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Department of Health
Annual Report
2008-09
Publisher: Adelaide: SA Dept of Health, 2009.
ISSN: 1833-0002
ISBN: 978-1-74243-004-1
Subjects: Health SA
Other Authors/Contributors: South Australia. Dept. of Health.
Hon John Hill MP
Minister for Health
Hon Jane Lomax-Smith MP
Minister for Mental Health and Substance Abuse
Dear Ministers
In accordance with the Public Sector Management Act 1995 and the Public Finance and Audit Act 1987 I am
pleased to submit the annual report and financial statements of the South Australian Department of Health
for presentation to Parliament.
This report provides an accurate account of the operations of the Department of Health for the financial year
ending 30 June 2009, in compliance with the Department of the Premier and Cabinet Circular on Annual
Reporting Requirements.
Yours Sincerely
Dr Tony Sherbon
Chief Executive
25 September 2009
Department of Health
Annual Report 2008 2009
Government of South
Australia, September 2009
ISSN 1833-0002
ISBN: 978-1-74243-004-1
This annual report was prepared by
The Office of the Chief Executive,
Department of Health
ABN: 97 643 356 590
The annual report can be accessed
at the Department of Health
internet site: www.health.sa.gov.au
Department of Health
11 Hindmarsh Square
Adelaide, South Australia 5000
Telephone: (08) 8226 0795
Facsimile: (08) 8226 0720
Contents
Health at a Glance 4
Year in Review Highlights
from the Chief Executive 6
Objectives, Role
and Legislation 8
Objectives 8
Role 8
Department of Health
organisational structure 8
Administrative and
legislative responsibilities 9
Strategic Directions 10
South Australia s Strategic Plan 10
SA Health-led targets 10
T2.1 Smoking 10
T2.2 Healthy weight 12
T2.4 Healthy South Australians 13
T2.5 Aboriginal healthy life expectancy 14
T2.6 Chronic diseases 16
T2.7 Psychological wellbeing 18
T6.3 Early childhood birthweight 20
All of Government Targets 21
Strengthening Primary
Health Care 24
Reducing the percentage
of cigarette smokers 24
Increasing the percentage of South Australians
with a healthy weight 25
Increasing the healthy life expectancy of
South Australians 29
Improving the health of those living with
chronic disease 32
Reducing the proportion of low
birthweight babies 34
Enhancing Hospital Care 36
Improving coordination of hospital and
emergency services across metropolitan
and country regions 36
Improving efficiency and effectiveness
of hospital care 37
Developing the new
Royal Adelaide Hospital 46
Investing in the redevelopment of
metropolitan hospitals 47
Expanding GP Plus Services in
community settings 47
Clinical Networks and Clinical Senate 48
Ensuring safety and quality 48
Understanding blood usage trends and
implementing organ donation reform 50
Reforming Mental Health Care 51
Increasing the capacity of community
mental health services 51
Increasing the capacity of non acute adult
stepped care mental health facilities 53
Redeveloping Glenside and progressing
further infrastructure improvements 54
Promoting positive mental health in the
community and expanding mental health
literacy programs 55
Improving the Health of
Aboriginal People 58
National Partnership Agreements 58
Developing culturally appropriate
models of care 59
Extending Aboriginal
community engagement 62
Increasing access and equity 62
Fostering a healthy lifestyles culture 63
Addressing the social determinants of
Aboriginal health 65
Ensuring cultural respect and cultural inclusion 66
Protecting Public Health 67
Review of the Public and Environmental
Health Act 1987 67
Health in All Policies 67
Safe Drinking Water Bill 67
Public and Environmental Health (Legionella)
Regulations 2008 68
Environmental health indicators 68
Contaminated site remediation 68
Rural health promotion pest control safety 68
Mosquito control and arbovirus prevention 69
Infection control program for tattooing industry 69
Public health food initiatives 70
Communicable disease control 71
Emergency management 72
Pandemic influenza planning and preparedness 73
Health and Medical Research 74
The South Australian Health and
Medical Research Institute 74
Centre for Intergenerational Health 75
Research funding 75
Information and
Communication Technology 76
Information security 76
ICT centralisation 76
COAG Reform of Federal State
Financial Relationships 77
National Health Professional
Registration and Accreditation
Scheme 78
Health Workforce and
Human Resource Activity 79
Health workforce plan 79
Medical, Nursing and Midwifery and
Allied Health workforce strategies 80
Allied Health workforce 81
Graduate recruitment 83
Attraction, retention and engagement strategy 83
Industrial issues 83
Employment arrangements as at 30 June 2009 84
Training and development 86
Occupational Health Safety and
Injury Management 88
Carers Recognition Act 2005 92
Disability Action Plan 93
Reconciliation 95
Environmental Reports 96
Greening of Government, Sustainability Reporting
and Energy Efficiency Action Plan 96
Asbestos management 103
South Australian Urban Design Charter 105
Freedom of Information 106
Financial activity 108
Use of consultants 108
Employees overseas travel 111
Fraud 112
Account payment performance 113
Contractual arrangements 115
Department of Health Audited
Financial Statements 116
Independent Auditor s Report 117
Statement of comprehensive income 119
Statement of financial position 120
Statement of cash flows 121
Disaggregated disclosures - expenses and income 122
Disaggregated disclosures - assets and liabilities 123
Appendices 151
Acronyms 166
Glossary of Terms 167
Health at a Glance
On any day, on average
1 024 people were admitted to public hospitals.
50 of these admissions were Aboriginal and Torres Strait Islanders and 32 were
war veterans or war widows.
1 410 people were treated in accident and emergency departments.
5 358 people were seen in hospital outpatient clinics.
SA Ambulance Service responded to 675 incidents and assessed, treated or
transported 601 patients, of which 46% were patients whose lives were
potentially threatened.
Each week, on average
787 South Australians had an elective surgery procedure in a metropolitan
public hospital.
2 628 patient visits were made by Royal District Nursing Service nurses.
1 425 women were screened for breast cancer.
3 040 women were screened for cervical cancer.
470 people were screened for bowel cancer.
page 4 Department of Health Annual Report 2008 09
In this year
5 573 patients were transferred by Royal Flying Doctor Service aircraft between
metropolitan, rural and interstate health services.
963 people received dialysis, usually three times per week.
In the 2008 calendar year, 19 672 women gave birth to 19 969 babies with
99.8% attending antenatal care.
18 410 babies and their families were enrolled for the Universal Contact Visit.
The total number of families participating in Family Home Visiting was 2 136,
including 950 new families, with 390 completing the two-year program during
the year.
The Australian Red Cross Blood Service collected 74 255 units of blood from
donors for use in public and private hospitals.
860 862 doses of vaccine for all childhood, adolescent and adult vaccination
programs throughout South Australia were distributed at a total cost of
$27 004 980. In addition, the department responded to 14 154 calls about
vaccinations from health professionals and the general public.
4 708 835 tests were performed by SA Pathology (trading as Institute of
Medical and Veterinary Science).
9 397 calls were made to Quitline on 13 7848 with 1 299 referrals from health
professionals and 5 641 Quitpacks were distributed.
Approximately 110 000 South Australian calls were made to healthdirect
Australia on 1800 022 222.
15 580 packages were provided by the Metro Home Link program to support
discharge from public hospitals and a further 13 977 were provided as part of the
hospital avoidance program.
182 704 courses of dental care were commenced by the SA Dental Service.
63 primary schools commenced phase one roll out of the Eat Well Be Active
Primary Schools program.
155 child care centres were accredited under the Start Right, Eat Right
program.
30 369 consumers within South Australia had contact with a community mental
health service.
page 5Department of Health Annual Report 2008 09
Year in Review Highlights from the Chief Executive
As expected, 2008-09 has been a busy, challenging and productive year and I am pleased to report solid
progress towards the high level aims of South Australia s Health Care Plan 2007-2016. The Health Care Plan
was developed by the South Australian Government to deliver all South Australians a quality, safe, complete
and affordable health care system. The challenges of an ageing population, increased prevalence of chronic
diseases and shortages in doctors and nurses are significant but not insurmountable.
This year the Department of Health has made significant progress in strengthening health promotion and
preventative initiatives and enhancing South Australia s hospitals, including planning for the new Royal
Adelaide Hospital. The Department of Health has focused on, improving GP Plus Service strategies, addressing
the shortage of health care workers, reforming mental health care and improving the health of Aboriginal
South Australians.
The commencement of the new Health Care Act 2008 on 1 July 2008 has been fundamental to the reform of
the health care system. The new Act created a unified health system for South Australia, improving statewide
co-ordination and integration of public health services, reducing fragmentation and duplication of services
and streamlining governance arrangements. The Act also established the Health Performance Council, an
independent body providing advice to the Minister on the performance of the health system and health
outcomes for South Australians.
The South Australia: Our Health and Health Services 2008 report, prepared for the first time by the
Department of Health and released on 1 July 2008, provides a comprehensive picture of the health status of
South Australians. It shows the performance of our public hospitals is improving with substantial reductions in
long term waiting lists for elective surgery and improvements in emergency department efficiency. The report
will be updated at least every four years to monitor changes in our health status.
Early in the year the SA Health Strategic Plan 2008-2010 was released. The strategic plan communicates
our vision, mission and values so that our workforce, clients, stakeholders and the community understand
where we are heading as an organisation and what they can expect from SA Health. It reinforces SA Health s
strategic directions and strengthens the relationship with South Australia s Strategic Plan 2007 and South
Australia s Health Care Plan 2007-2016. A significant addition to the strategic plan is the addition of research
as a new strategic enabler.
On 17 May 2009, the Australian Government announced, in response to a proposal by the South Australian
Government, that a $200 million state of the art Health and Medical Research Institute would be built close
to the new Royal Adelaide Hospital on North Terrace. This is an incredibly exciting development bringing
significant benefits to South Australia s economy and ensuring South Australia has a leading role on the global
health and medical research stage. Planning for the new facility is well under way.
Planning for the most advanced hospital in Australia, the new Royal Adelaide Hospital, continued with
the development of a Model of Care and the release of an Expression of Interest for services in design,
construction, commissioning, finance and facilities management. The Model of Care strives for clinical
excellence and quality of care through a patient centred approach. Preparation of the site continued with
comprehensive investigation into soil and groundwater. The remediation plan being developed will contribute
to rehabilitation of the environment, improved access to the River Torrens, and new cultural and open spaces.
During the year $78 million was invested in capital projects to redevelop metropolitan hospitals and health
service infrastructure. The investment includes continued refurbishment of the Flinders Medical Centre
Coronary Care Unit and the new south wing extension; completion of the research facilities and infrastructure
upgrades as part of the stage 2B redevelopment of The Queen Elizabeth Hospital; and continued
redevelopment of the Stage B Lyell McEwen Hospital including a 30 bed adult acute mental health unit, a 20
bed aged acute mental health unit and the completion of a SA Pathology facility. An additional $17 million
was invested in the purchase of major medical equipment.
The redevelopment of the Glenside Campus in accordance with the Glenside Campus Master Plan
continued this year. The new 129 bed hospital will provide mental health and drug and alcohol dependency
services. Architects have been appointed to lead the design of the new facilities, open space and site wide
infrastructure. The builder for the first element of the new facility, a 15 bed Intermediate Care Centre is
expected to be appointed next year.
page 6 Department of Health Annual Report 2008 09
The Mental Health 2009 Act was passed by Parliament in June 2009. The new Act expands and protects the
rights of people with mental illness. It recognises the needs of people from culturally and linguistically diverse
backgrounds, the role of carers and the circumstances of children who are experiencing or who are affected
by people with a serious mental illness. The new Act is a significant measure in the protection of persons with
mental illness.
During the year the department met the challenge of the H1N1 Influenza 09 (swine flu) pandemic. While the
threat of H1N1 Influenza 09 continues, the immediate, professional and decisive response, in collaboration
with the Australian and other State and Territory Governments, demonstrates our preparedness and capability
to manage a widespread pandemic influenza outbreak. I would like to thank all involved for their dedicated
and tireless effort.
The department undertook initiatives during 2008-09 to help South Australians make health a focus and
priority. A multitude of projects concentrated on achieving healthy weight for South Australians of all
ages, reducing cigarette smoking and providing support for new parents and their newborn babies. The
department s GP Plus Health Strategy continues to deliver more health services closer to where people live. In
addition to the GP Plus Centres already operating at Woodville and Aldinga, another four GP Plus Health Care
Centres will open in the coming years delivering more health services to the communities of South Australia.
During the year the department commenced the Obesity Prevention and Lifestyle (OPAL) initiative, a three way
partnership between Australian, State and Local Governments to promote healthy eating and physical activity.
The initiative addresses chronic disease in the community by helping families to eat well, move more and live
longer. It enhances, coordinates and supports existing healthy lifestyle programs, like be active Play Time, Start
Right Eat Right, Eat Well Be Active Primary Schools and Community Foodies, and identifies opportunities to
generate new programs. Under OPAL we will work closely with schools, workplaces, community organisations
and businesses to promote and support children and families to eat well and be active.
Several new action plans to enhance the health of South Australians were released this year including the
Chronic Disease Action Plan, the HIV Action Plan and the Hepatitis C Action Plan. The action plans make practical
recommendations to prevent the continued and emerging challenges of chronic disease, HIV and Hepatitis C, and
ultimately decrease the burden on our health system. The plans include priorities and actions that complement
existing initiatives by the South Australian and Australian Governments and in a partnership approach with non
government organisations, medical professionals, research organisation and the community.
During 2008-09 additional funding was committed by the South Australian and Australian Governments to
continue to reduce elective surgery waiting times. An additional 1 179 procedures were performed during
2008-09 compared with 2007-08 and 86% of patients received their surgery within the benchmark national
waiting times, up from 80.3% in 2007-08. Overall, 44 444 elective surgery procedures were undertaken in
metropolitan hospitals this year.
Another exciting achievement was the introduction of MedSTAR, the new single statewide emergency medical
retrieval service, which was launched in March 2009. MedSTAR provides rapid and high level emergency
medical care to acutely ill and injured South Australians. Specialist teams working in partnership with SA
Ambulance Service and the Royal Flying Doctor Service are dispatched from a single central location. This
innovative new service is delivering more support for country and metropolitan health services, and a more
coordinated process of patient transport and retrieval.
I am pleased with the progress we have made this year and the changes implemented to improve the health
of all South Australians. Our many achievements in the past 12 months would not be possible without the
professionalism and enthusiasm of staff at all levels in the Department of Health and across SA Health. I would
like to thank them for their unrelenting effort and energy in difficult times. The road ahead will undoubtedly
present new challenges and I am confident we will meet those challenges with the vigour and innovation that
has made 2008-09 a success.
Dr Tony Sherbon
Chief Executive Officer
page 7Department of Health Annual Report 2008 09
Objectives, Role and Legislation
Objectives
Our key objective is to lead and deliver a comprehensive and sustainable health system that aims to ensure
healthier, longer and better lives for all South Australians. The Department of Health recognises the myriad
of challenges confronting our health system, including national and global workforce shortages, our
ageing population and rapidly increasing demand on hospital and other health services. In this context, the
Department of Health is guided by South Australia s Health Care Plan 2007-2016, which provides a clear vision
for the sustainable provision of health services, the SA Health Strategic Plan 2008-2010, and South Australia s
Strategic Plan 2007.
Role
The role of the Department of Health is to assist the Minister for Health and the Minister for Mental Health
and Substance Abuse to set strategic directions for SA Health, support the delivery of public health services,
formulate health policy, facilitate public and consumer consultation on health issues, and monitor the
performance of South Australia s health system by providing timely advice, research and administrative
support. The Department of Health is committed to protecting and improving the health of all South
Australians by providing leadership in health reform, health and medical research, policy development and
planning with an increased focus on wellbeing, illness prevention, early intervention and quality care.
Department of Health organisational structure
In 2008-09, the Department of Health comprises 10 divisions reporting through Executive Directors to the
Chief Executive:
> Office of the Chief Executive
> Policy and Intergovernment Relations
> Operations
> Statewide Service Strategy
> Public Health and Clinical Coordination
> Aboriginal Health
> Communications
> Finance and Administration
> Workforce Development
> Information and Communication Technology (ICT) Services.
SA Health is the brand name for the health portfolio of services and agencies responsible to the Minister for
Health and the Minister for Mental Health and Substance Abuse. SA Health is the corporate identify for the
portfolio only and not the legal entity.
The legal entities include but are not limited to: Department of Health; Central Northern Adelaide Health
Service; Children, Youth and Women s Health Service; Southern Adelaide Health Service; Country Health SA;
Drug and Alcohol Services of South Australia and SA Ambulance Service.
page 8 Department of Health Annual Report 2008 09
SA Health Structure as at 30 June 2009
Health Performance Council
Department of Health
Regional Health Services/Agencies
Health Performance Council
Secretariat
Chief Executive
Tony Sherbon
Country
Health SA
Chief Executive
Officer
George Beltchev
Children, Youth
and Women s
Health Service
Chief Executive
Officer
Gail Mondy
Central Northern
Adelaide Health
Service
Chief Executive
Officer
Karleen Edwards
SA
Ambulance
Service
Chief Executive
Officer
Ray Creen
Southern
Adelaide Health
Service
Chief Executive
Officer
Cathy Miller
Internal Audit
Minister for Health
Hon John Hill MP
Minister for Mental Health &
Substance Abuse
Hon Jane Lomax-Smith MP
Office of the
Chief Executive
Executive Director
Nicki Dantalis
Communications
Executive Director
Taryn Schubert
Policy and
Intergovernment
Relations
Executive Director
David Filby
Public Health
and Clinical
Coordination
Executive Director
Stephen Christley
Statewide
Service Strategy
Executive Director
David Panter
Operations
Executive Director
David Swan
Workforce
Development
Executive Director
Etienne Scheepers
Aboriginal
Health
Executive Director
April Lawrie-Smith
ICT Services
Chief Information
Officer
David Johnston
Finance and
Administration
Executive Director
John O Connor
Administrative and legislative responsibilities
The Department of Health has administrative responsibility for ensuring that the governance responsibilities of
Ministers and incorporated hospitals across the State are appropriately discharged. The Health Care Act 2008
provides for the administration of hospitals and other health services, and establishes the Health Performance
Council and Health Advisory Councils. The Department of Health supports the councils with the discharge of
their governance and administrative responsibilities. The department undertakes the appointment of council
presiding members on behalf of the Minister for Health. Under the Health Care Act 2008 the Chief Executive
Officers of the Incorporated Hospitals (Regional Health Services and SA Ambulance Service) are accountable to
the Chief Executive of the the Department of Health for the administration of that service.
The Department of Health also ensures that those responsible for legislation committed to Ministers or
relevant to the public health system are appropriately advised about the discharge of their duties. Appendix 1
provides a full list of the relevant legislation committed to the Minister for Health and the Minister for Mental
Health and Substance Abuse at 30 June 2009.
Appendix 2 lists the incorporated hospitals under the Health Care Act 2008. It should be noted that these
entities have responsibility for preparing their own annual reports for tabling in Parliament.
Appendix 3 provides a list of boards and committees responsible to the Minister for Health and the Minister
for Mental Health and Substance Abuse. It also lists Health Advisory Councils established by the Minister
for Health under the Health Care Act 2008. These boards and committees are listed on the Boards and
Committees Information System (BCIS) if some or all of the members are appointed by a Minister or the
members receive remuneration.
The Ambulance Services 1992, the Hospitals Act 1934, Institute of Medical and Veterinary Science Act 1982
and the South Australian Health Commission Act 1976 were repealed as of 1 July 2008.
The Health Care Act 2008 was fully proclaimed on the 1 July 2008. The Mental Health Act 2009 was assented
to on the 11 June 2009, and will commence on 1 July 2010. The Nursing and Midwifery Practice Act 2008
was assented to on the 4 December 2008, the Kapunda Hospital (Variation of Kapunda Trust) Act 2009 was
assented to on the 26 February 2009, the Mount Gambier Hydrotherapy Pool Fund Act 2009 was assented to
on the 9 April 2009, and the Statutes Amendment (Public Health Incidents and Emergencies) Act 2009 was
assented on 25 June 2009.
Department of Health Annual Report 2008 09 page 9
Strategic Directions
The four key strategic directions of the Department of Health are articulated in the SA Health Strategic Plan
2008-10. These strategic directions are to:
1. Strengthen primary health care
2. Enhance hospital care
3. Reform mental health
4. Improve the health of Aboriginal people.
There is a direct relationship between these strategic directions and South Australia s Strategic Plan 2007
through common strategic actions and high level key performance indicators. In addition, key elements from
major health plans, such as the SA Health Care Plan 2007-2016, are incorporated in the SA Health Strategic
Plan and linked to the relevant strategic directions.
The following sections of the annual report provide an overview of the Department of Health s activities,
initiatives and performance in relation to South Australia s Strategic Plan 2007 targets and the SA Health
Strategic Plan strategic directions.
South Australia s Strategic Plan
South Australia s Strategic Plan 2007 consists of 98 measurable targets under the following six interrelated
objectives:
1. Growing prosperity
2. Improving wellbeing
3. Attaining sustainability
4. Fostering creativity and innovation
5. Building communities
6. Expanding opportunity.
SA Health is the lead agency for six of the 12 targets under Objective 2: Improving wellbeing, which aims to
improve the quality of life and wellbeing of South Australians. SA Health also is the lead agency for Target 6.3
Early childhood birth weight under Objective 6: Expanding opportunity. SA Health contributes to a range of
other government targets.
Progress against the SA Health-led and other government targets is summarised below.
SA Health-led targets
SA Health has lead agency responsibility for seven South Australia s Strategic Plan 2007 targets. A more
detailed explanation of activities and initiatives to address these targets is contained under the relevant
sections of this report.
T2.1 Smoking
Reduce the percentage of young cigarette smokers by 10 percentage points between 2004 and 2014.
For the purposes of monitoring and reporting against this target, young people comprise the 15 29 year-old
age group.
The baseline year for this target was 2004, with a smoking prevalence of 27.9%. Three year moving averages
indicate that following a period of decline there is a small increase in young smokers (see Figure 1 and 2).
page 10 Department of Health Annual Report 2008 09
Figure 1 Smoking prevalence for 15 to 29 year old South Australians,
3 year moving averages (2004 baseline)
Pe
rc
en
t
0
5
15
25
35
30
20
10
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
- 01 - 02 - 03 - 04 - 05 - 06 - 07 - 08 - 09 - 10 - 11 - 12 - 13 - 14
Persons 30.3 29.3 28.7 29.0 27.1 24.4 22.7 23.4
Target 17.9
Baseline 27.9
Figure 2 Gender, Smoking prevalence for 15 to 29 year old South Australians, 3 year moving averages
33.2
27.4
32.6
25.9
32.4
24.9
31.7
26.1
29.4
24.7
26.1
22.7
24.5
20.8
24.5
22.3
1999
- 01
2000
- 02
2001
- 03
2002
- 04
2003
- 05
2004
- 06
2005
- 07
2006
- 08
2007
- 09
2008
- 10
2009
-11
2010
- 12
2011
- 13
2012
- 14
Pe
rc
en
t
0
5
15
25
40
35
30
20
10
Males
Females
Baseline
Note: The baseline is based on the 2004 single year figure.
Black error bars are 95% confidence intervals for respective data points
Source: The Cancer Council of South Australia.
Click on the link for more detailed information on T2.1 Smoking.
Department of Health Annual Report 2008 09 page 11
T2.2 Healthy weight
Increase the proportion of South Australians 18 and over with healthy weight by 10 percentage
points by 2014.
Body Mass Index (BMI) is used to estimate the total amount of fat for men and women over the age of 18.
BMI is calculated by dividing weight in kilograms by height in metres squared (m2). A healthy BMI for an adult
is between 18.5 and 24.9.
South Australian Monitoring and Surveillance System (SAMSS) data puts the current proportion of the South
Australian population in the healthy weight range at 40.0% (2008). This is a decrease from the baseline rate
(2003) of 42.0%, representing an increase in the number of South Australians who are outside the healthy
weight range (see Figure 3). This is true for both males and females, with a lower percentage of males having
a healthy weight (see Figure 4).
Figure 3 Prevalence of healthy weight for South Australians, 18 years and over (2003 baseline)
42.0 42.5 43.6
52.0
42.5 41.0 40.0
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Pe
rc
en
t
0
10
30
50
60
40
20
Persons
Target
Baseline
Year
Note: Black error bars are 95% confidence intervals for respective data points.
Source: SA Health, South Australian Monitoring and Surveillance System.
page 12 Department of Health Annual Report 2008 09
Figure 4 Gender, prevalence of healthy weight for South Australians, 18 years and over
35.2
48.7
36.6
48.3
37.4
49.7
35.6
46.5
34.6
45.5
36.0
48.7
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Pe
rc
en
t
0
10
30
50
60
40
20
Males
Females
Baseline
Year
Note: Black error bars are 95% confidence intervals for respective data points.
Source: SA Health, South Australian Monitoring and Surveillance System.
Click on the link for more detailed information on T2.2 Healthy weight.
T2.4 Healthy South Australians
Increase the healthy life expectancy of South Australians by 5% for males and 3% for females by
2014.
Health Adjusted Life Expectancy summarises the expected number of years to be lived in the equivalent of full
health . This approach quantifies life expectancy within a population with adjustment for years lived in less
than full health.
The Department of Health South Australian Burden of Disease Study puts the current health adjusted
life expectancy for men at 70.3 years and women at 75.2 years (2005 07, three year moving preliminary
data). This is an increase from the baseline rate (1999 01) of 69.0 years for men and 74.2 years for women
(see Figure 5). The target rate for 2014 is 72.5 years for men and 76.4 years for women. The data shows
improvement over the past three years in health adjusted life expectancy for both males and females towards
the 2014 target.
page 13Department of Health Annual Report 2008 09
Figure 5 Health adjusted life expectancy for South Australians (1999 2001 baseline)
69.0
74.2
69.1
74.2
69.4
74.3
72.5
76.4
69.6
74.6
69.7
74.8
70.2
75.2
70.3
75.2
Source: SA Health, South Australian Burden of Disease Study, www.health.sa.gov.au/burdenofdisease/
Males
Females
Baseline
Y
ea
rs
64
70
74
78
80
76
72
68
66
Target
1999
- 01
2000
- 02
2001
- 03
2002
- 04
2003
- 05
2004
- 06
2005
- 07
2006
- 08
2007
- 09
2008
- 10
2009
- 11
2010
- 12
2011
- 13
2012
-14
Click on the link for more detailed information on T2.4 Healthy South Australians.
T2.5 Aboriginal healthy life expectancy
Lower the morbidity and mortality rates of Aboriginal South Australians.
Increasing Aboriginal healthy life expectancy is a key target of South Australia s Strategic Plan 2007. Aboriginal
people have a significantly lower life expectancy than the non-Aboriginal population of South Australia.
Premature mortality is measured using Years of Life Lost (YLL). The most recent rate for YLL for Aboriginal
people in SA is 138.2 YLL/1000, a gap of 78.7 YLL/1000 compared with the total non-Aboriginal SA
population (2004-06 provisional adjusted 3 year annual average). This is an improvement from the baseline
rate of 153.6 YLL/1000; a gap of 85.8 YLL/1000 compared to the total non-Aboriginal SA population (1999
01 adjusted 3 year annual average) (see Figures 6 and 7).
page 14 Department of Health Annual Report 2008 09
Figure 6 Premature mortality (YLL) for South Australia,
3 yearly annual averages (1999 2001 baseline)
A
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er
1
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00
200
180
160
140
120
100
80
60
40
20
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1999 - 2001 2000 - 2002 2001 - 2003 2002 - 2004 2003 - 2005 2004 - 2006
(provisional)
Indigenous 153.6 149.4 149.3 149.6 156.5 138.2
Non-indigenous 67.8 68.1 66.5 64.2 62.7 59.5
Baseline
Source: SA Health, South Australian Burden of Disease Study, www.health.sa.gov.au/burdenofdisease/
page 15Department of Health Annual Report 2008 09
Figure 7 Gender, premature mortality (YLL) for South Australia,
(age-sex standardised) 3 yearly annual average
175.6
131.9
76.7
59.8
166.7
132.5
75.6
59.8
179.1
120.0
74.1
59.1
194.4
119.2
71.0
54.5
170.8
128.7
72.2
56.4
1999 - 2001 2000 - 2002 2001 - 2003 2002 - 2004 2003 - 2005
154.6
122.1
67.1
52.0
2004 - 2006
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200
220
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120
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Male indigenous
Female indigenous
Male non-indigenous
Female non-indigenous
Baseline
(provisional)
Uses High Series Projections of indigenous population by age by year for South Australia from ABS Cat 3238.0, 0-4, then
10 year age groups to 55+. Population figures for 1999 and 2000 were not available within ABS Cat 3238.0, so rate
calculations use 2001 estimates for 1999-2001 period, then 2001, 2002, 2003 and 2004 for the periods 2000-02, 2001-03,
2002-04 and 2003-05 respectively. Results are age and sex adjusted to the Australia 2001 population to determine if there
would be any differences in outcomes if the age and sex of the population were the same. Deaths included were in the
specified period (not necessarily the year of registration).
Data Source: Department of Health, South Australian Burden of Disease Study. www.health.sa.gov.au/burdenofdisease/
Click on the link for more detailed information on T2.5 Aboriginal healthy life expectancy.
T2.6 Chronic diseases
Increase by five percentage points, the proportion of people living with a chronic disease whose self-
assessed health status is good or better.
In relation to this target, chronic diseases include conditions such as heart disease, stroke, chronic and
obstructive pulmonary disease, and diabetes. These conditions represent approximately 70% of the overall
burden of disease in South Australia.
The percentage of South Australians with a chronic disease whose self-assessed health status is good or better
has not shown a trend since the baseline of 2003. SAMSS data puts the current proportion of people living
with a chronic disease whose self-assessed health status is good or better at 72.7% (2008) (see Figures 8 and
9). The target rate for 2014 is 77.6%.
page 16 Department of Health Annual Report 2008 09
Figure 8 South Australians with a chronic disease reporting an excellent, very good or good
health status (2003 baseline)
72.6
77.6
69.9 72.6 70.9 72.769.3
Pe
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en
t
60
64
72
78
80
68
62
70
76
74
66
Health status
excellent, very
good or good
Target
Baseline
Year
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Note: Black error bars are 95% confidence intervals for respective data points.
Source: SA Health, South Australian Monitoring and Surveillance System.
Figure 9 Gender, South Australians with a chronic disease reporting an excellent,
very good or good health status
71.9
73.2
68.1
71.2
73.9
71.6
66.6
71.5
69.0
72.4
69.7
74.9
Pe
r
ce
nt
Males
Females
Baseline
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
60
70
68
66
64
78
80
76
74
72
62
Note: Black error bars are 95% confidence intervals for respective data points.
Source: SA Health, South Australian Monitoring and Surveillance System.
Click on the link for more detailed information on T2.6 Chronic diseases.
Department of Health Annual Report 2008 09 page 17
T2.7 Psychological wellbeing
Equal or lower than the Australian average for psychological distress by 2014.
The measure for this target is the Kessler K10 (K10) measure of psychological distress. The K10 scale consists
of 10 questions on non-specific psychological distress and ascertains the level of anxiety and depressive
symptoms a person may have experienced in the most recent four-week period. Baseline and monitoring data
is for South Australians aged 18 years and over.
The most recent data from the Australian Bureau of Statistics (ABS) 2007-08 National Health Survey (NHS)
puts the proportion of South Australian people experiencing psychological distress as measured by the K10 at
12.9% compared with the national rate of 12.0%. This is an improvement from the baseline (2001 ABS NHS)
rate of 13.6% for South Australians compared with the national rate of 12.3%. However, this most recent
data does not compare favourably with the previous (2004-05 ABS NHS) data, which showed South Australia s
rate of psychological distress as 12.2%, compared with the national rate of 13.0%.
Figure 10 Levels of psychological distress (2001 baseline)
13.6
12.3
10.9 10.7 8.5 8.9 12.9
12.0
10.1 9.6 9.312.2
13.0
Pe
rc
en
t
0
6
10
14
16
12
8
4
2
South
Australia
Australia
Baseline
Year
2001
(ABS)
2002
(SAMSS)
2006
(SAMSS)
2007
(SAMSS)
2008
(SAMSS)
2007-08
(ABS)
2004-05
(ABS)
2005
(SAMSS)
2004
(SAMSS)
2003
(SAMSS)
Note: 2002 data is for July to December 2002
Black error bars are 95% confidence intervals for respective data points.
Source: ABS Cat No. 4364.0 and SA Health, South Australian Monitoring and Surveillance System (SAMSS).
page 18 Department of Health Annual Report 2008 09
Figure 11 Gender, levels of psychological distress
Pe
rc
en
t
South Australian Males
South Australian Females
Australian Males
Australian Females
Baseline
11.6
15.4
9.6
14.8
8.7
13.0
8.9
12.4
8.2
11.8
6.9
12.1
8.0
10.6
6.3
10.8
7.5
10.2
9.6
14.6
10.8
15.0
12.3
13.4
9.6
14.3
0
2
4
6
8
10
12
14
16
18
2001
(ABS)
2002a
(SAMSS)
2006
(SAMSS)
2007
(SAMSS)
2008
(SAMSS)
2007-08
(ABS)
2004-05
(ABS)
2005
(SAMSS)
2004
(SAMSS)
2003
(SAMSS)
Note: 2002 data is for July to December 2002
Black error bars are 95% confidence intervals for respective data points.
Source: ABS Cat No. 4364.0 and SA Health, South Australian Monitoring and Surveillance System.
Click on the link for more detailed information on T2.7 Psychological wellbeing.
page 19Department of Health Annual Report 2008 09
T6.3 Early childhood birthweight
Reduce the proportion of low birthweight babies.
Low birthweight babies are defined as live births with a birthweight less than 2 500 grams. The most recent
data from the SA Health Pregnancy Outcome Unit puts the proportion of low birthweight babies as a
proportion of total live births in South Australia at 6.43% (2008) compared with the baseline rate of 6.5%
(2003) (see Figure 12).
Figure 12 Low birthweight infants as a proportion of total live births for South Australia (2003 baseline)
Total Population
Indigenous
Non Indigenous
Pe
rc
en
t
20
18
16
14
12
10
8
6
4
2
0
Baseline
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
6.0 6.2 6.3 6.2 6.2 6.9 6.4 6.5 6.1 6.8 6.2 6.6 6.5 6.5 7.0 6.4 6.4 6.3
10.1 12.2 11.1 12.4 12.7 12.3 11.5 13.4 15.6 17.6 16.2 18.9 17.3 17.4 17.7 13.4 16.2 16.3
5.9 6.0 6.2 6.0 6.0 6.7 6.3 6.4 5.9 6.5 6.0 6.2 6.2 6.2 6.7 6.2 6.1 6.0
Note: Annual rates of Indigenous low birthweight babies can fluctuate due to relatively small numbers.
Source: SA Health, Pregnancy Outcome Unit.
Click on the link for more detailed information on T6.3 Early childhood birthweight.
page 20 Department of Health Annual Report 2008 09
All of Government Targets
The following provides an overview of the Department of Health s progress against
relevant all of government targets:
T1.7 Performance in the public sector
customer and client satisfaction with government services
Increase the satisfaction of South Australians with government services by 10% by 2010, maintaining
or exceeding that level of satisfaction thereafter.
The department undertook initiatives to assess customer and client satisfaction, and inform approaches to
improve and maintain client satisfaction. Two of the more significant initiatives were:
> The Patient Evaluation of Health Services (PEHS) Program is an initiative of the South Australian Safety and
Quality Council and is managed by the Department of Health. Statewide patient satisfaction surveys aim to
monitor consumer satisfaction with health services and have been conducted since 2001.
The PEHS presents satisfaction scores for a sample of 4785 adult patients who received at least one night
of care in the South Australian public hospital system during May to July 2008. Data was collected from
August to November 2008 by the Computer Assisted Telephone Interviewing system.
This survey covered the key dimensions of patients satisfaction with coordination and consistency of
care, information and communication, availability of care, involvement in care and treatment, access to
the hospital and patient s rights and needs. The overall satisfaction score of 88.0 for the Public hospital
inpatients in South Australia: patient satisfaction survey was higher than the overall satisfaction scores for
all other PEHS survey years.
The highest satisfaction level was found in the area of coordination and consistency of care, closely
followed by information and communication between patient and service provider, with both areas scoring
above 90.
> The department developed the household survey for the public sector using the Canadian Common
Measurement Tool questions and conducted an initial survey in 2008. The questions measured customer
experiences, expectations and needs in the areas of overall satisfaction, accessibility, timeliness, fairness,
information, knowledge/competence, extra mile/courtesy and outcome.
In 2008-09 the department conducted a follow-up survey using the same measurement tool. As with the
first survey, the data from the second survey was provided to the Department of the Premier and Cabinet,
the lead agency for this target.
T1.8 Performance in the public sector government decision making
Become by 2010, the best-performing jurisdiction in Australia in timeliness and transparency of
decisions which impact the business community (and maintain that rating).
As part of the South Australian Government s Red Tape Reduction Program, the Competitiveness Council
required all government agencies to develop red tape reduction plans indicating how the regulatory burden on
business and red tape would be reduced by 25%. The first tranche of reductions was delivered during 2007
08. During 2008-09 the Department of Health developed further initiatives to contribute to the next tranche
of savings. The majority of these initiatives relate to continued improvements in supply chain management, in
particular reducing red tape for business through improved tendering arrangements.
T1.9 Performance in the public sector administrative efficiency
Increase the ratio of operational to administrative expenditure in the State Government by 2010,
and maintain or better that ratio thereafter.
The Department of Health was required by the South Australian Government to meet savings of $2.6 million
during 2008-09 in relation to administrative efficiency measures. Through a review of internal operations, the
departmental savings target was absorbed within existing resources with no impact on service delivery.
Of the total SA Health expenditure, operational expenditure accounts for 96%, with administrative
expenditure accounting for 4%, which is consistent with last year s ratio.
page 21Department of Health Annual Report 2008 09
T3.13 Energy efficiency
Improve the energy efficiency of government buildings by 25% from 2000-01 levels by 2014.
SA Health is responsible for approximately 50% of government building energy use. Since 2000-01 the
energy efficiency of the buildings SA Health occupies has improved by 14%. More detailed information
regarding energy efficiency performance and the steps to further energy efficiency are outlined on
page 116 of this report.
T5.1 Boards and committees
Increase the number of women on all State Government boards and committees to 50% on average by
2008, and maintain thereafter by ensuring that 50% of women are appointed, on average, each quarter.
As at 1 June 2009, 54% of board and committee members across the Department of Health were women.
The number of women on Department of Health boards and committees has continued to increase since 1
June 2007, demonstrating that the department is successfully meeting this target.
T5.2 Chairs of boards and committees
Increase the number of women chairing State Government boards and committee to 50% by 2010.
As at 1 June 2009, women chaired 38% (28 out of 72) of all Department of Health boards and committees
(as recorded on the Boards and Committees Information System (BCIS)). Six boards and committees did not
have a chairperson appointed on 1 June 2009.
Strategies to increase the proportion of female chairs include:
> Consulting women s networks and registers, and individual boards and committees to facilitate the
participation of women with suitable skills and experience on boards and committees.
> Consulting SA Health networks with a view to obtaining names of possible chair candidates.
> Addressing the possibility and appropriateness of appointing a female chair when liaising with boards and
committees in relation to upcoming vacancies.
T6.22 Diversity in the public sector people with disabilities
Double the number of people with disabilities employed by 2014
The Department of Health has increased the number of people employed with disabilities and a Disability
Action Plan is being implemented in SA Health.
The number of people in the Department of Health employed with disabilities who require work place
adaptation represents 1.82% of the department s total workforce.
page 22 Department of Health Annual Report 2008 09
T6.23 Diversity in the public sector - Women
Women comprising half of the public sector employees in the executive levels (including chief
executives) by 2014
As at June 2009, women represented 37% of the total executive management structure of the Department
of Health. To ensure further progress towards the target level, the department is developing a Women in
Leadership Strategy which will actively support women in the emerging-executive and executive levels to
continue to develop their leadership skills and potential. Initiatives include the formation of a Women in
Leadership Group and the appointment of an executive sponsor.
This is in addition to leadership programs that provide participants with an increased ability to understand
and interpret health care policy for local settings; greater understanding and competence in the practical
application of theoretical components of leadership; increased self awareness in managing themselves, teams
and those around them, including managing upwards and managing their environment; and greater ability to
analyse, manage and lead in a complex environment and difficult strategic and operational situations. These
programs will assist the development of women aspiring to achieve executive appointments.
T6.24 Diversity in the public sector Aboriginal employees
Increase the participation of Aboriginal people in the South Australian public sector, spread across all
classifications and agencies, to 2% by 2010 and maintain or better those levels through to 2014.
Addressing attraction and retention issues relevant to the Aboriginal health workforce, and increasing
workforce skills and the knowledge base necessary to provide culturally appropriate services to Aboriginal
people is part of the department s plan to increase the number of Aboriginal people in the South Australian
public sector.
In April 2009, the Minister for Health launched the SA Health Aboriginal Workforce Reform Strategy which
forms SA Health s commitment to building a stronger, larger, more dispersed Aboriginal health workforce.
The strategy outlines six objectives which inform SA Health of the key areas for action in relation to Aboriginal
employment and workforce development.
page 23Department of Health Annual Report 2008 09
Strengthening Primary Health Care
Reducing the percentage of cigarette smokers
Tobacco smoking continues to be the single biggest cause of premature death in South Australia, with 1 130
South Australians dying each year due to a smoking related illness. Implementation of the South Australian
Tobacco Control Strategy 2005-2010 continued in 2008-09. The five year strategy aims to improve the health
of South Australians by reducing harm caused by tobacco smoking in the community. By 2010 the objective
is to have reduced smoking prevalence to 17% among all adults. This goal complements Target 2.1 in South
Australia s Strategic Plan 2007 to reduce cigarette smoking prevalence in young people (15-29 years) by 10%
by 2014.
A range of initiatives have been implemented in 2008-09 to reduce smoking prevalence, particularly among
young people. In addition, ongoing enforcement activities to ensure compliance with legislative requirements
continue.
Restrictions on temporary tobacco stalls
On 19 January 2009, changes in the Regulations resulted in the display and promotion of tobacco products
from temporary stalls being prohibited. Prior to this tobacco companies could legally establish temporary
tobacco stalls at youth oriented events to sell and promote tobacco products to young people.
Advertising campaigns
Two campaigns aired in 2008-09 in South Australia. The first was the National Tobacco Campaign (NTC),
known as Refresh, which featured five commercials with the key message; Every cigarette is doing you
damage;. The NTC Refresh commercials use graphic health images to encourage smokers to consider the
impact smoking has on their health.
The second campaign, known as Separation, illustrates a young boy s fear when separated from his mother
and makes the comparison with how a child might feel if they lost a parent to a smoking related illness. This
commercial encourages smokers to consider the effect their smoking and potential smoking related illnesses
have on their family and friends.
Consistent with previous years, calls to the Quitline remained high during all periods of campaign activity.
Youth smoking cessation project
The Youth Friendly Quit Program, which is based at Quit SA, has continued to develop strategies to engage
young people to reduce the prevalence of smoking among this population group. Internet based interventions
have been developed to encourage interaction and provide greater support for young people. The program
has developed MySpace and Facebook social networking sites and includes mobile text messaging options
into media campaigns. SMS responses to campaigns were high among people aged 15-29 years.
Enforcement
To assess compliance with the Tobacco Products Regulation Act 1997, 386 workplaces and hospitality venues
and 852 licensed retailers were inspected during 2008-09.
Fourteen expiation notices were issued for smoking in an enclosed area, eight retailers were issued with
expiation notices for selling tobacco without a valid retail tobacco merchant s licence and seven expiation
notices were issued to retailers for non-compliance with point of sale requirements.
page 24 Department of Health Annual Report 2008 09
Cooperation with Department of Education and Children s Services
The Smarter than Smoking SA project, which is based at Quit SA, continued to work with the Department of
Education and Children s Services (DECS) to develop and promote resources to assist in the delivery of tobacco
education in schools. In response to feedback from teachers, the Smarter than Smoking SA project has developed
a CD ROM which includes resources to inform teachers, staff, parents and students about tobacco, as well as a
practical document for schools and early childhood settings to use for development of smoke-free policies.
In 2008, a record number of upper primary and secondary schools registered to participate in the annual
Critics Choice anti-tobacco program with 33 049 students participating. The students watched, critiqued and
discussed 12 anti-tobacco television commercials sourced from Australia and overseas.
Increasing the percentage of South Australians with a healthy weight
Overweight and obesity is one of the major challenges facing health systems around the world due to the risk
of chronic disease and costs of morbidity, disability and mortality. Approximately one in five children in South
Australia aged four years is overweight or obese. Younger people are gaining weight faster than previous
generations and weight gain is accelerating as modern life influences weight patterns1.
The Eat Well Be Active Healthy Weight Strategy provides the framework for action to increase the percentage
of adults in the healthy weight range to 52% by 2014, in line with South Australia s Strategic Plan Target 2.2.
The concerted action being taken in South Australia reflects good practice from around the world. Preventing
obesity is a major priority with more than $9 million allocated in 2008-09. The estimated cost of obesity is
higher than previously estimated, at around $4.3 billion per annum for South Australia2.
Workforce development is one of the four action areas of the Eat Well Be Active Healthy Weight Strategy,
along with School and Community Programs, Community Education, and Policy and Legislation.
School and community programs
Healthier lifestyles can reduce chronic diseases and the need for health services. Prevention is better than cure
and supporting behaviour change in the social context of everyday lives means settings such as pre-schools,
schools and communities are critical to the South Australian approach.
Obesity Prevention and Lifestyle
South Australia is the first state in Australia to introduce the French EPODE approach to reducing childhood
obesity. Obesity Prevention and Lifestyle (OPAL) will be an exemplar in bringing together local, state and
Australian governments, communities, schools, workplaces, and business and community organisations to
support children and families to eat well and be active. Local government will play a lead role, acknowledging
its influence in reducing obesogenic environments. The initial six sites are the Cities of Marion, Onkaparinga,
Mount Gambier, Playford, Port Augusta and Salisbury.
be active Play Time
Early childhood is an important time to develop fundamental movement skills that will support children to
be active throughout their life. Led by the Office for Recreation and Sport, this Department of Health funded
program builds the skills of parents and carers to foster active play with a particular focus on disadvantaged
communities. Since its inception in 2008, 16 community organisations have been contracted to deliver 158
sessions which have been attended by 583 parents and carers.
1 Allman-Farinelli M, King L, Bonfiglioli C, Bauman A. (2006) The Weight of Time: Time influences on overweight and
obesity in men. NSW Centre for Overweight and Obesity: Sydney.
2 Access Economics (2008) The Growing Cost of Obesity in 2008: three years on. Report for Diabetes Australia: Canberra
page 25Department of Health Annual Report 2008 09
Eat Well Be Active primary schools
The Eat Well Be Active primary schools initiative has been developed to:
> increase children s level of physical activity, consumption of fruit, vegetables and water
> decrease screen based leisure activities (for example television, computer game usage) and the consumption
of soft drink, juice beverages and energy dense, nutrient poor foods.
Two private providers, Bluearth Foundation and the Australian Council for Health Physical Education and
Recreation (ACHPER) SA Branch, are funded by the Department of Health to work with schools over a
period of 2.5 years. Their focus is on teacher training and curriculum and is designed to increase teachers
confidence, skills and commitment in this area of learning thereby promoting long-term sustainability beyond
the funding period.
The program, managed by DECS, commenced in April 2009 with 63 schools participating initially. Additional
schools across South Australia are expected to join the program in 2010.
Parenting, Eating and Activity for Child Health
This targeted weight management program for overweight five to nine year olds has a family approach
to achieving healthy lifestyles. During 2008-09 six health practitioners completed facilitator training and
commenced recruitment of families to the program. Parents are offered 10 training sessions over six months
including follow up phone support and fun physical activity sessions for the child. Parenting, Eating and
Activity for Child Health will be implemented in more areas in 2009, with training, support and evaluation
provided by the Flinders University of South Australia nutrition and dietetics discipline.
Breastfeeding
Healthy eating is essential for good health at all ages, starting with prenatal nutrition. Breastfeeding helps
protect against a range of conditions later in life including obesity and chronic disease. As part of the
Breastfeeding Strategic and Action Plan 2008-2012, SA Health is supporting birthing units across SA to
become Baby Friendly Hospital Initiative (BFHI) accredited. BFHI accreditation requires staff in the particular
units to undertake appropriate training. SA Health provides a web based breastfeeding training package. Since
it began, 3 206 health personnel have completed the e-learning and 1 452 SA staff completed the course in
2008-09.
Start Right Eat Right
Food preferences are established early in life and children s eating behaviours are influenced by families and
other environmental factors outside the home. Start Right Eat Right is a nutrition award scheme recognising
long day care centres that promote healthy food. Training is provided in menu planning, hygiene and
supportive eating environments. During 2008-09, 120 centres were trained. A total of 219 centres have been
trained (78% of eligible centres) and of these, 155 have achieved accreditation.
Community Foodies
This program trains volunteers to run basic nutrition education programs for community members. The
program now operates at 14 sites across the state. In total, 122 Foodies have been trained, including 17
of Aboriginal background (14 in 2008-09). A recent extension of the Foodies model is the African Cultural
Mentors Communities Foodies Project which uses the expertise and resources of a cultural mentor to ensure
nutrition concepts are presented in a style suitable to African community members.
page 26 Department of Health Annual Report 2008 09
Community education
Interventions to improve community awareness, knowledge and attitudes are underpinned by the objective
of encouraging lifestyle behaviour change in the long term. Social marketing campaigns seek to present
consistent, evidence based messages to the community in order to raise awareness, increase knowledge,
change attitudes and behaviour.
Go for 2&5 campaign
There is evidence that diets high in fruit and vegetables can significantly reduce the risk of a number of
chronic conditions (particularly heart disease, certain cancers, stroke and type 2 diabetes).
The Go for 2&5 fruit and vegetable marketing campaign incorporates television, radio, print and outdoor
media, as well as a range of posters, fact sheets and recipe books. The campaign targets the main shopper
and meal preparer in the family. Although 88% of South Australian adults say they have seen or heard the
Go for 2&5 message, there is confusion as to what constitutes a serve . The next phase of the campaign will
focus on this issue as well as quick and easy meal ideas.
Measure Up campaign
Many people underestimate the influence excess weight and waist circumference has on increasing the risks of
chronic disease. The Australian Better Health Initiative funded the Measure Up campaign which aims to address
this misperception and raise appreciation of how easy it is to put on weight, why behavioural change is necessary,
and what people need to do to improve their lifestyle. Evaluation results for phase one are being compiled.
Policy and legislation
Public policy can be a powerful contributor in creating healthy societies as experienced with the reduction in
smoking and improvement in road safety.
Healthy Food in South Australian Health Facilities directive
Leading by example, SA Health has introduced a policy directive, Healthy Food and Drink Choices for Staff
and Visitors in SA Health Facilities, to ensure healthy food and drink choices are available and promoted across
SA Health. Commencing in April 2009, this policy applies to food outlets and vending machines as well as
fundraising, advertising and sponsorship activities.
Health in all Planning position
Urban planning plays a key role in reducing obesogenic environments. SA Health commissioned a systematic
review of the impact of urban planning on population health outcomes and has funded a Health in all
Planning position within Planning SA to influence key policy initiatives including the 30 Year Plan for Greater
Adelaide.
Television Advertising and the Consumption of Unhealthy Food and Drinks by Children discussion paper
In August 2008, the Minister for Health released the discussion paper, Television Advertising and the
Consumption of Unhealthy Food and Drinks by Children. Sixty-three submissions were received. The Minister is
considering the results of the consultations while encouraging voluntary changes in practice by the industry.
Active Living Coalition
SA Health has funded the National Heart Foundation to coordinate the Active Living Coalition. This initiative
promotes collaborative partnerships between government and other agencies to support physical activity
as part of the daily routine through the design and development of the environment. During 2008-09, the
Coalition analysed South Australia s planning system to identify the issues and opportunities that impact on
the adoption of active living in South Australia and worked in partnership with the Northgate Joint Venture
project team to promote active living principles in this new housing development.
page 27Department of Health Annual Report 2008 09
Workforce development, research and evaluation
The health sector workforce is well placed to promote healthy lifestyles to the South Australian population.
Developing health professionals knowledge and understanding of risk factors, support materials and referral
options extends the reach of the programs in the community. Research and evaluation monitors trends,
identifies successful programs and informs future resource allocation decisions.
Healthy Eating and Physical Activity in the Early Years
Funded by the Department of Health and implemented by DECS, Early Years Educators promote healthy
eating habits and physical activity through site based inquiry processes. Twenty eight early childhood settings
sites (kindergartens, pre-school, children s centres and childcare centres) participated in this initiative in 2008
09. Evaluation of the 2007-08 participants showed that 95% of sites increased the level of family partnerships
and are more accountable and better equipped to implement healthy eating.
Eat Well Be Active Start Young
Child maternal health nurses can influence parents and families of young children to eat well and be active.
Outcomes of the Eat Well Be Active Start Young initiative include the Ngartunna Waiendi Babies on the Move
DVD about gross motor development for Indigenous babies and low literacy resources.
page 28 Department of Health Annual Report 2008 09
Increasing the healthy life expectancy of South Australians
The South Australian Government continues to promote and develop programs and new initiatives in line with
the primary aim of the SA Health Care Plan 2007-2016; keeping South Australians healthy and improving
access to quality, safe, complete and affordable health care.
In November 2003 the South Australian Government launched its health framework for early childhood
services, Every Chance for Every Child: Making the Early Years Count. Through this initiative, the government
initiated the Universal Contact Visit and the Family Home Visiting program.
Universal Contact Visit
This service provides support to new parents with a newborn baby through a contact visit by a child and family
health nurse. The aims of the universal contact visit are to:
> assess the health of infants by undertaking a developmental health check
> assist parents with providing information about parenting and appropriate services
> engage parents and family members in a positive partnership with health service providers, including staff
and other services provided by the Children, Youth and Women s Health Service.
During 2008-09, 18 410 universal contact visits were conducted, constituting 93.95% of the total birth
numbers for that period.
Family Home Visiting
Families who are eligible for the Family Home Visiting program enter through the Universal Contact Visit,
where a qualified child and family health nurse visits families, predominantly in their homes within the first
weeks of their baby s life.
The Family Home Visiting program is a preventative parenting program that aims to provide children with the
best possible start in life and to enhance child development and parental attachment, thus improving health
and wellbeing. The program assists families to provide a safe and supportive environment for their children
and better links families to available resources and networks within the community.
The program is conducted through approximately 34 visits per family by a child health nurse, commencing at
six to twelve weeks of age and concluding at two years of age. The nurse builds a relationship with the family
and works closely with other agencies to broker support services for the family.
Family Home Visiting now operates across the greater Adelaide metropolitan area including Mount Barker
and southern hills, Murray Bridge, Port Augusta, the middle and lower Eyre Peninsula, Mount Gambier, the
Riverland and Barossa Valley.
A total of 4 264 families have accepted Family Home Visiting since its inception including 950 new families
who commenced during 2008-09. More than 1 200 families have finished the two year program, including
390 families over the course of 2008-09. As at 30 June 2009, 1 391 families with infants up to the age of
two, were actively involved in the program.
More than 76% of families offered Family Home Visiting services during 2008-09 commenced the program,
with approximately 20% of babies involved in the program being of Indigenous descent.
page 29Department of Health Annual Report 2008 09
GP Plus Health Care Strategy
The GP Plus Health Care Strategy was launched in August 2007. The strategy addresses key recommendations
arising from the Generational Health Review to provide a fully integrated and accessible health care system
and to increase prevention and early intervention services to promote good health.
GP Plus Health Care Centres
GP Plus Health Care Centres are state-of-the-art primary health care services complementing general practice
and acting as navigators that link the acute and primary health care systems to provide a more balanced
health system and better care for consumers closer to where they live.
GP Plus Health Care Centres at Aldinga and Woodville continue to focus on providing integrated primary
health care services and developing improved coordination and delivery of care.
The Aldinga GP Plus Centre has increased the services provided to the local community and initiated new
services such as a nurse-led chronic respiratory disease clinic and a lifestyle advisor for people at risk of
developing a chronic disease.
The Woodville GP Plus Centre continues to provide a range of services to the community, with a particular
focus on young people and vulnerable populations such as refugees, Indigenous people and those from a
cultural and linguistically diverse background. Sexual health, mental health, drug and alcohol issues, and
access to general practitioners (GP) after hours are some of the key health needs addressed.
There has been substantial progress towards building the new GP Plus Centre at Elizabeth, which is due to
open in 2010. Planning is underway for GP Plus Centres at Marion, Ceduna and Port Pirie.
GP Plus Health Networks
The new model for GP Plus Health Networks has been implemented in Central Northern Adelaide Health
Service and Southern Adelaide Health Service to collaborate on the first phase of the Regional Health Services
Health Improvement Plans.
The metropolitan health regions originally created the networks (formerly known as Primary Health Care
Networks) during 2004, which included some variation in structure and function. The intent of the new
model is to encompass the best elements of the original networks, enhance the planning and operational
functions, and provide more opportunity to engage with general practice. The revised model now
incorporated in the Regional Health Services Health Improvement Plans will assist more comprehensive
reporting of population health data and analysis of the health needs and service availability across the
Regional Health Services.
Country Health SA has chosen the inner country region to pilot a modified GP Plus Health Network model.
This pilot encompasses the areas of Adelaide Hills, Fleurieu Peninsula, Kangaroo Island, Murray Mallee,
Gawler and Barossa. The model reflects the unique aspects of country regions regarding health status, service
provision models and the primary health care workforce profile.
Practice Nurse Initiative
Funding has been allocated to employ 50 practice nurses per year for a four year period across Central
Northern Adelaide Health Service and Southern Adelaide Health Service. The practice nurse initiative is a
commitment by SA Health to strengthen primary health care through support for general practice in key areas.
Over the past year 73 practice nurses were placed in participating general practices and 22 have ongoing
employment after their placement. A mentor nurse has worked with a further 15 practices over four months
to support their practice nurse in implementing chronic disease management systems.
page 30 Department of Health Annual Report 2008 09
Women s Health
Women s Health Action Plan
The South Australian Women s Health Action Plan 2006/07-08 translates the South Australian Women s
Health Policy into action while building on existing programs and services for women across the state. The
Action Plan was extended until December 2008 to enable further progress on 12 key initiatives. The Action
Plan Report Card was published in April 2009 to provide information on the achievements for women s health.
Major achievements include:
> Progress in developing Indigenous maternity initiatives across the Regional Health Services to improve access
for Indigenous women to pregnancy services and improve health outcomes for Indigenous families.
> Promotion of increased safety for women through an emphasis on integrated approaches to address
violence against women, including participation in the piloting of the Family Safety Strategy in three
Regional Health Services.
> Development of best practice guidelines for provision of services to women who have experienced sexual violence.
> Improvement of health service delivery to women with disabilities, following the development of Disability
Action Plans by all Regional Health Services.
Cervix screening
The South Australian Cervix Screening Program (SACSP) is a partner of the National Cervical Screening
Program, a joint initiative of the Australian, State and Territory Governments. SACSP aims to reduce the
incidence and mortality from invasive cancer of the cervix by:
> increasing the proportion of women who are screened at appropriate intervals
> promoting high quality screening and follow-up.
The statewide social marketing campaign, Pap Smear Awareness Week, utilised a new message in 2008
09, One Test, 15 Minutes, Every Two Years . The campaign targeted women in the northern metropolitan
area who have not had a Pap smear for over four years and young women who have received the cervical
cancer vaccine. In excess of 700 campaign kits were sent to general practices, health services, community
organisations, libraries and businesses.
Approximately 80 Community Small Grants were provided to support community participation in encouraging
under-screened women to participate in screening.
SACSP screened an average of 3 040 women each week.
Funding for new initiatives in men s health
The Department of Health provided funding for four men s health initiatives contributing towards the
implementation of the South Australian Men s Health Strategic Framework 2008-2012 including:
> Florey Adelaide Male Ageing Study , Chief Investigator: Professor Gary Wittert, University of Adelaide. SA
Health contributed funding to support a longitudinal study of chronic disease among 1200 men aged 35-80
and living in the north-west regions of Adelaide. The study investigates the biomedical, socio-demographic,
behavioural, physical and psychological factors that interact to contribute to the health of men. It examines
endocrinology of ageing, prostate health, obesity and utilisation of health services.
> Men s Health and Wellbeing in South Australia An Analysis of Service Use and Outcomes by
Socioeconomic Status , Chief Investigator: Mr John Glover, University of Adelaide. An analysis of South
Australian men s health and medical service use by age and socioeconomic status by examining existing
Australian and South Australian data, as well as research findings and literature which provided information
about health service use by men.
> Report on Improving Men s Participation in Primary Health Services in South Australia , Chief Investigator:
Dr Richard Fletcher, University of Newcastle. An analysis of the ways in which men s participation in children s
early development and in family care activities enhances health and wellbeing of family members with a view
to informing policy development and father-inclusive practice in children s centres in South Australia.
> Violence Intervention Training Package for South Australian Health Regions , Contractor: Ms Dallas Colley,
Nada Counselling Consulting and Training. Development and implementation of processes to maintain
sustainable good practice to support and retain the workforce of men s anti-violence group workers.
page 31Department of Health Annual Report 2008 09
Improving the health of those living with chronic disease
The increasing burden of chronic disease is one of the challenges facing SA Health. The recently published
Chronic Disease Action Plan 2009-2018 outlines SA Health s 10 year plan to address chronic disease
management. The plan provides evidence and actions to support the prioritisation of early intervention and
disease management strategies.
Australian Better Health Initiative
The joint Australian, State and Territory Better Health Initiative 2006-2010 is designed to support the
prevention, early detection, management and integration of chronic disease care to reduce the burden
of these diseases on the community. Progress in developing actions and strategies from the Chronic Disease
Action Plan has continued and includes:
> The development and implementation of educational and training strategies that enable and encourage
health professionals to provide self management support, and delivering programs which empower and
prepare people to better manage their health and health care.
> Purchasing a statewide licence for the Partners in Health assessment tool, which is used to monitor
and assess patient self management capacity.
> Implementation of a new collaborative model for GP Plus Health Networks in metropolitan health services
to assist with the first phase of GP Plus Health Improvement Plans.
> Commencement of an internet trial of the Stanford model of chronic disease self management
through County Health SA. Stanford University will conduct the evaluation using a randomised
control trial methodology.
> Further development of the Cancer Coordination program which focuses on improving patient access to
multi-disciplinary cancer teams.
> Commencement of state and national evaluations of the Australian Better Health Initiative, with final
reports due mid 2010.
Chronic Disease Community program
The Chronic Disease Community program aims to improve the quality of life for people living with
chronic disease through the provision of a tailored care plan. The program accepts referrals from a
range of acute and primary health care settings including general practice, hospital inpatients, outpatients
and emergency departments.
The program targets recently hospitalised patients (within 12 months prior) with one or more priority
chronic diseases. Activity increased by 10% in 2008-09. Patients may be referred to other services following
completion of their program including:
> generic self-management education
> disease specific education
> ongoing lifetime risk factor management and behavioural management programs.
Do It For Life
The Do It For Life program aims to prevent or detect the early onset of preventable chronic disease by focusing
on reducing modifiable risk factors (smoking, nutrition, alcohol, physical activity and stress) in individuals
identified at high risk of developing a chronic disease. The program prioritises high risk population groups
including those who are Indigenous, culturally or linguistically diverse, live in rural or remote areas or are low
income earners.
Lifestyle advisors and lifestyle support officers are new roles which have been created to assist people to make
positive lifestyle changes and reduce their risk of developing a chronic disease. To date 37 full time equivalent
positions are in place, following the recruitment of 13 new full time positions in June 2009. The majority of
participants in 2008-09 were women aged 25-55 years from metropolitan and country regions. The most
commonly reported risk factors were physical inactivity (75%) and poor nutrition (60%).
page 32 Department of Health Annual Report 2008 09
Nurse case management programs
Integrated Community Care for Older People
The program is a partnership between the Central Northern Adelaide Health Service, Royal District Nursing
Service, Adelaide Western GP Network and local GPs. It started in September 2008 and targets patients whom
GPs or the hospital identified as having complex health care needs. The program also targets patients at risk of
episodic deterioration which may result in unplanned hospitalisation.
The three clinical nurse consultants employed by the Royal District Nursing Service have provided care and
advocacy services to 164 clients since the program commenced. The program nurses provided a level of
care in the home which augmented other ambulatory care interventions and helped reduce demand for GP,
community, or hospital based interventions. The nurse led activities included ongoing review of client status
and clinical interventions such as taking observations and pathology samples.
Southern Adelaide Health Service Community Complex Case Management program
The program began its pilot phase in January 2009, working with people identified as having complex physical
and social needs. Using a variety of referral points, the program identified and addressed the key management
issues required to provide an effective complex case management service to clients. It helped to build a
common pathway with other agencies to streamline processes, simplify the client journey and improve service
access, coordination and integration of care across the continuum.
HealthConnect SA
HealthConnect SA is an e-Health initiative of the Australian Government, which has facilitated the transition
from paper based recording, storing and sharing of clinical information to electronic means. HealthConnect
SA has been instrumental in facilitating the development of secure primary health care communications
infrastructure and has developed applications for improved prevention and management of patients with
chronic disease.
In the 2008-09 financial year, 1 320 secure messaging packages were provided to primary health care
providers across South Australia to enable the secure transmission of electronic referrals and letters and the
receiving of electronic discharge summaries from public hospitals. A prototype e-Health Care Planning System
was developed. A development group comprising GPs, practice managers, allied health providers, practice
nurses, consumers and Medicare guided the design and development of the prototype and endorsed the
functional specification. The active participation of key stakeholders in the development process and the
incorporation of lessons learned from the previous care planning trial have guided the development.
In 2008-09, numerous electronic support tools were deployed to more than 650 primary health care clinicians
in South Australia via an interoperable desktop PrimaryCare SidebarTM that offers access to:
> Clinical Audit Tool, a software tool that interoperates with the GP clinical system to provide practice staff
with meaningful clinical information about their patient data, enabling them to identify and follow-up
patients with specific health risk profiles, view and cleanse data, and report in a standardised format.
> A range of electronic assessment tools aimed at assisting in the prevention and management of chronic
disease (for example Australian Type 2 Diabetes Risk Assessment Tool and Mental Health K10).
> e-Redbook, the Royal Australian College of General Practitioner Preventative guidelines presented in a
patient-specific display.
> Health Provider Registry Quicklook , providing quick and easy desktop access to healthcare providers on the
Health Provider Registry.
The South Australian Government s contribution to HealthConnect SA in 2008-09 was $289 000. SA
Health received $2.9 million in Australian Government revenue and associated expenditure authority for
HealthConnect SA in 2008-09.
The HealthConnect SA national program ended on 30 June 2009 and the PrimaryCare Sidebar project will
continue in 2009-10 as a SA Health initiative.
page 33Department of Health Annual Report 2008 09
Reducing the proportion of low birthweight babies
Low birthweight babies are more likely to suffer from chronic disease and are often associated with
populations living under the burden of sub-optimal social, economic and health conditions. Over the past five
years an average of 78% of perinatal deaths in South Australia were babies born with a birth weight of less
than 2 500g.
The proportion of low birthweight live births in the state decreased from 6.7% in 2003-05 to 6.4% in 2006
08. It is consistently higher among Indigenous babies but the proportion of low birthweight babies decreased
among both Indigenous and the other South Australian babies between these two periods. The proportion
decreased from 17.5% in 2003-05 to 15.4% in 2006-08 among Indigenous babies and from 6.4% to 6.1%
among other South Australian babies.
National and international literature indicates that the complex nature and permutation of risk factors make it
difficult to shift the population mean for low birth weight babies.
A number of major risk factors contributing to low birthweight include a paucity of pre-conception education
to teens, smoking during pregnancy, use of alcohol and illicit drugs, infection, poor nutrition, short inter-
pregnancy interval, family violence, poor control of medical conditions and lack of antenatal care; particularly
for Indigenous women and those women living in adverse circumstances.
Providing pre-conception education that addresses risk factors for low birth
weight
Several programs are attempting to reduce low birthweight baby numbers, particularly in the Indigenous
community in which the proportion of low birth weight is greater than in the non-Indigenous (16.3%
compared with 6.0% in 2008). However, the low birthweight proportion among Indigenous live births has
decreased from 17.5% in 2003-05 to 15.4% in 2006-08. Provision of pre-conception education is particularly
emphasised as part of these programs.
Programs include:
> Anangu Bibi Aboriginal Family Birthing Program at Port Augusta
> The Young Mums Program at Whyalla
> Nganampa Health Council Child and Maternal Health Program
> SA Healthy Ways program in seven country areas
> The Smoke Free Pregnancy Project in public hospitals
> Northern Women s Community Midwifery Program and Muna Paendi
> The Southern Aboriginal Maternity Care Project.
page 34 Department of Health Annual Report 2008 09
Reducing smoking in pregnant women
Smoking among pregnant women has been steadily declining (see Figure 13) however, it remained at 57.3%
among Indigenous women compared with 14.5% among the wider community in 2008.
Pe
rc
en
t
Recording of intervention in smoking as part of the revised Pregnancy Record and referral of women to
Quitline and Drug and Alcohol Services SA (DASSA) are additional measures introduced to attempt to decrease
the prevalence of maternal smoking.
Figure 13 Prevalence of maternal smoking in South Australia 1998-08
30
25
20
15
10
5
0
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Year
Source: Pregnancy Outcome Unit, SA Health (data from SA perinatal data collection).
Ensuring sustainable access to best practice antenatal care
Best practice antenatal care includes the assessment and management of domestic violence, stress, substance
misuse, alcohol use, cigarette smoking, adequate nutrition and supplementation. Ensuring access to effective
antenatal care and promoting early antenatal engagement for women of low socio-economic and Indigenous
backgrounds is a focus area for increasing birthweight and improving birthing and health outcomes.
The Children, Youth and Women s Health Service will establish a steering group to address the South
Australian Strategic Plan T6.3 target to reduce the proportion of low birthweight babies. The group will focus
on the key influences and will encourage strategic alliances with all organisations contributing to reducing the
incidence of low birthweight.
page 35Department of Health Annual Report 2008 09
Enhancing Hospital Care
Enhancing hospital care through improving the coordination of hospital services, increasing the efficiency
and effectiveness of hospital care, securing capital infrastructure improvements, and expanding out of
hospital programs is a key objective of the SA Health Strategic Plan 2008-2010 and South Australia s Health
Care Plan 2007-2016.
During the year, the Department of Health continued to implement strategies to achieve this objective.
The department remains committed to ensuring safety and quality, promoting organ donation and protecting
blood supplies.
Improving coordination of hospital and emergency services across
metropolitan and country regions
The Department of Health has established a new statewide pathology service (SA Pathology), finalised a single
statewide retrieval service (MedSTAR) and a new ambulance service delivery model.
SA Pathology
SA Pathology was formed on 1 July 2008, with the union of the state s three public pathology services
Institute of Medical and Veterinary Science (IMVS), SouthPath and the Women s and Children s Hospital
Division of Laboratory Medicine. The new entity provides quality pathology services to South Australian
medical practitioners and public hospitals through a networked system of 18 laboratories including branch
laboratories in rural hospitals, general laboratories in large metropolitan hospitals and specialist laboratories
providing tertiary referral and reference laboratory services. It operates in the private pathology market under
the IMVS trading name.
Central Northern Adelaide Health Service is responsible for SA Pathology and information about its activities
for 2008-09 is available in the Central Northern Adelaide Health Service Annual Report 2008-09.
MedSTAR
The MedSTAR statewide retrieval service became operational in February 2009 with a base and offices at
Adelaide Airport. MedSTAR provides rapid and high level emergency medical care to acutely ill and injured
South Australians. Specialist teams are dispatched from one central location and work in partnership with
SA Ambulance Service and the Royal Flying Doctor Service. The co-location of helicopters and fixed wing
assets decreases the time taken to respond to patients, provides better support to rural centres, timely clinical
management and ongoing education and training.
SA Ambulance Service
During 2008-09 SA Ambulance Service focused on implementing a number of new initiatives as identified in
the Defining the Road Ahead service delivery model for 2008-15.
The new service delivery model was developed to bring about new and improved ways of delivering
ambulance services to the community. These new models of service delivery reflect SA Ambulance Service s
vision to provide patients with alternative care pathways and the most appropriate ambulance response for
their needs.
Key initiatives which were implemented in 2008-09 included Single Paramedic Response and Intervention
becoming a part of regular operations, the Extended Care Paramedic pilot in the southern metropolitan area,
and SA Ambulance Service transitioning to the new Medical Priority Dispatch System.
page 36 Department of Health Annual Report 2008 09
Improving efficiency and effectiveness of hospital care
The Department of Health has improved the efficiency and effectiveness of hospital care in a range of areas
of health service delivery. Implementation of recommendations contained in the South Australian Metropolitan
Hospital Efficiency and Performance Review resulted in the improvement of a range of hospital services.
South Australian Metropolitan Hospital Efficiency and Performance Review
In May 2007 the Department of Health commissioned a review of the efficiency and performance
of several metropolitan hospitals to ensure resources are being utilised efficiently and to identify
performance opportunities.
The April 2008 report contained recommendations to improve the structural, accounting and management
practices of Regional Health Services and hospitals. The report s recommendations aimed to build capacity
to deliver increased services, maximise effective use of resources, deliver care in the appropriate settings and
improve workforce utilisation.
The recommendations have been reviewed in detail by Regional Health Services and hospitals and
implementation plans are being actioned.
Actions in response to the recommendations which proposed policy improvements and efficiency measures
including improved length of stay for patients, reduction in workers compensation claims and enhanced
control of staffing levels have been completed.
More complex recommendations such as theatre utilisation reviews, clinical and administrative staffing
levels, and diagnostic utilisation are being assessed at each site. As these recommendations are
implemented, benefits will be realised.
Hospital services
The Resource Weighted Output indicator combines hospital services into a single output measure that
demonstrates overall resource utilisation (Figure 14). The rise in annual value over the past three years reflects
increasing activity over that period.
Figure 14 Hospital services 2006-07 Actual, 2007-08 Actual, and 2008-09 Resource Weighted Hospital Outputs
2006-07 Actual 2007-08 Actual 2008-09 Actual
Year
0
150 000
250 000
350 000
400 000
450 000
500 000
100 000
50 000
200 000
300 000
Re
so
ur
ce
W
ei
gh
ed
H
os
pi
ta
l O
ut
pu
ts
Source: Department of Health Quarterly Funding Model
page 37Department of Health Annual Report 2008 09
Elective Surgery Strategy and waiting list reductions
As part of the Department of Health s Elective Surgery Strategy, $14.1 million was allocated across
metropolitan and country hospitals. The allocation provided a total of $11.9 million for additional procedures
above base hospital activity and $2.2 million for reform initiatives including:
> opening additional theatres, including on weekends
> opening additional beds to accommodate increased activity
> recruiting additional staff
> transferring patients between hospitals with capacity
> prioritising access to theatres to specialties with elevated numbers of patients on waiting lists.
In addition, the Australian Government provided funding of $13.6 million for an additional 2 262
procedures in the 2008 calendar year to reduce the number of patients waiting longer than acceptable
national waiting times.
As a result of the State and Australian Government initiatives, 44 444 procedures were undertaken
in metropolitan hospitals3 in 2008-09. This is an increase of 1179 (2.49%) procedures over 2007-08
(see Figure 15).
There was a 97% reduction in the number of overdue patients as at 30 June 2009 compared with the
previous year. Additionally, there was a 98% reduction in the number of patients waiting longer than 12
months for their surgery (see Figures 16 and 17).
As a consequence, 86.0% of patients received their surgery within benchmark national waiting times, an
increase from 80.3% in 2007-08.
Figure 15 Elective surgery procedures at metropolitan hospitals
2006-07 Actual 2007-08 Actual 2008-09 Actual
Year
0
40 000
10 000
20 000
30 000
N
um
be
r
of
e
le
ct
iv
e
su
rg
er
y
pr
oc
ed
ur
es
Source: Department of Health Booking List Information System
3 Noarlunga joined the department s data collection in February 2008. Country Health SA is not part of the data
collection set.
Department of Health Annual Report 2008 09page 38
Figure 16 Timeliness, elective surgery provided within urgency waiting times (%)
Urgent Semi Urgent Non Urgent Total
Urgency
0
30
50
70
80
90
100
20
10
40
60
Pe
rc
en
t
2006-07 2007-08 2008-09 Target
Source: Department of Health Booking List Information System
Figure 17 Patients overdue for Elective Surgery Strategy procedures as at June 30
Urgent Semi Urgent Non Urgent Total Patients Over Due
Urgency
0
400
800
1200
1400
1600
200
650
1000
N
um
be
r
of
P
at
ie
nt
s
30 Jun 07 30 Jun 08 30 Jun 09
Source: Department of Health Booking List Information System
page 39Department of Health Annual Report 2008 09
Emergency department presentations and waiting times
The comparison of emergency department (ED) waiting times against national standards set by the Australian
College of Emergency Medicine is a method of measuring whether patients are seen within timeframes that
are clinically appropriate for the assessed urgency categories. In 2008-09, 357 410 ED presentations were
made to metropolitan hospitals, which is a decrease of 7 139 (2.0%) from 2007-08 levels (Figure 18). The
overall timeliness of performance was 64.7%, which was an increase of 3.1 percentage points against 2007
08 levels (see Figure 19).
Figure 18 Emergency department presentations
2006-07 2007-08 2008-09
Year
200 000
225 000
400 000
250 000
275 000
300 000
325 000
350 000
375 000
N
um
be
r
of
e
m
er
ge
nc
y
de
pa
rt
m
en
t
pr
es
en
ta
ti
on
s
Source: Department of Health Emergency Department Data Collection
Figure 19 Emergency department patients seen within triage waiting times (%)
Triage 1 Triage 2 Triage 3 Triage 5Triage 4
Triage
0
30
50
70
80
90
100
20
10
40
60
Pe
rc
en
t
2006-07 2007-08 2008-09 Target
Source: Department of Health Emergency Department Data Collection
page 40 Department of Health Annual Report 2008 09
Incident reporting
The department records events which could have or did lead to unintended or unnecessary harm to a person
and which may have also resulted in complaints, loss or damage (see Figure 20). The safety and quality
in health care provision for patients, staff and visitors can be improved by understanding the nature and
frequency of such events.
Although the number of incident reports increased in 2008-09 compared with 2007-08, increases in
the frequency of incidents does not necessarily indicate a decrease in performance, but may indicate an
improvement in the reporting culture.
Figure 20 Incident reports as a proportion of separations (for every 100 hospital separations there was 7.5 incidents)
2006-07 2007-08 2008-09
Year
0
3
5
7
8
9
10
2
1
4
6
Pe
rc
en
t
Source: Department of Health Advanced Incident Management System
page 41Department of Health Annual Report 2008 09
Day of surgery admission rates
The department expects hospitals to manage the utilisation of their beds in the most efficient manner,
requiring patients to be admitted to hospital on the day of their surgery.
In 2008-09, the average day of surgery admission rate for metropolitan hospitals was 86%, an improvement
from 83.3% in 2007-08 (Figure 21).
Figure 21 - Day of surgery admission rates
Actual
Target
Trendline
70%
75%
80%
85%
90%
95%
100%
Ju
l 2
00
7
A
ug
2
00
7
Se
p
20
07
O
ct
2
00
7
N
ov
2
00
7
D
ec
2
00
7
Ja
n
20
08
Fe
b
20
08
M
ar
2
00
8
A
pr
2
00
8
M
ay
2
00
8
Ju
n
20
08
Ju
l 2
00
8
A
ug
2
00
8
Se
p
20
08
O
ct
2
00
8
N
ov
2
00
8
D
ec
2
00
8
Ja
n
20
09
Fe
b
20
09
M
ar
2
00
9
A
pr
2
00
9
M
ay
2
00
9
Ju
n
20
09
Source: Department of Health Metropolitan hospitals
Department of Health Annual Report 2008 09page 42
Relative Stay Index
The Relative Stay Index (RSI) compares length of stay performance of a hospital with a standard performance
measure based on all acute hospitals in Australia. The calculation takes account of the complexity and the age
of patients.
The RSI is calculated as a 12 month average. Performance against the RSI improved for all metropolitan
hospitals with the exception of Lyell McEwin Hospital (LMH) (indicated in Figure 22). The RSI for LMH did not
change from 2007-08 to 2008-09.
Figure 22 Metropolitan hospital relative stay index: comparison of 12 month rolling average
2007-08 and 2008-09
WCH FMC TQEH RGH RAH LMH NHSMH
Hospital
0.800
0.950
1.050
1.100
0.900
0.850
1.000
Re
la
ti
ve
S
ta
y
In
de
x
2007-08 2008-09
Source: Integrated South Australian Activity Collection and Australian Institute of Health and Welfare.
Note: not comparable to previous annual report. Coefficients from AIHW based on 2006-07 data. DRG v 5.1 used.
Hospital 2007-08 2008-09
Woman s and Children s Hospital (WCH) 1.072 1.064
Flinders Medical Centre (FMC) 1.033 1.031
The Queen Elizabeth Hospital (TQEH) 1.020 0.985
Repatriation General Hospital (RGH) 1.043 1.006
Royal Adelaide Hospital (RAH) 0.970 0.949
Lyell McEwin Hospital (LMH) 0.980 0.980
Modbury Hospital (MH) 0.918 0.874
Noarlunga Hospital (NH) 0.910 0.903
Source: Integrated South Australian Activity Collection and Australian Institute of Health and Welfare. Note: not
comparable to previous annual report. Coefficients from AIHW based on 2006-07 data. DRG v 5.1 used.
page 43Department of Health Annual Report 2008 09
Ambulance response times
SA Ambulance Service has key performance indicators which help to measure the level of service being
provided in metropolitan areas. For category A4 cases, SA Ambulance Service is required to provide ambulance
intervention to 50% of cases within eight minutes and ambulance transport capability to 90% of cases within
18 minutes. For category B5 cases, SA Ambulance Service is required to provide ambulance transport response
to 90% of cases within 18 minutes and for category C6 ambulance transport response to 90% of cases within
60 minutes.
SA Ambulance Service s performance against these criteria for 2008-09 is provided in Table 1
Table 1 SA Ambulance Service s performance
KPI description
2008-09
performance
KPI
requirement
Category A Ambulance intervention response time (8 minutes urban centres) 55.3% 50%
Category A Ambulance transport response time (18 minutes urban centres) 99.4% 90%
Category B Ambulance transport response time (18 minutes urban centres) 96.8% 90%
Category C Ambulance transport response time (60 minutes urban centres) 89.9% 90%
Figure 23 Urban Centre response times
Category A (Cat 1) - Ambulance intervention response time (8 minutes - Urban centres) -Target 50%
Category A (Cat 1) - Ambulance transport response time (18 minutes - Urban centres) - Target 90%
Category B (Cat 2) - Ambulance transport response time (18 minutes - Urban centres) - Target 90%
Category C (Cat 3 & 4) - Ambulance transport response time (60 minutes - Urban centres) - Target 90%
Month
Re
sp
on
se
t
im
e
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
Jul 08 Aug 08 Sep 08 Oct 08 Nov 08 Dec 08 Jan 09 Feb 09 Mar 09 Apr 09 May 09 Jun 09
4 Category A is defined as life-threatening (lights and sirens response)
5 Category B is defined as serious (lights and sirens response)
6 Category C is defined as neither life-threatening nor serious (non lights and sirens response)
page 44 Department of Health Annual Report 2008 09
Palliative care
The Palliative Care Services Plan 2009-2016 was completed in May 2009 and will be released in the
2009-10 financial year.
The plan was developed with active input from a cross sector steering committee and reference group.
Consultations were held with key stakeholders during the development of the plan.
The plan positions palliative care within an end of life continuum and outlines a reform framework to
reshape palliative care services in light of increasing demand for all end of life care. It includes a particular
emphasis on expanding community based palliative care to allow more people to die at home when this is
their preferred option.
Maternity and paediatric services
The Statewide Child Health Clinical Network embraces child health service planning for children from
six weeks to 18 years and incorporates wellness and illness treatment.
There has been a number of child health service planning initiatives that the network has been involved in,
for example providing advice on children s services during the development of the Palliative Care Service Plan
and the Chronic Disease Action Plan and the drafting of the Rehabilitation Clinical Network Draft Service Plan.
A key focus for the network has been to continuously engage and communicate with key stakeholders.
In 2008-09 key projects undertaken include:
> the development of
- a South Australian Service Framework for Children and Young People
- a clinical guideline development process
- a directory of mental health service to support general practitioners working with children
> initial work on paediatric oral health.
The steering committee has provided written feedback and developed discussion papers on the following:
> an implementation strategy for the Vulnerable Infants Service Plan
> the draft South Australian Children s Plan
> the Country Health SA Early Childhood Services Plan
> the SA Health Protection Health and Wellbeing of Children Coordinating Group s draft Children s Centres
Health and Wellbeing Framework
> the SA Health Medical Imaging Advisory Committee.
The SA Maternal and Neonatal Clinical Network Steering Committee aims to achieve better perinatal health
outcomes for families in South Australia.
The focus for this year has been the development of a draft Neonatal Service Plan. The draft plan is expected
to be completed in 2009-10.
In 2008-09 the network facilitated:
> the revision of the Standards for Maternal and Neonatal Services in SA 2009
> the revision of the statewide Water Birth Policy
> the inaugural statewide Collection of Cord Blood in SA Public Health Units for the Purposes of Private Cord
Blood Banking policy
> supporting the development of new Perinatal Practice Guidelines and review of the established guidelines
> the development of the Standards for the Management of the Bariatric Obstetric Woman in SA 2009.
The network is facilitating the development of a statewide consultant advice service for health providers
seeking urgent clinical advice regarding the management of a patient in their care. Currently there are several
similar independent systems in operation. Consolidating services will achieve greater efficiency and process for
health providers with access to a specialist consultant 24 hours a day, seven days per week, ensuring better
health outcomes for patients.
Additionally, the network is developing a statewide clinical practice policy related to the management of
emergency caesarean section delivery and the steering committee has drafted the SA Neonatal Services Plan.
page 45Department of Health Annual Report 2008 09
Developing the new Royal Adelaide Hospital
In August 2008 the South Australian Government launched the new Royal Adelaide Hospital (RAH) Master
Plan. The new $1.7 billion RAH will be located in the city s west end and will incorporate the services of the
current RAH, and include some of the more complex services from The Queen Elizabeth Hospital (TQEH).
Opening in 2016, the hospital will be the cornerstone of South Australia s Health Care Plan 2007-2016.
As Australia s most advanced hospital and the largest hospital in South Australia, it will provide more than
80 000 same day and overnight admissions per year, 800 beds (including 100 same day), an ambulatory care
centre, operating theatre suite, all clinical and non-clinical support services necessary for the provision of high
quality and safe patient care, and an excellent facility for teaching and research.
Public Private Partnership Expression of Interest
The new RAH will be delivered as a Public Private Partnership (PPP) under the South Australian Government s
Partnerships SA model.
This partnership will facilitate SA Health s operation of the new RAH with the provision of all core clinical
services, staffing, teaching, training and research, while the private sector will finance, design, construct
and maintain the new hospital building.
In June 2009 an Expression of Interest sought submissions from consortia, capable of providing
the following services:
> design
> construction
> commissioning
> finance
> provision of a range of facilities management services over the contract term.
Submissions closed in July 2009. Short listed consortia will be identified from the submissions to proceed
to the next phase of the procurement process, Request for Proposal.
Model of care
In November 2008 the Minister for Health released the model of care for the new RAH.
The South Australia s Health Care Plan 2007-2016 requires that the design of the new hospital allows
clinicians to explore alternative models of care using the world s best practice experiences.
Development of the Model of Care has been an ongoing process and has included consultation with the
clinical community to further refine the model.
A summary of the planning principles for the Model of Care for the new hospital include:
> An encompassing and whole system commitment to modernisation and continuous improvement.
> Integrated care across disciplines, sectors and organisations is central to innovation.
> Patients are at the centre of the system.
> Evidence informs decisions and practices.
> The workforce is supported to become more flexible and involved in shaping the future.
> The new RAH will strive to become a learning organisation, employ an expert workforce and invest in the
development of its staff.
> Partnerships with other providers, industry, universities and other key stakeholders will be actively promoted.
The goal is to strive for clinical excellence and quality of care through a patient centred Model of Care within a
creative, learning organisation that has the ability to incorporate clinical and technological change.
The work suggests that the patient centred model of care includes a number of basic principles related to the
physical design and environment; to behaviours, attitudes and the general culture of the organisation and its
staff, and to systems supporting patient care.
It is expected that this will remain an evolving document, with ongoing review as practice changes and
associated improvements occur.
page 46 Department of Health Annual Report 2008 09
Site rehabilitation
The site has been investigated for soil and groundwater contamination.
A remediation plan is being developed by an environmental contractor and independent environmental
auditor will ensure that the plan delivers an appropriate environmental outcome and complies with legislative
requirements.
The Department of Health will implement a rehabilitation plan for the contaminated site for use as open space
and public hospital.
Investing in the redevelopment of metropolitan hospitals
In 2008-09 the capital investment for the redevelopment of South Australian metropolitan hospitals totalled
$78 million and included:
> $44.11 million at the Flinders Medical Centre( FMC) as part of $154 million redevelopment to provide for
the refurbishment of the Coronary Care Unit, continuing installation of the new engineering infrastructure
and the new south wing extension.
> $12.7 million as part of the $127 million Stage 2B redevelopment at The Queen Elizabeth Hospital (TQEH)
completing the research facilities and infrastructure upgrades.
> $12.9 million as part of the $43.5 million Stage B Lyell McEwin Hospital (LMH) redevelopment, including a
30 bed adult acute mental health unit, 20 bed aged acute mental health unit and the completion of a SA
Pathology facility.
> $363 000 to complete the $3.8 million radiation therapy facility at the LMH.
> $3.15 million to commence the $201.65 million LMH Stage C redevelopment.
> $4.85 million as part of the $15 million refurbishment of the RAH to increase ward capacity and sustain the
infrastructure until completion of the new RAH.
> $164 000 to progress the Children s Cancer Centre at the Women s and Children s Hospital.
Expanding GP Plus Services in community settings
The 2008-09 financial year is the second year of funding for GP Plus Service strategies. The investment
continues SA Health s commitment to reducing hospital demand, improving patient outcomes and providing
care closer to home. An additional $10.6 million for 2008-09 represents a 50% funding increase for the
expansion of existing strategies and the roll out of key new initiatives, including:
> The Extended Care Paramedic pilot program is an initiative with the SA Ambulance Service where specifically
trained and skilled paramedics provide enhanced clinical assessment and management of patients in out of
hospital settings to avoid transportation to hospitals.
> Rapid Access Clinics provide streamlined access to specialised medical services in the home environment.
The clinics promote community support services traditionally provided in the hospital setting.
> Better Care in the Community addresses the core issues behind repeat hospital admissions and ED
presentations for people with chronic conditions. The program develops individual clinical pathways for
clients in partnership with GPs.
> Metro Home Link services provide packages of care to clients, aimed at avoiding unnecessary hospital
admissions or facilitating early discharge from hospital.
> Rehabilitation in the Home reduces hospital pressure by providing access to rehabilitation services at home
and linking clients with community services.
> Implementation of primary prevention activities targeting healthy weight, nutrition, alcohol and tobacco use.
page 47Department of Health Annual Report 2008 09
Clinical Networks and Clinical Senate
The Clinical Networks increase the level of involvement clinicians have in planning health services to improve
health outcomes for South Australians and to ensure a strong and sustainable workforce.
The Clinical Senate comprises members and key leaders from nursing, allied health, general practice,
medical specialties and chairs of the Statewide Clinical Networks. The Clinical Senate provides broad
clinical representation and informs the Minister for Health and the Chief Executive.
Statewide Clinical Networks
The eight Statewide Clinical Networks (the networks) provide clinical leadership and plan future services.
During the year:
> The Statewide Orthopaedic and Rehabilitation Clinical Networks formed a steering committee to develop
an Orthopaedic Rehabilitation recommendation paper.
> The Cardiology, Renal, Rehabilitation and Maternal and Neonatal Clinical Networks worked on preparing
service plans.
> The Statewide Cancer Clinical Network developed comprehensive clinical pathways for upper
gastro-intestinal, lymphoma, and adolescents and young adults.
> The Statewide Child Health Clinical Network is establishing a sustainable Child and Adolescent Mental
Health Service Directory and a formal approach for the provision of high quality clinical paediatric
practice guidelines.
> The Statewide Mental Health Clinical Network worked with the Mental Health Unit, Department of Health
and provided recommendations regarding the First Episode Psychosis Hub and Spoke Clinical Model.
New Clinical Networks are being established for Stroke, Palliative Care and Older People.
Clinical Senate
The Clinical Senate is the leading forum for clinical issues in South Australia and provides SA Health
with strategic clinical advice.
Over the past 12 months the Clinical Senate has:
> Provided recommendations regarding the development of an accountability framework based on national
standards for health care delivery across the care continuum.
> Supported dedicated medical leadership in Country Health SA as part of integrated state health delivery.
> Discussed hospitals for the future including international examples and how these can potentially influence
the development of the new RAH.
> Endorsed the development of the Job Planning Project as an integral part of workforce reform.
Ensuring safety and quality
The SA Health Safety and Quality Committee provides leadership in continuous improvement in safety
and quality of health care in South Australia and facilitates the implementation, monitoring and evaluation
of programs and initiatives designed to address the priorities in the SA Safety and Quality Framework and
Strategy 2007-2011.
The framework is aligned with the Australian Commission on Safety and Quality in Health Care s national
priorities and will ensure the Department of Health benefits from national incentives.
The Department of Health s safety and quality programs are an integral part of the cycle of improvement.
Highlights include:
page 48 Department of Health Annual Report 2008 09
TeamSTEPPS
TeamSTEPPSTM is a teamwork and communication training program developed in the United States that was
piloted in five South Australian sites, concluding in October 2008.
The evaluation of the pilot demonstrated improvements in patient safety culture, teamwork and relationships,
and clinical handover. Subsequently the Department of Health will implement the program in an additional
five sites.
Falls and Fall Injury Prevention Program
Falls and fall injuries are a threat to the continued independence of older people and also place a significant
demand on emergency, acute, residential and primary health services.
The South Australian Falls Advisory Group has been established as the peak body to provide advice in the
development, monitoring and planning of strategies. Current strategies include:
> a training program to assist with implementing best practice in hospitals and residential aged care
> development of indicators and training
> education and research to build workforce capacity.
South Australian universities have contributed to the development of postgraduate education in this area
for clinicians.
The South Australian Falls Advisory Group conducted the SA Falls Prevention Forum, April Falls Day events and
investigated the role of personal alarms in reducing harm among older people.
Medication safety and pharmaceutical reform
A strategic medication safety work plan, aligned with national priorities, was prepared to promote an efficient
and consistent approach to reducing medication related incidents in South Australia. Key performance
measures will enable evaluation of the strategies within the plan.
Supporting safe medication use through standardised medication charts is a focus in South Australia and
nationally. A new version of the National Inpatient Medication Chart (NIMC) was released in January 2009
and is in use in all South Australian public metropolitan hospitals and most country hospitals.
Release of an A4 version, which can be incorporated into electronic prescribing systems, allows for adoption
of the chart in rural and remote areas where these systems are important for GPs. Paediatric versions of the
NIMC for implementation in all Australian hospitals treating children and babies were approved by State,
Territory and Australian Government Health Ministers in December 2008.
The South Australian Medication Safety program hosted a national forum in December 2008 to review and
discuss venous thromboembolism (VTE) risk assessment and prophylaxis. The meeting reviewed results of
current initiatives to improve VTE prevention and had a particular focus on documentation with specific
reference to implications for the NIMC.
The Department of Health is continuing the implementation of pharmaceutical reform with the aim of
enhancing access, equity and safety of medication use across hospitals and the community. To support the
introduction of the Pharmaceutical Benefits Scheme component of the reforms, a new pharmacy management
IT system is being implemented in public hospitals to ensure patients receive appropriate quantities of their
medicines when they leave hospital. Improving medication management for patients through implementation
of the Australian Pharmaceutical Advisory Council s guiding principles is a key outcome of the reforms.
Pharmacists in all participating hospitals will provide appropriate support by improving:
> the management and review of medication at admission, during the period of care and prior to discharge
> communication between the hospital, patients and primary healthcare providers.
page 49Department of Health Annual Report 2008 09
Adverse event reporting and analysis
The Department of Health is proactive in the management of incidents and is developing an incident
management toolkit to improve consistency.
The Department of Health continued to analyse adverse events reported into the Incident Management
System. Learning from incidents and taking action to improve systems can reduce the risk of adverse events.
The department supports root cause analysis training to identify system weaknesses or gaps, and identify
improvement opportunities.
Information regarding safe practice is shared across SA Health via a safety alert broadcast system.
Understanding blood usage trends and implementing
organ donation reform
BloodSafe and BloodMove
The Department of Health and the Australian Red Cross Blood Service have continued the BloodSafe
collaboration throughout 2008-09.
BloodSafe s internet based e-Learning program has received accolades locally and nationally including a
positive response to the program s content and mode of delivery from BloodSafe e-Learning participants.
BloodSafe e-Learning has 24 988 registered users. The Department of Health has worked with stakeholders
throughout Australia to establish BloodSafe e-Learning as a national educational program. The program will
be funded by State, Territory and Australian Governments.
The BloodMove Program manages blood and blood products across the health sector, promoting safe
and timely movement of product. The program is working to improve the movement of blood stocks and
inventory management throughout South Australia.
Red cell utilisation
The Department of Health undertook a study to investigate the causes of high blood (red cell) utilisation in
South Australia.
South Australia s blood usage appeared considerably higher than the national average in 2006. A major
contributor to high blood utilisation in South Australia is the relatively high level of hospital activity per
resident population. When this is taken into consideration the variance between South Australia s usage when
compared to the national average is small.
Organ and tissue donation reform
In July 2008 the National Organ Donation Summit was held in Adelaide. National and international key note
speakers attended the summit and shared their experiences in the field of organ donation.
The Department of Health has committed to work closely with the newly formed National Organ Donation
and Transplantation Authority following the signing of the National Communications Charter for Organ and
Tissue Donation for Transplantation in May 2008.
The department is working with the South Australian Transplantation and Organ Donation Advisory Council
and the South Australian Organ Donation Agency to implement the Australian Government s National Organ
Donation Reform Package.
South Australia s organ donation rate of 43 donors in 2008 was the highest on record and the highest per
resident population in Australia. The RAH was also the highest donating hospital in Australia with 25 donors.
page 50 Department of Health Annual Report 2008 09
Reforming Mental Health Care
Mental illness and mental health problems affect many South Australians. The reforms and legislative changes
being undertaken in South Australia to improve mental health services and outcomes are consistent with the
National Mental Health Policy which aims to:
> Promote the mental health and well-being of the Australian community and, where possible, prevent the
development of mental health problems and mental illness
> Reduce the impact of mental health problems and mental illness, including the effects of stigma on
individuals, families and the community
> Promote recovery from mental health problems and mental illness
> Assure the rights of people with mental health problems and mental illness, and enable them to participate
meaningfully in society.
During the year the Department of Health made significant progress towards implementing mental health
reforms that will continue to improve the health and wellbeing of South Australians.
Mental Health Act 2009
The Mental Health Act 2009 was passed by the Parliament in June 2009 and will come into operation on
1 July 2010. The new Act expands and protects the rights of people with mental illness, recognises the needs
of people from culturally and linguistically diverse backgrounds, the role of carers and the circumstances of
children who are experiencing or who are affected by people with a serious mental illness. It enables some
hospitals in the country to be declared Limited Treatment Centres and provides for acute care beds for mental
health patients in country South Australia for the first time.
Increasing the capacity of community mental health services
The introduction of the stepped model of care involves all aspects of mental health care service delivery and
continues to provide the platform for the progression of mental health reforms in the community. The stepped
model is integral in the development of a care continuum that engenders a community partnership approach
to improve care coordination.
Community mental health services
During 2008-09 the Department of Health implemented community mental health reforms including:
> developing a new adult model of care for adult community mental health in conjunction with clinicians,
consumers, carers and other key stakeholders
> identifying six new geographic areas to deliver services across the metropolitan area
> a business case to inform facility development and site locations for six new community mental
health centres.
page 51Department of Health Annual Report 2008 09
Non government services
Non government organisations (NGOs) are an important care coordination link for the delivery of services to
people with a mental illness. New contract arrangements with NGOs to deliver services such as rehabilitation,
support, accommodation and counselling to vulnerable people suffering a mental illness were commenced.
The Department of Health developed new service quality standards and provided funding to develop and train
the NGO workforce.
GP shared care
The Department of Health committed funding of $9.7 million over four years to recruit 30 allied health
workers to work in private GP clinics across South Australia.
During 2008-09 general practices increased their mental health workforce capacity to approximately
28 mental health professionals, an increase of seven from last year. The remaining two mental health
professionals will be recruited in 2009-10.
Mental health professionals assisted 2 232 mental health consumers and provided 14,868 occasions of service.
Services to older people
During the year work commenced on the implementation of a new model of care for mental health services to
older people, and extensive modelling for the new transitional care units and intensive care behavioural units
was completed.
As part of the process for implementing new aged care reforms, an aged care transition clinician was
appointed and 24 aged extended care residents were transferred from Glenside Campus to the aged care
residential sector.
Worked commenced on the development of 20 new aged acute beds at the LMH and planning began for a
20 bed aged acute facility at TQEH.
Youth first episode psychosis
The Department of Health developed a model of care, identified a facility and recruited clinical staff to provide
a service for young people experiencing mental illness and early psychosis.
Country Nurse Practitioners
Four nurse practitioner positions were recruited in country South Australia during 2008-09. These
positions were created to supplement the shortage of GP services in many areas and the limited pool
of visiting psychiatrists.
page 52 Department of Health Annual Report 2008 09
Increasing the capacity of non acute adult stepped care
mental health facilities
The Social Inclusion Board s report, Stepping Up: A Social Inclusion Action Plan for Mental Health Reform
2007-12 recommended that a new stepped model of care be developed. The new stepped system of care
was designed to address the gap between acute and sub acute services. In particular, the report emphasised
the need to include supported accommodation, intermediate care and community recovery centres in the
levels of care.
Supported accommodation facilities
During 2008-09 two community housing providers were appointed to construct 53 new supported
accommodation places across the metropolitan area. Grant funding of $13.8 million has been approved for
this accommodation initiative. Planning also commenced on the design and development of 20 supported
accommodation places as part of the redevelopment of the Glenside Campus.
During the year, the acquisition of two new properties at Dover Gardens was completed.
Services provided to supported accommodation facilities will be led by the NGO and supported with clinical
input from the Department of Health.
Intermediate care facilities
Intermediate care facilities are being established for people with a mental illness who need short term support
to be treated more effectively in a supported, home like environment. The first three metropolitan sites have
been identified at Glenside, Noarlunga and Queenstown.
A model for intermediate care in the country was completed.
Community Recovery Centres
Community Recovery Centres are designed to help adults living at home or who have been treated in hospital,
but need additional non acute support so that they can lead independent lives in the community. The three
centres are staffed 24 hours a day and were fully operational during the year.
page 53Department of Health Annual Report 2008 09
Redeveloping Glenside and progressing further
infrastructure improvements
South Australia s mental health system is being reformed to improve mental health services across the state. A
significant element of this reform is the redevelopment of the Glenside Campus.
Glenside redevelopment
The Glenside Campus Redevelopment Master Plan guides the development and construction of the Glenside
Campus including the new hospital and health facilities, roadways and pathways, retail and commercial areas,
new homes, and public open space.
The new state of the art 129 bed hospital will provide mental health, and drug and alcohol dependency
services. The facility will comprise 40 secure rehabilitation beds, six mother and infant perinatal beds, 53
acute beds and 30 drug and alcohol specialist detoxification beds. The site will also accommodate a drug and
alcohol outpatient facility, a 15 bed Intermediate Care Centre and 20 supported accommodation places.
Swanbury Penglase Architects (SPA) in association with MAAP Architects were appointed to lead the design of
the new health facilities, open space and site wide infrastructure.
A series of consultations by the architect have been undertaken to inform the concepts, ideas and designs for
the health facilities. The final concept design is expected to be released in late 2009.
A builder will be appointed for the first element of the new health facilities, a 15 bed Intermediate Care
Centre, in 2009-10.
Other infrastructure improvements
Numerous mental health infrastructure projects have been initiated or completed including:
> construction of a 30 bed adult acute mental health facility at the LMH and development of a new 20 bed
aged acute facility
> refurbishment and upgrade of the 20 bed Morier Ward facility at the Noarlunga Hospital
> planning for the 20 bed aged acute facility at TQEH
> preparation of a business case to develop six community mental health centres.
> planning for the proposed redevelopment of the forensic facility at James Nash House.
page 54 Department of Health Annual Report 2008 09
Promoting positive mental health in the community and expanding
mental health literacy programs
Promoting positive mental health
Promoting positive mental health will enable the community to recognise the risk factors and early signs
of mental illness and reduce the stigma and discrimination associated with it. The following activities build
awareness, skills and knowledge of positive mental health and wellbeing for all South Australians.
Mental Health First Aid
The Mental Health First Aid Training Program will build the capacity of communities to support people with a
mental illness. The program educates South Australians and reduces the stigma and discrimination associated
with mental illness. More than 20 Mental Health First Aid training workshops were delivered by Relationships
Australia (SA) across South Australia to community and health related groups.
beyondblue
The Department of Health and beyondblue are working closely to improve the management of, and reduce
the negative public image associated with depression and anxiety.
Activities include dissemination of depression and anxiety related materials, promoting the health and
wellbeing of specific age groups, assisting rural communities through the drought and postnatal depression
prevention activities.
Young people
A range of mental health initiatives targeting young people were undertaken, including:
> Healthy Young Minds, which aims to improve and expand child and adolescent mental health services in
high demand areas. The service has been set up to service an extra 1000 young people each year.
> Headroom Project, which aims to promote positive mental health for children and young people, and
provides information and support to families and friends. Key features of Headroom include a website and
printed mental health literacy resources.
Building knowledge, skills and communities
SA Health funds Relationships Australia (SA) to deliver the Strength for Communities and Skills for Living
Programs. The program promotes support initiatives for individuals, families and community groups seeking to
prevent and overcome mental health difficulties. A library with self help materials that focus on mental health
awareness and individual and community capacity building is also provided.
Mental Health Week
The theme of Mental Health Week in October 2008 was Mental Health what do you know? . The week
informed the public of the need to seek help early and where to obtain assistance. During the week the
winners of the 2008 Dr Margaret Tobin Awards for Excellence in Mental Health, which acknowledges the
achievements of individuals and organisations who make an outstanding contribution to mental health
services in South Australia, were announced. There was wide media coverage across South Australia.
Rural areas
Counselling and assistance for drought affected communities was delivered through Country Health SA.
SA Health recently relaunched the Rise Above It campaign to raise awareness and promote help for people
living in drought affected communities. The campaign is based in the Riverland and is voluntarily fronted by
Adelaide Crows coach Neil Craig. A helpline, 131 465, provides information about where help and support
can be accessed.
page 55Department of Health Annual Report 2008 09
Performance
During 2008-09 the Department of Health implemented a new suite of key performance indicators to
measure readiness, demand, efficiency and outcomes for mental health services.
Mental health readmission within 28 days
A measure of success in providing appropriate care to mental health patients is examining the number of
people who are readmitted within 28 days of being discharged. High readmission rates can indicate that either
the inpatient treatment or post discharge follow up care was inappropriate or deficient. In 2007-08, 8.7% of
acute mental health patients were readmitted within 28 days of discharge. This indicator decreased to 7.6% in
2008-09 (Figure 24). SA Health aims to reduce acute mental health readmissions within 28 days of discharge
through new initiatives such as community recovery centres, 24 hour supported accommodation, intermediate
care and improved complex patient management.
Figure 24 Mental health readmissions within 28 days (%)
2006-07 2007-08 2008-09
Year
Pe
rc
en
t
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
Community care within seven days of discharge
Post discharge community health service follow up is an important strategy for reviewing client care during
the vulnerable period immediately following discharge. In 2006-07, the percentage of acute mental health
inpatients receiving community care services within seven days of their discharge was 33%, and this improved
to 44% for 2008-09 (Figure 25).
page 56 Department of Health Annual Report 2008 09
Figure 25 Patients receiving community based mental health services within 7 days of discharge from hospital
2006-07 2007-08 2008-09
Year
0
20
30
40
45
15
10
5
25
35
Pe
rc
en
t
Average length of stay
In 2006-07 the average length of stay for inpatients in acute mental health units was 18.1 days. This figure
remained steady at 18.1 days for 2008-09 (Figure 26).
Figure 26 Mental health average length of stay
2006-07 2007-08 2008-09
Year
0
6.0
10.0
14.0
18.0
20.0
16.0
4.0
2.0
8.0
12.0
Pe
rc
en
t
page 57Department of Health Annual Report 2008 09
Improving the Health of Aboriginal People
The Department of Health is focused on improving Aboriginal health in collaboration with other government
and non government organisations. The COAG National Partnership measures to close the gap in Indigenous
health outcomes, together with targets in South Australia s Strategic Plan 2007, provide the platform to
improve Aboriginal health in South Australia.
National Partnership Agreements
The Department of Health participated in a bilateral process with the Australian Government to develop
National Partnership Agreements specifically related to improving Indigenous health outcomes. The COAG
National Indigenous Reform Agreement targets related to health are:
> to close the gap in life expectancy within a generation
> to halve the gap in mortality rates for Indigenous children under five within a decade.
National Partnership Agreement closing the gap
Planning is underway for the National Partnership Agreement s broad objectives including:
> tackling smoking
> primary care health services
> fixing the gaps and improving the patient journey
> healthy transition to adulthood
> making Indigenous health everyone s business
> data collection and evaluation.
National Partnership Agreement Indigenous early childhood development
The Department of Health has participated in bilateral negotiations with the Australian Government to target
Indigenous early childhood development. The National Partnership Agreement comprises three elements:
> Children and Family Centres. The Australian Government has committed $25.22 million for
South Australia to established integrated Children and Family Centres in communities with
high disadvantaged Indigenous populations
> Antenatal and teenage sexual and reproductive health services. South Australia has been allocated $5.35
million over five years to:
- Improve the sexual health, well being and safety of Indigenous children and young people in targeted
rural and remote South Australian communities.
- Improve access to sexual health services for Indigenous young people.
- Expand the Aboriginal Family Birthing Program to include Pt Augusta, Whyalla, Ceduna, Murray Bridge,
Coober Pedy and some metropolitan areas.
> Maternal and child health programs. An allocation of $4 million has been made for maternal and child
health programs as part of the Australian Government s New Directions election commitment which focuses
on an equal start in life for Indigenous children.
page 58 Department of Health Annual Report 2008 09
Developing culturally appropriate models of care
The Department of Health has continued to implement a range of health care programs and strategies through
its Regional Health Services aimed at providing culturally appropriate health care for Aboriginal people.
Centre for Excellence in Aboriginal Health
The Centre for Excellence in Aboriginal Health was announced by the Minister for Health in June 2007.
A steering committee has been established to undertake detailed planning for the Centre. Following an 18
month community and agency consultation process, a number of key areas of activity have been identified,
including research and evaluation, employment and training, and identification and sharing of innovative and
best practice service models.
Aboriginal adult and child health checks
The promotion and uptake of the Medical Benefits Scheme s adult and child health checks in the Aboriginal
community continued to provide greater access to primary health care services in the prevention, early
diagnosis and management of acute illness and chronic disease.
During 2008-09 SA Health regional health services conducted Aboriginal specific health checks for adults and
children as part of a comprehensive primary health care strategy.
Women s health
Improved access to culturally appropriate ante and postnatal care services is being achieved through
integration of Close the Gap child and maternal health initiatives and the expansion of the Anangu Bibi
program. Anangu Bibi incorporates the Our Culture Our Babies Our Future Framework together with the
perinatal guidelines which set out key principles and actions to inform culturally responsive practice. The
program partners Aboriginal maternal and infant care workers with a midwife and doctors in providing care
for Indigenous women during pregnancy, birth and the post natal period.
Aboriginal Well Women s Screening Program
The SACSP aims to reduce the incidence of and mortality from invasive cancer of the cervix by increasing the
proportion of women who are screened at recommended intervals.
Key activities conducted through the Aboriginal Well Women s Screening Program during 2008-09 included:
> health promotion work across the state, including remote locations
> projects with 17 community controlled health services, and rural and remote Country Health SA agencies, to
provide culturally competent screening services to Aboriginal women
> a biennial continuing education seminar for Aboriginal women s health workers from across the state
> production and distribution of culturally appropriate information resources for community women and
women s health workers
> continuing professional education for medical practitioners and practice nurses.
page 59Department of Health Annual Report 2008 09
Maternal and infant health
Improving Aboriginal birthing outcomes will have an effect on South Australia s Strategic Plan Target T2.5,
to improve Aboriginal healthy life expectancy. Low birth weight is known to contribute to the risk of chronic
disease in adult life, especially cardiovascular, renal and dental disease and type 2 diabetes. The proportion
of babies born in South Australia who had low birth weight (<2500g) is much higher among babies of
Indigenous women compared with the general population (16.3% compared with 6%) (Table 2).
Antenatal visits that include regular health assessment throughout the pregnancy, help prevent and/or provide
early detection of illness. This provides an opportunity to address issues that influence low birth weight. Table
3 shows the number of Indigenous and non Indigenous women who had seven or more antenatal visits,
indicating regular assessment.
Low birthweight babies
Table 2 2008 Pregnancy Outcome Unit data, live births by birthweight grouping and Indigenous
status (one unknown race and two unknown birthweight have been excluded)
Birthweight Number/Percentage Aboriginality
Non indigenous Indigenous Total
Low Birthweight <2500g Number 1155 102 1257
Percentage (%) 6.0% 16.3% 6.3%
Birthweight 2500g
Number 18024 523 18547
or more
Percentage (%) 94.0% 83.7% 93.7%
Total Number 19179 625 19804
Percentage (%) 100.0% 100.0% 100.0%
Percentage of women receiving seven antenatal visits
Table 3 2007 Pregnancy Outcome Unit data, women who had seven or more antenatal visits
(unknown antenatal visits excluded) by Indigenous status
Number of Antenatal Visits Number/Percentage Aboriginality
Non indigenous Indigenous Total
Anv Less than 7 Number 1299 205 1504
Percentage (%)l 7.2% 36.0% 8.1%
7 or more Number 16667 365 17032
Percentage (%) 92.8% 64.0% 91.9%
Total Number 17966 570 18536
Percentage(% 100.0% 100.0% 100.0%
(Anv: antenatal visits)
Infant and perinatal mortality
Perinatal and infant mortality are much higher among babies of Aboriginal women.
The perinatal mortality rate for South Australia for all births was 10.1 deaths per 1000 births in 2008. The
mortality rate was much higher among babies of Aboriginal women (23.6 per 1000 births) compared with
non-Aboriginal mothers (9.7 per 1000 births) (Table 4).
The overall total population infant mortality rate for South Australia was 3.7 deaths per 1000 live births in
2008. This was much higher for babies of Aboriginal women (8.0 per 1000 live births) compared with non-
Aboriginal women (3.5 per 1000 live births) (Table 5).
page 60 Department of Health Annual Report 2008 09
Perinatal mortality
Table 4 2008 Pregnancy Outcome Unit data, all births by perinatal death grouping and Indigenous
status
Outcome Number/Percentage Aboriginality All births in South Australia
Non indigenous Indigenous
Perinatal death Rate per 1000 9.7 23.6 10.1
Percentage (%) 0.97% 2.36% 1.01%
Infant mortality
Table 5 2008 Pregnancy Outcome Unit data, infant deaths (neonatal deaths and post neonatal
deaths) by Indigenous status
Outcome/Total Aboriginality
Non-Indigenous Indigenous Total
Outcome Neonatal death 47 4 51
Post neonatal death 21 1 22
Total infant deaths 68 5 73
Total live births 19193 625 19818
Infant mortality rate per 1000 live births 3.5 8 3.7
Note: This table relates to infant deaths of live born babies before one year of age.
Pregnancy Outcome Unit September 2009
Family Home Visiting Program
There has been increased access to and acceptance of the Aboriginal Family Home Visiting Program by
Indigenous people (see Figure 27). The Family Home Visiting program commenced in Port Lincoln in October
2008 and further expansion is expected in the Eyre Peninsula, Mt Gambier and the upper South East, the
Yorke Peninsula and the Mid North.
Figure 27 Percentage of vulnerable Aboriginal families with young children accepting sustained
home visiting services
8 0%
7 5%
7 0%
6 5%
6 0%
5 5% Pe
rc
en
t
5 0%
4 5%
4 0%
Jul-07 Sep-07 Nov-07 Jan-08 Mar-08 May-08 Jul-08 Sep-08 Nov-08 Jan-09 Mar-09 May-09
Month
page 61Department of Health Annual Report 2008 09
Oral and dental health
The Aboriginal Liaison Program identifies Aboriginal adults in need of dental care and provides a culturally
appropriate referral pathway for treatment at SA Dental Service clinics. The program was expanded to new
areas in 2008-09 and, as a result, the number of Aboriginal adults receiving public dental care increased from
1 891 in 2007-08 to 2 877 in 2008-09, an increase of 52%.
Related programs for children increased the number of Aboriginal children treated by the School Dental
Service by 14%.
SA Dental Service has established a dental clinic in the Umoona Tjutagku Health Service in Coober Pedy
and during 2008-09 dental staff were flown to Coober Pedy on a regular basis to provide treatment to
Aboriginal people in the area with 243 clients seen (49 children and 194 adults). SA Dental Service also
supported the establishment of a dental clinic in the Tullawon Health Service at Yalata with 70 clients seen
(44 children and 26 adults).
In March 2009, the Australian Government Minister for Ageing announced the national roll out of the Nursing
Home Oral and Dental Health Plan which will incorporate the training component of the national project
Better Oral Health in Residential Care undertaken by the South Australian Dental Service and which involved
the Aboriginal Residential Aged Care facility in Coober Pedy.
Pandemic influenza
The Department of Health, through the South Australian Aboriginal Health Partnership (SAAHP), has brought
together the Aboriginal Health Council of South Australia Inc., the Australian Government Department of
Health and Ageing, and several NGOs to discuss and initiate pandemic influenza planning for Aboriginal
communities in South Australia. Initial funding has been sourced to employ consultants to develop a
Pandemic Influenza Preparedness Plan for Aboriginal Medical Services (including the Aboriginal Community
Controlled Sector) to form an annex of SA Health s overall Pandemic Influenza Plan.
Extending Aboriginal community engagement
During 2008-09 the Department of Health conducted a number of activities to ensure that South Australia s
Aboriginal community was engaged in the design, monitoring and evaluation of all health service initiatives.
Effective Aboriginal community engagement involves a number of local programs dispersed across SA Health.
For example, Aboriginal community Yarn sessions were coordinated across the Central Northern Adelaide
Health Service by the Watto Purrunna primary health care service. This was the first time that Aboriginal
people were invited to come together in Central Northern Adelaide Health Service to discuss and contribute to
the development of their health services.
Increasing access and equity
During 2008-09 the Department of Health continued to strengthen the infrastructure capacity of both SA
Health and Aboriginal communities to address Aboriginal health needs.
Aboriginal health infrastructure
A broad consultation process across SA Health Regional Health Services has been undertaken by the
Department of Health to identify Aboriginal capital infrastructure proposals for consideration in future
planning activity. Project construction has already commenced to replace the Oodnadatta Clinic, due for
completion in November 2009.
page 62 Department of Health Annual Report 2008 09
Aboriginal Step Down Units
The Kanggawodli (Caring House) capital works project was completed in 2008, with the existing Step Down
service staff relocating in December 2008. A full complement of staff was recruited in March 2009, and the
facility opened for clients in April 2009. The facility has a 40 bed capacity, with four pods, each with three
single rooms and a family room enabling accommodation of 16 primary clients and 24 secondary clients
(escorts and up to two children).
Aboriginal Health Information Technology
Working in collaboration with the South Australian Aboriginal Health Partnership, the Aboriginal Health
Council of SA Inc and Aboriginal Community Controlled Health Services, the department developed a
mechanism to provide Information Communication Technology support to the Aboriginal Community
Controlled Health Services providing advice on Information Community Technology systems and software.
Information Communication Technology Services has worked extensively with Ceduna Koonnibba Aboriginal
Health Service, Pika Wiya Aboriginal Health Service and Nunyara Wellbeing Centre in supporting their
Information Communication Technology needs during their transition to becoming Aboriginal Community
Controlled Health Services. A shared Patient Information Recall System database has been created in
collaboration with Communicare to allow each service to house their client data on the one server. This makes
it possible, with patient consent, to allow client health records to be shared across the three health services.
Aboriginal Community Enhancement Program
The Aboriginal Community Enhancement Program is a Department of Health initiative that assists Aboriginal
incorporated community organisations in the rural and remote areas of South Australia to address the health,
wellbeing and social needs of their communities. There were 12 successful Aboriginal communities that
received funding in 2008-09: Point Pearce Aboriginal Corporation, Marree Arabunna People s Committee,
Marree Progress Association, Ninkowar Association, Oak Valley Community, Colebrook Community Centre,
Quorn, Raukkan Community Council, Port Pirie Regional Aboriginal Community Centre, Arabunna Nulla Kari-
Ku Wanka Association and Bullinda Homelands.
Some of the successful projects include: Arabunna Youth Club Shade Area and Laundry Upgrade, Marree
Healthy Cooking Group, Listen to Ngarrindjeri Women Singing, Oak Valley Art/Women s Centre Activities,
Raukkan Community Shop, Bush Music, Building a Stronger Future (working with young people), Connecting
Health and Country initiatives and a Community Gathering Space.
Fostering a healthy lifestyles culture
Encouraging a healthy lifestyle culture is critical to ensuring improved and sustainable health. The Department of
Health implemented numerous initiatives targeting substance use and promoting good nutrition during 2008-09.
page 63Department of Health Annual Report 2008 09
Health promotion
Promoting the health and wellbeing of Aboriginal South Australians is a priority for the Department of Health.
Strategies and initiatives to encourage good health for children and their families around issues such as
antenatal care, good nutrition and healthy lifestyles include:
> The Healthy Ways program employs Aboriginal Health Workers and dieticians in Yalata, Oak Valley, Whyalla,
Coober Pedy, Oodnadatta and Marree to improve nutrition for Aboriginal mothers, babies and young
children. It also supports positive child development through promoting healthy foods in stores, devising
healthy activities for women s groups, promoting nutritious foods at mother s groups and play groups, and
working with local schools to promote healthier snacks and lunchboxes.
> The Community Foodies Program trains Aboriginal volunteers as peer educators in both Victor Harbor and
in the far north of the state to work with local nutritionists and others to promote healthy eating in their
local community. Seventeen Aboriginal community Foodies have been trained (14 in 2008-09).
> In 2008 the Department of Health developed a Children s Centres Health and Wellbeing Framework to
support the capacity of Children s Centres to promote health, strengthen parenting and improve access to
health services. COAG funding has been received to ensure the framework is implemented in a culturally
appropriate way for Aboriginal children and families.
> Workforce Planning and Development. The Department of Health contributed funding the David Unaipon
College of Indigenous Education and Research, University of SA, to develop a training package to equip
Aboriginal health workers to promote healthy eating and physical activity as a contribution to promoting
good health and healthy weight, and preventing chronic disease.
> The Department of Health supported the Department of Transport, Energy and Infrastructure (DTEI) to
research freight issues for remote South Australian Aboriginal communities in relation to the availability and
price of healthy affordable food. This informed the South Australian Government s submission to the House
of Representatives Standing Committee on Aboriginal and Torres Strait Islander Affairs Inquiry into Remote
Community Stores in Aboriginal and Torres Strait Communities (February 2009).
Substance use programs
DASSA Aboriginal community communication strategy
Drug and Alcohol Services SA (DASSA) continued to provide a weekly radio program (Corka Yarnin) for Aboriginal
communities living in the Adelaide metropolitan region through community radio station 89.7 PBA FM.
Statewide Indigenous Males Health Camp
DASSA, in collaboration with the Aboriginal Drug and Alcohol Council SA and Ceduna Koonibba Aboriginal
Health Service, hosted a Statewide Aboriginal Males Health Camp from 27-31 October 2008. More than 75
Aboriginal males from various parts of the state attended the camp which had a theme of Aboriginal Male
Leadership . The camp was broken up into three sections: recreational activities (sports, fishing and hunting);
workshops (family support, drug and alcohol issues, domestic violence and leadership); and cultural (sharing of
stories and experiences as an Indigenous male).
page 64 Department of Health Annual Report 2008 09
Addressing the social determinants of Aboriginal health
The Department of Health plays a lead role in reducing inequities in health outcomes for Aboriginal people
and this continued in 2008-09.
Community Development Framework
Community Health Improvement Strategic Framework
The Community Health Improvement Strategic Framework was developed as a guide to the Community
Health Improvement Branch to enhance the capacity of communities to be self determining and to address
social disadvantage by developing meaningful partnerships with the Aboriginal community, Regional Health
Services, government and non government services to improve local level Indigenous health outcomes.
The focus of this initiative has been to work in those locations across South Australia where Aboriginal
Community Controlled Health Services do not exist.
The Department of Health has been working in the Yorke Peninsula, Hills Mallee Southern, Riverland and
Copley/Aroona, and Roxby Downs regions. Secondary priority areas in rural and remote locations were
included as a focus to build and strengthen on existing programs.
An Employment Expo was held in the Point Pearce community in April 2009 with more than 20 agencies
attending, which was lead by the local men s group.
Fixing Houses for Better Health: Remote Aboriginal Lands
The Department of Health is involved in the Australian Government funded Fixing Houses for Better Health
Program (FHFBH) in the Anungu Pitjantjatara Yankunyjatjara (APY) Lands. This is a national program with a
focus on safety and health that employs a survey/fix methodology. For the latter half of 2008 it was the only
formal and focussed repair and maintenance housing program on the APY Lands.
In 2008-09 the department assessed and tested 166 domestic septic tank systems across the APY Lands. The
removal of human waste and wastewater remains an important public health issue in remote Australia. The
assessment found a number of structural and service problems with the systems. Following the assessment,
the department subsequently issued 99 approvals to the Office of Aboriginal Housing for the repair or
replacement of systems found to be defective.
In addition to ensuring the safe removal and treatment of waste from houses, the FHFBH program also
surveyed and fixed items in the fields of:
> electrical safety
> fire safety
> potable water supply
> bathing and laundry facilities
> cooking and food storage facilities.
To date, 907 houses in remote Aboriginal communities across South Australia have received in excess of 10 000
fixes under FHFBH programs to maintain them in a safe and functional condition. (Data supplied by Healthabitat
Pty Ltd, the current national supplier for the Australian Government of the FHFBH Program 2006-09).
page 65Department of Health Annual Report 2008 09
Ensuring cultural respect and cultural inclusion
SA Health Aboriginal Cultural Respect Framework
In December 2007 the Minister for Health launched the SA Health Aboriginal Cultural Respect Framework.
There are four embedded documents within the SA Health Cultural Respect Framework which include the SA
Aboriginal Health Policy, SA Health Aboriginal Health Impact Statement, SA Health Reconciliation Statement,
SA Health Employment Policy. The utilisation of Aboriginal Health Impact Statements has increased since the
launch of the SA Health Cultural Respect Framework across SA Health. The Department of Health provided
training session across regional locations to assist in the uptake of Preparing an Aboriginal Health Impact
Statement and increased Aboriginal participation across the health system. A training session was provided at
the Country Primary Health Care Forum in June 2009.
Cultural awareness training
One of the requirements of the SA Health Cultural Respect Framework is the implementation of Aboriginal
cultural awareness training to SA Health staff. During 2008-09 cultural awareness training sessions were
provided at various health services including the RAH and LMH. Cultural awareness training allows staff to
develop an understanding of Aboriginal culture, helping them to deliver health services that are culturally safe
for Aboriginal people.
Aboriginal workforce strategies
As the main service provider for health and wellbeing in this state, the Department of Health is committed to
building a workforce dedicated to better servicing Aboriginal people and communities across South Australia.
In April 2009 the department launched the SA Health Aboriginal Workforce Reform Strategy 2009-2013
which represents its policy commitment to increasing Aboriginal employment and development within the
department and across all Regional Health Services.
During the year the department and the Regional Health Services provided the following opportunities to
Aboriginal people to build the current and future workforce:
> SA Aboriginal and Torres Strait Islander People s Scholarship Investment Fund:
- 11 new recipients
- 11 graduating recipients
> provided 46 scholarships for recipients to study an undergraduate degree
> provided 15 Aboriginal cadetships.
The cadetships have included vocations such as enrolled nursing, pathology and business administration.
page 66 Department of Health Annual Report 2008 09
Protecting Public Health
The Department of Health protects and promotes public health through communicable disease control
activities; by population based screening programs; by identifying, investigating and managing environmental
factors that impact on the health of the public; by minimising potential environmental health risk factors
arising from air, water, soil and hazardous substance; and by addressing the environmental determinants of
health in the context of the food supply. In 2008-09, specific activities included:
Review of the Public and Environmental Health Act 1987
The Public and Environmental Health Act 1987 is the principal legislation for the protection of the health of
the public of South Australia. A review of the Act, necessary to account for more contemporary public health
issues, concluded in December 2008.
The draft Public Health Bill, developed as a result of the review, will be available for public consultation in
2009-10. The Bill aims to provide a comprehensive and systematic framework for public health protection and
promotion, and robust powers for the prevention of illness, injury and disability of public health significance.
The legislation will align South Australia with international best practice in public health law and position
South Australia at the front of Australian public health legislation.
Health in All Policies
Health in All Policies (HiAP) promotes healthy public policy. HiAP is a way of working across government to
encourage all sectors to consider what the health impacts of policies and practices might be, and how a
healthier population can assist a sector to achieve their goals.
In September 2008 the South Australian Government agreed to apply the HiAP approach to South Australia s
Strategic Plan and directed the Chief Executive Group to oversee the implementation and evaluation. Applying
HiAP to SASP was the key recommendation of Professor Ilona Kickbusch s final report as Adelaide Thinker in
Residence.
The Department of Health and the Department of the Premier and Cabinet (DPC) are working together to
apply HiAP to seven SASP targets: T3.9 Water Security, T4.8 Digital Technology (Broadband), T 1.24 Overseas
Migration, T3.6 Transit Oriented Developments, T2.2 Healthy Weight, T6.12 Education and Early Years, and
T2.5 Aboriginal Road Safety.
Safe Drinking Water Bill
In 2008-09 the Department of Health developed a discussion paper proposing the development of a Safe
Drinking Water Bill. The proposed Bill will enhance the protection of public health by providing clear direction
on how to assure drinking water quality and how to verify compliance with the Australian Drinking Water
Guidelines. It will provide guidance to all South Australian water providers, including SA Water. Formal
consultation on the Safe Drinking Water Bill Discussion Paper commenced in June 2009.
page 67Department of Health Annual Report 2008 09
Public and Environmental Health (Legionella) Regulations 2008
Following a series of high profile legionellosis outbreaks across Australia, the Department of Health developed
regulations and supporting guidelines to control Legionella in manufactured water systems in South Australia.
The Public and Environmental Health (Legionella) Regulations 2008 commenced on 1 October 2008.
The regulations, which are administered by councils and the department, place specific regulatory controls on
the operation and maintenance of high risk manufactured water systems (including cooling water systems and
warm water systems). If not properly managed, such systems can create conditions favourable to the growth
of Legionella, the causative agent of legionellosis or Legionnaires Disease.
To assist industry and councils with the application and administration of the regulations, the Department of
Health developed fact sheets and educational resources and conducted information sessions across the state.
Environmental health indicators
The department is developing local government environmental health indicators that will provide concise and
useful information about the health status of a South Australian population and the environmental factors
associated with human health. The project will improve health by providing the means for evaluating services
and conditions based on local evidence and tailoring of future activities according to local priorities.
A discussion paper titled Developing Local Government Environmental Health Indicators for South Australia
was released in December 2008. Ten submissions were received from local government.
Contaminated site remediation
Clovelly Park
The Department of Health supports the Environment Protection Authority (EPA) to protect the public from
harm associated with contaminated sites. In 2008-09 the department investigated the indoor air quality of
homes in Clovelly Park following the discovery of several industrial chemicals in the soil and ground water in
the area. With the EPA, the department collected indoor air samples from a number of dwellings in January
and March 2009.
The results of the sampling indicated that for the majority of the housing in the area the chemicals were either
not present or at concentrations too low to be of concern. However, two social housing facility buildings
which abut the industrial complex had levels of concern and these facilities will not be re-tenanted. All
residents in the area were advised not to use bore water unless proven to be safe.
LeFevre Peninsula Primary School
Following complaints of respiratory symptoms from students at the LeFevre Peninsula Primary School, the EPA
requested the department assess the potential environmental health risks posed by an adjacent development
site to children attending the school, and to engage in a community consultation process.
The assessment analysed data collected by the EPA (including ambient air and dust samples from the school
and an adjacent development site), characterised the risk and potential for adverse health effects from a range
of pollutants. The assessment resulted in improved environmental management practices being initiated to
significantly reduce dust emissions from the development site. The department and the EPA are continuing
community consultation.
Rural health promotion pest control safety
The Department of Health s controlled substances officers attended three agricultural field days to raise
awareness of the safe use of pesticides and the importance of employing licensed pest controllers. The field
days attract up to 15 000 people per day and are an excellent opportunity for industry members to discuss
their individual pesticide and poisons issues with the department s controlled substances officers.
page 68 Department of Health Annual Report 2008 09
Mosquito control and arbovirus prevention
Under the framework of the South Australian Integrated Mosquito Management Strategy, the Department
of Health works with local councils, state government agencies, universities and the community to reduce
mosquito borne diseases including Ross River virus, Barmah Forest virus and Murray Valley encephalitis.
The department provides an on-the-ground mosquito control program on Torrens Island and supports local
government mosquito control programs across South Australia.
Through its Fight the Bite campaign the department encourages personal and household protection against
mosquitoes to prevent the spread of mosquito borne disease. In 2008-09 Fight the Bite resources were
distributed widely, focusing on areas where arbovirus is endemic. Additionally, Fight the Bite advertisements
were placed in the print media with community service announcements on local radio.
Infection control program for tattooing industry
Body piercing and tattooing are popular procedures with potential health risks. Blood borne viruses such
as hepatitis B and C, HIV and other bacterial infections can be transmitted to operators or clients by
contaminated equipment or unhygienic premises and procedures.
In 2008-09 the Department of Health participated in the SafeWork SA Safe Communities Program to reduce
the incidence of workplace infection in body piercing and tattooing businesses in the state. Other partners
included the Hepatitis C Council of South Australia, Southern Primary Health, the City of Onkaparinga and the
industry. Six specialist infection control educational workshops were held, focusing on minimising infection
risks to staff and clients. Workshops were attended by 50 body piercers, 70 tattooists and 25 environmental
health officers.
Preventative strategies addressed included:
> ensuring practitioners are trained in best practice infection control
> blood borne virus transmission information tailored for this industry
> educating environmental health officers on skin penetration practices and relevant infection control
strategies to equip them with the knowledge to thoroughly inspect these premises.
page 69Department of Health Annual Report 2008 09
Public health food initiatives
Local government activities under the Food Act 2001
The Food Act 2001 makes provision for local government to report to the Department of Health on the
performance of functions under the Act. Local councils are empowered to assess compliance with legislated
standards of hygiene in relation to the manufacture, transportation, storage and handling of food for sale.
They are also responsible for actions to prevent the sale of unfit food and to investigate complaints related to
the sale of unfit food.
Councils conduct food business inspections and provide activity reports to the department to assist in
assessment of the effectiveness of administration of the Food Act 2001. Data provided is used to:
> establish the size and composition of food businesses
> identify the frequency of food business inspections
> determine the overall effectiveness of inspections conducted.
Table 6 identifies the number of food businesses, the proportion of businesses by food safety risk categories
and the number of inspections conducted by local government in the reporting period.
Table 6 Food inspections by risk categories
Food Safety Risk Classification
High Medium Low Total
Number of businesses 1 575 7 864 3 349 12 860
Inspections conducted 1 195 5 628 1 496 8 319
Follow up inspections 265 2 062 256 2 583
Food safety audits
The Australia New Zealand Food Standards Code Standard 3.3.1 became enforceable under the Food Act
2001 in South Australia from October 2008. The new standard mandates audited food safety programs for
food services to vulnerable persons. The department is working with industry and local government to ensure
the effective management of the audit process in SA and to develop a sustainable auditor workforce.
The Department of Health has conducted food safety audits of all public hospitals captured by the standard
and not for profit delivered meals organisations including Meals on Wheels in South Australia.
Enforcement of country of origin labelling of food
In 2008-09 the Department of Health conducted a survey to measure compliance of South Australian food
businesses with new country of origin labelling requirements. The Australia New Zealand Food Standards
Code Standard 1.2.11, requires all packaged food and particular unpackaged foods to identify the country or
countries of origin of the food, and whether it is a mix of local and/or imported foods.
Two hundred and eighty four food businesses were inspected with 143 (50.4%) compliant with the standard.
Food businesses that were not compliant were verbally advised of the legislative requirements, provided with
an information brochure and sent a written warning.
Follow up inspections on 117 previously non compliant food businesses determined 96 (86.5%) were
now compliant, six were no longer trading, and 15 were still either partly or non compliant (13.5%). Four
businesses had multiple non compliances and were issued expiation notices.
page 70 Department of Health Annual Report 2008 09
Communicable disease control
Disease surveillance and investigation
Notification of disease to the Department of Health during 2008-09 was dominated by respiratory cases,
including a large cyclic increase due to pertussis (whooping cough). Influenza, notifiable since May 2008,
included reports of the first cases of H1N1 Influenza 09 (swine flu). Other notifiable diseases were reported
at expected numbers for the year and almost 10 000 notifications were recorded through the period. Disease
control and investigation activities included 54 clusters of infection, mostly community outbreaks.
Specialist support
In 2008-09 regulations were passed to make chikungunya virus notifiable under the Public and Environmental
Health Act 1987; and Department of Health s medical notification form Report of Notifiable Disease or Related
Death (Public and Environmental Health Act 1987) was updated to include chikungunya virus, influenza and
rotavirus. GPs and medical specialists practising in South Australia were informed of these changes.
The fourth edition of You ve Got What? a publication on the prevention and control of notifiable and other
infectious diseases was published. Public health physicians also delivered eight presentations on the clinical
management of meningococcal infection.
OzFoodNet investigates food borne disease in order to describe its epidemiology and identify ways to
minimize foodborne illness in Australia. Five foodborne or suspected food borne outbreaks (including a multi-
jurisdictional Hepatitis A outbreak) and 11 suspected food borne clusters were investigated during 2008-09.
The department also contributed to the WHO Global Salm-Surv Level-1 International Training Course on
Foodborne Pathogens and Disease Surveillance, including Antimicrobial Resistance in Foodborne Pathogens,
held in Guam in February 2009. The department contributed to several national OzFoodNet projects including
development of norovirus outbreak investigation guidelines and journal publications.
HIV/HCV policy and programs
In 2008-09 the Department of Health published the SA Health Hepatitis C Action Plan 2009-2012, and the SA
Health HIV Action Plan 2009-2012. The action plans are monitored by the new SA Health Steering Committee
on HIV/AIDS and Hepatitis C.
The department reshaped the funding for non government HIV and hepatitis C services through a public
tender process, based on the new health strategy implementation plan for this sector. The plan contains eight
redeveloped NGO service models:
> Hepatitis C prevention and health promotion program
> health promotion program for people with HIV/AIDS
> targeted HIV/AIDS and sexually transmitted infection (STI) prevention program
> HIV/AIDS primary care coordination program
> community respite care service for people with HIV/AIDS
> community support and counselling service for people with HIV/AIDS and Hepatitis C
> STI and blood borne virus program for people from culturally and linguistically diverse backgrounds
> HIV and Hepatitis C workforce development program.
The department reviewed its investment in Aboriginal HIV and STI prevention and, together with the Northern
Territory and Western Australia, contributed to the Centre for Sexual Health in Alice Springs. The department
also supported a sexual health coordination project at the Aboriginal Health Council of South Australia.
To address recent rises in HIV diagnoses among men who have sex with men, the department facilitated
a cross sector working group of epidemiologists, clinicians, non government agencies and affected
communities. The working group implemented a targeted sexual health and HIV testing campaign as part of
its more comprehensive response.
page 71Department of Health Annual Report 2008 09
The department developed an accreditation system for GPs who can prescribe highly specialised drugs for the
treatment of HIV and published the Code for the Case Management of Behaviours that Present a Risk for HIV
Transmission as a SA Health Directive.
SA immunisation coordination
A total of 806 862 doses of vaccine were distributed by the department in 2008-09, with a total value of
$27 004 980. This included 246 454 doses of the influenza vaccine for the 65 years and over program, which
is 12 041 doses greater than the previous year.
As at 30 June 2009, 93% of children in South Australia are fully vaccinated by two years of age. In 2008, 71%
of Year 8 female students in South Australia completed a full course of human papillomavirus (HPV) vaccination.
Infection control
Promotion of the Wash, Wipe, Cover don t infect another! campaign during 2008 and early 2009 provided
the community with ready access to educational materials on hand and respiratory hygiene, which will help to
slow the transmission of respiratory illnesses within the community.
In 2008-09 the department committed to the implementation of the national Hand Hygiene Australia
program in acute care hospitals in South Australia. The program forms part of the WHO first Global Patient
Safety Challenge and is designed to improve the compliance of health care workers with basic hand hygiene
practices, known to be one of the most effective ways of preventing health care associated infection. The key
performance indicators for the program include the percentage compliance with hand hygiene, as measured
by a standardised observational method, and the rate of health care associated bloodstream infection caused
by golden staph .
The auditing of hospital sterilising and medical equipment reprocessing facilities continued in 2008-09 with
audits of all metropolitan hospitals. The organisation of sterilisation and reprocessing facilities across country
regional centres is under review.
The department continues to maintain and further enhance the National Antibiotic Usage Surveillance
Program (NAUSP). Improvement in antibiotic prescribing patterns in acute care hospitals is a major strategy
of the Australian Commission for Safety and Quality in Health Care to limit the development and spread
of antibiotic resistant micro organisms in health care facilities. The NAUSP contributes significantly to this
objective by providing the means to monitor the effects of interventions aimed at improving antibiotic use.
Emergency management
During 2008-09 a significant emphasis was placed on improving and increasing the Department of Health s
ability to respond to critical events. This involved extensive preparedness planning and the development of a
range of response plans and annexes both for pandemic and other critical situations.
Response to critical events
The 24 hour response team received 34 incident calls. Major events that required a response included:
> extreme heat during early 2009
> retrieval of trauma victims from Ashmore Reef
> deployment of a medical team during Port Augusta prison riots
> response to the H1N1 Influenza 09 (swine flu).
H1N1 Influenza 09
The Department of Health established emergency response teams and implemented measures including
border protection, media campaigns and public information, coordinated personal protective equipment for
frontline workers, management and distribution of anti virals and extensive contact tracing in response to the
H1N1 Influenza 09 (swine flu) outbreak.
page 72 Department of Health Annual Report 2008 09
Education, training and exercises
Education, training and regular exercises are vital for emergency preparedness.
The department conducted or attended training in Major Incident Medical Management Systems, border
control, event planning, exercise planning and medical deployment.
The department participated in exercise events including Adelaide Airport crash, pandemic influenza, mass
casualties, oil spill response, power failure response, counter terrorism response and EmergoTrain exercises.
Pandemic influenza planning and preparedness
Significant planning and preparation enabled the Department of Health to respond quickly and efficiently
to the H1N1 Influenza 09 (swine flu) outbreak, declared a pandemic by the World Health Organization in
June 2009.
Operational Plan for Pandemic Influenza
The Department of Health s Operational Plan for Pandemic Influenza was used during the H1N1 Influenza 09
(swine flu) pandemic to minimise and mitigate the consequences of a pandemic for South Australia.
Version 10 is being drafted and will include information and learnings from the H1N1 Influenza 09
(swine flu) pandemic.
South Australian Human Disease Hazard Plan for Pandemic Influenza
The South Australian Human Disease Hazard Plan for Pandemic Influenza, developed under emergency
management arrangements in South Australia, is intended for use by all government, non government
and community organisations involved in emergency management response and recovery activities. It
complements the department s Operational Plan for Pandemic Influenza and covers South Australian
Government strategies to manage the potential impacts of a pandemic influenza outbreak in South Australia.
The Human Disease Hazard Plan for Pandemic Influenza was developed following wide consultation with
stakeholders including the State Pandemic Influenza Working Group.
Statutes Amendment (Public Health Incidents and Emergencies) Act 2009
The Statutes Amendment (Public Health Incidents and Emergencies) Act 2009 was passed by Parliament
in June 2009.
The Act strengthens South Australia s existing laws to manage public health emergencies. It bolsters the
Emergency Management Act 2004 and the Public and Environmental Health Act 1987 with new powers for
senior health officials in the event of a public health emergency.
The Act enables the department s Chief Executive to declare a public health incident or emergency under the
Public and Environmental Health Act 1987 after consultation with the department s Chief Medical Officer and
the State Co-ordinator (appointed under the Emergency Management Act 2004) and with the approval of the
Minister for Health.
When this occurs, the Chief Executive is able to exercise new powers, which include directing people to
remain isolated or segregated from others, or taking other measures to prevent the transmission of a disease
or condition. A range of other Emergency Management Act 2004 powers are also exercisable by the Chief
Executive under a declaration.
page 73Department of Health Annual Report 2008 09
Health and Medical Research
The South Australian Health and Medical Research Institute
South Australia has a proud tradition of world class health and medical research. Our researchers are of the
highest calibre and our research is nationally and internationally renowned.
In order to ensure South Australia s strong position in health and medical research in the future, the South
Australian Government commissioned the Review of Health and Medical Research in South Australia,
conducted by Professor John Shine AO and Mr Alan Young.
The Shine Young Review made three key recommendations aimed at supporting the strategic directions for
health and medical research in South Australia:
> establish an independent health and medical research institute
> house the health and medical research institute in a new flagship research facility
> build and maintain a health and medical research fund.
Responding to the recommendations, the Department of Health began a project to establish the South
Australian Health and Medical Research Institute. The project is working closely with the three South
Australian universities, the Department for Further Education, Employment, Science and Technology (DFEEST)
and other research organisations.
The South Australian Health and Medical Research Institute will be independent of, but work in partnership
with, both South Australian Government and existing research organisations.
The South Australian Health and Medical Research Institute will:
> be a centre of excellence for health and medical research in SA
> support new and leading areas of research in human medicine and health
> attract national and international leading researchers
> build partnerships between researchers and research bodies to promote research excellence
> foster the application of research knowledge to benefit the health and wellbeing of people within and
outside of South Australia
> offer significant economic advantages to the state, by attracting significant funding from national and
international sources
> support South Australian and Australian Government research objectives
> create synergies between researchers and care providers.
A new $200 million Health and Medical Research Facility, funded by the Australian Government, will be built
adjacent to the new Royal Adelaide Hospital, in the city s west end, and will become the headquarters for the
South Australian Health and Medical Research Institute.
This will create a significant opportunity to develop a health and medical precinct that will attract up to 675
researchers to South Australia and combine best practice in health care delivery, education and research.
page 74 Department of Health Annual Report 2008 09
Centre for Intergenerational Health
The Centre for Intergenerational Health (CIH) is a joint venture between DFEEST, Flinders University of South
Australia, the University of Adelaide and the University of South Australia. The aim of the centre is to provide
a unique interdisciplinary capability for research into factors that are crucial for sustaining good health, within
and between generations, and particularly in later life.
In 2009 a review was conducted of the structure, governance and themes of the CIH. An additional theme
of early childhood was introduced to add to the existing themes of healthy reproduction, healthy weight,
psychological health and wellbeing, and healthy ageing. It is anticipated that the themes may change as the
CIH develops.
Under the early childhood theme, the CIH has co-sponsored the policy and research priority setting
component of the Early Childhood Development Data Linkage Demonstration Project; a project that promotes
cross university and cross government collaboration.
Post doctoral fellows have been appointed in two universities with ongoing negotiations occurring with
one other.
Research funding
In 2008-09 the Department of Health funded seven projects awarded research grants from the Australian
Research Council Linkage Program. All projects address priority areas for the Department of Health and build
the capacity of South Australian health and medical researchers:
> Evaluating the long-term costs and benefits of community-based initiatives. Lead investigator: A/Prof
Jonathon Karnon, University of Adelaide
> Exploring resilience in relation to physical activity and dietary behaviours among children from neighbourhoods
of low socioeconomic position. Lead investigator: Dr Jim Dollman, University of South Australia
> Priority Setting in Child Protection: developing an evidence-based strategy to reduce child abuse and neglect
and associated harms. Lead investigator: Prof Leonie Segal, University of South Australia
> Development and implementation of an evidence-based primary health care workforce planning model
to support best practice chronic disease management. Lead investigator: Prof Leonie Segal, University of
South Australia
> Heatwaves, population health, and emergency management in Australia - a qualitative study. Lead
investigator: Dr Peng Bi, Research Institute for Climate Change & Sustainability, Adelaide University
> Australia s Baby Boomer Generation, Obesity and Work Patterns, Causes and Implications Lead
investigator: Prof Graeme Hugo, University of Adelaide
> Citizen engagement: Listening to citizens views about Australia s health system and prevention. Lead
investigator: Prof Brian Oldenburg, Monash University.
The Minister for Health signed two important Memorandums of Understanding which contribute significantly
to the research effort in South Australia:
> The Cardiovascular Research Development Program is a joint program between the Minister for Health and
the National Heart Foundation (SA Division) Inc. The program will support four research fellows and two
developmental research grants focused on ensuring South Australians reduce their cardiovascular risk and
receive the best cardiovascular care.
> The Cancer Council of SA and the Minister for Health agreed to joint investment into Cancer Control
Projects over the next five years. This partnership will be used to support programs and research in three
key areas:
- prevention and early detection programs
- more support for sufferers and their families
- research aided by improved data collection.
Funding has been specifically dedicated to the development and re-engineering of research data infrastructure
including the re-development of the SA Cancer Registry and a bio-specimen database.
page 75Department of Health Annual Report 2008 09
Information and Communication Technology
Information security
In August 2008 the Department of Health received advice that Information and Communication Technology
(ICT) Services had maintained certification to the international Information Security Management Standard
IS027001:2006.
The Department of Health is one of a few agencies to achieve formal certification to this international
information security management standard. The information security standard provides a systematic approach
to managing information to ensure it remains secure. The focus is on people, processes and ICT systems
protecting SA Health and client information.
The standard auditor s certification report commended the level of commitment to security management
and the improvement demonstrated at all levels, and concluded that the SA Health ICT Services Information
Security Management System had achieved a high level of maturity.
ICT centralisation
To facilitate the introduction of state based systems that will support delivery of the electronic health record
right information at the right place at the right time to support clinical decision making and improved patient
safety and care , the Department of Health is centralising the management and control of ICT services across
SA Health.
The new single ICT service delivery model for SA Health has been developed and is being progressively
implemented from 1 July 2008. The model has been designed to specifically support the operations of
SA Health, establishing clear and transparent operating protocols between ICT Services and customers,
capitalising on opportunities for consolidation and standardisation, improving ICT service accountability,
transparency and performance, enabling a more responsive environment and better use of resources to better
align ICT services and functions to health outcomes.
page 76 Department of Health Annual Report 2008 09
COAG Reform of Federal State Financial Relationships
As part of the COAG reform of Federal State Financial Relationships, in 2008-09 the Department of Health
was actively involved with the DPC and the Department of Treasury and Finance in negotiating the new
arrangements for health care funding.
These negotiations culminated at the November 2008 COAG meeting where new Federal State Financial
Arrangements were agreed. The intent of these reforms is to reduce the number of Specific Purpose
Payments provided to jurisdictions and to move the focus of these financial arrangements from an input
control focus to an outcome performance focus.
For health, the COAG meeting delivered four new agreements, an overarching National Healthcare Agreement
and three specific areas for reform through National Partnership Agreements.
The new National Healthcare Agreement sets out the key reform directions for the health system and
takes a whole of system approach, including performance not only in state areas of responsibility but also
the Australian Government and private sector. The National Healthcare Agreement also sets performance
benchmarks in the areas of prevention, hospital and related care, primary care and social inclusion and
Indigenous health.
The National Partnership Agreements focus on more discrete areas of intervention, and include rigorous
performance requirements. They focus on reform in the following areas:
> hospital and health workforce reform activity based funding, health workforce, sub acute care, and taking
pressure off public hospitals
> preventive health
> closing the gap on Indigenous health outcomes.
page 77Department of Health Annual Report 2008 09
National Health Professional Registration and
Accreditation Scheme
Following the signing of the Council of Australian Governments (COAG) Intergovernmental Agreement on
the health workforce on 26 March 2008, the Department of Health has been actively involved in working
collaboratively with other jurisdictions to create a single national registration and accreditation system for 10
health professions.
These professions include: chiropractors, dentists (including dental hygienists, dental prosthetists and
dental therapists), medical practitioners, nurses and midwives, optometrists, osteopaths, pharmacists,
physiotherapists, podiatrists, and psychologists. It was also agreed that from 2012 three additional professions
will be added to the scheme: Chinese medicine practitioners, Aboriginal and Torres Strait Islander clinical
health practitioners, and medical radiation practitioners. Subsequently, it has been agreed that occupational
therapists should be added to those to come into the scheme in 2012.
The new arrangement will help health professionals move around the country more easily, reduce red tape,
provide greater safeguards for the public and promote a more flexible, responsive and sustainable health
workforce. For example, the new scheme will maintain a public national register for each health profession
that will ensure that a professional who has been banned from practising in one place is unable to practise
elsewhere in Australia. The scheme will also require the registration of students in the health professions.
In 2008-09 the Department of Health participated in and actively supported the development of the
Health Practitioner Regulation (Administrative Arrangements) National Law 2008 which was assented to in
Queensland Parliament in November 2008. This legislation was the first stage in establishing the National
Registration and Accreditation Scheme, establishing the governance framework for the scheme. In June 2009
the exposure draft of the Health Practitioner Regulation National Law 2009 was released for consultation.
This second stage of the legislative process sets out the legal framework for the scheme, which, once passed
in Queensland Parliament, will be introduced into all parliaments across Australia, including South Australia, to
adopt the new national law so that the scheme can commence from 1 July 2010.
page 78 Department of Health Annual Report 2008 09
Health Workforce and Human Resource Activity
Health workforce plan
The shortage of health professionals in nursing, allied health and specific medical specialties presents an
ongoing challenge, particularly in country and some inner metropolitan areas. Changing patterns of work and
increasing numbers of part time workers further the need for additional health practitioners to provide the
required coverage of clinical services.
These are major challenges for South Australia given the long lead times required to train health professionals
and the approaching retirement of many in the workforce. The impact of the loss of older workers is more
acute in health than in other sectors as some clinical professionals require significant periods of supervised
clinical experience. Without sufficient numbers of experienced clinical supervisors, the capacity of the system
to both replace the loss, through increasing training numbers and expanding the workforce to meet demand,
is limited.
In environments where access to health workers is limited (especially rural and remote South Australia), the
importance of having a workforce with the right skills used to maximum effect is magnified. This is also the
case where population based health services are necessary, such as in mental health, where new models of
service provision may be required.
2008-09 saw a closer alignment between service planning and reform and workforce reform initiatives under
the SA Health Strategic Plan 2008-10. The Model of Care service reforms, along with the Department of
Health s commitment to the National COAG initiatives, are driving much of the workforce reform programs in
South Australia.
Organisational Change and Workforce Reform Committee
In 2008-09 the purpose and governance of the Department of Health s Workforce Reform Committees was
reviewed to enable optimal alignment between service reform and strategic workforce planning. Following
this review, the SA Health Workforce Strategy Committee was replaced by the Organisational Change and
Workforce Reform Committee (OCWRC). This committee has responsibility for systemic workforce reform,
leadership and advice in the context of SA Health s Patient Centred Model of Care.
The committee has representation from all major health professional groups and Regional Health Services.
The SA Health OCWRC will employ cultural change and workforce innovation approaches to ensure a safe,
efficient and effective work environment to attract and retain world class health professionals.
Workforce Reform Groups
There are seven Workforce Reform Groups that act as profession based subcommittees to the OCWRC:
> The Aboriginal Workforce Reform Group
> Mental Health Workforce Reform Group
> Medical and Dental Workforce Reform Group
> Corporate Workforce Reform Group
> Health Support Workforce Reform Group
> Nursing and Midwifery Workforce Reform Group
> Allied Health, Scientific and Complementary Workforce Reform Group.
Each of the Workforce Reform Groups has developed an action plan outlining key strategic responsibilities.
The chairs of the Workforce Reform Groups meet bi-monthly to ensure there is an interdisciplinary approach
to workforce reform.
page 79Department of Health Annual Report 2008 09
Medical, Nursing and Midwifery and Allied Health workforce strategies
The Department of Health has undertaken several initiatives across the medical, nursing and midwifery and
allied health workforce areas that contribute to workforce reform. These initiatives will help to deliver a strong
and capable workforce for the future.
Medical workforce
An increased number of medical graduates will start to enter the trainee workforce and the consultant
workforce, strengthening the ability to meet medical workforce requirements through home grown medical
graduates over the next decade. The Department of Health, in conjunction with the Australian Medical
Association (SA) and the Medical Board of South Australia, is focussing on ways of improving doctors health
to ensure a healthy workforce.
Recruitment
The Department of Health continued the Medical Careers Expo, highlighting future career opportunities in
South Australia for medical students and doctors in training. The Big Careers in Medicine Expo was held in the
Ridley Pavilion, Adelaide Event and Exhibition Centre, on 24 May 2009, attracting more than 200 attendees.
Training
The Department of Health supports doctors in training receiving training in the private sector as either a
component of their intern year or specialist training. South Australia remains at the forefront of this Australian
Government funded program.
The department continues to support learning and personal development of medical practitioners through the
Health LEADS program.
Nursing and Midwifery workforce
Two nursing and midwifery strategies (Delivering the Future and the Aboriginal Nursing and Midwifery
Strategy 2008-11) provide the foundation for building a valued and sustainable nursing and midwifery
workforce.
Nursing and Midwifery Practice Act 2008
Over the past year the Department of Health and major stakeholders have contributed to the development of
the Nursing and Midwifery Practice Act 2008 which was assented on 4 December 2008.
The primary purpose of the Act is to protect the health and safety of the public and to regulate the
provision of nursing and midwifery care for the purpose of maintaining high standards of competence and
conduct by nurses, midwives, students and services providers.
The provisions of the Act enable registration of nurses and midwives as separate groups within the broader
nursing and midwifery professions. In addition there are now separate student and removed person s
registers. The Act positions South Australia to develop systems and processes to assist with a successful
transition to the National Accreditation and Regulation Scheme in 2010.
Clinical Placement Project
The Department of Health Multidisciplinary Clinical Placement Project is undertaking mapping of placement
demand and capacity across the public and private sectors in South Australia. This work covers the placements
of more than 4 000 students. The project is progressing an enterprise wide public sector Memorandum of
Agreement for use by public health services with education providers requiring clinical placements. Supporting
business processes are also in development. The project is linking with the work of the new National Health
Workforce Taskforce on professional entry level clinical placements.
page 80 Department of Health Annual Report 2008 09
Transition to Practice Program for Mental Health Nurses
A new program, Transition to Practice Program for Mental Health Nurses, to support mental health nursing
graduates commenced in May 2009.
The program provides an opportunity for mental health nurse graduates to gain experience in mental health
nursing in their first year of practice. The program aims to support professional resilience, contemporary
practice and workforce development.
Evaluation tools will review the program s outcomes from the perspectives of graduates, clients and
service providers.
Vietnam partnership
In March 2009 a delegation from South Australia which included representatives from the Department of
Health and the university sector, the Nurses Board of South Australia and the Australian Nursing Federation
(SA) travelled to Vietnam to explore a working collaboration with the Vietnam Ministry of Health to develop
the capacity of registered nurses.
An in principle agreement was reached with the Vietnam Ministry of Health and senior health officials to work
with the South Australian partners to build capacity within the Vietnam nursing profession in the Da Nang
province. The key stakeholders of this collaboration are the Da Nang National Technical College of Medicine
No II, C Hospital Da Nang and Da Nang General Hospital.
The Vietnam partnership will provide support in the areas of developing:
> nurse educators/teachers
> nurse leadership/management
> English language proficiency.
A project management board has been established in conjunction with the partnership stakeholders to
progress the collaboration.
Allied Health workforce
The major focus during 2008-09 for the Allied and Scientific Health Office (ASHO), has been workforce
reform, communication and research.
Workforce reform
The Advanced and Extended Scope of Practice project to explore the potential for allied health assistants
(AHAs) commenced in July 2008. The project is determining the state of readiness for AHAs roles, and gaining
understanding of the supporting and inhibiting factors as they affect design, implementation, spread and
sustainability. This is being undertaken through the piloting of three advanced and extended scope of practice
roles and through the support of organisations and teams to develop the capacity to redesign roles in line with
new models of care and strategic plans.
The AHA project has seen 16 AHAs in 2008-09 successfully complete the Certificate IV in AHA (facilitated by
Royal Rehabilitation Centre, Sydney). Career pathway capabilities, skills sets and competencies that may be
encompassed within the work of assistants are being examined. ASHO is working to support existing AHAs to
attain qualifications and consider career advancement, recognising that the development of a capable support
workforce is important to meeting future health service needs.
The Country Health South Australia workforce project has been conducted to develop strategies to attract,
retain and support allied health workforce in country areas.
Initial research and framework development has commenced to meet national credentialing requirements for
the allied and scientific health workforce.
page 81Department of Health Annual Report 2008 09
A range of forums and communication networks have been developed and maintained to facilitate the
engagement of this diverse workforce in health reform initiatives, including statewide professional advisory
groups, task specific working parties and the Allied and Scientific Health web page.
In April 2009 the second Allied and Scientific Health Excellence Awards were held to recognise the significant
contribution from this part of the health workforce to clinical care, research and innovative practice. A total of
11 awards were presented.
Whilst the major focus of this project has been the development of a model for the use of Allied Health
Assistants in the public sector, work in 2009 has extended to the non government and private sector through
partnership with the SA Heath and Community Services Skills Board. Existing workers have had their skills
recognised and 27 students have enrolled in the Certificate III or IV in AHAs.
This project also focussed on attraction and promotion, resulting in the development of resources targeting
school students. SA Health s ASHO stand at the 2009 Careers Expo showcased a range of potential health
careers in science, technology, therapy or research. Through a partnership with the Vocational and Education
Training (VET) sector, the Department of Health is actively targeting school leavers to commence careers in
health as AHAs.
The Online Continuing Professional Development Program has been extended to allied and scientific health
staff within other government agencies. This program enables access to expert clinical presentations and
forums regardless of where practitioners work.
The collaborative partnership with the Centre for Allied Health Evidence supports the allied and scientific
health workforce to undertake research and to integrate evidence into practice. Journal Clubs have been
maintained and expanded, and were made available online in 2008-09. There has been a focus on translation
of evidence into practice through improved engagement of managers to ensure they understand the change
of service required once the evidence is sourced by the Journal Clubs.
ASHO co-authored Allied, Scientific and Complementary Health Professionals: A New Model for Australian
Allied Health , which appeared in Australian Health Review in February 2009.
Physician assistants
The Department of Health has been trialling the role of physician assistants in the South Australian public
health sector since late 2008. The physician assistants participating in the trial are qualified to practice under
the supervision of a registered medical practitioner. They are authorised to conduct physical examinations,
consult, diagnose and treat illnesses and assist in a wide range of procedures. This trial is currently being
evaluated by an independent, external evaluator.
Accredited training
In 2008-09 436 participants undertook accredited training delivered through the three Registered Training
Organisations funded by SA Health.
School to work Trade a Week of School: Experience Working in Allied Health
A one week Trade a Week pilot program was completed with the cooperation of the Allied Health
departments at the RAH and Hampstead Rehabilitation Centre. For one week in May 2009, a group of 10
high school students were offered the opportunity to experience work in allied health which included hands-
on activity, group work and observation of a range of both allied health professionals and assistants. The week
gave students a unique opportunity to see and experience allied health.
Careers in health
In response to predicted workforce shortages, strategies to attract and recruit new workers (particularly school
students) were implemented in 2009. With the changes to the SA Certificate of Education in 2009, many
schools are now supporting and delivering VET health qualifications to their year 10-12 students.
A careers booklet, postcard and accompanying CD were distributed to all secondary schools in South
Australia. These resources promote a wide variety of health careers that can be completed through VET.
page 82 Department of Health Annual Report 2008 09
Graduate recruitment
The Department of Health Graduate Recruitment Program provides a targeted and coordinated approach to
graduate recruitment. A six month competency based graduate development program offers participants an
introduction to the skills and knowledge required to work in a health environment. Graduates who complete
the program qualify for a nationally recognised Certificate III in Government. Twelve graduates completed the
program in 2008.
Attraction, retention and engagement strategy
A Workforce Strategy team was established in July 2008 to oversee the development of strategic initiatives to
improve the attraction, retention and engagement of workforce within SA Health.
A strategy has been developed with initiatives broadly addressing: promoting organisational directions,
data gathering, strategies for specific workforce cohorts and general attraction, retention and engagement
strategies.
One initiative completed in the 2008-09 year was the development and implementation of SA Health
Attendance Management Guidelines. These guidelines provide managers and employees with information
regarding their rights and responsibilities. They focus on manager behaviour and building relationships as a
key tool in improving employee attendance.
Industrial issues
Enterprise agreements were approved by the Industrial Relations Commission of South Australia for employees
covered by the Department of Health Salaried Medical Officers Enterprise Agreement 2008 and Department of
Health Clinical Academics Enterprise Agreement 2009. The agreements provide for, among other things: salary
increases; attractive professional development provisions; improved on call and recall provisions; attraction and
retention provisions for specialists; increases to paid maternity leave; and commitment to clinical change and
workforce reform to achieve ongoing health service improvement and particular strategic directions.
A negotiated settlement was reached with the Ambulance Employee Association to vary the classification
structure and rates of paramedics as a result of a work value case lodged in the Industrial Relations
Commission of South Australia. The settlement recognises the professionalisation of paramedics and
particularly SA Ambulance Service operation procedures that require and enable paramedics to undertake
clinical procedures.
page 83Department of Health Annual Report 2008 09
Employment arrangements as at 30 June 2009
The Department of Health s employment arrangements for the financial year 2008-09 as at 30 June are
represented in the tables below:
Table 7 Employee numbers, gender and status
Total number of employees
Persons 987
Full time equivalent 937.7
Gender % Persons % Full Time Equivalent (FTE)
Male 38.8 40.4
Female 61.2 59.7
Number of persons during the 08-09 financial year
Separated from the agency 130
Recruited to the agency 228
On leave without pay 30
Table 8 Number of employees by salary bracket
Salary Bracket Male Female Total
$0 - $47,999 37 84 121
$48,000 - $60,999 78 149 227
$61, 000- $78,199 138 221 359
$78,200 - $98,499 92 114 206
$98,500+ 38 36 74
Total 383 604 987
Table 9 Status of employees in current position
FTEs Ongoing Short-term contract Long-term contract Casual Total
Male 211.0 92.3 74.5 0.6 378.4
Female 373.8 104.7 79.3 1.4 559.2
Total 584.8 197.0 153.8 2.0 937.6
Persons Ongoing Short-term contract Long-term contract Casual Total
Male 212 94 76 1 383
Female 401 114 86 3 604
Total 613 208 162 4 987
page 84 Department of Health Annual Report 2008 09
Table 10 Executives by status in current position, gender and classification
Classification Ongoing Tenured Untenured Other Total
M F M F M F M F M F Total
EL0101 1 0 0 0 0 0 0 0 1 0 1
EXEC0A 0 0 1 0 5 0 0 0 6 0 6
EXEC0B 0 0 0 0 1 3 0 0 1 3 4
EXEC0C 0 0 0 0 1 0 0 0 1 0 1
EXEC0D 0 0 0 0 3 0 0 0 3 0 3
EXEC0F 0 0 0 0 1 0 0 0 1 0 1
SAES1 0 0 0 0 13 12 0 0 13 12 25
SAES2 0 0 0 0 5 3 0 0 5 3 8
Total 1 0 1 0 29 18 0 0 31 18 49
Note: M=Male, F=Female
Table 11 Average days leave per full time equivalent employee
Leave Type 2005-06 2006-07 2007-08 2008-09
Sick Leave 6.9 7.5 8.3 7.3
Family Carer s Leave 0.3 0.4 0.5 0.4
Miscellaneous Special Leave 7.0 0.8 0.9 0.8
Table 12 Aboriginal and/or Torres Strait Islander Employees
Salary Bracket ATSI staff Total staff % ATSI %Target*
$0 - $47,999 4 121 3.3 2
$48,000 - $60,999 4 227 1.8 2
$61, 000- $78,199 13 359 3.6 2
$78,200 - $98,499 5 206 2.4 2
$98,500+ 2 74 2.7 2
Total 28 987 2.8 2
Note: *Target from SASP
page 85Department of Health Annual Report 2008 09
Table 13 Number of employees by age bracket by gender
Age Bracket Male Female Total % of Total 2008 Workforce Benchmark %*
15 - 19 0 3 3 0.3 6.5
20 - 24 19 34 53 5.37 10.3
25 - 29 48 75 123 12.46 11.1
30 - 34 47 75 122 12.36 10.7
35 - 39 43 71 114 11.55 11.7
40 - 44 52 77 129 13.07 11.4
45 - 49 45 87 132 13.37 11.9
50 - 54 53 90 143 14.49 10.3
55 - 59 43 60 103 10.44 8.2
60 - 64 27 26 53 5.37 5.3
65+ 6 6 12 1.22 2.6
Total 383 604 987 100 100.0
*Source: Australian Bureau of Statistics Australian Demographic Statistics, 6291.0.55.001 Labour Force Status (ST LM8) by
sex, age, state, marital status employed total from Feb78 Supertable, South Australia at May 2009.
Table 14 Cultural and linguistic diversity
Name M F Total % of Agency %SA Community*
Number of Employees born overseas 81 129 210 21.28 20.3
Number of Employees who speak language(s)
35 61 96 9.73 16.6
other than English at home
* Benchmarks from ABS Publication Basic Community Profile (SA) Cat No. 2001.0, 2006 census.
Table 15 Number of employees with ongoing disabilities requiring workplace adaptation
Male Female Total % of Agency
6 12 18 1.82
Training and development
Leadership and management development
The Health LEADS programs commenced in 2007 and are offered on a centrally-funded basis to meet SA
Health s specific needs.
Health LEADS is a leadership development initiative that complements people s technical excellence with
enhanced leadership skills, allowing them to become well-rounded leaders.
This initiative links world-class leadership principles with the vision, goals and organisational context of SA Health.
Health LEADS will shape people, at all levels, to meet challenges into the future and help create a sustainable
health system through greater leadership capability.
The programs will be delivered for three successive years, with a yearly intake for each of the programs.
page 86 Department of Health Annual Report 2008 09
The two leadership and development programs are:
> Emerging LEADS program for new managers and future leaders
> Future LEADS program for individuals who are in senior clinical and executive roles.
All programs have four experiential workshops (across eight days during the year) and involve out-of-session
group activities and opportunities for self-paced learning.
The programs are limited to a maximum of 150 participants per year across SA Health, with 17 Department of
Health employees participating in 2008-09.
Leadership and management training expenditure
Table 16
Training and Development Total Cost % of Total DH Salary Expenditure
Total training and development expenditure $2 008 503 2.47%
Total leadership and management development expenditure $ 423 475 0.52%
Equal employment opportunity programs
The Department of Health utilises the South Australian Government s youth traineeship schemes and the
Indigenous employment and disability registers prior to vacancies being advertised
Table 17 Traineeships and Aboriginal cadetships
Traineeships* Aboriginal cadets**
Department of Health 3 0
SA Health 32 14
*Traineeships included clerical, aged care, allied health, information technology and dental assistant
**Aboriginal cadets undertook Certificate IV in enrolled nursing, neurophysiology, community services and /or mental health
Table 18 - Documented review of individual performance management
Documented review of individual performance management Total
% Reviewed within the last 12 months 12.46
% review older than 12 months 27.96
% Not reviewed 59.57
page 87Department of Health Annual Report 2008 09
Occupational Health Safety and Injury Management
There has been steady progress against the SA Health Portfolio Implementation Plan for the Safety in the
Public Sector 2007-2010 Strategy supported by significant input from Regional Health Services on a number
of improvement initiatives.
Key achievements for the Department of Health include:
> A review of the application of AS4360 (Risk Management) to the SA Health s achievement of T2.11
(Improving Wellbeing) of the South Australia s Strategic Plan.
> Launch and implementation of the policy and guidance materials aimed at managing violence and
aggression in health care.
> Launch of the inaugural SA Health workshop in November 2008 as part of SafeWork month events and the
coordination and support of SA Health entrants into the SafeWork Awards:
- An average of 56 delegates attended each workshop held at the Children, Youth and Woman s Health
Service, of which 75% of respondents stated that the workshop they attended would influence them to
make changes in their workplaces.
> The SafeWork Awards 2008 culminated in an award presentation dinner where the Minister for Industrial
Relations presented two SA Health winners with awards. The RGH won the Public Sector Leadership
Award for Injury Prevention and Management in recognition for its reduction in the number and
severity of workplace injuries over the past decade. These initiatives, including an onsite physiotherapy
treatment service, have helped deliver above-average return to work and rehabilitation outcomes for
hospital employees. BreastScreen SA was awarded a $10 000 Augusta Zadow Scholarship for a project
which identified the OHSW risks involved with emerging digital mammography technology, developing
and providing instruction in new techniques to manage these risks, and producing and distributing an
educational DVD on the safe ergonomic operation of this new equipment.
To manage operational risks, the Department of Health is also leading the following initiatives to improve
performance against the targets:
> Meeting regularly with senior OHSW and Injury Management (IM) managers from across SA Health to
discuss performance and intervention strategies.
> Leading the development of effective strategies to reduce or eliminate injuries associated with violence,
aggression or bullying in the workplace through the Safe Conduct and Respectful Behaviour Taskforce.
> Coordinating the implementation of the Public Sector Workforce Division long- term claims project into
SA Health.
> Providing quarterly and ad-hoc performance reporting to Regional Health Services.
> A working group is reviewing and standardising injury management documentation incorporating recent
changes to legislation.
Following completion in July 2010, a final evaluation report will be developed in consultation with Regional
Health Services which will identify priorities and objectives for the future SA Health OHSW and IM strategic plan.
page 88 Department of Health Annual Report 2008 09
Worker s Compensation
Recent improvement to workers compensation trends across the Department of Health (Table 19) is associated
with the increased focus on improving safety outcomes and evaluating and reporting performance.
Table 19 Agency gross workers compensation expenditure for 2008-09 compared with 2007-08
Expenditure 2008 09 ($) 2007 08 ($)
Variation
($) + (-)
% Change
+ (-)
Income Maintenance $41 344 $93 512 -$52 168 -55.8%
Lump Sum Settlements Redemptions Sect.42 $0 $0 $0 -
Lump Sum Settlements Permanent Disability Sect. 43 $15 525 $0 $15 525 -
Medical/Hospital Costs combined $28 499 $38 232 -$9 733 -25.5%
Other $59 698 $48 736 $10 962 22.5%
Total Claims Expenditure $145 067 $180 480 -$35 413 -19.6%
SA Health has decided to move to a single WorkCover registration and the negotiation of transitional
arrangements for the WorkCover evaluation program commencing in 2010 is a significant initiative which will
direct greater attention on the objectives and priorities contained in the SA Health Portfolio Implementation
Plan. A single registration will require Regional Health Services to focus on the continuous improvement of
safety management systems and progress including:
> A stock-take of current location registrations. The review has led to the exclusion of a number of sites which
do not form part of the SA Health governance structure, for example, Royal District Nursing Society and
Royal Society for the Blind of South Australia.
> Planning for the transfer of budgets from Regional Health Services to the Department of Health for
WorkCover registration levy payments for the 2009-10 financial year and beyond.
The Workforce Wellbeing and Safety Committee, and Health and Safety
Representatives Forum
The Department of Health s peak occupational health, safety and welfare committee provides an ongoing
strategic advisory capability to the Chief Executive. The focus of the Workforce Wellbeing and Safety
Committee in 2008-09 was the monitoring and reviewing of the departmental OHSW and IM Framework
and Implementation Plan 2008 10, ensuring the departmental plan meets the requirements of the Safety
in the Public Sector 2007-10 Strategy. This work will contribute to the department s WorkCover evaluation
scheduled in 2010.
The departmental Health and Safety Forum of elected health and safety representatives was instrumental
in influencing and supporting the departmental OHSW and IM Framework and SA Health Portfolio
Implementation Plan. The Forum was the consultative mechanism during the development and review of
policies and procedures.
page 89Department of Health Annual Report 2008 09
Training
The development of OHSW and IM leadership and capabilities is in line with identified priorities and was
supported through the delivery of information and training sessions. Key initiatives include:
> The Department of Health has initiated a series of OHSW related seminars. These have been developed with
a focus on creating a safety culture to deliver sustainable improvements to our organisation. The seminar
series will be sponsored by the Regional Health Services and will cover topics to support the new single SA
Health OHSW Management System. These seminars will commence in November 2009 and will enhance
the knowledge of all executives, senior management, and health and safety representatives who will be
encouraged to attend.
> Manager and supervisor OHSW and IM training sessions involving 179 Department of Health personnel
were delivered, where covered topics included: OHSW legislative framework, hazard management
techniques, policies and procedures, injury management and the role of the Employee Assistance Program.
Employee Assistance Program
The Employee Assistance Program (EAP) continued to be available for all Department of Health employees.
EAP offers an independent, confidential and culturally sensitive counselling service to employees and their
families on a 24 hour, seven day basis.
> A total of 86 new referrals were made to the service which resulted in 183 counselling sessions.
> Services used were for mediation, consultancy advisory services, management advisory and training sessions.
Approximately 60% of services were for personal related issues and 40% for work related matters.
Safety and performance
During the year there were no notifiable injuries or occurrences, or notices served pursuant to the
Occupational Health Safety and Welfare Act 1986 or the Occupational Health Safety and Welfare Regulations
1992 (Table 20)
While the Department of Health met some of its safety and performance targets against the Safety in the
Public Sector 2007-2010 Strategy (Table 21), it should be noted that the Department of Health is a relatively
small administrative unit with a low threshold number of claims in any specific injury year. As a consequence,
minor variations in performance have a significant impact on target achievement relative to larger
administrative units. Target achievement is impacted by the small sample size.
Table 20 OHS notices and corrective action taken
Number of notifiable occurrences pursuant to OHS&W Regulations Division 6.6 Nil
Number of notifiable injuries pursuant to OHS&W Regulations Division 6.6 Nil
Number of notices served pursuant to OHS&W Act s35, s39 and s40 (default, improvement and
prohibition notices)
Nil
page 90 Department of Health Annual Report 2008 09
Table 21 Meeting safety performance targets
Base:
2005-06
Performance: 12 months to
end of June 2009*
Final Target
Notional
No. or % Actual Quarterly Variation No. or %
Target**
1. Workplace Fatalities 0 0 0 ? 0 0
2. New Workplace Injury Claims 9 8 8 ? 0 7
3. New Workplace Injury Claims
Frequency Rate
6.1 5.9 5.2 ? 0.8 4.9
4. Lost Time Injury Frequency Rate*** 1.3 3.7 1.1 ? 2.5 1.1
5. New Psychological Injury Claims 1 1 1 ? 0 1
6. Rehabilitation and Return to Work:
6a. Early Assessment within 2 days 88.9% 12.5% 80% ? -67.5% 80% or more
6b. Early Intervention within 5 days 100% 100% 80% ? 20.0% 80% or more
6c. RTW within 5 business days 62.5% 37.5% 75% ? -37.5% 75% or more
7. Claim Determination
7a. Claims determined in 10 business
days
66.7% 33.3% 75% ? -41.7% 75% or more
7b. Claims still to be determined after 3
months
0% 22.2% 3% ? 19.2% 3% or less
8. Income Maintenance Payments for
Recent Injuries:
2007 08 Injuries (at 24 months
development)
NA $22 732 $24 975 ? -$2,243 Below previous
2 years average
2008 09 Injuries (at 12 months
development)
NA $15 152 $14 823 ? $328 Below previous
2 years average
* Except for Target 8, which is YTD. For Targets 5, 6c, 7a and 7b, performance is measured up to the previous quarter to
allow reporting lag.
** Based on cumulative reduction from base at a constant quarterly figure.
***Lost Time Injury Frequency Rate Injury frequency rate for new lost-time injury/disease for each one million hours worked.
This frequency rate is calculated for benchmarking and is used by the WorkCover Corporation.
Lost Time Injury frequency rate (new claims): Number of new cases of lost-time injury/disease for year x 1 000 000
Number of hours worked in the year.
page 91Department of Health Annual Report 2008 09
Carers Recognition Act 2005
The Carers Recognition Act 2005 requires all South Australian Government agencies to ensure that their
organisation and its employees take action to reflect the principles of the Carers Charter in the provision of
services to carers and the people they care for. South Australian Government Portfolio Chief Executives are
required to report annually on their progress in implementing the SA Carers Policy through annual progress
reports to the DFC and through their annual reports.
The Department of Health s progress in implementing the SA Carers Policy for 2008-09 includes the following:
> The department has continued to liaise with the DFC and is represented on the SA Carers Reference
Group and the Across-Government Implementation Group. This provides a forum for discussion with other
government agencies and carer organisations on issues affecting carers.
> Performance agreements with the health regions and the SA Ambulance Service require the implementation
of the Carers Policy and the provision of annual progress reports on implementation to the Department of
Health by 31 July each year.
> The SA Health annual progress report outlines the actions the Department of Health, the Regional Health
Services and SA Ambulance Service have taken to support the SA Carers Recognition Act 2005 in 2008-09.
The report is provided to the DFC in September 2009.
Provision of services to carers and the people they care for:
> SA Health considers carers during strategic planning, program and service planning. The department works
with the Regional Health Services to ensure the carer perspective, consultation with carers and carer support
is included in service delivery, particularly with regard to clinical service reform and primary health care
programs that focus on hospital alternatives, home support, discharge planning and transitional care.
> Service planning and service provision across SA Health includes consideration of the particular needs of
Aboriginal and young carers to ensure their needs are identified and supported.
> The Mental Health Unit within the Department of Health has appointed a consumer consultant and a carer
consultant to provide consumer and carer perspectives on issues in the development and implementation of
policy and service delivery that best meets the needs of consumers and carers.
For employees who are carers:
> Staff orientation sessions include information on support for carers and Carers SA is invited to be present to
provide advice to interested employees.
> Carers Week was celebrated with a morning tea at which the Chief Executive acknowledged the important
role that carers play in our community and the importance of the workplace actively supporting them, both
as employees and consumers.
> A register of carers has been established to provide information relevant to carers including information
about sessions held for carers by community organisations. Carers on the register are regularly consulted
about relevant policy development to ensure their needs are reflected.
> An information brochure specifically for carers is being developed.
> A range of flexible work practice policies are already in place and accessed by carers and a range of health
and wellbeing initiatives are offered to all staff, including carers, to improve their own wellbeing.
page 92 Department of Health Annual Report 2008 09
Disability Action Plan
The Promoting Independence Disability Action Plans for SA (2000) document provides a policy framework for
all South Australian Government portfolios and their agencies to develop Disability Action Plans.
The Department of Health s progress in implementing the key outcome areas in 2008-09 includes:
Ensure accessibility to their services to people with disabilities
The SA Health Disability Action Plan (2008) was updated to take account of the change in governance when
the Health Care Act 2008 came into effect on 1 July 2008 and was released in July 2008. It gives direction for
the Department of Health, the Regional Health Services and the SA Ambulance Service to develop strategies
and actions to eliminate practices that discriminate against people with disabilities who use or are employees
of health services.
The majority of Department of Health owned buildings were designed historically to provide a high level of
access as part of their functional design brief. Access specific budgets are not allocated from the Department
of Health capital programs but the department has an ongoing coordinating role that integrates resources
for disability access assessment into both current and proposed capital works programs on an ongoing basis.
Disability access is also incorporated in design planning for building refurbishments.
Ensure information about their services and programs is inclusive of people
with disabilities
The Department of Health works across SA Health to provide advice and support in relation to printed
publications, information and electronic communications, including how information can be provided in a
range of formats to people with disabilities. This includes audio-cassette, Braille, diskette, large and illustrated
print, plain English, internet (utilising non-discriminatory information technology), radio, video (including
captions), free call telephone numbers, telephone typewriter, and National Relay Service. In addition, people
who are deaf or have hearing impairment have access to appropriate interpreters.
The department s Online Services Project has identified disability access as a high requirement and this will be
included in the design and build phases of the project. This includes both services to the public through the
internet and to SA Health through the intranet.
Deliver advice or services to people with disabilities with awareness and
understanding of issues affecting people with disabilities
In 2008-09 the department developed an on-line disability awareness training program. All Department of
Health staff will be required to undertake this training.
page 93Department of Health Annual Report 2008 09
Provide opportunities for consultation with people with disabilities in decision
making processes regarding service delivery and in the implementation of
complaints and grievance mechanisms
SA Health promotes complaints processes through its publication, Your Rights and Responsibilities and
also through the Health and Community Services Complaints Commissioner. Consumers of public, non
government and private health or community services, including consumers with disabilities, can make a
complaint to the Commissioner.
Each portfolio chief executive will ensure that their portfolio has met
the requirements of the Disability Discrimination Act 1992 and the Equal
Opportunity Act 1984
The SA Health Disability Action Plan (2008) requires the Department of Health, the Regional Health Services
and the SA Ambulance Service to meet the requirements of the Disability Discrimination Act and the Equal
Opportunity Act.
A consolidated SA Health progress report will be sent to the Department for Families and Communities in
August 2009 for inclusion in the South Australian Government report.
Portfolio and their agencies to explore how they can meet the South
Australian Strategic Plan Target (T6.22) to double the number of people with
disabilities employed in the public sector by 2014
Refer to the report on the South Australia s Strategic Plan target T6.22 Diversity in the public sector people
with disabilities in this document.
page 94 Department of Health Annual Report 2008 09
Reconciliation
SA Health is committed to reconciliation and working towards a united Australia. The SA Health Reconciliation
Working Group comprises executives and senior officers from across the Department of Health and Regional
Health Services and takes responsibility for developing and implementing strategic reconciliation initiatives.
The Department of Health also contributes to reconciliation at a wider government level and is a member of
the South Australian Government Reconciliation Reference Committee.
As a portfolio, the SA Health Statement of Reconciliation formalises our commitment to reconciliation and
to improving the cultural, spiritual, physical, emotional, social and economic wellbeing of Indigenous South
Australians. The statement is displayed prominently in SA Health locations including regional offices, health
services divisions, branches and units.
To guide our efforts towards reconciliation, and translate the commitments made in the Statement of
Reconciliation to action, we have developed the SA Health Reconciliation Action Plan 2008-10. 2008-09
marked the first complete operational and reporting period for the plan.
The plan includes six destinations as the critical outcomes to be achieved, a range of activities that can be
undertaken to help achieve the destinations, and the landmarks (performance indicators) that will inform us
about progress. The plan confirms that reconciliation is a joint responsibility shared by everyone in SA Health.
The six destinations are:
> Broader opportunities for Aboriginal people to pursue better health
> Enhanced respect and understanding of cultural diversity within work environments as well as the
general community
> Meaningful partnership with Aboriginal communities and other stakeholders in the planning, design,
implementation, delivery and evaluation of services to Aboriginal individuals and families
> Developing strong Aboriginal community leadership
> Developed Aboriginal labour force to enhance workforce capacity
> Support SA Health commitment to reconciliation.
Throughout 2008-09 the department and Regional Health Services have undertaken a range of activities to
progress the destinations of the Reconciliation Action Plan. The SA Health Reconciliation Working Group is
considering providing Indigenous cultural awareness training for SA Health.
Every year Reconciliation Week is celebrated nationally in May-June. This is a time to reflect on the
achievements to bring together Indigenous and other Australians, and to consider future opportunities to
achieve reconciliation in Australia.
A range of events were held by the department and Regional Health Services during 2009 Reconciliation
Week, including DVD screenings and morning teas for staff and community members. In addition, the
Department of Health organised a series of cultural walks along the Kaurna walking trail open to government
employees, as a contribution to the government s calendar of reconciliation events.
page 95Department of Health Annual Report 2008 09
Environmental Reports
Greening of Government, Sustainability Reporting and Energy
Efficiency Action Plan
The following report comprises an overview of SA Health s progress in implementing the Cabinet endorsed
Greening of Government (GoGO) Action Plan (2006) and the Energy Efficiency Action Plan (2001).
Eight key strategic milestones have been established for agencies to work towards. The table below shows
progress against these strategic milestones.
Table 22 Eight strategic milestones
Greening of Government
Strategic milestones Status as at June 30 2009
1
Established Chief Executive Statement of
Commitment to greening of agency operations
Completed
2
Allocated resources to set up governance and
initiate internal review
Completed
3
Completed initial review of environmental
impacts and determined priorities and allocated
resources
Initial review completed. A broader and more sophisticated whole-of
-health carbon footprint analysis is currently being progressed with
a draft report scheduled for the review of the Health GoGO Steering
Committee during 2009-10
Energy and water efficiency targets have been developed for all
4 Set performance goals/internal targets
major SA Health facilities. Formal waste management target for
acute care facilities are being developed as part of a whole-of-health
waste management review to be completed in 2010
An Energy Efficiency Implementation Plan has been developed and
5
Approved agency implementation plan and
communication plan
formally endorsed by the GoGO Steering Committee and the Chief
Executive. A Draft GoGO Implementation Plan has been developed
and is undergoing further refinement prior to seeking formal
executive endorsement during 2009-10
6
Reported on status/progress in reaching
performance goals/targets
Compliance with the energy and water efficiency targets established
for all major facilities is regularly reviewed as part of the work of the
SA Health GoGO Steering Committee
Many elements of the department s 2009 Energy Efficiency
7 Initiated agency Implementation Plan Implementation Plan have been put into effect, with further progress
expected to occur over forthcoming years
8
Undertaking ongoing measuring, monitoring,
reporting and continuous improvement of
performance
Systems are in place for measuring and reporting on performance in
achieving the energy and water efficiency targets
Our progress toward delivering on sustainability is addressed through the various priority areas for action
established in the GoGO Action Plan including:
> energy
> water
> waste
> green buildings
> travel and fleet management
> green procurement.
page 96 Department of Health Annual Report 2008 09
GoGO Priority Area 1: Energy
In November 2001 the South Australian Government approved the Government Energy Efficiency Action Plan,
a comprehensive whole of government energy management program targeted to improve energy efficiency
across all sectors of government s operations. This initiative is an integral part of the National Greenhouse
Strategy and incorporates the South Australian Government s State Strategic Plan target (T3.13) to improve
the energy efficiency of government buildings by 25 percent from 2000-01 levels by 2014 .
SA Health is a very large consumer of gas and electricity, accounting for approximately 51% of all building
energy consumed by the government sector in South Australia. As such, it is recognised as one of the key
portfolios in determining whether this ambitious target will be achieved. The table below provides energy use
information for all building energy consumed by the SA Health in the period 2000-01 through to 2008-09.
Table 23 Department of Health building energy consumption 2008-09
Absolute Totals Energy Efficiency
Square Metres Occupied Bed Days FTEs
Year
Total
Energy GJ
GJ
change
as a
% of
2000
01
Spend $
Square
metres
Gj/m2
Change
as a %
of 2000
01
OBD s
GJ
per
OBD
Change
from
2000
01
FTE s
GJ
per
FTE.
Change
as a %
of 2000
01
Health
Units
1,250,165 17,479,410 950,943 1.31 1,470,350 0.85 21,127 59.2
Base year
2000-01
SAAS
Office
6,700
6,935
260,652
313,755
na
21,876 0.32
na
na
673
813
10
8.5
Total 1,263,800 18,053,817 980,703 1.27 1,470,425 0.85 22,613 56
Health
Units
1,215,253 -3% 29,024,560 1,082,929 1.12 -15% 1,598,000 0.76 -11% 26,812 45.3 -23%
2008-09 SAAS 8,879 33% 389,924 1,138 7.8 -22%
Office 5,851 -16% 338,573 20,378 0.29 -9% 938 6.2 -27%
Total 1,229,983 -2.68% 29,753,057 1,103,307 1.10 -14% 1,598,000 0.76 -11% 28,887 42.6 -24%
SASP
Target:
Minus
25% by
2014
Health
Units
SASS
Office
Total
0.99
0.24
0.96
-25%
-25%
-25%
0.64
0.64
-25%
-25%
44.4
7.5
6.4
41.92
-25%
-25%
-25%
-25%
page 97Department of Health Annual Report 2008 09
Progress towards 25% energy efficiency target
In absolute terms, SA Health consumed 2.68% less energy in 2008-09 than it did in the 2000-01 baseline.
However, absolute energy consumption is not a measure of energy efficiency. Rather, energy efficiency is
determined by reference to energy use per some form of business output or other business measure.
> Square metres: Energy use per square metres of occupied space is widely recognised as perhaps the best
measure of the energy efficiency of hospitals and overnight stay facilities. Energy use per square metre
(m2) of occupied healthcare space was 1.12 GJ/m2 in 2008-09, down from 1.31 GJ/m2 in 2000-01. This
represents an improvement of 14%.
> Occupied bed days (OBD): Average energy use per OBD in 2008-09 was 0.76 GJ, down from a 0.85 GJ in
2000-01. This represents an improvement in energy efficiency of 11% on this measure.
> FTEs: SA Health energy use per FTE in 2008-09 was 46 GJ, down from 56 GJ per FTE in 2000-01. This
represents an improvement in energy efficiency per FTE of 24%.
The above three methods for assessing energy efficiency suggest SA Health is progressing well in pursuit of
the 25 percent reduction by 2014 target. It should be noted that progress toward the target is not expected
to be linear.
Achievement of the full 25% efficiency target will be largely contingent on the success of the major ongoing
redevelopment projects at TQEH, LMH, FMC and Glenside Campus. Cumulatively these sites account for 28%
of SA Health s baseline energy use. Full achievement of the energy efficiency targets established for these sites
would improve SA Health energy efficiency by a further 7% by 2014.
In addition, there are other energy saving initiatives currently funded or part of other redevelopment projects
such as the Glenside Campus redevelopment, the SA Health Medical Research Institute, the GP Plus projects
and the upgrades at Berri, Ceduna and Whyalla Hospitals that will likely deliver further significant energy
efficiency gains across SA Health. The current estimate is that cumulatively these projects have the potential
to deliver an additional 2-4% improvement in SA Health s energy efficiency performance.
The RAH, which currently consumes 22% of the Health portfolio s energy use, will be replaced in 2016. The
new RAH is targeting to use less than half the energy of the current RAH. If this target is achieved, this project
will improve SA Health s energy efficiency by approximately 11%. However, this will not be delivered until
2016, two years after the target date established for SASP T 3.13 to be achieved by (2014).
Energy efficiency highlights 2008-09
Energy and water saving fund (EWSF): A total of $600 000 was allocated from the Department of
Health 2008-09 minor works program for EWSF projects (allocated on dollar-for-dollar basis, with additional
funding to be provided by Regional Health Services, bringing the total value of initiatives to $1.2 million). The
projects funded through the 2008-09 EWSF include additional solar hot water services at Port Pirie, Gawler
and Noarlunga hospitals, a combined lighting, water saving and air-conditioning improvement project at
SA Pathology s Frome Rd campus and a facility wide lighting upgrade at the SA Ambulance Service s main
administration buildings.
FMC redevelopment: The FMC redevelopment, which will be completed in 2012-13, should see site wide
energy efficiency improvement from the 2000-01 baseline by 25%. As at July 2009, energy use per square
metre (MJ/m2/p.a) at FMC has fallen by 9% while energy efficiency per OBD has improved by 34% since
2000-01. Significant additional energy efficiency gains are expected to be achieved as the redevelopment
continues through to 2012-13.
Citi Centre: Three of the 10 floors of SA Health s Citi Centre building underwent a lighting upgrade during
2008-09. Lighting energy consumption on these three floors is calculated to be reduced by 35%.
page 98 Department of Health Annual Report 2008 09
Solar hot water (SHW):
> During 2008-09 the largest SHW water array in South Australia was installed at FMC.
> SHW was installed on an additional four country hospitals in 2008-09. At present, approximately two thirds
of all country and regional hospitals and three of the seven major metropolitan sites (LMH, RGH and FMC)
have SHW installed.
> The Glenside and TQEH campuses will also have SHW progressively installed as part of their ongoing
redevelopments. Additional SHW capacity will also be installed at LMH as part of the next stage of its
redevelopment.
GoGO Priority Area 2: Water
Since 2003-04 SA Health water use at its 62 major water consuming sites has fallen by 18%, from
1 559 216 kilolitres (kl) in 2003-04 to 1 344 583 kl in 2008-09.
Figure 28 Department of Health water consumption comparison
K
ilo
lit
re
s
p.
a
0
1 800 000
1 600 000
1 400 000
1 200 000
1 000 000
800 000
600 000
400 000
200 000
Year
2003-04 2004-05 2005-06 2006-07 2007-08 2008-09
page 99Department of Health Annual Report 2008 09
Water efficiency highlights 2008-09
Installation of rainwater tanks and high efficiency plumbing fixtures has become standard practice for SA
Health redevelopments. Examples of this policy during 2008-09 include:
> During 2008-09 rainwater tanks were connected to seven additional Country Health SA hospitals (Cowell,
Cleve, Kimba, Booleroo, Quorn, Orroroo and Streaky Bay). Combined additional rainwater storage capacity
at these sites is 1708 kl (1.7 million litres). Rainwater from these tanks is passed through UV filtration and
blended with the existing hospital filtered water system to feed hot water services.
> As at 2008-09, more than 85% of country acute care facilities capture and reuse rainwater.
> As part of the FMC redevelopment, the following water efficiency initiatives were installed during 2008-09:
- A 300 kl rainwater tank, treatment and reuse system was installed.
- Reject water form the reverse osmosis plant is to be captured for reuse for toilet flushing.
- Recovery of all new-build stormwater for reuse within the facility to minimise consumption.
- High efficiency sanitary fixtures and fittings selected (minimum four stars under the Water Efficiency
Labelling Scheme).
- Landscaping designed for ultra low water use.
- Fire services water consumption minimised by capturing and reusing system test water.
- Sub-meters installed in selected locations to enhance water management capacities.
- New generation highly water efficient cooling towers, which use approximately one sixth the water of
conventional cooling towers, were commissioned during 2008-09. It is estimated these cooling towers
will reduce FMC water consumption by approximately 20%.
New ultra low use urinals (as opposed to fully water urinals) were trialled on selected urinals at both the TQEH
and in Citi Centre during 2008-09. Early indications are that this system delivers substantial water savings
without compromising user amenity. Consideration will be given to rolling out this technology more broadly
across SA Health in coming years.
GoGO Priority Area 3: Waste
Highlights 2008-09:
> Waste management and waste minimisation during construction and deconstruction continues to be a
major focus for all SA Health redevelopments (with a 2002 Zero Waste South Australia audit suggesting that
approximately 50% of waste to landfill in Adelaide was construction waste). Recent projects, including the
TQEH Stage 2 Inpatients and FMC New South Wing projects, achieved recycling rates of construction waste
(by weight) of above 90%. Similar targets have been established for all future SA Health redevelopments.
> During 2008-09 work continued on the complex task of establishing waste benchmarks and consistent
waste monitoring and reporting formats for major SA Health facilities. It is anticipated that waste
benchmarks and reduction targets will be established for all major SA Health facilities during 2009-10.
GoGO Priority area 4: Built facilities
Highlights 2008-09:
> The FMC New South Wing is targeting a five star facility as measured by the GreenStar Healthcare rating
tool. A five star target has also been specified for the following projects: Ceduna District Health Service
redevelopment; Glenside Campus redevelopment; the Marion and Elizabeth GP Plus centres; and the
remaining stages of the TQEH and LMH redevelopments.
> SA Health, in collaboration with Victorian Department of Human Services and the Australian Capital
Territory Department of Health, commenced a project in 2008-09 to comprehensively evaluate the cost
and benefits (both financial and environmental) of specifying various GreenStar Healthcare ratings for
future redevelopments (four, five and six stars). It is anticipated that this cost benefits analysis will lead
to a consistent policy in regard to the use of GreenStar rating tools or similar on future healthcare
building projects.
page 100 Department of Health Annual Report 2008 09
GoGO Priority Area 5: Travel and fleet
> There is a continued focus on increasing the use of four cylinder and hybrid vehicles in the SA Health fleet.
This is reflected in a significant increase in both categories.
Table 24 Composition of Department of Health fleet vehicles 2008-09
Composition of Health fleet vehicles (excluding ambulances) 2004-05 to 2008-09.
2004-05 2005-06 2006-07 2007-08 2008-09
% change from
2004-05
Change in composition of fleet
4cyl passenger 228 331 459 456 617 171%
6cyl passenger 1,300 1,244 1,155 993 842 -35%
Hybrid - Petrol/Electric 2 3 14 52 100 4900%
Other 210 247 244 235 266 27%
Total 1,740 1,825 1,872 1,735 1,825 5%
Corporate staff travel survey
In 2008-09 the Department of Health, in conjunction with the TravelSmart program, undertook a survey
of travel behaviour and modal choice for Department of Health CBD employees. The results of this survey
(completed by 55% of staff) were collated into a report in late 2008-09. The recommendations from this
report are currently being reviewed for possible implementation to both encourage more environmentally
supportive travel behaviours and, where relevant, reduce the cost of travel to the department.
Figure 29 shows that as at March 2009, the Department of Health s CBD workforce modal choice for journey
to and from work is considerably more environmentally supportive than the national average.
Figure 29 Department of Health travel choice for CBD workers journey to work
70%
60%
50%
40%
30%
20%
10%
0%
Motor vehicle Public Transport Bicycle/walk
38%
58%
53%
36%
9% 7%
Department of Health (Travel survey results 2009)
National Average (ABS 2007)
Department of Health Annual Report 2008 09 page 101
GoGO Priority Area 6: Procurement
Highlights 2008-09:
SA Health embarked on a major reform of its procurement and supply chain activities which will see a
consolidation of procurement, contracting and supply chain service across the portfolio. The consolidation
of procurement services will support a consistent approach to environmental sustainability in procurement
practices. During 2009-10 the supply chain consolidation project team, led by the Strategic Procurement Unit,
will work closely with relevant bodies to develop sustainable procurement guidelines, polices and training
modules.
> Environmental sustainability is a key consideration in the selection of building materials, loose furniture,
equipment and fittings for SA Health redevelopments. The GreenStar Healthcare tool is used on
redevelopment projects to assist in balancing the many sustainability issues associated with materials and
equipment selection. Criteria established and assessed using GreenStar include:
- proportion of recycled content
- reduced water and energy consumption
- indoor air quality implications
- product stewardship (for example wood from sustainably managed plantations)
- whole of life impacts (including manufacturing process, disposability, reusability, durability and
maintainability)
- minimisation of packaging
- embodied energy (for example, use of fly ash as a substitute for cement in concrete).
page 102 Department of Health Annual Report 2008 09
Asbestos management
The Cabinet guidelines for Asbestos Management in Government Buildings and the use of pre-qualified
asbestos removal contractors has enabled the continuing management and removal of asbestos by SA Health.
During 2008-09 SA Health continued the process of recording asbestos registers in the Strategic Asset
Management Information System to improve reporting and monitoring. This process has resulted in a large
increase in the number of non residential sites being identified as containing asbestos.
For those facilities containing asbestos, the material is removed as part of any redevelopment works in the
areas being upgraded. For other facilities not being redeveloped, funding may be available from the annual
compliance program. In 2008-09 this included removal of asbestos from Jamestown and Booleroo Country
Hospitals and Modbury Hospital.
The data included in Tables 25 and 26 reflect the current status of all non residential and residential SA Health
buildings for which an asbestos register exists.
Table 25 Residential asbestos management report 2008-09
Health (Residential) : Asbestos management report 2008-09
Number of Sites
At start At end of Category Interpretation
Category of year year Description One or more item(s) at these sites
1 0 0 Remove should be removed promptly
2 1 1 Remove as soon as practicable
should be scheduled for removal at a
practicable time
3 1 4 Use care during maintenance
may need removal during maintenance
works
4 0 0 Monitor condition
has asbestos present. Inspect according to
legislation and policy
5 0 0
No asbestos identified / identified
asbestos has been removed
(All asbestos identified as per OHS&W
4.2.10(1) has been removed)
6 99 96 Further information required (These sites not yet categorised)
Definitions:
Category: The site performance score, determined by the lowest item performance score at each site.
Number of Sites in Category: A count of how many sites have the corresponding site performance score, with separate
counts done at the start and the end of each year.
Category Description: Indicates the recommended action corresponding to the lowest item performance score (recorded in
the asbestos register by a competent person, as per OHS & W Regulations (SA) 1995, 4.2.10).
Interpretation: A brief real world example of what each category implies for a site.
page 103Department of Health Annual Report 2008 09
Table 26 Non-residential asbestos management report 2008-09
Health (Non-Residential) : Asbestos management report 2008-09
Number of Sites
At start At end of Category Interpretation
Category of year year Description One or more item(s) at these sites
1 7 3 Remove should be removed promptly
2 21 9 Remove as soon as practicable
should be scheduled for removal at a
practicable time
3 52 11 Use care during maintenance
may need removal during
maintenance works
4 93 6 Monitor condition
has asbestos present. Inspect according to
legislation and policy
5 13 0
No asbestos identified / identified
asbestos has been removed
(All asbestos identified as per OHS&W
4.2.10(1) has been removed)
6 108 260 Further information required (These sites not yet categorised)
Definitions:
Category: The site performance score, determined by the lowest item performance score at each site.
Number of Sites in Category: A count of how many sites have the corresponding site performance score, with separate
counts done at the start and the end of each year.
Category Description: Indicates the recommended action corresponding to the lowest item performance score (recorded in
the asbestos register by a competent person, as per OHS & W Regulations (SA) 1995, 4.2.10).
Interpretation: A brief real world example of what each category implies for a site.
page 104 Department of Health Annual Report 2008 09
South Australian Urban Design Charter
In 2008 SA Health released Master Plans for two key projects which comply with the South Australian Urban
Design Charter. These Master Plans are for the Glenside Campus Redevelopment (released April 2008) and the
new Royal Adelaide Hospital Precinct (released August 2008).
Glenside Campus redevelopment
The redevelopment of the Glenside Campus will focus on the delivery of improved mental health and
substance abuse services that are better integrated with the broader community.
The redevelopment of this site will bring together a variety of land uses on the Glenside Campus, including
state-of-the-art health care facilities that provide for new clinical models of care in a way that is integrated
with retail and commercial activities, housing, a cultural hub and significant usable public open space.
As many as possible of the existing trees on site will be retained and other green areas will be increased as
part of the redevelopment, including a new wetlands area which is likely to provide additional habitat for
native birds, terrestrial, aquatic species and an ideal location for further native tree planting.
There are 11 buildings and a wall on the campus which are included on the State Heritage Register and these
will all be retained. The iconic heritage buildings located in the centre of the site will form the core of the
cultural precinct.
The government is also committed to providing affordable housing on the Glenside Campus.
The new Royal Adelaide Hospital
In June 2007, the South Australian Government announced an investment of $1.7 billion over the next
decade to build Australia s most advanced hospital to replace the ageing RAH.
The new RAH will be built next to the Adelaide Railway Station and will be a stunning addition to the west
end precinct. It will create opportunities for other developments and contribute to the rejuvenation of the
west end by creating additional public open space and enhancing the River Torrens Linear Park.
The decommissioning of the existing RAH is also expected to return a portion of this site to parklands.
The new RAH will be one of the greenest major developments in the nation, with the strongest environmental
codes guiding its design and construction. It will optimise energy and water efficiency in building and
landscape design, as well as established techniques such as solar orientation and storm water reuse and will
result in the rehabilitation of the site.
page 105Department of Health Annual Report 2008 09
Freedom of Information
Information statement
The Freedom of Information Act 1991 gives members of the public a legally enforceable right to access
information held by the South Australian Government, subject to certain restrictions.
Functions of the department affecting the public
The major interface of the Department of Health with the public involves setting the policy framework for
health care and delivering services in public and environmental health, health prevention and promotion,
and hospital and community services.
Public participation
The public can contribute to policy development within the Department of Health in a number of ways.
External expertise and policy advice is sought through statutory and non statutory advisory committees,
comprising both government and non government representatives. Advice is taken from peak non
government organisations and a consultative process may be undertaken in the planning, development and
implementation of policy.
The Department of Health consults with major consumer groups, circulates discussion papers, calls for
submissions on particular topics and convenes public meetings regarding legislative reform and impacts within
metropolitan and country areas. Community input is generally sought prior to implementation of decisions
relating to planning, development and evaluation of services.
These processes facilitate access to services and assist informed decisions about health.
Types of documents held
The Department of Health holds various health publications including administrative files, books, discussion
and background papers, reports, reviews, serial publications, pamphlets, codes of practice, surveys, guidelines,
policies, programs, strategies, directories, evaluations and assessments and proposals. Other documents held
include procedure manuals, administrative circulars on general management, finance, staffing, plant and
equipment, property and motor vehicles, and industrial circulars.
The internet site at www.health.sa.gov.au provides an overview of the department s roles and functions and
contains media releases, service provider details, publications and news items.
The constitutions of hospitals and health centres incorporated under the Health Care Act 2008 may be
inspected in the Legal and Governance Unit, 11 Hindmarsh Square, Adelaide (telephone: 8226 6178).
The RAH/SA Pathology library is the first point of contact for policies and documents. The library keeps
information on where publications are stored and whether they are free, for sale, or accessible for inspection.
Access to documents can be arranged by contacting the library. The address of the library is:
RAH/SA Pathology Library
Level 1, Eleanor Harrald Building
Frome Road, Adelaide
(PO Box 14, Rundle Mall, Adelaide, South Australia 5000)
Telephone:08 8222 4163 or 08 8222 3134
Facsimile: 08 8222 3152
SA Health publications archive is available at:
http://www.publications.health.sa.gov.au
page 106 Department of Health Annual Report 2008 09
Arrangements and procedures for seeking access to records and policies
Applications for access to information under the Freedom of Information Act 1991 including purchase costs
or amendment of the Department of Health s records should be addressed to:
The Principal Project Officer FOI
Office of the Chief Executive
Department of Health
PO Box 287 Rundle Mall
Adelaide SA 5000
Telephone: 8226 0795
Principal documents affecting the public are listed in Appendix 4, while Appendix 5 lists all of the
Department of Health s publications.
page 107Department of Health Annual Report 2008 09
Financial activity
Use of consultants
Department of Health
There were 37 consultancies in 2008-09 with total expenditure of $1 571 394.
Summary
Table 27 Consultancies in 2008-09
Range No of Consultants Expenditure
Below $10 000 9 $47 606
$10 000 - $50 000 20 $472 392
Above $50 000 8 $1 051 396
TOTAL 37 $1 571 394
page 108 Department of Health Annual Report 2008 09
Details of consultancies $10 000 - $50 000
Table 28 Details of consultancies $10 000 $50 000 in 2008-09
Consultant Purpose of Consultancy
(summary of the service for which they were engaged)
PriceWaterhouseCoopers Private taxation ruling regarding living away from home and ongoing advice to the
Department until the matter is resolved.
Harrison Research Pty Ltd To conduct quantitative and qualitative research into the public s thoughts and concerns
about the recently released Country Health Care Plan.
PSI Consulting Provide independent probity specialist advice regarding evaluation plan documents and
ensure they are in accordance with probity requirements. Review, comment and provide
a written report on the tender process as observed including the key processes and
procedures required to ensure a defensible procurement.
Community Matters Research with key stakeholders and provide a comprehensive report with recommendations
about the planning and development of the proposed SA Healthy Weight Research and
Evaluation Unit.
Evolution Research Determine the suitability of the indicators used to define people with chronic and complex
needs, the suitability of the service model and design an evaluation for subsequent
coordination of services for people with chronic and complex needs.
Locher & Associates Undertake a review and evaluation of the Mental Health Emergency Services Memorandum
of Understanding. Advise on gaps that may exist, how to resolve them, recommend areas
for overall service improvement and address risks and benefits of any proposed changes.
Adelaide Research and Innovation Consultations with Department of Health, Central Northern Adelaide Health Service and
Southern Adelaide Health Service for the proposed Networking Planning Template included
in the Final Report of the initial evaluation of Primary Health Care Networks 2006 and
development of a final agreed Network Planning Template.
Health Outcomes International Evaluation of the shared care with General Practitioner program, to determine if the
objectives set out in the program are being achieved and make recommendations for
improvement (Stage 1 and Stage 2).
MMT Consultancy Services An evaluation of five day and group rehabilitation programs, including the efficiency of
each service and to provide recommendations on the preferred features of the current
service delivery.
Miranda Roe Eat well be active disability sector capacity building review.
KutJara Consultants (John Tregenza) Development of a Proposal & Plan for the establishment of an Aboriginal Community
controlled Health Service in the Hills, Mallee Southern Office for Aboriginal and Torres Strait
Islander Health Planning Region.
J. Krassie & Associates Development of nutritional standards and common menu guidelines of the SA Public
Hospitals System.
Kickbusch Health Consultant Planning of and participation in International Health In All Policies meetings.
Alan Lohf Ensure contract management systems are implemented for the ongoing management
of all data in relation to Client Activity Reporting System and Individual Psychosocial
Rehabilitation Support Service, including provision of expert advice to the Department.
KPMG Evaluation of the data collection process and the reporting systems for
Non Government Organisations.
Dunnottar Computing Logist Pty Ltd To provide a technical architecture design specification for the Spatial Information Portal
(SIP) and project plan outlining the processes and timeline for developing a proposed
architecture and pilot implementation to meet current and projected business requirements.
KDN Services Pty Ltd Delivery of a workshop with stakeholder involvement (clinical, administrative and
managerial) and the development of a briefing paper to identify costs and resourcing
implications for the purpose of a proposed business case to support the ICT plan.
Dr Chris Reynolds Conduct an independent review of the governance and regulatory efficiency of the food
safety management process undertaken by South Australian Government regulators.
Mary Anne Williams Development of a plan to ensure that Aboriginal Community Controlled Health Services
(ACCHS) in South Australia are prepared for seasonal and pandemic influenza outbreaks.
To provide ACCHS education sessions and to facilitate education and training for Aboriginal
health workers.
page 109Department of Health Annual Report 2008 09
Details of consultancies above $50 000
Table 29 Details of consultancies above $50 000 in 2008-09
Consultant Purpose of Consultancy
(summary of the service for which they were engaged)
Beyond . Kathleen Stacey
& Associates
Evaluation of the degree to which the SA Aboriginal Health Partnership has
achieved the outcomes listed in its framework agreement, evaluation of strengths
and weaknesses of collaboration and cooperation between partner organisations
and to make recommendations to enhance these qualities and the SA Aboriginal
Health Partnership.
Hardes and Associates Provide a projection model that can be used to quantify future demand of acute
hospital services-and to model alternate demand/supply scenarios.
Harrison Research Pty Ltd Measure, analyse and progressively track SA s understanding of the public health care
system; community alignment with the State Government Health Care Plan 2007
2016 and provide recommendations that address the brand equity of SA Health.
CPD Biz Pty Ltd Antenatal Scoping Project. Summarise current services and consumers characteristics;
identify commonalities across best practice models; draft framework for antenatal
service delivery identifying strengths and weaknesses, key points of expansion
and strengthening service pathways; identify impact of existing funding model on
underserved consumers and provide recommendations for action.
University of South Australia Equip Indigenous health service providers to prevent chronic disease and promote
healthy weight to Indigenous Australian communities in metropolitan, rural and
remote South Australia, by encouraging healthy eating and being active.
Quality Management Services Implementation of Psychosocial Rehabilitation Support Service Standards.
Ernst and Young Review of Finance and Administration and Workforce Development Functions.
Ernst and Young Professional services rendered in accordance with the contract for service in relation
to the Health and Medical Research Institute Full Business Case.
page 110 Department of Health Annual Report 2008 09
Employees overseas travel
The table below summarises information relating to approved overseas travel by the Department s employees
during 2008-09 in accordance with Department of Premier and Cabinet Circular PC013.
Table 30 Details of overseas travel by Department of Health employees in 2008-09
Number of Total cost to
employees Destination Reasons for Travel department $
1 Quebec, Canada To attend the Annual Quebec Public Health Conference and
participate in a series of meetings and consultations with key contacts
and senior staff of the Quebec Public Health Institute, the Minister of
Health and related agencies, concerning the five areas identified in
the SA Health and the Quebec Public Health Institute Collaborative
Agreement which was signed in Adelaide in February 2008. $ 3,308*
1 Abu Dhabi, United
Arab Emirates
To attend and present at the Patient Safety Conference, in relation
to the role and planning of a centralised Central Sterilising Services
Department and redesigning care during the decontamination and
sterilization section of the Patient Safety Conference. $ 1,150*
1 South Africa To attend the inaugural meeting of the Global Decontamination
Discussion Group. To be involved in the initial discussions to develop
a global document which can be used as a basis for education
throughout the world on decontamination - truth and best practice. $ 1,038*
1 London, UK and
Edinburgh, Scotland
and Vancouver,
Canada
To attend the Oxford International Learning Collaborative meeting
representing the Chief Nurse. Meetings with the National Health
Service Education for Scotland, conference in London and meetings
with the University of British Columbia and Vancouver. $ 19,109
3 Vietnam To discuss the working collaboration to build capacity of the nursing
profession. Discussions held with the Vietnam Ministry of Health and
the Australian Embassy. $ 44,221
2 London, United
Kingdom
To look at comparable hospital developments to that of the new Royal
Adelaide Hospital and to learn the lessons the United Kingdom system
has to offer given its now extensive history in delivering hospital
Private Finance Initiative schemes. $ 64,274
2 Colombo, Sri Lanka To work in partnership with the World Health Organisation and a Sri
Lankan team to develop a 12 month work plan to implement Health
In All Policies in Sri Lanka. $ 25,238
1 London, United
Kingdom
To identify strategies for the South Australian Government to engage
the food industry in promoting healthy eating and preventing
overweight and obesity. $ 36,500
1 Berlin, Germany and
London, UK
To attend the International Forum on Quality and Safety in Health
Care and to undertake site visits to a number of German hospitals. $ 15,477
1 Atlanta, USA and
Dusseldorf, Germany
and Nice, France
To attend the 3rd International Congress on Pre-diabetes and the
Metabolic Syndrome in Nice, the Behavioural Risk Factor Surveillance
System conference in Atlanta. The conferences are important to the
continued development of population health, chronic disease and
risk factor monitoring and surveillance in South Australia (SA) and the
involvement of the unit in major SA biomedical cohort studies. $ 17,820
1 Northern Pacific,
Guam
Nominated by the OzFoodNet to participate as a trainer in the WHO
Global Salm-Surv Level-1 International Training Course. $ 3,557
1 London, UK and
Dublin, Ireland
To meet with the Chief Health Professions Officer England and the
Competencies Project Team and Officer to explore the adaptation of
their work to the Australian environment. $ 19,158
page 111Department of Health Annual Report 2008 09
2 South Carolina and
Washington DC, USA
To attend and present at the Oacis User Group and to visit the
Advisory Board Company to examine and discuss the ED Compass
information system. $ 23,842
1 Barcelona, Spain and
London, UK
To attend the Organisation Development Partnership network
International Seminar titled Global Recession and its implications
for Managing Healthcare Systems in Barcelona and visiting several
hospital trusts in the UK. $ 23,926
1 Brussels, Belgium To attend the meeting of the European Society for Paediatric Infectious
Diseases. To gain information regarding any changes made to the National
Vaccine Schedule and visit an overseas vaccine manufacturing plant.
$ 2,247*
1 Boston, USA and
Toronto and Montreal,
Canada
To accompany the Minister in visiting a number of hospital
developments which have relevance to the development of the
new Royal Adelaide Hospital and to look at health strategies in
these jurisdictions. $ 32,591
3 Paris, France For Obesity Prevention And Lifestyle program initial training. $ 30,854
2 London, UK and
Helsinki, Finland
To attend two international conferences and visit with National Health
Service representatives. $ 12,595
$376,905
* All travel and accommodation expenses were met by a third party
Note: In accordance with Department of Premier and Cabinet Circular PC013, costs associated with overseas travel include
salary (and related on-costs), travel and accommodation.
The table below summarises information relating to approved overseas travel by Non Departmental employees (Regional
employees) during 2008-09 that the Department funded.
2 London, UK To attend the Clinicians at the Helm - Engaging Clinical Leaders
in Hospital Reform conference in London as well as visiting several
UK Trusts.
$ 33,896
$33,896
Fraud
The Department of Health has adopted and promoted the Code of Conduct for South Australian Public
Sector Employees, which provides guidance to staff on appropriate behaviour. In addition, the department has
specific policies and procedures in relation to the identification and reporting of fraud and corruption.
There have been no incidents of fraud, material or otherwise that have been reported or detected through
departmental review processes.
page 112 Department of Health Annual Report 2008 09
Account payment performance
Table 31 Paid by due date
Number of Percentage of accounts Value in $A of Percentage of accounts
accounts paid paid (by number) accounts paid paid (by value)
July 2008 2 916 95.98% $325 592 373.90 99.68%
August 2008 2 677 91.68% $302 505 715.50 99.35%
September 2008 3 219 94.29% $269 988 289.98 98.91%
October 2008 3 240 95.66% $317 332 919.86 99.47%
November 2008 2 652 95.53% $269 919 477.87 99.46%
December 2008 2 986 94.26% $276 283 737.18 99.71%
January 2009 2 453 90.65% $279 249 754.17 98.85%
February 2009 2 707 92.83% $255 156 396.67 98.83%
March 2009 2 979 91.46% $263 127 558.89 99.23%
April 2009 3 332 93.18% $311 121 793.69 98.76%
May 2009 3 737 94.20% $297 691 427.77 99.15%
June 2009 5 286 95.92% $321 895 417.40 98.94%
Total 08-09 38 184 93.97% $3 489 864 862.88 99.20%
Table 32 Paid late but paid within 30 days of due date
Number of Percentage of accounts Value in $A of Percentage of accounts
accounts paid paid (by number) account paid paid (by value)
July 2008 96 3.16% $953 533.95 0.29%
August 2008 180 6.16% $1 410 670.08 0.46%
September 2008 139 4.07% $2 636 305.67 0.97%
October 2008 107 3.16% $1 285 782.41 0.40%
November 2008 73 2.63% $1 395 743.48 0.51%
December 2008 101 3.19% $572 644.13 0.21%
January 2009 198 7.32% $2 849 140.19 1.01%
February 2009 137 4.70% $2 186 248.08 0.85%
March 2009 181 5.56% $1 626 741.16 0.61%
April 2009 183 5.12% $3 201 691.08 1.02%
May 2009 184 4.64% $2 392 561.58 0.80%
June 2009 159 2.89% $2 917 070.99 0.90%
Total 08-09 1 738 4.28% $23 428 132.80 0.67%
page 113Department of Health Annual Report 2008 09
Table 33: Paid more than 30 days from due date
Number of Percentage of accounts Value in $A of Percentage of accounts
accounts paid paid (by number) account paid paid (by value)
July 2008 26 0.86% $95 962.52 0.03%
August 2008 63 2.16% $554 355.38 0.18%
September 2008 56 1.64% $328 200.27 0.12%
October 2008 40 1.18% $405 723.06 0.13%
November 2008 51 1.84% $80 844.37 0.03%
December 2008 81 2.56% $243 561.22 0.09%
January 2009 55 2.03% $388 887.92 0.14%
February 2009 72 2.47% $836 151.49 0.32%
March 2009 97 2.98% $424 866.82 0.16%
April 2009 61 1.71% $701 024.88 0.22%
May 2009 46 1.16% $148 231.32 0.05%
June 2009 66 1.20% $518 998.98 0.16%
Total 08-09 714 1.76% $4 726 808.23 0.13%
Table 34 Accounts paid total
Number of Percentage of accounts Value in $A of Percentage of accounts
accounts paid paid (by number) account paid paid (by value)
July 2008 3 038 100.00% $326 641 870.37 100.00%
August 2008 2 920 100.00% $304 470 740.96 100.00%
September 2008 3 414 100.00% $272 952 795.92 100.00%
October 2008 3 387 100.00% $319 024 425.33 100.00%
November 2008 2 776 100.00% $271 396 065.72 100.00%
December 2008 3 168 100.00% $277 099 942.53 100.00%
January 2009 2 706 100.00% $282 487 782.28 100.00%
February 2009 2 916 100.00% $258 178 796.24 100.00%
March 2009 3 257 100.00% $265 179 166.87 100.00%
April 2009 3 576 100.00% $315 024 509.65 100.00%
May 2009 3 967 100.00% $300 232 220.67 100.00%
June 2009 5 511 100.00% $325 331 487.37 100.00%
Total 08-09 40 636 100.00% $3 518 019 803.91 100.00%
page 114 Department of Health Annual Report 2008 09
Table 35 Accounts summary
Number of accounts
paid
Percentage of accounts
paid (by number)
Value in $A of
account paid
Percentage of accounts
paid (by value)
Paid by due date 38 184 93.97% $3 489 864 862.88 99.20%
Late but
< 30 days
1 738 4.28% $23 428 132.80 0.67%
>30 days
due date
714 1.76% $4 726 808.23 0.13%
Total 40 636 100.00% $3 518 019 803.91 100.00%
Contractual arrangements
During 2008-09 there were no operational contracts greater than $4 million which exceeded beyond
a single year.
page 115Department of Health Annual Report 2008 09
Department of Health Audited Financial Statements
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Independent Auditor s Report
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Statement of comprehensive income
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Statement of financial position
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Statement of cash flows
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Disaggregated disclosures - expenses and income
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Disaggregated disclosures - assets and liabilities
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Appendices
Appendix 1 Legislation Committed to Health Ministers
(as at 30 June 2009)
Minister for Health
Blood Contaminants Act 1985
Chiropractic and Osteopathy Practice Act 2005
Consent to Medical Treatment and Palliative Care Act 1995
Dental Practice Act 2001
Food Act 2001
Gene Technology Act 2001
Health and Community Services Complaints Act 2004
Health Care Act 2008
Health Professionals (Special Events Exemption) Act 2000
Kapunda Hospital (Variation of Kapunda Trust) Act 2009
Medical Practice Act 2004
Mount Gambier Hydrotherapy Pool Fund Act 2009
Nursing and Midwifery Practice Act 2008
Occupational Therapy Practice Act 2005
Optometry Practice Act 2007
Pharmacy Practice Act 2007
Physiotherapy Practice Act 2005
Podiatry Practice Act 2005
Prohibition of Human Cloning Act 2003
Psychological Practices Act 1973
Public and Environmental Health Act 1987
Public Charities Funds Act 1935
Reproductive Technology (Clinical Practices) Act 1988
Research Involving Human Embryos Act 2003
Transplantation and Anatomy Act 1983
Minister for Mental Health and Substance Abuse
Controlled Substances Act 1984
Drugs Act 1908
Mental Health Act 1993 (Mental Health Act 2009 assented to, but will not commence until 1 July 2010)
Public Intoxication Act 1984
Tobacco Products Regulation Act 1997
page 151Department of Health Annual Report 2008 09
Appendix 2 Hospitals
Hospitals incorporated under the Health Care Act 2008
(as at 30 June 2009)
Name Date of incorporation
Country Health SA Hospital Incorporated 15 May 2008
Central Northern Adelaide Health Service Incorporated 26 February 2004
Children, Youth and Women s Health Service Incorporated 26 February 2004
Southern Adelaide Health Service Incorporated 26 February 2004
page 152 Department of Health Annual Report 2008 09
Appendix 3 Boards and Committees Responsible to the
Health Ministers (as at 30 June 2009)
Minister for Health
BCIS Boards and Committees
Chiropractic and Osteopathy Board of South Australia
Commissioners of Charitable Funds
Dental Board of South Australia
Dental Board of South Australia Codes and Policies Committee
Dental Board of South Australia Complaints Committee
Dental Board of South Australia Education Committee
Dental Board of South Australia Finance Committee
Dental Board of South Australia Governance Committee
Dental Board of South Australia Registration Committee
Dental Professional Conduct Tribunal
Health and Medical Research Advisory Council of South Australia
Health Performance Council
Medical Board of South Australia
Medical Professional Conduct Tribunal
Nurses Board of South Australia
Nurses Board of South Australia ANMC Advisory Committee
Nurses Board of South Australia Education and Accreditation Advisory Committee
Nurses Board of South Australia Midwifery Advisory Committee
Nurses Board of South Australia Professional Practice and Strategic Initiatives Advisory Committee
Nurses Board of South Australia Resources Advisory & Investment/Audit Committee
Occupational Therapy Board of South Australia
Optometry Board of South Australia
Pharmacy Board of South Australia
Physiotherapy Board of South Australia
Podiatry Board of South Australia
Postgraduate Medical Council of South Australia
Public and Environmental Health Council
Reproductive Technology Eligibility Review Panel
South Australian Council for Safety and Quality in Health Care
South Australian Council for Safety and Quality in Health Care Consumer and Community Advisory Committee
South Australian Council on Reproductive Technology
South Australian Psychological Board
BCIS Health Advisory Councils
Incorporated
Balaklava Riverton Health Advisory Council Inc
Barossa and Districts Health Advisory Council Inc
Berri Barmera District Health Advisory Council Inc
Bordertown and District Health Advisory Council Inc
Ceduna District Health Services Health Advisory Council Inc
Ceduna Koonibba Aboriginal Health Advisory Council Inc
Coorong Health Service Health Advisory Council Inc
page 153Department of Health Annual Report 2008 09
Country Health SA Board Health Advisory Council Inc
Eastern Eyre Health Advisory Council Inc
Eudunda Kapunda Health Advisory Council Inc
Gawler District Health Advisory Council Inc
Hills Area Health Advisory Council Inc
Kangaroo Island Health Advisory Council Inc
Kingston/Robe Health Advisory Council Inc
Lower Eyre Health Advisory Council Inc
Lower North Health Advisory Council Inc
Loxton and Districts Health Advisory Council Inc
Mallee Health Service Health Advisory Council Inc
Mannum District Hospital Health Advisory Council Inc
Mid North Health Advisory Council Inc
Mid-West Health Advisory Council Inc
Millicent and Districts Health Advisory Council Inc
Mount Gambier and Districts Health Advisory Council Inc
The Murray Bridge Soldiers Memorial Hospital Health Advisory Council Inc
Naracoorte Area Health Advisory Council Inc
Northern Yorke Peninsula Health Advisory Council Inc
Penola and Districts Health Advisory Council Inc
Pika Wiya Health Advisory Council Inc
Port Broughton District Hospital and Health Services Health Advisory Council Inc
Renmark Paringa District Health Advisory Council Inc
South Coast Health Advisory Council Inc
Waikerie and Districts Health Advisory Council Inc
Yorke Peninsula Health Advisory Council Inc
Unincorporated
Far North Health Advisory Council
Hawker District Memorial Health Advisory Council
Leigh Creek Health Services Health Advisory Council
Port Augusta, Roxby Downs, Woomera Health Advisory Council
Port Lincoln Health Advisory Council
Port Pirie Health Service Advisory Council
Quorn Health Services Health Advisory Council
SAAS Volunteers Health Advisory Council
Southern Flinders Health Advisory Council
The Whyalla Hospital and Health Services Health Advisory Council
Veterans Health Advisory Council
Minister for Mental Health and Substance Abuse
BCIS Boards and Committees
Controlled Substances Advisory Council
Prescribers Advisory Council (sub-committee)
page 154 Department of Health Annual Report 2008 09
Appendix 4 Principal Documents
Aboriginal Health
SA Health Aboriginal workforce reform strategy: 2009-2013
Community Health
Inside out: an organisational map for primary violence prevention
Country Health
Careers in Country Health SA
Credentialling in SA country public health services
Draft strategy for planning country health services in SA
Mid-West Community Health: promoting healthy life choices, building healthy communities, providing
treatment and care
Scope of clinical practice in SA country public health services
Strategy for planning country health services in SA
Food
Food Act report year ending 30 June 2008
Healthy food and drink choices for staff and visitors in SA Health facilities
Health Promotion
PEACH: parent handbook
Health Services
Annual Report 2007-08 (in two parts)
South Australia s Health Care Plan 2007-2016
South Australia: our health and health services
Local Government
Developing Local Government Environmental Health Indicators for South Australia: a discussion paper
Mental Health
Adult Mental Health Service: working with you
Report of the Select Committee on Proposed Sale and Redevelopment of the Glenside Hospital Site Interim
Report
South Australian Mental Health Sharing Excellence 2009, Lakes Resort, West Lakes 17 June 2009
Patient Care
A guide to maintaining confidentiality in the public health system for health service employees, visiting
clinicians, volunteers, trainees, students, contractors
Palliative Care Services Plan 2009-2016
Public hospital inpatients in South Australia: patient safety culture
Public hospital inpatients in South Australia: patient satisfaction survey
When a person dies: the hospital autopsy process: information for family and friends
page 155Department of Health Annual Report 2008 09
Pharmaceutical
2009 pharmaceutical reforms: now it s easier and safer to get the medicines you need
Public Health
2007 National Australian children s nutrition and physical activity survey: South Australian findings
Cancer in South Australia 2006 with projections to 2009: a report on the incidence and mortality patterns of
cancer: cancer series no. 29
Chronic disease action plan for South Australia: 2009-2018
Code for the Case Management of Behaviours that Present a Risk for HIV Transmission: SA Health Directive
Delivering the Future and the Aboriginal Nursing and Midwifery Strategy 2008-2011
Disability Action Plan 2008-2013
Eat Well Be Active: community programs: fifth progress report to SA Health, Health Promotion SA,
July 2007-June 2008
Do It For Life : making lifestyle changes for better health information for health professionals
Do It For Life : making lifestyle changes for better health referral information for health professionals
An epidemiological analysis of osteoporosis among South Australian adults
Guidelines for the control of legionella in manufactured water systems in South Australia
HIV Action Plan 2009-2012
Hepatitis C action plan 2009-2012
Is your lifestyle killing you?: Do It For Life and make lifestyle changes for better health
Physical activity among South Australian adults, September 2007 (published July 2008)
A South Australian Safe Drinking Water Bill
The state of public and environmental health report for South Australia 2007-08
Vaccination awareness: community fact sheet
Wash, wipe, cover don t infect another!
Residential care
Residential care scoping project 2008: final report
SA Health
Marjorie Jackson-Nelson Hospital precinct final master plan
SA Health Strategic Plan 2008-2010
page 156 Department of Health Annual Report 2008 09
Women s Health
Pap smears: what they are and why women should have them: presentation notes to accompany the
illustrated PowerPoint presentation and flip chart
Perinatal Practice Guidelines. Section 1: Antenatal, Intrapartum, Postpartum and complications of pregnancy
Perinatal Practice Guidelines. Section 1: Antenatal, Intrapartum, Postpartum and complications of pregnancy.
Ch 1 Preconception advice
Perinatal Practice Guidelines. Section 1: Antenatal, Intrapartum, Postpartum and complications of pregnancy.
Chapter 14C Uterine rupture
Perinatal Practice Guidelines. Chapter 4: Induction of labour techniques
Perinatal Practice Guidelines. Section 1: Antenatal, Intrapartum, Postpartum and complications of pregnancy.
Chapter 14D: Seizures in pregnancy
Pregnancy outcome in South Australia 2007
State-wide clinical networks: maternal & neonatal news, issue 2
Twenty-second report of the Maternal, Perinatal and Infant Mortality Committee on maternal, perinatal and
post-neonatal deaths in 2007
Women s health action plan report card
Workforce
The policy for credentialling and defining the scope for clinical practice for medical and dental practitioners
page 157Department of Health Annual Report 2008 09
Appendix 5 Publications 1 July 2008-30 June 2009
Aboriginal and Torres Strait Islander People
SA Health Aboriginal workforce reform strategy: 2009-2013
Adelaide: Dept. of Health, Aboriginal Health Division April 2009
http://www.publications.health.sa.gov.au/atsi/45/
Careconnect.sa
Connections edition 2
Adelaide: Dept. of Health, ICTS July 2009
http://www.publications.health.sa.gov.au/concarc/2/
Connections edition 3
Adelaide: Dept. of Health, ICTS Oct 2008
http://www.publications.health.sa.gov.au/concarc/3/
Connections edition 4
Adelaide: Dept. of Health, ICTS Feb 2009
http://www.publications.health.sa.gov.au/concarc/4/
Connections edition 5
Adelaide: Dept. of Health, ICTS May 2009
http://www.publications.health.sa.gov.au/concarc/5/
Community Health
Inside out: an organisational map for primary violence prevention
Adelaide: Dept. of Health, The Adelaide Hills Community Health Service, May 2009
http://www.publications.health.sa.gov.au/allied/8/
Community mental health review implementation bulletin, issue 2
Adelaide: Dept. of Health, Mental health Operations, Aug 2008
http://www.publications.health.sa.gov.au/commehr/2/
Country Health
Careers in Country Health SA
Adelaide: Dept. of Health, Country Health SA March 2009
http://www.publications.health.sa.gov.au/fs/34/
Credentialling in SA country public health services
Adelaide: Dept. of Health, Country Health SA, July 2008
http://www.publications.health.sa.gov.au/med/8/
Draft strategy for planning country health services in SA
Adelaide: Dept. of Health, Country Health SA Nov 2008
http://www.publications.health.sa.gov.au/spp/76/
Mental health communique, issue 3
Adelaide: Dept. of Health, Country Health SA July 2008
http://www.publications.health.sa.gov.au/menhc/1/
Mid-West Community Health: promoting healthy life choices, building healthy communities,
providing treatment and care
Adelaide: Dept. of Health, Country Health SA Aug 2008
http://www.publications.health.sa.gov.au/hprom/12/
Scope of clinical practice in SA country public health services
Adelaide: Dept. of Health, Country Health SA July 2008
http://www.publications.health.sa.gov.au/med/9/
page 158 Department of Health Annual Report 2008 09
Strategy for planning country health services in SA
Adelaide: Dept. of Health, Country Health SA Dec 2008
http://www.publications.health.sa.gov.au/spp/82/
Food
Food Act report year ending 30 June 2008
Adelaide: Dept. of Health, Food Policy & Programs Branch March 2009
http://www.publications.health.sa.gov.au/fooactr/23/
Healthy food and drink choices for staff and visitors in SA health facilities
Adelaide: Dept. of Health, Health Promotion Branch March 2009
http://www.publications.health.sa.gov.au/food/39
Healthy food and drink choices for staff and visitors in SA health facilities:
getting ready for healthier choices: fact sheet 1
Adelaide: Dept. of Health, Health Promotion Branch March 2009
http://www.publications.health.sa.gov.au/fs/22/
Healthy food and drink choices for staff and visitors in SA health facilities:
recommended supply of food and drinks: fact sheet 2
Adelaide: Dept. of Health, Health Promotion Branch March 2009
http://www.publications.health.sa.gov.au/fs/23/
Healthy food and drink choices for staff and visitors in SA health facilities:
summary of nutrient criteria: fact sheet 3
Adelaide: Dept. of Health, Health Promotion Branch March 2009
http://www.publications.health.sa.gov.au/fs/24/
Health Services
Annual Report 2007-08 [in two parts]
Adelaide: Dept. of Health, Office of the Chief Executive Sept 2008
http://www.publications.health.sa.gov.au/dh/4/
Delivering the Future and the Aboriginal Nursing and Midwifery Strategy 2008-2011
Adelaide: Dept. of Health, Nursing & Midwifery Office 2008
http://www.publications.health.sa.gov.au/nurs/1/
South Australia: our health and health services
Adelaide: Dept. of Health, Policy & Intergovernment Relations Aug 2008
http://www.publications.health.sa.gov.au/pop/1/
State-wide clinical networks: rehabilitation news, issue 9
Adelaide: Dept. of Health, Renal Clinical Network Aug 2008
http://www.publications.health.sa.gov.au/swcnreh/7/
State-wide clinical networks: renal news, issue 3
Adelaide: Dept. of Health, Renal Clinical Network Sept 2008
http://www.publications.health.sa.gov.au/swcnren/3/
Statewide SA Retrieval Service newsletter
Adelaide: Dept. of Health, Statewide Retrieval Service Aug 2008
http://www.publications.health.sa.gov.au/staretn/2/
page 159Department of Health Annual Report 2008 09
HealthConnect SA
HealthClix, edition 9
Adelaide: Dept. of Health, HealthConnect, July 2008
http://www.publications.health.sa.gov.au/heaclix/9/
HealthClix, edition 10
Adelaide: Dept. of Health, HealthConnect, Oct 2008
http://www.publications.health.sa.gov.au/heaclix/10/
HealthClix, edition 11
Adelaide: Dept. of Health, HealthConnect, Dec 2008
http://www.publications.health.sa.gov.au/heaclix/11/
HealthClix, edition 12
Adelaide: Dept. of Health, HealthConnect, March 2009
http://www.publications.health.sa.gov.au/heaclix/12/
HealthClix, edition 13
Adelaide: Dept. of Health, HealthConnect, June 2009
http://www.publications.health.sa.gov.au/heaclix/13/
Health Promotion
PEACH: parent handbook
Adelaide: Flinders University/Dept. of Health, 2009
http://www.publications.health.sa.gov.au/hprom/42/
Local Government
Developing Local Government Environmental Health Indicators for South Australia: a discussion paper
Adelaide: Dept. of Health, Applied Environmental Health Branch Dec 2008
www.health.sa.gov.au/pehs/publications/0812-EH-indicators-discussion-paper.pdf
Medical Records
Code-Fix vol.2, issue. 2
Adelaide: Dept. of Health, Medical Record Advisory Unit July 2008
http://www.publications.health.sa.gov.au/codfix/6/
Code-Fix vol.2, issue. 3
Adelaide: Dept. of Health, Medical Record Advisory Unit Sept 2008
http://www.publications.health.sa.gov.au/codfix/7/
Code-Fix vol.2, issue. 4
Adelaide: Dept. of Health, Medical Record Advisory Unit Dec 2008
http://www.publications.health.sa.gov.au/codfix/8/
Code-Fix vol.3, issue. 1
Adelaide: Dept. of Health, Medical Record Advisory Unit April 2009
http://www.publications.health.sa.gov.au/codfix/9/
Track records, volume 9, issue 2
Adelaide: Dept. of Health Medical Record Advisory Unit July 2008
http://www.publications.health.sa.gov.au/tr/22/
Track records, volume 9, issue 3
Adelaide: Dept. of Health Medical Record Advisory Unit Dec 2008
http://www.publications.health.sa.gov.au/tr/23/
page 160 Department of Health Annual Report 2008 09
Mental Health
Adult Mental Health Service: working with you
Adelaide: Dept. of Health, Mental Health Sept 2008
http://www.publications.health.sa.gov.au/mhs/6/
Community mental health implementation bulletin issue 3
Adelaide: Dept. of Health, Mental Health May 2009
http://www.publications.health.sa.gov.au/commehr/3/
Report of the Select Committee on Proposed Sale and Redevelopment of the Glenside Hospital Site
Adelaide: Dept. of Health, Mental Health May 2009
www.publications.health.sa.gov.au/mhs/42/
South Australian Mental Health Sharing Excellence 2009, Lakes Resort, West Lakes 17 June 2009
Adelaide: Dept. of Health, Mental Health June 2009
http://www.publications.health.sa.gov.au/fs/19/
Orthopaedics
State-wide clinical networks: orthopaedic news, issue 6
Adelaide: Dept. of Health, Orthopaedic Clinical Network Nov 2009
http://www.publications.health.sa.gov.au/swcnort/5/
State-wide clinical networks: orthopaedic news, issue 7
Adelaide: Dept. of Health, Orthopaedic Clinical Network Dec 2008
http://www.publications.health.sa.gov.au/swcnort/6/
State-wide clinical networks: orthopaedic news, issue 8
Adelaide: Dept. of Health, Orthopaedic Clinical Network Jan 2009
http://www.publications.health.sa.gov.au/swcnort/7/
State-wide clinical networks: orthopaedic news, issue 9
Adelaide: Dept. of Health, Orthopaedic Clinical Network Feb 2009
http://www.publications.health.sa.gov.au/swcnort/8/
State-wide clinical networks: orthopaedic news, issue 10
Adelaide: Dept. of Health, Orthopaedic Clinical Network March-April 2009
http://www.publications.health.sa.gov.au/swcnort/9/
Patient Care
A guide to maintaining confidentiality in the public health system for health service employees, visiting
clinicians, volunteers, trainees, students, contractors
Adelaide: Dept. of Health, Med Record Adv Unit / Res Policy & Ethics Unit, Oct 2008
http://www.publications.health.sa.gov.au/patri/3/
Palliative Care Services Plan 2009-2016
Adelaide: Dept. of Health, Statewide Service Strategy Division, May 2009
http://www.health.sa.gov.au/Portals/0/palliative-care-plan-2009-2016.pdf
Public hospital inpatients in South Australia: patient safety culture
Adelaide: Dept. of Health, Pop Res & Outcome Studies Unit, March 2009
http://www.publications.health.sa.gov.au/hos/33/
Public hospital inpatients in South Australia: patient satisfaction survey
Adelaide: Dept. of Health, Pop Res & Outcome Studies Unit, March 2009
http://www.publications.health.sa.gov.au/hos/32/
Patient Journey Communique issue 22
Adelaide: Dept. of Health, Country Health SA July 2008
http://www.publications.health.sa.gov.au/patjc/22/
page 161Department of Health Annual Report 2008 09
Patient Journey Communique issue 23
Adelaide: Dept. of Health, Country Health SA Aug 2008
http://www.publications.health.sa.gov.au/patjc/23/
Patient Journey Communique issue 24
Adelaide: Dept. of Health, Country Health SA Sept 2008
http://www.publications.health.sa.gov.au/patjc/24/
Patient Journey Communique issue 25
Adelaide: Dept. of Health, Country Health SA Oct 2008
http://www.publications.health.sa.gov.au/patjc/25/
Patient Journey Communique issue 26
Adelaide: Dept. of Health, Country Health SA Nov 2008
http://www.publications.health.sa.gov.au/patjc/28/
Patient Journey Communique issue 27
Adelaide: Dept. of Health, Country Health SA Dec 2008
http://www.publications.health.sa.gov.au/patjc/29/
Patient Journey Communique issue 28
Adelaide: Dept. of Health, Country Health SA Feb 2009
http://www.publications.health.sa.gov.au/patjc/30/
Patient Journey Communique issue 29
Adelaide: Dept. of Health, Country Health SA March 2009
http://www.publications.health.sa.gov.au/patjc/31/.
Patient Journey Communique issue 30
Adelaide: Dept. of Health, Country Health SA April 2009
http://www.publications.health.sa.gov.au/patjc/32/
State-wide clinical networks: cancer news, issue 5
Adelaide: Dept. of Health, Cancer Clinical Network Dec 2008
http://www.publications.health.sa.gov.au/swcncan/4/
State-wide clinical networks: child health news, issue 2
Adelaide: Dept. of Health, Cancer Clinical Network Dec 2008
http://www.publications.health.sa.gov.au/swcnch/2/
When a person dies: the hospital autopsy process: information for family and friends.
Adelaide: Dept. of Health 2009
http://www.publications.health.sa.gov.au/death/8/
Pharmaceutical
2009 pharmaceutical reforms: now it s easier and safer to get the medicines you need
Adelaide: Dept. of Health, Pharmaceutical Reforms, March 2009
http://www.publications.health.sa.gov.au/fs/21/
Pharmaceutical reforms newsletter, issue 4
Adelaide: Dept. of Health, Safety & Quality Unit, Sept 2008
http://www.publications.health.sa.gov.au/pharref/4/
page 162 Department of Health Annual Report 2008 09
Public Health
2007 National Australian children s nutrition and physical activity survey: South Australian findings
Adelaide: Dept. of Health, Health Promotion Branch, Dec 2009
http://www.publications.health.sa.gov.au/food/37/
Cancer in South Australia 2006 with projections to 2009:
a report on the incidence and mortality patterns of cancer: cancer series no. 29
Adelaide: Dept. of Health, SA Cancer Registry, Epidemiology Branch, Oct 2008
http://www.publications.health.sa.gov.au/cansarep/5/
Chronic disease action plan for South Australia: 2009-2018
Adelaide: Dept. of Health, Statewide Service Strategy Division Jan 2009
http://www.publications.health.sa.gov.au/dis/17/
Code for the Case Management of Behaviours that Present a Risk for HIV Transmission: SA Health Directive
Adelaide: Dept. of Health, Office of the CEO, Jan 2009
http://www.health.sa.gov.au/PEHS/publications/09-HIV-directive-code.pdf
Disability Action Plan 2008-2013
Adelaide: Dept. of Health, Policy and Legislation Branch, July 2008
http://www.publications.health.sa.gov.au/spp/40/
Eat Well Be Active: community programs: fifth progress report to SA Health,
Health Promotion SA, July 2007-June 2008
Adelaide: Dept. of Health, Population Research and Outcome Studies Unit, July 2008
http://www.publications.health.sa.gov.au/food/45/
Do It For Life : making lifestyle changes for better health information for health professionals
Adelaide: Dept. of Health, July 2008
http://www.publications.health.sa.gov.au/hprom/18/
Do It For Life : making lifestyle changes for better health referral information for health professionals
Adelaide: Dept. of Health, July 2008
http://www.publications.health.sa.gov.au/hprom/19/
An epidemiological analysis of osteoporosis among South Australian adults
Adelaide: Dept. of Health, Population Research and Outcome Studies Unit, July 2008
http://www.publications.health.sa.gov.au/dis/22/
Guidelines for the control of legionella in manufactured water systems in South Australia
Adelaide: Dept. of Health, Environmental Services Section, Sept 2008
http://www.publications.health.sa.gov.au/envh/49/
HIV Action Plan 2009-2012
Adelaide: Dept. of Health, Public Health May 2009
http://www.publications.health.sa.gov.au/cdc/29/
Hepatitis C action plan 2009-2012
Adelaide: Dept. of Health, Communicable Disease Control Branch, April 2009
http://www.publications.health.sa.gov.au/cdc/28/
Is your lifestyle killing you?: Do It For Life and make lifestyle changes for better health
Adelaide: Dept. of Health, Communicable Disease Control Branch, April 2009
http://www.publications.health.sa.gov.au/hprom/17/
Medication safety news. Issue 1
Adelaide: Dept. of Health, Medication Safety & Quality, March/April 2009
http://www.publications.health.sa.gov.au/medsanews/1/
Physical activity among South Australian adults, September 2007
Adelaide: Dept. of Health, Population Research and Outcome Studies Unit. July 2008
http://www.publications.health.sa.gov.au/epi/12/
page 163Department of Health Annual Report 2008 09
Public health bulletin South Australia, volume 5, number 3
Adelaide: Dept. of Health, Public Health. Nov 2008
http://www.publications.health.sa.gov.au/phbsa/12/
Public health bulletin South Australia, volume 6, number 1
Adelaide: Dept. of Health, Public Health. Mar 2009
http://www.publications.health.sa.gov.au/phbsa/13/
Sharp & to the point, issue 25
Adelaide: Dept. of Health, Communicable Disease Control Branch. Sept 2008
http://www.publications.health.sa.gov.au/shapt/25/
Sharp & to the point, issue 26
Adelaide: Dept. of Health, Communicable Disease Control Branch Dec 2008
http://www.publications.health.sa.gov.au/shapt/26/
Sharp & to the point, issue 27
Adelaide: Dept. of Health, Communicable Disease Control Branch March 2009
http://www.publications.health.sa.gov.au/shapt/27/
A South Australian Safe Drinking Water Bill
Adelaide: Dept. of Health, Public Health 2009
http://www.publications.health.sa.gov.au/envh/75/
The state of public and environmental health report for South Australia 2007 08
Adelaide: Dept. of Health, Dec 2008
http://www.publications.health.sa.gov.au/envh/68/
Vaccination awareness: community fact sheet
Adelaide: Dept. of Health, Infection Control 2009
http://www.publications.health.sa.gov.au/fs/26/
Wash, wipe, cover don t infect another!
Adelaide: Dept. of Health, Communicable Disease Control Branch 2009
http://www.publications.health.sa.gov.au/cdc/27/
Residential Care
Residential care scoping project 2008: final report
Adelaide: Dept. of Health CNAHS, Jan 2009
http://www.publications.health.sa.gov.au/res/8/
SA Health
Marjorie Jackson-Nelson Hospital precinct final master plan
Adelaide: Dept. of Health. Statewide Service Strategy, July 2008
http://www.publications.health.sa.gov.au/spp/31/
SA Health Strategic Plan 2008-2010
Adelaide: Dept. of Health. Office of the Chief Executive, Feb 2009
http://www.publications.health.sa.gov.au/spp/87/
South Australia s Health Care Plan 2007-2016
Adelaide: Dept. of Health, Nov 2008
http://www.publications.health.sa.gov.au/spp/3/
State-wide clinical network: cardiology news, issue 7
Adelaide: Dept. of Health, Statewide Service Strategy, Aug 2008
http://www.publications.health.sa.gov.au/swcncar/7/
State-wide clinical networks: newsletter, issue 9
Adelaide: Dept. of Health, Statewide Service Strategy, Sept 2008
http://www.publications.health.sa.gov.au/swcnreh/7/
page 164 Department of Health Annual Report 2008 09
State-wide clinical networks: rehabilitation news, issue 10
Adelaide: Dept. of Health, Rehabilitation Clinical Network, Dec 2008
http://www.publications.health.sa.gov.au/swcnreh/10/
Women s Health
Pap smears: what they are and why women should have them: presentation notes to accompany the
illustrated PowerPoint presentation and flip chart
Adelaide: Dept. of Health, SA Cervix Screening Program 2009
http://www.publications.health.sa.gov.au/hprom/40/
Pap news, no. 22
Adelaide: Dept. of Health, SA Cervix Screening Program 2009
http://www.publications.health.sa.gov.au/papn/18/
Perinatal Practice Guidelines. Section 1: Antenatal, Intrapartum, Postpartum and complications of pregnancy
Adelaide: Dept. of Health, SA Perinatal Practice Workgroup, May 2009
http://www.publications.health.sa.gov.au/nurs/20/
Perinatal Practice Guidelines. Section 1: Antenatal, Intrapartum, Postpartum and complications of pregnancy.
Ch 1 Preconception advice
Adelaide: Dept. of Health, SA Council on Reproductive Technology, May 2009
http://www.publications.health.sa.gov.au/ppg1/1/
Perinatal Practice Guidelines. Section 1: Antenatal, Intrapartum, Postpartum and complications of pregnancy.
Chapter 14C: Uterine rupture
Adelaide: Dept. of Health, SA Perinatal Practice Workgroup, May 2009
http://www.publications.health.sa.gov.au/ppg1/4/
Perinatal Practice Guidelines. Chapter 4: Induction of labour techniques
Adelaide: Dept. of Health, SA Perinatal Practice Workgroup, May 2009
http://www.publications.health.sa.gov.au/ppg1/24/
Perinatal Practice Guidelines. Section 1: Antenatal, Intrapartum, Postpartum and complications of pregnancy.
Chapter 14D: Seizures in pregnancy
Adelaide: Dept. of Health, SA Perinatal Practice Workgroup, May 2009
http://www.publications.health.sa.gov.au/ppg1/5/
Pregnancy outcome in South Australia 2007
Adelaide: Dept. of Health, Epidemiology Branch, Dec 2008
http://www.publications.health.sa.gov.au/pregout/7/
State-wide clinical networks: maternal & neonatal news, issue 2
Adelaide: Dept. of Health, Maternal & Neonatal Clinical Network, Oct 2008
http://www.publications.health.sa.gov.au/swcnmn/2/
Twenty-second report of the Maternal, Perinatal and Infant Mortality Committee on maternal, perinatal and
post-neonatal deaths in 2007
Adelaide: Dept. of Health, Epidemiology Branch, Dec 2008
http://www.publications.health.sa.gov.au/repmatp/23/
Women s health action plan report card
Adelaide: Dept. of Health, Women s Health Statewide, Feb 2009
http://www.publications.health.sa.gov.au/spp/101/
Workforce
The policy for credentialling and defining the scope for clinical practice for medical and dental practitioners
Adelaide: Dept. of Health, Public Health & Clinical Coordination Division, April 2009
http://www.publications.health.sa.gov.au/med/12/
page 165Department of Health Annual Report 2008 09
Acronyms
ABS Australian Bureau of Statistics
APY Anangu Pitjantjatjara Yankunytjatjara
AHA Allied Health Assistant
BCIS Boards and Committees Information System
BFHI Baby Friendly Hospital Initiative
BMI Body Mass Index
CHSA Country Health SA
CIH Centre for Intergenerational Health
CNAHS Central Northern Adelaide Health Service
COAG Coalition of Australian Governments
DASSA Drug and Alcohol Services South Australia
DECS Department of Education and Children s Services
DFC Department for Families and Communities
DPC Department of Premier and Cabinet
EPA Environment Protection Authority
FMC Flinders Medical Centre
FTE Full-time equivalent
GP General Practitioner
HiAP Health in All Policies
ICT Information and communication technology
LMH Lyell McEwin Hospital
MH Modbury Hospital
NIMC National Inpatient Medication Chart
NGO Non Government Organisation
NH Noarlunga Hospital
NHS National Health Survey
NTC National Tobacco Campaign
OBD Occupied Bed Days
OHSW Occupational Health Safety and Welfare
RAH Royal Adelaide Hospital
RGH Repatriation General Hospital
RSI Relative Stay Index
SAAS South Australian Ambulance Service
SACHRU South Australian Community Health Research Unit
SACSP South Australian Cervix Screening Program
SAHS Southern Adelaide Health Service
SAMSS South Australian Monitoring and Surveillance System
SASP South Australia s Strategic Plan
SHW Solar Hot Water
TQEH The Queen Elizabeth Hospital
VTE Venous Thromboembolism
WCH Women s and Children s Hospital
YLL Years of Life Lost
page 166 Department of Health Annual Report 2008 09
Glossary of Terms
Aboriginal/Torres Strait Islander health worker
An Aboriginal/Torres Strait Islander person who provides clinical and primary health care for individuals,
families and community groups.
Allied health clinician
A generic term to describe a wide range of tertiary qualified health professionals who are not doctors
or nurses.
Body Mass Index (BMI)
Body Mass Index (BMI) is used to estimate the total amount of fat for men and women over the age of 18.
BMI is calculated by dividing weight in kilograms by height in metres squared. A healthy BMI for an adult is
between 18.5 and 24.9.
Chief medical officer
A public sector employee who is a qualified medical doctor who advises the government on health
related matters.
Chronic disease
A disease that persists for a long period of time.
Clinician
A generic term to describe a wide range of health professionals.
Co-morbidity
Where a person has two or more health problems at the same time.
Department of Health
The public sector agency (administrative unit) established under the Public Sector Management Act 1995 with
responsibility for the policy, administration and operation of South Australia s public health system.
General Practitioner
A medical practitioner/doctor who works in primary health care and refers patients to specialist medical care.
GP Plus Health Care Strategy
A strategy to provide a fully integrated and accessible health care system that increases prevention and early
intervention services to promote good health.
Health region
A regional area comprising one or a number of health services (includes Central Northern Adelaide
Health Service, Children, youth and Women s Health Service, Southern Adelaide Health Service and
Country Health SA).
Health system
All health services provided to the people of South Australia.
Indigenous person
A person of Aboriginal and/or Torres Strait Islander descent who identifies, and is accepted as such
by the community with which they are associated.
Low Birthweight babies
Live births with a birthweight less than 2500 grams.
Medical practitioner/doctor
A person who is qualified (registered on the general register or on both the general and specialist registers)
to diagnose physical and mental illness, disorders and injuries, and prescribe medications and treatment to
promote good health.
page 167Department of Health Annual Report 2008 09
Neonatal
Applies to an infant at any time during the first four weeks of life.
Perinatal
Relating to the period from about three months before to one month after birth.
Primary health care
Often the first point of contact that a person has with the health system, such as general practice, community
nurses, pharmacists, social workers and other health providers. Primary health care is both an approach to
dealing with health issues as well as a level of health service. It can include a range of strategies from health
promotion, health protection, disease prevention, advocacy, social action and community development.
SA Health
South Australian public health system, services and agencies.
Separation
The formal process by which a hospital records the completion of treatment and/or care
for an admitted patient.
Socioeconomic disadvantage
A relative lack of financial or material means experienced by a group in a society which may limit their access
to opportunities and resources that are available to the wider community.
page 168 Department of Health Annual Report 2008 09
For more information
Office of the Chief Executive
Department of Health
PO Box 287 Rundle Mall
ADELAIDE 5000
Telephone: +61 8 8226 0795
www.health.sa.gov.au
Non-english speaking: (08) 8226 1990 for information in
languages other than English, call the interpreting and
Translating Centre and ask them to call the Department
of Health. This service is available at no cost to you.
Department of Health, Government of South Australia.
FIS: 9164 All rights reserved. ISSN: 1833-0002 ISBN: 978-1-74243-004-1
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