DHF Annual Report 2009 - NT Health Digital Library - Northern ...

Visit the department’s website at www.nt.gov.au/healthThis report is available online at www.nt.gov.au/health/Publications/Corporate_Publication2Department Health and Families

The Honourable Kon Vatskalis MLA The Honourable Rob Knight MLAMinister for Health,Minister for Senior and Young TerritoriansChildren and Families, Child Protection Parliament HouseParliament House DARWIN NT 0801DARWIN NT 0801The Honourable Malarndirri McCarthy MLAMinister for Women’s PolicyParliament HouseDARWIN NT 0801Dear MinistersI am pleased to present you with the Annual Report for the Department of Health andFamilies for the financial year 1 July 2009 to 30 June 2010.The report describes activities and performance outcomes against the Department’sCorporate plan and key achievements to the output areas.With regard to my duties as the Accountable Officer pursuant to Section 13 of the FinancialManagement Act I advise to the best of my knowledge and belief that:a) proper records of all transactions affecting the agency and it’s employees were keptunder my control by Department of Business and Employment (DBE) on behalf of theDepartment observing the provisions of Section 28 of the Public Sector Employment andManagement Act and Section 12 of the Financial Management, the financialmanagement regulations and applicable Treasurer’s Directions;b) procedures within the agency afforded proper internal control. A current description ofthese can be found in the Department’s Accounting and Property Manual which iscontinuously updated in accordance with the Financial Management Act;c) no indication of malpractice, major breach of legislation or delegation, major error in oromission from the accounts and records exists with the exception of one case of fraud;d) in accordance with the requirements of Section 15 of the Financial Management Act, theinternal audit capacity available to the agency was adequate, and the results of allinternal audits were reported to the Audit Committee and the Chief Executive;e) all Employment Instructions issued by the Commissioner for Public Employment havebeen satisfied; andf) procedures within the agency complied with the requirements of the Information Act.In conclusion, I believe the Department has been able to provide an acceptable level ofhealth and family services for Territorians balancing the demands for service and theresources available.Yours sincerelyMr Jeff Moffet30 September 2010Department Health and Families 5

Chief Executive ForewordChief ExecutiveMr Jeff MoffetWhile the Territory has a relatively small populationwe confront a range of complex challenges, some ofwhich are common to all health systems in Australia,like workforce shortages and escalating costs. Thereare however others that impact quite differently inthe Territory than elsewhere, not least of which areAboriginal health needs and the dispersed pattern ofpopulation across the 1.3 million square kilometres ofthe Northern Territory.Demand for health and family services in the NorthernTerritory continues to grow so it is not surprising thatthe Department over the past year has also seenadditional people in Territory emergency departmentsthan we did just a few years ago and we have recordedat risk over the same time. Recent national reportsshow that Territory hospitals are among the busiestin the country. This Annual Report demonstratescontinuing strong growth in demand whether in thevital support given to the Territory’s families andchildren.The Northern Territory Government invested a record$1.12 billion in the Health and Families portfolioin 2009-10. The Department has been focussingon spending wisely and effectively, with the focuson achieving good outcomes and meeting theexpectations of the broader community in CentralAustralia, the Top End, in town and in the bush.areas. Compared to 2005-06 for example there are30% more nurses, 50% more professional staff and41% more doctors employed in the agency. Caring forbudget with an 86% increase in the number ofprofessional staff in NT Families and Children overthe last few years.Importantly we are making real efforts to build aninclusive workplace and a diverse workforce. In2009–10 about 10% of the Department’s staff wereAboriginal or Torres Strait Islander and some 23% of ourstaff came from a non English speaking background.Within a challenging international, national and localeconomic environment, gains have been made, asis shown by the indicators and activity across thevarious Divisions and program areas. Of course,more needs to be done.The health status of the Territory’s Aboriginaland Torres Strait Islander people continues to beunacceptably lower than non-Aboriginal Territorians.Unlike other jurisdictions Aboriginal Territorianscomprise the majority of our clients in almost everyarea of the Department’s activity. Our Departmenthas Aboriginal health squarely in the core businesscorner, and we have real improvements on foot toprovide a sound contribution in this area. One ofthe key planks is our partnership with the Aboriginalcommunity controlled health sector and the AustralianGovernment. Together we are embarking on reformthat is tackling some of the system and service issuesthat have bedevilled Aboriginal health for decades,and we are seeing real change.Our Department is working hard to addressinequities, but there is much we can all do to improveour individual health and wellbeing. Tobacco andalcohol are two of the biggest contributors to illhealthfor Territorians. Studies show consistently thatTerritorians have Australia’s highest rates of tobaccoconsumption. Territorians consume alcohol atlevels that lead to unacceptable violence, avoidableaccidents and reduced workplace performance.Tobacco and alcohol add illness and disability to thelives of too many Territorians.8Department Health and Families

The Department has continued its efforts to tacklethese and other determinants of health. In step withchanges in the broader community, for example theextension of smoking bans in licensed premises, theDepartment is making its own efforts to tackle smokingin the workplace. Like other employers we continue towork to provide our staff and customers with a safeenvironment, so from 1 July 2009 a DepartmentalwideSmoke Free Policy was introduced, covering hospitals, and Departmental vehicles. To help ourpatients and staff we have offered smoking cessationsupport, such as nicotine replacement therapy, whichhas been shown to help people to quit.Like the rest of Australia, the Northern Territorystands at the threshold of health sector reform. InMay the Northern Territory Government joined otherjurisdictions in signing up to a milestone agreementthat will lead to the introduction of national healthreform. This marks a fundamental shift in the wayhealth care is funded and delivered. Changes arecoming to the way general practice and primary healthcare are funded with the Australian Governmentassuming full funding and policy responsibilities. Inaddition, the Australian Government will become aThe critical issues will be to protect what works wellin our health sector while working hard to ensure thatwe remain active, engaged and open to new ways ofworking that deliver better outcomes for Territorians. well and is on the front foot on many of the issuesassociated with this reform.reforms but also from our ongoing work to do betterhere at home. The Department has been a majorcontributor, along with the Territory community in thedevelopment of the Territory 2030 strategic plan whichis the Government’s road map for the future. Some ofour Territory 2030 objectives are to reform the Territoryhealth system, focus on better lifestyle practices andmore comprehensive out-of-hospital support. To this new facilities in the past year.These include the $27 million Radiation OncologyUnit in Darwin and Barbara James House, a$4 million accommodation facility for cancer patientsand their families, who need to be in Darwin toaccess cancer treatment. Construction of thePalmerston GP Super Clinic nears completion,with the adjacent Palmerston Urgent Care AfterHours Service already providing care from 6.00 pmuntil 8.00 am, seven days a week.In late 2009 the Government announced anindependent Inquiry into the Child Protection System.The Board of Inquiry is due to present its report in thesecond half of 2010.The Department views the Inquiry as a valuableopportunity for analysis of how the Territory’scare and protection system needs to look in thefuture. The Department’s submission to the Inquiryexamined all areas of the child protection system,such as workforce retention and development, intake,statutory intervention, out of home care, legislation,the role of the non-government sector, the role ofother government agencies, services in rural andremote locations and support for families, includingservices for Indigenous children and families. on the professionalism and dedication of our manystaff members, be they in service provision, policyor support roles. I sincerely thank everyone for theirefforts over the past 12 months.On behalf of the Executive team I wish to thank thoseserving on the Advisory Councils and the Committeesthat provided valuable input and assisted us in theplanning and delivery of services. I would like toextend my appreciation to the many communitymembers who have supported our hospitals andother services as volunteers.I wish to note the departure of former Chief Executive,Dr David Ashbridge, who so ably led the Departmentover several years, including most of this year. Davidhas taken up an exciting new opportunity in a leadingrole in the Victorian Health system. His inspiringleadership helped make the Department theorganisation it now is, and we thank him for hiscontribution.I would also like to thank Mr Alan Wilson, who wasacted as Chief Executive for several months beforereturning to New Zealand to take up a senior healthexecutive position.Recognition and thanks also goes to Ms JennyCleary for her valuable contribution whilst acting inthe position of Chief Executive during the year.Our team has made a real difference in so manypeople’s lives, and we should all be proud ofour achievements. I thank you all for yourwonderful support.Department Health and Families 9

10Department Health and Families

Our MinistersDuring 2009-10 Ministerial responsibility for the Department fell to three Ministers:Minister for Health, Children and Families, Child ProtectionHon Konstantine Vatskalis MLAMinister for Young and Senior Territorianscurrently Hon Daniel (Rob) Knightpreviously Hon Malarndirri McCarthy MLAMinister for Women’s PolicyHon Malarndirri McCarthy MLAOur ExecutiveThe Executive Leadership Group (ELG) provides strategic management and leadership to the agency. Thisgroup experienced a considerable change during this year due to resignations including the Chief Executive.ELG VisionGetting the best out of our resources and our peopleELG MissionWe provide strategic leadership to our staff in the support of the healthy wellbeing of all Territoriansand we ensure the alignments of all our available resources to best meet this challengeJeff MoffetChief ExecutiveThe Chief Executive commenced in the position in September 2010 after acting as the Chief Executive of WACountry Health Service, the largest country health service in Australia.He is a highly experienced health administrator who has occupied senior leadership and management rolesin the rural and remote health sector for the past decade. Jeff Moffet has extensive management experienceoverseeing health service delivery in the vast Pilbara and Kimberley regions. He held a clinical position as aphysiotherapist in Darwin in the early 1990s.Department Health and Families 11

Dr Barbara PatersonCorporate Plan Priority Action Leader for:Targeting Smoking, Alcohol and Substance AbuseBarbara is a medical graduate and Public Health Physician. She has over 18 years experience in Aboriginalservice provision with the AIDS/STD Unit of the Centre for Disease Control and child health policy andprogram development. She became a Fellow of the Australasian Faculty of Public Health Medicine in 1995.As Program Director, Maternal, Child and Youth Health, she had a Territory-wide role in development andmonitoring of evidence based policy, strategies and programs, contributing to national policy directions.Barbara began her current roles in August 2008.Prof. Shane HoustonExecutive Director, Systems Performance and Aboriginal PolicyCorporate Plan Priority Action Leader for:Safety, Quality and AccountabilityProfessor Shane Houston is a Gangulu man from Central Queensland. He has worked in Aboriginal Affairsfor more than 30 years holding many roles at local, state and national levels. Shane has worked intenselyMedical Service and National Coordinator of the Aboriginal and Torres Strait Islander Health Organisation.He has also held senior executive positions in the public sector for more than 17 years. In his currentrole he is responsible for monitoring the performance of the Northern Territory health system and for thedevelopment and promulgation of a strategic Aboriginal policy agenda.Professor Houston completed his PhD at Curtin University in 2003 graduating with a Chancellor’sCommendation. Shane was appointed Adjunct Professor of Health Sciences at Curtin University in 2006 andProfessor in the School of Medicine University of Notre Dame, Sydney in 2008. In 2009 Shane was awardedthe Chief Minister’s Public Service Medal for meritorious and outstanding public service for his contributionsaimed at improving the cultural security of services in the health sector.12Department Health and Families

Jenny ClearyExecutive Director Health ServicesCorporate Plan Priority Action Leader for:Promoting and Protecting Health and Wellbeing and Preventing InjuryJenny has worked in various areas of public health for more than 20 years. In October 2006 she wasappointed to her current role of Executive Director Health Services with the Northern Territory Departmentof Health and Families. The role encompasses all government health service delivery in the Territory outside ofthe hospital setting including remote health centres, urban community health centres, child health and wellbeing,health development and oral health, preventable chronic disease, mental health and aged and disability services.Prior to this Jenny worked in health system reform, primary health care and public health services managementand policy. She played a key role in implementing the three successful remote area Northern TerritoryCoordinated Care Trials.Jenny has a Masters in Public Health and represents the Territory on the Australian Population HealthDevelopment Principal Committee and Chairs its Child Health and Wellbeing Subcommittee.Clare Gardiner-BarnesExecutive Director NT Families and ChildrenCorporate Plan Priority Action Leader for:Healthy Children and Young People in Safe and Strong FamiliesSince January 2010, Clare has been the acting Executive Director, NT Families and Children and waspermanently appointed to the position in June 2010.Prior to working in the Territory Clare worked for the Queensland Government within both the Department ofEducation and Training and the Department of Families undertaking a range of duties including: acting in the position of Assistant Director-General, Student Services with responsibility for policy andimplementation of disability services, child protection, health and wellbeing, behaviour management and leading the implementation of the senior schooling reforms including the ‘earning or learning’ policy andClare holds a Diploma of Teaching (Primary), Graduate Diploma of Arts (Leadership) and a Masters in SocialWelfare Administration and Planning. She has a strong interest in developing effective partnerships acrossGovernment and non government agencies to better align strategy and practice.Department Health and Families 13

Peter BeirneCorporate Plan Priority Action Leader for:Attract, Develop and Retain a Workforce for the FuturePeter Beirne has responsibility for Performance and Resources areas including People and Services,Information Management, Finance and Facilities. Peter is Chair of a number of the Department’sgovernance committees on behalf of the Chief Executive and is also a representative on the AuditCommittee and Principal Quality and Safety Committee.Peter has a commercial background from a number of industries in New Zealand and the UnitedKingdom. Peter worked for 10 years in public health sector management in New Zealand. He holds athe Institute of Directors, New Zealand.Peter is the Northern Territory representative on both the National Health and Information PrincipalCommittee and the Health Workforce Principal Committee.Jan EvansActing Deputy Chief Executive for Acute CareCorporate Plan Priority Action Leader for:Connecting CareJan Evans has been in the Northern Territory Public Service in senior management positions since 1989.She was with the Department of Justice for 10 years before transferring to the Department of Health andFamilies in 1998. Since joining the Department of Health and Families Jan has held senior Executivepositions with responsibility for Executive Services, Ministerial Liaison, Media, Public Relations andCorporate Communications, Legal Services, Audit Services, Corporate Services, Human Resources,Industrial Relations and Workforce.In August 2007 Jan took on the role of Deputy General Manager at Royal Darwin Hospital and actedas General Manager for periods of time throughout 2009 and 2010 whilst a new General Manager wasrecruited. In July 2010 Jan commenced acting in the position of Deputy Chief Executive for Acute Care.14Department Health and Families

Dr Barbara PatersonMBChB, DCH, DGM, DRCOG, MRCGP,MPH, FAFPHMBuilding on evidence to reduce theburdenMost people in the Northern Territory live long,productive lives. However, our population is alsosubject to a heavy burden of disease and we face adisadvantage, with life expectancy at birth in theTerritory some 12.6 years less for Aboriginal thannon-Aboriginal women and 19.3 years less forAboriginal than non-Aboriginal men. While wecontinue to respond to the many immediate needsfor health and family services, we must continueand increase our focus on prevention, includingan engagement beyond the health sector to helpaddress the underlying determinants of health. Toachieve the best possible health outcomes and makeour policies, programs and services must be informedby the best evidence available.The burden of disease and injuryBurden of disease and injury (BOD) is aninternationally accepted method to assess theimpact of about 180 diseases in terms of both deathand disability. It is used as a priority setting tool inhealth planning when considering cost effectivenessanalysis or interventions.This year, the second Territory Burden of Diseaseand Injury Report was produced by the Health GainsPlanning Branch of the Department. The study also comparison of BOD in the same population over time.Mental health conditions, cardiovascular disease,diabetes and cancer accounted for over 50% of theburden of disease in the Territory, as shown in table 1.Table 1 Percentage contributions of the top ten majordisease categories to the total disability adjusted life years(DALY) by sex, Northern Territory, 1999-2003Major diseasecategoryPercentage of totalMale(DALY=100 750)Female(DALY=73.843)Persons(DALY=174 593)Mental 14.9 18.3 16.3Cardiovascular 13.9 10.3 12.4Diabetes 10.9 10.0 10.5Cancer 9.3 9.6 9.4Neurological 7.4 8.0 7.6Chronic6.9 7.2 7.0respiratoryUnintentional7.9 4.3 6.4injuriesIntentionalinjuries6.2 2.6 4.7The number of years lived before suffering a disabilityor death, as measured by the health adjusted lifeexpectancy, is estimated to be 19 years shorter forTerritory Aboriginal females than the national average(56 years in comparison to 75 years) and for TerritoryAboriginal males 20 years shorter (51 years incomparison to 71 years).Comparing the Territory with Australia as a whole,the relative disease burden among the Aboriginalpopulation is 3.6 times greater than the non-Aboriginalpopulation and 1.2 greater than national rates. Togetherthe Territory’s burden of disease is 1.7 times the nationaland services in the Territory.Department Health and Families 15

In comparing data between 1994-98 and 1999-03, theAboriginal population showed a small improvementin fatal outcomes, however this was more than offsetby the increase in non-fatal outcomes leading to the non-Aboriginal population the total disease burdenremained stable with a small reduction in fatal outcomesoffset by an increase from non-fatal conditions.To a substantial extent the improvements in fataloutcomes can be credited to improvements inmedical science and the contributions from primaryhealth care and hospital services. However thereare costs associated with people ‘living longerbut living sicker’. It is important in this context toconsider the attributable risk factors for disease andinjury in order to prevent or moderate their impact.BOD study. High body mass index (obesity and overweight), physical inactivity, tobacco and alcohol eachcontributed to between 5% and 11% of the diseaseburden, but not surprisingly low socioeconomic statuswas the leading risk factor, with 27% attribution of thetotal Territory burden of disease and injury.Table 2: The determinants of health and risk factorsRisk factorAttributableDALYsAttributableproportionLow socio-economic46 790 26.8%statusHigh body mass index 19 362 11.1%Physical inactivity 19 280 11.0%Tobacco 14 191 8.1%Alcohol 7 794 4.5%High blood cholesterol 7 364 4.2%High blood pressure 6 803 3.9%Low fruit and vegetable5 736 3.3%intakeIntimate partner3 316 1.9%violenceIllicit drugs 2 694 1.5%While improved survival has come with the advancesin medical science and improved services, the priorityof reducing and preventing the incidence of diseaseremains. Prevention however, requires us to addressthe determinants of poor health and substantialchanges in life-style behaviours associated withdisease risk. Risky behaviours include smoking,high alcohol consumption, poor diet low in fruit andvegetables and little exercise.Income and social status, education and housing areinternationally recognised determinants of health.Education is a strong predictor of health withcountries that invest heavily in education showingbetter health outcomes. Education is also a predictorfor teen pregnancy, with increasing years of formalCommunity engagement, social support networksthe health and wellbeing of populations. These areall extremely pertinent in the Territory, where we havelarge disparities in income, education and housingbetween Aboriginal and non-Aboriginal Territorians.The ‘Pathways to Community Control’ strategy is animportant factor in developing culturally appropriateservices with local governance.factors lie within the direct control or responsibilityof health departments and affecting change requiresstrong public policy and support from industry andin contributing to cross government planning andcollaboration, providing information and evidence toinform policy and debate, as well as promoting healthylifestyles, encouraging early diagnosis of disease andimproving management of existing conditions.Preventable chronic conditionsThe landmark Northern Territory Preventable ChronicDisease Strategy (PCDS) was launched in 1999 toprovide an integrated approach to primary prevention management of chronic disease. It also played ain this area. The PCDS was a ‘working strategy’ thatwould change as new evidence became available.This year, following formal review and extensiveconsultation and collaboration with partners in thenon-government, private and Aboriginal healthsectors, the new Chronic Conditions Prevention andManagement Strategy 2010–2020 was launched. serves as the framework encompassing a systemwideapproach to prevent and reduce the impactof chronic conditions for all Territorians, taking intoaccount the determinants of health.The theme for the next Chronic Disease NetworkConference to be held in September 2010 is ‘Health16Department Health and Families

18The role of legislation in improvinghealth outcomesContemporary research drives policy, which in turnunderpins legislation and regulatory regimes thatprotect people from harm.Tobacco use continues to be the number one causeof preventable death and illness in the NorthernTerritory and is directly implicated in over 15 000deaths in Australia each year and leaves many moredisabled or chronically ill. Nearly 20% of adult deathsand 3% of hospital admissions in the Territory areattributable to smoking.During 2009-10 the amendments to the TobaccoControl Regulations removed the exemption forlicensed premises to comply with indoor smokingbans. This change was successfully implemented on 2January 2010, resulting in a complete ban on smokingin all enclosed public areas in the Territory. This inturn, has seen an increase in calls to the Quitline ofcomparison to the same period in 2009.In June 2010, further reforms to the Northern TerritoryTobacco Control Act saw the introduction of: a ban on smoking in all public outdoor eatingand drinking areas (with exempt areas for the prohibition on the display of tobacco products power for owners and occupiers of outdoorpublic areas to declare the area smoke free with licensing of tobacco retailers which will requirean annual licence fee and renewal process, aswell as new licence conditions that will ban fruitdata to be submitted.These amendments complete Government’scommitment to tobacco control reform to ensurethat the Territory now has a regulatory framework ontobacco comparable with other legislation in Australia.to protecting staff and the public from environmentaltobacco smoke, reducing exposure to smoking andtobacco products and improving the monitoring oftobacco sale and supply.Amendments to the Volatile Substance Abuse Actalso came into effect during 2009-10. These changesallow for more expedient assessment processes andDepartment Health and Familiesexpansion of mandatory treatment options that is notonly residential but also non residential and otherappropriate interventions, thereby increasing thescope of treatment options.Although not directly responsible for alcohol legislation,the Department has professionals with specialistknowledge and interest in alcohol prevention, educationand health promotion who contribute to policy andprogram planning in partnership with the Departmentof Justice and Northern Territory Police. This year, theDepartment was involved in an analysis of the Costsand Harms of Alcohol within the Northern Territory.The report shows that Territorians are drinkingat levels far in excess of the rest of the country.On average, Australians drink approximately 10 litresof pure alcohol per person per year and Aboriginal andnon-Aboriginal Territorians consume approximately15 litres per year, which is 50 per cent higher.The total social cost of alcohol in the NorthernTerritory is estimated at $642 million per year. At acost of $4197 per adult, this is substantially higherthan the national level of $943.There are a number of potential legislative andenforcement measures currently being considered toreduce consumption and subsequent harms causedby alcohol, however the drinking culture of theTerritory must also change. This high consumptioncannot be simply attributed to a small number of‘problem drinkers’ in certain sectors of the community,heavy and regular alcohol consumption is considereda social norm and this needs to be further opened upto public debate.We cannot waitThe rapid rise in the prevalence of chronic conditionsis seen nationally and throughout the developedworld and is predicted to increase. In the Territory wehave the added burden with even higher rates in theAboriginal population. The social and health servicecosts of our burden of disease and injury placeconsiderable pressures on our hospitals and primaryhealth care services and society at large.This situation makes it imperative that the Territoryplaces a priority on prevention, to address thedeterminants of health and social risk factors, torecognise the importance of early years throughinvestment in early childhood health, family supportand education services as well as to provide bestpractice management of chronic conditions.

Aboriginal Health and FamiliesProf. Shane HoustonPhD.Aboriginal Health ReformImproving Aboriginal health and the wellbeing of familiesis a priority for the Department not the least becauseAboriginal Territorians make up such a large slice of ourbusiness. In 2009–10 Aboriginal people were the majorityof our clients. Aboriginal people comprise 70% of ourhospital inpatients. In Families and Children ServicesAboriginal people make up about 75% of children in outof home care.Aboriginal health and wellbeing is core business, this isnot just a statement of policy aspiration, but a servicefact. Unlike other jurisdictions where Aboriginal peoplecomprise a minority of service consumers, the Territorymust embrace the issues associated with deliveringservices to Aboriginal communities and families to theheart of its policy and programming decision making.The Government set an ambitious agenda in AboriginalHealth and Families - A Five Year Framework for Actionbased on two key needs: Building Better Services andBuilding a Better Department. Over the past year anumber of important milestones and achievements havebeen met and a number of moments of clarity have beenrealised on this important and ongoing journey.Building better services has involved a number of differentelements. With our partners AMSANT (AustralianMedical Services Alliances of the Northern Territory)and the Australian Government, the Department hascontinued the roll out of expanded primary health careservices in the bush. Over the last year this growth can beIn 2009–10 we have seen a 5% growth in the RemoteHealth Budget. There are now more staff working ina 3% increase in staff numbers over last year and themajority of these have been in front line roles like nursesand Aboriginal community workers. In a national climateof workforce shortages in key occupations we are seeingyears ago. Over the same period we have seen newservices like the Remote Outreach Midwives programand the many initiatives being run by the new AboriginalCommunity Workers hitting the ground where they areneeded. These changes are important given more than80% of Aboriginal Territorians live outside Darwin.New staff and programs will generate new demandfor services not just in the primary care setting but inhospitals and in family and children services areas too.true in our case and the Department has already seenadditional hospital activity because our primary healththe health needs of Aboriginal people.The Department provides services across the Territory24 hours a day. Providing the best services we canrequires strong and constant attention to the issuesof quality and safety. We have a highly professionalstaff operating in an environment that is so different tothe skills and professional behaviours of staff equip themto discharge their responsibilities well.Based on the work the Department has undertakenunder the rubric of its Cultural Security policy, newcross cultural training courses were designed andtheir implementation commenced importantly as acontribution to the new whole of the Northern TerritoryGovernment Cross Cultural Training agenda. Ensuringthat staff are able to understand and operate effectivelyin the cross cultural space is critical in a DepartmentDepartment Health and Families 19

where Aboriginal people make up the majority of ourclient base. Understanding this policy and how the success now forms part of the orientation for new staffin our agency. Evaluation of the orientation programindicates that staff understand the importance ofeffectively engaging in the cross cultural service spaceand have a real hunger for more information and moretraining to help them do well in the Territory’s Aboriginaldominated service environment. The Department willin the coming year, respond to this and build yet bettercross cultural competence in staff and services.The employment of Aboriginal people stands as a strongpolicy objective within the agency. Already about 10%of staff are Aboriginal or Torres Strait Islander and wecontinue to look for better ways of attracting Aboriginalpeople to the agency. The Department’s effort to build aschool career pipeline continues with an ongoing focuson apprenticeships and engagement with Aboriginalstudents. Creating new roles within the Departmentin response to new opportunities and demands alsoprovides an opportunity to grow Aboriginal employment.For example the creation of the Aboriginal CommunityWorker role as an important bridge between familiesfunction gap and generates local job opportunities in theDepartment for Aboriginal people in the bush.The Department’s commitment is not just in trying toattract new Aboriginal staff but in providing developmentopportunities for existing staff so that they can buildlong term careers in our agency. 2009–10 saw thecommencement of the second intake of the Stepping UpProgram. Open to Aboriginal staff across the Departmentthe Program provides a structured career developmentopportunity where individual career developmentplans are mapped and negotiated for the successfulparticipants. These plans include access to formalcourses and placements in new roles that are meant toexpand the experience and competence of participants.Eighteen Aboriginal staff from different parts of theTerritory have now been part of this innovative initiativeand early indicators show that the Program is valuedand producing results.Alongside of these efforts to engage Aboriginal staff inmore senior roles are the Department’s efforts to engageAboriginal people more broadly in the planning, provisionand evaluation of health and families services in theTerritory. Over the year the Department has been partof a program of development that seeks to encourageAboriginal participation in the delivery of services. WithAMSANT and the Australian Government, the Territoryhas been working to map, encourage and facilitate thedevelopment of regional arrangements that will integrateTerritory funded and Australian Government fundedprimary health care services into a single regional modelin which Aboriginal communities play the dominantmanagement role.Integration under this regionalised model will provide aequitable distribution of resources and services, bettertargeted at local needs and managed by locals from engagement, not just in terms of making the system abetter more responsive operation, but also in terms ofdelivering healthier outcomes to those who get involved.The policy foundation for this work, Pathways toCommunity Control, was developed here in the Territoryand is increasingly gaining national recognition as a wellstructured model that has potential in many locationsacross the country.Better skilling our people, better integrating andexpanding services on the ground are essential to ahealthier future for Aboriginal Territorians. Being able tobetter monitor our efforts and the outcomes from them isalso vital. In the Territory Departmental and communitycontrolled health services provide the great majority ofprimary health care services to Aboriginal Territorians.Clients sometimes move between providers andensuring that critical health information is available at thepoint of service is essential if we are to do the best wecan. Many thousands of Aboriginal people in the bushhave agreed to join a shared electronic health recordsystem and over the past year we have seen continuingsuccess and use of this system. Similarly, Aboriginalcommunity controlled services and the Departmenthave agreed to consistent reporting against a numberof key performance indicators. This year more than 80individual community based reports against those keyindicators were released to providers. This developmentprovides an example of co-operation in the interests ofclient needs and better performance.There are many challenges in moving to reform thedelivery of health and wellbeing services to Aboriginal see real promise in the work that the Department hasundertaken but they too will no doubt see, as we do, thatthere remains much to be done. Doing better requiresan ongoing commitment to review and adaptation ascircumstances change but also sustaining what works inan increasingly complex policy and service environment.20Department Health and Families

Corporate Plan 2009 - 2012Vision, Mission and Organisational ValuesOverviewThe Department of Health and Families’ Corporate Plan 2009-2012 (launched in Augustbeing of the greatest importance. These areas overlap and intermesh, and together theythe highest standard of health and family services to all Territorians.Department’s Corporate Plan, our blueprint for advancing our vision of Healthy TerritoriansLiving in Healthy Communities.Department Health and Families 21

Promoting and Protecting Health andWellbeing and Preventing InjuryThe key to improving population health and wellbeing lies in a stronger focus on promoting good health, encouragingthe adoption of healthy behaviours, controlling the spread of disease and preventing harm and injury.and illness prevention should be a more prominent part of Australia’s health system. Whilst the current healthsystem is geared towards detecting, diagnosing and treating health problems, a more proactive approach is tofocus on health promotion, health protection and prevention across the life span.This includes taking action on the social determinants of health to promote equitable health outcomes acrossAustralia, particularly in relation to Aboriginal people especially those living in remote communities. It involveseliminating or reducing common risk factors,such as tobacco use, unhealthy diet, physicalinactivity and the harmful use of alcohol. It alsoinvolves developing effective responses topublic health emergencies and natural disasters,controlling important emerging health threats,and addressing the health related aspects ofclimate change.We delivered in 2009-10Public Health Coordinators are now inplace across Health Service Delivery Areasworking with staff to implement communitybasedstrategies to address chronic disease.Key focus areasFocusing on health promotion and minimisingunhealthy behaviours and their impacts.Improving health awareness to reduce costpressures on the health system that are derived frompreventable chronic diseases.Assist in ‘closing the gap’ in health outcomes and lifeexpectancy between Aboriginal and non Aboriginalpopulations in the Territory.Building staff capacity and expertise in health promotion is critical to success. A total of 139 Departmentalstaff attended health promotion quality training using the Quality Improvement Planning System ProgramIV in Population Health was granted under the Commonwealth Productivity Places Program. Twenty-ninepeople attended Health Impact Assessment training in Alice Springs and Darwin.Launched the Northern Territory Chronic Conditions Prevention and Management Strategy 2010-2020 inNovember 2009. The strategy was developed in collaboration with non-government, private and Aboriginalhealth sectors and serves as a framework to guide the prevention and management of chronic conditionsfor all sectors across the Territory. It is intended for use by a broad range of stakeholders - overnment, nongovernmentand private health sectors, Aboriginal Community Controlled Health Services, research andeducation organisations and consumers.Implemented activities highlighted in the Cardiac Services Review including Nutritionists working withOutback Stores, Arnhem Land Progress Association (ALPA) and individual store managers to implementnutrition policies. Training packages titled ‘Eat Better, Move More’ were also developed for communitybased staff.Implemented the Department’s Smoke Free policies in all community health facilities. This has included freeaccess to Nicotine Replacement Therapy and counselling for staff. Tobacco control activities commenced inthe majority of East Arnhem communities, including roll out of health promotion resources in local languages,brief interventions offered to health centre clients, QUIT smoking programs and community education.To prevent outbreaks of disease the Department integrated and enhanced existing surveillance systems24Department Health and Families

to detect, monitor, report and evaluate public health threats.Continued to work with the Road Safety Coordination Group to provide health related road crash data andcontribute to policy development. Developments include routine reporting of emergency department andhospitalisation injury data with a particular focus on falls, road trauma, water related injury and alcoholrelated injury.Worked with the Department of Justice and Northern Territory Police on alcohol policy and legislation toreduce alcohol related injury. An economic analysis of alcohol related harms was released in July 2010.Implemented the 2009-10 actions in the NT Suicide Prevention Action Plan 2009-11 (launched in Aliceactions and initiatives aimed at reducing suicide and fostering individual and community resilience andnew initiatives include a range of suicide intervention training options that target both Aboriginal and non-Aboriginal populations and also young people over the age of 15.Other initiatives include the provision of training workshops to address non-fatal self-harming behaviouramong young people and the facilitation of annual forums focusing on mental health and suicide prevention.Developed a Departmental Climate Change Policy and Action Plan which includes seven action areascovering abatement of the Department’s greenhouse gas emissions and adaptation to the health impactsof climate change.In 2009-10, the Department provided$9 million for greenhouse abatementtechnology upgrades in Royal Darwin andAlice Springs Hospitals to reduce overallcarbon emissions. The Department workedwith the Department of Construction andInfrastructure to ensure that the design of thenew Emergency Department at Alice SpringsHospital will demonstrate best practice inThe Department participated in the NorthernTerritory Government’s Climate ChangeSteering Committee and contributed to theDepartment of Lands and Planning’s sustainability strategic planning process.Additional InitiativesA further eye blitz was held in Alice Springs in early2009-10 with ongoing work to sustain ophthalmicprocedures throughout the year. Further negotiationsare being conducted between the Departmentof Health and Families and Fred Hollows for theconstruction of an Eye Clinic as part of the out-patientsarea of Alice Springs Hospital.Where we are going in 2010-11Launch a Chronic Conditions, Prevention and Management strategy Implementation Plan at the ChronicDisease Network Conference in September 2010.Implement a Mental Health Service 24 hour triage liaison and response service.Undertake a Mental Health Consumer and Carer Participation Review.Establish the Men’s Health Strategy unit.Establish a ‘healthy workforce’ policy (active at work). Progress the development of an Aboriginal Child Health Strategy through the Aboriginal Child HealthAdvisory Group. Develop an NT Early Childhood Development Plan in partnership with the Department of Education andTraining, Police, Fire and Emergency Services, Department of Housing, Local Government and RegionalServices, Children and Families through the Early Childhood Steering Committee. Implement the Whole of Government Disability Strategy.Department Health and Families 25

Finalise Adult Guardianship reform in the Northern Territory including informal decision making frameworks.in the Northern Territory. A pilot will be undertaken in late 2010 to test the framework within the operatingenvironment. In addition, the organisation engaged to facilitate this work NDS NT (National DisabilityService NT), has provided a peak body role for a number of consultation and staff training activities, criticalto reform in the disability service sector. This has included promoting the disability insurance campaignnationally, including in the Territory.Implement Secure Care. Tier 1 Stabilisation and Assessment services will operate as expanded capacity atboth the Darwin and Alice Springs In-Patient Mental Health facilities to enable stabilisation and assessment ofyoung people and cognitively impaired adults whose behaviours place them at a high to extreme risk of harm.Tier 2 Secure Care Group Homes will see new purpose built facilities that will have capacity for 24 hour carefor up to eight young people and eight adults with high risk behaviours. There will be one facility in Darwin andone in Alice Springs. Client groups will be co-located however, each will be within a separate wing of the homeand there will be no interaction between the two client groups. Introduce new Public and Environmental Health legislation.workers. Promote free vaccination for all clinical and non-clinical staff in the Department. Continue the fully funded adult pertussis containing vaccine (dTpa booster) for all new parents and carersin the Territory to protect young infants from pertussis.Climate Change Action Plan. Maintain sentinel chicken surveillance, human disease surveillance and mosquito monitoring andsurveillance. Alert the public during risk periods for mosquito borne disease. Carry out mosquito controlaround major population centres, as well as exotic vector exclusion. Support the Top End and Central Australia Falls Prevention Networks to improve delivery and coordinationof falls prevention and management programs.26Department Health and Families

PRIORITY ACTION AREA 2Healthy Children and Young Peoplein Safe and Strong FamiliesExecutive DirectorNT Families and ChildrenMs Claire Gardiner-BarnesACTIVITY REPORTDepartment Health and Families 27

Healthy Children and Young People inSafe and Strong FamiliesThe Northern Territory has a high proportion of young people: 24.5% of the total population is aged between 0-14live in the Northern Territory and over 50% of the Territory’s Aboriginal population are aged 25 years or younger.Today’s young are the leaders and parents of tomorrow and their health, safety and wellbeing are essential.The foundations for health and wellbeing are laid down before birth and during early childhood. Good antenatalcare is needed to optimise maternal and birth outcomes together with services to support parents, promotechild development and learning. Early detection and management of health and developmental problemscan have a positive impact on both current andfuture health, educational attainment and socialfunctioning.Key focus areasAll families want the best for their children andyoung people. Some families require only minimalmay struggle with the many challenges of raisinghealthy, strong children and providing a safe familyand community environment. When necessary, theDepartment undertakes protective interventionsto safeguard the wellbeing of children and youngpeople facing unacceptable risk or harm. TheDepartment also supports families, young peopleand communities to address antisocial behaviourof young people.We delivered in 2009-10Enhancing the system for integrated maternity, earlychildhood and school-age health and wellbeing services.Strengthening the Northern Territory’s childprotection system.Building family and community strength and resilience.Working together with the non-government sector tosupport vulnerable families.as antisocial behaviour, domestic and family violence.Implemented a pregnancy education book for Aboriginal and Torres Strait Islander women to provideconsistent and accessible pregnancy and early parenting information.to Aboriginal women under 25 years and their infants and families in some remote communities.aim of decreasing teenage pregnancy rates and improving early access to health care during pregnancy.knowledge in a culturally safe way to Aboriginal women and girls in remote communities around sexualhealth, pregnancy and early parenting education. This program acknowledges the importance of cultureas a component of health and wellbeing.program incorporates key assessment and information prompts for practitioners to assist in identifyingrisk factors associated with failure to thrive including a focus on family function and social factors toprovide a comprehensive picture of the child’s life, assessment of social supports (risks) and act as anearly warning system, and provides a basis for appropriate interventions.and enhancing their skills, utilising and building on their knowledge and providing a platform for practitionersto provide referrals for more targeted interventions and services.28Department Health and Families

to parents at key ages i.e. exclusive breastfeeding until six months, introduction of solids at six months,hygiene and oral health.program, to address issues impacting on parenting and developing early literacy skills. Psycho-socialstimulation of infants has been demonstrated to be as equally important as nutrition in rehabilitatingways that recognise the Territory’s diverse cultural and linguistic nature.address the new National Framework for Protecting Australia’s Children. including sexual health issues in children and young people. The review recommended comprehensivereform. A key aspect of the reform was the introduction of Structured Decision Making tools to improvethe consistency and accuracy of decision making at intake.particular connection to Aboriginal culture. between 16 and 24 years exiting the Out of Home Care system.and child protection considerations to the disability service sector. The MOU is being considered as partof the Community Services Network Program’s agenda. Government funding from the Alice Springs Transformation Plan. A Family Group Conference model is beingused in the pilot, with the Community Justice Centre providingindependent convenors for the conferences. 48 youth camp participants for 2009-10 (Tangentyere 38,Brahminy 10). consolidated Family Support Centres in Darwin and AliceSprings. The Inter-agency Collaboration Panels located inDarwin and Alice Springs Family Support Centres considered89 families (Darwin 44, Alice Springs 45).of domestic and family violence has been implemented.It seeks to improve community and agency awarenessacross the Territory about the effects of child abuse andneglect, mandatory reporting obligations and other initiativesto improve the safety of children.funds to eight non government organisations (crisisaccommodation services) to enable provision of additionalsupport services, including counselling, for women and/orchildren escaping domestic and family violence.Department Health and Families 29

Where we are going in 2010-11In 2010-11 the focus will be on activities such as: A review of out of home care and the establishment of new models. Grow Therapeutic Services capacity in Katherine. Establish, as part of the Differential Response Framework implementation, Aboriginal Targeted FamilySupport Services in Darwin and Katherine and expand the Alice Springs service with Australian Governmentfunding from the Alice Springs Transformation Plan. Develop an NT Violence Against Women Strategy to increase access to counselling services to reduce theincidence and impact of domestic and family violence. Implement Phase Two of the “Be Someone” campaign which targets witnesses of domestic and family violence. Substantially increase core funding to the Northern Territory Council of Social Services (NTCOSS) toimprove the capacity of the non government organisation (NGO) sector to advocate on critical socialinclusion issues. Proactively work with the NGO sector to explore new service models and the role of partnerships in the deliveryof family support and care and protection services, including scoping a workforce development strategy. Open new Safe Houses in Wadeye and Gunbulanya. Develop accommodation options in Palmerston for young people at risk. Expand the capacity of Emergency Departments to respond to victims of family violence through a joint NTFamilies and Children and Acute Care Division initiative. On 11 November 2009 the Northern Territory Government announced a public inquiry into the Territory’sChild Protection service. Upon the release of the Inquiry’s recommendations the Department will implementthe recommendations made by Government, which will include a strong cross Government focus.30Department Health and Families

PRIORITY ACTION AREA 3Targeting Smoking, Alcoholand Substance AbuseDr Barbara PatersonMBChB, DCH, DGM, DRCOG, MRCGP,MPH, FAFPHMACTIVITY REPORTDepartment Health and Families 31

Targeting Smoking, Alcohol andSubstance AbuseSmoking, alcohol and substance abuse affects thehealth and wellbeing of individuals and their families as the health and community service system. Tacklingsmoking, alcohol and substance abuse, and thedamage it causes, is a priority for the Departmentbecause of its imposts on all facets of health rangingfrom disease, injury, disability, family violence and childdevelopment, protection and care. Aboriginal peopleare at particular risk of smoking-related disease,including preventable chronic disease, because of theirhigh rates of smoking.Many Territorians consume alcohol at levels judged as risky in the long term. The alcohol attributable death rate ofAboriginal Territorians is more than eight times the national average, and twice that of non-Aboriginal people. Heavydrinkers and their families are more likely to experience alcohol-related violence, injury and illness.The Department has an important role in reducing the impact of substance abuse through the provision oftreatment and rehabilitation services, acute and primary health care and in providing family support and children’sprotection services. The agency also has a role to prevent substance related harm through the development andimplementation of effective legislation, policy, health promotion and education.We delivered in 2009-10The Department of Health and Families Smoke Free Policy came into effect on 1 July 2009 across allDepartment services, premises and grounds. It supports staff and patients to quit smoking through theprovision of smoking cessation courses and nicotine replacement therapy. Introduced changes to the Tobacco Control Regulations banning smoking in all enclosed public areas from 2January 2010, supported by a comprehensive public campaign.Provided improved protections from environmental tobacco smoke by amending the Tobacco Control Act andits Regulations to provide for restrictions on smoking in outdoor eating and drinking venues, prohibiting thedisplay of tobacco products at point of saleand to better monitor tobacco sales throughthe introduction of tobacco retail fees.Enhanced access to alcohol and other drugscreening, referral and interventions forpatients in Alice Springs and Royal DarwinHospitals by implementing the hospitalbased Interventions Project.Key focus areasDeveloping and delivering targeted health promotionand educational strategies and messages.Assisting in the development and implementationof effective legislation and policy, including having alegislative and clinical responsibility under the VolatileSubstance Abuse Prevention Act, Tobacco Control Actand the Poisons and Dangerous Drugs Act.Offering a range of treatment and rehabilitation services,acute and primary health care and family support andchild protection services.Partnered with the Department of Justice ona joint funded Menzies School of Health Research Substance Misuse Research Program to contribute to alocal knowledge and research base on alcohol and other drugs.Supported people to quit smoking through print advertising and airing two new television commercials aboutAdditional InitiativesPublished the Northern Territory Tobacco Action Plan2009-2012 as a framework to guide tobacco controlactivities and strategies across the Northern Territory.32Department Health and Families

the health effects of smoking from December 2009 to March 2010.Developed and applied new methods for determining the proportion of deaths in the Territory and admissionsin Territory hospitals which are attributable to alcohol as part of the Northern Territory Alcohol IndicatorsProject and to inform public policy on alcohol.Where we are going in 2010-11 Legislative options for the storage of volatile substances in retail outlets will be developed. New legislation to replace the Poisons and Dangerous Drugs Act will provide the Territory with contemporarymedicines and therapeutic goods legislation which harmonises with other Australian legislation and supportscontemporary best practice. A public awareness campaign about the new outdoor smoking restrictions under the Tobacco Control Actwill be developed and implemented. Targeted education and information campaign about smoke free areas in outdoor eating areas will beimplemented for registered food businesses. Commencement of the Remote Tobacco Education and Cessation Team, based in Darwin and AliceSprings. A detailed review into the harms and economic costs of tobacco in the Northern Territory will be conducted. A ‘how to’ guide for Management Areas and Management Plans under the Volatile Substance AbusePrevention Act will be developed. The construction of new Sobering Up Shelters in Katherine and Tennant Creek will be completed. Six joint Mental Health and Alcohol and Other Drug positions will be piloted in East Arnhem to supportclients affected by co-morbidity. Construction of a Nhulunbuy Special Care Centre(alcohol and rehabilitation centre) Manager’s Cottage andcompleted. Integration of Brief Intervention training into all Departmentof Health and Families primary and acute care services,including development of an internet based learningmodule.Department Health and Families 33

34Department Health and Families

PRIORITY ACTION AREA 4Connecting CareA/Deputy Chief Executive for AcuteCare ServicesMs Jan EvansACTIVITY REPORTDepartment Health and Families 35

Connecting CareAlmost every Australian will receive hospital care at some time in their life, whether in a birthing suite, outpatientsdepartment, emergency department, medical or surgical ward, cancer care facility, or a palliative care unit.Many will attend community health and remote health centres, and renal dialysis units, or receive help formental health concerns. Support services for families and children are also accessed frequently.A particular priority is to help people better manage their health and wellbeing in a non-hospital setting. Whenhospital visits are necessary, these should be handled in ways that are more convenient to the patient, offercare, earlier discharge and hospital-in-the-home strategies, and closer collaboration with General Practitionersand community health services.The Northern Territory is the nation’s most culturally diverse and geographically dispersed jurisdiction. It has a smallpopulation yet many complex health challenges. It also has the nation’s highest per capita rate of hospital admissions.Providing more alternatives to in-patient care must be the way of the future. Aboriginal people have a high burdenof disease that requires particular attention. This is aspecial challenge in the more remote communities.Key focus areasFamilies and the individuals who comprise them arecentral to the Northern Territory’s social fabric and to preventive, primary and acute health care provision, andthe support services that we provide. The Department’smatrix of health care and family services will continueto help Territorians have a good start in life, enjoy ahealthy childhood and adolescence.We delivered in 2009-10Working effectively and proactively with partners in thebuild the best possible service system for the NorthernTerritory.Placing clients and their needs at the centre of serviceplanning and service delivery.Ongoing participation in Territory Growth Town forums, collaborating with relevant agencies, to ensurethe Territory Growth Town initiatives.Planning is currently underway with a range of stakeholders to commence sexual health research into thecultural context and risk for adolescents. The Northern Territory component of this research is supportedthrough the Indigenous Early Childhood Development National Partnership Agreement with Menzies Schoolof Health Research managing the project. Research partners in the Northern Territory include Danila Dilba partners include South Australia and Western Australia governments.Appointed a Project Manager to conduct a needs analysis relating to opportunities for adolescent sexualhealth promotion in the Northern Territory. It is envisaged that seven Adolescent Sexual Health Promotion forms part of the Indigenous Early Childhood Development National Partnership Agreement. Senior Healthto provide support and advice to specialist and remote primary health care staff to develop and implementadolescent health programs.Employed a Project Coordinator in February 2010 to undertake a needs analysis investigating the current approach,barriers/opportunities and models of service delivery for adolescents with complex behavioural problems.36Department Health and Families

The Chief Minister’s Youth Round Table has conducted a number of research projects in 2009-10 including: Young Fathers.The Community Services Program Network has been established as a collaboration between Agedand Disability, Alcohol and Other Drugs Programs, Mental Health Services, NT Families and Childrenand Aboriginal Community Organisations. It has been focusing on innovative approaches to providing careand support for adolescents with high level needs due to past trauma and complex health issues.Signed a Memorandum of Understanding between the Northern Territory and Western AustralianGovernments to provide health service delivery to the people of the Kimberley region of WesternAustralia. A meeting was held between the Health Chief Executives of Northern Territory, WesternAustralia and Queensland to discuss progressing matters of common interest across the threeNorthern Australian jurisdictions.General Practitioner (GP) Proceduralist training has been developed and assigned with six rural GPpositions commencing January 2011. Areas available for training include obstetrics, anaestheticsand emergency medicine.Advertised the Top End Aero Medical Service tender in December 2009. Evaluation of this tender isprogressing and should be completed by October 2010. The Department is being assisted during thistender process by a probity auditor and aviation adviser. An interim aero medical service provider has beencontracted to provide services to rural and remote communities across the Top End from 1 July 2010. Theinterim provider will be in place until the new contract is awarded.A Business Plan for Specialist Outreach Services Northern Territory incorporating existing servicesand new services under Medical Specialist Outreach Assistance Program – Indigenous Chronic DiseaseThis plan is currently being implemented.Client resources have been developed comprising a DVD about the Elective Surgery journey whichhas been translated into 11 of the most common Aboriginal languages and an Educational Flip Chart foruse by health professionals to explain to Aboriginal patients the elective surgery process and key points.A further DVD has also been produced which will educate hospital based health professionals about howthey can make the elective surgery journey less traumatic for Aboriginal people. These resources will beportable DVD players for Community Centres and Clinics.National initiatives in improving access to elective surgery services are ongoing in the Northern Territory. Stage 3 Elective Surgery Waiting List Reduction Plan National Partnership Agreement and will receive theassociated reward funding. One of the outcomes includes a 20% decrease in the number of patients waitingfor elective surgery who are currently overdue. This is an excellent outcome demonstrating improvedaccess to elective surgery in the Northern Territory. Bonus payments are being utilised to continue tosupport growth in elective surgery including improvements in timeliness for procedures.Implementation of the Cardiac Services review has begun through supply of additional exercise stresstesting machines and staff to facilitate the testing and administration process. The Royal Darwin Hospital underway for the development of a Northern Territory Specialist Cardiac Services Plan that will provide thedetail of service expansion needs in the Northern Territory for specialist cardiac services and provide expertcosting advice for implementation of these services.Full implementation of the Chronic Disease Coordination Unit based at Royal Darwin Hospital will continueto improve the discharge planning process for patients with complex needs.Department Health and Families 37

Increased use of a Territory wide multidisciplinaryteam approach for clients withcancer has improved care and treatmentplans for cancer patients.A DVD featuring Jimmy Little was developedfor Renal Service clients that promotesperitoneal dialysis for people from remotecommunities. Other resources for clientsAdditional InitiativesUpgrade of two minor surgical procedural rooms to fulloperating theatres at Royal Darwin Hospital. The twoand have enabled increased surgical throughput.program which enables clinicians to make their own electronic animated resources.Resources for clients with cancer have been developed and released through the CanNET project. posters and fact sheets on the new Alan Walker Cancer Care Centre.Implemented a Shared Care Management framework between NT Families and Children, Aged andDisability, Mental Health and Alcohol and Other Drugs Programs to enhance access to integrated mentalhealth and substance misuse services for highly mobile young people.Client Summary level access has been implemented in the Community Care Information System (CCIS) toand Disability, Mental Health and Alcohol and Other Drugs Programs.Hospital with completion expected in November 2010. These extensions represent the enhanced in-patientcapacity which will accommodate secure care clients. (Children and adults with a mental impairmentexhibiting high risk and challenging behaviours.)Planning and design work for extensions to the Mental Health Unit located in Alice Springs Hospitalis complete. The tender is expected to be awarded by 15 October 2010. Completion is anticipated by March 2011.Collaborated with the Department of Education and Training to build the capacity of the early childhoodsystem to deliver coordinated services.and the emergency department.Mobile Outreach Services, Child Protection Services and Remote Aboriginal Community Workers areproactively supporting families, children and young people living in remote areas.Currently developing practical processes for systematically engaging relevant professions in the monitoringof children in Out of Home Care.Allocated $50 000 one off funding to the Northern Territory Council of Social Service (NTCOSS) to work withthe sector on options for an Alcohol and Other Drug peak body, including its model of operation and fundingsources. NTCOSS will report to the Minister at the conclusion of this project.Commenced the development of a non-government engagement strategy with the formation of a workinggroup. Membership of the working group includes representatives from the non-government and localgovernment sectors. Following the deliberations of the working group the Department has developed adiscussion paper to seek feedback on an engagement strategy from non-government organisations.Contributed to additional services at ‘headspace’, including alcohol and other drug counselling sessions,weekly GP sessions and weekly psychiatrist sessions for case discussion. The aim of these services is toimprove access to mental health and wellbeing services for young people aged 12 to 25 years by bringingtogether local youth mental health, drug and alcohol, primary care and education, training and supportagencies. Each ‘headspace’ service has been established by a consortium of local agencies working inpartnership to facilitate provision of more coordinated, integrated and holistic care for young people.38Department Health and Families

Created four additional positions in Central Australia and Top End Child and Adolescent Mental HealthTeams to expand services to a number of remote communities.Funding was provided to Gove District and Katherine District Hospitals to formalise the roles of AdvancedNurse Practitioner and Nurse Practitioner respectively.Alice Springs Hospital (ASH) established a new partnership with Royal Victorian Eye and Ear Hospitalwhich provides an Ear Nose Throat (ENT) surgical team one week per month to boost ENT capacity. Thisagreement was renewed in December 2009 and will continue for all of 2010.In January 2010, a new agreement between ASH and Royal Adelaide ENT commenced which also providedan ENT team every four weeks to also boost capacity.In early 2009 an agreement between ASH and Flinders Medical Centre Orthopaedic Department commencedwhich provides experienced Surgeons attending three days per fortnight to boost surgical capacity at AliceSprings and oversee training of overseas trained orthopaedic surgeons.Where we are going in 2010-11Negotiated with Queensland Health to form a collaborative training pathway for Rural Generalists. This willsupport the smaller numbers in the Northern Territory to join others within a similar training cycle. All Rural Workshop will occur in August 2010. Areas available for training include obstetrics, anaesthetics andemergency medicine. Paediatrics, mental health and public health may also be included as areas of interest.The redesign and refurbishment of the day procedure unit at Alice Springs Hospital is due for completionat the end of November 2010. Surgical equipment has been purchased for all Northern Territory hospitalsenabling an increase in surgical capacity.Increased use of the Quality Improvement Planning Program System (QIPPS) across the Northern Territoryis supporting ‘joined-up’ planning and implementation of health promotion activities in remote communities.Redevelop Katherine and Royal Darwin Hospital Emergency Departments.Trialling software to improve Patient Management and Clinical Information Technology capabilities in RoyalDarwin and Alice Springs Hospital Emergency Departments.Construction of the Palmerston GP Super Clinic is expected to be complete on time in the second half of2010. The Department of Health and Families has negotiated a partnership between the Northern TerritoryGovernment and Flinders and Charles Darwin Universities to deliver a range of training and workforceopportunities within an integrated multi-disciplinary healthcare environment at the Super Clinic.Secure Care Stabilisation and Assessment services will be delivered from Mental Health Inpatients Units atRoyal Darwin and Alice Springs Hospitals to enable the stabilisation and assessment of young people andcognitively impaired adults whose behaviours place them at a high to extreme risk of harm.Secure Care group homes will havecapacity for 24 hours care for up to eightyoung people and eight adults with highrisk behaviours. There will be one facility inDarwin and one in Alice Springs.Department Health and Families 39

40Department Health and Families

PRIORITY ACTION AREA 5Safety, Quality and AccountabilityExecutive DirectorSystems Performanceand Aboriginal PolicyProfessor Shane HoustonPhDACTIVITY REPORTDepartment Health and Families 41

Safety, Quality and AccountabilityOptimising safety and quality is the essentialfoundation for the effective delivery of servicestargeting the health, community wellbeing andsocial advancement of all Territorians. TheDepartment is committed to developing anddelivering a system of services that is underpinnedby cultural security, safety and quality which isaccountable in a meaningful way to the community.This applies to the whole Departmental workforceand the services they deliver, including thoseservices provided through agreements with thenon-government sector.We delivered in 2009-10We have collaborated with relevant agenciesto ensure that health and family servicesneeds are appropriately included in theplanning and implementation of TerritoryGrowth Town initiatives.Key focus areasDemonstrating our organisation’s commitment to achievingculturally secure services through implementing andmonitoring effective organisational, system-wide and staffimplemented practices.Establishing a Safety and Quality Framework consistentwith the national reform agenda, which is based on theimperative to improve care and service delivery andthereby reduce harm. The major tools of safety andquality-driven reform are derived from new understandingsof incident analysis, business improvement practice andchange management.Developing and employing research, knowledge exchangeprocesses, performance monitoring and reporting to informand continuously improve both planning and practices.Northern Territory Aboriginal Health Forum partners have developed a Framework that establishes aplatform for greater levels of community involvement and engagement in the design, development andimplementation of health services to Aboriginal Territorians.Five Regional Cultural Security Negotiation Sessions across the Department and about 50 CommunityConsultations were concluded. The information gathered is being used to build a program of reform thattackles and prioritises those issues to be integrated with our service delivery.The Department is leading a joint National Advisory Group on Aboriginal and Torres Strait Islander HealthNetwork (NATSIHON) project that will develop a consolidated set of core measures of Cultural Competencein health and wellbeing service delivery at the organisational, systemic and individual staff levels.The Department of Health and Families, the Department of Business and Employment and the Graduate‘Aboriginal Cross Cultural Training in the Northern Territory Public Service’. New training courses based onthis work have been established and offered to the Northern Territory Public Service.The draft Departmental Safety and Quality Framework is in the consultation process.The Principal Safety and Quality Committee (PSQC) with Departmental-wide Executive membership thatoperates to advise on Territory and national safety and quality initiatives has been established.The Safety and Quality Advisory Service was established to provide PSQC with technical and logisticalsupport in introducing Departmental strategies to align with national safety and quality standards.Safety and quality induction information sessions were provided to 200 clinical staff through the Department’sstaff orientation program.The Departmental Risk Management Policy has been updated and a Risk Management Frameworkdeveloped and implemented. All divisions now have a risk management assessment related to theirbusiness plans. The RiskMan software program, facilitating the recording of risks and risk management,has been implemented in most hospitals and in Mental Health and planning has commenced to introducethis program across the Department.The Northern Territory Public Hospital Network implemented the Australian Charter of HealthcareRights devised by the Australian Commission on Safety and Quality in Healthcare in 2009. The Charterdescribes the rights of patients and other people using the Australian health system. These rights are42Department Health and Families

essential to make sure that, wherever and whenever care is provided, it is of high quality and is safe.The Australian Charter of Healthcare Rights is now on display in all Northern Territory public hospitalsand pamphlets are available in clinical areas. These resources are available in many languages. The initial Report on the Implementation of the Nursing Hours Per Patient Day Management Tool for Nursing implemented at Royal Darwin Hospital. The model has had a positive impact on recruitment of nursing staffwith wards staffed to meet patient acuity. The implementation of the recommendations of the Sullivan Report on the Review of Hospital SecuritySystems, Royal Darwin Hospital has improved paediatric procedures and training, improved security The Report on the Governance of Complaint Handling and Implementation of Open Disclosure at Royal Disclosure Standard will be implemented during 2010. Implementation of the recommendations of the Independent Review of Governance Arrangements at RoyalDarwin Hospital by the Australian Council of Healthcare Standards has led to improvements to the Hospital’spolicy framework, practices supporting clinical governance and the structural relationships betweencorporate and clinical governance within the Hospital and between the Hospital and the Department ofHealth and Families. In 2009-10 the Department supported 44 new, 41 on going and 15 completed research projects at MenziesSchool of Health Research. Remote Health made a major contribution to the writing and editing of the Central Australian RuralPractitioners Association (CARPA) Standard Treatment Manual in 2009. This has now been distributed. The Best Practice Committee reviews remote clinical protocols or guidelines on an ongoing basis and 15were updated as a result of this process in 2009-10. The NT Aboriginal Health Forum Key Performance Indicators were implemented in both the Departmentand Aboriginal community controlled health centres across the Territory. In April 2010, the Living Knowledge Learning Network Workshops were piloted in Nhulunbuy, Alice Springs,Katherine, Tennant Creek and Darwin and evaluated as successfully promoting the transfer of knowledgeand research, and encouraging a proactive research agenda within the agency. Seven Living Knowledgeseminars were held in Darwin and eight Living Knowledge bulletins sharing knowledge with managers andpolicy makers were circulated. Health Library Services expanded the Clinical Practice Guideline Quality Improvement Program whichincluded the roll out of a web based document management system which provides access to over 1500clinical guidelines online. Health Library Services expanded the availability of on-line point of care resources assisting doctors,clinicians, nurses and other healthcare professionals with the best available evidence-based clinicalreference tools for their information needs. Health Library Services developedeLibGuides, assisting Departmental staffto better access online library resources inareas such as Aboriginal health, dietetics Health Library Services is modellingand developing a training and educationspace in consultation with Departmentstakeholders to provide an eLearningLibrary for the whole of the Department,supporting staff development, researchand education.Department Health and Families 43

Seven training programs designed to enhance staff knowledge of the Department’s performance framework,assist staff creating KPIs and encourage performance monitoring were held in Darwin and Alice Springs.Individual staff performance monitoring occurs through the Department’s Performance Managementframework using the Work Partnership Plan (WPP) which is introduced to all new starters in orientationtraining and is promoted to managers through the Department’s tailored Management and Leadership program areas during 2009-10.Where we are going in 2010-11The Cultural Security Report will be published and launched with key projects commenced.The Department will reform Aboriginal Cross Cultural Training in line with new Northern Territory PublicSector standards.Cultural Security strategies will be implemented and assessed.consideration.A Departmental safety and quality communication plan, inclusive of a quarterly safety and qualitycommuniqué will be established.The Root Cause Analysis quality assurance process will be formalised.Agreed Departmental safety and quality priorities will be established for: national standards in handoverA Northern Territory Safety and Quality Forum will be facilitated.The clinical safety and quality training module for staff orientation will be reviewed.Risk Man software, facilitating the recording and management of risks, will be progressively implementedacross the Department.44Department Health and Families

PRIORITY ACTION AREA 6Attract, Develop and Retain aWorkforce for the Futureand ResourcesMr Peter BeirneBBS CA M INSTDACTIVITY REPORTDepartment Health and Families 45

Attract, Develop and Retain a Workforcefor the FutureDeveloping and retaining a workforce to meet both short and long term needs is a core necessity for anyorganisation. The well documented global shortage of skills and the ageing nature of Australia’s populationcompound the challenges.years. This number includes 28% of executives and 24% of physical and technical staff.The retention challenge also relates to younger staff: around 36% of all 25-29 year olds leave employment inthe Department in an average year, and around 44% of 25-29 year old nurses leave in any one year.The shortage of Australian-trained medical staff means that 33% of medical practitioners currently working in theNorthern Territory are trained overseas. The availability of Australian-trained medical staff is a national challenge.People who identify as being of Aboriginal and/or Torres Strait Islander descent make up around 30% of theTerritory’s population and across the board about 60% of our clients, yet only 10% of our staff are Aboriginal.Optimising service delivery requires the workforce tomatch the needs of both the workplace and clients.This requires innovation and reform of practiceand service delivery models, with a clear focus on the current models and ways of thinking, as well aspromoting alternative workforce designs. All of thesechallenges are highlighted in two key Departmentalplanning documents, the Strategic Workforce Planand Aboriginal and Torres Strait Islander StrategicWorkforce Plan. They will be addressed through theannual business planning cycles in the Department.Key focus areasOptimising service delivery through workforce planning,community needs.Innovation and reform of workforce practice and servicedelivery models.Implementing our Strategic Workforce Plan and Aboriginaland Torres Strait Islander Strategic Workforce Plan.Matching the workforce to the needs of the workplaceand clientsWe delivered in 2009-10Developed a suite of Human Resources (HR) Reports on various aspects of the workforce. The reportsprovide regular information to support management decision-making around workforce issues such asrecruitment activities, staff turnover, skills gaps and leave entitlements.Completed a Review of Nursing and Midwifery education and training across the Northern Territory.Recommendations are being considered in light of national reforms and other local reviews.Worked collaboratively with Flinders University and Charles Darwin University (CDU) to establish new healthto support and strengthen the current workforce and plan for new, advanced and extended roles.The First Line Leadership and Management Development Program commenced in Alice Springs with27 participants.Conducted two rounds of the Professional Excellence Status (PES) Scheme resulting in 11 applicantsbeing awarded PES. This is a scheme designed to recognise and reward the efforts of employees whose46Department Health and Families

Established an Indigenous Nursing and Midwifery Employment Working Group with a bi-cultural partnershipmodel to assist with the implementation of the Department’s Aboriginal Cultural Security Policy and increasethe number of Aboriginal and Torres Strait Islander nurses and midwives in the Territory.Implemented measures aimed at encouraging employees to update their Equal Employment Opportunity(EEO) records and improve data on the Aboriginal and Torres Strait Islander workforce.Supported a total of 15 cadets under the Indigenous Cadetship Support Program (formerly known as theTraining Organisation scope.Established a School-to-Work Working Group to develop a framework with a strategic approach to careeropportunities in health for school students in the Territory.Explored the potential value of expanding the Year 2 Speciality Program that enables staff who havecompleted the Graduate Nurse Program (GNP, Year 1) to move into speciality areas (currently remote andcommunity) supported with a formal program of study and employment.Redeveloped the Nursing and Midwifery website, including career pathway information.Commenced the Charles Darwin University (CDU) / Department of Health and Families’ Bridging Programfor nurses from India. 81.3% of participants gained registration. The Department employed 37 of the 38 whosuccessfully completed the program. The other nurse was employed in the private sector.Agreement 2008-2011.Developed a Strategic Workforce Planning website which contains information on a range of topics including other useful websites.Finalised the Overseas Recruitment Policy and Guidelines. Implementation has been supported by a reviewof the Department’s Overseas Recruitment Intranet site to further support managers with easy access toinformation and to inform them of their obligations. Established online reporting to ensure compliance withlegislative obligations and improve monitoring in relation to 457 Visa Holders.The Northern Territory Post-graduate Medical Council has prepared Northern Territory Standards forAccreditation of Prevocational Medical Education, Training and Supervision inTerritory Hospitals. TheMedical Board of the Northern Territory (MBNT) has endorsed the standards.The Department has been recognised for its achievements in Vocational Education and Training as aFinalised the Professional Practice Supervision and Support Framework for Allied Health Professionalsincluding the development of a Professional Clinical Supervision Training Toolkit for mentors and supervisors.Enhanced the current group of nursing and midwifery ‘employed’ models for post graduate studies. Postgraduatestudents are employed by the Department and enrolled at CDU in order to complete the requiredtheoretical and clinical practicums.Both graduates are employed as Nurse Practitioners within the Department’s Remote Mental Health Services.Department Health and Families 47

Where we are going in 2010-11In providing Workforce and Professional Development the Department will: Access and implement the Council of Australian Governments’ national health workforce reform initiatives. Strengthen workforce planning across the Department. Publish an annual report on the Department’s workforce based on the indicators used in the StrategicWorkforce Plans. Launch a one-stop web based shop for Careers and Recruitment information. Finalise the Recruitment and Attraction research project and implement agreed report recommendations.Implement the Overseas Recruitment Policy Guidelines and Procedures. Review application of Departmental policies supporting pre-employment screening practices.Complete the roll-out of the suite of Human Resources reports to enhance the information available to managers. Develop and implement a Rural Generalist Training Pathway Program across Territory hospitals. Implement the Northern Territory Bonded Medical Scheme to provide scholarships for industry sponsoredmedical students into the Northern Territory Medical Program. Conduct a Departmental Staff Satisfaction Survey. Conduct a Census Day focused on improving the level and accuracy of Aboriginal and Torres Strait Islanderworkforce data within the Department. Finalise a Departmental School-to-Work Framework to support career opportunities in health for schoolstudents in the Territory. Consolidate the post graduate employment and academic study options with Charles Darwin Universityand Centre for Remote Health.Health in 2010 and plan for further expansion for Critical Care, Paediatrics and Emergency and DisasterPlanning in 2011.Develop a Midwifery Exchange Program between the Department and the Royal Women’s Hospital inMelbourne to provide ongoing professional development opportunities for all midwives.Implement the antenatal ultrasound project for health professionals in remote communities. Healthprofessionals who undertake the endorsed education will be able to undertake basic ultrasound scanningwithin the local community as opposed to urban centres.Establish the Maternity Education and Workforce Sub-group to address the workforce and educationrecommendations from the Territory’s Maternity Services Review.from November 2010 for Nurse Practitioners and eligible Midwives.Identify and develop strategic projects that will contribute to improving the numbers of Aboriginal Nursesand Midwives employed in the Territory.Develop partnerships with Territory health education providers in order to ensure course content and clinicalplacements meet the needs of the Department at VET (vocational education and training), undergraduateand postgraduate entry points.48Department Health and Families

Implement the Professional PracticeSupervision and Support Schemefor Allied Health staff acrossthe Department.Trial areas of Allied Health Professionalsworkforce reform including AlliedHealth Assistant and extended scopeof practice roles.Develop and implement a DepartmentalSuccession Planning toolkit includingstaff workshops.Deliver online training and developmentprograms which will increase access toquality professional training opportunities for urban, regional and remote employees.Implement the e-Learning Strategy.Develop and retain Aboriginal and Torres Strait Islander people through supporting programs such as WorkExperience, School-based Apprentices, Apprenticeships and Cadetships.Provide reformed Aboriginal and Cultural Awareness training to staff to develop skills, knowledge and attitudeto work with Aboriginal and Torres Strait Islander people in order to contribute to improved health outcomes.Align Aboriginal Clinical Learning service activities to the new service level agreement with Central AustralianRemote Health Development Services for professional development of Aboriginal Health Workers.Work towards achieving 80% of Aboriginal Health Workers across the Northern Territory having learningand assessment plans in place.Department Health and Families 49

Strategic ProjectsFive strategic projects need a special mention as they do not necessarily align with the Priority Action Areasand they need intensive focus prior to becoming normalised into core business.Hospital Services Planning ProjectAs part of the Government’s commitment to establish a hospital for the people of Palmerston, Ernst and Youngwas commissioned to develop a 20 year Hospital Services Plan for the Northern Territory.Extensive consultations have been undertaken with clinicians, Departmental staff and a broad range of externalstakeholders. Population projections, burden of disease information, technology, workforce, infrastructure andfor Territorians.The Ernst and Young Report has been received by the Department of Health and Families and is currentlybeing considered.The Report covers six main areas: organisationA Peer Review of the infrastructure options from the Report has been conducted and is currentlybeing considered. The reports will be presented to Government for consideration in the coming months.Maternity ServicesIn 2007 the Department of Health and Families commissioned a Review of Maternity Services. The resultingdocument ‘Developing an Integrated Maternity Service’ was published in 2008 and contains recommendationsrelating to maternity services and the Department’s response to them.Underlying principles of the Northern Territory Integrated Maternity Service are: traditional practices of Aboriginal women should be supported and combined with evidence-basedcare where possible.In response to the Review, the Department established two leadership positions one in midwifery and onein obstetrics. The Midwifery Co-Director commenced in February 2009 and the Obstetric Co-Director willcommence in September 2010 on a consultancy basis.50Department Health and Families

The Integrated Maternity Services Clinical Reference Group (CRG) was established in February 2009 andthis Group guides the implementation of the agreed review recommendations and advice on other issues.Organisations and consumer representatives. The Co-Directors, with the support of the Maternity ServicesCRG, are facilitating the implementation of the recommendations in the Review.‘Healthy Pregnancy, Health Baby’ has been developed in collaboration with Aboriginal women. Models ofmaternity care providing continuity of care and carer have been developed in both Alice Springs, for urbanand remote women and in Darwin, for remote women. Plans are developing to expand continuity models forurban based women in Darwin, including increased access to the Royal Darwin Hospital birth centre for lowrisk women.There is a focus on the Aboriginal maternity workforce. Five Aboriginal women in the Territory have commencedtheir Bachelor of Midwifery degrees, two in Darwin, two in Alice Springs and one in Tennant Creek. Work hascommenced on a professional development program for Aboriginal Health Workers, Strong Women workersand others involved in maternity care.eHealtheHealthNT is focused on advancing health care delivery through a range of systems to assist health careproviders with securely storing, sharing and transmitting important patient care information.The eHealthNT Shared Electronic Health Record is operating at 95 participating health clinics, GeneralPractices, and public hospitals across the Northern Territory. The range of systems are providing 37 000Territorians, including 67% of Aboriginal people living in rural and remote communities, with the means ofensuring important health information is available when needed for care.The Department is undertaking collaborative work with the National e-Health Transition Authority (NEHTA) toimplement secure messaging web services linking Primary Care and Acute Care sectors within the NorthernTerritory as a national e-Health demonstration project.Successful pilots of Electronic Transfer of Prescriptions for community pharmacy dispensing and ElectronicAdvanced Medication Management in residential aged care were completed in April 2010. The results of thesepilots have informed ongoing national developments of community-wide electronic prescription and dispensingsystems.In 2009-10 within the Integrated Health Information Network the Department has: completed the Primary Care Information System (PCIS) Rollout Program to the remaining 22 remotehealth centres, making a total of 54 health centres transitioned to using fully electronic health records, registered healthcare consumers in Northern Territory Prisons for the eHealthNT Shared Electronic HealthRecord service in readiness for the rollout of PCIS to prison health services in early 2010-11 as part of commenced implementation of an eHealthNT Consumer Registration Card, issuing a total of 4170 cards in commenced the rollout of the MedChart Advanced Medication Management and Decision Support System implemented the Picture Archiving and Communication System (PACS) Digital Radiology System into Department Health and Families 51

initiated planning of major upgrades of the Royal Darwin Hospital (RDH) Block 6 main server room facilities completed initial planning studies to integrate and implement new national infrastructure services andsolutions being developed by the National eHealth Transition Authority (NEHTA), including the nationalNorthern Territory Medical ProgramThe Australian Government announced a commitment of $27.8 million towards the Northern Territory MedicalProgram (NTMP) infrastructure with an additional amount committed towards the program’s recurrent coststo support Industry Sponsored Scholarship places. The recurrent funds will be combined with the presentcommitment of the Northern Territory Government (see chart below). Two medical training facilities are beingbuilt, one at Charles Darwin University and the other at Royal Darwin Hospital.The Flinders University is undertaking to admit 24 industry sponsored students each year to the NTMP underthe Northern Territory Bonded Medical Scheme (NTBMS). The scholarships, following academic eligibility, willprioritise Northern Territory residents and Aboriginal students to develop an Aboriginal medical workforce andto support Territory medical students to complete their studies at home.Each of the eligible students will be offered a scholarship under the NTBMS which will fund their universitycourse fees. Selected candidates will enter into an agreement with the Department of Health and Families,bonding the scholarship recipient to work in the Territory for a two year period of time following completion ofthe course.to enter the NTMP. These students will commence Clinical Sciences at CDU for two years but will not be eligible toenter the Medical Program until 2013. This pathway will provide a double degree in science and medicine.Table 4: Funding sourcesFundingSource 2009-10 2010-11 2011-12 2012-13 2013-14Australian Government 0 0.5M 1.6M 2.2M 2.3MNorthern Territory Government2.2M 2.2M 2.3M 2.4M 2.4M*(Indexed)Northern Territory Government -0.3MCommencement PrepaymentTotal 2.5M 2.7M 3.9M 4.6M 4.7M*Table 5: Student numbersStudent Numbers2010 2011 2012 2013 2014 2015Year 1 24 24 24 24 24Year 2 24 24 24 24Year 3 31 32 36 40 40 40Year 4 31 31 32 36 40 4052Department Health and Families

Radiation Oncology Services February 2010. The AWCCC provides both radiation therapy services and medical oncology (chemotherapy)to Territorians who require cancer care. The two linear accelerator facility is equipped with the latest in medicaltechnology used in treating cancer.The radiation oncology services are provided under a commercialagreement with Northern Territory Radiation Oncology Pty Ltd. Theexisting Royal Darwin Hospital chemotherapy services have alsobeen relocated to the AWCCC to ensure patients can access a singlecomprehensive cancer care service. RDH continues to receive clinicaland quality assurance support through an agreement with the RoyalAdelaide Hospital on behalf of the South Australian Department of Health. radiation therapy treatments to approximately 360 patients who wouldhave previously been required to travel interstate for long periods toreceive treatment. This facility is further enhanced by the provision of newself-caring patient accommodation at Barbara James House, allowinggreater access and support for patients travelling from outside the greaterDarwin area, particularly those travelling from Central Australia.Department Health and Families 53

54Department Health and Families

Service Map DetailsDepartment Health and Families 55

OverviewCoordination of health and wellbeing services acrossthe vast and varied Northern Territory landscapeis complex. Getting the most from our servicesand supporting the coordinated implementation ofGovernment policies across the Northern Territory isa responsibility that falls to the Top End and CentralAustralian Coordination Units. The Top End (TE)region takes in Darwin, Palmerston, Katherine andArnhem area and the Central Australia (CA) regioncovers Alice Springs, Tennant Creek and the Barkly.participated and coordinated input into strategicdirections related to non government organisationtaken a lead role in developing and updatingDepartmental counter disaster plans.The regional plans can be accessed throughhttp://www.health.nt.gov.au/Coordination is achieved through:ongoing consultation with communities to obtaincoordination with other Government agencies tofacilitation around planning from a regionalperspective.The coordination units are able to provide andmaintain a good working relationship with thecommunities and people.Regional plans are reviewed annually to includeemerging issues. These plans provide an effectiveplatform to promote cross program outcomes and areviewed as a performance agreement between theDepartment and regional communities.Over the past year the Regional Coordinators have:facilitated Staff Forums and regional businessplanning to develop Regional Plans aligned withthe Department of Health and Families Corporateengaged in a number of community strategiesincluding Alcohol Management Plans, Taskingand Coordination Groups on Antisocial BehaviourMeasures, Regional Partnership Agreements andprogram, cross divisional and cross agency56Department Health and Families

NT HEALTH FACILITIESDEPARTMENT OF HEALTH AND FAMILIESDanila DilbaWallhallowEva DownsBenmaraAnthony LagoonMittiebah StationAlexandriaAnyinginyi Congress AMSSoudan StationIlpurlaCentral Australian Aboriginal CongressCAAC AMSHospitalDHF Staffed Health FacilityNon DHF Health FacilityDHF Visiting/Mobile ServiceVisiting Non DHF ServiceNOTE:Other DHF services including Northern TerritoryFamilies and Children (NTFC) offices are locatedwithin main towns and provide visiting regional services.Department Health and Families 57

Across the TerritoryIn 2009-10 the Department of Health and Families Corporate Plan 2009-2012 was launched and promotedby Executive members at Staff Forums held in Darwin, Alice Springs, Tennant Creek, Katherine and Nhulunbuy.Workshops were held to develop Regional Plans for Central Australia, Katherine and East Arnhem that alignwith the Corporate Plan 2009-2012.Department of Health and Families Disaster Management has functional responsibilities for medical, publichealth and welfare and plans were updated to align with the NT All Hazards Approach to disaster management.potential patients, advice to the broader counter disaster groups and update of changing procedures to alignDepartmental staff participated in disaster management workshops across the Territory to assist the Shiresto plan and implement their responsibility in recovery management.East ArnhemRegionThe Nhulunbuy Alcohol andOther Drugs ResidentialRehabilitation Centre reopenedin 2009 underDepartmental managementwith a 20 bed capacity.Services include ambulatory,residential programs with abroad client base including alcohol, Volatile SubstanceAbuse, dual diagnosis, mandated and voluntary clients.Alcohol and Other Drugs staff coordinatedthe development of Volatile Substance AbuseManagement Plans with remote communities. Draftplans for Yirrkala and Ramingining are to be signedoff in 2010-11.The Smoke Free policy implementation continues withsmoking cessation projects in Gapuwiyak, Milingimbi,Ramingining and Yirrkala including collaborative workwith James Cook University at Galiwin’ku.Gove District Hospital has implemented theEarly Warning System which detects early patientdeterioration for quick response and care planning.The system has extended to Royal Darwin Hospitaland is planned for extension across the region toRemote Health Centres.The Centre for Disease Control and Gove District position to provide public health services.In August 2009 a Memorandum of Understandingto provide for the care of Machado Joseph Diseaseaffected people into the future and research forprevention and best practice treatments was signedon Groote Eylandt. The signatories were MachadoJoseph Disease Foundation (MJDF), Departmentof Health and Families, Department of Families,Housing, Community Services and Indigenous Affairs(FaHCSIA), Anindilyakwa Land Council (ALC) and EastArnhem Shire. The Department, through the Aged andDisability Program has recruited an MJD Coordinatorand an Implementation Plan has been drafted.The Core of Life program is being implementedby formally trained Departmental staff across EastArnhem. It provides education through role playand interaction to demystify misconceptions aboutpregnancy, contraception, breastfeeding and parentingand is targeted towards high school students.The Expanding Health Services Delivery Initiative hasremote health and includes Aboriginal CommunityWorkers, Continuous Quality ImprovementCoordinators, Public Health Coordinators, Health58Department Health and Families

Through the East Arnhem Regionalisation processcommunity consultation has commenced inStrait Islanders (OATSIH) and Aboriginal MedicalServices Alliance of the NT (AMSANT) partnersto advance the pathway of community control ofprimary health care services within the region.The Primary Care Information System (PCIS), a clientfocusedinformation system tailored for remote healthservices, was rolled out in Alyangula, Angurugu,Umbakumba, Bickerton Island and Numbulwar. Thisinterfaces with the Shared Electronic Health Recordand provides remote health staff in this area accessA Domestic Violence Support Worker was recruitedby NT Families and Children for East Arnhem regionto provide family support to clients.Regular features at campaigns and events, suchas the Gove Festival and the Garma Festival and inschools are hand washing with ‘Gerry the Germ’ andspreading good nutrition messages with ‘Vegie Man’.A large number of East Arnhem Departmental staffparticipated in the Yothu Yindi Foundation (YYF)annual Garma Festival in August 2009. A coordinatedapproach focused on interactive displays aimed athealth promotion and education with information hygiene, physical activity, keeping children safe andsmoke free.Five East Arnhem renal clients based in Darwin wereable to attend Garma and visit family for the weekbecause renal nurses from Darwin provided theirdialysis at Gove District Hospital.Katherine RegionIn November 2009 theKatherine District Hospitalcelebrated its 75th Anniversary.The Hon Kon Vatskalis MLA,Minister for Health unveiledthe commemorative stone,planted a tamarind tree andacknowledged the servicethe Hospital had given to thecommunity over the 75 years.In August 2009 the Aboriginal cultural area atKatherine Hospital was formally opened by localAboriginal elders with dancers and guests. Thespace, dedicated to Aboriginal cultural ceremonies, isshaded and secluded and features a sand coveredKatherine Nurse Ms Jane Hair, won the Mental HealthCategory and Nurse of the Year at the 2010 NorthernTerritory Nursing and Midwifery Excellence Awards.The John James Memorial Foundation continues toprovide specialist visits to the Katherine region andprovide specialists to supplement existing visits fromDarwin.Canberra Eye Hospital specialists visited inSeptember 2009.BreastScreen NT provided a screening service inKatherine in July 2009.Health Promotion programs provided in theregion included: Six weekly nutrition articles in the Katherine Timesto promote healthy eating. Heart Foundation Walking program launched inMay 2010 at the Katherine Community Marketswith 20 people signed up. Nutritionist/ Dietician working with school canteenmanagers to review menus and implementNorthern Territory Government Healthy Eatingand Nutrition Policy. Campaigns at events, schools and Katherine Showre hand washing with ‘Gerry the Germ’ and spreadinggood nutrition messages with ‘Vegie Man’. Iron Chef Cook Off competition commenced inJune 2010 at Katherine Community Markets aspart of the Go For 2 & 5 campaign.Department Health and Families 59

A new position, Alcohol and Other Drug CommunityCounsellor/Educator was recruited in early 2010.A new apprentice commenced on a two yearapprenticeship program with Alcohol and Other Drugs(AOD) in March 2010. Both positions have enhancedthe AOD services in the region and contributed toenabling Volatile Substance Abuse ManagementPlans development with communities and clinicalcare for AOD clients.Since October 2009, Departmental staff from variousprograms participated in the interagency response toassist the Binjari Community to re-engage followingseveral major anti-social incidents. The response wasconducted within the Binjari Action Plan, coordinatedby the Territory Police in liaison with the Binjaricommunity, Northern Territory and Federal agenciesand NGOs. The Department’s direct participationincluded - Safe Kids Strong Futures, Peace@Home (NTFC staff working with the Territory Police Child Protection, Mental Health, Aged and Disability,Women’s Health Educator, Alcohol and Other Drugs.Participation occurred in improving Youth Activitiesin Katherine and Binjari through interagency youthgroups in liaison with Department funded nongovernment agencies delivering youth services. Thisincluded AOD small grant funding for Binjari childrento access school holiday programs.The Department facilitated six meetings of theCommunity Helping, Action and Information Network(CHAIN) throughout the year which providesnetworking opportunities for providers in Katherine.Over 75 non government agencies, Northern Territoryand Australian Government organisations are on theCHAIN distribution emailing list.Central AustraliaThe W & E Rubuntja Researchand Medical Education building,home of the Baker Institute:Infectious Diseases and theFlinders University NorthernTerritory Rural Clinical School,was opened at the Alice SpringsHospital campus in March 2010.It provides a Central Australianbase for diabetes and vascular disease research aswell as research into other chronic diseases affectingAboriginal health.Agreement was reached on the provision of renalservices for Central Australian patients, includingthose from Western Australia and South Australia.Capacity was greatly expanded with a new 48 stationprivate partnership for renal services in the NorthernTerritory with Fresenius Medical Care responsible forproviding the dialysis services and the Alice SpringsHospital and Territory Renal Services responsiblefor clinical governance. Dialysis services were alsoexpanded with the introduction of a demountable atFlynn Drive providing two stations for self dialysisand a Home Dialysis Care program in remote centresincluding Ti Tree, Ali Curing and Santa Teresa.The Safe and Sober project commenced in 2010 asan initiative of the Alice Springs Transformation Plan’sAlcohol Rehabilitation Action Group. The project wasdeveloped by representatives of all the Alcohol andOther Drugs (AOD) stakeholders in Alice Springs andas a result Congress is to receive $5.4 million over twoand a half years to implement this ambulatory casemanagement and therapeutic intervention project.A $3.4 million NT Trachoma Strategy commencedin 2010, coordinated from Alice Springs. Theproject involves screening and treatment of adultsat Community Clinics and of children as part of theHealthy School Aged Kids program. A TrachomaEducator was recruited to deliver training inpartnership with the International Centre for EyeEducation at Central Australian Aboriginal Congressand service education and trachoma updates areregularly delivered to remote area nurses.60Department Health and Families

very effective with the Alice Springs region achievingan impressive 42% vaccination coverage rate. Aneducation campaign on sexually transmitted diseaseswas also a priority in 2009-10 with Central Australia’sCDC working with young people to develop the DVDAny Chance. The DVD promotes choices in sex,alcohol and safety and is being distributed throughoutthe Northern Territory.Alice Springs Hospital (ASH) introduced a numberof innovations in 2009-10 including a Paediatric UnitPlaygroup conducted by Tangentyere Council. Anextension of the Hospital in the Home program toseven days a week resulted in 2567 bed days savedover the twelve months to June 2010. The ASHMidwifery Group Practice provided 240 women witha choice of care including a designated Midwife andhome birthing.The Alice Springs Hospital Drovers Volunteer ServiceService category of the 2009 Rural and OutbackAwards. Founder of the Drovers, Ms Di Deans, wasalso recognised as the 2009 Centralian of the Year.The Drovers fundraising provided more than $50000 worth of equipment and materials, including awig library for those suffering hair loss as a result ofdisease or medical treatment.Central Australian Mental Health Services staff gainedaccreditation in Mental Health First Aid InstructorTraining in order to provide training to other serviceproviders in the broader community and to raiseawareness and education around mental health. Thisand prevention strategies in line with the NationalMental Health Standards. A Psychology OutpatientClinic for clients was established taking referrals fromcase managers, psychiatrists and medical staff andan emphasis on mental ill health prevention was thefocus of the Youth Mental Health First Aid service.The Aged and Disability program increased utilisationof the Community Services Program Network ClientManagement Framework in 2009-10. Guidelineswere developed and implemented and these haveresulted in interagency shared case management.The development of an NT wide practice manual isunderway to ensure equity in service access andeligibility in the disability sector.Central Australian Oral Health Services focused onmanagement of its waitlist in 2009-10 and as a resultsaw a reduction in waiting times for dental servicesin Alice Springs to approximately six months. OralHealth Services maintained its collaboration withAdelaide and Melbourne Universities and provided dental students. Work experience placements werealso provided for local high school students. Allremote communities were provided with access toservices via mobile dental trucks and regular visits toremote clinics.Targeted Families Support program achievedexcellent results in 2009-10 and additional andfunding was provided to Central Australian AboriginalCongress to expand the service in Alice Springs. ATargeted Family Support Service was implementedin Tennant Creek using an inter agency casemanagement protocol. Therapeutic services wereestablished for children and young people in the ChildProtection, Out of Home Care system and/or SafeFamilies program at Tangentyere Council.Remote Health Services conducted the basic trainingcourse for community based workers at Haasts Bluff.Joint service plans were completed with WYN Health(Willowra, Yuendemu and Nyirripi Health), WAHAC(Western Aranda Health Aboriginal Corporation)and Anyiniginyi. Remote Medical Practitioner casereviews and clinical records audits were implementedand activity and incident data reviewed by RemoteHealth Executive on a monthly basis. A process to standards has commenced and Remote HealthServices have increased employment of communitymembers to assist with service delivery.Health Development adopted a multi-disciplinaryapproach for service delivery based alonggeographical lines in order to deliver a rangeof specialised programs to remote Aboriginalcommunities. The Failure to Thrive project wasestablished as a collaborative project betweenGovernment and non-government agencies inCentral Australia and has resulted in an integrated/care pathway case management model, a ChildHealth Resource Directory and the re-establishmentof Under 10s case management meetings for theDepartment and other service providers.Department Health and Families 61

A number of Counter Disaster exercises wereconducted providing Departmental staff withopportunities to develop emergency managementskills whilst working under controlled conditions.Exercises were held at Northern Territory EmergencyServices headquarters in Alice Springs and TennantCreek, the Alice Springs Airport and at Alice SpringsHospital.Health also supported Laramba in coordinating theGood Skin project, a multi-disciplinary approachincluding community members, Departmentalprograms, local government, education and NGOs.The Barkly Health Liaison Committee continuedits work of consultation and collaboration with nongovernment organisations in the region.and the incumbent is working at Elliott Health Centre.Tennant Creek Hospital (TCH) expanded services in2010 with development of the Ear Nose and ThroatClosing the Gap surgical block and planning isunderway to provide an additional eight renal dialysisin all clinical areas. 2010 also saw the appointmentof the TCH Board under the new Hospital Boards Act2009 with strong community membership. established to enhance service coordination. Thesepositions include a Remote Health Area Managerand a Health Development Area Manager. A numberof other successful appointments were made atthe Tennant Creek Hospital including the GeneralManager / Director of Nursing, Director of Medical and Clinical Nurse Consultant Renal Dialysis. TheAlcohol and Other Drug Service of Central Australiaprovided a new position to work with the BarklyRegion Alcohol and Drug Abuse Advisory Groupand Anyinginyi Congress to develop and delivercommunity alcohol management plans and services.Oral health services have been provided by a visitingTherapist visits school aged children six times per Yulara six times per year. Central Australian OralHealth Services facilities have also been extended toElliott supporting the Territory Growth Towns strategy.Environmental Health coordinated training withCDU, the Barkly Shire Council and BatchelorManagement Facilities for Ampilatwatja, Elliott, AliCurung, Alpurrurulam and Arlpara. Environmental62Department Health and Families

Across the TerritoryDigital Regions expanding the current Shared electronic Health Record through the introduction and development of implementation of a Telehealth Network.These projects will be supported by the implementation of the National Broadband Network and will helpdeliver health services to our remote and regional communities.East ArnhemRegionDigital Regions video enablednetwork links will include GoveDistrict Hospital with links tothe other Northern Territoryhospitals, and to/from theGrowth Towns of Gapuwiyak,Galiwin’ku, Ramingining,Yirrkala and Milingimbi.The East Arnhem Departmental Regional Plan alignswith the Corporate Plan 2009-12 will be distributed tokey stakeholders.Volatile Substance Abuse Plans signed off forGapuwiyak, Numbulwar and Galiwin’ku.In April 2010 funding of $3.8 million was approved forthe construction of six (two) bedroom housing on theGove District Hospital grounds to increase housingcapacity for health staff to East Arnhem region,construction is planned for completion by July 2011.Katherine RegionThe Katherine DepartmentalRegional Plan that aligns withthe Corporate Plan 2009-2012 will be distributed to keystakeholders.A new Sexual Assault ReferralCentre will open in Katherineand expected to be operationalin August/September 2010.Digital Regions video enabled network links willinclude Katherine Hospital with links to the otherTerritory hospitals, and to/from the Growth Towns ofLajamanu and Kalkaringi.Upgrade to the Emergency Department of KatherineHospital for better patient and staff working areaswill commence.Two nurses eligible for Nurse Practitioner statusare expected to be registered in 2010-11 to workin the new role in the Emergency Department ofKatherine Hospital.Operation of Safe Houses in Ngukurr, Yarralin,Beswick, Kalkarindji and Lajamanu will continuethrough partnership funding from NT Closing the Gapand the Australian Government.Department Health and Families 63

Funding will continue for the Remote and FamilyCommunity Worker program in Borroloola. It isanticipated that the program will be extended intoLajamanu and Kalkarindji prior to Christmas 2009.Central AustraliaRegionThe Alice Springs YouthHub is being developedcollaboratively by Governmentand non-government youthservices providers. NorthernTerritory Families and Childrenwill be providing an after hourschild protection response teamfrom August 2010 along with a identify and target families with children in AlternateCare and/or Child Protection systems and work toreunify those children and young people with theirfamilies. the Living Knowledge Learning Network offersGovernment and non-government health servicesproviders opportunities to share the latest eHealthNT program for the provision of Shared Digital Regions enhancement.A range of other Departmental programs and healthservices in Tennant Creek will have new premises inSeptember 2010 with a move to the newly renovatedMatt Glynn Building at 172 Paterson Street. TennantCreek will also be the recipient of a new Soberingup Shelter to be managed by the Barkly RegionAlcohol and Drug Abuse Advisory Group. Planningwill continue through 2010-11 to develop the facilitywhich will be able to accommodate up to 24 clients.Tennant Creek Hospital is planning for the addition ofeight new dialysis beds.Plans for a Secure Care Facility in Alice Springs will of a site and establishment of an operating modelthat links the facility with other service providers inAlice Springs will be priorities. Consultation with thecommunity will continue throughout the process.developments in 2010-11. A new EmergencyDepartment and a 12 bed Short Stay Unit are plannedfor construction at Alice Springs Hospital (ASH) and willinvolve a major restructure of the ASH campus.To advance the Northern Territory 2030 initiativesthe idea of Alice Springs as a Health Hub will beexamined. A conference is to be organised andconducted in 2010-11 to bring together a range ofstakeholders and interested parties to explore thepotential for Alice Springs to build on the currentrange of health services delivered to tri-state clientsand the implications for Central Australia and beyondin expanding its role.Central Australia and the Barkly region will also besupporting Departmental initiatives including: the CanNET project to expand and improve cancer bowel screening preventative education program64Department Health and Families

Our PeopleDepartment Health and Families 65

OverviewThis reporting period was characterised by the need to balance continuous improvementof our regular ‘people’ business whilst participating in national reform conversations andprojects.The Northern Territory workforce groups were represented on all Council of AustralianGovernment (COAG) workforce development projects and participated in the consultationprocesses for the Hospital and Health Reform Commission’s work. The next reporting periodshould see the fruition of this work.Preparation for the implementation of the National Registration and Accreditation Schemefor the health professions demanded a huge commitment by the Department in time, effortand resources. Everyone involved in the process of stakeholder consultation, developing Northern Territory would be in a position to participate in this momentous health workforcereform. The National Scheme commenced in the Territory on 1 July 2010, covering 10health professions: medical, nursing and midwifery, pharmacy, physiotherapy, dental(Dentists, Dental Prosthetists, Dental Therapists, Dental Hygienists), psychology, optometry,osteopathy, chiropractic and podiatry. Four more professions are scheduled to join thepractice, Chinese medicine, medical radiation practice and occupational therapy.The Department received national recognition for its Strategic Workforce Plan andAboriginal and Torres Strait Islander Strategic Workforce Plan in October 2009 by winningthe inaugural award for “Policy Innovation” at the Community Services and Health IndustrySkills Council’s National Accolades for Excellence. The uniqueness of these plans is thattogether they not only identify the skills shortage gaps and future workforce requirementsfor the Territory, they also provide practical strategies to support current employees andachieve the future workforce the Territory needs. They are designed to motivate and inspireall areas of the Department to become involved in caring and planning for our workforce.Both plans will continue to drive the strategic workforce agenda across the Department andwill evolve to address future heath service needs.The plans focus on attraction, recruitment, development and retention strategies that willin this reporting period and will continue into the next. Work on new ways to create a and other Apprentice programs implemented. Partnerships with academic institutions sawcreative models for post graduate learning in skill shortage areas like midwifery, renal andNurse Practitioners. New partnerships were developed for undergraduate programs suchas science and medicine.Our work on development opportunities for employees is bearing fruit with 560 activities onour calendar,15 811 registrations and $5.4 million expenditure on training and development activities.The achievements of this reporting period were a balance between the ordinary and theextraordinary through the commitment of a dedicated and enthusiastic workforce.66Department Health and Families

Snapshot of our peopleFigure 1 shows full time equivalent (FTE) and the proportion of staff by category andgender. Since 2008-09 there has been growth of 10% in nursing, 7% in medical and 15%areas. The Department had 447 FTE employees who were permanent part time, 3272time. At the end of 2009-10, the Department had a total of 5916 FTE, an increase of 6%compared to 2008-09.2000.0035%35%FTE Staffing End of Financial Year1500.001000.00500.0035%25%26%26%12%12%12%11%12%11%8%8%8%4%4%4%2%2%2%2%1%2%0.002007/082008/092009/102007/082008/092009/102007/082008/092009/102007/082008/092009/102007/082008/092009/102007/082008/092009/102007/082008/092009/102007/082008/092009/10Nursing Administration Physical Professional(Inc Dental)ClassificationMALE FEMALEMedical Technical Aboriginal ExecutiveHealthWorkerEquity and DiversityPrograms and initiatives targeted at increasing workforce participation from EqualEmployment Opportunity (EEO) groups help us build a workforce that is representative ofthe Department’s client base.Current Department Equity and Diversity programs are targeted at Aboriginal people, peopleof non-English speaking backgrounds, people with declared disabilities, and the matureaged. Strategies shaped around supporting an equitable and representative workforce have table below is based on the proportion of Department employees who have volunteeredtheir EEO status.Table 6: Equal Employment Opportunity Statistics based on MyHR EEO data2007-08 2008-09 2009-10Disability 6% 5% 4%Non-English Speaking Background 14% 18% 23%Aboriginal and Torres Strait Islander 10% 10% 10%Department Health and Families 67

Aboriginal and Torres Strait Islander WorkforceInvestment in the Aboriginal and Torres Strait Islander workforce continues to be a priorityfor the Department with several initiatives ongoing across the Department. These initiativesstrengthen links between education, employment and development for the Department’scurrent and potential Aboriginal and Torres Strait Islander workforce. Below are some keyinitiatives that highlight the Department’s continued investment in attempts to “Grow ourown” workforce.Attracting Aboriginal and Torres Strait Islander StaffVarious campaigns and programs were conducted to increase Aboriginal and Torres StraitIslander employment across the Department as follows: displays were set-up in the Alice Springs and Tennant Creek Future Careers Expos in Nursing and Midwifery were promoted as career options at the East Arnhem Careers Apprenticeships and Cadetships were promoted in the Taste of University – Charles hosted two Aboriginal students from Kormilda College for a day per week for four weeks employed nine Aboriginal school-based apprentices who undertook either workexperience or work placements within the Department, prior to a formal sign-up into aschool-based apprenticeship.Aboriginal Health Worker ProgramHealth Care (Practice) and are employed in the following locations - Ramingining, Borroloola,Milingimbi, Gapuwiyak, Elliott, Canteen Creek, Yuendumu and Alice Springs.Aboriginal and Torres Strait Islander ProfessionalDevelopment ProgramThe Aboriginal and Torres Strait Islander Professional Development Program: Stepping Up,has now recruited and is supporting a second intake of nine participants into the program.Stepping Up provides individually tailored programs designed to enhance practical skills forworking within Government. This is an accelerated development program that represents anopportunity for Aboriginal and Torres Strait Islander staff to develop skills and competenciesto open up career pathways within the Department. Sixty-six per cent of participants fromthe program. Members of Stepping Up from Intake 1 and 2 come from a diversity of positionsand locations from across the Department.68Department Health and Families

National Indigenous Cadetship ProgramThe Department currently has a total of 15 cadets under the Indigenous Cadetship SupportProgram, studying degrees in Nursing, Environmental Health, Social Work, Psychologyand Physiotherapy.Cultural Awareness457attendedculturalawarenesssessionsThe Aboriginal Cultural Awareness Program (ACAP) aims to provide staff with the skills,knowledge and attitudes necessary to work effectively with Aboriginal clients in order toachieve improved health. During 2009-10, 457 people attended the program. A further 201Remote Workforce DevelopmentIn today’s labour market, the ability to attract and retain staff is perhaps the greatestchallenge. The Department acknowledges that efforts to grow our own, retain mature agedpeople and increase Aboriginal and Torres Strait Islander employment are essential toachieving a sustainable workforce into the future.secure appropriate training and development opportunities for staff in remote areas.Training achievements for remote based employees for the reporting year included: Aboriginal Cultural Awareness Program (ACAP) training was provided in Nhulunbuywith three sessions to 19 participants and in Tennant Creek with three sessions to 31 a comprehensive Training Calendar was developed and implemented for Nhulunbuyand Tennant Creek. Nhulunbuy had 23 corporate training activities with 152 participants ten remote Aboriginal staff received Aboriginal and Torres Strait Islander Study Grants to Remote Workforce Development Grants were awarded across 22 different disciplines andactivities that included individual professional development, conference attendance, group the on-line Corporate Orientation Program was delivered for Tennant Creek staff with100% attendance.Women in LeadershipHistorically, women have not occupied management or executive roles in the sameproportion as men and efforts to reduce this during the reporting period have included: 13 women graduated from the First Line Leadership and Management DevelopmentPilot Program conducted in Darwin compared to four men. This 12 month development 17 women graduated from the Darwin Middle Manager Leadership and ManagementDepartment Health and Families 69

40Apprentices /Trainees13 women are currently participating in the First Line Leadership and ManagementWomen as Leaders Program. This program is designed to help women develop greater undertake the Public Sector Management Program (PSMP). The PSMP is a tertiary levelThe Department supported two women at the Director level to participate in HealthExecutive Action Learning Sets, facilitated by Queensland Health. Another was supportedto participate in the Australian and New Zealand School of Government, dedicated toTen people received an Aboriginal and Torres Strait Islander Studies Assistance Grantfor professional development activities, the value of the grants totalled $30 004.Apprenticeship Program the Diploma in Dental Technology.70Department Health and Families

Supporting our PeopleHuman Resource ServicesThe Human Resource Services Unit provides a broad range of advice, guidance andsupport to managers and staff on matters such as conditions of employment, performancemanagement, grievances, discipline, and recruitment and selection. Human Resource (HR)Consultants are located in Darwin, Casuarina, Katherine and Alice Springs with consultantsvisiting Tennant Creek and Nhulunbuy when required. HR Services acts as a liaison pointfor the central agencies and the unions. Regular meetings with stakeholders are held toprovide an opportunity for the HR Consultants and Managers to discuss any workplaceissues prior to escalation. Some consultants are trialling an ‘on-site service’ where theyvisit various workplaces for the day. This provides managers and staff with opportunities forface-to-face discussions.The Commissioner for Public Employment received a total of 33 formal Section 59Grievances during the year for the Department. Seven cases were brought forward from2008-09.Under Section 48 Medical Incapacity, the Department had 14 new cases and one case wascarried forward from 2008-09. Of the 15 cases, eight were completed.Under Section 44 Inability to Discharge Duties, the Department had two cases broughtforward from 2008-09 with no new cases commencing in 2009-10. Of the two broughtforward, one was closed.Under the Department’s Grievances Policy and Guidelines, the Chief Executive receiveda total of 21 grievance requests. Seven requests were carried forward from 2008-09. Ofthe 28 requests, 23 have been resolved. Grievance management policies for staff andmanagers are available on the Department’s intranet site.and family members through the Employee Assistance Program (EAP), including a visitingservice at Royal Darwin Hospital. The EAP service is well utilised across the Department.Industrial RelationsThe Industrial Relations Unit (IRU) provided advice and resources to implement variouscommitments arising out of previous union collective agreements. The unit has been heavilyinvolved in monitoring national trends in the terms and conditions of other jurisdictions in orderto evaluate the Department’s position in relation to employment matters. The Unit continuedto be involved in the formation and renewal of several occupational market allowances.The Industrial Relations Consultants continued to provide specialist human resource adviceto managers on managing key external and internal relationships that affect their workplaces.The Northern Territory Public Sector 2008-2010 Union Collective Agreement ceases inAugust 2010 and negotiations have been entered into by the employer with employeerepresentatives seeking a new agreement. The IRU has been involved in discussions withelements of the employer’s offer to employees. The IRU will be central to the implementationof the agreement matters.Department Health and Families 71

Agreement 2008-10 will expire, and discussions towards a new agreement have commencedOccupational Health and SafetyTwo additional full time positions have been created within the Occupational Health andSafety Unit (OH&S) to provide a dedicated service to Royal Darwin, Alice Springs, Katherine,Gove District and Tennant Creek Hospitals. These additional positions will play a key role inpreparing for accreditation checks.Successful recruitment to the two Central Region OH&S positions has strengthened theDepartment’s capacity to maintain injury prevention strategies in line with the Top End andaligned with the Department’s Occupational Health and Safety Management System.The OH&S Steering Committee’s membership represents a Union-Department partnership,to which a robust OH&S committee structure across the Department provides regularreporting on OH&S performance.Under Section 34 of the Territory’s Workplace Health and Safety Act (2007) the Departmentor its workers, may at any time, start negotiations for the formation of a workgroup. Thepurpose of establishing a workgroup is to progress to the election and introduction of aHealth and Safety Representative (HSR). To further strengthen consultation and participationarrangements between the Department and staff, negotiations to establish workgroupshave commenced and are ongoing.251TrainedmanualhandlingresourcestaffWork continues on developing new and reviewing existing OH&S related Departmentaldocuments aligned with the Territory’s Workplace Health and Safety Act 2007 andRegulations 2008 and nationally recognised best practice.OH&S training forms part of the Department’s Orientation Program and is provided on aregular basis through the Departmental Corporate Training Calendar and on an ad-hoc basisas required. Due to the nature of our business, body stress incidents continue to account forthe highest number of injuries to health staff. A major training focus for this reporting periodhas been on the provision of manual handling training for resource personnel. Manualhandling resource staff within the work areas provide on-site in-service for existing staffin addition to induction training for new staff, including the correct use of mechanical aids.There are a total of 251 trained resource staff throughout the Department, with 210 locatedin Acute Care Services.The provision of training and general OH&S worksite inspections has been undertaken inWorkers’ CompensationA total of 159 new claims were lodged, resulting in a total cost of $3 362 862 comparedto the previous year’s cost of $3 666 986 representing an 8.3% reduction. The averagelost time due to all injuries was 12 days, compared to 18 days for 2008-09. Claims lodgedby nurses accounted for 86 of the new claims at a cost of $2 820 607. Whilst there is anincrease in claims lodged by nurses in comparison with previous years, the claims weremanaged expediently and averaged a time loss of 11 days compared to 30 days lost timeaverage in the previous year.72Department Health and Families

Managing AggressionAggression Management Plans have been developed and utilised across the Department.Aggression Management training sessions are delivered by the OH&S Unit through a varietyof avenues including, all Orientation and Mandatory training programs, individual work areasand Corporate Calendar sessions. These sessions aim to provide workers with strategiesto minimise the incidence of aggressive behaviour and manage aggressive situations theymay encounter within their work areas. A total of 738 employees undertook this training, themajority of whom were front line staff. public media education programs are currently being assessed for use in high risk areas.Learning and DevelopmentThe Department is committed to building a culture that values investment in professionaldevelopment and encourages life long learning. The Department has developed acomprehensive Training and Development Calendar that provides staff with an opportunityto select from over 560 training activities.The Department also recognises that future success relies on retaining, nurturing and‘growing our own’ leaders and has made a major investment in increasing the leadershipand management capability of our workforce.The Department continues its commitment to developing its people by facilitating a widerange of training and development programs across the Territory. A total of 15 811 trainingand staff development course registrations were received in 2009-10.$5.4 million was spent on training and development activities for 2009-10, includingexpenditure for the Aboriginal and Torres Strait Islander Cadetship Program. During thereporting period, there has been a continued focus on increased delivery of corporatemanagement capacity.Assistance with Studies (By-Law 41)The Department supported 209 requests for studies assistance to the value of$156 538 for fees and study leave.$5.4MTraining anddevelopmentUndergraduate Medicine and Health Sciences Admission Test (UMAT)The Department provided funding of $2700 to 18 Territory-based secondary students toassist with meeting the cost of sitting the Undergraduate Medicine and Health SciencesAdmission Test held in various locations around Australia. The test is used to assist withthe selection of students into the medicine, dentistry and health science degree programsat undergraduate level.General Studies Assistance GrantsThe Department provided 69 General Studies Assistance Grants to the value of$90 087 to the Territory’s health and community services workforce. Funding priorities werebased on current and future skills gaps.Department Health and Families 73

Aboriginal representation in the health and community services workforce was encouragedby providing additional studies assistance through the Aboriginal and Torres Strait IslanderStudies Assistance Grants totalling $23 786 to 10 people.Nursing and Midwifery Studies Assistance GrantsGrants totalling $72 154 were awarded to 22 undergraduate nursing and midwiferystudents, 35 postgraduate nursing and midwifery students and 10 nurses and midwiveswere supported to attend conferences and courses.Corporate Training CalendarThe Department’s Training and Development Calendar is a one stop shop for staff to plantraining across a broad range of areas including corporate, clinical and OH&S. Released inJanuary of each year, the calendar is updated quarterly.Staff attendance at training and development activities are recorded on the PersonnelIntegrated Pay System (PIPS) database, Staff Development and Training Module.Recruitment and Selectionthe Department to 201 staff members, an increase of 12% on last year. The roles andresponsibilities of Chairpersons are covered in depth and the Merit Selection Guide isprovided to all participants. Individual support is offered to Chairpersons through HumanResource Services Consultants and Employment Assistance Services Australia.The Department’s Recruitment and Selection policies and related documents have been(OCPE) directions and are available on the Department’s intranet site in the Managers andStaff Service Centre.Orientation75%of allnew staffcompletedOrientationDepartmental Orientation is a multi-disciplinary Orientation Program for all new staff. TheOrientation Program is designed to cover mandatory training requirements and othertimeframe. An average of 75% of new staff attended the orientation program across theTerritory.Bullying and Harassment AwarenessThe Department has continued to place a strong focus on the prevention and elimination ofbullying and harassment in the workplace across the Territory.In addition to the guidelines and policies developed to support a consistent approach in themanagement of harassment and bullying in the workplace, the following training programswere delivered for managers and staff.74Department Health and Families

Eliminating bullying and harassment awareness sessions for managers and staffThis program aims to reduce the number of incidents of bullying and harassment byaddressing the responsibilities of managers, introducing policies and procedures, identifying attended information sessions.Mediation skills for managersThis program supports the Bullying and Harassment Awareness Framework by providingmanagers with practical mediation skills. The skills workshop is an introduction to mediationworkplace. During 2009-10, 130 managers completed this program across the Territory, anincrease of 91% compared to last year.Dealing with the tough stuffThis one day program provides managers with a set of skills, based on practical positivesituations. Sixty-six participants attended this program.130managerscompletedMediationskills trainingCertificate III in Health Support ServicesThis program provides Patient Care Assistants (PCAs) with accredited training, workplaceskills and a high level of competence in the application of these skills within the workplace,staff. The Department continues to support PCAs to undertake this training with 30 PCAscurrently enrolled in the program.Management TrainingEssentials TrainingEssentials of leading people Parts 1 and 2Part 1 of this program focuses on developing skills and providing tools to assist with peoplemanagement. The program covers human resource management delegations, WorkPartnership Plans, communication, legal responsibilities and the relationship betweenleadership and management. A total of 123 staff completed this program. performance. This program was completed by 104 employees.Essentials of managing procurement Parts 1 and 2introduced in 2009. The programs provide participants with improved understanding andservices. A total of 293 participants have attended the training in 2009-10.Department Health and Families 75

Finance for Cost Centre ManagersThis program helps Cost Centre Managers to gain a better understanding of financialmanagement including delegations, budget management and responsibilities. InThe First Line and Middle Manager Leadership and Management Development Programspolicies and procedures and incorporate a range of learning interventions. The programs17Graduated‘Build ourLeaders’‘Building our Leaders’ First Line Leadership and Management Development Programthis program takes the participant through three ‘destinations’ – Managing Yourself,Managing Others and Managing in the Organisation. 17 staff members graduated from thisprogram in December 2009 and currently 21 staff members are participating in the programin Alice Springs.‘Leading the Way’ Middle Manager Leadership and Management Development Programtakes the participant through the same three destinations, but at a higher level. Twenty-twostaff members graduated from the program in December 2009 and 31 staff members havebeen selected to commence the program in July 2010.The Department’s Executive Leadership DevelopmentThe Department’s Executive Directors have completed 360 degree assessments againstthe OCPE Executive Capabilities. The Department has partnered with South Australian (SA)Health regarding their leadership and management programs for emerging Executive leaders.Two Departmental staff members participated in the SA Health Executive Leadership andDevelopment Program delivered by Mt Eliza Executive Education as part of the MelbourneBusiness School. Two Directors are participating in the Health Executive Action Learning Setsfacilitated by Queensland Health and one Director is participating in the Australian and NewZealand School of Government, promoting outstanding public sector leadership.OCPE Executive Leadership Development ProgramsPublic Sector Management ProgramTen staff members are due to complete the PSMP program this year.Discovery – Women as Leaders ProgramTwo staff members completed the program in 2009.Productivity Places Program (PPP)The Department has utilised places under the Australian Government funded initiative‘Productivity Places Program’ to enhance skills, build capacity and create pathways fromthe Administration to the Professional Stream. Placements include:76Department Health and Families

Graduate ProgramThe Department has supported one Graduate of Politics and Economics within theGovernment Relations and Strategic Policy Unit.Work Partnership PlanThe Department’s Performance Management Framework, the Work Partnership Plan(WPP), is introduced to all new starters through the Departmental Orientation Program.The WPP is supported by a comprehensive ‘How to Guide’ and ‘A Guide to Giving andReceiving Feedback’ readily available through the Department’s intranet site.Two Hour WPP information sessions are offered to regional centres. These sessions aretailored to meet the needs of the region and in the reporting period have included ‘WPP forWPP sessions have been delivered to program areas including the Aboriginal Health Workerinduction programs and the Remote Orientation Program.e-LearningIn December 2009, the Department was allocated funding through the Digital RegionsInitiative for the implementation of an eLearning Strategy including the development, useand implementation of: eLearning Authoring tools.Developments in the eLearning Strategy to date include: appointment of an eLearning Strategy Project Manager and the establishment of an Terms of Reference for the eLearning Working Group and the eLearning Strategy ProjectPlan have been developed and endorsed by the eLearning Working Group. an environmental scan for a suitable LMS, collaborative tools and content developmentsoftware is currently underway. The environmental scan includes investigations into a working group has been established to draft a new format and structure for theDepartment training and Development Intranet site. The goal of the Working Groupis to develop a structure that will enable all Departmental Training and Developmentinformation to be accessed through one portal.Department Health and Families 77

Clinical Learning (Nursing)The Clinical Learning (Nursing) Section provides continuing education and professionaldevelopment for Nurses and Midwives across the Territory. A number of courses have beenendorsed for the awarding of continuing professional development with the Royal Collegeof Nursing Australia. A number of products have been developed and delivered in response Clinical Handover.Clinical Learning (Aboriginal)The Top End Clinical Learning, Aboriginal Unit provides continuing education andprofessional development for Aboriginal Health Workers.Comprehensive training needs analyses has commenced to identify common trainingrequirements and individual development needs.During the reporting period a number of training programs were developed and delivered,including: Basic Computer Skills.Aboriginal Health Worker training for Central Australia is contracted to Central AustralianRemote Health Development Services. The contract has been renegotiated for a further12 months with greater accountability and reporting measures in place.Shared ServicesThe Department uses the Northern Territory Government’s shared services for a rangeof functions, including payroll, recruitment and government accounting services. TheDepartment of Business and Employment provides these services under agreedarrangements.Employment InstructionsEmployment Instructions are rules issued by the Commissioner for Public Employmentthat cover important human resource matters. Under the Public Sector Employment andManagement Act, all agencies are required to report against the 14 Employment Instructions.These instructions have been addressed within this section and in Appendix 5.78Department Health and Families

GovernanceDepartment Health and Families 79

FrameworkCorporate Governance and clear accountability and responsibility.The Executive Leadership Group plays a central role inmaintaining the accountability and responsibility within theorganisation through diligent monitoring and responsiblerisk management. Accountability, responsibility,effective leadership and capable management hasbeen supported by the continued provision of extensivemanagement training for supervisory and middle levelmanagers across the organisation.Collaboration with stakeholders and accessing abroad range of specialist advice are essential inputs substantially from the contributions made by the Familyand Children, Mental Health, Senior Territorians,Disability Services, Youth Justice, Youth Round Tableand Health Advisory Councils and Committees someof which contain both community and Departmentalrepresentatives and report to the respective Ministers. terms of reference and senior membership: theseare the Executive Leadership Group, the ResourceManagement Committee, the Occupational Health andSafety Steering Committee, the Department of Healthand Families and Unions Consultative Committee, theStrategic Information Management Committee, theStrategic Workforce Committee, the Principal Safetyand Quality Committee and the Audit Committee.Details of the groups are available at Appendix 4.Clinical GovernanceClinical governance provides a framework whichensures the highest possible safety and qualityof clinical care and is an especially importantcomponent of the Department’s overall governance.Clinical care is delivered by frontline staff with astrong sense of professional responsibility. Executiveand senior management accept that they have a keyresponsibility for the quality of services delivered bythe Department and that they share accountabilitywith clinicians and other professionals providingservices. Where possible, services should be basedon locally applicable evidence of effectiveness andsafety. The Executive and managers at all levels(including senior clinicians and other professionalswith management responsibilities) ensure that:an environment promoting evidence based practiceand fostering safety, quality and continuouscritical incidents are monitored, effective responsesare developed, and regular reports on quality are the Department works collaboratively with staff andall stakeholders, including consumers, to improvesafety and quality across the organisation.A Principal Medical Advisor, Principal Nursing Advisor,Principal Aboriginal Health Worker and Principal AlliedHealth Advisor provide high level advice. These groupsand individuals complete a comprehensive governancedirection of health and community services.80Department Health and Families

NT Family & ChildrenAdvisory CouncilDepartment of Health and FamiliesCorporate Governance Management Environment, June 2010MinisterialDHFMINISTER FOR WOMEN’SPOLICYMINISTER FOR SENIORTERRITORIANS AND FORYOUNG TERRITORIANSMINISTER FORHEALTHCHILDREN AND FAMILIESCHILD PROTECTIONHealthAdvisory CouncilChief ExecutiveA/Alan WilsonExecutive Leadership GroupExecutive Director Acute CareA/Helen MasonExecutive Director Health Protection/ChiefHealth OfficerBarbara PatersonResourceManagementCommitteeExecutive Director Health ServicesJenny ClearyExecutive Director NT Families & ChildrenClare Gardiner-BarnesDisability AdvisoryCouncilExecutive Director System Performance &Aboriginal PolicyShane HoustonChief Operations Officer Performance &ResourcesPeter BeirneAuditCommitteeNT Community AdvisoryGroup on Mental HealthSenior TerritoriansAdvisory CouncilStrategicWorkforceCommitteeNT Youth Round TableStrategic InformationManagementCommitteeDHF & UnionsConsultative CouncilOH&S SteeringCommitteePrincipal Nursing AdviserGreg RickardPrincipal Medical AdviserAlan RubenPrincipal Allied Health AdviserRenae MoorePrincipal AHW AdviserPeter PangqueeNT Youth JusticeAdvisory CommitteePrincipal Safety& QualityCommitteeDepartment Health and Families 81

Risk ManagementThe purpose of risk management within theDepartment is to support better decision makingthrough a good understanding of risks and theirlikely impact. The aim is not to eliminate risk, butto consolidate the culture, systems and processesrequired to manage the risks involved in our activitiesand as a result to maximise opportunities andminimise negative outcomes.Two enterprise models: one for corporate risk and theother for client risk were implemented during the year,consolidating previous models. The consolidationwill lead to greater consistency and clarity of riskexposures across the organisation. RiskMansoftware has been implemented in the hospitalsduring 2009-10 and will spread over the rest of theDepartment in 2010-11.analysis, evaluation, assignment, registration and thedevelopment of mitigation plans for risk reduction arebeing incorporated into key departmental systemsand processes to increase the prevalence of riskbased decision making. Management is responsiblefor implementing the risk management models withintheir respective areas of responsibility.The outcomes of these activities will both informand be informed by the Department’s planningand performance management processes. TheDepartment’s Executive and the Audit Committeeplay a monitoring role in relation to the organisationalImprovements to the linkages between the riskmanagement initiatives and the Department’s internalaudit function were realised with the implementationof an integrated Risk and Assurance Framework. TheFramework brings about a more risk based approachto internal audit planning and reporting and is set outin the Department’s Internal Audit Manual.AuditA number of reviews, evaluations and audits wereundertaken in 2009-10. The outcomes of these arereported to the Audit Committee who undertakeon behalf of the Chief Executive to monitor theimplementation of key recommendations.On 25 February 2010 Alice Springs Hospital staffbecame aware that a person employed as a medicalintern (the ‘intern’) working at the Hospital hadallegedly fraudulent documentation and was not 2010 the following reviews were commissioned: the Department of Health and Families The objective of the consultancy was to reviewthe adequacy and effectiveness of the systemsand processes in place relating to credentialing formedical practitioners in the Department of Healththe processes followed in the appointment of theintern to Alice Springs Hospital were in line withnormal junior medical staff recruitment practice, itto assist hospitals through the provision of morerobust policy on the credentialing and appointmentof medical practitioners in the Northern TerritoryHospital Network. Medical Board Systems and Processes The objective of the consultancy was to assess theMedical Board’s compliance with its documentedsystems and processes and their alignmentwith national standards/ best practice for theregistration of medical practitioners in the NorthernThe review found that the Board’s processesfor the registration of medical practitioners werecomparable with processes in other jurisdictionsin Australia and that there was a high degree ofcompliance with the stipulated processes andprocedures in the processing of applications forregistration.The Internal Audit function commissioned a numberof internal audits/reviews during 2009-10.82Department Health and Families

Royal Darwin Hospital Medical Evacuations The objective of this audit was to review the extentof compliance with the policies and proceduresregarding medical evacuations at RDH. A number recommendations made on a new guidelineand form and investigating alternatives usingcommercial aircraft.Alice Springs Hospital Compliance AuditThe objective of this audit was to review policies and rostering and staff utilisation. Minor issues areas reviewed.Remote Staff Safety Review The objective of this review was to considerthe adequacy and effectiveness of the systemsand processes in place to manage the safety ofDepartmental staff working in remote locations.In the opinion of the auditor these systems andprocesses were not adequate, despite somegood guidelines in individual programs. TheDepartment is in the process of respondingto this audit’s recommendations, creatingconsistent Departmental policies and processesand addressing other safety concerns throughits Occupational Health and Safety Unit andSteering Committee. As recommended, it isalso considering a risk assessment of relevantDepartmental facilities.Probity AuditsThe Department has a procurement policy whichrequires probity audits to be undertaken based onprobity audits were conducted and/or are in progress the auditors.Katherine Hospital Compliance AuditThe objective of this audit was to review policiesand recommendations made for improvement.The following audits were conducted by the Northern End of Year Review 2008-09The objective of this audit was to review the year controls over reporting, accounting andaccounting and material transactions and balanceswith the primary purpose of providing supportto the audit of the Treasurer’s Annual FinancialStatement for year ending 30 June 2009. No during the audit and the accounting and controlprocedures examined in relation to the end of year satisfactory.Rights of Private Practice at Royal Darwin HospitalThree Year Compliance Audits Government hospitals within the Northern Territorybegan in 2009-10. It was conducted in accordancewith the protocols and processes detailed in a threeyear Strategic Internal Audit Plan for Acute CareServices. The following audits were conducted:Royal Darwin Hospital Compliance AuditThe objective of this audit was to review and resources. The audit made a number ofrecommendations for improvement in these areas.The objective of the review was to review rightsof private practice at the Royal Darwin Hospital.The audit highlighted a number of shortcomingswith the overall administration of private practicearrangements at the Hospital and recommendedthat the Department strengthen its controls overthe management of these arrangements.Pensioner and Carer Concession SchemeThe objective of the audit was to assess the internalcontrols of the Agency over the managementof the Northern Territory Pensioner and CarersConcession Scheme (NTPCCS). In general theinternal controls over the NTPCCS were foundto provide reasonable assurance that there iscompliance with prescribed requirements.Department Health and Families 83

However recommendations were made toimprove supporting documentation, updating ofthe procedures manual, authorising of delegateapprovals and travel and spectacle concessionpayments.Insurance ArrangementsIn accordance with Treasurer’s Direction R2.1Insurance Arrangements, the following informationprovides an overview of the agency’s insurancearrangements and details the key mitigation strategiesand processes in each insurable risk categoryAs a general principle, and in accordance with theTreasurer’s Directions, the Department self insuresits risks and manages potential exposures throughextensive mitigation practices. Where insurable riskevents occur, the Department meets these costs asthey fall due.in R2.1, the Department has in place the followingmitigation strategies and processes: property and assets – facility, plant and equipment The costs of self insurance claims are monitored bythe Department with the exception of property andassets insurance category which are not separatelyrecorded, but form a component of the larger repairsand maintenance costs. The total costs for selfinsurance claims for the other insurance categoriesare as follows:Table 7: Self insurance claims cost 2008-09 to 2009-102008-09 2009-10$000 $000Workers Compensation 3,400 3,413Public Liability 0 23Indemnities 1,340 425Under Treasurer’s Direction R 2.1.6.2, theDepartment has a standing Treasurer’s approval topurchase commercial insurance on behalf of fostercarers to cover carers for public liability, motor vehicleand building and contents risks. The commercialinsurance premium expenditure is as followsTable 8: Commercial insurance premium expenditure 2008-09 to 2009-102008-09$0002009-10$000Insurance Premiums 39 42The contractual relationship is between the fostercarers and the insurer, therefore the Department is notparty to information regarding claims costs under thecommercial insurance policies. 84Department Health and Families

Coronial FindingsThe Coroners Act enables the Coroner to make recommendations on public health and safety after the deathof a person. Any recommendation that contains a comment relating to an agency must be passed on to theChief Executive (CE) of that agency. Within 3 months after receiving the report or recommendation, the CEis required under the Coroners Act actions taken or to be taken on the Coroner’s recommendations.All recommendations handed down that relate to the Department of Health and Families are monitored quarterlyand reported to the CE. Monitoring continues until evidence is provided to demonstrate implementation andsustainability of the improvement activities.A Coronial Inquest may be held at the discretion of the Coroner following an unexpected death. The followingFigure 2: Coronial Findings per year 2003-10Coronial Findings per year 2003 - 2010876543210Acute CareHealth ProtectionHealth ServicesNTFC2003/042004/052005/062006/072007/082008/092009/10Health Services & AcuteCareActions in response to Coronial recommendations in 2009-10 included: Complaints HandlingPeople who use the Department of Health and Families services are encouraged through the internet, publicsign posting and brochures to provide feedback and to discuss any concerns about services they receive. Thisservice users have their complaints heard and resolved’.Key elements of the policy are: encouragement by staff of feedback from service users about their services.Department Health and Families 85

Action to resolve a complaint is based on the evidence, addresses any system, process or staff issues andis informed by the principles of public interest and good governance. The complaints process is an integralimprovement in the complaints handling process.The Department also takes referrals from the Health and Community Services Complaints Commission andcommunication issues were the three highest complaint categories.Table 9: number of Complaints by Type – 2009 - 2010Acute CareHealth ServicesComplaint Type 2007-08 2008-09 2009-10 2007-08 2008-09 2009-10Access 180 215 151 40 7 23Communication / Information 97 79 73 6 4 6Consent / Decision Making 0 0 1 0 0 0Corporate Services 50 54 32 0 1 0Costs 6 6 6 1 0 0Grievances 4 3 8 0 0 0Privacy / Discrimination 28 9 24 0 0 1Professional Conduct 17 35 17 0 1 6Treatment 109 100 87 6 2 10TOTAL 491 501 399 53 15 46Table 10: Complaints Outcomes – 2009 to 2010Acute CareHealth ServicesOutcome2007-08 2008-09 2009-10 2007-08 2008-09 2009-10Account Adjusted 1 2 2 0 0 0Apology Provided 85 51 40 33 4 6Change In Procedure Effect 7 4 1 1 4 0Compensation Paid 3 0 0 1 0 1Complaint Letter Sent 0 0 0 0 0 0Complaint Withdrawn 0 1 0 0 0 0Concern Registered 42 32 28 10 0 2Conciliation Reached 0 1 0 0 0 0Counselling 12 12 10 3 0 0Disciplinary Action Taken 0 2 0 0 0 0Explanation Provided 239 272 225 33 7 30Policy Change Effected 2 1 1 0 0 3Referral Elsewhere 10 13 21 1 0 0Refund Provided 0 0 0 0 0 0Service Obtained 204 249 150 8 1 11Undefined 21 8 1 0 7 0TOTAL 626 648 479 90 23 53 86Department Health and Families

NTFC options for a complaint outcome can include: convene case conference or family meeting to discuss concerns.Table 11: Number of NTFC Complaints by outcomes 2009-10NT Families and Children(NTFC)Complaint Outcome 2009-10 2008-09 2007-08Account adjusted 1 1 -Apology provided 5 5 4Concern registered 7 19 29Conciliation agreement reached 7 9 6Explanation provided 89 53 32Policy change effected 2 - 1Referred elsewhere 4 11 1Change in Procedure/Practice - 5 1Complaint Withdrawn - - 1Disciplinary Action taken - - 1Service obtained 11 6 9Undefined 1 5 3TOTAL 127 114 88The most common complaint outcome as shown in the table above is ‘explanation provided’.Investigation into complaints has resulted in the Department making changes to policy to improve proceduresand systems as follows: A review and revision of the case transfer policy and procedures for children in care of the Chief Executivehas been implemented and a case transfer template introduced. Structured Decision Making Screening and Priority tools are now being used by NTFC Central Intake team.The NTFC Care and Protection Policy and Procedures Manual is being updated for this purpose. Trainingwill also be developed to support implementation of the policy.Department Health and Families 87

Table 12: Number of NTFC complaints by type in 2009-10Complaints by type 2009-10 2008-09 2007-08Requested service not provided 14 19 15Inadequate or no service 3 9 11Referral 31 9 9Communication/information 2 - -Information wrong/misleading 4 8 -Providers attitude 9 9 5Insufficient or inadequate information 19 17 11Consent not informed/failure to warn 1 1 2Consent not obtained 1 3 1Failure to consult consumer 7 7 8Policy/procedure/standard of practice 6 7 1Processing payments/funding support 10 - -Inadequate/no response to complaint 12 11 4Access to records 1 - 1Cultural appropriateness 1 - 2Privacy/confidentiality 3 5 4Reports 2 4 2Competence 2 2 1Care of child in out of home care 16 9 3Case management 1 2 -Case management coordination 5 - 3Poor response to case management tasks 20 17 6Relationship conflict 5 7 -Administrative practices - 2 1Security - 2 1Accuracy/Inadequacy of records - 2 1Assault - 2 1Illegal practice - - 1Reprisal/retaliation - 1 -Breach of duty of care - 4 -Damage or Injury to persons or property - 2 -TOTAL 175 161 94Please Note: The total number of complaint types indicates that some complaints lodged represent more thanone issue therefore the total number of complaint outcomes may vary as a result.88Department Health and Families

Sentinel Eventsdeath or serious harm to a client has occurred’.In 2004 Australian Health Ministers agreed to the national collection of sentinel event data. The DepartmentTable 13: Sentinel Events Per year and CategorySentinelEventCategoryNumber ofeventsNumber ofevents2008 - 2009 2009 - 2010Sentinel Event Type1 - - Procedures involving the wrong patient or body partresulting in death or major permanent loss of function2 - - Suicide of a patient in an inpatient unit3 - - Retained instruments or other material after surgeryrequiring re operation or further surgical procedure4 - - Intravascular gas embolism resulting on death orNeurological damage5 - - Haemolytic Blood transfusion reaction resulting fromABO incompatibility6 - - Medication error leading to the death of a patientreasonably believed to be due to incorrectadministration of drugs7 - 1 Maternal death or serious morbidity associated withlabour or delivery8 - - Infant discharged to wrong family or infant abduction9 14 27 Unexplained, unexpected death or serious illness ordisability reasonably believed to be preventableMuch of this measurement is undertaken in hospitals, and reporting of this data has three purposes: for transparency to provide important information to patients and consumers who are increasingly conscious to drive improvement by routinely providing information and timely performance feedback to cliniciansand manager.The World Health Organisation suggests that, in order to enhance patient safety, healthcare services need an‘increased ability to learn from mistakes, through better reporting systems, skilful investigation of incidents andresponsible sharing of data’.Sentinel event data is recorded and monitored centrally. All recommendations from investigations are monitoredthrough to completion and evidence is collected to demonstrate implementation.due to improved reporting.Department Health and Families 89

Information and PrivacyThe Information and Privacy Unit deals with formal applications for access to information under the InformationAct (the Act). It also assists staff, members of the public and other organisations to access Government andpersonal information in less formal ways. The Unit provides advice on all aspects of privacy protection ofpersonal information that the Department of Health and Families holds.There has been a marked increase in FOI and informal applications in recent years as shown below.Table 14: Number of Matters Dealt with During the YearYearFOIApplicationsAdministrativeAccessReviewsTOTALS2005-2006 20 -2006-2007 21 52007-2008 20 122008-2009 45 172009-2010 76 193 235 316 389 713 98In total, the Unit released more than 32 000 pages of Government and personal information to applicantsduring the reporting period. Details of the way FOI applications were dealt with are set out in the following table.Table 15: Formal Application outcomes under the Information ActAccess applications open at start of year 8Access applications accepted during the year 68Access granted in full 38Access granted in part 15Access refused in full 9Access applications not accepted 4Access applications transferred 4Access applications withdrawn 2Access applications open at end of year 4One application for correction of personal information was lodged during the year. The application was acceptedand the information was corrected as requested by the applicant. Information Commissioner under section 103 of the Act. The Department co-operates with the Commissionerin the resolution of complaints including attending mediation where appropriate.The Unit provides training about information access, data protection and records handling to new employeesat regular Orientation sessions.90Department Health and Families

Human Research Ethics CommitteeThe Manager of the Information and Privacy Unit is appointed as the Information and Privacy Advisor tothe Human Research Ethics Committee of the Department of Health and Families and Menzies School ofHealth Research. This Committee is constituted in accordance with the National Health and Medical ResearchCouncil Act 1992 (Commonwealth) and the National Statement on Ethical Conduct in Human Research.The Committee supports the research activities of the Department and Menzies and considers researchproposals submitted by health providers and researchers proposing to access personal information ofparticipants in the Top End of the Northern Territory. In 2009-10 the Committee considered 122 researchproposals for ethics approval. Its Fast Track Committee, of which the Manager of the unit is also a member,considered a further 46 proposals for research considered to be low risk or requiring only minor amendment.Privacy ProtectionThe Information and Privacy Unit provides advice and assistance to Departmental staff and members ofthe public on issues of privacy protection. The Unit investigates complaints made to the Department aboutCommissioner in relation to privacy complaints and privacy protection issues more generally.The Unit plays a key role in vetting data access for non standard requests for access to information systems,and its approval is required by the Data Access Protocol for requests to access personal medical informationheld in the Department’s data warehouse. The Unit provided staff with advice on research design, use ofof information. The Unit provides assistance and advice in the development of formal Information SharingArrangements with other Northern Territory Government and non government agencies to ensure informationis being dealt with in accordance with the Information Privacy Principles in the Territory’s Information Act.Privacy AwarenessPrivacy policies and brochures were developed and forms were redesigned for program areas of theDepartment during 2009-10. The Unit participated in International Privacy Awareness Week in May 2010,distributing information, email tips of the day, and regular internet updates to all staff. Throughout the reportingDepartment Health and Families 91

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The following section provides a summary of how coordinated services across theDepartment and Government work together to contribute to improvement in each of thePriority Action Areas of the Department’s Corporate Plan 2009-12. This section also reports and performance management framework. This framework requires agencies to reporton achieving performance measures set out in Budget Paper No 3 (BP3). Performancemeasures used throughout the Annual Report are those published in the 2010-11 Budget$1 051.6 million to $1 120.2 million. The increase was due to additional funding providedby the Australian and Northern Territory Governments relating to the increased demand forhealth and social services provided by the Department. A breakdown of the major fundingvariations follows:Northern Territory Government initiatives ($22.6 million) included: $7.2 million for additional Oncology services at the Alan Walker Cancer Care Clinic and $2.6 million to provide temporary backup power generation capacity at Royal Darwin $2 million for mandatory reporting of domestic violence.The Department also secured increased Australian Government funding of $20.1 million adjustments relating to Australian Government funding were : $1.3 million for Organ Tissue Donation program.During 2009-10 the Department also generated additional ‘Fee for Service’ revenue thatincreased budget capacity by $14.5 million. This was mainly attributable to Acute Careservices provided to interstate clients and other compensable patients in the NorthernTerritory Hospital Network.In 2009-10 the Department’s expenses were $0.7 million below budget (0.06%). Theshortfall in budgeted expenses was the result of externally funded programs that remainincomplete as at 30 June 2010. The expenditure relating to these tied programs will be these funding agreements.surplus cash to fund its outstanding obligations in 2009-10.94Department Health and Families

Table 16: Budget by Output groups2009-10PublishedBudget$0002009-10FinalEstimates$000%Change2009-10Expense$000% Changeto FinalEstimateNT Families & Children 105,393 116,528 10.6% 114,086 -2.1%Family and ParentSupport Services 14,141 14,173 11,266Child Protection Services 25,366 26,681 28,489Out of Home Care 29,807 33,989 34,791Youth Services 15,426 14,590 14,130Family Violence andSexual Assault Services 20,040 26,484 24,646Childrens Commissioner 612 612 763Acute Services 602,329 630,636 4.7% 628,636 -0.3%Admitted PatientServices 480,752 503,079 500,218Non Admitted PatientServices 121,576 127,556 128,418Health & WellbeingServices 290,633 310,064 6.7% 314,922 1.6%Community HealthServices 171,263 182,653 181,180Mental Health Services 37,306 39,316 40,551Services for Frail Agedand Disabled 66,166 72,215 75,004Support for SeniorTerritorians 15,898 15,880 18,187Public Health Services 53,250 63,003 18.3% 61,873 -1.8%Environmental HealthServices 5,111 5,619 5,764Disease Control Services 19,979 25,814 25,037Alcohol and Other DrugServices 22,286 25,237 24,801Health Research 5,874 6,334 6,2711,051,605 1,120,231 6.5% 1,119,517 -0.1%Note: The 2009-10 final estimate published in the Budget Papers was $1 121.081 million.Subsequent to the publication of the Budget papers a variation to the Department’s budget wasapproved under Section 19 of the Financial Management Act to transfer $0.85 million from operationalbudget to asset acquisitions.Department Health and Families 95

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NT Families and ChildrenDepartment Health and Families 97

NT Families and ChildrenNT Families and Children Division (NTFC) works to both prevent and respond to: Domestic and family violence.The Division’s prevention and early intervention work is particularly focussed upon: Strengthening family and community capacity to raise children in safe nurturing Building young people’s leadership and participation in their local community, to support Supporting equity between women and men across Northern Territory society.intervention, support, protection and care in order to gain and maintain a quality of life,including physical safety and shelter. The work done by the Division’s workforce andNTFC’s partners in the non-government sector is therefore often undertaken in challengingcircumstances and with vulnerable children, young people and adults with complex needs.NTFC is made up of four branches. The Family and Individual Support Services (FISS) Branch provides leadershipon policy and service development in the areas of sexual assault, family violence,homelessness, family support services and women’s policy. The Care and Protection Services Branch aims to protect and minimise harm to when they are no longer able to safely stay with their families and are in the care of theand overseeing adoption services. The Youth Services (YS) Branch provides strategic leadership in the establishment anddelivery of high quality, cost effective programs and services for young people including The Strategic Policy and Performance (SPP) Branch provides strategic advice onNTFC policies, legislation, research, evaluation, performance and reporting activities.NTFC is also supported by two units: the Business and Corporate Support Executive Unitand the Non Government Organisation Services Development Unit.The Division is committed to supporting families and communities in a way that Encouragesstrength and independence.98Department Health and Families

Key Achievementsfurther increases in demand on the Northern Territory’s child protection system. in 2008-09 to 414.9 positions in 2009-10.Key system improvements included the development of a partnership with the Children’sResearch Centre in the United States to implement a suite of Structured Decision Makingtools in the Territory, completion of a review of the Central Intake Service and substantial32%increase instaffA key partnership with the Department of Justice’s Community Justice Centre saw thefunded through the Transforming Alice Springs program.In 2009-10, 66 external service providers received over $31 million to deliver services toassist individuals and families to minimise harm, strengthen capacity and achieve wellbeingand independence. This included services for youth, victims of sexual assault, familyand domestic violence, people who are homeless or at risk of homelessness as well asIn addition to funding services, NTFC also provided a total of $209 231 to 130 organisations Family and Parent Support Services – $19 480 under International Women’s Day Grants Youth Services – $189 751 from Youth Engagement projects to 68 organisations todeliver 114 projects.In 2009-10, a number of services expanded as a result of new or increased fundingpartnerships with the Australian Government and through increased Northern TerritoryGovernment funding including: Growth in Closing the Gap Therapeutic Services personnel and further growth is Expansion of the Mobile Outreach Service to provide services to children and youngpeople who have experienced trauma as a result of any form of child abuse.Department Health and Families 99

Family and Parent SupportHighlighting the Department’s commitment to the development and implementation ofservices that support individuals and families, Family and Parent Support Services output,which in NTFC’s structure is delivered by the Family and Individual Support Services (FISS)Branch, brings together: Homelessness Services - support systems for individuals and families experiencing crisis. Child and Parenting Support Team - support to assist families in responding to thechallenges of parenting. OutputOutput cost2008-09Actual2009-10Budget2009-10RevisedBudget2009-10Actual($’000) 10 115 14 141 14 173 11 266Performance Measure2008-09Actual2009-10Estimate2009-10Actual2010-11EstimateQuantityClients accessing crisis support services 1, 2 2 724 3 250 3 300 3 250Days of crisis support 2, 3 240 517 240 000 240 470 240 000Clients accessing protective service familysupport services 4 1 007 2 000 N/A N/AForums, workshops and consultations heldfor women’s advancement 39 39 44 391 This data is obtained annually from the supported accommodation assistance program (SAAP)national data collection published by the Australian Institute of Health and Welfare. SAAP data ispublished one year in arrears and therefore 2008-09 actuals relate to the 2007-08 financial year.SAAP became a part of the National Affordable Housing Agreement (NAHA) in January 2009.2 Crisis support services include accommodation, counselling, general advocacy, financial andemployment assistance, referral to specialist services and basic support such as meals, laundryand shower facilities, recreation and transport.3 Total number of days that support was provided to all clients of crisis support services.4 This measure previously counted the number of ‘Referral-In Events’ received for family supportservices through NTFC’s Central Intake. Due to changes within Central Intake undertaken on 1 July2009 this indicator is no longer used as it cannot be accurately measured. A review of Care andProtection Performance Indicators is presently being undertaken, and a new indicator regardingclients accessing protective service family support services will be published as part of the 2010-11budget process.100Department Health and Families

Key AchievementsAdditional funds of $2.6 million were allocated to shelters to enhance service delivery aspart of the implementation of mandatory reporting of domestic violence.The inaugural NT Homelessness Summit was held in early November 2009. The summitbrought together community and Government stakeholders to:Share information about the changes introduced through the National Affordable HousingIdentify responses to key homelessness issues facing the Territory.the Department’s investment plan to alleviate homelessness.A Child and Parenting Support Team was created with a focus on universal, preventionand early intervention approaches to supporting families and communities and promotingpositive outcomes for children and young people. projects and activities:In partnership with Women’s Health Strategy Unit funded a project to gain a picture ofmigrant and refugee women’s health issues and barriers to health service access in theDevelopment of a website to draw together whole-of-government, national andDevelopment of a set of indicators on the status of women in the Territory.Child Protection ServicesThe Child Protection Services has an ongoing commitment to develop a higher qualitycare and protection system in the Northern Territory.2008-09Actual2009-10Budget2009-10RevisedBudget2009-10ActualOutputOutputcost($’000) 25 740 25 366 26 699 28 489Department Health and Families 101

Performance MeasureQuantity2008-09Actual2009-10Estimate2009-10Actual2010-11EstimateNotifications of child harm 1 6 190 6 400 6 585 6 800Proportion of notifications receivingan initial child danger assessment 2 100% 100% 100% 100%Child protection notifications that arefurther investigated 3 2 370 3 200 3 140 3 800Child protection notifications dealtwith by other means 4 3 820 3 200 3 681 3 400Clients accessing intensive familypreservation services 5 114 80 106 80TimelinessInvestigations of reportscommenced 2 :- Category 1: within 1 day ofassessment 83% 100% 83% 100%- Category 2: within 3 days ofassessment 48% 80% 51% 80%- Category 3: within 5 days ofassessment 23% 70% 26% 70%1 In the Northern Territory, any person who suspects that a child is being, or has been, abused has alegal responsibility to report that concern. This measure is the total number of all notifications.2 All notifications are assessed to ensure that the report is valid before determining if aninvestigation is required and a determination of which category of response is required.3 The number of notifications that proceed to investigation.4 This indicator provides an account of reports dealt with by means other than investigation. Themethodology of reporting “dealt with by other means” has been amended to align with nationalcounting rules.5 Intensive family preservation services aim to prevent entries into the Child Protection and Out ofHome Care system.Key AchievementsClosing the Gap and additional Northern Territory Government funding was used to expandthe Child Abuse Taskforce, which has seen an increase in child protection positions in theTop End Taskforce team to nine and in Central Australia to four as at 30 June 2010.The Targeted Family Support Service being trialled by Central Australian AboriginalCongress in Alice Springs was evaluated and has since been expanded to include nonIndigenous families in Alice Springs. The model has also been expanded to Darwin with Wurlinjang being contracted to commence service delivery in early 2010-11.102Department Health and Families

The Youth Triage Team was formed in May 2010 as an initiative of the Alice Springs YouthAction Plan to provide a coordinated and consistent response for youth at risk after hours.In the early stages the project is focusing on the development of operational guidelines andengagement with the NGO sector and other government agencies operating after hours. 196.8 positions in 2008-09 to 224 positions in 2009-10.Memorandum of Understanding with the Northern Territory Police as a combined responseto child harm and exploitation. The objectives of the Memorandum of Understanding includemutual assistance, cooperation and information sharing.Over the past 12 months, NTFC continues to work with key stakeholders to develop andcustomise Structured Decision Making (SDM) tools for use by NTFC. These are: Intakethe Family Strengths and Needs Assessment tool initially being used by the Targeted FamilySupport Services. The SDM Intake Screening Tool will be completed for all Child Protectioninvestigation. Children under two years of age are given special consideration by the tool.The Remote Aboriginal Family and Community Worker Program was expanded to includethe following communities: Ali Curung.The Intake Review Implementation Project was initiated by NTFC to ensure theimplementation of recommendations arising from the comprehensive review of NTFC’sCentral Intake Service and commenced in 2008-09. The report had noted the inability ofthe Central Intake Team to manage increasing workloads and the consequent delay inreferral to child protection work units. The report made 41 recommendations, including recommendations were completed in 2009-10.The Community Care Information System (CCIS) system was upgraded to improvefunctionality and to address a number of reporting issues such as its inability to cross linksibling group information, manage places of care to the standard required to manage riskschildren and young people in Out of Home Care. A total of $369 750 has been investedin 2009-10 to improve CCIS functionality. $558 000 has been allocated in the 2010-11Department Health and Families 103

Out of Home Care ServicesThe service system that provides for the care, support and treatment of children and youngpeople in the care of the Chief Executive works to provide stability and positive futures forchildren assessed as unable to remain safely in their ususal family home.2008-09Actual2009-10Budget2009-10RevisedBudget2009-10ActualOutputOutputcost($’000) 27 975 29 807 34 007 34 791Performance Measure2008-09Actual2009-10Estimate2009-10Actual2010-11EstimateQuantityChildren in substitute care during the year 1 862 1 150 955 1 200Days of care 2 201 532 226 000 230 383 236 000New clients entering substitute care 344 400 396 440QualityChildren on a care and protection orderleaving care after less than 12 months, whohad one or two placements. 3 86% 80% 90% 80%1 Number of children who were in out of home care at any time during the financial year where theChief Executive has some form of legal responsibility for the child’s care. This includes temporaryCustody Agreements, Holding Orders, Transfer of Orders from Interstate (finalised or pending),Immigration Act Orders (Adoption or Unattached Minor), Family Matters Court Orders (includingAdjournment of Proceedings, Interim Orders, Direction to Parents, Direction to Residency, JointGuardianship and Sole guardianship), Family Law Court Orders, Supreme Court Orders and local2 di t t d tiTotal number of days that care is provided to children in substitute care.3 This figure counts Cases not children. If a child had more than one case of Service Type“Substitute care and Guardianship” of Service Sub Type “Substitute Care General” then he/she willbe counted once for every case.Key Achievementswith children in care who have experienced trauma from abuse and neglect. There havebeen 70 referrals to Therapeutic Services in Darwin since operations commenced, with 24clients currently accessing the service.$6 million was allocated to increase foster care allowances to help retain foster and familycarers, and purchase items for children and young people in out of home care. This yearsaw an increase of 61 foster carers for the Top End. Fifty-four potential carers were engagedin foster care training and 29 completed the training.There were four successful Intercountry adoptions and one local adoption and 10 trainingsessions provided.Across Alice Springs and Tennant Creek an additional 40 foster carers were approved.Thirty foster carers attended core training sessions which included ‘Our Carers Our Kids’training and additional training in relation to the Care and Protection of Children Act.104Department Health and Families

Youth ServicesThe Northern Territory Government’s Youth Justice Strategy, announced in 2008, aims tohelp both young people and their families address any youth behavioural issues that maycontribute to anti-social or criminal activities in the community.The Youth Justice Strategy includes: The administration of the Family Responsibility Program (FRP), including FamilyResponsibility Agreements and Family Responsibility Orders through amendments tothe Youth Justice Ac The operation of Family Support Centres in Darwin and Alice Springs to coordinate the The coordination and administration of Inter-agency Collaboration Panels, consisting ofAlice Springs as a cross-agency referral, information sharing and service coordination The operation of the Youth Justice Advisory Committee. priorities for young people aged 12 to 25 years.OYA supports initiatives that improve young Territorians’ personal wellbeing, promotes theirpositive achievements and assists them to reach their goals. Major activities of OYA includethe Youth Minister’s Round Table of Young Territorians (Round Table), Youth RegionalConsultations, National Youth Week celebrations, administration of the Youth EngagementGrants Program, sponsorship of Awards, co-ordination, monitoring and review of theNorthern Territory Government’s Youth Policy Framework and youth research.2008-09Actual2009-10Budget2009-10RevisedBudget2009-10ActualOutputOutputcost($’000) 11 889 15 426 14 591 14 130Performance MeasureQuantityGrants issued for youth advancementactivitiesQualityClient satisfaction with youthadvancement activities2008-09Actual2009-10Estimate2009-10Actual2010-11Estimate89 100 101 10085% > 90% > 95% > 90%Department Health and Families 105

Key AchievementsIn 2009-10, the Family Support Centres case managed 138 people comprising 53 familiesand 85 young people.Inter-agency Collaboration Panels (ICPs) continued to meet in Darwin and Alice Springsto ensure all available information is gathered and shared about a family of concern, andto ensure that both Government and community services work in partnership to meet theneeds of parents and young people. During the year ICPs met on a monthly, and sometimesfortnightly basis to consider referrals related to around 100 families.Youth camps continue to be facilitated by the funded service providers. During 2009-10,81 young people participated in a youth rehabilitation camp. An independent evaluationcamps and inform future directions.The Youth Services Branch provided support to the Youth Justice Advisory Committee(YJAC). The committee held four face to face meetings during 2009-10, three in AliceSprings and one in Darwin. The YJAC commenced work on a discussion paper on thelater in 2010.The 2009 Round Table projects and subsequent recommendations were presented tomade available to the public via the OYA website: www.youth.nt.gov.au.The Department provided an additional $60 000 which was equally shared between‘headspace’ (Palmerston) and Darwin Community Arts (Malak) to work collaboratively withother youth sector organisations to run positive activities for young people. The activitieswhere designed to build relationships and cohesion between youth in each region andencourage a high level of youth participation.In 2009-10, 146 registered events were held across the Territory as part of National YouthWeek. Event organisers were encouraged to register their events with OYA to obtain freeadvertising on the OYA website and free merchandise.Family Violence and Sexual Assault ServicesThe Family Violence and Sexual Assault Services coordinate, deliver and fund a range ofprevention and intervention services for adult and child victims of family violence and sexualassault. In addition, the Service facilitates education within families and communities aboutthe incidence and impact of violence and implement strategies to reduce violence and theharm it causes.2008-09Actual2009-10Budget2009-10RevisedBudget2009-10ActualOutputOutputcost($’000) 18 788 20 040 26 518 24 646106Department Health and Families

Performance Measure2008-09Actual2009-10Estimate2009-10 2010-11Actual EstimateQuantityIncident of new sexual assault cases receivingsupport 1 577 995 1068 720Number of family violence counselling services8 8 8 91 From July 2009 to March 2010, data relating to the ‘incidents of new sexual assault casesreceiving support’ included cases from both Sexual Assault Referral Centres and the MobileOutreach Service which has resulted in an inflated figure. In March 2010 when the Mobile OutreachService was expanded to include therapeutic services for children suffering trauma from all forms ofchild abuse and neglect rather than purely sexual abuse, the data was separated and will bereported separately in future annual reports.Key AchievementsTwo additional counsellor positions for the Sexual Assault Referral Centres (SARC) (oneeach in Alice Springs and Darwin) were created to address the rising demand for servicesresulting from increasing referrals.The development of co-located Police Child Soft Interview Room facilities at Alice Springsand Darwin SARC provides for more seamless service delivery to children who have beensexually abused.Community open days held by the Alice Springs and Tennant Creek SARC servicesprovided an opportunity for other service providers and community members to view thenew premises.The Mobile Outreach Service Plus has been expanded to provide a therapeutic serviceto Aboriginal and Torres Strait Islander children living in remote areas who are sufferingtrauma as a result of sexual abuse as well as all other forms of child abuse and neglect. Angurugu. The Women’s Safe Place commenced operations in July 2009 and the Men’sSafe Place opened in March 2010. Safe Places employ local people from the community andare more than a crisis accommodation service. Their primary function within the communityis to serve as a hub for family violence education and intervention as well as family andindividual wellbeing.The ‘Be Someone’ campaign was launched on White Ribbon Day on 25 November2009 and encourages witnesses of domestic violence to report incidences to the Police.The campaign featured television and radio commercials and press advertisements.Childrens Commissionerprovisions contained in the Care and Protection of Children Act and has been operationalfor just over a two year period. The Commissioner’s primary functions include ensuring thewellbeing of protected children by investigating complaints related to the provision of servicesto protected children and monitoring the administration of the Act, in so far as it relates toprotected children. The Commissioner is also required to monitor the implementation of anyGovernment decision arising from the ‘Inquiry into the Protection of Aboriginal Children fromSexual Abuse’ (Little Children are Sacred Report).Department Health and Families 107

2008-09Actual2009-10Budget2009-10RevisedBudget2009-10ActualOutputOutputcost($’000) 594 612 612 763Performance MeasureQuantityForums, workshops andconsultations held2008-09Actual2009-10Estimate2009-10Actual2010-11Estimate48 80 93 80Complaints investigated 26 40 50 45Key AchievementsBy request of the Minister for Child Protection, the Children’s Commissioner conducted response by NTFC’s Centralised Intake Team (CIT). The second related to a systemicreview of the Intake Service. Both investigations raised a number of issues regardingwere made to NTFC regarding these issues which have been or are in the process ofbeing implemented. The Children’s Commissioner will continue to review and monitorthe implementation of these recommendations.The Children’s Commissioner, as part of monitoring the administration of the Act,conducted a care plan audit using a randomised 10% sample of the total children whoare under a type of supervisory arrangement and in the Chief Executive’s (CE) care.It is a statutory requirement for children entering the CE’s care to have in place a careplan. The care plan must establish the needs of the child and how those needs will beparties. The audit focused on determining whether a care plan had been established andif so, was it adequate given the circumstances of the child.The Child Deaths Review and Prevention Committee was established pursuant tosection 209 of the Care and Protection of Children Act. Some of the Committee’sfunctions include establishing and maintaining a Child Deaths Register, conducting orsponsoring research into child deaths, raising public awareness about the causes andnature of child deaths in the Northern Territory, and making recommendations aimed atreducing and preventing child deaths.its own annual report.108Department Health and Families

Acute CareDepartment Health and Families 109

Acute CareThe Acute Care Division is responsible forthe leadership and management of the located in Darwin, Alice Springs, Nhulunbuy,Katherine and Tennant Creek, supporting650 public hospital beds and a range of acutecare services, including inpatient, outpatientand Emergency Department services.OutcomeImproved health and wellbeing ofthose in the Territory communitywho require acute or specialist care.In addition the Division provides critical network services including the Patient AssistanceTravel Scheme (PATS), Specialist Outreach Services, Ambulance and Aero retrievalservices, policy development, supply and coordination of blood and blood products andnational funding agreements.Admitted Patient ServicesAdmitted patient services comprises of acute and non-acute medical care or treatmentsto patients who undergo a formal admissions process. In 2009-10, the revised budgetallocated $503.1 million to acute care admitted services, with actual expenditure amountingto just under $500.2million, representing a marginal underspend of approximately 0.6%.Output 2008-09 2009-10 2009-10 2009-10Actual Budget Revised ActualBudgetOutput cost ($’000) 457 481 480 752 503 079 500 218Performance Measure 1 2008-09Actual2009-10Estimate2009-10Actual2010-11EstimateQuantitySeparations 2 106 488 110 200 110 800 112 500- Same-day separations (excluding haemodialysis) 17 413 18 200 18 995 18 600- Overnight separations (excluding haemodialysis) 45 569 46 100 46 797 46 800- Haemodialysis separations 43 506 45 900 45 008 47 100Weighted Separations 3 66 776 72 700 68 892 74 000Average length of stay 4 5. 5 5. 6 5. 4 5. 6Interstate patient travel 4 3 042 3 000 3 212 3 300Intrastate patient travel 4 21 035 22 700 23 458 23 100Elective surgery waiting list admissions 6 346 7 600 6 662 7 700Emergency admissions 5 31 212 32 300 33 290 33 200QualityBeds accredited by the ACHS 6 100% 100% 100% 100%TimelinessElective surgery waiting times:- Category 1: admission within 30 days 77% 88% 76% 88%- Category 2: admission within 90 days 60% 70% 53% 70%110Department Health and Families

1. “Due to remoteness, the dispersed population and absence of alternative health care providers,number of the measures in the table are therefore not directly comparable with other jurisdictions.”2. Separation refers to the completion of an episode of admitted patient care where the period ofhospitalisation ranges from admission to discharge, transfer or death. It may also refer to a portion ofa hospital stay, resulting in the change of type of care for example, from acute to rehabilitation care.3. A weighted separation is a measure of the complexity of a hospital separation. In 2008-09 weightedrecords outstanding for 2009-10 are included in the Weighted Separations as follows: RDH (10868) ASH (198) KDH (104) TCH (842) GDH (2).4. Estimates include escorts (approved family members or friends) accompanying patients. Previousseparately reported categories have been merged.5. Emergency admission has replaced emergency procedures, providing a common base forcomparison to Elective Surgery Waiting List admissions.6. Australian Council on Health Standards.Acute Weighted SeparationsHospital patients vary in their clinical complexity, the severity of their illness and the amountof hospital resources consumed in the provision of their treatment. Simply counting theof those patients, because a complex case can consume substantially more resources.Weighted separations of admitted acute patients accounts for this and measures the acuityadjusted level of activity done in public hospitals. separations employ the most recently published national cost weights from the 2008-09National Hospital Cost Data Collection (NHCDC). Similarly, results for previous years havebeen back-cast using national cost weights from the applicable NHCDC year. Results maybe subject to future variation, due to a lag in assigning clinical codes to patients dischargedIn the past, hospital weighted separations were calculated using Territory cost weightsand emphasised hospital activity relative to total Northern Territory activity. The change and provides for a better alignment to the recent national agenda on hospital and healthworkforce reform.Figure 4 –Inpatient Separations and Weighted Separations, 2006-07 to 2009-10'000120120.0100100.08080.06060.04040.02020.0006/07 07/08 08/09 09/10Financial YearAcute Separations Non-Acute Separations Weighted Separations0.0Department Health and Families 111

In 2009-10, growth in weighted separations occurred across the entire hospital network.complexity of cases presenting to Territory hospitals.Table 17: Growth in Inpatient Weighted SeparationsRoyal DarwinHospitalAlice SpringsHospitalKatherineHospitalTennant CreekHospitalGove DistrictHospital2006-07 37 195 18 714 3 974 2 026 1 979 63 8882007-08 38 135 20 014 3 941 1 812 1 732 65 6332008-09 37 898 20 767 4 323 1 923 1 865 66 7762009-10 38 680 21 798 4 299 2 074 2 041 68 892Growth2008-09 to 2009-10 2.1% 5.0% -0.6% 7.9% 9.4% 3.2%TotalOver this period, the two larger hospitals accounted for the majority of growth observedacross the network, although concentrated at Alice Springs Hospital. Activity at Alice SpringsHospital has increased consistent with population growth, ever improving access to hospitalsfrom remote communities and enhanced efforts through targeted initiatives and programs.In 2009 10 major contributors to growth in Alice Springs included patients admitted fordiseases and disorders of the circulatory system and nervous system. Additionally, newborn care and pregnancy, childbirth and the puerperium contributed heavily to growth ininpatient weighted separations over this period.70%of Hospitalpatients areAboriginal by the large volume of same-day cases, which generally have relatively lower complexity.The majority of same day cases are typically patients admitted for renal dialysis and accountfor about 70% of all same day treatments.Aboriginal and Non-Aboriginal ActivityThe Aboriginal population makes up about 30% of the Territory’s total population, a far largerproportion than any other jurisdiction. In 2009-10, across the hospital network, Aboriginalpeople accounted for nearly 70% of all hospital acute separations.consistent over recent years. In 2009-10, all Territory public hospitals, with the exceptionof Royal Darwin Hospital, had a greater number of Aboriginal acuity adjusted separationsthe Aboriginal population and higher number of Aboriginal people in the catchment areas ofthe rural and remote hospitals, compared with the higher number of non-Aboriginal peoplein the urban population of the greater Darwin area.112Department Health and Families

Figure 5 – Weighted Separations by Aboriginal status, 2009-10Per Cent100806040200Royal DarwinHospitalAlice SpringsHospitalKatherine HospitalTennant CreekHospitalGove District HospitalAboriginalNon-Aboriginalof all acute type patients, excluding those admitted for haemodialysis. Across the hospitalnetwork, the most common MDC was pregnancy, childbirth and the puerperium (see Figureand disorders of the respiratory system ranked highest among Aboriginal patients.Figure 6 – Top 5 Major diagnostic categories by Aboriginal status, separations, 2009-10'00076543210MDC:14 MDC:04 MDC:06 MDC:08 MDC:05AboriginalNon-AboriginalMDC:14 - Pregnancy, Childbirth & the PuerperiumMDC:04 - Diseases & Disorders of the Respiratory SystemMDC:06 - Diseases & Disorders of the Digestive SystemMDC:08 - Diseases & Disorders of the Musculoskeletal System & Connective TissueMDC:05 - Diseases & Disorders of the Circulatory SystemDepartment Health and Families 113

In 2009-10, as shown in Figure 7, the average length of stay for any patients treated withinthe hospital network (excluding all same day patients) was 5.4 days. This is a marginaldecrease from 2008-09 when the average was 5.5 days. However, with the exception ofTennant Creek Hospital (TCH), on average, Aboriginal patients experienced longer periodsof stay when admitted to a Territory hospital.Figure 7 – Average length of stay excluding same day, 2009-10'00076543210MDC:14 MDC:04 MDC:06 MDC:08 MDC:05AboriginalNon-AboriginalThe longer average length of stay for Aboriginal patients presenting at ASH and RDH,suitable community-based care.Gap Roadsatellitedialysis unitRenal ServicesThe Territory has the highest prevalence of renal disease in Australia. In recent years, totalrenal expenditure has increased in approximate proportion to total renal separations (seeFigure 8). The treatment of end stage renal disease is an expensive and high supportactivity and is a key driver of increasing health care costs in the Territory.The Territory has the highest prevalence of renal disease in Australia. In recent years, totalrenal expenditure has increased in approximate proportion to total renal separations (seeFigure 8). The treatment of end stage renal disease is an expensive and high supportactivity and is a key driver of increasing health care costs in the Territory.Figure 8 – Renal dialysis treatments, separations, 2007-08 to 2009-10'000 $M5050404030$21.7$24.1$27.33020201010007/08 08/09 09/10Financial YearAboriginal Non-Aboriginal Renal Expenditure - $M0114Department Health and Families

There are three types of treatment for people with end stage renal disease. Haemodialysisis the most common form of treatment in the Territory, followed by peritoneal dialysis andlastly transplantation. In 2009-10, across the Territory, more than 92% of renal replacementtherapy was provided to Aboriginal Australians and over 60% of these treatments wereprovided to patients residing in non urban areas.Renal services are delivered from the two main centres (RDH and ASH) utilising satelliteservice centres in a hub and spoke model to meet the growing demand for renal servicesacross the Territory.Figure 9: Renal dialysis treatments by Hospital'000201807/08161408/09121009/1086420AboriginalNon-AboriginalAboriginalNon-AboriginalAboriginalNon-AboriginalAboriginalNon-AboriginalAboriginalNon-AboriginalRoyal Darw in Hospital Alice Springs Hospital Gove District Hospital Katherine Hospital Tennant Creek HospitalElective and Emergency SurgeryElective surgery is surgery that is planned and that can be delayed for at least 24 hours.The capacity of hospitals to provide elective surgery to patients within recommended timeframes is a key performance measure and is managed through wait lists. These lists aredynamic, with new patients continuously being added and others removed.In 2008, the Australian Government initiated an Elective Surgery Wait List (ESWL) ReductionPlan to address the number of overdue patients waiting on the ESWL. To date, the Territoryto people on the ESWL. Maintained efforts have contributed to the reduction of the ESWL.In 2009-10, the total number patients on ESWL decreased by 13% in the year, however,and more importantly, the number of patients waiting longer than the recommended waitingtimes decreased by 34% in the same period.“successfulwait listreduction”Key AchievementsTo make the elective surgery journey less traumatic educational material for healthprofessionals and clients have been developed and translated into 11 of the mostcommonly spoken Indigenous languages.Sustained effort in the Australian Government Elective Surgery Waiting List ReductionPlan (ESWLRP) resulted in the Territory achieving relevant targets. Associated bonuspayments are being utilised to continue support for growth in elective surgery, includingimprovements in timeliness for procedures.Department Health and Families 115

Enhanced surgical capacity at Alice Springs Hospital by strengthening partnershipsand establishing agreements with other public and private health organisations.Centre, Royal Adelaide Hospital and Royal Victorian Eye and Ear Hospital providingexperienced surgeons to boost surgical capacity and oversee training in selectspecialties. Concurrently, negotiations have commenced with Fred Hollows Foundationfor the construction of an Eye Clinic at Alice Springs Hospital.Work continues on the redesign and refurbishment of the day procedure unit, fundedcompletion in November 2010.Additionally, the Royal Darwin Hospital received an upgrade to two minor surgicalopened in October 2009 and have greatly assisted the ability of Royal Darwin Hospital toundertake the more complex procedures on the elective surgery waiting list.Commencement of a new satellite renal dialysis service in Alice Springs, to help meet theexpanding needs of Central Australia. The Gap Road satellite dialysis unit commencedoperation in April 2010 and provides clinical care and management for 48 additionalrenal patients. Work also began in 2009-10 on the expansion of the Tennant CreekSatellite unit, adding eight additional dialysis stations by February 2011 and planned toservice an additional 48 renal patients.Non-Admitted Patient ServicesNon-admitted care is care provided to a person who receives direct care within the emergencydepartment or other designated clinics within the hospital and who is not formally admittedat the time when the care is provided. In 2009-10, the revised budget allocated $127.6million to acute care non-admitted services, with actual expenditure amounting to just under$128.4 million, representing a marginal overspend of approximately 0.7%.Output2008-09Actual2009-10Budget2009-10RevisedBudget2009-10ActualOutput cost ($’000) 115 477 121 576 127 556 128 418Outpatient AttendancesPerformance MeasureQuantity 12008-09Actual2009-10Estimate2009-10Actual2010-11EstimateNon-admitted specialist clinic occasions of service 2 172 480 175 400 189 589 195 000Emergency department attendances 3 129 165 129 700 132 583 134 900Timeliness 4- Category 1: resuscitation - attended to immediately 100% 100% 100% 100%- Category 2: emergency - attended to within 10 minutes 62% 70% 63% 70%- Category 3: urgent - attended to within 30 minutes 48% 70% 49% 70%- Category 4: semi-urgent - attended to within 60 minutes 50% 60% 51% 60%- Category 5: non-urgent - attended to within 120 minutes 90% 85% 91% 85%116Department Health and Families

1.2.3.4.Due to remoteness, the dispersed population and absence of alternative health care providers, NorthernTerritory public hospitals fill numerous non-acute care service gaps in the community. A number ofthese measures are therefore not directly comparable with other jurisdictions.Number of specialist consultations for non-admitted patients.Number of patients presenting at an emergency department who are registered and triaged (clinicallyassessed). This now includes patients who did not wait to be seen by a doctor, consistent with nationalreporting.Percentage of emergency department presentations where treatment commenced within clinicallyappropriate waiting time for category.10%increase inoutpatientspecialistserviceNon-admitted specialist clinics occasions of serviceOutpatient specialist clinic attendances increased by nearly 10% to 189 589 occasions ofservice. The majority of growth occurred in the Darwin region followed by Alice Springs withthe remaining three hospitals making only marginal contributions to total growth. Much ofand ASH underpinned by the commencement of the community midwifery practice late in2008-09 and the closure of private obstetric/gynaecology service at Alice Springs over thesame period. Similarly, continued efforts to address the Northern Territory’s ESWL, impactssurgical and medical activity in addition to associated activity done on preadmission.Emergency Department AttendancesIn 2009-10 the number of ED attendances across the hospital network increased by 2.7%.The largest contributor to growth in ED attendances over this period was ASH. Patientswho did not wait to see a doctor decreased by 4.6% over the same period. Medianwaiting time for all patients seen by a doctor decreased marginally from 41 minutes in2008-09 to 38 minutes in 2009-10.Figure 10 - Non-admitted specialist clinic occasions of service – all NT Hospitals2005-06 to 2009-10'00020019018016014014415216017212010080604020005/06 06/07 07/08 08/09 09/10Financial YearDepartment Health and Families 117

Figure 11 - Emergency Department attendances – all Northern Territory Hospitals 2005-06to 2009-1013313012912512312512012011511005/06 06/07 07/08 08/09 09/10Financial YearKey AchievementsStrategies aimed at improving Sub-Acute Care services through the National PartnershipAgreement (NPA) on Hospital and Health Workforce reform, are well underway. Keystrategies in 2009-10 include a multi-disciplinary rehabilitation step-down unit at RoyalDarwin Hospital and development of a psycho-geriatric service in both Darwin and AliceSprings. Also included in this is increased capacity to provide outpatient and home basedrehabilitation services in Alice Springs.Increased focus on development of hospital Emergency Departments (ED) also providedthrough the NPA on Hospital and Health Workforce reform led ‘Taking the Pressure offNew software for improved client informationmanagement,additional nurse practitioners in Katherine EDand redevelopment for Katherine and RoyalDarwin Hospital Emergency Departments.Major redevelopment planning commenced forAlice Springs Hospital Emergency Departmentwhich will see an expansion of cubicles,effectively almost doubling the current size ofthe ED.118Department Health and Families

HospitalsAlice Springs HospitalTotal Beds: 189(includes 6 for Mental Health Patients)Alice Springs Hospital provides acute care services to the Central Australian region, whichhas a population of approximately 60 000. Around 2000 tourists are hospitalised eachyear accounting for close to 4000 bed days annually. The Hospital’s catchment area isapproximately 1 605 680 square kilometres and includes the southern half of the NorthernTerritory and the border regions of South Australia, Western Australia and Queensland.The closest major hospitals are Royal Darwin Hospital, Royal Adelaide Hospital, FlindersMedical Centre and Women’s and Children’s Hospital in Adelaide. The teaching hospitals inAdelaide receive the vast majority of referrals for specialised tertiary services.The Hospital manages an off campus Renal Dialysis Unit in Flynn Drive, along withsatellite units in Alice Springs and Tennant Creek. The satellite unit has 26 haemodialysischairs in Alice Springs, eight chairs in Tennant Creek providing haemodialysis services topatients in Alice Springs and Tennant Creek. In addition patients have been trained forhome dialysis with units located in Ali Curung, Ti Tree, Mt Liebig, Santa Theresa and morerecently Amoonguna. The unit also coordinates renal transplantation services. A further 10acute care dialysis ports are located in the Hospital. In 2009 a Dialysis Unit operated byNephrocare opened in Alice Springs and the Hospital maintains responsibility for clinicalservices for these patients.Alice Springs Hospital has achieved Baby Friendly Accreditation, Food Safe Accreditationand the Pathology laboratory and Radiography is accredited to National Association ofTesting Authority/International Standards Organisation standards.The Hospital provides a range of clinical, diagnostic and support services including: General medicine, paediatrics, obstetrics and gynaecology, general surgery, renal,ophthalmology, ear nose and throat, orthopaedic, emergency medicine, intensive care rheumatology, urology, cardiology, respiratory, pain service, gastroenterology, plastic Medical Specialist outreach to remote communities for obstetric, adult and paediatric Financial support for some specialist outreach.Department Health and Families 119

In 2009-10 the Hospital opened a 12 bed rapid assessment and discharge unit. The sameyear the Hospital opened a 20 bed continuing ward for subacute (Rehabilitation and GeriatricEvaluation and Management) and patients waiting transfer to residential care.The Hospital also opened the Midwifery Group Practice which enables Alice Springs womenand community mothers to be cared for throughout their pregnancy, birthing and post-natalcare. Women can choose to birth at home or in the Hospital. In 2009-10, there were 161births managed through the Midwifery Group Practice with 42% being Aboriginal and TorresStrait Islander mothers.Gove District HospitalTotal Beds: 30 + 2 respite care bedsThe East Arnhem region is serviced by the Gove District Hospital, which is located in thetown of Nhulunbuy on the Gove Peninsula. There are a number of remote communityhealth centres that refer patients to the Hospital for inpatient, outpatient and specialist care. encompasses medical advice, visits to remote community health centres and the evacuationof patients to Royal Darwin Hospital.Gove District Hospital has achieved Baby Friendly Accreditation, Food Safe Accreditationand the Pathology laboratory and Radiography are accredited to National Association ofTesting Authority/International Standards Organisation standards.Gove District Hospital provides: 24 hour accident and emergency care General surgical, medical and paediatric care Two respite places and two emergency respite places Elective and emergency surgery Maternity services including caesarean capability Pharmacy Visiting specialists care 24 hour medical imaging (on call service after hours) Pathology (on call service after hours) Stores Mortuary (post mortems are not performed) Cyclone shelter (the stores building is the town designated cyclone shelter) The Hospital is supported by the following services with most being operated off site: Retrieval service from remote communities and evacuation services to Royal DarwinHospital Physiotherapy services Occupational Therapy services (on an as needs basis) Social Worker for inpatients (on site) Mental Health Services Alcohol and Other Drug services Domiciliary Care / Community Resource Co-ordination/ Palliative Care Nurse Speech Therapy120Department Health and Families

Audiologist (visits from Darwin) Centre for Disease Control Nutrition services (available on site by prior arrangement) Adult Guardianship (provided from Darwin) Family and Community Services Aged and Disability Services Domestic Violence Coordinator Dentistry (public and private practices available) Indigenous LiaisonKatherine HospitalTotal Beds: 60Katherine Hospital services the Katherine region and remote areas, covering an area ofapproximately 340 000 km2 between the Western Australian and Queensland borders andextending south to Dunmarra and north to Pine Creek. The population of the Katherineregion is around 19 000 with an annual tourist presence of more than 500 000 visitors.Katherine Hospital is accredited with the Australian Council on Healthcare Standards until15 June 2014. The Hospital also has achieved Baby Friendly Accreditation, Food SafeAccreditation and the Pathology laboratory and Radiography is accredited to NationalAssociation of Testing Authority/International Standards Organisation standards.The Hospital provides a range of clinical, diagnostic and support services including: 24 hour accident and emergency care Obstetrics and gynecology General surgical, medical and paediatric care Renal dialysis Pharmacy Radiography Pathology Physiotherapy Social Worker Visiting medical specialists Aero medical retrieval and Medivac Service.Royal Darwin HospitalTotal Beds: 393 (includes 26 for Mental Health Patients)Royal Darwin Hospital is the Northern Territory’s largest tertiary referral and universityteaching hospital providing acute hospital services to the residents and visitors of the TopEnd of the Territory. It is also Australia’s National Critical Care and Trauma Response Centrewhilst acting as a tertiary referral hospital for the remainder of the Territory, the KimberleyRegion of Western Australia and our northern neighbours in the event of a disaster in theregion. The Hospital has a catchment population of around 150 000 people and directlyserves an area of 127 000 km2.Department Health and Families 121

The Hospital has a strong and successful association with the Flinders University of SouthAustralia through the joint initiative of the Northern Territory Clinical School. The associationwith Flinders University allows the hospital to engage teaching staff and thereby enhanceenjoys close association with the Menzies School of Health Research and the CharlesDarwin University.Royal Darwin Hospital has achieved Baby Friendly Accreditation and the Pathologylaboratory and Diagnostic Imaging is accredited to National Association of Testing Authority/International Standards Organisation standards. Royal Darwin Hospital is accredited until8 May 2013.The Hospital provides a comprehensive range of clinical, diagnostic and support servicesincluding: Anaesthetics, Cardiology, Dermatology, Ear, Nose and Throat, ECG/EEG, EmergencyMedicine, Forensic Pathology, General Medicine, Head and Neck Surgery, Hyperbaric,Infectious Diseases, Intensive Care, Microbiology, Obstetrics and Gynaecology,Ophthalmology, Orthopaedics, Paediatrics, Renal, Rheumatology, Plastics, Sleep Audiology, Nutrition/Dietetics, Occupational Therapy, Pathology, Pharmacy,Physiotherapy, Prosthetic and Orthotic, Radiology, Seating Equipment and Technology Indigenous Liaison, Interpreter.Tennant Creek HospitalTotal beds: 20Tennant Creek Hospital services the 7500 residents of Tennant Creek and the Barkly region.It covers an area of approximately 250 000 km2 extending south to Ali Curung, north toElliott, west to the Western Australia border and east to the Queensland border.Tennant Creek Hospital is accredited with the Australian Council on Healthcare Standardsuntil 20 February 2013. The Hospital also has achieved Food Safe Accreditation untilJanuary 2011 and the Pathology laboratory is accredited to National Association of TestingAuthority/International Standards Organisation standards.The Hospital provides the following services: 24-hour accident and emergency care Outpatients with visiting medical, surgical and paediatrics specialists Review clinic, which covers recall patients, chronic diseases patients and paediatricpatients Minor operations Antenatal, postnatal and emergency midwifery services Renal dialysis Clinical support services (radiography, and pathology) Aero medical retrieval and Medivac service.122Department Health and Families

Patients requiring services that are not available in Tennant Creek are referred to AliceSprings Hospital through either inter hospital transfers or the Patient Assistance TravelScheme.National Critical Care and Trauma ResponseThe National Critical Care and Trauma Response Centre (NCCTRC) is an AustralianGovernment funded initiative, intended to enhance Royal Darwin Hospital (RDH), theGreater Darwin Medical Group and Australia’s regional preparedness to provide a medicalAn agreement with the Australian Government has injected an additional $63 million overfour years into RDH since 2004-05. An additional $57 million is anticipated for the period ofthe next agreement being 2009-10 to 2012-13.To date, $1.3 million has been spent on constructing a multi-purpose facility for the NCCTRCtrauma response continues to increase. Currently there are approximately 65 health careprofessionals employed through the Centre, including 16 Doctors, 10 Nurses and 29 AlliedHealth Professionals augmenting readiness capacity and daily operations of RDH.The NCCTRC has an increasing leadership role in national preparedness by expertparticipation at national committees and forums and providing education and credentialingnationally. The NCCTRC’s priorities in 2009-10 included focusing on preparedness activitiesand returning both experience and learning into the Australian Health Disaster ManagementFramework. Alexandra Hospital Disaster Response Service. This relationship links the Hospital with thefour trauma hospitals in Queensland through their state-wide trauma network. As part of thisavailable at short notice to augment a sustainable response at the Hospital and to enhanceour capacity to maintain core business continuity during incidents.staff to date were completed.The NCCTRC has developed an innovative bar code scanning system utilising barcodesprinted on a new national triage ‘SMART’ tag to track patients involved in mass casualtydisasters. Triaging is a critical component of disaster response and with the use of SmartTags allows patients to be separated into colour coded categories according to injuryNew hand-held 3G enabled bar-code scanners have been programmed and were trialledPatients had paper SMART tags attached during triage process, in this instance the preprintedbar-code was scanned and sent in real time to a specially designed website whichwas accessible by the Emergency Department at RDH. Preliminary results have shownearlier data transfer was received within 25 minutes compared to the normal reporting ofpatient severity and number. Interstate ambulance experts who observed the trial haveprovided positive feedback.Department Health and Families 123

124Department Health and Families

Health and Wellbeing ServicesDepartment Health and Families 125

Health and Wellbeing Services:Community Health ServicesThe Health Services Division aims to build the capacity of the community to maintain andimprove health through education, prevention, early intervention and access to culturallysecure assessment, treatment and support services. Services and support are providedthrough Government and non-government providers in a number of settings including acutemental health inpatient units, community care centres, rural health centres, clinics, schoolsand in the home.Performance Measure2008-09Actual2009-10Budget2009-10RevisedBudget2009-10ActualOutputOutputcost($’000) 166 435 171 263 182 653 181 1802008-09Actual2009-10Estimate2009-10Actual2010-11EstimateQuantityGovernment-managed rural community health54 54 54 54centresFunded non-government-managed rural community 30 30 30 30health centresCommunity health events urban 1 130 821 128 000 128 153 132 000Well person checks 2 4 950 4 400 2 181 4 100Resident child population

in remote communities. Children are measured regularly according to a schedule based on their age. Data iscollected annually and is analysed to report on the nutritional status of children at a community level. The methodto a computer based system PCIS. This has eliminated some double counting of children who had receivedservices in more than one community. Also, there has been a reduced level of GAA due to the implementationassessments which incorporates GAA.with increased recurrent funding to maintain the improved waiting times and increase services to remotecommunities. The reduction in activity levels between 2009-10 and 2010-11 is due to the end of intensive DentalWaitlist Reduction activity.5 The trend in low birth weight over last few years has been steadily downward for both Aboriginal and non-Aboriginal babies. The explanation for the apparent increase this year is not known and it is not clear if theincrease is an artefact of data entry changes or whether it is a real increase. Remote Health is establishingquality support positions to work with remote PHC teams on improving data quality.6 The trend over last few years has been steadily downward for Indigenous children under 5. The explanation forthe apparent increase this year is not known and it is not clear if the slight increase is an artefact of data entrychanges or whether it is a real increase. Remote Health is establishing quality support positions to work withremote PHC teams on improving data quality.Health Services PolicyHealth Services Policy is responsible for strategic primary health care (PHC) policy andservice development initiatives.Key AchievementsWorked with Australian Government Department of Health and Ageing and the AboriginalMedical Services Alliances Northern Territory (AMSANT) to continue reform of the NTAboriginal Primary Health Care system: developed system-wide approaches to working with providers to analyse and use analysed system-wide reform needs and priorities using the World Health Organisation’s drafted 10 year Aboriginal Primary Health Care (PHC) System Reform Plan for prepared guidelines to support regionalisation of Aboriginal PHC services.Health DevelopmentOral Health ServicesThe Department of Health and Families provides free oral health services to: adults and their dependants who hold a current Centrelink Health Care Card or Pensioner rural communities disadvantaged by distance which are located on islands or are 100 holders of a current Cleft Lip and Palate Card under the Commonwealth Health SchemeDepartment Health and Families 127

Key Achievements Over 47 000 occasions of service were provided through core Northern Territory oralhealth funding, an 18% increase on the previous year. A further 3900 occasions ofservice were provided to Aboriginal children in remote communities through the Closingthe Gap program with funding from the Australian Government. waiting times for an assessment for general dental treatment in the Darwin/Palmerstonarea. Prior to the Blitz, more than 60% of waiting list clients had been waiting more thantwo years. The average waiting time was reduced to less than nine months. Complementing the reduction in waiting times for general assessment was a 15%increase in the level of service provision to remote communities. An oral health screening component was included in the revised Health Under 5 Kidsprogram. This ‘Lift the Lip’ screening process will help identify early signs of dentalproblems allowing early referral to the dental team. commenced with the establishment of three school-based apprenticeship positions. TheDepartment of Health and Families is the only provider of this training in the NorthernTerritory. The establishment of this program will support the development of a localworkforce. The numbers of students involved will increase in coming years as theprogram matures. those for students from other universities and this extended experience increases theopportunity to attract students back to the Territory following their graduation.Public Health, Nutrition & Physical ActivityThe three priority areas are: healthy lifestyle including promotion of physical activity.Aboriginal people, particularly those in remote communities, are a high priority group fornutrition interventions. The main role of the nutrition team is implementing the Food andNutrition Policy by capacity building through: training primary health care providers to deliver brief nutrition and physical activity communication and networking with other government and non-government agenciessuch as the Department of Education and Training (DET), Aboriginal Medical Services monitoring and surveillance e.g. monitoring remote food supply through store surveys andand providing secretariat support to the Chief Minister’s Active Living Council and developingan action plan for 2008-11.128Department Health and Families

Key AchievementsMore than 70 facilitators were trained to deliver Eat Better, Move More, a resourcekit and education program to promote healthy eating and physical activity in remotecommunities. Sessions from the program were delivered in approximately 20 remotecommunities.Reviewed and updated the NT Infant Feeding Guidelines and accompanying educationresource for mothers and caregivers in remote communities, Feeding Babies.Developed and enhanced the system for analysis of the NT Market Basket Survey. Thiswill enable faster and more detailed analysis of results.Contributed to the development of the National Strategy for Food Security in RemoteIndigenous Communities.Provided funding to Menzies School of Health Research for research into Aboriginalperspectives on the role of physical activity in health improvement.From January 2010 funding has been provided to DET for a nutritionist to assist with theimplementation and review of the policy and for inservicing and training of teachers andstaff involved in the delivery of nutrition education and provision of meals to students/children in schools and childcare facilities.Preventable Chronic Disease (PCD) ProgramThe Chronic Conditions Prevention and Management Strategy 2010-2020 is the revisedand updated Territory strategy used by all sectors and health organisations as the guidingframework for collaborative and individual work in both prevention and management ofchronic diseases. The eight key priority areas in the Strategy are: continuous quality improvement.Key AchievementsThe revised Strategy was launched in November 2009 and has been used to informa number of key initiatives such as the GP Super Clinic in Palmerston, the HospitalServices Review and planning for future reform.The 13th Chronic Disease Network Conference, “Prevention is the Best Medicine”with themes relating to the social determinants of health, health promotion and earlydetection, was held in Darwin in September 2009. The conference provided valuablenetworking opportunities among chronic disease practitioners from the Territory and alsointerstate. It attracted highly regarded keynote speakers and was well attended by over200 people each day.The Chronic Disease Network also produced four editions of ‘The Chronicle’ andfacilitated regional network meetings.Models of diabetes education and group work with both diabetic clients and others withchronic diseases have been established in remote communities. The groups have beenDepartment Health and Families 129

oth mixed and single sex groups. Participation and engagement has been strong, withpeople appreciating the opportunity to develop a deeper knowledge and understandingof their illness. An increased focus on insulin use for type 2 diabetes control with trainingand support for both patients and health professionals has also been established.The processes supporting care coordination for people with late stage renal diseaseto improve their management and outcomes were further strengthened, with referralguidelines and templates established, weekly case conferencing linking renal servicesand remote PHC teams and training modules in renal care and palliative care developedand delivered in Darwin and Alice Springs.PCD program staff worked in partnership with both government and non governmentorganisations to increase the focus on tobacco control and to support community programs.The release of the Tobacco Action Plan allows joint planning for community work.Women’s Health Strategy Unit (WHSU)The role of the WHSU is to: facilitate action in partnership with stakeholders to develop and implement best practicemodels that improve women’s health.Key Achievementsprovision of health services to migrant and refugee women. Implementation Guide.Maternal, Child and Youth Health (MCYH)MCYH provides program support, training and practical assistance to remote area healthcentres and communities for core programs such as pregnancy care, Growth Assessmentand Action (GAA) and Healthy School Aged Kids (HSAK). In addition, the Strong Women,Strong Babies, Strong Culture Program is supported in eight communities. The MCYHprogram works collaboratively with the non-government Aboriginal Medical Services.In 2010, the program leadership was enhanced through the appointment of the Childand Youth Health Program Leader with maternity services issues being taken up by theMidwifery Co-Director of Integrated Maternity Services, through the Maternity ServicesClinical Reference Group.Key AchievementsThe new Healthy Under Five Kids Program was rolled out across remote communities inthe Northern Territory as the universal child health program for Aboriginal children underThe Darwin Midwifery Group Practice (MGP) was implemented and provides continuityof pregnancy, birth and postnatal care to remote Aboriginal women, who travel to Darwinto give birth.Support was provided to two Aboriginal Health workers in the Darwin MGP and one fromthe Tennant Creek Hospital to commence studies in Bachelor of Midwifery.130Department Health and Families

Healthy Pregnancy Healthy Baby information books for Aboriginal and Torres StraitIslander women and their families were distributed.Funding was provided to non-government organisations to improve outcomes forNorthern Territory children through pregnancy, parenting and life skills educationprograms i.e. Core of Life and Paperbark/Pandanus programs.Partnered with key Departments and organisations to consolidate existing programsand provide a platform of universal services from which targeted programs could beUnder Five Kids and oral health services to implement ‘Lift The Lip’ and tooth varnish.Established an Aboriginal Child Health Advisory Group, including members fromGovernment and non-government organisations, to guide important research andprogram agendas to improve child health across the Northern Territory.Implemented the World Health Organisation Growth Charts across the Northern Territory anduploaded anthropometric calculators on every Department of Health and Families’ computer.Hearing PolicyHearing Policy is responsible for: and providing high-level strategic advice, strategic direction and project management of otitismedia and hearing health initiatives.Key AchievementsImplemented the NT Universal Neonatal Hearing Screening, achieving 97% coverage ofhospital delivered neonates in the last quarter of 2009-10.Designed an information management solution to share web based integrated audiologyand Ear, Nose and Throat (ENT) specialist advice with other care providers. This will beimplemented in 2010-11.Continued targeted outreach Audiology and ENT service delivery to support primaryhealth care in improve hearing in Aboriginal children.Delivered services as part of the Australian Government Intervention as shown in thetable below.Table 18 : Australian Government Intervention (AGI) and Closing the Gap Audiology andENT Service Activity April 2008 – June 2010ServiceTotalServicesIndividualClientsENT Consultation 3 861 3 413Audiological Assessment 6 243 4 424ENT Surgical 601 552Totals 10 705 8 389Department Health and Families 131

Health Promotion Strategy Unit (HPSU)The role of the HPSU is to lead the continuous quality improvement of health promotionpractice. HPSU: provides the expertise, tools and resources to equip and support staff to design, develop, provides specialist advice to support the integration of health promotion in health implements workforce development strategies to improve the skills, knowledge andKey AchievementsThe uptake of the Quality Improvement Program Planning System (QIPPS) continues togrow, with more staff across the Department of Health and Families now using QIPPSto plan health promotion action. The Departmental workforce continue to be providedsupport in the use of QIPPS with training programs facilitated by the HPSU held inDarwin, Alice Springs, Nhulunbuy and Katherine over the year. Further support andtraining, often on a one-to-one basis, is provided by the Health Promotion Strategy Unit.The HPSU facilitated education in the use of Health Impact Assessment in Darwin andAlice Springs. The HPSU was successful in gaining funding for this education programunder the Allied Health Professional Development Funding Program.The HPSU along with other branches in the Department, has worked closely with theSchool of Health Sciences at Charles Darwin University to support the development andimplementation of a Bachelor of Health Sciences in 2011. This undergraduate programwill offer four majors including one in health promotion.to the HPSU under the Commonwealth Productivity Places Program.Remote HealthThe goal of the Remote Health Branch is to ensure that evidence-based, best practiceprimary health care services are delivered to the remote population throughout theNorthern Territory. Services are delivered through Departmental remote health centres,non-government organisations (some funded by the Department) and independentcommunity-controlled health organisations.Services include the provision of 24-hour emergency care, primary clinical care, populationhealth programs, referral and access to retrieval, medical and allied health specialistservices, provision of essential medications and management of chronic illness. Servicesare delivered by multidisciplinary health teams at remote health centres located throughoutthe Territory.Around 90% of all consultations and health contacts at remote health centres are withAboriginal people. However, services are equally accessible to non-Aboriginal residentsand non-residents, such as tourists.Most of the remote population serviced by the branch is Aboriginal, relatively young, highlymobile and widely dispersed. These people have relatively low levels of literacy in English, arelatively high burden of illness and injury and high rates of complex chronic co-morbiditiesand infectious disease.132Department Health and Families

The core clinical and health promotion business of the Remote Health Branch involves: implementing the Chronic Conditions Prevention and Management Strategy in remote community linkages for visiting programs.Key AchievementsIn partnership with the Aboriginal Medical Service Alliance NT and the AustralianGovernment Department of Health and Ageing, the roll-out of the Expanding HealthServices Delivery Initiative has continued with regionalisation activity in progress in EastArnhem, West Arnhem, Central Australia and the Barkly.Through Alcohol and Other Drug (AOD) funding from the Australian Government, fulltimeAOD workers are now in place at Borroloola, Oenpelli, Daly River and Umbakumba.Additional funding has also been received for recruitment of an additional AOD workerat Elliot. The transfer of funding to the Department from the East Arnhem Shire Councilwill enable the recruitment of two additional AOD workers at Angurugu. To support theroll-out of Alcohol and Other Drugs Intervention activity across the Northern Territory,Service Partnership Agreements are now in place at all Departmental sites. during 2009-2010, with 10 full-time doctors now based in communities in the Top End,The management of chronic disease in remote communities has been strengthened withthe appointment of Public Health Co-ordinators now in place in Health Service DeliveryAreas across the Northern Territory who are working with staff to implement communitybasedintervention strategies.In partnership with other ante-natal education providers, a co-ordinated approach toante-natal education for families has been facilitated.Initiatives to attract and retain a male Aboriginal health workforce have seen an increaseThe expansion of radiology facilities has continued, and implementation of the PACSnetwork for the NT hospitals has been successfully expanded to include remote healthcentres. Nguiu and Jabiru were brought on line with digital radiology in July 2010, withimages being instantly and automatically transmitted, stored and available for readingby the radiologists at Royal Darwin Hospital. Yuendumu and Papunya will be added inAugust. Maningrida, Borroloola, Wadeye and Alyangula, where digital radiology servicesare already available, will be added to the PACS network in the coming months.Department Health and Families 133

Community HealthThe Community Health branch delivers diverse services across the Territory from theregional hubs of Darwin, Nhulunbuy, Katherine, Tennant Creek and Alice Springs.Across the continuum of care, services focus on at risk and managed care clients and earlychild and family needs. Service provision spans from birth to aged and palliative care afterhours support. In addition, hearing services are provided to urban and remote Aboriginalclients. Well women’s screening, while an urban based service, also caters for the remoteAboriginal population.The branch participates in regional and national primary health care reforms and aimsto improve access and equity of services for urban communities. Working with key localstakeholders and groups is a key element of this. The branch also manages the prisonerhealth contract and a range of services via contract arrangements with non governmentCare After Hours GP service in Palmerston and operations for the planned Palmerston GPSuper Clinic.Community Health manages the Territory’s participation in the National Health Call CentreNetwork (NHCCN) which provides telephone access to personalised, professional, healthassessment advice and referral options. The service is available 24 hours a day, sevendays a week via a 1800 (free call) number. In 2009-10 the Territory handled 13 492 calls.In 2009-10 the Community Resource Team who facilitate discharge planning, transferredto the Royal Darwin Hospital with the aim of providing seamless care for clients. Also, theurban nutritionists, previously based in the Health Development Branch, transferred into theCommunity Health Branch. This move further facilitates the centralisation of urban servicesin centres and aligns work force to client needs.Accreditation was achieved for Community Health Services for three years in 2010.School Health Services (SHS)The aim of the SHS is to ensure school aged youth engage in their health and wellbeing soas to make informed choices that promote optimal future health and life outcomes.Key AchievementsUrban school-based immunisation programs were delivered in Middle Schools forHuman Papilloma Virus (HPV), Varicella, Boostrix and Pneumovax.Working with school canteens and breakfast clubs to include healthy options on schoolcanteen menus.School health expos were undertaken in 11 schools.Child and Family Health Nursing Services (CFH)The aim of the service is to work in partnership with and support families to nurture thehealth and wellbeing of their children.134Department Health and Families

School Screening Services (SSS)The Service currently provides surveillance for all urban transition school students (4-5yr olds) in Government urban primary schools in the Territory. The children undergoanthropometric measurements and assessments including hearing and visual screening.The School Screening Nurses liaise with school administration, teachers and parents/ support to parents/guardians and teachers when issues arise, and offer opportunistichealth education to students, parents/guardians and teachers as the need arises andrefer appropriately to internal and external agencies, for example NT Hearing Services,Optometrists, GPs, Nutritionists and Aboriginal Health Organisations.Key AchievementsIn 2009-10 school screening checks were undertaken on 3069 students (4-5 year olds).Hearing ServicesHearing services are provided in urban centres and remote communities and covercomprehensive diagnostic audiological and audiometric services, liaison with and educationof, other health professionals on management of hearing loss, and education of parents andteachers.Key Achievements3540 clients were assessed for hearing loss across the Northern Territory.Audiology staff visited 59 remote communities.Neonatal Hearing Screening was rolled out across all Territory Hospitals.Community and Primary Care (CPC) ServicesCPC undertake:nursing care for clients with a chronic disease or long-term illness including woundspecialist nursing care and advice in the areas of spinal injury, continence, stoma, woundsocial work services in Darwin and Palmerston.Key AchievementsQUIT smoking campaigns were run through Community Care Centres in Palmerstonand Casuarina.Falls prevention programs were conducted across all Territory centres.Top End centres worked in partnership with Activate NT and Homeless Connect toimprove client outcomes.136Department Health and Families

Well Women’s Cancer Screening ProgramWell Women’s Cancer Screening incorporates two national programs both of which aimto detect cancers at an early stage to prevent mortality and morbidity. These services areBreastScreen NT and the NT Cervical Screening program.BreastScreen NT is a free breast x-ray screening program targeted at women with nobreast symptoms who are aged between 50 and 69. Clinics are provided in Alice Springs,Katherine, Tennant Creek, Darwin, Palmerston and Nhulunbuy.Key AchievementsIn 2009-10 a total of 4855 women were screened and 85% (4167) were in the targetage group.Access to the Northern Territory electoral roll facilitated an increase in the participationof women aged 50–69 years in breast screening. Of all women screened, 64% lived inouter regional, 21% in remote, 13% in very remote areas and 1% were interstate womenscreened in the Territory.Step–down assessments continue for women with a screening detected abnormality.Under this process, women who have a screen detected abnormality may return to routinescreening after further X-rays. This has reduced the number of women needing to attenda full assessment clinic. In 2009-10 88 women attended a step-down assessment. Ofthese women, only 14 (15%) continued on to attend a full assessment clinic.The Darwin and Alice Springs services have been successfully converted to ComputedRadiography (CR) and additional CR equipment has been purchased to travel aroundto the remote towns of Tennant Creek, Katherine, Nhulunbuy and to Palmerston whereshort term screening blocks are held.Primary Health Care in NT PrisonsThe Department’s Community Health Branch has taken responsibility for the primary healthcare service in Territory Prisons. The Department has a requirement to provide primaryhealth care services to adult prisoners (prisoners) and juvenile detainees (detainees)within correctional institutions in the Territory. Prisoners and detainees under custody ofprimary health services that align with normal community standards of care.Key AchievementsThe Community Health Branch provided health screening to 3600 prisoners in correctionalinstitutions in the Territory.Palmerston Super Clinic and Urgent Care After-Hours ServiceThe Palmerston GP Super Clinic is a joint initiative of the Australian and Northern TerritoryGovernments to improve primary health care for the people of Palmerston and thesurrounding rural areas. The Super Clinic will provide multidisciplinary primary health care,with a focus on chronic disease prevention and self-management.The Palmerston Urgent Care After-Hours Service (UCAHS) was established in DecemberDepartment Health and Families 137

increased access to after-hours medical care for residents of Palmerston and thesurrounding rural area. The UCAHS is open every night from 6pm to 8am to treat urgentillnesses and minor injuries.Key AchievementsTreated over 8800 clients at the Urgent Care After-Hours Service.Successfully tendered for the supply of nurses and paramedics and for the supply of Commenced construction of the Palmerston GP Super Clinic in September 2009.Mental Health ServicesMental health is integral to improving the health status of all Territorians. Through the MentalHealth Program, the Top End and Central Australian Mental Health Services and nongovernmentorganisations are funded to provide:specialist mental health assessment, treatment and case management for adult, childconsultation liaison services to acute and primary health care services and otherconsumer and carer support and rehabilitation.Output2008-09Actual2009-10Budget2009-10RevisedBudget2009-10ActualOutput cost ($’000) 38 271 37 306 39 316 40 551138Department Health and Families

Performance Measure2008-09Actual2009-10Estimate2009-10Actual2010-11EstimateQuantityIndividuals receiving community-based public 5 020 4 900 5 544 5 150mental health services 1Individuals under 18 years of age receiving 911 900 1 047 1 000services 1community-based public mental healthNon-weighted occupied bed days by11 631 10 900 10 877 12 400designated services 2Non-weighted inpatient separations from 1 042 1 020 940 1 140designated services 2Mental health budget allocated to nongovernment14% 12% 14% 14%organisations 3QualityPublic mental health services accredited 4 100% 100% 100% 100%Post-discharge community mental healthN/A 20% 14% 30%care 528 day mental health readmissions 6 11% 10% 9% 11%1 Community-based public mental health services include all mental health services provided by Government(excluding government-funded non-government organisations) dedicated to the assessment, treatment,rehabilitation or care of non-admitted patients. Since 2007-08 there has been an increase of 16% in numbers ofall individuals presenting for service. To manage demand there has been an increased reliance on consultation/liaison services rather than direct service delivery especially in rural/remote localities. Persons aged less than18 years provided service in 2009-10 increased by 13.5% compared to 2008-09. New demand continues at highlevels in both the Top End and Central Australia and it is likely that the 2010/11 forecast will be exceeded.2 Measure refers to inpatient services provided within two approved treatment facilities (Darwin and Alice SpringsMental Health Inpatient Units), declared pursuant to section 20 of the Mental Health and Related ServicesAct 1998. Ongoing efforts to manage high occupancy levels (to 100% or lower) continue to result in generallymore manageable levels of throughput activity. Sub-acute mental health care beds provided by the NGO sectorare also having a positive impact on this in Darwin. The growth in non-weighted occupied bed days and non-secure care initiative in both Darwin (5 beds) and Alice Springs (6 beds).3 This measure indicates the proportion of the mental health budget invested in the non-government sector fordelivery of services and support to consumers of mental health services and their carers. The NT proportion ofNGO funding continues to exceed the national average on a per capita basis. It is expected that the proportion ofNGO funds compared to total direct care mental health expenditure may decrease slightly over the next year dueto new specialist clinical initiatives being implemented.4 Mental health services accredited against relevant industry standards of best practice (National Standards forMental Health Services).5 New measure commenced from 2008-09: indicates the proportion of separations from mental health inpatientunit(s) for which a community service contact was recorded in the seven days immediately following discharge.follow-up rates for people in Darwin and other regional centres as a result of implementation of the newMental Health Triage and response Service announced in the Budget. Remote clients, who comprise 30% ofadmissions, are followed-up on discharge by remote health centres (activity that is not included in this indicator),and by specialist mental health staff on thier next visit, generally outside the 7 day period.6 New measure commenced from 2008-09: indicates the percentage of separations from the mental healthservices’ acute mental health inpatient units which results in unplanned readmission to the same or to anotherpublic acute mental health inpatient unit within 28 days of discharge. Inpatient units in both Alice Springs andDarwin were able to maintain a relatively low rate of readmission, well within the prevailing national rate.Department Health and Families 139

Key AchievementsImplemented the NT Suicide Prevention Action Plan in collaboration with other NorthernTerritory and Australian Government Departments.Commenced expansion of child and adolescent services to a number of remote Aboriginalcommunities.Implemented the National Perinatal Depression Initiative to increase communityawareness and improve detection and treatment of mental illness during pregnancy andtrial of culturally appropriate screening in remote communities.Commenced implementation of the Mental Health and Palliative Care initiative. Theaim of this time-limited project is to improve recognition and treatment of mental healthproblems experienced by people with a terminal illness and to improve palliative careservices to people with a serious mental illness.Commenced planning for the implementation of an NT-wide 24 hour mental health triageand response service based in Darwin is well advanced. The expanded services will beoperational early 2010-11.Undertook planning for 11 additional acute mental health inpatient beds funded throughthe Secure Care Initiative. These beds will enable care to be provided to special needsgroup in a separate environment, such as young people and mothers with babies whoare experiencing mental illness. Acute assessment and stabilisation will also be providedto young people and people with a cognitive disability. Building works will commenceearly in 2010-11.Inpatient Mental HealthTotal separations decreased by 102, or 9.5% and bed days remained relatively stable in2009-10 compared to 2008-09. This resulted in a longer average length of stay of 11.6days (up from 10.9 days). Access to additional supported care options in the communityhas provided alternatives to the management of patients in the acute care setting, allowingbetter care for the patients with severe illness.The proportion of Aboriginal inpatients only marginally increased compared to the previousyear. Of the 940 separations, 47% (up from 45%) were Aboriginal patients. Consistent withprevious years, males are more likely to require inpatient care than females. In 2009-10,58% of inpatients were male and 42% were female.140Department Health and Families

Table 20: Mental Health Inpatient Separations by unit, Aboriginal indicator and gender2009-10 2009-10 2009-10 2009-10Unit location Aboriginal indicator Total Female Male TotalCentral Australian InpatientUnitAboriginal 127 54 68 122Non-Aboriginal 110 29 49 78Sub-total 237 83 117 200Top End Inpatient Unit Aboriginal 341 129 189 318Non-Aboriginal 464 184 238 422Sub-total 805 303 427 740Total 1042 396 544 940Community Mental Health ServicesA total of 5544 people were provided with mental health services in 2009-10 in a communitysetting. This is an increase of 524 persons (10%) compared to 2008-09.Aboriginal people made up 42% of all individuals provided with community based mentalhealth services in 2009–10. This is an increase in participation from a rate of 39% for theprevious year.The number of people under the age of 18 years seen by community mental health servicesincreased by 136 (15%) in 2009–10 compared to the previous year. This group represents19% of all people who received mental health services.Table 21: Persons provided with community mental health services by Aboriginal indicatorand age group2008-092009-10Aboriginal indicator Total Under 18 18+ years TotalyearsAboriginal 1 971 372 1 941 2 313Non-Aboriginal 3 049 675 2 556 3 231Total 5 020 1 047 4 497 5 544Department Health and Families 141

Community Support Services for Frail Aged People andPeople with a DisabilityAged and Disability Services maximise community participation and independence of seniorTerritorians, people across the lifespan with disabilities, people who care for the frail agedand people with a disability, including providing pensioner concessions to eligible clients.Services are provided to people in their homes and in the community.The Aged and Disability Program works in partnership with clients, non-government serviceproviders, advocacy groups, Australian Government and Northern Territory Governmentdepartments and local government, to improve the quality of life for people with disabilityincluding the frail aged, and their carers.2008-09Actual2009-10Budget2009-10RevisedBudget2009-10ActualOutputOutputcost($’000) 69 566 66 166 72 215 75 004Performance Measure2008-09Actual2009-10Estimate2009-10Actual2010-11EstimateQuantitySupported accommodation places 155 155 155 155Clients accessing professional support 7 296 6500 6 114 6 900services 1Clients accessing community support 4 650 5 000 5567 5 000services 2Occasions clients access professionalsupport services 3 52 568 62 170 62 414 63 000TimelinessAged Care Assessment Team clientsreceiving timely intervention inaccordance with priority at referral 4 82% 84% 86% 80%1 Professional support services include Adult and Disability teams, Aged Care Assessment Program, Children'sDevelopment Team, Community Adult Health Team, TIME Scheme, Transitional Care Unit, Local AreaCoordination and SEAT Service. The estimate for clients accessing professional support services for 2010-11 isless than the actual for 2008-09. This is primarily due to aggregating of the quarterly point of time data to anappropriate estimate. In addition, data validation activities are ongoing to include specialist adult health servicesand other therapy services in this measure. This work has not been completed, making estimation more complIt is anticipated that this issue will be resolved for the 2011-12 estimate.2 Community support services include services funded through the Commonwealth State/Territory DisabilityAgreement (CSTDA) and the Home and Community Care (HACC) Program provided by non-governmentorganisations. Due to data issues the actual figure for 2009-10 has not been able to be verified.3 The growth in occasions of clients accessing professional support services in 2010-11 reflects the best practiceapproach to assessment and support planning being undertaken and increased complexity of clients requiringhigher levels of intervention.4 The 2009-10 actual timeliness improved slightly based on a one-off blitz in the hospital setting. Timeliness willreduce in 2010-11 given projected increase in client numbers.142Department Health and Families

Aged and Disability ProgramSupport services are provided to frail aged people and people with disabilities and theircarers in their homes and in the community to enable them to maximise their participationin the community and remain independent for as long as possible. Services includeprofessional support services such as assessment, case management, allied healthand specialist services including specialist children’s development therapies, as well ascommunity support services and accommodation support.Responsibility for these clients is shared with the Australian Government which jointlyfunds some services. The National Disability Agreement (NDA) came into effect on1 January 2009, replacing the previous Commonwealth State Territory Disability Agreement(CSTDA). The Home and Community Care Program (HACC) is the other major fundingagreement between the Australian and Northern Territory Governments.Key AchievementsAdopted a centralised intake process for all aged and disability clients across theNorthern Territory, ensuring equitable access to services provided and or funded by theAged and Disability Program.Commenced work in the development of the Secure Care Facilities in Darwin and AliceSprings. Clients who require secure care have complex behaviours which may havebecome more intense over time and require a level of intensive therapy not able to beaccessed in their homes. referrals to specialist Aged and Disability Program services.and Mobility Equipment (TIME) Scheme, The NT Pensioner and Carer ConcessionScheme (NTPCCS), the NT Seniors Card Scheme and the Companion Card Scheme.The Northern Territory Companion Card was launched in December 2009. Therequire attendant care support from a companion, better access to events and activities.Seven Northern Territory wide community-based Transition Care places were madeoperational. Transition care places provide low intensity therapy services, such asphysiotherapy, occupational therapy, dietetics, podiatry, speech therapy, nursing and/or personal care services. for up to 12 weeks of care with a possible extension ofsix weeks, either in the client’s own home or in a bed-based residential setting. TheTransition Care Program works to improve the quality of life for older Territorians andhelp them remain independent.$400 000 was used to lever re-investment across the program with a focus on thedevelopment of additional block funded supported accommodation placements.An additional $598 000 was invested in Home and Community Care services with afocus on respite services.A review of the Territory Independence and Mobility Equipment Scheme (TIME) / SeatingEquipment and Technology (SEAT) Service was completed and recommendationsaccepted for implementation.Implemented psycho-geriatric services.Launched the Aged and Disability Program Policy Manual.Department Health and Families 143

Commenced development and implementation of a whole-of-government disabilityframework.Engaged in National Disability Agreement reform agenda.Attracted a new service provider to the Territory.Aged Care Assessment TeamsAged Care Assessment teams (ACAT) provide assessment services to frail aged people. meet their needs, and facilitates access to residential aged care when appropriate.Total assessments increased from 1141 in 2008-09 to 1165 in 2009-10.Table 22 – ACAT assessments by regionLocation Total ACAT Assessments for 2009-10Alice Springs 295Katherine 128Top End Remote 85Darwin Urban 657TOTAL 1 165GuardianshipThe Public Guardian is the Minister for Children and Families and can be appointed asthe Guardian when there is no other suitable person to perform the role or can be jointlyappointed with a community guardian. Guardianship orders are applied for, and wheninvestigated can be made for either a community or a public guardian. The communityguardian is an unpaid family member, carer etc. The Public Guardian is a Departmentalemployee appointed in the absence of anyone else being willing or able to take on the role.Number of new orders made appointing the Public Guardian 131Number of review of orders appointing the Public Guardian 178In 2009-10, 147 applications for Guardianship were received and 119 Guardianship orderswere made by the Court. This constitutes an increase in the number of applications and thenumber of orders made, this trend is expected to continue.Number of applications received 147Number of new Guardianship orders made 119Number of reviews 245144Department Health and Families

Support for Senior Territorians and Pensioner ConcessionsSubsidies and support services are provided to senior Territorians, pensioners, carers andand community participation. This includes the Territory’s Pensioner and Carer ConcessionScheme, which provides a number of concessions and rebates to eligible clients.OutputOutput cost($’000)2008-09Actual2009-10Budget2009-10RevisedBudget2009-10Actual13 191 15 898 15 880 18 187Key AchievementsPerformance MeasureQuantity2008-09Actual2009-10Estimate2009-10Actual2010-11EstimatePensioner concession recipients 1 20 661 19620 21362 20 000Grants issued for senior's advancement 2 44 44 42 42QualityClient satisfaction with senior's advancement activities 95% 95% 95% 95%TimelinessApplicants able to access pensioner concessions within 14days100% 100% 100% 100%1 Services or items for which the Department of Health and Families provides concessions and rebates are electricityor alternate energy costs, local council property rates, water charges, sewerage charges, garbage charges, motorvehicle registration, driver's licenses, spectacles, public transport and interstate travel. There is a trend of increasingmembership parallel to the ageing of the NT population. The difference between the 2009-10 actual and the estimatesfor 2009-10 and 2010-11 is due to methodology for estimation. At the time that the 2009-10 and 2010-11 forecastswere submitted to Treasury, an estimated rather than calculated forecast was used based on a clean up of thedatabase underway at that time. The Pensioner Concession database has since been updated and the actualnumber of members was higher than the forecast estimate and will be higher than the published estimate for both2009-10 and 2010-11. The increase in actual membership is consistent with an increasing population aged 65 yearsand over.2 The 2009-10 actual and 2010-11 estimate reflect larger grants provided to fewer projects, but not a reduction inservice.The Northern Territory Pensioner and Carer Concession Scheme (NTPCCS) had21 264 members during 2009-10. This is an increase of 603 on 2008-09.Seniors Month Grants Program - 44 grants were issued to assist community organisationsand businesses to host events and activities during Seniors Month in August 2009.and craft activities, come and try events and day tours.The Aged and Disability Program continued to build on the success of Seniors Month2009 during 2009-10.The Seniors Card Scheme had 14 754 active members during 2009-10 which is anincrease of 1661 members from 2008-09.Department Health and Families 145

146Department Health and Families

Public Health ServicesDepartment Health and Families 147

Public Health ServicesEnvironmental HealthEnvironmental Health (EH) acts to prevent and control physical, chemical, biologicaland radiological agents in the environment from adversely affecting human health.EH services include environmental health standards development, statutory surveillanceand enforcement, complaint resolution, community environmental health education andadvice, waste management, food and water safety, radiation protection and poisons control.2008-09Actual2009-10Budget2009-10RevisedBudget2009-10ActualOutputOutputcost($’000) 5 263 5 119 5 619 5 764Performance Measure2008-09Actual2009-10Estimate2009-10Actual2010-11EstimateQuantityRegulatory compliance activities 1 9 544 9 600 9 939 9 700QualityPremises achieving a satisfactorystandard of compliance withenvironmental health legislation 2within 28 days of receiving legalnotice 3 100% 100% 100% 100%TimelinessEnvironmental health complaintsinvestigations initiated within oneworking day of notification 91% 92% 92% 95%1 Regulatory compliance activities include premises inspections, issue of licences,registrations and legal notices, complaint investigations, food sampling, radiationequipment inspections, processing of development and building applications, septicsystem activities (for example, vector and vermin monitoring).2 Environmental health legislation consists of the Food Act, Public Health Act,Notifiable Diseases Act, Radiation (Safety Control) Act and Poisons and DangerousDrugs Act and regulations subordinate to each.3 Legal notices are those which relate to issues of imminent or actual public healthrisk, and require the owner to carry out alterations, repairs and general improvementworks to ensure the health of the public. These notices usually require theowner/occupier to carry out this work in a set timeframe and require at least anotherinspection to check compliance with the notice.148Department Health and Families

Regulatory Compliance ActivitiesThe performance measures above, when compared to the level of activity in the previousyear, show: there was an overall increase of 3.5% in activities in 2009-10 (9939) compared to there was a slight decrease (8%) in the number of licences, registrations and the number of public health complaints received decreased by 14%, continuing the trendset in 2006-07.Figure 12: Environmental Health regulatory and other activities 2007-08 to 2009-10450040003500300025002000150010005000InspectionsLicences,Registrations &AuthorisationsMisc. RegulatoryActivitiesComplaintInvestigationsHealth ProtectionActivitiesHealth Promotion& EHW Activities2007-08 4101 4019 1201 488 617 2492008-09 3698 3996 1200 385 163 1022009-10 4164 3695 1308 338 192 242Inspections comprise inspections of food premises, public health premises, radiation premises and equipment,poisons premises.Licences, Registrations & Authorisations comprise food premises registrations, health premises registrations,radiation licences and registrations, poisons authorisations and registrations, pharmacotherapy authorisations,amphetamine authorisations.Miscellaneous Regulatory Activities comprise issue of legal notices, food sampling and surveys, water andpool sampling, processing of building and development applications, bore construction permits, septic tanksystem activities, water quality activities, therapeutic drug recalls and destructions, food recalls and seizures,legislation and policy development.Complaint Investigations comprise public health and food complaints. Health Protection Activities compriseadult and larval mosquito monitoring.Health Promotion and EHW Activities comprise health promotion/education and Environmental Health Workeractivities.Department Health and Families 149

Key AchievementsNo Germs on MeThe ‘No Germs on Me’ hand washing campaign is an ongoing social marketing campaignwashing with soap and water after going to the toilet, after changing babies’ nappies andbefore touching food.The campaign was developed to assist in addressing the high rates of infectious diseasesamong Aboriginal babies and children in the Northern Territory. Recent international researchhas demonstrated that routine hand washing with soap and water can reduce the incidenceof diarrhoeal and respiratory disease among children by as much as 50%.In conjunction with Outback Stores and the Arnhem Land Progress Association (ALPA),point of sale materials to encourage the purchasing of soap will be displayed in Aboriginalcommunity stores for six months. Research conducted as part of the original pilot projectindicated that while many people said that they washed their hands using soap, soap wasinfrequently found in homes.Television commercials promoting hand washing will also be aired during 2010-11 as wellas the use of point of sale materials being displayed in community stores.Outback Stores and ALPA will provide pre and post sales data to the Environmental Healthprogram for evaluation purposes.being utilised by a number of interested agencies within the Northern Territory as well asbeing increasingly used both interstate and internationally as highlighted by its adapted usein Papua New Guinea.Food SafetyThe Environmental Health Program monitors the food supply in the Northern Territory forcompliance with the Australia New Zealand Food Standards Code, which is adopted by theNorthern Territory Food Act.The Food Standards Code requires that food handlers have ‘skills and knowledgecommensurate with their work activities’.The Department’s Environmental Health Program regularly run free food safety sessions forfood handlers. Sessions are provided Territory-wide and these aim to provide food handlerswith important food safety information that will decrease the likelihood of consumersproducts. 263 food handlers have attended this training since 1 July 2009. handling practices are detected during surveillance at food businesses.150Department Health and Families

Public and Environmental Health ActDrafting of a new proposed Public and Environmental Health Act has been completed. InJune 2010, Cabinet approved the release of a Discussion Paper and an exposure draftPublic and Environmental Health Bill 2010 for public consultation purposes. Extensiveconsultations on the draft Bill were held in Darwin and Alice Springs between June and Julyduring consultation on the draft Bill. A Regulatory Impact Statement for the proposed Bill isbeing prepared and it is anticipated that the draft Bill will be introduced into the LegislativeAssembly Sittings in late 2010.Darwin Harbour Recreational Water QualityBeaches in the Darwin urban region were closed in early June following the detection ofhigh levels of E.coli in the sea water. The Environmental Health Branch undertook a beachmonitoring program, and in the year to 30 June 2010 in excess of 100 water samples wereanalysed for indicator microorganisms. Water quality at the beaches improved rapidlyfollowing the removal of over 50 tonnes of algae from the foreshore. Mindil Beach wasthe last beach to be reopened on 22 June 2010. In addition to taking water samples formicrobiological analysis, comprehensive sanitary inspection surveys were undertaken inorder to determine potential sources of contamination to the beach and foreshore areas. Thebeach water quality monitoring program, was conducted in accordance with the NorthernTerritory Recreational Microbiological Water Quality Guidelines, and will be ongoing.Drug MonitoringPoisons Control Section monitored 26 965 prescriptions for Schedule 8 (S8) drugs tocontrol prescription drug abuse during 2009-10. A total of 250 contracts were registeredprescribing doctor and pharmacy on the Drug Monitoring System (DMS) database. Thecontract has been worded so that the patient agrees to allow Poisons Control to adviseother doctors, pharmacists and Alcohol and Other Drug Services Nurses about the detailsof his/her contract.There are two types of contracts: voluntary contracts and mandatory contracts. Voluntarycontracts can be used when patients are prescribed medicines which may potentiallybe misused or diverted such as non restricted S8s, benzodiazepines, anabolic steroids,analgesics and pseudoephedrine. Mandatory contracts are required for all opiatepharmacotherapy program maintenance patients being treated with methadone,buprenorphine or buprenorphine/naloxone.All Northern Territory community pharmacies (and some hospital pharmacy departments)have access to the web front end of DMS, the Poisons Control S8 Website via secureinternet login. The usage of this website by pharmacists has facilitated up to date, rapid S8information being made available. This year has also seen the commencement of a roll-outof the website to medical practices.The Schedule 8 and Restricted Schedule 4 Substances Clinical Advisory Committee (CLAC)meets quarterly during the year. The role of the Committee is to advise the Chief HealthDepartment Health and Families 151

Figure 13: NT Schedule 8 drug prescription and patient contracts 1992-93 to 2008-09No. of S8Prescriptions35000300002500020000150001000050000100080060040020001992-931993-94No. ofPatient Contracts1994-951995-961996-971997-981998-991999-002000-012001-022002-032003-042004-052005-062006-072007-082008-092009-10YearNo. of S8 PrescriptionsNo. of Patient ContractsOne of the issues handled by CLAC through 2009-10 was the shortage of Methadone tabletsmanufactured by Sigma Pharmaceuticals (Australia) Pty Ltd. These tablets became out ofstock nation wide with supplies becoming low in the Northern Territory in late December2009/early January 2010.On the recommendation of CLAC, methadone liquid’s status as a restricted S8 substancewas revoked, until such time as methadone tablets were again available. This enabledmethadone liquid to be more accessible to patients who had a legitimate need for its use aspart of their pain management and where alternate medications was not clinically indicatedor in the patient’s best interest.In late January 2010, upon advice that methadone tablet availability was returning to normalwith no future supply issues anticipated in the Northern Territory, methadone liquid wasagain declared a restricted S8 substance, taking effect on 1 February 2010.Radiation ProtectionThe Radiation Protection Act commenced on 5 October 2009. Additional authorisationsrequired under the Act are summarised as follows: of these were for sealed radioactive material because sealed sources are now registeredunder the Act. There are currently 83 radiation places registered.issued. Of the current licences, 183 can generally be described as relating to industry,93 medical and 129 others. 164 licences were previously counted as permits under the(repealed) Radiographers Act. There were 79 inspections of a radiation place.The Radiation Protection Act covers ionising radiation and, from April 2010, one categoryof non-ionising radiation - solaria. Tanning beds in the Northern Territory must be registeredand a licence is required for their possession and use. Currently there are two tanning bedsin the Territory.152Department Health and Families

Disease Control ServicesTerritory and provides clinical services, including screening and contact tracing, for sexualhealth, blood born viruses, tuberculosis, leprosy and other mycobacterial diseases. CDC’srole includes policy and clinical guideline development for these diseases.CDC is responsible for the development and implementation of the Territory’s immunisationprogram, and provides advice and education to health staff and the public on immunisation.responses, including the management of outbreaks, also forms part of its core business.Under the guidance of the community paediatrician, the rheumatic heart disease (RHD)program provides important support for the diagnosis and long term management ofthose with RHD. The trachoma program is working in partnership with a national programtowards the elimination of trachoma. The Safety and Injury Unit researches and developspolicy on injury prevention and Medical Entomology undertakes mosquito surveillance andenvironmental management of disease carrying and other nuisance insects.2008-09Actual2009-10Budget2009-10RevisedBudget2009-10ActualOutputOutputcost($’000) 23 527 19 979 25 814 25 037Performance Measures2008-09 2009-10 2009-10 2010-11Actual Estimate Actual EstimateQuantityNotification of:Sexually Transmitted Infections 1 5 962 6 500 5 817 6 000HIV 19 18 19 18Hepatitis C 213 180 157 180Occasions of service at Clinic 34 in Darwin andAlice Springs10 865 12 007 12 024 14 000Mosquito traps analysed 2 2 294 2 090 2 060 1 780Hectares treated by Mosquito Control Program 2 873 1 140 1 080 1 435QualityChildren fully immunised- at age 12 months 3 90% 91% 90% 91%- at age 2 years 4 93% 93% 93% 93%People completing treatment for tuberculosis 95% 95% 95% 95%TimelinessPublic health response instigated within100% 100% 100% 100%guidelines and specified timeframeMosquito larval control operations withinguidelines and specified timeframe of trigger(tides, rain, mosquito numbers) 5 100% 100% 100% 100%Department Health and Families 153

1. SHBBV 2009-10 data may not be complete. This issue is currently being addressed. Actual numbers forSTIs are expected to be greater than reported.2. Mosquito traps analysed are overnight mosquito trap collections set weekly from major towns in the Territory.Information is used to assess mosquito disease risks, evaluate mosquito control programs and formedia alerts and warnings.3. To be assessed as fully immunised, each child must have received the recommended number of vaccina-4. To be assessed as fully immunised, each child must have received the recommended number of vaccinationsfor diphtheria, tetanus, pertussis, poliomyelitis, measles, mumps and rubella and either vaccine for5. urban areas bordering the northern suburbs.Key AchievementsSexual Health and Blood Borne Viruses (SHBBV)There have been major achievements in sexual health and blood borne virus (SHBBV)programs built upon work undertaken in recent years. The SHBBV unit has a majorcommitment to research and has forged strong links with the Menzies School of HealthResearch (MSHR) to undertake a number of research activities aimed at enabling sexualhealth service providers to design and deliver programs that are evidence based and locallyrelevant. A major project being conducted by the National Centre in HIV Epidemiology andClinical Research and involving a broad range of both the Department and communitycontrolled health services will focus on implementing a comprehensive best practiceapproach in remote community health centres. This project has the dual aims of loweringthe rates of sexually transmitted infections and developing a framework of quality andperformance indicators to inform program delivery and evaluation.Rates of chlamydia infection have increased in the Northern Territory in recent years, as theyfalling over the last several years with trichomonas decreasing in 2009-10. The number ofbut has been showing an increasing trend since 2007 particularly in infections acquiredoverseas and via heterosexual contact.A six month ‘HIV Travellers Campaign’ commenced on May 2010. This campaign aims toincrease awareness in Territory residents of the increased risks of acquiring HIV throughunsafe sex in high prevalence countries, in particular in South East Asia.11 to increase screening in urban at risk populations and, in line with the 2010-13 nationalhepatitis C strategy, to increase the number of people receiving hepatitis C treatment.In partnership with the Department of Education and Training, the Unit has commenced ato Aboriginal youth. A Project Coordinator is undertaking an analysis of needs and currentapproaches, barriers/opportunities and models of service delivery. Seven adolescent Health consultation being a cornerstone of the project.154Department Health and Families

High quality sexual health services as well as clinical care for HIV and hepatitis B and Ccontinue to be provided via Clinic 34 services in the Northern Territory. Client numbers haveprograms. In response, an additional nursing position has been created in Clinic 34 Darwin.An accreditation process for the Darwin Clinic 34 has commenced using the AustralianCouncil of Healthcare Standards Evaluation and Quality Improvement Program (EQuIP).input and guidance of the Northern Territory Health Promotion Advisory Group.The Northern Territory Sexual Health Advisory Group provides direction and oversight forsexual health services in the Territory. It has a wide representation from both Governmentthree year framework is currently underway.ImmunisationThe Immunisation section provides technical and logistic support for the delivery ofimmunisations by Government and non-government primary care providers throughout theTerritory. Immunisation rates for Territory children are essentially the same as national rates atall ages. This is achieved despite the challenges of having relatively fewer General Practitionersthan elsewhere and that over 30% of the population lives in remote communities.Key AchievementsTable 23: Northern Territory immunisation rates(From Australian Childhood Immunisation Register calculated at 30 June 2010)12-

of on-shore detections of exotic Aedes mosquitoes in the Darwin port area, one of Aedesalbopictus and three of Aedes aegypti. All were quickly detected and eliminated. The jointsurveillance and control operations with Australian Quarantine and Inspection Service (AQIS)have proven invaluable in keeping these exotic mosquitoes out of the Northern Territory.Medical Entomology regularly sprays by helicopter the Leanyer, Holmes Jungle, Mickettand Shoal Bay swamps and this has helped maintain relatively low numbers of all mosquitospecies in the northern suburbs of Darwin. There was a slight decrease in the area treatedthere was a decrease in the overall number of traps analysed due to a revision of the adultmosquito surveillance program, the average number of mosquitoes trapped and analysedper week in Darwin increased from 152 in 2008-09 to 216 in 2009-10. Active researchcontinues, particularly in conjunction with Charles Darwin University (CDU). One result ofthis research has been improved effectiveness in salt marsh mosquito survey and controlto assist the Timor Leste Ministry of Health (MoH) develop and implement vector controlprograms. Funding available at the end of the project allowed for an extra dengue controltraining workshop to be held in a regional town and insecticide resistance testing to be carriedout in Dili. This enabled further improvements in their dengue vector control programs.A major achievement was the monitoring and aerial control of mosquitoes in Ilparpa swampMedical Entomology in cooperation with Power Water, the Alice Springs Town Council andthe Environmental Health branch was a great success, with common banded mosquitonumbers kept very low.The combined Department/Darwin City Council mosquito engineering program in Darwinin the lower reaches of freshwater Sandy Creek near Royal Darwin Hospital led to animmediate decrease in mosquito numbers in the area. Other work included elimination ofbreeding areas at Vestey’s Lake and Leanyer Swamp.Medical Entomology also provides important advice for all urban development in the NorthernTerritory. A major biting insect investigation and draft report for the proposed new city ofWeddell was completed in June. Biting insects have been nominated as the most importantissue in this development and the report will guide the urban layout and development ofDarwin’s second satellite city. Medical Entomology guidance on biting insects has also beenaccepted and will inform the planning of the new Darwin suburb of Muirhead. In particular,there will be a one kilometre biting insect buffer zone put in place.Community Physician and Injury PreventionThe Safety and Injury Unit maintains its interest in road and water safety by participationin the Road Safety Coordination Group and the Northern Territory Water Safety AdvisoryCouncil and by providing relevant injury data for those groups. In the past 12 months furtherdevelopment work has been done to consolidate the Northern Territory Falls PreventionNetworks. Training workshops for ‘leaders in falls prevention’ were run in both CentralAustralia and the Top End and a falls prevention conference attended by over 95 participantswas held in Darwin in May. The Unit participates on the National Injury Prevention WorkingGroup which is promoting the implementation of the revised National Falls Prevention BestPractice Guidelines, released in November 2009. Alcohol related injury remains an importantfocus and a system for regular reporting of alcohol attributable deaths and hospitalisations156Department Health and Families

has been established in conjunction with the Health Gains Branch. The Unit continues towork with the Department of Justice and the Northern Territory Police in the development ofalcohol policy and programs.Community PaediatricianThe Community Paediatrician plays a key role in the coordination of visits by paediatriciansto remote communities. Forty-one Top End communities are programmed for visits at oneto three monthly intervals depending on population size. Supervision is provided for twotrainee community paediatric registrars each year and urban paediatric clinics are providedfor Child Development, Child Disability and High Risk follow up as well as urban AboriginalCommunity Controlled Health Services.The Community Paediatrician provides leadership for programs run by the Child and YouthHealth Strategy Team, the Rheumatic Heart Disease Prevention program, the TrachomaControl Program, Kidsafe and the Head Lice Prevention program. Support is also providedto programs run by MSHR.Rheumatic Heart Disease ProgramAcute Rheumatic Fever (ARF) and its consequence Rheumatic Heart Disease (RHD)continue to be major public health problems in the Northern Territory. There were 45previous year. Almost 29% were recurrent episodes.The RHD program provides a broad range of education, health promotion and clinicalsupport activities for both patients and their families as well as for Government and nongovernmenthealth care providers.The RHD Register provides logistic support for the care and follow-up of almost 2000patients in the Northern Territory as well as over 150 patients from South Australia, WesternAustralia and Queensland. The register enables clinicians to have comprehensive and upto-dateinformation on RHD patients wherever they are seen and provides reminder noticesand support for prophylactic treatment and specialist appointments. The Register alsoprovides data for analysis to guide program implementation and evaluation. This past yearconsiderable effort has been focused on improving the data quality and patient informationin the Register.During 2009 there has been an improvement in the overall coverage of prophylactictreatment as compared to the previous years.Table 24: Prophylaxis coverage 2007 – 2009Prophylaxis Received (scheduled Injections) 2007 2008 2009 Totalless than 50% 46.00% 43.60% 37.30% 42.20%50 to 80% 32.80% 35.40% 39.80% 36.10%greater than 80% 21.20% 21.00% 23.00% 21.80%In the past 12 months the RHD Program has provided over 300 individualised healthpromotion sessions to patients and their families throughout the Territory. Throughout2009-10 program staff provided training to over 680 health care professionals and paraprofessionalsin the Territory and travelled to over 50 remote health services in all regionsof the Territory.Department Health and Families 157

In July 2009 a National Coordination Unit for RHD in Australia (RHD Australia) wasestablished as were Australian Government-funded programs in Western Australia andQueensland. The Northern Territory program is the model informing the development ofthese programs and has also been instrumental in the development of data standards foran approved centralised dataset for RHD in Australia.Trachoma ProgramThe Northern Territory Trachoma Strategy 2009, developed in partnership with the AboriginalMedical Services Alliance Northern Territory (AMSANT) received funding of $3.4 millionfrom the Australian Government to expand current trachoma control programs across theNorthern Territory. The Strategy is supported by the Trachoma Strategy Advisory Group andthe Trachoma Strategy Working Group and will report to the Northern Territory AboriginalHealth Forum.Central to the Northern Territory Strategy is the World Health Organisation recommendedSAFE strategy for the elimination of blinding trachoma: Surgery for those at risk of blindness,Antibiotics for treating individuals and reducing infection in the community, Facial cleanlinessand hygiene promotion to reduce transmission, and Environmental improvements such aswater supply and sanitation.Training and education in Trachoma management and prevention has been provided toover 300 primary health care providers across the Northern Territory. The Trachoma HealthPromotion program assisted in the design of the “Clean Faces- Strong Eyes” trachomaeducation tool kits. Guidelines for the Management for Trachoma in the Northern Territoryto support primary health care services to implement the SAFE Strategy were developedand distributed.Surveillancein the number of cases of mumps, pertussis, hepatitis B and C, syphilis and trichomoniasis.There was only one case of hepatitis A, the lowest annual number recorded since electronicfor hepatitis A which commenced in 2006. There were no cases of invasive Haemophilusand Barmah Forest virus infections, dengue and HIV. There were two cases of Murrayof 2009 and the increased testing that took place.The surveillance section continues to produce monthly newsletters for all Territory healthpractitioners alerting them to the current status of communicable diseases. It also representsthe Territory at the national level on communicable disease surveillance issues, in particularin 1996 joined the Australian Sentinel Practices Research Network (ASPREN). The section158Department Health and Families

calendar year)Vaccine Preventable Disease 1 2004 2005 2006 2007 2008 2009Haemophilus Influenzae Type b (Invasive) 3 1 2 2 2 0Influenza 39 61 40 183 199 2075Measles 3 0 0 0 3 1Mumps 0 7 7 58 52 14Pertussis 27 92 96 27 478 223Pneumococcal disease 92 71 56 66 60 93Vectorborne 1 2004 2005 2006 2007 2008 2009Barmah Forest 22 51 130 91 75 120Dengue Virus infection 19 14 21 15 23 42Malaria 40 48 66 30 19 14Murray Valley Encephalitis 1 1 0 0 1 2Ross River Virus 233 209 277 299 262 442Typhus (all forms) 0 1 0 2 1 1Bloodborne 1 2004 2005 2006 2007 2008 2009Hepatitis B - newly acquired 8 5 9 9 8 4Hepatitis B – chronic/unspecified 21 401 496 510 415 327Hepatitis C - newly acquired 0 3 3 4 6 5Hepatitis C – chronic/unspecified 265 267 262 221 209 171HTLV1 asymptomatic/unspecified 43 70 114 106 83 46Sexually Transmissible 1 2004 2005 2006 2007 2008 2009Chlamydial Infection 1616 1626 2057 2177 2288 2148Gonococcal infection 1574 1806 1772 1594 1549 1529Human Immunodefiency Virus 10 4 13 7 15 19Syphilis 281 231 273 295 254 140Syphilis congenital 4 3 6 2 1 3Trichomoniasis 559 830 1427 1955 2206 1760Gastrointestinal 1 2004 2005 2006 2007 2008 2009Campylobacteriosis 214 255 263 289 257 214Cryptosporidiosis 111 83 71 111 102 154Hepatitis A 14 66 30 5 3 1Rotavirus 408 260 608 291 200 263Salmonellosis 387 395 404 525 494 514Shigellosis 116 197 125 173 177 95Typhoid 0 0 3 3 1 0Other 1 2004 2005 2006 2007 2008 2009Acute Post Strepococcal Glomerulonephritis 17 102 12 23 38 40Adverse Vaccine Reaction 36 28 46 48 45 50Legionellosis 2 3 3 3 1 3Leprosy 1 3 1 0 1 0Melioidosis 20 35 27 34 23 30Meningococcal infection 12 11 6 6 9 8Rheumatic Fever 64 50 54 81 48 55Tuberculosis 29 27 35 55 34 30Zoonosis 1 2004 2005 2006 2007 2008 2009Leptospirosis 2 5 2 1 1 4Q Fever 3 2 5 2 3 31 Due to late notifications and data cleaning the number of cases for some diseases for the years 2004-2008might vary slightly from that reported in the last Annual ReportDepartment Health and Families 159

Tuberculosis and Leprosy Unitwith around one per year for leprosy. The Unit provides direct clinical care, both medical andnursing, as well as Directly Observed Therapy (DOT) to the large majority of tuberculosispatients currently under treatment. This usually involves three times weekly nursing outreachvisits to each patient on DOT.In addition, the Unit also provides care for latent tuberculosis infection and non-tuberculousmycobacterial disease. Management of active tuberculosis is likely to become moreresource-intensive in the coming years as we begin to see increasing numbers of multidrugresistant tuberculosis (MDR-TB), for which drug treatment is more costly, the durationto cure longer and drug side effects more probable. An increase in the regional prevalenceFour clinics per week are run in Darwin as well as regular clinics in Alice Springs, Nhulunbuy, workload for nursing and medical staff. This often requires outreach visits into both urbanand remote communities.Refugee Health and Unauthorised Fishers and the Irregular Maritime ArrivalsThe Tuberculosis Unit continues to provide screening for tuberculosis for intermittent maritimenow undertaken by the Refugee Health Service at Vanderlin Drive Medical Clinic.apprehended by the Australian Government. The screens are federally funded and for thesemeasure during 2009. Northern Territory.In July 2009 the H1N1 epidemic in Australia was in full swing and had a major impacton the Northern Territory. A survey conducted by the CDC surveillance section found thatstrain.CDC worked in close cooperation with general practitioners, hospitals and laboratories toof remote communities. CDC coordinated the response with both the Department andCommunity Controlled services to ensure that all clinics were well informed and hadadequate supplies of antiviral medication and protective equipment to deal with peopleIn September 2009, the Australian Government made available to everyone over 10 yearsstrain (Panvax®). From September 2009 to April 2010, CDC employed dedicated staff tosupport the vaccination campaign both in urban and remote settings. By May 2010, at least160Department Health and Families

27% of the Territory population had received the vaccine with an uptake over 40% in someparts of the Territory.Alcohol and Other Drugs ServicesThe Alcohol and Other Drugs Program (AODP) develops policies, strategies and programsto prevent and respond to the misuse of alcohol, tobacco and other drugs.The AODP includes policy development and legislative compliance, community development,accredited training, services development and treatment and care services and programs.The Program employs a range of staff across the Territory, including doctors, nurses,to support and develop individual and community level responses to alcohol, tobacco andother drug related harm.Output2008-09Actual2009-10Budget2009-10RevisedBudget2009-10ActualOutput cost ($’000) 21 577 22 286 25 237 24 801Performance Measure 2008-09ActualQuantityCommunity education and communitydevelopment activities2009-10Estimate2009-10Actual2010-11Estimate345 340 366 360Completed accredited training units 1 255 240 288 240Utilisation rate of sobering up shelter bed35% 31% 33% 31%hoursAdmissions to sobering up shelters 20 376 18 000 20 771 18 000Closed episodes 2 in non government treatment 2 678 2 200 2 618 2 200services 3Closed episodes 2 in alcohol and other drugs 731 600 969 750treatment services 4QualityAccredited training units meeting national90% 90% 90% 90%accreditation guidelinesClosed episodes completed in non government 53% 65% 54% 60%treatment servicesClosed episodes completed in governmenttreatment services24% 30% 24% 30%Department Health and Families 161

1 The Alcohol and Other Drugs Program delivers a range of vocational education and trainingaccredited qualifications, where a qualification comprises 14 units. Alcohol and Other Drug workers ingovernment and non government settings can participate in one or more of these units that comprise aqualification.2 An episode of alcohol and other drugs treatment is a "period of contact, with defined dates ofcommencement and cessation, between a client and a treatment provider that occurs in one settingand in which there is no change in the main treatment type or principal drug of concern, and there hasnot been a non planned absence of contact for greater than three months" (National Health DataDictionary). A closed episode of treatment is one where there is a valid date of cessation. Treatmentservices submit data one quarter in arrears and so the count reported here is for the 12 months 1April2009 to 31 March 2010.3 The number of episodes provided in the non-government sector through agencies funded by theAlcohol and Other Drugs Program.4 The number of episodes provided in the government sector through agencies directly funded andadministered by the Alcohol and Other Drugs Program.Key AchievementsTreatment and careThe Alcohol and Other Drugs Program delivers and funds a range of community basedtreatment services and programs, including withdrawal services, residential rehabilitation,outpatient counselling, pharmacotherapy services and aftercare.In 2009-10, AODP invested a total of $8.6 million funding into 30 treatment services toprovide 3587 episodes of treatment across the Northern Territory, with alcohol continuing tobe the principal drug of concern at 67% of all episodes.A summary of treatment episodes is shown in Table 26 below.Table 26: Number of closed episodes of treatment in Alcohol and Other Drug Treatment Services byprincipal drug of concern, 1 April 2008 - 31 March 2009 and 1 April 2009 – 31 March 2010. OtherDrug Treatment Services by principal drug of concern, 1 April 2008 - 31 March 2009 and 1 April2009 – 31 March 2010.Principal drug of concern Apr 08 - Mar 09 Apr 09 – Mar 10Alcohol 2 409 2 398Amphetamines 75 96Cannabis 381 294Opioids 312 306Volatile substances 119 238Other 113 255As shown in Table 27, during the period April 2009–March 2010, assessment only wasthe most common main treatment type provided (38% or 1367 episodes), followed bycounselling (20% or 714 episodes) and residential rehabilitation (15% or 548 episodes).162Department Health and Families

Table 27: Number of closed episodes of treatment in Alcohol and Other Drug Treatment Services bymain treatment type, 1 April 2008 - 31 March 2009 and 1 April 2009 – 31 March 2010.Main Treatment Type Apr 08 - Mar 09 Apr 09 – Mar 10Assessment Only 898 1 367Counselling 581 714Information and Education only 344 298Other 179 146Pharmacotherapy 130 114Rehabilitation 345 548Support and case management only 330 55Withdrawal Management (Detoxification) 600 345Not stated 2 0Total episodes 3 409 3 587 services operating in Darwin, Nhulunbuy, Katherine, Tennant Creek and Alice Springs.This is an increase of 395 admissions on the previous year. Sobering up shelters protectintoxicated individuals who are vulnerable to harm and reduce antisocial behaviour.The amended Volatile Substance Abuse Prevention Act and associated Regulationscame into operation on 22 February 2010. The amendments provide for streamliningand improved timeliness in the treatment order processes, a broader range of treatmentoptions for referral, and an increase in the period of the order.In 2009-10, there were 216 requests for assessment for court ordered treatment underthe Volatile Substance Abuse Prevention Act. 147 were children and 69 were adults, witha total of 17 people ordered for treatment issued over the 2009-10 year.The $4 million capital upgrade of the Banyan House residential rehabilitation facility wascompleted in September 2009. The upgraded facilities provide three new residentialaccommodation blocks, containing 18 beds and include two dedicated withdrawalAODP is managing the design and construction of a new purpose built sobering upshelter to replace the existing facility in Katherine. The capital funds for the new shelterwere provided by the Australian Government and is due for completion by August 2010.St Vincent de Paul Society (Vincentcare) was funded in 2009-10 to operate TransitionalAftercare services (both residential and outreach) from the recently renovated andupgraded Bees Creek Road site from September 2010.In October 2009, the Alcohol and Other Drugs Program took over the managementand operation of the Nhulunbuy Special Care Centre. The treatment programs havebeen redeveloped and extended to provide residential rehabilitation services as well asoutpatient and outreach alcohol and other drug services to the region.An independent review into alcohol and other drugs treatment services in Alice Springswas completed in June 2010. The review provided for individual service level review forincorporation into revised service agreements and is the basis for ongoing professionaldevelopment priorities and quality improvement decisions.The Hospital Based Interventions Project commenced in Alice Springs and Royal DarwinHospital. The Project provides for tobacco and alcohol screening and brief interventionsfor patients and intervention and referral advice and support for staff.A pilot project to increase alcohol and other drug intervention and support in the RDHEmergency Department commenced in February 2010. Under the pilot an alcohol andDepartment Health and Families 163

other drugs nursing position is based in the Emergency Department four hours perweekday, to provide assessment, brief intervention, ongoing referrals, education andliaison with Emergency Department staff.Community Development and Training AODP supported communities to develop and implement Volatile Substance Abuse(VSA) Management Areas and Management Plans under the Volatile Substance AbusePrevention Act. In 2009-10, three areas and one plan were declared across the NorthernTerritory. An Alcohol Education Flipchart and DVD resource, Grog – Making the Change, hasbeen developed for dissemination in health and community settings. A total of 257 twohour training sessions on how to use the resource have been conducted over the 2009-10 year. A total of $213 000 in small grants funds were allocated to community groups andincorporated organisations to facilitate community activities to respond to, and/orprevent, the use of alcohol, tobacco and other drugs. The Alcohol and Other Drugs Program Training Unit supported 1013 students in thewith a completion rate of 84.1%. In 2009-10 the Council of Aboriginal Alcohol Programs Services (CAAPS) and AODPjointly delivered accredited alcohol and other drugs training for remote Aboriginallevel course in 2009-10.TobaccoIn December 2009, the Tobacco Control Regulations were amended to ban smoking in allindoor public areas from 2 January 2010. To support these changes a media campaign‘No Body Smokes Here Anymore’ was aired from December 2009 to February 2010.In June 2010, further reforms to the Tobacco Control Act and its supporting regulationswere passed to allow for bans on smoking in outdoor eating areas, prohibition of point ofsale display and advertising of tobacco products, and the introduction of tobacco retaillicense fees. The reforms will protect staff and the public from environmental tobaccosmoke and reduce exposure of tobacco products in the community.In 2009-10, a total of 35 health professionals were trained in the National Accredited TobaccoCessation program, 40 people were trained to deliver the Quit Fresh Start Course and a164Department Health and Families

Health ResearchHealth research spans population health, the burden of disease, communicable and noncommunicable diseases, social and environmental determinants of health, and healthinformation systems. Research is undertaken by the Department as well as externalorganisations such as the Menzies School of Health Research (MSHR) and the CooperativeResearch Centre (CRC) for Aboriginal and Torres Strait Islander Health, which have multidisciplinaryresearch programs.2008-09Actual2009-10Budget2009-10RevisedBudget2009-10ActualOutputOutputcost($’000) 5 898 5 874 6 334 6 271Performance Measure2008-09Actual2009-10Estimate2009-10Actual2010-11EstimateQuantityNumbers of grants provided 5 3 5 3TimelinessGrant payments made within stipulatedtimeframe100% 100% 100% 100%Health Research funding is used to make grants to the MSHR, the Father Flynn Fellowshipand the CRC for Aboriginal and Torres Strait Islander Health. In 2008-09 two additional oneoff grants were also provided. Details are given below.Menzies School of Health ResearchMSHR is the major Australian health and medical research institute with a primary focus onthe health of Aboriginal people and people living in tropical and remote areas. Its researchfalls into six major interdisciplinary research divisions: Services, Systems and Society.The Department has provided funding to MSHR for infrastructure costs and has collaboratedon a range of projects.The Department and MSHR have developed a joint program to support DHF staff to conductand perform research evaluation. It provides for the delivery of research courses across thewhole research process, as modules and short courses and access to research expertise.It also helps to link staff to appropriate collaborators.Department Health and Families 165

Father Flynn FellowshipThe Father Flynn Fellowship, funded by the Department, honours a great ophthalmologist,missionary and medical researcher. The Fellowship was awarded to Professor Anne Changin April 2007 and continued until March 2010. In April 2010, the Fellowship was awardedto Dr Peter Bourke, clinical immunologist/allergist for a three year term until March 2013.Cooperative Research Centre for Aboriginal and Torres Strait Islander HealthThe Cooperative Research Centre on Aboriginal Health (CRCAH) became the CooperativeResearch Centre on Aboriginal and Torres Strait Islander Health (CRCATSIH) in January 2010.The CRCATSIH is currently being hosted by the Lowitja Institute until 30 June 2014, whenits funding cycle ends. The Lowitja Institute is a collaborative research organisation thatbrings together Aboriginal organisations, research institutions and government agenciesto facilitate evidence-based research into Aboriginal and Torres Strait Islander health. Aswell as the Department, Northern Territory participants include, MSHR, Charles DarwinUniversity (CDU), and Danila Dilba Health Service.The CRCATSIH aims to: promote high-quality research through increased Aboriginal control of the healthresearch agenda and through partnerships with key stakeholders in the Aboriginal health undertake strategic research to investigate health conditions, health service delivery primary healthcare, to build sustainable prevention and to reduce the disease burden on build capacity in Aboriginal people to allow greater control of health research through advocate in line with our communications strategy for research-informed changes to thedelivery of health services to Aboriginal people.Centre for Remote HealthThe Department provided funding to the Centre for Remote Health (a joint training andresearch centre of Flinders and Charles Darwin Universities) for assistance with theadministrative functions of the Central Australia Human Research Ethics Committee.Care for Child Development Program:Departmental funding was provided to MSHR to implement, on a trial basis the Care forChild Development (CCD) program. The CCD program has been developed by the WorldHealth Organisation and UNICEF to promote healthy attachment between parent and child,supporting parents’ responsiveness to their children addressing concerns about neglectand poor development. The Department of Education and Training are also contributingfunds to this trial.166Department Health and Families

Our moneyOverviewstatements: the Operating Statement, the Balance Sheet, and the Cash Flow Statement.These statements and the accompanying notes have been prepared in accordance with the both expenses and revenue and continues the Department’s strong emphasis on resourcemanagement.Main results at a glance Expenses were contained within 0.06% of Budget targets. The equity position improved by $239 million to $680 million. Revenue earned exceeded budget by 0.4%.Operating StatementTable 28: Operating Statement SummaryOperating Statement 2009-10 2008-09 VariationSummary $000 $000 $000 %Operating Revenue 1 090 187 1 028 563 61 624 5.7%Operating Expenses 1 119 514 1 011 787 107,727 10.6% -29 328 16 776 -46 103Government accounting framework does not fund non cash expenses such as depreciation.$31.9 million. The improved result can be attributed to externally funded programs that werenot completed as planned by 30 June 2010.Operating RevenueTable 29: Operating RevenueOperating Revenue 2009-10 2008-09 Variation$000 $000 $000 %Commonwealth NPP & SPP 211 141 35 497 175 644 494.8%RevenueGrants Revenue 56 518 234 993 -178 475 -75.9%Total Commonwealth Revenue 267 659 270 490 -2 830 -1.0%Output Revenue 743 087 689 823 53 264 100%Sales of Goods and Services 44 534 36 563 7 971 21.8%Other Revenue 34 906 31 687 3 219 10.2%Total 1 090 187 1 028 563 61 624 6%Department Health and Families 167

Sales of Goods &Services4%Other Revenue3%CommonwealthRevenue19%Grants Revenue5%Output Revenue69%The Department’s principal source of revenue (68% or $743 million) is output revenueprovided by the Territory Government to fund core health and family services across theNorthern Territory. In 2009-10 output appropriation grew by $53.3 million, or 7.7%. Thegrowth in output appropriation has enabled the Department to meet the higher cost ofdelivering services and to expand and enhance priority services.The majority of the Department’s remaining revenue came from Australian Government Treasury to State and Territory Treasuries. The States and Territories then appropriate thefunding to the Department responsible for the delivery of services. In 2009-10 SPP andNPP payments of $211 million were received by the Department, in addition the Departmentreceived an additional $56 million in direct funding from Australian Government Departments.The total funding received from the Australian Government of $267.7 million was down on2008-09 by $2.8 million or 1%. The reduction in Australian Government funding is a resultof the one off payment in 2008-09 of $14.7 million for Acute Care projects for HospitalEmergency Departments, Sub Acute Care and Activity Based Funding reforms.The ongoing funding agreements with the Australian Government showed modest increasesin line with CPI.Other minor revenue categories were within budgeted expectations.Operating ExpensesTable 30: Operating ExpensesOperating Expenses 2009-10 2008-09 Variation$000 $000 $000 %Personnel Expenses 567 870 504 517 63 354 12.6%Administrative Expenses 374 570 340 275 34 294 10.1%Grants and Subsidies 177 074 166 995 10 080 6.0%Total 1 119 514 1 011 787 107 727 10.6%168Department Health and Families

In 2009-10 the Department incurred expenses of $1.119 billion, an increase of 10.6% on theDepartment, it was within budget targets and is indicative of the increase in services beingprovided, as well as the increased cost of service delivery in the health and welfare sectors. years with employee expenses continuing to be the major expense category accounting forjust over 50% of total expenses.Employee ExpensesEmployee expenses grew by 12.6% in 2009-10 to $567.9 million as a result of Enterprise Bargaining Agreements negotiated however additional allowances werenegotiated for surgeons outside of the EBA process and normal wage indexationwas applied. Total staff numbers increased by 349 full time equivalent positions during the staff. The increased staff have been employed across the Department to meet the demand forservices and to expand targeted services in priority areas.Administrative ExpensesAdministrative expenses increased by 10.1% in 2009-10, these expenses include repairsand maintenance, depreciation of assets, and purchased goods and services. The majorincreases by category of expense were: $1.5 million for client travel.The increase in these expenses is due in part to the increased demand for services andthe enhancement of some services funded by the Government. In particular the Patient new Scheme. Repairs and maintenance expenses increased to fund emergency powergeneration options for Royal Darwin Hospital.Department Health and Families 169

Grants and Subsidies expense also includes subsidy payments for pensioners concessions.The NT Pensioners and Carers Concession Scheme (NTPCCS) includes concessions to alleligible Territory seniors, pensioners and carers for their electricity, water and sewerage costs.In 2009-10 the Government increased the subsidy to cover 100% of all tariff increases, this hasresulted in a 95% increase in subsidies paid to clients.Balance SheetTable 31: Balance Sheet SummaryBalance Sheet Summary 2009-10 2008-09 Variation$000 $000 $000Assets 821 470 554 502 266 968Liabilities 141 092 113 127 27 965Equity 680 378 441 375 239 003In 2009-10 the Department undertook a major revaluation of health infrastructure assets.independent valuation showed an increase in the value of building assets held onthe asset register of $228.7 million. In addition the Department of Construction andInfrastructure transferred completed capital projects of $56.7 million into the Department’sasset register. (These asset transfers are detailed in Appendix II)Cash balances reduced by $10.5 million as a result of expenses incurred to acquitexternally funded projects from 2008-09.Statement of Cash FlowsTable 32: Cash Flow Statement SummaryCash Flow StatementSummaryCash at Beginning of reportingperiod2009-10 2008-09 Variation$000 $000 $00078 950 36 888 42 062Receipts 1 100 229 1 051 922 48 307Payments (1 093 653) (1 013 134) (80 519)Equity Injections 7 897 5 104 2 793Equity withdrawals (25 004) (1 830) (23 174)Cash at end of reportingperiod68 419 78 950 -10 531The Cash Flow Statement shows the Department’s cash receipts and payments for theStatement, after the elimination of all non cash transactions, with cash movements from170Department Health and Families

the Balance Sheet. The net result is an increase in the agency’s cash balances ofto timing differences between receipt of Australian Government revenue and the plannedexpenditure of these funds.SummaryTable 33: Budget Target SummaryBudget Target Summary 2009-10 Final 2008-09 Actual VariationBudget$000 $000 $000 %Operating Revenue 1 088 331 1 090 187 1 856 -0.2%Operating Expenses (1 120 231) (1 119 514) 717 0.1% (31900) (29 328) -2 572The Department’s performance in both revenue generation and expenditure control show aresult that is within 1% of planned targets. Expenditure across the Agency was well managedwith all output groups coming within 3% of their annual budget target. The Department alsothe Australian Government in 2010-11 and forward years.Department Health and Families 171

CERTIFICATION OF THE FINANCIAL STATEMENTSfrom proper accounts and records in accordance with the prescribed format, the Financial Management Actand Treasurer’s Directions.We further state that the information set out in the Comprehensive Operating Statement, Balance Sheet, At the time of signing, we are not aware of any circumstances that would render the particulars included in………………………………….Jeff MoffetChief ExecutiveSeptember 2010………………………………….David RyanSeptember 2010172Department Health and Families

Operating StatementNOTE 2010$'0002009$'000INCOMETaxation RevenueGrants and Subsidies RevenueCurrent 56 493 234 993Capital 25 0AppropriationOutput 743 087 689 823Commonwealth 211 141 35 497Sales of Goods and Services 44 534 36 563Interest Revenue 0 0Goods and Services Received Free of Charge 4 28 990 26 899Gain on Disposal of Assets 5 4 (38)Other Income 5 913 4 826TOTAL INCOME 3 1 090 187 1 028 563EXPENSESEmployee Expenses 567 870 504 517Administrative ExpensesPurchases of Goods and Services 6 303 393 272 040Repairs and Maintenance 19 355 18 867Depreciation and Amortisation 10, 11 22 564 21 350Other Administrative Expenses (1) 29 258 28 018Grants and Subsidies ExpensesCurrent 166 588 157 922Capital 564 3 981Community Service Obligations 9 923 5 092Interest Expenses 18 0 0TOTAL EXPENSES 3 1 119 514 1 011 787NET SURPLUS/(DEFICIT) (29 328) 16 776OTHER COMPREHENSIVE INCOMEAsset Revaluation Surplus 228 707 660TOTAL OTHER COMPREHENSIVE INCOME 228 707 660COMPREHENSIVE RESULT 199 379 17 4361 Includes DBE service charges.The Comprehensive Operating Statement is to be read in conjunction with the notes to the financial statements.Department Health and Families 173

Balance SheetNOTE 2010$'0002009$'000ASSETSCurrent AssetsCash and Deposits 7 68 419 78 950Receivables 8 30 081 23 992Inventories 9 6 876 6 235Prepayments 1 426 3 094Other Assets 0 0Total Current Assets 106 802 112 272Non-Current AssetsProperty, Plant and Equipment 10 714 577 442 094Intangibles 11a 87 132Heritage and Cultural Assets 11c 5 5Total Non-Current Assets 714 668 442 230TOTAL ASSETS 821 470 554 502LIABILITIESCurrent LiabilitiesDeposits Held 15 1 250 873Payables 12 69 610 52 846Borrowings and Advances 13 0 0Provisions 14 48 790 42 424Other Liabilities 15 2 814 1 015Total Current Liabilities 122 464 97 158Non-Current LiabilitiesProvisions 14 18 628 15 969Total Non-Current Liabilities 18 628 15 969TOTAL LIABILITIES 141 092 113 127NET ASSETS 680 378 441 375EQUITYCapital 557 092 517 468Asset Revaluation Surplus 16 242 607 13 900Accumulated Funds (119 320) (89 993)TOTAL EQUITY 680 378 441 375The Balance Sheet is to be read in conjunction with the notes to the financial statements.174Department Health and Families

Statement of Changes in Equity2009-10NOTEEquity at1 July$'000Compre-hensiveresult$'000Transactionswith ownersin theircapacity asowners$'000Equity at30 June$'000Accumulated Funds (89 993) (29 328) (119 320)(89 993) (29 328) (119 320)Asset Revaluation Surplus 16 13 900 228 707 242 607Capital - Transactions with Owners 517 468 517 468Equity InjectionsCapital Appropriation 4 495 4 495Equity Transfers In 56 731 56 731Other Equity Injections 1 072 1 072Specific Purpose PaymentsNational Partnership Payments 2 330 2 330Commonwealth - CapitalEquity WithdrawalsCapital Withdrawal (25 004) (25 004)Equity Transfers Out 0 0517 468 0 39 624 557 092Total Equity at End of Financial Year 441 375 199 379 39 624 680 3782008-09Accumulated Funds (106 768) 16 776 0 (89 993)(106 768) 16 776 0 (89 993)Asset Revaluation Surplus 16 13 240 660 13 900Capital - Transactions with Owners 499 597 499 597Equity InjectionsCapital Appropriation 4 450 4 450Equity Transfers In 16 321 16 321Other Equity Injections 0 0Specific Purpose PaymentsNational Partnership Payments 654 654Commonwealth - CapitalEquity WithdrawalsCapital Withdrawal (1 830) (1 830)Equity Transfers Out (1 723) (1 723)406 597 0 17 871 517 468Total Equity at End of Financial Year406 068 17 436 17 871 441 375This Statement of Changes in Equity is to be read in conjunction with the notes to the financial statements.Department Health and Families 175

Cash Flow StatementNOTE2010$’0002009$’000CASH FLOWS FROM OPERATING ACTIVITIESOperating ReceiptsTaxes ReceivedGrants and Subsidies ReceivedCurrent 55 491 232 856Capital 1 445 0AppropriationOutput 743 087 689 823Commonwealth 211 141 35 497Receipts From Sales of Goods And Services 88 688 93 758Interest Received 0 0Total Operating Receipts 1 099 852 1 051 933Operating PaymentsPayments to Employees (556 367) (492 247)Payments for Goods and Services (351 237) (348 410)Grants and Subsidies PaidCurrent (166 070) (155 234)Capital (879) (3 633)Community Service Obligations (9 410) (4 981)Interest Paid 0 0Total Operating Payments (1 083 965) (1 004 505)Net Cash From/(Used In) Operating Activities 17 15 888 47 428CASH FLOWS FROM INVESTING ACTIVITIESInvesting ReceiptsProceeds from Asset Sales 0 5Total Investing Receipts 0 5Investing PaymentsPurchases of Assets (9 689) (8 629)Advances and Investing Payments 0 0Total Investing Payments (9 689) (8 629)Net Cash From/(Used In) Investing Activities (9 689) (8 624)CASH FLOWS FROM FINANCING ACTIVITIESFinancing ReceiptsProceeds of BorrowingsDeposits Received 377 (16)Equity InjectionsCapital Appropriation 4 495 4 450Commonwealth Appropriation 2 330 654Other Equity Injections 1 072 0Total Financing Receipts 8 274 5 088Financing PaymentsRepayment of BorrowingsFinance Lease Payments 19 0 0Equity Withdrawals (25 004) (1 830)Total Financing Payments (25 004) (1 830)Net Cash From/(Used In) Financing Activities (16 730) 3 258Net Increase/(Decrease) in Cash Held (10 531) 42 062Cash at Beginning of Financial Year 78 950 36 888CASH AT END OF FINANCIAL YEAR 7 68 419 78 950The Cash Flow Statement is to be read in conjunction with the notes to the financial statements176Department Health and Families

Index Notes to the Financial StatementsINDEX OF NOTES TO THE FINANCIAL STATEMENTS1 Objectives and Funding2 3 Comprehensive Operating Statement by Output GroupINCOME4 Goods and Services Received Free of Charge5 Gain on Disposal of AssetsEXPENSES6 Purchases of Goods and ServicesASSETS7 Cash and Deposits8 Receivables9 Inventories10 Property, Plant and Equipment11a11cIntangiblesHeritage and Cultural AssetsLIABILITIES12 Payables13 Borrowings and Advances14 Provisions15 Other LiabilitiesEQUITY16 ReservesOTHER DISCLOSURES17 Notes to the Cash Flow Statement18 Financial Instruments19 Commitments20 Contingent Liabilities and Contingent Assets21 Events Subsequent to Balance Date22 23 Write-offs, Postponements and Waivers24 Schedule of Territory ItemsDepartment Health and Families 177

1. Objectives and fundingThe Department of Health and Families’ mission is to improve the health status and wellbeing of all peoplein the Northern Territory.Additional information in relation to the Department of Health and Families and its principal activities maybe found in section Department at a Glance of the Annual Report.The Department is predominantly funded by, and is dependent on the receipt of Parliamentary appropriations.functions and deliver outputs. For reporting purposes, outputs delivered by the Agency are summarisedOperating Statement by Output Group.2. Statement of significant accounting policiesa) Basis of Accounting Management Act and related Treasurer’s Directions. The Financial Management Act requires the cost convention. Accounting Standards. The effects of all relevant new and revised Standards and Interpretations issued bythe Australian Accounting Standards Board (AASB) that are effective for the current annual reporting periodhave been evaluated. The Standards and Interpretations and their impacts are:AASB 101 Presentation of Financial Statements (September 2007), AASB 2007-8 Amendments toAustralian Accounting Standards arising from AASB 101, AASB 2007-10 Further Amendments to AustralianAccounting Standards arising from AASB 101.This Standard has been revised and introduces a number of terminology changes as well as changesto the structure of the Comprehensive Operating Statement and Statement of Changes in Equity. OtherComprehensive Income is now disclosed in the Comprehensive Operating Statement and the Statement ofChanges in Equity discloses owner changes in equity separately from non-owner changes in equity.AASB 123 Borrowing Costs, AASB 2009-1 Amendments to Australian Accounting Standards – Borrowing178Department Health and Families

The revised Standard AASB 123 mandates the capitalisation of all borrowing costs attributable to thesector entities to continue to choose whether to expense or capitalise borrowing costs relating to qualifyingassets. The Standards do not impact the Financial Statements because Department of Health and Familieshas not changed its policy with regards to borrowing costs and continues to expense the costs.AASB 2009-2 Amendments to Australian Accounting Standards – Improving Disclosures aboutFinancial InstrumentsThe Standard amends AASB 7 Financial Instruments: Disclosures to require enhanced disclosures about fairvalue measurements. It establishes a three-level hierarchy for making fair value measurements, requiring thoseAASB 2009-6 Amendments to Australian Accounting Standards, AASB 2009-7 Amendments to AustralianAccounting Standards [AASB 5, 7, 107, 112, 136 & 139 and Interpretation 17]The Standards make editorial amendments to a range of Australian Accounting Standards and Interpretations.AASB 2009-6 also makes additional amendments as a consequence of the issuance of a revised AASB101 Presentation of Financial Statements (September 2007). These Standards do not impact the FinancialStatements.b) Australian Accounting Standards and Interpretations Issued but not yet Effectivein issue but not yet effective.Standard/Interpretation Summary Effective for annual reportingperiods beginning on or afterAASB 2009-5 Further amendmentsto Australian AccountingStandards arising from the annualimprovements project [AASB 5, 8,101, 107, 117, 118, 136 and 139]AASB 2009-13 Amendments toAustralian Accounting Standardsarising from interpretation 19AASB 124 Related partydisclosures (Dec 2009)AASB 2009-14 Amendmentsto Australian Interpretation –Prepayments of a minimum fundingrequirementAASB 9 Financial instrumentsAASB 2009-11 Amendments toAustralian Accounting Standardsarising from AASB 9 [AASB 1, 3, 4,5, 7, 101, 102, 108, 112, 118, 121,127, 128, 131, 132, 136, 139, 1023and 1038 and Interpretations 10and 12]Some amendments will result inaccounting changes for presentation,recognition or measurement purposes,while other amendments relate toterminology and editorial changes.Consequential amendment to AASB 1arising from publication of Interpretation19.Government related entities have beengranted partial exemption with certaindisclosure requirements.Amendment to Interpretation 14 arisingfrom the issuance of Prepayments of aminimum funding requirement1 of the IASB’s project to replace IAS39 Financial instruments: recognitionand measurement (AASB 139Financial Instruments: recognition andmeasurement).This gives effect to consequentialchanges arising from the issuance ofAASB 9.1 Jan 20101 Jul 20101 Jan 20111 Jan 20111 Jan 20131 Jan 2013Department Health and Families 179

c) Agency and Territory Itemsand equity over which the Department of Health and Families has control (Agency items). Certain items,while managed by the Agency, are controlled and recorded by the Territory rather than the Agency (Territoryitems). Territory items are recognised and recorded in the Central Holding Authority as discussed below.Central Holding AuthorityThe Central Holding Authority is the ‘parent body’ that represents the Government’s ownership interest inGovernment controlled entities.The Central Holding Authority also records all Territory items, such as income, expenses, assets andliabilities controlled by the Government and managed by Agencies on behalf of the Government. The mainTerritory item is Territory income, which includes taxation and royalty revenue, Commonwealth generalThe Central Holding Authority also holds certain Territory assets not assigned to Agencies as well as certainTerritory liabilities that are not practical or effective to assign to individual Agencies such as unfundedsuperannuation and long service leave.The Central Holding Authority recognises and records all Territory items, and as such, these items are notitems managed on behalf of Government, these items have been separately disclosed in note 24 - Scheduleof Territory Items.d) Comparativesconsistency with current year disclosures.e) Presentation and Rounding of Amountsand have been rounded to the nearest thousand dollars, with amounts of $500 or less being rounded downto zero.f) Changes in Accounting PoliciesThere have been no changes to accounting policies adopted in 2009-10 as a result of management decisions.g) Accounting Judgements and Estimatesrecognised amounts of assets, liabilities, revenues and expenses and the disclosure of contingent liabilities.The estimates and associated assumptions are based on historical experience and various other factorsthat are believed to be reasonable under the circumstances, the results of which form the basis of makingthe judgements about the carrying values of assets and liabilities that are not readily apparent from othersources. Actual results may differ from these estimates.The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accountingestimates are recognised in the period in which the estimate is revised if the revision affects only that period,or in the period of the revision and future periods if the revision affects both current and future periods.180Department Health and Families

ond rate, estimates of future salary and wage levels and employee periods of service. using a discount rate based on the published 10-year Government bond rate. Doubtful Debts – Note 2(o), 8: Receivables & 18: Financial Instruments Depreciation and Amortisation – Note 2(k), Note 10: Property, Plant and Equipment and Note 11.h) Goods and Services TaxIncome, expenses and assets are recognised net of the amount of Goods and Services Tax (GST), exceptwhere the amount of GST incurred on a purchase of goods and services is not recoverable from theof the asset or as part of the expense.Receivables and payables are stated with the amount of GST included. The net amount of GST recoverablefrom, or payable to, the ATO is included as part of receivables or payables in the Balance Sheet. i) Income RecognitionIncome encompasses both revenue and gains.Income is recognised at the fair value of the consideration received, exclusive of the amount of goodsand services tax (GST). Exchanges of goods or services of the same nature and value without any cashconsideration being exchanged are not recognised as income.Grants and Other ContributionsGrants, donations, gifts and other non-reciprocal contributions are recognised as revenue when the Agencyobtains control over the assets comprising the contributions. Control is normally obtained upon receipt.Contributions are recognised at their fair value. Contributions of services are only recognised when a fairvalue can be reliably determined and the services would be purchased if not donated.AppropriationOutput Appropriation is the operating payment to each agency for the outputs they provide and is calculatedas the net cost of Agency outputs after taking into account funding from Agency income. It does not includeany allowance for major non-cash costs such as depreciation.Commonwealth appropriation follows from the Intergovernmental Agreement on Federal FinancialRelations, resulting in Special Purpose Payments and National Partnership payments being made by theCommonwealth Treasury to state treasuries, in a manner similar to arrangements for GST payments. Thesepayments are received by Treasury on behalf of the Central Holding Authority and then on passed to therelevant agencies as Commonwealth Appropriation.Department Health and Families 181

Revenue in respect of Appropriations is recognised in the period in which the Agency gains control of the funds.Sale of GoodsRevenue from the sale of goods is recognised (net of returns, discounts and allowances) when: the Agency retains neither continuing managerial involvement to the degree usually associated with the costs incurred or to be incurred in respect of the transaction can be measured reliably.Rendering of ServicesRevenue from rendering services is recognised by reference to the stage of completion of the contract.The revenue is recognised when:Interest RevenueGoods and Services Received Free of ChargeGoods and services received free of charge are recognised as revenue when a fair value can be reliablydetermined and the resource would have been purchased if it had not been donated. Use of the resourceis recognised as an expense.Disposal of AssetsA gain or loss on disposal of assets is included as a gain or loss on the date control of the asset passesto the buyer, usually when an unconditional contract of sale is signed. The gain or loss on disposal iscalculated as the difference between the carrying amount of the asset at the time of disposal and the netproceeds on disposal. Refer also to note 5.Contributions of AssetsContributions of assets and contributions to assist in the acquisition of assets, being non-reciprocal transfers,are recognised, unless otherwise determined by Government, as gains when the Agency obtains control ofthe asset or contribution. Contributions are recognised at the fair value received or receivable.j) Repairs and Maintenance ExpenseFunding is received for repairs and maintenance works associated with Agency assets as part of OutputRevenue. Costs associated with repairs and maintenance works on Agency assets are expensed as incurred.k) Depreciation and Amortisation ExpenseItems of property, plant and equipment, including buildings but excluding land, have limited useful lives andare depreciated or amortised using the straight-line method over their estimated useful lives.182Department Health and Families

Amortisation applies in relation to intangible non-current assets with limited useful lives and is calculatedand accounted for in a similar manner to depreciation.The estimated useful lives for each class of asset are in accordance with the Treasurer’s Directions and aredetermined as follows:BuildingsRemote HousingPlant and Equipment (refer below)Computer HardwareFurniture & Fittings, Security SystemsCatering Equipment, Temperature Control SystemsLeased Plant and EquipmentHeritage and Cultural AssetsIntangibles50 Years25 Years4 to 15 Years4 Years5 Years9 Years10 Years15 Years3 Years100 Years3 to 6 YearsAssets are depreciated or amortised from the date of acquisition or from the time an asset is completed andheld ready for use.l) Interest Expensein which they are incurred.m) Cash and DepositsFor the purposes of the Balance Sheet and the Cash Flow Statement, cash includes cash on hand, cashat bank and cash equivalents. Cash equivalents are highly liquid short-term investments that are readilyn) InventoriesInventories include assets held either for sale (general inventories) or for distribution at no or nominalconsideration in the ordinary course of business operations.General inventories are valued at the lower of cost and net realisable value, while those held for distributionare carried at the lower of cost and current replacement cost. Cost of inventories includes all costs associatedwith bringing the inventories to their present location and condition. When inventories are acquired at no ornominal consideration, the cost will be the current replacement cost at date of acquisition.Inventory held for distribution are regularly assessed for obsolescence and loss.Department Health and Families 183

o) ReceivablesReceivables include accounts receivable and other receivables and are recognised at fair value less anyallowance for impairment losses.The allowance for impairment losses represents the amount of receivables the Agency estimates are likelyto be uncollectible and are considered doubtful. Analyses of the age of the receivables that are past due asat the reporting date are disclosed in an aging schedule under credit risk in Note 18 Financial Instruments.Reconciliation of changes in the allowance accounts is also presented.Accounts receivable are generally settled within 30 days and other receivables within 30 days.p) Property, Plant and EquipmentAcquisitionsAll items of property, plant and equipment with a cost, or other value, equal to or greater than $5,000are recognised in the year of acquisition and depreciated as outlined below. Items of property, plant andequipment below the $5,000 threshold are expensed in the year of acquisition.The construction cost of property, plant and equipment includes the cost of materials and direct labour, andComplex AssetsMajor items of plant and equipment comprising a number of components that have different useful lives, areaccounted for as separate assets. The components may be replaced during the useful life of the complex asset.Subsequent Additional CostsCosts incurred on property, plant and equipment subsequent to initial acquisition are capitalised when it isthey are accounted for as separate assets and are separately depreciated over their expected useful lives.Construction (Work in Progress)As part of Financial Management Framework, the Department of Construction and Infrastructure isresponsible for managing general government capital works projects on a whole of Government basis.Therefore appropriation for most capital works is provided directly to the Department of Construction andInfrastructure and the cost of construction work in progress is recognised as an asset of that Department.Once completed, capital works assets are transferred to the Agency.q) Revaluations and ImpairmentRevaluation of AssetsSubsequent to initial recognition, assets belonging to the following classes of non-current assets are revaluedtheir fair value at reporting date: Buildings.184Department Health and Families

Fair value is the amount for which an asset could be exchanged, or liability settled, between knowledgeable,willing parties in an arms length transaction.Plant and equipment are stated at historical cost less depreciation, which is deemed to equate to fair value.Impairment of AssetsAn asset is said to be impaired when the asset’s carrying amount exceeds its recoverable amount.Non-current physical and intangible Agency assets are assessed for indicators of impairment on anannual basis. If an indicator of impairment exists, the Agency determines the asset’s recoverable amount.The asset’s recoverable amount is determined as the higher of the asset’s depreciated replacement costand fair value less costs to sell. Any amount by which the asset’s carrying amount exceeds the recoverableamount is recorded as an impairment loss.Impairment losses are recognised in the Comprehensive Operating Statement unless the asset is carriedat a revalued amount. Where the asset is measured at a revalued amount, the impairment loss is offsetagainst the Asset Revaluation Surplus for that class of asset to the extent that an available balance existsin the Asset Revaluation Surplus.In certain situations, an impairment loss may subsequently be reversed. Where an impairment lossis subsequently reversed, the carrying amount of the asset is increased to the revised estimate of itsrecoverable amount. A reversal of an impairment loss is recognised in the Comprehensive OperatingStatement as income, unless the asset is carried at a revalued amount, in which case the impairmentreversal results in an increase in the Asset Revaluation Surplus. Note 16 provides additional information inrelation to the Asset Revaluation Surplus.r) Leased AssetsLeases under which the Agency assumes substantially all the risks and rewards of ownership of an assetFinance LeasesFinance leases are capitalised. A leased asset and a lease liability equal to the present value of the minimumlease payments are recognised at the inception of the lease.Lease payments are allocated between the principal component of the lease liability and the interest expense.Operating LeasesOperating lease payments made at regular intervals throughout the term are expensed when the payments recognised as an integral part of the consideration for the use of the leased asset. Lease incentives are tobe recognised as a deduction of the lease expenses over the term of the lease.s) PayablesLiabilities for accounts payable and other amounts payable are carried at cost which is the fair value of theconsideration to be paid in the future for goods and services received, whether or not billed to the Agency.Accounts payable are normally settled within 30 days.Department Health and Families 185

t) Employee Benefitsmeasured at present value, calculated using the Government long term bond rate.No provision is made for sick leave, which is non-vesting, as the anticipated pattern of future sick leave tobe taken is less than the entitlement accruing in each reporting period.As part of the Financial Management Framework, the Central Holding Authority assumes the long serviceleave liabilities of Government Agencies, including Department of Health and Families and as such no longu) SuperannuationEmployees’ superannuation entitlements are provided through the: non-government employee nominated schemes for those employees commencing on or after 10 August 1999.The Agency makes superannuation contributions on behalf of its employees to the Central Holding Authorityor non-government employee nominated schemes. Superannuation liabilities related to governmentsuperannuation schemes are held by the Central Holding Authority and as such are not recognised inv) Contributions by and Distributions to GovernmentThe Agency may receive contributions from Government where the Government is acting as owner of theAgency. Conversely, the Agency may make distributions to Government. In accordance with the FinancialManagement Act and Treasurer’s Directions, certain types of contributions and distributions, includingthose relating to administrative restructures, have been designated as contributions by, and distributions to,Government. These designated contributions and distributions are treated by the Agency as adjustmentsto equity.The Statement of Changes in Equity provides additional information in relation to contributions by, anddistributions to, Government.w) CommitmentsDisclosures in relation to capital and other commitments, including lease commitments are shown at note19 and are consistent with the requirements contained in AASB 101, AASB 116 and AASB 117.Commitments are those contracted as at 30 June where the amount of the future commitment can bereliably measured.186Department Health and Families

3. Comrehensive operating statement by output groupINCOMENote Acute Services NT Families andChildren2010$’0002009$’0002010$’0002009$’000Health and Wellbeing Public HealthServices2010$’0002009$’0002010$’0002009$’000Total OutputsTaxation Revenue 0 0 0 0 0 0 0 0 0 0Grants and Subsidies RevenueCurrent 12,987 153,557 4,899 12,218 35,227 55,021 3,380 14,197 56,493 234,993Capital 0 0 0 0 25 0 0 0 25 0AppropriationOutput 389,149 360,083 91,404 77,655 220,080 210,578 42,455 41,509 743,087 689,825Commonwealth 159,150 21,768 13,929 2,677 27,040 9,275 11,022 1,777 211,141 35,497Sales of Goods and Services 39,685 32,630 109 67 4,473 3,644 268 222 44,534 36,563Interest Revenue 0 0 0 0 0 0 0 0 0 0Goods and Services Received Free of Charge 4 17,110 15,876 2,192 2,034 8,201 7,610 1,487 1,380 28,990 26,899Gain on Disposal of Assets 5 3 (17) 0 0 1 (21) 0 0 4 (38)Other Income 959 2,153 254 410 2,973 1,881 1,726 382 5,913 4,826TOTAL INCOME 619,043 586,050 112,787 95,061 298,019 287,988 60,338 59,467 1,090,187 1,028,565EXPENSESEmployee Expenses 355,023 316,737 40,288 30,884 147,196 134,833 25,364 22,062 567,870 504,517Administrative ExpensesPurchases of Goods and Services 6 206,820 186,083 15,793 11,340 66,637 62,107 14,143 12,510 303,393 272,040Repairs and Maintenance 13,992 13,628 990 966 3,702 3,616 671 657 19,355 18,867Depreciation and Amortisation 10, 11 14,143 13,470 1,600 1,564 5,903 5,443 917 873 22,564 21,350Other Administrative Expenses (1) 17,374 16,571 2,194 2,399 8,204 7,667 1,487 1,381 29,258 28,018Grants and Subsidies ExpensesCurrent 21,285 26,468 52,722 44,977 73,291 68,042 19,290 18,434 166,588 157,922Capital 0 0 492 2,970 72 663 0 348 564 3,981Community Service Obligations 0 0 8 0 9,915 5,092 0 0 9,923 5,092Interest Expenses 18 0 0 0 0 0 0 0 0 0 02010$’0002009$’000Department Health and Families 187

3. Comrehensive operating statement by output group continued...TOTAL EXPENSES 628,637 572,957 114,087 95,100 314,920 287,463 61,872 56,265 1,119,514 1,011,787NET SURPLUS/(DEFICIT) (9,594) 13,093 (1,300) (39) (16,900) 525 (1,534) 3,202 (29,328) 16,776OTHER COMPREHENSIVE INCOMEAsset Revaluation Surplus 189,417 0 0 0 39,290 0 0 660 228,707 660TOTAL OTHER COMPREHENSIVE INCOME 189,417 0 0 0 39,290 0 0 660 228,707 660COMREHENSIVE RESULT 179,823 13,093 (1,300) (39) 22,390 525 (1,534) 3,862 199,379 17,436This Comprehensive Operating Statement by Output Group is to be read in conjunction with the notes to the financial statements.1 Includes DBE service charges.188Department Health and Families

2010$'0002009$'0004. GOODS AND SERVICES RECEIVED FREE OFCHARGEDepartment of Business and Employment 28 990 26 89928 990 26 8995. GAIN ON DISPOSAL OF ASSETSNet proceeds from the disposal of non-current assets 4 10Less: Carrying value of non-current assets disposed (0) (48)Gain on the disposal of non-current assets 4 (38)6. PURCHASES OF GOODS AND SERVICESThe net surplus/(deficit) has been arrived at after charging the followingexpenses:Goods and Services Expenses:Property Maintenance 7 788 7 452General Property Management 4 831 2 268Power 13 174 12 975Water and Sewerage 1 160 1 096Accommodation 3 198 3 528Advertising (1) 64 58Audit Fees 336 55Bank Charges 73 41Client Travel 32 476 30 908Clothing 340 279Communications 5 940 6 358Consultant Fees (2) 3 383 3 183Consumables/General Expenses 6 632 5 401Cross Border Patient Charges 28 935 19 769Document Production 1 192 988Entertainment/Hospitality 332 270Food 4 279 4 072Freight 1 671 1 590Information Technology Charges 23 936 22 998IT Consultants 4 235 4 719IT Hardware and Software Expenses 4 093 3 602Insurance Premiums 42 39Laboratory Expenses 5 726 5 184Legal Expenses (4) 4 100 3 446Library Services 1 161 1 175Marketing and Promotion (3) 2 511 1 594Medical/Dental Supply and Services 91 742 80 307Membership and Subscriptions 959 886Motor Vehicle Expenses 11 934 11 250Office Requisites and Stationery 3 153 3 149Official Duty Fares 9 258 9 783Other Equipment Expenses 6 786 7 603Recruitment Expenses (5) 8 495 7 093Reg/Advisory Boards/Committees 402 355Relocation Expenses 850 769Training and Study Expenses 5 267 4 719Transport Equipment Expenses 185 396Travelling Allowance 2 786 2 582Department Health and Families 189

2010$'0002009$'000Note 6 (cont)Unallocated Corporate Credit Card Expenses (40) 78Penalty Interest – Late Payments 6 18Goods and Services Cost Allocation 3 3303 393 272 040(1) Does not include recruitment advertising or marketing and promotion advertising.(2) Includes marketing, promotion and IT consultants.(3) Includes advertising for marketing and promotion but excludes marketing andpromotion consultants’ expenses, which are incorporated in the consultants’ category.(4) Includes legal fees, claim and settlement costs.(5) Includes recruitment related advertising costs.7. CASH AND DEPOSITSCash on Hand 23 22Cash at Bank 68 396 78 92868 419 78 9508. RECEIVABLESCurrentAccounts Receivable 3 715 3 918Less: Allowance for Impairment Losses ( 873) (1 186)2 842 2 732GST Receivables 4 111 4 053Other Receivables (1) 23 128 17 20727 239 21 260Total Receivables 30 081 23 992(1) Other receivables includes accrued revenue for cross border patient charges,Grants and subsidies and Department of Veteran Affairs revenue.9. INVENTORIESInventories Held for DistributionAt current replacement cost 6 876 6 235Total Inventories 6 876 6 235During the year the Department of Health and Families was required to write-off $0.179m ($0.160m in 2008-09) ofinventories, the majority being pharmaceuticals due to their short shelf life and the necessity to keep certain life saving itemson hand.190Department Health and Families

10. PROPERTY, PLANT AND EQUIPMENT2010$'0002009$'000LandAt Fair Value (1) 27 744 17 847BuildingsAt Fair Value (1) 1 030 482 715 015Less: Accumulated Depreciation (338 234) (323 043)Less: Accumulated Impairment Losses (2) (81 341) (1 126)610 906 390 846Construction (Work in Progress)At Capitalised Cost (3) 39 257 95339 257 953Plant and EquipmentAt Cost 85 218 73 925Less: Accumulated Depreciation (48 548) (41 478)36 670 32 447Leased Plant and EquipmentAt Capitalised Cost 175 501Less: Accumulated Depreciation (175) (501)0 0Total Property, Plant and Equipment 714 577 442 093(1) Property, Plant and Equipment ValuationsAn independent valuation was undertaken by the Australian Valuation Office (AVO) as at 30 June 2010 for the five hospitalsand the remote health clinics.The fair value of these assets was determined based on any existing restrictions on asset use. Where reliable marketvalues were not available, the fair value of these assets was based on their depreciated replacement cost.(2) Impairment of Property, Plant and EquipmentAgency property assets were assessed for impairment as at 30 June 2010. Impairment changes for Buildings wererecognised in the Asset Revaluation Surplus.(3) Construction (Work in Progress)Primarily relates to RDH Radiation Oncology Unit, RDH National Trauma Centre and ASH Fire Protection & Airconditioning.Department Health and Families 191

10 PROPERTY, PLANT AND EQUIPMENT (Continued)2010 Property, Plant and Equipment ReconciliationsA reconciliation of the carrying amount of property, plant and equipment at the beginning and end of 2009-10 is set out below:Land Buildings Construction(Work inProgress)Plant &EquipmentLeasedPlant &EquipmentTotal$’000 $’000 $’000 $’000 $’000 $’000Carrying Amount as at1 July 200917 847 390 846 953 32 447 0 442 093Additions 376 9 313 9 689DisposalsDepreciation (15 191) (7 327) (22 519)Additions/(Disposals) fromAdministrative RestructuringAdditions/(Disposals) from3 436 12 630 38 303 2 237 56 606Asset TransfersRevaluation6 461 222 246 228 707Increments/(Decrements)Impairment LossesImpairment Losses ReversedCarrying Amount as at 30June 201027 744 610 906 39 257 36 670 0 714 5772009 Property, Plant and Equipment ReconciliationsA reconciliation of the carrying amount of property, plant and equipment at the beginning and end of 2008-09 is set out below:Land Buildings Construction(Work inProgress)Plant &EquipmentLeasedPlant &EquipmentTotal$’000 $’000 $’000 $’000 $’000 $’000Carrying Amount as at1 July 200816 183 391 975 71 31 371 0 439 599Additions 827 7 802 8 629Disposals (48) (48)Depreciation (14 558) (6 746) (21 305)Additions/(Disposals) fromAdministrative RestructuringAdditions/(Disposals) from1 004 12 601 882 71 14 558Asset TransfersRevaluation660 660Increments/(Decrements)Impairment LossesImpairment Losses ReversedCarrying Amount as at 30June 200917 847 390 846 953 32 447 0 442 093192Department Health and Families

11aINTANGIBLES2010$'000Carrying amountsIntangibles with a finite useful life(a) Internally generated intangiblesAt valuation 4 161 4 161Less: Accumulated Amortisation (4 074) (4 029)Written down value – 30 June 87Total Intangibles 87Reconciliation of movementsIntangibles with a finite useful life(a) Internally generated intangiblesCarrying amount at 1 July 132AdditionsDisposalsDepreciation and Amortisation (45)Additions/(Disposals) from Administrative RestructuringAdditions/(Disposals) from Asset TransfersRevaluation Increments/(Decrements)Impairment LossesImpairment Losses ReversedOther MovementsCarrying Amount as at 30 June 87Department Health and Families 193

11c HERITAGE AND CULTURAL ASSETS2010$'0002009$'000Carrying amountAt valuation 5 5Less: Accumulated Depreciation 0 0Written down value – 30 June 5 5Reconciliation of movementsCarrying amount at 1 July 5 5AdditionsDisposalsDepreciation 0 0Additions/(Disposals) from Administrative RestructuringAdditions/(Disposals) from Asset TransfersRevaluation Increments/(Decrements)Impairment LossesImpairment Losses ReversedOther MovementsCarrying Amount as at 30 June 5 5Heritage and Cultural Assets ValuationThe Department of Health and Families has one Cultural Asset, which was capitalised at cost upon purchase in December2006.2010$’0002009$’00012. PAYABLESAccounts Payable 7 119 5 987Accrued Expenses (1) 56 187 41 238Other Payables (2) 6 304 5 621Total Payables 69 610 52 846(1) Includes liability for cross border patient expenses and other accrued operationalexpenses(2) Includes Grants and Subsidies and Community Service Obligations payable13. BORROWINGS AND ADVANCESCurrentLoans and Advances 0 0Finance Lease Liabilities (refer note 19) 0 0Non-CurrentLoans and Advances 0 0Finance Lease Liabilities (refer note 19) 0 0Total Borrowing’s and Advances 0 0194Department Health and Families

14. PROVISIONSCurrentEmployee BenefitsRecreation Leave 36 073 31 585Leave Loading 6 788 5 655Recreation Leave Fares and other benefits 761 768Other Current ProvisionsOther Provisions – include provisions for Superannuation,Payroll Tax and Fringe Benefits Tax payable5 168 4 41648 790 42 424Non-CurrentEmployee BenefitsRecreation Leave 18 628 15 96918 628 15 969Total Provisions 67 418 58 393The Agency employed 5 917 employees as at 30 June 2010 (5 568 employeesas at 30 June 2009).2010$’0002009$’00015. OTHER LIABILITIESCurrentDeposits Held (1) 1 250 873Unearned Revenue (2) 2 814 1 015Total Other Liabilities 4 064 1 888(1) Accountable Officers Trust Account (see note 22) and other monies held on Trust.(2) Revenue received prior to services provided.16. RESERVESAsset Revaluation Surplus(i) Nature and Purpose of the Asset Revaluation SurplusThe asset revaluation surplus includes the net revaluation increments anddecrements arising from the revaluation of non-current assets. Impairmentadjustments may also be recognised in the Asset Revaluation Surplus.(ii) Movements in the Asset Revaluation SurplusBalance as at 1 July 13 900 13 240Increment/(Decrement) – Land 6 461 660Impairment (Losses)/Reversals - Land 0 0Increment/(Decrement) - Buildings 222 246 0Impairment (Losses)/Reversals - Buildings 0 0Balance as at 30 June 242 607 13 900Department Health and Families 195

2010$’0002009$’00017. NOTES TO THE CASH FLOW STATEMENTReconciliation of CashThe total of Agency Cash and Deposits of $68 419 recorded in the BalanceSheet is consistent with that recorded as ‘cash’ in the Cash Flow Statement.Reconciliation of Net Surplus/(Deficit) to Net Cash From Operating ActivitiesNet Surplus/(Deficit) (29 328) 16 776Non-Cash Items:Depreciation and Amortisation 22 564 21 350Asset Write-Offs/Write-Downs 45 39(Gain)/Loss on Disposal of Assets (10) 22Repairs and Maintenance – minor new works – non cash 58 20Capital Grants – non cash 32 0Changes in Assets and Liabilities:Decrease/(Increase) in Receivables (6 088) 10 508Decrease/(Increase) in Inventories (641) (230)Decrease/(Increase) in Prepayments 1 668 (1 223)Decrease/(Increase) in Other Assets 0 0(Decrease)/Increase in Payables 16 764 (9 741)(Decrease)/Increase in Provision for Employee Benefits 8 274 8 127(Decrease)/Increase in Other Provisions 752 819(Decrease)/Increase in Other Liabilities 1 798 961Net Cash From Operating Activities 15 888 47 428Non-Cash Financing and Investing ActivitiesNon Cash Asset TransfersDuring the financial year the Agency acquired land and buildings with anaggregate fair value of $56.731 million (2009:$16.321) by non cash assettransfers from Department of Construction and Infrastructure.196Department Health and Families

18. FINANCIAL INSTRUMENTS(a)A financial instrument is a contract that gives rise to a financial asset of one entity and a financial liability or equity instrument ofanother entity. Financial instruments held by the Department of Health and Families include cash and deposits, receivables andpayables. The Department of Health and Families has limited exposure to financial risks as discussed below.Categorisation of Financial InstrumentsThe carrying amounts of the Department of Health and Families financial assets and liabilities by category are disclosed in thetable below.2010 2009$000 $000Financial AssetsCash and deposits 68 419 78 950Loans and receivables 30 081 23 992Financial LiabilitiesFair value through profit and loss (FVTPL):Designated as at FVTPL 70 860 53 719(b)Credit RiskThe Agency has limited credit risk exposure (risk of default). In respect of any dealings with organisations external to Government,the Agency has adopted a policy of only dealing with credit worthy organisations and obtaining sufficient collateral or other securitywhere appropriate, as a means of mitigating the risk of financial loss from defaults.The carrying amount of financial assets recorded in the financial statements, net of any allowances for losses, represents theAgency’s maximum exposure to credit risk without taking account of the value of any collateral or other security obtained.ReceivablesReceivable balances are monitored on an ongoing basis to ensure that exposure to bad debts is not significant. A reconciliation andaging analysis of receivables is presented below.Aging of Aging of Impaired Net ReceivablesReceivablesReceivables$000 $000 $0002009-10Not Overdue 26 813 26 813Overdue for less than 30 Days 2 282 2 282Overdue for 30 to 60 Days 147 147Overdue for more than 60 Days 1 711 873 838Total 30 953 873 30 081Reconciliation of the Allowance for Impairment LossesOpening 1 186Written off during the year (358)Recovered during the year 2Increase/(decrease) in allowance recognised in profit or loss 43Total 873Department Health and Families 197

18. FINANCIAL INSTRUMENTS (continued)2008-09Not Overdue 22 307 22 307Overdue for less than 30 Days 1 122 1 122Overdue for 30 to 60 Days 345 345Overdue for more than 60 Days 1 404 1 186 218Total 25 178 1 186 23 992Reconciliation of the Allowance for Impairment Losses (a)Opening 807Written off during the year (128)Recovered during the year (6)Increase/(decrease) in allowance recognised in profit or loss 513Total 1 186(c) Liquidity riskLiquidity risk is the risk that the Agency will not be able to meet its financial obligations as they fall due. The Agency’sapproach to managing liquidity is to ensure that it will always have sufficient liquidity to meet is liabilities when they falldue.The following tables detail the Agency’s remaining contractual maturity for its financial assets and liabilities. It should benoted that these values are undiscounted, and consequently totals may not reconcile to the carrying amounts presentedin the Balance Sheet.2010 Maturity analysis for financial assets & liabilitiesFixed Interest RateVariable InterestLess than aYear1 to 5 YearsMore than5 YearsNon InterestBearingTotalWeightedAverage$’000$’000AssetsCash and deposits 68 419 68 419Receivables 30 081 30 081Total FinancialAssets:98 500 98 500$’000$’000$’000$’000%LiabilitiesDeposits Held 1 250 1 250Payables 69 610 69 610Total FinancialLiabilities:70 860 70 860198Department Health and Families

18. FINANCIAL INSTRUMENTS (continued)2009 Maturity analysis for financial assets & liabilitiesFixed Interest RateVariable InterestLess than aYear1 to 5 YearsMore than5 YearsNon InterestBearingTotalWeightedAverage$’000$’000AssetsCash and deposits 78 950 78 950Receivables 23 992 23 992Total FinancialAssets:102 942 102 942$’000$’000$’000$’000%LiabilitiesDeposits Held 873 873Payables 52 846 52 846Total FinancialLiabilities:53 719 53 719(d) Market RiskMarket risk is the risk that the fair value of future cash flows of a financial instrument will fluctuate because of changes inmarket prices. It comprises interest rate risk, price risk and currency risk.i) Interest Rate RiskThe Department of Health and Families is not exposed to interest rate risk as Agency financial assets and financial liabilitiesare non-interest bearing.ii)Price RiskThe Department of Health and Families is not exposed to price risk as the Department does not hold units in unit trusts.iii)Currency RiskThe Department of Health and Families is not exposed to currency risk as Department of Health and Families does not holdborrowings denominated in foreign currencies or transactional currency exposures arising from purchases in a foreigncurrency.Department Health and Families 199

18. FINANCIAL INSTRUMENTS (continued)(e)Net Fair ValueThe fair value of financial instruments is estimated using various methods. These methods are classified into the followinglevels:Level 1 – fair value is calculated using quoted prices in active markets. Instruments whose carrying amount is deemed to beequal to its fair value qualify for this level of classification.Level 2 – to be used for those instruments that cannot be classified as either Level 1 or Level 3.Level 3 – fair value is estimated using inputs other than quoted market data, for example, net present value.2010 Total Carrying Net Fair Value Net Fair Value Net Fair Value Net Fair ValueAmount Level 1 Level 2 Level 3Total$’000 $’000 $’000 $’000 $’000Financial AssetsCash and Deposits 68 419 68 419 68 419Receivables 30 081 30 081 30 081Total Financial Assets: 98 500 98 500 98 500Financial LiabilitiesDeposits Held 1 250 1 250 1 250Payables 69 610 69 610 69 610Total Financial Liabilities: 70 860 70 860 70 8602009 Total Carrying Net Fair Value Net Fair Value Net Fair Value Net Fair ValueAmount Level 1 Level 2 Level 3Total$’000 $’000 $’000 $’000 $’000Financial AssetsCash and Deposits 78 950 78 950 78 950Receivables 23 992 23 992 23 992Total Financial Assets: 102 942 102 942 102 942Financial LiabilitiesDeposits Held 873 873 873Payables 52 846 52 846 52 846Total Financial Liabilities: 53 719 53 719 53 719200Department Health and Families

19. COMMITMENTS2010$’0002009$’000(i)Capital Expenditure CommitmentsCapital expenditure commitments primarily relate to the purchase of Plant andEquipment. Capital expenditure commitments contracted for at balance date but notrecognised as liabilities are payable as follows:Within one year 1 445 4 257Later than one year and not later than five years 0 0Later than five years 0 01 445 4 257(ii)(iii)(iv)Other Expenditure CommitmentsOther non-cancellable expenditure commitments not recognised as liabilities arepayable as follows:Within one year 68 409 105 635Later than one year and not later than five years 41 047 18 364Later than five years 0 0109 457 123 999Operating Lease CommitmentsThe Agency leases equipment, predominately photocopiers under non-cancellableoperating leases expiring from 3 to 5 years. Leases generally provide the Agencywith a right of renewal at which time all lease terms are renegotiated. Futureoperating lease commitments not recognised as liabilities are payable as follows:Within one year 681 651Later than one year and not later than five years 717 972Later than five years 0 01 398 1 623Finance Lease CommitmentsThe Agency currently has no finance lease commitments.Within one year 0 0Later than one year and not later than five years 0 0Later than five years 0 0Total Minimum Finance Lease Payments: 0 0Less: future lease finance charges 0 0Total Finance Lease liabilities 0 0Current (note 13) 0 0Non-Current (note 13) 0 0Total Finance Lease Liabilities 0 0Department Health and Families 201

20. CONTINGENT LIABILITIES AND CONTINGENT ASSETSa) Contingent liabilitiesThe Department of Health and Families had no contingent liabilities as at 30 June 2010 or 30 June 2009.b) Contingent assetsThe Department of Health and Families had no contingent assets as at 30 June 2010 or 30 June 2009.21. EVENTS SUBSEQUENT TO BALANCE DATENo events have arisen between the end of the financial year and the date of this report that require adjustment to,or disclosure in these financial statements.22. ACCOUNTABLE OFFICER’S TRUST ACCOUNTIn accordance with section 7 of the Financial Management Act, an Accountable Officer’s Trust Account has beenestablished for the receipt of money to be held in trust. A summary of activity is shown below:Nature of Trust MoneyOpeningBalance1 July 2009Receipts Payments ClosingBalance30 June 2010Retention money 0 339 945 0 339 945Bond money 320 875 109 831 180 552 250 153Security Key deposits 7 186 750 3 563 4 374Unclaimed money 85 420 61 270 (1 861) 148 552413 482 511 796 182 254 743 023202Department Health and Families

23. WRITE-OFFS, POSTPONEMENTS AND WAIVERSAgency Agency Territory Items Territory Items2010$’000No. ofTrans.2009$’000No. ofTrans.Write-offs, Postponements and 389 651 122 413Waivers Under theFinancial Management ActRepresented by:Amounts written off, waived andpostponed by DelegatesIrrecoverable amounts payable to 217 617 77 297the Territory or an Agency writtenoffLosses or deficiencies of money 0 2 2 1written offPublic property written off 45 18 43 115Waiver or postponement of rightto receive or recover money orpropertyTotal written off, waived and 262 637 122 413Amounts written off, postponedand waived by the Treasurer2010$’000No. ofTrans.2009$’000No. ofTrans.Irrecoverable amounts payable tothe Territory or an Agency writtenoffLosses or deficiencies of moneywritten offPublic property written offWaiver or postponement of rightto receive or recover money orpropertyTotal written off, postponedand waived by the Treasurer127 14127 14 0 0Write-offs, Postponements andWaivers AuthorisedUnder Other Legislation (a) 14 2 51 7Department Health and Families 203

24. SCHEDULE OF TERRITORY ITEMSThe following Territory items are managed by the Department of Health andFamilies on behalf of the Government and are recorded in the Central HoldingAuthority (refer note 2(c)).TERRITORY INCOME AND EXPENSES2010$’0002009$’000IncomeTaxation RevenueGrants and Subsidies RevenueCurrent 0 0Capital 6 299 22 618Fees from Regulatory Services 591 866Other Income 72 1Total Income 6 962 23 485ExpensesCentral Holding Authority Income Transferred 6 962 23 485Total Expenses 6 962 23 485Territory Income less Expenses 0 0TERRITORY ASSETS AND LIABILITIESAssetsOther Receivables 0 0Total Assets 0 0LiabilitiesCentral Holding Authority Income Payable 0 0Total Liabilities 0 0Net Assets 0 0Capital Income relates to the following infrastructure projects funded through the Department of Construction and Infrastructure:1) Angurugu and Umbakumba Clinic Upgrade2) Radiation Oncology Unit (Alan Walker Cancer Care Centre)3) Palmerston Super Clinic4) Alice Springs Hospital co-generation project5) Transitional After Care Service Bees Creek two bedroom managers cottage204Department Health and Families

AppendicesDepartment Health and Families 205

Appendix IFunding to External ProvidersGrant funding to external service providers the Department of Health and Families (the(commonly called non-government organisations, NGOs) within the broader NorthernTerritory health and community services system. In 2009-10, the Department provided 662grants to 173 different external organisations or agencies. (hyperlink to External Funding list)The Department’s grant funding is provided as: time (e.g. up to 3 years) to support ongoing service delivery, projects or other activities,and/or purchase of equipment or other capital items, service improvements, time-limitedprojects or community events. these grants are diverse, including: people living in remote and urban areas, people dealingwith the impact of substance misuse, families and carers, young people, people who areageing, people with disabilities, people dealing with mental health issues, Aboriginal peopleand non-Aboriginal people. All Territory regional centres have grant-funded service outlets.The Department funds external organisations because it aims to: create opportunities for disadvantaged and marginalised groups to have a voice inpolicy and service planning which they may not otherwise have (e.g. through funding to take account of contemporary evidence on social determinants of health which indicatesthat improved health status requires strategies that address structural issues such asAboriginal community control, employment and education. promote, protect and improve the health and well-being of all Territorians in partnership create better pathways to services for individuals and communities by supporting NGOs contribute to establishing genuine partnerships between local communities and theAll Departmental service divisions are involved in managing service agreements andrelationships with NGOs, and ensuring that appropriate management, accountability andcontrol arrangements are in place over the payment, ongoing monitoring, and acquittal206Department Health and Families

of grants (see Table below for details of funding per Output Group). The Department’sFinancial Services Branch is involved in the administration of funding agreements and grantson government-NGO relations and also oversights the necessary Departmental systemsand business processes required for monitoring and managing grants and relationshipsprojects which resulted in: The formation of a non-Government Engagement Strategy Working Group.Grants $ Subsidies $ Total $Acute Care 24,028,401.67 24,028,401.67NT Families and Children 31,566,796.54 37,590.00 31,604,386.54Health and Wellbeing Services 56,138,721.25 6,122,866.15 62,261,587.40Public Health Services 19,424,400.79 19,424,400.79Department Health and Families 207

Appendix II2009-10 Capital and Minor Works Programs2009-10Program$0002010-11Program$0002009-10EquityTransferIn $000SummaryRevoted Works from 2008-09 56 514 40 193 50 694New Works in 2009-10 25 173 109 481 2 600New Works in 2010-11 0 39 313 0Land Acquisitions and Asset Transfers 0 0 3 436Total Program 81 687 188 987 56 7302009-10 Program – As published in the 2009-10 Budget Paper 4.2010-11 Program – As published in the 2010-11 Budget Paper 4.Equity Transfer In – transfer of the increased asset value from Department ofConstruction and Infrastructure for completed capital projects.Note: includes accumulated works from previous years.208Department Health and Families

2010-11Program$0002009-10EquityTransfer In$0002009-10Status as atProjectProgram $00030 June 2010Revoted Works from 2008-09Alice Springs HospitalElective Surgery Upgrade 310 341 0 Construction InFire Protection, Air-conditioning and Remediation 1 711 0 13 526Completed PUpgrade and Expand Existing Renal Facilities 2 870 870 0 In ProgressUpgrade Emergency Power, Water Reticulation and 2 925 0 0 Construction InElectrical Systems 3 ProgressUpgrade the Emergency Department 4 5 573 19 096 0TenderBulla – Upgrade Health Centre 350 0 507 D Completed t tiCasuarina – Sexual Assault Referral Centre Office Fit-out 0 0 647CompletedDarwin – Accommodation for Radiation Oncology Patients0 0 660Completedand CarersDarwin - Relocation to and Associated Fit-out of2 790 2 500 6 Darwin PlazaConstruction House, Casuarina Plaza and Darwin Plaza. 5 Completed,Casuarina Plaza InDarwin – Residential Care Facility 1 000 1 000 0 Project under reviewMiligimbi – Construct New Health Centre 6 4 500 4 500 0 f ltDesign t Phase iMinyerri – Upgrade Health Centre 460 160 0 Construction InRoyal Darwin HospitalUpgrade and Refurbish Staff Accommodation on2 000 2 308PCompletedCampusReplacement of Sterilisers 1 000 400 0CompletedTennant Creek Hospital – Fire Safety Upgrade (Stage 3) 700 0 1 941CompletedMinor New Works 2 969 0 4 844 Construction InCommonwealth Funded ProjectsAcross the Territory – Mobile Dental Clinic Rooms549 177 978PConstruction Inand Hearing Booths 7 ProgressAcross the Territory – Six 6 Self Care144 124 2 176CompletedHaemodialysis Facilities 8Across the Territory – Transportable Clinic Rooms 9 1 383 0 648 Construction InProgressAlice Springs Hospital – NT Clinical School1 550 0 0 Deleted fromResearch Facility (Baker Heart Institute and FlindersUniversity)Program - PrivatelyConstructedAreyonga – Upgrade Health Centre 631 0 730 Construction InGove District Hospital – Flexi-bed Respite Facility 1 156 0 135 Deleted P fromProgramJilkminggan – Upgrade Health Centre 647 0 656CompletedKatherine – Construct New Sobering Up Shelter 2 588 1 387 202 Construction InNhulunbuy – East Arnhem Special Care StaffAccommodation500 200 0 Construction P InProgressNhulunbuy – East Arnhem Transitional After Care500 200 0 Construction InFacilityProgressNgukurr – Upgrade Health Centre 750 646 0 Design PhaseNuigu – Well-Being Centre 0 1 109CompletedPalmerston Super Clinic 8 000 3 350 292 Construction InRoyal Darwin HospitalRadiation Oncology Unit 3 335 2 638 14 027PCompletedElective Surgery Theatre Upgrade 0 0 0CompletedNational Trauma Centre 1 405 0 3 728CompletedTennant Creek – Transitional After Care Facility 0 296 0 Construction InWadeye – Construct New Health Centre 7 218 2 308 545 Construction P InYirrkala – Upgrade Health Centre 0 0 1 030Completed P56 514 40 193 50 694Department Health and Families 209

New Works 2009-10Alice Springs HospitalFire Protection, Air-conditioning and 5 300Remediation 1Upgrade Emergency Power, Water 2 000Reticulation and Electrical Systems3Secure Care Facility 10 2 500Across the Territory – Additional2 000Accommodation for Victims of DomesticViolenceBarkly Region –Renal Facilities Expansion 2 449Darwin – Accommodation for Radiation 2 000Oncology Patients and Carers 7Royal Darwin HospitalSecure Care Facility and Relocation 2 000of Physiotherapy 11Upgrade and Refurbish Staff4 000Accommodation on Campus38 346 0 Construction inProgress10 783 0 Design Phase2 500 0 Design Phase0 0 Deleted fromProgram2 269 0 Tender EvaluationPhase198 0 Completed1 934 0 Physiotherapy has3 350 0 Construction inProgressMinor New Works 2 9242 216 2 220 Construction in25 173 61 5962 220New Works Added to the ProgramDuring 2009-10Alice Springs Hospital – Fit out forrelocated staff from Administration Ward0360 0 Design PhaseAlice Springs and Darwin - Renal Drop-In 075 380 CompletedCentresRenal-Ready Haemodialysis Rooms at0820 0 Construction InManingrida, Alpurrurulam and BarungaProgressRoyal Darwin Hospital – High Voltage043 500 0 Design PhasePower Upgrade 12Electrical System, Chiller and Stand-ByCommonwealth Funded ProjectsAlice Springs Hospital – Energy0 2500 Construction InEfficiency ProjectsProgressFly Creek – Supported0 5800Design PhaseAccommodation FacilityRoyal Darwin Hospital –0 2 3000Design PhaseEmergency Department FastTrack0 47 885380Total New Works for 2009-10 25,173 109 4812 600210Department Health and Families

New Works 2010-11Alice Springs – Construction of two eightbedsecure transitional care facilities forchildren and adultsBorroloola – Upgrade existing HealthCentreDarwin – Construction of two eight-bedsecure transitional care facilities for childrenand adultsKatherine Region –Renal Facilities0 5 900 0 DesignPhase0 800 0 DesignPhase0 3 500 0 DesignPhase0 2 836 0 DesignPhaseExpansionMinor New Works 0 7 677 DesignPhaseCommonwealth Funded ProjectsRoyal Darwin Hospital –Construction of a 50-unit patientaccommodation complex0 18 600 0 DesignPhaseTotal New Works for 2010-11 0 39 313 01 Alice Springs Hospital – Fire Protection, Air-conditioning and RemediationThis is an ongoing project to address the non-compliance of previous works carried out in 2001-02by John Holland Group. Work is being staged to accommodate decanting of individual areas.2 Alice Springs Hospital – Upgrade and Expand Existing Renal FacilitiesThis represents the balance of funds allocated to the project which has been privately outsourced.3 Alice Springs Hospital – Upgrade Emergency Power, Water Reticulation and Electrical SystemsThis is a staged project.4 Alice Springs Hospital – Upgrade the Emergency DepartmentThis project was delayed pending an application to the Australian Government Health and HospitalsFund for an additional $13.6 million which was subsequently been approved.5 Darwin - Relocation to and Associated Fit-out of Construction House, Casuarina Plaza andDarwin PlazaThis project is dependent on relocation of other agencies occupying these buildings.6 Milingimbi – Construct New Health Centre7 Across the Territory – Mobile Dental Clinic Rooms and Hearing BoothsUnits have been located in the following communities for ongoing child health checks. Ti Tree,Docker River, Laramba, Kintore, Ampilatwatja, Epenarra, Yuendumu, Papunya, Santa Teresa,Ali Curung, Alpurrurulam, Hermannsburg, Gapawiyak, Angurugu, Galiwinku, Maningrida, Nguiu,Oenpelli, Ngukurr, Lajamanu and Borroloola.Department Health and Families 211

Appendix IIILegislation ResponsibilitiesUnder the current Administrative Arrangements Order our Ministers are responsible foradministering a range of Acts and subordinate legislation. Collectively this includes responsibilityfor administering 47 pieces of legislation, 29 Acts and 18 subordinate regulations.Acts Administered by Independent Agencies Health and Community Services Complaints Act Menzies School of Health Research ActResponsibility administered by Department of Health and Families on behalf of theMinister for HealthCancer (Registration) Act Carers Recognition Act 2006 Emergency Medical Operations Act Food Act Health Practitioner Regulation (National Uniform Legislation) Act 2010 Health Practitioners Act Hospital Boards Act 2009 Human Tissue Transplant Act Medical Services Act Natural Death Act 1988 Poisons and Dangerous Drugs Act Private Hospitals and Nursing Homes Act Public Health Act Radiation Protection Act Therapeutic Goods and Cosmetics Act Tobacco Control ActVolatile Substance Abuse Prevention Act212Department Health and Families

Responsibility administered by Department of Health and Families on behalf of theMinister for Children and Families, Child Protection, Senior Territorians, Young Territorians,and Women’s Policy Adoption Of Children Act Adult Guardianship Act Care and Protection of Children Act Disability Services Act Guardianship of Infants Act Mental Health and Related Services Act Youth Justice ActRegulations Administered by Department of Health and Families Adoption of Children Regulations Cancer (Registration) Regulations Care and Protection of Children (Children’s Services) Regulations Health and Community Services Complaints Regulations Mental Health and Related Services Regulations Natural Death Regulations Poisons and Dangerous Drugs Regulations Public Health (Barbers’ Shops) Regulations Public Health (Cervical Cytology) Regulations Public Health (Medical and Dental Inspection of School Children) Regulations Public Health (General Sanitation, Mosquito Prevention, Rat Exclusion and Prevention)Regulations Public Health (Medical and Dental Inspection of School Children) Regulations Public Health (Night-Soil, Garbage, Cesspits, Wells And Water) Regulations Public Health (Noxious Trades) Regulations Public Health (Nuisance Prevention) Regulations Public Health (Shops, Boarding-Houses, Hostels and Hotels) Regulations Radiation Protection Regulations Tobacco Control Regulations Volatile Substance Abuse Prevention Regulations Youth Justice RegulationsDepartment Health and Families 213

Appendix IVCouncils, Committees and GroupsMinisterial Groups:Health Advisory CouncilCouncil was completed in December 2009.Expressions of interest were invited formembership for the second term of theCouncil was on 11 February 2010.Membership to December 2009Members of the Council to December2009 were:Chairperson:Dr Charles KilburnMembers:Ms Paula ArnolProf Jonathan CarapetisMs Yvonne FalckhDr Sarah GilesMs Fiona Justin,Ms Anne KempAssoc Prof Sabina KnightMs Margaret MasseyMr Eddie MulhollandMs Alisha PengellyDr Jill PettigrewDr Bruce SimmonsDr Brian SpainSecretariat:Victoria Walker, Director, GovernmentRelations and Strategic PolicyMeetings:Health Advisory Council meetings wereheld in July and November 2009.Membership at 30 June 2010Chairperson:Dr Sarah GilesMembers:Prof Jonathan CarapetisMs Alison FaignezMs Yvonne FalckhMs Anne KempAssoc Prof Sabina KnightDr Liz MooreMr Eddie MulhollandDr Didier PalmerDr Sanjit PauDr Jill PettigrewDr Bruce SimmonsMs Victoria Walker, Director, GovernmentRelations and Strategic PolicySecretariat:Ms Rosalyn Malyon, Health EconomistGovernment Relations and Strategic PolicyMeetings:Health Advisory Council meetings wereheld in February, April and May 2010.Key areas of terms of referenceUnder its terms of reference, the Councilwill:Provide informed and impartial advice andperspectives to the Minister for Health on:a) strategic issues that affect the health of b) effectiveness and appropriateness ofand 214Department Health and Families

Minister for Health.2. Consider health issues across the rangeof community, regional and sectoralinterests, as requested by the Ministerfor Health.Key Achievements:Both Councils have provided advice to theMinister for Health on a range of matterson presentations of key policies and newinitiatives of the Department.Council held a Round Table in May 2010,that looked at strategies to reduce alcoholrelated death and illness in the Territory.Disability Advisory CouncilMembership:The membership tenure of the 2007-2010Disability Advisory Council expired on30 July 2010. This rendered all positionsvacant. Membership during 2009-10consisted of:Chairperson:Bill Medley, West Arnhem ShireDeputy Chairperson:Meghan Williams, Carers NTMembers:Djapirri Mununggirritj, CommunityRepresentativeBonnie Solly, Somerville CommunityServicesWendy Morton, NT Council of SocialServicePenny Fielding, Director Aged andDisability Services, DHFRebecca Burgess, Program Manager,FaHCSIAMaria Marriner, General Manager StudentServices, DEETJoyce Bowden, Community RepresentativeSecretariat:Annamaree Wee, Management SupportMembers of the Council who left in 2009-10:Kay HolocekJoan MacphersonDebra LyonsJanine StewartNew Members of the Council in 2009-10:Joyce BowdenMeetingsThe council met in November 2009 andMay 2010. Key areas from terms ofreferenceUnder its terms of reference, the council will:1 Provide strategic and impartial adviceand perspectives to the Minister forChildren and Families Services on:a) matters affecting the best interests ofpeople with disabilitiesb) measures to support families andcommunities to adequately supportpeople with disabilitiesc) strategies that respond to thediverse needs and circumstances ofTerritorians with disabilities and theirfamilies.2. Contribute to and draw from thedeliberations of other governmentadvisory bodies as required. requested by the Minister for Childrenand Families Services or the DHF ChiefExecutive.4. Provide the mechanism for thecommunity and consumers to work withgovernment to progress an accessible,equitable, good quality and integrateddisability service system.5. Promote a whole of government andwhole of community approach inaddressing the range of issues facedby, and needs of, people with differingdisabilities.6. Consult with regional groups workingto enhance community services andparticipation for people with disabilities.Department Health and Families 215

7. Raise community awareness of the rightsof people with disabilities and the role ofgovernment, business and community.Key Achievements:Provided feedback on disability policy andstrategic direction. Developed a wholeof government approach on access andinclusion of people with disabilities. Thishas been supported by the employmentof a Project Manager – Disability Accesswithin the Department of Health andFamilies.Northern Territory Community AdvisoryGroup on Mental HealthMembership:Members of the Advisory Group as at 30June 2010 are:Chairperson:Doreen Dyer, Community RepresentativeDeputy Chairperson:Greg Johnson, Community RepresentativeWill McGregor, Community RepresentativeMembers:Alison Lillis, Community RepresentativeDoreen Dyer, Community RepresentativeMichelle Masters, CommunityRepresentativeEva Briscoe, Community RepresentativeChristine Sutton, Community RepMonte Karena, Community RepresentativeTess Narkle, Community RepresentativeBronwyn Hendry, Director Mental Health,Department of Health and FamiliesSecretariat:Members who left in 2009-10:Eva Briscoe (membership ceased 16 April2010) andWill Macgregor (membership ceased 8January 2010).Saturday 22 August 2009Saturday 5 December 2009Saturday 13 February 2010Saturday 22 May 2010.Key areas from terms of referenceUnder its terms of reference, the NTCAGwill:Provide an ongoing mechanism forconsumer and carer input into mentalhealth policy decision making processes,particularly in relation the National MentalHealth Plan and the Mental HealthStatement of Rights and Responsibilities.Assist the Minister in the formulation ofmental health policies, plans, associatedlegislation, monitor the implementation andensure Mental Health services meet theneeds of consumers and their carers.Provide advice and reports to the Minister onmatters relating to other departments, whichaffect the rights and welfare of consumersand their carers.Provide consumer and carer representationon the National Mental Health Consumerand Carer Forum.Promote the involvement of consumers andcarers in the formulation and implementationof national mental health policies.Provide advice to the Minister on othermatters relating to the needs of consumersand their carers in the Northern Territory.Key Achievements:Consumer and Carer Representativesattended the National Mental HealthConsumer and Carer Forums anddistributed a report of Northern Territorymental health issues and achievementsto all forum members. The groupMeetings:The Advisory Group met on:216Department Health and Families

conducted their own planning forum andmaintained representation on the ApprovedProcedures and Quality AssuranceCommittee and the Police and LiaisonCommittee.Senior Territorians Advisory CouncilThe Northern Territory Advisory Councilon Ageing ceased in October/November2008. After this date work commenced onthe development of new terms of referenceand guidelines for what is now called theSenior Territorians Advisory Council (STAC).Advertisements for membership of the STACwere called for in late August 2009 andmembers were appointed in December 2009.The STAC is an independent group formedas an advisory body for the Minister forSenior Territorians.Membership:STAC membership consists of nine people,diversity of the community to ensureequitable representation of all Territoryseniors. Current STAC membershipincludes:Janet Durling (Chair)Art Libien (Deputy Chair)Brian HilderLillian MannColin HardakerKathy MartinGraham KempBanambi Wunungmurra.(STAC) provides advice to the Ministerfor Senior Territorians on senior’s issues,government programs and policies andoutcomes for seniors in the Territory.2009-10 Key Achievements:Review of the Terms of ReferenceAppointment of a new Advisory Council.Inaugural meeting of the STAC.Development of a work plan.2010 Priorities:The STAC have developed a work plan toidentify priorities and provide a frameworkfor the council to work towards. The planwill be reviewed and updated regularly toof the Council.The current STAC priorities include:Ageing PolicyHousingCost of Living / Affordable ServicesHealthCommunicationTransportEmployment / Education.Resignations in 2010:Loraine BrahamSecretariat:Secretariat support is provided by the Agedand Disability Program.Meetings:and April 2010.Key Terms of Reference:The Senior Territorians Advisory CouncilDepartment Health and Families 217

Northern Territory Family and ChildrenAdvisory CouncilMembers of the Council as at 30 June2010 are:Chairperson:Jane LloydMembers:Charlie KingLiza BalmerNareen CarterMarilyn RobertsSusana SaffuFiona HussinRegina BennettGeoff StewartSally BoltonLisa BennetPaul RajanSecretariat:Meetings:The Terms of Reference provide for theNTFC Advisory Council to meet three timesper year.Council had input in 2009-10 requiredadditional meetings so six were held in:August 2009September 2009November 2009February 2010March 2010May 2010.Key areas from terms of reference1. Provide high-level knowledge-basedand impartial advice and perspectives tothe Minister for Children and Families.2. Provide a mechanism for experts fromthe community to work with governmentto progress an accessible, equitable,good quality and integrated servicesystem.3. Monitor and comment on the impactof public policy including the FamilyViolence Strategy and its mandatoryreporting on the community. requested by the Minister for Childrenand Families or the Chief Executive,Department of Health and Families.Key Achievements:Consultation with Colmar Brunton aboutresearch methodology and messages forthe development of a social marketingcampaign addressing the introduction ofmandatory reporting of domestic violencein the Northern Territory.Meeting with members of the Board ofInquiry into child protection in the NorthernTerritory and preparation of a writtensubmission to the Board of Inquiry.Establishment of a website promotingthe role of the NTFC Advisory Council,identifying individual members and providinglinks to related websites and resources.Northern Territory Youth JusticeAdvisory CommitteeMembershipMembers of the Committee as at 30 June2010 are:Chairperson:Antoinette Carroll, Youth Justice AdvocacyProject Worker, Central AustralianAboriginal Legal Aid ServiceMembers:Peter Curwen-Walker, General ManagerJuvenile Detention, NT CorrectionalServicesBarbara Kelly, NT Manager for SexualAssaults Referral Centre, NTFCSuzan Healy, Principal, Casuarina SeniorCollegeMichael White, Superintendent, NT Police,Fire and Emergency ServicesHelena Blundell General Criminal LawPractitioner, NT Legal Aid Commission,218Department Health and Families

Stewart Willey, Manager YouthDevelopment Unit, Julalikari CouncilAboriginal CorporationSecretariat:Meetings:The Advisory Committee met in September2009, March 2010 and June 2010. Ateleconference was also held in April 2010.Key areas from terms of reference:Monitor and evaluate the operation andadministration of the Youth Justice Act.Advise the Minister on issues relevant tothe administration of youth justice, includingthe planning, development , integration andimplementation of government policies andprograms concerning youth.Collect, analyse and provide to the Ministerinformation relating to issues and policiesconcerning youth justice.Key Achievements:Challenges, Possibilities and FutureDirection: a National Assessment ofAustralia’s Children’s Courts.Met and discussed with the YouthMagistrate, Ms Sue Oliver, concerns aboutnot having a separate Children’s Court.Continued to advocate for youth justice inthe Northern Territory.Northern Territory Youth Round TableThe Youth Round Table is convened ona calendar year basis and therefore thefollowing summarises the membershipand activities of the 2009 and 2010 RoundTables.Membership 2009Chairperson:Felicity WardleDeputy Chairperson:Larnie McClintockMembers:Cindy SchultzCraig PettiforElise MooEthan Woods-AlumHoneylyn LissonJessica CunninghamJustin HeimLuke PhillipsNicole ShottonRebecca HealyRebekah RaymondRobert PullinoSharah LyonsSteven PedlarSecretariat:Membership 2010Chairperson:Lauren MossDeputy Chairperson:Aroha JenningsMembers:Aaron DowlingAmelia Kunoth-MonksCeleste BrandDimity JessupElspeth BluntEun Ju Kim-BakerGavin HendersonHannah WoerleJoshua MayKelvia-Lee JohnsonKylie-Maree SamboRebecca RowberrySephyr CrookSkye ClaytonSecretariat:Meetings:The Youth Round Table meets quarterlyover a weekend in February, May andAugust and December.Department Health and Families 219

Key areas from terms of reference:The Youth Minister’s Round Table of YoungTerritorians is a direct communicationavenue between young Territorians andthe Northern Territory Government. TheRound Table consists of 16 memberswho are aged 15 to 25 years. RoundTable members are representative of thegeographic, cultural and ethnic diversity inthe Northern Territory.Membership term is one calendar year.Members meet four times a year withthe Minister for Young Territorians or anominated representative. Teleconferencesare held monthlyMembers consult with young peoplethroughout their communities and presentissues and concerns raised to government.Members provide a youth perspective andfeedback on government policy, programsand initiatives as required.Members conduct community-basedresearch projects on youth issues, andpresent recommendations to government atMembers attend events and consultationson invitation. Members develop networks topromote positive youth involvement in thecommunity and decision making roles.groups with young Territorians. Findingsfrom these focus groups were reported tothe NT Police Commissioner and the NTLicensing Commission.Round Table members provided input intothe House of Representatives inquiry intothe impact of violence on young Australians.This input was tabled in the report titled‘Avoid the Harm – Stay Calm’, which wasproduced in July 2010.Round Table members have conductedsurveys and focus groups with youngTerritorians on the use of alcohol and otherdrugs and the link to violent behaviour.Round Table members have establishedlinks with a variety of organisations wherethey can offer assistance and promotethe work being undertaken by young Neighbourhood Watch, Multicultural YouthNorthern Territory, Consumer Affairs, andthe NT Licensing Commission.Key Achievements 2009Felicity Wardle participated on aDepartment of Health and Families sexualhealth advisory groupUnited Nations Youth Associationconference April 2009Lions Youth of the Year Quest.2009 members also assisted, promoted andvolunteered at National Youth Week events.Key Achievements 2010Round Table members surveyed 492issues that affect their lives. The mainissues of alcohol and drug use and the linkto violence were discussed further in focus220Department Health and Families

Departmental Groups:Department of Health and Families’Executive Leadership GroupMembership:Members of the Group as at 30 June 2010are:Chairperson:Alan Wilson, A/Chief ExecutiveMembers:Clare Gardiner-Barnes, Executive DirectorNT Families and ChildrenJenny Cleary, Executive Director HealthServicesHelen Mason, A/Executive Director AcuteCare ServicesBarbara Paterson, Executive DirectorHealth ProtectionShane Houston, Executive DirectorSystems Performance and AboriginalPolicySecretariat:the CEMembers who left in 2009-10:David Ashbridge, Chief ExecutiveJenny Scott, Executive Director, NTFamilies and ChildrenMeetings:MonthlyKey areas from terms of referenceProvide governance direction for theDepartment of Health and Familiesstrategic committees: Strategic Workforce Committee Audit Committee OHS Steering Committee Resource Management Committee DHF Unions Consultative Committee Strategic Information ManagementSteering Committee Principal Quality and Safety Committee.Review organisational performance.Discuss and debate current, emerging, keyand critical issues.Decision making and establishingorganisational directions.Department of Health and Families &Unions Consultative CouncilMembershipMembers of the Council as at 30 June2010 are:Chairperson:(The role of the Chair alternated betweendepartmental and union representatives.)DHF Yvonne Falckh, NT Secretary, ANFDepartmental Members:Kate McTaggart, A/Senior Director Peopleand ServicesJan Evans, A/Deputy Chief Executive AcuteCareJenny Cleary, Executive Director HealthServicesClare Gardiner-Barnes, Executive Director,NT Families and ChildrenGreg Rickard, Principal Nursing AdvisorDanny Coombes, Industrial RelationsConsultantRon Hosking, Industrial RelationsConsultantVera Whitehouse, Assistant DirectorOrganisational LearningUnion representation:Yvonne Falckh, NT Secretary, AustralianNursing FederationPaul Morris, NT Regional Director,Community and Public Sector UnionMatthew Gardiner, NT Secretary, Liquor,Hospitality and Miscellaneous Workers’UnionAustralian Medical Association NT Inc.David Nebauer, NT President, Associationof Professional Engineers, Scientists andManagers, AustraliaBryan Wilkins, Territory Organiser,Department Health and Families 221

Australian Manufacturing Workers’ UnionOCPE representation:On an as required basis.Secretariat:Maria Jennings, Business Manager Peopleand Services, DHFMembers of the Council who left in2009-10:Peter Boyce, Senior Director Peopleand ServicesJenny Scott, Executive Director, NTFamilies and ChildrenAlan Wilson, Deputy Chief Executive AcuteCareMeetings:The Council met in August and DecemberKey areas from Terms of ReferenceThe Council is designed to provide a forumfor consultation and negotiation betweenDHF and Unions on matters of mutualconcern. The Council’s objectives are to:service by DHF for the Northern Territoryimprove a mutual understanding ofprovide a forum for consultation and opendiscussion between DHF senior staffand staff representatives with the aim ofresolving any differences in a mutuallyfacilitate the mutual exchange ofinformation.Key discussions:The main activity for the ConsultativeCouncil is to ensure that there is regularcommunication at the highest levelCommissioner for Public Employment andthe principal health unions about majorissues that affect the health workforce.Key discussions in 2009-10 included:Aboriginal Health Worker Professionalpayroll related matters.Outcomes of key discussions werereported to the DHF Executive LeadershipGroup.Strategic Workforce CommitteeMembershipMembers of the Committee as at 30 June2010 are:Chairperson:Members:the Chief ExecutiveAlan Wilson, Deputy Chief Executive AcuteCare ServicesVicki Taylor, General Manager AliceSprings HospitalShane Houston, Executive Director SystemPerformance and Aboriginal PolicyKate Mctaggart, A/Senior Director Peopleand ServicesLinda Blair, A/Director Strategic WorkforcePlanningClare Gardiner-Barnes, Executive Director,NT Families & ChildrenSally Matthews, Director Health ServicesPolicy,Greg Rickard, Principal Nursing AdvisorPeter Pangquee, Principal AboriginalHealth WorkerRenae Moore, Principal Allied HealthAdvisor222Department Health and Families

Alan Ruben, Principal Medical AdvisorSecretariat:Norma Box, Senior Consultant StrategicWorkforce PlanningMembers of the Committee who left in2009-10:Peter Boyce, Senior Director People andServicesRobin Osborne, Director Media andCorporate CommunicationsMichelle Brown, Director Policy andSystems Support, NT Families andChildrenMeetingsThe Committee met in August, October andJune in 2010.Key areas from Terms of ReferenceThe Strategic Workforce Committee isresponsible for steering, monitoring andreporting on a strategic agenda thatprovides leadership and direction in relationto human resource management, strategicworkforce planning, workforce developmentand reform across the Department. Theand direction in regard to aligning theDepartment’s workforce priorities to theendorsed priority actions areas containedwithin the key departmental plans.Key Achievements:Key activities undertaken in 2009-10included:training priorities and strategic workforceto service delivery models/educationpathways, strengthening educationlinkages with schools and managingCouncil of Australian Governments’participated in the development of theNorthern Territory Public Sector Capabilitysponsorship of Recruitment and Attractionsponsorship of Physical / Technical CareerAllied Health Professions Workforce PlanProfessional Practice Supervision andNursing Career Structure Review reportreport on expansion of access to the FringeOther key discussions included:Resource Management CommitteeMembershipMembers of the Committee as at 30 June2010 are:Chairperson:Shane Houston, Executive DirectorSystems Performance & Aboriginal PolicyMembers:Jan Evans, A/Executive Director AcuteCare ServicesJenny Cleary, Executive Director HealthServicesClare Gardiner Barnes, Executive DirectorNT Families & ChildrenKate McTaggart, A/Senior Director Peopleand ServicesRick Gowing, Director, Business Servicesthe Chief ExecutiveSecretariat:Jillian Frost, Executive AssistantDepartment Health and Families 223

Members of the Council who left in2009-10:Alan Wilson, Executive Director Acute CareServicesHelen Mason A/Executive Director AcuteCare ServicesJenny Scott Executive Director NT Families& ChildrenPeter Boyce Senior Director People andServicesMeetings:FortnightlyKey areas from terms of referenceThe Department of Health and Families’Resource Management Committeeundertakes the following functions onbehalf of the Chief Executive.Monitoring the delivery/effectiveness of thegiven resource.Building/understanding the relationshipsbetween current performance, futuredemand and likely supply so that we canbe more convincing in resource arguments.Building the best co-ordinated and timelysubmissions for resources for the nextyear.Monitoring implementation of Full TimeEquivalents and budget targets includingrevenue across the Department.Monitoring the implementation of thevarious capital programs including majorminor and equipment.Establishing and monitoring wherepossible a closer link between operationalperformance information and resourceimplications.Encouraging the development of earlyvariations.effectiveness of the middle manager.Resource Management training program.Oversight of the development of a one toavailable with government health strategiesand policies and service demands andcapacity to balance them.Oversight of the development of next years’budget submission including new serviceproposals, works and equipment priorities.Knowing and understanding the nature andimplications of Cabinet submissions likelyto effect resource allocations as they arebeing developed.Oversight of the development or variousresource strategies required by Cabinetstrategy to reduce energy consumption byAdvising the CE of actions necessary tooperate within budget.Audit CommitteeMembership:Members of the Committee as at 30 June2010 were:Chairperson:Iain Summers, Independent MemberDeputy Chairperson:Shane Houston, Executive DirectorSystems Performance & Aboriginal PolicyMembers:Secretariat:Jillian Frost, Executive AssistantMembers of the Committee who left in2009-10:Leigh Eldridge, Manager PolicyImplementation, DCMLachlan Miller, Director Risk & Assurance*224Department Health and Families

Meetings:The Committee met in August, Septemberand November in 2009 and February andMay in 2010.Key areas from terms of referenceThe Audit Committee undertakes thefollowing functions on behalf of the ChiefExecutive (CE):1. Monitor strategic risk management andthe adequacy of the internal controls2. Monitor the adequacy of theDepartment’s internal controlenvironment and review the adequacyof policies, practices and proceduresin relation to their contribution to andimpact on, the Department’s internalcontrol environment.3. Oversee the internal audit functionincluding development of audit programsand monitoring of audit outcomes andthe implementation of recommendations. public accountability documents (suchas annual reports) prior to their approvalby the CE.5. Assess the state of organisationalgovernance in the Department andrecommend strategies for improvement.6. Liaise with external auditors regardingaudits conducted and respective auditplans.7. Within the context of the committee’sprimary role, undertake any otherfunctions determined from time to timeby the CE.Key Achievements: Implementation of Internal Audit Manual Implementation of the RiskManagement and AssuranceFramework and implementation of the Corporate RiskManagement Policy and Guidelines.Strategic Information ManagementSteering CommitteeMembershipMembers of the Committee as at 30 June2009 are:Chairperson: Jill Macandrew, A/Chief Operationsthe CEMembers: Sally Matthews, Director HealthServices Policy Len Notaras, General Manager RoyalDarwin Hospital Jenny Scott, Executive Director NTFamilies & Children Barbara Paterson, A/Chief Health Peter Boyce, Senior Director Peopleand Services Richard Smith, Manager CorporateReporting Kate McTaggart, Director People andOrganisational Learning Steve Guthridge, Director Health GainsPlanning Branch Robin Smith, General ManagerKatherine Hospital Ian Pollock, A/Director SystemsPerformance David Ryan Acting Chief Financial Ann Ritchie, Director Library ServicesSecretariat:Jackie Plunkett, Project CoordinatorDepartment Health and Families 225

Meetings:The Committee met in July and October in2008 and February and May in 2009Key areas from terms of referenceThe Department’s Strategic InformationManagement Committee undertakes thefollowing functions on behalf of the ChiefExecutive (CE):1. Prioritise and approve investmentproposals in relation to major informationmanagement, knowledge managementand information and communicationstechnology initiatives.2. Set the strategic agenda for thedevelopment and use of informationtechnology, communications andinformation services across the agencyto underpin management decisionmaking and planning.3. Monitor delivery of major informationmanagement, knowledge managementand information & communicationstechnology work program initiatives.4. Provide direction in relation to theagency’s:a) involvement in national informationcommittees and health informationprojectsb) requirements in relation to wholeof-governmentinitiativesc) alignment with national strategies andstandardsd) development of information policiesand procedures.5. Consult with and communicate toInformation Management groups.6. Develop and periodically review thedepartment’s Information Strategy toensure alignment with the Department’sStrategic Directions and priorities.7. Communicate on progress andachievement of the Department’sInformation Strategy.management, knowledge managementand information and communicationstechnology initiatives.2. Set the strategic agenda for thedevelopment and use of informationtechnology, communications andinformation services across the agencyto underpin management decisionmaking and planning.3. Monitor delivery of major informationmanagement, knowledge managementand information & communicationstechnology work program initiatives.4. Provide direction in relation to theagency’s:a) involvement in national informationcommittees and health informationb) requirements in relation to whole-of-c) alignment with national strategies andd) development of information policiesand procedures.5. Consult with and communicate toInformation Management groups.6. Develop and periodically review thedepartment’s Information Strategy toensure alignment with the Department’sStrategic Directions and priorities.7. Communicate on progress andachievement of the Department’sInformation Strategy.Key Achievement: Development of the StrategicInformation Plan 2009-2012.Key Achievements: Development of the StrategicInformation Plan 2009-2012.Management Committee undertakes thefollowing functions on behalf of the ChiefExecutive (CE):1. Prioritise and approve investmentproposals in relation to major information226Department Health and Families

Occupational Health and Safety SteeringCommitteeMembership Members of the Committee as at 30June 2010 are:Chair person: Deputy Chair: Kate McTaggart, A/Senior DirectorPeople & Services.Members: Kate McTaggart, A/Senior DirectorPeople & Services Peter Cass, A/Assistant Director HumanResources and OH&S Robin Smith, General ManagerKatherine Hospital Jill Davis, Director Health Developmentand Oral Health Clair Gardiner-Barnes, ExecutiveDirector, NT Families & Children Dr Barbara Paterson, ExecutiveDirector, Health Protection Christine Short, Manager Performance& Research Yvonne Falckh, Australian NursesFederation (ANF) Paula Bradford, Liquor Hospitality &Miscellaneous Union (LHMU) Paul Morris, Community Public SectorUnion (CPSU) Penny Parker, Senior Safety andQuality AdvisorKey areas from Terms of ReferenceProvide strategic direction on OH&S issuesto the various Workplace OH&S Committeesacross the Department to ensure that it:a) meets its legislative responsibilitiesb) is integrated with other Departmentalmanagement systems and with thecore functions of the organisationc) aids the improvement of the overallOH&S performance of the Department.Monitor and review the work of theWorkplace OH&S Committees in line withDepartmental OH&S Policy.Review OH&S across the Department.Report to DHF Executive Leadership Group.Key Achievements:1. The OH&S Steering Committee metfour times during 2009-10 reportingthrough the Executive LeadershipGroup to the Chief Executive onoccupational health and safety issues.2. Responsibilities, Accountabilities &Authority documentation.3. The Steering Committee endorsedthe OH&S business case resulting inan additional two OH&S FTEs fundingbeing made available.Secretariat: Jan Jones, A/Manager OH&S UnitMeetings:The Committee met in August and NovemberDepartment Health and Families 227

Appendix VEmployment InstructionsDetailed information on topics within this table addressing the EmploymentInstructions is provided in the Our People section of the main report. This agencysupports the Employment Instructions by providing staff with access to the Managersand Staff Service Centre, a one-stop online shop aimed at answering questionsrelating to employment within this agency. Further advice is provided by People andOrganisational Learning staff.See Overleaf228Department Health and Families

Employment InstructionsEmployment Instruction No.1Advertising, Selection, Appointment, Transfer andPromotion - Agency to develop procedures for therecruitment and selection of employees which are consistentwith the Act, Regulations, By-Laws, Employment Instructions,relevant awards and determinations. Chief Executives arerequired to report annually on the number of employees ofeach designation and any variation in numbers since the lastreport.Employment Instruction No.2Probation – Chief Executive is to establish a probationaryprocess within their agency. Chief Executive should conveydetails of the probationary process to probationaryemployees within the first week of report for duty.Information about the probation process is available on theagency’s intranet in the Managers and Staff Service Centreand on the OCPE websitehttp://www.ocpe.nt.gov.au/__data/assets/pdf_file/0016/22642/ei02.pdfEmployment Instruction No.4Performance Management – Chief Executive is to reportannually on management training and staff developmentprograms. Chief Executive shall develop and implementperformance management systems for their Agency.Recruitment information is available on the agency’s intranethttp://internal.health.nt.gov.au/pol/recruitment.shtmlor the Northern Territory Government internethttp://finke.nt.gov.au/dcis/rms.nsf/NTGEmploymentHome?OpenFormGrowth in staff numbers is reported in the Our People section.DHF provides a comprehensive, tailored Recruitment and Selection trainingprogram which is available to all staff across the Northern Territory. 201employees attended this training in 2009/10.Information about the probation process is available on the agency’s intranet inthe Managers and Staff Service Centre and on the OCPE websitehttp://www.ocpe.nt.gov.au/__data/assets/pdf_file/0016/22642/ei02.pdfPolicies and guidelines are available on the agency’s intranet site in theManagers and Staff Service Centre. Departmental policies and guidelinesintegrate the rules of natural justice i.e. that the person directly affected by animpending decision must be afforded a fair hearing prior to that decisionThe principles of natural justice are covered in all DHF Management andLeadership programs.Information on this Instruction is available on the agency’s intranet site in theManagers and Staff Service Centre and is also comprehensively covered ininformation session. The agency has implemented a Work Partnership Planthat assists with providing and receiving feedback to enhance individual andorganisational performance. Managers and staff work together to carry out thisplan.Department Health and Families 229

Employment Instruction No.5Medical Incapacity – Deals with medical examinationsduring an inability or discipline investigation.Employment Instruction No.6Inability to Discharge duties – Chief Executive to providethe Northern Territory Government’s Office of theCommissioner for Public Employment with information on theextent to which this employment instruction has been used bythe agency. Chief Executive may establish proceduresregarding this employment instruction within the Agency.Employment Instruction No.7Discipline – Chief Executive to provide the Northern TerritoryGovernment’s Office of the Commissioner for PublicEmployment with information on the extent to which thisemployment instruction has been used by the agency. ChiefExecutive may establish procedures regarding disciplinewithin their agency.Employment Instruction No.8Management of Grievances – Chief Executive shallestablish written grievance setting procedures for the agencythat should be available to employees and outline steps fordealing with grievances.Employment Instruction No.9 -Transfers – Omitted and incorporated into Instruction 1(Incorporated in Employment Instruction1)Employment Instruction No.10Employee Records – Agencies are required to establishsystems and procedures and ensure all records aremaintained in a secure and confidential area.Employment Instruction No.11Equal Employment Opportunity Management Programs –Chief Executive to devise and implement programs to ensureequal employment opportunities and outcomes are achieved.Chief Executive to report annually on programs and initiativesInformation on this Instruction is available on the agency’s intranet site in theManagers and Staff Service Centre. The agency had 14 new cases commenceand one case was brought forward from 2008-09.Information on this Instruction is available on the agency’s intranet site in theManagers and Staff Service Centre. Under Section 44 Inability to DischargeDuties the agency had two cases brought forward from 2008-09. One casewas completed and one remains on hand.Discipline procedure is available on the agency’s intranet in the Managers andStaff Service Centre. The DHF tailored 1 day program The Essentials ofLeading People Part 2 assists managers and employees to understand andinterpret this instruction. Under Section 49 Discipline the agency had 27 newcases commence and 12 cases brought forward from 2008-09. A total of 18cases were completed during the reporting period.Grievance policy information in available on the agency’s intranet in theManagers and Staff Service Centre. The DHF tailored 1 day program TheEssentials of Leading People Part 2 assists managers and employees tounderstand and interpret this instruction. Under the Department’s GrievancePolicy and Guidelines the Chief Executive received a total of 21 grievancerequests in 2009-10. Seven cases were brought forward from 2008/09. Of the28 cases, 23 cases were resolved during the reporting period.All personnel files are securely maintained by the Department of Business andEmployment on behalf of the agency. Access to personnel files and thePersonnel Integrated Pay System (PIPS) database is restricted and thisaccess is reviewed regularly.Equal Employment policies and guidelines are available on the agency’sintranet located at http://internal.health.nt.gov.au/pol/eeo.shtmlIn showing a commitment to this Employment Instruction this Departmentcurrently has three participants of the OCPE Willing and Able Project atvarious locations. More information on this project can be found at230Department Health and Families

DRAFT ANNUAL REPORT 2009 10the Agency has developed. Report should also includedetails on specific action in relation to Aboriginal employmentand career development, and also measures to enableemployees to balance work and family responsibilitiesEmployment Instruction No.12Occupational Health and Safety Programs– ChiefExecutive to develop programs to ensure employees areconsulted in the development and implementation ofOccupational Health and Safety Programs. Chief Executiveto report annually on Occupational Health and SafetyPrograms. Records must be kept on risk assessment,maintenance control and information, instruction and trainingprovided to employees.Employment Instruction No.13Code of Conduct – Chief Executive may issue guidelinesregarding acceptance of gifts and benefits to employees.Chief Executive may issue an agency specific Code ofConduct.Employment Instruction No.14Part-time Employment – Chief Executive, on request of theCommissioner, provide the number of part-time employeesby salary stream.http://www.ocpe.nt.gov.au/equity_diversity_flexibility/disability_in_the_workplace/willing_and_able_strategyOther details are in the Our People section of this report.Review of the Departmental Occupational Health and Safety ManagementSystem is undertaken on an annual basis. The provision of additional FTEresources and the recruitment and retention of staff to the Central Region hasstrengthened the capacity to develop and embed policies and proceduresaimed at ensuring staff and clients’ safety across the Department. OHStraining is an integral part of the Department’s Orientation Program and isavailable through the Corporate Training Calendar. Occupational Health andSafety (OH&S) information, policies, guidelines and reporting proforma areavailable on the Agency’s intranet OHS homepage.The agency has created an orientation program that new employees attendand the agency has an online induction which can be found in the Managersand Staff Service Centre. New employees are directed to access the agencyintranet and ensure they are aware of the Code of Conduct. Employees mayalso access the Code of Conduct on the NTG website:http://www.ocpe.nt.gov.au/ntps_careers/working_in_ntps/pay_and_conditions/code_of_conductThe agency supports part time and flexible working practices. Information onflexible working arrangements can be found on the agency’s intranet in theManagers and Staff Service Centre under the heading of Flexible WorkingSolutions. At the end of the reporting period this agency employed 447 FTE ona permanent part time basis, and 160 on a temporary part time basis, togetherrepresenting 10.3% of total FTE staff.Department Health and Families 231

Appendix VIAcronymsAASAustralian AccountingStandardsACAPAged Care AssessmentProgramACATAged Care Assessment TeamACEAcute Care ExecutiveACHSAustralian Council onHealthcare StandardsACIRAustralian ChildhoodImmunisation RegisterADSCAAlcohol and Other DrugsServices Central AustraliaAFPAustralian Federal PoliceAGAustralian GovernmentAHCAAustralian Health CareAgreementAHMACAustralian Health MinistersAdvisory CouncilAHWAboriginal Health WorkerAHMPPIAustralian HealthManagement Plan forAIDSSyndromeAMSANTAboriginal Medical ServicesAlliance of the NorthernTerritoryAMWUAustralian ManufacturingWorkers UnionANFAustralian Nursing FederationAODAlcohol and Other DrugsAODPAlcohol and Other DrugsProgram (within theDepartment)AOTAAccountAQISAustralian Quarantine andInspection ServiceASMOFAustralian Salaried MedicalASHAlice Springs HospitalASSADAustralian SecondaryStudents Alcohol and DrugATFSSAboriginal Targeted FamilySupport ServicesATOAVOBCBereavement CareBP3Budget Paper 3CAAAPUCentral Australia AboriginalAlcohol Programs Unit232Department Health and Families

CAAPSCouncil for Aboriginal AlcoholProgram ServicesC&FHChild and Family HealthCACentral AustraliaCAMHSCentral Australian MentalHealth Services (within DHF)CAAPSCouncil of Aboriginal AlcoholPrograms ServicesCCISCommunity Care InformationSystemCDCCentre for Disease Control(within DHF)CDEPCommunity DevelopmentEmployment ProgramCDNACommunicable DiseasesNetwork of AustraliaCDUCharles Darwin UniversityCEChief ExecutiveCFOCHAINCommunity Helping, Actionand Information NetworkCHOCIACompetition ImpactAssessmentCLACThe Schedule 8 andRestricted Schedule 4Clinical Advisory ServiceCMALCChief Ministers Council ofAustralian GovernmentsCOAGCouncil of AustralianGovernmentsCPCCommunity and Primary CareServicesCPIConsumer Price IndexCPSChild Protection ServicesCPSUCommunity and Public SectorUnionCRCCooperative Research CentreCREDITCourt Referral Evaluationfor Drug Intervention andTreatment NTCRGClinical Reference GroupCSSCommonwealthSuperannuation SchemeCSTDACommonwealth, State andTerritory Disability AgreementCQIContinuous QualityImprovementCTComputed TomographyDASADrug and Alcohol ServicesAssociationDBEDepartment of Business andEmploymentDCCDarwin Correctional CentreDETDepartment of Education andTrainingDEETDepartment of Employment,Education and TrainingDepartment Health and Families 233

DHFDepartment of Health andFamiliesDFVACDomestic and FamilyViolence Advisory CouncilDIMADepartment of Immigrationand Multicultural AffairsDMODMSDrug Monitoring SystemDPHDarwin Private HospitalDPIDepartment of Planning andInfrastructureDoHADepartment of Health andAgeingDOJDepartment of JusticedTpaDiphtheria, Tetanus, PertussisDUCCDepartment and UnionConsultative CommitteeDVADepartment of Veteran AffairsEAEast ArnhemEACHExtended Aged Care atHomeEASEmployee AssistanceServicesEBAEnterprise BargainingAgreementECGElectrocardiographyEDEmergency DepartmentEEOEqual EmploymentOpportunityEHEnvironmental HealthEHWEnvironmental Health WorkerENEnrolled NurseENTEar Nose and ThroatEHSDIExpanding Health ServiceDelivery InitiativeESWLElective Surgery Wait ListFaCSIADepartment of Family,Community Services andIndigenous AffairsFISSFamily and Individual SupportServicesFOIFreedom of InformationFRAFamily ResponsibilityAgreementFROFamily Responsibility OrderFSANZFood Standards of Australiaand New ZealandFTEFull Time EquivalentGAAGrowth Assessment andActionGDHGove District HospitalGEEPGovernment Energy234Department Health and Families

GENDCGeneric Disease ControlGHANTGood Health alliance NTGPGeneral PracticeGPNTGeneral Practice NetworkNorthern TerritoryGRMGGlobal ResourceManagement GroupGSTGoods and Services TaxHACCHome and Community CareHBSHome Birth ServicesHCSCCHealth and CommunityServices ComplaintsCommissionHIVVirusHONHonorableHPVHuman Papilloma VirusHPSUHealth Promotion StrategyUnitHRHuman ResourcesHSAKHealthy School Aged KidsHSRHealth and SafetyRepresentativesHTLV1Human T-cell LymphotropicVirus Type 1ICD-10-AMInternational Statisticaland Related HealthProblems, Tenth Revision,ICTInformation andCommunication TechnologyIDUIntravenous Drug UserIFFIllegal Foreign FishersIFRSInternational FinancialReporting StandardsIFVPPIndigenous Family ViolencePrevention PartnershipIMMDCImmunisation DiseaseControlIPUInformation and Privacy UnitIRIndustrial RelationsITInformation TechnologyKDHKatherine District HospitalLKLNLiving Knowledge LearningNetworkLHMUAustralian Liquor, Hospitality& Miscellaneous WorkersUnionMACAMotor AccidentCompensation ActMCYHMaternal, Child and YouthHealthMEBMedical Entomology BranchMDCMajor Diagnosis CategoryMGPMidwifery Group PracticeDepartment Health and Families 235

MHSMental Health ServicesMJDMachado Joseph DiseaseMLA MemberMinister of the LegislativeAssemblyMoHMinistry of HealthMOSMobile Outreach ServiceMoUMemorandum ofUnderstandingMRIMagnetic ResonanceImagingMSHRMenzies School of HealthResearchNAPCANNational Association forPreventing Child Abuse andNeglectNDANational Disability AgreementNCCTRCNational Critical Care andTrauma Response CentreNEHTANational e-Health AuthorityNGONon government organisationNHCCNNational Health Call CentreNetworkNHMRCNational Health and MedicalResearch CouncilNHPPDNursing Hours per PatientDayNSWNew South WalesNTNorthern TerritoryNTFCNorthern Territory Familiesand ChildrenNTGNorthern TerritoryGovernmentNTAGONorthern Territory AuditorNTFCACNorthern Territories Familiesand Children AdvisoryCouncilNTGPASSNorthern TerritoryGovernment and PublicAuthorities SuperannuationSchemeNTPCCSNorthern Territory Pensionerand Carer ConcessionSchemeNTPSNorthern Territory PublicSectorNTYANNorthern Territory YouthAffairs NetworkOATSIHTorres Strait Islander HealthOCPEfor Public EmploymentOHSOccupational Health andSafetyOOHCOut Of Home CareOSHCOutside of School HoursCareP2PProvider to Provider SecureClinical Messaging ServicePACSPicture Archiving andCommunication SystemPaDDAPoisons and DangerousDrugs Act236Department Health and Families

PASSPolicy and System SupportPATSPatient Assisted TravelSchemePCDPreventable Chronic DiseasePCDSPreventable ChronicDiseases StrategyPCISPrimary Care InformationSystemPESProfessional ExcellenceStatusPHCPrimary Health CarePHCAPPrimary Health Care AccessProgramPIPSPersonnel Information andPayroll SystemPPSProfessional Practice andSupervisionPROMPTProtocol Management andProduction ToolPSCPalmerston Safe CommunityQIPPSQuality ImprovementProgram Planning SystemRANRemote Area NurseRAFCWRemote Aboriginal Familyand Community WorkersR&MRepairs and MaintenanceRDHRoyal Darwin HospitalRFDSRoyal Flying Doctor ServiceRHDRheumatic Heart DiseaseRRVRoss River VirusS8Schedule 8SASouth AustraliaSAAPSupported AccommodationAssistance ProgramSAFE NTScreening Assessmentfor Employment NorthernTerritorySARCSexual Assault ReferralCentreSEATSeating Equipment andTechnical ServiceSEMSSecure Electronic MessagingSystemSHSSchool Health ServicesSHBBVUSexual Health and BloodBorne Virus UnitSTARSSatellite To All Remote SitesSTDSexually Transmitted DiseaseSTDCHSexually Transmitted DiseaseCommunity HealthSTISexually TransmittedInfectionSUSSobering-up ShelterTAFSTreasurer’s Annual FinancialStatementTBTuberculosisDepartment Health and Families 237

TBCTBCHTuberculosis CommunityHealthTCHTennant Creek HospitalTETop EndTEDGPTop End Division of GeneralPracticeWHOWorld Health OrganisationWHSUWomen’s Health StrategyUnitWPPWork Partnership PlanYSYouth ServicesYWCAYoung Women’s ChristianAssociationTEMHSTop End Mental HealthServices (within DHF)TIMETerritory Independence andMobility Equipment SchemeUMATUndergraduate Medicineand Health SciencesAdmission TestVSAVolatile Substance AbuseVSAPAVolatile Substance AbusePrevention ActWAWestern AustraliaWHGWomen’s Health Generic238Department Health and Families

Department Health and Families 239