ACT HEALTH
Objectives
ACT Health aims to achieve good health for all residents of the Territory by planning, providing and purchasing quality community based health services, hospital and extended care services, managing public health risks, and promoting health and early care interventions.
In providing services, ACT Health’s objectives are to:
•	improve population health outcomes;
•	provide better access to appropriate services;
•	promote the independence of consumers and their carers;
•	provide comprehensive information to consumers and actively involve them in decision making;
•	improve patient safety and quality of care;
•	keep staff safe and healthy;
•	manage environmental risks to ensure the safety of all people on ACT Health premises; and
•	improve care options and the continuity of care across the care spectrum.
2008-09 Priorities
Strategic and operational initiatives to be pursued in 2008‑09 include:
•	progressing the implementation of “Access Health”;
•	continuing to work on the efficiencies and reforms that will bring ACT hospital costs closer to the national average;
•	meeting the continued growth in demand for acute care, aged care, cancer treatment, mental health and community health services through extra capacity and by redesigning care delivery systems through the Access Improvement Program;
•	commencing a comprehensive capital asset development plan to build a sustainable and modern health system to ensure safety, availability and viability of quality health care in the ACT in the future;
•	strengthening the workforce against current and anticipated nursing and midwifery, allied health and medical workforce shortages;
•	expanding services for the rapidly growing number of ACT residents living with chronic illness;
•	expanding the cardiac catheter laboratory at The Canberra Hospital to meet future demands for Interventional Cardiology in the ACT;
•	maintaining accreditation with appropriate bodies; and
•	working with the Commonwealth Government on improving the health and wellbeing within the Aboriginal and Torres Strait Islander community.
Business and Corporate Strategies
In order to achieve its objectives, efficiency measures and manage business and financial risks, ACT Health, together with its partners, will maximise and allocate the community’s resources to:
•	achieve a comprehensive health system that protects and improves the health of people;
•	plan for the future expansion of health infrastructure across the Territory; 
•	develop new models of care and service delivery for the Territory; and
•	achieve a system of care and support that improves the quality of life for vulnerable groups.
Estimated Employment Level
2007‑08 Budget			2007‑08
Est. Outcome	2008‑09
Budget	
4,171		Staffing (FTE) 	4,337	4,418	

Strategic Indicators
Strategic Indicator 1
Emergency Department access block
Acute Care Services
Proportion of persons who are admitted via the emergency department, who wait more than eight hours from commencement of treatment for admission to a ward.  This provides an indication of the effectiveness of public hospitals in meeting the need for acute care and emergency department care. 

Strategic Indicator 2
Maximising the quality of hospital services
The following four indicators are a selection of the patient safety and service quality indicators that are used to monitor ACT public hospital services.  The targets provide an indication of the desired maximum mean outcome over time.  Given the nature of the indicators, small fluctuations during a particular period can skew results.  The success of ACT Health in meeting these indicators requires a consideration of performance over time rather than for any given period.
1.	Rate of unplanned return to the operating theatre
The proportion of people who undergo a surgical operation who require an unplanned return to the operating theatre within a single episode of care due to complications of their condition.  This provides an indication of the quality of theatre and post-operative care.
	2007‑08
Targets	2007‑08
Est. Outcome	2008‑09
Target	
The Canberra Hospital	<0.7%	0.8%	<0.7%	
Calvary Public Hospital	<0.46%	0.35%	<0.50%	

Strategic Indicators cont.
2.	Rate of unplanned hospital readmission
The proportion of people separated from hospital who are re‑admitted to hospital within 28 days of their separation due to complications of their condition (where the re‑admission was unforseen at the time of separation).  This provides an indication of the effectiveness of hospital-based and community services in the ACT in the treatment of persons who receive hospital-based care.
	2007‑08
Targets	2007‑08
Est. Outcome	2008‑09
Target	
The Canberra Hospital	2.0%	1.1%	2.0%	
Calvary Public Hospital	1.0%	0.7%	1.0%	

3.	Rate of post-operative pulmonary embolism
The proportion of people admitted to hospital for longer than seven days who underwent a surgical procedure during that stay and subsequently experienced a post-operative pulmonary embolism.  This provides an indication of the quality of care and the effectiveness of the hospital system in meeting the needs of patients, as pulmonary embolism are to some extent avoidable through the use of appropriate prophylaxis.
	2007‑08
Targets	2007‑08
Est. Outcome	2008‑09
Target	
The Canberra Hospital	<1.0%	1.0%	<1.0%	
Calvary Public Hospital	<1.0%	2.0%	<1.0%	

4.	Hospital acquired infection rate (bacteraemia)
The proportion of people admitted to hospitals that acquire a bacteraemial infection during their stay.  This provides an indication of the safety of hospital-based services.  
	2007‑08
Targets	2007‑08
Est. Outcome	2008‑09
Target	
The Canberra Hospital	0.5%	0.10%	<1 per 1,000	
Calvary Public Hospital	0.09%	0.15%	<1 per 1,000	

Strategic Indicators cont.
Strategic Indicator 3
Reaching the optimum occupancy rate for acute adult overnight hospital beds
Bed occupancy
The mean percentage of adult overnight acute medical and surgical beds in use.  This provides an indication of the efficient use of resources available for hospital services.

Strategic Indicator 4
Reducing the usage of seclusion
Seclusion rate
The proportion of clients of Mental Health ACT who are subject to seclusion during an inpatient episode.  This measures the effectiveness of Mental Health ACT over time in providing services that minimise the need for seclusion.

Strategic Indicators cont.
Strategic Indicator 5
Maintaining consumer and carer participation
Consumers and carer representation on relevant mental health committees
The proportion of Mental Health ACT committees in which consumers and carers are represented. This measure ensures that the Committees which monitor the delivery and planning of our mental health services have effective input from mental health consumers.

Strategic Indicator 6
Access to acute care (mental health clients)
Mental health acute care
The proportion of mental health clients admitted to hospital from the emergency department who wait more than 8 hours from the time of commencement of treatment to the time of transfer to a ward.  The long-term aim is to maintain a maximum level of 10 per cent.

Strategic Indicators cont.
Strategic Indicator 7
No waiting for access to emergency dental health services
Oral health
Percentage of assessed emergency clients seen within 24 hours.  This provides an indication of the responsiveness of the dental service to emergency clients. 

Strategic Indicator 8
Achieve lower than the Australian average in the decayed, missing or filled teeth (DMFT) index
Age	ACT	Australia	
DMFT index at 5/6 years	2.30	1.89	
DMFT Index at 12 years	1.27	1.08	
Source: Water fluoridation and children’s dental health.  The Child Dental Health Survey 2002 (AIHW, Australian Research Centre for Population Oral Health 2006)	
The mean number of teeth with dental decay, missing or filled teeth at ages 6 and 12.  This gives an indication of the effectiveness of prevention, early intervention and treatment services in the ACT.  The aim for the ACT is to better the Australian average.

Strategic Indicator 9
Maintenance of the highest life expectancy at birth in Australia
Life expectancy at birth	ACT	Australia	Next Best State	
Females	83.9	83.0	(NSW, Vic, WA) 83.3	
Males	79.7	78.1	(WA) 78.6	
Source: Australia’s Health 2006 (Life expectancy 2002-04)			
Life expectancy at birth provides an indication of the general health of the population and reflects on a range of issues other than the provision of health services, such as economic and environmental factors.  The ACT has the highest life expectancy of any jurisdiction in Australia and the Government aims to maintain this result.

Strategic Indicators cont.
Strategic Indicator 10
Prevalence of circulatory disease
Circulatory disease
The proportion of the ACT population diagnosed with some form of circulatory disease.  

Source: National Health Survey 2004-05

Strategic Indicator 11
Prevalence of diabetes
Diabetes
The proportion of the ACT population diagnosed with some form of diabetes.  This provides an indication of the success of prevention and early intervention initiatives.  Prevalence rates may increase in the short term as a result of early intervention and detection campaigns.  This would be a positive result as experts predict that only half of those with diabetes are aware of their condition.  This can have significant impacts on their long-term health.

Source: National Health Survey 2004-05

Strategic Indicators cont.
Strategic Indicator 12
Reduction in the rate of broken hips (fractured neck of femur)
Reducing the risk of fractured femurs in ACT residents aged over 75 years
The reduction or maintenance of the rate of fractured femurs for ACT residents aged over 75 years.  This provides an indication of the success of public and community health initiatives to prevent hip fractures.  At present, the rate for ACT residents is 5.4 fractures per 1,000 ACT residents aged over 75 years.  The ageing of the population will significantly increase the number of people in this age group.  

Strategic Indicator 13
Access to radiotherapy services
Radiotherapy access times
Percentage of urgent radiotherapy patients who commence treatment within 48 hours.

Strategic Indicators cont.
Radiotherapy access times cont.
Percentage of all radiotherapy patients who commence treatment within standard timeframes.

Strategic Indicator 14
Reducing the average length of stay for acute rehabilitation care
Acute rehabilitation average length of stay 
This indicator measures the in-hospital length of stay of patients under the responsibility of the Aged Care and Rehabilitation Service, provides an indication of the capacity and effectiveness of sub-acute and community based services.  

Strategic Indicators cont.
Strategic Indicator 15
Improving hospital access times for older persons
Improving hospital access times for persons aged over 75 years
Percentage of admissions via Emergency Department (ED) by persons 75 years or more who wait more than 8 hours from commencement of treatment in ED to admission to ward.

Strategic Indicator 16
Maintain the waiting times for in-hospital assessments by the Aged Care Assessment Team
Aged Care Assessment Team
This is measured by the mean waiting time in working days between the request for, and provision of, assessment by the Aged Care Assessment Team (ACAT) for patients in public hospitals.  This provides an indication of the responsiveness of the ACAT team in assessing the needs of clients.

Strategic Indicators cont.
Strategic Indicator 17
Increasing the rate of discharge planning
Discharge planning
Proportion of aged care clients under the management of the Aged Care and Rehabilitation Service discharged with a comprehensive discharge plan.  This provides an indication of the effectiveness of services in planning and organising for the needs of clients following their hospital episode and the level of integration of hospital and community based care.

Strategic Indicator 18
Reduction in the youth smoking rate
Percentage of persons aged 12-17 years who smoke regularly
The ACT rate has dropped significantly since 1996 from 20 per cent to 15 per cent in 2001.  The rate then dropped to 9 per cent in 2004.  The Government aims to maintain this reduction in youth smoking with the objective of reaching 5 per cent in the long term.

Australian Secondary Students Alcohol and Drug 2004

Strategic Indicators cont.
Strategic Indicator 19
Universal newborn hearing screening
Newborn hearing screening
The Newborn Hearing Screening Program covers all babies born in ACT public and private hospitals who meet the criteria for screening.  This ensures that any anomaly in hearing test results can be attended to within weeks of birth, thus making treatment more effective in the short and long term. 

Strategic Indicator 20
Number of additions to the cervical screening register  
Cervical screening register
This level of reporting of cervical screens provides an indication of the effectiveness of early intervention health messages.
	2007‑08
Targets	2007‑08
Est. Outcome	2008‑09
Target	
Additions to the Cervical Cytology Register	34,000	34,000	34,000	

Strategic Indicators cont.
Strategic Indicator 21
Emergency department timeliness
Waiting times for treatment by triage category
The proportion of Emergency Department presentations that are treated within clinically appropriate timeframes.
Triage Category	2007‑08
Est. Outcome	2008‑09
Target	Long term
Target	
One (resuscitation seen immediately)	100%	100%	100%	
Two (emergency seen within 10 mins)	80%	80%	80%	
Three (urgent seen within 30 mins)	50%	75%	75%	
Four (semi-urgent seen within 60 mins)	55%	70%	70%	
Five (non-urgent seen within 120 mins)	78%	70%	70%	
 
Strategic Indicator 22
Breast screen participation rate for women aged 50-69 years
Breast Screening
Increase to 70 per cent over time, the proportion of women in the target age group (50 to 69 years) who have a breast screen in the 24 months prior to each counting period.  The latest available national breast screen average participation rate is 57 per cent (2001).

Strategic Indicators cont.
Strategic Indicator 23
The proportion of patients with a length of stay greater than 30 days who have a comprehensive discharge plan
Discharge Plans
Discharge planning is the quality link between hospital, community-based services, non‑government organisations and carers.  Doctors, nurses and allied health professionals continually assess patients during their stay to determine their post-hospital needs.  80 per cent of patients discharged from hospital is relatively straightforward.  It is the 20 per cent of patients who have more complex needs, who require a more robust discharge plan.  This indicator reports on the provision of complex discharge planning to target those patients whose length of stay is greater 30 days. 

.
Output Classes
	Total Cost1	Government Payment for Outputs	
	2007‑08
Est. Outcome
$’000	2008‑09
Budget
$’000	2007‑08
Est. Outcome
$’000	2008‑09
Budget
$’000	
Output Class 1: Health and Community Care	835,400	888,841	641,595	693,502	
Output 1.1: Acute Services	549,558	575,273	374,916	403,871	
Note: 
1.	Total cost includes depreciation of $18.503 million in 2007‑08 and $21.612 million in 2008‑09. 
Output Description
The Government provides public hospital services at The Canberra Hospital and Calvary Public Hospital.  These public hospitals provide a comprehensive range of acute care, including inpatient, outpatient and emergency department services.  The key strategic priority for acute services is to deliver timely access to effective and safe hospital care services.  This means focussing on:
•	reducing waiting times for admission to a hospital bed through emergency departments, with a specific emphasis on older patients who might otherwise experience long waits due to the complexity of their conditions;
•	achieving national benchmark performance standards for waiting times for access to elective surgery for category one patients; and
•	achieving bed occupancy rates of approximately 85 per cent over time.  Occupancy levels of around 85 per cent contribute positively to patient safety, reduce access block, ensure efficient workflows and minimise disruptions to elective surgery.
			
	Total Cost	Government Payment for Outputs	
	2007‑08
Est. Outcome
$’000	2008‑09
Budget
$’000	2007‑08
Est. Outcome
$’000	2008‑09
Budget
$’000	
Output 1.2: Mental Health Services	55,193	64,460	53,942	62,021	
Output Description
Mental Health ACT provides a range of services in hospitals, community health centres and peoples’ homes across the Territory.  Mental Health ACT works with its community partners to provide integrated and responsive mental health services including hospital‑based specialist services, supported accommodation services and community based service responses.

Output Classes cont.
The key strategic priorities for mental health services are ensuring that clients’ needs are met in a timely fashion and that care is integrated across hospital, community and residential support services.  This means focussing on:
•	ensuring timely access to emergency mental health care by reducing waiting times for urgent admissions to acute psychiatric units; and
•	ensuring that Mental Health ACT provides consumers with appropriate assessment, treatment and care that results in improved mental health outcomes.
			
	Total Cost	Government Payment for Outputs	
	2007‑08
Est. Outcome
$’000	2008‑09
Budget
$’000	2007‑08
Est. Outcome
$’000	2008‑09
Budget
$’000	
Output 1.3: Community Health Services 	102,522	104,790	96,650	97,940	
Output Description
Community Health provides a range of community based health services in a number of settings across the ACT, including health promotion and clinical programs such as maternal and child health services, immunisation, youth health services, women’s health services, alcohol and drug services, dental services, corrections health and Aboriginal liaison and interpreter services.  There is a wide range of allied health and nursing services that meet the needs of many people with chronic conditions as well as providing responses to acute presentations, including inpatient services and pre and post hospital care.
The key strategic priorities for community health include early intervention, improved access to community health care and better integration between acute, primary and community based care.  This includes:
•	ensuring timely access to public dental health care in cases of emergency need; 
•	providing health care assessments for people detained in corrective facilities; 
•	working with the acute care sector to ensure effective provision of allied health care to people in hospitals in order to maximise health outcomes;
•	improving accessibility to, and the appropriateness of, services for women of culturally and linguistically diverse backgrounds;
•	providing timely access to counselling services within the ACT Women’s Health Service;
•	ensuring that access, consistent with clinical need, is timely for community-based nursing and allied health services; and
•	ensuring that community-based services are in place to better provide for the acute and post-acute health care needs of the community.

Output Classes cont.
	Total Cost	Government Payment for Outputs	
	2007‑08
Est. Outcome
$’000	2008‑09
Budget
$’000	2007‑08
Est. Outcome
$’000	2008‑09
Budget
$’000	
Output 1.4: Public Health Services	24,587	26,596	23,442	25,073	
Output Description
Public Health Services provides high quality health and community services to the ACT and surrounding region.  The key strategic priorities for Public Health Services include the monitoring of prevention, early intervention and integrated care services to ensure that the ACT maintains its position as the healthiest jurisdiction in Australia.  This includes:
•	maintaining the ACT’s position as the jurisdiction with the greatest life expectancy in Australia; 
•	reducing the incidence of cardiovascular disease in the community; and
•	ensuring that the rate of hip fractures declines over the long term.
			
	Total Cost	Government Payment for Outputs	
	2007‑08
Est. Outcome
$’000	2008‑09
Budget
$’000	2007‑08
Est. Outcome
$’000	2008‑09
Budget
$’000	
Output 1.5: Cancer Services	23,900	32,010	18,870	26,678	
Output Description
Capital Region Cancer Services provides a comprehensive range of screening, assessment, diagnostic, treatment and palliative care services. Services are provided in inpatient, outpatient and community settings.
The key strategic priorities for cancer care services are early detection and timely access to diagnostic and treatment services.  This includes:
•	ensuring that population screening rates for breast and cervical cancer meet targets; and
•	waiting time for access to essential services such as radiotherapy are consistent with agreed benchmarks.

Output Classes cont.
	Total Cost	Government Payment for Outputs	
	2007‑08
Est. Outcome
$’000	2008‑09
Budget
$’000	2007‑08
Est. Outcome
$’000	2008‑09
Budget
$’000	
Output 1.6: Aged Care and Rehabilitation Services	36,230	45,699	32,056	40,789	
Output Description
The provision of an integrated, effective and timely response to aged care and rehabilitation services in inpatient, outpatient, emergency department, sub‑acute and community based settings.
The key strategic priorities for Aged Care and Rehabilitation Services are:
•	reducing waiting times for admission to a hospital bed through emergency departments;
•	ensuring that older persons in hospital wait the least possible time for access to comprehensive assessment by the Aged Care Assessment Team.  This will assist in their safe return home with appropriate support, or access to appropriately supported residential accommodation; and
•	improving discharge planning to minimise the likelihood of readmission or inadequate support for independent living, following completion of hospital care.
			
	Total Cost	Government Payment for Outputs	
	2007‑08
Est. Outcome
$’000	2008‑09
Budget
$’000	2007‑08
Est. Outcome
$’000	2008‑09
Budget
$’000	
Output 1.7: Early Intervention and Prevention	43,410	40,013	41,719	37,129	
Output Description
Increasing the focus on initiatives that provide early intervention to, or prevent, health care conditions that result in major acute or chronic health care burdens on the community.
The key strategic priorities for intervention and prevention are:
•	reducing the level of youth smoking in the ACT;
•	maintaining immunisation rates for children above 90 per cent;
•	providing hearing screening for all newborns in the ACT that meet the screening criteria; and
•	increasing the proportion of females screened through the BreastScreen Australia program for the target population (aged 50-69 years) to 70 per cent over time.

Accountability Indicators

	2007‑08
Targets	2007‑08
Est. Outcome	2008‑09
Target	
Output Class 1: Health and Community Care	
Output 1.1: Acute Services	
				
Patient activity				
a.	Cost weighted patient separations1, 2	73,400	76,000 	78,300	
b.	Non-admitted occasions of service	241,000	260,000	270,000	
c.	Percentage of category one elective surgery patients who receive surgery within 30 days of listing	95%	95%	95%	
This provides an indication of the responsiveness of the hospital system to those in urgent need of elective surgery.	
Notes:
1.	Cost weights presented using AR-DRG Version 5.0 mapped to National Public Weights Round 9.
2.	The 2007-08 target includes mental health cost weighted separations.   

	2007‑08
Targets	2007‑08
Est. Outcome	2008‑09
Target	
Output 1.2: Mental Health Services	
				
Patient activity				
a.	Cost weighted separations1, 2	n/a	n/a	2,250	
b.	Admitted patient separations 	1,100	1,126	1,100	
c.	Adult services 	170,000	150,000	170,000	
d.	Children and youth services	34,680	43,500	43,500	
e.	Older persons’ services	12,640	16,500	16,500	
f.	Psychogeriatric services bed days 	4,424	2,500	4,400	
g.	Psychogeriatric inpatient episodes of care2, 3	n/a	n/a	110	
This provides an indication of the number of services provided by Mental Health ACT.	
h.	Supported accommodation bed occupancy rate	95%	95%	95%	
The proportion of occupied supported accommodation bed days compared to the total available bed days.  This provides an indication of the efficient use of resources available for supported accommodation services.	
i.	The proportion of clients seen at an ACT Health community facility during the 7 days post discharge from the inpatient services	75%	76%	75%	
This provides an indication of the effectiveness of Mental Health ACT in providing an integrated response to the needs of its clients.	
j.	Percentage of clients with outcome measures completed	65%	60%	65%	
This provides a data platform for analysis of the appropriateness and effectiveness of mental health services in ensuring that client needs are met.	
Notes:
1.	Mental health cost weighted separations were not previously reported separately in this output (refer note in Output 1.1).  The estimated 2007‑08 number of mental health cost weighted separations is 2420.
2.	These are new measures in 2008-09.
3.	The estimated psychogeriatric episodes of cases for 2007‑08 is 110.

Accountability Indicators cont.
	2007‑08
Targets	2007‑08
Est. Outcome	2008‑09
Target	
Output 1.3: Community Health Services	
a.	Number of opioid treatment clients with management plans1	570	600	n/a	
b.	Percentage of opioid treatment clients with management plans 2	n/a	n/a	90%	
This provides an indication of the comprehensiveness of the service responses for people on opioid treatments. 	
c.	Mean waiting time for clients on the dental services waiting list	
12 months	
14.5 months	
12 months	
The responsiveness of Community Health to clients of the dental program provides an indication of the capacity of the adult dental program to meet the needs of the community.	
d.	Proportion of offenders and detainees in Quamby and the Belconnen Remand Centre with health care assessment plans within 24 hours of detention	100%	98%	100%	
This provides an indication of the effectiveness of Community Health in providing for the health needs of detainees and offenders.	
e.	Number of allied health care services provided for acute care patients in ACT public hospitals	95,600	90,000	95,600	
This provides an indication of the level of allied health services provided to hospital-based patients by Community Health.	
f.	Number of nursing (domiciliary and clinic based) occasions of service	70,800	70,800	72,200	
g.	Number of allied health regional services (occasions of service)	20,000	18,000	20,000	
h.	Percentage of the Women’s Health Service Intake Officer’s clients who receive an intake and assessment service within 14 working days of their initial referral	100%	100%	100%	
i.	Proportions of clients discharged from ACT Public Hospitals to a community health Program who have a completed discharge plan3	30%	30%	n/a	
				
Notes:
1.	This indicator is ceasing in 2008‑09
2.	This is a new indicator included in 2008‑09.  The target has been converted from a number to a percentage to provide a target that better measures performance.
3.	This measure is replaced by Strategic Indicator number 23.

Accountability Indicators cont.
	2007‑08
Targets	2007‑08
Est. Outcome	2008‑09
Target	
Output 1.4: Public Health Services	
a.	Samples analysed	7,000	7,000	7,000	
The number of specimens provided to the Health Protection Service Analytical Laboratory for analysis in connection with legislation enforcement, other services to ACT Government agencies and private activity.	
b.	Inspection compliance of licensable, registrable and non-licensable activities	80%	80%	85%	
c.	Response time to environmental health hazards, communicable disease hazards relating to measles and meningococcal infections and food poisoning outbreaks is less than 24 hours	100%	100%	100%	

	2007‑08
Targets	2007‑08
Est. Outcome	2008‑09
Target	
Output 1.5: Cancer Services	
				
Patient activity				
a.	Cost weighted admitted patient separations1	3,040	3,000	3,590	
b.	Non‑admitted occasions of service	40,400	43,000	46,700	
The number of hospital based services provided to clients.  These provide an indication of the number of services provided for hospital based cancer patients.	
Breast screening				
c.	Waiting time for results is less than 28 days	100%	99%	100%	
d.	Waiting time between the making of an appointment and the breast screen is less than 28 days	90%	80%	90%	
These give an indication of the total volume of services as well as providing an indication of the level of services provided to women in the target age group.  These provide an indication of the effectiveness of the service in providing timely advice to women on the results of their breast screen.	
Note:
1.	Cost weights presented using AR-DRG Version 5.0 mapped to National Public Weights Round 9.  Cost weighted activity at Clare Holland House (ACT Hospice) is included in the 2008-09 targets for the first time.  This is being included to ensure that all admitted patient activity provided at ACT public health facilities is reported across all outputs.

Accountability Indicators cont. 
	2007‑08
Targets	2007‑08
Est. Outcome	2008‑09
Target	
Output 1.6: Aged Care and Rehabilitation Services	
				
Patient activity				
a.	Cost weighted admitted patient separations1, 2	3,110	4,300	4,515	
b.	Non‑admitted occasions of service	1,550	1,550	1,600	
c.	Sub‑acute service - episodes of care	920	600	920	
d.	Sub‑acute service - occupied bed days	13,870	11,500	13,870	
This provides an indication of the level of services provided.	
e.	Number of people assessed in falls clinics	420	420	420	
This provides an indication of the demand for this service and the effectiveness of aged care services in minimising the fall risks for older people.	
Notes:
1.	Cost weights presented using AR-DRG Version 5.0 mapped to National Public Weights Round 9. Includes all aged care and rehabilitation inpatient activity at The Canberra Hospital and Calvary Public Hospital.
2.	The 2008-09 target includes Calvary sub-acute activity previously included in Output 1.1.

	2007‑08
Targets	2007‑08
Est. Outcome	2008‑09
Target	
Output 1.7: Early Intervention and Prevention	
				
Immunisation				
a.	Immunisation coverage for the primary immunisation schedule measured at 1 year of age, in accordance with the Australian Childhood Immunisation Register	92%	92%	92%	
				
Breast Screening				
b.	Total breast screens	12,000	12,000	12,000	
c.	Number of breast screens for women aged 50‑69	10,500	10,500	10,500	
The total number of women who have breast screens each year and the number of women in the major target group (aged 50 to 69 years) who access this service.  This gives an indication of the total volume of services as well as providing an indication of the level of services provided to women in the target age group.	
d.	Proportion of clients attending "Well Women's Check" within the Women's Health Service that are from culturally and linguistically diverse communities	25%	28%	25%	
e.	Proportion of children aged 0-14 who are entering substitute and kinship care within the ACT who have been referred to the Child at Risk Health Unit’s Out of Home Care Clinic	80%	80%	80%	

Changes To Appropriation
Changes to Appropriation - Departmental						
 	2007-08	2008-09	2009-10	2010-11	2011-12	
Government Payment for Outputs	Est. Out.	Budget	Estimate	Estimate	Estimate	
 	$'000	$'000	$'000	$'000	$'000	
2007-08 Budget	628,455	662,369	703,503	752,157	752,157	
2nd Appropriation						
General Practice Work in Canberra Campaign	50	75	77	79	81	
Paediatric Emergency Department Waiting Area	 - 	250	259	267	276	
Capital Asset Development Plan	1,200	 - 	 - 	 - 	 - 	
						
Aboriginal Torres Strait Islander Residential Alcohol and Other Drug Rehabilitation Facility	300	1,500	1,551	1,604	1,658	
Opthalmology Service	125	250	260	270	281	
						
2008-09 Budget Policy Adjustments 						
Growth in Demand for Acute Care Capacity	 - 	4,000	4,136	4,277	4,422	
Mental Health Growth and Promoting Recovery	 - 	2,000	2,075	2,153	2,224	
Increased Demand in Older Person's Services	 - 	1,000	1,034	1,069	1,106	
Growth in Cancer Services	 - 	1,000	1,034	1,069	1,106	
Growth in Demand for Elective Surgery	 - 	3,000	3,102	3,208	3,317	
Integrated Prevention of Chronic Disease	 - 	1,000	1,034	1,069	1,106	
Increased Critical Care Capacity	 - 	2,500	2,588	2,679	2,773	
Second Cardiac Catheter Laboratory	 - 	291	1,223	1,284	1,349	
Expansion of Palliative Care Services	 - 	78	161	167	173	
Scoping Study for Primary Care Walk In Centres	 - 	150	 - 	 - 	 - 	
Workforce Initiatives	 - 	1,000	1,034	1,069	1,106	
Sleep Studies Laboratory	 - 	30	125	131	138	
Integrated Aboriginal Torres Strait Islander Family Support Services	 - 	100	104	105	107	
Secure Adult Mental Health Unit	 - 	 - 	7	21	42	
Mental Health Assessment Unit	 - 	 - 	36	41	55	
Digital Mammography	 - 	242	1,126	1,250	1,312	
Primary Care Services at Companion House	 - 	43	38	40	42	
Neonatal Intensive Care Unit - Video Streaming Services	 - 	 - 	81	83	86	
Base Funding Envelope - Offset	 - 	(16,334)	(18,823)	(19,581)	(20,294)	
Acute Activity and Price Adjustment	7,000	23,037	24,209	25,396	26,631	
						
2008-09 Budget Technical Adjustments						
Rollover - Elective Surgery	(2,000)	2,000	 - 	 - 	 - 	
Revised Indexation Parameters	 - 	1,649	1,691	1,735	14,233	
Transfer Psychologist to DHCS	 - 	(102)	(103)	(105)	(107)	
Transfer IMPACT Program for Vulnerable Families to DHCS	 - 	(58)	(60)	(62)	(63)	
Commonwealth Government Funding for ACAP, HCC, AHCA, PHOFA, COAG and AIA	4,578	1,966	50	55	79	
Continuation of Growth Funding	 - 	 - 	 - 	 - 	39,907	
New South Wales Cross Border Revenue Offset	 - 	 - 	 - 	(3,138)	(6,040)	
Decreased Superannuation Contributions	(1,000)	(522)	(315)	(129)	(74)	
Health Service for the Alexander Maconochie Centre	 - 	988	1,018	1,048	1,080	
						
2008-09 Budget	638,708	693,502	732,255	779,311	830,269	

Changes to Appropriation - Territorial
 	2007-08	2008-09	2009-10	2010-11	2011-12	
Payment for Expenses on Behalf of Territory	Est. Out.	Budget	Estimate	Estimate	Estimate	
 	$'000	$'000	$'000	$'000	$'000	
2007-08 Budget	658	675	692	710	710	
2008-09 Budget Policy Adjustments 						
Increased Commonwealth Government Funding for Elective Surgery	1,920	 - 	 - 	 - 	 - 	
Intensive Care - Calvary Hospital	 - 	3,000	6,410	 - 	 - 	
						
2008-09 Budget Technical Adjustments						
Capital Upgrades Indexation	 - 	 - 	 - 	 - 	17	
Rollover - Commonwealth Government Funding for Elective Surgery	(1,720)	1,720	 - 	 - 	 - 	
						
2008-09 Budget	858	5,395	7,102	710	727	

Changes to Appropriation - Departmental						
 	2007-08	2008-09	2009-10	2010-11	2011-12	
Capital Injections	Est. Out.	Budget	Estimate	Estimate	Estimate	
 	$'000	$'000	$'000	$'000	$'000	
2007-08 Budget	36,319	27,601	5,187	7,550	7,550	
						
FMA Section 16B Rollover from 2006-07						
Rollover - TCH Extra Car Parking	242	 - 	 - 	 - 	 - 	
						
2nd Appropriation						
Gamma Camera Replacement Project	1,400	 - 	 - 	 - 	 - 	
Opthalmology Service	1,000	 - 	 - 	 - 	 - 	
Paediatric Emergency Department Waiting Area	250	 - 	 - 	 - 	 - 	
Computer Radiography Unit for Radiation Oncology	250	 - 	 - 	 - 	 - 	
Replace Existing Superficial X-Ray Radiotherapy Treatment Unit	272	 - 	 - 	 - 	 - 	
Aboriginal Torres Strait Islander Residential Alcohol and Other Drug Rehabilitation Facility	365	828	4,690	 - 	 - 	
						
2008-09 Budget Policy Adjustments 						
Commonwealth Government Funding for Elective Surgery	4,680	 - 	 - 	 - 	 - 	
ACT Health Skills Development Centre	 - 	1,300	 - 	 - 	 - 	
Adult Mental Health Inpatient Facility	 - 	3,000	12,630	8,000	 - 	
Mental Health Young Persons Unit	 - 	775	 - 	 - 	 - 	
Mental Health Assessment Unit	 - 	1,639	371	 - 	 - 	
Secure Adult Mental Health Unit	 - 	1,500	5,000	4,660	 - 	
Women’s and Children’s Hospital	 - 	4,000	27,500	42,500	16,000	
Neurosurgery Operating Theatre	 - 	2,500	3,000	 - 	 - 	
Surgical Assessment and Planning Unit	 - 	1,500	2,600	 - 	 - 	
Additional Beds	 - 	2,400	 - 	 - 	 - 	
New Gungahlin Health Centre	 - 	1,800	10,200	6,000		
Refurbishment of Health Centres	 - 	500	4,500	-	 - 	
Provision for Phase 1 - Clinical Services Redevelopment	 - 	2,000	6,000	12,000	37,000	
Digital Mammography	 - 	5,715	 - 	 - 	 - 	
Neonatal Intensive Care Unit - Video Streaming Services	 - 	200	 - 	 - 	 - 	
Provision for Project Definition Planning for the Capital Asset Development Plan	 - 	12,500	15,800	14,500	21,000	

Changes to Appropriation - Departmental cont.
 	2007-08	2008-09	2009-10	2010-11	2011-12	
Capital Injections cont.	Est. Out.	Budget	Estimate	Estimate	Estimate	
 	$'000	$'000	$'000	$'000	$'000	
2008-09 Budget Technical Adjustments						
Rollover - Adult Mental Health Acute Inpatient Unit	(2,000)	2,000	 - 	 - 	 - 	
Rollover - Secure Adult Mental Health Unit	(1,000)	1,000	 - 	 - 	 - 	
Rollover - Neonatal Intensive Care Unit	(600)	600	 - 	 - 	 - 	
Rollover - New Multistorey Car Park - The Canberra Hospital	(6,200)	6,200	 - 	 - 	 - 	
Rollover - Paediatric Emergency Department Waiting Area	(80)	80	 - 	 - 	 - 	
Rollover - Aboriginal Torres Strait Islander Residential Alcohol and Other Drug Rehabilitation Facility	(365)	365	 - 	 - 	 - 	
Rollover - Building Refurbishment and Upgrades	(200)	200	 - 	 - 	 - 	
Rollover - Electrical Lift and Major Plant upgrades	(240)	240	 - 	 - 	 - 	
Rollover - OH&S and Access	(90)	90	 - 	 - 	 - 	
Rollover - Linear Accelerator Procurement and Replacement	(5,500)	5,500	 - 	 - 	 - 	
Rollover - Fire System Upgrade (Phase 1) - TCH	(600)	600	 - 	 - 	 - 	
Rollover - Commonwealth Government Funding for Elective Surgery	(4,530)	4,530	 - 	 - 	 - 	
Revised Indexation Parameters - Capital Upgrades	 - 	20	21	21	111	
Revised Linear Accelerator Project	 - 	 - 	 - 	 - 	(772)	
						
2008-09 Budget	23,373	91,183	97,499	95,231	80,889	

2008‑09 Capital Works Program
Departmental
 	Estimated	Estimated	2008-09	2009‑10	2010‑11	Expected 	
	Total	Expenditure	Financing	Financing	Financing	Completion 	
	Cost 	Pre 2008‑09				Date  	
 	$’000	$’000	$’000	$’000	$’000	 	
Forward Design							
Mental Health Young Persons Unit	775	-	775	-	-	Jun 2009	
ACT Health Skills Development Centre	1,300	-	1,300	-	-	Jun 2009	
Total Forward Design	2,075	-	2,075	-	-		
							
New Capital Works							
Adult Mental Health Inpatient Facility	23,630	-	3,000	12,630	8,000	Sep 2010	
Secure Adult Mental Health Unit	11,160	-	1,500	5,000	4,660	Sep 2010	
Mental Health Assessment Unit	2,010	-	1,639	371	-	Aug 2009	
Provision for Project Definition Planning for the Capital Asset Development Plan1	63,800	-	12,500	15,800	14,500	Jun 2012	
Women’s and Children’s Hospital2	90,000	-	4,000	27,500	42,500	Jun 2012	
Neurosurgery Operating Theatre	5,500	-	2,500	3,000	-	Dec 2009	
Surgical Assessment and Planning Unit	4,100	-	1,500	2,600	-	Dec 2009	
Additional Beds	2,400	-	2,400	-	-	Feb 2009	
New Gungahlin Health Centre	18,000	-	1,800	10,200	6,000	Dec 2010	
Refurbishment of Health Centres	5,000	-	500	4,500	-	Jun 2010	
Provision for Phase 1 - Clinical Services Redevelopment3	57,000	-	2,000	6,000	12,000	Jun 2012	
Total New Works	282,600		33,339	87,601	87,660		
							
ICT Projects							
Digital Mammography	5,715	-	5,715	-	-	Jun 2009	
Neonatal Intensive Care Unit - Video Streaming Services	200	-	200	-	-	Jun 2009	
Total ICT Projects	5,915	-	5,915	-	-		
							
Capital Upgrades							
Electrical Services / Mechanical / HVAC - various sites	327	-	327			Jun 2009	
Hydraulics, Plumbing and Drainage - various sites	100	-	100			Jun 2009	
Fire Protection and Security Upgrades - various sites	183	-	183			Jun 2009	
Equipment Loans Scheme Relocation	620	-	620			Jun 2009	
TCH Discharge Lounge Relocation	150	-	150			Jun 2009	
TCH Bldg 7 Building Works	160	-	160			Jun 2009	
TCH Clinical Accommodation and 4 Gaunt Place Refurbishment	270	-	270			Jun 2009	
TCH Bldg 12 Condenser water system	300	-	300			Jun 2009	
TCH Bldg 12 Building works	370	-	370			Jun 2009	
TCH Bldg 6 Heating / Air-con Upgrades	300	-	300			Jun 2009	
TCH Floor Covering Replacement Program	200	-	200			Jun 2009	
TCH Mechanical and BMS Upgrades	310		310			Jun 2009	
Lighting and Security Upgrades	110	-	110			Jun 2009	
Total Capital Upgrades 	3,400	-	3,400				
						 	
Total New Capital Works	293,990	-	44,729	87,601	87,660	 	

Departmental cont.							
 	Estimated	Estimated	2008-09	2009‑10	2010‑11	Expected 	
	Total	Expenditure	Financing	Financing	Financing	Completion 	
	Cost 	Pre 2008‑09				Date  	
 	$’000	$’000	$’000	$’000	$’000	 	
							
Works in Progress							
Linear Accelerator Procurement and Replacement	18,700	12,300	5,900	500	-	Jun 2010	
Fire Systems Upgrades (Phase 1)	2,600	2,000	600	-		Jun 2009	
Adult Mental Health Acute Inpatient Unit- Forward Design	2,290	290	2,000	-	-	Jun 2009	
High Secure Mental Health Inpatient Unit - Forward Design	1,200	200	1,000	-	-	Jun 2009	
Neonatal Intensive Care Unit - Forward Design	795	195	600	-	-	Jun 2009	
New Multistorey Car park TCH	29,000	300	28,700	-	-	Jun 2009	
Paediatric Emergency Department Waiting Area	250	170	80	-	-	Jun 2009	
Aboriginal Torres Strait Islander Residential Alcohol and Other Drug Rehabilitation Facility	
5,883	
-	
1,193	
4,690	
-	
Jun 2010	
Building Refurbishment and Upgrades	1,593	1,393	200	-	-	Jun 2009	
Electrical, Lift and Major Plant Upgrades	1,240	1,000	240	-	-	Jun 2009	
OH&S and Assess Upgrades	390	300	90	-	-	Jun 2009	
Commonwealth Government Funding for Elective Surgery 	4,680	150	4,530	-	-	Jun 2009	
Total Works in Progress	68,621	18,298	45,133	5,190	-	 	
							
Total Departmental Capital Works	362,611	18,298	89,862	92,791	87,660	 	
Notes:
1.	$21 million is forecast for the 2011-12 financial year.
2.	$16 million is forecast for the 2011-12 financial year.
3.	$37 million is forecast for the 2011-12 financial year.

Territorial 
	Estimated	Estimated	2008-09	2009‑10	2010‑11	Expected 	
	Total	Expenditure	Financing	Financing	Financing	Completion 	
	Cost 	Pre 2008‑09				Date  	
	$’000	$’000	$’000	$’000	$’000		
							
New Capital Works							
Intensive Care - Calvary Hospital	9,410	-	3,000	6,410	-	Feb 2010	
							
Total New Works	9,410	-	3,000	6,410	-		
							
Capital Upgrades							
Suction Upgrade	300	-	300			Jun 2009	
Toilet Replacement	27	-	27			Jun 2009	
Kitchen Floor Covering Replacement	348	-	348			Jun 2009	
Total Capital Upgrades	675	-	675				
							
Total New Capital Works	10,085	-	3,675	6,410	-		

Territorial cont.							
	Estimated	Estimated	2008-09	2009‑10	2010‑11	Expected 	
	Total	Expenditure	Financing	Financing	Financing	Completion 	
	Cost 	Pre 2008‑09				Date  	
	$’000	$’000	$’000	$’000	$’000		
							
Works in Progress							
Increased Commonwealth Government Elective Surgery 	
1,920	
200	
1,720	
-	
-	Jun 2009	
							
Total Works in Progress	1,920	200	1,720	-	-		
							
Total Territorial Capital Works	12,005	200	5,395	6,410	-		
Commonwealth Grants
The major Commonwealth payments for which the Portfolio has responsibility are:
Name of Grant	Activities Funded by Grant	2008‑09
Estimate
$’000	
Australian Health Care Agreement	This relates to public patients treated in the ACT.  It also includes national mental health, palliative care and quality improvement.	131,600	
Home and Community Care	Expansion and development of home and community care services designed to provide basic maintenance and support services for identified target groups.	12,919	
National Public Health Outcomes Agreement	Provides a range of public health services including: breast cancer screening; family planning; funds to combat AIDS; drug education campaigns; women’s health program; female genital mutilation; alternative birthing; and cervical cancer screening.	3,601	
Australian Immunisation Agreement	Provision of funding for vaccines listed under the National Immunisation Program, including vaccines for the childhood immunisation program, influenza, pneumococcal vaccines for people aged 65 years and over and the new Human Papillomavirus vaccination program for females.	4,094	
Highly Specialised Drugs	Provision of highly specialised drug therapies under the National Health Act 1953.	13,937	
Aged Care Assessment Program	Funding is provided to support Aged Care Client Assessments undertaken by the Aged Care Assessment Team.	749	
Youth Health Services	Funding of a range of innovative health services for homeless youth in the ACT.	60	

Total
		166,960  	
166,960

ACT Health	
Operating Statement	
  2007-08			  2007-08	   2008-09		  2009-10	  2010-11	  2011-12		
    Budget			Est.Outcome	   Budget	   Var	  Estimate	   Estimate	  Estimate		
    $'000			   $'000	   $'000	    %	   $'000	    $'000	   $'000		
		Income								
		Revenue								
628,455		Government Payment for Outputs	641,595	693,502	8	732,255	779,311	830,269		
136,084		User Charges - Non ACT Government	153,262	154,174	1	160,619	166,661	173,578		
1,934		User Charges - ACT Government	1,134	1,183	4	1,232	1,262	1,322		
10,049		Grants from the Commonwealth	11,849	13,937	18	14,340	14,560	14,860		
228		Interest	228	228	-	228	228	228		
8,927		Other Revenue	8,327	8,011	-4	8,238	8,320	8,415		
1,025		Resources Received free of charge	1,025	1,050	2	1,075	1,100	1,130		
786,702		Total Revenue	817,420	872,085	7	917,987	971,442	1,029,802		
		Gains								
588		Other Gains	588	737	25	752	757	777		
588		Total Gains	588	737	25	752	757	777		
787,290		Total Income	818,008	872,822	7	918,739	972,199	1,030,579		
		Expenses								
348,605		Employee Expenses	354,459	383,211	8	411,603	441,915	473,694		
53,604		Superannuation Expenses	50,420	53,373	6	55,663	58,041	59,792		
214,816		Supplies and Services	232,645	241,491	4	251,879	262,980	278,106		
17,220		Depreciation and Amortisation	18,503	21,612	17	24,335	27,146	28,063		
0		Borrowing Costs	401	401	-	401	401	401		
10,074		Cost of Goods Sold	11,374	13,285	17	13,935	14,645	15,146		
153,875		Grants and Purchased Services	162,288	172,157	6	178,355	186,951	195,410		
3,580		Other Expenses	5,310	3,311	-38	3,406	3,506	3,816		
801,774		Total Ordinary Expenses	835,400	888,841	6	939,577	995,585	1,054,428		
-14,484		Operating Result	-17,392	-16,019	8	-20,838	-23,386	-23,849		

ACT Health	
Balance Sheet	
    Budget			Est.Outcome	   Planned		   Planned	   Planned	   Planned		
as at 30/6/08			as at 30/6/08	as at 30/6/09	   Var	as at 30/6/10	as at 30/6/11	as at 30/6/12		
   $'000			   $'000	    $'000	    %	    $'000	    $'000	    $'000		
		Current Assets								
12,564		Cash and Cash Equivalents	491	509	4	4,803	4,097	3,391		
22,396		Receivables	41,368	36,368	-12	31,368	31,368	31,368		
6,553		Inventories	6,205	6,205	-	6,205	6,205	6,205		
1,013		Other	6,433	6,433	-	6,433	6,433	6,433		
42,526		Total Current Assets	54,497	49,515	-9	48,809	48,103	47,397		
		Non Current Assets								
3,000		Investments	3,000	3,000	-	3,000	3,000	3,000		
412,026		Property, Plant and Equipment	526,652	602,034	14	614,873	656,866	855,724		
10,987		Intangibles	13,152	12,428	-6	11,463	10,498	9,533		
4,482		Capital Works in Progress	23,298	32,132	38	101,930	136,800	0		
430,495		Total Non Current Assets	566,102	649,594	15	731,266	807,164	868,257		
473,021		TOTAL ASSETS	620,599	699,109	13	780,075	855,267	915,654		
		Current Liabilities								
28,012		Payables	29,492	28,844	-2	28,044	27,244	26,444		
2,249		Finance Leases	1,922	2,596	35	1,922	2,596	1,539		
85,407		Employee Benefits	84,986	88,060	4	91,134	94,208	97,282		
4,110		Other	5,551	5,551	-	5,551	5,551	5,551		
119,778		Total Current Liabilities	121,951	125,051	3	126,651	129,599	130,816		
		Non Current Liabilities								
0		Payables	152	0	-100	0	0	0		
530		Interest Bearing Liabilities	0	0	-	0	0	0		
2,327		Finance Leases	2,883	1,730	-40	2,883	1,730	2,308		
5,876		Employee Benefits	6,114	7,665	25	9,217	10,769	12,321		
8,733		Total Non Current Liabilities	9,149	9,395	3	12,100	12,499	14,629		
128,511		TOTAL LIABILITIES	131,100	134,446	3	138,751	142,098	145,445		
344,510		NET ASSETS	489,499	564,663	15	641,324	713,169	770,209		
		REPRESENTED BY FUNDS EMPLOYED								
344,035		Accumulated Funds	336,874	412,038	22	488,699	560,544	617,584		
475		Reserves	152,625	152,625	-	152,625	152,625	152,625		
344,510		TOTAL FUNDS EMPLOYED	489,499	564,663	15	641,324	713,169	770,209		

ACT Health	
Cash Flow Statement	
  2007-08			  2007-08	   2008-09		  2009-10	  2010-11	  2011-12		
    Budget			Est.Outcome	   Budget	   Var	  Estimate	   Estimate	  Estimate		
    $'000			   $'000	   $'000	    %	   $'000	    $'000	   $'000		
		CASH FLOWS FROM OPERATING ACTIVITIES								
		Receipts								
628,455		Cash from Government for Outputs	638,708	693,502	9	732,255	779,311	830,269		
138,018		User Charges	159,396	160,357	1	166,851	167,923	174,900		
228		Interest Received	228	228	-	228	228	228		
10,049		Grants Received from the Commonwealth	11,849	13,937	18	14,340	14,560	14,860		
44,511		Other Revenue	46,211	46,240	..	46,686	46,974	47,389		
821,261		Operating Receipts	856,392	914,264	7	960,360	1,008,996	1,067,646		
		Payments								
397,851		Related to Employees	403,026	431,959	7	462,640	495,330	528,860		
214,591		Related to Supplies and Services	232,821	241,641	4	252,004	263,080	278,176		
153,875		Grants and Purchased Services	162,936	172,157	6	178,355	186,951	195,410		
48,650		Other	53,977	54,088	..	55,037	56,048	57,159		
814,967		Operating Payments	852,760	899,845	6	948,036	1,001,409	1,059,605		
6,294		NET CASH INFLOW/(OUTFLOW) FROM OPERATING ACTIVITIES	3,632	14,419	297	12,324	7,587	8,041		
		CASH FLOWS FROM INVESTING ACTIVITIES								
		Payments								
42,431		Purchase of Property, Plant and Equipment	43,017	104,132	142	104,077	102,072	88,184		
42,431		Investing Payments	43,017	104,132	142	104,077	102,072	88,184		
-42,431		NET CASH INFLOW/(OUTFLOW) FROM INVESTING ACTIVITIES	-43,017	-104,132	-142	-104,077	-102,072	-88,184		
		CASH FLOWS FROM FINANCING ACTIVITIES								
		Receipts								
36,319		Capital Injection from Government	23,373	91,183	290	97,499	95,231	80,889		
36,319		Financing Receipts	23,373	91,183	290	97,499	95,231	80,889		
		Payments								
1,000		Repayment of Finance Lease	1,000	1,452	45	1,452	1,452	1,452		
1,000		Financing Payments	1,000	1,452	45	1,452	1,452	1,452		
35,319		NET CASH INFLOW/(OUTFLOW) FROM FINANCING ACTIVITIES	22,373	89,731	301	96,047	93,779	79,437		
-818		NET INCREASE/(DECREASE) IN CASH HELD	-17,012	18	100	4,294	-706	-706		
13,382		CASH AT BEGINNING OF REPORTING PERIOD	17,503	491	-97	509	4,803	4,097		
12,564		CASH AT THE END OF THE REPORTING PERIOD	491	509	4	4,803	4,097	3,391		

ACT Health	
Statement of Changes in Equity	
    Budget			Est.Outcome	   Planned		   Planned	   Planned	   Planned		
as at 30/6/08			as at 30/6/08	as at 30/6/09	   Var	as at 30/6/10	as at 30/6/11	as at 30/6/12		
   $'000			   $'000	    $'000	    %	    $'000	    $'000	    $'000		
322,675		Opening Balance	331,368	489,499	48	564,663	641,324	713,169		
		Accumulated Funds								
-14,484		Operating Result for the Period	-17,392	-16,019	8	-20,838	-23,386	-23,849		
		Reserves								
0		Increase/(Decrease) in asset revaluation reserve	152,150	0	-100	0	0	0		
-14,484		Total Income And Expense For The Period	134,758	-16,019	-112	-20,838	-23,386	-23,849		
		Transactions Involving Equity Holders Affecting Accumulated Funds								
36,319		Capital Injections	23,373	91,183	290	97,499	95,231	80,889		
344,510		Closing Balance	489,499	564,663	15	641,324	713,169	770,209		
Notes to the Budget Statements
Significant variations are as follows:
Operating Statement
•	government payment for outputs:
–	the increase of $13.140 million in the 2007‑08 estimated outcome from the original budget is due to increased Commonwealth specific purpose funding ($4.578 million), increased acute activity ($7 million), deferred funding from 2006-07 ($2.887 million) and programs funded through the 2007‑08 Budget Second Appropriation ($1.675 million).  These are partially offset by programs deferred to 2008‑09 ($2 million) and a reduction in superannuation expenses ($1 million); and
–	the increase of $51.907 million in the 2008‑09 Budget from the 2007‑08 estimated outcome is mainly due to the growth in the health funding envelope that was previously incorporated ($33.914 million) and the growth in acute activity and prices growth ($23.037 million), partially offset by the lower levels of Commonwealth specific purpose funding ($4.104 million), mainly associated with the scaling back of the Human Papillomavirus (HPV) vaccination program.
•	user charges - non ACT Government:  the increase of $17.178 million in the 2007‑08 estimated outcome from the original budget relates to higher cross border revenue from NSW ($12.578 million), increased cost of goods sold ($1.3 million) and increased pharmaceutical sales to private hospitals ($0.9 million) and increased patient and other revenue ($2.4 million).
•	user charges - ACT Government:  the decrease of $0.8 million in the 2007‑08 estimated outcome from the original budget relates to a reclassification of revenue between ACT Government and non ACT Government.
•	grants from the Commonwealth:  the increase of $1.8 million in the 2007‑08 estimated outcome from the original budget and the increase of $2.088 million from the 2008‑09 Budget from the 2007‑08 estimated outcome relates to increased reimbursements for highly specialised drugs.
•	other revenue:  
–	the decrease of $0.6 million in the 2007‑08 estimated outcome from the original budget relates to reclassification of some revenue categories to user charges; and  
–	The decrease of $0.316 million in 2008‑09 Budget from the 2007‑08 estimated outcome relates in part to the removal of a one‑off Commonwealth Government grant for the Health Connect Project.
•	employee expenses:
–	the increase of $5.854 million in the 2007‑08 estimated outcome from the original budget relates mainly to increased activity at The Canberra Hospital; and
–	the increase of $28.752 million in the 2008‑09 Budget from the 2007‑08 estimated outcome is mainly due to wage increases ($18.050 million), new initiatives ($7.847 million), activity adjustment ($4.940 million), prison health services ($0.929 million), the full year effect of prior year initiatives ($0.843 million) and the full year effect of 2007‑08 Budget Second Appropriation ($0.356 million).  These are partially offset by planned savings ($4.408 million).
•	supplies and services:
–	the increase of $17.829 million in the 2007‑08 estimated outcome from the original budget relates to programs funded through the 2007‑08 Budget Second Appropriation ($1.207 million), deferred programs ($2.260 million), increased Commonwealth funded programs ($1.372 million), increased highly specialised drugs ($1.8 million), pharmaceutical sales to private hospitals ($0.9 million), as well as higher costs associated with increased activity at The Canberra Hospital; and
–	the increase of $8.846 million in the 2008‑09 Budget from the 2007‑08 estimated outcome is mainly due to indexation ($9.6 million), new initiatives ($5.440 million), the full year of prior year initiatives ($0.673 million) and increased highly specialised drugs ($1.8 million).  These are partially offset by savings of ($5.889 million) and reduced Commonwealth funded programs ($4.104 million).
•	grants and purchased services:
–	the increase of $8.413 million in the 2007‑08 estimated outcome from the original budget relates to programs funded through the 2007‑08 Budget Second Appropriation ($0.3 million), deferred programs ($0.242 million), increased Commonwealth funded programs ($1.159 million), higher activity at Calvary Public Hospital ($3.5 million) and reallocation of expenses from other categories ($2.9 million); and
–	the increase of $9.869 million in the 2008‑09 Budget from the 2007‑08 estimated outcome is mainly due to indexation ($2.7 million), new initiatives ($2.713 million), the full year effect of prior year initiatives ($2.404 million) and programs funded through the 2007‑08 Budget Second Appropriation ($1.2 million).
•	other expenses:  the increase of $1.730 million in the 2007‑08 estimated outcome the from the original budget and the decrease of $1.999 million from the 2008‑09 Budget from the 2007‑08 estimated outcome relates to the settlement of a legal case.
Balance Sheet
•	cash and cash equivalents:  the decrease of $12.073 million in the 2007‑08 estimated outcome from the original budget relates to the planned expenditure on plant and equipment and information technology systems.
•	receivables:  the increase of $18.972 million in the 2007‑08 estimated outcome from the original budget reflects a higher NSW cross border receivable.
•	property, plant and equipment:  
–	the increase of $114.626 million in the 2007‑08 estimated outcome from the original budget relates mainly to the revaluation of non current assets; and
–	the increase of $75.382 million in 2008‑09 Budget from the 2007‑08 estimated outcome relates to new and existing capital works projects.
•	intangibles:  
–	the increase of $2.165 million in the 2007‑08 estimated outcome from the original budget relates to completion of information technology systems; and  
–	the decrease of $0.724 million in the 2008‑09 Budget from the 2007‑08 estimated outcome reflects depreciation on existing systems.
•	capital works in progress:  the increase of $18.816 million in the 2007‑08 estimated outcome from the original budget and the increase of $8.834 million in the 2008-09 Budget to the 2007‑08 estimated outcome reflects the various completion dates of existing and new capital works projects.
•	current and non current finance leases:  the decrease of $0.299 million in the 2008‑09 Budget from the 2007‑08 estimated outcome and the decrease of $0.479 million in the 2008‑09 Budget from the 2007‑08 estimated outcome reflects the timing of the motor vehicle lease expiry and replacement program.
Statement of Changes in Equity
Variances in the statement are explained in the notes above.

ACT Health	
Statement of Income and Expenses on Behalf of the Territory	
  2007-08			  2007-08	   2008-09		  2009-10	  2010-11	  2011-12		
    Budget			Est.Outcome	   Budget	   Var	  Estimate	   Estimate	  Estimate		
    $'000			   $'000	   $'000	    %	   $'000	    $'000	   $'000		
		Income								
		Revenue								
658		Payment for Expenses on behalf of Territory	858	5,395	529	7,102	710	727		
591		Taxes Fees and Fines	591	613	4	635	650	676		
143,247		Grants from the Commonwealth	154,549	153,023	-1	159,307	166,487	173,754		
144,496		Total Revenue	155,998	159,031	2	167,044	167,847	175,157		
		Gains								
0		Total Gains	0	0	-	0	0	0		
144,496		Total Income	155,998	159,031	2	167,044	167,847	175,157		
		Expenses								
658		Grants and Purchased Services	858	5,395	529	7,102	710	727		
143,838		Transfer Expenses	155,140	153,636	-1	159,942	167,137	174,430		
144,496		Total Ordinary Expenses	155,998	159,031	2	167,044	167,847	175,157		
0		Operating Result	0	0	-	0	0	0		

ACT Health	
Statement of Assets and Liabilities on Behalf of the Territory	
    Budget			Est.Outcome	   Planned		   Planned	   Planned	   Planned		
as at 30/6/08			as at 30/6/08	as at 30/6/09	   Var	as at 30/6/10	as at 30/6/11	as at 30/6/12		
   $'000			   $'000	    $'000	    %	    $'000	    $'000	    $'000		
		Current Assets								
214		Cash and Cash Equivalents	276	276	-	276	276	276		
86		Receivables	24	24	-	24	24	24		
300		Total Current Assets	300	300	-	300	300	300		
300		TOTAL ASSETS	300	300	-	300	300	300		
		Current Liabilities								
300		Payables	300	300	-	300	300	300		
300		Total Current Liabilities	300	300	-	300	300	300		
300		TOTAL LIABILITIES	300	300	-	300	300	300		
0		NET ASSETS	0	0	-	0	0	0		
		REPRESENTED BY FUNDS EMPLOYED								
0		Accumulated Funds	0	0	-	0	0	0		
0		TOTAL FUNDS EMPLOYED	0	0	-	0	0	0		

ACT Health	
Budgeted Statement of Cashflows on Behalf of the Territory	
  2007-08			  2007-08	   2008-09		  2009-10	  2010-11	  2011-12		
    Budget			Est.Outcome	   Budget	   Var	  Estimate	   Estimate	  Estimate		
    $'000			   $'000	   $'000	    %	   $'000	    $'000	   $'000		
		CASH FLOWS FROM OPERATING ACTIVITIES								
		Receipts								
658		Cash from Government for EBT	858	5,395	529	7,102	710	727		
591		Taxes, Fees and Fines	591	613	4	635	650	676		
143,247		Grants Received from the Commonwealth	154,549	153,023	-1	159,307	166,487	173,754		
64		Other Revenue	84	539	542	710	71	73		
144,560		Operating Receipts	156,082	159,570	2	167,754	167,918	175,230		
		Payments								
658		Grants and Purchased Services	858	5,395	529	7,102	710	727		
64		Other	84	539	542	710	71	73		
143,838		Territory Receipts to Government	155,140	153,636	-1	159,942	167,137	174,430		
144,560		Operating Payments	156,082	159,570	2	167,754	167,918	175,230		
0		NET CASH INFLOW/(OUTFLOW) FROM OPERATING ACTIVITIES	0	0	-	0	0	0		
0		NET INCREASE/(DECREASE) IN CASH HELD	0	0	-	0	0	0		
214		CASH AT BEGINNING OF REPORTING PERIOD	276	276	-	276	276	276		
214		CASH AT THE END OF THE REPORTING PERIOD	276	276	-	276	276	276		
Notes to the Budget Statements
Significant variations are as follows:
Statement of Income and Expenses on behalf of the Territory
•	payment for expenses on behalf of the Territory: 
–	the increase of $0.2 million in the 2007‑08 estimated outcome from the original budget relates to Commonwealth infrastructure funding for Calvary Public Hospital; and  
–	the increase of $4.537 million in the 2008‑09 Budget from the 2007‑08 estimated outcome also relates to Commonwealth infrastructure funding for Calvary Public Hospital ($1.520 million) and capital works funding for the Intensive Care Unit/High Dependency Unit at Calvary Hospital ($3 million).
•	grants from the Commonwealth:
–	the increase of $11.302 million in the 2007‑08 estimated outcome from the original budget relates mainly to increased funding for the elective surgery stage 1 ($2.5 million) and stage 2 ($6.6 million), Australian Immunisation Agreement ($1.372 million) and illicit drug diversion ($0.659 million); and
–	the decrease of $1.526 million in the 2008‑09 Budget from the estimated outcome relates to the removal of the above mentioned elective surgery Commonwealth grants ($9.1 million), removal of the illicit drugs diversion ($0 659 million) and a reduction to the Australian Immunisation Agreement ($5.042 million).  These are partially offset by expected indexation on the Australian Health Care Agreement ($12.213 million) and growth of the home and community care program ($0.979 million).
•	grants and purchased services:  the variance is the same as that identified for ‘payment for expenses on behalf of the Territory’.
•	transfer expenses:  the variance is the predominantly same as that identified for ‘grants from the Commonwealth’.