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Legislative Assembly for the ACT: 1996 Week 4 Hansard (16 April) . . Page.. 957 ..

MRS CARNELL (continuing):

Mr Speaker, I do not resile for one moment from the tenet of ministerial responsibility; but all too often I have heard excuses given for mistakes or budget problems which have occurred in the health portfolio, with senior staff saying that it is not their problem, or blaming someone else. As several members of this Assembly well know, that has been the case under previous governments as well. The fact is that budget management problems are everyone's problems because they reflect badly on the department and the people who work in it, and no doubt contribute to staff morale problems.

We have also experienced a virtually annual problem with many managers and clinical staff not taking the budget seriously, believing that on past experience they can simply overspend and they will be bailed out. Given the increasing pressures on funding to the ACT, including reductions in Commonwealth grants, that is simply not possible, and managers and clinicians are going to have to learn that the budget bottom line means just that. Under the performance agreement structure there will be very clear accountabilities, including budget management accountabilities, with both individual and mutually shared accountabilities for performance.

Today I can also foreshadow the introduction of legislation to create a single statutory authority that will incorporate the service provision areas of the department, separating them clearly from the policy, strategic advice and regulatory functions of the new central office. The creation of such a clear split between the purchasing and the providing of health and community care services will reduce duplication and overlap and ensure very transparent accountabilities throughout the organisation. Again, it will very clearly bring home the responsibilities for financial management within the organisation, with, for example, Woden Valley Hospital being responsible for management of its own budget.

Ms McRae: Why did you not keep Greg Fraser? He knew how to do it.

MR SPEAKER: Order! The Treasurer should be heard in silence.

Ms McRae: Like the Liberals always hear us in silence. Yes, Mr Speaker.

MR SPEAKER: Do not be cheeky.

MRS CARNELL: Purchasing contracts are being developed between the central office and the providers, based on cost, volume, quality, and access to services. Thus the department will not manage Woden Valley Hospital or community care. Under a statutory board, these services will be responsible themselves for achieving the outputs that are specified. This in turn will create incentives to deliver high-quality, accessible and efficient services in the most appropriate setting, focused on the needs of the individual, integrated services and continuity of care. The department will also press ahead with changes agreed under the operational efficiency review carried out last year. This will lead to more streamlined operations in ancillary and support services. Mr Speaker, to give just one example, I remain to be convinced that we can afford 56 tradespeople at Woden Valley Hospital alone. Due to changes in the Medicare agreement, new incentives also will be introduced from 1 July to improve the treatment of elective surgery patients according to their clinical need, in accordance with the Commonwealth's waiting times urgency categorisation system.

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