the Territory and developing the Department’s capability to effectively carry out itsnew role as health system manager under the new funding and performancearrangements.Creating the Territory Hospital NetworksPlanning was undertaken and functional changes made to enable the HospitalNetworks to operate within the Department from April 2011. This processestablished two networks:• the Top End Hospital Network – responsible for the operations of Royal Darwin,Gove District and Katherine Hospitals; and• the Central Australian Hospital Network – responsible for the operations of AliceSprings and Tennant Creek Hospitals.This saw the development of operating arrangements which supported the smallerregional hospitals through increased clinical governance, staff support and visitingservices from the Territory’s two major hospitals.Governing Councils will replace the existing hospital boards, one for each HospitalNetwork. The new Governing Councils, established through legislation, will report tothe Minister for Health, as is the case for existing hospital boards.Chairpersons and members of the Top End and Central Australian Hospital NetworkGoverning Councils have been appointed by the Minister for Health in anticipation oftheir commencement on 1 July 2012.Top End Hospital Network Governing Council MembersMr Colin McDonald (Chairperson), Ms Jennifer Peers, Mr James Sullivan, Mrs AnneShepherd, Ms Patricia Angus, Mr John Paterson, Ms Diane Walsh, Mr RossSpringolo and Dr Tamsin Cockayne.43

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012Central Australian Hospital Network Governing CouncilProfessor John Wakerman (Chairperson), Dr Bruce Simmons, Mrs Joyce Measures,Mr Damien Ryan, Ms Dale Wakefield, Mr John Gibb, Dr Liz Moore, Mr ElliotMcAdam and Ms Helen Kilgariff.Establishing the Strategy and Reform DivisionThe new funding and performance arrangements in the National Health Agreementhave created new requirements for the Department to manage. The priorities for2011-12 were positioning the Department for the commencement of Activity BasedFunding arrangements and the increased focus on hospital performance. Thecontext of these immediate priorities is a stronger emphasis on the performance ofthe health system as a whole, to facilitate the increased delivery of care outside ofhospitals in primary care settings.The Strategy and Reform Division was created to provide the Department with thecapacity to address and manage this agenda of change. Established through arestructuring of what was the Acute Care Division, the Strategy and Reform Divisionremains responsible for strategic policy and planning related to acute care servicedelivery within the larger heath system context.The Strategy and Reform Division comprises a number of branches to address itsnew and broadened responsibilities:• Activity Based Funding which undertakes modelling, analysis and reportingrelated to the implementation of direct Australian Government funding ofhospitals, based on the application of the funding framework to the activity inNorthern Territory Government hospitals;• System Performance which manages the analysis and reporting of data tovarious national bodies and participates in the development of appropriateperformance measurement;• Policy and Service Development which manages the Patient Assistance TravelScheme (PATS), Specialist Outreach Services, Ambulance and MedicalRetrieval Services, policy development, supply and coordination of blood andblood products and national funding agreements; and• projects related to service developments such as the planning of PalmerstonHospital and the Clinical Redesign Project.Together, these branches support a range of hospital services, including inpatient,outpatient and Emergency Department (ED) services.44

DEPARTMENT OF HEALTH – Annual Report 2011-12Our HospitalsRoyal Darwin Hospital (RDH) is the primary tertiary hospital in the NorthernTerritory, being its largest tertiary referral and university teaching hospital. It alsoprovides acute hospital services to the residents and visitors of the Top End. Thehospital has a catchment population of around 150 000 people and directly servicesan area of 127 000 km 2 . It had 55 440 separations during 2011-12.As the Territory’s major tertiary hospital, RDH provides a comprehensive range ofclinical, diagnostic and support services. This includes a number of specialisedservices provided for the whole Territory. The hospital has a strong and successfulassociation with the Flinders University of South Australia through the joint initiativeof the Northern Territory Medical Program.RDH has full accreditation by the Australian Council on Healthcare Standards until8 May 2013.RDH houses Australia’s National Critical Care and Trauma Response Centre. TheHospital won international recognition for its role in the retrieval, treatment andtransfer of victims of the 2002 Bali bombings.Katherine Hospital services the Katherine region and the remote area ofapproximately 340 000 km 2 between the Western Australian and Queenslandborders, extending south to Dunmarra and north to Pine Creek. The population ofthe Katherine region is around 20 000, but has a large tourist presence leading to8051 separations during 2011-12.Katherine Hospital is accredited with the Australian Council on Healthcare Standardsuntil 15 June 2014.Gove District Hospital is located in the town of Nhulunbuy on the Gove Peninsulaand services the East Arnhem region which covers over 40 000km 2 from Milingimbiin the northwest to Numbulwar and Groote Eylandt in the southeast. The catchmentpopulation is approximately 16 000 people. It had 2393 separations during 2011-12.There are a number of remote community health centres that refer patients to theHospital for inpatient, outpatient and specialist care. The hospital also provides aDistrict Medical Officer service to the region. This service encompasses medicaladvice and visits to remote community health centres.Gove District Hospital has achieved Australian Council on Healthcare Standards andBaby Friendly Accreditation.The Alice Springs Hospital is a teaching hospital, accredited by the AustralianCouncil on Healthcare Standards.Alice Springs Hospital provides a range of clinical, diagnostic and support servicesto the region of Central Australia, a region of around 1.6 million km 2 , covering theCentral Australia and Barkly regions of the Northern Territory and reaching the45

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012border regions of Western Australia, South Australia and Queensland. This regionhas a population of around 50 000 people and a large visitor/tourist presenceaccounting for 43 034 separations in 2011-12.Construction works have been taking place at the Alice Springs Hospital throughoutthe last year: a new Emergency Department and 24/7 Medical Imaging Service andmajor redevelopment to operating theatres are nearing completion; the existing eightbed acute Mental Health Unit has been expanded and redeveloped by the additionof six new beds; and planning is under way for a new Teaching and Training Facilityto replace existing outdated facilities, to be constructed at the Alice Springs Hospitalcampus in 2013.Tennant Creek Hospital is an accredited hospital which services the 250 000km 2area that encompasses the Barkly region, reaching to Ali Curung (Alekarenge) andElliot in the Northern Territory and across to the Western Australia border. Around7000 people reside in the region, including about 3500 people living in TennantCreek. These residents and a small number of visitors accounted for around 6360separations in the 2011-12 financial year. A range of clinical, diagnostic and supportservices are provided through the Tennant Creek Hospital. This year preliminarywork has begun on the new Emergency Department at the hospital.Key Achievements• The two Hospital Networks commenced networked operations in April 2012within the Department and will commence full operation as Government BusinessDivisions on 1 July 2012.• The Department and its non-government organisation partners are working todevelop a Northern Territory Cardiac Secondary Prevention Framework to:• provide a strategic direction for coordinated and integrated multidisciplinarycardiac rehabilitation and describe innovative models of care for cardiacrehabilitation;• cover all three phases of cardiac rehabilitation across the Northern Territorypopulation and maximise access to all groups; and• guide and inform service providers on how to prioritise patient groups anddeliver cardiac secondary prevention.• Elective surgery educational material developed for health professionals andclients has been made available for the Department’s Orientation and AboriginalCultural Awareness Programs, as well as being hosted on the AustralianIndigenous Health InfoNet site.• There has been a significant capital works programs across the five Territoryhospitals in 2011-12 which included:• the opening of a 16 bed Indigenous Mothers’ Accommodation Facility toprovide safe and supportive accommodation for mothers who need to travel46

DEPARTMENT OF HEALTH – Annual Report 2011-12from remote communities to access RDH antenatal obstetric and postnatalobstetric services;• the building of a 100 bed Medihotel to provide hostel type accommodation andsupport services on the RDH campus. (This will ensure access to prearrangedclinical care similar to that generally available in the community and providefacilities for a family member or carer to be on site to assist in the provision ofcare. The facility is on track to accept patients from October 2012);• RDH ED infrastructure expansion to include a fast track area and specialistpaediatric beds; and• designs finalised for extension of the critical care areas of RDH to establishtwo additional operating theatres and an expanded operating suite as well as a12 bed short stay unit in the ED by 2014.• A greater Darwin Clinical Services Framework has been developed.• The Department worked with the sector to focus on creating specialist outreachservices based on need.• Eight new renal chairs were added to the Tennant Creek Renal Unit.• Full clinical coordination of aeromedical services was transitioned to CareFlightin February 2012.• Alice Springs Hospital was successful in its bid to the Australian Government’sHospitals and Health Fund (HHF) for a new Clinical Teaching and Trainingfacility to replace existing outdate facilities. Planning will commence soon for thisto be constructed on the Alice Springs Hospital campus in later 2013.• The Central Australia Domestic and Family Violence Project is a joint initiativebetween the Department and the Department of Children and Families. ThisProject has seen the creation and employment of three new family and domesticviolence positions – two located in the Alice Springs Hospital EmergencyDepartment and one other at the Tennant Creek Hospital.• March 2012 saw a Rehabilitation Clinic established at the Tennant CreekHospital and regular clinics have been held since then. The clinic is a greatcollaboration between the Top End Rehabilitation staff, Central AustraliaRehabilitation and Allied Health staff, Aged and Disability Services and theTennant Creek Hospital.• Funding has been secured to establish a Central Australia Prosthetic andOrthotics Service. Planning is well advanced for this and it will be functional inlate 2012. This will enable Alice Springs and Tennant Creek Hospitals to providea more responsive service, as previously this service was provided in Darwin andserviced by visiting staff to Alice Springs.47

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012Hospital OutputsAdmitted Patient ServicesAdmitted patient services comprise acute and non-acute medical care or treatmentsto patients who undergo a formal admission process.The trend of increasing numbers of hospital services continued in 2011-12 with an8.2% growth in total separations over the previous year. This growth in separationsis evident in all service categories.In 2011-12, the Territory expended just over $632.1M in the delivery of admittedpatient services. Additional expenditure is a function of growing demand on theservices hospitals offer, with 6.2% growth in admitted weighted activity from 2010-11. This growth is also reflected in patient travel, outpatients and ED services (seenon-admitted patient services on page 58).Output Cost($’000)2007-08Actual2008-09Actual2009-10Actual2010-11Actual2011-12Budget2011-12Actual403 386 457 481 500 218 562 595 570 856 632 07448

DEPARTMENT OF HEALTH – Annual Report 2011-12Key Hospital Services 1 2007-08Actual2008-09Actual2009-10Actual2010-11Actual2011-12ActualTotal Separations 2 99 866 106 488 110 800 115 592 125 026 119 850- overnight separations (excludinghaemodialysis)- same-day separations (excludinghaemodialysis)2012-13Budget43 172 45 569 46 797 48 224 49 460 50 30017 223 17 413 18 995 20 018 21 899 21 550- haemodialysis separations 39 471 43 506 45 008 46 078 53 667 48 000- weighted separations 3 82 515 66 776 68 892 71 053 75 483 72 750Average length of stay 4 5.6 5.5 5.4 5.4 5.3 5.4Elective surgery waiting list6 153 6 346 6 662 6 484 7 250 7 200admissions 6Emergency admissions 7 955 31 212 33 290 35 670 37 024 37 400Elective surgery waiting times- Category 1: admission within 30days- Category 2: admission within 90days80% 79% 76% 88% 84% 88%60% 61% 53% 70% 67% 70%Interstate patient travel 5 2 836 3 042 3 212 3 515 3 604 3 600Intrastate patient travel 5 20 067 21 035 23 458 24 131 24 091 24 7001 Due to remoteness, the dispersed population and absence of alternative health care providers, Northern Territory public hospitals fill numerousnon-acute care service gaps in the community. A number of the measures in the table are therefore not directly comparable with otherjurisdictions.2 The total number of admitted patients who have separated from a Northern Territory hospital.3 A weighted separation is a measure of the complexity of a hospital separation using average weight for episodes that have the same diagnosisand treatment. Cost weights from the National Hospital Cost Data Collection have been applied.4 The average number of days in hospital for patients who stay at least one night.5 The number of travel requests.49

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012Variation in a Key DeliverableActual haemodialysis separations for 2011-12 were 16.5% higher than in 2010-11.There is a strong likelihood that some of this reported increase comes from poordelineation of dialysis, home dialysis and the new start figures and where they arereported. Haemodialysis inpatient separations have increased from 2010-11 and thisis most likely related to disease incidence and improved access to dialysistreatment. There has been a corresponding increase in Home Based dialysis whichis the result of planned initiatives to increase awareness of the advantages ofdialysing closer to home. A project is underway to validate the increase in renalseparations and to support future service planning based on demand modelling.Acute Weighted SeparationsThe care required by hospital patients varies depending on the clinical complexityand severity of their illness which, in turn, impacts on the hospital resources requiredin the provision of their treatment. Separations of admitted acute patients can beweighted to adjust for this, resulting in weighted separations which more accuratelyrepresent the resources required in providing care.The high proportion of (less expensive) haemodialysis separations in the Territoryresults in the case weighted separations being lower than unweighted separations(Figure 7).Figure 7 : Inpatient Separations and Weighted Separations, 2007-08 to 2011-12In 2011-12, there was a growth in weighted separations in all Territory hospitalsexcept Gove District Hospital which had a marginal decrease of 0.6% (Table 3).Over this period, the two larger hospitals grew by more than 4% which is consistentwith both population growth and the effect of an ageing population as in previousyears. Across the hospital network, growth in weighted separations continues to beinfluenced by the large volume of same day cases, which generally have relativelylower complexity. The majority of same day cases (including haemodialysis) are50

DEPARTMENT OF HEALTH – Annual Report 2011-12typically patients admitted for renal dialysis who account for 71% of all same daytreatments.Table 3 :Weighted Separations by HospitalHospitals 2007-08 2008-09 2009-10 2010-11 2011-12 % Growth2010-11 to2011-12Royal38 135 37 898 39 371 40 958 43 222 5.5DarwinAlice20 014 20 767 21 681 22 574 23 497 4.1SpringsKatherine 3 941 4 323 4 166 4 272 4 512 5.6Tennant 1 812 1 923 2 128 2 262 2 342 3.5CreekGoveDistrict1 732 1 865 2 047 1 920 1 909 -0.6Generally, the increase in total weighted separations reflects the increasing volumeand complexity of cases presenting to Territory hospitals. This growth also alignswith the over budget position for the Hospitals Output Group.Aboriginal and Non-Aboriginal ActivityThe Aboriginal population makes up about 27% of the Territory’s total population, afar larger proportion than in any other jurisdiction. In 2011-12, Aboriginal peopleaccounted for nearly 60% of all hospital acute separations.Figure 8 : Weighted Separations by Aboriginal status, by hospital, %, 2011-12100.090.080.070.060.050.040.030.020.010.00.0% non-Aboriginal% AboriginalHospital profiles of acute inpatient weighted separations by Aboriginal status haveremained consistent over recent years. In 2011-12, all Northern Territory hospitals,with the exception of Royal Darwin Hospital, had a greater number of Aboriginalacuity adjusted separations compared to non-Aboriginal (Figure 8). This reflects, inpart, the relative health status of the Aboriginal population and higher number ofAboriginal people in the catchment areas of the rural and remote hospitals,51

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012compared with the higher number of non-Aboriginal people in the urban populationof the Greater Darwin Region.In 2011-12, the top five major diagnosis categories (MDCs) accounted forapproximately 50% of all acute type patients, excluding those admitted forhaemodialysis (Figure 9). Overall, the most frequent reason for admission was themajor diagnostic category (MDC) pregnancy, childbirth and the puerperium(postnatal period), also being the most frequent reason for admission for non-Aboriginal patients. Diseases and disorders of the respiratory system was the mostfrequent reason for admission amongst Aboriginal patients. This pattern isconsistent with the last two years.Figure 9 :Northern Territory Hospitals Inpatient Separations - Top Five MDCs byAboriginal status, 2011-12MDC:14 - Pregnancy, Childbirth and the Puerperium (known as the postnatal period)MDC:04 - Diseases and Disorders of the Respiratory SystemMDC:08 - Diseases and Disorders of the Musculoskeletal System & Connective TissueMDC:06 - Diseases and Disorders of the Digestive SystemMDC:09 - Diseases and Disorders of the Skin, Subcutaneous Tissue & BreastIn 2011-12, the average length of stay (ALOS) for patients treated in Territoryhospitals (excluding all same day patients) was 5.3 days. This is lower than 2009-10and 2010-11 when the average was 5.4 days (Figure 10). With the exception ofTennant Creek and Katherine Hospitals, (2.9 Aboriginal ALOS, compared to 2.3 non-Aboriginal and 3.3 Aboriginal ALOS compared to 2.8 non-Aboriginal respectively)Aboriginal patients, on average, experienced significantly longer periods of staywhen admitted to a Territory hospital.52

DEPARTMENT OF HEALTH – Annual Report 2011-12Figure 10 : Average Length of Stay Excluding Same Day by Hospital, 2011-12The longer average length of stay for Aboriginal patients presenting at Royal DarwinHospital (7.2 days) and Alice Springs Hospital (5 days), reflects the prevalence ofcomplex and chronic health problems being managed by these larger hospitalswhere there are more specialist services. It also indicates the difficulty in transferringpatients back to their communities, in many cases hindered by remoteness ordifficulty in providing suitable community based care.Renal ServicesThe Northern Territory has the highest prevalence of renal disease in Australia. Inrecent years, total renal expenditure has increased in approximate proportion to totalrenal separations (Figure 11).Figure 11 : Renal Dialysis Treatments 2007-08 to 2011-12There are three types of treatment for people with end stage renal disease.Haemodialysis is the most common form of treatment in the Territory, followed byperitoneal dialysis and transplantation. In 2011-12, across the Territory, 92.5% ofrenal replacement therapy was provided to Aboriginal people.53

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012Renal services are delivered from the two main centres (Alice Springs and Darwin)which utilise satellite service centres in a hub and spoke model to meet the growingdemand across the Territory and in a variety of community and home settings.Dialysis services in Central Australia are provided at Flynn Drive, Gap Road, AliceSprings Hospital and Tennant Creek Hospital. In the Top End dialysis is provided atNightcliff, Palmerston, Royal Darwin Hospital and Katherine Hospital.The goal of providing services to people closer to their home has led to theexpansion of home dialysis services. Home based dialysis options were accessed by30 people using peritoneal dialysis and 36 people using haemodialysis. Thesepatients have been trained to perform their own dialysis and either have a machinein their own home, or dialyse in a multi-user dialysis or relocatable facility. In theNorthern Territory, there are 20 self-care facilities and eight people dialyse in theirown homes.At the hospital level, Royal Darwin Hospital and Alice Springs Hospital have aboutthe same level of renal dialysis separations of Aboriginal people while Royal DarwinHospital has the highest number of dialysis separations of non-Aboriginal people(Figure 12).Figure 12 : Renal Dialysis Treatment Separations by Hospital and Aboriginal Status 2007-08 to 2011-12Emergency and Elective SurgeryThe Territory experiences high demand for emergency surgical procedures with aper capita rate that is almost twice that of the emergency surgical demand in otherjurisdictions. The increasing demand for emergency surgery, particularly in RoyalDarwin, Alice Springs and Katherine Hospitals, is reflected in the high ratio ofemergency to elective surgery with 48% of all theatre activity attributed toemergency surgery in 2011-12 (Table 4).54

DEPARTMENT OF HEALTH – Annual Report 2011-12Table 4 :Total Number of Elective and Emergency Surgery Admissions by PublicHospital 2009-12Hospitals 2009-10 2010-11 2011-12Elective Emergency Elective Emergency Elective EmergencyRoyal Darwin 6 526 5301 6 173 5 621 6 618 5 908HospitalAlice Springs 3 173 2624 3 055 3 258 2 818 3 199HospitalKatherine656 283 649 333 587 369HospitalGove District 527 221 353 171 446 138HospitalTennant Creek 19 28 28 5 10 1HospitalTotals 10 901 8 457 10 258 9 388 10 479 9 615Elective surgery is defined as a requirement for a procedure with an admission datemore than 24 hours in the future.Nationally, the capacity of hospitals to provide elective surgery to patients withinclinically recommended times is limited by the competing demands for theatre times,availability of specialist and surgeons and access to overnight beds. In the NorthernTerritory, this is compounded by a lack of private hospitals which is a significantdriver for elective surgery activity in other jurisdictions.The number of elective surgery admissions continues to increase with activity of10 479 in 2011-12, compared to 10 258 in 2010-11, an increase of 2.2%.Jurisdictions report to the Australian Government on the proportion of people seenwithin an agreed triage waitlist compared to an agreed target:• Category 1 (Urgent, procedures to be undertaken within 30 days) - in 2011-12,84% were seen within time compared to the Northern Territory baseline of 79.1%and 2012 target of 83%;• Category 2 (Semi-urgent, procedures to be undertaken within 90 days) - in the2011-12, 67% were seen within time compared to the Northern Territory baselineof 56.9% and 2012 target of 59%• Category 3 (Non-urgent, procedures to be undertaken within 365 days) – in2011-12, 84% were seen within time compared to the Northern Territory baselineof 81.6% and 2012 target of 84%.The Northern Territory has continued to make improvements in meeting electivesurgery targets under the National Partnership Agreement. In 2011, more people inthe Territory were seen within the benchmark times than required to meet the 2012national performance benchmark. In addition, there is a continuing trend of lesspeople waiting for surgery. For those who did wait, they waited for shorter periods.55

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012The Territory will be assessed against the 2012 target, full year performance, late in2012 and work continues to improve our elective surgery performance:• a review of the guidelines for elective surgery waitlist management to ensure:appropriate categorisation of patients according to their clinical urgency effectivemanagement of visiting surgeons waitlists; and additional resources for theatrescheduling and case management;• data validation to ensure that reports accurately reflect activity;• increased visits by RDH specialists to Katherine and Gove Hospitals;• pooling of specialist positions to improve recruitment and rotation services toregional sites;• increasing the endoscopic lists and upgrading to increase efficiency and qualityof care; and• implementation of telemedicine for some clinics, including pre admission clinics,to reduce need for travelling to the urban area.Patient Assisted Travel SchemeThe Northern Territory Patient Assistance Travel Scheme (PATS) exists to provideequity of access to specialist services for Territory residents. It provides assistancewith the cost of interstate and intrastate travel and accommodation for patients whoare required to travel over 200 kilometres to access specialist health services.Activity has steadily increased from 2005-06 to 2011-12 with assistance provided for3604 interstate and 24 091 intrastate travel requests in the current year (Table 5).Possible drivers of increased PATS activity include: increased specialist outreachand telehealth services diagnosing illness earlier; increasing the number of requeststo travel to access diagnostic services (radiology remains the highest reason forintrastate travel); increases in initial consultations; and consequential increases inthe number of reviews.Table 5 : Number of Patient Travel Requests, 2006-07 to 2011-12Category 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12Interstate 2 688 2 837 3 042 3 214 3 515 3 604Intrastate 20 640 20 067 21 035 23 462 24 132 24 091TOTAL 23 328 22 904 24 077 26 676 27 647 27 69556

DEPARTMENT OF HEALTH – Annual Report 2011-12PATS accounted for 73.9% of patient travel requests in 2011-12 (Table 6).Table 6 : Number of Patient Travel Requests, by Program, 2006-07 to 2011-12Program 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12Inter Hospital 1 937 1 727 1 927 2 177 2 264 2 260TransferMedivac4 905 4 773 4 322 5 109 5 194 4 971PatientPATS Patient 16 486 16 404 17 828 19 390 20 189 20 464TOTAL 23 328 22 904 24 077 26 676 27 647 27 695Escort travel activity is increasing and reflects the increasing patient travel activity(Table 7).Table 7 : Number of Patient Travel Escorts 2006-07 to 2011-12Category 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12Interstate 983 1 025 1 424 1 551 1 555 1 603Intrastate 4 202 4 647 5 319 5 688 6 182 6 411TOTAL 5 185 5 672 6 743 7 239 7 741 8 01457

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012Non-Admitted Patient ServicesNon-admitted care is care provided to a person who receives direct care within theEmergency Department or other designated clinics within the hospital and who is notformally admitted at the time when the care is provided. There was a 9.8% growth inthe number of outpatient occasions of service between 2010-11 and 2011-12.Key Deliverables 2007-08Actual2008-09Actual2009-10Actual2010-11Actual2011-12Actual2011-12BudgetNon-admitted specialist 160 046 172 480 189 589 163 472 179 417 168 100service 2clinic occasions ofEmergency department 125 310 129 165 132 583 141 370 144 799 142 300attendances 3Emergency departmentwaiting times:- Category 1:100% 100% 100% 100% 100% 100%resuscitation -attended toimmediately- Category 2:59% 62% 63% 65% 64% 70%emergency -attended to within10 minutes- Category 3: urgent - 47% 48% 49% 53% 49% 70%attended to within30 minutes- Category 4: semiurgent47% 50% 51% 54% 50% 60%- attended towithin 60 minutes- Category 5: nonurgent- attended towithin 120 minutes87% 90% 91% 90% 90% 85%1Due to remoteness, the dispersed population and absence of alternative health careproviders, Northern Territory public hospitals fill numerous non-acute care service gaps inthe community. A number of these measures are therefore not directly comparable with otherjurisdictions.2Number of specialist consultations for non-admitted patients.3Number of patients presenting at an emergency department who are registered and triaged(clinically assessed).In part reflecting this growth in activity, just under $168.3M was expended on nonadmittedpatient services, an increase of 3.8% on the revised budget allocation of$161.7M.Output Cost($’000)2007-08Actual2008-09Actual2009-10Actual2010-11Actual2011-12Actual2011-12Budget99 609 115 477 128 418 145 881 168 265 161 74058

DEPARTMENT OF HEALTH – Annual Report 2011-12Non-admitted Specialist Clinic Occasions of ServiceOutpatient specialist clinic attendances increased by 8% to 225 482 occasions ofservice (including radiology occasions of service) (Figure 13). The majority of growthoccurred in the Darwin region. This growth is largely due to continued efforts toaddress the Northern Territory’s elective surgery wait list that impacted onassociated pre-admission surgical and medical activity.Figure 13 : Non-admitted Specialist Clinic Occasions of Service (with Radiology) – allNorthern Territory Hospitals 2006-07 to 2011-12Emergency Department AttendancesEmergency Department (ED) waiting times measure the proportion of patients seenwithin benchmarks, set according to the urgency of treatment required. Nationally,waiting times in ED are seen as indicative of overall hospital performance and arethe focus of the new National Emergency Access Targets (NEAT) under the NationalPartnership Agreement on Improving Public Hospital Services. In addition, they arepublished on the MyHospitals website.The Northern Territory has the busiest per capita emergency departments at RoyalDarwin Hospital (RDH) and Alice Springs Hospital (ASH) (Table 8).Table 8 : Total Emergency Department Attendances 2007-08 to 2010-12Hospitals 2007-08 2008-09 2009-10 2010-11 2011-12Royal Darwin 56 370 56 279 58 198 61 836 64 441Alice Springs 33 905 36 514 39 195 41 608 42 188Gove District 7 747 8 076 8 251 8 790 8 671Katherine 15 055 15 033 14 783 14 888 15 316Tennant12 374 13 263 12 154 14 295 14 183CreekTotal 125 451 129 165 132 581 141 417 144 79959

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012The Northern Territory also had one of the highest increases in ED presentations inthe nation at 6.7% between 2009-10 and 2010-11, second only to Western Australia.Between 2007-08 and 2011-12 attendances grew by 15.4% (Figure 14).Figure 14 : ED Attendances – all Northern Territory Hospitals 2007-08 to 2011-12The objective and output of the National Emergency Access Target focuses on twoperformance indicators:• the percentages of ED patients, who physically leave the ED for admission tohospital are referred for treatment or are discharged within 4 hours - the target is90% of all patients across all triage categories by 2015; and• the number and source and percentage of ED attendances which are unplannedre-attendances within 48 hours of previous attendances. (Reporting has notcommenced against this indicator).The baseline for the first target of leave/discharge within four hours is 66.2% in theNorthern Territory, with the December 2012 target set at 69%. Territoryperformance for the December 2011 quarter showed a leave/discharge rate of 67%.In relation to the proportion of people seen on time by triage category, Territoryperformance shows maintenance of the service standard for categories 1 and 5 anda drop in the proportion seen within the standard waiting times for categories 2, 3and 4 (Table 9).Table 9 :Proportion of Patients seen within Standard Waiting Times – Triage Categories1 to 5Triage Category 2007-08 2008-09 2009-10 2010-11 2011-121. Resuscitation 100% 100% 100% 100% 100%2. Emergency 59% 62% 63% 65% 64%3. Urgent 47% 48% 49% 53% 49%4. Semi urgent 47% 50% 51% 54% 50%5. Non urgent 87% 90% 91% 90% 90%60

DEPARTMENT OF HEALTH – Annual Report 2011-12A number of service improvement strategies are in train to improve the timeliness ofour emergency departments at RDH, Katherine Hospital and ASH:• development of a fast track area to ‘stream’ patients to appropriate services andpersonnel;• creation of a separate paediatric waiting area with dedicated staff;• software to better track pathology and radiology results;• implementation of the Clinical Initiative Nurse and Rapid Assessment and TriageConsultant program; and• establishment of the Allied Health Personnel Team.Royal Darwin Hospital,Northern Territory61

DEPARTMENT OF HEALTH – Annual Report 2011-12Health and Wellbeing ServicesOutput GroupHealth and wellbeing services build the capacity of the community to improve andmaintain health.Delivered by the Health Services Division, health and wellbeing services includepreventative and primary care and early intervention services. These services areset up to focus on and respond to the needs of individuals at each point of contactand through ongoing relationships with individuals and their communities.Community Health Services OutputThe Community Health output includes a mix of primary care services delivered inboth urban and remote settings. These include: oral health; hearing health; food andnutrition services; breast and cancer screening services; adult and child healthchecks; palliative care; school health; home birthing services; and healthdevelopment services such as health education and health promotion.Community health services are provided from government managed health servicesand non-government and Aboriginal community controlled health services in urban,regional and remote settings. Visiting services are also provided to smallcommunities and outstations in very remote areas that do not have permanent staff.One of the activities at theInternational Women’s Day atPirlangimpi62

DEPARTMENT OF HEALTH – Annual Report 2011-12Key Deliverables 2007-08ActualEpisodes of healthcare services ingovernmentmanagedremotehealth centresCommunity healthevents urbanAdult HealthchecksHealthy Under 5Kids ChecksOral healthoccasions ofserviceProportion ofscreenedIndigenous babiesborn with low birthweightProportion ofscreenedIndigenous children

DEPARTMENT OF HEALTH – Annual Report 2011-12From left: Virginia Galarla withgrandchildren, Lorna and MabelGalarla at the InternationalWomen’s Day in PirlangimpiAnalysis of the proportion of screened Aboriginal babies born with a low birth weightto Aboriginal mothers in public hospitals over the financial year 2011-12 shows aslight increase on previous years. This reflects a slightly higher proportion ofextreme preterm live born infants (1.6% of total) delivered to Aboriginal mothers.However, single births to Aboriginal mothers had a lower proportion of infants bornwith a low birth weight.In 2010, the Department changed the growth reference dataset, for the proportion ofscreened Aboriginal children under five years who are underweight, from the Centrefor Disease Control 2000 growth charts to the World Health Organisation (WHO)2006 Child Growth Standards. The change in the comparator resulted in a statisticalreduction in underweight recorded. In 2011, the Australian Institute of Health andWelfare reported statistically significant improvements in underweight, wasting,stunting and anaemia over the period 2004 to 2010 (Aboriginal and Torres StraitIslander Health Performance Framework 2010 Report: Northern Territory).Remote HealthThe Remote Health Branch is responsible for the delivery of evidence based, bestpractice primary health care services to Aboriginal and non-Aboriginal people inremote communities through a network of health centres managed by theDepartment. Remote health also collaborates with health services managed by nongovernmentorganisations and independent Aboriginal community controlled healthservices.The Remote Health Branch provides direct care to clients in a collaborativemultidisciplinary team approach involving rural medical practitioners, remote areanurses, Aboriginal health practitioners, Aboriginal community workers and alliedhealth professionals. Services include primary health care, emergency care, medicalevacuations, care and treatment for chronic disease and public health programs. Inthe remote health centre setting, a collaborative approach ensures the delivery ofintegrated and coordinated care to clients. This includes services targetingpreventable chronic disease, maternal, child and youth health, oral and ear health,sexual health, mental health, alcohol and other drugs and issues associated withage and disability.64

DEPARTMENT OF HEALTH – Annual Report 2011-12Consultation with the community and community organisations also occurs to fosterand develop community capacity, facilitate community decision making, promote andsupport the employment of local people and establish effective governance systems.Key AchievementsThere have been a number of achievements in Remote Health over the last year.• Regional remote health service planning and delivery was progressed across anumber of health service delivery areas by working closely with AboriginalMedical Services Alliance Northern Territory and the Office for Aboriginal andTorres Strait Islander Health. The Red Lily Health Board in West Arnhem wasestablished, the Department’s community health centre at Yirrkala wastransitioned to Miwatj Health Services and Regional Steering Committees wereestablished in Central Australia and the Barkly. Clinical Public Health AdvisoryGroups have also been established in the Barkly, East Arnhem and WestArnhem.• Improvements in mental health service delivery to remote communities wereachieved in partnership with Mental Health. A successful project trialled inManingrida has established a service framework which is improving servicesmore broadly in remote communities.• A cohesive local approach to alcohol management in remote communities hasbeen established by working closely with the Department of Justice on AlcoholManagement Plans in remote communities and by increasing Remote Health’sAboriginal alcohol and other drugs workforce.• Remote health accreditation standards have been developed in partnership withthe Royal Australian College of General Practitioners (RACGP) and theAustralian Council of Healthcare Standards (ACHS). These are now endorsed byRACGP and ACHS and Remote Health will commence a process to accredit itsservices.• Facilities upgrades, including new health centres, are in progress.65

DEPARTMENT OF HEALTH – Annual Report 2011-12Health DevelopmentThe role of the Health Development Branch is to improve health outcomes forpopulation groups through working with key partners to develop and facilitate theimplementation of evidence-based health promotion and illness and injuryprevention practice. This relies on a strong relationship with policy makers, primaryhealth care providers, communities and other health service providers at a local andnational level.The branch has a range of functions including:• health program development, particularly at the primary health care level;• training and education;• policy advice;• provision of evaluation and monitoring tools and services;• collaborative planning;• health education and health promotion capacity building; and• direct service provision in some health services.Primary health program development work is undertaken the Child and YouthHealth, Chronic Conditions, Nutrition and Physical Activity, Health Promotion,Hearing Health, Men’s Health and Women’s Health Strategy Units.Top End and Central Australian regional teams deliver Health Development servicesrelated to the above programs through a focused multidisciplinary, multi-programapproach.The Branch is also responsible for the provision of the majority of public child andadult dental services throughout the Northern Territory.Key AchievementsThere have been significant achievements in the area of chronic diseasemanagement.• The Northern Territory has implemented improved delivery of care for chronickidney disease by linking renal specialist teams and remote primary health care(PHC) teams using telephone case conferencing and following patients throughthe system. This has enabled improved monitoring of chronic kidney disease andimproved access to dialysis treatment, including increased home based dialysis.66

DEPARTMENT OF HEALTH – Annual Report 2011-12• There has been an expansion in dental resources:• The First Annual Report of the ChronicConditions Prevention and ManagementStrategy (CCPMS) 2010-2020, was releasedin January 2012. The CCPMS Self-Management Framework of the CCPMS, isnow complete and in the approval process.• A Department project to developchronic conditions self-management tools forAboriginal and Torres Strait Islander clients inremote communities has recently commencedin partnership with Flinders University andMenzies School of Health Research. Thetools will be developed by integrating theNorthern Territory Australian IntegratedMental Health Initiative and Flinders SelfmanagementProgram tools into easy to usescreening tools for Territory clinicians workingwith patients with chronic conditions.• a Health Workforce Australia funding agreement was signed for theacceptance of 12 final year dental students from James Cook University in2013, eight students in the Top End and four in Central Australia; and• related funded capital infrastructure includes three additional dental chairs inboth Darwin and Alice Springs.• The beginning of the final evaluation phase of the three phased Early ChildhoodAnaemia Prevention Project. This is a joint program between Aboriginalcontrolled community health organisations, Fred Hollows Foundation and theDepartment.Community HealthThe role of the Community Health Branch is to provide a range of key primary healthcare services across the urban centres of Darwin, Palmerston, Alice Springs,Katherine, Tennant Creek and Nhulunbuy and to provide services in partnership withother health stakeholders in the urban environment. These services focus on thosein the urban community most in need or at risk and where access to health servicesmay be a challenge. Services also include Territory-wide well women’s breastscreening and hearing screening.Services are delivered through programs focusing on:• community and primary care which includes: wound management, palliative careand brief health interventions for concerns such as smoking and obesity; andsome specified services around social work, nutrition and specialised nurse care;67

DEPARTMENT OF HEALTH – Annual Report 2011-12• child and family health services providing universal key contacts and theschedule of childhood immunisation to children up to four years of age using afamily partnership model;• home birth in Darwin;• urban and remote hearing testing for ear health and pathways for clients toaccess services; and• Well Women’s Cancer Screening based in urban centres with planned visits forall Territory women.Key AchievementsCommunity Health’s achievements in 2011-12 include:• the Child and Family Health Service transition to a standardised childassessment tool in line with the Children’s Development Team and RemoteHealth to promote standardisation of assessments and reporting across theTerritory; and• establishment of a nursing service in the Police watch houses in Darwin,Katherine and Alice Springs for four nights a week in partnership with NorthernTerritory Police.Mental Health Services OutputMental health is integral to improving the health status of all Territorians. The MentalHealth Program, including Top End and Central Australia Mental Health Services,and non-government organisations, is funded to provide:• mental health promotion, prevention and early intervention;• specialist mental health assessment, treatment and case management for adult,children, youth and forensic populations;• specialist acute inpatient services in Darwin and Alice Springs;• consultation and liaison services to acute and primary health care services andother relevant service providers;• suicide prevention; and• consumer and carer support and rehabilitation.68

DEPARTMENT OF HEALTH – Annual Report 2011-12Key Deliverables 2007-08Actual12342008-09Actual2009-10Actual2010-11Actual2011-12Actual2012-13BudgetIndividuals receivingcommunity-basedpublic mental healthservices 1 4 737 5 020 5 544 5 823 6 589 6 900Individuals under 18receiving communitybasedpublic mentalhealth services 1 837 911 1 047 1 058 1 192 1 350Non-weighted occupied 10 992 11 631 10 877 11 526 10 444 13 200designated services 2bed days byNon-weighted inpatient 1 037 1 042 940 918 992 1 100designated services 2separations fromPost-dischargen/a 18% 14% 16% 19% 30%health care 3community mental28 day mental health n/a 11% 9% 11% 11% 10%readmissions 4Community-based public mental health services include all mental health services providedby government (excluding government-funded non-government organisations) dedicated tothe assessment, treatment, rehabilitation or care of non-admitted patients.Measure refers to inpatient services provided within two approved treatment facilities(Darwin and Alice Springs Mental Health Inpatient Units), declared pursuant to section 20 ofthe Mental Health and Related Services Act 1998.Measure indicates the proportion of separations from mental health service organisations’acute care unit(s) for which a community service contact was recorded in the seven daysimmediately following that separation.This measure indicates the percentage of separations from the mental health services’ acutemental health inpatient units that results in unplanned readmission to the same or similarunit within 28 days of discharge. Northern Territory data includes both planned andunplanned readmissions.Output Cost($’000)2007-08 2008-09 2009-10 2010-11 2011-12 2011-12Actual Actual Actual Actual Budget Actual34 812 38 271 40 551 43 524 47 984 48 731Variations in Key DeliverablesThere is an increasing trend in individuals receiving community-based public mentalhealth services, with a significant increase between 2010-11 and 2011-12 (13%).Consistent across all age groups, this increase is largely a reflection of new andexpanded services, such as the Northern Territory Crisis Assessment TelephoneTriage and Liaison Service (NTCATT) and additional child and adolescent mentalhealth services.The 2011-12 budget for non-weighted occupied bed days and non-weightedseparations predicted additional activity associated with planned new beds underthe Secure Care Initiative (Darwin five beds and Alice Springs six beds). This69

DEPARTMENT OF HEALTH – Annual Report 2011-12initiative has experienced delay and will be commissioned early in 2012-13.Meanwhile, the number of beds in the Alice Springs Mental Health Unit was furtherreduced due to building works, resulting in an increased number of patients admittedto other wards in the Alice Springs Hospital which are not counted in the tableabove.The 2011-12 budget for the post-discharge community mental health care indicatorpredicted significant improvement based on the implementation of the NTCATT.Modest improvement has been made, up from 16% in 2010-11 to 19% in 2011-12.This measure will be the focus of a quality improvement project in 2012-13 in orderto increase progress towards the set target.Key Achievements• An additional 766 individuals received specialist mental health services in 2011-12, an increase of 13% compared with 2010-11. This was achieved throughimplementation of the Territory-wide 24 hour mental health crisis assessmentand triage team, NTCATT, specialist perinatal mental health services andincreased funding for specialist child and adolescent mental health services.• NTCATT operates 24 hours, 365 days per year and provides the first point ofcontact, particularly after hours, for referrals and advice for Territorians whorequire mental health services. This enables increased access to assessments inDarwin and telephone support to community members and service providersthroughout the Northern Territory.• The continued roll out of the National Perinatal Depression Initiative in theNorthern Territory worked to extend community awareness and improvedetection and treatment of mental illness during pregnancy and in the first yearfollowing birth. A small specialist Perinatal Mental Health Service wasestablished and over 300 mothers were referred to the service during the year.• Additional investment in child and adolescent services in Darwin and AliceSprings enabled expansion of services to rural and remote communities andimproved access to specialist assessment in Darwin and Alice Springs. Thenumber of young people under the age of 18 years receiving specialist mentalhealth services also increased by 13% in 2011-12.• Suicide prevention was a key focus for the year. An additional $600 000 fundingfor suicide prevention initiatives enabled a further increase in the availability ofsuicide prevention training for frontline workers and community members andimplementation of new suicide prevention initiatives. This included an innovativeprogram called Counterpunch that combines boxing and psychological strategiesfor young people aged 10 to 25 years. Over 80 people participated in theprogram in 2011-12.70

DEPARTMENT OF HEALTH – Annual Report 2011-12Community Support Services for Frail Aged Peopleand People with a Disability OutputSupport is provided to frail aged people and people with disabilities and their carersin their homes and in the community to enable them to maximise their participationand independence in the community. Services include assessment, casemanagement, allied health and specialist services such as specialist children’sdevelopment therapies. Community support services and accommodation support isalso provided.Key Deliverables 2007-08ActualSupportedaccommodationplaces2008-09Actual2009-10Actual2010-11Actual2011-12Actual2012-13Budget135 155 155 164 178 180Clients accessing 7 150 4 650 5 567 4 388 6 875 2 105services 1community supportClients accessing 4 442 7 296 6 114 6 564 4 147 6 900services 2professional supportOccasions clients 54 922 52 568 62 414 62 707 67 939 63 100support services 2access professionalAged CareAssessment Teamclients receivingtimely intervention inaccordance withpriority at referral87% 82% 86% 75% 80% 80%12Community support services include community care and support, in-home support,community access and respite care, but exclude supported accommodation (group homes).Professional support services include Adult and Disability teams, Aged Care AssessmentProgram, Children's Development Team, Community Adult Health Team, TIME Scheme,Transitional Care Unit, Local Area Coordination and SEAT Service.Output Cost($’000)2007-08Actual2008-09Actual2009-10Actual2010-11Actual2011-12Budget2011-12Actual61 913 69 566 75 004 83 609 84 211 97 32171

DEPARTMENT OF HEALTH – Annual Report 2011-12Variations in Key DeliverablesThe increase in Supported accommodation places reflects an increased demand forthis service type.The number of clients accessing community support is predicted to declinesignificantly in 2012-13 as responsibility for some functions is transferred to theAustralian Government to streamline service delivery. Home and Community Careservices for those over 65 years and Aboriginal people over 50 years are theresponsibility of the Australian Government. The fluctuation in actual servicesrecorded for this measure between 2008-09 and 2009-10 was due to data validationprocesses; the significant increase (+55.9%) in this measure between 2010-11 and2011-12 was due to improved reporting by service providers.The variation in the measure Aged Care Assessment Team clients receiving timelyintervention reflects an increase in demand from an ageing population.Key Achievements• There has been investment in accommodation services with an increase insupported accommodation places to 178, an increase of 14 from 2010-11. Twomore places are expected in 2012-13.• The Adult Decision Making Bill was introduced into Parliament on 2 May 2012.The Bill will replace the current Adult Guardianship Act.• Work commenced on the development of a National Disability Insurance Schemefollowing the release of the Productivity Commission’s report on Disability Careand Support in August 2011. The Territory and Australian Governments areworking together on this development.• Two secure care group home facilities have been constructed, one each inDarwin and Alice Springs. The secure care facilities will provide an intensivetherapeutic environment in order to stabilise residents’ behaviour, increasingtheir skills and decreasing their high risk behaviours, allowing them to thentransition to less restrictive service options. The group homes will begin scaledoperations in late 2012.• There have been amendments to the Disability Services Act to enable admissionfor involuntary treatment and care in secure care group homes and the regulationand monitoring of restrictive practices in residential services.72

DEPARTMENT OF HEALTH – Annual Report 2011-12Support for Senior Territorians and PensionerConcessions OutputSubsidies and support services are provided to senior Territorians, pensioners,carers and other low income groups to maintain financial independence and promotehealth, fitness and community participation. This includes the Northern TerritoryPensioner and Carer Concession Scheme which provides a number of concessionsand rebates to eligible clients.Key Deliverables 2007-08ActualPensioner concession 1recipientsGrants issued forseniors’ advancementApplicants able toaccess pensionerconcessions within 14days2008-09Actual2009-10Actual2010-11Actual2011-12Actual2012-13Budget20 206 20 661 22 362 22 342 24 759 24 600n/a 44 42 52 53 52100% 100% 100% 100% 100% 100%1Services or items for which the Department of Health provides concessions and rebates areelectricity or alternate energy costs, local council property rates, water charges, seweragecharges, garbage charges, motor vehicle registration, drivers’ licences, spectacles, publictransport and interstate travel.2007-08 2008-09 2009-10 2010-11 2011-12 2011-12Actual Actual Actual Actual Budget ActualOutput Cost ($’000) 11 884 13 191 19 187 21 305 19 806 24 988Carer support at the AgedCare facility at GardensTerrace.73

DEPARTMENT OF HEALTH – Annual Report 2011-12Variations in Key DeliverablesThe increase in Pensioner concession recipients between 2010-11 and 2011-12 isconsistent with an increasing population aged 65 years and over.The increases in Grants issued for seniors’ advancement since 2009-10 is due tosmaller grants being issued.Key Achievements• The 53 grants issued for Seniors Month events across the Territory supportedactivities such as Tools for Better Health, Elliot Art and Craft workshops andinformation sessions.• The 2012 Seniors Card Directory was launched in February 2012.Mark CavanaghMember of the Northern Territory team at theNational Disability Tenpin BowlingChampionships.74

DEPARTMENT OF HEALTH – Annual Report 2011-12Public Health Services OutputGroupPublic Health Services are delivered by the Health Protection Division, whichincorporates the Alcohol and Other Drugs Program, the Centre for Disease Control,Environmental Health, Health Gains Planning and the Office of the Chief HealthOfficer. The Division aims to promote, protect and improve the health and wellbeingof all Territorians, focussing on population based approaches to safety, protectionand prevention.Environmental Health ServicesEnvironmental Health (EH) acts to prevent and control physical, chemical, biologicaland radiological agents in the environment from adversely affecting human health.EH services include environmental health standards development, statutorysurveillance and enforcement, complaint resolution, community environmental healtheducation and advice, waste management, food safety, drinking and recreationalwater quality, medicines and poisons control and radiation protection.Key Deliverables 2007-08Actual2008-09Actual2009-10Actual2010-11Actual2011-12Actual2012-13BudgetRegulatory compliance 10 675 9 544 9 939 9 725 9 888 10 000activities 1Premises achieving a 100% 100% 100% 100% 100% 100%notice 3satisfactory standardof compliance with EHlegislation 2 within 28days of receiving legalEH complaintsinvestigations initiatedwithin one working dayof notification91% 91% 92% 95% 98% 95%1 Regulatory compliance activities include premises inspections, issuance of licences,registrations and legal notices, complaint investigations, food sampling, food recalls,radiation equipment inspections, processing of development and building applications, septicsystem activities, water quality activities and health protection activities (for example, vectorand vermin monitoring).2 Environmental Health legislation consists of the Food Act, Public and Environmental HealthAct, Notifiable Diseases Act, Radiation Protection Act, Private Hospitals Act, HealthPractitioners Act and Poisons and Dangerous Drugs Act and relevant regulations.3 Legal notices are those which relate to issues of imminent or actual public health risk, andrequire the owner to carry out alterations, repairs and general improvement works to ensurethe health of the public. These notices usually require the owner/occupier to carry out thiswork in a set timeframe and require at least another inspection to check compliance with thenotice.75

DEPARTMENT OF HEALTH – Annual Report 2011-122007-08 2008-09 2009-10 2010-11 2011-12 2011-12Actual Actual Actual Actual Budget ActualOutput Cost ($’000) 5 163 5 263 5 764 5 928 6 851 6 762Variations in Key Deliverables - Regulatory ComplianceActivitiesThe performance measures above, when compared to the level of activity in theprevious year, include the following:• number of regulatory inspections increased by 21%;• number of miscellaneous regulatory activities increased by 25%;• the number of public health complaints received decreased by 11%; and• there was a 13% decrease in the number of licences, registrations andauthorisations applications received and subsequently issued, which contributedto a 1.1% difference between the budgeted and actual counts for Regulatorycompliance activities.Figure 15: Environmental Health regulatory and other activities 2009-10 to 2011-122009-10 2010-11 2011-12Inspections 4 164 3 377 4 073Licences, registrations & authorisations 3 695 4 285 3 795Misc. Regulatory activities 1 308 1077 1 349Complaint Investigations 338 317 282Health Protection activities 192 209 168Health Promotion & EHW activities 242 68 180Inspections comprise inspections of food premises, public health premises, radiation premisesand equipment and poisons premises. Licences, registrations and authorisations comprisefood premises registrations, health premises registrations, radiation licences and registrations,poisons authorisations and registrations, pharmacotherapy authorisations, amphetamineauthorisations. Miscellaneous regulatory activities comprise issue of legal notices, foodsampling and surveys, water and pool sampling, processing of building and developmentapplications, bore construction permits, septic tank system activities, water quality activities,therapeutic drug recalls and destructions, food recalls and seizures, legislation and policydevelopment. Complaint investigations comprise public health and food complaints. HealthProtection activities comprise adult and larval mosquito monitoring. Health Promotion andEHW activities comprise health promotion/education and Environmental Health Workeractivities.76

DEPARTMENT OF HEALTH – Annual Report 2011-12Key AchievementsFood SafetyThe Environmental Health Branch monitors the food supply in the Northern Territoryfor compliance with the Australia New Zealand Food Standards Code, which isadopted by the Northern Territory Food Act.The Safe Food is Everybody’s Business DVD and facilitators guide was launched inJune 2012. This resource was developed by the Environmental Health Branch inconjunction with the National Working Group on Aboriginal and Torres Strait IslanderEnvironmental Health and was funded by the Australian Government Department ofHealth and Ageing.The DVD is designed to assist Aboriginal and Torres Strait Islander people whoprepare and handle food, whether it is in food businesses, such as remotecommunity stores or take-away food outlets, or the kitchens of aged care or childcare facilities, to understand their responsibilities under the National Food SafetyStandards. The DVD, as well as being available in English, has been translated intoseven of the Aboriginal and Torres Strait Islander languages spoken in the NorthernTerritory.Safe Food is Everybody’s Business – aguide to food safety in remotecommunities.Public and Environmental Health ActThe new Act commenced on 1 July 2011. A new consolidated set of accompanyingRegulations is being drafted for implementation in 2013, to further modernise thelegislative framework for monitoring and regulating public and environmental healthin the Northern Territory.77

DEPARTMENT OF HEALTH – Annual Report 2011-128th National Aboriginal and Torres Strait IslanderEnvironmental Health ConferenceThe conference was held at the Darwin Convention Centre during 27-30 September2011. As the Territory was the hosting jurisdiction, the EH Branch played a lead rolein organising the conference and also presented on a range of topics includingmosquito surveillance, hygiene promotion, food safety, skin health, healthy homesprograms and waste management. Over 200 EH practitioners from across Australiaattended to showcase projects and engage with colleagues.Attendees at the 8 th NationalAboriginal and Torres StraitIslander Environmental HealthConference, September 2011Darwin Beach Water Quality MonitoringDuring the swimming season, June to September, beach water sampling isundertaken weekly by the Department of Natural Resources, Environment, the Artsand Sports. Water samples are tested in the Department of Primary Industry andFisheries, water laboratory in Berrimah for the indicator bacteria, enterococci,because epidemiological studies have identified a clear relationship betweenconcentrations of this bacteria and levels of illness in swimmers in marine waters.The results are sent to the EH Branch which provides public health advice based onthe water sampling results, which may include issuing precautionary advice againstswimming at beaches. Results of the 2010, 2011 and 2012 monitoring programs arepublicly available from the Department’s website. A beach water report card is alsoproduced as part of the monitoring program.78

DEPARTMENT OF HEALTH – Annual Report 2011-12Drug MonitoringThe Poisons Control Section monitored 34 809 prescriptions for Schedule 8 drugs tocontrol prescription drug abuse during 2011-12. A total of 241 contracts wereregistered during the year as part of the notification system. These contracts matcha patient with a prescribing doctor and pharmacy on the Drug Monitoring System(DMS) database. The contract has been worded so that the patient agrees to allowPoisons Control to advise other doctors, pharmacists and Alcohol and Other DrugService nurses about the details of his/her contract.All Northern Territory community pharmacies have access to a web based front endof the DMS via secure internet login. This website allows pharmacists to access upto date contract information and upload prescription data for monitoring. Roll out ofthe website to medical practices is continuing.The Schedule 8 (S8) and Restricted Schedule 4 (S4) Substances Clinical AdvisoryCommittee met three times during the year. The role of the Committee is to advisethe Chief Health Officer on all matters relating to Schedule 8 and restricted Schedule4 substances, including policy matters and the issuing of specific authorisations.Figure 16 : Northern Territory Schedule 8 drug prescription and patient contracts 1992-93 to2010-12A review of Schedule 8 of the Health Practitioners Act and the Pharmacy PremisesCommittee was conducted by an external consultant and consisted of significantpublic and stakeholder consultation. The review recommendations are currentlyunder consideration.79

DEPARTMENT OF HEALTH – Annual Report 2011-12Radiation ProtectionFour categories of authorisation are required under the Radiation Protection Act:• radiation licence to acquire, dispose of, manufacture, possess, sell, store,transport and use a radiation source;• certificate of accreditation to decommission, install, repair, service and test aradiation source;• registration of a radiation source; and• registration of a radiation place, in which a radiation source is used or stored.In 2011-12, there were 118 registrations for a radiation source, 46 radiation placeregistrations, 231 licences and 34 certificates of accreditation issued. There were 72inspections of a radiation place.Disease Control ServicesThe Centre for Disease Control (CDC) has offices in the five major urban centres inthe Northern Territory and provides clinical services, including screening and contacttracing for: sexual health; blood borne viruses; tuberculosis; leprosy; and othermycobacterial diseases. CDC’s role includes policy and clinical guidelinedevelopment for these diseases.CDC is responsible for running the Territory’s immunisation program and providesadvice and education to health staff and the public on immunisation. Surveillance formore than 90 notifiable diseases and mounting the necessary public healthresponses, including the management of outbreaks, also forms part of its corebusiness.CDC manages the Rheumatic Heart Disease (RHD) and Trachoma Programs. TheSafety and Injury Unit researches and develops policy on injury prevention andMedical Entomology undertakes mosquito surveillance and environmentalmanagement of disease carrying and other nuisance insects.Centre for Disease Controldisplay for Immunisation Week80

DEPARTMENT OF HEALTH – Annual Report 2011-12Key Deliverables 2007-08Actual2008-09Actual2009-10Actual2010-11Actual2011-12Actual2012-13BudgetNotifications of:- Sexually6 095 5 962 5 817 7 643 7 547 8 400TransmittedInfections- HIV 6 19 19 6 18 10- Hepatitis C 224 213 157 231 206 230Occasions of service at 8 043 10 865 12 024 10 976 12 146 14 000Clinic 34 in Darwin andAlice SpringsMosquito traps2 360 2 294 2 060 1 728 1 559 1 530analysed 1Hectares treated by 1 205 873 1 080 2 123 2 032 1 580Mosquito ControlProgramChildren fullyimmunised:- at age 12 months 91% 90% 90% 90% 92% 91%- at age 2 years 93% 95% 93% 95% 95% 93%People completingtreatment fortuberculosis95% 95% 95% 95% 94% 95%1 Mosquito traps analysed are overnight mosquito trap collections set weekly from major townsin the Territory.2007-08 2008-09 2009-10 2010-11 2011-12 2011-12Actual Actual Actual Actual Budget ActualOutput Cost ($’000) 24 360 23 527 25 037 25 141 25 013 28 026Variations in Key DeliverablesHectares treated by the Mosquito Control Program were higher than that estimateddue to heavy rainfall in May 2012, which led to extensive breeding in Holmes Jungleand Leanyer swamps. Extensive control was necessary which was successful inkeeping mosquito numbers down.Due to the relatively small number of children in this cohort, minor fluctuations in thenumber of children vaccinated can have a major effect on the percentage of childrenconsidered fully immunised. The higher vaccination rate reported this year mayreflect a small, but welcome, increase in the number of children vaccinated.Key AchievementsImmunisationImmunisation rates remain high due to a strong commitment by a wide variety ofimmunisation providers with coverage rates for children in the Northern Territorycomparable with the national average.81

DEPARTMENT OF HEALTH – Annual Report 2011-12Table 10 : Northern Territory immunisation rates (From Australian Childhood ImmunisationRegister calculated at 30 June 2012)12 -

DEPARTMENT OF HEALTH – Annual Report 2011-12early stages of developing their state RHD Registers. The Territory RHD ControlProgram has also worked with South Australia and New South Wales to assist withthe establishment of a RHD Control Program in both those states.TrachomaThe Northern Territory Trachoma Strategy has continued to expand this yeardeveloping further partnerships with the Indigenous Eye Health Unit at MelbourneUniversity and the Fred Hollows Foundation.In 2011-12, there was a downward trend in trachoma prevalence in all regions of theNorthern Territory. The overall prevalence of active trachoma in children in the 65communities screened was 7% (12% in 2010-11), with no trachoma found in 34% ofcommunities (21 of 65). There was a substantial decrease in the number ofcommunities with trachoma prevalence greater than 5%, from 40 (62.5%) in 2010, to29 (45%) in 2011.SurveillanceIn 2011, there were 11 407 notifications of scheduled notifiable diseases recorded inthe Northern Territory Notifiable Diseases System, which is an increase of 254(2.3%) from 2011. There were increases in cases of trichomoniasis, influenza,pertussis and pneumococcal disease, but decreases in cases of salmonellosis, RossRiver virus disease and rotavirus.There were four cases of meningococcal disease and four cases of Murray ValleyEncephalitis reported in 2011, with three of these acquired in the Northern Territory,the most since 2001. An outbreak of invasive pneumococcal disease due to serotype1 during the year prompted the formulation and implementation of a novel publichealth response to cases in the latter part of 2011. Of note, there were no cases ofmumps or congenital syphilis reported this year.Table 11 :Selected notifiable diseases in the Northern Territory 2006-2011 (calculated bycalendar year)Vaccine Preventable 2006 2007 2008 2009 2010 2011H Influenzae b 2 2 2 0 2 2Influenza 41 183 200 2079 503 638Measles 0 0 3 1 2 6Mumps 7 58 52 14 2 0Pertussis 97 27 478 224 333 383Pneumococcal disease 56 66 60 93 65 136Vectorborne 2006 2007 2008 2009 2010 2011Barmah Forest 130 90 75 121 87 63Dengue 21 15 23 41 64 29Malaria 66 30 19 14 17 24Murray Valley Encephalitis 0 0 1 2 0 483

DEPARTMENT OF HEALTH – Annual Report 2011-12Ross River Virus 277 299 262 442 342 192Typhus 0 2 1 1 1 1Bloodborne 2006 2007 2008 2009 2010 2011Hepatitis B -chronic/unspecified343 295 224 154 188 125Hepatitis B - new 9 9 8 4 3 4Hepatitis B - unspecified 147 201 183 160 160 179Hepatitis C - chronic 0 1 2 0 0 0Hepatitis C - new 3 4 6 5 0 3Hepatitis C - unspecified 262 218 206 170 207 211Human T-lymphotropic virusType 1 asymptomatic /unspecified113 106 83 71 85 54Sexually Transmissible 2006 2007 2008 2009 2010 2011Chlamydia 2057 2177 2288 2480 2692 2664Gonococcal infection 1772 1594 1549 1578 1971 1989HIV 13 7 15 20 7 11Syphilis < 2y 150 118 83 38 45 32Syphilis > 2y or unknown 123 177 171 102 98 60Syphilis congenital 6 2 1 3 0 0Trichomoniasis 1427 1955 2206 1760 2398 2862Gastrointestinal 2006 2007 2008 2009 2010 2011Campylobacteriosis 263 289 257 214 173 168Cryptosporidiosis 71 111 102 154 100 97Hepatitis A 30 5 3 1 4 3Rotavirus 608 291 200 268 335 177Salmonellosis 404 525 494 515 604 415Shigellosis 125 173 177 95 79 81Typhoid 3 3 1 0 2 3Other 2006 2007 2008 2009 2010 2011Acute Post-StreptococcalGlomerulonephritis12 23 38 40 15 26Melioidosis 27 34 23 30 106 61Meningococcal infection 6 6 9 8 3 4Rheumatic Fever 54 82 49 59 59 87Tuberculosis 36 54 36 30 33 4184

DEPARTMENT OF HEALTH – Annual Report 2011-12Tuberculosis and Leprosy ManagementTuberculosis (TB) remains an issue in the Northern Territory with continuing newdiagnoses in Aboriginal and non-Aboriginal populations. Within the non-Aboriginalpopulation, most cases are in overseas born persons from high TB burden countries.In 2011, there were 41 new cases of active tuberculosis, with cases identified in allregions of the Northern Territory. One new case of leprosy was identified. Inaddition, there were seven new notifications of non-tuberculous mycobacterialinfections. Similar numbers of notifications have been experienced over precedingyears.The Tuberculosis Unit provides screening for tuberculosis in unauthorised entrantsto Australia. Illegal foreign fisherpersons (IFF) and irregular maritime arrivals (IMA)are screened and managed in close association with the Department of Immigrationand Citizenship. The unit also provides clinical support to the Refugee HealthService at the Vanderlin Drive Medical Clinic. IFF and IMA arrivals represent asubstantial proportion of tuberculosis notifications i.e. 11 of the 41 cases notified in2011.85

DEPARTMENT OF HEALTH – Annual Report 2011-12Alcohol and Other Drug ServicesThe Alcohol and Other Drugs Program (AODP) develops policies, strategies andprograms to prevent and respond to the misuse of alcohol, tobacco and other drugs.The AODP includes policy development and legislative compliance, communitydevelopment, accredited training, services development and treatment and careservices and programs.The Program employs a range of staff across the Territory, including doctors,nurses, alcohol and other drug workers, psychologists, educators, policy officers andadministrators to support services and individuals and develop community levelresponses to alcohol, tobacco and other drug related harm.Key Deliverables 2007-08ActualCommunity educationand communitydevelopment activities2008-09Actual2009-10Actual2010-11Actual2011-12Actual2012-13Budget249 345 366 386 364 360Completed accredited 228 255 288 263 269 280training units 1Utilisation rate of31% 35% 33% 31% 30% 30%sobering up shelter bedhoursAdmissions to sobering 20 504 20 376 20 771 18 778 17 547 18 000up sheltersClosed episodes 2 in nongovernment2 662 2 678 2 618 2 636 2 573 2 960services 3treatmentClosed episodes1 650 1 419 1 414 1 679 1 692 1 774completed in nongovernmenttreatmentservicesClosed episodes in642 731 969 1 119 1 089 1 050government treatmentservicesClosed episodescompleted ingovernment treatmentservices173 175 233 398 300 3151The Alcohol and Other Drugs Program delivers a range of vocational education and trainingaccredited qualifications, where a qualification comprises of at least 12 units.2An episode of alcohol and other drugs treatment is a "period of contact, with defined dates ofcommencement and cessation" (National Health Data Dictionary). A closed episode oftreatment is one where there is a valid date of cessation. A completed episode is one wherethere is a valid date of cessation and the reason for cessation is 'completed'.3The closed episodes data is for the period April to March, not July to June, as serviceorganisations submit treatment data one quarter in arrears.Output Cost($’000)2007-08 2008-09 2009-10 2010-11 2011-12 2011-12Actual Actual Actual Actual Budget Actual19 597 21 577 24 801 27 316 31 131 33 64586

DEPARTMENT OF HEALTH – Annual Report 2011-12Variations in Key DeliverablesThe Sobering up shelter utilisation rate is affected by the overall number ofadmissions, opening hours and bed numbers. The rate in 2011-12 declinedcompared to 2010-11, largely because of the decline in total admissions.In Tennant Creek, between 2010-11 and 2011-12, total admissions to sobering upshelters declined. There was a reduction in the level of service offered by theTennant Creek Shelter during renovations and redevelopment. Anecdotally, thedecrease in the Darwin region is being partially accredited to the Alcohol Reforms.Key AchievementsTreatment and CareThe AODP delivers and funds a range of community based treatment services andprograms, including withdrawal services, residential rehabilitation, outpatientcounselling, pharmacotherapy services and aftercare.In 2011-12, a total of $14.1M was invested in alcohol and other drugs treatmentservices to provide 3662 episodes of treatment across the Northern Territory with,as shown in Table 12, alcohol continuing to be the principal drug of concern.Table 12 :Number of Closed Episodes of Treatment Services by Principal Drug of ConcernPrincipal drug ofconcernApril 2009 -March 2010April 2010 -March 2011April 2011 -March 2012 1Alcohol 2 398 2 605 2 374Amphetamines 96 111 131Cannabis 294 342 362Opioids 306 283 308Volatile substances 238 275 222Other 255 139 265Total episodes 3 587 3 755 3 6621The period April to March is used for comparison purposes as service organisations submittreatment data one quarter in arrears.The new Tennant Creek Sobering Up Shelter commenced operation in February2012. The formal opening was in May 2012 by the Department and the AustralianGovernment, in conjunction with the Department of Construction and Infrastructure.Community Education and TrainingThere are 10 community support officers that work across the Northern Territory; ofthose, five supported Top End communities, one worked across the East Arnhemand two in Katherine. Two community support officers work from Alice Springs andalso service Tennant Creek. Additionally, there are four Community Servicesapprentices being trained in Darwin and one in Katherine.87

DEPARTMENT OF HEALTH – Annual Report 2011-12Trainers provide accredited training in Certificate II, III, IV and Diploma qualificationswhich offer an AOD education avenue and pathway to those working in the frontlineservices. Of the current annual 753 full-time students engaged in this training:• 34% of the student population is Aboriginal; and• 71% of the student population is from a non-government organisation (NGO).Alcohol ReformsThe AOD Program was allocated additional funding of $5.2M in 2011-12 to manageand deliver the treatment elements of the reform process. This included funding fornew treatment beds, additional staff and a range of services including earlyintervention, withdrawal support and expanded outreach services.AODP has built on existing programs and services within NGOs and AOD serviceswherever possible. There has been a strong focus on enhancing current AODservice providers and building a collaborative sector.Training was provided for Alcohol Misuse Interventions to 70 medical practices and50 remote health centres throughout the Northern Territory. A culturally appropriateassessment tool for health professionals has also been developed and a suite ofresources on alcohol interventions was sent to all medical practices across theNorthern Territory.Withdrawal support has been increased by employing AOD nurses in the EmergencyDepartments of Royal Darwin and Alice Springs Hospitals. In some cases this hasreduced the referral timeframe from three weeks to three hours. Nurses are nowalso being employed in Katherine, Tennant Creek and Gove District Hospitals.TobaccoAODP leads the implementation of the Tobacco Action Plan 2010-13 and isresponsible for the administration and enforcement of the Tobacco Control Act. In2011-12, a total of $1.38M was allocated to tobacco control. This included $1.06M infunding from the Australian Government under the Closing the Gap NationalPartnership Agreement.88

DEPARTMENT OF HEALTH – Annual Report 2011-12The Northern Territory Quitline is the primary smoking cessation support service inthe Northern Territory. In 2011-12, there was a 15% increase in the number ofpeople that accessed Quitline when compared to the previous year. In 2011-12,approximately 16% of callers to the Quitline were identified as Aboriginal. This is a100% increase on the 8% for the same period the previous year and triple the 5%recorded in 2009-10. The increase in Aboriginal callers is attributed to the QuitlineEnhancement program.In 2011-12, 22 professional staff and 66 AOD frontline workers completed theirNational Accredited Tobacco Cessation course and are now qualified to provideevidence based tobacco cessation interventions across the Territory.Volatile Substance AbuseUnder the Volatile Substance Abuse Prevention Act (the Act) AODP receivesreferrals for assessment for court-ordered treatment under Section 33 of the Act.Referrals are received from the Police, health centres, family members and theDepartment of Children and Families. All referrals are subject to an assessment todetermine levels of risk and to match responses/ interventions. The majority ofreferrals are addressed through case management, by working with the individual,family and/or community and, if required, through voluntary access to treatmentservices.Community developed and controlled Management Plans are an important part ofcontrolling the sale and supply of volatile substances in communities and anessential part of the harm minimisation strategy. In 2011-12, five new VolatileSubstance Management Areas took effect. There are now a total of 22 ManagementAreas and 18 Management Plans in operation across the Northern Territory.The Opal fuel rollout is a significant contributor to a successful volatile substanceabuse Management Plan. This is an Australian Government initiative, supported bythe Northern Territory Government through the community engagement processesAODP staff adopt in supporting the development of a plan.89

DEPARTMENT OF HEALTH – Annual Report 2011-12Health ResearchHealth research spans population health, the burden of disease, communicable andnon-communicable diseases, social and environmental determinants of health andhealth information systems. Research is undertaken by the Department as well asexternal organisations such as the Menzies School of Health Research (MSHR) andthe Lowitja Institute, which have multi-disciplinary research programs.Key Deliverables 2007-08ActualNumbers ofgrants providedGrant paymentsmade withinstipulatedtimeframe2008-09Actual2009-10Actual2010-11Actual2011-12Actual2012-13Budget5 5 5 5 4 4100% 100% 100% 100% 50% 100%2007-08 2008-09 2009-10 2010-11 2011-12 2011-12Actual Actual Actual Actual Budget ActualOutput Cost ($’000) 11 637 5 898 6 271 7 265 7 619 7 498Variation in Key DeliverablesTwo grant payments were not made within stipulated timeframes because there wasa delay in signing the funding agreement.Menzies School of Health Research (MSHR)MSHR is a major Australian health and medical research institute with a primaryfocus on the health of Indigenous communities and people living in tropical andremote areas. Its research falls into six major interdisciplinary research divisions:• Child Health;• Healing and Resilience;• International Health;• Tropical and Emerging Infectious Diseases;• Preventable Chronic Diseases; and• Services, Systems and Society.Father Frank Flynn FellowshipThe Father Frank Flynn Fellowship is funded by the Department and honours a greatophthalmologist, missionary and medical researcher.90

DEPARTMENT OF HEALTH – Annual Report 2011-12National Institute for Aboriginal and Torres Strait Islander HealthResearch Limited (The Lowitja Institute)The National Institute for Aboriginal and Torres Strait Islander Health Research iscurrently being hosted by the Lowitja Institute until 30 June 2014. After that time, theInstitute will fund research and implement programs in its own right, therebyproviding a permanent organisation for Aboriginal and Torres Strait Islander healthresearch.The Lowitja Institute is a collaborative research organisation that brings togetherAboriginal organisations, research institutions and government agencies to facilitateevidence-based research into Aboriginal and Torres Strait Islander health. As wellas the Department of Health, Northern Territory participants include MSHR, CharlesDarwin University and Danila Dilba Health Services.Centre for Remote HealthThe Department provided funding to the Centre for Remote Health (a joint trainingand research centre of Flinders and Charles Darwin Universities) for assistance withthe administrative functions of the Central Australia Human Research EthicsCommittee.91

DEPARTMENT OF HEALTH – Annual Report 2011-12Corporate PlanThis is now the final year of the Department of Health’s Corporate Plan. TheCorporate Plan 2009-2012 guided the Department’s service delivery anddevelopment initiatives; and ensured the five priority action areas contributed to ourmission of promoting, protecting and improving the health and wellbeing of allTerritorians in partnership with individuals, families and the community. As we moveinto 2013 and the final implementation of the National Health Reform, theDepartment will be developing a service plan for 2013 and beyond.On 1 July 2012, the Top End and Central Hospital Networks and Governing Councilscommenced operation and these milestones provide the opportunity for arefocussing of our strategic thinking and objectives, with wider clinical andstakeholder engagement into our key areas of priority for the coming three to fiveyears. The Department remains committed to stakeholder engagement, patientsafety and quality services, Aboriginal employment and valuing our workforce.92

DEPARTMENT OF HEALTH – Annual Report 2011-12Promoting and Protecting Healthand Wellbeing and Preventing InjuryOverviewThe key to improving population health and wellbeing lies in a stronger focus onpromoting good health, encouraging the adoption of healthy behaviours, controllingthe spread of disease and preventing harm and injury.We delivered in 2011-12Promoting good health andpreventing chronic diseaseA range of activities were delivered thisyear to promote and protect health.• There was a focus on reducing intakeof sugar sweetened beverages inremote communities in an effort todecrease overweight and obesity ratesand resulting health conditions. Onesuch project is Swap Soft Drinks forWater, which aims to educate peopleabout the amount of sugar in sugarsweetened beverages and supporthealthier drink choices.Key focus areas• Focusing on health promotion andminimising unhealthy behavioursand their impacts.• Improving health awareness toreduce cost pressures on thehealth system that are derivedfrom preventable chronicdiseases.• Assisting in closing the gap inhealth outcomes and lifeexpectancy between Aboriginaland non-Aboriginal populations inthe Northern Territory.• A Construction Health Improvement Project was commenced which focuses onpromoting healthy lifestyles to prevent chronic disease in Territory constructionworkers. This involved strategies such as on site health screening and referralprograms.• A collaborative approach to health promotion was established which included:the delivery of school aged screening and health education sessions; communityhealth expos; support groups for mothers and babies; participation in festivaldays; working with remote stores; cooking sessions; and community gardenprojects.• Increased tobacco control activities in remote communities and increased focusand support for pregnant women to quit smoking• A Diabetes in Pregnancy National Health and Medical Research Councilpartnership began between the Department of Health, Menzies School of Health93

DEPARTMENT OF HEALTH – Annual Report 2011-12Research, Baker IDI Heart and Diabetes Institute, the Aboriginal MedicalServices Alliance Northern Territory and Healthy Living NT. The partnership aimsto improve recognition and management of diabetes in pregnancy and furtherexplore the impact and outcomes for women and their babies. This five yearproject is developing a clinical register, mapping patient journeys and engagingwith relevant service providers.Health promotion capacity buildingCapacity building is a key element in promoting and protecting health and wellbeing.A number of initiatives were progressed this year.A consultation draft of the Health Promotion Framework was developed in order to:• support a consistent approach to the description and implementation ofhealth promotion services and programs across the Northern Territory;• ensure health promotion is reflected in all business planning and servicedevelopment processes within the Department of Health, including hospitalsettings;• raise awareness of the range of strategies that sit across the healthpromotion continuum; and• facilitate a common understanding and language about health promotionstrategies and actions.Staff were trained in health promotion through a number of events:• a three day Health Promotion Short Course in Darwin with a total of 32participants;• a four day Health Promotion Short Course in Alice Springs with a total of 33participants;• the delivery of a four day specifically tailored Health Promotion in CommunityBased Primary Maternity Care course for 16 Midwives and AboriginalWorkers from across the Territory facilitated by Curtin University, WA;• two three-week workshops for Strong Women Strong Babies Strong Cultureworkers in March and June 2012; and• support for four Northern Territory Aboriginal women to undertake midwiferystudies at the Australian Catholic University, Queensland.• A new agreement was reached between the Department of Health and theDepartment of Education and Training for joint subscription and administration ofthe Quality Improvement Program Planning System (QIPPS). Department staffcontinue to be trained and supported to use QIPPS to plan, document and94

DEPARTMENT OF HEALTH – Annual Report 2011-12evaluate health promotion and secondary prevention projects; 177 people weretrained in 2011-12.• The Department continues to support and participate in the delivery of theCertificate IV in Population Health, Bachelor of Health Science and Master inPublic Health at Charles Darwin University (CDU).Promoting healthy childhoodHealthy development in infancy and childhood is a key determinant for health andwellbeing in adulthood. Activities targeting health in the early years included:• up-skilling in the delivery of education to community groups and families aboutantenatal care, postnatal care and child health through two comprehensivelyplanned workshops designed especially for Stronger Women Workers;• a school hygiene program through Strong Women and community basedworkers;• the delivery of education, health promotion and implementation of a one stophealth check and follow ups at Wadeye Health Clinic for Wadeye and Palumpaclients through partnerships between Strong Women Workers, Health Centrestaff and community schools;• support for community based workers to attend the World Health OrganisationInfant Feeding Counselling course and follow up training to enable these workersto work with families to deliver comprehensive education around first foods, foodintake, frequency and consistency;• the delivery of a comprehensive and well-coordinated hearing health service tochildren living in remote communities through appointment of Child HealthHearing Coordinators to work collaboratively with the Hearing Health Program,Northern Territory Hearing Services and visiting specialist;• beginning implementation and testing of the Hearing Health InformationManagement System; and• involvement in Youth Week including organising youth hunting and cultural trips.Building a healthier workforceA Healthy@Work program was launched on 23 April 2012 involving the:• Healthy@Work website which acts as a portal of healthy lifestyle information forstaff;• Healthy Lifestyle Sponsorship Fund offering staff the opportunity to accessfunding to implement programs and strategies promoting health and wellbeing intheir workplace;• Healthy Lifestyle Expo at Royal Darwin Hospital;95

DEPARTMENT OF HEALTH – Annual Report 2011-12• 10 000 steps pedometer challenge with over 500 staff participating; and• development of a stair use promotion program and resources for use acrossdepartmental facilities.SustainabilityFinal contracts for the supply and installation of significant energy and carbon savingprojects at Alice Springs Hospital (cogeneration) and Royal Darwin Hospital (airconditioning chiller replacement and boiler conversion to LPG) and orders for longlead time items.SupportCommencement of two Clinical Leaders with the Disability Equipment Program,formerly the Territory Independence and Mobility Equipment Scheme and SeatingEquipment Assessment and Technical Service, to support implementation of therecommendations from the Gatter Review (2009).Where we are going in 2012-13• Northern Territory cross-government Suicide Prevention Action Plan initiativesfocusing on young people will be implemented.• The Alice Springs Hospital (cogeneration) and Royal Darwin Hospital (airconditioning chiller replacement and boiler conversion to LPG) energy andcarbon saving projects will be completed.• The Health Promotion Framework will be finalised and endorsed by theDepartment, other government agencies and relevant stakeholders.• Healthy@Work healthy lifestyle programs will be integrated into professionaldevelopment opportunities for Aboriginal and Torres Strait Islander staff such asStepping Up.• The Healthy@Work Risk Profiling Study will be carried out.• The 2012 Chronic Diseases Network Conference will be on Promoting HealthyChildhood.96

DEPARTMENT OF HEALTH – Annual Report 2011-12Healthy Children and Young Peoplein Safe and Strong FamiliesOverviewToday’s young are the leaders and parents of tomorrow and their health, safety andwellbeing are essential. The foundations for health and wellbeing are laid downbefore birth and during early childhood. Good antenatal care is needed to optimisematernal and birth outcomes together with services to support parents and promotechild development and learning.We delivered in 2011-12Antenatal educationProjects relating to antenatal educationincluded:Key focus areas• Enhancing the system forintegrated maternity, earlychildhood and school-age healthand wellbeing services.• Remote Outreach Midwife, StrongWomen and Women's Health Educatorprovided a pregnancy education bookand other suitable resources to supportremote area staff to work with pregnantwomen; and• collaboration between Strong WomenWorkers (SWW) Remote Outreachmidwives, Women's Health Educators,Child Health Nurses, representativesfrom the Smith Family, Family as FirstTeachers, Red Cross and Save theChildren to offer a comprehensive preventative health service to mothers andbabies.Child health education and support• Building family and communitystrength and resilience.• Working together with the nongovernmentsector to supportvulnerable families.• Preventing and responding tonegative influences such asantisocial behaviour, domesticand family violence.• Support for mothers and babies groups and education sessions for parents andcarers via existing groups such as Families as First Teachers and the RedCross, as well as training for remote health and community services staff.• Support by nutritionists and child health nurses for SWW, community based childhealth workers and Anaemia Project workers to deliver projects in thecommunity.97

DEPARTMENT OF HEALTH – Annual Report 2011-12• Comprehensive parenting education and guidance to young parents and theirfamilies in collaboration with existing non-government organisations andparenting groups.• Education of remote staff by Child Health Nurses on the delivery of the HealthyUnder 5 Kids Program (HU5KP), with a key focus on the implementation ofGrowth Action Planning and follow up.• Training for more than 20 health professionals in the delivery of Talking AboutFeeding Babies and Little Kids, in conjunction with the Fred Hollows Foundation.The course up-skilled health professionals on infant feeding counselling andenabled them to deliver the course in their communities.• Health education programs to family groups in community schools aroundpersonal hygiene, resiliency, alcohol and tobacco and foetal alcohol syndrome.Child and youth health research and development• Support for the development of a whole of government plan to improve the healthof young people in the Territory.• Child and Youth Health Services Unit funded Menzies School of Health Researchto undertake key research to more accurately establish the health of youngpeople in the Territory, as well as the determinants of their health.Better health outcomes for Territory children.• Improved standardisation of the child health primary health care service modelacross the Territory, beginning with a focus on early childhood, as well as thesystems to support that service model.• A Child Health Plan that aims to build on the early years’ initiatives to deliverbetter health outcomes for children in the Territory.• A fluoride varnish program as part of the Healthy Under Five Kids Checks.• Child Health Nurse and Child Hearing Health Coordinator support for child healthprograms in communities including Healthy School Aged Kids, Healthy UnderFive Kids Checks, Young Women’s Community Health Program and Core of Life.• Support for the Department of Education and Training to establish integratedfamily service hubs.• A partnership with the Department of Children and Families to develop theservice options for children with disabilities in out of home care.98

DEPARTMENT OF HEALTH – Annual Report 2011-12Perinatal mental health• Training in perinatal mental health across the Territory to clinicians and services(government and non-government), involving approximately 260 participantsworking with mothers and babies in the Territory.• A small Territory-wide specialist perinatal mental health consultation service tosupport clinicians and provide services for women identified as at risk of, orhaving, perinatal depression.• A project to translate the perinatal depression screening tool into two languages.Where we are going in 2012-13• Continued work with Community Health, Remote Health and key communitycontrolled health services to further develop a standard child health primaryhealth care service for children and families in the Northern Territory.• Collaboration between the Department and Department of Children and Familiesto finalise the whole of government Northern Territory Early Childhood Plan.• Further developing an understanding of the distribution of health and illness ofchildren across the Territory.• Creating stronger partnerships with other government and non-governmentagencies that impact on the health and development of children in the Territoryand the communities where they live, to deliver more evidence-based programsto reduce the risks to children.• Piloting the Aboriginal language screening tool for specialist perinatal mentalhealth consultation services, once translated into two Aboriginal languages.• Creating partnership agreements with the South Australian Government(program developer) and City of Palmerston to pilot a multi strategy, communitybased obesity prevention initiative in the Palmerston community called ChildhoodObesity Prevention and Lifestyle (COPAL). Funded by the AustralianGovernment, COPAL aims to promote healthy eating and increase children’sparticipation in physical activity, with the long term goal of reducing rates ofchildhood obesity.Patricia Butler and baby MelodeeHenderson.99

DEPARTMENT OF HEALTH – Annual Report 2011-12Targeting Smoking, Alcohol andSubstance AbuseOverviewSmoking, alcohol and substance abuse affect the health and wellbeing of individualsand their families and have significant impacts on communities as well as the healthand community service system. Tackling smoking, alcohol and substance abuse andthe damage it causes, is a priority for the Department.We delivered in 2011-12Key focus areasSmoking• In 2011-12 a report on the costs andharms associated with tobacco use inthe Northern Territory wascommissioned through the SouthAustralia Centre for EconomicStudies. The report is due for releasein late 2012.• In conjunction with thecommencement of the departmentalSmokefree Policy, training wasoffered on tobacco cessation tonursing and other staff in all NorthernTerritory hospitals. Brief Interventionand Fresh Start smoking cessation• Developing and deliveringtargeted health promotion,educational strategies andmessages.• Assisting in the developmentand implementation of effectivelegislation and policy, includinghaving a legislative and clinicalresponsibility under the VolatileSubstance Abuse PreventionAct, Tobacco Control Act andthe Medicines, Poisons andTherapeutic Goods Act.• Offering a range of treatmentand rehabilitation services, acuteand primary health care andfamily support.training programs are also routinely offered by the Alcohol and Other DrugProgram (AODP).• Tobacco incentive grants significantly increased in 2011-12. Initial funding of$21 000 per annum increased to a total of $60 000. Funding of $30 000 was alsoallocated for the first time in Central Australia. An additional one off grant of$28 000 was provided to AFL Northern Territory to sponsor the under 15representative team, promote the Quitline and the healthy lifestyle activities andeducation for the players.• Evaluation of the Department’s Smoke Free Policy commenced and a staffsurvey was completed to assess the impact of the policy. Key survey findingsshowed awareness of the policy remained high at 99% and 71% supported thepolicy.100

DEPARTMENT OF HEALTH – Annual Report 2011-12• The Remote Tobacco Education and Cessation team began delivering the 100Quit Club; a remote tobacco cessation program designed to engage Aboriginaland remote communities in smoke free activities and Quit attempts.Other Drugs• The AODP provides training and information sessions that cover issues aroundalcohol and other drugs (AOD) and interaction with other illnesses or conditions(co-morbidity). The Registered Training Organisation unit of AODP deliverstraining for module CHCMH408 - Provide interventions to meet the needs ofconsumers with mental health and AOD issues, a competency based comorbidityunit of study for Certificate IV in AOD.• Tobacco, Alcohol and Other Drugs Services (TADS) provides a psychologist toheadspace for three hours a week to enhance the integrated service model.• TADS established a shared Medical Officer position with Top End Mental HealthServices to increase the management of co-morbidity AOD and mental healthservices. The position provides increased services to clients and will improve thedissemination of knowledge between services.• The AODP continued to work with the Council of Aboriginal Alcohol ProgramsServices to deliver Certificate III level training to Aboriginal workers in the AODfield.• The Administrator assented to the Medicines, Poisons and Therapeutic GoodsAct on 27 April 2012.Alcohol• The alcohol reforms introduced in July 2011 improved referral pathways for thosebefore the courts into treatment.• The official opening of the Tennant Creek Sobering Up Shelter was held in May.• Five new beds in rehabilitation facilities in Katherine commenced operation todirect offenders into treatment and break the cycle of reoffending. Existing andnew services have established assessment and referral mechanisms to ensurecontinuity of care so that people can receive appropriate support at the right timeand that health and related gains achieved through treatment are not at riskbecause of relapse.• A peak body for the AOD treatment service sector in the Northern Territory wasestablished in March 2012 to provide support and representation of all AODservice providers.Where we are going in 2012-13This area will be a key focus in the Department’s next five-year Service Plan for theNorthern Territory health system.101

DEPARTMENT OF HEALTH – Annual Report 2011-12Connecting CareOverviewConnecting Care is the Department’s strategy for partnering with other agencies andsectors to establish an integrated service system which supports the health andwellbeing of Territorians.We delivered in 2011-12• CareFlight has a full complement ofclinical staff, which achieves the firstmilestone towards a fully integratedservice model.Key focus areas• Placing clients and their needsat the centre of decision making,service planning and servicedelivery.• A new Medical Specialist Outreach• Working with our partners in toProgram service delivery model hasbuild the best possible servicebeen developed which equitablysystem for the Northernallocates services across theTerritory.Territory and ensures the delivery ofteam based services to improveclinical outcomes and more efficient use of resources.• The Northern Territory Cardiac Services Framework (10 year plan) and theNorthern Territory Cardiac Services Implementation Plan were finalised. A stronggovernance structure for planning and implementation of cardiac services hasbeen put in place comprising a strategic Territory Clinical Reference Group, anoperational group in the Top End and Central Australia and a CardiacRehabilitation Planning Group.• Initiatives to address elective surgery wait lists are continuing under theImproving Public Hospitals National Partnership Agreement. The NorthernTerritory is improving performance against benchmarks. The Elective SurgeryWait List policy has been revised to enhance the monitoring of patients whosesurgery is overdue and to better manage those who repeatedly do not attend.There has been an increased focus on liaison and coordination for patients fromremote areas and improved management practices by surgeons of their waitlists. Investment in additional surgical lists in Territory hospitals through fly in flyout services has significantly reduced the number of patients whose surgery isoverdue, particularly at Royal Darwin Hospital. A data validation project has alsorectified processes which meant an under reporting of our performance incompletion of procedures and numbers of patients seen within recommendedclinical time frames.• Water fluoridation plants have been installed and are now functioning in Nguiu,Wadeye and Maningrida to support better oral health outcomes.102

DEPARTMENT OF HEALTH – Annual Report 2011-12• The collaborative work of Child Health Hearing Coordinators (CHHC) with theHearing Health Program, Northern Territory Hearing Services and visitingspecialists has facilitated a comprehensive and well-coordinated hearing healthservice to children living in remote communities. The focus has been oncommunities with hearing health booths.• Key research to identify the health status and determinants of health of youngpeople in the Territory has been commissioned by the Child and Youth HealthStrategy Unit and is being undertaken by Menzies School of Health Research.• The Darwin Midwifery Group Practice integrates health services for pregnantAboriginal women from eight Top End remote communities, coordinating accessto primary community health services, acute care services and allied healthprofessionals as required.• A strategic approach to community engagement, community education andservice delivery to improve the sexual and reproductive health of the migrant andrefugee community in the Northern Territory has also been developed by aconsortium of key service providers led by the Women's Health Strategy Unit. Apilot project with the Somali community has been evaluated and funding optionsfor future research, resource development and service delivery have beenexplored.• General Practitioner (GP) services are now available at the Palmerston GPSuper Clinic, seven days per week including public holidays. After hours serviceprovision is also available on site.• Two secure care facilities have been constructed, one each in Darwin and AliceSprings, to support people with a cognitive impairment and complex needs. Theywill provide an intensive therapeutic environment designed to stabilise residents’behaviour and increase their skills so that they can then transition to lessrestrictive service options. Amendments to the Disability Services Act wereassented to in April 2012 to enable admission for involuntary treatment and carein Secure Care group homes and the regulation and monitoring of how residentswill be kept secure.St John Ambulance is one ofthe Department’s many servicedelivery partners.103

DEPARTMENT OF HEALTH – Annual Report 2011-12• The Department collaborated with the Department of Employment and Training(DET) in the development of the Northern Territory Early Childhood Plan andsupported the DET rollout of the Integrated Child and Family Services Project inthe Territory.• Development of a framework to increase the Department’s capacity to respond tomandatory reporting responsibilities in regards to domestic, family violence andchild abuse. This includes the establishment of a new Child Safety and WellbeingProgram Development Officer, who will represent the Department on the MultiAgency Assessment and Coordination team.• Development of the secure, web-based Grants Management System (GMS) isapproaching completion. The GMS will provide grant-funded non-governmentorganisations with a centralised source for information on grants and the abilityto lodge online funding applications and monitor and acquit grants.• Clinical Services planning for Palmerston Hospital was completed in 2011-12.• All work for Katherine Hospital’s redevelopment of its Emergency Departmentwas completed and handed over in July 2011.• Provision of Renal Ready Rooms in remote communities across the Top Endwas completed in March 2012.Where we are going in 2012-13• Annual service delivery plans for the Medical Specialist Outreach Program willbegin from 1 July 2012 based on extensive engagement with the ChronicConditions Strategy Unit and consultation with regional health servicemanagement teams.• The amended Disability Services Act, expected to take effect in August 2012, willenable involuntary admission for treatment and care in secure care group homesand the regulation and monitoring of how residents will be kept secure.• New works are planned at Royal Darwin Hospital for an operating theatreupgrade to provide additional capacity to reduce the wait time for electivesurgery. This project has been combined with the expansion of the Short StayUnit project.104

DEPARTMENT OF HEALTH – Annual Report 2011-12Safety, Quality and AccountabilityOverviewThis area of the Corporate Plan focuses on assuring the safety and quality of ourservices and ensuring that they meet the needs and expectations of those who usethem. This relies on sound processes for governance, risk management and qualityassurance.We delivered in 2011-12Improved governanceA key focus in 2011-12 was improvingand strengthening system performanceprocesses by implementingrecommendations from independentreview and analysis. Achievementsincluded:• developing a System PerformanceFramework to measure, improve anddemonstrate healthcare delivery;• establishing a System PerformanceImplementation Group to provideexecutive governance to theimplementation of the Framework;• further developing the ReportingShare Point to streamline reportingprocesses;Key focus areas:• Delivering culturally secureservices through effective, systemwide and staff implementedpractices.• Improving care through a newSafety and Quality Frameworkaimed to develop newunderstandings of incidentanalysis, business improvementpractice and changemanagement.• Developing and applyingresearch, knowledge exchangeand performance information toinform continuous improvement ofplanning and practice.• consolidating and strengthening resources and processes for performanceanalysis and reporting of assurance; and• implementing a systematic program of data governance and quality assurance.Safety trainingSafety training has been enhanced, over the past year, through a number ofinitiatives:• development of an online web based interactive safety and quality package andits roll-out across the Department;• delivery of root cause analysis training to clinicians across the Department;• provision of open disclosure training across Northern Territory hospitals; and105

DEPARTMENT OF HEALTH – Annual Report 2011-12• delivery of medication safety and clinical handover training at RDH by theAustralian Council on Health Care Standards.• All Clinical Learning training programs have been mapped against the nationalsafety and quality standards.Disaster managementtraining conducted at RoyalDarwin Hospital.Risk managementThe focus in 2011-12 for risk management has been to improve systems andprocesses. These include:• agreement of an Enterprise Wide Risk Management system design;• implementation, across Territory hospitals, of the National Safety and QualityStandards developed by the Australian Commission of Safety and Quality inHealthcare; and• finalisation of the procurement process to extend the hospital electronic incidentor risk management system across the remainder of the Department.Consumer and staff engagementA new Stakeholder Engagement Branch was established in February 2012 within therecently established Division of Aboriginal Policy and Stakeholder Engagement. Thecore function of this branch is to lead and support the Department’s effectiveengagement with its many stakeholders.The Department’s activities to engage with consumers and staff include:• release of a draft Stakeholder Engagement Framework for comment and thedevelopment of a Stakeholder Engagement Toolkit;• implementation of the National Charter of Healthcare Rights across all hospitalsand the development, at RDH, of Talking Posters in Aboriginal language toenable consumers to access the charter; and• significant revision of the Department’s Informed Consent Policy, relevantguidelines and forms for patients to better protect consumers’ rights andexpectations.106

DEPARTMENT OF HEALTH – Annual Report 2011-12Cultural securityCultural Security continues to be a strong priority for the Department, with theCultural Security Policy agenda underpinning a number of the Department’sactivities in 2011-12. These included:• an audit of the Cultural Security Policy that will inform the next phase of culturalsecurity initiatives across the Department;• the establishment of a Cultural Security Implementation Working Group to driveand oversee initiatives across the Department;• a project on measuring cultural competency project undertaken through theAustralian Health Ministers Advisory Council (AHMAC);• the implementation of the cultural competency self-assessment and audit tool;and• the establishment of cultural leave entitlement provisions for Aboriginal staff.Continuous quality improvement and accreditationAll remote Aboriginal primary health care centres are actively involved in continuousquality improvement to review and improve the delivery of chronic conditions care,maternal and child health programs, preventive care and mental health. Data fromquality audits show significant improvement in the delivery of care over the past 10years. A key outcome of this work is significant improvement in blood pressurecontrol which will reduce complications such as cardiac disease and kidney failure.The quality of hospital services continues to be assured by their ongoingaccreditation by the Australian Council for Healthcare Standards (ACHS). RDH,Katherine Hospital and Alice Springs Hospital have also achieved Baby FriendlyHospital Initiative reaccreditation.Accreditation of community-based services has also been maintained and extended:• Clinic 34 in Darwin was accredited through the Australian Council of HealthcareStandards Evaluation and the Quality Improvement Program (EQuIP); and• three Northern Territory Alcohol and Other Drugs non-government servicesbecame nationally accredited for the first time.Sharing knowledge and commissioned researchKey achievements include:• the Living Knowledge initiative which hosted four Learning Network seminars andproduced four Living Knowledge bulletins to share knowledge around theDepartment and with its government and non-government partners;• investigating links between periodontal disease and cardio-vascular diseasethrough a partnership with Menzies School of Health Research and theAustralian Research Centre for Population Oral Health;107

DEPARTMENT OF HEALTH – Annual Report 2011-12• research into the development of an Indigenous Benchmarking tool through aservice agreement between the Health Promotion Strategy Unit and CharlesDarwin University (CDU) which is due for completion in February 2013; and• a Healthy@Work risk profiling study to be undertaken in partnership with CDU toevaluate the Healthy@Work program and contribute to knowledge regarding theeffectiveness of workplace health promotion programs.Where we are going in 2012-13In the coming year, we will:• translate the Safety and Quality Framework into an agency-wide Safety andQuality Action Plan;• create a new system performance response through provision of agreed databenchmarked to national data definitions;• ensure more effective governance, definition and interpretation of data andreports through implementation of the System Performance Framework;• develop a common set of performance reports that are aligned across the systemlevel;• develop a standardised approach to assessing the satisfaction of patients withhospital services;• ensure ongoing use and development of the cultural competency assessmenttool across the Department to measure and improve cultural competency, as wellas the implementation of other aspects of the Cultural Security Policy agenda;and• embed improved safety and quality governance and processes in the newservice plan.108

DEPARTMENT OF HEALTH – Annual Report 2011-12Attract, Develop and Retain aWorkforce for the FutureOverviewAnalysing our workforce in light of the current internal and external environment andimplementing appropriate initiatives to address identified risks and opportunities iscritical to ensuring our workforce is dynamically and directly linked to the futuredirection of the organisation.We delivered in 2011-12• In response to the Council ofAustralian Government’s (COAG)national health workforce agenda anumber of initiatives took place,including:Key focus areas• Optimising service deliverythrough workforce planning,recruitment and retentionstrategies to meet identifiedcommunity needs.• coordinated the Northern TerritoryRegional Training Network(NTRTN), comprising keyeducation and health serviceproviders, in order to advancework on expanding clinicalplacements and overseeingimplementation of national reformprojects;• Innovation and reform inworkforce practice and servicedelivery models.• Implement our strategy toincrease our Aboriginalworkforce.• Matching the workforce to theneeds of the workplace andclients.• refurbished a state of the artSimulated Learning Environmentto enhance students’ simulated learning experience in the Northern Territorythat can be transported to support the clinical learning of rural and remotestudents;• conducted Inter Professional Clinical Supervisor workshops across theTerritory to increase capacity and quality of clinical supervision in governmentand non-government health, aged, primary and community serviceorganisations;• increased the number of clinical training placement days for health workforcestudents studying in oral health in the Northern Territory under a HealthWorkforce Australia Clinical Training Funding initiative; and• contributed to the development of national health workforce strategiesfocused on addressing workforce issues including: innovation and reform,rural and remote; and the Aboriginal health workforce.109

DEPARTMENT OF HEALTH – Annual Report 2011-12• Hosted an inaugural meeting to establish the Greater Northern AustraliaRegional Training Network (GNARTN) comprising representatives from theNorthern Territory, Queensland and Western Australia. The GNARTN aims tofocus on common cross-jurisdictional issues regarding the health workforce andwill collaborate with other Regional Training Networks to achieve broaderoutcomes for the benefit of the workforce and the Territory community.• A broad range of stakeholders with interests in Remote Medical Generalisttraining to employment have met and agreed to a set of principles to guide thisnew workforce. Training blocks were analysed and funding gained to furtherincrease capacity in support and placements next year.• Implemented legislative measures to ensure all registered health practitioners inthe Northern Territory were covered by the National Registration andAccreditation Scheme so they can practice anywhere across Australia and arelisted on a publicly accessible register.• Coordinated Area of Need applications for three medical practices to employoverseas medical graduates to address workforce shortages.• Implemented a revised Criminal History Check policy and process.• Implemented the eRecruit system across the Department.• Implemented a suite of human resources data reports to enhance the workforceinformation available to managers.• Promoted and coordinated participation in the Northern Territory Public SectorEmployee Survey 2011. A total of 1594 employees or 30% participated,compared to 16% in 2009-10.• Continued to consolidate and embed eLearning practices across the Department.Identified existing training programs that are appropriate to transition to an onlineformat.• Reviewed individual performance management planning and review process andreleased an enhanced Work Partnership Plan Framework.• Recruited 120 graduate nurses under the Graduate Nurse Program.• Reviewed the Employed Midwifery Model in conjunction with the implementationof the Bachelor of Midwifery Program at CDU and program commenced.• Introduced a new five level professional classification structure to provide bettercareer pathways and progression.• Delivered clinical and education programs across the Territory including newcourses: Root Cause Analysis, Alcohol Withdrawal and its Effects on ServiceDelivery, Substance Use; and Cancer Care.NOTE: Please refer to Our People section of the Annual Report for details ontraining activities delivered including Entry Level Employment Programs.110

DEPARTMENT OF HEALTH – Annual Report 2011-12First year medical studentsWhere we are going in 2012-13We will:• continue work to increase and strengthen the Aboriginal workforce within theDepartment as an important and integral component of health service deliveryincluding primary health care;• facilitate and support collaboration between the Northern Territory RegionalTraining Network and the GNARTN with a focus on key workforce issuesrelevant to the Territory;• represent Northern Territory interests in the development of local and nationalhealth workforce initiatives, such as development of a local workforce andflexible workforce models, particularly in remote areas;• work to maintain capacity for clinical placements for health workforce studentsthrough collaboration with our partners in the NTRTN;• support the Rural Medical Generalist training pathway to ensure a sustainableworkforce with skills to meet the needs of Territorians in more remote areas;• increase the uptake of work experience and work placements across theDepartment to provide career opportunities in health for Territory schoolstudents;• continue to focus on promoting Allied Health careers and Entry LevelEmployment Programs, particularly those targeted at Aboriginal people;• implement the Professional Practice Supervision and Support Scheme for AlliedHealth staff across the Department;• coordinate implementation of Valuing Our People and Northern Territory PublicSector Employee Survey strategies identified through employee focus groupmeetings held across the Department;111

DEPARTMENT OF HEALTH – Annual Report 2011-12• review the Aboriginal Cultural Awareness Program with a view to utilising on linelearning and extending the program to cultural safety and competence;• deliver the training and education activities outlined in the 2012-13 ClinicalTraining Calendars and continue to review existing training products to align withNational Health Care Standards;• coordinate the 2012-13 Graduate Nurse Program; and• implement recommendations from the Northern Territory Aboriginal HealthWorker Professional Review, including education and training, roles andresponsibilities; and cultural security in conjunction with the Aboriginalcommunity controlled sector.Aboriginal Liaison Officers atAlice Springs Hospital.From left: Christine Spencer,Walter Wesley and ElizabethPresley.112

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012Strategic ProjectsNorthern Territory Medical ProgramThe Northern Territory Medical Program (NTMP) is in its second year of operationand is a key strategy to increase the health workforce in the Territory and close thegap in Aboriginal health outcomes. For the first time, Territorians can train for acareer in medicine in the Territory.The NTMP is a tri-partner agreement between Flinders University, CDU and theNorthern Territory Government. In 2012, through the pathway created by the jointFlinders and CDU Bachelor of Clinical Sciences and the Flinders NTMP, each yearof medical study can be completed from high school to graduation as a doctor.Infrastructure funded by the Australian Government as part of this program includestwo new education facilities: the Flinders NTMP building on the CDU campus hasbeen completed; and work is progressing for a building on the Royal Darwin Hospitalgrounds.A further 24 students commenced their first year of the NTMP in 2012, 18 of whomare residents of the Northern Territory with two Aboriginal students.In 2012, the first year’s cohort of 11 high school graduates successfully progressedto Year 2 of their studies and were joined by a further 12 students commencing Year1 Bachelor of Clinical Sciences at CDU. This pathway will provide students with adouble degree in science and medicine and eligibility to enter the Medical Programafter completing two years of study. Numbers by year of study anticipated until 2015are shown in Table 13.Table 13 :Student Numbers2010 2011 2012 2013 2014 2015Year 1 24 30* 24 24 24Year 2 15* 30 24 24Year 3 31 32 36 40 40 40Year 4 31 31 32 36 40 40* 2011 Intake Year 1 students, 6 repeating in 2012, 1 deferral due to return in 2013 and 2withdrawals.113

DEPARTMENT OF HEALTH – Annual Report 2011-12Our PeopleOverviewHealth workforce shortages across Australia continue to drive an agenda forworkforce reform at the local and national level. The Department regularly with localstakeholders and strives to secure the workforce required to meet the health serviceneeds of Northern Territory communities.A number of national funding initiatives were taken up by the Territory to addresshealth workforce shortages including: improved facilities for training in oral healthand a state of the art simulated learning environment; a program to support clinicalsupervisors responsible for student placements in a clinical setting; andimplementation of a program designed to train and develop rural medical generalistswith greater capacity for primary health care and remote work.Legislation was implemented to support the final transfer of Northern Territoryregistered health professions to the National Registration and Accreditation Schemeon 1 July 2012. Health practitioners within any of the 14 nationally registeredprofessions can now register with a National Board and practice anywhere inAustralia. The National Scheme has streamlined the process for health practitionersvisiting or moving to the Northern Territory to obtain work and provide vital healthservices.Snapshot of Our PeopleAs at the end of 2011-12, the Department had a total of 5624.5 FTEs. Of these,469.9 FTE employees were ongoing part time; 3111.4 FTEs were ongoing full time;157.4 fixed term part-time; and 1603.5, fixed term full time.Staffing numbers fluctuate during the year due to seasonal changes. The abovefigures reflect FTEs as at 20 June 2012 (Figure 17).114

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012Figure 17 : Full Time Equivalent Staffing Trends including percentage of total in each category115

DEPARTMENT OF HEALTH – Annual Report 2011-12The Department continued its aim of building a workforce that is representative of itsclient base through participation in remote workforce development initiatives;encouraging increased participation from Equal Employment Opportunity (EEO)groups through employment campaigns; innovation in job design and health rolesthat expand career options; and an increased focus on developing our Aboriginalhealth workforce.Table 14 :Equal Employment Opportunity Statistics based on myHR EEO dataTarget Group 2009-10 2010-11 2011-12Aboriginal and Torres Strait Islander 10% 9% 8%Non-English Speaking Background 23% 26% 27%Disability 4% 5% 4%These percentages are derived from the number of staff who volunteered their EEO status.These figures (Table 14) also reflect the continued growth of our professionallyskilled workforce where Aboriginal people and people with a disability are lessrepresented. As explained below the Department continues its effort to increase thecapacity of its (potential) Aboriginal and Torres Strait Islander workforce.Aboriginal and Torres Strait Islander WorkforceStrengthening links between education, employment and development for theDepartment’s current and potential Aboriginal workforce continues to be a priority.Some key initiatives that highlight the Department’s continued investment inattempts to grow our own workforce are highlighted below.National Indigenous Cadetship ProgramThe Department employed 19 cadets under the program. The cadets are localAboriginal people studying in skill gap areas. The average age of a cadet is 27 yearsold.Group using MyLearning tools.116

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012Table 15 : National Indigenous Cadetships 2011-12DegreeNo. ofcadets 2011-12CompletedCadetshipResignedfromCadetshipContinuingCadetshipMedical Science 1 0 0 1Medicine 2 0 0 2Nursing 8 1 1 6Physiotherapy 2 1 0 1Exercise and SportsScience2 0 0 2Social Work 1 0 0 1Psychology 3 0 0 3Total 19 2 1 16Attracting Aboriginal and Torres Strait Islander StaffParticipation in various campaigns and programs to increase Aboriginal and TorresStrait Islander employment across the Department included:• the 2011 Careers Expo held in Darwin, Nhulunbuy, Katherine, Tennant Creekand Alice Springs to promote work experience (Year 10), work placement (Years11 and 12), school based and full time apprenticeships, entry level programparticipation and cadetships;• a Career Advisor Seminar held in February 2012 provided an opportunity forcareers in health to be promoted to students, teachers, career advisers, industryengagement officers, Group Training Northern Territory and other stakeholdersinvolved in the school to work transition;• an adopt a School Employment Forum in May 2012 provided students, teachers,career advisors and industry engagement officers with an understanding of thecareer pathways within the Department of Health; and• facilitating work tours to allow students from schools across the NorthernTerritory to gain an understanding of the diverse career opportunities andpathways that are available across the health workforce.Aboriginal and Torres Strait Islander ProfessionalDevelopment ProgramIn the three years since its implementation, the Stepping UP Program has had a totalof 25 participants.Stepping UP is an accelerated Aboriginal and Torres Strait Islander ProfessionalDevelopment Program that provides an opportunity for Aboriginal and Torres StraitIslander staff to develop and enhance skills and competencies to open up career117

DEPARTMENT OF HEALTH – Annual Report 2011-12pathways within the Department and the Northern Territory Government and willcontinue in 2013.Indigenous Employment Program (IEP)The Department supported 15 Aboriginal participants to undertake a Certificate II inCommunity Services. The Indigenous Employment Program is a key initiative toaddress the Northern Territory Public Sector Indigenous Employment targets underthe Department’s Aboriginal and Torres Strait Islander Workforce Plan. The programis specifically designed to attract Aboriginal people wishing to enter or return to theworkforce. Participants are provided with the foundation skills to gain employment inentry level positions.Cultural AwarenessDuring 2011-12, 687 staff (representing a 20% increase from 2010-11) attended theAboriginal Cultural Awareness Program which aims to provide staff with the skills,knowledge and attitudes necessary to work effectively with Aboriginal staff andclients in order to achieve improved health.Supporting our PeopleHuman Resource ServicesThe Human Resource Services Unit (HR) provides a consultancy service to allmanagers and staff on best practice human resource management. The aim of HR isto assist, provide advice and guide managers and staff on employment matters inaccordance with the Public Sector Employment and Management Act and thevarious Enterprise Agreements applying to staff in the agency. HR also acts as aliaison point for the central agencies and the unions.HR dealt with a number of cases during the year as shown in Table 16 below.Table 16 :Cases dealt with by HR UnitType of CaseCases received2011-12Remaining cases as at1 July 2012Appeals against promotions 4 0Grievances 81 8Discipline 5 2Inability 4 1Medical Incapacity 1 1Interventions (including31 2preliminary inquiries intoinappropriate behaviours)Performance Management 23 1Anti-Discrimination 2 1118

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012A total of 81 grievances were received during the reporting period and 24 caseswere carried over from last year. Of the 105 cases, eight remained open at the endof the reporting period. Thirty-five grievances related to allegations of bullying andharassment, inappropriate behaviour and unfair treatment. Seven grievances wereabout recruitment selection processes; this indicates that the tailored recruitmentand selection training provided has been effective. The remainder related tomanagement actions or decisions, or conditions of service. Of the 81 grievances, 19were referred to the agency for review by the Commissioner for Public Employmentand in all but six of the matters, the employee was satisfied with the review’s findingand/or the Commissioner agreed that the Department’s actions/decisions werereasonable.The update of the Department’s bullying and harassment training programs,scheduled for 2011-12 was put on hold pending the finalisation of the review of thePublic Sector Employment and Management Act and the development and releaseof the Commissioner for Public Employment’s Employment Instruction dealing withInappropriate Workplace Behaviours.Workplace Health and SafetyThe Department is committed to maintaining a work environment that is safe andminimises risks to the wellbeing of employees, contractors, suppliers, clients andvisitors.Workplace Health and Safety (WHS) Awareness training, including ManualHandling, Aggression Minimisation and Emergency Response, forms part of theDepartment’s Orientation Program and is provided on a regular basis through theTraining and Development Calendar. A diverse range of other awareness programsare also offered on an ad hoc basis.National Safe Work Australia Week (NSWAW), 24 – 28 October 2011, wascelebrated with the WHS Unit’s participation in and support of work area initiativesacross the Department. The Workplace Safety Leader Award competition toacknowledge compliance and continuous improvement actions undertaken in theworkplace during the previous 12 months was a large component of these activities.Workers’ CompensationAs shown in Table 17, there have been 125 claims from 790 reported incidentslodged with the Department of Business and Employment (DBE) in 2011-12, with acost to date of $3 663 783.For the same period last year, there were 135 claims from 844 reported incidents,costing a total of $4 285 098. (Note: The 2009-10 and 2010-11 figures included theDepartment of Children and Families).119

DEPARTMENT OF HEALTH – Annual Report 2011-12Table 17 : Workers Compensation Incidents and Claims 1 July 2011 - 30 June 20122009-10 2010-11 2011-12Total Cost $3 368 407 $4 285 098 $3 663 783NewIncidents 1 117 844 790Claims 159 135 125Managing AggressionTable 18 indicates the type of reported aggression and the classification ofemployees who have reported the aggressive behaviour.Table 18 : Aggression by Physical/Verbal Type – 1 July 2011 to 30 June 2012Incidencesofaggression2009-10 1 2010-11 1 2011-12 2Physical Verbal Physical Verbal Physical VerbalAdministrative 4 22 4 8 6 12Nurse 109 93 108 76 112 76Other 15 21 4 7 1 3Physical 32 12 17 13 21 4Professional 1 5 7 4 2 3Doctor 1 4Total 161 153 140 108 143 102YearlyPhysical andVerbal Totals(314) (248) (245)1Includes both Department of Health and Department of Children and Families2Department of Health data onlyThe Department continues its commitment to a policy of zero tolerance ofaggression against employees through the implementation of AggressionManagement Plans tailored to individual clinics and the Aggression MinimisationAwareness Training Program.Industrial RelationsThe Northern Territory Public Sector 2010-2013 Enterprise Agreement had anumber of implementation matters that the Industrial Relations Unit (IRU) wasinvolved with, such as the new Professional Officers’ reclassification structure. TheIRU worked with the Department of Business and Employment to assist intranslating staff to correct remuneration levels. The IRU was a key driver in havingover 700 professional positions examined in order to evaluate professional job valuelevels in the Department to achieve industrial compliance.In conjunction with the Office of the Commissioner for Public Employment, two newEnterprise Agreements were negotiated. The Northern Territory Public Sector120

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012Nurses Agreement was finalised with the Australian Nurses Federation, withapproval of the agreement being granted by FairWork Australia on 11 November2011. The agreement continued to place Territory nurses among the bestremunerated nurses within any national jurisdiction. The Northern Territory PublicSector Dental Officers’ Agreement was also negotiated with the Community andPublic Sector Union. This new agreement, in place until 2014, will continue tostrengthen the Department’s ability to attract dentists to work in oral health services.The IRU was involved in one unfair dismissal claim before FairWork Australia whichwas discontinued by FWA. Two claims were submitted to the FairWork Ombudsmanand on both occasions the Department was found to have complied with its statutoryobligations and no further action was required.There were no industrial disputes lodged with FairWork Australia or time lost due toother non-notified disputes. The Department continues to work through industrialmatters through the disputes resolutions clause of the relevant agreements to reachoutcomes.The IRU continues to provide guidance to managers on industrial and strategichuman resource management issues. It has a strong relationship with internal andexternal stakeholders and monitors national trends on terms and conditions ofemployment in key areas that impact on the Department.Learning and DevelopmentThe Department continues to invest in professional development and encourageslifelong learning. Our online Training and Development Calendar enables staff toselect from a wide range of training programs.The Department recognises that future success relies on retaining, nurturing andgrowing our own leaders and has made a major investment in increasing theleadership and management capability of our workforce.Key focus areas for 2011-12 have been implementation of the eLearning Strategyand continuation of First Line and Middle Managers’ Leadership Programs.Student Work PlacementsThe Work Placements Program provides secondary students with a hands onopportunity to explore a potential career pathway within their preferred healthindustry sector. During 2011-12, a total of 19 students participated in the program(Table 19).121

DEPARTMENT OF HEALTH – Annual Report 2011-12Table 19 :Student Work PlacementsIndustry SectorStudent ParticipationOral Health 6Community Services 3Administration 1Maternity 3Ground Maintenance 5Pathology 1Total 19Apprenticeship ProgramThe Department supported a total of 42 apprentices studying in a wide range ofhealth disciplines as shown below in (Table 20).Table 20 :2011-12 ApprenticesQualificationSchool BasedApprenticeshipCert II Primary Health 1Full-timeApprenticeshipCompletedduring 2011-12Cert III Aboriginal Health Work 1Cert IV Aboriginal Health Work 3Cert II in Business 1Cert III in Business 1 3Cert II Community Services 5Cert III Community Services 1 3Cert III Dental Assistance 9 2Diploma Dental Technology 2Cert III Electronics and2CommunicationCert III in Electrotechnology1SystemsCert III Hospitality (Cookery) 5Cert IV Human Resources 1Cert IV Population Health 1Total 18 16 8122

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012eLearningIn June, the MyLearning Learning Management System was launched as part of theongoing eLearning Strategy to increase the availability of training and developmentopportunities, particularly in remote and regional areas. The MyLearning system willenable improved planning, recording and reporting of training and developmentactivities.An eLearning Centre has been established to maintain the system, provide supportand deliver training in the area of eLearning content development.Orientation ProgramThe Department delivers a multi-disciplinary orientation program which coversmandatory training requirements and other relevant information that will assist theretention and increase productivity of new employees. A total of 1496 employeesattended in 2011-12 (Table 21).Table 21 : Orientation Attendance for 2011–12Darwin Katherine Gove AliceSpringsTennantCreekTOTAL882 80 56 442 36 1496GrantsThe Department encourages professional development and life-long learning foremployees through a range of grants and allowances (Table 22).Table 22 :Training Grants Issued/ReceivedCategoryValue$Number of PeopleSupportedStudies Assistance (By-Law 41) 108 861 178Undergraduate Medicine and Health3 600 24Sciences Admission Test (UMAT)General Studies Assistance Grants 100 872 80Aboriginal and Torres Strait Islander StudiesAssistance Grants19 990 12Remote Workforce Development 264 632 *38 Groups andindividualssupported,including 17 fromnurses andmidwivesNursing and Midwifery Studies AssistanceGrants46 719 37123

DEPARTMENT OF HEALTH – Annual Report 2011-12Training ProgramsThe Department has continued its investment in increasing the leadership andmanagement capability of our workforce, as shown in Table 23.Table 23 :Training Program AttendanceProgram TitleAttendanceTailored Leadership Departmental ProgramsLeading the Way Middle Manager Leadership and30Management Development ProgramBuilding our Leaders First Line Leadership and Management29Development ProgramOCPE Leadership ProgramsLookrukin – Indigenous Women’s Leadership Development3ProgramPublic Sector Management (PSM) Program 2012 5Discovery Women as Leaders - 2011 3Discovery Women as Leaders - 2012 4360 Degree Feedback – Senior leaders 1Future Leaders Program 1Executive Leaders Program 2ANZSOG – Leadership for Change Agents 8ANZSOG – Rethinking Service Delivery in Changing Times 7Department-specific Management Programs *Essentials of Leading People Part 1 228Essentials of Leading People Part 2 218Essentials of Managing Procurement Part 1 191Essentials of Managing Procurement Part 2 137Mediation 91Recruitment 183Government Decision Making 44Finance for Cost Centre Managers 147Other Training Programs *4 Wheel Drive Training 38Work Partnership Plans 70Senior Pay Progression 162Evaluations of training programs are undertaken by participants following each session andare based on achieving learning outcomes. The average score out of 5 rates the participant’sability to apply the skills and knowledge learnt.*Evaluations of these programs range between 4.2 – 4.7.The Department also provides training to employees of the Department of Childrenand Families.124

DEPARTMENT OF HEALTH – Annual Report 2011 - 2012Clinical Learning (Nursing)Table 24 :Clinical Learning Programs and AttendanceProgram TitleAttendanceBasic Life Support 416Advanced Life Support (adult and paediatric) 248Early Recognition and Management of the Critically Ill Patient158(includes adults and paediatrics)ECG 110Rostering and Staff Deployment 36Cardiac Care 72Clinical Teaching 17Preceptors 111Portfolios 29Remote Orientation 36Team Leader Training 148Documentation 19Preparation for Clinical Management 40Professional Development forums for Community Health and45unplanned delivery or one-off sessions in response to requestsfor trainingAll Clinical Learning (Nursing) courses scored greater than 93% on evaluations withan average score of 97% Department wide.Employment InstructionsEmployment Instructions are rules issued by the Commissioner for PublicEmployment that cover important human resource matters. Under the Public SectorEmployment and Management Act (the Act), agencies are required to assist theCommissioner for Public Employment to meet the annual reporting requirementsdetailed in Section 18(2) of the Act by reporting against the EmploymentInstructions, in particular, Part 2 - Employment Instructions and Other KeyIndicators, Part 3 – Redeployment, Discipline and Inability; and Part 4 – Examples ofBest/Innovative Practice (refer Appendix 1).125

DEPARTMENT OF HEALTH – Annual Report 2011-12Corporate GovernanceThe Department of Health is committed to effective corporate governance andensuring that the scope and quality of its governance functions and activities arecommensurate with the enormity of the challenges facing the health care sector.These are: escalating service expectations together with increasing demands forgreater patient wellbeing and safety; along with rising costs; developments inscience and technology; and a changing economic environment.The governance and effectiveness of our services are paramount given the impacton human wellbeing and the size of the health and community sector within theNorthern Territory. The Department’s governance framework consists of five keyelements: effective leadership; capable management; diligent monitoring;responsible risk management; and demonstrated accountability and responsibility.These elements support the principles promoted by the Australian National AuditOffice (ANAO) in its publication Public Sector Governance 2003.Corporate governance within the Department is supported by process, policies,legislation, regulatory obligations, customs and practices. It is also reliant on the waythe Department is directed, administered and controlled in achieving its goals andobjectives.Ultimate accountability rests with the Chief Executive, who is supported by theExecutive Leadership Team (ELT). The ELT is committed to ensuring that staff andstakeholders are well equipped with the processes and tools necessary for enactingtheir role in achieving corporate governance. The effectiveness of these internalprocesses, controls and governance activities is monitored through internal andexternal audit activities.The Department has bolstered the effectiveness of the Department’s CorporateGovernance framework by:• appointment of a leading industry recognised audit provider (Ernst & Young);• adoption of an Enterprise Wide Risk Management framework;• adoption of a revised risk management implementation plan;• revision of the Corporate Risk Register;• ongoing development of the risk based three year strategic audit plan; and• implementation of verification of audit recommendations.These strategic initiatives and system improvements will further assist theDepartment in meeting its fiduciary, regulatory and governance responsibilities.A number of subgroups to the ELT combined with advisory bodies to the Minister ofHealth, support this approach. Details of these groups are available at Appendix 2.126

DEPARTMENT OF HEALTH – Annual Report 2011-12The Department’s Audit Committee comprises internal and external members thatmonitor the state of the Department’s organisational governance and providerecommendations and strategic direction to the Chief Executive. This monitoringfunction is undertaken by the review of internal audit activities and reports, includingthe status of follow up actions against previously accepted audit recommendations.Additionally the Committee monitors the development and implementation of theRisk Management Framework that has been aligned to the AS/NZS ISO 31000:2009Risk Management – Principles and guidelines that provide an holistic approach tothe identification, assessment and communication of risk across the Department.Clinical GovernanceThe Department’s systematic approach to improving patient care and safety issupported by services and initiatives that address quality and safety issues, riskmanagement and workforce development.Executive and senior management have a key responsibility for the quality ofservices delivered by the Department; an accountability they share with cliniciansand other professionals providing services.The Department is also committed to consumer participation to ensure that:• consumers are actively involved in their care;• consumer feedback is used to inform improvement; and• consumer input assists in the development of information and resources forpatients and families.To assure the clinical effectiveness of its services, the Department has processes inplace to ensure that:• services adopt national standards of health care and evidenced based practicecombined with locally applicable evidence of effectiveness and safety;• the care environment promotes evidence based practice and fosters safety,quality and continuous improvement;• the right care is delivered to the right patient;• clinical audit and other performance measures are utilised to measure outcomesand effectiveness;• independent accreditation or certification is sought where appropriate;• the Australian Council on Health Care Standards are used to achieveaccreditation for the five hospitals;• non-hospital care, such as community care and remote health, adhere to nationalaccreditation and service delivery standards; and• the Department has a strong voice in the development of new national healthstandards that support remote and regional health care.127

DEPARTMENT OF HEALTH – Annual Report 2011-12Effective workforce is supported by:• all health professionals being registered with the relevant national board;• all self-regulated health professionals being eligible for practicing membershipwith the relevant professional association and/or possessing accreditedpractitioner status, where applicable;• specialists being credentialed and having defined scopes of practice; and• professional development opportunities.Risk Management is addressed through:• clinical risk management and improvement strategies being integrated withinimprovement and performance monitoring functions;• critical clinical incidents being monitored, effective responses developed andregular reports on quality are provided to managers;• a risk register being maintained, which is updated by the Department’s incidentmanagement systems; and• risks of deficiencies in service quality being identified and unacceptable riskseffectively addressed.In 2011-12, a Clinical Leadership Project was commenced to identify options for asystematic response to enhancing clinical leadership. This works alongside clinicalredesign and clinical services planning to increase the Department’s clinicalgovernance capacity and action.128

DEPARTMENT OF HEALTH – Annual Report 2011-12Consumer/Partnership EngagementStakeholder EngagementIn February 2012, a new Stakeholder Engagement Branch was established withinthe Division of Aboriginal Policy and Stakeholder Engagement in order to lead acoordinated approach to stakeholder engagement activities across the Department.There are a number of drivers for the imperative to establish a StakeholderEngagement Branch. These include:• the increasing complexity of integrated health care requires consultation andcollaboration with a range of government and non-government agencies, policyand technical experts, as well as patients, carers and advocates;• the unique challenges of delivery of healthcare services in the Northern Territorysuch as high numbers of clients who live in remote localities, high numbers ofclients who are Aboriginal, and the Northern Territory Emergency Response(NTER) and Closing the Gap initiatives which require inter sectoral, crossjurisdictionaland multi stakeholder collaboration;• the Australian Charter of Healthcare Rights and the National Safety and QualityHealth Services Standards include stakeholder engagement as an essentialfunction in the delivery of an effective healthcare service; and• increasing obligations to funding bodies for mandated reporting on stakeholderengagement activities, necessitate the development of a structured approacharound stakeholder engagement.The Department’s move to a more coordinated and systemic approach to engagingwith stakeholders will allow for increased credibility and accountability, improved riskmanagement and improved quality of policy and services.In June 2012 a departmental Stakeholder Engagement Framework was circulated tokey stakeholders for comment. The final draft is expected to be released inSeptember 2012 in combination with a Stakeholder Engagement Toolkit and thecommencement of a series of information sessions for staff. Other objectives for theBranch for the next twelve months include:• establish engagement structures and processes for the Aboriginal Policy andStakeholder Engagement Division;• finalise recruitment for staffing of the branch;• partner with departmental divisions to provide support in the development ofplans and policies;• in conjunction with divisions, reach agreement on evaluation processes and keyperformance indicators; and• provide facilitation services to develop engagement processes as necessary.129

DEPARTMENT OF HEALTH – Annual Report 2011-12Risk ManagementRisk management pervades the health and community service industry. To ensurethat the Department’s workforce, clients and stakeholders are protected from therisks of events and hazards, a comprehensive risk management system ismaintained. The Department has clear obligations to manage risks effectively, asdefined in the Financial Management Act, Workplace Health and Safety Act andTreasurer’s Directions. The Department is committed to an integrated RiskManagement Framework that is applied to all key activities undertaken by theDepartment. This is achieved by ensuring the Enterprise Wide Risk Management(EWRM) system design supports an organisational culture aimed at effectively andsystematically managing and treating risk to maximise opportunities and minimisenegative outcomes.The adoption and implementation of an Australian Standard’s compliant EWRMsystem provides the Department with a platform for meeting its regulatory andcompliance obligations. There is not a one size fits all interpretation and applicationof EWRM, therefore the Department has interpreted EWRM within its context and isapplying it accordingly for sustainable outcomes.The underlying premise of the EWRM framework is that the Department exists toprovide value to its clients in line with its mission, vision and strategies and thatthese provide the focus for building the future of the Department.The objectives of the EWRM framework are:• to ensure that the Department has systematic and effective processes in place toidentify, prioritise and manage existing and emerging risks;• to ensure that risk management is directly linked to strategic corporate planningactivities and corporate documentation;• to ensure that the Department’s culture fosters employee participation in theidentification, assessment and treatment of risks that pose a threat to theDepartment achieving its desired outcomes;• to ensure that risk management reporting facilitates enhanced disclosure ofpotential risks to appropriate levels of management, and that a proper level ofdue diligence is demonstrated; and• to improve our risk management strategies and performance and assist inmaintaining the Department’s image, reputation and performance.The four major elements that encapsulate the core of the framework are:• clinical and corporate governance;• internal and external environment;• internal and external audit and review; and• continuous quality improvement.130

DEPARTMENT OF HEALTH – Annual Report 2011-12AuditAudit is a key element of the Department’s governance framework. TheDepartment’s annual internal audit plan has provided the Audit Committee withconcise direction in their effort to evaluate the effectiveness of the risk and auditactivities and coverage across the Department. The recent appointment of Ernst &Young as a single audit provider has delivered a strong professional understandingof the health care environment that will ultimately enhance the capacity andcapability to the internal audit function. A number of internal and external reviews,evaluations and audits were undertaken in 2011-12, that have provided theDepartment with a range of recommendations in mitigating risk and improvingperformance.Internal Audits/Reviews engaged by the DepartmentThe internal audit plan for 2011-12 was developed through a risk based approachthat has resulted in the delivery of approximately 220 days of audit effort across theDepartment. The identification, prioritisation and sourcing of key organisational risksis critical to ensuring that internal audit resources are allocated to the areas of highimportance. In improving this process, the Department has elected to undertakeaudit verification activities to ensure that the recommendations are not onlyactioned, but to ensure that the risk mitigating actions are sustainable.The audit recommendations identified during 2011-12 have added significant valueto the Department’s efforts in achieving its objectives and support a continualimprovement of the Department’s internal controls.A number of internal audits/reviews were conducted as listed below.Fire SafetyThe audit objective was to seek assurance that the operation and matrix of the firecontrol management practices employed at 24/7 health care facilities effectivelymitigate the risks associated with a facility fire. This included how the variouscomponents such as fire detection, fire suppression, smoke control, emergencywarning, intercommunication systems, evacuation, training and other buildingmaintenance services are managed in the protection of patients and staff along withmitigating the spread of fire.Personal Expenditure Reimbursement ControlsThe objective of this was to determine if the controls for personal reimbursementsare effectively and efficiently managing expenditure and reimbursement. The auditexamined the propriety and appropriateness of expenses incurred by employees andthe controls pertaining to approval for reimbursement.131

DEPARTMENT OF HEALTH – Annual Report 2011-12Cultural SecurityThe objective was to gather a range of evidence that included analytical,documentary, physical and testimonial evidence that will provide a benchmarkingmeasure of the effectiveness of current Cultural Security Policy adoption within theDepartment, including staff uptake and participation.Hospital Compliance AuditsThe audit objective was to determine the adequacy of the control activities andenvironment at Northern Territory hospitals. Hospital Compliance Audits werecarried out on Royal Darwin, Alice Springs, Katherine, Tennant Creek and GoveDistrict Hospitals.Probity AuditsThe Department requires probity audits to be undertaken based on specific riskparameters. During the year a number of probity audits were conducted and/or arein progress with no adverse findings to date being reported by the auditors.Audits conducted by the NT Auditor GeneralThe following external audits were conducted by the Northern Territory AuditorGeneral’s Office in 2011-12.End of Year Review 2010-11The audit objective was to review the adequacy of selected aspects of end offinancial year controls over reporting, accounting and material financial transactionsand balances within the Department, with the primary purpose of providing supportto the audit of the Treasurer’s Annual Financial Statements (TAFS).No material weaknesses in controls were identified during the audit and theaccounting and control procedures examined in relation to end of year financialprocessing were found to be generally satisfactory.Compliance AuditThe audit objective was to examine the controls, systems and certain featuresassociated with the management of financial resources allocated to the Departmentfrom the public account. The key findings from this audit identified that adherence todocumented procedures was not consistent when engaging in procurementactivities. The Department has strengthened procurement processes andcompliance through the introduction of a Procurement Committee, advancedplanning and a dedicated Procurement Advisor embedded within the Department bythe Department of Business and Employment.Grants to Non-Government OrganisationsThe audit objective was to determine whether the performance managementsystems of the Department enable management to assess whether its objectives in132

DEPARTMENT OF HEALTH – Annual Report 2011-12relation to the utilisation of non-government organisations (NGOs) are beingachieved effectively and with regard to efficiency and economy and whether NGOsare operating in a way that will assist the Department to achieve its statedoutcomes.Grants ManagementThe objective of this engagement was to consider key risks and controls of theGrants Management System (GMS) project (and forming part of the PerformanceManagement Systems Audit (PMS) of Grants by the Department to NGOs for thedelivery of health services), specifically:• the departmental systems that are in place to monitor and handle NGOscontracts, activities and performance measures and if the systems providedetective and/or preventative controls; and• the evidence that the systems are achieving what they are designed to do.Internal Audit Plan 2012-13Information Technology (IT) Health CheckThe overall objective of this audit is to perform a health check of the Department’s ITservices, leveraging standards and benchmarked leading practices, to provide acurrent state assessment of user acceptance, capacity to meet business needs,system governance, critical systems, processes and supporting infrastructure. Theaudit outcome will assist in the development of the Department’s strategic internalaudit plan. Internal Audit will undertake an evaluation of selected IT processes andfunctions.Hospital Health ChecksThe overall objective of these audits is to determine the adequacy of the controlactivities and environment within the Top End and Central Australian HospitalNetworks over a three year period.Hospital Regulatory Compliance and GovernanceThe objective of this engagement will be to facilitate with management thedevelopment of an improvement plan to enhance the governance of regulatorycompliance in the hospital environment.This will be undertaken in two phases:• conducting a gap analysis questionnaire with management and an examinationof the current governance arrangements, comparing to contemporary goodpractice; and• identifying key areas of risk exposure and facilitating the development of theimprovement plan to address these risks.133

DEPARTMENT OF HEALTH – Annual Report 2011-12Record Keeping – Patient Medical RecordsThere are two overall objectives of this audit. The first objective is to assess patientrecord keeping in Royal Darwin Hospital and Alice Springs Hospital and evaluate ifrecords are being appropriately maintained, updated and controlled in accordancewith hospital records management policies, procedures and relevant legislativerequirements. The second objective is to assess the effectiveness of current policiesand procedures developed to manage the creation, receipt, maintenance, use anddisposal of corporate and clinical records.This audit requirement was established through strategic audit planning discussionswith the Director Risk and Assurance Services, Chief Executive and Ernst & Young.Outstanding Recommendation Verification AuditThe overall objective of this verification audit is to gather objective evidence thatactions arising from audit recommendations have been undertaken and completed.The verification process will establish the effectiveness and the sustainability of theactions in mitigating risk prior to the committee accepting closure of outstandingaudit recommendations that are ranked very high or extreme.Insurance ArrangementsIn accordance with Treasurer’s Direction R2.1 Insurance Arrangements, thefollowing information provides an overview of the agency’s insurance arrangementsand details the key mitigation strategies and processes in each insurable riskcategory identified in the Treasurer’s Direction.As a general principle and in accordance with the Treasurer’s Directions, theDepartment self-insures its risks and manages potential exposures throughextensive mitigation practices. Where insurable risk events occur, the Departmentmeets these costs as they fall due.134

DEPARTMENT OF HEALTH – Annual Report 2011-12In relation to the insurance risk categories identified in R2.1, the Department has thefollowing mitigation strategies and processes in place:• workers compensation: workplace assessments; Occupational Health and Safety(OHS) committees; safe work polices, training, guidelines and processes;incident investigation and management processes; workers’ compensationmanagement policies and processes; and return to work programs;• property and assets: facility, plant and equipment management policies andprocesses; asset management regimes; plant and equipment training; and fireand material safety equipment and processes;• public liability: workplace assessments; OHS committees; work site managementpolicies and processes; incident investigation and management processes; and• indemnities: indemnity policies and processes; legal review; practice policies andprocesses.The costs of self-insurance claims are monitored by the Department with theexception of property and assets insurance category, which is not separatelyrecorded, but forms a component of the larger repairs and maintenance costs. Thecosts for self-insurance claims for the other insurance categories follow (Table 25).Table 25 : Self-insurance claims cost 2009-10 to 2011-12Claims for 2009-10$0002010-11$0002011-12$000Workers Compensation 3 413 3 737 3 753Public Liability 23 0 1Indemnities 425 1 178 2 502Coronial FindingsThe Coroner’s Act enables the Coroner to investigate unexpected deaths and tomake recommendations for systems improvements that ensure that the healthservices we provide are delivered in a quality and safe manner.The coronial process and the work of the Coroner’s Office is an important aspect ofthe Department’s safety and quality framework. The Department is committed toworking with the Coroner in making systems improvements that will assist inreducing preventable deaths in our services.During 2009-10, there were three recommendations by the Coroner’s Office forchanges to Acute Care. In 2010-11, there were two Hospitals’ recommendations andone Health Service recommendation. In 2011-12, Health Services received tworecommendations for changes and Health Protection received one.135

DEPARTMENT OF HEALTH – Annual Report 2011-12Actions in response to coronial recommendations in 2011-12All emergency medical equipment in Northern Territory correctional servicesfacilities has been reviewed and standardised equipment purchased. Ongoingtraining in correct use of the emergency equipment is provided for health andcorrectional services staff.Health assessment procedures for prisoners and juvenile detainees at risk of suicideand self-harm have been revised to incorporate evidence based questioning todetermine at risk classification. Competency of primary health service providers andcorrectional staff is enhanced by mental health training and yearly updates. Thisskills staff in identifying and managing prisoners who present as being at risk of selfharmor suicide.ComplaintsMembers of the community have the right to comment or complain about thestandard of service provided by the Department and complaint investigation isrecommended as an essential component of a quality client care system which aimsto ensure care and services are more safe and effective.The Department is committed to:• participation of consumers in decisions about their health and wellbeing;• prompt investigation, procedural fairness and natural justice;• privacy for complainants and staff involved in the complaint;• resolution at the point of service whenever possible; and• encouraging feedback from consumers on services.136

DEPARTMENT OF HEALTH – Annual Report 2011-12Table 26 :Complaints by TypesComplaint TypeHospitalCareHospitalCareHospitalCareHealthServicesHealthServicesHealthServices2009-10 2010-11 2011-12 2009-10 2010-11 2011-12Access 151 53 84 23 40 28Communication /InformationConsent /Decision MakingCorporateServices73 32 40 6 9 141 2 8 0 4 1232 14 14 0 4 3Costs 6 10 3 0 10 13Grievances 8 1 0 0 8 20Privacy /DiscriminationProfessionalConduct24 14 11 1 1 417 11 3 6 17 18Treatment 87 73 49 10 6 20TOTAL 399 210 212 46 99 132The Community Health Branch accounts for most of the increase in the number ofcomplaints received by the Health Services Division evident in Table 26. Thisincrease is most likely due to the complaints process being made more accessible toclients. Community Health has implemented the Australian Charter of HealthcareRights and developed a protocol for advising clients wishing to make a complaint. Allclients receive an information pamphlet on their rights to raise issues about theirhealthcare and which encourages them to give feedback for quality managementpurposes.137

DEPARTMENT OF HEALTH – Annual Report 2011-12Table 27 :Complaints by OutcomesComplaint TypeHospital Hospital Hospital Health Health HealthCare Care Care Services Services Services2009-10 2010-11 2011-12 2009-10 2010-11 2011-12Account Adjusted 2 1 4 0 0 0Apology40 33 37 6 13 21ProvidedChange In1 0 4 0 2 6Procedure EffectCompensation0 4 3 1 0 3PaidComplaint Letter0 4 0 0 0 0SentComplaint0 2 3 0 0 4WithdrawnConcern28 14 25 2 9 29RegisteredConciliation0 2 1 0 7 5ReachedCounselling 10 1 1 0 0 5Disciplinary0 0 1 0 0 9Action TakenExplanation225 87 62 30 50 65ProvidedPolicy Change1 0 3 3 2 3EffectedReferral21 0 3 0 5 9ElsewhereRefund Provided 0 2 0 0 1 0Service Obtained 150 42 33 11 17 16Undefined 1 19 29 0 9 5TOTAL 479 211 209 53 115 180The Department also receives complaint referrals from the Health and CommunityServices Complaints Commission.Complaint resolution is based on evidence, system, process or staff issues and isinformed by the principles of public interest and good governance. The complaintprocess is an integral component of quality improvement and can influence bestpractice in service delivery and inform ongoing improvement in the complainthandling process.Sentinel EventsThe Australian Commission on Safety and Quality in Health Care (ACSQHC) definesa sentinel event as: “An event in which death or serious harm to a client hasoccurred”.138

DEPARTMENT OF HEALTH – Annual Report 2011-12In 2004, Australian Health Ministers agreed to the national collection of sentinelevent data and the Department reports annually against eight national categoriesand its own data on unexplained or unexpected deaths, or serious illnesses ordisability, reasonably believed to be preventable.The majority of the sentinel event measurement is undertaken in the hospitalenvironment and is reported to assure:• accountability to provide system level information to funding bodies, managersand clinicians;• transparency to provide important information to patients and consumers; and• timely performance feedback to stakeholders.Sentinel event data is recorded and monitored centrally. All recommendations frominvestigations are monitored through to completion and evidence is collected todemonstrate implementation.Nineteen sentinel events were recorded in 2011-12 compared to 25 in 2010-11.Information and PrivacyFreedom of InformationIn total 12 486 pages of government and personal information were released toapplicants, in full or in part, under the provisions of the Act during the reportingperiod.Details of Freedom of Information (FOI) applications and their outcomes arepresented in Table 28 below.Table 28 :Application outcomes under the Information Act (NT)Application OutcomeNo.Access applications open at start of year 6Access applications lodged during the year 66Access granted in full 56Access granted in part 6Access refused in full 1Access applications not accepted 3Access applications transferred 0Access applications withdrawn 0Access applications outstanding at end of year 3Access applications pending acceptance at end of year 3A person aggrieved by a review decision about an FOI application can lodge acomplaint with the Office of the Information Commissioner under section 103 of the139

DEPARTMENT OF HEALTH – Annual Report 2011-12Act. On behalf of the Chief Executive, the unit participates in the resolution ofcomplaints by cooperating with the Commissioner and attending mediation whereappropriate. One FOI complaint was resolved between the parties during thereporting period.Unit staff members provide training about FOI, informal information access, dataprotection and records handling to new employees at regular orientation sessionsand provide advice and assistance throughout the year.140

DEPARTMENT OF HEALTH – Annual Report 2011-12Our MoneyOverviewThe Department of Health’s financial performance is reported in three financialstatements: the Operating Statement, the Balance Sheet, and the Cash FlowStatement. These statements and the accompanying notes have been prepared inaccordance with the Northern Territory Government’s financial managementframework and relevant Australian accounting standards. The financial statementsinclude financial data from the 2011-12 financial year and comparative data from2010-11.Operating StatementTable 29 :Operating Statement SummaryOperating Statement Summary 2011-12$0002010-11$000Variation$000 %Operating Revenue 1 186 042 1 049 653 136 389 13.0%Operating Expenses 1 246 237 1 112 584 133 653 12.0%Deficit/Surplus -60 195 -62 931 2 736 -4.3%In 2011-12 the Department’s operating statement showed a deficit result of $60.2M.Deficit results are expected in Northern Territory Government agencies as theTerritory Government accounting framework does not fund non-cash expenses suchas depreciation. In addition, externally funded programs from prior years are fundedthrough cash balances.Operating RevenueTable 30 : Operating RevenueOperating Revenue2011-12$0002010-11$000Variation$000 %Commonwealth NPP & SPP Revenue 239 856 200 378 39 478 19.7%Grants Revenue 70 732 64 170 6 562 10.2%Output Revenue 779 895 694 852 85 043 12.2%Sales of Goods and Services 58 405 60 816 -2 411 -4.0%Other Revenue 37 154 29 436 7 718 26.2%Total 1 186 042 1 049 653 136 390 13.0%141

DEPARTMENT OF HEALTH – Annual Report 2011-12The Department’s principal source of revenue (66% or $779.9M) is output revenueprovided by the Northern Territory Government to fund core services across theTerritory. Output revenue in 2011-12, as compared to the 2010-11 appropriation,had a net increase of $85M. The growth in output appropriation has enabled theDepartment to meet the higher cost of delivering services, and to expand andenhance priority services.The majority of the Department’s remaining revenue came from the AustralianGovernment sources at $310.6M an increase of $46M.Figure 18 : Sources of Revenue 2011-12Under the Specific Purpose Payments (SPP) and National Partnership Payment(NPP) framework the agency received $239.9M in 2011-12. Funding from SPPs andNPPs flows from the Australian Treasury to state and Territory Treasuries. Thestates and territories then appropriate the funding to the agency responsible for thedelivery of services.In addition the Department received $70.7M in direct funding from AustralianGovernment agencies.142

DEPARTMENT OF HEALTH – Annual Report 2011-12ExpensesTable 31 : ExpensesExpenses2011-12$0002010-11$000Personnel Expenses 624 175 570 856Operating Expenses 458 195 382 952Grants and Subsidies 163 867 158 777Total 1 246 237 1 112 584In 2011-12, the Department incurred expenses of $1.246 billion. The actual year onyear growth in expenditure is $133.7M, or an increase of 12% on the previousfinancial year.Figure 19 : Expenses compared - 2011-12 with 2010-11Whilst this represents a significant increase in expenses across the Department, itwas indicative of the increase in services being provided by the agency, as well asthe increased cost of service delivery in the health and welfare sectors.The pattern of expenditure across classifications did not deviate significantly fromprevious years, with personnel expenses category accounting for 50% of totalexpenses, operating expenses 37% and grants and subsidies 13%.143

DEPARTMENT OF HEALTH – Annual Report 2011-12Personnel ExpensesPersonnel expenses in 2011-12 were $624.2M as compared to $570.9M in 2010-11,an increase of $53.3M. Increases in personnel expenses during 2011-12 areprimarily attributable to increased salary payments based on awards including theNorthern Territory Public Sector Medical Officers’ and Nurses and Midwives’Enterprise Agreements, which provided a competitive remuneration package toassist in recruitment and retention of medical officers and consequently improveservice delivery in the Northern Territory. The increase is also attributed to increasesin staff numbers to meet hospital demand pressures. As at 30 June 2012 theDepartment employed 5625 full time equivalent staff. Total staff numbers increasedby 271 full time equivalent positions during the financial year.Operating ExpensesOperating expenses increased by 19.6% in 2011-12, these expenses include repairsand maintenance, depreciation of assets, and purchased goods and services. Themajor increases by category of expense were:• $29M increase to Patient Assistance Travel Scheme and to Top End AeroMedical Retrieval Services costs ($15.9M of this variance is due to a change inclassification from grants to administrative expenses between the two years);• $11.1M in information technology mainly due to the My eHealth Record project;• $8.8M for medical and dental supplies and services;• $8.3M for cross-border patient charges;• $3.9M for power, water and sewerage costs; and• $31M for depreciation.The increase in these expenses is due in part to the increased demand for servicesand the enhancement of some services funded by the government. The increase indepreciation is a result of the revaluation of all hospital and health clinics in the priorfinancial year.Grants and SubsidiesGrants and subsidies expenses grew by 3.2% in 2011-12 for the Department. TheNorthern Territory Pensioners and Carers Concession Scheme (NTPCCS) includesconcessions to all eligible Territory seniors, pensioners and carers for theirelectricity, water and sewerage costs. In 2011-12 the government increased thesubsidy to cover 100% of all tariff increases while the number of eligible clientscontinued to grow, contributing to a $1.7M increase. Further increases in grantswere attributed to increased costs and number of clients for Individual SupportPackages which increased by $6M and other increases across a number of Territoryand Australian Government funded initiatives, which are mostly offset by the change144

DEPARTMENT OF HEALTH – Annual Report 2011-12in classification as mentioned above of $15.9M for Top End Aeromedical RetrievalServices, recorded in grants in 2010-11.Balance SheetTable 32 :Balance Sheet SummaryBalance Sheet Summary2011-12($000)2010-11($000)Variation($000)Assets 827 647 764 800 62 847Liabilities 172 787 140 736 32 051Equity 654 860 624 064 30 796The Department’s equity position has increased by $30.8M. Contributing to theincrease was $75.1M of completed projects being transferred in from theDepartment of Construction and Infrastructure, including the Palmerston SuperClinic, the new Wadeye Health Clinic and the Royal Darwin Hospital Radiation andOncology Unit. The increase in asset value from the completed projects was offsetby an increase in liabilities of $32M which included increased grant and recreationleave provision accruals.Statement of Cash FlowsTable 33 :Cash Flow Statement SummaryCash Flow Statement Summary2011-12($000)2010-11($000)Variation($000)Cash at beginning of reporting period 22 336 68 419 -46 083Receipts 1 193 853 1 064 133 129 720Payments -1 202 981 -1 103 113 -99 868Equity injections 25 435 8 129 17 306Equity withdrawals -8 704 -15 233 6 529Cash at end of reporting period 29 938 22 336 7 604The Cash Flow Statement shows the Department’s cash receipts and payments forthe financial year. The statement incorporates expenses and revenues from theOperating Statement, after the elimination of all non-cash transactions, with cashmovements from the Balance Sheet. End of year cash balances increased by $7.6M145

DEPARTMENT OF HEALTH – Annual Report 2011-12as a net result of all receipts and payments. The final result was mainly due toincreased revenue from 2010-11 National Partnership Payments received in thecurrent financial year as well as some received in advance relating to 2012-13 and aTreasurer’s Advance of $20M at year end to meet demand pressures. Cash wasfurther impacted by equity movements consisting primarily of capital appropriation of$4.8M, a cash injection approved by the Treasurer of $20M to adjust cash balancesheld within the Department and $8.7M of cash withdrawals transferred to theDepartment of Construction and Infrastructure, related to Australian Governmentcapital projects for which the cash was collected in prior financial years.SummaryTable 34 :Budget Target SummaryBudget Target Summary2011-12FinalBudgetSummary2011-12Actual$000Variation$000%Revenue 1 181 078 1 186 042 -4 964 -0.40%Expenses 1 215 602 1 246 237 -30 635 -2.50%Deficit/Surplus -34 524 -60 195 25 671The Department provided considerable input to ensure that actual expenditure wascontained within 2.5% of the budget allocated.146

DEPARTMENT OF HEALTH – Annual Report 2011-12Financial ReportCertification of the Financial StatementsWe certify that the attached financial statements for the Department of Health havebeen prepared from proper accounts and records in accordance with the prescribedformat, the Financial Management Act and Treasurer’s Directions.We further state that the information set out in the Comprehensive OperatingStatement, Balance Sheet, Statement of Changes in Equity, Cash Flow Statement,and notes to and forming part of the financial statements, presents fairly the financialperformance and cash flows for the year ended 30 June 2012 and the financialposition on that date.At the time of signing, we are not aware of any circumstances that would render theparticulars included in the financial statements misleading or inaccurate.Jeffrey MoffetFotis PapadakisChief Executive Officeron behalf of A/Chief Finance Officer28 September 2012 28 September 2012147

DEPARTMENT OF HEALTH – Annual Report 2011-12Comprehensive Operating StatementFor the year ended 30 June 2012Note 2012 2011$000 $000INCOMEGrants and subsidies revenueCurrent 70 732 64 170AppropriationOutput 779 895 694 852Australian Government 239,856 200,378Sales of goods and services 58,405 60,816Goods and services received free of charge 4 30,974 27,181Gain/(Loss) on disposal of assets 5 18 (4)Other income 6,162 2,259TOTAL INCOME 3 1,186,042 1,049,653EXPENSESEmployee expenses 624,175 570,856Administrative expensesPurchases of goods and services 6 373,437 305,473Repairs and maintenance 20,827 21,124Depreciation and amortisation 10, 11 30,967 27,917Other administrative expenses 1 32,964 28,438Grants and subsidies expensesCurrent 150,850 147,337Capital 0 122Community service obligations 13,017 11,318TOTAL EXPENSES 3 1,246,237 1,112,584NET SURPLUS/(DEFICIT) (60,195) (62,931)OTHER COMPREHENSIVE INCOMEAsset revaluation surplus 0 4,533TOTAL OTHER COMPREHENSIVE INCOME 0 4,533COMPREHENSIVE RESULT (60,195) (58,398)1 Includes DBE service charges.The Comprehensive Operating Statement is to be read in conjunction with the notesto the financial statements148

DEPARTMENT OF HEALTH – Annual Report 2011-12Balance SheetAs at 30 June 2012Note 2012 2011$000 $000ASSETSCurrent AssetsCash and deposits 7 29,938 22,336Receivables 8 35,178 28,614Inventories 9 6,338 7,528Prepayments 1,475 1,852Total Current Assets 72,930 60,329Non-Current AssetsProperty, plant and equipment 10 754,718 704,430Intangibles 11a 0 41Heritage and cultural assets 11b 0 0Total Non-Current Assets 754,718 704,471TOTAL ASSETS 827,648 764,800LIABILITIESCurrent LiabilitiesDeposits held (1,132) (1,023)Payables 12 (94,555) (68,969)Provisions 14 (54,315) (50,265)Other liabilities 15 (306) (134)Total Current Liabilities (150,307) (120,390)Non-Current LiabilitiesProvisions 14 (22,480) (20,346)Total Non-Current Liabilities (22,480) (20,346)TOTAL LIABILITIES (172,787) (140,736)NET ASSETS 654,860 624,064EQUITYCapital (650,167) (559,176)Asset revaluation surplus 16 (247,139) (247,139)Accumulated funds 242,446 182,251TOTAL EQUITY (654,860) (624,064)The Balance Sheet is to be read in conjunction with the notes to the financialstatements.149

DEPARTMENT OF HEALTH – Annual Report 2011-12Statement of Changes in EquityFor the year ended 30 June 2012NoteEquity at1 JulyComprehensiveresultTransactionswith owners intheir capacityas ownersEquity at30 June$000 $000 $000 $0002011-12Accumulated Funds (182,251) (60,195) (242,446)(182,251) (60,195) (242,446)Asset Revaluation Surplus 16 247,139 247,139Capital – Transactions with Owners 559,176 559,176Equity injectionsCapital appropriation 4,825 4,825Equity transfers in 75,328 75,328Other equity injections 20,610 20,610Specific purpose paymentsNational partnership paymentsCommonwealth – capitalEquity withdrawalsCapital withdrawal (8,704) (8,704)Equity transfers out (1,068) (1,068)559,176 90,991 650,167Total Equity at End of Financial Year 624,064 (60,195) 90,991 654,8602010-11Accumulated Funds (119,320) (62,931) (182,251)(119,320) (62,931) (182,251)Asset Revaluation Surplus 16 242,607 4,533 247,139Capital – Transactions with Owners 557,092 557,092Equity injectionsCapital appropriation 3,357 3,357Equity transfers in 13,133 13,133Other equity injections 4,772 4,772Specific purpose payments 0 0National partnership payments 0 0Commonwealth – capital 0 0Equity withdrawalsCapital withdrawal (15,233) (15,233)Equity transfers out (3,945) (3,945)557,092 (2,085) 559,176Total Equity at End of Financial Year 680,379 (58,398) (2,085) 624,064The Statement of Changes in Equity is to be read in conjunction with the notes tothe financial statements.150

DEPARTMENT OF HEALTH – Annual Report 2011-12Cash Flow StatementFor the year ended 30 June 2012CASH FLOWS FROM OPERATING ACTIVITIES Note 2012 2011$000 $000Operating ReceiptsGrants and subsidies receivedCurrent 74,082 59,814Capital 0 1,205AppropriationOutput 779,895 694,852Commonwealth 239,856 200,378Receipts from sales of goods and services 99,889 108,095Total Operating Receipts 1,193,722 1,064,345Operating PaymentsPayments to employees (614,710) (565,610)Payments for goods and services (423,155) (371,276)Grants and subsidies paidCurrent (143,903) (151,624)Capital 0 (122)Community service obligations (14,326) (10,248)Total Operating Payments (1,196,094) (1,098,880)Net Cash From/(Used in) Operating Activities 17 (2,373) (34,535)CASH FLOWS FROM INVESTING ACTIVITIESInvesting ReceiptsProceeds from asset sales 5 22 15Total Investing Receipts 22 15Investing PaymentsPurchases of assets (6,886) (4,233)Total Investing Payments (6,886) (4,233)Net Cash From/(Used in) Investing Activities (6,864) (4,218)CASH FLOWS FROM FINANCING ACTIVITIESFinancing ReceiptsDeposits received 109 (227)Equity injectionsCapital appropriation 4,825 3,357Commonwealth appropriation 0Other equity injections 20,610 4,772Total Financing Receipts 25,544 7,902Financing PaymentsFinance lease payments 19 0 0Equity withdrawals (8,704) (15,233)Total Financing Payments (8,704) (15,233)Net Cash From/(Used in) Financing Activities 16,840 (7,331)Net increase/(decrease) in cash held 7,603 (46,083)Cash at beginning of financial year 22,336 68,419CASH AT END OF FINANCIAL YEAR 7 29,938 22,336The Cash Flow Statement is to be read in conjunction with the notes to the financialstatements.151

DEPARTMENT OF HEALTH – Annual Report 2011-12Notes to the Financial StatementsFor the year ended 30 June 2012INDEX OF NOTES TO THE FINANCIAL STATEMENTSNote1. Objectives and Funding2. Statement of Significant Accounting Policies3. Comprehensive Operating Statement by Output GroupINCOME4. Goods and Services Received Free of Charge5. Gain / (Loss) on Disposal of AssetsEXPENSES6. Purchases of Goods and ServicesASSETS7. Cash and Deposits8. Receivables9. Inventories10. Property, Plant and Equipment11a. Intangibles11b. Heritage and Cultural AssetsLIABILITIES12. Payables13. Borrowings and Advances14. Provisions15. Other LiabilitiesEQUITY16. ReservesOTHER DISCLOSURES17. Notes to the Cash Flow Statement18. Financial Instruments19. Commitments20. Contingent Liabilities and Contingent Assets21. Events Subsequent to Balance Date22. Accountable Officer’s Trust Account23. Write-offs Postponements Waivers Gifts and Ex Gratia Payments24. Schedule of Territory Items152

DEPARTMENT OF HEALTH – Annual Report 2011-12Notes to the Financial StatementsFor the year ended 30 June 20121. OBJECTIVES AND FUNDINGThe Department of Health’s mission is to improve the health status and wellbeingof all people in the Northern Territory.The Department is predominantly funded by and is dependent on the receipt ofParliamentary appropriations. The financial statements encompass all fundsthrough which the agency controls resources to carry on its functions and deliveroutputs. For reporting purposes outputs delivered by the agency are summarisedinto several output groups. Note 3 provides summary financial information in theform of a Comprehensive Operating Statement by output group.2. STATEMENT OF SIGNIFICANT ACCOUNTING POLICIESa) Basis of AccountingThe financial statements have been prepared in accordance with therequirements of the Financial Management Act and related Treasurer’sDirections. The Financial Management Act requires the Department of Health toprepare financial statements for the year ended 30 June based on the formdetermined by the Treasurer. The form of agency financial statements is toinclude:(i) a Certification of the Financial Statements;(ii) a Comprehensive Operating Statement;(iii) a Balance Sheet;(iv) a Statement of Changes in Equity;(v) a Cash Flow Statement; and(vi) applicable explanatory notes to the financial statements.The financial statements have been prepared using the accrual basis ofaccounting which recognises the effect of financial transactions and events whenthey occur rather than when cash is paid out or received. As part of thepreparation of the financial statements all intra agency transactions and balanceshave been eliminated.Except where stated the financial statements have also been prepared inaccordance with the historical cost convention.The form of the agency financial statements is also consistent with therequirements of Australian Accounting Standards. The effects of all relevant newand revised Standards and Interpretations issued by the Australian Accounting153

DEPARTMENT OF HEALTH – Annual Report 2011-12Standards Board (AASB) that are effective for the current annual reporting periodhave been evaluated. The Standards and Interpretations and their impacts are:AASB 124 Related Party Disclosures (December 2009) AASB 2009-12Amendments to Australian Accounting Standards [AASB 5 8 108 110 112119 133 137 139 1023 & 1031 and Interpretations 2 4 16 1039 & 1052]The Standards amend the requirements of the previous version of AASB 124 toclarify the definition of a related party provide a partial exemption from relatedparty disclosure requirements for government-related entities and include anexplicit requirement to disclose commitments involving related parties. TheStandards do not impact the financial statements.AASB 2010-4 Further Amendments to Australian Accounting Standardsarising from the Annual Improvements Project [AASB 1 7 101 & 134 andInterpretation 13]The Standard amends a number of pronouncements as a result of theInternational Accounting Standards Board (IASB) 2008-2010 cycle of annualimprovements. Key amendments include clarification of content of statement ofchanges in equity (AASB 101) and financial instrument disclosures (AASB 7).The Standard does not impact the financial statements.AASB 2010-5 Amendments to Australian Accounting Standards [AASB 1 34 5 101 107 112 118 119 121 132 133 134 137 139 140 1023 & 1038and Interpretations 112 115 127 132 & 1042]The Standard makes numerous editorial amendments to a range of AustralianAccounting Standards and Interpretations including amendments to reflectchanges made to the text of International Financial Reporting Standards (IFRSs)by the IASB. The Standard does not impact the financial statements.AASB 2010-6 Amendments to Australian Accounting Standards –Disclosures on Transfers of Financial Assets [AASB 1 & 7]The Standard makes amendments to AASB 7 Financial Instruments: Disclosuresresulting from the IASB’s comprehensive review of off balance sheet activities.The amendments introduce additional disclosures designed to allow users offinancial statements to improve their understanding of transfer transactions offinancial assets including understanding the possible effects of any risks thatmay remain with the entity that transferred the assets. The Standard does notimpact the financial statements.b) Australian Accounting Standards and Interpretations Issued but not yetEffectiveAt the date of authorisation of the financial statements the Standards andInterpretations listed below were in issue but not yet effective.154

DEPARTMENT OF HEALTH – Annual Report 2011-12Standard/InterpretationSummaryEffective for annualreporting periodsbeginning on or afterAASB 9 FinancialInstruments (Dec 2010)AASB 2010-7Amendments to AustralianAccounting Standardsarising from AASB 9 (Dec2010) [AASB 1 3 4 5 7101 102 108 112 118120 121 127 128 131132 136 137 139 1023& 1038 and Interpretations2 5 10 12 19 & 127]AASB 13 Fair ValueMeasurement AASB2011-8 Amendments toAustralian AccountingStandards arising fromAASB 13 [AASB 1 2 3 45 7 9 2009-11 2010-7101 102 108 110 116117 118 119 120 121128 131 132 133 134136 138 139 140 1411004 1023 & 1038 andInterpretations 2 4 12 1314 17 19 131 & 132]AASB 2011-9Amendments to AustralianAccounting Standards –Presentation of Items ofOther ComprehensiveIncome [AASB 1 5 7 101112 120 121 132 133134 1039 & 1049]AASB 9 incorporatesrevised requirements forthe classification andmeasurement of financialinstruments resulting fromthe IASB’s project toreplace IAS 39 FinancialInstruments: Recognitionand Measurement(AASB 139 FinancialInstruments: Recognitionand Measurement).Replaces the guidance onfair value measurement inexisting AASB accountingliterature with a singlestandard. The Standarddefines fair value providesguidance on how todetermine fair value andrequires disclosures aboutfair value measurements.Requires entities to groupitems presented in othercomprehensive income onthe basis of whether theyare potentiallyreclassifiable to profit orloss subsequently.1 Jan 20131 Jan 20131 July 2012155

DEPARTMENT OF HEALTH – Annual Report 2011-12c) Agency and Territory ItemsThe financial statements of the Department include income, expenses,assets, liabilities and equity over which the Department has control (Agencyitems). Certain items while managed by the agency are controlled andrecorded by the Territory rather than the agency (Territory items). Territoryitems are recognised and recorded in the Central Holding Authority asdiscussed below.Central Holding AuthorityThe Central Holding Authority is the ‘parent body’ that represents theGovernment’s ownership interest in Government-controlled entities.The Central Holding Authority also records all Territory items such as income,expenses, assets and liabilities controlled by the Government and managedby agencies on behalf of the Government. The main Territory item is Territoryincome which includes taxation and royalty revenue Australian Governmentgeneral purpose funding (such as GST revenue) fines and statutory fees andcharges.The Central Holding Authority also holds certain Territory assets not assignedto agencies as well as certain Territory liabilities that are not practical oreffective to assign to individual agencies such as unfunded superannuationand long service leave.The Central Holding Authority recognises and records all Territory items andas such these items are not included in the agency’s financial statements.However as the agency is accountable for certain Territory items managed onbehalf of government these items have been separately disclosed in Note 24– Schedule of Territory Items.d) ComparativesWhere necessary comparative information for the 2010-11 financial year hasbeen reclassified to provide consistency with current year disclosures.e) Presentation and Rounding of AmountsAmounts in the financial statements and notes to the financial statements arepresented in Australian dollars and have been rounded to the nearestthousand dollars with amounts of $500 or less being rounded down to zero.f) Changes in Accounting PoliciesThere have been no changes to accounting policies adopted in 2011-12 as aresult of management decisions.156

DEPARTMENT OF HEALTH – Annual Report 2011-12g) Accounting Judgments and EstimatesThe preparation of the financial report requires the making of judgments andestimates that affect the recognised amounts of assets, liabilities, revenuesand expenses and the disclosure of contingent liabilities. The estimates andassociated assumptions are based on historical experience and various otherfactors that are believed to be reasonable under the circumstances theresults of which form the basis for making judgments about the carryingvalues of assets and liabilities that are not readily apparent from othersources. Actual results may differ from these estimates.The estimates and underlying assumptions are reviewed on an ongoingbasis. Revisions to accounting estimates are recognised in the period inwhich the estimate is revised if the revision affects only that period or in theperiod of the revision and future periods if the revision affects both currentand future periods.Judgments and estimates that have significant effects on the financialstatements are disclosed in the relevant notes to the financial statements.Notes that include significant judgments and estimates are:• Employee Benefits – Note 2(s) and Note 14: Non-current liabilities inrespect of employee benefits are measured as the present value ofestimated future cash outflows based on the appropriate government bondrate estimates of future salary and wage levels and employee periods ofservice.• Depreciation and Amortisation – Note 2(k) Note 10: Property Plant andEquipment and Note 11.h) Goods and Services TaxIncome, expenses and assets are recognised net of the amount of Goodsand Services Tax (GST) except where the amount of GST incurred on apurchase of goods and services is not recoverable from the Australian TaxOffice (ATO). In these circumstances the GST is recognised as part of thecost of acquisition of the asset or as part of the expense.Receivables and payables are stated with the amount of GST included. Thenet amount of GST recoverable from or payable to the ATO is included aspart of receivables or payables in the Balance Sheet.Cash flows are included in the Cash Flow Statement on a gross basis. TheGST components of cash flows arising from investing and financing activitieswhich are recoverable from, or payable to the ATO are classified as operatingcash flows. Commitments and contingencies are disclosed net of the amountof GST recoverable or payable unless otherwise specified.157

DEPARTMENT OF HEALTH – Annual Report 2011-12i) Income RecognitionIncome encompasses both revenue and gains.Income is recognised at the fair value of the consideration received exclusiveof the amount of GST. Exchanges of goods or services of the same natureand value without any cash consideration being exchanged are notrecognised as income.Grants and Other ContributionsGrants donations gifts and other non-reciprocal contributions are recognisedas revenue when the agency obtains control over the assets comprising thecontributions. Control is normally obtained upon receipt.Contributions are recognised at their fair value. Contributions of services areonly recognised when a fair value can be reliably determined and theservices would be purchased if not donated.AppropriationOutput appropriation is the operating payment to each agency for the outputsthey provide and is calculated as the net cost of agency outputs after takinginto account funding from agency income. It does not include any allowancefor major non-cash costs such as depreciation.Australian Government appropriation follows from the IntergovernmentalAgreement on Federal Financial Relations resulting in Special PurposePayments (SPPs) and National Partnership (NP) payments being made bythe Australian Government Treasury to state treasuries in a manner similar toarrangements for GST payments. These payments are received by Treasuryon behalf of the Central Holding Authority and then on passed to the relevantagencies as Australian Government appropriation.Revenue in respect of appropriations is recognised in the period in which theagency gains control of the funds.Sale of GoodsRevenue from the sale of goods is recognised (net of returns, discounts andallowances) when:• the significant risks and rewards of ownership of the goods havetransferred to the buyer;• the agency retains neither continuing managerial involvement to thedegree usually associated with ownership nor effective control over thegoods sold;• the amount of revenue can be reliably measured;158

DEPARTMENT OF HEALTH – Annual Report 2011-12• it is probable that the economic benefits associated with the transactionwill flow to the agency; and• the costs incurred or to be incurred in respect of the transaction can bemeasured reliably.Rendering of ServicesRevenue from rendering services is recognised by reference to the stage ofcompletion of the contract. The revenue is recognised when:• the amount of revenue stage of completion and transaction costsincurred can be reliably measured; and• it is probable that the economic benefits associated with the transactionwill flow to the entity.Goods and Services Received Free of ChargeGoods and services received free of charge are recognised as revenue whena fair value can be reliably determined and the resource would have beenpurchased if it had not been donated. Use of the resource is recognised asan expense.Disposal of AssetsA gain or loss on disposal of assets is included as a gain or loss on the datecontrol of the asset passes to the buyer usually when an unconditionalcontract of sale is signed. The gain or loss on disposal is calculated as thedifference between the carrying amount of the asset at the time of disposaland the net proceeds on disposal. Refer also to Note 5.Contributions of AssetsContributions of assets and contributions to assist in the acquisition of assetsbeing non-reciprocal transfers are recognised unless otherwise determinedby government as gains when the agency obtains control of the asset orcontribution. Contributions are recognised at the fair value received orreceivable.j) Repairs and Maintenance ExpenseFunding is received for repairs and maintenance works associated withagency assets as part of output revenue. Costs associated with repairs andmaintenance works on agency assets are expensed as incurred.k) Depreciation and Amortisation ExpenseItems of property, plant and equipment including buildings but excluding landhave limited useful lives and are depreciated or amortised using the straightlinemethod over their estimated useful lives.159

DEPARTMENT OF HEALTH – Annual Report 2011-12Amortisation applies in relation to intangible non-current assets with limiteduseful lives and is calculated and accounted for in a similar manner todepreciation.The estimated useful lives for each class of asset are in accordance with theTreasurer’s Directions and are determined as follows:BuildingsRemote HousingPlant and Equipment (refer below)Computer HardwareOffice EquipmentMedical/Dental, Scientific EquipmentFurniture & Fittings, Security SystemsCatering Equipment, Temperature Control SystemsLeased Plant and EquipmentIntangibles50 Years25 Years4 to 15 Years4 Years5 Years9 Years10 Years15 Years3 Years3 to 6 YearsAssets are depreciated or amortised from the date of acquisition or from thetime an asset is completed and held ready for use.a) Cash and DepositsFor the purposes of the Balance Sheet and the Cash Flow Statement, cashincludes cash on hand, cash at bank and cash equivalents. Cash equivalentsare highly liquid short-term investments that are readily convertible to cash.Cash at bank includes monies held in the Accountable Officer’s TrustAccount (AOTA) that are ultimately payable to the beneficial owner – referalso to Note 22.m) InventoriesInventories include assets held either for sale (general inventories) or fordistribution at no or nominal consideration in the ordinary course of businessoperations.General inventories are valued at the lower of cost and net realisable valuewhile those held for distribution are carried at the lower of cost and currentreplacement cost. Cost of inventories includes all costs associated withbringing the inventories to their present location and condition. Wheninventories are acquired at no or nominal consideration the cost will be thecurrent replacement cost at date of acquisition.The cost of inventories are assigned using a mixture of first-in first out orweighted average cost formula or using specific identification of theirindividual costs. Inventory held for distribution is regularly assessed forobsolescence and loss.160

DEPARTMENT OF HEALTH – Annual Report 2011-12n) ReceivablesReceivables include accounts receivable and other receivables and arerecognised at fair value less any allowance for impairment losses.The allowance for impairment losses represents the amount of receivablesthe agency estimates are likely to be uncollectible and are considereddoubtful. Analyses of the age of the receivables that are past due as at thereporting date are disclosed in an aging schedule under credit risk in Note 18Financial Instruments. Reconciliation of changes in the allowance accounts isalso presented.Accounts receivable are generally settled within 30 days and otherreceivables within 30 days.o) Property, Plant and EquipmentAcquisitionsAll items of property, plant and equipment with a cost or other value equal toor greater than $10 000 are recognised in the year of acquisition anddepreciated as outlined below. Items of property, plant and equipment belowthe $10 000 threshold are expensed in the year of acquisition.The construction cost of property, plant and equipment includes the cost ofmaterials and direct labour and an appropriate proportion of fixed andvariable overheads.Complex AssetsMajor items of plant and equipment comprising a number of components thathave different useful lives are accounted for as separate assets. Thecomponents may be replaced during the useful life of the complex asset.Subsequent Additional CostsCosts incurred on property plant and equipment subsequent to initialacquisition are capitalised when it is probable that future economic benefits inexcess of the originally assessed performance of the asset will flow to theagency in future years. Where these costs represent separate components ofa complex asset they are accounted for as separate assets and areseparately depreciated over their expected useful lives.161

DEPARTMENT OF HEALTH – Annual Report 2011-12Construction (Work in Progress)As part of the financial management framework the Department ofConstruction and Infrastructure is responsible for managing generalgovernment capital works projects on a whole of government basis.Therefore appropriation for capital works is provided directly to theDepartment of Construction and Infrastructure and the cost of constructionwork in progress is recognised as an asset of that Department. Oncecompleted capital works assets are transferred to the agency.p) Revaluations and ImpairmentRevaluation of AssetsSubsequent to initial recognition, assets belonging to the following classes ofnon-current assets are revalued with sufficient regularity to ensure that thecarrying amount of these assets does not differ materially from their fair valueat reporting date:• land; and• buildings.Fair value is the amount for which an asset could be exchanged, or liabilitysettled, between knowledgeable willing parties in an arm’s length transaction.Plant and equipment are stated at historical cost less depreciation which isdeemed to equate to fair value.Impairment of AssetsAn asset is said to be impaired when the asset’s carrying amount exceeds itsrecoverable amount.Non-current physical and intangible agency assets are assessed forindicators of impairment on an annual basis. If an indicator of impairmentexists, the agency determines the asset’s recoverable amount. The asset’srecoverable amount is determined as the higher of the asset’s depreciatedreplacement cost and fair value less costs to sell. Any amount by which theasset’s carrying amount exceeds the recoverable amount is recorded as animpairment loss.Impairment losses are recognised in the Comprehensive OperatingStatement. They are disclosed as an expense unless the asset is carried at arevalued amount. Where the asset is measured at a revalued amount theimpairment loss is offset against the asset revaluation surplus for that classof asset to the extent that an available balance exists in the asset revaluationsurplus.162

DEPARTMENT OF HEALTH – Annual Report 2011-12In certain situations an impairment loss may subsequently be reversed.Where an impairment loss is subsequently reversed the carrying amount ofthe asset is increased to the revised estimate of its recoverable amount. Areversal of an impairment loss is recognised in the Comprehensive OperatingStatement as income unless the asset is carried at a revalued amount inwhich case the impairment reversal results in an increase in the assetrevaluation surplus. Note 16 provides additional information in relation to theasset revaluation surplus.q) Leased AssetsLeases under which the agency assumes substantially all the risks andrewards of ownership of an asset are classified as finance leases. Otherleases are classified as operating leases.Finance LeasesFinance leases are capitalised. A leased asset and a lease liability equal tothe present value of the minimum lease payments are recognised at theinception of the lease.Lease payments are allocated between the principal component of the leaseliability and the interest expense. The Department of Health currently has nofinance leases.Operating LeasesOperating lease payments made at regular intervals throughout the term areexpensed when the payments are due except where an alternative basis ismore representative of the pattern of benefits to be derived from the leasedproperty. Lease incentives under an operating lease of a building or officespace is recognised as an integral part of the consideration for the use of theleased asset. Lease incentives are to be recognised as a deduction of thelease expenses over the term of the lease.r) PayablesLiabilities for accounts payable and other amounts payable are carried at costwhich is the fair value of the consideration to be paid in the future for goodsand services received whether or not billed to the agency. Accounts payableare normally settled within 30 days.s) Employee BenefitsProvision is made for employee benefits accumulated as a result ofemployees rendering services up to the reporting date. These benefitsinclude wages and salaries and recreation leave. Liabilities arising in respectof wages and salaries, recreation leave and other employee benefit liabilitiesthat fall due within twelve months of reporting date are classified as current163

DEPARTMENT OF HEALTH – Annual Report 2011-12liabilities and are measured at amounts expected to be paid. Non-currentemployee benefit liabilities that fall due after twelve months of the reportingdate are measured at present value calculated using the government longtermbond rate.No provision is made for sick leave which is non-vesting as the anticipatedpattern of future sick leave to be taken is less than the entitlement accruing ineach reporting period.Employee benefit expenses are recognised on a net basis in respect of thefollowing categories:• wages and salaries, non-monetary benefits, recreation leave, sick leaveand other leave entitlements; and• other types of employee benefits.As part of the financial management framework, the Central Holding Authorityassumes the long service leave liabilities of government agencies, includingDepartment of Health and as such no long service leave liability is recognisedin agency financial statements.t) SuperannuationEmployees' superannuation entitlements are provided through the:• Northern Territory Government and Public Authorities SuperannuationScheme (NTGPASS);• Commonwealth Superannuation Scheme (CSS); or• non-government employee-nominated schemes for those employeescommencing on or after 10 August 1999.The agency makes superannuation contributions on behalf of its employeesto the Central Holding Authority or non-government employee-nominatedschemes. Superannuation liabilities related to government superannuationschemes are held by the Central Holding Authority and as such are notrecognised in agency financial statements.u) Contributions by and Distributions to GovernmentThe agency may receive contributions from government where thegovernment is acting as owner of the agency. Conversely, the agency maymake distributions to government. In accordance with the FinancialManagement Act and Treasurer’s Directions, certain types of contributionsand distributions including those relating to administrative restructures havebeen designated as contributions by and distributions to government. Thesedesignated contributions and distributions are treated by the agency asadjustments to equity. The Statement of Changes in Equity providesadditional information in relation to contributions by and distributions togovernment.164

DEPARTMENT OF HEALTH – Annual Report 2011-12v) CommitmentsDisclosures in relation to capital and other commitments, including leasecommitments are shown at Note 19. Commitments are those contracted as at30 June where the amount of the future commitment can be reliablymeasured.(Continued)165

DEPARTMENT OF HEALTH – Annual Report 2011-123.COMPREHENSIVE OPERATING STATEMENT BY OUTPUT GROUPAcute Services Health & Wellbeing Public HealthTotalNote 2012 2011 2012 2011 2012 2011 2012 2011$000 $000 $000 $000 $000 $000 $000 $000INCOMEGrants and subsidies revenueCurrent 22,685 18,852 41,582 40,702 6,465 4,615 70,732 64,170AppropriationOutput 487,434 434,283 241,378 215,057 51,083 45,513 779,895 694,852Commonwealth 177,425 157,454 45,750 30,011 16,680 12,914 239,856 200,378Sales of goods and services 48,745 48,905 9,152 9,136 508 2,775 58,405 60,816Goods and services received free of charge 4 19,359 16,988 9,587 8,413 2,029 1,780 30,974 27,181Gain on disposal of assets 5 6 (4) 12 - - - 18 (4)Other income 3,927 898 1,901 885 333 477 6,162 2,260TOTAL INCOME 759,582 677,376 349,363 304,204 77,097 68,074 1,186,042 1,049,653EXPENSESEmployee expenses 430,469 388,903 164,230 154,776 29,475 27,178 624,175 570,856Administrative expensesPurchases of goods and services 6 279,316 222,013 77,916 69,429 16,205 14,029 373,437 305,472Repairs and maintenance 16,300 16,053 3,737 4,185 791 886 20,827 21,124Depreciation and amortisation 10, 11 20,312 18,500 8,975 7,934 1,679 1,483 30,967 27,917Other administrative expenses 1 21,106 18,135 9,794 8,496 2,065 1,807 32,964 28,438Grants and subsidies expensesCurrent 31,420 44,868 93,769 82,202 25,660 20,267 150,850 147,337Capital - 122 - 122Community service obligations - 4 13,017 11,313 - - 13,017 11,318TOTAL EXPENSES 798,923 708,476 371,438 338,458 75,875 65,650 1,246,237 1,112,584NET SURPLUS/(DEFICIT) (39,341) (31,100) (22,075) (34,254) 1,222 2,424 (60,195) (62,931)OTHER COMPREHENSIVE INCOMEAsset revaluation surplus - - - 4,533 - - - 4,533TOTAL OTHER COMPREHENSIVE INCOME - - - 4,533 - - - 4,533COMREHENSIVE RESULT (39,341) (31,100) (22,075) 29,721 1,222 2,424 (60,195) (58,398)1 Includes DBE service charges.166

DEPARTMENT OF HEALTH – Annual Report 2011-124. GOODS AND SERVICES RECEIVED FREE OF CHARGEGOODS AND SERVICES RECEIVED FREE OF CHARGE 2012 2011$000 $000Department of Business and Employment 30,974 27,18130,974 27,1815. GAIN/(LOSS) ON DISPOSAL OF ASSETSGAIN/(LOSS) ON DISPOSAL OF ASSETS 2012 2011$000 $000Net proceeds from the disposal of non-current assets 22 15Less: Carrying value of non-current assets disposed (4) (19)Gain/(Loss) on the disposal of non-current assets 18 (4)6. PURCHASES OF GOODS AND SERVICES(Continued)167

DEPARTMENT OF HEALTH – Annual Report 2011-12The net surplus/(deficit) has been arrived at after charging the 2012 2011following expenses: $000 $000Goods and services expenses:Property Maintenance 9,281 8,268General Property Management 2,960 5,254Power 15,623 11,992Water and Sewerage 1,340 1,100Accommodation 2,847 2,407Advertising (2) 68 43Agent Service Agreements 400 109Audit Fees 308 307Bank Charges 82 72Client Travel 56,948 27,927Clothing 370 285Communications 5,291 5,438Consultant Fees (1) 2,718 1,750Consumables/General Expenses 6,984 7,593Cross Border Patient Charges 39,486 31,225Document Production 897 1,021Entertainment/Hospitality 287 288Food 4,867 4,657Freight 1,807 1,779Information Technology Charges 22,979 20,755IT Consultants 15,172 3,342IT Hardware and Software Expenses 5,024 8,007Insurance Premiums 10 14Laboratory Expense 7,403 6,481Legal expenses (4) 4,675 4,139Library Services 1,171 1,039Marketing and promotion (3) 1,554 1,430Medical/Dental Supply and Services 113,158 104,326Membership and Subscriptions 471 446Motor Vehicle Expenses 11,796 10,861Office Requisites and Stationery 2,927 2,946Official duty fares 9,684 7,864Other Equipment Expenses 7,872 7,513Recruitment Expenses (5) 7,632 6,087Reg/Advisory Boards/Committees 706 729Relocation Expenses 509 548Training and Study Expenses 5,278 4,826Transport Equipment Expenses 250 202Travelling allowance 2,558 2,250Unallocated Corporate Credit Card Expenses 38 129Penalty Interest - Late Payments 1 13Goods and Services Cost Allocation 6 10373,437 305,473(1) Includes marketing, promotion and IT consultants.(2) Does not include recruitment, advertising or marketing and promotion advertising.(3) Includes advertising for marketing and promotion but excludes marketing and promotionconsultants’ expenses, which are incorporated in the consultants’ category.(4)Includes legal fees, claim and settlement costs.(5) Includes recruitment-related advertising costs.168

DEPARTMENT OF HEALTH – Annual Report 2011-127. CASH AND DEPOSITS2012 2011$000 $000Cash on hand 19 19Cash at bank 29,920 22,31629,938 22,3368. RECEIVABLESRECEIVABLES 2012 2011$000 $000CurrentAccounts receivable 9,058 4,902Less: Allowance for impairment losses (1,495) (1,575)7,563 3,327GST receivables 1,583 3,209Other receivables (1) 26,032 22,07827,615 25,287Total Receivables 35,178 28,614(1) Other receivables includes accrued revenue for cross border patient charges and grantsand subsidies.9. INVENTORIESInventories Held for Distribution 2012 2011$000 $000At current replacement cost 6,338 7,528Total Inventories 6,338 7,528169

DEPARTMENT OF HEALTH – Annual Report 2011-1210. PROPERTY, PLANT AND EQUIPMENTDuring the year the Department of Health was required to write-off $0.14m ($0.08m in 2010-11) of inventories, the majority being pharmaceuticals due to their short shelf life and thenecessity to keep certain life saving items on hand.2012 2011PROPERTY, PLANT AND EQUIPMENT $000 $000LandAt fair value 28,526 28,326BuildingsAt fair value 1,156,970 1,062,174Less: Accumulated depreciation (379,734) (356,966)Less: Accumulated Impairment Losses (85,214) (85,214)692,022 619,994Construction (Work in Progress)At capitalised cost - 23,384- 23,384Plant and EquipmentAt fair value 94,074 86,859Less: Accumulated depreciation (59,904) (54,133)34,170 32,726Leased Plant and EquipmentAt capitalised cost 151 151Less: Accumulated depreciation (151) (151)- -Total Property, Plant and Equipment 754,718 704,430Property, Plant and Equipment ValuationsThe latest independent revaluations was undertaken by the Australian Valuation Office(AVO) as at 30 June 2011 for the Batchelor Central Australian Campus and Hong StreetFlats. Revaluations for the five hospitals and the remote health clinics were undertakenas at 30 June 2010.The fair value of these assets was determined based on any existing restrictions onasset use. Where reliable market values were not available, the fair value of these assetswas based on their depreciated replacement cost.Impairment of Property, Plant and EquipmentAgency property assets were assessed for impairment as at 30 June 2011. Impairmentchanges for Buildings were recognised in the Asset Revaluation Surplus.170

DEPARTMENT OF HEALTH – Annual Report 2011-1210. PROPERTY, PLANT AND EQUIPMENT (continued)2012 Property, Plant and EquipmentA reconciliation of the carrying amount of property, plant and equipment at the beginning and end of 2011-12 is set out below:Land BuildingsConstruction(Work inProgress)Plant andEquipment Total$000 $000 $000 $000 $000Carrying Amount as at 1 July 2011 28,326 619,995 23,384 32,726 704,430Additions 250 6,636 6,886Disposals (4) (4)Depreciation (23,013) (7,912) (30,925)Additions/(Disposals) from asset transfers 200 94,791 (23,384) 2,724 74,331Revaluation increments/(decrements)Carrying Amount as at 30 June 2012 28,526 692,023 - 34,170 754,718Land BuildingsConstruction(Work inProgress)Plant andEquipment Total$000 $000 $000 $000 $000Carrying Amount as at 1 July 2010 27,744 610,906 39,257 36,670 714,577Additions 71 (71) 4,233 4,233Disposals (19) (19)Depreciation (19,899) (7,972) (27,871)Additions/(Disposals) from asset transfers 58 24,908 (15,802) (186) 8,979Revaluation increments/(decrements) 524 4,009 4,533Carrying Amount as at 30 June 2011 28,326 619,994 23,384 32,726 704,430171

DEPARTMENT OF HEALTH – Annual Report 2011-1211a. INTANGIBLESINTANGIBLES 2012 2011$000 $000Carrying amountsIntangibles with a finite useful life(a) Internally generated intangiblesAt valuation - -Less: Accumulated amortisation - -Written down value – 30 June - -(b) Other intangiblesAt valuation 4,161 4,161Less: Accumulated amortisation (4,161) (4,119)Written down value – 30 June 0 41Total Intangibles 0 41Reconciliation of movementsIntangibles with a finite useful life(a) Internally generated intangiblesCarrying amount at 1 July - -Additions - -Disposals - -Depreciation and amortisation - -Additions/(Disposals) from asset transfers - -Revaluation increments/(decrements) - -Carrying amount as at 30 June - -(b) Other intangiblesCarrying amount at 1 July 41 87Additions 0 0Disposals 0 0Amortisation (41) (45)Additions/(Disposals) from asset transfers - -Revaluation increments/(decrements) - -Carrying amount as at 30 June - 41172

DEPARTMENT OF HEALTH – Annual Report 2011-1211b. HERITAGE AND CULTURAL ASSETSHERITAGE AND CULTURAL ASSETS 2012 2011$000 $000Carrying amountAt valuation - -Less: Accumulated depreciation - -Written down value – 30 June - -Reconciliation of movementsCarrying amount at 1 July - 5Additions - -Disposals - -Depreciation - -Additions/(Disposals) from administrative restructuring - (5)Additions/(Disposals) from asset transfers - -Revaluation increments/(decrements) - -Carrying amount as at 30 June - -Heritage and Cultural Assets ValuationThe Department of Health had one Cultural Asset, which was capitalised at cost uponpurchase in December 2006. The asset was transferred to the Department of Children andFamilies during the restructure last financial year.12. PAYABLESPAYABLES 2012 2011$000 $000Accounts payable 27,927 15,922Accrued expenses (1) 57,904 49,960Other payables (2) 8,724 3,087Total Payables 94,555 68,969(1) Includes liability for cross border patient expenses and other accrued operational expenses(2)Includes Grants and Subsidies and Community Service Obligations payable173

DEPARTMENT OF HEALTH – Annual Report 2011-1213. BORROWINGS AND ADVANCESBORROWINGS AND ADVANCES 2012 2011$000 $000CurrentLoans and advances - -Finance lease liabilities (refer Note 19) - -- -Non-CurrentLoans and advances - -Finance lease liabilities (refer Note 19) - -- -Total Borrowings and Advances - -14. PROVISIONSPROVISIONS 2012 2011CurrentEmployee benefits$000 $000Recreation leave 39,934 37,388Leave loading 7,769 6,929Recreation leave fares and other benefits 776 557Other current provisionsOther provisions - includes provisions for Superannuation,Payroll Tax and Fringe Benefits Tax payableNon-CurrentEmployee benefits5,836 5,39154,315 50,265Recreation leave 22,480 20,34622,480 20,346Total Provisions 76,795 70,611* The Agency employed 5,625 employees as at 30 June 2012.(5,361 employees as at 30 June 2011).174

DEPARTMENT OF HEALTH – Annual Report 2011-1215. OTHER LIABILITIESOTHER LIABILITIES 2012 2011$000 $000CurrentDeposits held (1) 1,132 1,023Unearned revenue (2) 306 134Total Other Liabilities 1,438 1,157(1) Accountable Officers Trust Account (see note 22) and Hospital(2) Revenue received prior to services provided.16. RESERVESRESERVES 2012 2011$000 $000Asset Revaluation Surplus(i) Nature and purpose of the asset revaluation surplusThe asset revaluation surplus includes the net revaluationincrements and decrements arising from the revaluation of noncurrentassets. Impairment adjustments may also berecognised in the asset revaluation surplus.(ii) Movements in the asset revaluation surplusBalance as at 1 July 247,139 242,607Increment/(Decrement) – land - 524Impairment (losses)/reversals – land - -Increment/(Decrement) – buildings - 4,009Impairment (losses)/reversals – buildings - -Balance as at 30 June 247,139 247,139175

DEPARTMENT OF HEALTH – Annual Report 2011-1217. NOTES TO THE CASH FLOW STATEMENTReconciliation of Cash 2012 2011The total of agency 'Cash and deposits' of $29,938 recorded inthe Balance Sheet is consistent with that recorded as ‘Cash’in the Cash Flow Statement.Reconciliation of Net Surplus/(Deficit) to Net Cash fromOperating Activities$000 $000Net Surplus/(Deficit) (60,195) (62,931)Non-cash items:Depreciation and amortisation 30,967 27,917Asset write-offs/write-downs 46 219(Gain)/Loss on disposal of assets (148) (70)Repairs and Maintenance - minor new works - non cash 13 69Changes in assets and liabilities:Decrease/(Increase) in receivables (6,564) 1,467Decrease/(Increase) in inventories 1,189 (652)Decrease/(Increase) in prepayments 377 (426)(Decrease)/Increase in payables 25,586 (641)(Decrease)/Increase in provision for employee benefits 5,739 2,970(Decrease)/Increase in other provisions 445 223(Decrease)/Increase in other liabilities 172 (2,680)Net Cash from Operating Activities (2,373) (34,535)Non-Cash Financing and Investing ActivitiesFinance Lease TransactionsDuring the financial year the Agency acquired land and buildings with an aggregate fair valueof $75.328 million (2011: $13.133) by non cash asset transfers from the Department ofConstruction and Infrastructure and the Department of Lands and Planning.18. FINANCIAL INSTRUMENTSA financial instrument is a contract that gives rise to a financial asset of oneentity and a financial liability or equity instrument of another entity. Financialinstruments held by the Department of Health include cash and depositsreceivables and payables. The Department of Health has limited exposure tofinancial risks as discussed below.a) Categorisation of Financial InstrumentsThe carrying amounts of the Department of Health’s financial assets andliabilities by category are disclosed in the table below.176

DEPARTMENT OF HEALTH – Annual Report 2011-12FINANCIAL INSTRUMENTS 2012 2011$000 $000Financial AssetsCash and deposits 29,938 22,336Loans and receivables 35,178 28,614Financial LiabilitiesFair value through profit or loss (FVTPL):Designated as at FVTPL 95,687 69,992b) Credit RiskThe agency has limited credit risk exposure (risk of default). In respect of anydealings with organisations external to government the agency has adopted apolicy of only dealing with credit worthy organisations and obtaining sufficientcollateral or other security where appropriate as a means of mitigating therisk of financial loss from defaults.The carrying amount of financial assets recorded in the financial statementsnet of any allowances for losses represents the agency’s maximum exposureto credit risk without taking account of the value of any collateral or othersecurity obtained.ReceivablesReceivable balances are monitored on an ongoing basis to ensure thatexposure to bad debts is not significant. A reconciliation and aging analysis ofreceivables is presented below.177

DEPARTMENT OF HEALTH – Annual Report 2011-12CREDIT RISK2011-12Aging ofReceivablesAging ofImpairedReceivablesNetReceivables$000 $000 $000Not overdue 32,295 32,295Overdue for less than 30 days 1,658 1,658Overdue for 30 to 60 days 538 538Overdue for more than 60 days 2,182 1,495 687Total 36,673 1,495 35,178Reconciliation of the Allowance forImpairment LossesOpening 1,575Written off during the year (280)Recovered during the year 13Increase/(Decrease) in allowance recognised in187profit or lossTotal 1,4952010-11Not overdue 26,483 26,483Overdue for less than 30 days 640 640Overdue for 30 to 60 days (5,007) (5,007)Overdue for more than 60 days 8,073 1,575 6,498Total 30,189 1,575 28,614Reconciliation of the Allowance forImpairment LossesOpening 873Written off during the year (203)Recovered during the yearIncrease/(Decrease) in allowance recognised in905profit or lossTotal 1575c) Liquidity RiskLiquidity risk is the risk that the agency will not be able to meet its financialobligations as they fall due. The agency’s approach to managing liquidity is toensure that it will always have sufficient liquidity to meet its liabilities whenthey fall due.The following tables detail the agency’s remaining contractual maturity for itsfinancial assets and liabilities. It should be noted that these values are178

DEPARTMENT OF HEALTH – Annual Report 2011-12undiscounted and consequently totals may not reconcile to the carryingamounts presented in the Balance Sheet.2012 Maturity analysis for financial assets and liabilitiesFixed orVariableInterest BearingLessthan a 1 to 5Year YearsMorethan 5YearsNonInterestBearingWeightedTotal Average$000 $000 $000 $000 $000 %AssetsCash and deposits 29,938 29,938Receivables 35,178 35,178Total Financial Assets 65,116 65,116LiabilitiesDeposits held 1,132 1,132Payables 94,555 94,555Total Financial Liabilities 95,687 95,6872011 Maturity analysis for financial assets and liabilitiesFixed orVariableInterest BearingLessthan a 1 to 5Year YearsMorethan 5YearsNonInterestBearingWeightedTotal Average$000 $000 $000 $000 $000 %AssetsCash and deposits 22,336 22,336Receivables 28,614 28,614Total Financial Assets 50,950 50,950LiabilitiesDeposits held 1,023 1,023Payables 68,969 68,969Total Financial Liabilities 69,992 69,992179

DEPARTMENT OF HEALTH – Annual Report 2011-12d. Market RiskMarket risk is the risk that the fair value of future cash flows of a financialinstrument will fluctuate because of changes in market prices. It comprisesinterest rate, risk price risk and currency risk.(i) Interest Rate RiskThe Department of Health is not exposed to interest rate risk asagency financial assets and financial liabilities are non-interestbearing.(ii) Price RiskThe Department of Health is not exposed to price risk as the agencydoes not hold units in unit trusts.(iii) Currency RiskThe Department of Health is not exposed to currency risk as theagency does not hold borrowings denominated in foreign currencies ortransactional currency exposures arising from purchases in a foreigncurrency.e. Net Fair ValueThe fair value of financial instruments is estimated using various methods.These methods are classified into the following levels:Level 1 – derived from quoted prices in active markets for identical assetsor liabilities.Level 2 – derived from inputs other than quoted prices that are observabledirectly or indirectly.Level 3 – derived from inputs not based on observable market data.(Continued)180

DEPARTMENT OF HEALTH – Annual Report 2011-12NET FAIR VALUETotalCarryingAmountNet FairValueLevel 1Net FairValueLevel 2Net FairValueLevel 3Net FairValueTotal$000 $000 $000 $000 $0002012Financial AssetsCash and deposits 29,938 29,938 29,938Receivables 35,178 35,178 35,178Total Financial Assets 65,116 65,116 65,116Financial LiabilitiesDeposits held 1,132 1,132 1,132Payables 94,555 94,555 94,555Total Financial Liabilities 95,687 95,687 95,687TotalCarryingAmountNet FairValueLevel 1Net FairValueLevel 2Net FairValueLevel 3Net FairValueTotal$000 $000 $000 $000 $0002011Financial AssetsCash and deposits 22,336 22,336 22,336Receivables 28,614 28,614 28,614Total Financial Assets 50,950 50,950 50,950Financial LiabilitiesDeposits held 1,023 1,023 1,023Payables 68,969 68,969 68,969Total Financial Liabilities 69,992 69,992 69,992181

DEPARTMENT OF HEALTH – Annual Report 2011-1219. COMMITMENTSCOMMITMENTS 2012 2011$000 $000(i) Capital Expenditure CommitmentsCapital expenditure commitments primarily relate to thepurchase of Plant and Equipment. Capital expenditurecommitments contracted for at balance date but notrecognised as liabilities are payable as follows:Within one year 710 966Later than one year and not later than five years - -Later than five years - -710 966(ii) Other Expenditure CommitmentsOther non-cancellable expenditure commitments notrecognised as liabilities are payable as follows:Within one year 93,208 107,106Later than one year and not later than five years 66,623 84,932Later than five years - -159,831 192,037(iii) Operating Lease CommitmentsThe agency leases equipment, predominantly photocopiersunder non-cancellable operating leases expiring from 3 to 5years. Leases generally provide the agency with a right ofrenewal at which time all lease terms are renegotiated.Future operating lease commitments not recognised asliabilities are payable as follows:Within one year 495 550Later than one year and not later than five years 437 406Later than five years - -932 956(iv) Finance Lease CommitmentsThe agency currently has no finance lease commitments.Within one year - -Later than one year and not later than five years - -Later than five years - -Total Minimum Finance Lease Payments: - -Less: Future lease finance charges - -Total Finance Lease Liabilities - -Current (Note 13)Non-Current (Note 13)Total Finance Lease Liabilities - -182

DEPARTMENT OF HEALTH – Annual Report 2011-1220. CONTINGENT LIABILITIES AND CONTINGENT ASSETSa) Contingent LiabilitiesThe Department of Health had no contingent liabilities as at 30 June 2012 or30 June 2011.b) Contingent AssetsThe Department of Health had no contingent assets as at 30 June 2012 or 30June 2011.21. EVENTS SUBSEQUENT TO BALANCE DATENo events have arisen between the end of the financial year and the date of thisreport that require adjustment to or disclosure in these financial statements.22. ACCOUNTABLE OFFICER’S TRUST ACCOUNTIn accordance with section 7 of the Financial Management Act an AccountableOfficer’s Trust Account has been established for the receipt of money to be heldin trust. A summary of activity is shown below:Nature of Trust MoneyOpeningBalance Receipts PaymentsClosingBalance1/07/2011 30/06/2012Retention money -Bond money 302,597 181,247 136,720 347,124Security deposits 4,487 4,487 -Unclaimed money 144,123 18,675 40 162,758451,208 199,922 141,247 509,882183

DEPARTMENT OF HEALTH – Annual Report 2011-1223. WRITE-OFFS, POSTPONEMENTS, WAIVERS, GIFTS AND EX GRATIA PAYMENTSAgency Agency Territory Items Territory ItemsNo. ofTrans. 2011No. ofTrans. 2012No. ofTrans. 20112012$000 $000 $000 $000No. ofTrans.Write-offs, Postponements and Waivers Under the FinancialManagement ActRepresented by:Amounts written off, postponed and waived by DelegatesIrrecoverable amounts payable to the Territory or an agencywritten off206 533 72 275Losses or deficiencies of money written off 0 1 0 2Public property written off 46 105 219 88Waiver or postponement of right to receive or recover money orpropertyTotal Written Off, Postponed and Waived by Delegates 252 639 291 365Amounts written off, postponed and waived by the TreasurerIrrecoverable amounts payable to the Territory or an agencywritten offLosses or deficiencies of money written offPublic property written off15 2 25 2Waiver or postponement of right to receive or recover money orpropertyTotal Written Off, Postponed and Waived by the Treasurer 15 2 25 2Write-offs, Postponements and Waivers Authorised UnderOther LegislationUnder the Medical Services Act 59 7 106 18Gifts Under the Financial Management Act 0 1 0 0Ex Gratia Payments Under the Financial Management Act 0 0 0 0184

DEPARTMENT OF HEALTH – Annual Report 2011-1224. SCHEDULE OF TERRITORY ITEMSThe following Territory items are managed by the Department of Health on behalfof the government and are recorded in the Central Holding Authority (refer Note2(c)).TERRITORY INCOME AND EXPENSES 2012 2011$000 $000IncomeGrants and subsidies revenueCurrent - -Capital - 2,873Fees from regulatory services 127 277Other income - 1Total Income 127 3,151ExpensesCentral Holding Authority income transferred 127 3,151Total Expenses 127 3,151Territory Income less Expenses - -TERRITORY ASSETS AND LIABILITIES 2012 2011$000 $000AssetsGrants and subsidies receivable - -Other receivables - -Total Assets - -LiabilitiesCentral Holding Authority income payable - -Total Liabilities - -Net Assets - -185

DEPARTMENT OF HEALTH – Annual Report 2011-12Appendix 1: EmploymentInstructionsThe Public Sector Employment and Management Act (PSEMA) s18 requiresagencies to report on how they have upheld public sector principles. The prescribedhuman resource management and performance and conduct principles (PSEMA s5)are observed within the agency through the establishment and application ofprocesses. This is done in part through initiatives such as the whole of agencyOrientation Program to ensure employees are informed of and are aware of theirresponsibility to observe the principles, and through the provision of advice andsupport from Workforce Division staff. This Appendix summarises the informationrequired for the purposes of reporting against relevant Employment Instructions andidentified indicators in Parts 2, 3 and 4 of the Annual Agency Reporting Survey.Further relevant information is available in the Our People section in this Report.186

DEPARTMENT OF HEALTH – Annual Report 2011-12Part 2 - Employment Instructions and Other Key Indicators:A. Ensuring thatEmployeesUnderstand thePrinciples and Codeof ConductThe Department provides an Orientation Program that newemployees attend. This program was updated in April 2012and now incorporates advice about the importance of, andexpectation relating to, the prescribed principles in thePublic Sector Employment and Management Act.New employees are also directed to access the Agencyintranet to ensure they are aware of the Code of Conduct.Employees may also access the Code of Conduct on theOffice of the Commissioner for Public Employment (OCPE)websiteThe Human Resource presentation included in alldepartmental orientations delivered across the NorthernTerritory, specifically addresses the Code of Conduct andparticipants are provided with a task/questionnaire toconsolidate their understanding.The Essentials of Leading People Part 1 Training Programintroduces first time managers to their responsibilities underthe legislative framework. The Code of Conduct informsthis training.The Department’s accredited First Line and Middle ManagerLeadership Programs incorporate the Code of Conductspecifically and within every applicable competency.B. PromotingImpartial, Ethical andProfessionalBehaviourPromoting impartial, ethical and professional behaviourunderpins both of the Department-tailored accreditedleadership programs.During 2011-12, a one hour tailored Recruitment andSelection Workshop, emphasising the importance of fairand transparent merit selection was developed and rolledout across the agency and, as noted under EmploymentInstruction 2(A) above, the Orientation Program has beenreviewed and revamped to incorporate the prescribedprinciples.Conflict of Interest is covered in some detail through theHuman Resource presentation at every departmentalorientation and is reinforced through other relevantprograms such as the Department’s recruitment andselection training.C. EnsuringCommunication ofGovernment PrioritiesStaff are informed about government priorities relevant tothe workplace through: the corporate/business/budgetplanning and Work Partnership Plan (WPP) andperformance management processes; promotions on theagency intranet; whole of agency email broadcasts andnewsletters; and in divisional/branch meetings.187

DEPARTMENT OF HEALTH – Annual Report 2011-12D. Providing GoodClient ServiceE. ManagingPerformanceClinical service delivery in health facilities is assessed inaccordance with Australian Standards, AustralianAccreditation Standards, Health Registration and legislationto ensure consistency in client services across theDepartment.Information on managing performance is available on theagency’s intranet site in the HR Service Centre.The Department’s WPP program was audited in April 2011,consequent recommendations were addressed in a review,leading to updates and expansion of the program and arevised WPP and supporting documentation released in2011-12. The agency developed and implemented a SeniorOfficers’ Performance Based Pay Progression Scheme(PBPPS). The WPP and PBPPS are supported bycomprehensive How to Guides and A Guide to Giving andReceiving Feedback available through the Department’sintranet sites. The WPP is introduced to all new startersthrough orientation.One hour WPP information sessions, tailored to meet theneeds of the individual work place, are offered to workunits. The Essentials of Leading People Part 1 providestraining to managers in the use of the WPP form and theprocess. Performance Management is a competencycovered in both the Middle Manager and First Line Manageraccredited Leadership and Management DevelopmentPrograms.F. Employment Basedon MeritG. RemunerationCommensurate withResponsibilitiesRecruitment information is available on the agency’sintranet or the Northern Territory Government internetemployment siteThe agency prefers but does not require Selection PanelChairs to undertake training in merit based selection. Atleast one member of each panel must have the appropriateprofessional background for the position being recruited to.Internal training on selection and recruitment tailored to theDepartment’s policies and guidelines is run regularly. Theagency contributed to review and redevelopment of thewhole of government merit based selection program andwill adopt this program during 2012-13. A Merit SelectionAwareness Session is also offered to employees.The Professional stream restructuring provided anopportunity to provide training for staff with job design andestablishment decision-making responsibilities and toreview Job Evaluation System (JES) processes inconjunction with the JES Unit. Internal guidancedocumentation will be developed and implemented during2012-13. All 630 professional positions have beenevaluated.188

DEPARTMENT OF HEALTH – Annual Report 2011-12H. Managing forDiversity, PromotingEquity in Employmentand EliminatingUnlawfulDiscrimination and/orBullying orHarassmentEqual Employment policies and guidelines are available onthe agency’s intranet.32% of agency staff who participated in the 2011 NorthernTerritory Public Sector (NTPS) Staff Survey reported thatthey had been subjected to bullying or harassment in theprevious 12 months, compared to 26% of the NTPS as awhole. Ten focus groups were held in November 2011,resulting in a research paper on Workplace Bullying andreview of the agency’s policy and guidelines. An internallydeveloped on line Appropriate Workplace Behaviour modulewill be released in late 2012.The Department continues to provide tailored trainingprograms aimed at reducing the incidence of bullying andharassment, eliminating discrimination and managing withina diverse workforce. Mediation Skills for Managers providesmanagers with practical conflict resolution skills. This oneday program is an introduction to mediation and is designedto develop managers’ skills and confidence in responding todisputes in the workplace. The Essentials of LeadingPeople Part 2 program focuses on increasing participants’skills, knowledge and confidence in change management,workplace conflict, grievance management and managingpoor performance.Data is unreliable with regard to numbers of employees whohave completed cultural awareness training because the2011 NTPS Survey indicated that 54% of participants hadattended compared to 21% recorded in course data.MyLearning (the agency’s new on line learningmanagement system launched in June 2012) will ensurebetter recording of participating employee numbers in allfuture training activities. A review of Aboriginal CulturalAwareness Program (ACAP) delivery will be undertaken toensure continuing relevance of content and to takeadvantage of MyLearning. It is anticipated that thesechanges will achieve a significant increase in the numbersof staff accessing ACAP. A two hour ACAP briefing sessionhas been developed for Royal Darwin Hospital which is alsoused in their Graduate Nurse Program sessions.I. EmployeeConsultation andInput EncouragedIt is Department policy to consult staff on development andreview of policies. Given short time frames, it is not alwayspossible to achieve this. As a minimum, employeerepresentation is included within working groups.The Department hosts a number of forums involvingemployee representative groups and senior departmentalstaff, including the Department and Unions ConsultativeCouncil and site-specific Joint Consultative Committees.189

DEPARTMENT OF HEALTH – Annual Report 2011-12J. Promoting a SafeWorkplaceA new Workplace Health and Safety (WHS) ManagementStrategic Plan has been developed to reflect therequirements outlined in the new Work Health and Safetylegislation and implement initiatives for continuousimprovement of employee safety and wellbeing.WHS training is an integral part of the Department’sOrientation Program.The agency currently has 25 active Work Health SafetyCommittees and 61 Health and Safety Representatives(HSRs). Workplace Health and Safety (WHS) information,policies, guidelines and reporting proforma are available onthe agency’s intranet WHS homepageK. Promoting aFlexible WorkplaceThe agency supports flexible work practices.It is common practice to support a range of flexible workpractices and guidelines are in place to support theequitable and consistent application of flexible workpractices.Information on flexible work arrangements can be found onthe agency’s intranet in the HR Service CentreL. Workforce Planningand CapabilityRefer to Our People section of the Annual Report for detailson workforce initiatives, learning and development trainingactivities; and studies assistance support.The agency’s Strategic Workforce Plan and Aboriginal andTorres Strait Islander Strategic Workforce Plan areavailable on the intranet.M. Providing a FairSystem of ReviewGrievance policy information is available on the agency’sintranet in the HR Service CentreRefer Our People section of the Annual Report for detailson HR case management.N. Natural Justice The principles and application of natural justice are featuredin recruitment and selection and The Essentials of LeadingPeople training. The agency’s accredited First Line andMiddle Manager Leadership Program’s incorporate naturaljustice throughout every applicable competency.Agency policies and procedures for matters such asdiscipline, managing unsatisfactory performance andcriminal history checks emphasise the need for applicationof the principles of natural justice.Staff confidence in the observance of natural justiceprinciples is monitored through both the NTPS wide and theDepartment of Health Staff Surveys.190

DEPARTMENT OF HEALTH – Annual Report 2011-12Part 3 –Redeployment,Discipline and InabilityRefer Our People section of the Annual Report for detailson case management.Redeployment,Discipline and Inabilityor UnsatisfactoryPerformance CasesPart 4 – Examples ofBest/InnovativePracticeWork Partnership Plan (WPP) FrameworkThe Department reviewed its individual performancemanagement planning and review process, and released anenhanced WPP Framework. This is more accessible forusers, and encourages uptake of the NTPS Capability andLeadership Framework to guide goal setting andperformance development.eLearningThe Department officially launched the MyLearning learningmanagement system. MyLearning provides a platform forthe Department to develop and deliver training anddevelopment opportunities online 24/7 to staff across theTerritory. An eLearning Centre has been established toimplement and support eLearning across the Department.191

DEPARTMENT OF HEALTH – Annual Report 2011-12Appendix 2: Councils, Committees,GroupsMinisterial GroupsHealth Advisory CouncilIn the second year of the three yearterm, the Council has again been ableto draw on the best possible advice.This was achieved through itsbalanced representation of the healthprofessions from across the NorthernTerritory and the expertise ofmembers, as well as visiting experts,clinicians, academics, advocacygroups and departmental seniorofficials. Meetings were used toassess the evidence on the healthmatters under deliberation to enableconsidered and evidence basedrecommendations to the Minister.Professor Jonathon Carapetis, theMenzies School of Health Researchnominee resigned during the year andwas replaced by Dr Louise Maple-Brown, also of Menzies.MembershipAs at 30 June 2012ChairpersonDr Sarah GilesMembersJonathan CarapetisSandra DunnAnne KempLiz MooreEddie MulhollandSanjit PaulDidier PalmerJill PettigrewTrevor SandersBruce SimmonsMichael WilsonEx OfficioDr Barbara PatersonVictoria WalkerSecretariatNancy KingMeetingsMeetings of the Council were held 25August 2011, 1 December 2011, 9February 2012, and in Alice Springson 24 May 2012.The functions of the Council are to:• provide informed and impartialadvice and perspectives to theMinister for Health on:a) strategic issues that affect thehealth of Territorians;b) effectiveness andappropriateness of policy,strategies and planningpriorities; andc) specific matters requested bythe Minister for Health.• consider health issues across arange of community, regional andsectoral interests, as requested bythe Minister for Health.192

DEPARTMENT OF HEALTH – Annual Report 2011-12Northern TerritoryCommunity Advisory Groupon Mental HealthMembershipAs at 30 June 2012ChairpersonDavid MunroMembersChristine KuhlChristine SuttonDoreen DyerGreg Johnson (1st Deputy Chair)Michelle WilliamsMonte Karena (2nd Deputy Chair)Tess NarkleEx Officio MemberBronwyn HendrySecretariatMeg BeaumontMeetingsThe Advisory Group met on:20 August 2011, 14 December 2011and Friday 24 March 2012.Key Areas in Terms of ReferenceUnder its Terms of Reference, theNTCAG will:1. provide an ongoing mechanism forconsumer and carer input intomental health policy decisionmaking processes in the NorthernTerritory, particularly in relation tothe National Mental Health Planand the Mental Health Statementof Rights and Responsibilities;2. assist the Minister in theformulation of mental healthpolicies, plans, associatedlegislation, monitor theimplementation and ensure MentalHealth services meet the needs ofconsumers and their carers;3. provide advice and reports to theMinister on matters relating toother departments, which affect therights and welfare of consumersand their carers;4. provide consumer and carerrepresentation on the NationalMental Health Consumer andCarer Forum (NMHCCF);5. promote the involvement ofconsumers and carers in theformulation and implementation ofnational mental health policies; and6. provide advice to the Minister onother matters relating to the needsof consumers and their carers inthe Northern Territory.Key Achievements• The NTCAG supported MentalHealth Week activities andprovided advice on new NorthernTerritory initiatives includingProtocol for CooperativeArrangements in Mental HealthMatters between the NorthernTerritory Police Force and theDepartment of Health in line withthe secure care amendments tothe Mental Health and RelatedServices Act.• The NTCAG has also provided aNorthern Territory consumer andcurer perspective in thedevelopment of National initiativesand policies including; Roadmapfor National Mental Health Reform– 2012-2022, National MentalHealth Service PlanningFramework, National Mental HealthRecovery Framework and theNational Consumer Experiences ofCare Project.193

DEPARTMENT OF HEALTH – Annual Report 2011-12Senior Territorians AdvisoryCouncilThe STAC is an independent groupformed as an advisory body for theMinister for Senior Territorians.MembershipFrom July to December 2011, STACmembership consisted of eight seniorTerritorians from across the Territory.The membership through to December2011 was:Janet Durling (Chair)Art Libien (Deputy Chair)Brian HilderLillian MannColin HardakerDenyse EdneyKathy MartinGraham KempOn the completion of the tenure of theSTAC, a new council was appointeddrawn from representatives of seniorsorganisations. These included:• National Seniors Australia• University of the Third Age• Council on the Ageing NT• Katherine Senior CitizensAssociation• Tennant Creek Senior Citizens andPensioners Association.SecretariatSecretariat support is provided by theAged and Disability Program.MeetingsMeetings were held in July andOctober 2011.The inaugural meeting of the newSTAC was held in March 2012.Key Terms of ReferenceThe Senior Territorians AdvisoryCouncil (STAC) provides advice to theMinister for Senior Territorians onsenior’s issues, government programsand policies and identifies futureopportunities to progress outcomes forseniors in the Territory.194

DEPARTMENT OF HEALTH – Annual Report 2011-12Department of Health -Executive Leadership Team(ELT)MembershipAs at 30 June 2012ChairpersonJeffrey MoffetMembersPenny FieldingJenny ClearyBarbara PatersonWendy Ah ChinIan PollockStephen MooMike MelinoLiz StackhouseJill MacandrewJan CurrieNikki WalfordSecretariatCindy JarvisMeetingsMonthlyKey Areas from Terms of Reference1. Provide governance direction forthe Department’s strategiccommittees through:• Audit Committee;• Workforce sub-committee;• Occupation Health and Safety subcommittee;• Resource management subcommittee;• Performance sub-committee;• Department Union ConsultativeCommittee;• Information Management subcommittee;and• Quality and safety sub-committee.2. review organisationalperformance;3. discuss and debate current,emerging, key and critical issues;and4. decision making and establishingorganisational strategic directions.Key Achievements• Held staff forums in Katherine andAlice Springs.• Developed and actioned astrategic work plan• Finalised restructure of WorkforceDivision.• Focussed on ‘valuing our staff’initiatives, including acommissioned staff survey andfocus groups.• Commenced a sub group focussedon financial and performancegovernance.• Endorsed a framework forimplementation of new safety andquality standards.• Approved a new risk managementframework.• Approved a new BusinessContinuity Framework.• Endorsed the 2012-13 internalaudit plan.195

DEPARTMENT OF HEALTH – Annual Report 2011-12Department of Health andUnions Consultative CouncilMembershipAs at 30 June 2012ChairpersonThe role of the Chair alternatedbetween departmental and unionrepresentatives.Departmental membersGlenn O’BryanJenny ClearyMike MelinoNikki WalfordFiona RocheDanny CoombesRon HoskingUnion representativesYvonne FalckhKay DensleyMatthew GardinerFiona StaceyDavid NebauerBryan WilkinsOCPE representationRepresentatives attend meetings onan as required basis.SecretariatMaria JenningsMembers who left in 2011-12Jill MacandrewAngela BrannellyAlan RubenHelen NezeritisMeetingsThe Council met in July, October2011; March 2012.Key Areas from Terms of ReferenceThe main activity for the ConsultativeCouncil is to ensure that there isregular communication at the highestlevel between the Department, theOffice of the Commissioner for PublicEmployment and the principal healthunions about major issues that affectthe health workforce.The Department and UnionsConsultative Council’s objectives areto:1. promote an efficient and effectiveservice by the Department for theNorthern Territory community;2. promote good industrial relations;3. improve a mutual understanding ofmanagement and staff issues;4. provide a forum for consultationand open discussion betweensenior staff and staffrepresentatives with the aim ofresolving any differences in amutually acceptable manner;5. facilitate the mutual exchange ofinformation.Key discussionsThese included:• National Health Reform in theNorthern Territory;• Working with Children ClearanceChecks (Ochre Cards);• Workforce Reviews (AboriginalHealth Worker Profession; Nursingand Midwifery Education andTraining);• Management of OccupationalAggression;• Occupational Health and Safetyworkgroups; Health and SafetyRepresentatives;• Professional classificationstructure;• Payroll and recruitment relatedmatters;• Apprenticeship and CadetshipPrograms; and• Training and developmentactivities.Outcomes of key discussions werereported to the Executive LeadershipTeam.196

DEPARTMENT OF HEALTH – Annual Report 2011-12Strategic WorkforceCommitteeMembershipAs at 30 June 2012ChairpersonJill MacandrewMembersGlenn O’BryanLinda BlairPeter CassJenny ClearyWendy Ah ChinPeter PangqueeRenae MooreMike MelinoJan CurrieXavier SchobbenDouglas JosifSecretariatTiffany HaritosMembers of the Committee who leftin 2011-12Karen BuckinghamVera WhitehouseAngela BrannellyAlan RubenLiz StackhouseJackie Ah KitSally MatthewsMeetingsThe Committee met in August,October and December 2011; and inMarch, April and June 2012.Key Areas from Terms of ReferenceThe Strategic Workforce Committee isresponsible for steering, monitoringand reporting on a strategic agendathat provides leadership and directionin relation to human resourcemanagement, strategic workforceplanning, workforce development andreform across the Department. TheCommittee will provide specificleadership and direction in regard toaligning the Department’s workforcepriorities to the endorsed priorityactions areas contained within the keydepartmental plans.Key Achievements:• Endorsement of HRpolicies/guidelines:• Human Resource PolicyDevelopment, Managementand Review Policy andGuidelines;• Working With ChildrenClearance Card requirementcommunication, Policy andGuidelines;• Criminal History Check Policyand Guidelines;• Conference and ProfessionalDevelopment AttendancePolicy and Guidelines;• Registration of HealthPractitioners Policy;• Performance ManagementPolicy;• Excess Recreation and LongService Leave Policy andGuidelines; and• Cultural Leave Policy.Communication of healthreforms across the Department.197

DEPARTMENT OF HEALTH – Annual Report 2011-12Resource ManagementCommitteeMembershipAs at 30 June 2012ChairpersonIan PollockMembersJan CurrieJenny ClearyLiz StackhouseMike MelinoStephen MooWendy Ah ChinGlenn O’BryanDr Barbara PatersonNikki WalfordPenny FieldingSecretariatLusia LimMeetingsMonthlyKey Areas from Terms of ReferenceThe Department of Health ResourceManagement Committee undertakesthe following functions on behalf of theChief Executive:• monitoring thedelivery/effectiveness of the givenresource;• building/understanding therelationships between currentperformance, future demand andlikely supply so that we can bemore convincing in resourcearguments;• building the best co-ordinated andtimely submissions for resourcesfor the next year;• monitoring implementation of FullTime Equivalents (FTE) andbudget targets including revenueacross the Department;• monitoring the implementation ofthe various capital programsincluding major, minor andequipment;• establishing and monitoring wherepossible a closer link betweenoperational performanceinformation and resourceimplications;• encouraging the development ofearly warning indicators ofsignificant budget variations;• monitoring and influencing theeffectiveness of the middlemanager. Resource Managementtraining program;• oversight of the development of aone to five year forward looklinking resources available withgovernment health strategies andpolicies, service demands andcapacity to balance them;• oversight of the development ofnext years’ budget submissionincluding new service proposals,works and equipment priorities;• knowing and understanding thenature and implications of Cabinetsubmissions likely to affectresource allocations as they arebeing developed;• oversight of the development orvarious resource strategiesrequired by Cabinet e.g. five yearaccommodation plan and astrategy to reduce energyconsumption by 10% over fiveyears; and• advising the CE of actionsnecessary to operate withinbudget.198

DEPARTMENT OF HEALTH – Annual Report 2011-12Audit CommitteeMembershipAs at 30 June 2012ChairpersonIain SummersMembersAntoni MurphyJan CurrieJill Macandrew*Dr Barbara Paterson*Ian Pollock*Dean Gardner*Angela BronleyMike Melino*Jenny Cleary**denotes ex-officio membersSecretariatVicki GoddenMembers who left during 2011-12Jill Macandrew*Liz Stackhouse*MeetingsThe Committee met in August,September and November in 2010 andFebruary and May in 2011.Key Areas from Terms of ReferenceThe Audit Committee undertakes thefollowing functions on behalf of theChief Executive:• monitor strategic risk managementand the adequacy of the internalcontrols established to manageidentified risks;• monitor the adequacy of theDepartment’s internal controlenvironment and review theoutcomes and the implementationof recommendations;• review financial statements andother public accountabilitydocuments (such as annualreports) prior to their approval bythe Chief Executive;• assess the state of organisationalgovernance in the Department andrecommend strategies forimprovement;• liaise with external auditorsregarding audits conducted andrespective audit plans; and• within the context of thecommittee’s primary role,undertake any other functionsdetermined from time to time bythe Chief Executive.Key Achievements• Appointment of a single auditprovider Ernst & Young.• Adoption of an Enterprise WideRisk Management Framework.• Initiated development of a riskassurance map and audit universethat will assist in future strategicaudit planning.• Ensuring more data secureapproach to monitoring internalaudit recommendations.adequacy of policies, practices andprocedures in relation to theircontribution to and impact on, theDepartment’s internal controlenvironment;• oversee the internal audit functionincluding development of auditprograms and monitoring of audit199

DEPARTMENT OF HEALTH – Annual Report 2011-12Strategic InformationManagement SteeringCommitteeMembershipAs at 30 June 2012ChairpersonStephen MooMembersJan CurrieBronwyn HendryJenny ClearyIan PollockGlenn O’BryanDr Barbara PatersonPenny FieldingFiona LynchRichard B SmithJo WrightTrudi MalyHelen AlbionSecretariatJackie PlunkettMeetingsThe Committee met four times withinthe financial year.Key Areas from Terms of ReferenceThe Department’s StrategicInformation Management Committeeundertakes the following functions onbehalf of the Chief Executive:• prioritise and approve investmentproposals in relation to majorinformation management,knowledge management andinformation and communicationstechnology initiatives; and• set the strategic agenda for thedevelopment and use ofinformation technology,communications and informationservices across the agency tounderpin management decisionmaking and planning.• provide direction in relation to theagency’s:• involvement in national informationcommittees and health informationprojects;• requirements in relation to wholeof-governmentinitiatives;• alignment with national strategiesand standards;• development of informationpolicies and procedures;• consult with and communicate toInformation Management groups;• develop and periodically review theDepartment’s Information Strategyto ensure alignment with theDepartment’s strategic directionsand priorities; and• communicate on progress andachievement of the Department’sInformation Strategy.Key Achievements• Advancing the shared electronicHealth Record to My electronicHealth Record.• Deployment of the TelehealthNTNetwork into 57 remotecommunities.• eLearning Framework established:• Deployment of Communicare intoEast Arnhem.• Continuity of Care project atAmpilatwatj.• Establishment of the eMedicationsManagement Application Medchartrollout at Royal Darwin Hospital.200

DEPARTMENT OF HEALTH – Annual Report 2011-12Occupational Health andSafety Steering CommitteeMembershipAs at 30 June 2012ChairpersonJill MacandrewDeputy ChairGlenn O’BryanMembersFiona RocheAngela BrannellyJill DavisMike MelinoDean GardnerChristine ShortSharon McInnesSecretariatKaren SinelMeetingsQuarterlyKey Areas from Terms of ReferenceProvide strategic direction on OHSissues to the various Workplace OHSCommittees across the Department toensure that it:• meets its legislativeresponsibilities;• integrates OHS with other agencymanagementsystems and with the corefunctions of the organisation;• aids the improvement of the overallOHS performance of theDepartment;• monitors and reviews the work ofthe Workplace OHS Committees inline with departmental policy;• reviews OHS across theDepartment; and• reports to the ExecutiveLeadership Group.201

DEPARTMENT OF HEALTH – Annual Report 2011-12Appendix 3: External Funding2011-12 Grant & Subsidy Payments Greater than $10KDivision Organisation TotalAboriginal Policyand StakeholderEngagementAMSANT Aboriginal Medical ServicesAlliance of the NT Inc430 250Aboriginal Policy and Stakeholder Engagement Total 430 250Acute CareAboriginal Hostels Ltd 324 746Cancer Council of the NT Inc 67 225Department of Health and Aging 43 860Flinders University 3 896 000National Blood Authority 2 505 349Royal Flying Doctors Service 2 622 182St. John Ambulance Australia NT Inc 19 825 050Western Desert Nganampa WalytjaPalyantjaku Tjutaku Aboriginal Corporation186 489Acute Care Services Total 29 470 901Health ProtectionAFL Northern Territory Ltd 28 000Amity Community Services 501 168AMSANT Aboriginal Medical ServicesAlliance of the NT IncAnimal Management in Rural and RemoteCommunities Inc180 00010 000Anyinginya Health Aboriginal Corporation 80 000Atyenhenge-Alterre Aboriginal Corporation 24 000Barly Region Alcohol and Drug AbuseAdvisory Group Inc1 209 923Barkly Shire Council 75 257Bushmob Inc 552 091Cancer Council of the NT Inc 65 000CatholicCare NT 859 654202

DEPARTMENT OF HEALTH – Annual Report 2011-12Health Protection (Continued)Central Australian Aboriginal AlcoholProgram UnitCentral Australian Aboriginal CongressIncCentral Australian Aboriginal MediaAssociation (CAAMA)Central Australian Affordable HousingCompany Inc984 8282 396 85110 00050 284Centre For Remote Health 32 204Council for Aboriginal Alcohol ProgramServices Inc291 756Department of Health Queensland 33 719Djabulukgu Association Inc 20 000Drug and Alcohol Services AssociationAlice Springs Inc1 992 045East Arhnem Shire Council 539 374Eastern Health 59 715Employee Assistance Service NT Inc 174 913F.O.R.W.A.A.R.D. 1 536 829Family Planning Welfare Association ofthe NT Inc39 176Forster Foundation – Banyan Housing 874 896Holyoake 574 929Ilpurla Aboriginal Corporation 50 000Julalikari Council Aboriginal Corporation 78 169Kalano Community Association Inc 975 297Katherine West Health Borad 172 000Local Government Association of theNorthern TerritoryMabunji Aboriginal Resource AssociationInc107 50010 000Macdonnell Shore Council 33 210Mission Australia 1 131 843National Institute for Aboriginal and TorresStrait Islander Health Research LimitedNgaanyatjarra Health Service AboriginalCorporationNorthern Territory AIDS and HepatitisCouncil Inc150 00010 0001 074 281203

DEPARTMENT OF HEALTH – Annual Report 2011-12Health Protection (Continued)Northern Territory Council of SocialServiceNorthern Territory Police, Fire andEmergency Services80 000118 000Red Dust Role Models Ltd 61 796Roper Gulf Shire Council 90 722Ss Vincent De Paul Society 130 000Sunrise Health Service AboriginalCorporation140 000Tangentyere Council Aboriginal Inc 457 274The Salvation Army (NT) Property Trust 970 866Tiwi Islands Shire Council 10 200Top End Association for Mental Health Inc(Team Health)20 000University of South Australia 100 000Victoria Daly Shire Council 76 488Warlpiri Youth Development AboriginalCorporation25 352West Arnhem Shire Council 81 604Wurli Wurlingjang Aboriginal CorporationInc370 108Health Protection Total 19 721 322Health ServicesAlawa Aboriginal Corpoation 79 998Alice Springs Senior Citizens 13 439Alzheimers Australia NT Inc 348 783Anglicare NT 1 361 589Animparrinpi Yutlitju Womens Association 20 018Anyimginyi Health Aboriginal Corporation 106 475Arthritis Foundation of the NorthernTerritory Inc78 115Asthma Foundation of the NT Inc 250 697Australian Breastfeeding Association – NTRegional BranchAustralian Red Cross Society – NorthernTerritory Division18 3791 793 359Bagot Community Inc 424 219204

DEPARTMENT OF HEALTH – Annual Report 2011-12Health Services (continued)Barky Shire Council 387 392Bawinanga Aboriginal Corporation 70 633Belyuen Comminity Government Council 68 211Beyond Blue Limited 39 586Bindi Inc 606 934Bushmob Inc 12 328Calvary Home Care Services Limited 279 383Cancer Council of the NT Inc 256 400Carers NT Inc 378 751Carpentaria Disability Services Inc 7 198 869Central Australia SupportedAccommodation (CASA) Inc2 625 203Central Australian Aboriginal Congress Inc 1 148 956Central Desert Shire Council 192 610Childbirth Education Association DarwinInc37 235Childbirth Education Association Inc 53 849City of Palmerston 50 000Community Support Inc 1 285 421Council on the Aging 123 668D & R Community Services Pty Ltd 196 959Danila Dilba Biluru Butji Binnilutlum HealthService Aboriginal Corporation433 107Darwin Community Legal Services Inc 109 283Deaf Children Australia 15 782DeafNT Inc 15 782Diabetics Association of the NT Inc 759 441Disability Advocacy Service 58 715Djabulukgu Association Inc 508 813East Arnhem Shire Council 852 706Family Planning Welfare Association ofthe NT Inc688 429General Practice Network NT Ltd 277 700Golden Glow Corporation (NT) Pty Ltd 105 540Grow NT 175 911Guide Dogs Association of SA and NT Inc 75 887Guide Dogs Association of SA and NT Inc 75 887205

DEPARTMENT OF HEALTH – Annual Report 2011-12Health Services (continued)Healthscope Limited 890 001HPA Inc 853 217Industry Education Networking Pty Ltd 597 848Integrated Disability Action Inc 20 984Jilamara Arts and Craft Association 59 093Julalikari Council Aboriginal Corporation 921 115Kalano Community Association Inc 132 847Katherine West Health Boards 3 619 371Kidsafe Child Accident PreventionFoundation of Australia – NT Division98 539Larrakia Nation Aboriginal Corporation 607 827Laynhapuy Homeland Association Inc 118 246Life Without Barriers 9 694 997Lifeline Central Australia 236 785Lifestyle Solutions (Aust) Ltd 6 788 487Ltyentye Apurte IngkerrenyekekenheApmere Aboriginal Corporation (SantaTeresa Women’s Centre)Mabunji Aboriginal Resource AssociationInc74 21232 444Macdonnelle Shire Council 500 154Mampu Maninja-Kurlangu Jarlu Patu-KuAboriginal Corporation (Yuendumu)Marle Ingkeherekenhe ArndaritjikaAboriginal CorporationMental Health Association of CentralAustralia127 48445 4511 476 988Mental Health Carers NT 318 097Mental Health Council of Australia 18 329Mission Australia 188 106Miwatj Health Aboriginal Corporation 1 870 684National Disability Services Ltd 329 440National Partnership Agreement onPreventative Health130 000Natural Family Planning Council NT Inc 11 280Ngaruwanajirri Inc 81 680Women's Council Aboriginal Corporation 47 487North Australian Pastoral Company(NAPCO) Ltd (Alexandria Station)12 705206

DEPARTMENT OF HEALTH – Annual Report 2011-12Health Services (continued)Northern Territory Mental Health Coalition 144 236Northern Territory Trade and LaborCouncil160 000NT Friendship and Support Inc 241 694Peppimenarti Association Inc 851 661Roper Gulf Shire Council 216 745Royal Flying Doctor Service 336 270Somerville Community Service Inc 7 524 634Step Out Community Access Service Inc 949 812Sunrise Health Service AboriginalCorporation3 893 058Tangentyere Council Inc 494 028Territory Care and Support Services 1 572 972The Salvation Army (NT) Property Trust 49 476Top End Association For Mental HealthInc (Team Health)Top End Mental Health ConsumerOrganisation Inc2 017 401137 546Total Recreation 240 401Uniting Church In Australia FrontierServices550 727Victoria Daly Shire Council 296 618Waltja Tjutangku Palyapayi AboriginalCorporation185 742West Arnhem Shire Council 167 301Wurli Wurlingjang Aboriginal CorporationIncYouth And Family Education ResourcesPty Ltd863 228190 000Health Services Total 74 572 003People & ServicesPeople &Services TotalCentral Australian Remote HealthDevelopment Services Ltd88 70488 704GRAND TOTAL 124 283 180207

DEPARTMENT OF HEALTH – Annual Report 2011-12Appendix 4: Capital and Minor WorksSummary 2011-12Program$’0002012-13Program$’0002011-12EquityTransferIn $’000Revoted Works from 2010-11 134 412 58 271 68 802New Works in 2011-12 37 063 30 651 6 319New Works in 2012-13 0 63 718 0Land Acquisitions and Asset Transfers In 0 0 200Land Acquisitions and Asset TransfersOut0 0 -1 068Total Program 188 987 152 640 74 2532011-12 program – As published in the 2011-12 Budget Paper 4.2012-13 Program – As published in the 2012-13 Budget Paper 4.Equity Transfer in – transfer of the increased asset value from Department of Constructionand Infrastructure for completed capital projects.Note: Includes accumulated works from previous years and delivery fees.Project 2011-12Program$’000Revoted Works from 2010-11Alice Springs Hospital2012-13Program$’0002011-12EquityTransferIn $’000Status as at30 June2012Fire Protection, Air-conditioning 19 199 4 557 4 328 Constructionand Remediation 1 in ProgressAlice Springs Hospital – Fit outfor relocated staff fromadministration ward400 0 0 DesignPhaseSecure Care Facility 2 000 0 2 651 CompletedUpgrade Emergency Power,Water Reticulation andElectrical Systems 2 7 763 4 732 0 In variousstages oftender and inprogressAlice Springs – Construction oftwo eight-bed secure transitionalcare facilities for children andadultsBarkly Region – Renal FacilitiesExpansion5 730 556 6 616 Completed418 0 3 551 Completed208

DEPARTMENT OF HEALTH – Annual Report 2011-12Project 2011-12Program$’0002012-13Program$’0002011-12EquityTransferIn $’000Status as at30 June2012Darwin - Relocation to andassociated fit-out ofConstruction House, CasuarinaPlaza and Darwin Plaza 3 1 582 643 2 489 CompletedDarwinPlaza,CasuarinaPlaza, andConstructionHouse;Darwin – Construction of twoeight-bed secure transitionalcare facilities for children andadultsGove District Hospital – Firesafety upgradeHealth Housein Designphase5 630 0 6 808 Completed365 0 319 CompletedKatherine Region – Renal2 836 0 0 Deleted fromfacilities expansion 4 ProgramOenpelli Health Centre –450 0 0 ProjectUpgrade Health Centre 5 DeferredRoyal Darwin HospitalFire safety upgrades and newmulti-purpose room905 0 461 CompletedHigh Voltage Electrical System, 41 500 37 787 0 In progressUpgrade 6Chiller and Stand-By PowerMortuary – AdditionalRefrigerated StorageSecure Care Facility andRelocation of PhysiotherapyUpgrade and refurbish staffaccommodation on campus0 0 493 Completed0 0 1 246 Completed447 0 4 714 CompletedMinor New Works 1 171 0 1 171 CompletedAustralian Funded ProjectsAlice Springs HospitalEnergy Efficiency Projects 0 0 572 CompletedElective Surgery Upgrade 0 0 821 CompletedUpgrade the Emergency20 492 4 673 0 ConstructionDepartment 7 In ProgressAlice Springs – Mobile DentalTruck Fit-outs550 0 552 Completed209

DEPARTMENT OF HEALTH – Annual Report 2011-12Project (Continued) 2011-12Program$’000Across the Territory – MobileDental Clinic Rooms andHearing BoothsAcross the Territory –Transportable Clinic RoomsBees Creek Transitional AfterCare Facility – ManagersCottageKatherine – New Sobering UpShelterNgukurr – Upgrade HealthCentre2012-13Program$’0002011-12EquityTransferIn $’000Status as at30 June2012171 0 276 Completed0 0 706 Completed0 0 328 Completed0 0 1 409 Completed646 0 134 CompletedPalmerston Super Clinic 0 0 8 104 CompletedRenal-Ready HaemodialysisRooms at Maningrida,Alpurrurulam and BarungaRoyal Darwin Hospital524 0 1 322 CompletedConstruction of a 50-unit patient 16 000 5 323 0 Constructionaccommodation complex 8 In ProgressRadiation Oncology Unit 1 022 0 7 171 CompletedElective Surgery Upgrade 9 384 0 558 Part of RDHEmergencyDepartmentandOperatingTheatreprojectEmergency Department FastTrackTennant Creek – Construct newSobering Up ShelterTennant Creek – TransitionalAftercare FacilityWadeye – Construct NewHealth Centre2 630 0 2 822 Completed1 597 0 1 711 Completed0 0 343 Completed0 0 7 128 Completed134 412 58 271 68 802210

DEPARTMENT OF HEALTH – Annual Report 2011-12Project 2011-12Program$’000New Works 2011-122012-13Program$’0002011-12EquityTransferIn $’000Status as at30 June2012Alice Springs Hospital –Remediation and upgrade ofoperating theatres and centralsterilising services department 1 16 000 0 0 Constructionin ProgressTennant Creek Hospital – Fire 3 300 1 300 0 Constructionsafety upgrade stage 4 10 in ProgressTop End – Construct new renal 3 041 0 0 Location tofacility 11 be confirmedAustralian Funded ProjectsRoyal Darwin HospitalEmergency Department4 600 22 023 0 In Designupgrade 12 PhaseOperating theatre upgrade 13 4 900 0 0 Fundingcombinedwith theproject aboveMinor New Works 5 222 4 675 5 212 ConstructionIn ProgressNew Works Added to theProgram During 2011-1237 063 27 998 5 212Pirlangimpi – Upgrade Health0 975 0 ConstructionCentre 14 in ProgressRoyal Darwin HospitalBuilding 6 – Upgrade fireprotection systems0 375 0 CompletedNew generator 15 0 800 0 Constructionin ProgressUpgrade Facilities in support ofthe National Trauma CentreAustralian Funded Projects0 203 1 107 CompletedPalmerston Hospital – Site0 300 0 Constructionworks 16 in Progress0 2 653 1 107Total New Works for 2011-1237 06330 6516 319211

DEPARTMENT OF HEALTH – Annual Report 2011-12Project 2011-12Program$’000New Works 2012-132012-13Program$’0002011-12EquityTransferIn $’000Status as at30 June2012Alice Springs Hospital –0 5 000 0 Constructionoperating theatres and wards 1Remediation and upgrade ofin ProgressBorroloola – Upgrade existing0 800 0 In DesignHealth Centre 17 PhaseGove District Hospital –0 650 0 In DesignContinuation of Fire Upgrades 18 PhaseMilingimbi – Construct New0 4 500 0 Tender to beHealth Centre 19 awarded inAugust 2012Royal Darwin Hospital –0 1 600 0 In DesignSystems 20Upgrade Fire DetectionPhaseAustralian Funded ProjectsElliott – Construct new Health0 6 170 0 In DesignCentre 21 PhaseGaliwinku – Construct new0 6 400 0 In DesignHealth Centre 21 PhaseKatherine Hospital – Construct a0 7 700 0 In DesignAccommodation Facility 2212-room (24 bed) PatientPhaseNgukurr – Construct new Health0 5 930 0 In DesignCentre 21 PhaseNtaria – Construct new Health0 6 400 0 In DesignCentre 21 PhasePalmerston Hospital – Stage 1 22 0 10 000 0 In DesignPhasePapunya – Upgrade Existing0 1 750 0 In DesignHealth Centre 21 PhaseTennant Creek Hospital –0 3 700 0 In DesignDepartment 22Upgrade the EmergencyPhaseMinor New Works 0 3 118 0 In DesignPhaseTotal New Works for 2012-13 0 63 718 0212

DEPARTMENT OF HEALTH – Annual Report 2011-121 Alice Springs Hospital – Fire Protection, Air-conditioning and Remediation - this isan ongoing project to address the non compliance of previous works carried out in 2001-02.Work is being staged to accommodate decanting of individual areas.2 Alice Springs Hospital – Upgrade Emergency Power, Water Reticulation andElectrical Systems - continuation of program. Stage 1 of the upgrade of hydrant andsprinkler mains and water pipes completed with works in the Main Ward commenced.Tender for replacement of generators and associated upgrade being evaluated.3 Darwin - Relocation to and Associated Fit-out of Construction House, CasuarinaPlaza and Darwin Plaza - the final stage of this project is the relocation of staff back toHealth House late 2012.4Katherine Region – Renal facilities expansion – this project is being outsourced to theservice provider (to be announced).5Oenpelli Health Centre – Upgrade Health Centre – this project is to be funded throughthe Minor New Works Program.6Royal Darwin Hospital – High Voltage Electrical System, Chiller and Stand-By PowerUpgrade - improve electrical system safety, reliability and capacity. The project spansseveral years. Contracts for all work have been awarded. Laying of HV Ring Main conduit isalmost complete; construction of HV Switch Room and the generator fuel tank foundationshas commenced; initial Ring Main units and transformers delivered; generators on site May2012. HV Switch Room is due August 2012 with Project Completion June 2013.7Alice Springs Hospital – Upgrade the Emergency Department - contract forconstruction was awarded June 2011 with completion scheduled in November 2012.8Royal Darwin Hospital - Construction of a 50-unit patient accommodation complex –works expected to be completed September 2012.9Elective Surgery Upgrade – this represents the balance of funds from the electivesurgery project to provide for surgeons’ accommodation. This work will be included as partthe project to upgrade the emergency department and the operating theatres.10Tennant Creek Hospital – Fire safety upgrade stage 4 – final stage of the program forfire safety works - expected to be completed August 2012.11Top End – Construct new renal facility – location to be agreed12Royal Darwin Hospital - Emergency Department upgrade – increase in beds in theEmergency Department and Short Stay Unit. Combined with Operating Theatre Upgrade;Tender for design advertised in August 2012.13Royal Darwin Hospital – Operating Theatre Upgrade – Additional two theatres;combined with Emergency Department upgrade.14Pirlangimpi – Upgrade Health Centre - Tender awarded 3 May 2012; to be completedOctober 201215Royal Darwin Hospital - New generator - replacement of a leased generator.16Palmerston Hospital – Site works - water and sewer head-works as part of the sitedevelopment for the new Palmerston hospital.17Borroloola – Upgrade existing Health Centre – new project18Gove District Hospital – Continuation of Fire Upgrades – part of 3-year fire and safetyand security program across NT hospitals -new project transferred from Minor New Works.213

DEPARTMENT OF HEALTH – Annual Report 2011-1219 Milingimbi – Construct New Health Centre - Contract for construction awarded 31 July2012.20Royal Darwin Hospital – Upgrade Fire Detection Systems - part of 3-year fire andsafety and security program across NT hospitals - new project transferred from Minor NewWorks.21Funding of $50.29m for the construction of 7 new Health Centres and the upgradeof 4 Health Centres has been approved through the Australian Government’s Health andHospital Fund. New Health Centres are to be built at Elliott, Galiwinku, Ngukurr and Ntaria in2012-13 and in Numbulwar, Canteen Creek and Robinson River in 2013-14 and upgrades toHealth Centres at Papunya in 2012-13 and at Titjikala (Maryvale), Maningrida, andKaltukatjara (Docker River) in 2013-14.22 New hospital projects – funding approved through the Australian Government’s Healthand Hospital Fund for short-term patient accommodation at Katherine Hospital, constructionof the Palmerston Hospital and upgrade of the Emergency Department at Tennant CreekHospital. Additional funding to upgrade the Emergency Department and short-term patientaccommodation at Gove District Hospital is also approved for 2013-14.214

DEPARTMENT OF HEALTH – Annual Report 2011-12Appendix 5: LegislativeResponsibilitiesUnder the current Administrative Arrangements Order our Minister is responsible foradministering a range of Acts and subordinate legislation. This includesresponsibility for administering 39 pieces of legislation, 24 Acts and 15 Regulations.Acts Administered by Independent Agencies• Menzies School of Health Research ActResponsibility administered by Department of Health onbehalf of the Minister for Health• Adult Guardianship Act• Cancer (Registration) Act• Carers Recognition Act• Disability Services Act• Emergency Medical Operations Act• Food Act• Health Practitioner Regulation (National Uniform Legislation) Act• Health Practitioners Act• Hospital Networks Governing Councils Act• Medical Services Act• Medicines, Poisons and Therapeutic Goods Act• Mental Health and Related Services Act (except Part 15)• Natural Death Act• Notifiable Diseases Act• Poisons and Dangerous Drugs Act• Private Hospitals Act• Public and Environmental Health Act• Radiation Protection Act• Therapeutic Goods and Cosmetics Act• Tobacco Control Act (except provisions about licensing and enforcement)• Transplantation and Anatomy Act• Volatile Substance Abuse Prevention Act215

DEPARTMENT OF HEALTH – Annual Report 2011-12• Water Supply and Sewerage Services Act (provisions about water qualitystandards)Regulations Administered by Department of Health• Cancer (Registration) Regulations• Mental Health and Related Services Regulations• Natural Death Regulations• Poisons and Dangerous Drugs Regulations• Public Health (Barbers' Shops) Regulations• Public Health (Cervical Cytology Register) Regulations• Public Health (General Sanitation, Mosquito Prevention, Rat Exclusion andPrevention) Regulations• Public Health (Medical and Dental Inspection of School Children) Regulations• Public Health (Night-Soil, Garbage, Cesspits, Wells And Water) Regulations• Public Health (Noxious Trades) Regulations• Public Health (Nuisance Prevention) Regulations• Public Health (Shops, Boarding-Houses, Hostels and Hotels) Regulations• Radiation Protection Regulations• Tobacco Control Regulations• Volatile Substance Abuse Prevention Regulations216

DEPARTMENT OF HEALTH – Annual Report 2011-12Appendix 6: AcronymsACAPAboriginal Cultural AwarenessProgramAMSANTAboriginal Medical Services AllianceNorthern TerritoryAOTAAccountable Officer’s Trust AccountAODAlcohol and Other DrugsAODPAlcohol and Other Drugs ProgramASHAlice Springs HospitalAASBAustralian Accounting StandardsBoardACSQHCAustralian Commission on Safety andQuality in Health CareACHSAustralian Council for HealthcareStandardsAHMACAustralian Health Ministers’ AdvisoryCouncilANAOAustralian National Audit OfficeATOAustralian Taxation OfficerALOSAverage Length of StayCAAMACentral Australian Aboriginal MediaAssociationCASACentral Australia SupportedAccommodationCDCCentre for Disease ControlCDUCharles Darwin UniversityCEOChief Executive OfficerCHHCChild Health Hearing CoordinatorsCOPALChildhood Obesity Prevention andLifestyleCCMPSChronic Conditions Prevention andManagement StrategyCSSCommonwealth SuperannuationSchemeCOAGCouncil of Australian GovernmentsDBEDepartment of Business andEmploymentAVOAustralian Valuation Office217

DEPARTMENT OF HEALTH – Annual Report 2011-12DETDepartment of Employment andTrainingDMSDrug Monitoring SystemEBMMEat Better Move MoreEDEmergency DepartmentEWRMEnterprise Wide Risk ManagementEHEnvironmental HealthEEOEqual Employment OpportunityERPEstimated Resident PopulationEQuIPEvaluation and the QualityImprovement ProgramELTExecutive Leadership GroupFWAFairwork AustraliaFOIFreedom of InformationFTEFull Time EquivalentGPNNTGeneral Practice Network NorthernTerritoryGPNTEGeneral Practice Northern TerritoryEducationGPGeneral PractitionerGSTGoods and Services TaxGMSGrants Management SystemGNARTNGreater Northern Australia RegionalTraining NetworkGAAGrowth Assessment and ActionHSRsHealth and Safety RepresentativesHU5KHealthy Under Five KidsHHFHospitals and Health FundHRHuman ResourcesIFFIllegal Foreign FisherpersonsIEPIndigenous Employment ProgramIRISIndigenous Risk Impact ScreenIRUIndustrial Relations UnitITInformation TechnologyIASBInternational Accounting StandardsBoardIFRSInternational Financial ReportingStandards218

DEPARTMENT OF HEALTH – Annual Report 2011-12IMAIrregular Maritime ArrivalsJESJob Evaluation SystemMDCsMajor Diagnosis CategoriesMOUMemorandum of UnderstandingMSHRMenzies School of Health ResearchNEATNational Emergency Access TargetsNMHCCFNational Mental Health Consumer andCarer ForumNPNational PartnershipNSWAWNational Safe Work Australia WeekNGONon-Government OrganisationNAPCONorth Australian Pastoral CompanyNTCATTNorthern Territory Crisis AssessmentTelephone TriageNTERNorthern Territory EmergencyResponseNTGPASSNorthern Territory Government andPublic Authorities SuperannuationSchemeNTMPNorthern Territory Medical ProgramNTPCCSNorthern Territory Pensioners andCarers Concession SchemeNTPSNorthern Territory Public SectorNTRTNNorthern Territory Regional TrainingNetworkOH&SOccupational Health and SafetyOCPEOffice of the Commissioner for PublicEmploymentPATSPatient Assistance Travel SchemePMSAPerformance Management SystemsAuditPHCPrimary Health CarePSEMAPublic Sector Employment andManagement ActQIPPSQuality Improvement ProgramPlanning SystemRHDRheumatic Heart DiseaseRACGPRoyal Australian College of GeneralPractitionersRDHRoyal Darwin HospitalS4Schedule 4219

DEPARTMENT OF HEALTH – Annual Report 2011-12S8Schedule 8STACSenior Territorians Advisory CouncilSPPSpecific Purpose PaymentsSWWStrong Women WorkersTADSTobacco, Alcohol and Other DrugsServicesTAFSTreasurer’s Annual FinancialStatementsTBTuberculosisVSMPsVolatile Substance Management PlansWPPWork Partnership PlanWHSWorkplace Health and SafetyWHOWorld Health Organisation220

Department of HealthPO Box 40596Casuarina NT 0811Telephone: (08) 8999 2400Facsimile: (08) 8999 2700www.nt.gov.au/health