Annual Report 2004-2005 - Forensicare

Chief Executive Officer’s Report
Forensicare embraced its seventh year as a
statutory authority in 2004-2005 with all
the enthusiasm and commitment that has
characterised our organisation from its
inception.
This Annual Report to the Victorian
Parliament features an insight into our
flagship clinical services reform initiative,
the Consolidating and Strengthening
Clinical Program project (CSCP), pages 22-
23, and an overview of the service demand
and productivity growth trends over the
past 5 years since the opening of the
Thomas Embling Hospital, page 7.
Financial Situation
In a year that began with a substantial
negative budget projection, the organisation
delivered a turnaround of $2.113m, ending
the year with a slight surplus of $0.327m
(excluding depreciation and capital
revenue). In the context of this financial
management challenge, virtually all
performance targets were met, and many
significantly exceeded. The momentum to
make tangible gains in our clinical services,
and in the corporate services that support
them, continued unabated, in spite of not
only the financial challenges, but also
continuing demand growth pressures.
Consolidating and Strengthening
Clinical Programs
Our legislation mandates that we not only
provide specialist forensic mental health
services, but that we drive our development
and effectiveness with research, and by
implication, through the application of
evidence. The basis of the CSCP project
has been research conducted within
Forensicare, together with international
research evidence. The program will
implement a ‘whole of clinical service’
enhancement throughout Forensicare that
will better meet the needs of our patients,
whilst seeking to reduce the likelihood of
reoffending and improving community
safety. It is ambitious and entails pervasive
change in service delivery, and will be
emulated internationally.
Developmental work on CSCP continued
throughout the year, and the preliminary
stages of implementation commenced. The
project involves nearly all our clinical staff
and is very time consuming. It is gratifying,
even at this early stage of implementation,
that there is high level interest from both
national and international forensic mental
health agencies, senior academics and
clinicians.
Our Growth and Ongoing
Service Development
Service demand pressures resonate through
the health sector and are certainly not
unique to our specialist area of mental
health. The reality is that resources will
always be limited and demand will exceed
supply. We have endeavoured to be
innovative and pragmatic in meeting these
challenges, and we will continue to strive
to do so.
We currently operate however, in a
situation in which we are disadvantaged
in terms of capacity. The parameters within
which our service capacity was calculated
(in the mid 1990’s) have changed with the
unanticipated increase in the prison
population. While the prison population
now appears to be levelling at around
3,700, it is 1,200 higher than what was
projected when our service capacity
planning was undertaken. The introduction
of the Crimes (Mental Impairment and
Unfitness to be Tried) Act 1997, and its
significant reforms to the system of dealing
with mental illness and criminal
responsibility, has had the effect of
consuming more resources than planned.
The combined effect of the increasing
prison population and the new mental
impairment legislation has led to a serious
and escalating shortfall in our secure
inpatient capacity, and in turn our prison
and community services. Beds at the
Thomas Embling Hospital operate at 100%
capacity, which creates concerning delays
in our ability to admit and treat prisoners
with a serious mental illness, adjudicated
mental impairment patients and
challenging civil patients from general
mental health services. An innovative bed
expansion concept (necessarily involving
significant capital expenditure) has been
proposed by us and is under active
consideration by the Department of Human
Services.
Any significant new bed capacity will
inevitably take years to commission.
Constructive and open dialogue on this
matter continues with the Mental Health
Branch, Department of Human Services.
We are also seeking active support from the
Department of Justice, so that the project
may be jointly progressed within the
Government budgetary process.
Over the coming months, a set of strategies
will be formulated to manage demand
pressures in the interim.
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