Annual Report 2010 - NT Health Digital Library - Northern Territory ...

D E PA R T M E N T O F H E A LT HAnnual Report2010–2011

AcknowledgementThe authors are grateful to the many people throughout the Department who have assisted inthe production of this report.(Cover photographs are courtesy of Interactive Communication and Development.)© Northern Territory Government 2011.This publication is copyright. The information in this report may be freely copied and distributedfor non-profit purposes such as study, research, health service management and publicinformation subject to the inclusion of an acknowledgment of the source. Reproduction for otherpurposes requires the written permission of the Chief Executive of the Department of Health,Northern Territory.Printed by the Government Printer of the Northern Territory, 2011.An electronic version is available at: http://health.nt.gov.au/Publications/Corporate_Publications/index.aspxGeneral enquiries about this publication should be directed to:Executive Director, System Performance and Aboriginal PolicyDepartment of HealthPO Box 40596, Casuarina, NT 0811Telephone: (08) 8999 2871Fax: (08) 8999 2568

Table of ContentsPurpose of Report ........................................................................................................... 4Target Audience .............................................................................................................. 4Chief Executive’s Foreword ............................................................................................. 6Our Ministers ................................................................................................................. 10Our Department ............................................................................................................ 10Our Executive................................................................................................................ 11Department of Health at a Glance ................................................................................. 17Key Achievements and Aims ......................................................................................... 18Overview ....................................................................................................................... 21Safety and Quality ......................................................................................................... 27Chief Health Officer’s Report ......................................................................................... 31Aboriginal Health Report ............................................................................................... 33Output Groups Performance Reporting ......................................................................... 35Acute Care................................................................................................................ 37Top End Hospital Network ........................................................................................ 51Central Australian Hospital Network.......................................................................... 53Health and Wellbeing Services ................................................................................. 56Public Health Services .............................................................................................. 65Connecting the Department of Health’s Activity to the Territory 2030 Plan .................... 86Corporate Plan .............................................................................................................. 87Promoting and Protecting Health and Wellbeing and Preventing Injury..................... 88Healthy Children and Young People in Safe and Strong Families ............................. 94Targeting Smoking, Alcohol and Substance Abuse................................................... 97Connecting Care ..................................................................................................... 101Safety, Quality and Accountability ........................................................................... 104Attract, Develop and Retain a Workforce for the Future .......................................... 108Strategic Projects.................................................................................................... 113Regional Achievements and Services Map ............................................................. 119Our People .................................................................................................................. 128Governance ................................................................................................................ 140Corporate Governance ........................................................................................... 140Clinical Governance ................................................................................................ 142Consumer/Partnership Engagement ....................................................................... 143Risk Management ................................................................................................... 144Audit ....................................................................................................................... 145Insurance Arrangements......................................................................................... 148Coronial Findings .................................................................................................... 148Complaints.............................................................................................................. 149Sentinel Events ....................................................................................................... 151Information and Privacy .......................................................................................... 152Legislation .............................................................................................................. 153Our Money .................................................................................................................. 154Appendices ................................................................................................................. 195Appendix 1: Employment Instructions ..................................................................... 196Appendix 2: Councils, Committees, Groups ............................................................ 200Appendix 3: External Funding ................................................................................ 212Appendix 4: Capital and Minor Works ..................................................................... 216Appendix 5: Legislative Responsibilities ................................................................. 221Appendix 6: Acronyms ............................................................................................ 223Department of Health Annual Report 2010-11 3

Purpose of ReportPurpose of ReportWelcome to the Annual Report for the Department of Health.This Annual Report aims to:• fulfil our obligation to the Parliament and Territorians to provide an account of ouractions against budget for 2010-11;• highlight the key achievements of our organisation, services and people for theprevious financial year;• outline services we provide, our vision, mission, values, core business objectives andhow we measure our performance; and• provide insight and information relating to the Department’s direction in planning,including the Corporate Plan 2009-12.This Annual Report has been produced in accordance with Section 28 of the PublicSector Employment and Management Act and Section 12 of the Financial ManagementAct.Target AudienceThis report is intended to be used by any person or organisation interested in how thisagency operates and what it does.Our Department works in partnership with other government and non-governmentorganisations to ensure the wellbeing of all Territorians. We work collaboratively withpeople in communities to ensure that individual needs are met.This Annual Report provides a summary of our agency’s achievements and highlightsthe important role all employees take in bringing together and delivering services inevery part of our jurisdiction.This is a high-level accountability report therefore the primary audience is our Ministersand their parliamentary colleagues. It is also an important tool to communicate with otherinterested parties such as potential employees, students and the general public who mayuse the report seeking specific information.If the information you are looking for is not contained within this report please contact uson (08) 8999 2400 or access our website at: http://health.nt.gov.au.Please note that wherever this report refers to Aboriginal people this should also betaken to include Torres Strait Islanders and also to mean Aboriginal and Torres StraitIslander peoples.4 Department of Health Annual Report 2010-11

Purpose of ReportThe Honourable Kon Vatskalis MLAThe Honourable Rob Knight MLAMinister for HealthMinister for Senior TerritoriansParliament HouseParliament HouseDARWIN NT 0800 DARWIN NT 0800Dear MinistersI am pleased to present you with the Annual Report for the Department of Health for thefinancial year 1 July 2010 to 30 June 2011.The report describes activities and performance outcomes against the Department’sCorporate Plan and key achievements of the output areas.With regard to my duties as the Accountable Officer pursuant to Section 13 of theFinancial Management Act, I advise to the best of my knowledge and belief, that:a) proper records of all transactions affecting the agency and its employees were keptunder my control by the Department of Business and Employment (DBE) on behalf ofthe Department, observing the provisions of Section 28 of the Public SectorEmployment and Management Act and Section 12 of the Financial Management Act,the Financial Management Regulations and applicable Treasurer’s Directions;b) procedures within the agency afforded proper internal control. A current descriptionof these 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 inor omission from the accounts and records exists;d) in accordance with the requirements of Section 15 of the Financial Management Act,the internal 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 Employmenthave been 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 balanceof health services for Territorians considering the demands for service and the resourcesavailable.Yours sincerelyJeff Moffet30 September 2011Department of Health Annual Report 2010-11 5

Transmittal LetterChief Executive’s ForewordIn my first year back in the Territory I am reminded of the unique characteristics of theNorthern Territory and the opportunities and challenges this brings. Our challengesinclude the Territory’s geographically dispersed population where 44% of Territorians livein areas classified as remote or very remote. To add to this, over 30% of Territorians areAboriginal with a higher burden of disease than the non-Aboriginal population. Thismeans service providers confront a complex range of issues when providing healthservices and supporting the wellbeing of our population.To this end, I bring to the Territory my commitment to ensure that the Departmentcontinues to work hard on the development and provision of health and communitybased services right across the Territory. This report provides many examples of theinnovation and achievement within our services, reflecting the very diverse and talentedpeople within the Department of Health, and their capacity to harness the power ofteamwork and partnering.I am keen to maintain and enhance our focus on quality and safety, consumer andcommunity engagement and Aboriginal employment strategies. This focus is reflected inthe new sections within this report providing information on the NT health context, healthoutcomes, safety and quality indicators and a new section on partner and consumerengagement. It is also reflected in the increased emphasis on Aboriginal employmentwithin the chapter on Our People.Some key changes began to take effect in the health sector across the nation and in theNorthern Territory in 2010-11 as a result of the national health reforms initiated by theCouncil of Australian Governments and finalised in early August 2011. The keyobjectives of the National Health Reform Agreement are to improve health outcomes andprovide long term sustainability for the Australian health care system.As a result, on 14 December 2010, following an extensive public consultation process,the Northern Territory Government announced that two Hospital Networks will beestablished here. One, comprising Royal Darwin, Katherine and Gove District Hospitals,will cover the Top End; the other, comprising Tennant Creek and Alice Springs Hospitals,will service Central Australia. The Hospital Networks will be fully operational by July2012.Community representation and input into health service direction and delivery will also bestrengthened in the Territory through the implementation of two Governing Councils forthe hospital networks. The Governing Councils will lead community engagement and willbe actively involved in the strategic direction of the hospital networks. These changesare critical to ensure greater local leadership, both by the community and clinicians, inhow services are provided and developed in the networks. In the future, as a result ofNational Health Reforms, there will be far more information made publicly available toour consumers and stakeholders about how our system is performing, not only within theTerritory, but compared to other public hospitals and health systems across the nation. Aparticular focus of this reporting will be safety and quality, with the AustralianCommission on Safety and Quality becoming a permanent feature of the Australianhealthcare system and leading the way in terms of national strategy and standardsetting.6 Department of Health Annual Report 2010-11

Chief Executive’s ForewordThe Health Reform Agenda presents both a great opportunity and challenge for theNorthern Territory health system to improve the way we meet the needs of ourcommunity. Enormous trust is placed in our hands every day by the individuals, familiesand communities we serve.We must continue to build on and honour the trust of our consumers and communities,and commit to doing all we can to manage and develop the safety and quality of ourservices. There is no higher priority for me than the safety and quality of our system andI am committed to taking the next steps to further enhance our safety and qualityperformance, building on the very good work of the past.However, we cannot reform and develop our health system on our own. In the NorthernTerritory, as is the case in other parts of Australia, our system is one that encompassesand relies on many government and non-government service partners working togetherto provide the best health and community based services we can, and to ensure that wekeep consumers’ health and wellbeing at the centre of our decision making and ourbehaviour. I am committed to strengthening our partner and stakeholder engagementand this will be a focus for our Department for the next financial year.Optimising our services requires a workforce to match the needs of both the workplaceand clients. This requires innovation and reform in practice and service delivery models,with a clear focus on identified community needs, particularly cultural security awarenessand competence. It entails challenging current models and ways of thinking, as well aspromoting alternative workforce designs. The plans we have for creating a ruralgeneralist medical practitioner training course in 2012 are an example of this approach.Special mention should be made of our many Aboriginal employees who now make upnine per cent of our total workforce. We will continue to work hard to develop and growthis vital part of our workforce in order to maximise service quality and access to the highproportion of Aboriginal and Torres Strait Islander consumers in the Territory and toprovide meaningful and fulfilling career opportunities for Aboriginal people.The Department also consumes significant resources in delivering its services and weare conscious of the need for delivering value, being efficient in what we do, and beingfinancially accountable to government and the public. The Department has soundcorporate governance systems and will continue to strengthen these systems. In2010-11, the Department received approvals for additional capital resources forinfrastructure upgrade and development - including many remote clinics, a PalmerstonHospital and multiple Emergency Department and patient accommodation initiativesacross the Territory. Our total capital program now exceeds $380 million and we aredeveloping our governance and delivery systems to ensure we deliver on thesecommitments in a timely and well planned way.The year ahead will bring with it many challenges, particularly with the roll out of theNational Health Reform Agenda and the development of the Hospital Networks and theirGoverning Councils. As usual the challenges also bring great opportunities for the5000-plus staff members who work for the Northern Territory Department of Health. Ihave complete confidence that we are up to the task and are well placed to meet ourresponsibilities, building on and honouring the community’s well-founded faith in ourskills, professionalism and compassion.There is no doubt that the National Reform Agenda offers an opportunity to evolve theNorthern Territory health system to develop and further meet the needs of Territoriansand will require the Department to consider strategies to maximise the sustainability ofour health system. This will require locally driven change. However, the one thing thatDepartment of Health Annual Report 2010-11 7

Chief Executive’s Forewordwill not change is the high level of care we provide to the Territory community and ourcommitment to ongoing improvement.On behalf of the Executive team I wish to thank all staff, our service partners and allthose who have served on the various Advisory Councils, Hospital Management Boardsand the Committees who have provided valuable community and stakeholder input andassisted us in providing and improving services to our community. I would also like toextend my appreciation to the many community volunteers who have supported ourhospitals and other facilities and bodies in the past year.I look forward to working with our staff, volunteers and partners in 2011-12 to ensure thatour health system continues to deliver and develop quality services to the manycommunities that we serve.Jeff MoffetChief Executive30 September 20118 Department of Health Annual Report 2010-11

Organisational ChartDepartment of Health Annual Report 2010-11 9

Our ExecutiveOur MinistersMinister for HealthHon Konstantine Vatskalis MLAMinister for Senior TerritoriansHon (Rob) Daniel Robert Knight MLAOur DepartmentOur VisionHealthy Territorians living in Healthy Communities.Our MissionWe promote, protect and improve the health and wellbeing of all Territorians inpartnership with individuals, families and the community.Our Values• Respect and cooperation• Responsibility to society• Pride in our work• We are here for our clients10 Department of Health Annual Report 2010-11

Our ExecutiveOur ExecutiveThe Executive Leadership Group (ELG) provides strategic management andleadership to the agency. This group experienced some change during this yeardue to the effects of implementing National Health Reforms.VisionGetting the best out of our resources and our people.MissionWe provide strategic leadership to our staff in the support of the healthy wellbeingof all Territorians and we ensure the alignments of all our available resources tobest meet this challenge.Jeff Moffet, Chief ExecutiveJeff commenced with the Department in September 2010 after sixyears of senior leadership roles in WA Country Health Service, thelargest country health service in Australia.He is a highly experienced health administrator who has occupiedsenior leadership and management roles in the rural and remotehealth sector for the past decade. Jeff Moffet has extensivemanagement experience overseeing health service delivery in the vast Pilbara andKimberley regions. He held a clinical position as a Physiotherapist in Darwin in the early1990s.Jeff represents the Territory on the Australian Health Ministers’ Advisory Council(AHMAC), chairs the Health Workforce Principal Committee reporting to AHMAC and isa board member of the National eHealth Transition Authority and Menzies School ofHealth Research. He is both very experienced with and strongly committed to improvingpatient safety and service quality, Aboriginal employment, engaging our partners andvaluing our staff.Department of Health Annual Report 2010-11 11

Our ExecutiveDr Barbara Paterson - Chief Health Officer andExecutive Director, Health Protection DivisionBarbara is a medical graduate and Public Health Physician. She hasover 18 years experience in Aboriginal health, including experience as aDistrict Medical Officer for remote Aboriginal communities, research andservice provision with the Auto Immune Deficiency Syndrome/SexuallyTransmitted Disease Unit of the Centre for Disease Control and child health policy andprogram development. She became a Fellow of the Australasian Faculty of Public HealthMedicine in 1995. As Program Director, Maternal, Child and Youth Health, she had aTerritory-wide role in development and monitoring of evidence based policy, strategiesand programs contributing to national policy directions.Barbara began her current roles in August 2008. The Health Protection Division is madeup of Environmental Health, Centre for Disease Control, Alcohol and Other Drugs andHealth Gains Planning.Jill Davis, A/Executive Director Health ServicesJill came to the Northern Territory in 2004 as Program Director, OralHealth Services and was subsequently appointed as Director,Health Development in 2007. Jill introduced significantorganisational reforms in both areas resulting in strengthenedmanagement structures which have led to improved client servicedelivery.After working in mental health and community development in the early 1970s in NSW,Jill moved to South Australia where she worked in community health centres incommunity health education and family therapy roles. Following a couple of years in asocial health policy role, she then moved to the ACT where she was employed as theDirector of the ACT Government’s Health Advancement Unit, then the Oral HealthProgram and later the Community Rehabilitation Program. Before moving to theNorthern Territory, Jill managed the oral health services of the Northern Sydney/CentralCoast Area Health Service. Jill has a Graduate Diploma in Public Health.Jenny Cleary, Executive Director, Top End HospitalNetworkJenny has worked in various areas of public health for more than 20years. In October 2006 she was appointed to Executive Director HealthServices with the Northern Territory Department of Health. The roleencompasses government health service delivery in the NorthernTerritory outside of the hospital setting including remote health centres,urban community health centres, child health and wellbeing, health development andoral health, preventable chronic disease, mental health and aged and disability services.In September 2011 she took up her current role leading the Top End Hospital Network.Prior to 2006 Jenny worked in health system reform, primary health care and publichealth services management and policy. She played a key role in implementing the threesuccessful remote area Northern Territory Coordinated Care Trials.12 Department of Health Annual Report 2010-11

Our ExecutiveJenny has a Masters in Public Health and represents the Territory on the AustralianPopulation Health Development Principal Committee and chairs its Child Health andWellbeing Subcommittee.Penny Fielding, Executive Director Health ReformPenny has worked in various areas of health for more than 15years.Following a number of positions across public health and primaryhealth care in Central Australia, Penny moved to Darwin in 2007 tolead Aged and Disability Services. During this period she led theimplementation of the Disability Services Review.In January 2011 she commenced her current role of Executive Director Health Reform.The role encompasses leading the Northern Territory response to the National HealthReform agenda. This provides an opportunity for health system reform with a focus onenhanced clinical leadership, safety and quality and system performance. The HealthReform Division also includes Health Planning, Acute Care Policy, Service Developmentand System Performance.Penny has a Masters in Primary Health Care and a strong interest in continuity of carefor patients and clients across the service system.Mike Melino, A/Executive Director, CentralAustralian Hospital NetworkMike Melino was appointed General Manager of the Alice SpringsHospital in September 2010 and more recently has taken on the roleas Acting Executive Director of the Central Australian Hospitalnetwork.From 2007 to 2010 Mike was the Executive Director, Mental Health Services for CountryHealth in South Australia. In this role he was responsible for significant reform of mentalhealth services for Country SA, including the development of a new model of care andthe implementation of a single, integrated service delivery system for mental health inCountry SA.Mike has held a number of other senior executive positions in rural health as a ChiefExecutive of Country Hospitals and Area Health Manager in Country Health SA.Other senior operational management appointments in health involved working closelywith general practice, universities, other government sectors and non-governmentorganisations. Mike has a core interest in improving service delivery systems and inorganisational development.Department of Health Annual Report 2010-11 13

Our ExecutiveJackie Ah Kit, A/Executive Director, SystemsPerformance and Aboriginal PolicyJackie was born in Darwin, raised in the Northern Territory and is theproud descendant of a Warramunga woman and a Waanyi man.For the past two decades, Jackie has worked in senior managementroles leading high profile and innovative programs within complexhuman services organisations. From 2000 to 2006, she held the position of ChiefExecutive Officer with the Port Lincoln Aboriginal Health Service. Since then, she hasheld executive positions with both Health SA and the Northern Territory Department ofHealth.In December 2008, Jackie took up the position of Director, Aboriginal Policy with theDepartment and since March 2011, Jackie has been the acting Executive Director,Systems Performance and Aboriginal Policy. Jackie is passionate about increasing thenumber of Aboriginal and Torres Strait Islander people employed by the Department andexpanding the profile of its workforce to a level that is reflective of its client base andtheir usage.Liz Stackhouse, Executive Director, Planning andInfrastructureLiz has had a long career in the Australian health system.She was the Chief Executive at Launceston General Hospital forseven years before spending two years in Canberra with the NationalHealth and Hospital Reform Commission.On 1 March 2010, Liz was appointed as General Manager, Royal Darwin Hospital. Withthe implementation of the National Health Reform and Hospital Networks, she becamethe Acting Executive Director of the Top End Hospital Network which includes RoyalDarwin Hospital, Gove District Hospital and Katherine Hospital.In September 2011 Liz was appointed Executive Director, Planning and Infrastructure inorder to deal with a significant capital and infrastructure program of works, whileproviding leadership of our ongoing accommodation, minor new works and repairs andmaintenance programs. She is a Fellow of the Institute of Chartered Accountants andprior to her career in the Australian health system worked with Deloitte and Coopers andLybrand.14 Department of Health Annual Report 2010-11

Our ExecutiveJill Macandrew, Senior Director, People andServicesJill commenced with the Department in 1977 as a DentalTherapist and went on to manage the School Dental Service.Other positions she has held within the Department include:Manager, Casuarina Community Care Centre; Director,Community and Public Health; Top End Co-ordinator; ActingDirector, Aged and Disability; Acting Chief Operations Officer; and Senior Director, Officeof the Chief Executive.Jill has played a key role in two major departmental restructures. She holds qualificationsin Dental Therapy, Teaching and Health Promotion; and is a Public Sector ManagementGraduate. In April 2011, Jill was appointed as Senior Director, People and Services.Stephen Moo, Chief Information OfficerStephen has been employed in the health sector for over 25 years andduring the last 12 years has had direct responsibility for the design,development, implementation and on-going systems management formajor corporate client and clinical information systems and informationcommunications infrastructure.Stephen has been Director of eHealth NT for the past seven years and is the principalarchitect and sponsor for the development and implementation of a comprehensiveeHealth program that is widely regarded as being the most advanced of its kind inAustralia.Stephen has been Chair of the National Health Chief Information Officer Forum for thepast two years and has played a key role in the development of the National eHealthStrategy and the development of national eHealth foundation services and standards bythe National eHealth Transitional Authority.Ian Pollock, A/Chief Finance OfficerIan commenced as Chief Finance Officer in July 2010. He startedwith the Department in 1998 as a Business Manager at the RoyalDarwin Hospital, before moving to work as the Manager,Performance and Contracts in Acute Care. In 2007 he was employedas the Director of Information Services in the Department ofEducation and Training and returned to the Department of Health in2008, as the Director, Acute Care Systems Performance.Ian has a Masters in Health Service Management, a Graduate Diploma from the Instituteof Company Directors and a Bachelor of Business. He has worked in a number of keyservice development portfolios including renal and radiation oncology services and hasalso managed the Northern Territory Hospital Cost Data Collection.Department of Health Annual Report 2010-11 15

Our ExecutiveJan Currie, Senior Director, Office of the ChiefExecutiveJan Currie has been in the Northern Territory Public Service in seniormanagement positions since 1989. She was with the Department ofJustice for 10 years before transferring to the Department of Healthand Families in 1998. Since joining the Department, Jan has heldsenior Executive positions with responsibility for Executive Services,Ministerial Liaison, Media, Public Relations and Corporate Communications, LegalServices, Audit Services, Corporate Services, Human Resources, Industrial Relationsand Workforce.In August 2007, Jan took on the role of Deputy General Manager at Royal DarwinHospital and acted as General Manager for periods of time throughout 2009 and 2010whilst a new General Manager was recruited. In July 2010 to March 2011 Jan acted inthe position of Deputy Chief Executive, Acute Care. In March 2011 Jan commenced asSenior Director, Office of the Chief Executive.16 Department of Health Annual Report 2010-11

Department at a GlanceDepartment of Health at a GlanceOver the last five years on average, each month, the Department spent or provided….Key Activities 2006-07 2007-08 2008-09 2009-10 2010-11Average operating expense ($’000s) 66 444 73 807 84 316 93 293 92 715Hospital separations 7 919 8 322 8 876 9 233 9 633Specialist clinic consultations 12 573 13 337 14 340 15 799 13 621Emergency Department attendances 9 299 10 443 10 749 11 049 11 781Children participating in Growth and 252 264 325 299 296*Assessment Program/Under 5 KidsChecksProvision of professional supportservices for frail aged people andpeople with a disability (client count)569 596 608 510 547Community support services for frailaged people and people with adisability (client count)Individuals receiving communitybased mental health services306 370 388 464 365396 395 418 462 485Environmental health activities 859 890 795 828 810People admitted to sobering upsheltersOccasions of service at Clinic 34 inDarwin and Alice Springs1 431 1 632 1 709 1 731 1 565643 670 905 1 002 915Community health events urban 9 033 8 906 10 902 10 679 9 514Oral health occasions of service 3 538 3 306 3 335 3 947 3 674*This indicator has changed from being data associated with the Growth and Assessment Program to theUnder 5 Kids Checks from 2010-11. This will continue to include data collected for the previous program, butwill be more comprehensive as data collection is improved.Most of the indicators above show continued growth, with higher growth (particularly inhospital services and in child health checks) in 2008-09. This was associated with theimpact of the Australian Government’s NT Emergency Response and the resultingExpanding Health Services Delivery Initiative. Otherwise variations tend to be due tochanges in data definitions and counting rules (e.g. community support services for frailaged people and people with a disability and specialist clinic consultations) or to staffshortages (e.g. oral health occasions of service and environmental health activities).Department of Health Annual Report 2010-11 17

Key AchievementsKey Achievements and AimsKey Achievements 2010-11(Please use the links or page references provided to find further information on theseitems.)The following achievements fulfil key aims within our Corporate Plan 2009-2012 and alsomeet Territory 2030 Plan targets.These achievements relate to our priority to ensure healthy children and young people instrong safe families and will assist with Territory 2030 targets for improving the healthand wellbeing of young and adult Territorians:• all Yirrkala children under five are on a Care Plan and there have been nounderweight babies at birth in the last 12 months (see page 95); and• a Mental Health Service 24 hour triage liaison and response service has beenimplemented (see page 61).The following group of achievements relates to our priorities to promote and protect goodhealth and wellbeing and prevent injury and also to target smoking, alcohol andsubstance abuse:• the implementation plan for the 10-year Chronic Conditions Prevention andManagement Strategy (CCPMS) (see page 91) was launched in September2010;• the Department made good progress in its efforts to reduce smoking in theTerritory including changes to the Tobacco Control Act (see page 97);• the Northern Territory Oral Health Promotion Plan was launched by the Ministerfor Health in March 2011 (see page 59);• men’s health promotion activities, programs, and interventions continue to beimplemented in remote communities contributing to the Territory 2030 target forincreasing life expectancy among Aboriginal Territorians; and• the Hospital Based Interventions Project has been of great benefit within RoyalDarwin Hospital, with far greater intervention on alcohol, tobacco and other drugsavailable for hospital inpatients (see page 98).These activities will make a substantial contribution to Territory 2030 Plan targets andactions around prevention of chronic disease across the life cycle for Aboriginal and nonAboriginal Territorians and for closing the gap in life expectancy.These achievements will assist in our Corporate Plan objective of connecting care:• significant gains have been made in engaging with Aboriginal communities abouttheir health through consultation with Local Reference Groups in Territory GrowthTowns (see page 101);18 Department of Health Annual Report 2010-11

Key Achievements• a five year contract with an optional five year extension has been successfullynegotiated with St John Ambulance (NT) for the provision of a Territory wideEmergency Road Ambulance and Medical Transportation Service (see page 39);• Royal Darwin and Alice Springs Hospitals continued to be the busiest per capitaemergency departments in Australia with 141 370 attendances and 35 670admissions to Territory Emergency Departments; however, the proportion ofEmergency Department attendances seen within our targets for each triagecategory (except Category 1 Resuscitation which continues to meet the target of100%) all improved during 2010-11;• continued development and improvement of the Primary Care InformationSystem providing fully electronic health records in 54 health centres across theTerritory and in prison health services (see page 115); and• the Top End Medical Retrieval Services tender was awarded, providing for a fullintegrated service model for the first time in the Northern Territory (see page 39).This achievement will assist with our objective of ensuring safety, quality andaccountability as well as ensure best treatment for chronic conditions:• sixteen Continuous Quality Improvement positions have been filled in order tosupport remote primary health care staff to focus on best practice throughauditing clinical practice (see page 106).These achievements relate to our Corporate Plan objective which is to attract, developand retain a workforce for the future and is consistent with Territory 2030 workforcetargets:• the Department supported its largest number of apprentices, 37 in total, of which21 were Aboriginal. Apprentices are studying in a wide range of important healthdisciplines (see page 131); and,• collaboration between the Department, Flinders University and Charles DarwinUniversity led to the successful opening of the Flinders NT Medical Program onCDU campus by the Hon Julia Gillard MP, Prime Minister of Australia, in June2011 (see page 117).This is a strategic project which our Corporate Plan 2009-2012 and Budget Paperspromised to implement and meets the Territory 2030 Plan objective for reforming ourhealth system:• the new Alan Walker Cancer Care Centre (see page 38) has completed its firstfull year, providing both radiation oncology and chemotherapy services.Key Aims for 2011-12Our aims for 2011-12 primarily meet objectives within our Corporate Plan and also assistwith meeting Territory 2030 Plan targets.• Implementation of the Top End and Central Australian Hospital Networks includingGoverning Councils will be completed by June 2012.Department of Health Annual Report 2010-11 19

Key Achievements• The Hearing Health Information Management System and coordinated care modelfor prevention, early identification and management of ear conditions and hearingloss will be implemented.• The Department will support the development of a whole of government plan toimprove the health of young people in the Territory.• 2011-12 will see the first release of sales data as a proxy measure of tobaccoconsumption in the Northern Territory.• An Action Plan for incorporating the National Safety and Quality standards intodepartmental business and accreditation planning will be developed.• A range of strategies aimed at increasing the participation of Aboriginal people intothe health and community workforce in joint partnership with key education and nongovernment health provider partners will be designed and implemented.• Legislative options on smoking and children (smoke free children’s events) and onsmoking in cars with children will be considered by the Northern TerritoryGovernment.• Clinical services planning for a Palmerston Hospital will be completed.The following aims were also given in the Treasury Budget Papers (No. 3) for 2011-12:• An integrated grants management system will be implemented to manage nongovernmentorganisation funding agreements.• Work will be carried out on secure care accommodation services for adults withcomplex care needs.20 Department of Health Annual Report 2010-11

OverviewOverviewThe Northern Territory Health ContextProviding equitable access to core health services represents a challenge unique to theNorthern Territory in both demographic and geographic terms. As shown in Figure 1below, a very high proportion of our population compared to the rest of Australia livesoutside urban areas. 44% of the Northern Territory population lives in remote or veryremote areas compared to 2% in Australia.Figure 1: 2010 Estimated Resident Population 1 , Remoteness Areas, NorthernTerritory and Australia80%70%60%50%40%30%20%10%0%Major Cities of AustraliaInner & Outer RegionalAustraliaRemote and Very RemoteAustraliaNorthern TerritoryAustralia(Source: Australian Bureau of Statistics (ABS) Regional Population Growth, Australia, 2009-10 (ABS Cat.No. 3218.0)) 1 Based on Preliminary 2010 Estimated Resident PopulationThe major demographic difference shown in Figure 2 is 30.4% of our population isAboriginal and most of that group (74%) lives in very remote areas making access tocore health services a constant challenge for the Department.Figure 2: 2006 Estimated Resident Population, Remoteness Areas, NorthernTerritory by Aboriginal Status80%70%60%50%40%30%20%10%0%Outer Regional Australia Remote Australia Very Remote AustraliaAboriginalnon-Aboriginal(Source: ABS Experimental Estimates of Aboriginal and Torres Strait Islander Australians, Jun 2006 (Cat.No. 3238.0))The next few graphs (Figures 3-6) demonstrate some key outcome measures for theDepartment.Department of Health Annual Report 2010-11 21

OverviewFigure 3 below demonstrates the life expectancy gap between Aboriginal and non-Aboriginal people; closing this gap is a major focus for the Department.Figure 3: Life expectancy at birth, Northern Territory and Australia, 1967 to 200690.080.070.060.050.040.030.020.010.00.0Years19671970197319761979198219851988199119941997200020032006NT Aboriginal maleNT non-Aboriginal maleAustralian male100.090.080.070.060.050.040.030.020.010.00.0Years19671970197319761979198219851988199119941997200020032006NT Aboriginal femaleNT non-Aboriginal femaleAustralian female(Source: Health Gains Planning Branch, Health Protection Division)Life expectancy has improved significantly over the past forty years, both in the NorthernTerritory and in Australia; however a considerable gap in life expectancy still existsbetween Aboriginal and non-Aboriginal populations. Closing the gap in life expectancybetween Aboriginal and non-Aboriginal Territorians is a target of the Northern TerritoryGovernment’s Territory 2030 Plan and the main focus for both the Department and itslocal and national partners in improving health outcomes.The improvement of life expectancy in Aboriginal people living in the Territory during thelast forty years was more pronounced among females with an improvement of 16 yearscompared to an eight year increase for Aboriginal males. The life expectancy of non-Aboriginal males and females has increased by 16.5 years and 12.4 years respectively.The gap between Aboriginal females and non-Aboriginal females living in the Territoryhas narrowed due to a rapid improvement in the life expectancy of Aboriginal females. Incontrast, the gap between Aboriginal males and non-Aboriginal males has widened dueto the slower improvement in life expectancy in Aboriginal males.22 Department of Health Annual Report 2010-11

OverviewFigure 4: Potential Avoidable and Non-Avoidable Years of Life Lost, NT Aboriginaland non-Aboriginal, 1985 to 200612000No. of Years1000080006000400020000Aboriginal avoidablenon-Aboriginal avoidableAboriginal non-avoidablenon-Aboriginal non-avoidable(Source: Health Gains Planning Branch, Health Protection Division)A potentially avoidable death is one that, theoretically, could have been avoided given anunderstanding of causation, the adoption of available disease prevention initiatives andthe use of available health care. Non-avoidable deaths on the other hand may have noknown preventive options, or limited success with treatment, or occur in a person who isalready 65 years or older, or be due to factors such as living conditions and other socialdeterminants that occur outside the health care sector. The numbers in Figure 4 areexpressed by potential years of life lost rather than number of deaths.Potential avoidable years of life lost for NT Aboriginal people have constantly improvedbetween 1985 and 2006. In contrast, the non-avoidable years of life lost in NT Aboriginalpeople declined between 1985 and 1991 and increased after 1992. Meanwhile the non-Aboriginal population showed slow but steady improvements in both avoidable and nonavoidableyears of life lost.Vigorous effort is warranted to address the social determinants of health to close the lifeexpectancy gap between Aboriginal and non-Aboriginal Territorians.Department of Health Annual Report 2010-11 23

OverviewAlcohol consumption is a key social determinant of health that has a major impact on thehealth and wellbeing of the Northern Territory community and is a key component of theDepartment’s efforts to close the gap in life expectancy. Figure 5 shows totalhospitalisations per 10,000 population that the Department classifies as being alcoholrelatedover the period 2004-05 to 2008-09.Figure 5: Alcohol-attributable Hospitalisations, NT, 2004-05 to 2008-09500450400350300250200150100500hospitalseparations per10,000 populationAboriginalNon-AboriginalMaleFemale(Source: Health Gains Planning Branch, Health Protection Division)Alcohol-attributable hospitalisation rates were much higher in males than in females inboth the NT Aboriginal and NT non-Aboriginal population.The alcohol-attributable hospitalisation rate for Northern Territory Aboriginal men wasmore than five times higher than that for non-Aboriginal men. The alcohol-attributablehospitalisation rate for Territory Aboriginal women was more than ten times higher thanthat for non-Aboriginal women.The Department, in partnership with the Department of Justice and other nongovernment organisations, is undertaking many activities aimed at reducing the rate ofalcohol consumption in the Territory.24 Department of Health Annual Report 2010-11

OverviewThere has been great success in translating health service efforts into improved healthoutcomes as shown in the improvements in incidence and mortality rates for cervicalcancer in the NT.Figure 6: Cervical Cancer Rates by Aboriginal StatusCases per 100,000 population80706050403020100IncidenceCases per 100,000 population80706050403020100MortalityAboriginalAboriginalnon-Aboriginalnon-AboriginalAboriginal trend lineAboriginal trend linenon-Aboriginal trend linenon-Aboriginal trend line(Source: Health Gains Planning Branch, Health Protection Division)Figure 6 indicates that the incidence of cervical cancer among Aboriginal women in theTerritory was much higher than non-Aboriginal women. This cancer is largelypreventable through Pap smear programs. For a variety of reasons participation in Papsmear programs by Aboriginal women was low.In recent years participation in Pap smear programs by Aboriginal women has improved.This has led to a steady decline in both cervical cancer incidence and mortality andcontinuous improvement in cervical cancer survival in Aboriginal patients. The humanpapilloma virus immunisation program should ensure those incidence rates declinefurther and sustain the improvements over the long term.Department of Health Annual Report 2010-11 25

OverviewFigure 7: Infant Mortality Rates – NT and Australia Compared120Deaths per 1,000 live births1008060402001967 1977 1987 1997 2007NT AboriginalNT non-AboriginalAustralian(Source: Health Gains Planning Branch, Health Protection Division)Infant mortality has improved significantly for both Aboriginal and non-Aboriginalpopulations over the 40 year period from 1967 to 2006 as can be seen in Figure 7. Mostprominent is the 81% fall in NT Aboriginal infant mortality rate from 83.6 deaths per 1000live births in the period 1967-1970 to 15.7 in 2006. The fall in the Aboriginal infantmortality rate has not been consistent through this period, with a rapid decline up untilthe mid 1980s followed by a much slower improvement in the past 20 years. The non-Aboriginal infant mortality rate has fallen to and remained consistent with the Australianrate after the mid 1990s.The neonatal death rate (up to age 28 days) is generally regarded as an indicator of thequality of pregnancy related services, while the post-neonatal death rate (from 28 days toone year) is commonly related to living conditions. The improvements in the infantmortality rate shown above can be attributed to substantial improvements in bothneonatal and post-neonatal death rates among the Aboriginal population.26 Department of Health Annual Report 2010-11

Overview8. Preventing and Managing Pressure Injuries which describes the systems andstrategies to prevent patients developing pressure injuries and best practicemanagement when pressure injuries occur.9. Recognising and Responding to Clinical Deterioration in Acute Health Carewhich describes the systems and processes to be implemented by health serviceorganisations to respond effectively to patients when their clinical conditiondeteriorates.10. Preventing Falls and Harm from Falls which describes the systems and strategiesto reduce the incidence of patient falls in health service organisations and bestpractice management when falls do occur.The National Safety and Quality in Health Standards (NSQHS) are awaiting finalapproval from the Australian Health Ministers. The Department will identify the healthservices that are to be assessed against the NSQHS. Health services such as hospitalsand day procedure services across Australia are preparing to implement the NSQHS,with the Commission working towards implementation from 1 January 2013.The graphs included below show trends in safety and quality in Northern Territory publichospitals. These have been validated for the national health reform process myHospitalwebsite, or relate to the standards above.Figure 8: NT Public Hospital Inpatient Mortality Numbers and % within eachDiagnosis Category 2010-1110%9%8%7%6%5%4%3%2%1%0%AcutemyocardialinfarctionFracture of neckof femurHeart failure Influenza StrokeN.B. During any one episode a patient may have several relevant diagnoses.As can be seen in Figure 8, strokes have the highest likelihood of mortality at 9.5% or 36patients deceased out of the 380 admitted with this condition during 2010-11. Thediagnosis leading to the highest number of deaths during the year was influenza (with 77deaths) however, because 2600 patients were admitted with influenza, these deathsrepresented only 3.0% of those admitted for this condition. The Department continues toimplement chronic condition management strategies that are aimed at strokes, heartfailure and acute myocardial infarction such as cardiovascular risk assessment andimproved technology. Point of care testing and electrocardiograms (ECGs) withelectronic transmission to specialist centres enable primary health care staff to initiate28 Department of Health Annual Report 2010-11

Overviewbest practice treatment for heart attacks in remote settings which reduces heart damageand risk of heart failure.14%12%10%8%6%4%2%Figure 9: NT Mental Health Hospital Re-admissions within 28 Days0%2007-08 2008-09 2009-10 2010-11Figure 9 shows the percentage of separations from the mental health services’ acutemental health inpatient units which resulted in re-admission to the same or to anotherpublic acute mental health inpatient unit within 28 days of discharge. In 2009-10, theinpatient units in Alice Springs and Darwin were able to maintain a relatively low rate ofre-admission, well within the prevailing national rate. In 2010-11, the inpatient units inAlice Springs and Darwin were able to maintain a relatively low rate of re-admission(11%), within the prevailing national target of 12%. Small fluctuations from year to yearare to be expected, given the comparatively low numbers of acute mental healthadmissions in the Northern Territory (918 in 2010-11).250Figure 10: Falls in NT Public Hospitals 1 2007 to 20112001501005002007-08 2008-09 2009-10 2010-111. Please note that these falls are only those reported and resulting in injury. Delays in coding may have alsoresulted in undercounting for 2010-11.All Northern Territory hospitals are very aware of the risk of falls for their patients and aretaking action to minimise this. Royal Darwin Hospital introduced “Preventing Falls andDepartment of Health Annual Report 2010-11 29

OverviewHarm in Older people” best practice guidelines for Australian Hospitals in 2009. This waslaunched on April 1 st 2009, beginning the inaugural April Falls Day event. It is amultidisciplinary program to raise awareness of falls across the hospital. This event hasbeen held every year on April 1 st since and has also been occurring at the other NTpublic hospitals during 2010-11.In October 2010, Alice Springs Hospital was awarded an extensive achievement rating ataccreditation for their falls management program.All hospitals have mandatory falls education for nursing and patient care assistant staffand follow the policy and guidelines for falls minimisation and risk assessment. Thisresults in continual evaluation of falls and feedback to staff on further action that could betaken.Figure 11: Hospital Acquired Staphylococcus Aureus (SA) Bacteraemia, MethicillinResistant (MRSA) and Methicillin Sensitive (MSSA) numbers and rate per 10,000patient days in NT Public Hospitals 2010-11302520151050No.s0.6Episodesof SAB(MRSA only)0.9Episodesof SAB(MSSA only)Figure 11 indicates that the Territory experienced 18 cases of MRSA (representing a rateper 10,000 patient days of 0.6) and 27 cases of MSSA infections (representing a rate of0.9) during 2010-11. This was an improvement on the figures for 2009-10 of 0.7 and 1.3respectively. Other jurisdictions ranged from 0.2 to 0.4 for MRSA and 0.7 to 1.0 forMSSA during 2009-10 (Report on Government Services 2011: Table 10A.50).Prevention and reduction in the rates of hospital acquired bacteraemia is a major focusof the Infection Control Unit. Accurate data is collected and fed back to the hospitals’infection control and quality committees and benchmarked against national publisheddata. The Infection Control Unit’s multidisciplinary staff and the committees implementthe Department’s infection control program.Primary strategies to reduce rates include the Hand Hygiene program, education ofnurses and medical staff, training in appropriate use and type of intravenous lines andthe creation in 2011 of a vascular access consultant position, responsible for overseeingauditing, insertion, training, education and reporting. This position reports directly back tothe Infection Control Unit and provides accurate data of the type above to ensure thehospitals meet Australian Commission on Safety and Quality guidelines in this area.30 Department of Health Annual Report 2010-11

Chief Health Officer’s ReportChief Health Officer’s ReportDr Barbara PatersonChief Health OfficerMBChB, DCH, DGM, DRCOG, MRCGP, MPH, FAFPHMPublic Health and the Role of Legislation inImproving Health OutcomesHealth challenges have evolved in the last 100 years, as have theresponses by health services. In the Northern Territory the historical excess of illnessesand deaths due to infectious diseases has been substantially reduced and replaced as amajor cause of morbidity and mortality by chronic diseases such as diabetes, heart andkidney disease. This change is seen in other states and territories of Australia andthroughout the developed world.The wave of chronic disease threatens to overwhelm us and we also have significantchallenges in achieving Closing the Gap targets relating to Indigenous disadvantage.To respond we need to ensure that our primary, secondary and tertiary health servicesare of the highest quality and that we continue to support the development of Aboriginalcontrolled services. However, to achieve ongoing health improvement, we must not onlytreat but also prevent diseases and injury. We must address the common risk factorsthat lead to this burden of excess morbidity and mortality, including social andenvironmental risk factors.Historically, legislation has made a significant contribution to improving the health of thepopulation. Since the industrial revolution and the turn of the 20 th Century, Europe, theUnited States of America and Australia have seen sweeping changes in our health andwellbeing as a result of the introduction of legislative controls on housing andenvironmental health, sanitation, food hygiene, communicable diseases, industrialhygiene and occupational health. Today, legislation continues to play a key role inimproving and protecting the health of the population.This year saw the commencement of the Public and Environmental Health Act on1 July 2011. This Act has replaced the outdated Public Health Act and provides a flexibleapproach to regulating and monitoring current and any emerging public andenvironmental health issues in the Northern Territory.Tobacco usage is the single largest preventable cause of death and disease in Australiaand contributes 7.8% to the total Australian burden of disease and injury. The estimatedtotal social cost of tobacco use in 2004–05 was around $31.5 billion nationally. A study isunder way in the NT to determine the harms and costs of tobacco in the Territory.This year saw the establishment of the NT Tobacco Control Advisory Committee whichwill provide progress reports and recommendations on the implementation of the NTTobacco Action Plan (2010-2013). This Action Plan provides a comprehensive strategicframework to coordinate efforts across government, non-government organisations,health professionals and other stakeholders to reduce tobacco related harm throughoutthe Northern Territory. The Action Plan includes a range of priority activities that spanthree key areas for action: health care interventions; community interventions; and policyand legislation interventions.Department of Health Annual Report 2010-11 31

Chief Health Officer’s ReportThere has been a significant strengthening of legislation as a result of amendments tothe Tobacco Control Act and Regulations during 2010 and 2011. The Act bans smokinginside pubs, and clubs and in all public outdoor eating and drinking areas (with exemptareas for licensed venues). There is also provision for the owner of an area intended foruse by the public to voluntarily declare an outdoor area as smoke free. The display oftobacco products at the point of sale is now prohibited, there are greater powers toimpose licence conditions on vendors and an annual licence fee has been introduced.These amendments provide protection for the public and staff against the harms ofenvironmental tobacco smoke and improve the monitoring of tobacco sale and supply.Importantly, these changes help to “de-normalise” smoking within the population as wellas serving to protect children and youth from exposure to tobacco smoke in publicplaces. By banning the display of tobacco products they also reduce the stimulus tochildren to start smoking. It is estimated that 80% of current smokers commencedsmoking before 18 years of age.Another positive measure has come from the Australian Government which hasannounced that all tobacco products sold in Australia will be required by legislation to besold in plain packaging by 1 July 2012. Their rationale is to reduce the attractiveness andappeal of tobacco products to consumers, in particular young people; increase thevisibility of the mandated health warnings; reduce the ability of packaging to misleadconsumers about the harms of smoking; and ultimately to reduce smoking rates.Alcohol continues to cause considerable harm in the Territory, with total social cost ofalcohol in the Northern Territory estimated to be $642 million per year. Since my lastreport, the Northern Territory Government has introduced the ‘Enough is Enough AlcoholReforms’, led by the Department of Justice, that commenced on 1 July 2011. Two newActs have been passed, the Alcohol Reform (Prevention of Alcohol Related Crime andSubstance Misuse) Act, and the Alcohol Reform (Substance Misuse Assessment andReferral for Treatment Court) Act (administered in the Local Court known as the SMARTCourt) and amendments have been made to the existing Liquor Act in order to targetproblem drinkers to tackle alcohol-related crime and anti-social behaviour in ourcommunity. A major focus of the reforms is to encourage and assist more people to seektreatment and alcohol treatment services are being expanded and enhanced to cater forthe new demand. I am confident that these reforms will make a significant contribution toaddressing the harms of alcohol in the Territory.Broad community education and awareness of the harms of alcohol and “safe” drinkinglevels are also required to target broader sectors of the community where heavy andregular alcohol consumption is considered a social norm. Alcohol takes a significant tollon health through conditions such as alcoholic liver cirrhosis, hypertension, stroke andcertain cancers as well as causing a great deal of injury. We must continue to fosterpublic debate and explore the evidence of what has been shown to affect attitudinal andbehavioural change and reduce alcohol consumption and alcohol related harm, whetherthrough legislative or non legislative means.Health improvements are often gained through legislation introduced by othergovernment departments. Significant examples include the introduction of compulsoryseat belts, changes in speed limits and reducing the legal blood alcohol concentration fordriving from 0.08 to 0.05 which have made a significant contribution to reducing roaddeaths and serious injuries over the past 40 years. As health professionals we mustcontinue to work with other government departments and assist with data and researchevidence to contribute to legislative reform.32 Department of Health Annual Report 2010-11

Aboriginal Health ReportAboriginal Health ReportJackie Ah KitA/Executive Director, Systems Performance and Aboriginal PolicyWhile we continue to work for the health and wellbeing of allTerritorians, Aboriginal health is central to the Department’sactivities. In 2010-11, 70% of our hospital admissions and 72% ofservice occasions at our health centres involved Aboriginal people.Many of our activities are firmly targeted at improving the health of Aboriginal Territoriansand at closing the gap in life expectancy between Aboriginal and non-AboriginalTerritorians. In 2006 (the earliest this data is available) this gap was just over 15 yearsfor women and was 21 years for men.Our targets for closing this gap are spelt out in our Corporate Plan, the Northern TerritoryGovernment’s Territory 2030 Plan and the Australian Government’s National PartnershipAgreement on Closing the Gap in Indigenous Health Outcomes. We are focused onmeasuring, analysing and reporting our performance on health outcomes and the safetyand quality of our services.The Department reviewed its organisational performance management this year toidentify improvements using regular traffic light reports on our key activities. This allowsmanagement and service delivery workers to improve their services to the Territorypublic on a continuing basis. Already we and our partners in Aboriginal CommunityControlled Health Organisations (ACCHOs) are using the NT’s Aboriginal Health KeyPerformance Indicators to work out whether community members are being monitoredfor chronic disease and appropriately treated. The creation of 16 Continuous QualityImprovement positions will help to ensure Health Centres constantly monitor their workand maximise their health promotion and chronic disease prevention efforts. In this waywe may be able to reduce the trend of increasing acute hospitalisations and eventuallyreduce health expenditure.Partnerships with the community are central to the way the Department operates. Thekey partnership in Aboriginal health is through the Northern Territory Aboriginal HealthForum (NTAHF) which is made up of representatives of the Department, the Departmentof Health and Ageing, the Aboriginal Medical Services Alliance NT and more recently theDepartment of Families, Housing, Community Services and Indigenous Affairs(FaHCSIA). The NTAHF has made significant progress in Aboriginal primary health carereform through implementation of the Expanding Health Service Delivery Initiative toimprove access to health and education services. The NTAHF is guided by the Pathwaysto Community Control Framework, a tripartite framework which recommends a gradualroll out of regional ACCHOs across the Territory.In order to provide culturally secure and more effective health services, the Departmentis developing its plan of creating regional health providers in remote areas controlled byACCHOs. The aim is for each region or health service delivery area to have one mainprimary health care service provider under community control. The Red Lily AboriginalHealth Corporation was established and significant progress towards regionalisation wasmade in Barkly and West Arnhem during 2010-11.Department of Health Annual Report 2010-11 33

Aboriginal Health ReportThe idea is that each primary health careprovider will ensure that they offer an agreedset of core primary health care functions. Arecent review is currently being finalised andwill provide a comprehensive set of corefunctions that can be agreed by allpartners of the NTAHF and be applicableto regionally-based Aboriginal primaryhealth care across the Northern Territory.A Competency and Capability Framework(CCF) assessment tool has been developed to assist with the regionalisation process inthe Territory. The CCF assessment tool is still in its trial stages. It provides a mechanismfor self-assessment and also for a formal assessment by government in order totransition to a Regional ACCHO for the relevant health service delivery area.The employment of more Aboriginal staff should lead to Aboriginal Territorians beingmore likely to use health services and improve their health outcomes.We have increased our efforts to attract, retain and promote Aboriginal staff. In 2010-11,we had the largest intake of Aboriginal apprentices and cadets (37 in total, of which 21were Aboriginal), the third year of the promotional Stepping UP program and the majorityof Aboriginal Health Workers now have training plans.Reviews that focus on the cultural security of Royal Darwin Hospital and feed-in serviceshave commenced. These reviews consider the admissions process and the broaderpatient journey. Recommendations on appropriate reforms to improve the patient journeywill make the system more responsive to the needs of Aboriginal and Torres StraitIslander clients.Similarly, departmental staff members have been working on a national project:‘Measuring Cultural Competence in Health and Wellbeing Service Delivery’. TheTerritory has recently circulated a report to national stakeholders proposing a frameworkthat clearly identifies a set of core cultural competence measures that could beimplemented across jurisdictions. If cultural competence is measured then it can bemanaged appropriately. Services would then need to ensure that they are culturallycompetent; increasing the likelihood that Aboriginal people will use such services.The life expectancy gap between Aboriginal and non-Aboriginal female Territorians,while still wide, is closing and cervical cancer rates have sharply dropped. Chronickidney disease care coordination is also showing improved outcomes for patients and aslowing in the number of patients commencing dialysis. In the next year, through ourincreased efforts in chronic condition management and primary health care, we shouldsee more improvements, particularly in the risk factors for chronic disease – smoking,alcohol consumption, exercise and diet.34 Department of Health Annual Report 2010-11

Output Groups Performance ReportingOutput Groups Performance ReportingThis section reports on output groups consistent with Working for Outcomes – theNorthern Territory Government’s financial and performance management framework.This framework requires agencies to report on achieving performance at an Output levelwith performance measures set out in Budget Paper No 3.During the 2010-11 financial year the Department was split into two separate agencies:the Department of Health; and the Department of Children and Families (DCF).Consequently $135.5 million for the NT Families and Children Output Group wastransferred out of the Department’s budget.Allowing for the transfer out of the NT Families and Children Output Group, theDepartment of Health’s budget has increased $76.6 million from an opening allocation of$1022.2 million to $1098.8 million.The increase was due to additional funding provided by the Australian Government andNorthern Territory Government relating to the increased demand for health and socialservices provided by the Department. A breakdown of the major funding variationsfollows.Northern Territory Government initiatives ($15.8 million) included:• funding for the Northern Territory Public Sector Medical Officers’ EnterpriseAgreement 2011-2013;• $3 million for St John Ambulance Australia (NT) to cover emergency road ambulanceand medical transportation services; and• $1 million to manage existing exceptional and complex needs clients in thecommunity.The Department secured a net increase of $17 million for Australian Government fundedprograms, this included new funding agreements executed in 2010-11 and additionalexpense capacity to acquit Australian Government funding received in 2009-10. Themajor adjustments relating to Australian Government funding were:• $7.3 million for Office for Aboriginal and Torres Strait Islander Health primary healthprograms including the Expanding Health Services Delivery Initiative;• $2.6 million for the Medical Specialist Outreach Program;• $2.0 million for the Alan Walker Radiation Oncology Unit;• $1.1 million for the Organ Tissue Donation Program;• $0.9 million for Specialist International Medical Graduates; and• $0.5 million for the Northern Territory Medical Program.During 2010-11, the Department generated an additional $32 million in ‘Fee for Service’revenue. This was mainly attributable to Acute Care services provided to interstateclients and other compensable patients charges, plus the recovery of shared corporateservice costs from DCF and an increase in the Department of Business andEmployment’s services that were free of charge.As shown below, in 2010-11 the Department’s expenses were $13.8 million (1.25%)above budget. The additional expenditure was largely attributable to increased demandDepartment of Health Annual Report 2010-11 35

Output Groups Performance Reportingfor hospital services, the pensioner concession scheme, individual subsidy packages forpeople with disabilities and the enhanced Top End Medical Retrieval Service.Key Deliverables 2010-11Budget$’0002010-11Estimate$’000%Change2010-11Actual$’000%changefromEstimateNT Families & Children 135 554Family and Parent SupportServices12 041Child Protection Services 31 134Out of Home Care 42 423Youth Services 14 654Family Violence and SexualAssault Services34 675Children’s Commissioner 627Acute Services 647 342 692 134 6.9% 708 476 2.36%Admitted Patient Services 517 546 549 601 562 595Non Admitted Patient Services 129 796 142 533 145 881Health & Wellbeing Services 311,132 337 495 8.5% 338 458 0.29%Community Health Services 177 482 190 045 190 020Mental Health Services 42 542 45 293 43 524Services for Frail Aged and73 873 83 614 83 609DisabledSupport for Senior Territorians 17 235 18 543 21 305Public Health Services 63 695 69 172 8.6% 65 650 -5.09%Environmental Health Services 6 697 6 952 5 928Disease Control Services 25 544 25 749 25 141Alcohol and Other Drug25 140 29 123 27 316ServicesHealth Research 6 314 7 348 7 265Total 1 157 723 1 098 801 1 112 584 1.25%Note: The 2010-11 final estimate published in the Budget Papers was $1089.9 million.Subsequent to the publication of the Budget Papers, variations to the Department’s budget wereapproved under Section 18 ($10 million for a Treasurers Advance) and Section 20 (1) (transferout of $1.1 million to capital works) of the Financial Management Act.36 Department of Health Annual Report 2010-11

Acute Care Output GroupAcute CareConsistent with a number of reform agendas, including preparedness for theimplementation of the National Health and Hospital Reform, in April 2011 the Acute CareDivision was redesigned into three separate divisions as follows:• Top End Hospital Network – responsible for the operations of Royal Darwin, GoveDistrict and Katherine Hospitals;• Central Australian Hospital Network – responsible for the operations of Alice Springsand Tennant Creek Hospitals;• Health Reform Division – comprising Health Reform, Health Planning and AcuteCare Systems Performance and Acute Care Policy and Service Development andsome network functions including the Patient Assistance Travel Scheme (PATS),Specialist Outreach Services, Ambulance and Medical Retrieval Services, policydevelopment, supply and coordination of blood and blood products and nationalfunding agreements.Together these sections support 698 public hospital in-patient beds and a range ofhospital services, including inpatient, outpatient and Emergency Department services.OutcomeImproved health and wellbeing of those in the Northern Territory community who requireacute or specialist care.Key AchievementsIn 2010-11, the three divisions focused on a number of reform activities to enhance thecore activity of provision of hospital services to Territorians. These achievements aresummarised below.As part of the Department of Health’s response to the National Health Reformprocesses, community consultation was undertaken to develop the model for twohospital networks in the Northern Territory: the Top End Hospital Network comprisingRoyal Darwin, Gove District and Katherine Hospitals; and the Central Australian HospitalNetwork, comprising Tennant Creek and Alice Springs Hospitals.The full model for the hospital networks will be implemented by July 2012. In the interim,key highlights have included structural changes to provide local management of regionalhospitals through the network structure. Clinical governance and service developmentwork with the regional hospitals has also been undertaken with, for example, a focus onimproved clinical governance in the Katherine Hospital Emergency Department. TheRoyal Darwin Hospital Director of the Emergency Department has provided oversight forthis project and other senior consultants have provided mentorship and clinicalleadership support to those working at Katherine.This year saw hospital boards actively operating in all five Territory hospitals. TheseBoards have taken on leadership roles in working with departmental staff on the role andfunctions of the hospital network Governing Councils. This has included all boardscoming together and discussing opportunities for the Governing Councils to leadcommunity engagement in hospital business, to provide advice to the Department andDepartment of Health Annual Report 2010-11 37

Acute Care Output Groupthe Minister about issues important to local consumers of our health services and to beactively involved in strategic planning and direction. This work will be completed in early2011-12.Alice Springs, Gove District and Royal Darwin Hospitals received re-accreditation. Thiswas a significant achievement that continues to demonstrate Northern Territory hospitals’commitment to safety and quality. This ongoing focus on safety and quality included thefirst Northern Territory Safety and Quality Forum, bringing together a range ofstakeholders to discuss safety and quality issues impacting on service provision andlearning from the experience of others.The Alan Walker Cancer Care Centre has completed its first full year, providing bothradiation oncology and chemotherapy services. This facility is further enhanced by theprovision of new self-caring patient accommodation at Barbara James House, allowinggreater access and support for patients travelling from outside the greater Darwin area,particularly those travelling from Central Australia.Work commenced towards development of the 10-year Heart Health Plan. This includeda comprehensive review by KPMG of a range of options to consider as part of the furtherdevelopment of cardiac specialist services in the Northern Territory. It is anticipated thata service model will be implemented in 2011-12 as part of finalising the Heart HealthPlan.In July 2010, the first schedule of the Tri-State Agreement for renal services wasfinalised between Western Australia and South Australia, agreeing to the flow andboundaries for client management. Following this agreement, in order to developprocesses to ensure the smooth transfer from renal patients across the tri-state areaborders, the Australian Government commissioned the Central Australian Renal Study.This study, released in June 2011 and endorsed by the partners (the Australian,Northern Territory and South Australian Governments), outlines the experience of renalproviders, examines the evidence and provides an analysis of current and future demandfor dialysis services in the Central Australian region. The study also proposes AliceSprings as a hub for regional renal services. The next step for this important piece ofwork will be the development of an implementation plan across the service continuum bythe partners.A mobile respite dialysis bus has been established as the result of a feasibility study andan initiative trialled in the Top End. Its first trip was to the 2010 Garma Festival where itprovided services to allow four patients to attend the festival. The success of this hasgarnered national interest. The renal dialysis bus has spent the remainder of thisfinancial year in Central Australia, with a focus on providing patients with an opportunityto have respite in their own community, while still being able to dialyse with nursingsupport.There is now additional renal chair capacity in Alice Springs, due to the opening of theGap Road service in April 2010, so the focus for this financial year has been on theexpansion of short term renal patient accommodation capacity to allow those having torelocate to Alice Springs an opportunity to be housed while they are waiting for longerterm accommodation. The refurbishment of the former Bath Street Lodge into the AlyerreLodge provides accommodation for 35 renal patients.Royal Darwin and Alice Springs Hospitals are the busiest per capita emergencydepartments in Australia. This continued in 2010-11 with 141 370 attendances and35,670 admissions to Territory Emergency Departments. The proportion of Emergency38 Department of Health Annual Report 2010-11

Acute Care Output GroupDepartment attendances seen within our targets for each triage category (exceptCategory 1 Resuscitation which continues to meet the target of 100%) all improvedduring 2010-11.Elective surgery educational material for health professionals and clients has beendeveloped and translated into 11 of the most commonly spoken Aboriginal languages.This material is intended to assist professionals to explain key points of the electivesurgery process to clients and to educate hospital based health professionals about howthey can make the elective surgery journey less traumatic for their clients.The Northern Territory Program of Experience in Palliative Approach, known as thePEPA project, won the first prize for a poster presented at the 18 th InternationalCongress on Palliative Care in Canada. There were 270 other entries in this prestigiousaward. The focus of the project is delivering training to Aboriginal Health Workers andAboriginal Aged Care Workers in assessment, interventions and discussion of end of lifeand palliative issues with Aboriginal and Torres Strait Islander clients. Support has alsobeen provided to community members to assist people to return home to “finish up”.The signing of a new five year contract with an optional five year extension, with St JohnAmbulance (NT) represents an investment of more than $100 million, a significantincrease in funding. The new contract includes enhanced services to reduce pressure onemergency response teams including, expansion of services in Katherine to a 24/7service; the introduction of a Medical Transportation Service providing an alternatetransportation service for low care patients in Darwin and Alice Springs and the inclusionof Clinical First Response and Support units to assist with the management of highpriority emergency response.On 16 June 2011, the Top End Medical Retrieval Services contract was awarded toCareFlight, valued at $25 million per annum for 10 years. The awarding of a newcontract provides for a fully integratedservice in the Northern Territory for thefirst time. This means integration of fulllogistics coordination, near new aircraft,improved maintenance and engineeringand medical and clinical staffing. This fullyintegrated model will allow for clinicalefficiencies and quicker response timesacross the Top End. Patient transport inthe Katherine region has beenstrengthened with the use of a patienttransport plane since 1 July 2009, to andfrom Katherine.This financial year has also seen a significant increase in the capital works programs forthe five Territory hospitals and significant additions to patient accommodation both onand off campus. Associated with efforts to reduce elective surgery waitlists, two newtheatres have been built at Royal Darwin Hospital. Emergency Departmentrefurbishment work commenced at Royal Darwin and Katherine Hospital. The contractfor a new Emergency Department and 24-hour Medical Imaging Service at Alice SpringsHospital was awarded in June 2011.A short term accommodation complex commenced construction on the Royal DarwinHospital campus in September 2010. On completion, the accommodation will provide for50 units and 100 beds for patients and their carers. In May 2011, the Minister for Health,with the Australian Government Minister for Indigenous Health, announced Health andDepartment of Health Annual Report 2010-11 39

Acute Care Output GroupHospitals Fund awards for the refurbishment work of the Emergency Departments atTennant Creek and Gove District Hospitals and patient accommodation at TennantCreek, Gove District and Katherine Hospitals.Joint funding of $110 million for a Palmerston Hospital was also announced. Planning forthe service scope within the first new hospital in the Northern Territory for more thanthirty years is underway, with a focus for 2011-12 being service planning to complementservice provision from Royal Darwin Hospital and provide for the future needs of theGreater Darwin region. Functional and concept plans for the design of the hospital willalso be undertaken in 2011-12.Admitted Patient ServicesAdmitted patient services comprise acute and non-acute medical care or treatments topatients who undergo a formal admission process. In 2010-11, the revised budgetallocated $549.6 million to Acute Care admitted services, with actual expenditureamounting to just over $562.6 million, representing a budget deficit of approximately2.4%. This deficit is a function of growing demand on Acute Care services with 3.4%growth in admitted weighted activity. Budgeted weighted separations for 2011-12 of 71900 represent a growth of only 1%. A forecast of 3% growth or 74 000 weightedseparations is more likely given current trends.2009-10Actual2010-11Budget2010-11Estimate2010-11ActualOutput Cost ($’000) 500 218 517 546 549 601 562 595Key Deliverables 1 2009-10Actual2010-11Budget2010-11Estimate2010-11Actual2011-12BudgetSeparations 2 110 800 112 500 114 400 115 592 117 500- same-day separations18 995 18 600 19 600 20 018 19 800(excluding haemodialysis)- overnight separations46 797 46 800 46 800 48 224 49 200(excluding haemodialysis)- haemodialysis separations 45 008 47 100 48 000 46 078 48 500- weighted separations 3 68 892 74 000 71 200 71 053 71 900Average length of stay 4 5.4 5.6 5.4 5.4 5.4Intrastate patient travel 5 3 212 3 300 3 300 3 515 3 500Interstate patient travel 5 23 458 23 100 23 100 24 131 24 200Elective surgery waiting list6 662 7 700 7 000 6 484 7 100admissions 6Emergency admissions 33 290 33 200 36 300 35 670 36 700Elective surgery waiting times- Category 1: admission within 30 76% 88% 88% 86% 88%days- Category 2: admission within 90 53% 70% 70% 62% 70%days1. 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 of themeasures in the table are therefore not directly comparable with other jurisdictions.2. The number of admitted patients who have separated from a Northern Territory hospital.40 Department of Health Annual Report 2010-11

NEWS IN BRIEFMENA-OECD Initiative extendedfor two yearsMorocco's Chairmanship of theMENA-OECD Initiative was extendedfor two years, given the "dynamic" ofthe kingdom in the region,announced in Paris the Minister incharge of Economic and GeneralAffairs and co-president of the initiativefor the investment program, NizarBaraka.Since 2009 Morocco has been holdingthe co-chair of the program of theOrganization for Economic Co-operationand Development (OECD) for theMiddle East and North Africa region,for an initial term of three years.According to the Minister, theMoroccan Chairmanship focused itsefforts on one of the major issues,namely the integration of the MENA-OECD to develop synergies with theaim to build a common future. Hestressed, in this regard, the importanceof exchanging experiencebetween OECD countries and theMENA region to bring the best practicesand find solutions to variousissues confronting the region, particularlythe implementation of the genderapproach.Morocco took part in 16thministerial conference of nonalignedcountries held inIndonesiaMoroccan secretary of state to theminister of foreign affairs and cooperation,Latifa Akharbach, representedthe Kingdom in the 16th ministerialconference of the Non-Aligned Countries,from May 23 to May 27 inIndonesia.The conference, held under thetheme "a shared vision of nonalignedcountries for the next 50years", will be followed by a meetingto mark the fiftieth anniversary of theNon-Aligned Organisation.A foreign ministry statement saidMorocco, which is committed to themovement's founding principles,stresses the importance of South-South and three-way cooperation topromote human and sustainabledevelopment.Accession of Morocco and Jordanto GCCThe accession of Morocco andJordan to the Gulf CooperationCouncil (GCC) is likely to strengthenpartnership and Arab economic cooperation.Morocco reaffirmed his favorableposition to join the Gulf Co-operationCouncil (GCC), said the CommunicationsMinister, Spokesman of theGovernment, Khalid Naciri.Given its serious nature, this questionrequires a deep consideration of allits diplomatic and administrativeaspects (…) to identify the appropriateformulas enabling Morocco andthe GCC countries to give a tangiblecontent to this profound interaction,the Minister said at a press briefingfollowing the weekly cabinet meeting."We are still at the beginning of theprocess and we will find appropriateapproaches that will enable us tobring satisfactory answers to the peoplesof Morocco and Gulf countries,"the Minister added.The GCC had addressed an invitationto Morocco on March 10th, 2011to join this regional grouping.EU and GCC experts meet toboost cooperation in clean energyEnergy experts and scientists fromthe European Union (EU) and theGulf Cooperation Council (GCC)began a meeting in Brussels on May11th, 2011 with the objective to promotecommon interests of stakeholdersin the two regional blocs active inthe field of clean energy. The EU-GCC Clean Energy Network held itssecond Discussion Groups' Meeting.The idea behind the network was tobe a catalyst to promote cooperationand activities between companies,organizations and universities in theclean energy sector, as announcedby Professor John Psarras, directorof the project from the EU side.He told the gathering that the Greekprofessor noted that the Brusselsmeeting was the second DiscussionGroups' gathering of the network withthe aim to brief the participants of theoutcome of the first DiscussionGroups' Meeting held in Abu Dhabi inNovember 2010 and to build on thoseresults. The first plenary meeting ofthe network was held last January inAbu Dhabi. He said the networkworked on an informal technical levelto help and support the official EU-GCC energy group. The network has200 registered members from bothsides.Psarras said that the two-day meetingwill focus on discussing specificco-operation within the Five DiscussionGroups: Renewable EnergySources, Energy Demand ManagementEnergy Efficiency, CleanNatural Gas related Clean Technologies,Electricity InterconnectionsMarket Integration, Carbon Captureand Storage. Hamza Kazim, from theMasdar Institute, UAE, which is theleading counterpart of the EU fromthe GCC side in the network said theyhave had held several meetings anddiscussions on how to make this networksustainable . "We are reallykeen to see this network sustain itselfand moving forward. We haverequested the GCC to select the topinstitutions from different countries inorder be promoters for the GCC networks,"said Kazim.He said the Kuwait Institute forScience and Research is among thepartners in the network. Over twodays, EU and GCC experts will discussa number of issues such asRenewable Energy Sources, CarbonCapture and Storage, ElectricityInterconnections and MarketIntegration.Pakistan and Britain co-operate forgas explorationPakistan and the United Kingdom(UK) will enhance experts level cooperationfor the development of oil andgas sector in Pakistan, particularly forextraction of natural gas from theshales. Tijaris 120 - May-June 201141

Acute Care Output GroupYearTable 1: Weighted Separations by HospitalRoyalDarwinHospitalAliceSpringsHospitalKatherineHospitalTennantCreekHospitalGoveDistrictHospital2006-07 37 195 18 714 3 974 2 026 1 9792007-08 38 135 20 014 3 941 1 812 1 7322008-09 37 898 20 767 4 323 1 923 1 8652009-10 38 680 21 798 4 299 2 074 2 0412010-11 39 943 22 597 4 377 2 189 1 947Growth2009-10 to 2010-11 3.3% 3.7% 1.8% 5.6% -4.6%Over this period, the two larger hospitals grew by more than 3% which is consistent withboth population growth and the effect of an ageing population as in previous years.Across the hospital network, growth in weighted separations continues to be influencedby the large volume of same-day cases, which generally have relatively lowercomplexity. The majority of all same day cases (including haemodialysis) are typicallypatients admitted for renal dialysis and account for about 70% of all same daytreatments.Aboriginal and Non-Aboriginal ActivityThe Aboriginal population makes up about 30% of the Territory’s total population, a farlarger proportion than any other jurisdiction. In 2010-11, across the hospital network,Aboriginal people accounted for nearly 70% of all hospital acute separations.Hospital profiles of acute inpatient weighted separations by Aboriginal status haveremained consistent over recent years. In 2010-11, all NT hospitals, with the exception ofRoyal Darwin Hospital, had a greater number of Aboriginal acuity adjusted separationscompared to non-Aboriginal (see Figure 13). This reflects, in part, the relative healthstatus of the Aboriginal population and higher number of Aboriginal people in thecatchment areas of the rural and remote hospitals, compared with the higher number ofnon-Aboriginal people in the urban population of the greater Darwin area.Figure 13: Weighted Separations by Aboriginal status,by hospital, per cent, 2010-111009080706050403020100%Royal DarwinHospitalAlice SpringsHospitalKatherineHospitalTennant CreekHospitalGove DistrictHospitalAboriginalNon-Aboriginal42 Department of Health Annual Report 2010-11

Acute Care Output GroupIn 2010-11, the top five major diagnosis categories (MDCs) accounted for approximately40% of all acute type patients, excluding those admitted for haemodialysis as shown inFigure 14. Across the hospital network, the most common MDC was pregnancy,childbirth and the puerperium (postnatal period) in Aboriginal and non-Aboriginalpatients. However, diseases and disorders of the respiratory system ranked highestamongst Aboriginal patients. These factors are consistent with 2009-10.Figure 14: NT Hospitals Inpatient Separations - Top Five Major DiagnosticCategories by Aboriginal status, separations, 2010-117.0'0006.05.04.03.02.01.00.0MDC:14 MDC:04 MDC:08 MDC:06 MDC:09Aboriginalnon-AboriginalMDC:14 - Pregnancy, Childbirth & the Puerperium (known as the postnatal period)MDC:04 - Diseases & Disorders of the Respiratory SystemMDC:06 - Diseases & Disorders of the Digestive SystemMDC:08 - Diseases & Disorders of the Musculoskeletal System & Connective TissueMDC:09 - Diseases & Disorders of the Skin, Subcutaneous Tissue & BreastIn 2010-11, as shown in Figure 15 below, the average length of stay for any patientstreated within the hospital network (excluding all same day patients) was 5.4 days. Thisis consistent with 2009-10 when the average was also 5.4 days. With the exception ofTennant Creek Hospital, on average, Aboriginal patients experienced significantly longerperiods of stay when admitted to a Territory hospital.Department of Health Annual Report 2010-11 43

Acute Care Output GroupFigure 15: Hospital and Average Length of Stay Excluding Same Day, 2010-118Days76543210Royal DarwinHospitalAlice SpringsHospitalKatherineHospitalGove DistrictHospitalTennant CreekHospitalAboriginal Non-Aboriginal Hospital Network - AverageThe longer average length of stay for Aboriginal patients presenting at Alice SpringsHospital and Royal Darwin Hospital, reflects the prevalence of complex and chronichealth problems being managed at larger hospitals with more specialist services. It alsoindicates the difficulty in transferring patients back to their communities, in many caseshindered by remoteness or difficulty in providing suitable community-based care.Renal ServicesThe Northern Territory has the highest prevalence of renal disease in Australia. In recentyears, total renal expenditure has increased in approximate proportion to total renalseparations (see Figure 16). The treatment of end stage renal disease is an expensiveand high support activity and is a key driver of increasing health care costs in theTerritory.There are three types of treatment for people with end stage renal disease.Haemodialysis is the most common form of treatment in the Territory, followed byperitoneal dialysis and transplantation. In 2009-10, across the Territory, more than 93%of renal replacement therapy was provided to Aboriginal Australians.Renal services are delivered from the two main centres (Alice Springs and Darwin)utilising satellite service centres in a hub and spoke model to meet the growing demandfor renal services across the Territory. Dialysis services in Central Australia are providedat Flynn Drive, Gap Road, Alice Springs Hospital and Tennant Creek Hospital. Self caredialysis is provided at Nightcliff, Palmerston, Royal Darwin Hospital and KatherineHospital.44 Department of Health Annual Report 2010-11

Acute Care Output GroupFigure 16: Renal Dialysis Treatments 2006-07 to 2010-1150454035302520151050'000 / $'000s2006-07 2007-08 2008-09 2009-10 2010-11Aboriginal non-Aboriginal Renal Expenditure - $MA key goal in supporting people closer to home resulted in an expansion of home dialysisservices. Home based dialysis options were accessed by 39 people using peritonealdialysis and 36 people using haemodialysis. These patients have been trained toperform their own dialysis and have either a machine in their own home or dialyse inmulti-user dialysis facilities.In the Top End there are eight Renal Ready Rooms attached to Health Centres and onein Central Australia.Figure 17 below shows renal dialysis treatments by hospital (with dialysis activity) andAboriginal status with similar Aboriginal separations in Royal Darwin Hospital and AliceSprings Hospital but more non-Aboriginal separations in Royal Darwin Hospital.Figure 17: Renal Dialysis Treatment Separations by Hospital and Aboriginal Status2006-07 to 2010-1120000180001600014000120001000080006000400020000'000AboriginalNon-AboriginalAboriginalNon-AboriginalAboriginalNon-AboriginalAboriginalNon-AboriginalRoyal Darwin Hospital Alice Springs Hospital Katherine Hospital Tennant CreekHospital2006-07 2007-08 2008-09 2009-10 2010-11Department of Health Annual Report 2010-11 45

Acute Care Output GroupPatient Assisted Travel SchemeThe Northern Territory Patient Assistance Travel Scheme (PATS) provides assistancewith the cost of interstate and intrastate travel and accommodation for patients who arerequired to travel over 200 kilometres to access specialist health services. Theaccommodation allowance has increased to $35 per night in a commercial setting. Thesubsidy is $10 per night in a private home. This places the Northern Territory subsidy asmore than is provided in NSW, QLD, SA and the same as the ACT. Patients travelling ina private vehicle are now reimbursed for each patient travelling in the one vehicle(capped at three eligible patients per vehicle), for an allowance of 15 cents per kilometreper patient. All jurisdictions provide a subsidy within 4c per km of the Territory subsidyrate.The number of patient travel requests, across the program of inter-state transfer, MedicalRetrieval Services (Medivac) and PATS, provide a stable pattern, both on the category oftransfer and whether an interstate or intrastate transfer, with a 971 increase in thenumber of requests in 2010-11 from 26 676 in 2009-10. Intrastate requests representaround 87% of the requests (some interstate requests may have been wronglycategorised).Table 2: Number of Patient Travel Requests, 2005-06 to 2010-11Category 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11Interstate 2 544 2 688 2 837 3 042 3 214 3 515Intrastate 19 317 20 640 20 067 21 035 23 462 24 132TOTAL 21 861 23 328 22 904 24 077 26 676 27 647Table 3 shows the split across the programs, with PATS accounting for 73% of patienttravel requests in 2010-11.Table 3: Number of Patient Travel Requests, by Program, 2005-06 to 2010-11Program 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11Inter Hospital Transfer 1 765 1 937 1 727 1 927 2 177 2264Medivac Patient 5 093 4 905 4 773 4 322 5 109 5 194PATS Patient 15 003 16 486 16 404 17 828 19 390 20 189TOTAL 21 861 23 328 22 904 24 077 26 676 27 647Patients travelling interstate for surgery or other intensive therapies are nowautomatically provided an escort and are eligible for reimbursement of ground transportcosts of up to $40 per trip. This has resulted in an increase in the number of escorts,from 4564 in the 2005-06 financial year to 7727 this financial year.Table 4: Number of Patient Travel Escorts 2005-06 to 2010-11Category 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11Interstate 890 983 1025 1424 1551 1555Intrastate 3674 4202 4647 5319 5688 6172TOTAL 4564 5185 5672 6743 7239 7727The top three intrastate referrals were for radiology, general surgery and obstetrics, withgeneral surgery and radiology and cardiology being the most frequent reasons for46 Department of Health Annual Report 2010-11

Acute Care Output Groupreferral interstate. There is opportunity to consider these referral patterns as part offuture service planning.Emergency and Elective SurgeryThe Territory’s ability to achieve national targets for elective surgery wait times iscomplicated by many factors that are outside the direct influence of our healthsystem. These include:• high demand for emergency surgical procedures that is almost twice that of theemergency surgical demand in other jurisdictions thus restricting available theatrecapacity for elective surgery;• the same medical workforce operate in the public and private sectors, thus limitingthe scope for elective surgery outside the public sector, coupled with only only oneprivate hospital in the Northern Territory; and• limited capacity for elective surgery across the smaller Northern Territory hospitals.Table 5: Total Number of Elective Surgery Admissions by Public Hospital 2010-11Urgency Category RDH ASH KH GDH TCH TOTALCategory 1 - Urgent 2 952 821 159 65 3 997Category 2- Semi-Urgent 1 838 1 046 243 139 16 3 282Category 3- Non-Urgent 753 381 235 144 1 1 514TOTAL 5543 2248 637 348 17 8 7932010-11 saw continued high numbers of elective surgery occasions of service, but alower volume of 6484 admissions when compared to 6662 admissions in 2009-10.Thisreduction in volume was a result of a continued focus on 'blitzing' in 2009-10 inspecialties where there was a high need for surgery.This year provided for a consolidation of activity and resources leading to planninginitiatives to increase theatre infrastructure, particularly at RDH. The focus for 2011-12will be working towards meeting the benchmarks proposed by the National HealthReform Expert Panel Review of Elective Surgery and Emergency Access Targets andagreed to by all jurisdictions by 2016. These strategies will involve case management forthose regularly unable to attend their surgery, increased theatre capacity at RDH andimproved management of wait lists.Department of Health Annual Report 2010-11 47

Acute Care Output GroupNon-Admitted Patient ServicesNon-admitted care is care provided to a person who receives direct care within theemergency department or other designated clinics within the hospital and who is notformally admitted at the time when the care is provided. In 2010-11, the revised budgetallocated $142.5 million to Acute Care non-admitted services, with actual expenditureamounting to just under $145.9 million, representing a marginal deficit of approximately2.7%. This is largely due to the growth in the numbers of outpatient occasions of service(including radiology) in 2010-11.2009-10 2010-11 2010-11 2010-11Actual Budget Estimate ActualOutput Cost ($’000) 128 478 129 796 142 533 145 881Key Deliverables 2009-10Actual2010-11Budget2010-11Estimate2010-11Actual2011-12BudgetNon-admitted specialist clinic 189 589 195 000 163 100 163 472 164 800occasions of service 2Emergency department132 583 134 900 134 900 141 370 139 500attendances 3Emergency department waitingtimes:- Category 1: resuscitation -100% 100% 100% 100% 100%attended to immediately- Category 2: emergency -63% 70% 70% 65% 70%attended to within 10 minutes- Category 3: urgent - attended 49% 70% 70% 53% 70%to within 30 minutes- Category 4: semi-urgent -51% 60% 60% 54% 60%attended to within 60 minutes- Category 5: non-urgent -91% 85% 85% 90% 85%attended to within 120 minutes1. 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 of thesemeasures are therefore not directly comparable with other jurisdictions.2. Number of specialist consultations for non-admitted patients.3. Number of patients presenting at an emergency department who are registered and triaged (clinicallyassessed).Variations in Key DeliverablesThe reduction in non-admitted specialist clinic occasions of service in 2010-11 shown inthe table above is due to changes in counting rules to ensure consistency with nationalreporting. The number of Radiology Clinic occasions of service has been excluded,unlike previous years.Non-admitted Specialist Clinic Occasions of ServiceWhen radiology services are included, outpatient specialist clinic attendances increasedby over 9% to 206 520 occasions of service (including Radiology occasions of service),as shown in Figure 18. The majority of growth occurred in the Darwin region followed byAlice Springs, with the remaining three hospitals making only marginal contributions to48 Department of Health Annual Report 2010-11

Acute Care Output Grouptotal growth. This growth is largely due to continued efforts to address the NorthernTerritory’s elective surgery wait list that impacted on associated pre-admission surgicaland medical activity.Figure 18: Non-admitted Specialist Clinic Occasions of Service (with Radiology) –all Northern Territory Hospitals 2006-07 to 2010-11250200'000Nationally consistentcount 163 4721501005002006-07 2007-08 2008-09 2009-10 2010-11Emergency Department AttendancesRoyal Darwin and Alice Springs Hospitals are the busiest per capita emergencydepartments in Australia. Emergency Department waiting times measure the proportionof patients seen within benchmarks, set according to the urgency of treatment required.Nationally, waiting times in Emergency Departments have been an area of focus forimprovement, with all jurisdictions striving to meet agreed benchmarks for seeingpatients by 2015.In 2010-11 the number of ED attendances across the hospital network, increased by6.2%. Both RDH and ASH had growth in ED attendances of 6.2% for 2010-11.Figure 19: Emergency Department Attendances – all Northern Territory Hospitals2006-07 to 2010-11145'0001401351301251201151102006-07 2007-08 2008-09 2009-10 2010-11Department of Health Annual Report 2010-11 49

Acute Care Output GroupTable 6 indicates the number of attendances or presentations to EDs for each NorthernTerritory hospital. This shows a steady increase of Emergency Department activity since2005-06.Table 6: Total Emergency Department Attendances 2005-06 to 2010-11Hospitals 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11RDH 51 634 56 121 56 370 56 279 58 198 61 836ASH 31 394 31 918 33 905 36 514 39 195 41 608Gove10 673 8 964 7 747 8 076 8 251 8 790DistrictKatherine 14 801 15 210 15 055 15 033 14 783 14 888Tennant 11 502 10 934 12 374 13 263 12 154 14 295CreekTotal 120 004 123 147 125 451 129 165 132 581 141 417Table 7 shows improvement across most Emergency Department presentation triagecategories. In 2010-11 all (100%) of Category 1, or Resuscitation presentations,continued to be seen within the benchmark. The proportion of presentations with anEmergency Category 2 (a benchmark requiring them to be seen within 10 minutes)continues to improve and increased to 65% in 2010-11 (from 63% in 2009-10).Table 7: Proportion of Patients seen within Standard Waiting Times – TriageCategories 1 to 5TriageCategory2005-06 2006-07 2007-08 2008-09 2009-10 2010-111. Resuscitation 100% 100% 100% 100% 100% 100%2. Emergency 59% 56% 59% 62% 63% 65%3. Urgent 59% 54% 47% 48% 49% 53%4. Semi urgent 53% 49% 47% 50% 51% 54%5. Non urgent 88% 88% 87% 90% 91% 90%In 2010-11 53% of people presenting with a Category 3 or Urgent category (to be seenwithin 30 minutes) represents continued improvement since 2007-08.The proportion of people with a Category 4 or Semi urgent (need to be seen within onehour) continues to see some improvement from 51% in 2009-10 to 54% in 2010-11. Thehigh volume of presentations against this category continues to be a challenge. There isopportunity to implement a range of strategies to ensure streaming of less urgentpatients to less urgent care services.Non-urgent presentations (need to be seen within two hours) declined slightly in 2010-11with 90% of people are being seen within this time frame.50 Department of Health Annual Report 2010-11

Local Hospital NetworkTop End Hospital NetworkRoyal Darwin HospitalTotal active overnight beds: 367 with capacity for up to 420.Royal Darwin Hospital is the Northern Territory’s largest tertiary referral and universityteaching hospital providing acute hospital services to the residents and visitors of theTop End of the Territory and the primary tertiary hospital Territory-wide. The hospital hasa catchment population of around 150 000 people and directly serves an area of 127 000km 2 .The hospital has a strong and successful association with the Flinders University ofSouth Australia through the joint initiative of the Northern Territory Medical Program. Theassociation with Flinders University allows the hospital to engage teaching staff andthereby enhance its available expertise in wide ranging fields, along with training doctors.The hospital also enjoys close association with the Menzies School of Health Researchand Charles Darwin University.Royal Darwin Hospital has achieved Baby Friendly Accreditation and the PathologyLaboratory and Diagnostic Imaging is accredited to National Association of TestingAuthority/International Standards Organisation standards. Royal Darwin Hospital has fullaccreditation by the Australian Council of Healthcare Standards until 8 May 2013.The hospital provides a comprehensive range of clinical, diagnostic and support servicesas the Territory’s major tertiary hospital. This includes a number of specialised servicesprovided for the NT.Gove District HospitalTotal active overnight beds: 32.The 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 hospital for inpatient, outpatient and specialist care.The hospital also provides a District Medical Officer service to the region. This serviceencompasses medical advice and visits to remote community health centres.Gove District Hospital has achieved Australian Council on Healthcare Standards andBaby Friendly Accreditation, Food Safe Accreditation and the Pathology Laboratory andRadiography are accredited to National Association of Testing Authority/InternationalStandards Organisation standards.The hospital provides a comprehensive range of clinical, diagnostic and support servicesincluding:• 24 hour Accident and Emergency care, General Surgical, Medical and PaediatricCare, two respite places and two Emergency respite places, Elective and EmergencySurgery, Maternity Services including caesarean capability, Visiting Specialists Care,24 hour Medical Imaging (on call service after hours);• Pharmacy, Pathology (on call service after hours); and• Stores, Mortuary (post mortems are not performed) and Cyclone Shelter (the storesbuilding is the town designated cyclone shelter).Department of Health Annual Report 2010-11 51

Local Hospital NetworkKatherine HospitalTotal active overnight beds: 60.Katherine Hospital services the Katherine region and remote areas, covering an area ofapproximately 340 000 km 2 between the Western Australian and Queensland bordersand extending south to Dunmarra and north to Pine Creek. The population of theKatherine region is around 19 000 with an annual tourist presence of more than 500 000visitors.Katherine Hospital is accredited with the Australian Council on Healthcare Standardsuntil 15 June 2014. The hospital also has achieved Baby Friendly Accreditation, FoodSafe Accreditation and the Pathology Laboratory and Radiography is accredited toNational Association of Testing Authority/International Standards Organisationstandards.The hospital provides a comprehensive range of clinical, diagnostic and support servicesincluding:• 24 hour Accident and Emergency Care, Obstetrics and Gynaecology, GeneralSurgical, Medical and Paediatric Care, Elective Surgery, Renal Dialysis;• Pharmacy, Radiography, Pathology, Physiotherapy, Social Worker, Visiting MedicalSpecialists;• Aboriginal Liaison Officer to assist with 85% Aboriginal clients;• Mortuary (post mortems are not performed) and Stores; and• access to Medivac and Retrieval services.52 Department of Health Annual Report 2010-11

Local Hospital NetworkCentral Australian Hospital NetworkAlice Springs HospitalTotal active overnight beds: 183.Alice Springs Hospital provides acute care services to the Central Australian region,which has a population of approximately 60 000. Around 2000 tourists are hospitalisedeach year accounting for close to 4000 bed days annually. The hospital’s catchmentarea is approximately 1 605 680 km 2 and includes the southern half of the NorthernTerritory and the border regions of South Australia, Western Australia and Queensland.Alice Springs Hospital achieved full accreditation through the Australian Council onHealthcare Standards for four years in September 2010. Three ‘Excellent Achievement’grades were awarded for appropriateness and effectiveness of care and management offalls. Recommendations from this survey are currently being actioned. Alice SpringsHospital has also achieved accreditation in the areas of Pathology, Radiology, FoodSafety and Baby Friendly Hospital Initiative.The hospital provides a range of clinical, diagnostic and support services including:• General Medicine, Paediatrics, Obstetrics and Gynaecology, General Surgery, RenalMedicine, Ophthalmology, Ear Nose and Throat, Orthopaedics, EmergencyMedicine, Intensive Care, Anesthetics, Midwifery Group Practice, Palliative Care,Allied Health services including Welfare, Diagnostic and Treatment (includingHospital in the Home);• Visiting Medical Officers provide services including Neurology, Neurosurgery,Oncology, Rheumatology, Urology, Cardiology, Respiratory Medicine, Pain Services,Gastroenterology, Plastic Surgery, Sleep Studies, Dermatology, RehabilitationMedicine and Endocrinology; and• Medical Specialist Outreach provides services to remote communities for Obstetrics,Adult and Paediatric Medicine, Eye clinics and Ear Nose and Throat clinics.There are a number of major works currently underway or about to start at the hospital,the main works being:• the expansion of the Mental Health Unit which will provide an additional 6 beds(these works are expected to be completed sometime in October 2011);• a new Emergency Department is being constructed to help ASH meet future demandgrowth with current demand showing increases of 7.5% annually; and• a new 24 hour Medical Imaging Service.Department of Health Annual Report 2010-11 53

Local Hospital NetworkTennant Creek HospitalTotal active overnight beds: 20.Tennant Creek Hospital services the 7500 residents of Tennant Creek and the Barklyregion. It covers an area of approximately 250 000 km 2 extending south to Ali Curung,north to Elliott, west to the Western Australia border and east to the Queensland border.Tennant Creek Hospital is accredited with the Australian Council on HealthcareStandards until 20 February 2013. The hospital also has achieved Food SafeAccreditation until January 2012 and the Pathology Laboratory is accredited to NationalAssociation of Testing Authority/International Standards Organisation standards.The hospital provides a comprehensive range of clinical, diagnostic and support servicesincluding:• 24-hour Accident and Emergency Care, Outpatients with visiting Medical, Surgicaland Paediatrics Specialists, Review Clinic, which covers recall patients, ChronicDiseases patients and Paediatric patients, Minor operations, Medical, Paediatric andMinor Surgical Inpatient services;• Antenatal, Postnatal and Emergency Midwifery services;• Renal Dialysis, Social Worker, Clinical Support services (Radiography, Pathologyand Ultrasound);• Aero Medical Retrieval and Medivac service; and• Aboriginal Liaison.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.54 Department of Health Annual Report 2010-11

National Critical Care and Trauma Response CentreNational Critical Care and Trauma Response CentreThe Australian Government funds the National Critical Care and Trauma ResponseCentre (NCCTRC) at the Royal Darwin Hospital to maintain a state of readiness formajor national health incidents and the implementation of strategic priorities.This initiative increases the capacity for an effective health response to an emergency inour northern region, and to emergencies involving significant casualties.The NCCTRC has an increasing leadership role in national preparedness by expertparticipation at national committees and forums and providing education andcredentialing nationally. These initiatives include:• 1300 training positions with more than 30 specialised trauma and disaster coursesand 150 dedicated education and training days;• a focus on preparedness activities and returning both experience and learning intothe Australian Health Disaster Management Framework;• developing an Australian Medical Assistance Team for rapid deployment to respondto a mass casualty incident (more than 180 people have undertaken the specialisedAusMAT training course);• an official partnership agreement signed in November 2010 with the National TraumaRegistry Institute based at the Alfred Hospital in Melbourne;• being appointed to oversee the deployment of military within the Department ofHealth (the Australian Defence Force Health Agreement ensures military personnelgain experience in the day-to-day civilian system);• funding the $2.8 million Picture Archiving Communications System (PACS); and• continuing work on a mass casualty barcoding project; there has been significantinterest in this project and depending on funding from Emergency ManagementAustralia, the NCCTRC hopes to further develop the project and commence nationaltrials in 2012 with all jurisdictions.Department of Health Annual Report 2010-11 55

Health and Wellbeing Services Output GroupHealth and Wellbeing 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 includingacute mental health inpatient units, community care centres, rural health centres and inthe home.Community Health ServicesThese services build the capacity of the community to maintain and improve healththrough education, prevention, early intervention and access to culturally appropriateassessment, treatment and support services. Medical, nursing, Aboriginal health, alliedhealth, oral health, nutrition and breast and cervical cancer screenings are providedthrough government and non‐government providers in a number of settings includingcommunity care centres, 54 government managed and 30 non government managedrural health centres, clinics, schools and in the home.2009-10Actual2010-11Budget2010-11Estimate2010-11ActualOutput Cost ($’000) 181 180 177 482 190 045 190 020Key Deliverables 2009-10Actual2010-11Budget2010-11Estimate2010-11Actual2011-12BudgetEpisodes of health care inN/A N/A 384 000 433 128 385 000health centres 1government managed remoteCommunity health events urban 128 153 132 000 114 000 114 173 120 000Adult Health Checks N/A N/A 4 000 1 678 4 000Healthy Under 5 Kids Checks N/A N/A 4 000 3 556 4 000Oral health occasions of service 47 367 45 000 44 600 44 088 44 600Proportion of screened Aboriginal 14.6% 12.5% 12.5% 14.4% 12.5%babies born with low birth weightProportion of screened Aboriginal 13.2% 11.75% 8% 8% 8%children under 5 years who areunderweight1 This is a new indicator and comes from the Aboriginal Health Key Performance Indicator set (AHKPIs).Variations in Key DeliverablesCommunity health events urban - the estimate for 2010-11 was adjusted downward toreflect the transfer of community based discharge planners to Acute Care. The 2011-12budget figure includes data for health events at the Palmerston Urgent Care After HoursService which have not previously been included in this service count.Adult Health Checks - this is a new indicator from 2011-12 onwards replacing the WellPerson Checks and comes from the NT Aboriginal Health Key Performance Indicator(KPI) data set. The actual number is now based on Medicare claims for adult healthchecks and excludes pap smear tests which informed the estimates previously. Medicare56 Department of Health Annual Report 2010-11

Health and Wellbeing Services Output Groupclaims under-estimate services provided due to under-claiming but are more accuratelymeasurable.Healthy Under 5 Kids Checks (HU5Ks) - this is a new indicator from 2011-12 onwardsreplacing the Growth Assessment and Action (GAA) program. The HU5Ks Program is amore comprehensive program, but will continue to include data which was collectedunder the previous GAA program. Work is ongoing in the Department to develop thecapacity of existing data sets to provide more accurate information on numbers ofchildren engaged with HU5Ks across the Territory, along with more detailed estimates ofthe levels of coverage by, as well as compliance with, these program schedules of childhealth checks.Proportion of screened Aboriginal babies born with low birth weight – the proportion ofAboriginal low birth weight babies has changed little over time and the apparent increasein 2009-10 and 2010-11 is not statistically significant. This trend may be influenced bythe rising proportion of pre-term babies and increased rates of smoking amongAboriginal pregnant women, which both work against a decline in perinatal death rates,including stillbirths and neonatal deaths.Proportion of screened Aboriginal children under 5 years who are underweight - in 2010,the Department moved to the use of WHO 2006 growth standards to measureunderweight in children from the previous measurement using Centre for DiseaseControl 2000 growth standards. There has been an apparent reduction in rates as aresult of this change but this does not represent a real improvement in this indicator.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.Remote Health manages 54 remote health centres across the Territory. Services includethe provision of 24 hour emergency care, primary clinical care, population healthprograms, referral and access to retrieval, medical and allied health specialist services,provision of essential medications and management of chronic illness. Services aredelivered by multi-disciplinary health teams at remote health centres.Health DevelopmentThe overall role of the Health Development Branch is to improve health outcomes forpopulation groups through working with key partners such as policy makers, primaryhealth care providers, communities and other health service providers at a local andnational level. Evidence-based health promotion and illness and injury preventionunderpin the Health Development approach.This is achieved through a range of functions including:• health program development, particularly at the primary health care level;• training and education;• policy advice;• provision of evaluation and monitoring tools and services;Department of Health Annual Report 2010-11 57

Health and Wellbeing Services Output Group• collaborative planning;• health education and health promotion capacity building; and• direct service provision in some health services.Primary health program development work is undertaken by Strategy Units focused onChild and Youth Health, Chronic Conditions, Nutrition and Physical Activity, HealthPromotion, Hearing Health, Men’s Health and Women’s Health.There are two large regional teams which deliver Health Development services related tothe above programs through regional focused multi-disciplinary, multi-program teams.The Branch is also responsible for the provision of the majority of public child and adultdental services throughout the Northern Territory.Community HealthThe role of the Community Health Branch is to provide a range of key primary healthcare services across the urban centres of Darwin, Palmerston, Alice Springs, Katherine,Tennant Creek and Nhulunbuy and to provide services in partnership with other healthstakeholders in the urban environment. Territory-wide services focus on those in theurban community most in need or at risk and where access to health services may be achallenge. In addition, Territory-wide Well Women’s breast screening and hearingscreening also make up a significant part of the Branch’s services.Services are delivered via program units focused on:• community and primary care (including wound management, palliative care and briefhealth intervention around concerns such as smoking and obesity) and include somespecified services offered around social work, nutrition and specialised nurse care;• child and family health nursing built around a universal home visiting servicesupporting families in partnership;• the Darwin home birth service;• school health services which includes provision of a range of immunisations forschool children right across the Territory and a number of school nurses focusedaround health promotion in the school environment;• urban and remote hearing services based on testing for ear health and pathways forclients to access services;• the Well Women’s Cancer Screening Program (based in urban centres with plannedvisits for all Territory women); and• contract management of Primary Health Care in Northern Territory Prisons and thePalmerston Super Clinic and Urgent Care After-Hours Services.Key Achievements• A new Health Centre was opened at Wadeye in November 2010. Stage 1, with afloor space of 1000 square metres, has 13 consultation rooms, men’s, women’s andbaby areas, an emergency room, x-ray room, ambulance bay, reception, pharmacy,offices, toilets, storerooms, cleaners rooms and waiting areas and is now the main58 Department of Health Annual Report 2010-11

Health and Wellbeing Services Output Groupclinical section of the health centre. Stage 2, which was previously the old healthcentre, has a floor space of 660 square metres and is the Wellbeing Centre. Thisarea is where health promotion and early intervention programs, staff and communityeducation and training will be planned and delivered.• The Men’s Health Strategy Unit was established in February 2011 with theappointment of a Program Leader and the transfer of the Aboriginal Men’s HealthAdvisor into the Unit. The Unit conducted a Men’s Health Week event in conjunctionwith Andrology Australia in Darwin in June 2011.• The Northern Territory Oral Health Promotion Plan was launched by the Minister forHealth in March 2011. The plan identifies key action areas and strategies at both theindividual and population levels and encourages collaboration between thegovernment, non-government and private sectors to deliver lasting improvements inoral health. The Plan supports an increased focus on health promotion and diseaseprevention as critical components of an effective oral health service.• Services commenced at the Special Needs Dental Clinic at the Royal DarwinHospital. The service, which is provided and managed by Oral Health Services,delivers specialised oral health care to people with complex dental needs and withconcurrent physical, developmental and medical issues. The Special Needs DentalService provides support and outreach to a range of groups including residentialaged care and disability services. Local oral health providers are supported by avisiting specialist in Special Needs Dentistry.• Chronic kidney disease care coordination is showing improved outcomes for patientsand a slowing in the number of patients commencing dialysis.• The Annual Chronic Disease Network (CDN) Conference in September 2010 focusedon health literacy and attracted 296 participants with strong engagement fromAboriginal health professionals who represented 30% of participants. Thisattendance was a sharp increase compared to previous years.• The Chronic Conditions Prevention and Management Strategy (CCPMS)Implementation Plan 2010-2012 was presented to the 2010 CDN Conference. TheStrategy, which was launched by the Minister for Health at the 2009 CDNConference, has been agreed as the guiding framework across the Territory for thedevelopment of new program areas in chronic disease care. Three Working Groupshave been established to monitor the implementation of the Strategy, with each ofthese working groups responsible for overseeing particular key action areas.Plan priorities include:• production of the first CCPMS Annual Report;• development of a NT-wide Chronic Conditions Self Management Framework;• inclusion of mental health screening in primary care; and• options to improve access to cardiac and respiratory rehabilitation services.• The Palmerston GP Super Clinic commenced operations on 4 October 2010 and isoperated by FCD Health Ltd, a joint-venture company of Flinders and Charles DarwinUniversities.Department of Health Annual Report 2010-11 59

Health and Wellbeing Services Output Group• A new urban men’s health service was introduced in Community Health with adedicated male health nurse in Darwin.• Breastscreen NT was successfully re-accredited for four years. Work oninfrastructure upgrades is continuing to allow increased flexibility in screening andmeeting Australian Standards.Mental Health ServicesMental health is integral to improving the health status of all Territorians. Through theMental Health Program, the Top End and Central Australian Mental Health Services andnon-government organisations are funded to provide:• mental health promotion, prevention and early intervention;• specialist mental health assessment, treatment and case management for adult,children, youth and forensic populations;• specialist acute inpatient services in Darwin and Alice Springs;• consultation liaison services to acute and primary health care services and otherrelevant service providers; and• consumer and carer support and rehabilitation.2009-10Actual2010-11Budget2010-11Estimate2010-11ActualOutput Cost ($’000) 40 551 42 542 45 293 43 524Key Deliverables 2009-10Actual2010-11Budget2010-11Estimate2010-11Actual2011-12BudgetIndividuals receiving communitybased5 544 5 150 5 500 5 823 6 000services 1public mental healthIndividuals under 18 years of age 1 047 1 000 1 000 1 058 1 200mental health services 1receiving community-basedNon-weighted occupied bed days 10 877 12 400 12 400 11 526 14 000by designated services 2Non-weighted inpatient940 1 140 1 000 918 1 270services 2separations from designatedPost-discharge community mental 14% 30% 22% 16% 30%health care 328 day mental health9% 11% 11% 11% 10%readmissions 41 Community-based public mental health services include all mental health services provided byGovernment (excluding government-funded non-government organisations) dedicated to the assessment,treatment, rehabilitation or care of non-admitted patients.2 Measure refers to inpatient services provided within two approved treatment facilities (Darwin andAlice Springs Mental Health Inpatient Units), declared pursuant to section 20 of the Mental Health andRelated Services Act 1998.3Measure indicates the proportion of separations from mental health service organisations’ acute careunit(s) for which a community service contact was recorded in the seven days immediately following thatseparation.4 This measure indicates the percentage of separations from the mental health services’ acute mental healthinpatient units that results in unplanned readmission to the same or similar unit within 28 days ofdischarge.60 Department of Health Annual Report 2010-11

Health and Wellbeing Services Output GroupVariations in Key DeliverablesDemand for community-based mental health services continues to increase beyondpopulation growth expectations.The 2010-11 budget and estimate for non-weighted occupied bed days and nonweightedseparations predicted additional activity associated with beds to be establishedunder the Secure Care Initiative in both Darwin (5 beds) and Alice Springs (6 beds). Boththese services will be commissioned in the 2011-12 financial year.The 2010-11 budget for the post-discharge community mental health care indicatorpredicted significant improvement based on the implementation of a Mental HealthTriage and Response Service. Commencement of this service was delayed to June2011. Further improvement in this indicator is anticipated with the implementation of thenew Mental Health Triage and Response Service in 2011-12.Key Achievements• Implemented an NT-wide 24 hour Mental Health Triage and Response Servicebased in Darwin. This service is a telephone triage and liaison service providing thefirst point of contact, particularly after hours, for referrals and advice regardingpeople who reside in the Territory who require mental health services. The serviceoperates 24 hours, 365 day per year and will be able to respond to emergency andurgent assessments and to provide advice and information regarding mental healthissues. The service is available throughout the Northern Territory and will facilitateimproved services to consumers and carers, a stronger level of support to GeneralPractitioners and remote clinics and will provide an improved response in the Darwinarea and to the Royal Darwin Hospital Emergency Department.• Completed the Mental Health and Palliative Care initiative. In the NT the projectincluded the introduction of routine screening for mental health problems associatedwith terminal illness and improved palliative care services to people with a seriousmental illness.• Continued roll out of the National Perinatal Depression Initiative which is an initiativeto increase community awareness and improve detection and treatment of mentalillness during pregnancy and in the first year following birth. In 2010-11 activityincluded:• conducting training for primary health, midwifery and child and family healthclinicians; and• establishing a small specialist perinatal team in the Top End.Department of Health Annual Report 2010-11 61

Health and Wellbeing Services Output GroupCommunity Support Services for Frail Aged People andPeople with a DisabilitySupport services are provided to frailaged people and people with disabilitiesand their carers in their homes and inthe community to enable them tomaximise their participation in thecommunity and remain independent foras long as possible. Services includeprofessional support services such asassessment, case management, alliedhealth and specialist services includingspecialist children’s developmenttherapies, as well as community supportservices 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 on 1January 2009, replacing the previous Commonwealth State Territory DisabilityAgreement (CSTDA). The Home and Community Care Program (HACC) is the othermajor funding agreement between the Australian and Northern Territory Governments.2009-10Actual2010-11Budget2010-11Estimate2010-11ActualOutput Cost ($’000) 75 004 73 873 83 614 83 609Key Deliverables 2009-10Actual2010-11Budget2010-11Estimate2010-11Actual2011-12BudgetSupported accommodation places 155 155 164 164 164Clients accessing community5 567 5 000 5 000 4 388 5 200support services 1Clients accessing professional6 114 6 900 6 900 6 564 7 100support services 2Occasions clients access62 414 63 000 63 000 62 707 77 560professional support servicesAged Care Assessment Teamclients receiving timely interventionin accordance with priority at referral86% 80% 80% 75% 80%1 Community support services include community care and support, in-home support, community accessand respite care, but exclude supported accommodation (group homes).2 Professional support services include Adult and Disability teams, Aged Care Assessment Program,Children's Development Team, Community Adult Health Team, TIME Scheme, Transitional Care Unit,Local Area Coordination and SEAT Service.Variations in Key DeliverablesThe reduced number of clients recorded as receiving community support services in2010-11 was due to data cleansing by providers.62 Department of Health Annual Report 2010-11

Health and Wellbeing Services Output GroupThe expected growth in occasions of clients accessing professional support services in2011-12 reflects the commissioning of new purpose built facilities to provide Secure CareServices in Darwin and Alice Springs.Aged Care Assessment Team timeliness reduced in 2010-11 due to the increase inclient numbers.Key Achievements• The number of supported accommodation places was increased to 164, an increaseof nine from 2009-10.• Implementation of the Territory Independence and Mobility Equipment Scheme(TIMES) Review commenced.• Drafting of a new Adult Guardianship Act began.• The National Disability Strategy (NDS) was endorsed by the Council of AustralianGovernments (COAG) in February 2011. The NDS project is focusing on improvingaccess to mainstream services for people with a disability. The Northern Territory is amember of the Development Officials Working Group which is overseeing thedevelopment of an implementation plan for the NDS. The NDS includes six areas ofpolicy action:• inclusive and accessible communities;• rights protection, justice and legislation;• economic security;• personal and community support;• learning and skills; and• health and wellbeing.• The National Disability Strategy’s focus is on improving access to mainstreamservices for people with disability and will guide policy and program development byall levels of government and actions by the whole community for the next ten years.A national Development Officials’ Working Group has been established to overseethe development of an implementation plan for the NDS that includes priority actionsand associated reporting.• Significant work has progressed resulting in the development of a quality frameworkfor disability services in the Northern Territory. A pilot was undertaken and a reporthas been provided to the Aged and Disability Program (A&DP) for consideration.A&DP will continue to work with NDS NT on the development of the qualityframework and other key projects during 2011-12.Department of Health Annual Report 2010-11 63

Health and Wellbeing Services Output GroupSupport for Senior Territorians and PensionerConcessionsSubsidies and support services are provided to senior Territorians, pensioners, carersand other low income groups to maintain financial independence and promote health,fitness and community participation. This includes the NT Pensioner and CarerConcession Scheme which provides a number of concessions and rebates to eligibleclients.2009-10Actual2010-11Budget2010-11Estimate2010-11ActualOutput Cost ($’000) 18 187 17 235 18 543 21 305Key Deliverables 2009-10Actual2010-11Budget2010-11Estimate2010-11Actual2011-12BudgetPensioner concession 1 recipients 21 362 20 000 22 100 22 342 22 300Grants issued for seniors’42 42 52 52 52advancementApplicants able to access pensionerconcessions within 14 days100% 100% 100% 100% 100%1 Services or items for which the Department of Health provides concessions and rebates are electricity oralternate energy costs, local council property rates, water charges, sewerage charges, garbage charges,motor vehicle registration, drivers’ licences, spectacles, public transport and interstate travel.Variations in Key DeliverablesThe increase in pensioner concession recipients evident between 2009-10 and 2010-11is consistent with an increasing population aged 65 years and over.From 2010-11 onwards, smaller seniors’ advancement grants were provided for moreprojects.Key Achievements• There were 22 342 members of the Northern Territory Pensioner and CarerConcession Scheme at the end of 2010-11, an increase of 980 from 2009-10.• Fifty-two grants were issued for Seniors Month events across the Territory.• A new look Seniors Card Directory was launched in January 2011 which merged theTourism and Leisure Directory and the General Directory into one.64 Department of Health Annual Report 2010-11

Public Health Services Output GroupPublic Health ServicesThese services strengthen the capacity of individuals, families and communities toimprove and protect their health through promotion and prevention strategies andappropriate interventions that minimise harm from disease, substance use andenvironmental factors. This is also supported through multi-disciplinary research andeducation.Environmental HealthEnvironmental Health acts to prevent and control physical, chemical, biological andradiological agents in the environment from adversely affecting human health. EHservices include environmental health standards development, statutory surveillance andenforcement, complaint resolution, community environmental health education andadvice, waste management, food and water safety, radiation protection and poisonscontrol.2009-10Actual2010-11Budget2010-11Estimate2010-11ActualOutput Cost ($’000) 5 764 6 697 6 952 5 928Key Deliverables 2009-10Actual2010-11Budget2010-11Estimate2010-11Actual2011-12BudgetRegulatory compliance9 939 9 700 9 700 9 725 10 000activities 1Premises achieving a100% 100% 100% 100% 100%days of receiving legal notice 3satisfactory standard ofcompliance with environmentalhealth legislation 2 within 28Environmental healthcomplaints investigationsinitiated within one working dayof notification92% 95% 95% 95% 95%1.Regulatory compliance activities include premises inspections, issuance of licences, registrations and legalnotices, complaint investigations, food sampling, radiation equipment inspections, processing ofdevelopment and building applications, septic system activities, water quality activities, food recalls andhealth protection activities (for example, vector and vermin monitoring).2.Environmental health legislation consists of the Food Act, Public and Environmental Health Act, NotifiableDiseases Act, Radiation Protection Act and Poisons and Dangerous Drugs Act and regulations subordinateto each.3.Legal notices are those which relate to issues of imminent or actual public health risk and require theowner to carry out alterations, repairs and general improvement works to ensure the health of the public.These notices usually require the owner/occupier to carry out this work in a set timeframe and require atleast another inspection to check compliance with the notice.Variations in Key DeliverablesRegulatory Compliance ActivitiesThe figures given for regulatory compliance activities above, when compared to the levelof activity in the previous year, show:Department of Health Annual Report 2010-11 65

Public Health Services Output Group• there was a decrease of 214 in compliance activities in 2010-11 (9725) compared to2009-10 (9939) largely due to the reallocation of staff resources to manage incidentssuch as the beach water quality monitoring;• there was a significant increase (16%) in the number of licences, registrations andauthorisations issued in 2009-10 from 3695 to 4285 in 2010-11;• health protection activities increased by 9% due to increased environmental healthsampling; and• the number of public health complaints received decreased by 6%, continuing thetrend over the past three years.Figure 20: Environmental Health Activities 2008-09 to 2010-11450040003500300025002000150010005000InspectionsLicences,Registrations &AuthorisationsMisc.RegulatoryActivitiesComplaintInvestigationsHealthProtectionActivitiesHealthPromotion &EHW ActivitiesInspections comprise inspections of food premises, public health premises, radiation premises andequipment, poisons premises.Licences, Registrations & Authorisations comprise food premises registrations, health premisesregistrations, radiation licences and registrations, poisons authorisations and registrations, pharmacotherapyauthorisations, amphetamine authorisations.Miscellaneous Regulatory Activities comprise issue of legal notices, food sampling and surveys, waterand pool sampling, processing of building and development applications, bore construction permits, septictank system activities, water quality activities, therapeutic drug recalls and destructions, food recalls andseizures, legislation and policy development.Complaint Investigations comprise public health and food complaints.Health Protection Activities comprise adult and larval mosquito monitoring.Health Promotion and EHW Activities comprise health promotion/education and Environmental HealthWorker activities.Key AchievementsNo Germs on Me2008-09 2009-10 2010-11The No Germs on Me hand washing campaign is an ongoing social marketing campaigndeveloped by the Department’s Environmental Health Branch (EHB) to promote thebenefits of routine hand washing with soap and water after going to the toilet, afterchanging babies’ nappies and before touching food.66 Department of Health Annual Report 2010-11

Public Health Services Output GroupThe campaign was developed to assist in addressing the high rates of infectiousdiseases among Aboriginal babies and children in the Northern Territory. Recentinternational research hasdemonstrated that routine hand washingwith soap and water can reduce theincidence of diarrhoeal and respiratorydisease among children by as much as50%.The campaign continues to generatehigh levels of interest both within andoutside of the Territory. Marketingmaterials were recently made availablenationally through the national WorkingGroup on Aboriginal and Torres StraitIslander Environmental Health.The EHB, in conjunction with the Working Group, developed additional resources tospecifically encourage pre-primary and primary aged school children to wash their handsregularly with soap. Resources include ‘germ’ costumes, stickers, posters and learningand teaching aids. A DVD titled ‘The True Story about Germs’ was also developed. ThisDVD explains the history of how micro-organisms were discovered and their role indisease causation. The DVD is targeted at high school aged children and adults. All ofthese resources were designed for use by environmental health practitioners, teachersand other public health professionals.Food SafetyThe EHB monitors the food supply in the Northern Territory for compliance with theAustralia New Zealand Food Standards Code, which is adopted by the Northern TerritoryFood Act.The Food Standards Code requires that food handlers have “skills and knowledgecommensurate with their work activities”. The EHB regularly runs free food safetysessions for food handlers. Sessions are provided Territory wide and aim to provide foodhandlers with important food safety information that will decrease the likelihood ofconsumers experiencing food safety problems such as food poisoning, or finding foreignmatter in food products.Since 1 July 2009, 377 food handlers have attended this training, with 114 attending in2010-11. Environmental Health Officers may direct food handlers to attend training ifpoor food handling practices are detected during surveillance at various foodbusinesses.Public and Environmental Health ActThe new Public and Environmental Health Act commenced on 1 July 2011 in theNorthern Territory and replaces the outdated Public Health Act 1952.The Public and Environmental Health Act represents a significant step in public healthlegislation reform. During 2011-12, subordinate guidelines, standards and regulations willbe developed to further modernise the flexible legislative framework for monitoring andregulating public and environmental health in the Northern Territory.Department of Health Annual Report 2010-11 67

Public Health Services Output GroupDarwin Beach Water Quality MonitoringIn June 2010, following the detection of high levels of bacteria in water samples takenfrom Lake Alexander, the Department initiated weekly E. coli and enterococci bacteriamonitoring at 11 public beaches around Darwin Harbour. The detection of bacteria levelsabove Northern Territory Recreational Microbiological Water Quality Guidelinessubsequently led to the Department closing several Darwin Harbour beaches toswimming during the 2010 dry season and early in the 2011 dry season.The EHB coordinated the beach water monitoring program on behalf of the governmentin the 2010 dry season. The Department of Natural Resources, Environment, The Artsand Sport took over responsibility for beach water sampling from 1 May 2011, as part oftheir Integrated Darwin Harbour Monitoring and Research Program. The Departmentcontinues to analyse these results, take appropriate action on any elevated samplingresults and provide public health information. The National Health and Medical ResearchCouncil guidelines were formally adopted and gazetted by the Chief Health Officer underthe new Public and Environmental Health Act on 6 July 2011.Drug MonitoringAs shown in Figure 21, the Poisons Control Section monitored 30 615 prescriptions forSchedule 8 (S8) drugs to control prescription drug abuse during 2010-11. A total of 291contracts were registered during the year as part of the notification system. Thesecontracts match a patient with a prescribing doctor and pharmacy on the Drug MonitoringSystem (DMS) database. The contract has been worded so that the patient agrees toallow Poisons Control to advise other doctors, pharmacists and Alcohol and Other DrugServices Nurses about the details of his/her contract.Figure 21: NT Schedule 8 drug prescription and patient contracts 1992-93 to2010-11No. of S8Prescriptions35000300002500020000150001000050000100090080070060050040030020010001992-931993-941994-951995-961996-971997-981998-991999-002000-012001-022002-032003-042004-052005-062006-072007-082008-092009-102010-11No. ofPatient ContractsNo. of S8 PrescriptionsNo. of Patient ContractsThere are two types of contracts, voluntary contracts and mandatory contracts. Voluntarycontracts can be used when patients are prescribed medicines which may potentially bemisused or diverted such as non-restricted Schedule 8s, benzodiazepines, anabolicsteroids, analgesics and pseudoephedrine. Mandatory contracts are required for allopiate pharmacotherapy program maintenance patients being treated with methadone,buprenorphine or buprenorphine/naloxone.68 Department of Health Annual Report 2010-11

Public Health Services Output GroupAll Northern Territory community pharmacies have access to the web front end of DMS,the Poisons Control Schedule 8 Website via secure internet login. This website allowspharmacists to access up to date contract information. Roll out of the website to medicalpractices is continuing.The Schedule 8 and Restricted Schedule 4 Substances Clinical Advisory Committee(CLAC) meets face to face three times during the year. The role of the Committee is toadvise the Chief Health Officer on all matters relating to Schedule 8 and restrictedSchedule 4 substances, including policy matters and the issuing of specificauthorisations.One of the issues handled by the CLAC in 2010 was the increasing misuse of aprescription only medicine Alprazolam. The Chief Health Officer wrote to medicalpractitioners on 3 December 2010 to increase awareness of the issue and to provideprescribers with resources to better manage patients using this medicine.Poisons Control staff have continued to hold education sessions for GP Registrars,medical practices, Charles Darwin University students in clinical sciences and pharmacyand others on demand.Medicines, Poisons and Therapeutic Goods BillWork has continued on the Medicines, Poisons and Therapeutic Goods Bill during2010-11. The Exposure draft of the Bill was released on 22 March 2011. Publicconsultation on the draft was conducted over the following 10 weeks. The draft Bill hasbeen revised to incorporate feedback from the consultation with stakeholders. The Billwill be finalised in late 2011.Radiation ProtectionFour categories of authorisation are required under the Radiation Protection Act. Thesecategories are summarised as follows:• radiation licence to acquire, dispose of, manufacture, possess, sell, store, transportand use a radiation source;• certificate of accreditation to decommission, install, repair, service and test aradiation source;• registration of a radiation source; and• registration of a radiation place, in which a radiation source is used or stored.During the previous financial year, there were 217 registrations for a radiation source,101 radiation place registrations, 386 licences and 58 certificates of accreditation issued.There were 93 inspections of a radiation place.Disease Control ServicesThe Centre for Disease Control (CDC) has offices in the five major urban centres in theNorthern Territory and provides clinical services, including screening and contact tracing,for sexual health, blood borne viruses, tuberculosis, leprosy and other mycobacterialdiseases. CDC’s role includes policy and clinical guideline development for thesediseases.Department of Health Annual Report 2010-11 69

Public Health Services Output GroupCDC is responsible for the development and implementation of the Territory’simmunisation program and provides advice and education to health staff and the publicon immunisation. Surveillance for more than 90 notifiable diseases and mounting thenecessary public health responses, including the management of outbreaks, also formspart of its core business.CDC also manages the rheumatic heart disease and trachoma programs. Under theguidance of the community paediatrician, the rheumatic heart disease (RHD) programprovides important support for the diagnosis and long term management of those withRHD. The trachoma program is working in partnership with a national program towardsthe elimination of trachoma. The Safety and Injury Unit researches and develops policyon injury prevention and Medical Entomology undertakes mosquito surveillance andenvironmental management of disease carrying and other nuisance insects.2009-10Actual2010-11Budget2010-11Estimate2010-11ActualOutput Cost ($’000) 25 037 25 544 25 749 25 141Key Deliverables 2009-10ActualNotification of:2010-11Budget2010-11Estimate2010-11Actual2011-12Budgetsexually transmitted infections 5 817 6 000 7 100 7 643 7 200HIV 19 18 7 6 7Hepatitis C 157 180 210 231 210Occasions of service at Clinic 12 024 14 000 12 000 10 976 13 00034 in Darwin and Alice SpringsMosquito traps analysed 1 2 060 1 780 1 780 1 728 1 835Hectares treated by mosquito 1 080 1 435 2 130 2 123 2 000control programChildren fully immunised:- at age 12 months 2 90% 91% 93% 90% 93%- at age 2 years 3 93% 93% 93% 95% 93%People completing treatmentfor tuberculosis95% 95% 95% 95% 95%1.Mosquito traps analysed are overnight mosquito trap collections set weekly from major towns in theTerritory. Information is used to assess mosquito disease risks, evaluate mosquito control programs andfor media alerts and warnings.2. The 2010-11 estimate and 2011-12 budget for the child immunisation rate at 12 months was shown as 93%in the 2011-12 Budget Paper No. 3 and above, but this rate was published in error, normally thisimmunisation rate is very stable and should have stayed at 91% as in the 2010-11 budget.3. The actual child immunisation rate at two years for 2010-11 (95%) is based on coverage for DTPa(Diphtheria, tetanus, pertussis) only. The ACIR (Australian Childhood Immunisation Register) calculatedfully vaccinated coverage rate for the Northern Territory is not available at this time. DTPa is a goodindicator of fully vaccinated coverage for children at this age.Key AchievementsSexual Health and Blood Borne VirusesOversight and program direction for sexual health and blood borne viruses is provided bythe Northern Territory Sexual Health Advisory Group. The Group has wide70 Department of Health Annual Report 2010-11

Public Health Services Output Grouprepresentation from both government and non-government services and is chaired bythe Chief Health Officer.The Sexual Health and Blood Borne Virus Unit (SHBBV) provide high quality sexualhealth services including clinical care for Human Immunodeficiency Virus (HIV) andhepatitis B and C via Clinic 34 services. Client numbers utilising these services havecontinued to increase, especially in the Darwin region. In particular, treatment forhepatitis C has increased markedly in the past year in line with key priority areas of theNational C Hepatitis Strategy 2009-2013. Major renovations in recent years at Clinic 34in Darwin and Alice Springs have enhanced service delivery. Accreditation for DarwinClinic 34 is nearing completion using the Australian Council on Healthcare StandardsEvaluation and Quality Improvement Program.Work continues on an Australian Government funded five year project to provideculturally appropriate sexuality education to youth in the Northern Territory. The aim is toestablish a consistent and coordinated approach to sexual health education with a focuson 10-14 year olds. This is to be achieved through support to communities and localeducators to enable the delivery of holistic sexuality education. The project’s key partneris the Department of Education and Training (DET) and schools will act as the leadorganisation in the communities where possible. The teaching resource has beendeveloped locally by Central Australian Aboriginal Congress and includes topics onpuberty, healthy relationships, sexually transmitted infections (STIs), safe sex,pregnancy, well women’s/men’s checks and body care.The health promotion officer of the SHBBV Unit supports activities across the NorthernTerritory with input and guidance from the Northern Territory Health Promotion AdvisoryGroup. A six month HIV traveller’s campaign has recently concluded and is currentlybeing evaluated. This campaign aimed to increase awareness in Northern Territoryresidents of the increased risks of acquiring HIV through unsafe sex in high prevalencecountries, in particular in South East Asia. A new hepatitis C campaign is being plannedto increase screening and the number of people receiving hepatitis C treatment.Recently developed resources include sexual health men’s/women’s flip charts foreducators in remote communities and a DVD resource addressing youth sex and alcoholuse.Work continues on strengthening relationships with key stakeholders within the NorthernTerritory and nationally. Funding continues to be provided to key non-governmentorganisations and Aboriginal community controlled organisations for SHBBV serviceprovision to the community. These organisations include the Northern Territory AIDS andHepatitis Council, Central Australian Aboriginal Congress, Wurli-Wurlinjang, KatherineWest and Sunrise Aboriginal health services and Family Planning NT.The SHBBV unit continues to have a major commitment to research. A major researchproject (STRIVE) conducted by the Kirby Institute, commenced in 2010-11. This projectworks with remote departmental and community controlled health services and focuseson implementing a sexual health quality improvement program. The aims are to helpremote primary health care services to achieve best practice targets in STI control andthereby lower the burden of STIs in remote communities. Strong links with the MenziesSchool of Health Research continue. A three year research project into sexual behaviouramong young Aboriginal people began in 2010.The SHBBV unit oversees the Northern Territory needle and syringe program (NSP)which distributes sterile injecting equipment to prevent the transmission of blood borneviruses. During this financial year, the NSP has been externally evaluated to provideDepartment of Health Annual Report 2010-11 71

Public Health Services Output Groupdirection for future funding and program activity. Early findings indicate the currentprogram is meeting its objectives.Rates of chlamydia, gonorrhoea and trichomonas infection have increased in the lastyear. This increase has coincided with an increase in testing. Even so, the high STI ratesare a cause for concern. The number of HIV notifications per year in the NorthernTerritory remains low and after recent years of increasing infections, numbers in the lastyear have returned to the five year average.ImmunisationImmunisation rates fluctuate marginally throughout the year however, due to a strongcommitment by a wide variety of immunisation providers, coverage rates in the NorthernTerritory for both non-Aboriginal and Aboriginal children remain comparable with thenational average.Table 8: Northern Territory Immunisation Rates (from Australian ChildhoodImmunisation Register calculated as at 31 December 2011)12-

Public Health Services Output Groupnumber of mosquitoes trapped per week in the 11 continuous carbon dioxide traps inDarwin was 353 compared to 216 last year. Northern salt marsh mosquito numbers werehigher this year (average 155 per trap) compared to last year (average 67 per trap).In 2010-11, there were 268 laboratory identified cases of Ross River virus (RRV) in theNorthern Territory compared to 320 last year. Of this number, there were 188 RRVcases in the Darwin region compared to 234 last year. There were 63 cases of BarmahForest virus (BFV) disease in all regions of the Territory, compared with last year’s totalof 98 cases. The total number of cases in the Territory was well below the expected fiveyear mean of 98.Four cases of mosquito borne Murray Valley encephalitis (MVEV) were recorded in theNorthern Territory this year, the largest number in many years. The cases werecontracted in the Barkly (two) and Katherine (one) regions, with one case contracted inan unspecified location. There was also one case of Kunjin (KUNV) disease contractedin the Barkly region with the unusual symptoms of encephalitis. The absence of MVEVcases in Alice Springs was coincident with relatively low Culex annulirostris numbers atIlparpa swamp and very low numbers in the town, due to the effectiveness of the Ilparpaswamp drainage scheme and the effluent management program of pulse release andsubsequent drying periods.There was a case of locally acquired dengue in Darwin in 2010, which was likelyacquired from an overseas infected dengue mosquito which alighted from aninternational flight coming into Darwin Airport from Bali. Close follow up revealed noincursion or local establishment of dengue mosquitoes. This was the first case of locallyacquired (but introduced) dengue since the 1950s, but there is no ongoing potential forfurther local transmission resulting from this incursion and infection.The sentinel chickens showed widespread and continued KUNV activity this year acrossthe Top End from January 2011 and extended south to Tennant Creek and Alice Springsin April/May 2011. In contrast, the MVEV seroconversions followed what seems to be theusual pattern in the Territory, with MVEV activity starting in the south in March 2011 andextending to the north later in the season (towards May 2011).The Department issued many press releases warning of MVEV and KUNV disease risksstarting in the wet season with a media release every month from February to June 2011(four) and was extended to the end of July 2011. There were also two warnings for RRVand BFV disease just before and at the beginning of the wet season, with most of thewarnings receiving cover in the media.An imported malaria case in the suburb of Leanyer required precautionary adultAnopheles vector control using an ultra low volume application of insecticide in earlyApril 2011 to reduce the potential for introduced malaria transmission. There were nocases of locally transmitted malaria resulting from this imported case.While there has been no establishment of dengue vector mosquitoes in the Territory,there have been three separate incidents of on-shore detections of exotic Aedes in theDarwin port area, two of Aedes albopictus (in December 2010 and March 2011) and oneof Aedes aegypti (in January 2011). These were quickly detected and eliminated by thejoint Australian Quarantine Inspection Service and Medical Entomology surveillance andcontrol operations. The NT remains one of the very few tropical regions of the world thatis free from dengue mosquitoes.The combined Darwin City Council/Department mosquito engineering program in Darwincarried out major clearing and excavation of drains in Leanyer Swamp and contributedDepartment of Health Annual Report 2010-11 73

Public Health Services Output Groupsignificant funds to Parks and Wildlife to carry out drain maintenance works near RoyalDarwin Hospital. Other major works included the elimination of breeding areas atVesteys Lake, in the Kulaluk dune areas and in drainage from the Fannie Bay racecourse area.A major biting insect investigation and report by Medical Entomology for the newresidential area of Weddell in June 2009 has resulted in the Department of Lands andPlanning agreeing to fund a three year investigation for possible biting insect mitigationmeasures and to guide the urban layout and development in this major new expansion ofDarwin. Medical Entomology will have a lead role in a three year research program thatwill commence in 2011-12.Community Physician and Injury PreventionThe Safety and Injury Unit continues to participate in the Road Safety CoordinationGroup and NT Water Safety Council as well as conduct an annual survey of fireworksinjuries. In the past 12 months, a major focus has been on alcohol related injury giventhe major role that alcohol has in causing a broad range of injury and other harms. TheUnit has worked very closely with the Alcohol and Other Drugs Program in contributingto the development and implementation of the NT Government’s Enough is Enoughreforms of alcohol policy.Community PaediatricianThe Community Paediatrician plays a key role in the coordination of visits bypaediatricians to remote communities. Forty-one Top End communities are programmedfor visits at one to three monthly intervals, depending on population size. Supervision isprovided for two trainee community paediatric registrars each year and urban paediatricclinics are provided for child development, child disability and high risk follow up as wellas urban Aboriginal Community Controlled Health Services.The Community Paediatrician provides leadership for programs run by the Child andYouth Health Strategy Team, the Rheumatic Heart Disease Prevention program, theTrachoma Control Program, Kidsafe and the Head Lice Prevention program. Support isalso provided to programs run by Menzies School of Health Research.Rheumatic Heart Disease Control ProgramAcute Rheumatic Fever (ARF) and Rheumatic Heart Disease (RHD) continue to bemajor public health problems in the Northern Territory. There were 50 confirmed casesof ARF notified in the Northern Territory in 2010-11, similar to the previous year, with28% recorded as recurrent episodes.The RHD program provides a broad range of education, health promotion and clinicalsupport activities for 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 2236 patients inthe Northern Territory. Since early 2010, the NT Registry has also provided support forboth Queensland and Western Australia RHD patients while they establish their ownRHD Registries. The NT Register also monitors RHD patients from South Australia. Theregister enables clinicians to have comprehensive and up to date information on RHDpatients. It provides reminder notices and support for prophylactic treatment andspecialist appointments. The Register also provides data for analysis to guide program74 Department of Health Annual Report 2010-11

Public Health Services Output Groupimplementation and evaluation. During 2010-11 considerable effort has been focused onimproving the data quality and patient information in the Register.Benzathine Penicillin G adherence rates (or the rate at which patients finish the wholecourse of treatment) continue to be a challenge for health services for overallcompliance. Overall the adherence rate across the Northern Territory is 60%; more workneeds to be done to improve this rate.In the past 12 months, the RHD Program has provided over 350 individualised healthpromotion sessions to patients and their families throughout the Territory. Throughout2010-11 program staff provided training to over 680 health care professionals and paraprofessionalsand travelled to over 50 remote health services in all regions of theNorthern Territory.The national body RHD Australia continues to support the NT RHD Control Program.RHD Australia is developing a national data set of indicators to guide jurisdictionalreporting. The Northern Territory program has been integral in providing on-goingsupport for the establishment of RHD Australia and for programs in Queensland,Western Australia and South Australia.TrachomaThe Northern Territory Trachoma Strategy 2009, developed in partnership with theAboriginal Medical Services Alliance of the Northern Territory (AMSANT), receivedfunding from the Australian Government to expand current trachoma control programsacross the Northern Territory. The Strategy is supported by the Trachoma StrategyAdvisory Group and the Trachoma Strategy Working Group and reports to the NorthernTerritory Aboriginal Health Forum.The Trachoma Strategy has significantly increased delivery of trachoma controlmeasures to communities at risk of trachoma, with over $1.4 million in grant fundingprovided to the Aboriginal Community Controlled Sector to expand existing trachomacontrol programs. Trachoma screening is incorporated into the Healthy School Age Kids(HSAK) annual check, conducted by Remote Health Services, Health DevelopmentServices and Aboriginal Community Controlled Health Services. Following screening,treatment is generally delivered by remote primary health care services with supportfrom the trachoma program.The recent investment in the Trachoma Strategy has resulted in an increase in thenumber of children screened for active trachoma across the NT. Community coverage oftrachoma screening in the five endemic regions was 74%, with 64 out of 86 at-riskcommunities screened for active trachoma. There was a downward trend in trachomaprevalence in most regions of the NT. The overall prevalence of active trachoma inchildren in the 64 communities screened was 12%, with no trachoma found in 23% ofcommunities (15) and 48% (31) with a trachoma prevalence rate of over 10%.The Clean Face Strong Eyes health promotion program, delivered in communities at riskof trachoma, resulted in a decrease in the number of children with dirty faces, a knownrisk factor for trachoma. The overall prevalence of clean faces was 80% as determinedby the absence of dirt, dust and crusting on cheeks and forehead at time of annualtrachoma screen.Department of Health Annual Report 2010-11 75

Public Health Services Output GroupSurveillanceIn 2010, there were 11 155 notifications of scheduled notifiable diseases recorded in theNorthern Territory Notifiable Diseases System, which is an increase of only 131 (1.2%)from 2009. However, there were increases in the number of cases of trichomoniasis,chlamydia, gonococcal infection, melioidosis, salmonellosis, pertussis and dengue whichwere offset by decreases in cases of influenza, Ross River virus disease,cryptosporidiosis and campylobacteriosis cases. This is detailed in Table 9 below.The increase in cases of sexually transmitted infections is likely due to an increase intesting as part of the STRIVE research project into enhanced sexual health servicedelivery.There were only three cases of meningococcal disease, the lowest number since 1993.Northern Territory cases of meningococcal disease are most commonly type B, so thisfall, which reflects national trends, is unlikely to be due to the meningococcal vaccinationprogram which is against type C infection.However, there was one case of Kunjin notified in 2010 (not listed in Table 9) and therehave been four cases of Murray Valley encephalitis and one of Kunjin acquired in theTerritory in the first half of 2011. There has also been one case of newly acquiredhepatitis C in 2011.In addition to notifiable diseases, the Surveillance Section monitors EmergencyDepartment presentations for influenza-like illness and during the flu season analysesdata from the national web-based influenza surveillance system, Flutracking and theAustralian Sentinel Practices Research Network (ASPREN). In 2010, it commencedmonitoring Emergency Department presentations to detect outbreaks of gastro-intestinaldisease.The section continues to produce monthly newsletters for all NT health practitionersalerting them to the current status of communicable diseases. It also represents theTerritory at the national level on communicable disease surveillance issues, in particularinfluenza surveillance.76 Department of Health Annual Report 2010-11

Public Health Services Output GroupTable 9: Selected notifiable diseases 1 in the Northern Territory 2005-2010(calculated by calendar year)Vaccine Preventable Disease 2005 2006 2007 2008 2009 2010Haemophilus Influenzae type b(invasive) 1 2 2 2 0 2Influenza 61 40 183 199 2075 503Measles 0 0 0 3 1 2Mumps 7 7 58 52 14 2Pertussis 92 97 27 478 223 333Pneumococcal disease 71 56 66 60 93 65Vector borne 2005 2006 2007 2008 2009 2010Barmah Forest 51 130 91 75 121 87Dengue 14 21 15 23 41 64Malaria 47 66 30 19 14 17MVE 1 0 0 1 2 0Ross River Virus 209 277 299 262 443 343Typhus (all forms) 1 0 2 1 1 1Blood borne 2005 2006 2007 2008 2009 2010Hepatitis B -chronic/unspecified271 342 298 227 156 187Hepatitis B – newly acquired 5 9 9 8 4 3Hepatitis B - unspecified 127 153 208 185 162 164Hepatitis C - chronic 17 0 1 2 0 0Hepatitis C – newly acquired 3 3 4 6 5 0Hepatitis C - unspecified 250 262 220 206 171 209HTLV1asymptomatic/unspecified69 113 106 83 46 85Sexually Transmissible 2005 2006 2007 2008 2009 2010Chlamydia 1626 2057 2177 2288 2148 2692Gonococcal infection 1806 1772 1594 1549 1528 1970HIV 4 13 7 15 19 7Syphilis 231 273 295 254 140 143Syphilis congenital 3 6 2 1 3 0Trichomoniasis 830 1427 1955 2206 1760 2398Gastrointestinal 2005 2006 2007 2008 2009 2010Campylobacteriosis 255 263 289 257 214 173Cryptosporidiosis 83 71 111 102 154 100Hepatitis A 66 30 5 3 1 4Rotavirus 260 608 291 200 268 331Salmonellosis 395 404 525 494 515 604Shigellosis 197 125 173 177 95 79Typhoid 0 3 3 1 0 2Department of Health Annual Report 2010-11 77

Public Health Services Output GroupOther 2005 2006 2007 2008 2009 2010Acute Post StreptococcalGlomerulonephritis 102 12 23 38 40 15Adverse Vaccine Reaction 28 46 48 45 51 60Legionellosis 3 3 3 1 3 3Leprosy 3 1 0 1 0 1Melioidosis 35 27 34 23 30 106Meningococcal infection 11 6 6 9 8 3Rheumatic Fever 50 54 81 49 58 59Tuberculosis 27 36 54 36 30 33Zoonosis 2005 2006 2007 2008 2009 2010Leptospirosis 5 2 1 1 4 2Q Fever 2 5 2 3 3 11. Due to late notifications and data cleaning the number of cases for some diseases for the years2005 to 2009 may vary slightly from that reported in the last Annual Report.Tuberculosis and Leprosy UnitIn 2010-11 there were 31 new cases of active tuberculosis identified and one new caseof leprosy. In addition, there were five new notifications of non-tuberculous mycobacterialinfections. This caseload corresponds to similar numbers of notifications over previousyears. During 2010-11 active tuberculosis cases were identified in all regions of theTerritory.The Tuberculosis and Leprosy Unit provides a broad range of clinical services for thecontrol of mycobacterial disease in the Northern Territory. These include:• Directly Observed Therapy for patients with active tuberculosis;• diagnosis and treatment for latent tuberculosis infection;• diagnosis and treatment for non-tuberculous mycobacterial disease;• contact tracing and management of tuberculosis outbreaks;• outreach tuberculosis clinics in NT prisons;• outreach tuberculosis clinics in remote Aboriginal communities;• tuberculosis clinical services for immigration detainees (see below under RefugeeHealth); and• shared care for tuberculosis patients admitted to hospital.Far from being eradicated, tuberculosis remains a significant medical challengeinternationally and within the Northern Territory. In our region, increasing numbers ofmulti-drug resistant tuberculosis cases for which drug treatment is more costly, theduration to cure longer and drug side effects more likely, are impacting on our services.Four clinics per week are run in Darwin with regular clinics also run in Alice Springs,Nhulunbuy, Katherine and outreach visits made to remote Aboriginal communities.Refugee Health, Unauthorised Fishers and the Irregular Maritime ArrivalsThe Tuberculosis Unit continues to provide screening for tuberculosis (TB) inunauthorised entrants to Australia. This includes illegal foreign fisherpersons and78 Department of Health Annual Report 2010-11

Public Health Services Output Groupirregular maritime arrivals. The TB unit also provides clinical support to the RefugeeHealth Service at Vanderlin Drive Medical Clinic.The number of illegal foreign fisherpersons has declined over the past few years. In2010-11, 27 illegal foreign fisherpersons were assessed by CDC staff at Gove. Bycontrast, the number of irregular maritime arrivals detained in Australian Governmentimmigration detention facilities has increased to approximately 1500 persons.Alcohol and Other Drugs ProgramThe Alcohol and Other Drugs Program (AODP) develops policies, strategies andprograms to prevent and respond to the misuse of alcohol, tobacco and other drugs. TheAODP includes policy development and legislative compliance, community development,accredited training, services development and treatment and care services andprograms.The Program employs a range of staff across the Territory, including doctors, nurses,alcohol and other drug workers, psychologists, educators, policy officers andadministrators to support individuals and develop community level responses to alcohol,tobacco and other drug related harm.2009-10Actual2010-11Budget2010-11Estimate2010-11ActualOutput Cost ($’000) 24 801 25 140 29 123 27 316Key Deliverables 2009-10ActualCommunity education andcommunity development activities2010-11Budget2010-11Estimate2010-11Actual2011-12Budget366 360 360 386 360Completed accredited training units 1 288 240 280 263 280Utilisation rate of sobering up33% 31% 31% 31% 31%shelter bed hoursAdmissions to sobering up shelters 20 771 18 000 20 400 18 778 20 400Closed episodes 2 in non2 618 2 200 2 600 2 636 2 820government treatment servicesClosed episodes completed in non 1 414 1 320 1 560 1 679 1 690government treatment servicesClosed episodes 2 in government969 750 1 000 1 119 1 000treatment servicesClosed episodes completed ingovernment treatment services233 225 300 398 3001. The Alcohol and Other Drugs Program delivers a range of vocational education and training accredited qualifications,where a qualification comprises 12 units.2.An episode of alcohol and other drugs treatment is a "period of contact, with defined dates of commencement andcessation" (National Health Data Dictionary). A closed episode of treatment is one where there is a valid date ofcessation. A completed episode is one where there is a valid date of cessation and the reason for cessation is‘completed’.Department of Health Annual Report 2010-11 79

Public Health Services Output GroupThe New Katherine Sobering Up Shelter was developed and opened in March 2011 bythe Department and the Australian Government, in conjunction with the Department ofConstruction and Infrastructure.Community Education and TrainingThere are 10 community support positions that work across the Northern Territory: five tosupport the Top End; one in East Arnhem; and two in Katherine. Tennant Creek isserviced by Alice Springs that employs two Community Support Officers. Additionally,there are four Community Services Apprentices employed and being trained in Darwinand one in Katherine.Trainers provide accredited training in Certificate II, III, IV and Diploma qualifications,providing an Alcohol and Other Drugs (AOD) education avenue and pathway to thoseworking in the frontline services. There is currently an annual student load of 842students and the program supports a high level of full time Aboriginal students, rural andremote students and a high participation rate of staff from non-governmentorganisations.Of the 842 full-time students engaged in the Certificate II, III, IV and Diploma AODTraining;• 31% of the student population is Aboriginal; and• 72% of the student population is from a non government organisation.The AODP provides small grants to support community development. These grants are$154 000 for Remote Area Alcohol Action Strategy funds in Central Australia and$30 000 for Top End community grants.Aboriginal specific alcohol education and training programs delivered by the AODP are:• 102 Aboriginal Alcohol Flip Chart training programs conducted in relation to alcoholand youth, domestic violence, decision making, DUI, family, health, mental health,brain injury, culture, pregnancy, community and social issues; and• 20 programs conducted on the National Indigenous Alcohol Guidelines.Alcohol ReformsFollowing extensive cross-agency collaboration between the Department of HealthAODP and the Department of Justice during 2010-11, comprehensive alcohol reformmeasures commence from 1 July 2011.The reforms will provide a consistent response across the Northern Territory to targetproblem drinkers who cause alcohol-related crime and anti-social behaviour in ourcommunity. The reforms will implement administrative and court ordered voluntary andmandatory treatment orders for problem drinkers.TobaccoThe AODP was allocated $1.8 million for tobacco control in 2010-11, including $1.16million in funding from the Australian Government under the Closing the Gap NationalPartnership Agreement.Resulting activities included:Department of Health Annual Report 2010-11 81

Public Health Services Output Group• a remote tobacco cessation project to deliver targeted education, brief interventionand cessation services in remote communities;• operation of a 24 hour telephone counselling service – the NT Quitline;• enhancement of the NT Quitline and to make it more accessible and culturallyappropriate to Indigenous smokers;• a Small Grants Program of up to $3000 per grant designed to assist rural andremote Aboriginal communities develop tobacco interventions at the local level;• a hospital based intervention project in Darwin and Alice Springs; and• support for the development and implementation of a smoke-free AFLNT venue.The NT Quitline is a primary cessation support service in the Northern Territory andprovided counselling support to 1068 Territorians between 1 July 2010 and30 June 2011.A total of 48 Tobacco Cessation Education and Therapy Programs have been conductedthrough Indigenous Education and Therapy in Remote Communities where traditionalmodels such as QUIT are not appropriate. Additionally, a total of 10 QUIT TherapyPrograms have been completed over three week intervals, with up to 18 persons percourse completing the programs across the Territory.A total of 20 professional staff and 27 AOD frontline workers are now qualified to provideevidence based tobacco cessation interventions across the Territory, completing theirNational Accredited Tobacco Cessation course in 2010-11, each participant wasrequired to complete 80 hours of training in contemporary tobacco interventions.Legislative AmendmentsGovernment announced reforms to the Tobacco Control Act 2002 (the Act) in July 2008.The first stage of the reforms was the ban on smoking inside pubs and clubs, whichcommenced on 2 January 2010.The second stage of the reforms commenced on 2 January 2011 and involvedamendment to three key parts of the Act and Regulations:• Smoke Free Areas – the introduction of a ban on smoking in all public outdooreating and drinking areas (with exempt areas for licensed venues);• Displays and Point of Sale – the prohibition on the display of tobacco products atthe point of sale; and• Licensing of Tobacco Retailers – the introduction of an annual licence fee andgreater powers to impose licence conditions.To support the introduction of both stages of the amendments, the Department ran acomprehensive public awareness and media campaign Nobody Smokes Here Anymore,including $240 000 on the public awareness campaign and a direct mail out to allbusinesses affected by the second stage of the amendments.The Department of Justice currently assesses compliance with the Tobacco Control Actin licensed premises as part of its core regulatory function. An educative approach is82 Department of Health Annual Report 2010-11

Public Health Services Output Groupused to achieve compliance outcomes and to date no infringements have been issued tolicensed premises for non-compliance.In 2010-11, the AODP inspected 125 venues with outdoor eating and drinking areas toensure compliance with smoking legislative requirements. Where the venue was found tobe non-compliant, education and advice was provided.The AODP continued to answer email and telephone enquiries with regard to smokinglegislative compliance. AODP staff members have handled 450 tobacco relatedenquiries and have liaised with over a dozen associations, major event organisers,airports and hospitals to develop tobacco compliance policies.Volatile Substance AbuseDuring 2010-11, the AODP received 210 requests for assessment for court orderedtreatment, under Section 33 of the Volatile Substance Abuse Prevention Act (VSAPA),affecting 193 people.Of the 210 requests for assessment, 83 requests were from Central Australia and 127requests from the Top End.All referrals are subject to an assessment to determine levels of risk and to matchresponses or interventions. The majority of referrals are addressed without recourse tothe courts, through case management, by working with the individual, family orcommunity and if required, through voluntary access to treatment services. Nineapplications resulted in orders (seven in the Top End and two in Central Australia) fortreatment issued through the courts.There are currently a total of 22 Management Areas and 14 Management Plans in effectacross the Northern Territory.In Central Australia, 11 Management Areas have been declared and eight ManagementPlans are in place. A further Management Plan has been approved and is ready to beimplemented. In the Top End there are 11 Management Areas declared and sixManagement Plans in place. Two further Management Plans are under final negotiationwith the community and police. All NT Police Officers are authorised persons under theVSAPA, in addition five other people have completed the requirements of becoming anauthorised person.The Opal fuel roll out is a significant contributor to a successful VSA management plan.In 2010-11, Kakadu implemented Opal fuel with further negotiations for an extended rollout throughout the Top End, including Katherine and Darwin. This is an AustralianGovernment initiative, supported by the Northern Territory Government, VSAPAlegislation and community development processes.Department of Health Annual Report 2010-11 83

Public Health Services Output GroupHealth 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 LowitjaInstitute, which have multi-disciplinary research programs.2009-10Actual2010-11Budget2010-11Estimate2010-11ActualOutput Cost ($’000) 6 271 6 314 7 348 7 265Key Deliverables 2009-10Actual2010-11Budget2010-11Estimate2010-11Actual2011-12BudgetNumbers of grants provided 1 5 3 5 5 3Grant payments made within100% 100% 100% 100% 100%stipulated timeframe1.Grants include payments to the Lowitja Institute, Father Frank Flynn Fellowship and Menzies School ofHealth Research.Menzies School of Health ResearchMSHR is a major Australian health and medical research institute with a primary focuson the health of Aboriginal communities and people living in tropical and remote areas.Its research falls into six major interdisciplinary research divisions:• Child Health;• Healing and Resilience;• International Health;• Tropical and Emerging Infectious Diseases;• Preventable Chronic Diseases; and• Services, Systems and Society.Father Frank Flynn FellowshipThe Father Frank Flynn Fellowship is funded by the Department and honours a greatophthalmologist, missionary and medical researcher.National Institute for Aboriginal and Torres Strait Islander Health ResearchLimited (The Lowitja Institute)The National Institute for Aboriginal and Torres Strait Islander Health Research iscurrently being hosted by the Lowitja Institute until 30 June 2014. After that time, theInstitute will fund research and implement programs in its own right, thereby providing apermanent organisation for Aboriginal and Torres Strait Islander health research.The Lowitja Institute is a collaborative research organisation that brings togetherAboriginal organisations, research institutions and government agencies to facilitateevidence-based research into Aboriginal and Torres Strait Islander health. As well as the84 Department of Health Annual Report 2010-11

Public Health Services Output GroupDepartment, Northern Territory participants include MSHR, Charles Darwin Universityand Danila Dilba Health Services.The Lowitja Institute is dedicated to:• working with Australia’s leading health research institutions, policymakers andcommunity organisations to ensure world-class health research is targeted at areaswhere it can have the most impact in improving the health and lives of Australia’sAboriginal and Torres Strait Islander peoples;• ensuring that research outcomes are disseminated widely through knowledgeexchange and that promising interventions identified by research are implementedand evaluated; and• collaborating with Australian educational or training organisations to support theexpansion of a professional Aboriginal and Torres Strait Islander health and healthresearch workforce.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 Australian Human Research Ethics Committee.Best practice in early intervention, assessment and treatment of depressionand substance misuse (BEAT)The Department’s Health Protection and Health Services Programs are jointly fundingMSHR for BEAT. This will increase understanding of ways to strengthen mental, socialand emotional wellbeing for people living in remote communities.Department of Health Annual Report 2010-11 85

Public Health Services Output GroupConnecting the Department of Health’sActivity to the Territory 2030 PlanThe 20-year Territory 2030 Strategic Plan for the Northern Territory, the NorthernTerritory Government’s road map for the future, has been a major informer of theDepartment’s direction in 2010-11 and what it plans to do in the future.In 2011-12, when we revise our 2009-2012 Corporate Plan we will further incorporateTerritory 2030 targets and actions to guide our future and reflect the needs andaspirations of all Territorians.Territory 2030 has two main priorities that link with departmental activity: Health andWellbeing; and Society. It is important to note that while the Department plays a majorpart in achieving the priorities set out in the community-developed Territory 2030 Planwe do this with our partners. As the Territory 2030 document says, “Government,business and all community sectors must work together to achieve targets and realisegoals. Partnership and dialogue are crucial if we are to succeed.” Health and wellbeingis also socially determined; people’s economic situation, social and cultural support,education and housing all affect their health and wellbeing. For the health of Territoriansto improve, the Territory 2030 targets for education, society, the environment and theeconomy, also need to be reached.The Territory 2030 goal: “By 2018 to halve the Indigenous smoking rate”, will require cooperationand investment by the Australian and Northern Territory Governments, theprovision of services by both governments and their non-government organisationpartners and willingness by communities, families and individuals. This is a visionarygoal to aspire to and we are working together to achieve it.Further details on how we have progressed our objectives, targets and actions under theTerritory 2030 Strategic Plan are detailed within the section reporting progress againstthe Corporate Plan.86 Department of Health Annual Report 2010-11

Department of Health Annual Report 2010-11 87

Corporate Plan Activity StatementPromoting and Protecting Health andWellbeing and Preventing InjuryOverviewThe Territory 2030 Plan Health and Wellbeing section’s objectives and targets for:creating a culture where Territorians have a better understanding of their own healthissues and the health system; and ensuring the health and wellbeing of Territorians willbe better at all stages of the life course; are reflected in this Corporate Plan PriorityAction Area.The key to improving population health andwellbeing lies in a stronger focus onpromoting good health, encouraging theadoption of healthy behaviours, controllingthe spread of disease and preventing harmand injury.National reform processes have identifiedthat a focus on wellness, health promotion,primary health care and illness preventionshould be a more prominent part ofAustralia’s health system. Whilst the currenthealth system is geared towards detecting,diagnosing and treating health problems, amore proactive approach is to focus onhealth promotion, health protection andprevention across the life span.Key focus areas• Focusing on health promotionand minimising unhealthybehaviours and their impacts.• Improving health awareness toreduce cost pressures on thehealth system that are derivedfrom preventable chronicdiseases.• Assisting in ‘closing the gap’ inhealth outcomes and lifeexpectancy between Aboriginaland non Aboriginal populationsin the NT.This includes taking action on the socialdeterminants of health to promote equitable health outcomes across Australia,particularly in relation to Aboriginal people, especially those living in remotecommunities. It involves eliminating or reducing common risk factors such as tobaccouse, unhealthy diet, physical inactivity and the harmful use of alcohol. It also involvesdeveloping effective responses to public health emergencies and natural disasters,controlling important emerging health threats and addressing the health related aspectsof climate change.We delivered in 2010-11Promoting good health and preventing and managing chronic diseaseA collaborative approach is being used to deliver Health Promotion activities. Examplesof jointly planned large projects include School Screening and Community Health Exposwhich are becoming part of the Top End health calendar.The Department’s Health Promotion Network Symposium was held on 27 May 2011. Thetheme was 'Connecting through communication: health promotion that matters'. Over 70people attended.88 Department of Health Annual Report 2010-11

Corporate Plan Activity StatementFunding was provided to Healthy Living Northern Territory to develop and produce the‘Good Food for Diabetes’ booklet and flipchart for diabetes education. In 2010-11, 66health educators were trained in the delivery of 'Eat Better, Move More' and over 500people participated in these education sessions during the year.Community Health established a dedicated male health position based at Casuarina. AHealthy Construction Worker project is being established in partnership with Unions NT.NT Aboriginal male health camps were included as a case study within the release of theNational Male Health Policy as a form of best-practice men's health promotion. Men’shealth promotion activities, programs and interventions continue to be implemented inremote communities contributing to the Territory 2030 target for increasing lifeexpectancy amongst Aboriginal Territorians.Health Promoting Workplace policy will be incorporated into the Healthy Worker initiativeas part of the Preventative Health National Partnership Agreement. The draft Active atWork policy has been completed and will be incorporated into the Health PromotingWorkplace policy.Regular visits to all Tiwi Island communities by the Health Development Team continuedto occur. Program days included:• Women's Health Day at Prilangimpi;• assistance with catch-up for Childhood Immunisation Program at Nguiu by the ChildHealth Nurse;• school screening planning for 2011 including Pickataramoor Outstation School;• fortnightly visits by the Nutritionists on Chronic Disease Program Days;• support from the Strong Women’s Strong Babies Strong Culture team leader for theworkers on the ground; and• regular support visits by the Diabetes Educator and the Preventable Chronic DiseaseNurse Educator.There has been renewed focus on a shared care approach with child and maternalhealth to reduce the harms of substance use. The Alcohol and Other Drugs HospitalIntervention team provided improved alcohol and other drug services to Royal DarwinHospital and Alice Springs Hospital, including education, brief intervention and sharedcare to reduce the harms related to substance use.The Alcohol and Other Drugs Program operated treatment services for clients from theEast Arnhem region. More comprehensive programs are available with increased accessto include Dual Diagnosis and Volatile Substance Abuse Prevention Act (VSAPA) clients.The service provides outpatient education, counselling and withdrawal management;residential programming; day program and Time Effective Treatment options; and anextended program supports return to work options with time limited residential access.A migrant and refugee health workshop was held in Darwin in June 2011 focusing ontraining key stakeholders in best practice provision of services and community educationfor migrant and refugee communities regarding sexual and reproductive health. Aworking party of the key agencies involved has been formed to see that this work issustained.An audit of resources, infrastructure and programs for sport and physical activity inremote Territory communities was conducted. The purpose of the audit was to gain aDepartment of Health Annual Report 2010-11 89

Corporate Plan Activity Statementbetter understanding of where future efforts should be targeted to improve support forremote communities to engage in active living.The Health Development Branch established a Strong Families Strong Culture Project toreview and analyse the issues facing Aboriginal community-based staff in the branch anddevelop recommendations for future progress.The Renal Mobile Dialysis bus is now permanently located in Alice Springs and hascommenced regular dialysis visits for outlying community residents in need.In response to the ongoingnumber of cases of pertussis(also known as whoopingcough), the Departmentexpanded its adult pertussisvaccination program in March2011 to include offering thevaccine free to all fathers andcarers of infants from the 28thweek of the expectant mother’spregnancyFree vaccinations wereprovided for all clinical staffand seasonal flu vaccine wasmade available at no cost to clinical and non-clinical staff in the Department.Quality Improvement Program Planning SystemThe Quality Improvement Program Planning System (QIPPS) continued to expandthroughout 2010-11. This system supports improved health promotion planning andevaluation across the Department. A departmental Health Promotion Framework hasbeen drafted. A report entitled ‘Health promotion education and training options for theNT health workforce’ was completed in October 2010. The report providesrecommendations about the various health promotion professional developmentopportunities required for different staff groups across the Department.QIPPS highlights include:• 243 QIPPS users in the Department, including 27 new users since January 2011;• 247 QIPPS departmental projects and 64 Department of Education and Training(DET) projects;• 22 new projects since January 2011;• approval has been given to establish a joint QIPPS subscription with the DET;• a poster presentation was made at the National Health Promotion Conference in April2011; and• an NT QIPPS Reference Group was established in February 2011.90 Department of Health Annual Report 2010-11

Corporate Plan Activity StatementTrainingA maternity care and community-based workforce training needs analysis wascompleted in October 2010. The resulting report provides recommendations aboutcommunity development and health promotion professional development opportunitiesfor this workforce. Key recommendations will be implemented in 2011-12.Liaison with Charles Darwin University has continued in relation to the commencementof the Bachelor of Health Science course and the delivery of the Certificate IV inPopulation Health. The Bachelor of Health Science commenced in February 2011 andthe Certificate IV in Population Health in June 2011.Chronic Conditions Prevention and Management StrategyThe implementation plan for the 10 year Chronic Conditions Prevention andManagement Strategy (CCPMS) was launched in September 2010.The 14th Chronic Disease Network Annual Conference: ‘HEALTH LITERACY, OpeningDoors to Health and Wellbeing’ was held on 9–10 September 2010 in Darwin.The Central Australian Remote Health Burden of Disease Committee was established topromote good health and prevent and manage chronic disease. In the Top End, healthpromotion DVDs were developed at Maningrida.The Department presented ‘Health promotion education and training pathways in the NT’at the World Health Promotion Conference in July 2010.The Men's and Women's Health Strategy Units are working together examining optionsfor the development and implementation of gender and diversity tools and processes forthe Department of Health.The Falls Prevention networks were established in the Top End and Central Australia toimprove delivery and coordination of falls prevention and management programs.A full review of alcohol withdrawal services was undertaken as part of the alcoholreforms with new policies, assessment forms and procedures put in place to assist in themanagement of alcohol withdrawal in a more efficient manner.The activities listed above contribute to Territory 2030 Plan targets and actions aroundprevention of chronic disease across the life cycle for Aboriginal and non-AboriginalTerritorians.Mental HealthA Mental Health Service 24 hour triage liaison and response service was implementedassisting with Territory 2030 Plan targets for improving the health and wellbeing of youngand adult Territorians.Shared care of clients with dual diagnosis was further developed, including through aMemorandum of Understanding and increased education with NGOs and Mental HealthServices regarding mental illness, substance use and suicide prevention.In response to suicides on the Gove Peninsula, Mental Health Services worked with RioTinto to fund the provision of follow up to high risk members of the community. Malabamand Top End Mental Health Services have collaborated regarding the employment of aMental Health Worker and recruitment of psychologist services for Maningrida.Department of Health Annual Report 2010-11 91

Corporate Plan Activity StatementMental Health implemented Metabolic Syndrome monitoring across NT mental healthservices to assist in early identification of problems arising from administration ofmedications.Aboriginal Child HealthThe Aboriginal Child Health Strategy was incorporated into the development of the wholeof government NT Early Childhood Plan (NT ECP) which is currently being finalised.The Department worked in partnership with DET to develop the NT ECP. Key expertpapers on Early Childhood Development, which were commissioned from the MenziesSchool of Health Research to support the development of the NT ECP, have been widelydistributed. The Department is involved with the planning and is supporting the roll out byDET of the Integrated Child and Family Services Project, which is included in the NTECP and monitored by the NT Early Childhood Steering Committee.Addressing Climate Change Impacts on HealthClimate change adaptation and abatement activities included:• the Department’s Climate Change Committee began implementing its action planand contribute to the drafting of the Northern Territory Government climate changeadaptation strategy;• at Royal Darwin Hospital a $0.46 million energy efficient lighting upgrade wascompleted; $0.45 million funding was approved for a steam energy saving project;the most energy efficient chillers possible were selected as part of a major upgrade;and the new accommodation building designs were optimised for energy efficiency;and• at Alice Springs Hospital design, documentation and tendering was completed forboth a $2.1 million cogeneration system and an air conditioning energy optimisationproject; in addition the new Emergency Department will demonstrate best practiceenergy efficiency.Where we are going in 2011-12• The Healthy Worker Implementation Plan will commence in July 2011 to ensuredepartmental employees are role models for the wider community.• The use of the Health Promotion Framework by the Department, other governmentagencies and relevant stakeholders will be finalised and promoted.• The Tobacco Alcohol and Other Drugs Services’ Withdrawal Service will be relocatedas part of the Alcohol Reforms Review recommendations, enabling better utilisationof medical, nursing and allied health staff and a more efficient service for clients. Fullrelocation will occur after completion of the building extensions.• The Hearing Health Information Management System and coordinated care modelfor prevention, early identification and management of ear conditions and hearingloss will be implemented.• NT cross-government Suicide Prevention Action Plan initiatives focusing on youngpeople will be implemented.92 Department of Health Annual Report 2010-11

Corporate Plan Activity Statement• Men's Health programs will be delivered across all remote Health Service DeliveryAreas, including: Men's Health Days; the Men's Health Mobile Unit; men's activitiesor programs; integrating health and sport activities; and the Men's Shed Program.• The implementation of the review into the Territory Independence and MobilityEquipment Scheme will be completed providing a more equitable, streamlinedequipment service.• The Department will continue to work on the transition to the Australian Governmentof Home and Community Care services for non-Aboriginal people aged 65 yearsand over and Aboriginal people aged 50 years and over, as outlined in the NationalHealth and Hospitals Network Agreement.• The review of the Adult Guardianship Act will be finalised.• Large energy and carbon saving plants will be installed and commissioned at AliceSprings and Royal Darwin Hospitals.• Royal Darwin Hospital diesel fired boilers will be converted to LPG.• The fully funded adult pertussis containing vaccine (dTpa booster) will be continuedfor all new parents and carers in the NT to protect young infants.• Sentinel chicken surveillance, human disease surveillance and mosquito monitoringand surveillance will be maintained. The public will be alerted during risk periods formosquito borne disease. Mosquito control will be carried around major populationcentres, as well as exotic vector exclusion.Department of Health Annual Report 2010-11 93

Corporate Plan Activity StatementHealthy Children and Young People in Safeand Strong FamiliesThe Territory 2030 Plan target most relevant to the Department’s contribution to thisPriority Action Area of the Corporate Plan is that the health and wellbeing of Territorianswill be better at all stages of the life course, which includes making major gains inAboriginal and Torres Strait Islandermaternal and early childhood health anddevelopment.Key focus areasThe Northern Territory has a high proportionof young people: 24.5% of the totalpopulation is aged between 0-14 years,compared to the national figure of 18.3%.Over 13% of Australia’s total Aboriginalpeople aged 15-29 years live in theNorthern Territory and over 50% of theTerritory’s Aboriginal population are aged25 years or younger.Today’s young are the leaders and parentsof tomorrow and their health, safety andwellbeing are essential. The foundations forhealth and wellbeing are laid down beforebirth and during early childhood. Goodantenatal care is needed to optimisematernal and birth outcomes together withservices to support parents and promotechild development and learning. Earlydetection and management of health anddevelopmental problems can have apositive impact on both current and futurehealth, educational attainment and social functioning.All families want the best for their children and young people. Some families require onlyminimal support with the difficult role of parenting. Others may struggle with the manychallenges of raising healthy, strong children and providing a safe family and communityenvironment. The Department also supports families, young people and communities toaddress antisocial behaviour of young people.We delivered in 2010-11• Enhancing the system forintegrated maternity, earlychildhood and school-agehealth and wellbeing services.• Strengthening the NorthernTerritory’s child protectionsystem.• Building family and communitystrength and resilience.• Working together with the nongovernmentsector to supportvulnerable families.• Preventing and responding tonegative influences such asantisocial behaviour, domesticand family violence.A pregnancy education book for Aboriginal and Torres Strait Islander women continuedto be distributed. Community-based Remote Area Midwives were recruited to providelocally-based care in communities with high birth rates.Two Remote Area Midwives were appointed to the Barkly region. Maternal and ChildHealth programs were implemented across all Health Service Delivery Areas (HSDAs) inthe Top End. A dedicated Remote Area Midwife was appointed in the Tiwi HSDA.Resources are provided to support these programs on an ongoing basis.94 Department of Health Annual Report 2010-11

Corporate Plan Activity StatementAn audit was conducted of the use of nutrition supplements for children in remotecommunities. All Yirrkala children under five are on a Care Plan and there have been nounderweight babies at birth in the last 12 months.Staff members have a strong working relationship with the Families as First Teachers -Indigenous Parenting Support Services Program. This program works to build anawareness of health, hygiene and nutrition in order to address the improvement ofdevelopmental outcomes for young Aboriginal children.Health Gains Planning is assisting the Australian Institute of Health and Welfare (AIHW)with child health check data collection. The Child and Youth Health Strategy Unit hasassisted the analysis of rates of child growth, nutrition and anaemia in the Territory beingundertaken by the Office of Aboriginal and Torres Strait Islander Health (OATSIH) andthe AIHW in collaboration with the Department.The Anglicare Pandanus/Paperbark projectcontinues to provide pregnancy and earlyparenting education and support to Aboriginalwomen under 25 years and their infants andfamilies in selected remote communities. Reanalysisof causes of 'failure to thrive' inAboriginal children in the Territory began duringthe year.The Core of Life program continued to providepregnancy, birth and parenting education toyouth with the aim of decreasing teenagepregnancy rates and improving early access to health care during pregnancy. This isworking to achieve the Territory 2030 target for making major gains in Indigenousmaternal and early childhood health and development.The Child Youth Health Strategy Unit is working closely with the Department of Childrenand Families’ Office of Youth Affairs in a review of youth policy in the Territory. Thisfocuses on addressing the determinants of young people’s health, laying the groundwork to achieve the Territory 2030 objective that the health and wellbeing of Territorianswill be better at all stages of the life course.An Indigenous Adolescent Sexuality Education Project is ongoing. The goals of thisproject are to increase access to sexuality education for Aboriginal adolescents in theTerritory and to strengthen the capacity of community, workforce and other partners inthe delivery of culturally appropriate, youth orientated sexuality education. A diversegroup of stakeholders is involved, including the Department of Education. The project isusing the Congress Community Health Education Program educational packages (foryoung women and young men) as the core educational tool. These packages werecomprehensively mapped to the NT curriculum framework.Evaluation of the resource tool, training and remote engagement model and other projectactivities is being carried out by the Australian Research Centre for Sex, Health andSociety.The Child Youth Health Strategy Unit worked with service partners in Remote Health,Community Health and with key community-controlled health services in the Territory todevelop a ‘standard’ child health primary health care service model for the Territory. Thissupports the Territory 2030 target to make major gains in the health and wellbeing ofyoung Territorians.Department of Health Annual Report 2010-11 95

Corporate Plan Activity StatementFunding was received from OATSIH under the New Directions: Mothers and BabiesServices program for Child Health Nurse positions in Remote Health. Under this funding,two Child Health Nurses will be employed in each of the two Top End communitiesidentified as having the highest population of children under five years old – Maningridaand Wadeye. They will be employed alongside Aboriginal community-based workers, inorder to improve coverage of and compliance with the Healthy Under 5 Kids healthprogram to enable a greater focus on child health in remote communities and improvehealth and wellbeing outcomes for children and families.Where we are going in 2011-12In line with the Territory 2030 target of making major gains in Aboriginal and Torres StraitIslander maternal and early childhood health and development, the focus will be onactivities such as:• consolidating a more standardised child health primary health care service modelacross the Northern Territory, beginning with a focus on early childhood, as well asthe systems to support that service model;• finalising the whole of government NT Early Childhood Plan and commencingimplementation of more evidence-based programs to ensure that children in theTerritory receive the best possible start to their lives;• supporting the development of a whole of government plan to improve the health ofyoung people in the Territory;• developing a Child Health Plan that builds on these early years’ initiatives to deliverbetter health outcomes for children in the Territory;• strengthening partnerships with other government and non-government agencies thatimpact on the health and development of children in the Territory and with thecommunities where those children live, around the delivery of more evidence basedprograms to reduce the risk of adverse outcomes;• implementing a Healthy Children Initiative in partnership with Palmerston City Counciland the South Australian Department of Health;• developing more understanding of the distribution of the health and morbidity ofchildren across the Territory;• focusing on expansion of continuity of maternity care models for all women, withurban and remote Aboriginal women as a priority, involving maternity sharedelectronic care plans, maternal and perinatal mortality and morbidity reviews and NTNetworked Maternity Guidelines;• implementing the National Perinatal Mental Health Project in the Territory;• working in partnership with the Department of Education and Training to establishintegrated family service hubs; and• working in partnership with the Department of Children and Families to develop theservice options for children with disabilities in out of home care.96 Department of Health Annual Report 2010-11

Corporate Plan Activity StatementTargeting Smoking, Alcohol and SubstanceAbuseOverviewThis part of the Department’s Corporate Planrelates to two principal Territory 2030 Healthand Wellbeing Objectives. These are thehealth and wellbeing of Territorians will bebetter at all stages of the life course; and theTerritory makes considerable headway intolifestyle illnesses.Smoking, alcohol and substance abuseaffect the health and wellbeing of individualsand their families and have significantimpacts on communities as well as thehealth and community service system.Tackling smoking, alcohol and substanceabuse and the damage it causes, is a priorityfor the Department because of its imposts onall facets of health ranging from disease,injury, disability, family violence and childdevelopment, protection and care. Aboriginalpeople are at particular risk of smokingrelateddisease, including preventablechronic disease, because of their high ratesof smoking.Key focus areas• Developing and deliveringtargeted health promotion andeducational strategies andmessages.• Assisting in the developmentand implementation of effectivelegislation and policy, includinghaving a legislative and clinicalresponsibility under the VolatileSubstance Abuse PreventionAct, Tobacco Control Act andthe Poisons and DangerousDrugs Act.• Offering a range of treatmentand rehabilitation services,acute and primary health careand family support.Many Territorians consume alcohol at levels that put them at risk of alcohol-relateddisease or injury over their lifetime or at risk of injury on a single occasion of drinking.The alcohol-attributable death rate of Aboriginal Territorians is more than eight times thenational average and twice as high for non-Aboriginal Territorians. Heavy drinkers andtheir families are more likely to experience alcohol-related violence, injury and illness.The Department has an important role in reducing the impact of substance abusethrough the provision of treatment and rehabilitation services, acute and primary healthcare and in providing family support. The agency also has a role to prevent substancerelated harm through the development and implementation of effective legislation, policy,health promotion and education.We delivered in 2010-11Action on SmokingAmendments to the Tobacco Control Act and Regulations took effect on 2 January 2011:banning smoking in outdoor eating and drinking areas (with some exemptions forlicensed premises); banning the display of tobacco products at the point of sale; andintroducing tobacco retail licence fees.Department of Health Annual Report 2010-11 97

Corporate Plan Activity StatementThe Territory was commended for the progress it had made in the area of tobaccocontrol by the Australian Medical Association during their 2011 Dirty Ashtray Awards.A grant of $55 000 was provided to the Australian Football League NT to promote theNorthern Territory Quitline and to support a complete ban on smoking across all of itsfacilities and at all events including those in remote and regional areas and youth events.Regular tobacco cessation training is being conducted across the Northern Territory aspart of accredited training programs and targeted Quit training.All the tobacco or smoking control actions above relate to the Territory 2030 Plan targetsunder Making Headway on Life Style Diseases. These are: by 2030, reduce the numberof Territorians who smoke to the national average; by 2018, halve the Indigenoussmoking rate.Action on Other DrugsVolatile Substance Abuse Prevention Act Assessment Guidelines were updated.Two management areas and two management plans were declared. A total of 21 VolatileSubstance Abuse Management Areas and 13 Management Plans are in effect acrossthe Territory.The Department worked with the Australian Government to commence the roll out ofOpal fuel in the Kakadu region. Opal fuel is an unleaded petrol which has extremely lowlevels of aromatics, removing the ‘high’ petrol sniffers get when they sniff normalunleaded fuel.A new Medicines, Poisons and Therapeutic Goods Bill is expected to be tabled in theLegislative Assembly in late 2011.The two actions above relate to the Territory 2030 Plan target to reduce the number ofTerritorians using illicit drugs, cannabis or inhalants.Actions on Alcohol ConsumptionThe Katherine Sobering Up Shelter (SUS) building was completed and the servicecommenced in January 2011. The official opening was conducted on 17 March 2011.The Department’s Reducing Alcohol consumption flipcharts are being widely used.Feedback has been very positive with requests received from interstate organisations touse this resource.The use of alcohol screening tools was trialled and implemented for the Drink DriverEducation Program.These actions work towards the Territory 2030 Plan target “By 2020 reduce the amountof alcohol Territorians consume to the national average.”Working Across the SectorThe Hospital Based Interventions Project has been of benefit within Royal Darwin andAlice Springs Hospitals, with greater intervention available for hospital inpatients.The Department has developed and implemented the Territory-wide alcohol withdrawalmedication guidelines which are available on PROMPT (a web-based document98 Department of Health Annual Report 2010-11

Corporate Plan Activity Statementmanagement system providing quick and easy access to approved clinical policies,procedures and guidelines across the five hospitals) and linked with MedChart.The Department of Health worked with the Department of Justice on the NorthernTerritory Government alcohol reform process.A collaborative approach with Miwatj Health continues in the provision of medicalmanagement for clients accessing the Nhulunbuy Residential Rehabilitation Program. AnAustralian Government funded outreach position hosted by Miwatj Health is based at thecentre and works with the Department’s service daily to provide assessments, supportand outreach to clients.Where we are going in 2011-12• 2011-12 will see the first release of sales data as a proxy measure of tobaccoconsumption in the Territory.• Legislative options on smoking and children (smoke free children’s events) and onsmoking in cars with children will be considered.• Tobacco Incentive grants to support smoke free community and sporting events willbe increased.• An evaluation of the departmental Smoke Free policy will be completed andrecommendations reviewed to determine further action required.• Staff employed in alcohol and other drug treatment services will continue to beprovided professional development through nationally accredited alcohol and otherdrugs training, with clinical guidance being provided regarding volatile substanceabuse best practice.• Training in the delivery of contemporary Brief Interventions and MotivationalInterviewing Techniques will be available for staff entering the alcohol and otherdrugs (AOD) workforce.• The Department will continue investment in the development of a local Aboriginalworkforce through the employment, support and retention of Aboriginal apprenticesand trainees within the alcohol and other drugs sector in the Northern Territory.• A tobacco online training tool is to be finalised and rolled out across acute healthservices in the Territory.• A Remote Tobacco Education and Cessation team will be established in Darwin andAlice Springs.• Service enhancement to support the Northern Territory Government alcohol reformsprocess will be implemented.• The New Era in Corrections Project will expand treatment facilities for CorrectionalServices clients in specialist AOD treatment residential rehabilitation services.Department of Health Annual Report 2010-11 99

Corporate Plan Activity Statement• Pathways to treatment services will be refined to support outreach and ambulatorytreatment options to clients.• The Tennant Creek SUS will be constructed and operational.• The Department will continue working with national and local partners in primary,secondary and tertiary alcohol and other drug services to implement a highlydeveloped network of prevention and treatment options across the Northern Territory.100 Department of Health Annual Report 2010-11

Corporate Plan Activity StatementConnecting CareOverviewThe Territory 2030 target for a greater service provider mix in the health system is a verylarge part of the Department’s strategy of reform to improve the range of options forTerritorians to access health services.Most Australians will receive hospital care atsome time in their life, whether in a birthingsuite, outpatients department, emergencydepartment, medical or surgical ward, cancercare facility, or a palliative care unit.Many will attend community health andremote health centres, and renal dialysisunits, or receive help for mental healthconcerns. Support services for families andchildren are also accessed frequently.A priority is to help people better managetheir health and wellbeing in a non-hospitalsetting. When hospital visits are necessary,these should be handled in ways that are more convenient to the patient, offer betteroutcomes and provide cost efficiencies for the system. To do this involves a greaterfocus on outpatient care, earlier discharge and hospital-in-the-home strategies, andcloser collaboration with General Practitioners and community health services.The Northern Territory is the nation’s most culturally diverse and geographicallydispersed jurisdiction. It has a small population yet many complex health challenges. Italso has the nation’s highest per capita rate of hospital admissions. Providing morealternatives to in-patient care must be the way of the future. Aboriginal people have ahigh burden of disease that requires particular attention. This is a special challenge inthe more remote communities.Families and the individuals who comprise them are central to the Northern Territory’ssocial fabric and to departmental planning. They define our initiatives and benefit fromthe Department’s many partnerships in preventive, primary and acute health careprovision, and the support services that we provide. The Department’s matrix of healthcare and family services will continue to help Territorians have a good start in life, enjoya healthy childhood and adolescence, and a secure adulthood.We delivered in 2010-11Key focus areas• Working effectively andproactively with partners in thegovernment, non-governmentand for-profit sectors to buildthe best possible servicesystem for the NorthernTerritory;• Placing clients and theirneeds at the centre of serviceplanning and service delivery.Aboriginal health has improved significantly through consultation and engagement withLocal Reference Groups in Territory Growth Towns. The Department has assessedservices available against agreed core primary health care provision to identify gaps.Resulting Local Implementation Plans are central to the long-term health of thecommunity in each Territory Growth Town and progress reports are available quarterly.Department of Health Annual Report 2010-11 101

Corporate Plan Activity StatementThis is consistent with the Territory 2030 target “All Territorians will have improvedaccess to essential healthcare services by 2030”.Under the Indigenous Early Childhood Development National Partnership Agreement,the Department continues to work with key government and community controlledorganisations in the Territory with the Indigenous Adolescent Sexuality Education Projectto deliver improved adolescent sexual health promotion in the Territory. A team ofAboriginal Health Promotion Workers, suitably trained to deliver selected adolescentsexuality and reproductive health education, is being established.Through Specialist Outreach NT (SONT) there has been better integration andcollaboration of visiting services to remote Health Centres, especially through the use ofa shared calendar. This is working towards all Territorians having improved access toessential health care services by 2030.Services under the Medical Specialist Outreach Program - Indigenous Chronic Diseasehave commenced across the Territory focusing on the following chronic disease areas:oncology; cardio vascular; respiratory; renal and diabetes. The SONT Administrative Unitcontinues to work with other service providers to ensure better coordination of servicedelivery.A five year contract with an optional five year extension has been successfullynegotiated with St John Ambulance (NT) for the provision of a Territory wide EmergencyRoad Ambulance and Medical Transportation Service.The Top End Medical Retrieval Service tender was awarded to CareFlight NSW in June2011 which will provide a fully integrated service in the Northern Territory for the firsttime.Regionalisation of remote primary health care (PHC) services continues in collaborationwith the Aboriginal Medical Services Alliance NT. The aim is for each region to have onePHC service provider under community control. The Red Lily Aboriginal HealthCorporation was established and significant progress towards regionalisation was madein Barkly and West Arnhem during 2010-11. The Clinical and Public Health AdvisoryGroup is providing advice to the emerging boards in West Arnhem and Barkly.The Northern Territory Specialist Cardiac Services Plan has been finalised. The Plan hasdeveloped a model of service delivery in the Territory to 2020 and provides a transitionschedule for increasing the level and type of specialist services. The Departmentaccepted recommendations to develop an NT Cardiac Clinical Network, introduce anangioplasty service for low risk patients, expand cardiac outreach services and expandcardiac rehabilitation. The next step is to establish a Cardiac Clinical Reference Group toimplement the recommendations.Where we are going in 2011-12• The Darwin Group Home construction tender for secure care services in thecommunity closed on 29 June 2011. It is anticipated that a Darwin tender will beawarded in July 2011 with construction to commence soon after. Legislation to allowfor the provision of services in the facilities, including client containment, is beingprepared.102 Department of Health Annual Report 2010-11

Corporate Plan Activity Statement• Secure care group homes will have capacity for 24 hours care for up to eight youngpeople and eight adults with high risk behaviours. Clients will be provided with a highlevel of physical security that eliminates their exposure to significant risk of harm tothemselves and/or others. There will be one facility in Darwin and one in AliceSprings.• All work for Katherine Hospital’s redevelopment of its Emergency Department isexpected to be completed and handed over in July 2011.• Detailed design and documentation for Royal Darwin Hospital’s EmergencyDepartment has just been completed. Tenders will be advertised in late July 2011and work is expected to be completed by the end of December 2011.• New works are planned at Royal Darwin Hospital for an operating theatre upgrade toprovide additional capacity to reduce the wait time for elective surgery.• The Department will construct new renal facilities across the regions in the Top End.• The Top End Medical Retrieval Service will be implemented, transitioning from thecurrent interim service to the full service.Department of Health Annual Report 2010-11 103

Corporate Plan Activity StatementSafety, Quality and AccountabilityOverviewThis key priority action area of the Corporate Plan also relates to two Territory 2030Plan Health and Wellbeingobjectives: reforming the Territoryhealth system; and the health andwellbeing of Territorians will bebetter at all stages of the lifecourse; further details are shownbelow.Optimising safety and quality is theessential foundation for theeffective delivery of servicestargeting the health, communitywellbeing and social advancementof all Territorians. The Departmentof Health is committed todeveloping and delivering asystem of services that isunderpinned by cultural security,safety and quality. It isaccountable in a meaningful wayto the community. This applies tothe whole DoH workforce and theservices they deliver, includingthose services provided throughagreements with the nongovernmentsector.The themes of this priority actionarea are safety and quality,cultural security, risk management,continuous improvement, sharing knowledge and organisational performancemanagement.We delivered in 2010-11Safety and QualityKey focus areas• Demonstrating our organisation’scommitment to achieving culturallysecure services through implementingand monitoring effective organisational,system-wide and staff implementedpractices.• Establishing a Safety and QualityFramework consistent with the nationalreform agenda, which is based on theimperative to improve care and servicedelivery and thereby reduce harm. Themajor tools of safety and quality-drivenreform are derived from newunderstandings of incident analysis,business improvement practice andchange management.• Developing and employing research,knowledge exchange processes,performance monitoring and reporting toinform and continuously improve bothplanning and practices.The Department has been laying the foundations for better safety and quality in itsservices, consistent with the national reform agenda. The following actions have beenprogressed:• a Safety and Quality Framework has been developed for consideration by thePrincipal Safety and Quality Committee (PSQC);• a strategic work plan has been developed to implement new national standards insafety and quality across the Department;104 Department of Health Annual Report 2010-11

Corporate Plan Activity Statement• a proposal for greater consumer engagement to allow direct consumer involvementin safety and quality policies is being developed;• the inaugural Annual Safety and Quality Forum was held during the year, attended byover 70 health staff from private and departmental groups; the forum showcasedmany of the best NT Safety and Quality initiatives; and• safety and quality induction information was delivered to clinical staff at theDepartment’s Staff Orientation sessions involving 200 attendees during 2010-11.Cultural SecurityWork is ongoing to improve the way the Department does business by ensuring culturalsecurity. The central aim of cultural security is to shift from a place of ‘knowing’(awareness) to a place of ‘doing’ (behaviour). The cultural security policy is focusedacross all areas of the Department and includes the following initiatives:• service guidelines for managers and staff;• career pathways for Aboriginal Health Workers in remote communities;• admission protocols;• gender issues in service delivery;• building designs and standards; and,• culturally competent staff.Cultural security is now included in the orientation program for all staff.The Department is finalising a Competency and Capability Framework that sets out thestandards and requirements that must be met in the process of moving to regionalisedcommunity controlled health services. The framework has also been aligned with theOffice of Aboriginal and Torres Strait Islander Health Risk Assessment Profile.Cultural security relates to two Territory 2030 targets: government and governmentfundedhealth systems will be benchmarked against established cultural securitystandards by 2015; and having a health workforce to meet the needs of all Territorians.Risk ManagementA Risk Management Framework is being implemented across the Department.The implementation of RiskMan TMwithin hospitals has now been completed and isdelivering a comprehensive range of reports including customised patient safety reports.This information is supporting management in making informed decisions whilst dealingwith risk related issues. The RiskMan TM training program for all key users has fosteredcontinual improvement to both the RiskMan TM system and associated processes.Divisional risk register development and implementation has seen the corporate riskregister being effectively utilised during internal audit planning and risk managementstrategy development.Department of Health Annual Report 2010-11 105

Corporate Plan Activity StatementContinuous Quality ImprovementSixteen Continuous Quality Improvement positions have been filled in order to supportremote primary health care staff to focus on best practice through auditing clinicalpractice. Their key role is to support chronic disease risk factor monitoring and follow upaction. Services are using a range of tools, as well as NT Aboriginal Health KeyPerformance Indicator (AHKPI) data to review and improve service delivery.The use of NT AHKPIs to monitor and continuously improve services at health centre,regional and NT wide levels has increased.The NT is the first jurisdiction in Australia to produce community level and regional levelAHKPI reports from all providers in the jurisdiction. This assists in implementing theTerritory 2030 Plan objective of ensuring the health and wellbeing of Territorians will bebetter at all stages of the life course by creating a health data collection that is adequateand provides meaningful information.Sharing Knowledge and Monitoring PerformancePlanning has begun for another round of Regional Living Knowledge Learning Networkworkshops. Key achievements include:• running two Living Knowledge Learning Network seminars; and• producing four Living Knowledge bulletins sharing knowledge around the Departmentand with its government and non-government partners.This work assists with implementing the Territory 2030 Plan objective on reforming theTerritory health system and its target to establish the Territory as a world leader inremote area and Aboriginal health service delivery, linking education, research andpolicy and service provision by 2030.The Department's organisational performance system was reviewed during the year andthe review’s recommendations for creating a performance governance framework andbetter organisation of existing resources to promote continuous improvement throughperformance measurement, monitoring and analysis at all levels were accepted.Where we are going in 2011-12Improved GovernanceKey focus in 2011-2012 will be to improve and strengthen safety and qualityperformance and reporting and this will be achieved by:• finalising the Department’s Safety and Quality Framework;• developing and implementing a Communications Plan for Safety and Quality;• improving leadership through the recruitment of a Director for Safety and Quality;and• implementing the recommendations from the Organisational Performance Reviewconducted in 2011; in particular a Performance Management GovernanceFramework on the processes used to manage performance will be developed and106 Department of Health Annual Report 2010-11

Corporate Plan Activity Statementthe current structure for analysing and sharing performance information will beimproved.Improved Systems and ProcessesWe will:• implement and standardise a single risk management system across the wholeDepartment; and• develop and implement an Action Plan for incorporating the National Safety andQuality standards into departmental business and accreditation planning. Implementa regular internal Safety and Quality Audit program based on risks identified incollected dataConsumer and Staff EngagementWe will:• establish a Safety and Quality Consumer Forum;• facilitate a 2011-12 Northern Territory Safety and Quality Forum;• continue implementation of patient satisfaction surveys and initiatives; and• implement an eLearning package to improve staff awareness and knowledge ofsafety and quality.Cultural SecurityIn 2011-12 this will involve:• a review of the patient journey will be completed to ensure cultural security at RoyalDarwin Hospital, in line with the National Partnership agreement on Closing the Gapin Indigenous Health Outcomes, and will assist the Territory 2030 goal for closingthe gap;• a national group, led by the Department, developing a consolidated set of coremeasures of cultural competence in health and wellbeing service delivery will go tothe Australian Health Ministers’ Advisory Council for approval;• ensuring cultural competencies for the health sector inform the development andcommencement of new cultural awareness training programs;• conducting an audit of the activities and impact that cultural security has had on theDepartment; and• finalising the Competency and Capability Framework under the Pathways toCommunity Control Framework, with trials to be conducted in the East Arnhem,West Arnhem and Barkly regions.Department of Health Annual Report 2010-11 107

Corporate Plan Activity StatementAttract, Develop and Retain a Workforce forthe FutureOverviewThis area of the Corporate Plan relates to two targets under the Territory 2030 Plan.These both come under the 2030 objective for reforming the Territory’s health systemand are: to have a health workforce that meets the needs of all Territorians; and thenumber of Indigenous people in the health workforce will reflect the cultural profile of thecommunity by 2030. Analysing ourworkforce in light of the current internal andexternal environment and implementingappropriate initiatives to address identifiedrisks and opportunities is critical toensuring our workforce is dynamically anddirectly linked to the future direction of theorganisation.Key focus areas• Optimising service deliverythrough workforce planning,recruitment and retentionstrategies to meet identifiedcommunity needs.In the Northern Territory, people ofAboriginal and Torres Strait Islanderdescent account for 30% of the populationand for more than 65% of our client base.Yet only 9% of our current workforceidentify as Aboriginal or Torres StraitIslanders.Around 19% (some 1000 employees) ofthe Department’s total workforce areexpected to retire within the next five years.This number includes 40% of executivesand 24% of physical and technical staff.• Innovation and reform inworkforce practice and servicedelivery models.• Implementing our StrategicWorkforce Plan and Aboriginaland Torres Strait IslanderStrategic Workforce Plan.• Matching the workforce to theneeds of the workplace andclients.The high reliance on overseas trainedmedical staff continues. Over a third (35%) of medical practitioners currently working inthe Northern Territory has been trained overseas. Employing Australian-trained medicalstaff remains a national challenge.It is important that we take a long-term, strategic approach to workforce planning andresourcing, staff development and retention, employee engagement and succession inorder to mitigate the labour shortage, cultural and knowledge gap risks.The Northern Territory continues to access initiatives available under the national healthworkforce reforms focused on the registration, development and future growth of ourhealth professionals. Northern Territory representatives attended consultation forumsand working group meetings associated with a broad range of national reform initiativesto ensure that the progress of this work and decisions at the national level take intoaccount the circumstances and specific needs of the Northern Territory. Localstakeholders are regularly advised about opportunities to provide input to nationalprojects.The commencement of the National Registration and Accreditation Scheme on 1 July2010 was a key health workforce reform covering 10 health professions. NorthernTerritory representatives continue to work closely with the Australian Health Practitioner108 Department of Health Annual Report 2010-11

Corporate Plan Activity StatementRegulation Agency to provide operational support and to prepare four more healthprofessions to join the National Scheme on 1 July 2012.The Department supported its largest number of apprentices yet, 37 in total, of whom21 were Aboriginal. Apprentices are studying in a wide range of critical healthdisciplines.We delivered in 2010-11In response to the Council of Australian Government’s national health workforceinitiatives, a range of projects were implemented, these included:• establishing a Northern Territory Integrated Regional Clinical Training Network withkey education and health service provider partners;• creating the Northern Territory networked Simulated Learning Environment hub anddeveloping Clinical Supervision Support programs across all health disciplines;• significantly increasing the number of clinical training placement days for healthworkforce students in the Northern Territory through achieving approval to progresseight proposals submitted under the Health Workforce Australia Clinical TrainingFunding initiative;• developing a departmental-wide ‘School to Work’ Framework to support careeropportunities in health for high school students in the Northern Territory;• establishing a number of school-based apprenticeship programs throughout highschools in the Northern Territory;• providing seven places for Aboriginal students and a total of 14 school-basedapprenticeships in Dental Assisting (Certificate III) and Community Services(Certificate II); and,• providing a further three school-based apprenticeships under a pilot program to trialCertificate III in Hospital/Health Services Pharmacy.The Northern Territory led the project to establish national registration for Aboriginal andTorres Strait Islander Health Practice across Australia.The Department provided facilities, equipment and operational support to the local Officeof the Australian Health Practitioner Regulation Agency. This support ensurescontinuation of services to local health practitioners on commencement of the NationalRegistration and Accreditation Scheme. This will support health services being providedby qualified and experienced health practitioners, which will contribute to the 2030 targetof having a health workforce that meets the needs of all Territorians.Applications to secure Area of Need status for five medical practices were finalisedwhich will contribute to the 2030 target for improving access to essential health services.Working with Children Clearance Notices, or Ochre Cards, were implemented for all staffin roles identified as requiring clearance under the Care and Protection of Children Act.A departmental Succession Planning toolkit was drafted.Key components of the eLearning Strategy were implemented including: procurement ofa Learning Management Server and installation of Moodle (Modular Object-OrientedDynamic Learning Environment) providing access and training to desktop collaborationDepartment of Health Annual Report 2010-11 109

Corporate Plan Activity Statementtools to departmental training sections; and procurement and installation of eLearningcontent authoring software.Nine modules of the Remote Health Orientation Program were developed.The Alice Springs First Line Managers Leadership Program was completed and aDarwin Middle Managers Leadership and Development Program commenced.Thirty-five General Studies assistance grants and nine Aboriginal and Torres StraitIslander Studies assistance grants were allocated.The ongoing development of Aboriginal and Torres Strait Islander people continuedthrough programs such as work experience, school-based apprentices, apprenticeshipsand cadetships. Fifteen Aboriginal students were supported to complete a Certificate II inCommunity Services and offered permanent appointment on successful completion.Aboriginal and Cultural Awareness training was provided to staff to develop skills,knowledge and attitudes appropriate to working with Aboriginal and Torres Strait Islanderpeople in order to contribute to improved health outcomes.Training and assessment plans are in place for 80% of Aboriginal Health Workers in theTop End and 86% in Central Australia.The development of Alice Springs as an Australian Resuscitation Council, Advanced LifeSupport Course Centre commenced.A School-to-Work Steering Committee was established to develop and support careeropportunities in health for school students in the Territory.Post graduate employment and academic study options were expanded within CharlesDarwin University and the Centre for Remote Health to include additional areas of needsuch as Intensive Care, Emergency, Paediatrics and Cancer Care.A Midwifery Exchange Program was developed between the Department and the RoyalWomen’s Hospital in Melbourne in order to provide ongoing professional developmentopportunities for all midwives.An antenatal ultrasound project for health professionals in remote communities andsmaller hospitals commenced. This will develop policy, education requirements and acredentialing framework that will allow for specific pregnancy ultrasound scanning to beundertaken within the community.A Maternity Education and Workforce sub-group was established to address theworkforce and education recommendations from the NT Maternity Services Review.Partnerships continued to be developed with NT health education providers in order toensure course content and clinical placements meet the needs of the Department atvocational education and training, undergraduate and postgraduate entry points.The first two Charles Darwin University Nurse Practitioners graduated with their scopesof practice being within areas of mental health.Six successful allied health professional development programs were deliveredthroughout the Territory.110 Department of Health Annual Report 2010-11

Corporate Plan Activity StatementWhere we are going in 2011-12• Implement a revised Criminal History Check policy and process.• Progress the roll out of eRecruit, an end to end electronic recruitment system.• Implement the provision of a suite of human resources’ data reports to enhance theworkforce information available to managers.• Identify and implement a range of initiatives focused on improving the level andaccuracy of Aboriginal and Torres Strait Islander workforce data within theDepartment.• Finalise and implement a departmental School to Work Framework that will bestrategic in its approach to providing career opportunities in health for NT schoolstudents.• Expand the number of school-based apprenticeship offers to school based studentsin Certificate III in Dental Assisting; Certificate II in Community Services andCertificate III in Hospital/Health Services Pharmacy Support.• Design and implement a range of strategies aimed at increasing the participation ofAboriginal people in the health and community workforce in partnership with keyeducation and non-government health provider partners.• Assist in identifying and developing workforce requirements for new and existinghealth and community workers.• Identify capability, capacity and barriers of Regional Training Organisations andemployers in the delivery of training and education services.• Renew the agreement with the Australian Health Practitioner Regulation Agency forthe Northern Territory Office to manage the registration of three health professions inthe Territory until they join the National Registration and Accreditation Scheme.• Represent Northern Territory interests in the development and implementation offuture national health workforce reform initiatives.• Develop and implement the Valuing our People Strategy to enhance a workplacewhere employees are supported and engaged.• Facilitate, identify and align new clinical placements and improve the experience ofhealth workforce students through collaboration with our partners in the NorthernTerritory Regional Clinical Training Network.• Progress the creation of a Rural Generalist workforce for the Northern Territory toassist in meeting the goals of a sustainable medical workforce with skills to meet theneeds of Territorians in more remote areas. This is being done in collaboration withQueensland Health which has successfully developed a rural generalist workforce.In 2012, doctors presently on a personal training pathway towards becoming a ruralgeneralist will be identified and supported to become the vanguard of the NorthernTerritory trainees.Department of Health Annual Report 2010-11 111

Corporate Plan Activity Statement• Commence a tailored First Line Managers and Middle Managers LeadershipDevelopment Program.• Consolidate and embed eLearning practices across the Department.• Review current corporate training products and develop an eTransition Plan to alignto an online or blended learning methodology.• Release the enhanced Work Partnership Plan Framework including the Senior PayProgression Scheme.• Promote and manage Entry Level Employment Programs, particularly those targetedat Aboriginal people, such as cadetships, full time apprenticeships, school basedapprenticeships and the Indigenous Employment Program. There will be a particularfocus on promoting Allied Health careers.• Deliver the training and education activities outlined in the 2011 and 2012 ClinicalTraining Calendars to support the ongoing professional development for nurses,midwives and where appropriate, other health professionals.• Finalise the development and delivery of the following new training products:Introduction to Cancer Care; Root Cause Analysis; Effective Clinical Teams; andSubstance Use and its Implications on Effective Service Delivery.• Coordinate the 2011 and 2012 Graduate Nurse Program across the Territory.• Develop a range of suitable suite of merchandise and fact sheets to allow for acoordinated and targeted image of a career in health being broad and varied. Thiswill assist with marketing careers in health, primarily to high school students, in orderto build a skilled workforce by 2030.• Trial, evaluate and review Year 9 curriculum that has been developed with theDepartment of Education.• Review and redevelop the current Employed Midwifery model.• Collaborate with education providers to ensure that tertiary entry programs arerelevant to the health careers and for Aboriginal people accessing these programs.112 Department of Health Annual Report 2010-11

Strategic ProjectsStrategic ProjectsHospital Services Planning ProjectAs part of the Northern Territory Government’s commitment to establish a hospital for thepeople of Palmerston, Ernst and Young were commissioned to develop a HospitalServices Plan for the Northern Territory.The report provided significant guidance in relation to future demand for hospital servicesif service models were to stay the same and was based on future Northern Territorypopulation projections.The report also proposed a number of key service drivers and integrations that should beconsidered to reduce demand, and ensure sustainable demand for hospital services intothe future. This approach is consistent with best practice clinical improvementmethodologies.The report provided four infrastructure options. An option for a Palmerston Hospital, alsoa commitment under the Territory 2030 Plan, was one of the options proposed. This hasbeen accepted by the Northern Territory Government as the best option to managedemand now and into the future, through a staged approach designed to match changesin the Greater Darwin population.On 4 May 2011, the Chief Minister, the Hon Paul Henderson MLA and the Hon WarrenSnowdon MP, Minister for Indigenous Health announced the allocation of $110 millionfor the joint funding of a Palmerston Hospital, following an infrastructure submission bythe Department to the Australian Government Hospital and Health Fund.There is a need to undertake clinical services planning for Greater Darwin includingPalmerston and the rural areas, as part of meeting the service scope for a PalmerstonHospital. This will allow for decisions about the phasing in of a Palmerston Hospital tomeet expected future demand in these areas of significant population growth. In addition,this approach will need to consider future investment in the Royal Darwin Hospital site toensure the required service capacity across the whole region.A number of key tasks need to be completed to achieve this, including:• refining the scope for a Palmerston Hospital;• consideration of location based on scope and size of available land;• models of care to manage demand; and• development of a Greater Darwin Clinical Services Framework.This work will define the clinical services plan, service scope and functional brief for aPalmerston Hospital. It is envisaged that this planning work will be completed by the endof 2011.Stakeholder engagement, including clinicians and Palmerston community groups, will becritical to the success of this planning approach. Meetings have been held with keyclinicians and local community leaders to outline the plan for the way forward.A project taskforce, including the Department of Health, Department of Construction andInfrastructure, Northern Territory Treasury and independent health planning andinfrastructure expertise, has been established.Work will be undertaken to consider the impact of the service options suggested by Ernstand Young which were designed to modify service demand patterns, in order to build onthe assessment provided based on the current service models.Department of Health Annual Report 2010-11 113

Strategic ProjectsMaternity ServicesThe Northern Territory population isunique with 38% of births per yearbeing to Aboriginal women living inremote areas. Aboriginal women inthe Northern Territory have a higherfertility rate with higher rates ofteenage pregnancy than the rest ofAustralia.The NT Integrated Maternity Servicehas been in development since2008 and its underlying principlesare:(Source: Interactive Communications and Development Unit)• safety of mother and baby are paramount;• a single maternity service spanning antenatal, birthing and postnatal care;• women should have access to information about pregnancy;• women should have access to information about maternity care and choices for care;• appropriate professionals should be involved along a continuum of care from low tohigh risk;• continuity of care and carer should be provided wherever possible; and• Aboriginal women are entitled to consider the retention of traditional practices wherefeasible, combined with evidence-based care.The Medical Co-Director Integrated Maternity Services commenced on a part-timeconsultancy basis in September 2010. This leadership position works in partnership withthe Midwifery Co-Director Integrated Maternity Services to lead maternity reform in theNorthern Territory.The NT Integrated Maternity Services Clinical Reference Group identified the followingsix key priority areas for 2010-11 and these will be retained for 2011-12:1. NT Maternity Standards and Guidelines;2. NT Maternal and Perinatal Morbidity and Mortality Review;3. Shared Electronic Integrated Maternity Record;4. Expanding Continuity of Care Models for all women;5. Developing an Indigenous Maternity Care Workforce; and6. Northern Territory Policy Towards Normal Birth.Developments have been taking place to expand the existing successful continuity ofcare models for remote and urban based women across the Northern Territory. AliceSprings Hospital has seen improved outcomes for mothers under the Midwifery GroupPractice model of care, established in April 2009, including reduced rates of caesareansection. Plans are well underway to expand provision of this model of care in 2011-12.114 Department of Health Annual Report 2010-11

Strategic ProjectsIn Darwin, the Midwifery Group Practice for women who live in remote areas has provento be a crucial link between maternity services in remote settings and acute urbansettings and therefore of great benefit to women and families who need to move betweenthe services. Increased access to the Royal Darwin Hospital Birth Centre for low riskwomen has been achieved and will remain a high priority for 2011-12.In remote settings, dedicated Remote Area Midwife positions have been implemented inManingrida, Wadeye, Tiwi Islands and for Central Australia, two positions, workingacross clusters of communities, are based in Ntaria and Ali Curung. These positionsenable midwives to address all aspects of maternity care, including increased continuityof care, ensuring women are able to access maternity care in a seamless fashion, aswell as antenatal education, continuous quality improvement and develop maternity careprograms in partnership with locally based community women.An Advanced Shared Electronic Care Plan for maternity is well under way and maternityclinicians across the Territory have had input into the clinical modelling of this, workingclosely with eHealth Services. Maternity care information leaflets have been developedfor women and families across the Territory. An Aboriginal specific resource ‘HealthyPregnancy, Health Baby’ has been developed in collaboration with Aboriginal women.There is a focus on the Aboriginal maternity workforce. Four Territory Aboriginal womenare halfway through their Bachelor of Midwifery degrees, one in Darwin, two in AliceSprings and one in Tennant Creek. Work has commenced on a professionaldevelopment program for Aboriginal Health Workers, Strong Women workers and othersinvolved in maternity care.eHealtheHealthNT aims to advance health care delivery by securely storing, sharing andtransmitting important patient care information. eHealthNT is responsible for theoperation of the Nothern Territory’s Shared Electronic Health Record, which provides41 600 Territorians, including 67% of Aboriginal people living in rural and remotecommunities, with the means of ensuring important health information is available whenneeded for care at any of the 107 participating health centres, general practices, andpublic hospitals across the Northern Territory.The Department continued its collaborative work with the National eHealth TransitionAuthority (NEHTA) to implement secure messaging, linking primary care and acute caresectors within the Northern Territory as a national eHealth demonstration project. TheSecure Electronic Messaging Service, currently used as the principal means fordelivering clinical documents between NT hospitals, remote primary care clinics, urbangeneral practices and other healthcare providers, delivered an average of 30 000 clinicaldocuments per month from hospitals to over 300 sites across the Territory.In 2010-11 within the Integrated Health Information Network the Department has:• continued development and improvement of the Primary Care Information System(PCIS) providing fully electronic health records in 54 health centres across theTerritory and in prison health services, implementing maternal and child health careplans and successfully deploying WANScaler, a wide area network optimisationsolution, to improve network performance in remote health centres connected viasatellite;Department of Health Annual Report 2010-11 115

Strategic Projects• initiated the East Arnhem Patient Information Recall System Implementation projectin June 2010 with financial assistance from the Australian Government and inpartnership with Aboriginal Medical Services Alliance of the Northern Territory(AMSANT), to implement Communicare clinical software into four remote healthcentres, completing the roll out of fully electronic health records to all departmentallyoperated health centres;• continued implementation of the eHealthNT Consumer Registration Card, issuing atotal of 15 000 cards to persons registered for the Shared Electronic Health Record;• completed the roll out of the MedChart Advanced Medication Management andDecision Support System into Tennant Creek Hospital in March 2011, with the rollout in Royal Darwin and Alice Springs Hospitals suspended in January 2011 pendingresolution of system performance issues (due to re-commence in August 2011);• completed development of a new Pensioner Concessions system in January 2011;and• completed major upgrades to the Royal Darwin Hospital Block 6 main server roomfacilities and infrastructure to meet increased service demand and mitigate security,fire protection and environmental risk factors.The following projects are jointly funded by the Northern Territory Government and theAustralian Government Digital Regions Initiative and will be completed by June 2012:• development and implementation of an eLearning and Collaboration Framework andintegrated system to provide an end-to-end eLearning capacity to develop and retaina strong workforce;• upgrading Communications Technology infrastructure in 17 of the 20 TerritoryGrowth Towns to provide high speed broadband for health, education and policeservices;• development of an advanced electronic Shared Care Plan with the initialimplementation targeting a pregnancy plan of care and hearing health casemanagement linked to the Shared Electronic Health Record; and• development and implementation of a comprehensive telehealth service linking acutecare, primary care and private specialists across the Territory with tertiary hospitalsand specialists interstate to improve equity of access and quality of service delivery.This was implemented at Katherine Hospital in November 2010. Planning is nowunderway to extend telehealth services to Aboriginal Community Controlled HealthServices, six hospitals in the Kimberley Region of Western Australia and the GPSuper Clinic at Palmerston.116 Department of Health Annual Report 2010-11

Strategic ProjectsNT Medical ProgramThe Australian Government committed $27.8 million towards the Northern TerritoryMedical Program (NTMP) infrastructure with an additional amount committed towardsthe program’s recurrent costs to support Industry Sponsored Scholarship places. Thisfunding and that of the Northern Territory Government is shown in Table 12 below. Twoeducation facilities are being built at Charles Darwin University (CDU) and Royal DarwinHospital. In June 2011, the Hon Julia Gillard MP, Prime Minister of Australia, opened theFlinders NT Medical Program education facility on the CDU campus.Table 12: Recurrent Funding by financial year for NTMPSource 2009-10$’0002010-11$’0002011-12$’0002012-13$’0002013-14$’000Australian Government 0 500 1 600 2 200 2 300Northern Territory2 189 2 244 2 296 2 370 2 370Government (Indexed)NTG Commencement300PrepaymentTotal 2 489 2 744 3 896 4 570 4 670In 2011, 24 students commenced the NT Medical Program with Flinders University underthe Northern Territory Bonded Medical Scheme (NTBMS). All 24 students areTerritorians with 10 students recognised as Aboriginal. Each of the students haveaccepted a scholarship under the NTBMS which will fund their university course fees andbond the scholarship recipient to work in the Territory for a two year period, followingcompletion of the course.High school graduates were also chosen for future entry to the NTMP. In 2011, 11students commenced Clinical Sciences at CDU for two years and will be eligible to enterthe Medical Program in 2013. This pathway will provide a double degree in science andmedicine. The outcomes of the student demography for 2011 are well aboveexpectations and will assist in meeting the goals of a sustainable medical workforce withskills to meet the needs of Territorians. Numbers by year of study that are anticipateduntil 2015 are shown in Table 13.Table 13: Student 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 40Department of Health Annual Report 2010-11 117

Strategic ProjectsNorthern Territory Radiation OncologyNorthern Territory Radiation Oncology (NTRO), part of the Alan Walker Cancer CareCentre, provides Territorians with access to professional, high quality radiotherapycancer treatment without the need to travel interstate. The centre also provides oncologyservices including chemotherapy delivered by highly trained Royal Darwin Hospital staff.The Alan Walker Cancer Care Centre is equipped with the latest technology providingboth radiation therapy services and medical oncology (chemotherapy) to Territorianswho require cancer care. The centre is named in memory of Dr Alan Walker (1931-2007), a Northern Territory paediatrician credited with improving Aboriginal infantmortality and child health outcomes.The Radiotherapy Unit has been open for treatment since March 2010 and has treated432 patients to date.A 10 year service agreement with Royal Adelaide Hospital ensures that the Centre isoperated by highly-qualified staff. The Centre provides enhanced chemotherapy servicesand has treated 405 patients since its opening in March 2010. Of these, 122 patients hada combination of both radiotherapy and chemotherapy.(Source: Kara Burns : Northern Territory Government)

Regional ReportsRegional Achievements and Services MapOverviewCoordination of health and wellbeing services across the vast and varied NorthernTerritory landscape is complex. Getting the most from our services and supporting thecoordinated implementation of government policies is a responsibility that falls to the TopEnd and Central Australia Coordination Units. The Top End region takes in Darwin,Palmerston, Katherine and Arnhem. Central Australia region covers Alice Springs,Tennant Creek and the Barkly.The Top End and Central Australia Coordination Units aim to foster cooperation andcollaboration across departmental programs and endeavour to maintain strong workingrelationships with communities, government and non-government agencies. The unitsare responsible for developing the departmental Health Regional Plans, in conjunctionwith relevant program areas. The Regional Plans are reviewed regularly to ensure thatpriorities and objectives progress through to implementation and that ongoing andemerging issues are addressed. These plans provide an effective platform for promotingand delivering cross program outcomes.Over the past year the regional Coordination Units have provided a range of servicesaimed at improving cross program and cross agency collaboration including:• convening regional departmental monthly reference groups;• convening meetings with non-government health providers to seek feedback onservice provision and to assist with any concerns or issues;• facilitating program business planning in the regions aligned with the Department’sCorporate Plan 2009-2012;• assisting with the review of the Medical, Public Health and Welfare Group CounterDisaster plans; and• assisting with the Department’s Medical and Public Health responses to CycloneCarlos, flooding in the Daly River region and the aftermath of Cyclone Yasi in CentralAustralia and the Barkly.(Source: Kara Burns : Northern Territory Government)

Regional Reports120 Department of Health Annual Report 2010-11

Regional ReportsPerformance Highlights by Region 2010-11Across the TerritoryThe split from the Department of the Children and Families portfolio together with theactivation of the Department’s Emergency Management Plan 2009 for Cyclone Carlos inFebruary 2011 provided an opportunity to review emergency management arrangementsand this process is ongoing. The Coordination Units have assisted in the review processacross the Territory.The preliminary work required for the implementation of Hospital Networks - one in theTop End and one in Central Australia has been a major focus for the health sector in2010-11.Governing Councils will replace the existing hospital boards, be established vialegislation and will report to the Minister for Health. The NT Hospital Networks will be runas Government Business Divisions sitting within the Department of Health.Our regional hospitals, Tennant Creek, Katherine and Gove District all achievedaccreditation by the Australian Council for Healthcare Standards (ACHS). ACHSindependently assesses our hospitals’ performance in order to promote and improvequality and safety of health care.Implementation of the Shared Electronic Health Records (SEHR) was rolled out in theTop End in 2009-10. Four sites in East Arnhem will be completed after the roll out ofCommunicare to these communities in 2011.In December 2010, the Shared Electronic Health Records (SEHR) implemented anenhancement to the Primary Care Information System (PCIS) called eRegistration whichallows PCIS users to register their community members. Health Centres in the Top Endhave embraced the eRegistration process to register their community members.Top EndEast Arnhem RegionUnder the Department’s Smoke Free Policy, Gove District Hospital, allHealth Centres and departmental workplaces in East Arnhem are smokefree. QUIT programs and nicotine replacement options are continuing tobe offered to all staff and clients. Twenty additional East Arnhem staffmembers were trained in 2010-11 as QUIT educators and are now qualified to deliverQUIT sessions.Youth Suicide and Youth Diversion activities and support will be developed across theGove Peninsular interlinking with already existing community suicide preventioninitiatives. A cross agency group was formed in the Nhulunbuy area for that specificpurpose, with the Department as lead agency.Construction of six two-bedroom staff accommodation units on Gove District Hospitalcampus commenced, using funding from 2010. Completion of this project is expected bythe end of 2011. This accommodation will assist with recruitment and retention of staff.Department of Health Annual Report 2010-11 121

Regional ReportsThe Nhulunbuy Alcohol and Other Drugs Residential Rehabilitation Centre continues toprovide residential programs for clients with alcohol, volatile substance abuse and dualdiagnosis issues. The client base is both mandated and voluntary, with non residentialclient services also being offered.Substance abuse and misuse continued to be targeted in East Arnhem in 2010-11. TheVolatile Substance Abuse Act 2006 provided for communities to establish ManagementAreas and Management Plans through which the community can control the possession,use and supply of volatile substances. Alcohol and Other Drugs Volatile SubstanceAbuse (VSA) Management Plans have been declared in Yirrkala, Gapuwiyak,Numbulwar and Ramingining. In 2011-12, all East Arnhem communities are expected todevelop VSA plans.Under the Digital Regions Initiative National Partnership Agreement, Gove DistrictHospital has implemented eHealth initiatives such as: desktop video conferencing;installation of cameras in Emergency Department ceilings for coverage of resuscitationand specialist interactions; and a portable medical practitioner cart for mobile diagnosticservices in ward areas of the hospital, used to transmit patients’ vital signs to doctorsand specialists in other locations.The East Arnhem Steering Committee and the regionalisation partners, made up of theDepartment of Health, Office of Aboriginal and Torres Strait Islander Health (OATSIH)and Aboriginal Medical Services Alliance Northern Territory (AMSANT), have endorsedand signed the initial regionalisation proposal, planning unit and the employment of twoproject officers under the auspices of Miwatj Health to develop the final regionalisationproposal.A sub-committee of the East Arnhem Steering Committee, the Clinical and Public HealthAdvisory Group (CPHAG), has been established. The group comprises four healthservice providers and Steering Committee representatives. The purpose of the CPHAGis to provide joint health planning and opportunities for health service improvements forthe East Arnhem region.Departmental staff involvement in local festival and health promotion activities hasincreased with staff involvement in local youth music festivals, the yearly GovePeninsular Festival, Garma Festival and increased stalls for health promotion in EastArnhem Region, including the Mobile Renal Bus: Dialysis on the Move.A cross agency working party, Mums and Bubs, has been implemented in East Arnhemin partnership with staff from the Department of Children and Families, Miwatj, EastArnhem Shire, Arnhem Land Progress Aboriginal Corporation stores, the Department ofEducation and Training and the Australian Red Cross. The working group will identifyrecommendations for assisting children who are failing to thrive.Departmental staff are actively participating in the cross agency working groups of YouthInteragency Coordination, Family Interagency Network and the Interagency Tasking andCoordination. These groups address social, emotional and health related issues and antisocial behaviour across the Gove Peninsular with a multi disciplinary and cross agencyapproach.The Department is currently working to ensure a smooth transition of the welfarerecovery roles for disaster management in the Northern Territory to the newly createdDepartment of Children and Families.122 Department of Health Annual Report 2010-11

Regional ReportsKatherine RegionKatherine Hospital has successfully implemented the Modified EarlyWarning System that is used to identify deteriorating patients to ensureearly medical intervention as required.Under the Digital Regions Initiative, Katherine Hospital has implementeddesktop video conferencing, installation of cameras in EmergencyDepartment ceilings that allow specialists in Royal Darwin hospital toview and provide advice for resuscitation and specialist interactions anda medical practitioner cart for mobile diagnostic services.Under a trial medical specialist model, enhancement to medical care in KatherineHospital is being provided by rotating specialist consultants from Royal Darwin Hospital.The specialists provide expertise and advice to hospital medical staff in the specialtyareas of emergency medicine, general medicine and obstetrics and gynaecology.Canberra Eye Hospital specialists visited in September 2010 to undertake specialistconsultancies.Health Promotion programs provided in the region included:• activities conducted for National Nutrition Week, including Katherine Times articles,school newsletters, and visits to schools;• Katherine Urban Public Health nutritionist/dietician working with school canteenmanagers to review menus and implement the Northern Territory GovernmentHealthy Eating and Nutrition Policy;• campaigns at events, schools and Katherine Show about hand washing with ‘Gerrythe Germ’ and spreading good nutrition messages with ‘Veggie Man’; and• Iron Chef Cook Off teams competing to produce the best healthy meal as part of theGo For 2 & 5 campaign at the Katherine Community Markets in October 2010.A Well Women’s course was held in December 2010 with 11 participants, resulting infour participants being trained and assessed in order to conduct future Well Women’sChecks.Implementation of the remote intensive therapy program for children with complex needswas conducted, enabling access to specialist allied health interventions with links topaediatric rehabilitation specialist visits in Darwin. Two visits by the remote intensiveteam have taken place with intervention provided to nine paediatric clients with complexneeds in the Katherine region.A Sexual Assault Referral Centre (SARC) was established in Katherine in July 2010 withan onsite Coordinator/Counsellor and an Aboriginal Sexual Assault Worker. SARC areactively working with 30 families and individuals and are partnering with the GoodBeginnings charity organisation to deliver training on protective behaviours to pre-schoolchildren.The Department facilitated six meetings of the Community Helping, Action andInformation Network (CHAIN) throughout the year. Over 75 non governmentorganisations, Northern Territory and Australian Government organisations are membersof CHAIN.Department of Health Annual Report 2010-11 123

Regional ReportsAlcohol and Other Drug (AOD) training was delivered in Katherine with five certificatecompletions for Certificate III, Certificate IV and Diplomas in Community Services andAOD work.Brief intervention training and nicotine replacement therapies were offered to Katherinestaff and patients under the Department’s Smoke Free policy.The Katherine Sobering Up Shelter was opened in March 2011. The new shelter offersrehabilitation and treatment services for up to 18 people.In November 2010, two new Domestic and Family Violence Aboriginal Liaison officerswere recruited and are located in Katherine Hospital working closely with EmergencyDepartment clinical staff.A 96.5% immunisation rate in Katherine town area was recorded for children aged lessthan 15 months.Three Katherine Hospital nurses were nominated for the 2011 Nursing and MidwiferyExcellence Awards. Carey Spain (Emergency Department), Josie Goonan (Renal Unit)finalist in Acute Care and Phoebe Jamieson (Maternity Ward) was a finalist in theGraduate Nurse Award.Sue Moran, Manager School Health Services, was the recipient of the Living LegendAward at the 2011 Nursing and Midwifery Excellence Awards and also the Carol LloydNational Memorial Trophy (Family Planning Western Australia).Central AustraliaCancer services for Central Australians were expanded withthe commencement of a combined clinic in Alice Springs.The clinic involves a medical oncologist from RoyalAdelaide Hospital and a radiation oncologist and AlliedHealth team from Darwin.For women who need to travel to Darwin for breast or ovarian cancertreatment, the Stay in Touch Program is now available. The Program is funded by theNational Breast and Ovarian Cancer Centre and enables women from regional andremote locations to connect with their families whilst they are away from home.The national Bowel Cancer Screening program began in Central Australia in 2010-11with a Project Officer visiting communities throughout the Centre and the Barkly. Theproject is focused on educating people about bowel cancer, and implementing asustainable screening program that addresses cultural and environmental challenges inthe early detection of bowel cancer.The rates of sexually transmitted infections (STIs) in remote communities continued tobe addressed in 2010-11 with 11 Central Australian communities participating in theNational Health and Medical Research Council grant project STRIVE. STRIVE is aquality improvement research project designed to improve testing and management ofSTIs for young people in remote communities. There are 67 communities participating inSTRIVE across the Northern Territory, Western Australia’s Kimberley region and the farnorth of Queensland. Participating Central Australian communities include: Ali Curung,Canteen Creek, Epenarra, Haasts Bluff, Laramba, Mt Liebig, Papunya, Ti Tree,Wilora/Tara and Yuelamu.124 Department of Health Annual Report 2010-11

Regional ReportsThe STRIVE study is a community trial with sites participating through a randomly stagedprocess over three years. The study aims to provide enhanced sexual health support viaquality improvement assessments, implementation of action plans, upgraded patientinformation systems, site visits by the area STRIVE Coordinators and regular feedbackon the data collected. Sites also receive payments for improvements.Expansion and improvement of renal services for Central Australians was another majorfocus in 2010-11 in line with our Corporate Plan and Territory 2030 targets.Substance abuse and misuse continued to be targeted in Central Australia in 2010-11.The Volatile Substance Abuse Act 2006 provided for communities to establishManagement Areas and Management Plans through which the community can controlthe possession, use and supply of volatile substances. Eleven Management Areas havenow been declared in Central Australia and there are currently eight Management Plansin operation.The Central Australian Tobacco Reference Group was established in 2010 and has beenmeeting quarterly. It brings together key government and non government stakeholdersin tobacco control to support the implementation of the NT Tobacco Action Plan 2010-2012 as well as supporting the Department’s Smoke Free Policy.Implementation of the Shared Electronic Health Records (SEHR) project is underwayacross Central Australia. In 2010-11 a project team based in Alice Springs and workingwith stakeholders from across the region succeeded in registering 7500 consumers and35 health care facilities as well as the Alice Springs and Tennant Creek Hospitals. Morethan 22 000 documents per month were received including: current health profiles,primary health care centre summaries, antenatal reports, Emergency Departmentdischarge summaries, in-patient hospital records, out-patient records, pathology andmedical imaging reports. More than 2500 viewings per month have been made of theshared records.A collaborative project to address public health risks in remote communities was a finalistin the 2011 Environmental Health Initiatives Awards. The Department conducted wastemanagement audits of six major and 13 minor remote Aboriginal communities across theBarkly in 2009-10. The resulting reports cited landfill precincts and effluent disposalsystems as major public health threats. Audits of waste processes (including collection,waste streams, occupational health and safety training and community education) alsofound that waste management practices were inadequate to sustain healthy livingpractices. As a result the Department and the Barkly Shire Council developed a projectthat set about initiating a construction program to decommission old sites andrecommission and construct new infrastructure to alleviate the risk to public health.As part of the project, Bachelor Institute and Charles Darwin University were engaged astraining partners and together they have completed six workshops in each of theidentified communities. This training aims to have Barkly community members involvedin the design, construction and operation of infrastructure to improve the environmentalhealth of their communities.Valuing our staff was also a focus for the Department in Central Australia in 2010-11.Tennant Creek staff, from a variety of programs, moved into the Matt Glynn Building onPaterson Street in September 2010. The newly refurbished offices provide a significantlybetter environment for staff and clients of Remote Health, Mental Health, Alcohol andOther Drugs, Aged and Disabilities, Domiciliary Care and Child and Maternal Health.Department of Health Annual Report 2010-11 125

Regional ReportsThe Department also recognised more than 150 staff members across Central Australiaand the Barkly for their services over many years. Service Pins and Certificates werepresented by the Minister and Chief Executive for those completing five, ten, twenty orthirty years as at 31 December 2010.What’s coming up in the Regions 2011-12Across the TerritoryThe Hospital Networks in the Top End and Central Australia will be fully implementedand operational. These health reforms are the major driver for system performance andwill be a key focus for both the Department and the Networks during the 2011-12financial year.Concurrent health reforms will also strengthen local control and decision making andinclude the introduction of a Medicare Local for the Northern Territory (based in Darwinwith an office in Alice Springs) and Lead Clinicians Groups at the local level providinginput to groups at the Territory and national levels.Top EndIn Katherine, 12 units (for 24 patients) of short-term patient accommodation are currentlybeing designed and planned to be built in 2011-12.Renovations to Katherine Hospital Emergency Department are due to be completed inAugust 2011. These renovations will improve patient flow and patient, visitor and staffamenities.The Australian Government has provided Gove District Hospital with $13.2 million toredevelop and expand the Gove District Hospital Emergency Department and $5 millionto construct 12 non-clinical step-down (less intensive care) beds on the campus. It hasalso funded aged care beds with a projected site area of approximately 3000m 2 . Anarchitect has been appointed to review the master site plan for the Gove District Hospitalcampus and develop proposals for the site location for the Emergency Department,hostel accommodation and the flexible aged care facility.The Department will recognise service of staff in East Arnhem and Katherine bypresenting them with badges and certificates.Central AustraliaOral Health services will receive a major boost with new, fully equipped mobile dentalvans to deliver services to patients in Central Australian and Barky communities. Inconjunction with a team from the Westmead Children’s Hospital, an oral health surgeryblitz will be provided in August 2011 for Barkly school-aged children and there will be amajor upgrade of the dental clinic at Lake Nash.Alice Springs Hospital will also see a range of new acute care facilities available by theend of 2012. These include a new Emergency Department (which will provide 31treatment spaces including one paediatric treatment room, two secure assessmentrooms and three resuscitation areas) a five bed fast track and an eight/ten bed short stayfacility, triage, procedure and consultation area, as well as a relocated 24 hour medicalimaging centre.126 Department of Health Annual Report 2010-11

Regional ReportsRenal patients coming to Alice Springs for services will have access to much improvedand culturally appropriate accommodation with the opening of the Alyerre Hostel.Formerly known as the Bath Street Lodge, the renovated facility will be managed byAboriginal Hostels and accommodation will be available from July 2011.Expanded alcohol rehabilitation services will be available in Tennant Creek fromSeptember 2011 when a new Sobering Up Shelter is due to be completed. The newfacility will increase the current capacity of 16 beds to 26 beds.Department of Health Annual Report 2010-11 127

Our PeopleOur PeopleOverviewThe Northern Territory continues to access initiatives available under the National HealthWorkforce Reforms focused on the registration, development and future growth of ourhealth professionals. Northern Territoryrepresentatives attended consultationforums and working group meetingsassociated with a broad range of nationalreform initiatives to ensure that theprogress of this work and decisions at thenational level take into account thecircumstances and specific needs of theNorthern Territory. Local stakeholders areregularly advised about opportunities toprovide valuable input to national projects.Dr Greg Rickard, Principal NursingAdvisor was recognised in theQueen’s Birthday Honours for hisservices to Nursing. Greg received aMedal of the Order of Australia(OAM). Greg was also recognised atthe Nursing and Midwifery ExcellenceAwards for his dedication andcommitment to Nursing andMidwifery in the Northern Territory.A key health workforce reform was thecommencement of the National Registration and Accreditation Scheme on 1 July 2010covering 10 health professions. Northern Territory representatives continue to workclosely with the Australian Health Practitioner Regulation Agency to provide operationalsupport and to prepare for four more health professions to join the National Scheme on 1July 2012.Dr Christine Connors was a recipientof one of the prestigious 2011 Tributeto Northern Territory Women awards.The award recognises and celebratesthe achievements of women whohave made, or are making, asignificant contribution for women intheir community.The Department was recognised fordelivery of high quality training programsby winning the 2010 Northern TerritoryTraining Awards for the Employer of theYear category and the AustralianTraining Awards – Government category.The Department was short-listed for the2011 Northern Territory Training Awardsfor its Leadership Developmentprograms.In addition, the Department won the Chief Minister’s Award for Excellence in the PublicSector in the category of Strengthening Government and Public Administration for therecruitment and retention strategies implemented by the Office of the Principal NursingAdvisor.Snapshot of Our PeopleFigure 22 shows full time equivalent (FTE) and the proportion of staff by category andgender. Since 2009-10 there has been growth of 3% in medical and 4% in professionalstaff, reflecting ongoing recruitment and retention efforts in service delivery areas.Nursing numbers have remained stable.As at end of 2010-11 the Department had a total of 5361 Full Time Equivalents (FTEs), adecrease of 1% (or 78 FTE) from 5439 FTE (excluding staff areas that have now movedto the Department of Children and Families) in 2009-10. Of these, 462 FTE employees128 Department of Health Annual Report 2010-11

Our Peoplewere permanent part time, 3034 FTEs were permanent full time, 136 FTE temporarypart-time; and 1440 FTE temporary full time.Figure 22: Full Time Equivalent Staffing Trends including percentage of total ineach category as at end financial year 2008-09 to 2010-1125002000150035% 38%35%26%26%23%MaleFemale100012% 12% 13%11% 12% 10%5008% 8%10% 4% 4% 4%2%2% 2% 1%2%1%02008-092009-102010-112008-092009-102010-112008-092009-102010-112008-092009-102010-112008-092009-102010-112008-092009-102010-112008-092009-102010-112008-092009-102010-11Nursing Administration PhysicalProfessional(Inc Dental)Medical Technical Aboriginal ExecutiveHealth WorkerEquity and DiversityThe aim of building a workforce that is representative of the departmental client basecontinues to be a focus. In addition to our continued participation in the Willing and AbleProject and remote workforce development initiatives, increased participation from EqualEmployment Opportunity (EEO) groups is encouraged through our: employmentcampaigns; innovation in job design and health role scopes of practice that expandcareer options; and an increased focus on developing our Aboriginal and Torres StraitIslander health workforce.Table 14: Equal Employment Opportunity Statistics based on myHR EEO dataTarget Group 2008-09 2009-10 2010-11Disability 5% 4% 5%Non-English Speaking Background 18% 23% 26%Aboriginal and Torres Strait Islander 10% 10% 9%This table is based on the proportion of Departmental employees who have volunteered their EEO status.Department of Health Annual Report 2010-11 129

Our PeopleAboriginal and Torres Strait Islander WorkforceInvestment in the Aboriginal and Torres Strait Islander workforce continues to be apriority 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 somekey initiatives that highlight the Department’s continued investment in attempts to “Growour own” workforce. These initiatives are compatible with the Territory 2030 vision ofincreasing the number of Aboriginal people in the health workforce.Attracting Aboriginal and Torres Strait Islander StaffVarious campaigns and programs were conducted to increase Aboriginal and TorresStrait Islander employment across the Department:• displays were set up in the Alice Springs, Tennant Creek and Darwin Future CareersExpos in August 2010, promoting apprenticeships and cadetships;• the Closing The Gap Day at Casuarina Senior College in March 2011 provided anopportunity for careers in health to be promoted to a large number of students;• the first Australian Football League, NT Careers Expo was held in May 2011 whichaimed at appealing to young Aboriginal school students, particularly young men. TheDepartment took part by promoting careers and health programs; and• support for nine Aboriginal work experience students - four from Darwin and fivefrom Alice Springs.Aboriginal and Torres Strait Islander Professional DevelopmentProgramChildren and Families.The Aboriginal and Torres StraitIslander Professional DevelopmentUPProgram: Stepping is anaccelerated development programthat provides an opportunity forAboriginal and Torres Strait Islanderstaff to develop and enhance skillsand competencies to open up careerpathways within the Department andthe Northern Territory Government.UPStepping has finalisedrecruitment of a third intake ofAboriginal and Torres Strait Islanderstaff. Intake three consists of sixparticipants – three staff each fromthe Departments of Health and130 Department of Health Annual Report 2010-11

Our PeopleApprenticeship ProgramApprentices are studying in a wide range of health disciplines as shown below.QualificationCert II CommunityServicesTable 15: ApprenticesNumber ofapprenticesLocationType ofEmployment10 Darwin School BasedApprenticesCert II in Business 1 Darwin School BasedCert III in Business 3 2 in Darwin1 in KatherineCert III HealthServices AssistanceCert III CommunityServicesNTPS Full timeemployed2 Darwin NTPS Full timeemployed1 Katherine NTPS Full timeemployedCert IV AHW 3 1 inUmbakumbaCert IV PopulationHealthCert III DentalAssistanceDiploma DentalTechnologyCert IV HumanResourcesCert III HealthServices Assistance(Pharmacy)Cert III Hospitality(Cookery)Total 37NTPS Full timeemployed1 inRamingining1 in Darwin1 Darwin NTPS Full timeemployed1Alice SpringsNTPS Full timeemployed5DarwinSchool based1 Darwin NTPS Full timeemployed1 Darwin NTPS Full timeemployed2 Darwin School based6 Alice SpringsNTPS Full timeemployedNational Indigenous Cadetship ProgramThe Department employed 18 cadets under the Indigenous Cadetship Support Program,details are given below in Table 16. The cadets are local Aboriginal people studying inskill gap areas. The average age of a cadet is 34 years.Department of Health Annual Report 2010-11 131

Our PeopleDegreesMedicalScienceNo. ofcadets2010-11Table 16: Cadetships 2010-11CompletedCadetshipEmployed inDepartment oncompletionResignedfromCadetshipContinuingCadetship1 0 0 0 1Medicine 1 0 0 0 1Nursing 9 3 2 0 6Physiotherapy 2 0 0 0 2EnvironmentalHealth1 0 0 0 1Social Work 3 1 0 2 0Psychology 1 0 0 0 1Total 18 4 2 2 12Indigenous Employment Program (IEP)As a key initiative to increase Aboriginal employment, the Department supported 15people to undertake a Certificate II in Community Services, through ‘on the job andclassroom’ training. Participants will be employed permanently on successful completionof the qualification.Clinical Learning (Aboriginal)Professional development of Aboriginal Health Workers (AHWs) continues to bemanaged through a dedicated Clinical Learning team in the Top End and through aservice agreement with Central Australian Remote Health Development Services forCentral Region AHWs. A major focus has been on the completion of training andassessment plans for each AHW. In the Top End, 80% of AHWs have training andassessment plans in place and 86% in the Central Region.Cultural AwarenessThe 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 2010-11, 543 staff attended the program, an 18%increase on attendance from the previous year.Supporting our PeopleHuman Resource ServicesThe Human Resource Services Unit (HR) provides a consultancy service to all managersand staff on best practice human resource management. The aim of HR is to assist,advise and guide managers and staff on employment matters in accordance with thePublic Sector Employment and Management Act, various enterprise agreements andFair Work Act. A large proportion of the work is case management. All HR Consultantsare skilled in conflict management and are able to mediate, coach or conductinvestigations depending on the situation.132 Department of Health Annual Report 2010-11

Our PeopleHR Consultants are located in Darwin, Casuarina, Katherine and Alice Springs, withconsultants visiting Tennant Creek and Nhulunbuy when required. HR’s aim is to resolvecomplaints through alternative dispute methods prior to investigating matters. HR alsoacts as a liaison point for the central agencies and the unions. HR continues to provideservices to the Department of Children and Families.HR dealt with a number of cases during the year as shown in Table 17 below.Type of CaseTable 17: Cases dealt with by HR UnitCases received2010-11Remaining cases as at1 July 2011Appeals against promotions 10 3Grievances 57 24Discipline 16 4Preliminary inquiries intoinappropriate behaviours9 1Inability 2 2Medical Incapacity 6 6Interventions 21 3Performance Management 20 4Anti-Discrimination 3 2A total of 57 grievances were received during the reporting period and 11 cases werecarried over from last year. Of these 68 cases, 44 were resolved and 24 remain. Twentythreegrievances related to allegations of bullying and harassment, of which two weresubstantiated. The remaining grievances related to recruitment selection processes,application of conditions of service and unfair treatment. Twelve of the 44 grievancesresolved were reviewed by the Commissioner for Public Employment and in all but threematters the Commissioner confirmed that the Department’s actions/decisions werereasonable in the circumstances. Seven cases were mediated and seven wereinvestigated with the remaining cases being resolved through HR reviewing the claims.To address grievances, a one hour tailored Recruitment Selection Workshop has beendeveloped and will be rolled out across the Department in 2011-12. This is in addition tothe full day Recruitment and Selection Program already available to staff. TheDepartment’s current suite of bullying and harassment training programs are beingreviewed in consultation with the Office of the Commissioner for Public Employment.HR Consultants guide managers and staff through performance management plans. Theaim is to identify development needs and provide support to give the employee the bestopportunity to succeed. The 21 interventions shown in Table 17 are cases whereassistance, through conflict coaching techniques, was provided to managers and staff forany number of reasons.Industrial RelationsThe new Northern Territory Public Sector 2010-2013 Enterprise Agreement which cameinto effect on 12 December 2010 has a number of implementation matters that theIndustrial Relations Unit (IRU) will be working through with unions and staff. The IRU hasto address matters that put into effect the employment terms and conditions from thenew agreement in order to achieve industrial compliance.Department of Health Annual Report 2010-11 133

Our PeopleThe Northern Territory Medical Officers’ Public Sector Enterprise Agreement 2010-13came into effect on 25 February 2011 and a restructure of Medical Officers’classifications with significant changes to employment conditions will continue to bemanaged by the IRU. The Northern Territory Public Sector Nurses’ 2008-2011 UnionCollective Agreement will expire on 9 August 2011 and negotiations to reach a newagreement with the Australian Nurses Federation began on 28 April 2011.The Dental Officers’ 2008-2011 Agreement also expires on 9 August 2011 andnegotiations for a new agreement began with the Community and Public Sector Union on15 June 2011.The Industrial Relations Unit continued to:• be involved in monitoring national trends in the terms and conditions of otherjurisdictions in order to evaluate the Department’s position in relation toemployment matters;• be involved in the formulation of renewal of occupational market allowances; and• provide specialist human resource advice to managers on managing key externaland internal relationships that affect their workplaces.Occupational Health and SafetyThe Department is committed to maintaining a work environment that is safe andminimises risks to the wellbeing of employees, contractors, suppliers, clients and visitors.Occupational Health and Safety (OHS) Awareness training, including Manual Handling,Aggression Minimisation and Emergency Response forms part of the Department’sOrientation Program and is provided on a regular basis through the Training andDevelopment Calendar. A diverse range of awareness programs are also offered on anadhoc basis.OHS activities were carried out across all Acute Care facilities by the OHS team to assistwith accreditation success.National Safe Work Australia Week, 24 – 30 October 2010 was celebrated with theparticipation and support to work area initiatives across the Department.The Department has been taking steps to ensure compliance of the new WorkplaceHealth and Safety Act (WHSA) and Regulations by 1 January 2012.Workers’ CompensationAs shown in Table 18, there have been 135 claims from 844 reported incidents lodgedwith the Department of Business and Employment (DBE) by both the Department ofHealth and the Department of Children and Families in 2010-11 with a cost to date of$4,285,098.For the same period last year, there were 159 claims from 1117 reported incidents,costing a total of $3 368 407.134 Department of Health Annual Report 2010-11

Our PeopleTable 18: Workers Compensation Incidents and Claims 1 July 2010 - 30 June 2011 12008-09 2009-10 2010-11Total Cost $3 666 986 $3 368 407 $4 285 098NewIncidents 943 1 117 844Claims 130 159 135AggressionIncidents 333 314 248Claims 22 23 261 Includes both Department of Health and Department of Children and FamiliesManaging AggressionTable 19 indicates the type of reported aggression and the classification of employeeswho have reported the aggressive behaviour.Reported incidents of aggression lodged with the Department of Business andEmployment (DBE) during 2010-11 have reduced in total. However, there has been anincrease in physical aggression compared to verbal aggression. Of the 248 reportedincidences, 26 resulted in a Workers Compensation Claim.The Department established the Acute Care Network Aggression Management WorkingGroup to review the current reporting and data collection, to revise policy and guidelinesto ensure consistency across all sites and to develop an education and training packagefor frontline staff.Table 19: Aggression by Physical/Verbal Type – 1 July 2010 to 30 June 2011 1Incidences of 2008-09 2009-10 2010-11aggressionPhysical Verbal Physical Verbal Physical VerbalAdministrative 4 16 4 22 4 8Nurse 123 74 109 93 108 76Other 15 38 15 21 4 7Physical 43 9 32 12 17 13Professional 5 6 1 5 7 4Total 190 143 161 153 140 108Yearly Physicaland VerbalTotals(333) (314) (248)1 Includes both Department of Health and Department of Children and FamiliesThe Department continues its commitment to a policy of zero tolerance of aggressionagainst employees through the implementation of aggression management plans tailoredto individual clinics and the aggression minimisation awareness training program.Learning and DevelopmentThe Department has continued its commitment to building a culture that valuesinvestment in professional development and encourages lifelong learning. TheDepartment of Health Annual Report 2010-11 135

Our PeopleDepartment’s comprehensive Training and Development Calendar provides staff with anopportunity to select from a wide range of training programs online and has a number ofsearch options allowing for easier access to training information.Key focus areas for 2010-11 have been:• implementation of the eLearning Strategy;• implementation of First Line and Middle Managers Leadership programs;• increasing school based apprentices in key skill gap areas;• assignment of continuing education points to clinical learning products forprofessional registration purposes; and• alignment and development of an evidence based training model for AboriginalHealth Worker education.eLearningThe Department is implementing an eLearning Strategy to increase the availability oftraining and development opportunities, particularly in remote and regional areas. TheeLearning Strategy is addressing all areas of online learning including development, useand implementation of:• a learning management system which will improve planning, recording and reportingof training and development activities;• eLearning content development tools to provide the Department with the capacity todevelop and publish online training packages;• eLearning policies and procedures to ensure quality control of online trainingpackages; and• desktop collaboration tools enabling virtual classrooms which will increase access totraining and support, particularly to staff in remote and regional areas.The Department continues to deliver a multi-disciplinary orientation program for all newstaff. The orientation program is designed to cover mandatory training requirements andother relevant information that will assist the retention and increase productivity of newemployees. An average of 60% of new staff across the Northern Territory attended.Tennant Creek achieved a 90% attendance rate through the delivery of an onlineorientation program.Table 20: Orientation Attendance for July 2010 – June 2011Darwin Katherine GoveAliceSpringsTennantCreekTOTAL630 35 49 286 62 1062136 Department of Health Annual Report 2010-11

Our PeopleLeadership/Management ProgramsThe Department 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.Table 21: Leadership Program AttendanceProgram TitleAttendanceTailored Departmental Programs‘Leading the Way’ Middle Manager Leadership and Management29Development Program‘Building our Leaders’ First Line Leadership and Management22Development ProgramOCPE Leadership ProgramsKigaruk - Indigenous 3Public Sector Management (PSM) Program 2010 3Discovery Women as Leaders - 2010 3Discovery Women as Leaders - 2011 4360 Degree Feedback – Senior leaders 5Future Leaders Program - cohort 1 7Executive Leaders Program - cohort 1 2Management TrainingTable 22: Department-specific Management Program Evaluation and AttendanceProgram TitleEssentials of Leading PeoplePart 1Essentials of Leading PeoplePart 2Essentials of ManagingProcurement Part 1Essentials of ManagingProcurement Part 2Average Content EvaluationAttendanceResult4.6 1294.6 1074.8 1034.8 101Mediation 4.2 81Recruitment 4.5 114Government Decision Making 4.7 22Dealing with the Tough Stuff 4.5 155Finance for Cost CentreManagers4.5 109Evaluations are undertaken by participants following each session and are based onachieving learning outcomes. The average score out of 5 rates the participants’increased level of confidence against learning outcomes.Department of Health Annual Report 2010-11 137

Our PeopleGrantsThere is also significant investment and encouragement in professional developmentand life-long learning for employees through a range of grants and allowances.CategoryTable 23: Training Grants Issued/ReceivedValue$Number ofEmployeesSupportedStudies Assistance (By-Law 41) 156 538 209Undergraduate Medicine and Health SciencesAdmission Test (UMAT)900 6General Studies Assistance Grants 84 370 35Aboriginal and Torres Strait Islander StudiesAssistance Grants 27 329 9Remote Workforce DevelopmentNursing and Midwifery Studies AssistanceGrants226 777*Grants wereawarded across 27different disciplinesand activities56 660 53Other TrainingTable 24: Other Training Delivered Evaluation and AttendanceProgram TitleAverage Content EvaluationResultAttendance4 Wheel Drive Training 3.4 30Customer Service Skills 4.0 10IT Training – Word and Excel 4.2 37CV and Job Writing Skills 4.5 10Legal Skills Positive verbal feedback 38Medical Terminology Positive verbal feedback 7Advanced Life Support inObstetrics (ALSO) courseCourse still being delivered 4Evaluations are undertaken by participants following each session and are based onachieving learning outcomes.138 Department of Health Annual Report 2010-11

Our PeopleClinical Learning (Nursing)All evaluations received for clinical learning programs indicated a greater than 80% levelof satisfaction indicating attendees were mostly or completely satisfied with the program.Program TitleTable 25: Clinical Learning Programs and AttendanceAttendanceBasic Life Support 395Advanced Life Support (adult and paediatric) 255Early Recognition and Management of the Critically Ill Patient (includesadults and paediatrics) 160ECG 44Rostering and Staff Deployment 58Cardiac Care 72Clinical Teaching 35Preceptors 186Portfolios 135Remote Orientation 47Clinical Handover 26Team Leader Training 42Documentation 42Family Partnership Training 27Preparation for Clinical Management 48Professional Development forums for Community Health and unplanneddelivery or one-off sessions in response to requests for training 355Shared ServicesThe Department uses Northern Territory Government shared services for a range offunctions, including payroll, recruitment and government accounting services. TheDepartment of Business and Employment provides these services under agreedarrangements. We also provide shared services to the Department of Children andFamilies such as information technology, finance and human resource advice.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 EmploymentInstructions. These instructions are addressed within this section and in Appendix 1.Department of Health Annual Report 2010-11 139

GovernanceGovernanceCorporate GovernanceThe Department is committed to effective corporate governance and has processes inplace to ensure its primary governing responsibilities are carried out in respect to:• setting strategic direction and health priorities;• monitoring Department performance;• monitoring service delivery quality;• risk management;• regulatory compliance;• identification and reporting adverse incidents or events;• monitoring consumer and community clinical participation;• ensuring ethical and cultural practice; and• workforce development and employee obligations.The Department identifies that effective corporate governance requires a clearunderstanding of the respective roles of senior management and their relationships withothers in the Department structure. This corporate governance understanding issupported by process, policies, laws, regulatory obligations, customs and practicesengaged by the Department that affect the way the Department is directed, administeredand controlled. Corporate governance includes the Department’s relationship with all itsstakeholders because this is influenced by the governance structure in achieving theDepartment’s goals and objectives.The Department’s governance framework consists of five key elements: effectiveleadership; capable management; diligent monitoring; responsible risk management; andclear accountability and responsibility. The Executive Leadership Group deliverseffective leadership and capable management through a strong understanding of theDepartment’s performance, thus providing effective high level oversight.Ultimately, good corporate governance is the responsibility of the Executive LeadershipGroup and senior management. Whilst senior management are unable to oversee everyservice transaction, project or divisional undertaking, the Department does ensure that itinvolves staff and stakeholders influenced by departmental activities. This is achievedthrough processes and controls that assist in monitoring the Department’s governanceactivities. The effectiveness of these internal controls is reviewed from time to timethrough internal and external audit activities.An important aspect of the Department’s corporate governance is the nature and extentof accountability defined for key individuals within the Department and mechanisms thatidentify, reduce, or eliminate risks associated with the delivery of health services acrossthe Northern Territory. Considerable benefit is also obtained from a range of specialistcorporate groups which have specific terms of reference and senior membership such asthe Executive Leadership Group, Resource Management Committee, OccupationalHealth and Safety Steering Committee, the Department of Health and UnionsConsultative Committee, Strategic Information Management Committee, StrategicWorkforce Committee, Principal Safety and Quality Committee and Audit Committee.140 Department of Health Annual Report 2010-11

GGovernanceDepartment of Health Annual Report 2010-11 141

GovernanceCollaboration with stakeholders and accessing a broad range of specialist advice areessential inputs for effective governance. The Department benefits substantially from thecontributions made by the Mental Health, Senior Territorians, Disability and HealthAdvisory Councils and Committees and Hospital Boards which contain both communityand departmental representatives and report to the relevant Minister. Details of thecommittees and councils are available in Appendix 2.A number of high level advisers also provide vital advice in the following roles: PrincipalMedical Advisor, Principal Nursing Advisor, Principal Aboriginal Health Worker andPrincipal Allied Health Advisor. These groups and individuals complete a comprehensivegovernance structure that actively influences policy and the strategic direction of healthand community services which is illustrated earlier in the Governance chart.The development of a new Grants Management Framework will provide the governancestructure for the Department’s grants administration. It describes the legislative basis forour grant making, the business rules for grants administration, the roles of delegates anddecision-makers, the management and mitigation of risk and includes a new fundingagreement package.Clinical GovernancePatient safety and the provision of a quality health service require a strong framework ofclinical governance which is an especially important component of the Department’soverall governance. Clinical care is delivered by frontline staff with a strong sense ofprofessional responsibility.Executive and senior management accept that they have a key responsibility for thequality of services delivered by the Department and that they share accountability withclinicians and other professionals providing services. Where possible, services should bebased on national standards of health care, combined with locally applicable evidence ofeffectiveness and safety. The Executive and managers at all levels (including seniorclinicians and other professionals with management responsibilities) ensure that:• an environment promoting evidence-based practice and fostering safety, quality andcontinuous improvement operates across the Department;• all health professionals are registered with the relevant national board;• all self-regulated health professionals are eligible for practicing membership with therelevant professional association and/or possess accredited practitioner status,where applicable;• where applicable, specialists are credentialed for their scope of practice;• critical clinical incidents are monitored, effective responses are developed andregular reports on quality are provided to managers;• a risk register is maintained, which is updated by the Department’s incidentmanagement systems;• risks of deficiencies in service quality are identified and unacceptable risks areeffectively addressed;• independent accreditation or certification is sought where appropriate;• the Department works collaboratively with staff and all stakeholders, includingconsumers, to improve safety and quality across the organisation;142 Department of Health Annual Report 2010-11

GGovernance• the Australian Council of Health Care standards are used to achieve accreditation forthe five hospitals;• non-hospital care, such as community care and remote health, adhere to nationalaccreditation and service delivery standards; and• the Department has a strong voice in the development of new national healthstandards that support remote and regional health care.Consumer/Partnership EngagementThe Department and a range of other organisations make up the Northern Territoryhealth service system or sector. This system operates across vast and sometimessparsely populated areas and serves a diverse range of individuals, families andcommunities with multiple health and wellbeing needs. While the Department itselfdelivers many services directly, it also provides funding to certain external organisations,enabling those organisations to provide health and wellbeing services to individuals,families and communities.Responsibility for engagement with our partners and consumers is dispersed throughoutthe Department, but is ultimately the responsibility of the Executive Leadership Group.We also have, as shown on the Corporate Governance chart, key advisory councils thatare in part made up of representatives of our consumers and non-government partners.These advisory councils report to our Ministers. Details of the membership of thesecouncils are given in Appendix 2.Each year a significant proportion of the Department’s annual budget is allocated asgrants, with amounts varying from several hundreds to millions of dollars. Grantrecipients range from small, community-based voluntary associations, to large nationalorganisations providing multipleservices and employing many staff.They include a wide range of remoteand urban not for profit organisations,advocacy groups, peak bodies andlocal government organisations, aswell as some for profit organisations.The Department engages on manylevels with a range of partners in thehealth service system. We aim todevelop robust and transparentpartnerships, based on mutual trust,with the non government sector and with other service providers in order to improveplanning and delivery of services.In July 2010, the Department released an Engagement Strategy Discussion Paper andsought feedback from our funded services sector. An Engagement Strategy is to bereleased shortly.The Department’s Grant Funding Policy makes a number of statements in terms of itsrelationship with the sector. Specifically it:• acknowledges the autonomy of funded service providers;• notes a shared responsibility for outcomes and therefore a need for collaborativepartnerships between the Department and funded service providers; andDepartment of Health Annual Report 2010-11 143

Governance• commits to a transparent and collaborative relationship with funded service providers.The Department funds a wide range of service providers (see Appendix 3 online).We also work with key partners in the planning and delivery of health services, includingHealthy Living NT, National Disability Services, Aboriginal Medical Services Alliance ofthe Northern Territory, Good Health Alliance and the Local Government Association ofthe Northern Territory.During 2010-11, a key departmental consumer/partnership engagement involvedcreating Local Implementation Plans for Territory Growth Towns, where we engagedboth with community members and non-government health service providers to identifythe local health needs of communities.Risk ManagementThe Department is committed to ensuring that an integrated Risk ManagementFramework, aligned to the Australia/New Zealand Standard AS/NZ ISO 31000:2009Risk Management - Principles and Guidelines, is applied to all activities undertaken bythe Department. This will be achieved by the ongoing implementation of a Risk andAssurance Framework that supports an organisational culture aimed at effectively andsystematically managing and treating risk.Risk management is a key element of the Department’s governance framework. Thepurpose of risk management within the Department is to support better decision makingthrough a good understanding of risks and their likely impact. The aim is not to eliminaterisk, but to consolidate the culture, systems and processes required to manage the risksinvolved in our activities and as a result to maximise opportunities and minimise negativeoutcomes.The key components of the Department’s risk management practices are to:• enhance the disclosure of potential risks to appropriate levels of management andensure that an appropriate level of due diligence is demonstrated;• ensure that the Department has systematic and effective risk managementprocesses in place to identify, prioritise and manage current and emerging risks;• enhance operational performance by supporting the proactive management ofopportunities and threats;• align risk management with strategic planning; and• improve operational aspects of the Department including the allocation and use ofresources, compliance with relevant legislative and other obligations andincident/event management.Management is responsible for ensuring that risk management activities and processesare engaged within their respective areas of responsibility to ensure that an acceptablelevel of risk is maintained and monitored. The Department’s Executive and its AuditCommittee play a monitoring role in relation to the organisational risk profile and theadequacy of mitigations against risks that are deemed unacceptable.144 Department of Health Annual Report 2010-11

GGovernanceThe implementation of a risk and incident management software RiskMan has seenthe development of electronic risk registers for all hospitals. The Department-wideuptake of RiskMan will steadily increase its influence over risk management practiceswithin the Department. RiskMan is currently being integrated into the administrativemanagement of outstanding internal audit recommendations to provide a single truesource of information. This integration now provides a clear vision of the status ofoutstanding audit recommendations and will soon enhance the reporting capabilityassociated with outstanding audit recommendations to management.Improvements to the linkages between the risk management initiatives and theDepartment’s internal audit function were realised with the implementation of theintegrated Risk and Assurance Framework. The framework brings about a more riskbased approach to internal audit planning and reporting.Improvements to the linkages between risk management and the Department’s grantsprovision and administration processes are being addressed through the development ofa new Grants Management Framework. The Framework incorporates a riskmanagement approach to the establishment of monitoring and controls in our grantsmanagement.AuditAudit is another key element of the Department’s governance framework. TheDepartment’s annual internal audit plan has provided the Audit Committee with concisedirection in their effort to evaluate the effectiveness of risk and audit activities andcoverage across divisions within the Department. A number of reviews, evaluations andaudits were undertaken in 2010-11. The implementations of key recommendations fromaudit activities are monitored by the Audit Committee.Internal Audits/Reviews Engaged by the DepartmentThe internal audit plan for 2010-11 was developed through a risk based approach thathas resulted in a number of findings and recommendations. The internal auditrecommendations identified have been assessed and varying levels of implementationpriority allocated to each one. These recommendations have been compiled andtransferred to an outstanding recommendations database for monitoring ofimplementation progress, with an implementation status report provided to the AuditCommittee for review and comment. The audit recommendations identified during 2010-11, when implemented, will add significant value to the Department’s efforts in achievingits objectives and will also support a continual improvement of the Department’s internalcontrols. The internal audit function commissioned a number of internal audits/reviewsduring 2010-11 that have resulted in the following audits being conducted.Legislative ComplianceThe objective of this audit was to review the level of compliance within the Departmentwith the requirements of the Care and Protection of Children and Domestic and FamilyViolence Acts in regards to mandatory reporting requirements and the requirements ofthe Mental Health Act.Department of Health Annual Report 2010-11 145

GovernanceOrganisational Performance ManagementThe objective of this audit was to review the adequacy and effectiveness of theDepartment's performance management systems and processes. This audit focused onthe performance of the Department's systems and activities.ICT Business ContinuityThe objective of this audit was to review the adequacy and effectiveness of theDepartment's business continuity planning and disaster recovery systems andprocesses.Infrastructure and Facility ManagementThe adequacy and effectiveness of the Department's forward planning and infrastructuremanagement systems and processes related to facilities, plant and equipment wasreviewed.Work Partnership and PlanningThe objective of this audit was to review the adequacy and effectiveness of theDepartment's work partnership planning systems and processes.Orientation and Workplace InductionThe objective of this audit was to review the adequacy and effectiveness of theDepartment's orientation and employee induction systems and processes.Patient Journey Clinical HandoverThe objective of this audit was to map critical points in the patient journey where clinicalhandover occurs and identify which handover processes are most in need of review interms of residual risk.Probity AuditsThe Department has a procurement policy which requires probity audits to beundertaken based on specific risk parameters. During the year a number of probityaudits were conducted and/or are in progress with no adverse findings to date beingreported by the auditors.Hospital Compliance AuditsA program of internal audits covering all five government hospitals within the NorthernTerritory over three years began in 2009-10. It was conducted in accordance with theprotocols and processes detailed in a three year Strategic Internal Audit Plan for theDepartment of Health. The following audits were conducted during 2010-11.Katherine Hospital Compliance AuditThe objective of this audit was to review policies and procedures for assets andinventories, purchasing and the Patient Assisted Travel Scheme.146 Department of Health Annual Report 2010-11

GGovernanceGove District Hospital Compliance AuditThe objective of this audit was to review policies and procedures for: expenditurerevenue; assets and inventories.Tennant Creek Hospital Compliance AuditThe objective of this audit was to review policies and procedures for expenditure,revenue, assets and inventories.Audits conducted by the NT Auditor GeneralThe following external audits were conducted by the Northern Territory Auditor General’sOffice in 2010-11.End of Year Review 2009-10The audit objective was to review the adequacy of selected aspects of end of financialyear controls over reporting, accounting and material financial transactions and balanceswithin the Department, with the primary purpose of providing support to the audit of theTreasurer’s Annual Financial Statements (TAFS). No material weaknesses in controlswere identified during the audit and the accounting and control procedures examined inrelation to end of year financial processing were found to be generally satisfactory.Compliance AuditThe audit objective was to examine control systems and certain features associated withthe management of financial resources allocated to the Department from the publicaccount. The key findings from this audit identified that adherence to documentedprocedures was not consistent when engaging in procurement activities. TheDepartment has strengthened procurement processes and compliance through theintroduction of a Procurement Committee, advanced planning and a dedicatedprocurement advisor embedded by the Department of Business and Employment.Service Wide Procurement AuditThe audit objective was to ascertain the extent to which cost estimates for tenders arereliable. The audit also assessed whether, for each procurement transaction selected,the appropriate tier activity process was properly applied. The audit did not reveal anymatters that required remedial action.CareSys Applications AuditThe audit objective was to assess the adequacy of general computer controls thatsupport the CareSys IT environment. The audit identified a range of opportunities toimprove the control environment that supports CareSys in the areas of application useraccess management, authentication controls and documented procedures. The issuesidentified are currently being addressed.Department of Health Annual Report 2010-11 147

GovernanceInsurance ArrangementsIn accordance with Treasurer’s Direction R2.1 Insurance Arrangements, the followinginformation provides an overview of the agency’s insurance arrangements and detailsthe key mitigation strategies and processes in each insurable risk category identified inthe Treasurer’s Direction.As a general principle and in accordance with the Treasurer’s Directions, the Departmentself insures its risks and manages potential exposures through extensive mitigationpractices. Where insurable risk events occur, the Department meets these costs as theyfall due.In relation to the insurance risk categories identified in R2.1, the Department has in placethe following mitigation strategies and processes:• workers compensation - workplace assessments; OHS committees; safe workpolices, training, guidelines and processes; incident investigation and managementprocesses; workers’ compensation management policies and processes; and returnto work programs;• property and assets – facility, plant and equipment management policies andprocesses; asset management regimes; plant and equipment training; and fire andmaterial safety equipment and processes;• public liability – workplace assessments; OHS committees; work site managementpolicies and processes; incident investigation and management processes; and• indemnities – indemnity policies and processes; legal review; practice policies andprocesses.The costs of self insurance claims are monitored by the Department with the exception ofproperty and assets insurance category, which is not separately recorded, but forms acomponent of the larger repairs and maintenance costs. The total costs for selfinsurance claims for the other insurance categories are as follows:Table 26: Self insurance claims cost 2009-10 to 2010-11Claims for 2009-10$’0002010-11$’000Workers Compensation 3 413 3 737Public Liability 23 0Indemnities 425 1 178Coronial FindingsThe Coroner’s Act enables the Coroner to investigate unexpected deaths and to makerecommendations for systems improvements that ensure that the health services weprovide are delivered in a quality and safe manner.The Department views the coronial process and the work of the Coroner’s Office as animportant feature of its safety and quality framework. We are committed to working withthe Coroner and his office in making systems improvements that will assist in reducingpreventable deaths in our services. Figure 23 provides details of the number of Coronial148 Department of Health Annual Report 2010-11

GGovernanceInquests resulting in recommendations relating to the Department over the last threeyears.Figure 23: Coronial Findings with Recommendations Relating to the Department2008-09 to 2010-118765432102008-09 2009-10 2010-11Acute Care Health Services Health ProtectionActions in response to coronial recommendations in 2010-11 have included:• introduction of a new electronic Operating Theatre Booking system;• ear, nose and throat waitlisted patients managed by Elective Surgery rather thanSpecialist Clinics;• currently implementing elective surgery strategy to decrease wait times to achievenational targets and active monitoring of elective surgery performance, particularly toexamine wait times for individual patients;• minors considered to be complex or high risk will continue to receive care under thepaediatric team beyond their 14th birthday when normally they would be transferredto adult services; and• amended the Network Policy on autopsies and the use of tissue removed duringautopsies.ComplaintsThe Department of Health respects the right of members of the community to commentor complain about the standard of service it provides and recognises that complaintinvestigation is an essential component of a quality client care system which aims toensure care and services are more safe and effective.The Department also acknowledges:• participation of consumers in decisions about their health and wellbeing;• prompt investigation, procedural fairness and natural justice;• privacy for complainants and staff involved in the complaint;• resolution at the point of service whenever possible; and• encourages consumer feedback from consumer on services.Department of Health Annual Report 2010-11 149

GovernanceComplaint resolution is based on evidence, addresses systems, process or staff issuesand is informed by the principles of public interest and good governance. The complaintprocess is an integral component of quality improvement and can influence best practicein service delivery and inform ongoing improvement in the complaint handling process.The Department also receives complaint referrals from the Health and CommunityServices Complaints Commission and the Office of the Ombudsman. Complaints aredocumented by program as to type and outcome. The numbers of complaints actionedfor the financial year 2010-11 are detailed by these categories in the tables below.Complaint TypeTable 27: Complaint TypeAcuteCareAcuteCareLHNsHealth Services2008-09 2009-10 2010-11 2008-09 2009-10 2010-11Access 215 151 53 7 23 40Communication/ Information 79 73 32 4 6 9Consent / Decision Making 0 1 2 0 0 4Corporate Services 54 32 14 1 0 4Costs 6 6 10 0 0 10Grievances 3 8 1 0 0 8Privacy / Discrimination 9 24 14 0 1 1Professional Conduct 35 17 11 1 6 17Treatment 100 87 73 2 10 6TOTAL 501 399 210 15 46 99Table 28: Complaint OutcomesComplaint TypeAcuteCareAcuteCareLHNsHealth Services2008-09 2009-10 2010-11 2008-09 2009-10 2010-11Account Adjusted 2 2 1 0 0Apology Provided 51 40 33 4 6 13Change In Procedure Effect 4 1 4 0 2Compensation Paid 0 0 4 0 1Complaint Letter Sent 0 0 4 0 0Complaint Withdrawn 1 0 2 0 0Concern Registered 32 28 14 0 2 9Conciliation Reached 1 0 2 0 0 7Counselling 12 10 1 0 0Disciplinary Action Taken 2 0 0 0Explanation Provided 272 225 87 7 30 50Policy Change Effected 1 1 0 3 2Referral Elsewhere 13 21 0 0 5Refund Provided 0 0 2 0 0 1Service Obtained 249 150 42 1 11 17Undefined 8 1 19 7 0 9TOTAL 648 479 211 23 53 115Note: Complaint types may have more than one outcome therefore totals will differ.150 Department of Health Annual Report 2010-11

GGovernanceSentinel EventsThe Australian Commission on Safety and Quality in Health Care (ACSQHC) defines asentinel event as: “An event in which death or serious harm to a client has occurred”.In 2004, Australian Health Ministers agreed to the national collection of sentinel eventdata. The Department reports annually against categories one to eight as follows, whilecategory nine is the data collected by the Department. Please see Table 29 for furtherdetails.The majority of the sentinel event measurement is undertaken in the hospitalenvironment and the reporting of data serves the following purpose:• accountability to provide system level information to funding bodies, managers andclinicians;• transparency to provide important information to patients and consumers; and• timely performance feedback to stakeholders.Sentinel event data is recorded and monitored centrally. All recommendations frominvestigations are monitored through to completion and evidence is collected todemonstrate implementation.SentinelCategoryNumberof events2008-09Table 29: Sentinel Events and Category ListingNumberof events2009-10Numberof events2010-11Sentinel Event Type1 - - -Procedures involving the wrong patient orbody part resulting in the death or majorpermanent loss of function2 - - - Suicide of a patient in an inpatient unit3 - - 2Retained instruments or other material aftersurgery requiring re operation or furthersurgical procedure4 - - -Intravascular gas embolism resulting ondeath or neurological damage5 - - -Haemolytic Blood transfusion reactionresulting from ABO incompatibility6 - - -Medication error leading to the death of apatient reasonably believed to be due toincorrect administration of drugs7 - 1 -Maternal death or serious morbidityassociated with labour or delivery8 - - -Infant discharged to wrong family or infantabduction9 14 27 23Unexplained, unexpected death or seriousillness or disability reasonably believed to bepreventableNote: Two sentinel events (No.3) were reported in line with the ACSQHC reporting criterion.Department of Health Annual Report 2010-11 151

GovernanceInformation and PrivacyThe Information and Privacy Unit is located in the Legal Services Branch. The Unitprovides assistance to the Chief Executives of both the Department of Health andDepartment of Children and Families in processing formal applications for access toinformation under the Freedom of Information (FOI) provisions of the Information Act (theAct). It also provides advice to staff of both departments, members of the public andother organisations on how to access government and personal information in lessformal ways.The number of FOI applications in Table 30 excludes applications lodged for informationheld by the Department of Children and Families since its creation on 1 January 2011.Freedom of InformationIn total, 5369 pages of government and personal information were released to applicantsunder the provisions of the Information Act during 2010-11. Details of the way FOIapplications were dealt with are set out in Table 30.Table 30: Application outcomes under the Information Act2010-11 Application Outcome No.Access applications open at start of year 4Access applications lodged during the year 54Access granted in full 33Access granted in part 9Access refused in full 5Access applications not accepted 5Access applications transferred 0Access applications withdrawn 0Access applications outstanding at end of year 3Access applications pending acceptance at end of year 3One application for correction of personal information was lodged during the year. Theapplication was accepted and the information was corrected as requested by theapplicant. One request for review of an FOI decision was lodged during the reportingperiod. The decision on review was to confirm the decision made on the initialapplication. The review decision resolved the matter and it did not proceed to complaint.A person aggrieved by a review decision about an FOI application can lodge a complaintwith the Office of the Information Commissioner under section 103 of the Act. On behalfof the Chief Executives, the Unit participates in the resolution of complaints bycooperating with the Commissioner and attending mediation where appropriate. One FOIcomplaint was resolved between the parties during the reporting period.Unit staff members provide training about Freedom of Information, informal informationaccess, data protection and records handling to new employees at regular orientationsessions and provide advice and assistance throughout the year.152 Department of Health Annual Report 2010-11

GGovernanceHuman Research Ethics CommitteeThe Manager of the Information and Privacy Unit is currently the Department’snominated Information and Privacy Advisor to the Human Research Ethics Committee ofthe Department of Health and Menzies School of Health Research. This Committee isconstituted in accordance with the National Health and Medical Research Council Act1992 and the National Statement on Ethical Conduct in Human Research. Thecommittee supports the research activities of the Department and Menzies andconsiders research proposals submitted by health providers and researchers proposingto access personal information of participants in the Northern Territory. In 2010-11, thecommittee considered 172 research proposals for ethics approval. Its Fast TrackCommittee, of which the Manager of the Unit is also the Department’s representative,dealt with a further 26 proposals for research considered to be low risk or requiring onlyminor amendment.Privacy ProtectionThe Unit provides advice and assistance to departmental staff and members of thepublic on issues of privacy protection. On behalf of the Chief Executives, the Unitinvestigates complaints made to the Department about breaches of privacy underSection 104 of the Act and responds on their behalf to issues raised by the Office of theInformation Commissioner in relation to privacy complaints and privacy protection issuesmore generally. One complaint about an alleged interference with a person’s privacy wasdealt with during the reporting periodThe Unit plays a key role in vetting data access for non standard requests for access toinformation systems and its approval is required by the Data Access Protocol forrequests to access personal medical information held in the Department’s datawarehouse. The Unit provided staff with advice on research design, use of identified andde-identified information, eHealth initiatives, electronic surveillance, data-matchingproposals, use of portable storage devices and sharing of information.The Unit provides assistance and advice in the development of formal informationsharing arrangements with other NT government and non-government agencies toensure information is being dealt with in accordance with the Information PrivacyPrinciples in the NT Information Act. The Department was represented by the Managerof the Unit on the Information Commissioner’s inter-departmental Working Party onInformation Exchange.Privacy AwarenessThe Unit assisted in the development and/or redesign of privacy policies, brochures andforms for the Department. The Unit participated in International Privacy Awareness Weekin May 2011, distributing information and email tips of the day to staff and deliveredawareness training about privacy to departmental officers throughout the year in review.LegislationDetails of the Department’s legislative responsibilities are provided in Appendix 4.Department of Health Annual Report 2010-11 153

Our MoneyOur MoneyOverviewThe Department of Health’s financial performance is reported in three financialstatements: the Operating Statement, the Balance Sheet and the Cash Flow Statement.These statements and the accompanying notes have been prepared in accordance withthe Northern Territory Government’s financial management framework and relevantAustralian accounting standards. The financial statements include financial data from the2010-11 financial year and comparative data from 2009-10.(Note: balances in 2009-10 include NT Families and Children output, whereas 2010-11do not.)Main results at a glance• The Department reported an operating deficit of $62.9 million.• Expenses were contained within 1.3% of budget targets.• Revenue earned was within 1.6% of budget targets.Operating StatementIn 2010-11, the Department’s operating statement showed a deficit result of$62.9 million. Deficit results are expected in Northern Territory Government agencies asthe accounting framework does not fund non cash expenses such as depreciation. Inaddition, externally funded programs from prior years are funded through cash balances.Operating RevenueThe Department’s principal source of revenue (66% or $695 million) is output revenue(see Table 31 and Figure 24) provided by the Northern Territory Government to fundcore services across the Northern Territory.Output revenue in 2010-11, as compared to the 2009-10 appropriation, has a netdecrease of $48 million. This is as a consequence of NT Families and Children outputgroup being transferred out of the agency. Allowing for this transfer out, there is actualgrowth in output revenue of $43 million. The growth in output appropriation has enabledthe Department to meet the higher cost of delivering services and to expand andenhance priority services.154 Department of Health Annual Report 2010-11

Our MoneyTable 31: Operating Revenue2010-11 2009-10 Variation$’000 $’000 $’000 %Commonwealth NPP & SPP200 378 211 141 -10 763 -5%RevenueGrants Revenue 64 170 56 518 7 652 14%Output Revenue 694 852 743 087 -48 235 -6%Sales of Goods and Services 60 816 44 534 16 282 37%Other Revenue 29 436 34 906 -5 470 -16%Total 1 049 653 1 090 187 -40 534 -4%The majority of the Department’sremaining revenue, $264.6million, came from the AustralianGovernment. This reflects a $3million decrease in totalAustralian Government funding,however $19 million was relatedto the NT Families and Childrenoutput group in 2009-10. Thusthe Department actually receiveda net increase of approximately$16 million in funds from theAustralian Government.Under the Specific PurposePayments (SPP) and NationalPartnership Payment (NPP)framework the Department received $200.4 million in 2010-11. Funding from SPPs andNPPs flows from the Australian Government and Treasury to state and territorytreasuries. The states and territories then appropriate the funding to the agencyresponsible for the delivery of services.In addition the Department received $64.2 million in direct funding from AustralianGovernment agencies.Operating ExpensesOutputRevenue66%Sale ofGoods &Services4%Figure 24: RevenueOtherRevenue3%Commonwealth NPP& SPPRevenue15%GrantsRevenue6%In 2010-11, as shown in Table 32, the Department incurred expenses of $1.113 billion.Allowing for NT Families and Children output expenditure of $114 million (which isincluded within the 2009-10 figures above) the actual year on year growth in expenditureis $107 million, or an increase of 10.6% on the previous financial year.Department of Health Annual Report 2010-11 155

Our MoneyTable 32: Operating Expenses2010-11 2009-10 Variation$’000 $’000 $’000 %Personnel Expenses 570 856 567 870 2 986 1%Administrative Expenses 382 952 374 570 8 382 2%Grants and Subsidies 158 777 177 074 -18 297 -10%Total 1 112 584 1 119 514 -6 930 -1%600,000500,000400,000300,000200,000100,000Figure 25: ExpenditureWhilst this representsa significant increasein expenses acrossthe Department, itwas indicative of theincrease in servicesbeing provided by theagency, as well asthe increased cost ofservice delivery in thehealth and welfaresectors.As shown in Figure025, the pattern ofPersonnel Operational Grants & expenditure acrossSubsidiesclassifications did not2010 2011deviate significantlyfrom previous years,with the personnel expenses category accounting for 51% of total expenses, operationalexpenses 34% and grants and subsidies 14% during 2010-11.Employee ExpensesEmployee expenses in 2010-11 were $570.8 million as compared to $527.6 million in2009-10 (this excludes $40.3 million for NT Families and Children Output group), anincrease of $43.2 million. Increases in employee expenses during 2010-11 areattributable to increased salary payments based on awards including the NorthernTerritory Public Sector Medical Officers’ Enterprise Agreement 2011-13, which provideda competitive remuneration package to assist in recruitment and retention of medicalofficers and consequently improve service delivery in the Northern Territory. There werealso corresponding increases in overtime and penalty payments and an increase inrecreation leave accruals.As at 30 June 2011 the Department employed 5361 full time equivalent staff. Total staffnumbers decreased by 78 full time equivalent positions during the financial year.156 Department of Health Annual Report 2010-11

Our MoneyAdministrative ExpensesAdministrative expenses increased by 8.2% in 2010-11 (when $20.6 million for NTFamilies and Children Output group is removed from 2009-10 balances), these expensesinclude repairs and maintenance, depreciation of assets and purchased goods andservices.The major increases by category of expense were:• $13 million for medical and dental supplies and services;• $3.8 million for property maintenance, repairs and maintenance;• $2.3 million for cross border patient charges; and• $6.9 million for depreciation.The increase in these expenses is due in part to the increased demand for services andthe enhancement of some services funded by the government. The increase indepreciation is a result of the revaluation of all hospital and health centres in the priorfinancial year.Grants and SubsidiesGrants and subsidies expenses grew by 28% in 2010-11 for the Department (this allowsfor the $53.2 million previously expensed by the NT Families and Children Output). TheNT Pensioner and Carer Concession Scheme (NTPCCS) provides financial assistanceto eligible Northern Territory seniors, pensioners and carers by giving concessions fortheir electricity, water and sewerage costs. In 2010-11 the Northern TerritoryGovernment has again increased the subsidy to cover 100% of all tariff increases whilethe number of eligible clients continues to grow. Additional costs for the Top End MedicalRetrieval Service have also contributed to the growth in this expenditure classification.Balance SheetThe Department’s equity position has decreased by $56 million as shown in Table 33.Contributing to the decrease were the transfer out of the NT Families and ChildrenOutput Group resulting in a $12 million reduction in equity and the decrease in theagency’s assets which was reflective of the reduction in cash at bank balances.Table 33: Balance Sheet Summary2010-11 2009-10 Variation$’000 $’000 $’000Assets 764 800 821 470 -56,670Liabilities 140 736 141 092 -356Equity 624 064 680 378 -56 314Department of Health Annual Report 2010-11 157

Our MoneyStatement of Cash FlowsThe Cash Flow Statement Table 34 shows the Department’s cash receipts andpayments for the financial year. The statement incorporates expenses and revenuesfrom the Operating Statement, after the elimination of all non cash transactions, withcash movements from the Balance Sheet. Cash balances reduced by $46.1 million as aresult of externally funded projects from 2009-10 and additional employee expensesfunded from use of cash balances.Table 34: Cash Flow Statement Summary2010-11 2009-10 Variation$’000 $’000 $’000Cash at Beginning of reporting period 68 419 78 950 -10 531Receipts 1 064 133 1 100 229 -36 096Payments -1 103 113 -1 093 653 -9 460Equity Injections 8 129 7 897 232Equity withdrawals -15 233 -25 004 9 771Cash at end of reporting period 22 336 68 419 -46 084SummaryThe Department’s performance in both revenue generation and expenditure control showa result that is within 2% of planned targets as can be seen in Table 35.Table 35: Budget Target Summary2010-11 2010-11 VariationFinal ActualBudget$’000 $’000 $’000 %Operating Revenue 1 066 290 1 049 653 -16 637 -1.6%Operating Expenses 1 098 800 1 112 584 13 784 1.3%Deficit/Surplus -32 510 -62 931 -30 421158 Department of Health Annual Report 2010-11

Our MoneyFinancial ReportCertification of the Financial StatementsWe certify that the attached financial statements for the Department of Health have beenprepared from proper accounts and records in accordance with the prescribed format,the Financial Management Act and Treasurer’s Directions.We further state that the information set out in the Comprehensive Operating Statement,Balance Sheet, Statement of Changes in Equity, Cash Flow Statement, and notes to andforming part of the financial statements, presents fairly the financial performance andcash flows for the year ended 30 June 2011 and the financial position on that date.At the time of signing, we are not aware of any circumstances that would render theparticulars included in the financial statements misleading or inaccurate.………………………………….Jeffrey MoffetChief Executive Officer……………………………….Ian PollockA/Chief Finance Officer30 September 2011 30 September 2011Department of Health Annual Report 2010-11 159

Our MoneyINCOMETaxation RevenueGrants and Subsidies RevenueCOMPREHENSIVE OPERATING STATEMENTAs at 30 June 2011Note 2011 2010$’000 $’000Current 64 170 56 493Capital 0 25AppropriationOutput 694 852 743 087Commonwealth 200 378 211 141Sales of Goods and Services 60 816 44 534Goods and Services Received Free of Charge 4 27 181 28 990Loss on Disposal of Assets 5 (4) 0Other Income 2 259 5 917TOTAL INCOME 3 1 049 653 1 090 187EXPENSESEmployee Expenses 570 856 567 870Administrative ExpensesPurchases of Goods and Services 6 305 473 303 393Repairs and Maintenance 21 124 19 355Depreciation and Amortisation 10, 11 27 917 22 564Other Administrative Expenses (1) 28 438 29 258Grants and Subsidies ExpensesCurrent 147 337 166 588Capital 122 564Community Service Obligations 11 318 9 923Interest Expenses 18 0 0TOTAL EXPENSES 3 1 112 584 1 119 514NET SURPLUS/(DEFICIT) (62 931) (29 328)OTHER COMPREHENSIVE INCOMEAsset Revaluation Surplus 4 533 228 707TOTAL OTHER COMPREHENSIVE INCOME 4 533 228 707COMPREHENSIVE RESULT (58 398) 199 379The Comprehensive Operating Statement is to be read in conjunction with the notes to the financial statements1 Includes DBE service charges160 Department of Health Annual Report 2010-11

Our MoneyBALANCE SHEETAs at 30 June 2011ASSETSNOTE 2011 2010$’000 $’000Current AssetsCash and Deposits 7 22 336 68 419Receivables 8 28 614 30 081Inventories 9 7 528 6 876Prepayments 1 852 1 426Other Assets 0 0Total Current Assets 60 329 106 802Non-Current AssetsProperty, Plant and Equipment 10 704 430 714 577Intangibles 11a 41 87Heritage and Cultural Assets 11b 0 5Total Non-Current Assets 704 471 714 668TOTAL ASSETS 764 800 821 470LIABILITIESCurrent LiabilitiesDeposits Held 15 1 023 1 250Payables 12 68 969 69 610Borrowings and Advances 13 0 0Provisions 14 50 265 48 790Other Liabilities 15 134 2 814Total Current Liabilities 120 390 122 464Non-Current LiabilitiesProvisions 14 20 346 18 628Total Non-Current Liabilities 20 346 18 628TOTAL LIABILITIES 140 736 141 092NET ASSETS 624 064 680 378EQUITYCapital 559 176 557 092Asset Revaluation Surplus 16 247 139 242 607Accumulated Funds (182 251) (119 320)TOTAL EQUITY 624 064 680 378The Balance Sheet is to be read in conjunction with the notes to the financial statementDepartment of Health Annual Report 2010-11 161

Our MoneySTATEMENT OF CHANGES IN EQUITYAs at 30 June 2011NOTEEquityat 1 July$'000Comprehensiveresult$'000Transactionswith ownersin theircapacity asownersEquityat 30June$'000$'0002010-11Accumulated Funds (119 320) (62 931) (182 251)(119 320) (62 931) (182 251)Asset Revaluation Surplus 16 242 607 4 533 247 139Capital -Transactions with Owners 557 092 557 092Equity InjectionsCapital Appropriation 3 357 3 357Equity Transfers In 13 133 13 133Other Equity Injections 4 772 4 772Specific Purpose Payments 0 0National Partnership Payments 0 0Commonwealth - Capital 0 0Equity WithdrawalsCapital Withdrawal (15 233) (15 233)Equity Transfers Out (3 945) (3 945)557 092 0 2 085 559 176Total Equity at End of FinancialYear680 378 (58 398) 2 085 624 064162 Department of Health Annual Report 2010-11

Our MoneyNOTEEquity at 1 July$'0002009-10Accumulated 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 Fin Year 441 375 199 379 39 624 680 378This Statement of Changes in Equity is to be read in conjunction with the notes to the financial statementsDepartment of Health Annual Report 2010-11 163

Our MoneyCASH FLOW STATEMENTFor the year ended 30 June 2011NOTE2011$’0002010$’000Operating ReceiptsGrants and Subsidies ReceivedCurrent 59 814 55 491Capital 1 205 1 445AppropriationOutput 694 852 743 087Commonwealth 200 378 211 141Receipts From Sales of Goods And Services 108 095 88 688Total Operating Receipts 1 064 345 1 099 852Operating PaymentsPayments to Employees (565 610) (556 367)Payments for Goods and Services (371 276) (351 237)Grants and Subsidies PaidCurrent (151 624) (166 070)Capital (122) (879)Community Service Obligations (10 248) (9 410)Interest Paid 0 0Total Operating Payments (1 098 880) (1 083 965)Net Cash From/(Used In) Operating Activities 17 (34 535) 15 888CASH FLOWS FROM INVESTING ACTIVITIESInvesting ReceiptsProceeds from Asset Sales 5 15 0Repayment of Advances 0 0Sales of Investments 0 0Total Investing Receipts 15 0Investing PaymentsPurchases of Assets (4 233) (9 689)Advances and Investing Payments 0 0Total Investing Payments (4 233) (9 689)Net Cash From/(Used In) Investing Activities (4 218) (9 689)CASH FLOWS FROM FINANCING ACTIVITIESFinancing ReceiptsProceeds of BorrowingsDeposits Received (227) 377Equity InjectionsCapital Appropriation 3 357 4 495Commonwealth Appropriation 0 2 330Other Equity Injections 4 772 1 072Total Financing Receipts 7 902 8 274Financing PaymentsRepayment of Borrowings 0 0Finance Lease Payments 19 0 0Equity Withdrawals (15 233) (25 004)Total Financing Payments (15 233) (25 004)Net Cash From/(Used In) Financing Activities (7 331) (16 730)Net Increase/(Decrease) in Cash Held (46 083) (10 531)Cash at Beginning of Financial Year 68 419 78 950CASH AT END OF FINANCIAL YEAR 7 22 336 68 419164 Department of Health Annual Report 2010-11

Our MoneyNOTES TO THE FINANCIAL STATEMENTSFor the year ended 30 June 2011INDEX OF NOTES TO THE FINANCIAL STATEMENTS1. Objectives and Funding2. Statement of Significant Accounting Policies3. 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 Equipment11a. Intangibles11b. Heritage 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. Accountable Officer’s Trust Account23. Write-offs, Postponements, Waivers, Gifts and Ex Gratia Payments24. Schedule of Territory ItemsDepartment of Health Annual Report 2010-11 165

Our Money1. OBJECTIVES AND FUNDINGNOTES TO THE FINANCIAL STATEMENTSFor the year ended 30 June 2011The Department of Health’s mission is to improve the health status and wellbeing of all people in theNorthern Territory.Additional information in relation to the Department of Health and its principal activities may be foundin the Department at a Glance section of the Annual Report.The Department is predominantly funded by, and is dependent on the receipt of Parliamentaryappropriations. The financial statements encompass all funds through which the Agency controlsresources to carry on its functions and deliver outputs. For reporting purposes, outputs delivered bythe Agency are summarised into several Output Groups. Note 3 provides summary financialinformation in the form of a Comprehensive Operating Statement by Output Group.2. STATEMENT OF SIGNIFICANT ACCOUNTING POLICIESa) Basis of AccountingThe financial statements have been prepared in accordance with the requirements of the FinancialManagement Act and related Treasurer’s Directions. The Financial Management Act requires theDepartment of Health to prepare financial statements for the year ended 30 June based on the formdetermined by the Treasurer. The form of Agency financial statements is to include:(i)(ii)(iii)(iv)(v)(vi)a Certification of the Financial Statements;a Comprehensive Operating Statement;a Balance Sheet;a Statement of Changes in Equity;a Cash Flow Statement; andapplicable explanatory notes to the financial statements.The financial statements have been prepared using the accrual basis of accounting, which recognises the effect of financial transactionsand events when they occur, rather than when cash is paid out or received. As part of the preparation of the financial statements, all intraAgency transactions and balances have been eliminated.Except where stated, the financial statements have also been prepared in accordance with thehistorical cost convention.The form of the Agency financial statements is also consistent with the requirements of AustralianAccounting Standards. The effects of all relevant new and revised Standards and Interpretationsissued by the Australian Accounting Standards Board (AASB) that are effective for the current annualreporting period have been evaluated. The Standards and Interpretations and their impacts are:AASB 2009-5 Further Amendments to Australian Accounting Standards arising from the AnnualImprovements Project [AASB 5, 8, 101, 107, 117, 118, 136 & 139]A number of amendments are largely technical, clarifying particular terms or eliminating unintendedconsequences. Other changes include current/non-current classification of convertible instruments,the classification of expenditure on unrecognised assets in the cash flow statement and theclassification of leases of land and buildings. The Standard does not impact the FinancialStatements.166 Department of Health Annual Report 2010-11

Our MoneyNOTES TO THE FINANCIAL STATEMENTSFor the year ended 30 June 2011AASB 2010-3 Amendments to Australian Accounting Standards arising from the AnnualImprovements Project [AASB 3, 7, 121, 128, 131, 132 & 139]The amending Standard clarifies certain matters, including the measurement of non-controllinginterests in a business combination, transition requirements for contingent consideration from abusiness combination and transition requirements for amendments arising as a result of AASB 127Consolidated and Separate Financial Statements. The Standard does not impact the FinancialStatements.b) Australian Accounting Standards and Interpretations Issued but not yet EffectiveAt the date of authorisation of the financial statements, the Standards and Interpretations listed belowwere in issue but not yet effective.Standard/Interpretation Summary Effective for annualreporting periodsbeginning on or afterAASB 124 Related PartyDisclosures (Dec 2009)AASB 2009-12 Amendmentsto Australian AccountingStandards [AASB 5, 8, 108,110, 112, 119, 133, 137, 139,1023 & 1031 andInterpretations 2, 4, 16, 1039& 1052]AASB 2010-4 FurtherAmendments to AustralianAccounting Standards arisingfrom the AnnualImprovements Project [AASB1, 7, 101 & 134 andInterpretation 13]Government-relatedentities are granted partialexemption from relatedparty disclosurerequirementsAmends AASB 8Operating Segments torequire an entity toexercise judgement inassessing whether agovernment and entitiesknown to be under thecontrol of that governmentare considered a singlecustomer for purposes ofcertain operating segmentdisclosures.This Standard also makesnumerous editorialamendments to otherStandards.Key amendments includeclarification of content ofstatement of changes inequity (AASB 101) andfinancial instrumentdisclosures (AASB 7)1 Jan 20111 Jan 20111 Jan 2011Impact on financialstatementsDepartment of Health Annual Report 2010-11 167

Our MoneyStandard/InterpretationAASB 2010-5 Amendmentsto Australian AccountingStandards [AASB 1, 3, 4, 5,101, 107, 112, 118, 119, 121,132, 133, 134, 137, 139, 140,1023 & 1038 andInterpretations 112, 115, 127,132 & 1042]Interpretation 4 Determiningwhether an Arrangementcontains a LeaseInterpretation 14 AASB 119 –The Limit on a DefinedBenefit Asset, MinimumFunding Requirements andtheir Interaction, AASB 2009-14 Amendments to AustralianInterpretation – Prepaymentsof a Minimum FundingRequirementAASB 2010-6 Amendmentsto Australian AccountingStandards – Disclosures onTransfers of Financial AssetsAASB 9 Financialinstruments, AASB 2009-11Amendments to AustralianAccounting Standards arisingfrom AASB 9, AASB 2010-7Amendments to AustralianAccounting Standards arisingfrom AASB 9 (Dec 2010)Interpretation 12 ServiceConcession ArrangementsNOTES TO THE FINANCIAL STATEMENTSFor the year ended 30 June 2011SummaryMakes numerous editorialamendments to a range ofStandards andInterpretationsProvides guidance onidentifying leasearrangementsClarifies when refunds orreductions in futurecontributions should beregarded as available,particularly when aminimum fundingrequirement existsAmends AASB 7 FinancialInstruments: Disclosures,introducing additionaldisclosures designed toallow users of financialstatements to improvetheir understanding oftransfer transactions offinancial assetsAASB 9 simplifiesrequirements for theclassification andmeasurement of financialassets and liabilitiesresulting from Phase 1 ofthe IASB’s project toreplace IAS 39 Financialinstruments: recognitionand measurement(AASB 139 FinancialInstruments: recognitionand measurement).Provides guidance on theaccounting by operatorsfor public-to-private serviceconcession arrangementsEffective for annualreporting periodsbeginning on or after1 Jan 20111 Jan 20111 Jan 20111 July 20111 Jan 20131 Jan 2013Impact on financialstatements168 Department of Health Annual Report 2010-11

Our Moneyc) Agency and Territory ItemsNOTES TO THE FINANCIAL STATEMENTSFor the year ended 30 June 2011The financial statements of the Department of Health include income, expenses, assets, liabilitiesand equity over which the Department of Health has control (Agency items). Certain items, whilemanaged by the Agency, are controlled and recorded by the Territory rather than the Agency(Territory items). Territory items are recognised and recorded in the Central Holding Authority asdiscussed below.Central Holding AuthorityThe Central Holding Authority is the ‘parent body’ that represents the Government’s ownershipinterest in Government 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. Themain Territory item is Territory income, which includes taxation and royalty revenue, Commonwealthgeneral purpose funding (such as GST revenue), fines, and statutory fees and charges.The Central Holding Authority also holds certain Territory assets not assigned to Agencies as well ascertain Territory liabilities that are not practical or effective to assign to individual Agencies such asunfunded superannuation and long service leave.The Central Holding Authority recognises and records all Territory items, and as such, these itemsare not included in the Agency’s financial statements. However, as the Agency is accountable forcertain Territory items managed on behalf of Government, these items have been separatelydisclosed in note 24 - Schedule of Territory Items.d) ComparativesWhere necessary, comparative information for the 2009-10 financial year has been reclassified toprovide consistency with current year disclosures.e) Presentation and Rounding of AmountsAmounts in the financial statements and notes to the financial statements are presented in Australiandollars and have been rounded to the nearest thousand dollars, with amounts of $500 or less beingrounded down to zero.f) Changes in Accounting PoliciesThere have been no changes to accounting policies adopted in 2010-11 as a result of managementdecisions.g) Accounting Judgements and EstimatesThe preparation of the financial report requires the making of judgements and estimates that affectthe recognised amounts of assets, liabilities, revenues and expenses and the disclosure of contingentliabilities. The estimates and associated assumptions are based on historical experience and variousother factors that are believed to be reasonable under the circumstances, the results of which formthe basis for making judgements about the carrying values of assets and liabilities that are not readilyapparent from other sources. Actual results may differ from these estimates.The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions toaccounting estimates are recognised in the period in which the estimate is revised if the revisionaffects only that period, or in the period of the revision and future periods if the revision affects bothcurrent and future periods.Judgements and estimates that have significant effects on the financial statements are disclosed inthe relevant notes to the financial statements. Notes that include significant judgements andestimates are:Department of Health Annual Report 2010-11 169

Our Money• Employee Benefits – Note 2(t) and Note 14: Non-current liabilities in respect of employee benefitsare measured as the present value of estimated future cash outflows based on the appropriateGovernment bond rate, estimates of future salary and wage levels and employee periods ofservice.• Allowance for Impairment Losses – Note 2(o) and 8: Receivables and Note 18: FinancialInstruments• Depreciation and Amortisation – Note 2(k), Note 10: Property, Plant and Equipment and Note 11(a):Intangibles and 11(b): Heritage and Cultural Assets.h) Goods and Services TaxIncome, expenses and assets are recognised net of the amount of Goods and Services Tax (GST),except where the amount of GST incurred on a purchase of goods and services is not recoverablefrom the Australian Tax Office (ATO). In these circumstances the GST is recognised as part of thecost of acquisition of the asset or as part of the expense.Receivables and payables are stated with the amount of GST included. The net amount of GSTrecoverable from, or payable to, the ATO is included as part of receivables or payables in theBalance Sheet.Cash flows are included in the Cash Flow Statement on a gross basis. The GST components of cashflows arising from investing and financing activities which are recoverable from, or payable to, the ATOare classified as operating cash flows. Commitments and contingencies are disclosed net of theamount of GST recoverable or payable unless otherwise specified.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 anycash consideration being exchanged are not recognised as income.Grants and Other ContributionsGrants, donations, gifts and other non-reciprocal contributions are recognised as revenue when theAgency obtains control over the assets comprising the contributions. Control is normally obtainedupon receipt.Contributions are recognised at their fair value. Contributions of services are only recognised when afair value 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 iscalculated as the net cost of Agency outputs after taking into account funding from Agency income. Itdoes not include any 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 bythe Commonwealth Treasury to state treasuries, in a manner similar to arrangements for GSTpayments. These payments are received by Treasury on behalf of the Central Holding Authority andthen on-passed to the relevant agencies as Commonwealth Appropriation.Revenue in respect of Appropriations is recognised in the period in which the Agency gains control ofthe funds.Sale of GoodsRevenue from the sale of goods is recognised (net of returns, discounts and allowances) when:170 Department of Health Annual Report 2010-11

Our Money• the significant risks and rewards of ownership of the goods have transferred to the buyer;• the Agency retains neither continuing managerial involvement to the degree usually associated withownership nor effective control over the goods sold;• the amount of revenue can be reliably measured;• it is probable that the economic benefits associated with the transaction will flow to the Agency; and• 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. Therevenue is recognised when:• the amount of revenue, stage of completion and transaction costs incurred can be reliably measured;and• it is probable that the economic benefits associated with the transaction will flow to the entity.Interest RevenueInterest revenue is recognised as it accrues, taking into account the effective yield on the financial asset.Goods 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 resource isrecognised 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 passes to thebuyer, usually when an unconditional contract of sale is signed. The gain or loss on disposal is calculated asthe difference between the carrying amount of the asset at the time of disposal and the net proceeds ondisposal. 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 of theasset 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 asincurred.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.Amortisation applies in relation to intangible non-current assets with limited useful lives and is calculated andaccounted for in a similar manner to depreciation.Department of Health Annual Report 2010-11 171

Our MoneyNOTES TO THE FINANCIAL STATEMENTSFor the year ended 30 June 2011The estimated useful lives for each class of asset are in accordance with the Treasurer’s Directions and aredetermined as follows:20112010Buildings50 Years 50 YearsRemote Housing 25 Years 25 YearsPlant and Equipment (refer below) 4 to 15 Years 4 to 15 YearsComputer Hardware 4 Years 4 YearsOffice Equipment 5 Years 5 YearsMedical/Dental, Scientific Equipment 9 Years 9 YearsFurniture & Fittings, Security Systems 10 Years 10 YearsCatering Equipment, Temperature Control Systems 15 Years 15 YearsLeased Plant and Equipment 3 Years 3 YearsIntangibles 3 to 6 Years 3 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 ExpenseInterest expenses include interest and finance lease charges. Interest expenses are expensed in theperiod in which they are incurred.m) Cash and DepositsFor the purposes of the Balance Sheet and the Cash Flow Statement, cash includes cash on hand,cash at bank and cash equivalents. Cash equivalents are highly liquid short-term investments thatare readily convertible to cash. Cash at bank includes monies held in the Accountable Officer’s TrustAccount (AOTA) that are ultimately payable to the beneficial owner – refer also to note 22.n) 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 fordistribution are carried at the lower of cost and current replacement cost. Cost of inventories includesall costs associated with bringing the inventories to their present location and condition. Wheninventories are acquired at no or nominal consideration, the cost will be the current replacement costat date of acquisition.The cost of inventories are assigned using a mixture of first-in, first out or weighted average costformula or using specific identification of their individual costs. Inventory held for distribution areregularly assessed for obsolescence and loss172 Department of Health Annual Report 2010-11

Our Moneyo) ReceivablesReceivables include accounts receivable and other receivables and are recognised at fair value lessany allowance for impairment losses.The allowance for impairment losses represents the amount of receivables the Agency estimates arelikely to be uncollectible and are considered doubtful. Analyses of the age of the receivables that arepast due as at the reporting date, are disclosed in an aging schedule under credit risk in Note 18Financial 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$10,000 are recognised in the year of acquisition and depreciated as outlined below. Items ofproperty, plant and equipment below the $10,000 threshold are expensed in the year of acquisition.The construction cost of property, plant and equipment includes the cost of materials and directlabour, and an appropriate proportion of fixed and variable overheads.Complex AssetsMajor items of plant and equipment comprising a number of components that have different useful lives, are accounted for as separateassets. 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 is probable that future economicbenefits in excess of the originally assessed performance of the asset will flow to the Agency in future years. Where these costs representseparate components of a complex asset, they are accounted for as separate assets and are separately depreciated over their expecteduseful lives.Construction (Work in Progress)As part of the financial management framework, the Department of Construction and Infrastructure isresponsible for managing general government capital works projects on a whole of Governmentbasis. Therefore appropriation for most capital works is provided directly to the Department ofConstruction and Infrastructure and the cost of construction work in progress is recognised as anasset 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 arerevalued with sufficient regularity to ensure that the carrying amount of these assets does not differmaterially from their fair value at reporting date:• Land; and• Buildings;Fair value is the amount for which an asset could be exchanged, or liability settled, betweenknowledgeable, willing parties in an arms length transaction.Plant and equipment are stated at historical cost less depreciation, which is deemed to equate to fairvalue.Department of Health Annual Report 2010-11 173

Our MoneyImpairment 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 recoverableamount. The asset’s recoverable amount is determined as the higher of the asset’s depreciatedreplacement cost and fair value less costs to sell. Any amount by which the asset’s carrying amountexceeds the recoverable amount is recorded as an impairment loss.Impairment losses are recognised in the Comprehensive Operating Statement. They are disclosed asan expense unless the asset is carried at a revalued amount. Where the asset is measured at arevalued amount, the impairment loss is offset against the Asset Revaluation Surplus for that class ofasset to the extent that an available balance exists in the Asset Revaluation Surplus.In certain situations, an impairment loss may subsequently be reversed. Where an impairment loss issubsequently 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 additionalinformation in relation to the Asset Revaluation Surplus.r) Leased AssetsLeases under which the Agency assumes substantially all the risks and rewards of ownership of anasset are classified as finance leases. Other leases are classified as operating leases.Finance LeasesFinance leases are capitalised. A leased asset and a lease liability equal to the present value of theminimum lease payments are recognised at the inception of the lease.Lease payments are allocated between the principal component of the lease liability and the interestexpense.Operating LeasesOperating lease payments made at regular intervals throughout the term are expensed when thepayments are due, except where an alternative basis is more representative of the pattern of benefitsto be derived from the leased property. Lease incentives under an operating lease of a building oroffice space is recognised as an integral part of the consideration for the use of the leased asset.Lease incentives are to be recognised as a deduction of the lease expenses over the term of thelease.s) PayablesLiabilities for accounts payable and other amounts payable are carried at cost which is the fair valueof the consideration to be paid in the future for goods and services received, whether or not billed tothe Agency. Accounts payable are normally settled within 30 days.t) Employee BenefitsProvision is made for employee benefits accumulated as a result of employees rendering services upto the reporting date. These benefits include wages and salaries and recreation leave. Liabilitiesarising in respect of wages and salaries and recreation leave and other employee benefit liabilitiesthat fall due within twelve months of reporting date are classified as current liabilities and aremeasured at amounts expected to be paid. Non-current employee benefit liabilities that fall due aftertwelve months of the reporting date are measured at present value, calculated using the Governmentlong term bond rate.No provision is made for sick leave, which is non-vesting, as the anticipated pattern of future sickleave to be taken is less than the entitlement accruing in each reporting period.Employee benefit expenses are recognised on a net basis in respect of the following categories:• wages and salaries, non-monetary benefits, recreation leave, sick leave and other leaveentitlements; and174 Department of Health Annual Report 2010-11

Our Money• other types of employee benefits.As part of the financial management framework, the Central Holding Authority assumes the longservice leave liabilities of Government Agencies, including the Department of Health and as such nolong service leave liability is recognised in Agency financial statements.u) SuperannuationEmployees' superannuation entitlements are provided through the:v)• NT Government and Public Authorities Superannuation Scheme (NTGPASS);• Commonwealth Superannuation Scheme (CSS); or• non-government employee nominated schemes for those employees commencing on or after10 August 1999.The Agency makes superannuation contributions on behalf of its employees to the Central HoldingAuthority or non-government employee nominated schemes. Superannuation liabilities related togovernment superannuation schemes are held by the Central Holding Authority and as such are notrecognised in Agency financial statements.w) Contributions by and Distributions to GovernmentThe Agency may receive contributions from Government where the Government is acting as owner ofthe Agency. Conversely, the Agency may make distributions to Government. In accordance with theFinancial Management Act and Treasurer’s Directions, certain types of contributions anddistributions, including those relating to administrative restructures, have been designated ascontributions by, and distributions to, Government. These designated contributions and distributionsare treated by the Agency as adjustments to equity.The Statement of Changes in Equity provides additional information in relation to contributions by,and distributions to, Government.x) CommitmentsDisclosures in relation to capital and other commitments, including lease commitments are shown atnote 19 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.Department of Health Annual Report 2010-11 175

Our MoneyCOMREHENSIVE OPERATING STATEMENT BY OUTPUT GROUPNote Acute Services NT Families and Children Health and Wellbeing Public Health Services Total2011 2010 2011 2010 2011 2010 2011 2010 2011 2010$’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000INCOMEGrants and Subsidies RevenueCurrent 18 852 12 987 0 4 899 40 702 35 227 4 615 3 380 64 170 56 493Capital 0 0 0 0 0 25 0 0 0 25AppropriationOutput 434 283 389 149 0 91 404 215 057 220 080 45 513 42 455 694 852 743 087Commonwealth 157 454 159 150 0 13 929 30 011 27 040 12 914 11 022 200 378 211 141Sales of Goods and Services 48 905 39 685 0 109 9 136 4 473 2 775 268 60 816 44 534Interest Revenue 0 0 0 0 0 0 0 0 0 0Goods and Services Received Free of Charge 4 16 988 17 110 0 2 192 8 413 8 201 1 780 1 487 27 181 28 990Loss on Disposal of Assets 5 (4) 0 0 0 0 0 0 0 (4) 0Other Income 898 962 0 254 885 2 974 477 1 726 2 260 5 917TOTAL INCOME 677 376 619 043 0 112 787 304 204 298 019 68 074 60 338 1 049 653 1 090 187EXPENSESEmployee Expenses 388 903 355 023 0 40 288 154 776 147 196 27 178 25 364 570 856 567 870Administrative ExpensesPurchases of Goods and Services 6 222 013 206 820 0 15 793 69 429 66 637 14 029 14 143 305 472 303 393Repairs and Maintenance 16 053 13 992 0 990 4 185 3 702 886 671 21 124 19 355Depreciation and Amortisation 10, 11 18 500 14 143 0 1 600 7 934 5 903 1 483 917 27 917 22 564Other Administrative Expenses (1) 18 135 17 374 0 2 194 8 496 8 204 1 807 1 487 28 438 29 258Grants and Subsidies ExpensesCurrent 44 868 21 285 0 52 722 82 202 73 291 20 267 19 290 147 337 166 588Capital 0 0 0 492 122 72 0 0 122 564Community Service Obligations 4 0 0 8 11 313 9 915 0 0 11 318 9 923Interest Expenses 18 0 0 0 0 0 0 0 0 0 0TOTAL EXPENSES 708 476 628 637 0 114 087 338 458 314 920 65 650 61 872 1 112 584 1 119 514NET SURPLUS/(DEFICIT) (31 100) (9 594) 0 (1 300) (34 254) (16 900) 2 424 (1 534) (62 931) (29 328)OTHER COMPREHENSIVE INCOMEAsset Revaluation Surplus 0 189 417 0 0 7 945 39 290 0 0 7 945 228 707TOTAL OTHER COMPREHENSIVE INCOME 0 189 417 0 0 7 945 39 290 0 0 7 945 228 707COMREHENSIVE RESULT (31 100) ` 0 (1 300) (26 309) 22 390 2 424 (1 534) (54 986) 199 379Comprehensive Operating Statement by Output Group is to be read in conjunction with the notes to the financial statements.des DBE service charges176 Department of Health Annual Report 2010-11

Our Money4. GOODS AND SERVICES RECEIVED FREE OF CHARGE2011 2010$’000 $’000Department of Business and Employment 27 181 28 99027 181 28 9905. LOSS ON DISPOSAL OF ASSETSNet proceeds from the disposal of non-current assets 15 0Less: Carrying value of non-current assets disposed (19) (0)Loss on the disposal of non-current assets (4) 06. PURCHASES OF GOODS AND SERVICESThe net surplus/(deficit) has been arrived at after charging thefollowing expenses:Goods and Services Expenses:Property Maintenance 8 268 7 788General Property Management 5 254 4 831Power 11 992 13 174Water and Sewerage 1 100 1 160Accommodation 2 407 3 198Advertising (2) 43 64Agent Service Arrangements 109 0Audit Fees 307 336Bank Charges 72 73Client Travel 27 927 32 476Clothing 285 340Communications 5 438 5 940Consultant Fees (1) 1 750 3 383Consumables/General Expenses 7 593 6 632Cross Border Patient Charges 31 225 28 935Document Production 1 021 1 192Entertainment/Hospitality 288 332Food 4 657 4 279Freight 1 779 1 671Information Technology Charges 20 755 23 936IT Consultants 3 342 4 235IT Hardware and Software Expenses 8 007 4 093Insurance Premiums 14 42Laboratory Expenses 6 481 5 726Legal Expenses (4) 4 139 4 100Library Services 1 039 1 161Marketing and Promotion (3) 1 430 2 511Medical/Dental Supply and Services 104 326 91 742Membership and Subscriptions 446 959Motor Vehicle Expenses 10 861 11 934Office Requisites and Stationery 2 946 3 153Department of Health Annual Report 2010-11 177

Our MoneyOfficial Duty Fares 7 864 9 258Other Equipment Expenses 7 513 6 786Recruitment Expenses (5) 6 087 8 495Reg/Advisory Boards/Committees 729 402Relocation Expenses 548 850Training and Study Expenses 4 826 5 267Transport Equipment Expenses 202 185Travelling Allowance 2 250 2 786Unallocated Corporate Credit Card Expenses 129 (40)Penalty Interest – Late Payments 13 6Goods and Services Cost Allocation 10 3(1) Includes marketing, promotion and IT consultants.(2) Does not include recruitment advertising or marketing and promotionadvertising.(3) Includes advertising for marketing and promotion but excludes marketingand promotion consultants’ expenses, which are incorporated in theconsultants’ category.(4) Includes legal fees, claim and settlement costs.(5) Includes recruitment related advertising costs.305 472 303 3937. CASH AND DEPOSITSCash on Hand 19 23Cash at Bank 22 316 68 39622 336 68 4198. RECEIVABLESCurrentAccounts Receivable 4 902 3 715Less: Allowance for Impairment Losses (1 575) (873)3 327 2 842GST Receivables 3 209 4 111Other Receivables (1) 22 078 23 12825 287 27 239Total Receivables 28 614 30 081(1) Other receivables includes accrued revenue for cross border patient charges, Department of VeteranAffairs and grants and subsidies.9. INVENTORIESInventories Held for DistributionAt current replacement cost 7 528 6 876Total Inventories 7 528 6 876During the year the Department of Health was required to write-off $0.08m ($0.179m in 2009-10) ofinventories, the majority being pharmaceuticals due to their short shelf life and the necessity to keep certainlife saving items on hand.178 Department of Health Annual Report 2010-11

Our Money10. PROPERTY, PLANT AND EQUIPMENTLandAt Fair Value 28 326 27 744BuildingsAt Fair Value 1 062 174 1 030 482Less: Accumulated Depreciation (356 966) (338 234)Less: Accumulated Impairment Losses (85 214) (81 341)619 994 610 906Construction (Work in Progress)At Capitalised Cost 23 384 39 257Plant and Equipment23 384 39 257At Fair Value 86 859 85 218Less: Accumulated Depreciation (54 133) (48 548)Leased Plant and Equipment32 726 36 670At Capitalised Cost 151 175Less: Accumulated Depreciation (151) (175)0 0Total Property, Plant and Equipment 704 430 714 577Property, Plant and Equipment ValuationsAn independent valuation was undertaken by the Australian Valuation Office (AVO) as at 30 June 2011 forthe Batchelor Central Australian Campus and Hong Street Flats. Revaluations for the five hospitals and theremote health clinics were undertaken as at 30 June 2010.The fair value of these assets was determined based on any existing restrictions on asset use. Wherereliable market values were not available, the fair value of these assets was based on their depreciatedreplacement cost.Impairment of Property, Plant and EquipmentAgency property assets were assessed for impairment as at 30 June 2011. Impairment changes for Buildingswere recognised in the Asset Revaluation Surplus.Construction (Work in Progress)Primarily relates to RDH Radiation Oncology Unit and National Trauma Centre.Department of Health Annual Report 2010-11 179

Our Money10. PROPERTY, PLANT AND EQUIPMENT (Continued)2011 Property, Plant and Equipment ReconciliationsA reconciliation of the carrying amount of property, plant and equipment at the beginning and end of 2010-11 is set out below:Land Buildings Construction(Work inProgress)Plant &EquipmentTotal$’000 $’000 $’000 $’000 $’000Carrying Amount as at 1 July 2010 27 744 610 906 39 257 36 670 714 577Additions 71 (71) 4 233 4 233Disposals (19) (19)Depreciation (19 899) (7 972) (27 871)Additions/(Disposals) from Asset Transfers 58 24 908 (15 802) (186) 8 979Revaluation Increments/(Decrements) 524 4 009 4 533Carrying Amount as at 30 June 2011 28 326 619 994 23 384 32 726 704 4302010 Property, Plant and Equipment ReconciliationsA reconciliation of the carrying amount of property, plant and equipment at the beginning and end of 2009-10 is set out below:Land Buildings Construction(Work inProgress)Plant &EquipmentTotal$’000 $’000 $’000 $’000 $’000Carrying Amount as at 1 July 2009 17 847 390 846 953 32 447 442 093Additions 376 9 313 9 689DisposalsDepreciation (15 191) (7 327) (22 519)Additions/(Disposals) from Asset 3 436 12 630 38 303 2 237 56 606TransfersRevaluation Increments/(Decrements) 6 461 222 246 228 707Carrying Amount as at 30 June 2010 27 744 610 906 39 257 36 670 714 577180 Department of Health Annual Report 2010-11

Our Money11a. INTANGIBLESCarrying amountsIntangibles with a finite useful life(a) Internally generated intangiblesAt valuation 0 0Less: Accumulated Amortisation 0 0Written down value – 30 June 0 0(a) Other intangiblesAt valuation 4 161 4 161Less: Accumulated Amortisation (4 119) (4 074)Written down value – 30 June 41 87Total Intangibles 41 87Reconciliation of movementsIntangibles with a finite useful life(b) Other intangiblesCarrying amount at 1 July 87 132AdditionsDisposalsAmortisation (45) (45)Additions/(Disposals) from Administrative RestructuringAdditions/(Disposals) from Asset TransfersRevaluation Increments/(Decrements)Impairment LossesImpairment Losses ReversedOther MovementsCarrying Amount as at 30 June 41 87Department of Health Annual Report 2010-11 181

Our Money2011$'0002010$'00011b. HERITAGE AND CULTURAL ASSETSCarrying amountAt valuation 0 5Less: Accumulated Depreciation 0 0Written down value – 30 June 0 5Reconciliation of movementsCarrying amount at 1 July 5 5AdditionsDisposalsDepreciationAdditions/(Disposals) from Administrative Restructuring (5)Additions/(Disposals) from Asset TransfersRevaluation Increments/(Decrements)Impairment LossesImpairment Losses ReversedOther MovementsCarrying Amount as at 30 June 0 5Heritage and Cultural Assets ValuationThe Department of Health had one Cultural Asset, which was capitalised at cost upon purchase inDecember 2006. The asset was transferred to the Department of Children and Families.2011$’0002010$’00012. PAYABLESAccounts Payable 15 922 7 119Accrued Expenses (1) 49 960 56 187Other Payables (2) 3 087 6 304Total Payables 68 969 69 610(1)Includes liability for cross border patient expenses and otheraccrued operational expenses(2)Includes Grants and Subsidies and Community ServiceObligations payable182 Department of Health Annual Report 2010-11

Our Money13. BORROWINGS AND ADVANCESCurrentLoans and Advances 0 0Finance Lease Liabilities (refer note 19) 0 0Non-Current0 0Loans and Advances 0 0Finance Lease Liabilities (refer note 19) 0 00 0Total Borrowing’s and Advances 0 014. PROVISIONSCurrentEmployee BenefitsRecreation Leave 37 388 36 073Leave Loading 6 929 6 788Recreation Leave Fares and other benefits 557 761Other Current ProvisionsOther Provisions – include provisions forSuperannuation, Payroll Tax and Fringe Benefits Taxpayable5 391 5 16850 265 48 790Non-CurrentEmployee BenefitsRecreation Leave 20 346 18 62820 346 18 628Total Provisions 70 611 67 418The Agency employed 5 361 employees as at 30 June 2011(5 917 employees as at 30 June 2010)Department of Health Annual Report 2010-11 183

Our Money.2011$’0002010$’00015. OTHER LIABILITIESCurrentDeposits Held (1) 1 023 1 250Unearned Revenue (2) 134 2 814Total Other Liabilities 1 157 4 064(1) Accountable Officers Trust Account (see note 22).(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 revaluationincrements and decrements arising from the revaluation ofnon-current assets. Impairment adjustments may also berecognised in the Asset Revaluation Surplus.(ii) Movements in the Asset Revaluation SurplusBalance as at 1 July 242 607 13 900Increment/(Decrement) - Land 524 6 461Impairment (Losses)/Reversals - Land 0 0Increment/(Decrement) - Buildings 4 009 222 246Impairment (Losses)/Reversals - Buildings 0 0Balance as at 30 June 247 139 242 607184 Department of Health Annual Report 2010-11

Our Money2011$’0002010$’00017. NOTES TO THE CASH FLOW STATEMENTReconciliation of CashThe total of Agency Cash and Deposits of $22 336 recorded in theBalance Sheet is consistent with that recorded as ‘cash’ in theCash Flow Statement.Reconciliation of Net Surplus/(Deficit) to Net Cash From Operating ActivitiesNet Surplus/(Deficit) (62 931) (29 328)Non-Cash Items:Depreciation and Amortisation 27 917 22 564Asset Write-Offs/Write-Downs 219 45(Gain)/Loss on Disposal of Assets (70) (10)Repairs and Maintenance – minor new works – non cash 69 58Capital Grants – non cash 0 32Changes in Assets and Liabilities:Decrease/(Increase) in Receivables 1 467 (6 088)Decrease/(Increase) in Inventories (652) (641)Decrease/(Increase) in Prepayments (426) 1 668Decrease/(Increase) in Other Assets 0 0(Decrease)/Increase in Payables (641) 16 764(Decrease)/Increase in Provision for Employee Benefits 2 970 8 274(Decrease)/Increase in Other Provisions 223 752(Decrease)/Increase in Other Liabilities (2 680) 1 798Net Cash From Operating Activities (34 535) 15 888Non-Cash Financing and Investing ActivitiesNon Cash Asset TransfersDuring the financial year the Agency acquired land and buildingswith an aggregate fair value of $13.133 million (2010: $56.731) bynon cash asset transfers from the Department of Construction andInfrastructure and the Department of Lands and Planning.Department of Health Annual Report 2010-11 185

Our Money18. FINANCIAL INSTRUMENTSA financial instrument is a contract that gives rise to a financial asset of one entity and a financial liability orequity instrument of another entity. Financial instruments held by the Department of Health include cash anddeposits, receivables and payables. The Department of Health has limited exposure to financial risks asdiscussed below.(a) Categorisation of Financial InstrumentsThe carrying amounts of the Department of Health’s financial assets and liabilities by category are disclosedin the table below.Financial Assets2011 2010$000 $000Cash and deposits 22 336 68 419Loans and receivables 28 614 30 081Financial LiabilitiesFair value through profit and loss (FVTPL):Designated as at FVTPL 69 992 70 860(b) Credit RiskThe Agency has limited credit risk exposure (risk of default). In respect of any dealings with organisations externalto Government, the Agency has adopted a policy of only dealing with credit worthy organisations and obtainingsufficient collateral or other security where appropriate, as a means of mitigating the risk of financial loss fromdefaults.The carrying amount of financial assets recorded in the financial statements, net of any allowances for losses,represents the Agency’s maximum exposure to credit risk without taking account of the value of any collateral orother security obtained.ReceivablesReceivable balances are monitored on an ongoing basis to ensure that exposure to bad debts is not significant. Areconciliation and aging analysis of receivables is presented below.Aging ofReceivableAging ofImpairedNetReceivables$000 $000 $0002010-11Not Overdue 26 483 26 483Overdue for less than 30 Days 640 640Overdue for 30 to 60 Days (5 007) (5 007)Overdue for more than 60 Days 8 073 1 575 6 498Total 30 189 1 575 28 614Reconciliation of the Allowance forIOpening i t L873Written off during the year (250)Recovered during the yearIncrease in allowance recognised in profit or loss 952Total 1 575186 Department of Health Annual Report 2010-11

Our Money18 FINANCIAL INSTRUMENTS (continued)2009-10Not 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 ImpairmentLossesOpening 1 186Written off during the year (358)Recovered during the year 2Increase in allowance recognised in profit or loss 43Total 873(a)Liquidity riskLiquidity risk is the risk that the Agency will not be able to meet its financial obligations as they fall due. TheAgency’s approach to managing liquidity is to ensure that it will always have sufficient liquidity to meet isliabilities when they fall due.The following tables detail the Agency’s remaining contractual maturity for its financial assets and liabilities. Itshould be noted that these values are undiscounted, and consequently totals may not reconcile to thecarrying amounts presented in the Balance Sheet.2011 Maturity analysis for financial assets & liabilitiesInterest BearingFixed orVariableLess than aYear$’0001 to 5 Years$’000More than5 Years$’000Non InterestBearing$’000Total$’000WeightedAverage%AssetsCash and deposits 22 336 22 336Receivables 28 614 28 614Total Financial50 950 50 950Assets:LiabilitiesDeposits Held 1 023 1 023Payables 68 969 68 969Total FinancialLiabilities:69 992 69 992Department of Health Annual Report 2010-11 187

Our Money18. FINANCIAL INSTRUMENTS (continued)2010 Maturity analysis for financial assets & liabilitiesInterest BearingFixed orVariableLess than aYear$’0001 to 5 Years$’000Morethan 5Years$’000NonInterestBearingAssetsCash and68 419 68 419depositsReceivables 30 081 30 081Total Financial98 500 98 500Assets:$’000Total$’000WeightedAverage%LiabilitiesDeposits Held 1 250 1 250Payables 69 610 69 610Total FinancialLiabilities:70 860 70 860(c) Market RiskMarket risk is the risk that the fair value of future cash flows of a financial instrument will fluctuate because ofchanges in market prices. It comprises interest rate risk, price risk and currency risk.i) Interest Rate RiskThe Department of Health is not exposed to interest rate risk as Agency financial assets and financialliabilities are non-interest bearing.ii) Price RiskThe Department of Health is not exposed to price risk as the Agency does not hold units in unit trusts.iii) Currency RiskThe Department of Health is not exposed to currency risk as the Agency does not hold borrowingsdenominated in foreign currencies or transactional currency exposures arising from purchases in a foreigncurrency.(d) Net Fair ValueThe fair value of financial instruments is estimated using various methods. These methods are classified intothe following levels:Level 1 – derived from quoted prices in active markets for identical assets or liabilities.Level 2 – derived from inputs other than quoted prices that are observable directly or indirectly.Level 3 – derived from inputs not based on observable market data.188 Department of Health Annual Report 2010-11

Our Money2011 Total Carrying Net Fair ValueAmount Level 1Net Fair ValueLevel 2Net Fair ValueLevel 3Net Fair ValueTotal$’000 $’000 $’000 $’000 $’000Financial AssetsCash and Deposits 22 336 22 336 22 336Receivables 28 614 28 614 28 614Total Financial Assets: 50 950 50 950 50 950Financial LiabilitiesDeposits Held 1 023 1 023 1 023Payables 68 969 68 969 68 969Total FinancialLiabilities:69 992 69 992 69 9922010 Total Net Fair Value Net Fair Value Net Fair Value Net Fair ValueCarrying Level 1 Level 2 Level 3 TotalAmount$’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 FinancialLiabilities:70 860 70 860 70 860Department of Health Annual Report 2010-11 189

Our Money19. COMMITMENTSNOTES TO THE FINANCIAL STATEMENTSFor the year ended 30 June 20112011$’0002010$’000(i)(ii)(iii)(iv)Capital Expenditure CommitmentsCapital expenditure commitments primarily relate to the purchaseof Plant and Equipment. Capital expenditure commitmentscontracted for at balance date but not recognised as liabilities arepayable as follows:Within one year 966 2 981Later than one year and not later than five years 0 0Later than five years 0 0Other Expenditure Commitments966 2 981Other non-cancellable expenditure commitments not recognisedas liabilities are payable as follows:Within one year 107 106 68 409Later than one year and not later than five years 84 932 41 047Later than five years 0 0192 037 109 457Operating Lease CommitmentsThe Agency leases equipment, predominately photocopiers undernon-cancellable operating leases expiring from 3 to 5 years.Leases generally provide the Agency with a right of renewal atwhich time all lease terms are renegotiated. Future operatinglease commitments not recognised as liabilities are payable asfollows:Within one year 550 681Later than one year and not later than five years 406 717Later than five years 0 0956 1 398Finance 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 0190 Department of Health Annual Report 2010-11

Our Money20. CONTINGENT LIABILITIES AND CONTINGENT ASSETSa) Contingent liabilitiesThe Department of Health had no contingent liabilities as at 30 June 2011 or 30 June 2010.b) Contingent assetsThe Department of Health had no contingent assets as at 30 June 2011 or 30 June 2010.21. EVENTS SUBSEQUENT TO BALANCE DATENo events have arisen between the end of the financial year and the date of this report that requireadjustment 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 TrustAccount has been established for the receipt of money to be held in trust. A summary of activity isshown below:Nature of Trust MoneyOpeningBalance1 July 2010Receipts Payments ClosingBalance30 June2011Retention money 339 945 339 945 0Bond money 250 153 270 305 217 860 302 597Security deposits 4 374 359 245 4 487Unclaimed money 148 552 4 429 144 123743 023 270 664 562 479 451 208Department of Health Annual Report 2010-11 191

Our Money23. WRITE-OFFS, POSTPONEMENTS, WAIVERS, GIFTS AND EX GRATIA PAYMENTSAgency Agency Territory Items Territory Items2011$’000No. ofTrans.2010$’000No. ofTrans.2011$’000No. ofTrans.2010$’000No. ofTrans.Write-offs, Postponements and Waivers Under theFinancial Management ActRepresented by:Amounts written off, postponed and waived by DelegatesIrrecoverable amounts payable to the Territory or an Agency89 276 217 617written offLosses or deficiencies of money written off 0 2 0 2Public property written off 219 88 45 18Waiver or postponement of right to receive or recover money orpropertyTotal written off, postponed and waived by Delegates 308` 366 262 637Amounts written off, postponed and waived by the TreasurerIrrecoverable amounts payable to the Territory or an Agency8 1 127 14written offLosses or deficiencies of money written offPublic property written offWaiver or postponement of right to receive or recover money orpropertyTotal written off, postponed and waived by the Treasurer 8 1 127 14Write-offs, Postponements and Waivers AuthorisedUnder the Medical Services Act 106 18 14 2Gifts Under the Financial Management Act 0 0 0 0Ex Gratia Payments Under the Financial Management Act 0 0 16 3192 Department of Health Annual Report 2010-11

Our Money24. SCHEDULE OF TERRITORY ITEMSThe following Territory items are managed by the Department of Health onbehalf of the Government and are recorded in the Central Holding Authority(refer note 2(c)).TERRITORY INCOME AND EXPENSES2011$’0002010$’000IncomeGrants and Subsidies RevenueCurrent 0 0Capital 2 873 6 299Fees from Regulatory Services 277 591Other Income 1 72Total Income 3 151 6 962ExpensesCentral Holding Authority Income Transferred 3 151 6 962Total ExpensesTerritory Income less Expenses 0 0TERRITORY ASSETS AND LIABILITIESAssetsGrants and Subsidies Receivable 0 0Other 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 andInfrastructure:1) Tennant Creek Transitional After Care Service2) Alice Springs Hospital Solar City Co-generation3) Palmerston Super ClinicDepartment of Health Annual Report 2010-11 193

AppendicesAppendicesDepartment of Health Annual Report 2010-11 195

AppendicesAppendix 1: Employment InstructionsDetailed information on topics within this table addressing the Employment Instructions isprovided in the Our People section of the main report. This agency supports theEmployment Instructions by providing staff with access to the Managers and StaffService Centre, a one-stop online shop aimed at answering questions relating toemployment within this agency. Further advice is provided by People and OrganisationalLearning staff.Employment Instruction No.1Advertising, Selection, Appointment,Transfer and Promotion - Agency todevelop procedures for the recruitmentand selection of employees which areconsistent with the Act, Regulations,By-Laws, Employment Instructions,relevant awards and determinations.Chief Executives are required to reportannually on the number of employeesof each designation and any variationin numbers since the last report.Employment Instruction No.2Probation – Chief Executive is toestablish a probationary process withintheir agency. Chief Executive shouldconvey details of the probationaryprocess to probationary employeeswithin the first week of report for duty.Employment Instruction No.3Natural Justice – The rules of naturaljustice shall be observed in all dealingswith employees under the Act.Recruitment information is available on theagency’s intranet or the Northern TerritoryGovernment internet employment site.Growth in staff numbers is reported in the OurPeople section.DoH provides a comprehensive, tailoredRecruitment and Selection training programwhich is available to all staff across theNorthern Territory. 114 employees attendedthis training in 2010-11. Towards the end of thereporting period a one hour tailoredRecruitment and Selection Workshop wasdeveloped and will be rolled out across boththe Department of Health and the Departmentof Children and Families.Information about the probation process isavailable on the agency’s intranet in theManagers and Staff Service Centre and on theOCPE website.Policies and guidelines are available on theagency’s intranet site in the Managers andStaff Service Centre. Departmental policiesand guidelines integrate the rules of naturaljustice i.e. that the person directly affected byan impending decision must be afforded afair hearing prior to that decision beingmade; and the decision maker should beimpartial.The principles of Natural Justice are coveredin all DoH Management and Leadershiptraining programs.196 Department of Health Annual Report 2010-11

AppendicesEmployment Instruction No.4Performance Management – ChiefExecutive is to report annually onmanagement training and staffdevelopment programs. ChiefExecutive shall develop and implementperformance management systems fortheir Agency.Employment Instruction No.5Medical Incapacity – Identifies thesteps to be followed when a ChiefExecutive Officer is of the opinion thatan employee may be mediallyincapacitated.Employment Instruction No.6Inability to Discharge duties – ChiefExecutive to provide the NorthernTerritory Government’s Office of theCommissioner for Public Employmentwith information on the extent to whichthis employment instruction has beenused by the agency. Chief Executivemay establish procedures regardingthis employment instruction within theAgency.Employment Instruction No.7Discipline – Chief Executive to providethe Northern Territory Government’sOffice of the Commissioner for PublicEmployment with information on theextent to which this employmentinstruction has been used by theagency. Chief Executive may establishprocedures regarding discipline withintheir agency.Information on this Instruction is available onthe agency’s intranet site in the Managers andStaff Service Centre and is alsocomprehensively covered in Management andLeadership development programs; and as astand alone information session. The agencyhas implemented a Work Partnership Plan thatassists with providing and receiving feedbackto enhance individual and organisationalperformance. Managers and staff worktogether to carry out this plan. A recent auditindicates that WPP compliance is estimated tobe between 50% - 60%. Hospitals havereported high compliance rates of around 65%to 75% due to the reporting capacity of ‘OneStaff’ (personnel and payroll system).Information on this Instruction is available onthe agency’s intranet site in the Managers andStaff Service Centre. The agency commencedsix new cases with five cases being carriedover from 2009-10, seven cases were finalisedtwo lapsed and two remain on hand at the endof reporting period.Information on this Instruction is available onthe agency’s intranet site in the Managers andStaff Service Centre. Under Section 44 Inabilityto Discharge Duties the agency carried overone case from 2009-10, commenced twocases, finalised one case and two casesremain on hand at the end of the reportingperiod.Discipline procedure is available on theagency’s intranet in the Managers and StaffService Centre. The DoH tailored one dayprogram The Essentials of Leading PeoplePart 2 assists managers and employees tounderstand and interpret this instruction.Under Section 49 – Discipline, the agencycommenced 16 cases, finalised 12 and fourremain on hand.Department of Health Annual Report 2010-11 197

AppendicesEmployment Instruction No.8Management of Grievances – ChiefExecutive shall establish writtengrievance setting procedures for theagency that should be available toemployees and outline steps fordealing with grievances.Employment Instruction No.9 -Transfers – Omitted and incorporatedinto Instruction 1 (Incorporated inEmployment Instruction1)Employment Instruction No.10Employee Records – Agencies arerequired to establish systems andprocedures and ensure all records aremaintained in a secure and confidentialarea.Employment Instruction No.11Equal Employment OpportunityManagement Programs – ChiefExecutive to devise and implementprograms to ensure equal employmentopportunities and outcomes areachieved. Chief Executive to reportannually on programs and initiativesthe Agency has developed. Reportshould also include details on specificaction in relation to Aboriginalemployment and career development,and also measures to enableemployees to balance work and familyresponsibilitiesEmployment Instruction No.12Occupational Health and SafetyPrograms– Chief Executive to developprograms to ensure employees areconsulted in the development andimplementation of Occupational Healthand Safety Programs. Chief Executiveto report annually on OccupationalHealth and Safety Programs. Recordsmust be kept on risk assessment,maintenance control and information,instruction and training provided toemployees.Grievance policy information is available on theagency’s intranet in the Managers and StaffService Centre. The tailored one day programThe Essentials of Leading People Part 2assists managers and employees tounderstand and interpret this instruction. Underthe Department’s Grievance Policy andGuidelines, the Chief Executive received atotal of 57 grievance requests in 2010-11 and11 cases were brought forward from 2009-10.33 grievances were resolved and 24 remainopen.Incorporated in Employment Instruction 1.All personnel files are securely maintained bythe Department of Business and Employmenton behalf of the agency. Access to personnelfiles and the Personnel Integrated Pay System(PIPS) database is restricted and this access isreviewed regularly.Equal Employment policies and guidelines areavailable on the agency’s intranet.In showing a commitment to this EmploymentInstruction, in 2010-11 the Department ofHealth (Linen Services and Housekeeping,Royal Darwin Hospital) employed sixparticipants of the Willing and Able Scheme.More information on this project can be foundon OCPE’s site.Other details are in the ‘Our People’ section ofthis report.Review of the Departmental OccupationalHealth and Safety Management System isundertaken on an annual basis. OHS trainingis an integral part of the Department’sorientation program and is available throughthe Corporate Training Calendar. OccupationalHealth and Safety (OHS) information, policies,guidelines and reporting proforma are availableon the Agency’s intranet OHS homepage.198 Department of Health Annual Report 2010-11

AppendicesEmployment Instruction No.13Code of Conduct – Chief Executivemay issue guidelines regardingacceptance of gifts and benefits toemployees. Chief Executive may issuean agency specific Code of Conduct.Employment Instruction No.14Part-time Employment – ChiefExecutive, on request of theCommissioner, provide the number ofpart-time employees by salary stream.The Department has developed an OrientationProgram that new employees of both theDepartment of Health and Department ofChildren and Families attend as part of ashared service agreement. The Departmentalso has an online induction instruction andchecklist which can be found in the Managersand Staff Service Centre. New employees aredirected to access the agency intranet toensure they are aware of the Code of Conduct.Employees may also access the Code ofConduct on the OCPE websiteThe agency supports part time and flexibleworking practices. Information on flexibleworking arrangements can be found on theagency’s intranet in the Managers and StaffService Centre under the heading of FlexibleWorking Solutions. At the end of the reportingperiod, this agency employed 461.73 FTE onpermanent part time basis, and 136.28 FTE ontemporary part time basis.Department of Health Annual Report 2010-11 199

AppendicesAppendix 2: Councils, Committees, GroupsMinisterial Groups: Health Advisory CouncilA new three year term of the HealthAdvisory Council commenced in January2010, the first meeting being held inAlice Springs in 10 February 2010. Twonew appointments were made in 2010being Professor Sandra Dunn fromCharles Darwin University Darwin andMr Trevor Sanders, Anyinginyi HealthAboriginal Corporation, Tennant Creek.The Council noted with appreciation thework of the retiring members.MembershipAs at 30 June 2011.ChairpersonDr Sarah GilesMembersProfessor Jonathan CarapetisProfessor Sandra DunnMs Alison FaigniezMs Anne KempDr Liz MooreMr Eddie MulhollandDr Sanjit PaulDr Didier PalmerDr Jill PettigrewMr Trevor SandersDr Bruce SimmonsDr Michael WilsonEx OfficioDr Barbara PatersonMs Victoria WalkerSecretariatMs Nancy KingDuring this new three-year term, achange in the structure of Counciloccurred. The Council now compriseshealth professionals who are appointedas individuals, rather than asspokespersons of community andconsumer organisations or professions.Key Areas in Terms of ReferenceUnder its Terms of Reference, theCouncil will provide informed andimpartial advice and perspectives to theMinister for Health on:a) strategic issues that affect thehealth of Territorians;b) effectiveness andappropriateness of policy,strategies and planning priorities;and,c) specific matters requested by theMinister for Health;d) health issues across the range ofcommunity, regional and sectoralinterests, as requested by theMinister for Health.Key AchievementsKey matters considered by the Councilin 2010-11 include tobacco control,alcohol-related harm, national healthand hospitals reform, health workforceplanning and child and maternal health.Feedback and comment was provided tosenior officers on presentations of keypolicies and new initiatives of theDepartment including child and youthhealth and Aboriginal health servicesbeing delivered in Central Australia.Meetings were held on 12 August 2010and 25 November 2010; and on 10February and 26 May 2011.200 Department of Health Annual Report 2010-11

AppendicesNorthern Territory Community Advisory Group onMental HealthMembershipAs at 30 June 2011.ChairpersonDoreen DyerMembersChristine KuhlChristine SuttonDavid Munro (2nd Deputy Chair)Greg Johnson (1st Deputy Chair)Gwvynyth Cassiopeia-RoennfeldtMichelle WilliamsMonte KarenaTess NarkleEx Officio MemberBronwyn Hendry, Director MentalHealth, Department of HealthSecretariatMeg Beaumont, Mental Health,Department of HealthMeetingsThe Advisory Group met on:• Saturday 21 August 2010• Saturday 27 November 2010• Friday 25 February 2011• Saturday 21 May 2011The annual planning day was held on:Saturday 26 February 2011.Key Areas in Terms of ReferenceUnder its terms of reference, theNTCAG will:1. provide an ongoing mechanism forconsumer and carer input intomental health policy decisionmaking processes, particularly inrelation the National Mental HealthPlan and the Mental HealthStatement of Rights andResponsibilities;2. assist the Minister in theformulation of mental healthpolicies, plans, associatedlegislation, monitor theimplementation and ensure MentalHealth services meet the needs ofconsumers and their carers;3. provide advice and reports to theMinister on matters relating toother departments, which affect therights and welfare of consumersand their carers;4. provide consumer and carerrepresentation on the NationalMental Health Consumer andCarer Forum;5. promote the involvement ofconsumers and carers in theformulation and implementation ofnational mental health policies; and6. provide advice to the Minister onother matters relating to the needsof consumers and their carers inthe Northern Territory.Key Achievements• Consumer and carerrepresentatives attended theNational Mental Health Consumerand Carer Forums and distributeda report of Northern Territorymental health issues andachievements to the forum.• The group conducted a planningforum which includedrepresentation from Mental Healthcommunity organisations, theCommunity Visitor Program andMental Health Services.• Carer representation on theApproved Procedures and QualityAssurance Committee wasmaintained.• Participated in the Secure CareCommunity Consultations.Department of Health Annual Report 2010-11 201

AppendicesSenior Territorians Advisory CouncilThe STAC is an independent groupformed as an advisory body for theMinister for Senior Territorians. It wasestablished in December 2009.MembershipSTAC membership consists of ninepeople, aged over 50, who reflect thediversity of the community to ensureequitable representation of all Territoryseniors.Current membership as at 30 June2011.Janet Durling (Chair)Art Libien (Deputy Chair)Brian HilderLillian MannColin HardakerDenyse EdneyKathy MartinGraham Kemp2011 PrioritiesThe STAC has developed a work plan toidentify priorities and provide aframework for the council to worktowards. The plan will be reviewed andupdated regularly to reflect and reporton key achievements of the CouncilCurrent STAC priorities include:• review of the Active AgeingFramework• housing• cost of living / affordable services• health• communication• transport• employment / education.Members who left in 2010-11Banambi WunungmurraSecretariatSecretariat support is provided by theAged and Disability Program.MeetingsWere held in July and October 2010 andFebruary and April 2011.Key Terms of ReferenceThe Senior Territorians Advisory Council(STAC) provides advice to the Ministerfor Senior Territorians on senior’sissues, government programs andpolicies and identifies futureopportunities to progress outcomes forseniors in the Territory.2010-11 Key AchievementsReaching out to the major seniors’groups to seek comments on the ActiveAgeing Framework.202 Department of Health Annual Report 2010-11

AppendicesDepartment of Health - Executive Leadership GroupMembershipAs at 30 June 2011.ChairpersonJeff MoffetMembersJenny ClearyDr Barbara PatersonJackie Ah KitIan PollockStephen MooPeter BeirnePenny FieldingMike MelinoLiz StackhouseJill MacandrewSecretariatJan EvansMeetingsMonthlyKey Areas from Terms of Reference1. Provide governance direction for theDepartment of Health’s strategic committees:• Strategic Workforce Committee• Audit Committee• OHS Steering Committee• Resource Management Committee• Department and Unions Consultative Committee• Strategic Information ManagementSteering Committee• Principal Quality and Safety Committee.2. Review organisational performance.3. Discuss and debate current, emerging,key and critical issues.4. Decision making and establishingorganisational directions.Department of Health Annual Report 2010-11 203

AppendicesDepartment of Health - Unions Consultative CouncilMembershipAs at 30 June 2011.ChairpersonThe role of the Chair alternated betweendepartmental and union representatives.Yvonne Falckh, NT Secretary, ANFJill Macandrew, A/Senior DirectorPeople and Services DOHDepartmental MembersJenny Cleary, Executive Director HealthServicesLiz Stackhouse, A/Executive DirectorTop End Local Hospital Network,Mike Melino, A/Executive DirectorCentral Australia Local HospitalNetwork,Vera Whitehouse, Assistant DirectorOrganisational LearningAngela Brannelly, A/Principal Nursingand Midwifery AdvisorAlan Ruben, Principal Medical AdvisorDanny Coombes, Industrial RelationsConsultantRon Hosking, Industrial RelationsConsultantHelen Nezeritis, A/Executive DirectorCorporate Services, Department ofChildren and Families.Nominated Union RepresentativesYvonne Falckh, NT Secretary, AustralianNursing FederationPaul Morris, NT Regional Director,Community and Public Sector UnionMatthew Gardiner, NT Secretary, Liquor,Hospitality and Miscellaneous Workers’Union/United VoiceFiona Stacey, NT Executive Officer,Australian Medical Association NT Inc.David Nebauer, NT President,Association of Professional Engineers,Scientists and Managers, AustraliaBryan Wilkins, Territory Organiser,Australian Manufacturing Workers'UnionOCPE representationRepresentatives attend meetings on anas required basisSecretariatMaria Jennings, Business ManagerPeople and ServicesMembers who left in 2010-11Peter Beirne, Chief Operations Officer,DoH (Chair)Kate McTaggart, Acting Senior DirectorPeople and ServicesGreg Rickard, Principal Nursing AdvisorJan Evans, Acting Deputy ChiefExecutive Acute CareClare Gardiner-Barnes, ExecutiveDirector, NT Families and ChildrenMeetingsThe Council met in August, October andDecember 2010 and March 2011.Key Areas from Terms of ReferenceThe main activity for the ConsultativeCouncil is to ensure that there is regularcommunication at the highest levelbetween the Department, the Office ofthe Commissioner for PublicEmployment and the principal healthunions about major issues that affect thehealth workforce.204 Department of Health Annual Report 2010-11

AppendicesThe Department – Union ConsultativeCouncil’s objectives are to:1. promote an efficient and effectiveservice by DoH for the NorthernTerritory community;2. promote good industrial relations;3. improve a mutual understanding ofmanagement and staff issues;4. provide a forum for consultation andopen discussion between DoHsenior staff and staffrepresentatives with the aim ofresolving any differences in amutually acceptable manner;5. facilitate the mutual exchange ofinformation.Key discussionsThese included:• creation of new departments –Department of Health; andDepartment of Children andFamilies;• National Health Reform Agenda;• National Registration andAccreditation Scheme;• Criminal History Checks; andWorking with Children ClearanceChecks (Ochre Cards);• workforce reviews (AHW Profession;Nursing and Midwifery Educationand Training);• professional classification structure;• payroll and recruitment relatedmatters;• apprenticeship and cadetshipprograms;• training and development activities;• nurse uniforms;• Royal Darwin Hospital ServicesReviews; and,• RDH staff accommodation.Outcomes of key discussions werereported to the Executive LeadershipGroup.Department of Health Annual Report 2010-11 205

AppendicesStrategic Workforce CommitteeMembershipAs at 30 June 2011.ChairpersonJill Macandrew, A/Senior Director, Peopleand ServicesMembers• Karen Buckingham, A/Director StrategicWorkforce and Planning• Vera Whitehouse, Assistant Director,Organisational Learning andDevelopment• Peter Pangquee, Principal AboriginalHealth Worker Advisor• Renae Moore, Principal Allied HealthAdvisor• Angela Brannelly, A/Principal Nursingand Midwifery Advisor• Alan Ruben, Principal Medical Advisor• Liz Stackhouse, A/Executive DirectorTop End Local Hospital Network, RoyalDarwin Hospital• Mike Melino, A/Executive DirectorCentral Australia Local HospitalNetwork, Alice Springs Hospital• Jackie Ah Kit, A/Executive DirectorSystems Performance and AboriginalPolicy• Sally Matthews, Director HealthServices Policy• Jan Evans, A/Senior Director Office ofthe Chief Executive• Xavier Schobben, DirectorEnvironmental HealthSecretariatTiffany Haritos, Project Officer, StrategicWorkforce PlanningMembers of the Committee who left in2010-11• Peter Beirne, Chief Operations Officer(as Chair)• Kate McTaggart, A/Senior Director,People and Services• Alan Wilson, Deputy Chief ExecutiveAcute Care Services• Vicki Taylor, General ManagerAlice Springs Hospital• Shane Houston, Executive DirectorSystems Performance and AboriginalPolicy• Linda Blair, A/Director, StrategicWorkforce Planning• Clare Gardiner-Barnes, ExecutiveDirector, NT Families and Children• Greg Rickard, Principal Nursing AdvisorMeetingsThe Committee met in August andNovember 2010; and in February and Junein 2011.Key Areas from Terms of ReferenceThe Strategic Workforce Committee isresponsible for steering, monitoring andreporting on a strategic agenda that providesleadership and direction in relation to humanresource management, strategic workforceplanning, workforce development and reformacross the Department. The Committee willprovide specific leadership and direction inregard to aligning the Department’sworkforce priorities to the endorsed priorityactions areas contained within the keydepartmental plans.Key Achievements:• DoH Workforce Plan Progress Report.• NT Aboriginal Health Worker ReviewReport endorsed.• Nursing and Midwifery Education andTraining Review Report endorsed.• Sponsorship of the Stepping UpProgram.• Sponsorship of the IndigenousEmployment Program.• Sponsorship of the new ProfessionalClassification Structure.• Sponsorship of the biennial NTPSEmployee Survey.Facilitation of:• National Health Workforce Reforms;• 457 Visa Obligations;• monitoring of the Fringe Benefits Tax(FBT) Report;• endorsement of the Cultural SecurityReport;• communication across the Departmentregarding the Working with ChildrenClearance Checks; and• communication of health reforms acrossthe Department.206 Department of Health Annual Report 2010-11

AppendicesResource Management CommitteeMembershipAs at 30 June 2011.ChairpersonPeter BeirneMembersIan PollockJan EvansJenny ClearyLiz StackhouseMike MelinoRick GowingStephen MooDr Barbara PatersonJill MacandrewPenny FieldingSecretariatJillian FrostMeetingsMonthlyKey Areas from Terms of ReferenceThe Department of Health ResourceManagement Committee undertakes thefollowing functions on behalf of the ChiefExecutive:• monitoring the delivery /effectiveness of the given resource;• building / understanding therelationships between currentperformance, future demand andlikely supply so that we can be moreconvincing in resource arguments;• building the best co-ordinated andtimely submissions for resources forthe next year;• monitoring implementation of FullTime Equivalents and budgettargets including revenue across theDepartment;• monitoring the implementation ofthe various capital programsincluding major minor andequipment;• establishing and monitoring wherepossible a closer link betweenoperational performance informationand resource implications;• encouraging the development ofearly warning indicators ofsignificant budget variations;• monitoring and influencing theeffectiveness of the middlemanager. Resource Managementtraining program;• oversight of the development of aone to five year forward look linkingresources available withgovernment health strategies andpolicies and service demands andcapacity to balance them;• oversight of the development of nextyears’ budget submission includingnew service proposals, works andequipment priorities;• knowing and understanding thenature and implications of Cabinetsubmissions likely to effect resourceallocations as they are beingdeveloped;• oversight of the development orvarious resource strategies requiredby Cabinet e.g. five yearaccommodation plan and a strategyto reduce energy consumption by10% over five years; and• advising the CE of actionsnecessary to operate within budget.Department of Health Annual Report 2010-11 207

AppendicesAudit CommitteeMembershipAs at 30 June 2011.ChairpersonIain Summers, Independent MemberMembersPeter BeirneAntoni Murphy, Independent MemberJan EvansJill Macandrew*Dr Barbara Paterson*Ian Pollock*Dean Gardener*Rob Richards* Principal AuditorMike Melino*Liz Stackhouse**denotes ex-officio membersSecretariatVicki GoddenMembers who left during 2010-11Shane HoustonVic Czernezky, (deceased) IndependentMemberJill MacandrewDavid RyanChristine ShortMeetingsThe Committee met in August,September and November in 2010 andFebruary and May in 2011.Key Areas from Terms of ReferenceThe Audit Committee undertakes thefollowing functions on behalf of the ChiefExecutive:environment and review theadequacy of policies, practices andprocedures in relation to theircontribution to and impact on, theDepartment’s internal controlenvironment;• oversee the internal audit functionincluding development of auditprograms and monitoring of auditoutcomes and the implementation ofrecommendations;• review financial statements andother public accountabilitydocuments (such as annual reports)prior to their approval by the CE;• assess the state of organisationalgovernance in the Department andrecommend strategies forimprovement;• liaise with external auditorsregarding audits conducted andrespective audit plans;• within the context of the committee’sprimary role, undertake any otherfunctions determined from time totime by the CE.Key AchievementsMonitoring the development of theCorporate Risk RegisterMonitoring of the internal audit programand responses to auditrecommendations.Assurance reporting to the ChiefExecutive about the Department’sinternal audit capacity.• monitor strategic risk managementand the adequacy of the internalcontrols established to manageidentified risks;• monitor the adequacy of theDepartment’s internal control208 Department of Health Annual Report 2010-11

AppendicesStrategic Information Management Steering CommitteeMembershipAs at 30 June 2011.ChairpersonStephen Moo, Chief Information OfficerMembersJan Evans, A/Senior Director Office ofthe CE.Jill Davis, Director Health Developmentand Oral HealthRobyn Cahill, Director SystemsPerformanceIan Pollock, A/Chief Finance OfficerJill Macandrew, A/Senior DirectorPeople and ServicesDr Barbara Paterson, Chief HealthOfficerPenny Fielding, A/Executive Director,Health ReformFiona Lynch, A/Director Strategic Policyand Performance, NT Families &ChildrenMeri Fletcher, A/General ManagerKatherine HospitalRichard B Smith, Director CorporateReportingJo Wright, A/Director, Health GainsPlanningTrudi Maly, Director Library ServicesHelen Albion, Director ICT ServicesJackie Plunkett, ProgramImplementation Manager, DigitalRegions, Health eTowns, eHealthNTSecretariatAmanda Lanagan, Manager, DataGovernanceMeetingsThe Committee met four times in thefinancial year.Key Areas from Terms of ReferenceThe Department’s Strategic InformationManagement Committee undertakes thefollowing functions on behalf of the CE:• prioritise and approve investmentproposals in relation to majorinformationmanagement,knowledge management andinformation and communicationstechnology initiatives.• set the strategic agenda for thedevelopment and use of informationtechnology, communications andinformation services across theagency to underpin managementdecision making and planning.• monitor delivery of majorinformationmanagement,knowledge management andinformation and communicationstechnology work program initiatives.• provide direction in relation to theagency’s:• involvement in nationalinformation committees andhealth information projects;• requirements in relation to wholeof-governmentinitiatives;• alignment with national strategiesand standards;• development of informationpolicies and procedures;• Information Management groups;• the Department’s InformationStrategy to ensure alignmentwith the Department’s StrategicDirections and priorities; and• reporting on progress andachievement of the Department’sInformation Strategy.Key AchievementsCommencement of the Digital Regions –Health eTowns ProgramDepartment of Health Annual Report 2010-11 209

AppendicesPrincipal Safety and Quality CommitteeMembershipAs at 30 June 2011.ChairpersonAlan Ruben, Principal Medical AdvisorDeputy ChairPeter Beirne, Chief Operations OfficerMembersDr Barbara Paterson, ExecutiveDirector, Health Protection and ChiefHealth OfficerDean Gardner, Director of Risk andAssuranceJan Evans, A/Senior Director, Office ofthe Chief ExecutiveJenny Cleary, Executive Director ofHealth ServicesPenny Fielding, A/Executive Director,Health ReformJackie Ah Kit, A/Executive Director,Systems Performance and AboriginalPolicyMembers who left during 2010-11Peter Beirne, Chief Operations OfficerShane Houston, Executive Director,Systems Performance and AboriginalPolicyChristine Short, A/Director, Risk andAssurance ServicesSecretariat:Laurie Barrand, Senior Advisor, Safetyand Quality Advisory ServiceMeetingsMeetings were held in August andOctober 2010; February and April 2011.Key Areas from Terms of ReferenceThe role of the Principal Safety & QualityCommittee is to assist the ChiefExecutive in developing and sustainingthe culture and systems to facilitate safe,high quality care and services to DoHclients by:building an awareness andunderstanding of DoH safety and qualityinitiatives across all Divisions and withthe general public;redesigning systems across and withinthe Divisions of Health to engender aculture of safety and continuousimprovement;supporting those who work in the Healthsystem to deliver safer client care;improving data and information for saferHealth services;ensuring that DoH complies withobligations arising from the NationalSafety and Quality agenda.Key Achievements:Implementation of critical incidentmanagement systems to improve patientand staff safety.Adoption of national standards in safetyand quality.Developing an organisational frameworkfor safety and quality to streamlinemanagement of quality improvements.Creation of new Director of Safety andQuality position to co-ordinateDepartmental activities.Conducted a forum “Innovations andInspirations in Safety and Quality” for 72people to presentations on current andemerging topics in this field.210 Department of Health Annual Report 2010-11

AppendicesOccupational Health and Safety Steering CommitteeMembershipAs at 30 June 2011.ChairpersonJill Macandrew, A/Senior DirectorPeople and ServicesDeputy ChairKate McTaggart, Director People andOrganisational LearningMembersFiona Roche, A/Assistant DirectorHuman Resources and OHSRobin Smith, General ManagerKatherine HospitalJill Davis, Director Health Developmentand Oral HealthPenny Parker, Senior Safety and QualityAdvisorClare Gardiner-Barnes, Chief Executive,Department of Families and ChildrenChristine Short, Manager, Performanceand ResearchJanice Manicaros, A/Executive andStrategic Policy OfficerYvonne Falckh, Secretary, AustralianNurses Federation NTPaula Bradford, Organiser, United VoicePaul Morris, Regional Director,Community Public Sector Union NTMembers who left during 2010-11Leah Magee, Executive Officer, HealthProtectionJan Jones, OHS UnitSecretariatKaren Sinel, A/Manager OHS UnitMeetingsThe Committee met in September,December in 2010 and March in 2011.Key Areas from Terms of ReferenceProvide strategic direction on OHSissues to the various Workplace OHSCommittees across the Department toensure that it:• meets its legislative responsibilities• integrates OHS with other agencymanagement systems and with thecore functions of the organisation;• aids the improvement of the overallOHS performance of theDepartment.• monitors and reviews the work ofthe Workplace OHS Committees inline with departmental policy• reviews OHS across theDepartment.• reports to the Executive LeadershipGroup.Key AchievementsThe Steering Committee activitiesincluded:• endorsed departmental participationto support work area initiatives inrelation to national Safe WorkAustralia Week;• endorsed Merit Partners to conductreview of systems and processes inplace to manage remote staff safety -recommendations endorsed and arebeing implemented;• sponsorship the Health and SafetyRepresentative Election process; and• set directions for intervention workbased on a range of data and othertrend evidence.Department of Health Annual Report 2010-11 211

AppendicesAppendix 3: External FundingPAYMENTS BY ORGANISATION (>$10K)DIVISION ORGANISATION TOTALACUTE CARE SERVICESCANCER COUNCIL OF THE NT INC 139,633.00CAREFLIGHT NSW LIMITED 15,797,026.00DEPARTMENT OF HEALTH AND AGEING 31,555.00FLINDERS UNIVERSITY 3,017,473.00MISSION AUSTRALIA 600,000.00NATIONAL BLOOD AUTHORITY 2,181,185.00ROYAL FLYING DOCTORS SERVICE 3,496,242.00ST. JOHN AMBULANCE AUST. NT INC. 18,914,768.00WESTERN DESERT NGANAMPA WALYTJAPALYANTJAKU TJUTAKU ABORIGINALCORPORATION 188,152.00YOUNG WOMEN'S CHRISTIAN ASSOCIATION INC 74,923.00ACUTE CARE SERVICES Total 44,440,957.00HEALTH PROTECTIONAFL NORTHERN TERRITORY LIMITED 45,000.00ALICE SPRINGS TOWN COUNCIL 60,000.00AMITY COMMUNITY SERVICES 494,589.00ANEX 27,995.00ANYINGINYI HEALTH ABORIGINAL CORPORATION 163,000.00BARKLY REGION ALCOHOL AND DRUG ABUSEADVISORY GROUP INCORPORATED 907,020.00BARKLY SHIRE COUNCIL 38,706.00BUSHMOB INCORPORATED 441,142.00CATHOLICCARE NT 825,230.00CENTRAL AUSTRALIAN ABORIGINAL ALCOHOLPROGRAM UNIT 550,338.00CENTRAL AUSTRALIAN ABORIGINAL CONGRESSINCORPORATED 2,493,129.00CENTRAL AUSTRALIAN ABORIGINAL MEDIAASSOCIATION (CAAMA) 10,000.00CENTRE FOR REMOTE HEALTH 36,815.00COUNCIL FOR ABORIGINAL ALCOHOL PROGRAMSERVICES INC. 387,637.00DEPT OF HEALTH QLD 33,719.00DJABULUKGU ASSOCIATION INC. 40,000.00DRUG & ALCOHOL SERVICES ASSOCIATION ALICESPRINGS INC 1,457,984.00EAST ARNHEM SHIRE COUNCIL 491,500.00EASTERN HEALTH 58,004.00EMPLOYEE ASSISTANCE SERVICE NT INC 195,289.00F.O.R.W.A.A.R.D. 804,451.00FAMILY PLANNING WELFARE ASSOCIATION OF NTINC. 22,880.00FORSTER FOUNDATION - BANYAN HOUSE 655,039.00HOLYOAKE 409,042.00ILPURLA ABORIGINAL CORPORATION 100,000.00JULALIKARI COUNCIL ABORIGINAL CORPORATION 240,025.00212 Department of Health Annual Report 2010-11

AppendicesDIVISION ORGANISATION TOTALHEALTH PROTECTION (continued)KALANO COMMUNITY ASSOCIATION INC. 421,344.00MACDONNELL SHIRE COUNCIL 32,258.00MENZIES SCHOOL OF HEALTH RESEARCH 4,321,495.65MISSION AUSTRALIA 1,105,411.00MT THEO-YUENDUMU SUBSTANCE MISUSEABORIGINAL CORPORATION 24,626.00NATIONAL INSTITUTE FOR ABORIGINAL ANDTORRES STRAIT ISLANDER HEALTH RESEARCHLIMITED 150,000.00NORTHERN TERRITORY AIDS AND HEPATITISCOUNCIL INC. 1,067,852.00RED DUST ROLE MODELS LTD 48,385.00ROPER GULF SHIRE COUNCIL 51,566.00ST VINCENT DE PAUL SOCIETY 130,000.00SUNRISE HEALTH SERVICE ABORIGINALCORPORATION 70,000.00TANGENTYERE COUNCIL INCORPORATED 665,776.00THE SALVATION ARMY (NT) PROPERTY TRUST 459,474.00TOP END ASSOCIATION FOR MENTAL HEALTH INC(TEAM HEALTH) 20,000.00UNIVERSITY OF SOUTH AUSTRALIA 100,000.00VICTORIA DALY SHIRE COUNCIL 39,340.00WEST ARNHEM SHIRE COUNCIL 130,727.00WURLI WURLINGJANG ABORIGINAL CORPORATIONINC 309,960.00HEALTH PROTECTION Total 20,136,748.65HEALTH SERVICESABILITYFOCUS PTY LTD 211,821.00ALAWA ABORIGINAL CORPORATION 78,616.00ALICE SPRINGS SENIOR CITIZENS 13,041.00ALZHEIMERS AUSTRALIA NT INC 331,813.00AMSANT ABORIGINAL MEDICAL SERVICESALLIANCE OF THE NT INC 320,787.00ANGLICARE NT 1,320,054.00ANIMPARRINPI YUTLITJU WOMENS ASSOCIATION 19,645.00ANYINGINYI HEALTH ABORIGINAL CORPORATION 103,424.00ARTHRITIS FOUNDATION OF THE NORTHERNTERRITORY INC. 56,866.00ASTHMA FOUNDATION OF THE NT INC. 243,513.00AUSTRALIAN BREASTFEEDING ASSOCIATION 17,852.00AUSTRALIAN RED CROSS SOCIETY- NORTHERNTERRITORY DIVISION 1,755,357.00BAGOT COMMUNITY INCORPORATED 412,063.00BARKLY SHIRE COUNCIL 467,392.00BAWINANGA ABORIGINAL CORPORATION 69,095.00BELYUEN COMMUNITY GOVERNMENT COUNCIL 66,726.00BEYOND BLUE LIMITED 39,586.00BINDI INCORPORATED 581,940.00BUSHMOB INCORPORATED 27,501.00CALVARY HOME CARE SERVICES LIMITED 273,297.00CANCER COUNCIL OF THE NT INC 249,053.00CARERS NT INCORPORATED 387,616.00Department of Health Annual Report 2010-11 213

AppendicesDIVISION ORGANISATION TOTALHEALTH SERVICES (continued)CARPENTARIA DISABILITY SERVICES INC. 7,016,746.00CASA CENTRAL AUSTRALIA INCORPORATED 2,213,324.00CENTRAL AUSTRALIAN ABORIGINAL CONGRESSINCORPORATED 1,116,032.00CENTRAL DESERT SHIRE COUNCIL 200,417.00CHILDBIRTH EDUCATION ASSOCIATIONINCORPORATED (CA) 44,055.00CHILDBIRTH EDUCATION ASSOCIATIONINCORPORATED (TE) 36,168.00COMMUNITY SUPPORT INC 1,416,736.00COUNCIL ON THE AGEING (COTA NT) 113,522.00D & R COMMUNITY SERVICES PTY LTD 116,141.00DANILA DILBA BILURU BUTJI BINNILUTLUM HEALTHSERVICE ABORIGINAL CORPORATION 420,696.00DARWIN COMMUNITY LEGAL SERVICES INC 106,544.00DEAFNT INC. 42,085.00DIABETICS ASSOCIATION OF THE NT INC 737,680.00DISABILITY ADVOCACY SERVICE 57,032.00DJABULUKGU ASSOCIATION INC. 1,106,444.00EAST ARNHEM SHIRE COUNCIL 685,725.00FAMILY PLANNING WELFARE ASSOCIATION OF NTINC. 693,977.00GENERAL PRACTICE NETWORK NT LTD 366,844.00GOLDEN GLOW CORPORATION (NT) PTY LTD 322,414.00GROW NT 170,870.00GUIDE DOGS ASSOCIATION OF SA & NT INC. 73,712.00HEALTHSCOPE LIMITED 669,547.00HPA INCORPORATED 623,033.00INDUSTRY EDUCATION NETWORKING PTY LTD 699,575.00INTEGRATED DISABILITY ACTION INC. 20,383.00JILAMARA ARTS AND CRAFTS ASSOCIATION 57,400.00JULALIKARI COUNCIL ABORIGINAL CORPORATION 886,363.00KALANO COMMUNITY ASSOCIATION INC. 129,955.00KATHERINE WEST HEALTH BOARD 3,515,669.00KIDSAFE CHILD ACCIDENT PREVENTIONFOUNDATION OF AUSTRALIA - NT DIVISION 95,715.00LARRAKIA NATION ABORIGINAL CORPORATION 592,547.00LAYNHAPUY HOMELAND ASSOCIATION INC. 114,858.00LIFE WITHOUT BARRIERS 5,431,635.00LIFELINE CENTRAL AUSTRALIA INC 183,457.00LIFESTYLE SOLUTIONS (AUST) LTD 5,800,688.00LTYENTYE APURTE INGKERRENYEKEKENHEAPMERE ABORIGINAL CORPORATION (SANTATERESA WOMEN'S CENTRE) 72,593.00MABUNJI ABORIGINAL RESOURCE ASSOC INC. 30,797.00MACDONNELL SHIRE COUNCIL 711,203.00MAMPU MANINJA-KURLANGU JARLU PATU-KUABORIGINAL CORPORATION 164,706.00MARLE INGKEHEREKENHE ARNDARITJIKAABORIGINAL CORPORATION 44,460.00MENTAL HEALTH ASSOCIATION OF CENTRALAUSTRALIA 1,427,369.00MENTAL HEALTH CARERS NT 421,682.00214 Department of Health Annual Report 2010-11

AppendicesDIVISION ORGANISATION TOTALHEALTH SERVICES (continued)MENTAL HEALTH COUNCIL OF AUSTRALIA INC 15,505.00MENZIES SCHOOL OF HEALTH RESEARCH 25,000.00MISSION AUSTRALIA 184,040.00MIWATJ HEALTH ABORIGINAL CORPORATION 1,735,020.00NATIONAL DISABILITY SERVICES LTD 304,709.00NATURAL FAMILY PLANNING COUNCIL NT INC. 10,957.00NGARUWANAJIRRI INC 163,361.00NGINTAKA WOMENS COUNCIL ABORIGINALCORPORATION 46,451.00NORTH AUSTRALIAN PASTORAL CO. PTY LTD 12,341.00NORTHERN TERRITORY MENTAL HEALTHCOALITION 190,103.00NT FRIENDSHIP & SUPPORT INC 290,111.00PEPPIMENARTI ASSOCIATION INC. 832,190.00ROPER GULF SHIRE COUNCIL 212,026.00ROYAL FLYING DOCTORS SERVICE 419,193.00SOMERVILLE COMMUNITY SERVICES INC. 7,275,715.00STEP OUT COMMUNITY ACCESS SERVICE INC. 978,334.00SUDDEN INFANT DEATH ASSOCIATION OF THENORTHERN TERRITORY 50,000.00SUNRISE HEALTH SERVICE ABORIGINALCORPORATION 3,781,503.00TANGENTYERE COUNCIL INCORPORATED 543,275.00TERRITORY CARE & SUPPORT SERVICES 1,798,920.91THE SALVATION ARMY (NT) PROPERTY TRUST 46,681.00TOP END ASSOCIATION FOR MENTAL HEALTH INC(TEAM HEALTH) 1,802,929.00TOP END MENTAL HEALTH CONSUMERORGANISATION INC 135,037.00TOTAL RECREATION 233,512.00UNITING CHURCH IN AUSTRALIA FRONTIERSERVICES 575,887.00VICTORIA DALY SHIRE COUNCIL 310,148.00WALTJA TJUTANGKU PALYAPAYI ABORIGINALCORPORATION 180,419.00WEST ARNHEM SHIRE COUNCIL 151,885.00WURLI WURLINGJANG ABORIGINAL CORPORATIONINC 925,914.00YOUTH AND FAMILY EDUCATION RESOURCES PTYLTD 223,000.00HEALTH SERVICES Total 69,252,023.91PERFORMANCE AND RESOURCESCENTRAL AUSTRALIAN REMOTE HEALTHDEVELOPMENT SERVICES LTD 276,579.00PERFORMANCE AND RESOURCES Total 276,579.00Grand Total 134,106,308.56Department of Health Annual Report 2010-11 215

AppendicesAppendix 4: Capital and Minor WorksSummary2010-11Program$0002011-12Program$0002010-11EquityTransferIn $000Revoted Works from 2009-10 149 674 99 178 8 298New Works in 2010-11 39 313 35 234 3 232New Works in 2011-12 0 37 063 1 148Land Acquisitions and Asset Transfers 0 0 458Total Program 188 987 171 475 13 1362010-11 Program– As published inthe 2010-11Budget Paper 4.2011-12 Program– As published inthe 2011-12Budget Paper 4.Equity Transfer In– transfer of theincreased assetvalue fromDepartment ofConstruction andInfrastructure forcompleted capitalprojects.Note: includesaccumulated worksfrom previous years.ProjectRevoted Works from 2009-10Alice Springs Hospital2010-11Program$0002011-12Program$0002010-11EquityTransferIn $000Status as at30 June201138 346 19 199 378 Construction in870 0 0 Transferred toFire Protection, Air-conditioningand Remediation 1 ProgressAlice Springs Hospital – Fit out for 360 400 0 Design Phaserelocated staff from AdministrationWardSecure Care Facility 2 2 500 2 000 0 Construction inProgressUpgrade and Expand ExistingRenal Facilities 3 ASHEmergencyDepartmentUpgrade Emergency Power, WaterReticulation and Electrical Systems4Barkly Region – Renal FacilitiesExpansionDarwin – Accommodation forRadiation Oncology Patients andCarersDarwin - Relocation to and AssociatedFit-out of Construction House,10 783 7 763 0 In variousstages of tenderand in progress2 269 418 0 Construction inProgress198 0 3 570 CompletedCasuarina Plaza and Darwin Plaza. 5 2 500 1 582 0 Darwin PlazaCompleted,CasuarinaPlazaCompleted;ConstructionHouse inTenderEvaluation216 Department of Health Annual Report 2010-11

AppendicesProject2010-11Program$0002011-12Program$0002010-11EquityTransferIn $000Status as at30 June2011Darwin – Residential Care Facility 1 000 0 0 Deleted fromProgramMilingimbi – Construct New Health4 500 0 0 Project deferredCentre 6 to 2012/13Minyerri – Upgrade Health Centre 160 0 526 CompletedRoyal Darwin HospitalHigh Voltage Electrical System,43 500 41 500 0 In variousUpgrade 7 and in progressChiller and Stand-By Powerstages of tenderSecure Care Facility and1 934 0 0 CompletedRelocation of Physiotherapy 8Upgrade and Refurbish Staff3 350 447 0 Construction inAccommodation on Campus 9 ProgressReplacement of Sterilisers 400 0 709 CompletedMinor New Works 2 216 0 1 305 Construction InProgressCommonwealth Funded ProjectsAlice Springs and Darwin - RenalDrop-In CentresAlice Springs Hospital – EnergyEfficiency Projects75 0 170 Completed250 0 0 Construction InProgressUpgrade the Emergency19 096 20 492 0 Construction InDepartment 10 ProgressAreyonga – Upgrade Health Centre 0 0 60 CompletedAcross the Territory – Mobile177 171 0 Construction InBooths 11Dental Clinic Rooms and HearingProgressAcross the Territory – Six 6 Self124 0 0 CompletedCare Haemodialysis Facilities 12Fly Creek – SupportedAccommodation FacilityKatherine – Construct NewSobering Up ShelterNhulunbuy – East Arnhem SpecialCare Staff AccommodationNhulunbuy – East ArnhemTransitional After Care FacilityNgukurr – Upgrade Health Centre13580 0 583 Completed1 387 0 0 Completed200 0 502 Completed200 0 494 Completed646 646 0 Design PhasePalmerston Super Clinic 3 350 0 0 CompletedRenal-Ready HaemodialysisRooms at Maningrida,Alpurrurulam and BarungaRoyal Darwin Hospital820 524 0 Alpurrurlam andBarungaCompletedManingridaConstruction InProgressRadiation Oncology Unit 2 638 1 022 0 CompletedDepartment of Health Annual Report 2010-11 217

AppendicesProject2010-11Program$0002011-12Program$0002010-11EquityTransferIn $000Status as at30 June2011Elective Surgery Upgrade 341 384 0 Design PhaseEmergency Department FastTrackTennant Creek – TransitionalAfter Care FacilityWadeye – Construct NewHealth Centre2 300 2 630 0 Design Phase296 0 0 Completed2 308 0 0 Completed149 674 99 178 8 298New Works 2010-11Alice Springs – Construction of twoeight-bed secure transitional carefacilities for children and adultsBorroloola – Upgrade existing HealthCentreDarwin – Construction of two eightbedsecure transitional care facilitiesfor children and adults5 900 5 730 0 Construction InProgress800 0 0 Project deferredto 2012/133 500 5 630 0 TenderEvaluationKatherine Region – Renal Facilities2 836 2 836 0 Negotiating landExpansion 14Commonwealth Funded ProjectsRoyal Darwin Hospital –Construction of a 50-unit patientaccommodation complex18 600 16 000 0 Construction InProgressMinor New Works 7 677 1 171 3 232 Construction InProgress39 313 31367 3 232New Works Added to the ProgramDuring 2010-11Gove District Hospital – Fire safety0 365 0 Design PhaseupgradeKatherine Hospital – Modifications to0 0 104 CompletedAccident and EmergencyOenpelli Health Centre – Upgrade0 450 0 Design Phasehealth centreRoyal Darwin HospitalFire safety upgrades and newmulti-purpose room0 905 0 Construction InProgressRefurbish Ward 3A 0 0 441 CompletedCommonwealth Funded ProjectsTennant Creek – Construct newSobering Up ShelterAlice Springs – Mobile DentalTruck Fit-outsKatherine Hospital – Modificationsto Accident and Emergency0 1 597 0 Construction InProgress0 550 0 TenderEvaluationPhase0 0 300 Completed218 Department of Health Annual Report 2010-11

AppendicesOther Agency Funded ProjectsGove District Hospital – Upgradetoilets in stores building for cycloneshelter use0 0 303 Completed0 3 867 1 148Total New Works for 2010-1139 31335 2341 148New Works 2011-12Alice Springs Hospital – Remediationand upgrade of operating theatres andcentral sterilising services department10 16 000 0Tennant Creek Hospital – Fire safetyupgrade stage 40 3 300 0 Final stage ofprojectTop End – Construct new renal facility 0 3 041 0 Location to beconfirmedCommonwealth Funded ProjectsRoyal Darwin HospitalEmergency Departmentupgrade0 4 600 0 To increase theShort Stay Unitbeds by 9Operating theatre upgrade 0 4 900 0 To increaseelective surgerythroughputMinor New Works 0 5 222 0Total New Works for 2011-12 0 37 06301Alice Springs Hospital – Fire Protection, Air-conditioning and Remediation - This is an ongoingproject to address the non-compliance of previous works carried out in 2001-02 by John Holland Group.Work is being staged to accommodate decanting of individual areas. $16m transferred from the original2010-11 program to the 2011-12 program.2 Alice Springs Hospital – Secure Care Facility - To provide an additional six beds through extension ofthe existing mental health facility.3Alice Springs Hospital – Upgrade and Expand Existing Renal Facilities - This funding has beentransferred to the Alice Springs Hospital Emergency Department project.4 Alice Springs Hospital – Upgrade the Emergency Department - This project was delayed pending anapplication to the Australian Government Health and Hospitals Fund for an additional $13.6 million whichwas subsequently approved. Contract for construction was awarded June 2011.5 Darwin - Relocation to and Associated Fit-out of Construction House, Casuarina Plaza and DarwinPlaza - The tender for Construction House closed 8 June 2011 and is being evaluated by the Department ofConstruction and Infrastructure.6Milingimbi – Construct New Health Centre - This project has been delayed pending confirmation ofsuitable land from the Traditional Owners and agreement on the lease.7Royal Darwin Hospital – High Voltage Electrical System, Chiller and Stand-By Power Upgrade Toimprove electrical system safety, reliability and capacity; replace equipment approaching the end of itseconomic life; improve capacity for delivery of medical services during mains power outages; and reduceRDH’s greenhouse gas emissions by 8%. The tender is scheduled to be advertised on 7 July 2011.8Royal Darwin Hospital – Secure Care Facility and Relocation of Physiotherapy - To provide anadditional five beds through extension of the existing mental health facility.9Royal Darwin Hospital – Upgrade and Refurbish Staff Accommodation on Campus - 88 unitscompleted to date with a further 12 to be completed by September 2011.10 Alice Springs Hospital – Upgrade Emergency Power, Water Reticulation and Electrical Systems -This is a staged project.Department of Health Annual Report 2010-11 219

Appendices11 Across the Territory – Mobile Dental Clinic Rooms and Hearing Booths - Units have been located inthe 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 Borroloola, Lake Nashand Wadeye.12 Across the Territory – Six Self Care Haemodialysis Facilities - Construction completed with unitslocated at Ali Curung, Amoonguna, Ti Tree, Milingimbi, Ngukurr, and Hermannsburg.13 Ngukurr – Upgrade Health Centre - Funding for a new Health Centre has been approved through theAustralian Government’s Health and Hospital Funding process. The extent of work to be completed at theexisting Health Centre is currently being assessed.14 Katherine Region – Renal Facilities Expansion - Negotiations on securing land are in progress.Construction of this project may be outsourced to the service provider.220 Department of Health Annual Report 2010-11

AppendicesAppendix 5: Legislative ResponsibilitiesUnder the current Administrative Arrangements Order our Ministers are responsible foradministering a range of Acts and subordinate legislation. This includes responsibility foradministering 38 pieces of legislation, 23 Acts and 15 Regulations.Acts Administered by Independent Agencies• Menzies School of Health Research ActResponsibility administered by Department of Health onbehalf of the Minister for Health• Adult Guardianship Act• Cancer (Registration) Act• Carers Recognition Act• Disability Services Act• Emergency Medical Operations Act• Food Act• Health Practitioner Regulation (National Uniform Legislation) Act• Health Practitioners Act• Hospital Boards Act• Medical Services Act• Mental Health and Related Services Act (except Part 15)• Natural Death Act• Notifiable Diseases Act• Poisons and Dangerous Drugs Act• Private Hospitals and Nursing Homes Act• Public and Environmental Health Act• Radiation Protection Act• Therapeutic Goods and Cosmetics Act• Tobacco Control Act (except provisions about licensing and enforcement)• Transplantation and Anatomy Act• Volatile Substance Abuse Prevention Act• Water Supply and Sewerage Services Act (provisions about water quality standards)Department of Health Annual Report 2010-11 221

AppendicesRegulations Administered by Department of Health• Cancer (Registration) Regulations• Mental Health and Related Services Regulations• Natural Death Regulations• Poisons and Dangerous Drugs Regulations• Public Health (Barbers' Shops) Regulations• Public Health (Cervical Cytology Register) Regulations• Public Health (General Sanitation, Mosquito Prevention, Rat Exclusion andPrevention) 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 Regulations222 Department of Health Annual Report 2010-11

AppendicesAppendix 6: AcronymsAAS - Australian Accounting StandardsACAPAboriginal Cultural Awareness ProgramACCHOAboriginal Community Controlled HealthOrganisationACCHSAboriginal Community Controlled HealthServicesACHSAustralian Council on Healthcare StandardsACIRAustralian Childhood Immunisation RegisterACSQHCAustralian Commission on Safety andQuality in Health CareADSCAAlcohol and Other Drugs Services CentralAustraliaAFPAustralian Federal PoliceAHKPIAboriginal Health Key PerformanceIndicatorsAHMACAustralian Health Ministers Advisory CouncilAHWAboriginal Health WorkerAIDSAcquired Immune Deficiency SyndromeAMSANTAboriginal Medical Services Alliance of theNorthern TerritoryANFAustralian Nursing FederationAODAlcohol and Other DrugsAODPAlcohol and Other Drugs ProgramAOTAAccountable Officers Trust AccountASPRENAustralian Sentinel Practices ResearchNetworkASHAlice Springs HospitalATOAustralian Taxation OfficeAVOAustralian Valuation OfficeBP3Budget Paper 3CAAAPUCentral Australia Aboriginal AlcoholPrograms UnitCAAPSCouncil for Aboriginal Alcohol ProgramServicesC&FHChild and Family HealthCACentral AustraliaCAMHSCentral Australian Mental Health ServicesCAAPSCouncil of Aboriginal Alcohol ProgramsServicesCCISCommunity Care Information SystemCCPMSChronic Conditions Prevention andManagement StrategyCCSUChronic Conditions Strategy UnitCDCCentre for Disease ControlCDEPCommunity Development EmploymentProgramCDNACommunicable Diseases Network ofAustraliaCDUCharles Darwin UniversityCEChief ExecutiveCFOChief Finance OfficerCHAINCommunity Helping, Action and InformationNetworkCHOChief Health OfficerDepartment of Health Annual Report 2010-11 223

AppendicesCIACompetition Impact AssessmentCLACThe Schedule 8 and Restricted Schedule 4Clinical Advisory ServiceCMALCChief Ministers Council of AustralianGovernmentsCOAGCouncil of Australian GovernmentsCPCCommunity and Primary Care ServicesCPIConsumer Price IndexCPSUCommunity and Public Sector UnionCRCCooperative Research CentreCQIContinuous Quality ImprovementCREDITCourt Referral Evaluation for DrugIntervention and Treatment NTCRGClinical Reference GroupCSSCommonwealth Superannuation SchemeCSTDACommonwealth, State and TerritoryDisability AgreementCTComputed TomographyDASADrug and Alcohol Services AssociationDBEDepartment of Business and EmploymentDCCDarwin Correctional CentreDETDepartment of Education and TrainingDIMADepartment of Immigration and MulticulturalAffairsDMODistrict Medical OfficerDMSDrug Monitoring SystemDoHDepartment of HealthDoHADepartment of Health and AgeingDOJDepartment of JusticeDPHDarwin Private HospitalDPIDepartment of Planning and InfrastructuredTpaDiphtheria, Tetanus, PertussisDUCCDepartment and Union ConsultativeCommitteeEAEast ArnhemEACHExtended Aged Care at HomeEASEmployee Assistance ServicesEBAEnterprise Bargaining AgreementECGElectrocardiographyEDEmergency DepartmentEEOEqual Employment OpportunityEHEnvironmental HealthEHWEnvironmental Health WorkerENEnrolled NurseENTEar, Nose and ThroatEHSDIExpanding Health Service Delivery InitiativeESWLElective Surgery Wait ListFaCSIADepartment of Family, Community Servicesand Indigenous AffairsFISSFamily and Individual Support ServicesFOIFreedom of InformationFSANZFood Standards of Australia and NewZealand224 Department of Health Annual Report 2010-11

AppendicesFTEFull Time EquivalentGAAGrowth Assessment and ActionGDHGove District HospitalGEEPGovernment Energy Efficiency ProgramGENDCGeneric Disease ControlGHANTGood Health Alliance NTGPGeneral Practice / PractitionerGPNTGeneral Practice Network Northern TerritoryGRMGGlobal Resource Management GroupGSTGoods and Services TaxHACCHome and Community CareHBSHome Birth ServicesHCSCCHealth and Community Services ComplaintsCommissionHIVHuman Immunodeficiency VirusHon.HonorableHPVHuman Papilloma VirusHPSUHealth Promotion Strategy UnitHRHuman ResourcesHSAKHealthy School Aged KidsHSDAHealth Service Delivery AreaHSRHealth and Safety RepresentativesHTLV1Human T-cell Lymphotropic Virus Type 1ICD-10-AMInternational Statistical Classification ofDiseases and Related Health Problems,Tenth Revision, Australian ModificationICTInformation and Communication TechnologyIDUIntravenous Drug UserIFFIllegal Foreign FishersIFRSInternational Financial Reporting StandardsIMMDCImmunisation Disease ControlIPUInformation and Privacy UnitIRIndustrial RelationsITInformation TechnologyKDHKatherine HospitalLHNLocal Hospital NetworkLKLNLiving Knowledge Learning NetworkMACAMotor Accident Compensation ActMCYHMaternal, Child and Youth HealthMEBMedical Entomology BranchMDCMajor Diagnosis CategoryMGPMidwifery Group PracticeMHSMental Health ServicesMJDMachado Joseph DiseaseMLAMember of the Legislative AssemblyMoHMinistry of HealthMOSMobile Outreach ServiceMoUMemorandum of UnderstandingMRIMagnetic Resonance ImagingMSHRMenzies School of Health ResearchDepartment of Health Annual Report 2010-11 225

AppendicesNDANational Disability AgreementNCCTRCNational Critical Care and TraumaResponse CentreNEHTANational eHealth AuthorityNGONon-government organisationNHCCNNational Health Call Centre NetworkNHMRCNational Health and Medical ResearchCouncilNHPPDNursing Hours per Patient DayNSWNew South WalesNTNorthern TerritoryNTFCNorthern Territory Families and ChildrenNTGNorthern Territory GovernmentNTAGONorthern Territory Auditor General OfficeNTGPASSNorthern Territory Government and PublicAuthorities Superannuation SchemeNTMPNorthern Territory Medical ProgramNTPCCSNorthern Territory Pensioner and CarerConcession SchemeNTPSNorthern Territory Public SectorNTRONorthern Territory Radiation OncologyOATSIHOffice of Aboriginal and Torres StraitIslander HealthOCPEOffice of the Commissioner for PublicEmploymentOHSOccupational Health and SafetyOOHCOut Of Home CareOSHCOutside of School Hours CareP2PProvider to Provider Secure ClinicalMessaging ServicePACSPicture Archiving and CommunicationSystemPaDDAPoisons and Dangerous Drugs ActPASSPolicy and System SupportPATSPatient Assisted Travel SchemePCISPrimary Care Information SystemPESProfessional Excellence StatusPHCPrimary Health CarePHCAPPrimary Health Care Access ProgramPIPSPersonnel Information and Payroll SystemPPSProfessional Practice and SupervisionPROMPTProtocol Management and Production ToolPSQCPrincipal Safety and Quality CommitteeQIPPSQuality Improvement Program PlanningSystemRANRemote Area NurseR&MRepairs and MaintenanceRDHRoyal Darwin HospitalRFDSRoyal Flying Doctor ServiceRHDRheumatic Heart DiseaseRRVRoss River VirusS8Schedule 8SASouth Australia226 Department of Health Annual Report 2010-11

AppendicesSAAPSupported Accommodation AssistanceProgramSAFE NTScreening Assessment for EmploymentNorthern TerritorySARCSexual Assault Referral CentreSEATSeating Equipment and Technical ServiceSEHRShared Electronic Health RecordSEMSSecure Electronic Messaging SystemSHSSchool Health ServicesSHBBVUSexual Health and Blood Borne Virus UnitSONTSpecialist Outreach NTSTARSSatellite To All Remote SitesSTDCHSexually Transmitted Disease CommunityHealthSTISexually Transmitted InfectionSUSSobering-up ShelterTADSTobacco Alcohol and Drugs ServiceTAFSTreasurer’s Annual Financial StatementTBTuberculosisTBCTo Be ConfirmedTBCHTuberculosis Community HealthTCHTennant Creek HospitalTETop EndTEDGPTop End Division of General PracticeTIMETerritory Independence and MobilityEquipment SchemeUCAHSUrgent Care After Hours ServiceUMATUndergraduate Medicine and HealthSciences Admission TestVSAVolatile Substance AbuseVSAPAVolatile Substance Abuse Prevention ActWAWestern AustraliaWHOWorld Health OrganisationWHSUWomen’s Health Strategy UnitWPPWork Partnership PlanDepartment of Health Annual Report 2010-11 227

Department of HealthPO Box 40596Casuarina NT 0811Telephone: (08) 8999 2400Facsimile: (08) 8999 2700www.nt.gov.au/health