Central West Hospital and Health Service

Public availability

Copies of this annual report can be obtained from:Central West Health Glasson House139 Eagle StreetLONGREACH QLD 4730

Requests for copies to be posted can be made to:Central West HealthPO Box 510LONGREACH QLD 4730

Phone: +61 7 4652 8000Email: [email protected]: www.health.qld.gov.au/services/centralwest/default.asp

ISSN 2202-7130

The Queensland Government is committed to providing accessible services to Queenslanders from all culturally and linguistically diverse backgrounds. If you have difficulty in understanding the annual report, you can contact us on (07) 4652 8000 and we will arrange an interpreter to effectively communicate the report to you.

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Attribution

Content from this annual report should be attributed as:The State of Queensland Central West Hospital and Health Service annual report 2013–14

© Central West Hospital and Health Service 2014

iCentral West Hospital and Health Service | Annual Report 2013–2014

List of tablesLetter of compliance 1

Chair’s introduction 2

1. Chief Executive’s report 4

2. Overview of the Central West Hospital and Health Service 62.1 Introductory information 62.2 Agency role and main functions 72.3 Operating environment 82.4 Machinery of government changes 8

3. The year in review 93.1 Improved healthcare services 93.2 Upgrading and maintaining health facilities 93.3 Building and developing the health workforce 93.4 Governance, collaboration and engagement 9

4. Our performance 104.1 Central West Hospital and Health Service strategic plan 2012–16 104.2 Service delivery statements 174.3 Other plans and initiatives 18

5. Community profiles 20

6. Financial highlights 2013–14 336.1 Summary of financial performance 33

7. Governance and accountability 357.1 Central West Hospital and Health Service board and committees 357.2 Related entities 387.3 Executive management team 387.4 Senior management structure 407.5 Public Sector Ethics Act 1994 407.6 Risk management 407.7 Internal audit 417.8 External scrutiny 417.9 Information systems and record keeping 42

8. Workforce 438.1 Workforce profile 438.2 Workforce governance 438.3 Workforce planning, attraction and retention and performance 448.4 Training and development 448.5 Early retirement, redundancy and retrenchment 45

9. Open data 46

Abbreviations 47

Glossary 48

Compliance checklist 50

Financial statements 2013–14 51

Contents

Contents

1Central West Hospital and Health Service | Annual Report 2013–2014

12 September 2014

The Honourable Lawrence Springborg MPMinister for HealthMember for Southern DownsLevel 19, 147–163 Charlotte StBrisbane QLD 4000

Dear Minister

I am pleased to present the Annual Report 2013–2014 and financial statements for Central West Hospital and Health Service.

I certify that this Annual Report complies with:

• the prescribed requirements of the Financial Accountability Act 2009 and the Financial and Performance Management Standard 2009, and

• the detailed requirements set out in the Annual report requirements for Queensland Government agencies.

A checklist outlining the annual reporting requirements can be found at page 50 of this annual report or accessed at www.health.qld.gov.au/services/centralwest.

Yours sincerely

Edward Warren Board Chair Central West Hospital and Health Service

Letter of compliance

2 Chair’s introduction Central West Hospital and Health Service | Annual Report 2013–2014

Living and working in a remote part of this vast state creates many challenges across many fronts. One of these challenges is to deliver equitable healthcare services to the people of the central west compared to those readily available to people living in urban areas.

Having a local health board with members who live and work in our community, consulting directly with a community they know and care for and making decisions about the needs expressed by the community, has made a noticeable difference. The board has both raised the profile of the central west with governments and enabled improved resourcing decisions that have delivered better healthcare services and facilities.

In 2013–14, the board built on the success achieved in its foundation year. As promised, the modest surplus achieved in 2012–13 was re-invested as a community dividend to upgrade hospital and health facilities and address the backlog maintenance works across the region.

One of the four principles of the state government’s Blueprint for better healthcare in Queensland is to provide health services closer to home with a focus on patients and people. In 2013–14, we experienced first-hand the improvements telehealth technology has brought to patients, providing direct access to safe treatment with a wide range of specialists, delivered at call, in our own community.

In 2013–14, nearly 737 patients have been saved time and the inconvenience of travelling to a larger centre for health services thanks to the rapidly expanding use of telehealth in the central west, especially in many of our isolated communities. However, remote communities such as Birdsville, Bedourie, Jundah and Windorah, where telehealth promises the greatest benefits, still suffer from inadequate bandwidth and a lack of adequate telecommunications services to enable a full and robust telehealth experience.

The use of telehealth has also provided Queenslanders with value in healthcare services, another Blueprint principle, by saving a significant amount in air travel costs. Savings can be re-investment into service improvements and have assisted the health service in meeting targets built into its 2012–16 strategic plan.

Chronic and acute disease leading to avoidable hospital admission remains one of the biggest challenges for the health service. During the year, the board put a great deal of effort into building collaborative partnerships with other healthcare providers. Together, the partners aim to implement strategies to minimise service duplication between state and federal programs and between healthcare partners, to create a coordinated approach to attracting funding and to building our capacity to enhance preventative primary and community health programs in the future.

As a result, a comprehensive 10 year healthcare plan for the central west has been developed to guide future investment and innovation in service planning. In developing the plan, the board enjoyed constructive engagement with the Minister for Health, the Department of Health, local government, the Royal Flying Doctor Service, Medicare Local, the RAPAD group of councils, staff and community.

The plan incorporates the Queensland rural and remote health service framework classifications of rural and remote health facilities and the services these health facilities provide as outlined in the government’s plan Better Health for the Bush – a plan for safe, applicable healthcare for rural and remote Queensland. The framework guarantees a minimum service level at all health facilities; the first time this commitment has been made.

Finally, I wish to acknowledge that without the excellent work of our dedicated staff, the achievements outlined in this report would not have been possible. Our staff, under the guidance of the health service chief executive, senior leaders and managers, has demonstrated commitment to the values established by the board and the shared values of the Queensland government – putting customers first, bringing ideas into action, unleashing potential, being courageous and empowering people.

Chair’s introduction

3Central West Hospital and Health Service | Annual Report 2013–2014 Chair’s introduction

I also take this opportunity to thank my fellow board members for their support in governing the health service and taking the time to engage and listen to the views and aspirations of our staff and local communities. Their hard work, dedication and vision in the pursuit of improving services, upgrading facilities and designing programs to enable better health outcomes for the people of the central west is to be admired.

Engaging and empowering the community and building the capacity of our health workforce to meet the healthcare challenges of the central west remains a top priority of the board.

The achievements of 2013–14 show that a local board does make a difference. The board is proud of Central West Health’s progress as a responsive organisation, with engaged and supported staff, efficiently and effectively delivering excellence in healthcare to remote Queenslanders. I commend this report to you.

Ed Warren Board Chair

Back row (left to right): Bill Ringrose, Bruce Scott, Peter Skewes, Dr John Douyere, Michel Lok Front row (left to right): Jane Williams, Ed Warren, David Arnold

4 Chief Executive’s report Central West Hospital and Health Service | Annual Report 2013–2014

It is with great pleasure that I am able to present my report of the health service’s operations and reflect on what has been another successful year for Central West Health, the smallest of the 17 Queensland hospital and health services.

Over the year we provided more services, cared for more patients, increased our surgical and specialist visits,

increased telehealth use across the region and assisted more patients with travel assistance to access specialist services. We also invested heavily in our facilities to improve staff and patient safety and address long standing maintenance projects.

Many of our achievements this year were the result of building a sustainable workforce that works together as a team, delivering best practice and continuity of care to our patients. We now have more doctors, nurses and allied health professionals than ever before, established new dental positions in Barcaldine and placed our first chronic disease nurse practitioner in Boulia. Our operational and administrative staff are also developing better ways to support our front line services despite restrictions on our resources.

“I want to thank the staff of the health service for their commitment to making real change in our health services and our communities who continue to expect a great deal from us.”

Award modernisation and enterprise bargaining restructuring commenced in earnest during the year with the transition of employment arrangements for senior medical officers. All eligible doctors in the central west accepted employment contracts that will significantly simplify the administration of their pay and conditions. Further workplace reform can be anticipated and we will continue to work with our staff in an open, trusting and transparent manner.

By far the most important objective in the health board’s strategic plan is our commitment to safety and quality for our patients and staff.

During 2013–14 we implemented an organisational change to establish a clinical governance and innovation unit, bringing together our safety, quality, infection control, telehealth and clinical education staff into a single unit, headed by an experienced redesign advanced practitioner. Together, the unit provides a great depth of expertise to support clinicians to modernise our services, adopt new technologies and back-up our critical patient safety functions.

The health service demonstrated its commitment to safety in the workplace in dealing purposefully with serious concerns at a number of our older facilities and through the removal of asbestos containing materials from the Longreach hospital. The health service also demonstrated best practice when our workplace safety system was externally audited for compliance with AS/NZS 4801:2001 in March 2015 - a real credit to our work health and safety team.

Our patient and community feedback continues to demonstrate overwhelming support for the local health board and the positive changes being made in community health, hospital care and our general practices, and in addressing long standing problems with our facilities. We do listen to our communities and act promptly when your experience did not meet your expectation.

This year’s annual report includes a profile of our services in each town, providing communities with details of local service improvements, investments and activity. These profiles maintain our commitment to involving communities in the planning, delivery and performance of our health services.

On a final note, all central west’s hospitals and health centres became smoke-free in 2013–14. Far too many Queenslanders die each year from smoking related causes. Butts were put out across the region with patients offered nicotine replacement therapy to help kick the habit.

Michel Lok Chief Executive

1. Chief Executive’s report

5Central West Hospital and Health Service | Annual Report 2013–2014 Chief Executive’s report

North West HHS

Central West HHS

Mackay HHS

Central Queensland HHSWide

Bay HHS

South West HHSDarlingDowns

HHS

SunshineCoast HHS

Metro North HHS

Metro South HHS

West Moreton HHS

Gold CoastHHS

The Torres and Cape HHS

Cairns & Hinterland HHS

Townsville HHS

Potentially preventable

hospitalisations account for 13 per

cent of all admissions, (8 per cent statewide)

The cancer mortality rate is 1.4 times higher than the

Queensland rate

Aboriginal and Torres Strait Islander people

represent 8.3 per cent of the population (twice the

Queensland average)

Life expectancy in the central west is slightly lower than

the Queensland average. The burden of disease is 21 per cent higher than the

state average

The leading causes of death are ischaemic

heart disease, cerebrovascular

diseases, lung cancer, diabetes and chronic

lower respiratory diseases

Recent child immunisation rates were almost 100 per cent of 4 year olds fully

vaccinated; and our Aboriginal and Torres Strait Islander children have one

of the highest rates in Australia

6 in 10 residents report they are

overweight or obese with only half meeting

national physical activity guidelines

Injury and poisoning have caused the highest rate of

hospitalisation over the last five years

Although 91 per cent of residents rated their quality of life as ‘very good’ or ‘good’:– 1 in 3 adults have high blood pressure– 1 in 4 adults have high cholesterol– 1 in 5 residents are ‘daily smokers’– 1 in 7 adults had risky levels of alcohol

consumption– 1 in 10 adults have diabetes/high blood sugar

The estimated population of the central west is 12,387 (0.3% of Queensland’s total

population)

6 2. Overview Central West Hospital and Health Service | Annual Report 2013–2014

2.1 Introductory information

Central West Hospital and Health Service (Central West Health) was established as an independent statutory body on 1 July 2012 under the provisions of the Hospital and Health Boards Act 2011 (the Act).

As an independent statutory body, Central West Health is overseen by a local health board. Central West Health is responsible for providing public hospital and health services including hospital services (accident and emergency, inpatient care, general and elective surgery, medical imaging and maternity services) as well as a range of community and primary health care services (immunisation, child and maternal health, chronic disease, allied health and mental health services).

The central west covers some 396,650 square kilometres of the state and includes the communities of remote central western Queensland from Tambo, in the south-east, to Boulia in the north-west.

Central West Health serves a population of approximately 12,400 persons and also services a large number of visitors seeking an outback experience during the winter months. At June 2011, 8.3 per cent of the service’s population identified as of Aboriginal or Torres Strait Islander origin, 5.8 per cent of the total population were born overseas and 19.5 per cent of those born overseas speak a language other than English at home.1

The model of service delivery is based on five hospital hubs in Alpha, Barcaldine, Blackall, Longreach and Winton with satellite primary health clinics at Aramac, Boulia, Isisford, Jericho, Jundah, Muttaburra, Tambo and Windorah and a procedural hub at Longreach.

Region-wide services for child and maternal health, Aboriginal and Torres Strait Islander health and chronic disease management, together with a range of allied health and community health services are based in Longreach and other service hubs.

1 Queensland Regional Profiles, Central West Regional Planning Area, Queensland Government’s Statistician’s Office, Queensland Treasury and Trade, 2014

2. Overview of the Central West Hospital and Health Service

Central West Health’s doctors also work in general practices across the region under contract or right of private practice arrangements to deliver an integrated approach to primary and acute healthcare.

Central West Health’s strategic plan was developed following consultation with local communities, councils and health care partners, aiming to sustain quality health services in the bush and improve access to specialist care for our residents. The plan aligns with the Queensland government’s Blueprint for better health and the government’s objectives for the community to revitalise frontline services, invest in effective planning and infrastructure, realise value for money and increase transparency for performance.

In 2013–14, Central West Health employed more than 350 clinical, administrative and operational staff (full-time, part-time and casual) and spent $58.6 million on healthcare services.

Hospitals – Longreach, Barcaldine, Blackall, Winton and Alpha

Central West Health operates five public hospitals delivering 24 hour accident and emergency care, acute inpatient services, pharmacy, physiotherapy and radiology services and outpatient clinics. Longreach hospital is the region’s procedural hub offering surgical and elective procedures as well as gynaecological and obstetric services through its regional maternity service. Three of the hospitals provide high care residential aged care services under a multipurpose health service model.

Primary Health Centres – Aramac, Boulia, Isisford, Jericho, Jundah, Muttaburra, Tambo and Windorah

In smaller communities, Central West Health operates primary healthcare centres providing 24 hour accident and emergency services, local nursing and primary healthcare and regular visiting medical, community, allied and mental health services. The Jericho community clinic operates three days per week. Each primary healthcare centre operates a hospital based ambulance supported by volunteer community drivers except for Aramac which has a Queensland Ambulance Service station.

7Central West Hospital and Health Service | Annual Report 2013–2014 2. Overview

Regional visiting services

All hospital and primary health centres are supported by visiting community, allied and mental health services based in Longreach, providing outreach support for managing chronic disease, rehabilitation following hospitalisation and community mental health case managers. Visiting medical services are provided by doctors from the region’s hospitals or the RFDS. Allied health services are also provided through the Medicare Local.

Telehealth

All sites are equipped to support telehealth consultations to enable clinicians and consumers to speak with a general practitioner, consult a specialist, and in each hospital, access emergency department support from the Queensland Retrieval Service.

General practice

All doctors employed by Central West Health have rights to private practice and work in private practices or in medical centres operated by Central West Health. This arrangement ensures that communities of the central west continue to have access to community general practice services.

2.2 Agency role and main functions

The service agreement between the Central West Health and the Department of Health identifies the healthcare services to be provided, the funding arrangements for those services and the performance indicators and targets required to ensure the identified outputs and outcomes are being achieved.

Section 19 of the Hospital and Health Boards Act 2011 sets out the main functions of a health service which include: • ensuring the operations of the service

are carried out efficiently, effectively and economically

• complying with health service directives that apply to the health service

• aligning heath service plans with statewide service plans

• improving the quality of health services delivered

• developing local clinical governance arrangements

• engaging with clinicians, health consumers and local communities about the provision of health services

• cooperating with other providers of health services in planning for, and delivering, health services

• managing service performance against the performance measures stated in the service agreement.

The health service is also responsible for maintaining the state’s health infrastructure and undertaking minor capital works.

Central West Health’s strategic plan 2012–16 outlines the board’s vision and strategic objectives for the delivery of healthcare in the central west, aligns with the government’s health priorities and key performance indicators for service delivery.

Vision

Excellence in healthcare for remote Queenslanders.

Purpose

Central West Health’s purpose is to deliver a service system that keeps our residents healthy and acts swiftly and with safety to treat ill-health. In order to achieve this purpose, Central West Health builds partnerships to enhance coordination efforts and embrace technologies that will promote its vision.

Values

The values that guide our behaviours and practices and hold us accountable to our community are:• quality and safety first• respect, care and compassion for our patients

and staff• innovation and change, always striving to

improve• professionalism and integrity, being open, fair

and honest• connection with our community, keeping

patients at the centre of what we do.

Central West Health’s strategic objectives for 2012–13 were identified by the board as priority areas for action and were confirmed by central west communities through consultation and engagement activities. These strategic priorities are open to ongoing community consultation regarding emphasis, prioritisation and future refinement.

These strategic objectives are to:• ensure patients have access to safe and high

quality healthcare services• sustain existing healthcare services to our

communities in a financially responsible manner

8 2. Overview Central West Hospital and Health Service | Annual Report 2013–2014

• encourage innovation and the use of health technologies to improve access to specialised services

• attract and retain a skilled and motivated healthcare workforce to meet the future needs of our communities

• engage with our communities and stakeholders.

2.3 Operating environment

While the infrastructure through which we deliver many of our healthcare services has been relatively fixed for many years, the models of healthcare and the expectations of our patients and communities are constantly changing.

In common with other very remote parts of Queensland, health services in the central west face a number of challenges associated with distance and isolation, increasing levels of chronic disease, workforce retention, and providing sustainable services to a small and geographically remote population.

At a national level, healthcare is expected to continue to be a significant component of national gross domestic product due to the ageing population, increases in chronic diseases, co-morbidity complexities and health technology development.

The August 2011 National Health Reform Agreement committed both levels of government to changes to co-fund efficient hospital costs, establish independent regional hospital boards and increase local community and clinical engagement in decisions about the planning, design and performance of health services. The Hospital and Health Boards Act 2011 established 17 hospital and health services in Queensland, defining the role and functions of health boards and the chief executive of the Department of Health.

It is a key expectation that the board exercise financial prudence and business acumen to enable Central West Health to meet the healthcare needs of its communities within the funding available in its service agreement. The board has conducted public meetings in order to actively listen to the community when developing the priorities for action of its strategic plan. It has committed to leverage technologies and partnerships that will best deliver healthcare services in a financially responsible manner.

Risks and challenges

Central West Health’s strategic plan identifies key risks and challenges for 2013–14 which are considered by the board when making decisions on issues such as future models of service delivery, workforce capability and infrastructure requirements.

The key risks and challenges include:• service demand - coal and gas resource

development in the region is expected to add significant pressure to local emergency and healthcare services

• effective engagement – consulting with our communities, clinicians and other stakeholders to ensure health services are effectively planned, designed and delivered

• health workforce – recruiting and maintaining a flexible health workforce and reducing reliance on external staffing

• health infrastructure – many buildings have serious defects and are costly to maintain in order to meet compliance standards

• effective governance – existing governance systems need strengthening to be effective in monitoring performance and compliance

• balancing the budget – strategies are needed to sustain services and improve efficiency without adversely impacting on standards, patient safety and staff

• implementing health reform – the new paradigm requires new relationships to be developed with the Minister for Health, the Department of Health, the Medicare Local and regional councils.

2.4 Machinery of government changes

Central West Health, established under the provisions of the Act on 1 July 2012, became responsible for the delivery of health services in the central west service area previously undertaken by the Department of Health. This included a transfer notice under Section 307 of the Act to move the assets, liabilities, contracts and agreements and regulatory instruments associated with the former health service district to the new health service. The transfer notice also contained a lease provision relating to the state’s interest in land and buildings.

While no further machinery of government changes were made during 2013–14, planning was undertaken for the transfer of non-operational government employee housing to the Department of Housing and Public Works from 1 July 2014 as part of a whole-of-government initiative. The transfer will be achieved through amendments to the Deed of Lease arrangement with the Department of Health.

9Central West Hospital and Health Service | Annual Report 2013–2014 3. Year in review

3.1 Improved healthcare services• Reduced long wait lists for general dental work to zero• Maintained the highest full childhood immunisation rates in the state• Expanded medical and chronic disease services in Alpha and Jericho• Completed preparation for transfer of primary health clinics in Birdsville and Bedourie• Established the Iningai health arcade in Longreach• Grew telehealth services by 23% on the previous year• Recommenced podiatry services• Improved access to general practices in Longreach, Barcaldine and Blackall

3.3 Building and developing the health workforce• Reduced reliance on medical locums and nurse agency staffing by over 50%• Established a medical workforce strategy to enhance the attraction and retention of doctors• Welcomed ten additional permanent doctors to Longreach, Barcaldine and Winton hospitals• Filled the region’s first dental officer position in Barcaldine in more than five years• Established a permanent chronic disease nurse practitioner in Boulia • Employed 13 graduate registered nurses to commence their careers in the bush • Restructured the region’s patient safety and quality team under the leadership of a redesign

advanced practitioner• Delivered Aboriginal and Torres Strait Islander cultural practice training to 75 per cent of staff

3.2 Upgrading and maintaining health facilities• Established a strategic asset plan for the central west to prioritise facility renewal and

redevelopment projects• Completed planning for replacement facilities in Alpha and Aramac and the introduction of CT

services in Longreach• Refurbished the Winton doctor’s residence and staff quarters• Undertook a major $8 million refurbishment of the Longreach hospital • Invested $1.5 million on 29 backlog maintenance projects across the region• Completed fire safety works on the residential aged care wing at Barcaldine hospital• Added two accommodation units at Longreach hospital for expectant mothers • Took delivery of a new residence for the director of nursing in Windorah

3.4 Governance, collaboration and engagement• Initiated a 10 year health plan with our health partners and local councils with consultations held

across the region• Published a strategic plan 2014–18 following public and staff consultation• Met with all seven regional and shire councils over the year to discuss health service needs and

directions• Held public meetings in Alpha, Jericho and Aramac on service redesign and infrastructure renewal• Achieved activity targets of the Service Agreement and delivered more services to central west

communities• Re-invested the 2012–13 operating surplus in extra services, maintenance works and upgrades to

facilities• Appointed Crowe Horwath as internal auditors to the health service and approved a fraud control plan• Created an informatics role in the future to improve data capture, quality and use

3. The year in review Key achievements of 2013–14 included delivering successful outcomes in the broad areas of improved healthcare services, upgrading and maintenance of health facilities, building and developing the health workforce and governance, collaboration and engagement.

10 4. Our performance Central West Hospital and Health Service | Annual Report 2013–2014

Accreditation

An effective patient safety and quality system is a pre-requisite for accreditation as a healthcare service. The system supports effective clinical governance over the clinical workforce, clinical practices, health outcomes achieved and the records maintained for a patient.

Central West Health is accredited under the Australian Council on Healthcare Standards (ACHS) EQuIPNational program (www.achs.org.au), a four year program designed to meet the Australian Commission on Safety and Quality in Health Care’s national safety and quality health service standards. A survey (audit) was conducted by the ACHS in June 2013 which confirmed the health service’s unconditional accreditation with a further progress survey due in September 2014.

Central West Health also operates three medical practices that are expected to meet accreditation to the Royal Australian College of General Practitioners’ Standards (www.racgp.org.au). Winton and Alpha are currently accredited by AGPAL, with Barcaldine due to complete its accreditation survey in August 2014.

Increases in incident reporting

The patient safety system aims to minimise unintended patient harm occurring as a result of the provision of healthcare services. This goal is reached through an understanding and implementation of human factors principles, understanding weaknesses in systems and processes and developing interventions to strengthen these weaknesses.

Central West Health continues to report and investigate clinical incidents and near misses as an integral part of risk mitigation and continuous improvement. Incidents are analysed based on their severity and the area of health affected. In 2013–14, 341 incidents were reported, 235 being ‘near misses’ where staff identified a possible incident prior to it having any impact on the patient.

107 incidents were assessed as having the potential to cause harm to a patient, with a reduction in severity events in category one (potential to cause death – 2) and category two (may cause permanent or temporary disability 5). Each of these more serious incidents are investigated using Root Cause Analysis (RCA) or human error and patient safety systems (HEAPS) methods. Outcomes from those investigations have resulted in procedural improvements, such as bedside handover procedures that better detect patient deterioration.

0

20

40

60

80

100

120DeathDisablementMinimal harmNo harm

Patientaccident

BehavioralInvasive/non-invasive care

FallMedication

Reported incidents – top five causes

88

12

32

18

1

25

15

1

1

2218

5

2

4. Our performance4.1 Central West Hospital and Health Service strategic plan 2012–16

Strategic objective 1: Ensure patients have access to safe and high quality healthcare

Strategies:• invest in the patient safety and quality system • rigorously investigate all incidents in a timely manner and disseminate findings• ensure all health professionals are registered and credentialed to their scope of practice.

Measures of success:• increased rate of incident reporting• all heath professionals are credentialed for their scope of practice• high level of patient/consumer satisfaction with healthcare.

http://www.achs.org.au

http://www.racgp.org.au

11Central West Hospital and Health Service | Annual Report 2013–2014 4. Our performance

Queensland bedside audit (QBA)

Central West Health participates in the annual statewide bedside audit (QBA). This audit collects extensive information on a range of patient safety and quality areas of the National Safety and Quality Health Service Standards. These include some of the highest risks for patient safety and quality for which data is not systematically collected, such as falls, malnutrition, pressure injury, medication safety, patient identification, and recognising and responding to the deteriorating patient.

The 2013 QBA revealed that Central West Health outperformed statewide results in a range of areas including patient involvement in handovers, patient identification, pressure injury and fall prevention, managing deteriorating patients and medication safety.

Surgical safety

Central West Health reports surgical safety through the Queensland Audit of Surgical Mortality (QASM). There were no reported deaths in relation to surgical mortality 2013–14.

Practitioner credentialing

In addition to registration through the Australian Heath Practitioner Regulation Agency (AHPRA), doctors, specialists, midwives and some health professionals working in Central West Health are required to demonstrate the currency of their qualifications and recent practice experience to an appropriately convened credentialing committee.

Central West Health collaborates with other health services towards the maintenance of a central database through the Rural and Remote Clinical Unit hosted by the Cape York Hospital and Health Service, which lists the scope of practice endorsed for all doctors, specialists and other health professionals.

During 2013–14, all health professionals working in Central West Health were correctly credentialed.

Consumer feedback

Feedback from patients is an important element in improving our services.

Although every effort is made to resolve complaints informally, all formal feedback from patients is recorded in the Department of Health’s PRIME database. Complaints are generally acknowledged within 5 days, investigated and a response provided to the complainant.

2013–14 evidences a three year high of 376 in the level of feedback recorded, which included 353 compliments across all sites (up from 230 last year). 23 complaints (6 per cent of total feedback) were received compared to 15 per cent last year.

Patient feedback

0

50

100

150

200

250

300

350

400

ComplaintsCompliments

2013–142012–132011–12

34

26

23

353204149


Strategic objective 2: Sustain existing healthcare services to our communities in a financially responsible manner

Strategies:• support clinicians by ensuring resources are prioritised into preventative and primary care• develop a strategic health infrastructure strategy to guide healthcare planning and prioritising resource

investment• consult with the Alpha-Jericho and Diamantina communities to develop a shared service plan for the

future of healthcare services• review all service models to eliminate inefficiencies and the duplication of services with other health

and aged care providers• build organisational governance to strengthen performance, compliance, financial capability and

public accountability.

Measures of success:• better resource investment through health infrastructure planning• service plans for Alpha-Jericho and Diamantina Shire• balanced year-end budget• increase in own-source revenue.

Sustaining health services

Maintaining local health services is a key priority for the board.

Hospital and healthcare services provide communities of the central west with 24 hour care, seven days per week, including acute hospitalisation, emergency department and associated radiology, pharmacy and allied health services. Where a patient’s care needs extend beyond the clinical service capability of the facility at which they present, patients are referred to a higher level of facility in the service area, or if necessary, for evacuation.

In 2013–14 Central West Health was contracted to provide 3,963 weighted activity units (a standardised measure of activity reflecting the cost and complexity of different health interventions). Actual activity achieved was above target at 3,979 despite transferring activity from hospital outpatients to the private general practices and reduced services at longreach hospital due to refurbishment works.

From 1 July 2014, the health service commenced operating primary healthcare clinics in Birdsville and Bedourie with the support of the Diamantina Shire Council, following the Central and North West Queensland Medicare Local’s decision to cease operating these clinics.

The health service also commenced operating the general practice in Blackall following the resignation of the medical superintendent right of private practice, ensuring the community continues to have access to private general practice services in Blackall and Tambo.

Multipurpose Health Services

Multipurpose Health Services (MPHS) were approved by the former Australian Government Department of Health and Ageing and currently fall under the Australian Government’s Department of Social Services. In order to continue to receive funding, health services must provide a report on their operation.

Due to changes in portfolio arrangements following the 2013 federal election, MPHS funding arrangements remained centrally coordinated by the Queensland Government’s Department of Health. It is expected that direct contracting arrangements will be implemented during 2014–15.

Alpha Barcaldine Winton

Available aged beds 5 6 6

Occupancy 49% 97% 82%

Improved dental care

The health service attracted an additional $0.3 million in 2013–14 under the Treating more public dental patients National Partnership Agreement, enabling the health service to use vouchers and purchase dental care from local and visiting private dentists to reduce wait lists. The health service also contracted the Denture Adventurer, a mobile denture service, to clear wait lists for dentures.

In January 2014 the health service established two permanent dental officer positions based in Barcaldine and appointed its first dentist for over five years.


As a result of these actions, the health service was able to provide 12,657 occasions of service, reducing wait lists for general dental care by two thirds to 165 persons and eliminating long wait times (persons waiting over 2 years for general care).

Alpha-Jericho service redesign completed

A local health plan for the Alpha-Jericho region was completed in September 2013 and made available to the local community. An extended consultation process was subsequently completed in March 2014 with the assistance of the Barcaldine Regional Council and a consultancy from Health Workforce Queensland.

With the commitment of additional funding support from the Queensland Government under the Revitalising Regional Communities Program, the board approved plans that will see increases to medical and chronic disease services, the re-introduction of short-stay hospital admissions, enhancements to ambulance response and availability and the retention of residential aged care. Services at Jericho will be expanded from three to five days per week.

The health service is currently completing advanced planning for the proposed co-location of purpose built health and community safety facilities in Alpha.

Planning health services in partnership

Central West Health, together with the Central and North West Queensland Medicare Local, Queensland Ambulance, the RFDS and representatives of the seven regional and shire councils, via RAPAD, completed consultations on a proposed 10 year health plan during June and July 2014.

The plan outlines strategies for the key health agencies and councils to work together and share resources, address health risk factors and priorities, and implement services in identified gaps over the coming decade.

It is expected the plan will be endorsed by each agency’s board in the third quarter of 2014.

Infrastructure

A large number of health facilities in the central west were built more than fifty years ago, are in poor condition and would fail to meet current design standards.

The board completed a strategic asset assessment and infrastructure strategy in September 2013, outlining key infrastructure renewal priorities and guiding maintenance investment requirements. Submissions have been lodged for priority capital works and maintenance enhancement projects based on identified priorities.

Location Nature of works Status

Alpha Purpose built co-location project Decision pending

Aramac Construct new primary health centre

Application made

Barcaldine Relocation and expansion of dental clinic

Application made

Blackall Replace hospital building Planning

Boulia Refurbish and expand clinic Application made

Longreach Medical imaging facility for CT scannerAir conditioning ductwork replacement

Application madeApplication made

Windorah Replacement clinic building Planning

The health service completed major fire and electrical safety upgrades with an $0.8 million refurbishment of the Longreach hospital (including asbestos removal and roofing replacement) and fire sprinkler and safety works in Barcaldine.

The health service met backlog maintenance program targets for the year and attracted a $0.6 million incentive payment to cover the remaining unfunded value of works.

Budget responsibility

In 2012–13, Central West Health delivered a modest $2.4 million surplus on operations, largely due to fiscal repair savings in staffing, contractors, advertising, staff travel and consultancy expenses and through improved revenue collecting from private patient fees.

The board announced its plan to reinvest the surplus as a community dividend, focussing on the upgrade of health facilities and provision of additional services. The financial result for 2013–14 reflects this intention, with a $0.8 million deficit arising due to additional repairs and maintenance spending and delivering more services than planned.

The board’s principle budget strategies over the first two years of operation have focussed on stabilising the permanent health workforce and optimising own-source revenue receipts. As detailed in section 5 and elsewhere in this annual report, the health service has more than exceeded its target of reducing reliance on medical locum and agency nursing by 50 per cent and is progressively increasing private practice fee recoveries in general practice and private health insurance admissions.


Strategic objective 3: Encourage innovation and the use of health technologies to improve access to specialised services

Strategies:• expand telehealth services• re-establish specialist cardiac services and establish new services in areas of high patient travel• improve coordination of referrals to enhance patient care and reduce

re-presentation• increase patient transport aid.

Measures of success:• double telehealth clinics• telehealth cardiac clinics established across the health service• reduce patient transports by 10 per cent.

Expanding telehealth services

It has long been recognised that rural and remote Queenslanders face significant access barriers to routine specialist and other healthcare services.

Over the past two years, Central West Health has opened access to 38 separate telehealth clinics including cardiology, geriatrics, respiratory, vascular, paediatrics, orthopaedics, haematology, maternity, hepatology, renal/urology, rheumatology, endocrinology, general medicine and dermatology. These add to existing uses of telehealth in psychiatry, pre-admission and medical retrievals.

0

20

40

60

80

100

120

140

160

180

All oth

ers

Pre-A

dmiss

ion and

pre-a

naesthesia

Psych

iatry

Orthopaedic

surg

ery

Cardiology

Oncology

Midwife

ry

Telehealth sessions 2013–14

3340

85

110

153 153163

Telehealth occasions of service in Central West Health continued to grow, showing a further 23% increase in 2013–14 from 597 last year to 737 this year.

It is estimated that the use of telehealth has reduced the travel burden on families and patients and saved an estimated $0.8 million on air and road travel costs plus further accommodation savings.

Patient and family feedback for telehealth has been overwhelmingly positive.

Increase to patient travel assistance

The health service provides travel and financial assistance to eligible patients to access the nearest available eligible specialist service under the Queensland Government’s Patient Travel Subsidy Scheme (PTSS). In January 2013 the Queensland Government doubled the reimbursement rates for accommodation and mileage allowances.

1,513 patients received PTSS assistance at a total cost of $1.8 million, an increase of 36 per cent on 2012–13. 28 per cent of claims were made by escorts approved to travel to support the patient’s care or on compassionate grounds. In many areas, the need to travel away from the region is being reduced through better use of telehealth. Travel for diagnostic imaging is also expected to be reduced if the health service is able to establish a CT scanner at Longreach hospital.

Number of patients – top five specialities

0

50

100

150

200

250

300

350

400

OpthalmologyGeneral surgery

CardiologyOrthopaedicsDiagnostic imaging

355

228

182 179

102

Boosting surgical services

Central West Health welcomed the re-establishment of the flying surgical service based in Roma to expand access to elective surgery at Longreach hospital. The service re-commenced in April and will make up to 10 visits each year. Local doctors assist the visiting surgeons, providing opportunities to maintain skills and facilitate outpatient care to patients.


Enhancing access to specialist services

Central West Health commenced the development of a strategy for specialist services aimed at building new patient pathways with specialists offering both visiting services and telehealth consultations. The strategy will leverage the rural health outreach fund administered by CheckUP Queensland.

Central West Health re-established the Indigenous cardiac outreach program in early 2013 providing visiting cardiac assessment to communities throughout the central west in partnership with the region’s general practices.

In mid 2014 the health service successfully attracted visits from the Indigenous respiratory outreach program.

Improving clinical information systems

Increasingly, improvement in patient healthcare requires the operation of effective information

Building the region’s medical workforce

The shortage of doctors working in the bush is well documented and has left many rural communities reliant on irregular fly-in fly-out locum doctors.

Tackling the workforce challenge required a re-think about how Central West Health recruits and employs doctors. During 2013–14 the health service executed its medical workforce strategy, restructuring medical positions across the health service and adding resident and training roles to the structure. The design aims to establish a self-sustaining regional medical team able to work in both private general practice and in our hospitals, provide relief staffing and support regional training and supervision.

In early 2014 the long serving medical superintendent right of private practice resigned from Blackall hospital. The medical superintendent assisted the health service to transition the medical

systems. Central West Health uses a suite of patient and clinical management systems made available through the Department of Health. This ensures patients’ health records are visible across the public health system to support their healthcare.

In 2013–14 the health service completed implementation of emergency department information systems at all its regional hospitals to monitor the assessment and treatment of emergency room presentations. Hospital performance is published online at www.health.qld.gov.au/hospitalperformance.

Work also commenced to integrate public and private primary healthcare records at the Iningai health arcade in partnership with the Longreach Family Medical Practice, further enhancing support to manage patient care plans. Information sharing is possible as doctors are contracted to the medical practice and comply with stringent privacy and confidentiality procedures.

workforce model and facilitate the continuity of the general practice. Recruitment for both positions has been completed with doctors to commence in late 2014.

Over the year, the health service almost achieved full medical employment, attracting 10 permanent doctors, including long term vacancies in Barcaldine and Winton. Resident doctors have been established in Longreach and Barcaldine and are joined by doctors undertaking training pathways, whilst Winton and Blackall have welcomed rotating junior doctors also undertaking further training.

In May 2014, all eligible senior medical officers agreed to transfer to employment contracts and become for first true employees of the health service (all staff are expected to be transferred to the employment of the health service by the end of June 2015). Employment contracts will enhance flexibility and reduce unnecessary complexity in employment arrangements.

Strategic objective 4: Attract and retain a skilled and motivated healthcare workforce to meet our communities future needs

Strategies:• develop a recruitment strategy to address health workforce shortages• Involve staff in the planning, design and delivery of services• establish a culture that promotes and encourages innovation, leadership and collaboration• improve the ‘liveability’ of staff housing.

Measures of success:• 50 per cent reduction in external staffing levels• high level of staff satisfaction• a leadership strategy is developed.

http://www.health.qld.gov.au/hospitalperformance

http://www.health.qld.gov.au/hospitalperformance


Consumer and community engagement strategy

Section 40(1)(b) of the Hospital and Health Boards Act 2011 requires each health service to produce a consumer and community engagement strategy.

Following consultations across the region, the board published its consumer and community engagement strategy 2013–15 in December 2012.

Graduate nursing opportunities

Central West Health, in collaboration with the Department of Health’s Office of the Chief Nurse, created 18 temporary part time positions to place graduating nurses in 2013–14. The scheme was designed to provide a rural health experience for graduates after the number of vacancies for nurses in the public health system seriously declined in 2013. The initiative complemented Central West Health’s own strategy of recruiting graduates to build its future nursing workforce.

13 nurses accepted placements in the region in 2013–14 to undertake career development and training in facilities across the central west, and are supported by clinical facilitators. One third of the previous year’s 17 placements secured a permanent nursing position in the health service.

Safety in the workplace

The workplace safety system aims to ensure a safe and productive workplace for all. The system involves awareness raising, regular workplace assessment and audits, incident reporting, risk assessment and statutory compliance reviews.

Reporting and investigating workplace incidents forms an integral part of risk mitigation and continuous improvement. In 2013–14 there were 177 workplace incidents reported compared to 180 in 2012–13.

The number of occupational violence incidents fell by 23 per cent to 39 incidents and together with 29 motor vehicle incidents (collisions with wildlife), represent the health service’s highest risk factors. WorkCover claims and costs fell by

75 per cent through better incident prevention and rehabilitation/return to work planning.

An external audit of the Central West Health’s workplace safety system for compliance with AS/NZS 4801:2001 was completed in March 2013, results demonstrating sound processes and in many cases, best practice was demonstrated. No non-conformances were identified and only three major improvements recommended (strategic planning, contractor management, equipment safe operation procedures). The work health and safety team were commended for their efforts over the past three years in maintaining high safety system standards which will also result in WorkCover premium reductions.

Clinician engagement strategy

Section 40(1)(a) of the Hospital and Health Boards Act 2011 requires each health service to produce a clinician engagement strategy.

Clinicians within the health service were consulted in the preparation of the strategy and comment was sought from clinicians employed by other agencies working in the central west.

The strategy aims to provide flexible ways for clinicians to contribute to patient safety and quality improvement, involve clinicians in the planning, design and delivery of healthcare services, build opportunities to input to healthcare policy and support clinicians to develop skills and conduct to have access to professional development that supports best practice healthcare.

The clinician engagement strategy 2013–15 was published in early 2013.

Strategic objective 5: Engage with our community and stakeholders

Strategies:• develop community and clinician engagement strategies• give a voice to our communities through consultation and feedback• be open and transparent with communities on the activities and performance of the health service• build partnerships with local health and aged care providers• collaborate with resource developers to contribute to the capacity of local health services• launch a new website.

Measures of success:• health service plans and engagement strategies are published on the internet• consumers actively participating in facility meetings and direction.


The engagement strategy adopts the International Association for Public Participation core values to support open and meaningful engagement with health consumers and communities.

The objectives of the strategy are to build community understanding about healthcare systems, provide mechanisms for communities to have direct input to decision making, harness consumer feedback to improve services, and ensure communities are satisfied with the level of engagement undertaken.

The strategy has been welcomed by communities and reflects the strong support for local input into decision making in healthcare.

Board engagement in communities

To ensure the board was accessible to communities and stakeholders, the board resolved to convene its meetings in locations around the central west. This provides the opportunity for members of local communities and local service provider representatives to meet and talk informally with the board. There is also scope to have items placed on the board’s agenda.

Following each board meeting, a communiqué is produced to outline the matters discussed and key decisions made. The communiqué is circulated to stakeholders including health service staff, councils, local members of parliament and the media. Copies are posted in each facility for public access.

Notices were also posted in all sites to provide information about the board. ‘Getting to know your health board’ was inspired from community feedback about knowing who the members of the board were and how communities could contact the board. All enquiries are able to be directed to the board secretary at [email protected].

In line with the objectives of the consumer and community engagement strategy, the board convened meetings during the year in Barcaldine, Blackall, Boulia, Longreach and Windorah.

The board also participated in consultations in all central west communities for the 10 year health plan and met with local councils throughout the year.

Community advisory networks

Community advisory networks (CANs) have been established in Alpha, Barcaldine and Winton where the health service operates a Multipurpose Health Service (MPHS).

The CANs review the operation of the integrated health and aged care services delivered in the community, monitor policy developments, and contribute to the planning and implementation of MPHS services.

The board appreciates the important role undertaken by the CANs and is working with the Medicare Local to support local health advisory groups in a number of communities. Both agencies have committed to joint engagement and collaboration.

Health protocols

In line with Section 42 of the Hospital and Health Boards Act 2011, Central West Health and the Medicare Local entered into a partnership agreement in December 2012.

The health protocol recognises the important relationship between the two health agencies in providing comprehensive primary and acute healthcare to the central west. The protocol sets out action to build collaboration, undertake joint community engagement and healthcare planning, improve information sharing and enhance services in the region, including out of hours care.

In October 2013, following a joint board meeting with the Central and North West Queensland Medicare Local in June, the board took a further opportunity to meet with the Medicare Local board and senior staff to discuss service delivery challenges in the Diamantina region, noting the important role both play in supporting safe accident and emergency services and primary health care.

4.2 Service delivery statements

Budget Paper 5 – Service Delivery Statements for 2013–14 outlines the strategic directions, resources and performance standards for Central West Health, forming an integral part of the Queensland Government’s annual budget plan.

Actual activity achieved for the year was 3,979 weighted activity units representing less than a 1 per cent variation. Emergency department and outpatient activity was expected to decline due to the strategy of building private practice capacity and

increasing medical clinics over the year. Activity in other categories is partly dependent on the variable nature of emergency presentations in rural hospitals and the availability of visiting surgical services - the latter expected to increase over 2014–15 with the return of the flying surgical service. Home visit numbers were down due to the greater distances required to attend home visits in the vast central west area - contact with new mums has been maintained by telephone and telehealth.


Performance statement

Weighted Activity Units (WAUs) (Note1)

2013–14 target/est

2013–14 adjusted

2013–14 actual

Acute inpatients 1,921 1,775 1,914

Outpatients 705 966 812

Sub-acute 217 189 197

Emergency department 1,219 1,093 937

Mental health 82 148 92

Interventions and procedures

36 25 27

In-home visits (newborns)

187 145 149

Ambulatory mental health contact hours

1,886 – 2,356

1,503 Not Avail

Note 1 - Weighted Activity Units are a standardised way of representing hospital activity so that the volume of outpatient consultations and surgical interventions (which vary considerably in cost and complexity) can be compared.

MOHRI target

Central West Health operated within the Minimum Obligatory Human Resource Information (MOHRI) staffing targets approved within its service agreement with the Department of Health. During 2013–14, the MOHRI full time equivalent staffing target was increased from 278 to 304 as a result of the purchase of additional services and the transfer functions from the Department of Health to Central West Health.

2013–14 target/est

2013–14 adjusted

2013–14 actual

Full time equivalent employees

278 304 318

4.3 Other plans and initiatives

Disability action plan

The Queensland Government is committed to enabling people with disability to have greater choice and control over disability care and supports, and to providing social and economic opportunities for people with disability. In December 2013, the Queensland disability plan 2016-19: Enabling choices and opportunities, was released. The plan aims to prepare Queensland for the transformative National Disability Insurance Scheme (NDIS) and make mainstream and community services and sectors, such as education, health, transport, tourism and housing, accessible and inclusive.

The Queensland disability plan also contributes to Queensland’s commitments under the National Disability Strategy 2010–20.

Central West Health is committed to ensuring appropriate access to services for Queenslanders with a disability, many of whom may present with a related chronic health condition or require support to access specialist services. The need to better engage with people with a disability and their carers so that they may contribute to future healthcare planning and service delivery is recognised as an ongoing consideration.

Central West Health’s consumer and community engagement strategy 2013–15 was developed in consideration with principles adapted from the core values of the International Association for Public Participation. The design of engagement processes includes consideration of smaller communities and supports the involvement of seniors, young people, people with a disability and Aboriginal and Torres Strait Islander people to enable all Queenslanders in the central west the opportunity to exercise their rights and responsibilities.

Queensland cultural diversity policy

The Queensland cultural diversity policy – Queensland, rich in our diversity – promotes unity in our society and a sense of belonging for all Queenslanders, regardless of cultural, linguistic, religious and ethnic backgrounds. The policy supports the government’s vision to provide equality of opportunity for all Queenslanders so that each and every person can participate in our strong economy and enjoy our vibrant society. It focuses on improving outcomes related to language independence, education participation and attainment, economic independence and participation and community participation.

Central West Health has established mechanisms engage with Aboriginal and Torres Strait Islander communities and attends the biannual sitting of the Barcaldine Negotiation Table. The health service also supports Indigenous leaders in convening a health and well-being committee to explore cultural safety and health outcome improvements to health services.

Mental health action plan

Central West Health’s mental health service is guided by the Fourth national mental health plan 2009–14, the Queensland plan for mental health 2007–17 and the national standards for mental health services 2010.

During 2013–14, Central West Health continued to provide a recovery focussed program. The program included education and case management support to adults, children and their families to promote wellness and prevent further deterioration of mental health. Education and support was also provided to teachers and guidance officers to facilitate early intervention.

http://www.communities.qld.gov.au/gateway/reform-and-renewal/disability-services/national-disability-insurance-scheme-in-queensland

http://www.dss.gov.au/our-responsibilities/disability-and-carers/program-services/government-international/national-disability-strategy

http://www.dss.gov.au/our-responsibilities/disability-and-carers/program-services/government-international/national-disability-strategy


The mental health program maintained links with other local service providers including the RFDS, Anglicare, and the Medicare Local, to ensure the best outcomes for clients who often have a wide range of complex needs that cannot be met by any one service.

Several health promotion events were held around the region to provide information, increase community awareness of available services and offer opportunistic screening.

In partnership with Medicare Local, an after-hours mental health orientation package was developed to better support clinical staff working in health facilities when clients presented with mental health issues after hours.

In-service training sessions were also held with nursing and medical staff to increase knowledge and clinical safety in working with clients at risk of suicide.

During 2013–14, the health service also provided feedback on the issues papers published by the Queensland Mental Health Commission to feed into a whole-of-government mental health, drug and alcohol strategic plan.

Closing the gap on Indigenous health

In December 2007 the Council of Australian Governments (COAG) agreed to six targets for closing the gap between Indigenous and non-Indigenous Australians. Of the six, the two health-specific targets are to close the gap in the life expectancy of Aboriginal and Torres Strait Islander people within a generation (by 2033); and to halve the gap in mortality rates for Aboriginal and Torres Strait Islander children under five within a decade (2018).

The National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes focuses on evidence based priority areas within a scope agreed by all jurisdictions. These priority areas are tackling smoking, healthy transition to adulthood, making Indigenous health everyone’s business, primary healthcare services that can deliver and fixing the gaps and improving the patient journey.

Central West Health contributes to improving health outcomes for the 1,004 persons who stated they were of Aboriginal or Torres Strait Islander origin at the time of the 2011 Census.2

2 Queensland Regional Profiles, Central West Regional Planning Area, Queensland Government’s Statistician’s Office, Queensland Treasury and Trade, 2014

Key outcome areas that are monitored under the Service Agreement with the Department of Health include: • Discharges against medical advice have been

up to three times higher for Aboriginal and Torres Strait Islanders in remote Australia and represent up to 4% of discharges in the central west. The long term trend is continuing to reduce the gap.

• Potentially preventable hospitalisations are also three times higher for Aboriginal and Torres Strait Islanders in the central west - the same rate as the rest of the state. Preventable admissions during 2013–14 were as high as 25% for the year.

• Low birth weight babies (under 2,500g) have remained low in the central west and on par with the state average - although was still twice the non-Indigenous rate. Almost 90% of mothers are attending ante-natal classes and the number of mothers who smoke during pregnancy has continued to fall slowly over the past five years (46% in 2012–13).

During 2013–14 the health service established the Iningai health arcade in partnership with the private general practice and the Medicare Local. Community health and specialist services were relocated to the new site offering a one-stop shop for the community’s primary health care needs. Extensive consultation was undertaken with the local Aboriginal and Torres Strait Islander community to ensure a culturally appropriate, welcoming space was created, culminating in a successful partnership with Red Ridge and the community to produce a most impressive piece of welcoming artwork featured in the background of the board’s photo.

The health service adopted recommendations from the Aboriginal and Torres Strait Islander Health and Wellbeing Sub-Committee to establish trainee health worker positions in Boulia and Longreach. The sub-committee was established through the Barcaldine Negotiation Table facilitated by the Queensland Government’s Department of Communities, Child Safety and Disability Services. Training was arranged through Toowoomba TAFE. The Indigenous health team is now fully staffed for the first time in several years.

During 2013–14 the cultural capability team from the Department of Health visited Longreach and provided Cultural Practice Program (CPP) facilitators with training and also piloted a CPP via videoconference. By year’s end, 75 per cent of staff had completed cultural practice training.

20 5. Community profiles Central West Hospital and Health Service | Annual Report 2013–2014

5. Community profiles

AlphaHospital and Multipurpose Health Service

Overview

Alpha hospital and multipurpose health service and co-located general medical practice offer a range of emergency, primary and visiting allied and mental health services and provide five residential aged care beds. The hospital operates an ambulance service in partnership with the Queensland Ambulance Service. There are approximately 985 people living in hospital’s catchment area. The facility is located 141 kilometres from the Barcaldine hospital and 169 kilometres from Emerald hospital.

Goals

The MPHS aims to:• provide 24/7 emergency medical and short-stay

hospital care• deliver general practice, primary and allied health

clinics• provide caring and accessible aged care• assist patients to access specialist care.

2013–14 milestones

The health board completed a redesign of health services in Alpha and Jericho and held public meetings in March 2014 in both towns. The redesign increases medical and chronic disease services, re-introduces short-stay hospital admissions (Mon-Fri), augments ambulance services and maintains residential aged care.

Visiting medical services increased in May 2014 to three days per week and will increase to four days in 2014–15.

Advanced planning has been completed to develop co-located health and community safety services in Alpha.

Consultations were held on the 10 year central west health plan in March 2014.

Staff quarters were refurbished with $31,678 from Queensland Health’s backlog maintenance program.

$27,638 was invested to replace an infusion pump and ventilator under the health technology replacement program.

Alpha

Performance data

Last year (2012–13)

This year (2013–14)

Operating budget (expenses)

$2.46m $2.50m

Full time equivalent staffing

15.5 16.8

Emergency presentations 102 45

RFDS aero retrievals 30 13

Total hospital separations 76 54

Total occupied bed days 1,309 1,023

Weighted activity units 182 115

Residential care occupancy rate

(59%) (49%)

Telehealth consultations 8 29

Patient subsidy claims 216 222

Note – the greater availability of doctors at the private practice has reduced emergency presentations and occasions of service

21Central West Hospital and Health Service | Annual Report 2013–2014 5. Community profiles

AramacPrimary Health Centre

Overview

The Aramac primary health centre is a nurse-led emergency care and primary health service supported by a staffed Queensland Ambulance Service station. There are approximately 299 people living in Aramac. The centre is located 67 kilometres by sealed road from the Barcaldine hospital and multipurpose health service.

Goals

The primary health clinic aims to:• provide 24/7 emergency response services;• enable access to a range or primary and allied

health care services; and• assist patients to access specialist care.


The health board convened consultations on the 10 year central west health plan in Aramac in March 2014.

The health service is consulting the community, through the local health action group, and the Barcaldine Regional Council on plans to develop a new primary health clinic building.

During the year, medical clinics increased to a full two days per week with the same doctors conducting the clinics to enhance continuity of care.

There was a threefold increase in the use of telehealth consultations, reducing the burden of travel for residents.

Aramac received a replacement Gemini infusion pump health technology replacement program.

An extensive refurbishment of the director of nursing’s residence was completed using $69,805 from Queensland Health’s backlog maintenance program.

Aramac

Performance data




$0.78m $0.79m


Ambulance responses NA NA






BarcaldineHospital and Multipurpose Health Service

Overview

Barcaldine hospital and multipurpose health service and co-located general medical practice offers a range of emergency, inpatient, primary and allied health services, a dental hub, 6 bed residential care and home and community care services. There are approximately 3,286 people living in hospital’s catchment area. The facility is located 106 kilometres from the Longreach hospital and 568 kilometres from Rockhampton base hospital.

Goals

The MPHS aims to:• provide 24/7 emergency medical and inpatient




The health board met in Barcaldine in April 2014 and there were 6 meetings of the health advisory group.


A permanent medical superintendent commenced in July 2013. Three more permanent doctors have since been employed to fill the roster.

A dental hub was established in January 2014 and welcomed the region’s first dental officer in five years.

$158,112 was invested under the health technology replacement program to replace X-Ray, EBG, disinfection equipment and infusion pumps.

Staff quarters and residences were refurbished using $212,533 from Queensland Health’s backlog maintenance program.

Fire sprinkler and safety works on the residential aged care unit was completed in May 2014.

Barcaldine

Performance data




$7.22m $7.55m


42.2 50.9


% seen within recommended time

97% 98%






98% 97%

HACC clients 78 67

Service hours 8,578 8,377

Transports 1,474 1,432

Meals on Wheels 5,237 4,672



Note – the greater availability of doctors at the private practice has reduced emergency presentations and occasions of service


BlackallHospital

OverviewThe 18 bed Blackall hospital provides emergency, outpatient, pharmacy and X-ray services and is supported by visiting allied, community, mental health and specialist clinics. There are approximately 2,254 people living in the hospital’s catchment area. The facility is located 214 kilometres by sealed road from the Longreach hospital and 963 kilometres from Royal Brisbane and Princess Alexandra hospitals.

GoalsThe hospital aims to:• provide 24/7 emergency medical and inpatient

hospital care• support general practice, primary and allied health

clinics• assist patients to access specialist care.

2013–14 milestonesThe health board met in Blackall in May 2014 and consulted the council on the board’s medical workforce strategy and local plans.


The long-term medical superintendent resigned in June 2013 and assisted the health service to transition medical services and to negotiate the transfer of the general practice to sustain access to general practice services.

The health board commenced scoping for a future replacement for the ageing Blackall hospital and will complete a concept plan in 2014–15.

Blackall increased patient access to telehealth consultations by 30%.

Staff quarters and residences were refurbished with $154,115 from Queensland Health’s backlog maintenance program.

$39,901 was invested in replacement medical equipment under the health technology replacement program including emergency room lighting and a ventilator.

Blackall

Performance data




$4.90m $4.71m


23.9 23.9



98% 99%








BouliaPrimary Health Centre

Overview

The Boulia primary health centre is a nurse-led emergency care and primary health service. There are approximately 471 people living in the Boulia catchment with a large Indigenous community. The centre is located 542 kilometres from Longreach hospital and 304 kilometres from the Mt Isa hospital by sealed road.

Goals

The primary health clinic aims to:• provide 24/7 ambulance and emergency response

services• enable access to a range or primary and allied

health care services• assist patients to access specialist care.


The health board met in Boulia in July 2013.

Consultations were held on the 10 year central west health plan in Boulia in April 2014.

A nurse practitioner with advanced chronic disease qualifications commenced in Boulia in May 2014.

Two trainee Aboriginal and Torres Strait Islander health workers commenced in April 2014 as part of a strategy to develop local skills.

A morgue fridge and trolley and defibrillator were acquired using $61,680 from the health technology replacement program.

$268,825 was invested in staff housing and car park upgrades from Queensland Health’s backlog maintenance program.

Boulia

Performance data




$0.69m $0.78m


Ambulance responses 59 15






IsisfordPrimary Health Centre

Overview

The Isisford primary health centre is a nurse-led emergency care and primary health service. There are approximately 262 people living in the Isisford service catchment area. The centre is located 117 kilometres by sealed road from Longreach hospital.

Goals





Consultations were held on the 10 year central west health plan in Isisford in March 2014.

Medical clinics were transferred to the Longreach hub in May 2014, ensuring increased continuity of medical clinics.

Isisford received an upgraded Lifepak15 defibrillator using $31,212 from the health technology replacement program.

Isisford farewelled Gloria Baker after several years of service as the Director of Nursing. Gloria has taken a Nurse Practitioner role in North West HHS, a qualification she completed whilst in Isisford.

Isisford

Performance data




$0.59m $0.63m








JerichoCommunity Clinic

Overview

The Jericho community health clinic is a nurse-led primary health service. There are approximately 369 people living in the Jericho service catchment area. The clinic is located 86 kilometres from Barcaldine hospital and 194 kilometres from Longreach hospital by sealed road.

Goals

The primary health clinic aims to:• provide restricted emergency response services• enable access to a range of medical, primary and

allied health care services• assist patients to access specialist care.



The health board completed a redesign of health services in Alpha and Jericho and held public meetings in March 2014 in both towns. Jericho community clinic will be expanded to provide access to health services five days per week with an increased focus on chronic disease care.

Visiting medical services were increased in May 2014 to a full day each week with dedicated doctors providing continuity of care.

The full transfer of clinical services from Anglicare was completed during the first half year.

Jericho received an upgrade in data and line communication services to better support clinicians to access Queensland health medical records and introduce telehealth services.

An air conditioning unit was installed at the clinic to improve working conditions.

Jericho

Performance data




$0.07m $0.14m

Emergency presentations 12

Ambulance responses 0

RFDS aero retrievals 1

Weighted activity units not reported

Telehealth consultations 0

Patient subsidy claims 41


JundahPrimary Health Centre

Overview

The Jundah primary health centre is a nurse-led emergency care and primary health service. There are an estimated 100 people living in the Jundah with approximately 365 in the Barcoo shire. The centre is located 217 kilometres by sealed road from Longreach hospital.

Goals





Consultations were held on the 10 year central west health plan in Jundah in March 2014.

Jundah received an upgraded Lifepak15 defibrillator using $31,212 from the health technology replacement program.

Upgrades have been made to improve access, replace floor coverings to staff quarters and re-paint the clinic using $97,594 from the Queensland Health’s backlog maintenance program.

Works were completed to expand and improve Jundah clinic’s pharmacy and storage spaces with funds from the health service minor capital works fund.

Scoping was completed for an upgrade to the site’s ramps and ambulance access. These works will proceed in 2014–15.

Jundah

Performance data




$0.51m $0.52m








LongreachDistrict Hospital

Overview

Longreach hospital is the region’s major healthcare facility offering 31 bed inpatient care, 24 hour emergency department, pharmacy and medical imaging services, elective surgery, maternity services and a dental hub. There are approximately 4,308 people living in the hospital’s catchment area. The facility is located 687 kilometres by sealed road from the Rockhampton base hospital and 1,177 kilometres from Royal Brisbane and Princess Alexandra hospitals.

Goals

The hospital aims to:• provide 24/7 emergency medical and inpatient

hospital care• provide access to locally delivered surgical, specialist

and maternity services• assist patients to access further specialist care• support general practice, primary and allied health

services.


The health board met at the hospital in June 2014.


The hospital has successfully recruited all senior medical officers for its roster and also appointed a resident. The hospital also places junior and student doctors.

A permanent dentist commenced conducting clinics from February 2014.

General outpatient services were transferred to a bulk-billing practice at the Iningai health arcade following its establishment in March 2014.

The hospital successfully completed a major $8 million upgrade of fire and electrical standards and improvements to staff and patient safety.

Staff quarters and residences were upgraded with $109,914 from the Queensland Health’s backlog maintenance program.

$261,874 was invested in replacement medical equipment under the health technology replacement program.

Longreach

Performance data




$13.2m $12.1m


66.1 66.2



99.3% 99.8%

Elective surgery procedures

374 272

Newborns 101 98


Total hospital separations 1,297 1,279


Weighted activity units 1,533 1,446


Patient subsidy claims not available 699


MuttaburraPrimary Health Centre

Overview

The Muttaburra primary health centre is a nurse-led emergency care and primary health service. The clinic hosts a weekly medical clinic and regular visits from allied health and mental health professionals. There are approximately 329 people living in Muttaburra. The centre is located 127 kilometres by unsealed road from the Longreach hospital.

Goals





Consultations were held on the 10 year central west health plan in Muttaburra in March 2014.

Medical clinics were increased to a full day each week with the same doctors conducting the clinics to enhance continuity of care.

Telehealth consultations continued to increase as more residents made use of available specialist clinics.

The director of nurse’s residence refurbishment was completed in November 2013. The project was funded from the Queensland Health’s backlog maintenance program.

Muttaburra received an upgraded Lifepak15 defibrillator using $31,212 from the health technology replacement program.

Administrative services became a little easier following the acquisition of a multi-function copier/ scanner/printer.

Muttaburra

Performance data



Operating budget (expenses) $0.53m $0.54m








TamboPrimary Health Centre

Overview

The Tambo primary health centre is a nurse-led emergency care and primary health service. There are approximately 611 people living in the Tambo service catchment area. The centre is located 102 kilometres from Blackall hospital and 315 kilometres from Longreach hospital by sealed road.

Goals






Tambo welcomed a new director of nursing in March 2014 when the very experienced Faye McClure transferred from Aramac.

Medical clinics were changed in June 2014 to operate two full day clinics on consecutive days.

Tambo received an upgraded Lifepak15 defibrillator using $31,212 from the health technology replacement program.

Flooring and floor coverings to the director of nursing residence, clinic and relievers flat were replaced using $33,754 from the Queensland Health’s backlog maintenance program.

Tambo

Performance data




$0.7m $0.7m








WindorahPrimary Health Centre

Overview

The Windorah primary health centre is a nurse-led emergency care and primary health service. There are an estimated 158 people living in the Windorah service catchment area. The centre is located 313 kilometres by sealed road from Longreach hospital.

Goals





The health board met in Windorah in September 2013.


Telehealth consultations grew during the year as more residents made use of available specialist clinics

A new 4 bedroom director of nursing residence was delivered in June 2014 following the board’s commitment of the health service’s minor capital works funds.

Flooring repairs were made and floor coverings were replaced to the clinic and relievers flat using $35,594 from the Queensland Health’s backlog maintenance program.

Windorah received an upgraded Lifepak15 defibrillator using $31,212 from the health technology replacement program.

Windorah

Performance data




$0.43m $0.49m








WintonHospital and Multipurpose Health Service

Overview

Winton hospital and multipurpose health service and co-located general medical practice offer a range of emergency, inpatient, primary and allied health services and include a 6 bed residential care unit. There are approximately 1,388 people living in hospital’s catchment area. The facility is located 179 kilometres from the Longreach hospital and 599 kilometres from Townsville base hospital.

Goals

The MPHS aims to:• provide 24/7 emergency medical and inpatient





The Winton community advisory network met 6 times in 2013–14

The hospital welcomed the appointment of a permanent Medical Superintendent (to commence in July 2014). The doctor will be supported by a regularly rotating junior medical officer.

A nurse practitioner role and mental health team leader position based in Winton were created during the year.

Regular dental services were established in partnership with the RFDS dental service.

The doctor’s residence and the nurses’ quarters were extensively refurbished during the year.

Winton hospital replaced a slit lamp during the year from the health technology replacement program.

Winton

Performance data




$4.0m $5.8m


27.5 37.5



NA NA






90% 82%

HACC clients assisted 0 0



33Central West Hospital and Health Service | Annual Report 2013–2014 6. Financial highlights

Income

Central West Health’s total income received for 2013–14 was $57.7 million, an increase of $3.3 million (6 per cent) on 2012–13, and comprised:• $42.2 million of Queensland Government

contributions • $9.2 million of Australian Government

contributions, largely for aged and community care services

• $2.1 million from Australian Government grants • $3.1 million of user charges, including fees

from aged residents, private health insurance recoveries and private practice billings

• $1.1 million of other revenue.

Revenue sources

73%Queensland Governmentcontributions

16% Australian

Governmentcontributions

5%User charges

4%Australian

Government grants

2%Other revenue

Total income was $6.6 million higher than reported in the 2013–14 Service Delivery Statement (12.5 per cent). Additional service funding was secured during the year to implement election commitments to conduct post-natal home visits and double patient transport subsidies, revitalise regional health services, place graduate registered nurses, build telehealth capacity, re-commence outreach dental services and finance building maintenance works and capital upgrades.

Expenditure

The total expenditure for 2013–14 was $58.6 million, an increase of $6.4 million on 2012–13. Key expenditure included:• $36.3 million for staff wages and on-costs• $2.4 million for patient travel and retrieval• $3.2 million for clinical supplies, including

drugs and pathology• $6.3 million on other supplies and services• $5.5 million on maintaining facilities

Total expenditure was $7.5 million higher than reported in the 2013–14 Service Delivery Statement (12.5 per cent to 14.7 per cent). The increase in spending related to the Central West Health board’s commitment to re-invest the 2012–13 surplus as a community dividend into additional services and the upgrade and maintenance of the regions health infrastructure.

This increased investment resulted in the planned deficit of $0.8 million.

Staff costs increased by $3.3 million compared to 2012–13 as a result of both filling permanent vacancies and due to award wage rises. Patient travel increased by a further $0.4 million, and together with aeromedical evacuation and inter-hospital ambulance transfers (other supplies), represents more than 4 per cent of the health service’s annual budget.

Key expenses

69%Labour andconsultancy

4%Aeromedical and

patient travel

6%Clinical supplies

11%Other supplies

10%Depreciation, repairs

and maintenance

6. Financial highlights 2013–14 6.1 Summary of financial performance

34 6. Financial highlights Central West Hospital and Health Service | Annual Report 2013–2014

Financial position

The health service’s assets comprise land, buildings, medical and other equipment with modest cash, inventories and receivable balances. Its liabilities are largely represented by supplier and staffing accruals. Staff leave provisions are included in the government’s centralised employee leave scheme and are not included on the balance sheet.

The net value of the health service’s assets decreased over 2013–14 by $1.9 million to $47.4 million as a result of the $0.8 million operating deficit and further capital investment in facility upgrades. Equity was increased by $0.7 million arising from the transfer of building works and health equipment acquired by the Department of Health, offset by an equity withdrawal of $1.7 million largely relating to non-cash depreciation expenses.

Assets (%)

1%Inventoriesand other

9%Cash and receivables

8%Plant and

equipment

82%Land andbuildings

35Central West Hospital and Health Service | Annual Report 2013–2014 7. Governance and accountability

Governance refers to the system, policies and practices that ensure an organisation meets its mission and objectives. Corporate governance is the framework of rules, relationships, systems and processes within and by which authority is exercised and controlled in organisations. It involves strategic and operational planning, monitoring and reporting systems, setting corporate culture and expectations and ensuring the establishment and implementation of risk and compliance systems to protect the integrity of the organisation, safety of patients and secure the long term viability of the health service.

7.1 Central West Hospital and Health Service board and committees

The Hospital and Health Boards Act 2011 defines the role of Central West Health’s board, which is to control the health service. The board functions under the authority of the Act and the requirements of the Hospital and Health Boards Regulation 2012.

The health board consists of seven members appointed by the Governor in Council on the recommendation of the Minister for Health. Board members are persons the Minister considers to have the skills, knowledge and experience required for a service to perform its functions effectively and efficiently.

The Governor in Council approves the remuneration arrangements for all Hospital and Health Service board chairs, deputy chairs and members. Chairs, deputy chairs and members were paid an annual salary consistent with the Government policy and guidelines on Remuneration of part-time chairs and members of government boards, committees and statutory authorities, 26 February 2010 up until 18 May 2014 when payments and entitlements were allocated according to the updated Remuneration procedures for part-time chairs and members of Queensland government bodies.

Board members

The board members have been appointed on the basis of their qualifications, specialist expertise and capabilities, knowledge and experience. They have a combined wide range of specialist and complementary skills which include demonstrated strategic capability, auditing, accounting and financial management skills, legal expertise, clinical expertise, governance experience, community development and media relations skills.

The skill mix of the board has enabled sound governance, effective strategic planning and sound financial and risk management during 2013–14.

Edward Warren (Chair)

Ed Warren has strong board experience and a wealth of local knowledge of the central western Queensland region, along with a background in rural planning and development. He served as the Mayor of Winton Shire Council for five years from 2008–12 and as the Chair, Central West Regional Group of Local Governments. He served as a councillor on the Winton Shire Council between 1997–2001 and 2004–07.

Ed has also held a number of company directorships in the region, including the board chair of Remote Area Planning and Development (RAPAD) board for the same five year period as he was Mayor. He is a current director of the Australian Age of Dinosaurs and a family company. In the past he has served as a director of the Waltzing Matilda Centre and the Outback Queensland Tourism Association. Ed is also past president of Winton Race Club, Chair of the North West Racing Association and a member of the Queensland Country Racing Committee.

David Arnold (Deputy Chair)

David Arnold is the General Manager of the Central Western Queensland Remote Area Planning and Development (RAPAD) board and Rural Financial Counselling Service Queensland - Central Southern Region. He is a director of RAPAD Employment Services Queensland which delivers the Australian Government’s remote jobs and communities program as well being committee member of Regional Development Australia, Fitzroy and Central West.

7. Governance and accountability

36 7. Governance and accountability Central West Hospital and Health Service | Annual Report 2013–2014

David previously worked for the Queensland Department of Primary Industries in rural community development and planning and environment roles. David is also active in community organistions, being a past president of Longreach Home and Community Care, the former community health network and a past president and coach of the Longreach Swimming Club. He was awarded the Longreach Shire Council Australia Day Administrators Award in 2004 and the Senior Sportsman of the Year in 2008.

David has a Graduate Certificate of Science in Strategic Foresight, a Bachelor of Business and an Associate Diploma of Applied Science.

Jane Williams (member)

Jane Williams is a registered nurse with 20 years experience in rural and remote health provision in Queensland. Jane holds qualifications in rural and remote health, management, community services coordination, nursing, midwifery, immunisation and rural isolated practice. Jane has an extensive range of experience in nursing and in financial and operational management for both clinics and community organisations.

Jane commenced her career as a student nurse in 1986 at Rockhampton base hospital and was appointed Director of Nursing for Alpha hospital, Queensland Health in 1993. Jane is currently the acting telehealth coordinator for Central West Health. She is strongly involved with the local community and was the 2011 Citizen of the Year for Alpha and Jericho, received a 2011 Flood Hero Award for work during the 2010–11 floods and won the 2011 Tidy Towns Outstanding Achievers Award.

Dr John Douyere (member)

Dr John Douyere is the Medical Superintendent at Longreach hospital and has special interest in rural obstetrics, general practice, anaesthesia, dermatology and medical education. He has more than 15 years experience as a general practitioner in rural Queensland working with communities in Ayr, Charleville, Kilcoy and Longreach.

John began his professional career as a medical officer at Townsville hospital before taking on a role as house officer at the Cunningham Centre, Toowoomba, which provides training, education, research and support to health professionals in rural and remote Queensland where he gained advanced skills in anaesthetics, intensive care and obstetrics and gynaecology.

He is a member of the Rural Doctors Association of Queensland, Australian Medical Association and Australian College of Rural and Remote Medicine.

William Ringrose (member)

Bill Ringrose has extensive business experience in the areas of auditing, taxation, corporate governance, probity and propriety and is a partner in a chartered accounting firm based in Longreach and has previous experience auditing local governments under contract with the Queensland Audit Office. He regularly travels the region and has forged strong relationships with local people to address community issues.

Bill has previously held various community positions including treasurer for the Longreach local ambulance committee and Longreach state school parents and citizens’ association and has volunteered his skills and time for local sporting clubs and Meals on Wheels.

Bill has a Bachelor of Commerce and is a chartered accountant with the Institute of Chartered Accountants of Australia.

Bruce Scott (member)

Bruce Scott owns and operates a cattle station in the channel country. Dedicated to regional development and rural communities, he was Mayor of Barcoo Shire for 12 years, before retiring in April 2012, and is currently Chair of Desert Channels Queensland and a director of the Regional Natural Resource Management Groups Collective board. He was formerly a director of the Remote Area Planning and Development (RAPAD) board.

His interest in improved regional and remote telecommunication services and in the environment, particularly renewable energy and zero emissions technology, compliments his commitment to sustainable development in regional and remote areas that is demonstrated by the key roles he has played in his community as member of Cooper’s Creek Catchment Committee, Geothermal Energy Working Group, Queensland State Government Single Wire Earth Return (SWER) Reference Group, Central West Regional Planning and Advisory Committee, the Outback Regional Roads Group and the Regional Telecommunications Independent Review Committee.

Peter Skewes (member)

Peter Skewes has 30 years professional experience as a solicitor and accountant and has served on local government as both Deputy Mayor of the Blackall-Tambo Regional Council and as a councillor of the Blackall Shire Council.


He currently owns and operates a dual legal and accounting practice, as well as being a partner in the Duthie Park Grazing Company. As a local business owner and grazier, Peter also has a long standing record of community service across central western Queensland. Peter has worked with various health and arts organisations to help communities achieve progress and development.

Peter’s qualifications include a Bachelor of Laws, Graduate Diploma of Legal Practice, Bachelor of Business, Certified Practising Accountant, Notary Public and Solicitor of the Supreme Court of Queensland and High Court of Australia.

Appointment terms and meeting attendance

Name Office Number of meetings attended

Initial term of appointment

Current term of appointment

Edward Warren Chair 11 of 11 18/05/12 – 17/05/13 18/05/13 – 17/05/16

David Arnold Deputy Chair 11 of 11 29/06/12 – 17/05/13 18/05/13 – 17/05/16

Jane Williams Member 9 of 11 29/06/12 – 17/05/13 18/05/13 – 17/05/16

Dr John Douyere Member 10 of 11 07/09/12 – 17/05/13 18/05/13 – 17/05/16

Bill Ringrose Member 7 of 11 29/06/12 – 17/05/13 18/05/13 – 17/05/16

Bruce Scott Member 8 of 11 07/09/12 – 17/05/13 18/05/13 – 17/05/16

Peter Skewes Member 11 of 11 29/06/12 – 17/05/13 18/05/13 – 17/05/16

Committees of the board

The Hospital and Health Boards Act 2011 and Hospital and Health Boards Regulation 2012 require boards to establish a range of committees to assist them in carrying out their responsibilities. Central West Health’s board has four established committees to assist in carrying out its responsibilities.

Executive committee

The executive committee is established under section 32A of the Hospital and Health Boards Act 2011 to work with the health service chief executive to progress strategic issues identified by the board and strengthen the relationship with the chief executive to ensure accountability in the delivery of services. The committee met 11 times in 2013–14.

Executive committee members:• David Arnold (Chair)• Edward Warren• Bruce Scott• Jane Williams

Audit and risk committee

The purpose of the audit and risk committee is prescribed in section 31 of the Hospital and Health Boards Regulation 2012 and is established under section 35 of the Financial and Performance Management Standard 2009. In accordance with section 34 of the Hospital and Health Boards Regulation 2012, the committee provides independent assurance and advice to the board on the health service’s risk management, internal control and compliance frameworks and its external accountability responsibilities as prescribed in the Financial Accountability Act 2009, the Auditor-General Act 2009, the Financial Accountability Regulation 2009 and the Financial and Performance Management Standard 2009. The committee met 3 times in 2013–14.

Audit and risk committee members:• William Ringrose (Chair)• David Arnold• Dr John Douyere• Brett Walsh (independent member commenced

in May 2014)


Finance committee

The finance committee is a prescribed committee under section 31 of the Hospital and Health Boards Regulation 2012. In accordance with section 33, the committee’s purpose is to provide strategic advice and recommendations to the board regarding the efficient, effective and economical operation of the health service and the appropriateness of resource allocations and investments. The committee met 10 times in 2013–14 and includes members of the executive management team (designated *).

Finance committee members:• Peter Skewes (Chair)• William Ringrose• Bruce Scott• Lorraine Mathison*• Melissa Schröffel* (to 28 January 2014)• Stephen Harbort* (from 16 April 2014)• Brett Walsh (independent member commenced

March 2014)

Clinical governance and innovation committee

The patient safety and quality committee is a prescribed committee under section 31 of the Hospital and Health Boards Regulation 2012. In accordance with section 32, the committee’s purpose is to provide assurance and strategic advice to the board on matters relating to patient safety and quality improvement and accreditation, clinical governance systems, health partnerships and clinician engagement, and clinical performance and accountability.

In July 2013, the former board patient safety and quality committee was re-established as a separate committee from the previous (largely operational) patient safety and quality committee and re-titled as the clinical governance and innovation committee.

The committee met 7 times in 2013–14 and includes members of the executive management team (designated *).

Clinical governance and innovation committee members• Jane Williams (Chair)• Dr John Douyere• Dr David Rimmer*• Lorraine Mathison*

7.2 Related entities

Central West Health does not control any other entities.

7.3 Executive management team

Central West Health has a small and dynamic executive management team charged with the responsibility of supporting the chief executive to implement the board’s strategic plan and manage the performance and quality of Central West Health’s operations and services.

Health Service Chief Executive – Michel Lok

The position of health service chief executive is Central West Health’s accountable officer and responsible to the board for the implementation of policy and strategic direction, compliance with legislation and healthcare standards, the achievement of performance targets and the management of risk. The health service chief executive takes a leadership role in communicating and consulting with communities, stakeholders, health partners and staff of the central west.

Michel Lok was appointed as the Health Service Chief Executive on 30 July 2012. He has worked extensively at both the commonwealth and state levels in healthcare planning and delivery. Prior to taking his appointment, Michel was acting Chief Operating Officer and Chief Financial Officer with the Cape York Hospital and Health Service and guided the former health district through national health reforms and the establishment of the independent health service.

Previously Michel led the Australian Government’s international manufacturing inspectorate program at the Therapeutic Goods Administration, provided strategic advice on Australia’s research investment at the National Health and Medical Research Council, and led financial services and governance at several commonwealth departments. He also has experience in developing Aboriginal health services and supporting the implementation of patient information systems.

Michel is a member of the Australian Institute of Company Directors and is a Certified Practicing Accountant.

Executive Director Medical Services – Dr David Rimmer

The position of executive director medical services was established in April 2013 to take overall responsibility for clinical governance, direct the medical workforce, facilitate all phases of medical staff development, manage the performance of general practices operated by the health service and provide oversight of allied health services. The role takes strategic leadership in clinical redesign and promotes the adoption of telehealth and establishes and maintains effective clinical business tools.


Dr David Rimmer graduated from The University of Queensland in 1977. After 5 years of broad hospital experience, he established a private general practice with his brother in Toowoomba providing a wide range of services including obstetrics, palliative care and inpatient management.

In 1997 he moved to Brisbane and pursued further training in emergency medicine, working at Mater Private Emergency Centre for 3 years, then with RFDS as medical officer in Kowanyama for 3 years, and then as emergency visiting medical practitioner at Wesley Emergency Centre. He continued to provide intermittent locum services for RFDS until 2009 and since then has provided locum services to rural practices through Queensland Country Practice’s senior reliever, predominantly to Longreach.

He holds Fellowship of Royal Australian College of General Practitioners (FRACGP), Fellowship of the Australian College of Rural and Remote Medicine (FACRRM) and Diploma of the Royal Australian and New Zealand College of Obstetrics and Gynaecology (DRANZCOG). He also holds current certificates in Emergency Management of Severe Trauma, Advanced Life Support Obstetrics, Advanced Paediatric Life Support, Emergency Life Support and Advanced Cardiac Life Support.

Executive Director of Nursing and Midwifery Services – Lorraine Mathison

The position of executive director of nursing and midwifery services provides strategic leadership for the nursing profession, including recruitment and retention strategies and growing the local workforce through training and development opportunities to expand knowledge and skills. Additionally, the role has line management responsibility for health services in the district and plays a key leading role in patient care and safety and the development of new models of care to better meet the changing health needs of the community.

Lorraine Mathison is a registered nurse who has worked in the healthcare industry for 32 years. During this time she has worked in a wide variety of services within the healthcare system.

Positions have ranged from specialist clinical nurse consultant and educator in the health and tertiary sectors to executive management positions requiring knowledge across the fields in human resource management, finance, education, quality and safety. Her specific areas of interest are maternity and emergency nursing.

Lorraine holds a Masters in Advanced Clinical Practice, a Graduate Certificate in Management, a Bachelor of Nursing, is an endorsed midwife, an endorsed mental health nurse and is currently undertaking a Masters in Health Service Management. Lorraine was a recipient of the Premier’s Award in Excellence for ‘Developing workplace culture of excellence’ in 2009.

Chief Finance Officer – Stephen Harbort

The chief finance officer (CFO) leads the finance function to promote the efficient, effective and economic use of resources across Central West Health. The chief finance officer formulates strategy, develops policies, constructs plans and budgets, oversees financial operations, monitors compliance and provides strategic and operational advice to business units, health service executives and the board. The position also provides professional support and direction to the functions of building, engineering and maintenance services, and business management.

Stephen Harbort commenced as A/Chief Finance Officer on 16 April 2014 and was later appointed to the position on a permanent basis. Stephen has 36 years experience in a number of accounting and management positions around Queensland including accounting functions in banking, manufacturing, retailing, construction, and government and general management in quarrying. Stephen’s government roles have included the roles of Chief Financial Officer, RoadTek, Executive Director Finance, Facilities and Property in Main Roads, and Director of Plant Hire Services. He joined Central West Health in April 2014.

Stephen is a Certified Practising Accountant, holding an Executive Masters in Government and a Masters in Leadership. Stephen has been a facilitator for CPA Australia, Australian Institute of Management and a lecturer in business skills for the Queensland University of Technology.


7.4 Senior management structure

The following chart outlines the senior management positions and the functions for which they hold responsibility.

7.5 Public Sector Ethics Act 1994

The upholding of ethical standards of behaviour by all staff of the health service is a priority for the board. Central West Health adheres to the Code of Conduct (the code) for the Queensland Public Service as set out in part 4 of the Public Sector Ethics Act 1994.

The ethical values of the code have been incorporated into the values and strategic objectives of the health service’s strategic plan to ensure the principles of integrity and impartiality, promotion of the public good, commitment to the system of government and accountability and transparency, guide business activities, decision making and promote ethical behaviour in the workplace.

Board members and executive members employed by the health service undertake annual declaration of interests and inform the chair of any changes in their relevant interests. The board chair is responsible for ensuring the declared conflicts are appropriately managed. At the beginning of each board or committee meeting, members declare any conflict of interest, whether actual, potential, apparent, or that appears likely to arise and these are managed in consultation with the chair.

High standards of ethical behaviour are also expected of all Central West Health employees. The health service works to ensure all employees are aware of the principles and values of ethical behaviour, know their obligations under the code, and are encouraged to take personal responsibility

in upholding the code. For many staff, particularly clinical staff, these obligations will also be reflected through the professional qualifications and standards required by their registration bodies. All employees are expected to display a commitment to integrity and accountability in the way in which they undertake their duties.

• New employees attend an orientation program which includes a session on the code of conduct as part of their induction. Existing employees are similarly expected to undertake periodic refresher training on the code through face to face or on-line training which is always available.

• In 2013–14, 200 staff participated in code of conduct training and15 staff completed the online ethical decision making course.

• 17 staff undertook training in a new ethics, integrity and accountability program supporting the incorporation of ethical practices in day to day settings.

• Five staff participated in complaints management training convened by the Queensland Ombudsman with two managers completing ‘your ethical compass’ training.

7.6 Risk management

Hospital and health services are statutory bodies under the Financial Accountability Act 2009 which imposes a duty to manage the statutory body

Mental health

Executive Director Medical Services

Dr David Rimmer

Medical services Administration services Training Maternity

2 x Practices BEMS

Allied health Finance Community health

5 x Hospitals

10 x Primary health clinics

Clinical governance

Chief Finance Officer

Stephen Harbort

People and Culture Manager

Kathy Hartland

Executive Director Nursing and Midwifery

ServicesLorraine Mathison

Board

Board secretary

Health Service Chief Executive

Michel Lok


efficiently, effectively and economically and to establish and maintain appropriate systems of internal control and risk management.

Risk is present within all organisations, including in hospital and health systems. Effective risk management enables Central West Health to have increased confidence that it can deliver its services, manage risks and threats to an acceptable degree and make informed decisions about the opportunities and challenges that risks create.

Central West Health has maintained an enterprise risk management system based on the principles of ISO standard AS/NZS 31000:2009:• improves planning processes and focus on

quality and continuity of service• contributes to improving resource efficiency and

general performance• contributes to the development of a positive

organisational culture• enhances accountability, responsibility, and

decision-making.

Central West Health’s risk management process provides a systematic and consistent approach to managing risks. The board’s audit and risk committee has specific responsibility to oversight risk management and assess risk threats on behalf of the board. The board’s clinical governance and innovation committee works in conjunction with the audit and risk committee to assess clinical risks and review risk treatment, risk mitigation and communication with clinicians.

Risk management is a standing agenda item on the board’s monthly meeting agenda where the updated strategic risk register is monitored. The board receives notification of any emergent and escalated risks from its committees and executive team and the planned responses. The board’s risk appetite is set at any risk assessed as very high and otherwise any high risk that is not within the health board’s capacity to control.

In November 2013 the health board reviewed its strategic risk register, set its risk appetite and tolerances and confirmed strategic risk classifications. In February 2014, the board participated in a further review facilitated by internal auditors Crowe Horwath to inform the development of the internal audit strategy and workplan for 2014–15.

7.7 Internal audit

The Financial and Performance Management Standard 2009 requires that a statutory body have an internal audit function if directed by the Minister, or if the statutory body considers it is appropriate to establish the function (s29).

The board’s audit and risk committee recognises the importance of a robust internal audit function to monitor compliance of the health service and make recommendations to improve the efficiency and effectiveness. In 2013–14, Central West Health appointed Crowe Horwath as internal auditors.

During the year, Crowe Horwath developed an audit strategy and three year work plan, undertook a review of the boards strategic risk framework, conducted audits of payroll and asset administration and reviewed the CFO’s financial management assurance process.

7.8 External scrutiny

External audit

The Queensland Audit Office (QAO) provides independent external audit services to both state and local government public sectors in Queensland. The Auditor-General provides the Queensland parliament with an independent assessment of the financial management-related activities of public sector entities to enhance public sector accountability.

The audit and risk committee received the QAO’s 2013–14 client strategy in December 2013 and met with QAO officials regularly during the audit engagement of the Central West Health’s financial statements in 2013–14. The QAO has completed its examination of the 2013–14 financial statements and its opinion is contained in this report confirming the health service’s compliance with applicable accounting standards, legislation and other prescribed requirements.

On 21 November 2013, the QAO released its report of hospital and health service financial statements of 2012–13 noting all 17 health services performed well in discharging their financial reporting obligations in their first year (QAO Report 8: 2013–14: Results of audit: Hospitals and Health Services entities 2012–13).

On 11 February 2014, the QAO tabled the second of two reports concerning the objectives and administration of right of private practice arrangements in the public health system (Report 13: 2013–14: Right of private practice: Senior medical officer conduct). Although Central West Health was not specifically examined during the audit, the Department of Health’s response to the audit has resulted in changes to private practice and employment arrangements for doctors employed in the health service.


Crime and Misconduct Commission

Any matter giving rise to the potential for official misconduct is reported to the Crime and Misconduct Commission (CMC), which may elect to investigate the matter if it is not satisfied with the agency’s investigation.

In 2013–14, one matter was reported to the CMC of potential or suspected official misconduct or fraud. The matter was fully investigated with no further action required.

Health Quality and Complaints Commission (HQCC)

The commission was established under the Health Quality and Complaints Commission Act 2006 (HQCC Act). The HQCC Act gave the commission responsibility for monitoring quality and safety in all public and private health services and for the management and review of complaints in relation to health service delivery.

Two complaints outstanding as at 1 July 2013 have been closed and no new complaints were received in 2013–14.

The Office of the Health Ombudsman (OHO), operating under the new Health Ombudsman Act 2013, will replace the HQCC from 1 July 2014.

Anti Discrimination Commission Queensland (ADCQ)

The commission was established under the Anti-Discrimination Act 1991 (ADCQ Act). The legislation aims to protect people in Queensland from unfair discrimination, sexual harassment and other objectionable conduct and through the commission provides a means to bring a complaint and have it resolved. Matters not resolved in the commission may be referred to the Queensland Civil and Administrative Tribunal (QCAT) for hearing and determination.

There were no complaints to the ADCQ in 2013–14. An ongoing matter was heard in QCAT in June 2014 and a decision is pending.

Office of the Information Commissioner

The Office of the Information Commissioner (OIC) is Queensland’s independent statutory body established under the Right to Information Act 2009 (Qld) and the Information Privacy Act 2009 (Qld) to promote access to government-held information, and to protect people’s personal information held by the public sector.

Complaints about breaches of privacy are dealt with through the complaints management system and in 2013–14, no significant privacy related complaints were received.

In 2013–14, two applications were processed under the Right to Information Act 2009 (RTI Act) which was two fewer than the previous year. One decision contained non-personal information and was published to a public disclosure log.

Central West Health supports the right of patients to see what information is held about them by a health facility or service. In 2013–14, thirty-eight applications for access to health records were processed administratively which was eight more than the previous year. If an application cannot be processed administratively it is referred for processing under the Information Privacy Act 2009 (IP Act) or the RTI Act. In 2013–14, three applications were processed under the IP Act which was one more than was processed the previous year.

No applications under either the RTI Act or the IP Act required internal or external review.

Privacy awareness week was held from 4–11 May 2014, with the aim to support legislative compliance and to promote awareness of privacy rights and responsibilities. It is important that all employees understand their responsibilities to avoid agency privacy breaches and Central West Health focussed its activities around the theme, ‘Privacy. Take charge’.

7.9 Information systems and record keeping

Under the Public Records Act 2002, Central West Health is regarded as a separate public authority with responsibility for managing records in its health service. These responsibilities include having regard for the policies, standards and guidelines issued by the state archivist about the making and keeping of public records and ensuring that full and accurate records are made and kept of health service activities.

During 2013–14, Central West Health continued to use the business classification system for the codification and naming of official records. Ideally, Central West Health aspires to the implementation of an electronic document records management system, however was unable to progress implementation in 2013–14 due to cost and other priorities on resources.

The health service completed a project to better manage the archival of records. Spreadsheets of administrative records were reconciled with stored records and sentenced against the Queensland State Archives General Retention and Disposal Schedule for Administrative Records QDAN 249 version 7. A backlog of administrative records overdue for destruction was lawfully disposed.

43Central West Hospital and Health Service | Annual Report 2013–2014 8. Workforce

Central West Health is a major employer in the region and an integral part of the communities in which it operates. Maintaining a skilled and committed frontline workforce is vital to supporting communities maintain good health and respond to emergencies when they occur.

8.1 Workforce profile

Central West Health employs more than 350 employees, which includes doctors, nurses, health professionals and support staff across the region, the vast majority performing frontline roles delivering health services and supporting patient care. Nurses and operational support staff represented the largest employment groups at 45 per cent and 26 per cent of the total workforce respectively.

Full time equivalent (FTE) staffing 2013–14

0

20

40

60

80

100

120

140

160External FTEInternal FTE

Healthprofessionals

Trades Operational Nursing Medical Managerialand clerical

49.96 13.99

4.31

2.07

144.32 87.22 1 14.99

Total full-time staffing numbers for 2013–14 was 318 FTE as the health service worked to improve roster management and focus resources to frontline operations. Over the same period, external staffing fell from 21 full time equivalents to 8.5 FTE reflecting improvements to recruitment and retention, particularly in medical.

More than nine per cent of Central West Health’s operational staff identify as being an Aboriginal and/or Torres Strait Islander person, as do more than 6 per cent of administrative staff and 2.3 per cent of nursing staff.

Improvements in staff performance, productivity and retention were realised during the year with the following gains:• reduction to excess staff leave balances for

accrued days off (down 19 per cent) and annual leave (down 18 per cent)

• fewer days lost through workplace accidents and incidents (down 57 per cent to 74 days) and a 75 per cent reduction in workers compensation costs

• 30 per cent reduction in permanent staff resignations

• further reductions in medical locum (52 per cent) and agency nursing (64 per cent).

8.2 Workforce governance

The executive management team is responsible to the health service chief executive for the development and performance of Central West Health’s workforce. The team is supported by a staff development and education workgroup and an occupational health and safety committee. It engages the clinical workforce through a medical advisory committee and directors of nursing forum.

The health service chief executive reports to the board regarding the status of the health workforce, compliance with the requirements the service agreement, key performance indicators for occupational health and the workforce and progress on the delivery of the workforce plan.

The health service has complied with its obligations and duties under relevant legislation, directives, policies and industrial instruments applicable.

Apart from the health service chief executive, all other health service employees remain employees of the Department of Health until Central West Health becomes a prescribed employer in accordance with section 20(4) of the Hospital and Health Boards Act 2011 from July 2015.

The health service chief executive has issued human resource management sub-delegations in accordance with section 67 of the Hospital and Health Boards Act 2011.

8. Workforce

44 8. Workforce Central West Hospital and Health Service | Annual Report 2013–2014

In anticipation of the transfer of employment for senior health service employees (as defined by section 71A), initially involving senior medical officers, the chief executive has obtained board approval for the application of human resource management policies and procedures and released delegations for their administration. The health service became the employer of contracted senior medical officers on 4 August 2014.

Being spread over such a vast geographic area, Central West Health operates under a devolved model of workforce oversight and decision making processes to ensure staff are provided with appropriate local guidance and performance management.

The health service has a people and culture team that provide services and support to management and staff to implement the health service’s vision and values.

The main functions of the people and culture team are to:• ensure that contemporary and strategic

frameworks, policies and systems are developed and implemented to align and guide the delivery of people management

• provide a range or personnel services to support effective workplace management practices, assist with recruitment and complex case management, coordinate advice on industrial and workplace reform, and oversight payroll and recruitment services provided by Central Queensland Hospital and Health Service under a separate service agreement

• support the development of workforce strategies, evaluate change management proposals and implement workforce and learning and development plans.

The health service commenced planning to manage the devolution of employer responsibilities from the Department of Health and is aiming to complete the transition by end June 2015.

8.3 Workforce planning, attraction and retention and performance

During the year the 2013–14 workforce plan was developed. The plan identified the barriers to attraction and retention and built strategies to redesign service models, promote the profile of working in the bush, improve recruitment planning and develop a future workforce strategy by supplying students and graduates.

Central West Health has also further progressed the implementation of its medical workforce strategy, restructuring roles in a number of hospitals to create a shared workforce with private general practices capable which creates internal relief and peer support across the regional medical workforce. Training and support elements are built into the model to support interest for students, junior relievers, residents and provisional fellows under the rural generalist program. The strategy has cleared major recruitment roadblocks, adding ten senior medical officers and two resident medical officers during the year.

The central west is now well regarded as a place providing an opportunity to start a career and to develop rural generalist skills on a number of training pathways. The health service has a positive perception amongst prospective candidates.

Central West Health works in partnership with Rockhampton recruitment unit of the Central Queensland Hospital and Health Service to ensure recruitment processes meet the requirements of health service directives and policy. Rockhampton assists applicants and employees with all phases of the employment process, including pre-employment and police checks. Central West Health retains responsibility for identifying the recruitment strategy for vacancies, developing suitable job descriptions and completing all stages of the selection process.

In 2013–14:• 55 permanent recruitment processes were

undertaken• 328 permanent, temporary and casual

vacancies were filled • the average time to fill an advertised position

was 32 days.

8.4 Training and development

Training and development of the health workforce is the cornerstone for delivery of high quality, safe and patient centred care.

All health staff are required to maintain their professional skills and competencies in line with their registration requirements with the Australian Health Practitioner Regulation Agency and their credentialing and scope of practice. Staff complete an annual performance and development plan with their supervisor to identify training needs and monitor compliance with mandatory training obligations. A nurse educator is employed within the region to conduct professional training programs and support graduate nurses through their first year rotations. Two clinical facilitator positions have been established on a long term temp basis to oversee the nursing graduates

45Central West Hospital and Health Service | Annual Report 2013–2014 8. Workforce

and provide support, training and maintaining competencies to all nursing staff within the health service.

Professional development and career management is guided by the executive leadership team for each of the health streams as well as for administrative and operational staff.

Central West Health participated in the 2013 Working for Queensland employee survey conducted through the Queensland Government’s Public Service Commission. 56 per cent of health service staff responded to the survey, the highest proportion of any health service. Following feedback on the results, a staff action plan was prepared to address staff concerns and implement suggestions for improvement.

The health service commissioned a Fish Philosophy training program in March 2014 in response to suggestions raised by staff on workgroup behaviours and attitudes. The Fish Philosophy encourages employees to make a contribution to their workgroup by taking personal responsibility of culture, be enthusiastic and creative, and to encourage and recognise the efforts and achievements in their team. 204 staff completed the training program and 5 staff were trained as train the trainers for the program.

Central West Health’s people and culture unit also provided a variety of training and development opportunities for managers and employees including:• recruitment and selection training• performance and development training for

managers • understanding the position occupancy report • developing and maintaining a supportive and

safe workplace culture • resolving informal complaints at the local level• performance management

District orientation is conducted on the first Monday of every month, ensuring all new starters receive important information about their employment and complete several mandatory training units. 80 new employees attended these sessions in 2013–14.

Central West Health also continued to implement the Queensland Health Aboriginal and Torres Strait Islander Cultural Capability Framework. The training aims to build cross-cultural knowledge and skills, helping to improve access to delivery of mainstream health services and programs to the Aboriginal and/or Torres Strait Islander people of the central west health service area. 282 staff completed training during the year (75 per cent of all staff).

8.5 Early retirement, redundancy and retrenchment

Employees may be offered a redundancy package where their role ceases to be funded or is no longer required following a review. Affected employees who did not accept an offer of a redundancy are offered case management for a set period of time, where reasonable attempts are to be made to find alternative employment placements.

Two staff were offered a voluntary redundancy during the year, both opted for the employee placement option and are actively attempting to find alternative employment positions.

No redundancy, early retirement or retrenchment packages were paid during this period.

46 9. Open data Central West Hospital and Health Service | Annual Report 2013–2014

The Queensland Government is committed to opening up opportunities to allow Queenslanders to develop innovative services and solutions through making more government data available to the public.

The open data initiative is part of the Queensland government’s public sector renewal program and its vision is to create the best public service in the nation, truly focused on the end customer – Queenslanders.

Open data is focused on the basic or ‘raw’ data that is collected, generated and stored by government. The annual reporting requirements for reporting data on consultancies, overseas travel and the Queensland cultural diversity policy are required to be reported through the online data portal. Data relating to Central West Health’s reporting against these requirements is accessible through the Queensland government’s open data website at www.qld.gov.au/data.

9. Open data

http://www.qld.gov.au/data


Abbreviations Abbreviations used throughout this report

ACHS Australian Council on Healthcare Standards

AHPRA Australian Heath Practitioner Regulation Agency

AGPAL Australian General Practice Accreditation Limited

CAN Community advisory network

CFO Chief finance officer

COAG Council of Australian Governments

DoHA Department of Health and Ageing

DON Director of nursing

EDMS Executive director medical services

EDoNMS Executive director of nursing and midwifery services

FTE Full time equivalent

QGIF Queensland Government Insurance Fund

GST Goods and Services Tax

HACC Home and Community Care

HHS Hospital and Health Service

HR Human resources

HSCE Health service chief executive

IHPA Independent Hospital Pricing Authority

ISO International Organisation for Standardisation

KPI Key performance indicators

MOHRI Minimum Obligatory Human Resource Information

MORoPP Medical officer right of private practice

MPHS Multipurpose health service

MSRoPP Medical superintendent right of private practice

NEAT National emergency access target

NEST National elective surgery target

NHFB National health funding body

PHC Primary healthcare centre

PTSS Patient travel subsidy scheme

QBA Queensland bedside audit

QTC Queensland Treasury Corporation

RFDS Royal Flying Doctor Service

RoPP Right of private practice

SMO Senior medical officer

VMO Visiting medical officers

WAU Weighted activity unit

48 Central West Hospital and Health Service | Annual Report 2013–2014

GlossaryAmbulatory care The care provided to hospital patients who are not admitted to the hospital,

such as patients of emergency departments and outpatient clinics. Can also be used to refer to care provided to patients of community-based (non hospital) healthcare services

Australian Commission on Safety and Quality in Health Care

The Australian Commission on Safety and Quality in Health Care was created by Health Ministers in 2006, and funded by all governments on a cost sharing basis, to lead and coordinate healthcare safety and quality improvements in Australia

Australian Council on Healthcare Standards

The Australian Council on Healthcare Standards (ACHS) is an authorised accreditation agency with the Australian Commission on Safety and Quality in Health Care. The ACHS is authorised to accredit healthcare organisations to the National Safety and Quality Health Services Standards (NSQHSS). These standards form the basis of many of the accreditation programs provided by the ACHS

CheckUP CheckUP Australia is a not-for-profit industry body dedicated to advancing primary healthcare by fostering innovation and integration and working collaboratively to deliver practical solutions focused on best practice outcomes for a better primary healthcare sector and better health for all

EQuIP5 EQuIP5 is the 5th edition of the ACHS Evaluation and Quality Improvement Program and is a four-year continuous quality assessment and improvement accreditation program for healthcare organisations that supports excellence in consumer/patient care and services

EQuIPNational EQuIPNational is the four year evaluation and quality improvement accreditation program for health services to ensure a continued focus on quality across the healthcare organisation

Home and Community Care

Home and Community Care provides assistance to frail older people, their carers and younger people with a disability who are at risk of premature or inappropriate admission to long term residential care to receive assistance in their own homes

Hospital and Health Service

A Hospital and Health Service is a separate legal entity established by the Queensland government to deliver public hospital services and replaced the former health service districts

Indigenous Cardiac Outreach Program

The Indigenous Cardiac Outreach Program aims to improve early diagnosis, management and clinical care of patients who have or are at risk of cardiovascular disease in remote Aboriginal and Torres Strait Islander communities

International Association for Public Participation

The International Association for Public Participation is the preeminent international organisation advancing the practice of public participation which seeks to promote and improve the practice of public participation or community engagement, incorporating individuals, governments, institutions and other entities that affect the public interest throughout the world

National Safety and Quality Health Service Standards

The National Safety and Quality Health Services Standards (NSQHSS) form the basis of many of the accreditation programs provided by the Australian Council on Healthcare Standards

Glossary


National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes

This agreement was established to address targets set by the Council of Australian Governments and sets out specific action to be taken by the Australian Government and complementary action by State/Territory governments to address the gap in health outcomes experienced by Aboriginal and Torres Strait Islander people

National Emergency Access Target

The National Emergency Access Target (NEAT) is based on the proportion of patients who present to a public emergency department to be admitted, referred for treatment to another hospital or discharged within four hours

National Elective Surgery Target

The National Elective Surgery Target (NEST) requires an increase in the percentage of elective surgery patients seen within the clinically recommended time

Primary care First level healthcare provided by a range of healthcare professionals in socially appropriate and accessible ways and supported by integrated referral systems including health promotion, illness prevention, care of the sick, advocacy and community development

Service Delivery Statements

The Service Delivery Statements form part of the suite of state budget papers and provide budgeted financial and non-financial information for the budget year

Telehealth Telehealth involves the use of telecommunications and information technology to provide access to health assessment, diagnosis, intervention, consultation, supervision and information across distance

Royal Flying Doctor Service

The Royal Flying Doctor Service of Australia is a not-for-profit organisation delivering extensive primary healthcare and 24-hour emergency service to those who live, work and travel throughout Australia

Central West Hospital and Health Service | Annual Report 2013–2014 Glossary

50 Compliance checklist Central West Hospital and Health Service | Annual Report 2013–2014

Summary of requirement Basis for requirement Annual report reference

Letter of compliance

A letter of compliance from the accountable officer or statutory body to the relevant Minister

ARRs – section 8 page 1

Accessibility Table of contentsGlossary

ARRs – section 10.1 page 1 page48

Public availability ARRs – section 10.2 inside front cover

Interpreter service statement Queensland Government Language Services PolicyARRs – section 10.3

inside front cover

Copyright notice Copyright Act 1968ARRs – section 10.4

inside front cover

Information licensing QGEA – Information LicensingARRs – section 10.5

inside front cover

General information

Introductory information ARRs – section 11.1 page 6

Agency role and main functions ARRs – section 11.2 page 7

Operating environment ARRs – section 11.3 page 8

Machinery of government changes ARRs – section 11.4 page 8

Non-financial performance

Government’s objectives for the community ARRs – section 12.1 Chair’s introduction

Other whole-of-government plans / specific initiatives ARRs – section 12.2 page 18

Agency objectives and performance indicators ARRs – section 12.3 page 7pages 10–17pages 20–32

Agency service areas, and service standards ARRs – section 12.4 page 17

Financial performance

Summary of financial performance ARRs – section 13.1 page 33

Governance – management and structure

Organisational structure ARRs – section 14.1 page 40

Executive management ARRs – section 14.2 page 38

Related entities ARRs – section 14.3 page 38

Government bodies ARRs – section 14.4 N/A

Public Sector Ethics Act 1994 Public Sector Ethics Act 1994 (section 23 and Schedule)ARRs – section 14.5

page 40

Governance – risk management and accountability

Risk management ARRs – section 15.1 page 40

External scrutiny ARRs – section 15.2 page 41

Audit committee ARRs – section 15.3 page 37

Internal audit ARRs – section 15.4 page 41

Public Sector Renewal ARRs – section 15.5 Chair’s introduction

Information systems and recordkeeping ARRs – section 15.6 page 42

Governance – human resources

Workforce planning, attraction and retention, and performance

ARRs – section 16.1 page 44

Early retirement, redundancy and retrenchment Directive No.11/12 Early Retirement, Redundancy and RetrenchmentARRs – section 16.2

page 45

Open data Open data ARRs – section 17 page 46

Financial statements

Certification of financial statements FAA – section 62FPMS – sections 42, 43 and 50ARRs – section 18.1

page 41 of financial statements

Independent Auditors Report FAA – section 62FPMS – section 50ARRs – section 18.2

page 42 of financial statements

Remuneration disclosures Financial Reporting Requirements for Queensland Government AgenciesARRs – section 18.3

page 38 and 39 of financial statements

FAA Financial Accountability Act 2009 FPMS Financial and Performance Management Standard 2009ARRs Annual report requirements for Queensland Government agencies

ATTACHMENT A: Compliance checklist

Central West Hospital and Health Service

Financial statementsfor year ended 30 June 2014

1

Central West Hospital and Health Service Financial Statements 2013-14

Contents

Statement of Comprehensive Income ................................................................................... 1

Statement of Financial Position ............................................................................................ 2

Statement of Changes in Equity ........................................................................................... 3

Statement of Cash Flows ...................................................................................................... 4

Notes to and forming part of the financial statements ........................................................... 5

Management Certificate ...................................................................................................... 41

Independent Auditor’s Report ............................................................................................. 42

General Information

Central West Hospital and Health Service (Central West Health) is a Queensland Government statutory body established under the Hospital and Health Boards Act 2011. Central West Health is controlled by the State of Queensland which is the ultimate parent entity. The principal address of Central West Health is: Glasson House Eagle Street Longreach QLD 4730 A description of the nature of the operations and principal activities of Central West Health is included in the notes to the financial statements. For information in relation to financial statements of Central West Health, email [email protected]

Central West Hospital and Health Service Statement of Comprehensive Income For the year ended 30 June 2014

1

Statement of Comprehensive Income

Notes 2014 2013

$’000

$’000

Income from continuing operations

User charges and fees 4

55,149

52,004

Grants and contributions 5

2,111

2,187

Interest

1

2

Other revenue 6

479

211

Total income from continuing operations

57,740

54,404

Expenses from continuing operations

Employee expenses 7

489

514

Health service employee costs 8

31,906

28,617

Supplies and services 9

22,171

19,730

Depreciation 10

3,465

2,762

Impairment losses 11

(1)

3

Other expenses 12

555

348

Total expenses from continuing operations

58,585

51,974

Operating result from continuing operations

(845)

2,430

Other comprehensive income

Items that will not be re-classified to operating result

Increase in asset revaluation surplus 17

65

1,796

Total items that will not be re-classified to operating result 65

1,796

Total comprehensive income for the period

(780)

4,226

The accompanying notes form part of these statements.

Central West Hospital and Health Service Statement of Financial Position As at the 30 June 2014

2

Statement of Financial Position

Notes

2014

2013

$’000

$’000

Current assets

Cash and cash equivalents 13

3,515

5,139

Receivables 14

1,344

669

Inventories 15

456

473

Other current assets 16

36

144

Total current assets

5,351

6,425

Non-current assets

Property, plant and equipment 17

46,894

46,452

Total non-current assets

46,894

46,452

Total assets

52,245

52,877

Current liabilities

Payables 18

4,864

3,629

Accrued employee benefits 19

10

18

Total current liabilities

4,874

3,647

Total liabilities

4,874

3,647

Net assets

47,371

49,230

Equity

Contributed equity 43,924 45,004

Accumulated surplus

1,585

2,430

Asset revaluation surplus 20

1,862

1,796

Total equity

47,371

49,230


Central West Hospital and Health Service Statement of Changes in Equity For the year ended 30 June 2014

3

Statement of Changes in Equity

Notes

2014

2013

$’000

$’000

Accumulated surplus

Balance at the beginning of the financial year

2,430

-

Operating result from continuing operations

(845)

2,430

Balance at the end of the financial year

1,585

2,430

Asset revaluation surplus


1,796

-

Total other comprehensive income

Increase in asset revaluation surplus 20

66

1,796


1,862

1,796

Contributed equity


45,004

-

Transactions with owners as owners

Equity injections

1,724

45,857

Equity withdrawals

(3,469)

(2,753)

Net equity injection 22

(1,745)

43,104

Non-appropriated equity transfer

Net machinery of government transfers

Assets received

665

1,900

665

1,900


43,924

45,004

Total equity

47,371

49,230


Central West Hospital and Health Service Statement of Cash Flows For the year ended 30 June 2014

4

Statement of Cash Flows

Notes

2014

2013

$’000

$’000

Cash flows from operating activities

Inflows

User charges and fees

51,027

49,940

Grants and contributions

2,111

2,357

Health service employee expense recoveries

57

166

Interest receipts

1

2

GST collected from customers

24

42

GST input tax credits from ATO

1,418

1,113

Other

421

36

Outflows

Employee expenses

(497)

(496)

Health service employee costs

(31,906)

(28,617)

Other supplies and services

(20,871)

(17,772)

GST paid to suppliers

(1,436)

(1,217)

GST remitted to ATO

(22)

(40)

Other

(273)

(718)

Net cash provided by (used in) operating activities 21

54

4,796

Cash flows from investing activities

Outflows

Payments for property, plant and equipment

(3,402)

(762)

Net cash provided by (used in) investing activities

(3,402)

(762)

Cash flows from financing activities

Inflows

Equity injections

1,724

1,105

Net cash provided by (used in) financing activities

1,724

1,105

Net increase/(decrease) in cash and cash equivalents

(1,624)

5,139

Cash and cash equivalents at the beginning of the financial year 5,139

-

Cash and cash equivalents at the end of the financial year

13 3,515 5,139

The accompanying notes form part of these statements

Central West Hospital and Health Service Notes to and forming part of the Financial Statements For the year ended 30 June 2014

5

Notes to and forming part of the financial statements

Note 1 Objectives and strategic priorities of Central West Health Note 2 Summary of significant accounting policies Note 3 Major services, activities and other events Note 4 User charges and fees Note 5 Grants and contributions Note 6 Other revenue Note 7 Employee expenses Note 8 Health service employee costs Note 9 Supplies and services Note 10 Depreciation Note 11 Impairment losses Note 12 Other expenses Note 13 Cash and cash equivalents Note 14 Receivables Note 15 Inventories Note 16 Other current assets Note 17 Property, plant and equipment Note 18 Payables Note 19 Accrued employee benefits Note 20 Asset revaluation surplus by class Note 21 Reconciliation of operating surplus to net cash from operating activities Note 22 Non-cash financing and investing activities Note 23 Commitments for expenditure Note 24 Contingencies Note 25 Restricted assets Note 26 Trust transactions and balances Note 27 Financial instruments Note 28 Key management personnel and remuneration Note 29 Events after the reporting period


6

1 Objectives and strategic priorities of Central West Hospital and Health Service

Central West Hospital and Health Service (referred to in these statements hereafter as ‘Central West Health’) was established on 1 July 2012 as an independent statutory body governed by a Hospital and Health Board. Central West Health is accountable to the local community and the Queensland Parliament for the delivery of public hospital services and other health services to the communities of rural central western Queensland, extending from Tambo in the South-East to Boulia in the North-West.

Central West Health’s vision is to achieve excellence in health care for remote Queenslanders. To achieve this, it is essential that services are well planned and organised and that they evolve and change in line with changing health care practice and community needs. This is reflected in the following five strategic outcomes:

• Ensure patients have access to safe and high quality health care, invest in the patient safety and quality system, rigorously investigate incidents in a timely manner and disseminate findings

• Sustain existing health care services to our communities in a financially responsible manner, prioritise preventative and primary care, invest in health infrastructure planning and increase own-source revenue

• Encourage innovation and the use of health technologies to improve access to specialised services, expand use of telehealth services and establish specialist services in areas of high patient travel, improve co-ordination of referrals to enhance patient care and reduce re-presentation and increase patient transport aid

• Attract and retain a skilled and motivated health care workforce to meet our community’s future needs, promote and encourage innovation, leadership and collaboration

• Engage with our community and stakeholders, build partnerships with local health and aged care providers, collaborate with resource developers to contribute to the capacity of local health services.


7

2 Summary of significant accounting policies

(a) Statement of compliance

These financial statements have been prepared pursuant to section 62(1) of the Financial Accountability Act 2009 (the Act), and relevant sections of the Financial and Performance Management Standard 2009.

These financial statements are general purpose financial statements and have been prepared on an accrual basis in accordance with Australian Accounting Standards and Interpretations issued by the Australian Accounting Standards Board. In addition, the financial statements comply with Queensland Treasury and Trade’s Minimum Reporting Requirements for the year ending 30 June 2014 and other authoritative pronouncements.

With respect to compliance with Australian Accounting Standards and Interpretations, Central West Health has applied those requirements applicable to not-for-profit entities, as Central West Health is a not-for-profit public sector entity. Except where stated, the historical cost convention is used.

(b) The reporting entity

The financial statements include the value of all income, expenses, assets, liabilities and equity of Central West Health.

(c) Trust transactions and balances

Central West Health acts in a fiduciary trust capacity in relation to patient trust accounts. Consequently, these transactions and balances are not recognised in the financial statements.

Central West Health acts as an agent in respect of the transactions and balances of the Right of Private Practice bank accounts. Transactions relating to revenue retained by medical practitioners under a Right of Private Practice agreement are managed in an agency capacity, except for payments to Central West Health for recoverable costs which are recognised as controlled revenue in Central West Health’s accounts. At balance date any monies remaining in these bank accounts that represent Central West Health’s revenue is accrued as revenue in Central West Health’s accounts.

Although patient and Right of Private Practice funds are not controlled by Central West Health, trust activities are included in the audit performed annually by the Auditor-General of Queensland. Note 26 provides additional information on these transactions and balances.

(d) User charges and fees

User charges and fees are controlled by Central West Health when they can be deployed for the achievement of Central West Health objectives.

Government funding revenue is received in accordance with Central West Health’s Service Agreement with the Department of Health. Block funding from the Commonwealth and State governments is received for services and other State funding is provided for depreciation and minor capital works. Both Commonwealth and State funding is managed and paid by the Department of Health to Central West Health. Funding is recognised as revenue for the period in which it relates.

This funding revenue was previously recognised in 2012-13 as grants and contributions income. Comparatives have been restated to improve transparency across the years. Further details are contained in Note 2(v).

User charges and fees controlled by Central West Health are also comprised of hospital fees, sales of goods and services and rental income.

Hospital fees mainly consist of private patient hospital fees, interstate patient revenue, Department of Veterans’ Affairs revenue and residential aged care charges.

Private patient hospital fee revenue is recognised when invoices are raised. Interstate patient revenue and Department of Veterans’ Affairs revenue is recognised based on estimates of revenue earned.


8

2 Summary of significant accounting policies (continued)

(e) Grants and contributions

Grants, contributions, donations and gifts that are non-reciprocal in nature are recognised as revenue in the year in which Central West Health obtains control over them. This includes amounts received from the Australian Government for programs that have not been fully completed at the end of the financial year. Where grants are received that are reciprocal in nature, revenue is recognised over the term of the funding arrangements.

Contributed assets are recognised at their fair value. Contributions of services are recognised only when a fair value can be determined reliably and the services would be purchased if they had not been donated.

(f) Special payments

Special payments include ex gratia expenditure and other expenditure that Central West Health is not contractually or legally obligated to make to other parties. In compliance with the Financial and Performance Management Standard 2009, Central West Health maintains a register setting out details of all special payments greater than $5,000.

The total of all special payments (including those of $5,000 or less) is disclosed separately within Other expenses (Note 12). However, descriptions of the nature of special payments are only provided for special payments greater than $5,000.

(g) Cash and cash equivalents

In accordance with 31(2) of the Statutory Bodies Financial Arrangements Act 1982, Central West Health obtained approval through Queensland Treasury and Trade for a bank overdraft facility of $500,000 on its main operating bank account. This arrangement forms part of the whole of government banking arrangements with the Commonwealth Bank of Australia and allows Central West Health access to the whole-of-government debit facility up to its approved limit. As at 30 June 2014 the draw down balance is nil.

(h) Receivables

Trade debtors are recognised at their carrying value less any impairment. The recoverability of trade debtors is reviewed on an ongoing basis at an operating unit level, with provision being made for impairment. Trade receivables are generally settled within 60 days, while other receivables may take longer than twelve months. Any allowance for impairment is based on loss events disclosed in Note 27(c). All known bad debts are written off when identified.

(i) Inventories

Inventories consist mainly of pharmaceutical medical supplies held for distribution in hospitals and are provided to patients free of charge except for pharmaceuticals which are provided at a subsidised rate. Inventories are measured at weighted average cost, adjusted for obsolescence.

Unless material, inventories do not include supplies held for ready use in the wards throughout the hospital facilities and are expensed on issue from the Department of Health’s main storage facilities.

(j) Property, plant and equipment

Acquisition and recognition of assets

Actual cost is used for the initial recording of all non-current asset acquisitions. Cost is determined as the value given as consideration plus costs incidental to the acquisition, including all other costs incurred in getting the assets ready for use, including architects’ fees and engineering design fees.

The cost of items acquired or transferred in during the financial year has been judged by management to materially represent the fair value at the end of the reporting period.


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(j) Property, plant and equipment (continued)

Acquisition and recognition of assets (continued)

Where assets are received for no consideration from another Queensland Government entity (whether as a result of a machinery of Government change or other involuntary transfer), the acquisition cost is recognised as the gross carrying amount in the books of the transferor immediately prior to the transfer together with any accumulated depreciation. Assets acquired at no cost or for nominal consideration, other than from an involuntary transfer from another Queensland Government entity, are initially recognised at their fair value at the date of acquisition in accordance with AASB 116 Property, Plant and Equipment.

The majority of Central West Health’s assets were acquired under this arrangement. On 1 July 2012, land and buildings were transferred to Central West Health via a three year concurrent lease (representing Central West Health’s right to use the assets) from the Department of Health, and recognised as an adjustment to equity within the Statement of Changes in Equity. Under the terms of the lease no consideration in the form of a lease or residual payment by Central West Health is required.

In accordance with the definition of control under Australian Accounting Standards, Central West Health recognises the value of these assets in the Statement of Financial Position.

Items of property, plant and equipment with a cost or other value equal to more than the following thresholds and with a useful life of more than one year are recognised at acquisition. Items below these values are expensed on acquisition.

Class Threshold

Buildings $10,000

Land $1

Plant and Equipment $5,000

Land improvements are included in the building class.

Revaluation of non-current assets

Land and buildings are measured at fair value in accordance with AASB 116 Property, Plant and Equipment, AASB 13 Fair Value Measurement and Queensland Treasury and Trade’s Non-Current Asset Policies for the Queensland Public Sector. These assets are reported at their revalued amounts, being the fair value at the date of valuation, less any subsequent accumulated depreciation and impairment losses where applicable.

In respect of the abovementioned asset classes, the cost of items acquired during the financial year has been judged by management of Central West Health to materially represent their fair value at the end of the reporting period.

Plant and equipment is measured at cost net of accumulated depreciation and any impairment in accordance with Queensland Treasury and Trade’s Non-Current Asset Policies for the Queensland Public Sector. The carrying amounts for such plant and equipment at cost should not materially differ from their fair value.

Land and buildings measured at fair value are revalued on annual basis either by appraisals undertaken by an independent professional valuer, or by the use of appropriate and relevant indices.

Revaluations using independent professional valuer appraisals are undertaken at least once every five years. However, if a particular asset class experiences significant and volatile changes in fair value, that class is subject to specific appraisal in the reporting period, where practicable, regardless of the timing of the last specific appraisal.

The fair values reported by Central West Health are based on appropriate valuation techniques that maximise the use of available and relevant observable inputs and minimise the use of unobservable inputs.


10



Revaluation of non-current assets (continued)

Where assets have not been specifically appraised in the reporting period, their previous valuations are materially kept up-to-date via the application of relevant indices. Central West Health ensures that the application of such indices results in a valid estimation of the assets' fair values at reporting date. The State Valuation Service (SVS) supplies the indices used for these assets. Such indices are either publicly available, or are derived from market information available to SVS. SVS provides assurance of their robustness, validity and appropriateness for application to the relevant assets. Management assesses and confirms the relevance and suitability of indices provided by SVS based on Central West Health’s own particular circumstances and considers materiality when assessing whether to apply indices to each asset class.

Any revaluation increment arising on the revaluation of an asset is credited to the asset revaluation surplus of the appropriate class, except to the extent it reverses a revaluation decrement for the class previously recognised as an expense. A decrease in the carrying amount on revaluation is charged as an expense, to the extent it exceeds the balance, if any, in the revaluation surplus relating to that asset class.

Central West Health has adopted the gross method of reporting revalued assets. This method restates separately the gross amount and related accumulated depreciation of the assets comprising the class of revalued assets. Accumulated depreciation is restated proportionally in accordance with the independent advice of the appointed valuers/quantity surveyors. The proportionate method has been applied to those assets that have been revalued by way of indexation.

Materiality concepts under AASB 1031 Materiality are considered in determining whether the difference between the carrying amount and the fair value of an asset is material.

Fair value measurement

Fair value is the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date under current market conditions (i.e. an exit price) regardless of whether that price is directly derived from observable inputs or estimated using another valuation technique.

Observable inputs are publicly available data that are relevant to the characteristics of the assets being valued. Observable inputs used by Central West Health include, but are not limited to, published sales data for land and non operational housing.

Unobservable inputs are data, assumptions and judgements that are not available publicly, but are relevant to the characteristics of the assets being valued. Significant unobservable inputs used by Central West Health include, but are not limited to, subjective adjustments made to observable data to take account of the characteristics of Central West Health’s assets, internal records of recent construction costs (and/or estimates of such costs) for assets' characteristics/functionality, and assessments of physical condition and remaining useful life. Unobservable inputs are used to the extent that sufficient relevant and reliable observable inputs are not available for similar assets.

A fair value measurement of a non-financial asset takes into account a market participant’s ability to generate economic benefits by using the asset in its highest and best use.

Reflecting the specialised nature of health service buildings on hospital site residential facilities, fair value is determined using depreciated replacement cost methodology. Depreciated replacement cost is determined as the replacement cost less the cost to bring an asset to current standards.

The valuation assumes a replacement building will provide the same service function and form (shape and size) as the original building but built consistent with current building standards.


11



Fair value measurement (continued)

The key measurement quantities used in the determination of the asset to be revalued were:

• Gross floor area

• Number of floors

• Girth of the building

• Height of the building

• Number of lifts and staircases.

Area estimates were compiled by measuring floor areas of project service plan room or drawings obtained from the Department of Health. Refurbishment costs were derived from specific projects and are therefore indicative of actual costs.

The ‘cost to bring to current standards’ is the estimated cost of refurbishing the asset to bring it to current design standards and in an “as” new condition. This estimated cost is linked to the condition factor of the building assessed by the quantity surveyor. It is also representative of the deemed remaining useful life of the building. The condition of the building is based on visual inspection, asset condition data, guidance from asset managers and previous reports and inspection photographs if available (to show the change in condition over time).

In assessing the condition of a building, the following ratings were applied:

Category Condition

1 Very good condition – only normal maintenance required

2 Minor defects only – minor maintenance required

3 Maintenance required to return to acceptable level of service – significant maintenance required (up to 50% of capital replacement cost)

4 Requires renewal – complete renewal of internal fit-out and engineering services required (up to 70% capital replacement cost)

5 Asset unserviceable – complete asset replacement required

All assets of Central West Health for which fair value is measured or disclosed in the financial statements are categorised within the following fair value hierarchy, based on the data and assumptions used in the most recent specific appraisals:

• level 1 – represents fair value measurements that reflect unadjusted quoted market prices in active markets for identical assets;

• level 2 – represents fair value measurements that are substantially derived from inputs (other than quoted prices included within level 1) that are observable, either directly or indirectly; and

• level 3 – represents fair value measurements that are substantially derived from unobservable inputs .

None of Central West Health’s valuations of assets are eligible for categorisation into level 1 of the fair value hierarchy. As 2013-14 is the first year of application of AASB 13 by Central West Health, there were no transfers of assets between fair value hierarchy levels during the period.

More specific fair value information about Central West Health’s Property, Plant and Equipment is outlined in Note 17.


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Depreciation

Property, plant and equipment are depreciated on a straight-line basis so as to allocate the net cost or revalued amount of each asset, less its estimated residual value, progressively over its estimated useful life to Central West Health. Annual depreciation is based on fair values and Central West Health’s assessment of the remaining useful life of individual assets. Land is not depreciated as it has an unlimited useful life.

Assets under construction (work-in-progress) are not depreciated until they reach service delivery capacity. Service delivery capacity relates to when construction is complete and the asset is first put to use or is installed ready for use in accordance with its intended application. These assets are then reclassified to the relevant classes with property, plant and equipment.

Any expenditure that increases the capacity or service potential of an asset is capitalised and depreciated over the remaining useful life of the asset. Major spares purchased specifically for particular assets are capitalised and depreciated on the same basis as the asset to which they relate.

The depreciable amount of improvements to or on leasehold land is allocated progressively over the estimated useful lives of the improvements.

The estimated useful lives of the assets are reviewed annually and where necessary, are adjusted to better reflect the pattern of consumption of the asset. In reviewing the useful life of each asset factors such as asset usage and the rate of technical obsolescence are considered.

For each class of depreciable assets, the following depreciation rates were used:

Class Depreciation rates

Buildings 2.6% - 4.5%

Plant and Equipment 4.5% - 20.0%

Impairment of non-current assets

All non-current assets are assessed for indicators of impairment on an annual basis. If an indicator of possible impairment exists, Central West Health determines the asset’s recoverable amount (higher of value in use and fair value less costs to sell and depreciated replacement cost). Any amount by which the asset’s carrying amount exceeds the recoverable amount is considered an impairment loss.

The asset’s recoverable amount is determined as the higher of the asset’s value less costs to sell and depreciated replacement cost.

Where an impairment loss subsequently reverses, the carrying amount of the asset is increased to the revised estimate of its recoverable amount, so that the increased carrying amount does not exceed the carrying amount that would have been determined had no impairment loss been recognised for the asset in prior years. A reversal of an impairment loss is recognised as income, unless the asset is carried at a revalued amount, in which case the reversal of the impairment loss is treated as a revaluation increase.

Leased property, plant and equipment

Operating lease payments, being representative of benefits derived from the leased assets, are recognised as an expense of the period in which they are incurred.

Central West Health has no finance leased assets.

(k) Payables

Payables are recognised for amounts to be paid in the future for goods and services received. Trade creditors are measured at the agreed purchase/contract price, gross of applicable trade and other discounts. The amounts are unsecured and normally settled within 30 days.


13


(l) Financial instruments

Recognition

A financial instrument is any contract that gives rise to both a financial asset of one entity and a financial liability or equity instrument of another entity. Financial assets and financial liabilities are recognised in the Statement of Financial Position when Central West Health becomes party to the contractual provisions of the financial instrument.

Classification

Financial instruments are classified and measured as follows:

a. Cash and cash equivalents – held at fair value through profit or loss

b. Receivables – held at amortised cost

c. Payables – held at amortised cost.

Financial assets are assessed for indicators of impairment at the end of each reporting period. For certain categories of financial asset, such as trade receivables, assets that are assessed not to be impaired individually are additionally assessed for impairment on a collective basis. For assets carried at amortised cost, the amount of the impairment loss recognised is the difference between the asset’s carrying amount and the present value of estimated future cash flows, discounted at the financial asset’s original effective interest rate. When a trade receivable is considered uncollectible, it is written off against the allowance account. Subsequent recoveries of amounts previously written off are credited against the allowance account. Changes in the carrying amount of the allowance account are recognised in the Statement of Comprehensive Income.

Central West Health does not enter into transactions for speculative purposes, or for hedging. Apart from cash and cash equivalents, Central West Health holds no financial assets classified at fair value through profit or loss.

Other disclosures relating to the measurement and financial risk management of other financial instruments are included in Note 27.

(m) Employee benefits

The Hospital and Health Boards Act 2011 outlines the employment arrangements for Central West Health. Board members and the Health Service Chief Executive are directly engaged by Central West Health while Health Service Employees remain employed by the Department of Health.

Health service employees

In accordance with the Hospital and Health Boards Act 2011 (the Act) section 67, the employees of the Department of Health are referred to as Health Service Employees. Pursuant to section 80 of the Act, they remain employees of the Department of Health and are taken to be employed by Central West Health on the same terms, conditions and entitlements.

Under this arrangement:

• The Department of Health provides employees to perform work for Central West Health, and the Department of Health acknowledges and accepts its obligations as the employer of these Department of Health employees

• Central West Health is responsible for the day to day management of the Department of Health employees

• Central West Health reimburses the Department of Health for the salaries, on-costs and other employee related expenses relating to these employees.

As a result of this arrangement, Central West Health classifies the reimbursements to the Department of Health for departmental employees in these financial statements as Health service employee costs. These reimbursements are shown under Note 8.


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(m) Employee benefits (continued)

Health service executives

Health executives are directly engaged in the service of Central West Health in accordance with section 70 of the Act. The basis of employment for health executives is in accordance with section 74 of the Act.

The information detailed below relates specifically to the directly engaged employees:

Wages, salaries and sick leave

Wages and salaries due but unpaid at reporting date are recognised in the Statement of Financial Position at the current salary rates. As the department expects such liabilities to be wholly settled within 12 months of reporting date, the liabilities are recognised at undiscounted amounts.

Prior history indicates that on average, sick leave taken each reporting period is less than the entitlement accrued. This is expected to continue in future periods. Accordingly, it is unlikely that existing accumulated entitlements will be used by employees and no liability for unused sick leave entitlements is recognised. As sick leave is non-vesting, an expense is recognised for this leave as it is taken.

Wages and salaries due but unpaid at reporting date are recognised in the Statement of Financial Position at current salary rates. Non-vesting employee benefits such as sick leave are recognised as an expense when taken.

Payroll tax and workers' compensation insurance are a consequence of employing employees, but are not counted in an employee's total remuneration package. They are not employee benefits and are recognised separately as employee related expenses.

Annual leave and long service leave

Under the Queensland Government’s Annual Leave Central Scheme and Long Service Leave Central Scheme (established on 1 July 1999), levies are payable by Central West Health to cover the cost of employees’ annual leave (including leave loading and on-costs) and long service leave.

The levies are expensed in the period in which they are paid or payable. Amounts paid to employees for annual leave and long service leave are claimed from the scheme quarterly in arrears. The Department of Health centrally manages the levy and reimbursement process on behalf of Central West Health.

No provision for annual leave is recognised in Central West Health's financial statements as the liability is held on a whole-of-government basis and reported in those financial statements pursuant to AASB 1049 Whole of Government and General Government Sector Financial Reporting.

Superannuation

Employer superannuation contributions are paid to QSuper, the superannuation scheme for Queensland Government employees, at rates determined by the Treasurer on the advice of the State Actuary. Contributions are expensed in the period in which they are paid or payable and Central West Health’s obligation is limited to its contribution to QSuper.

The QSuper scheme has defined benefit and defined contribution categories. The liability for defined benefits is held on a whole-of-government basis and reported in those financial statements pursuant to AASB 1049 Whole of Government and General Government Sector Financial Reporting.

Board members and Visiting Medical Officers are offered a choice of superannuation funds and Central West Health pays contributions into complying superannuation funds. Contributions are expensed in the period in which they are paid or payable. Central West Health's obligation is limited to its contribution to the superannuation fund and therefore no liability is recognised for accruing superannuation benefits in Central West Health’s financial statements.

Key management personnel and remuneration

Key management personnel and remuneration disclosures are made in accordance with section 5 of the Financial Reporting Requirements for Queensland Government Agencies issued by Queensland Treasury and Trade. Refer to Note 28 for the disclosures on key management personnel and remuneration.


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(n) Insurance

Property and general losses above a $10,000 threshold are insured through the Queensland Government Insurance Fund (QGIF) under the Department of Health’s insurance policy. Health litigation payments above a $20,000 threshold and associated legal fees are also insured through QGIF. Premiums are calculated by QGIF on a risk assessed basis.

Central West Health is covered in respect of its obligations for employee compensation through the Department of Health’s cover with WorkCover Queensland.

Central West Health pays fees for these insurances to the Department of Health as part of a fee for service arrangement. This is included in other supplies and services (refer to Note 9).

(o) Services received free of charge or for a nominal value

Contributions of services are recognised only if the services would have been purchased if they had not been donated and their fair value can be measured reliably. When this is the case, an equal amount is recognised as revenue and an expense.

Central West Health receives corporate services support from the Department of Health for no cost. Corporate services include payroll services, accounts payable services, finance transactional services, taxation services, supply services and information technology services. As the fair value of these services is unable to be estimated reliably, no associated revenue and expense in recognised in Central West Health’s Statement of Comprehensive Income.

(p) Contributed equity

Non-reciprocal transfers of assets and liabilities between wholly-owned Queensland Public Sector entities as a result of machinery of government changes are adjusted to Contributed Equity in accordance with Interpretation 1038 Contributions by Owners Made to Wholly-Owned Public Sector Entities. Appropriations for equity adjustments are similarly designated.

Transactions with owners as owners include equity injections for non-current asset acquisitions and non-cash equity withdrawals to offset non-cash depreciation funding received under the Service Agreement with the Department of Health.

(q) Taxation

Central West Health is a State body as defined under the Income Tax Assessment Act 1936 and is exempt from Commonwealth taxation with the exception of Fringe Benefits Tax (FBT) and Goods and Services Tax (GST). FBT and GST are the only Commonwealth taxes accounted for by Central West Health.

Central West Health and the Department of Health satisfy section 149-25(e) of the A New Tax System (Goods and Services) Act 1999 (the Act) and were able, with other Hospital and Health Services, to form a “group” for GST purposes under the Division 149 of the Act. This means that any transactions between the members of the group do not attract GST. However, all entities are responsible for the payment or receipt of any GST for their own transactions. As such, GST credits receivable from and payable to the Australian Taxation Office (ATO) are recognised and accrued (refer to Note 14). The GST transactions with the Australian Taxation Office are lodged and managed via the Department of Health.

(r) Issuance of financial statements

The financial statements are authorised for issue by the Chair of the Board, the Health Service Chief Executive, and the Chief Finance Officer, at the date of signing the Management Certificate.

(s) Accounting estimates and judgements

The preparation of financial statements necessarily requires the determination and use of certain critical accounting estimates, assumptions and management judgements that have the potential to cause a material adjustment to the carrying amounts of assets and liabilities within the next financial year. Such estimates, judgements and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised and in future periods as relevant.


16


(s) Accounting estimates and judgements (continued)

Estimates and assumptions with the most significant effect on the financial statements are outlined in the following notes:

Receivables – Note 14

Valuation of property, plant and equipment – Notes 2(j) and 17

Contingencies – Note 24

Depreciation – Notes 2(j) and 10.

In November 2011 the Australian government passed the Clean Energy Act 2011, which resulted in the introduction of a price on carbon emissions made by Australian businesses from 1 July 2012.

From 1 July 2014, the government plans to abolish the carbon tax. The withdrawal of the carbon pricing mechanism is not expected to have a significant impact on the department's critical accounting estimates, assumptions and management judgements.

(t) Economic dependence

Central West is dependent on funding provided by the Department of Health under a Service Agreement pursuant to the requirements of the Hospital and Health Boards Act 2011. The Service Agreement details the hospital, health and other services to be provided by Central West Health along with the funding provided by the Department of Health for the provision of these services.

The current Service Agreement between the Department of Health and Central West Health is a three year funding agreement for the period 1 July 2013 to 30 June 2016.

(u) Rounding and Comparatives

Amounts included in the financial statements are in Australian dollars and have been rounded to the nearest $1,000 or, where the amount is $500 or less, to zero unless the disclosure of the full amount is specifically required.

Comparative information has been restated to be consistent with disclosures in the current reporting period.

(v) Voluntary change in accounting policy

Central West Health has made a voluntary change in accounting policy for the recognition of funding provided by the Department of Health under a service agreement between the Department and Central West Health. The service agreement specifies those public health services purchased by the Department from Central West Health.

In 2012-13 the Department of Health provided this funding as grant payments but for 2013-14 has determined that the payment is not of a grants nature but rather is procurement of public health services. The Department of Health purchases specific public health services from Central West Health under a service agreement and the Department of Health has determined that it receives approximately equal value for the payment provided, and directly receives an intended benefit.

To align with this basis of funding provided by the Department of Health under a service agreement, Central West Health now recognises the 2013-14 funding of $48.5m as user charges and fees revenue for 2013-14 rather than as grants revenue which occurred in 2012-13. The main effect is that the revenue is now recognised under the criteria detailed in AASB 118 Revenue for 2013-14, rather than under AASB 1004 Contributions in 2012-13. The revenue recognition criteria are described in Note 2(d) User charges and fees and Note 2(e) Grants and contributions.

This change in accounting policy has been applied retrospectively with the effect that grants and contributions revenue for 2012-13 has reduced by $48.5m and user charges and fees revenue has increased by the same amount.


17


(w) New and revised accounting standards

The only Australian Accounting Standard changes applicable for the first time as from 2013-14 that have had a significant impact on Central West Health’s financial statements are those arising from AASB 13 Fair Value Measurement, as explained below.

AASB 13 Fair Value Measurement became effective from reporting periods beginning on or after 1 January 2013. AASB 13 sets out a new definition of 'fair value' as well as new principles to be applied when determining the fair value of assets and liabilities. The new requirements apply to all of Central West Health’s assets (excluding leases) that are measured and/or disclosed at fair value or another measurement based on fair value. The impacts of AASB 13 relate to the fair value measurement methodologies used and financial statement disclosures made in respect of such assets.

Central West Health reviewed its fair value methodologies (including instructions to valuers, data used and assumptions made) for all items of property, plant and equipment measured at fair value to assess whether those methodologies comply with AASB 13. No revision to the valuation methodologies was required.

AASB 13 has required an increased amount of information to be disclosed in relation to fair value measurements for assets. For those fair value measurements of assets that substantially are based on data that is not 'observable' (i.e. accessible outside Central West Health), the amount of information disclosed has significantly increased. Note 2(j) explains some of the principles underpinning the additional fair value information disclosed. Additional information is set out in Note 17 Property Plant and Equipment.

Central West Health reports as a Tier1 under AASB 1053 Application of Tiers.

At the date of authorisation of the financial report, the expected impacts of new or amended Australian Accounting Standards with future commencement dates are as set out below.

AASB 10 Consolidated Financial Statements redefines and clarifies the concept of control of another entity, and is the basis for determining which entities should be consolidated into an entity's financial statements. AASB 2013-8 applies the various principles in AASB 10 for determining whether a not-for-profit entity controls another entity.

AASB 11 Joint Arrangements deals with the concept of joint control and sets out new principles for determining the type of joint arrangement that exists, which in turn dictates the accounting treatment. The new categories of joint arrangements under AASB 11 are more aligned to the actual rights and obligations of the parties to the arrangement.

A revised version of AASB 119 Employee Benefits became effective for reporting periods beginning on or after 1 January 2013. The only implications for Central West Health relate to clarifications made in relation to termination and short term employee benefits. The changes set out in the revised AASB 119 will not have a material impact on disclosure for the prior period or the current period. AASB 1055 Budgetary Reporting applies from reporting periods beginning on or after 1 July 2014. Central West Health will need to include in its 2014-15 financial statements the original budgeted figures from the Income Statement, Balance Sheet, Statement of Changes in Equity, and Cash Flow Statement as published in the 2014-15 Queensland Government's Service Delivery Statements. The budgeted figures will need to be presented consistently with the corresponding (actuals) financial statements, and will be accompanied by explanations of major variances between the actual amounts and the corresponding original budgeted figures.

All other Australian accounting standards and interpretations with future commencement dates are either not applicable to Central West Health’s activities, or have no material impact on Central West Health.


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3 Major services, activities and other events

Administrative arrangements and government health reform

On 2 August 2011, Queensland, as a member of the Council of Australian Governments, signed the National Health Reform Agreement committing to major changes in the way that health services in Australia are funded and governed. These changes took effect from 1 July 2012 and include:

• moving to a purchaser-provider model, with health service delivery to be purchased from legally independent hospital networks (statutory bodies to be known as Hospital and Health Services (HHS’s) in Queensland);

• introducing national funding models and a national efficient price for services, with the majority of services to be funded on an activity unit basis into the future, noting that Central West Health funding does not receive funding for activities but is funded to provide community service obligations;

• defining a refocused role for state governments in managing the health system, including:

o the use of purchasing arrangements and other levers to drive access and clinical service improvements within and across the HHS’s,

o a responsibility to intervene to remediate poor performance, either at the state’s initiative or in response to prompting by the National Health Performance Authority, which will publicly report on performance of the HHS’s and healthcare facilities.

The Health and Hospitals Network Act 2011 (HHNA), enabling the establishment of the new health service entities and the Department of Health was passed by the Queensland Parliament in October 2011. On 17 May 2012, the Minister for Health introduced amending legislation into the Parliament to expand the functions of HHS’s under the HHNA. The amended legislation is known as the Hospital and Health Boards Act 2012 (HHBA).

Under the new arrangements, the Department of Health is responsible for the overall management of the health system including state-wide planning, industrial relations, major capital works, Health service purchasing and performance monitoring and issuing mandatory standards through Health Service Directives.

The 17 Hospital and Health Services (HHS’s) were established as independent statutory bodies and are responsible for the safe, efficient and effective delivery of public health care through its hospitals and health services.

Funding revenue is received in accordance with Service Agreements with the Department of Health. The Department purchase of health services based on a nationally set funding and efficient pricing models determined by the Independent Hospital Pricing Authority (IHPA) established independently from the Commonwealth.

IHPA was established to develop and specify national classifications to be used to classify activity in public hospitals for the purposes of Activity Based Funding. IHPA determines the national efficient price for services provided on an activity basis in public hospitals and develops data and coding standards to support uniform provision of data. In addition to this, IHPA determines block funded criteria and what other public hospital services are eligible for Commonwealth funding.

The Commonwealth and State Government contributions for activity based funding is pooled and allocated transparently via a National Health Funding Pool. The Commonwealth and State Government contribution for block funding and training, teaching and research funds is also pooled and allocated transparently via a State Managed Fund. State funding is also provided for depreciation and minor capital works. Public Health funding from the Commonwealth Government is managed by the Department of Health.

The National Health Funding Body and the National Health Funding Pool have complete transparency in reporting and accounting for contributions into and out of pool accounts. The Administrator is an independent statutory office holder, distinct from Commonwealth and State departments.


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3 Major services, activities and other events (continued)

Major services

Central West Health conducts a range of activities to support the health and wellbeing of Central West residents and visitors and facilitates access to specialist services that are not available locally. These activities, which are reflected in the Service Agreement with the Department of Health, include:

Prevention, Promotion, Protection

Aims to prevent illness or injury, promote and protect good health and well-being of the population and reduce the health status gap between the most and least advantaged in the community.

Primary Health Care

Address health problems or established risk factors of individuals and small targeted groups providing curative, promotion, preventative and rehabilitation services. The services include early detection and intervention services and risk factor management programs.

Ambulatory Care

Aims to provide equitable access to quality and timely emergency and outpatient services provided by Queensland’s public hospitals and primary health centres.

Acute Care

Aims to increase equity and access to high quality acute hospital services for patients on a state-wide basis and includes the provision of medical, surgical and obstetric services in Queensland hospitals.

Rehabilitation and Extended Care

Limited rehabilitation and extended care, allied and community health services are available, in line with the clinical service capability level of each facility. This service predominantly targets the needs of people with long-term conditions that have chronic consequences.

Integrated Mental Health Services

Central West Health provides community mental health promotion, community based illness prevention, counselling and support for patients and works in partnerships with other Health Services for patients requiring extended treatment services at a designated mental health unit.

Residential Aged Care

A small number of permanent and respite care aged care beds are offered by Central West Health in Barcaldine, Winton and Alpha under the integrated Multi-purpose Health Service model.

Patient Transport and Retrievals

Central West Health provides travel and accommodation assistance to eligible residents to access the nearest available eligible specialist services in accordance with guidelines issued by the Department of Health. In emergency situations, patients may be transferred to larger facilities by Queensland Ambulance Service or flown to major hospitals by Retrieval Services Queensland.

Diamantina Shire Council

Central West Health has a service arrangement with Diamantina Shire Council to fund the provision of healthcare services. (Refer Note 29 for transition to primary healthcare centres).


20

2014 2013

$’000 $’000

4 User charges and fees

Government funding

Block funding 51,261 48,284

Teacher training funding 321 170

Total Government funding 51,582 48,454

Hospital fees 2,978 2,909

Sale of goods and services 558 614

Rental income 31 27

55,149 52,004

5 Grants and contributions

Australian Government grants

Nursing home grants 329 400

Other specific purpose grants 1,782 1,781

Total Australian Government grants 2,111 2,181

Donations other - 6

2,111 2,187

6 Other revenue

Health service employee expense recoveries* 58 166 Recoveries** 266 35 Other 155 10

479 211 *Health service employee expenses are recovered for services provided to external parties not including the Department of Health or other Hospital and Health Services. ** Health service recovers graduate wages under Dental and GP graduate programs


21

2014 2013 $’000 $’000

7 Employee expenses

Employee benefits*

Wages and salaries 408 411

Employer superannuation contributions 34 40

Annual leave levy/expense 23 16

Long service leave levy/expense 5 4

470 471

Employee related expenses*

Payroll tax 19 21

Other employee related expenses - 22

489 514

* Employee expenses represent the cost of employment for board members and the Health Service Chief Executive, employed directly by Central West Health. Refer to Note 2(m).

The number of employees includes full-time employees and part-time employees measured on a full-time equivalent basis (reflecting Minimum Obligatory Human Resource Information (MOHRI).

Number of Central West Health employees 1

1

The number of employees does not include the Chair of the Board and Board Members refer to Note 2(m) and Note 28.

8 Health service employee costs

Health service employee expenses 30,809 27,878

Health service employee related expenses 836 543

Other health service employee related expenses 261 196

31,906 28,617

* Health service employee costs represent the cost of Department of Health employees contracted to Central West Health. Refer Note 2(m).

The number of employees includes full-time employees and part-time employees measured on a full-time equivalent basis (reflecting Minimum Obligatory Human Resource Information (MOHRI).

Number of Department of Health – Health service employees 317 292


22

2014 2013

$’000 $’000

9 Supplies and services

Consultants and contractors 6,314 7,233

Electricity and other energy 1,045 862

Patient travel 1,839 1,347

Aeromedical services 2,111 2,208

Other travel 571 408

Insurance payment to the Department of Health* 309 431

Building services 164 123

Water 89 97

Computer services 188 156

Motor vehicles 177 150

Communications 563 526

Repairs and maintenance 2,083 1,170

Expenses relating to capital works 106 49

Operating lease rentals 844 835

Drugs 355 417

Clinical supplies and services 2,597 2,074

Catering and domestic supplies 514 513

Inter entity hospital and health service supplies and services 1,308 478

Remote healthcare services 309 120

Other 685 533

22,171 19,730

*Includes Queensland Government Insurance Fund (QGIF). Refer Note 2(n). 10 Depreciation

Buildings 2,584 2,059

Plant and equipment 881 703

3,465 2,762

11 Impairment losses

Impairment losses on receivables (9) (1)

Bad debts written off 8 4

(1) 3


23

2014 2013

$’000 $’000

12 Other expenses

External audit fees* 140 140

Other audit fees 49 -

Bank fees 1 2

Inventory written off 57 68

Net losses from disposal of property, plant and equipment 226 -

Special payments

Ex-gratia payments** 11 -

Other legal costs 32 69

Journals and subscriptions 6 11

Advertising 23 6

Other 10 52

555 348

* Total audit fees payable to the Queensland Audit Office relating to the 2013-14 financial year are estimated to be $140,000 (2013: $140,000). There are no non audit services included in this amount.

** Central West Health accrued $11,117 for a payment to be made to a tenant for early vacation of a lease on premises to be taken up by Central West Health.

13 Cash and cash equivalents

Cash on hand 3 3

Cash at bank 3,506 5,130

Cash held with QTC 6 6

3,515 5,139

Central West Health’s bank accounts are grouped within the whole-of-government set-off arrangement with the Queensland Treasury Corporation (QTC). Central West Health does not earn interest on surplus funds and is not charged interest or fees for accessing its approved cash overdraft facility as it is part of the whole-of-government banking arrangements.

Interest earned on the aggregate set-off arrangement balance accrues to the Consolidated Fund.

Cash and cash equivalents are subject to a number of internal and external restrictions that limit amounts available for discretionary or future use. These include $4,897 of trust monies (2013: $10,467) which are not grouped within the whole-of-Government set-off arrangement and are able to be invested and earn interest for the trust bank accounts (refer to Note 26).

Cash deposited at call with the Queensland Treasury Corporation earns interest at a rate of 3.43 per cent (2013: 4.06%). Interest earned on cash held with the Commonwealth Bank of Australia was at a rate of 2.47 per cent during the 2013-14 financial year (2013: 2.70%).


24

2014 2013

$’000 $’000

14 Receivables

Current

Trade debtors 1,229 580

Less: Allowance for impairment (3) (12)

GST input tax credits receivable 121 103

GST payable (3) (2)

Total Current 1,344

669

Movements in the allowance for impairment loss

Current

Balance at the beginning of the year 12

Amounts written off during the year (8) 4

Increase/(decrease) in allowance recognised in operating result (1) 8

Balance at the end of the year 3 12

15 Inventories

Inventories held for distribution:

Medical supplies and equipment 447 459

Catering and domestic 2 3

Other 7 11

456 473

16 Other current assets

Prepayments 36 144

36 144


25

2014 2013

$’000 $’000

17 Property, plant and equipment

Land

At fair value 2,002 1,926

2,002 1,926

Buildings

At fair value 108,933 107,136

Less: Accumulated depreciation (68,889) (66,306)

40,044 40,830

Plant and equipment

At cost 8,919 8,392

Less: Accumulated depreciation (4,924) (4,696)

3,995 3,696

Capital works in progress

At cost 853 -

Total property, plant and equipment 46,894

46,452

Land

Land is measured at fair value using independent revaluations, desktop market valuations or indexation by the State Valuation Service within the Department of Natural Resources and Mines. Independent revaluations are performed with sufficient regularity to ensure assets are carried at fair value.

In 2013-14 Central West Health engaged the State Valuation Service to provide indices for all land holdings at 30 June 2014. The fair value of land is based on individual factor changes per property derived from the review of market transactions. These market movements are determined having regard to review of land values undertaken for each local government area issued by the Valuer-General. All local government property market movements are reviewed annually by market surveys to determine any material change in values. These ongoing market investigations assist in providing an accurate assessment of the prevailing market conditions and detail the specific market movements applicable to each property.

The revaluation program resulted in a net increment of $65,369 to the carrying amount of land (2013: nil).

Buildings

An independent revaluation of 95% of the gross value of the building portfolio was performed during 2012-13 by independent quantity surveyors Davis Langdon. Valuations were based on the estimated replacement cost less the cost to bring the building to current standards. The valuation assumes a replacement building will provide the same service function and form (shape and size) as the original building but built consistent with current building standards. Significant judgement is also used to assess the remaining service potential of the buildings within the portfolio.

Non-operational housing was revalued in 2012-13 using indices provided by the State Valuation Service. These indices approximated the movement in market prices for labour and other key resource inputs, as well as changes in design standards as at reporting date.

Refer to Note 2(j) for further details on the revaluation and assumptions methodology applied.

In 2013-14 Central West Health obtained advice from Davis Langdon that construction prices have not moved since 2012-13, confirming the existing recorded depreciated values of the building portfolio as fair value. The non operational housing component of the portfolio is immaterial within the asset class. Management accepted the current building values as fair value and did not seek indices from the State Valuation Service as a result of this advice.

As indices were not applied to the buildings’ valuation for 2013-14 there was no net increment to Central West Health’s building portfolio (2013: $1.8 million).


26

17 Property, plant and equipment (continued)

Property, plant and equipment reconciliation

Land Buildings Plant and equipment

Work in progress

Total

Level 2 Level 3 Level 3

$’000 $’000 $’000 $’000 $’000 $’000

Carrying amount at 1 July 2013 1,851 75 40,830 3,696 - 46,452

Acquisitions 10 - 1,797 742 853 3,401

Disposals - - - (226) - (226)

Transfers in - - - 670 - 670

Transfers out - - - (4) - (5)

Revaluation increments 66 - - - - 66

Depreciation - - (2,583) (881) - (3,464)

Carrying amount at 30 June 2014 1,927 75 40,044 3,995 853 46,894

Land Buildings Plant and equipment

Total

$’000 $’000 $’000 $’000 Carrying amount at 1 July 2012 - - - - Acquisitions via machinery of government 1,924 39,193 3,638 44,756

Acquisitions 2 427 352 781

Transfers in - 1,473 409 1,881

Revaluation increments - 1,796 - 1,796

Depreciation - (2,059) (703) (2,762)

Carrying amount at 30 June 2013 1,926 40,830 3,696 46,452


27

Plant and equipment Plant and equipment is carried at cost less any accumulated depreciation and any accumulated impairment losses. Level 3 significant valuation inputs and relationship to fair value

The fair value of health service site buildings is computed by quantity surveyors. The methodology is known as the Depreciated Replacement Cost valuation technique. The following table highlights the key unobservable (Level 3) inputs assessed during the valuation process and the relationship to the estimated fair value.

Description Fair value at 30 June 2014

$’000

Significant unobservable inputs

Unobservable inputs quantitative measures Ranges used in valuations $’000

Unobservable inputs – general

Land under Reserve (Trust land)

75 Professional valuation based on usage and sale restrictions

N/a N/a

Buildings – non operational housing

2,533

Replacement cost estimates

Ranges from 4 to 257 Ranges from 1,400 to 16,200

Replacement cost is based on tender pricing and historical building cost. An increase in the estimated replacement cost would increase the fair value of the assets. A decrease in the estimated replacements cost would reduce the fair value of the assets.

Buildings - special purpose hospital facilities

37,511

Buildings - special purpose hospital facilities

Cost to bring to current standards

Ranges from Nil to 10,159

Costs to bring to current standards are based on tender pricing and historical building cost data. An increase in the estimated cost would increase the fair value of the assets. A decrease in the estimated cost would reduce the fair value of the assets.

Remaining lives estimated

5 years to 30 years

1 to 3

The remaining useful lives are based on industry benchmarks. An increase in estimated remaining useful lives would increase the fair value of assets. A decrease in the estimated remaining useful lives would reduce the fair value of the assets. The condition rating is based on the physical state of the assets. An improvement in the condition rating (possible high of 1) would increase the fair value of the assets. A decline in the condition rating (possible low of 5) would reduce the fair value of the assets.

Condition Rating

For further information on Condition Ratings refer to Note 2. Significant Accounting Policies (j) Property, plant and equipment. Usage of alternative quantitative values (higher or lower) for each unobservable input that are reasonable in the circumstances as at the revaluation date would not result in material changes in the reported fair value. The condition rating of an asset is used as a mechanism to determine the cost to bring to current standards and also to estimate the remaining life. There are no other direct or significant relationships between the unobservable inputs which materially impact fair value.


28

2014 2013

$’000 $’000

18 Payables

Department of Health payables* 2,199 1,537

Trade creditors 152 324

Accrued expenses 2,377 1,766

Other creditors 136 2

4,864 3,629

* Department of Health payables are due to outstanding payments for payroll and other fee for service charges.

19 Accrued employee benefits

Salaries and wages accrued 7 14

Other employee entitlements payable 3 4

10 18

20 Asset revaluation surplus by class

Land

Balance at the beginning of the financial year - -

Revaluation increment/(decrement) 66 -

Balance at the end of the financial year 66

-

Buildings

Balance at the beginning of the financial year 1,796 -

Revaluation increment/(decrement) - 1,796

Balance at the end of the financial year 1,796

1,796

Balance at the end of the financial year 1,862 1,796


29

2014 2013

$’000 $’000

21 Reconciliation of operating surplus/(deficit)to net cash flows from operating activities

Operating result from continuing operations (845) 2,430 Non-cash items:

Depreciation expense 3,465 2,762 Equity withdrawal (3,465) (2,753) Net losses on disposal of property, plant and equipment 226 - Impairment losses (1) 3

Changes in assets and liabilities:

(Increase)/decrease in trade and payroll receivables (658) 862 (Increase)/decrease in GST input tax credits receivable* (18) (103) (Increase)/decrease in inventories 18 (96) (Increase)/decrease in recurrent prepayments 108 (45) Increase/(decrease) in GST payable* 1 2 (Increase)/decrease in accrued employee benefits 9 (18) Increase/(decrease) in payables 1,214 1,753

Net cash generated by operating activities 54 4,796

*The GST transactions with Australian Taxation Office are lodged and managed by the Department of Health.

22 Non-cash financing and investing activities

Assets and liabilities received or transferred by Central West Health as a result of machinery of government transfers are set out in the Statement of Changes in Equity.

23 Commitments for expenditure

(a) Non-cancellable operating leases

Central West Health’s non-cancellable operating leases in relation to office accommodation are reported by the Department of Health.


30

2014

2013

$’000

$’000

23 Commitments for expenditure (continued)

(b) Capital expenditure commitments

Capital expenditure commitments inclusive of anticipated GST, contracted for at reporting date but not recognised in the accounts are payable as follows:

Not later than one year 217

223

Later than one year and not later than five years -

-

Later than five years -

-

Total 217

223

(c) Other expenditure commitments

Material classes of other expenditure commitments inclusive of anticipated GST, contracted for at reporting date but not recognised in the accounts are payable as follows:

Supplies and services 131

110

Repairs and maintenance 274

666

Remote healthcare services -

309

Total 405

1,085

Not later than one year 405

1,085

Later than one year and not later than five years -

-

Later than five years -

-

Total 405

1,085

24 Contingencies

Litigation in progress

2014 2013 cases cases

Cases have been filed with the courts as follows:

Supreme Court - 1

District Court - -

Magistrates Court - -

Tribunals, commissions and boards 1 -

1 1

Health litigation is underwritten by the Queensland Government Insurance Fund (QGIF). Central West Health’s liability in this area is limited to an excess per insurance event of $20,000. Refer Note 2(n). Central West Health is responsible for claims from 1 July 2012 with pre 1 July 2012 claims remaining the responsibility of the Department of Health. Central West Health legal advisers and management believe it would be misleading to estimate the final amounts payable (if any) in respect of the litigation before the courts at this time.


31

25 Restricted assets

Central West Health receives cash and other donations from benefactors in the form of gifts, donations and bequests for stipulated purposes. At 30 June 2014, an amount of $10,847 (2013: $16,222) in General Trust has been set aside for the specified purposes underlying the contribution. Refer to Note 13.

26 Trust transactions and balances

Central West Health acts in a custodial role in respect of these transactions and they are not recognised in the financial statements but are disclosed below for information purposes.

2014 2013

$’000 $’000

Patient trust receipts

Winton Patient Trust 86 57

Longreach Patient Trust 1 2

Barcaldine Patient Trust 24 22

Blackall Patient Trust - 1

Total receipts 111 82

Patient trust related payments


Longreach Patient Trust 1 1


Blackall Patient Trust - 1

Total payments 110 95

Increase/(decrease) in net patient trust assets 1 (13)

Trust assets

Current assets - cash 31 30

Patient trust deposits


Longreach Patient Trust - 1


Blackall Patient Trust - -

Total assets 31 30

All patient trust monies are held by Central West Health on behalf of the patients while admitted to Hospital.


32

26 Trust transactions and balances (continued)

Central West Health employs Senior Medical Officers (SMO) with a Right of Private Practice in Longreach and Barcaldine who have Option A supplements. Any medical locum employed in Central West Health only receives a per diem payment.

Central West does not employ any doctors under the Option B arrangement.

In 2012-13 Central West Health engaged doctors, medical locum and junior relieving doctors in Winton, Alpha, Aramac and Barcaldine under the Medical Superintendents and Medical Officers with a Right of Private Practice (refer to Note 2(c)). As this practice ceased in January 2013, only revenue from billings prior to that date have been be received and distributed to doctors during 2013-14.

100 per cent of revenue received from Option A doctors’ billings is paid to Central West Health.

2014

2013

$’000

$’000

Right of Private Practice trust revenues and expenses

Revenue

Billings 612

808

Interest 2

-

Total revenue 614

808

Expenses

Payments to Doctors -

308

Payment to Central West Health recoverable 551

463

Total expenditure 551

771

Right of Private Practice trust assets

Current assets

Winton Right of Private Practice 12

14

Barcaldine Right of Private Practice 53

23

Total Right of Private Practice assets 65

37

Current liabilities

Payables

Right of Private Practice deposits – recoverables


8


18

Right of Private Practice deposits – held for doctors


6


5

Total Right of Private Practice liabilities 65

37

Central West Health is responsible for administrating and operating the accounts for right of private practice at Barcaldine and Winton practices.


33

27 Financial instruments

(a) Categorisation of financial instruments

Central West Health has the following categories of financial assets and financial liabilities:

Note 2014 2013 $’000 $’000 Financial assets

Cash and cash equivalents 13 3,515 5,139

Receivables 14 1,344 669

4,859 5,808

Financial liabilities

Payables measured at amortised cost 18 (4,864) (3,629)

(4,864) (3,629)

(b) Financial risk management Central West Health is exposed to a variety of financial risks – credit risk, liquidity risk, market risk and interest rate risk. Financial risk is managed in accordance with Queensland Government and agency policies. Central West Health’s policies provide written principles for overall risk management and aim to minimise potential adverse effects of risk events on the financial performance of the department.

Risk Exposure Measurement method Credit risk Ageing analysis, cash inflows at risk Liquidity risk Monitoring of cash flows by active management of accrual accounts Market risk Interest rate sensitivity analysis

(c) Credit risk exposure Credit risk is the potential for financial loss arising from a counterparty defaulting on its obligations. The maximum exposure to credit risk at balance date is equal to the gross carrying amount of the financial asset, inclusive of any allowance for impairment. The carrying amount of receivables represents the maximum exposure to credit risk. As such, receivables are not included in the disclosure below. Refer to Note 14 for further information.

Credit Risk is considered minimal given that Central West Health deposits are held by the State through Queensland Treasury Corporation. Maximum exposure to credit risk

Category

Financial assets

Cash 3,515 5,139

3,515 5,139

No collateral is held as security and no credit enhancements relate to financial assets held by Central West Health. No financial assets and financial liabilities have been offset and presented in the Statement of Financial Position. No financial assets have had their terms renegotiated as to prevent them from being past due or impaired and are stated at the carrying amounts as indicated.


34

27 Financial instruments (continued)

(c) Credit risk exposure (continued)

Ageing of past due but not impaired as well as impaired financial assets are disclosed in the following table:

2014 Financial assets past due but not impaired

Overdue $’000

Receivables Less than 30 days

30-60 days

61-90 days

More than 90 days

Total

Past due but not impaired 150 50 25 22 248

Total 150 50 25 22 248

2014 Individually impaired financial assets

Overdue $’000

Less than 30 days

30-60 days

61-90 days

More than 90

days Total

Receivables (gross)

3 3 Individually impaired - - - (3) (3)

Carrying Amount 0 0 0 0 0

2013 Financial assets past due but not impaired

Overdue $’000

Receivables Less than 30 days

30-60 days

61-90 days

More than 90

days Total

Past due but not impaired 174 35 14 20 243

Total 174 35 14 20 243

2013 Individually impaired financial assets

Overdue $’000

Less than 30 days

30-60 days

61-90 days

More than 90

days Total

Receivables (gross) 12 12 Individually impaired - - - (12) (12)

Carrying Amount 0 0 0 0 0

(d) Liquidity risk

Liquidity risk is the risk that Central West Health will not have the resources required at a particular time to meet its obligations to settle its financial liabilities.

Central West Health is exposed to liquidity risk through its trading in the normal course of business and aims to reduce the exposure to liquidity risk by ensuring that sufficient funds are available to meet employee and supplier obligations as they fall due.

Central West Health bank accounts form part of the whole-of-government banking arrangement with the Commonwealth Bank of Australia. Under this arrangement, Central West Health has access to the whole-of-government debt facility with limits approved by Queensland Treasury and Trade. Central West Health has an approved debt facility of $500,000 under whole-of-government banking arrangements to manage any short term cash shortfalls. The following table sets out the liquidity risk of financial liabilities held by Central West Health. It represents the contractual maturity of financial liabilities, calculated based on undiscounted cash flows relating to the liabilities at reporting date. The undiscounted cash flows in these tables differ from the amounts included in the Statement of Financial Position that are based on discounted cash flows.


35

27 Financial instruments (continued)

(d) Liquidity risk (continued)

2014 Payable in

1 year or

less 1 to 5 years

More than 5 years

Total

Note $’000 $’000 $’000 $’000


Payables (4,864) - - (4,864)

18 (4,864) - - (4,864)

2013 Payable in

1 year or

less 1 to 5 years

More than 5 years

Total

Note $’000 $’000 $’000 $’000


Payables (3,629) - - (3,629)

18 (3,629) - - (3,629)

(e) Market risk

Market risk is the risk that the fair value or future cash flows of a financial instrument will fluctuate because of changes in market prices. Market risk comprises: foreign exchange risk; interest rate risk; and other price risk. Central West Health does not undertake any hedging in relation to interest rate risk. Changes in interest rate have a minimal effect on the operating result of Central West Health.

(f) Interest rate sensitivity analysis Changes in interest rate have a minimal effect on the operating result of Central West Health. This is demonstrated in the interest rate sensitivity analysis below:

Carrying amount

2014 Interest rate risk

Financial instruments -1% 1%

$’000 Profit Equity Profit Equity

Deposits at call 11 (0) (0) 0 0

Potential impact on profit and equity (0) (0) 0 0

Carrying amount

2013 Interest rate risk

Financial instruments -1% 1%

$’000 Profit Equity Profit Equity

Deposits at call 16 (0) (0) 0 0

Potential impact on profit and equity (0) (0) 0 0

(g) Fair value

Apart from cash and cash equivalents, Central West Health does not recognise any financial assets at fair value in the Statement of Financial Position.

The fair value of trade receivables and payables is assumed to approximate the value of the original transaction, less any allowance for impairment.


36

28 Key management personnel and remuneration

The following details for key executive management personnel include those positions that had authority and responsibility for planning, directing and controlling the activities of Central West Health during 2013-14. Further information on these positions can be found in the body of the Annual Report under the section relating to Executive Management. (a) Key executive management personnel

Position Responsibilities Contract

classification and appointment authority

Date appointed (resigned)

Health Service Chief Executive (HSCE)

The Health Service Chief Executive is responsible for the efficient and effective management of Central West Health and to support and implement the Board’s strategic plans for the improved health care of Central West residents and visitors.

S24/S70 01 Appointed under HHBA s33

30/07/2012

Executive Director Medical Services (EDMS)

The Executive Director of Medical Services is responsible for safe and effective delivery of medical and allied health services, including recruitment, retention and development of the workforce, and leads clinical governance within the Health Service.

MEDFC2 01 17/04/2013

Executive Director Nursing and Midwifery Services (EDoNMS)

Executive Director Nursing and Midwifery Services oversights the safe and efficient operation of all hospital and health centres, maternity and community health services and provides leadership to the nursing stream.

NG11.2 01 01/07/2012

Chief Finance Officer (CFO)

The Chief Finance Officer is responsible for budget planning and forecasting, financial control and performance, statutory compliance and supporting effective business decision making within Central West Health.

AO8 02 01/07/2012 (19/05/2014)

A/Chief Finance Officer (A/CFO)

The Chief Finance Officer is responsible for budget planning and forecasting, financial control and performance, statutory compliance and supporting effective business decision making within Central West Health.

AO8 03 16/04/2014

Director of Corporate Services (DoCS)

The Director of Corporate Services was responsible for managing the corporate functions for Central West Health. This position ceased in December 2013.

AO8 01/07/2012 (25/11/2012)


37

28 Key management personnel and remuneration (continued) (b) Key executive management personnel remuneration

Section 74 of the Hospital and Health Boards Act 2011 (the Act) provides that the contract of employment for health service executive staff must state the term of employment, the person's functions and any performance criteria as well as the person's classification level and remuneration package. Section 76 of the Act provides the Chief Executive authority to fix the remuneration packages for health executives, classification levels and terms and conditions having regard to remuneration packages for public sector employees in Queensland or other States and remuneration arrangements for employees employed privately in Queensland.

The remuneration policy for the Central West Health Service Chief Executive is set by a direct engagement common law employment contract setting out the remuneration and other terms of employment including non-salary benefits such as motor vehicles.

Remuneration of other key executive management personnel are determined by their awards and industrial agreements determined by the Department of Health.

For the 2013-14 year, remuneration packages of key management personnel increased by 2.5 to 3 per cent in accordance with government policy.

Remuneration expenses for key executive management personnel comprise the following components:

• Short-term employee benefits which include: o Salaries, allowances and leave entitlements paid and provided for the entire year or for that part

of the year during which the employee occupied the specified position. o Non-monetary benefits – consisting of provision of remote area housing, exempt benefits and

fringe benefits tax applicable benefits. • Long term employee benefits include amounts expenses in respect of long service leave entitlements

earned. • Post employment expenses include amounts expensed in respect of employer superannuation

contributions. • Termination benefits are not provided for within individual contracts of employment. Contracts of

employment provide only for notice periods or payment in lieu on termination, regardless of the reason for termination.

• There were no performance bonuses paid in the 2013-14 financial year (2013: nil).

1 July 2013 - 30 June 2014

Position

Short term employee expenses Long term

employee expenses

Post-employment

expenses

Termination benefits

Total expenses Monetary

expense

Non-monetary benefits

$’000 $’000 $’000 $’000 $’000 $’000

HSCE 247 55 5 24 - 331

EDMS 344 65 4 27 - 440

EDoNMS 139 45 4 17 - 205

CFO 70 30 2 11 30 143

A/CFO 25 2 1 3 - 31


38

28 Key management personnel and remuneration (continued) (b) Key executive management personnel remuneration (continued) 1 July 2012 - 30 June 2013

Position

Short term employee expenses Long term

employee expenses

Post-employment

expenses

Termination benefits


expense


$’000 $’000 $’000 $’000 $’000 $’000

HSCE 206 46 3 20 - 275

EDMS 37 8 1 5 - 51

EDoNMS 110 38 3 16 - 167

CFO 102 17 2 16 - 137

DoCS 48 8 1 6 - 63

(c) Board remuneration

Central West Health is independently and locally controlled by the Hospital and Health Board (the Board). The Board appoints the Health Service Chief Executive and exercises significant responsibilities at a local level, including controlling the financial management of Central West Health and the management of Central West Health’s land and buildings (Section 7 Hospital and Health Boards Act 2011). Board appointments are for three year terms.

Board members

Board member Position Date of appointment/reappointment

Edward Warren Chair Appointed 01/07/2012 Reappointed 18/05/2013

David Arnold Deputy Chair Appointed 01/07/2012 Reappointed 18/05/2013

Jane Williams*^ Board Member Appointed 01/07/2012 Reappointed 18/05/2013

William Ringrose Board Member Appointed 01/07/2012 Reappointed 18/05/2013

Peter Skewes Board Member Appointed 01/07/2012 Reappointed 18/05/2013

Bruce Scott Board Member Appointed 07/09/2012 Reappointed 18/08/2013

John Douyere* Board Member Appointed 07/09/2012 Reappointed 18/08/2013

* Board members who are employed by either Central West Health or the Department of Health are not paid board fees. ^ Employed by the Department of Health since November 2013.


39

28 Key management personnel and remuneration (continued) (c) Board remuneration (continued) 1 July 2013 - 30 June 2014

Board member

Short term employee expenses Post-

employment expenses


expense


$’000 $’000 $’000 $’000

Edward Warren 57 - 5 62

David Arnold 28 - 2 30

Jane Williams 14 - 1 15

William Ringrose 28 - 3 31

Peter Skewes 32 - 3 35

Bruce Scott 35 - 3 38

1 July 2012 - 30 June 2013

Board member

Short term employee expenses Post-

employment expenses


expense


$’000 $’000 $’000 $’000

Edward Warren 59 - 5 64

David Arnold 26 - 2 28

Jane Williams 26 - 2 28

William Ringrose 26 - 2 28

Peter Skewes 30 - 2 32

Bruce Scott 26 - 2 28

29 Events after the reporting period Transfer of general purpose housing to the Department of Housing and Public Works

As part of a whole-of-Government initiative, management of all non-operational housing transitioned to the Department of Housing and Public Works (DHPW) on 1 January 2014. Legal ownership of housing assets will transfer to the DHPW on 1 July 2014.

As at 30 June 2014, Central West Health held non-operational housing assets with a total net book value of $3.5 million under a Deed of Lease arrangement with the Department of Health. Effective 1 July 2014, the Deed of Lease arrangement in respect of these assets will cease, and the assets will be transferred to the Department of Health at their net book value, prior to their transfer to the DHPW.

As this transfer will be designated as a Contribution by Owners, the transfer will be undertaken through the Central West Health’s Equity account. Therefore, this transaction will have no impact on the Statement of Comprehensive Income in the 2014-15 financial year.

Central West Health will have continuing access to the staff housing under a memorandum of understanding agreement with DHPW.


40

29 Events after the reporting period (continued)

Longreach Hospital rectification works

The Department of Health Rural and Remote Infrastructure Rectification Works has delivered a program of works at the Longreach Hospital which entered a 12 months maintenance period during the current financial year. At the end of the maintenance period the Department will transfer the improvement to Central West Health at the lower of cost and fair value.

Purchase of Black Stump Medical Practice

On 22 July 2014 Central West Health purchased the Black Stump Medical Practice in Blackall. Central West Health will operate the practice as a general medical practice.

Senior Medical Officer and Visiting Medical Officer Contracts

Effective 4 August 2014, Senior Medical Officers and Visiting Medical Officers will transition to individual employment contracts.

Individual contracts mean senior doctors will have a direct employment relationship with Central West Health and employment terms and conditions tailored to individual or medical specialty circumstances (within a consistent state-wide framework).

As a direct employment relationship will be established between contracted medical officers and Central West Health, employee-related costs for contracted Senior Medical Officers and Visiting Medical Officers will be recognised by Central West Health (they are currently recognised as Health service employee costs) from the date the contracts are effective.

Non-contracted Senior Medical Officers and Visiting Medical Officers will remain employed under current award arrangements, continuing to be employed by the Department of Health.

Birdsville and Bedourie Health Services

Central West Health commenced operating two healthcare clinics in the Diamantina Shire from 1 July 2014 in Birdsville and Bedourie.

Other matters

No other matter or circumstance has arisen since 30 June 2014 that has significantly affected, or may significantly affect Central West Health’s operations, the results of those operations, or Central West Health’s state of affairs in future financial years.

Department of the Health, Queensland

2013–14 Annual Report www.health.qld.gov.au

Central West Hospital and Health Service - Queensland ... · Central West Health Glasson House ......

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