ACT HEALTH
Objectives
ACT Health aims to achieve good health for all residents of the Territory by planning, purchasing and providing quality community based health services, hospital and extended care services, managing public health risks, and promoting health and early care interventions.
ACT Health’s objectives are grouped around the following five key performance areas:
•	community and consumers;
•	safety and quality of care;
•	partnerships;
•	accountability and internal systems; and
•	ACT Health’s people.
2009-10 Priorities
Strategic and operational initiatives to be pursued in 2009-10 include:
•	continuing to work on the efficiencies and reforms that will bring ACT hospital costs closer to the national peer group benchmark;
•	implementing the new National Healthcare Agreement (NHA) with the Commonwealth Government.  The NHA outlines a number of priority areas for improving access, quality and timeliness of primary and community care, hospital and extended care services.  National reporting of progress against agreed targets will be a key feature of the new agreement;
•	implementing National Partnership Programs (NPPs), Hospital and Workforce Reform, Prevention and Aboriginal and Torres Strait Islander Health programs;
•	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;
•	continuing implementation of a comprehensive capital asset development plan including the necessary e-health capacity, to build a sustainable and modern health system to ensure safety, availability and viability of quality health care in the ACT for now and into 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;
•	establishing a Mental Health Assessment Unit (MHAU) to provide quicker transfer to a specialised service for mental health patients who present at an emergency department;
•	enhancing the medical retrieval service to provide emergency transport for critically ill patients in the ACT and surrounding region;
•	establishing a ‘Walk-in centre’ on the campus at the Canberra Hospital (TCH); 
•	maintaining accreditation with appropriate bodies; and
•	working to improve health and wellbeing within the Aboriginal and Torres Strait Islander community.
Business and Corporate Strategies
ACT Health has a comprehensive and effective governance framework which manages strategic and operational risk, infrastructure and workforce planning, activity, information technology and financial performance.
ACT Health is committed to:
•	achieving a comprehensive health system that protects and improves the health of people;
•	being an effective and efficient service provider;
•	working in partnership with other government services and community organisations;
•	developing new models of care and service delivery;
•	ongoing improvement in the cost of acute health services against the national peer hospital costs;
•	strengthening staff skills and professionalism; and
•	achieving a system of care and support that improves the quality of life for vulnerable groups. 

Estimated Employment Level
2008-09
Budget			2008-09
Est. Outcome	2009-10
Budget	
4,418		  Staffing  (FTE)	4,559	4,702	

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 21
Maximising the quality of hospital services
The following three 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 outcomes 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.
Note:
1.	The 2008-09 Strategic Indicator for ‘Rate of Post-operative pulmonary embolism’ has been removed.  The Australian Council on Healthcare Services which provides accreditation of hospitals and health facilities deemed that the indicator was of limited value due to the small number of people with a hospital stay of greater than 7 days.
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.
	2008-09
Target	2008-09
Est. Outcome	2009-10
Target	
The Canberra Hospital	<0.7%	0.9%	<0.85%	
Calvary Public Hospital	<0.5%	0.46%	<0.5%	

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.

	2008-09
Target	2008-09
Est. Outcome	2009-10
Target	
The Canberra Hospital	2.0%	1.3%	<2.0%	
Calvary Public Hospital	1.0%	1.4%	<1.0%	

3.	Hospital acquired infection rate (bacteraemia)
The number of people admitted to hospitals per 10,000 occupied bed days who acquire a bacteraemial infection during their stay.  This provides an indication of the safety of hospital-based services.
		2008-09
Est. Outcome	2009-10
Target	
The Canberra Hospital		<8.6 per10,000	<7 per 10,000	
Calvary Public Hospital		<3 per 10,000	<3 per 10,000	
Note:
1.	This indicator is now used as a national performance benchmark in the Australian Health Care Agreements as a rate per 10,000 occupied bed days.  As such ACT Health is adopting the national definition in 2009-10.  The 2008-09 target for TCH was <1 per 1,000 and <1 per 1,000 for Calvary.  Using the previous methodology the result in 2008-09 for TCH is estimated at 0.86 and Calvary 0.3.

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.

17%

15%

10%

0%

10%

20%

2008-09 Est Outcome

2009-10 Target

Long Term

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 6 years	1.91	1.96	
DMFT Index at 12 years	1.27	1.02	
Source:  Australia’s Health 2008 (2002 data)	
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	83.5	WA 83.9	
Males	80.0	78.7	VIC 79.3	
Source:  Australia’s Health 2008 (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 for ACT residents aged over 75 years.  The ageing of the population will significantly increase the number of people in this age group.  

Strategic Indicator 131
Access to radiotherapy services
Radiotherapy access times 
Percentage of urgent radiotherapy patients who commence treatment within standard time frames.
Category	2008-09 Est Outcome	2009-10 Target	Long Term Target	
Urgent - treatment starts within 48 hours	100%	100%	100%	
Semi Urgent - treatment starts within 4 weeks	81%	85%	100%	
Non Urgent Category A - treatment starts within 4 weeks	60%	65%	100%	
Non Urgent Category B- treatment starts within 6 weeks	61%	65%	100%	
Note:
1.	Additional categories of urgency are presented in this years’ measure in comparison to 2008-09.

Strategic Indicators cont.
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 and provides an indication of the capacity and effectiveness of sub-acute and community based services.

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 Indicators cont.
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 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 Indicators cont.
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 between 2002 (15.3 per cent) and 2005 (8.6 per cent).  The Government aims to continue to reduce youth smoking rates with the objective of reaching 5 per cent in the long term.

15.3%

8.6%

5.0%

0%

5%

10%

15%

20%

25%

2002

2005

Long Term

Source:  ACT Chief Health Officer’s Report 2008.

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 Indicators cont.
Strategic Indicator 201
Two year participation rate in the Cervical screening program
Cervical screening program
The two year participation rate provides an indication of the effectiveness of early intervention health messages.  The ACT aims to exceed the national average for this indicator.
	ACT Rate	National Rate	
Two year participation rate	63.3%	61.5%	
Source:  Cervical Screening in Australia 2006-07 (Australian Institute of Health and Welfare, April 2009)
Note:
1.	This measure has been changed to reflect that women are screened every two years.

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	2008-09
Est. Outcome	2009-10
Target	Long Term
Target	
One (resuscitation seen immediately)	100%	100%	100%	
Two (emergency seen within 10 mins)	85%	80%	80%	
Three (urgent seen within 30 mins)	50%	75%	75%	
Four (semi-urgent seen within 60 mins)	50%	70%	70%	
Five (non-urgent seen within 120 mins)	73%	70%	70%	

Strategic Indicators cont.
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 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 are 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 than 30 days. 

Output Classes
	Total Cost1	Government Payment for Outputs	
	2008-09
Est. Outcome
$’000	2009-10
Budget
$’000	2008-09
Est. Outcome
$’000	2009-10
Budget
$’000	
Output Class 1:
Health and Community Care	910,000	973,168	704,955	748,692	
Output 1.1:  Acute Services	590,317	643,881	411,342	451,438	
Note: 
1.	Total Cost includes depreciation of $20.3 million in 2008-09 and $22.873 million in 2009-10.
Output Description
The Government provides public hospital services at TCH 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	
	2008-09
Est. Outcome
$’000	2009-10
Budget
$’000	2008-09
Est. Outcome
$’000	2009-10
Budget
$’000	
Output 1.2:  Mental Health Services	64,429	75,645	62,101	73,207	
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	
	2008-09
Est. Outcome
$’000	2009-10
Budget
$’000	2008-09
Est. Outcome
$’000	2009-10
Budget
$’000	
Output 1.3:  Community Health Services 	106,879	97,576	99,533	90,403	
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. 
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; 
•	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	
	2008-09
Est. Outcome
$’000	2009-10
Budget
$’000	2008-09
Est. Outcome
$’000	2009-10
Budget
$’000	
Output 1.4:  Public Health Services	26,551	31,011	25,076	29,424	
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	
	2008-09
Est. Outcome
$’000	2009-10
Budget
$’000	2008-09
Est. Outcome
$’000	2009-10
Budget
$’000	
Output 1.5:  Cancer Services	32,951	33,584	26,667	27,181	
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;
•	waiting time for access to essential services such as radiotherapy are consistent with agreed benchmarks; 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.

Output Classes cont.
	Total Cost	Government Payment for Outputs	
	2008-09
Est. Outcome
$’000	2009-10
Budget
$’000	2008-09
Est. Outcome
$’000	2009-10
Budget
$’000	
Output 1.6: 
Aged Care and Rehabilitation Services	46,797	45,319	40,961	39,338	
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	
	2008-09
Est. Outcome
$’000	2009-10
Budget
$’000	2008-09
Est. Outcome
$’000	2009-10
Budget
$’000	
Output 1.7: 
Early Intervention and Prevention	42,076	46,152	39,275	37,701	
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; and
•	providing hearing screening for all newborns in the ACT that meet the screening criteria.

Accountability Indicators

	2008-09
Targets	2008-09
Est. Outcome	2009-10
Targets	
Output Class 1:  Health and Community Care	
Output 1.1:  Acute Services	
				
Patient activity				
a.	Cost weighted patient separations 	78,3001	82,8221 	84,6862	
b.	Non-admitted occasions of service	270,000	274,000	283,000	
c.	Percentage of category one elective surgery patients who receive surgery within 30 days of listing	95%	95%	95%	
d	Number of allied health care services provided for acute care patients in ACT public hospitals3	95,600	93,000	95,600	
Notes:
1.	Cost weights presented using AR-DRG Version 5.0 mapped to National Public Weights Round 9.
2.	Cost weights presented using AR-DRG Version 5.1 mapped to National Public Weights Round 11.  This figure requests an estimated 3 per cent growth on the estimated outcome for 2008-09 of 82,220 cost weights using round 11 weights.
3.	This indicator was reported under Output 1.3 in the 2008-09 Budget.  The 2008-09 target and estimated outcome is provided for comparative purposes.

	2008-09
Targets	2008-09
Est. Outcome	2009-10
Targets	
Output 1.2:  Mental Health Services	
				
Patient activity				
a.	Cost weighted separations	2,2501	2,7861	3,1522	
b.	Admitted patient separations 	1,100	1,452	1,200	
c.	Adult services (18 - 64 years)	170,000	165,300	170,000	
d.	Children and youth services (0 - 17 years)	43,500	38,200	43,500	
e.	Older persons’ services (65+ years)	16,500	16,600	16,700	
f.	Psychogeriatric services bed days 	4,400	3,478	4,400	
g.	Psychogeriatric inpatient episodes of care	110	104	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%	71%	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%	54%	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.	Cost weights presented using AR-DRG Version 5.0 mapped to National Public Weights Round 9.
2.	Cost weights presented using AR-DRG Version 5.1 mapped to National Public Weights Round 11.  This figure requests an estimated 3 per cent growth on the estimated outcome for 2008-09 of 3,060 cost weights using round 11 weights.

Accountability Indicators cont.
	2008-09
Targets	2008-09
Est. Outcome	2009-10
Targets	
Output 1.3:  Community Health Services	
				
a.	Percentage of opioid treatment clients with management plans 	90%	95%	90%	
This provides an indication of the comprehensiveness of the service responses for people on opioid treatments. 	
b.	Mean waiting time for clients on the dental services waiting list	12 months	9 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.	
c.	Proportion of offenders and detainees in Bimberi and the Alexander Maconachie Centre with health care assessment plans within 24 hours of detention	100%	100%	100%	
This provides an indication of the effectiveness of Community Health in providing for the health needs of detainees and offenders.	
d.	Number of allied health care services provided for acute care patients in ACT public hospitals1	95,600	93,000	n/a	
e.	Number of nursing (domiciliary and clinic based) occasions of service	72,200	72,200	72,200	
f.	Number of allied health regional services (occasions of service)	20,000	18,000	20,000	
g.	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%	
				
Note:
1.	This indicator is now reported under output 1.1 Acute Services.

Accountability Indicators cont.
	2008-09
Targets	2008-09
Est. Outcome	2009-10
Targets	
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	85%	85%	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%	

	2008-09
Targets	2008-09
Est. Outcome	2009-10
Targets	
Output 1.5:  Cancer Services	
				
Patient activity				
a.	Cost weighted admitted patient separations1	3,590	4,532	4,668	
b.	Non-admitted occasions of service	46,700	47,160	48,570	
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 screening2				
c.	Total breast screens	12,000	11,500	12,000	
d.	Number of breast screens for women aged 50-69	10,500	10,000	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	
e.	Percentage of women who receive results of screen within 28 days3	100%	98%	100%	
f.	Waiting time between the making of an appointment and the breast screen is less than 28 days4	90%	30%	n/a	
g.	Percentage of screened who are assessed within 28 days5	n/a	59%	90%	
These provide an indication of the effectiveness of the service in providing timely advice to women on the results of their breast screen.	
Notes:
1.	Cost weights used for 2008-09 were reported using AR-DRG Version 5.0 mapped to National Public Weights Round 9.  In 2009-10, ACT Health is moving to AR-DRG Version 5.1 mapped to National Public Weights Round 11.  However, for Cancer Services the change in cost weights does not result in a change in the total level of activity.  As such, the estimated outcome for 2008-09 of 4,532 cost weights is the same in both cost weight versions.  The estimate for 2009-10 reflects a growth of 3 per cent on 2008-09 activity.
2.	These indicators were reported under output 1.7 Early Intervention and Prevention in the 2008-09 Budget.  The 2008-09 targets and estimated outcomes are provided for comparative purposes.
3.	This measure has been renamed from ‘Waiting time for results is less than 28 days’.
4.	This indicator is being replaced by the following indicator which is more clinically relevant for the breast screening program.
5.	New indicator.  The 2008-09 estimated outcome is provided for comparative purposes.

Accountability Indicators cont.
	2008-09
Targets	2008-09
Est. Outcome	2009-10
Targets	
Output 1.6:  Aged Care and Rehabilitation Services	
				
Patient activity				
a.	Cost weighted admitted patient separations 	4,5151	5,4841	5,2052	
b.	Non-admitted occasions of service	1,600	2,100	2,165	
c.	Sub-acute service - episodes of care	920	6003	1,6504	
d.	Sub-acute service - occupied bed days	13,870	12,9005	24,5006	
This provides an indication of the level of services provided.	
e.	Number of people assessed in falls clinics	420	400	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.  The considerable increase in cost weighted separations in 2008-09 is related to strong increased demand for geriatric inpatient services.
2.	Cost weight target for 2009-10 is presented using AR-DRG Version 5.1 mapped to National Public Weights Round 11.  This figure represents an estimated 3 per cent growth on the estimated outcome for 2008-09 of 5,054 cost weights using round 11 weights.
3.	The lower than target estimated outcome for 2008-09 is related to a higher than initially estimated average length of stay for patients accessing the sub-acute service at Calvary Public Hospital (up to an average of 21 days from the initial estimate of 15 days).
4.	The estimated number of sub acute episodes of care for 2009-10 reflects new national counting methods for sub-acute services and includes all sub-acute care provided within output 1.6, which includes activity at both TCH and Calvary Public Hospital.  Previously, only activity at the sub-acute service at Calvary Public Hospital was included in this measure.  The target represents an estimated growth of 3 per cent during 2009-10.
5.	The 12,900 bed days reported in 2008-09 is within 2 per cent of the revised target of 90 per cent occupancy for the sub-acute service at Calvary Public Hospital.  The original target for 2008-09 (13,870 bed days) was based on occupancy of 95 per cent. 
6.	The estimated number of sub-acute episodes of bed days for 2009-10 reflects new national counting methods for sub-acute services and includes all sub-acute care provided within output 1.6, which includes activity at both TCH and Calvary Public Hospital.  Previously, only activity at the sub acute service at Calvary Hospital was included in this measure.  The target represents an estimated growth of 3 per cent during 2009-10.

Accountability Indicators cont.
	2008-09
Targets	2008-09
Est. Outcome	2009-10
Targets	
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 screening1				
b.	Total breast screens	12,000	11,500	n/a	
c.	Number of breast screens for women aged 50-69	10,500	10,000	n/a	
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.	
Community Health				
d.	Proportion of clients attending ‘Well Women's Check’ within the Women's Health Service that are from culturally and linguistically diverse communities	25%	29%	30%	
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%	
				
Note:
1.	This measure is now reported under output 1.5 Cancer Services.

Changes to Appropriation
Changes to Appropriation - Departmental						
 	2008-09	2009-10	2010-11	2011-12	2012-13	
Government Payment for Outputs	Est. Out.	Budget	Estimate	Estimate	Estimate	
 	$'000	$'000	$'000	$'000	$'000	
						
2008-09 Budget	693,502	732,255	779,311	830,269	830,269	
						
2009-10 Budget Policy Adjustments						
Mental Health Growth	 - 	2,000	2,068	2,138	2,211	
Increased Critical Care Capacity	 - 	2,500	2,585	2,673	2,764	
Growth in Demand for Acute Care Capacity	 - 	3,000	7,218	7,478	7,749	
Growth in Demand for Surgery	 - 	2,000	2,068	2,138	2,211	
Growth in Cancer Services	 - 	1,000	1,035	1,069	1,106	
Diagnostic Mammography	 - 	608	629	651	674	
Increased Demand in Older Persons Services	 - 	1,000	1,035	1,069	1,106	
Integrated Prevention of Chronic Disease	 - 	1,000	1,035	1,069	1,106	
Health Workforce Development	 - 	500	1,521	2,621	3,541	
GP Workforce Initiatives	 - 	1,500	2,517	3,571	4,655	
A Healthy Future - Preventative Health Program	 - 	3,750	3,567	3,688	 - 	
Mental Health Assessment Unit	 - 	1,458	2,624	2,740	2,856	
An E-Healthy Future	 - 	350	1,381	1,061	11,050	
Offset - Base Funding Envelope 	 - 	(20,666)	(29,282)	(31,966)	(41,029)	
Medical Retrieval Services	 - 	800	1,500	1,538	1,576	
Expansion of the ACT Magistrate Courts Forensic Mental Health Court Liaison Team	 - 	135	140	 - 	 - 	
Mental Health Training	 - 	300	300	 - 	 - 	
Extension of Paid Maternity Leave	 - 	778	806	830	857	
SPP - National Healthcare 	6,646	12,244	14,691	19,155	26,069	
Revised Wage Parameters	 - 	(1,928)	(5,092)	(7,542)	(10,267)	
Efficiency Dividend	 - 	 - 	(6,128)	(6,565)	(7,082)	
						
2009-10 Budget Technical Adjustments						
Revised Indexation Parameters	 - 	(521)	(534)	(547)	59,033	
Revised Indexation Parameters - Community Sector Funding	 - 	(142)	(147)	(153)	187	
Revised Superannuation Contributions	 - 	3,018	3,018	3,018	3,018	
Revised Commonwealth Grant - Health Care Assessment, Illicit Drug, Immunisation Agreement, HACC	3,035	(2,584)	(2,522)	(2,644)	(2,680)	
National Partnership - Health Services	308	308	387	386	382	
National Partnership - Hospital and Health Workforce Reform	18,165	 - 	 - 	980	1,320	
National Partnership - Preventative Health 	 - 	40	137	1,248	2,277	
National Partnership - Indigenous Early Childhood Development	 - 	250	300	330	340	
Rollover - Australian Immunisation Agreement	(352)	352	 - 	 - 	 - 	
Rollover - Illicit Drug Diversion Initiative	(333)	333	 - 	 - 	 - 	
Rollover - Taking the Pressure off Public Hospitals/Walk-in Centre	(9,969)	893	2,554	2,643	2,734	
Rollover - Sub-Acute Care	(7,336)	1,739	1,804	1,864	1,929	
Rollover - Activity Based Funding	(860)	422	438	 - 	 - 	
						
2009-10 Budget	702,806	748,692	790,964	844,810	909,962	

Changes to Appropriation - Territorial
 	2008-09	2009-10	2010-11	2011-12	2012-13	
Payment for Expenses on Behalf of Territory	Est. Out.	Budget	Estimate	Estimate	Estimate	
 	$'000	$'000	$'000	$'000	$'000	
						
2008-09 Budget	5,395	7,102	710	727	727	
						
2009-10 Budget Technical Adjustment						
Capital Upgrades Indexation	 - 	 - 	 - 	 - 	19	
						
2009-10 Budget	5,395	7,102	710	727	746	

						
						
Changes to Appropriation - Departmental						
 	2008-09	2009-10	2010-11	2011-12	2012-13	
Capital Injections	Est. Out.	Budget	Estimate	Estimate	Estimate	
 	$'000	$'000	$'000	$'000	$'000	
						
2008-09 Budget	91,183	97,499	95,231	80,889	80,889	

FMA Section 16B Rollovers from 2007-08						
Adult Mental Health Acute Inpatient Facility	278	 - 	 - 	 - 	 - 	
High Secure Mental Health Inpatient Unit	188	 - 	 - 	 - 	 - 	
Neonatal Intensive Care Unit	189	 - 	 - 	 - 	 - 	
Building Refurbishment and Upgrades	470	 - 	 - 	 - 	 - 	
Electrical, Lift and Major Plant Upgrades	420	 - 	 - 	 - 	 - 	
OH&S and Access 	106	 - 	 - 	 - 	 - 	
Linear Accelerator Procurement and Replacement	285	 - 	 - 	 - 	 - 	
Paediatric Emergency Department Waiting Area	140	 - 	 - 	 - 	 - 	
Clinical Equipment for Calvary Hospital	902	 - 	 - 	 - 	 - 	
Dental Health Program - Restorative Waiting List Reduction	60	 - 	 - 	 - 	 - 	
Ophthalmology Service	1,000	 - 	 - 	 - 	 - 	
Radiography Equipment	250	 - 	 - 	 - 	 - 	
Gamma Camera Replacement Project	1,400	 - 	 - 	 - 	 - 	
Replace Existing Superficial X-Ray Radiotherapy Treatment Unit	272	 - 	 - 	 - 	 - 	
Linear Accelerator Purchase	3,200	 - 	 - 	 - 	 - 	
						
3rd Appropriation						
Pharmacy Cool Room Upgrade	295	 - 	 - 	 - 	 - 	
Expansion of the Oncology Clinics and Cancer Services Facilities	395	 - 	 - 	 - 	 - 	
Safety Upgrades	200	 - 	 - 	 - 	 - 	
						
2009-10 Budget Policy Adjustments						
Procurement and Installation of a PET/CT Scanner	 - 	4,542	 - 	 - 	 - 	
An E-Healthy Future	 - 	7,000	25,000	35,000	23,185	
Enhanced Community Health Centre - Belconnen	 - 	4,958	32,470	13,916	 - 	
Walk-in Centre - TCH	 - 	2,157	 - 	 - 	 - 	
Diagnostic Mammography	 - 	694	 - 	 - 	 - 	
Offset - Base Funding Envelope 	 - 	(694)	 - 	 - 	 - 	

Changes to Appropriation - Departmental cont.
 	2008-09	2009-10	2010-11	2011-12	2012-13	
Capital Injections cont.	Est. Out.	Budget	Estimate	Estimate	Estimate	
 	$'000	$'000	$'000	$'000	$'000	

2009-10 Budget Technical Adjustments						
Capital Upgrades Indexation	 - 	 - 	 - 	 - 	91	
Rollover - Adult Mental Health Inpatient Facility	(4,445)	(8,685)	12,853	277	 - 	
Rollover - High Secure Mental Health Inpatient Unit	(2,500)	(3,000)	2,704	2,796	 - 	
Rollover - Mental Health Assessment Unit	(1,545)	1,545	 - 	 - 	 - 	
Rollover - Women & Children's Hospital	(3,424)	(15,611)	12,234	2,870	3,931	
Rollover - Neurosurgery Suite/SAPU - TCH	(2,903)	6,894	1,009	 - 	 - 	
Rollover - New Gungahlin Health Centre	(1,799)	(9,501)	8,873	2,427	 - 	
Rollover - Refurbishment of Health Centres	(500)	(1,168)	1,668	 - 	 - 	
Rollover - Provision for Phase 1 CSR	(1,427)	910	11,815	(32,961)	663	
Rollover - Provision for Project Definition Planning	(1,521)	(505)	3,950	(5,549)	3,625	
Rollover - Mental Health Young Persons Unit	(775)	775	 - 	 - 	 - 	
Rollover - ACT Health Skills Development Centre	(1,300)	1,300	 - 	 - 	 - 	
Rollover - New Multistorey Car Park - TCH	(27,302)	23,366	19,936	 - 	 - 	
Rollover - Elective Surgery	(2,056)	2,056	 - 	 - 	 - 	
Rollover - Digital Mammography	(5,565)	5,565	 - 	 - 	 - 	
Rollover - NICU Video Streaming Services	(50)	50	 - 	 - 	 - 	
Rollover - ATSI Alcohol & Other Drug Rehab Facility	(693)	(2,838)	3,531	 - 	 - 	
Cessation - Linear Accelerator, CADP Projects	 - 	 - 	(500)	(3,228)	(77,228)	
						
2009-10 Budget	43,428	117,309	230,774	96,437	35,156	

2009-10 Capital Works Program
Departmental
 	Estimated	Estimated	2009-10	2010-2011	2011-2012	Expected 	
	Total	Expenditure	Financing	Financing	Financing	Completion 	
	Cost 	Pre 2009-10				Date  	
 	$’000	$’000	$’000	$’000	$’000	 	
New Capital Works							
Enhanced Community Health Centre - Belconnen	51,344	-	4,958	32,470	13,916	Feb 2012	
Walk-In Centre - TCH	2,157	-	2,157	-	-	Mar 2010	
							
Total New Works	53,501	-	7,115	32,470	13,916		
							
Capital Upgrades							
Disability Access Works - Non-Acute Sites (Stage 1)	475	-	475				
Disability Access Works - Patient Accommodation and Gaunt Place (Stage 1)	134	-	134				
Building Upgrades - Including Asbestos Removal Non-Acute Sites (Stage 1)	525	-	525				
Electrical, Plumbing, Floor Coverings and Air-Conditioning Upgrades (Stage 1)	225	-	225				
Energy Savings and Sustainability Works	305	-	305				
Safety Upgrades	325	-	325				
Refurbishment of Non-Clinical Accommodation at TCH	300	-	300				
Address Building Condition and Asbestos Audit Requirements	380	-	380				
TCH Upgrades to Ambulatory Areas, Intensive Care Facilities, pathology Laboratories and ED	525	-	525				
Workplace Redesign to Meet Accommodation and OH&S Standards	290	-	290				
Total Capital Upgrades 	3,484	-	3,484				
							
Total New Capital Works	56,985	-	10,599	32,470	13,916		

Departmental cont.
	Estimated	Estimated	2009-10	2010-11	2011-12	Expected 	
	Total	Expenditure	Financing	Financing	Financing	Completion 	
	Cost 	Pre 2009-10				Date  	
	$’000	$’000	$’000	$’000	$’000	 	
Works in Progress							
Linear Accelerator Procurement and Replacement	17,700	17,200	500	-	-	Jun 2010	
Secure Adult Mental Health Unit - Forward Design	1,200	200	1,000	-	-	Jun 2010	
Adult Mental Health Inpatient Facility -Forward Design	2,290
	845	1,445	-	-	Jan 2010	
Adult Mental Health Inpatient Facility	23,630	-	2,500	20,853	277	Jun 2011	
Secure Adult Mental Health Unit	11,160	-	1,000	7,364	2,796	Dec 2011	
Mental Health Assessment Unit	2,010	94	1,916	-	-	Dec 2009	
Women & Children's Hospital1	90,000	576	11,889	54,734	18,870	Jun 2012	
Neurosurgery Operating Theatre2	10,500	694	9,086	720	-	Aug 2010	
Surgical Assessment and Planning Unit 	4,100	403	3,408	289	-	Aug 2010	
New Gungahlin Health Centre	18,000	1	699	14,873	2,427	Sep 2011	
Refurbishment of Health Centre	5,000	-	3,332	1,668	-	Dec 2010	
Provision for Phase 1 CSR2,3	36,000	573	6,910	23,815	4,039	Jun 2012	
Provision for Project Definition Planning4	63,800	10,979	15,295	18,450	15,451	Jun 2012	
Digital Mammography	5,715	150	5,565	-	-	Jun 2010	
NICU Video Streaming Services	200	150	50	-	-	Jul 2009	
Mental Health Young Persons Unit	775	-	775	-	-	Jun 2010	
ACT Health Skills Development Centre	1,300	-	1,300	-	-	Jun 2010	
New Multistorey Car Park TCH2	45,000	1,698	23,366	19,936	-	Oct 2010	
Aboriginal Torres Strait Islander Residential Alcohol & Other Drug Rehabilitation Facility	5,883	500	1,852	3,531	-	Jun 2011	
Elective Surgery (Commonwealth Funding)	4,680	2,624	2,056	-	-	Aug 2009	
Total Works in Progress	348,943	36,687	93,944	166,233	43,860	 	
							
Total Departmental Capital Works	405,928	36,687	104,543	198,703	57,776	 	
Notes:
1.	$3.930 million is forecast for the 2012-13 financial year.
2.	$21 million has been transferred from the Provision for Phase 1 CSR project to the New Multistorey Car Park TCH ($16 million) and the Neurosurgery Operating Theatre ($5 million).
3.	$0.664 million is forecast for the 2012-13 financial year.
4.	$3.625 million is forecast for the 2012-13 financial year.

Territorial
	Estimated	Estimated	2009-10	2010-11	2011-12	Expected 	
	Total	Expenditure	Financing	Financing	Financing	Completion 	
	Cost 	Pre 2009-10				Date  	
	$’000	$’000	$’000	$’000	$’000		
Capital Upgrades							
Improved Patient Amenity	150	-	150	-	-	Jun 2010	
Infrastructure Improvements	230	-	230	-	-	Jun 2010	
Occupational Health and Safety Upgrades	312	-	312	-	-	Jun 2010	
Total Capital Upgrades	692	-	692	-	-		
							
Total New Capital Works	692	-	692	-	-		
							
Works in Progress							
Intensive Care - Calvary Hospital	9,410	3,000	6,410	-	-	Feb 2010	
Total Works in Progress	9,410	3,000	6,410	-	-		
							
Total Territorial Capital Works	10,102	3,000	7,102	-	-		

ACT Health
Operating Statement
  2008-09			  2008-09	2009-10		  2010-11	    2011-12	  2012-13	
    Budget			Est.Outcome	Budget	     Var	  Estimate	    Estimate	  Estimate	
    $'000			    $'000	$'000	      %	    $'000	     $'000	   $'000	
		Income							
		Revenue							
693,502		Government Payment for Outputs	704,955	748,692	6	790,964	844,810	909,962	
154,174		User Charges - Non ACT Government	165,164	192,881	17	200,969	209,074	214,343	
1,183		User Charges - ACT Government	783	832	6	862	922	952	
13,937		Grants from the Commonwealth	13,937	0	-100	0	0	0	
228		Interest	278	278	-	278	278	278	
8,011		Other Revenue	11,926	9,938	-17	10,063	10,201	10,401	
1,050		Resources Received Free of Charge	1,100	1,125	2	1,150	1,180	1,210	
872,085		Total Revenue	898,143	953,746	6	1,004,286	1,066,465	1,137,146	
		Gains							
737		Other Gains	1,016	1,038	2	1,050	1,077	1,105	
737		Total Gains	1,016	1,038	2	1,050	1,077	1,105	
872,822		Total Income	899,159	954,784	6	1,005,336	1,067,542	1,138,251	
		Expenses							
383,211		Employee Expenses	390,752	417,289	7	438,830	469,585	506,197	
53,373		Superannuation Expenses	53,173	57,984	9	59,580	60,331	60,854	
241,491		Supplies and Services	252,436	270,107	7	286,313	303,492	321,701	
21,612		Depreciation and Amortisation	20,300	22,873	13	27,574	35,057	40,675	
401		Borrowing Costs	401	401	-	401	401	401	
13,285		Cost of Goods Sold	14,285	15,142	6	16,051	17,014	18,034	
172,157		Grants and Purchased Services	174,692	185,174	6	195,284	207,061	119,545	
3,311		Other Expenses	3,961	4,198	6	4,450	4,717	5,000	
888,841		Total Ordinary Expenses	910,000	973,168	7	1,028,483	1,097,658	1,172,407	
-16,019		Operating Result	-10,841	-18,384	-70	-23,147	-30,116	-34,156	

ACT Health
Balance Sheet
    Budget			Est.Outcome	    Planned		   Planned	   Planned	   Planned		
as at 30/6/09			as at 30/6/09	as at 30/6/10	   Var	as at 30/6/11	as at 30/6/12	as at 30/6/13		
   $'000			   $'000	     $'000	    %	    $'000	    $'000	    $'000		
		Current Assets								
509		Cash and Cash Equivalents	16,781	16,075	-4	15,537	14,999	14,461		
36,368		Receivables	32,236	27,236	-16	27,236	27,236	27,236		
6,205		Inventories	6,685	6,685	-	6,685	6,685	6,685		
6,433		Other	1,509	1,509	-	1,509	1,509	1,509		
49,515		Total Current Assets	57,211	51,505	-10	50,967	50,429	49,891		
		Non Current Assets								
3,000		Investments	3,000	3,000	-	3,000	3,000	3,000		
602,034		Property, Plant and Equipment	532,630	535,155	..	607,327	712,976	917,682		
12,428		Intangibles	11,215	20,595	84	33,095	48,460	55,844		
32,132		Capital Works in Progress	38,964	134,524	245	261,344	210,456	2,075		
649,594		Total Non Current Assets	585,809	693,274	18	904,766	974,892	978,601		
699,109		TOTAL ASSETS	643,020	744,779	16	955,733	1,025,321	1,028,492		
		Current Liabilities								
28,844		Payables	29,935	29,135	-3	28,335	27,535	26,735		
2,596		Finance Leases	3,009	2,319	-23	3,009	2,319	3,009		
88,060		Employee Benefits	95,947	98,029	2	100,604	103,119	104,538		
5,551		Other	12,490	12,490	-	12,490	12,490	12,490		
125,051		Total Current Liabilities	141,381	141,973	..	144,438	145,463	146,772		
		Non Current Liabilities								
0		Payables	13	13	-	13	13	13		
1,730		Finance Leases	2,319	3,009	30	2,319	3,009	2,319		
7,665		Employee Benefits	4,981	6,533	31	8,085	9,637	11,189		
9,395		Total Non Current Liabilities	7,313	9,555	31	10,417	12,659	13,521		
134,446		TOTAL LIABILITIES	148,694	151,528	2	154,855	158,122	160,293		
564,663		NET ASSETS	494,326	593,251	20	800,878	867,199	868,199		
		REPRESENTED BY FUNDS EMPLOYED								
412,038		Accumulated Funds	358,922	457,847	28	665,474	731,795	732,795		
152,625		Reserves	135,404	135,404	-	135,404	135,404	135,404		
564,663		TOTAL FUNDS EMPLOYED	494,326	593,251	20	800,878	867,199	868,199		

ACT Health
Cash Flow Statement
  2008-09			  2008-09	   2009-10		  2010-11	    2011-12	  2012-13		
    Budget			Est.Outcome	   Budget	     Var	  Estimate	    Estimate	  Estimate		
    $'000			    $'000	   $'000	      %	    $'000	     $'000	   $'000		
		CASH FLOWS FROM OPERATING ACTIVITIES								
		Receipts								
693,502		Cash from Government for Outputs	702,806	748,692	7	790,964	844,810	909,962		
160,357		User Charges	167,947	198,713	19	201,831	209,996	215,295		
228		Interest Received	278	278	-	278	278	278		
13,937		Grants Received from the Commonwealth	13,937	0	-100	0	0	0		
46,240		Other Revenue	54,434	53,672	-1	54,010	54,475	55,103		
914,264		Operating Receipts	939,402	1,001,355	7	1,047,083	1,109,559	1,180,638		
		Payments								
378,769		Related to Employees	383,310	413,838	8	434,886	465,701	503,263		
53,190		Related to Superannuation	53,173	57,984	9	59,580	60,331	60,854		
241,641		Related to Supplies and Services	252,002	269,648	7	285,829	302,978	321,333		
0		Borrowing Costs	401	401	-	401	401	401		
172,157		Grants and Purchased Services	174,692	185,174	6	195,284	207,061	219,545		
54,088		Other	60,688	61,986	2	63,348	64,878	66,551		
899,845		Operating Payments	924,266	989,031	7	1,039,328	1,101,350	1,171,947		
14,419		NET CASH INFLOW/ (OUTFLOW) FROM OPERATING ACTIVITIES	15,136	12,324	-19	7,755	8,209	8,691		
		CASH FLOWS FROM INVESTING ACTIVITIES								
		Payments								
104,132		Purchase of Property, Plant and Equipment and Capital Works	67,146	128,887	92	237,615	103,732	42,933		
104,132		Investing Payments	67,146	128,887	92	237,615	103,732	42,933		
-104,132		NET CASH INFLOW/ (OUTFLOW) FROM INVESTING ACTIVITIES	-67,146	-128,887	-92	-237,615	-103,732	-42,933		
		CASH FLOWS FROM FINANCING ACTIVITIES								
		Receipts								
91,183		Capital Injection from Government	43,428	117,309	170	230,774	96,437	35,156		
91,183		Financing Receipts	43,428	117,309	170	230,774	96,437	35,156		
		Payments								
1,452		Repayment of Finance Lease	1,452	1,452	-	1,452	1,452	1,452		
1,452		Financing Payments	1,452	1,452	-	1,452	1,452	1,452		
89,731		NET CASH INFLOW/ (OUTFLOW) FROM FINANCING ACTIVITIES	41,976	115,857	176	229,322	94,985	33,704		
18		NET INCREASE/ (DECREASE) IN CASH HELD	-10,034	-706	93	-538	-538	-538		
491		CASH AT BEGINNING OF REPORTING PERIOD	26,815	16,781	-37	16,075	15,537	14,999		
509		CASH AT THE END OF THE REPORTING PERIOD	16,781	16,075	4	15,537	14,999	14,461		

ACT Health
Statement of Changes in Equity
    Budget			Est.Outcome	    Planned		   Planned	   Planned	   Planned	
as at 30/6/09			as at 30/6/09	as at 30/6/10	   Var	as at 30/6/11	as at 30/6/12	as at 30/6/13	
   $'000			   $'000	     $'000	    %	    $'000	    $'000	    $'000	
489,499		Opening Balance	461,739	494,326	7	593,251	800,878	867,199	
		Accumulated Funds							
-16,019		Operating Result for the Period	-10,841	-18,384	-70	-23,147	-30,116	-34,156	
		Reserves							
-16,019		Total Income And Expense For The Period	-10,841	-18,384	-70	-23,147	-30,116	-34,156	
		Transactions Involving Equity Holders Affecting Accumulated Funds							
91,183		Capital Injections	43,428	117,309	170	230,774	96,437	35,156	
564,663		Closing Balance	494,326	593,251	20	800,878	867,199	868,199	
Notes to the Budget Statements
Significant variations are as follows:
Operating Statement
•	government payment for outputs:
•	the increase of $11.453 million in the 2008-09 estimated outcome from the original budget relates to increased Commonwealth funding ($9.989 million) and rollovers ($1.464 million); and
•	the increase of $43.737 million in the 2009-10 Budget from the 2008-09 estimated outcome relates to growth and new initiatives ($24.266 million), indexation ($22.473 million), increased Australian Healthcare Agreement and other new National Partnership funding ($8.049 million) and changes to superannuation rates ($3.018 million).  These are partially offset by planned savings ($9.678 million) and the removal of rollovers from 2007-08 ($4.149 million).
•	user charges - non ACT Government:
•	the increase of $10.990 million in the 2008-09 estimated outcome from the original budget relates mostly to increased cross border health revenue from NSW and prior year adjustments; and
•	the increase of $27.717 million in the 2009-10 Budget from the 2008-09 estimated outcome relates mainly to the reclassification of Commonwealth Highly Specialised Drugs funding from grants from the Commonwealth ($13.937 million), the transfer of some Commonwealth funding previously collected through the Territorial account and increased cross border revenue from NSW.
•	grants from the Commonwealth:  the decrease of $13.937 million in the 2009-10 Budget from the 2008-09 estimated outcome is due to the reclassification of the reimbursement by the Commonwealth for Highly Specialised Drugs to user charges — non ACT Government.
•	other revenue:
•	the increase of $3.915 million in the 2008-09 estimated outcome from the original budget relates to one-off programs mainly associated with the Commonwealth funded Health Connect project; and
•	the decrease of $1.988 million in the 2009-10 Budget from the 2008-09 estimated outcome relates to the removal of one-off programs.
•	employee expenses:
•	the increase of $7.541 million in the 2008-09 estimated outcome from the original budget relates to increased activity at TCH; and
•	the increase of $26.537 million in the 2009-10 Budget from the 2008-09 estimated outcome relates to wages increases ($18.972 million), growth and new initiatives ($11.538 million) and increased Australian Healthcare Agreement Funding ($2.292 million).  These are partially offset by planned savings ($6.775 million).
•	superannuation expenses:  the increase of $4.811 million in the 2009-10 Budget from the 2008-09 estimated outcome relates to changes to the contribution rates for CSS and PSS members, wage increases, growth and new initiatives.
•	supplies and services:
•	the increase of $10.945 million in the 2008-09 estimated outcome from the original budget relates to increased activity at TCH, rollovers from 2007-08 and increased Commonwealth funded programs mainly associated with the Australian Immunisation Agreement; and
•	the increase of $17.671 million in the 2009-10 Budget from the 2008-09 estimated outcome relates to indexation ($8.5 million), growth and new initiatives ($7.525 million) and increased Australian Healthcare Agreement funding ($5.098 million).  These are partially offset by planned savings ($2.903 million) and removal of rollovers ($1 million).
•	depreciation and amortisation:
•	the decrease of $1.312 million in the 2008-09 estimated outcome from the original budget relates to delayed implementation of major information technology and other capital works projects; and
•	the increase of $2.573 million in the 2009-10 Budget from the 2008-09 estimated outcome relates mainly to the completion of major information technology projects.
•	cost of goods sold:  the increase of $1 million in the 2008-09 estimated outcome from the 2008-09 Budget and the increase of $0.857 million in the 2009-10 Budget from the 2008-09 estimated outcome relates to increased volume and cost of medical and surgical supplies to private hospitals.
•	grants and purchased services:
•	the increase of $2.535 million in the 2008-09 estimated outcome from the original budget relates mainly to Commonwealth funded programs ($2.259 million) and rollovers ($0.667 million); and
•	the increase of $10.482 million in the 2009-10 Budget from the 2008-09 estimated outcome relates mainly to indexation on grants payments to non government organisations including Calvary Public Hospital, growth to the home and community care program and new initiatives.
Balance Sheet
•	cash and cash equivalents:  the increase of $16.272 million in the 2008-09 estimated outcome from the original budget relates to a reduction in receivables, receipt of Commonwealth project funds and unspent information technology project funding.
•	receivables:  the decrease of $4.132 million in the 2008-09 estimated outcome from the original budget and $5 million in the 2009-10 Budget from the 2008-09 estimated outcome relates to a reduction in cross border receivables from NSW.
•	other current assets:  the decrease of $4.924 million in the 2008-09 estimated outcome from the original budget relates to a reduction in prepayments.
•	property, plant and equipment:  the decrease of $69.404 million in the 2008-09 estimated outcome from the original budget relates to delays in the Capital Asset Development Plan (CADP).
•	intangibles:  the increases of $9.380 million in the 2009-10 Budget from the estimated outcome relates to major information technology projects, including those associated with the CADP.
•	capital works in progress:  the increase of $6.832 million in the 2008-09 estimated outcome from the original budget and the increase of $95.560 million in the 2009-10 Budget from the 2008-09 estimated outcome relate to the completion of CADP projects currently underway or commencing in 2009-10.
•	current and non current finance leases:  the increase of $1.002 million in the 2008-09 estimated outcome from the original budget relates to the timing of motor vehicle lease expiry and replacement program.
•	other current liabilities:  the increase of $6.939 million in the 2008-09 estimated outcome from the original budget relates to increased revenue received in advance for Commonwealth funded programs.
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
  2008-09			  2008-09	   2009-10		  2010-11	    2011-12	  2012-13		
    Budget			Est.Outcome	   Budget	     Var	  Estimate	    Estimate	  Estimate		
    $'000			    $'000	   $'000	      %	    $'000	     $'000	   $'000		
		Income								
		Revenue								
5,395		Payment for Expenses on behalf of Territory	5,395	7,102	32	710	727	746		
613		Taxes Fees and Fines	613	635	4	650	676	693		
153,023		Grants from the Commonwealth	153,610	0	-100	0	0	0		
159,031		Total Revenue	159,618	7,737	-95	1,360	1,403	1,439		
		Gains								
0		Total Gains	0	0	-	0	0	0		
159,031		Total Income	159,618	7,737	-95	1,360	1,403	1,439		
		Expenses								
5,395		Grants and Purchased Services	5,395	7,102	32	710	727	746		
153,636		Transfer Expenses	154,223	635	-100	650	676	693		
159,031		Total Ordinary Expenses	159,618	7,737	-95	1,360	1,403	1,439		
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 30/6/09			as at 30/6/09	as at 30/6/10	   Var	as at 30/6/11	as at 30/6/12	as at 30/6/13		
   $'000			   $'000	     $'000	    %	    $'000	    $'000	    $'000		
		Current Assets								
276		Cash and Cash Equivalents	294	294	-	294	294	294		
24		Receivables	6	6	-	6	6	6		
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		TOTAL FUNDS EMPLOYED	0	0	-	0	0	0		

ACT Health
Budgeted Statement of Cash Flows on Behalf of the Territory
  2008-09			  2008-09	   2009-10		  2010-11	    2011-12	  2012-13		
    Budget			Est.Outcome	   Budget	     Var	  Estimate	    Estimate	  Estimate		
    $'000			    $'000	   $'000	      %	    $'000	     $'000	   $'000		
		CASH FLOWS FROM OPERATING ACTIVITIES								
		Receipts								
5,395		Cash from Government for EBT	5,395	7,102	32	710	727	746		
613		Taxes, Fees and Fines	613	635	4	650	676	693		
153,023		Grants Received from the Commonwealth	153,610	0	-100	0	0	0		
539		Other Revenue	539	710	32	71	73	75		
159,570		Operating Receipts	160,157	8,447	-95	1,431	1,476	1,514		
		Payments								
5,395		Grants and Purchased Services	5,395	7,102	32	710	727	746		
539		Other	539	710	32	71	73	75		
153,636		Territory Receipts to Government	154,223	635	-100	650	676	693		
159,570		Operating Payments	160,157	8,447	-95	1,431	1,476	1,514		
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		
276		CASH AT BEGINNING OF REPORTING PERIOD	294	294	-	294	294	294		
276		CASH AT THE END OF THE REPORTING PERIOD	294	294	-	294	294	294		

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 $1.707 million in the 2009-10 Budget from the 2008-09 estimated outcome relates to the capital works program at Calvary Public Hospital.
•	grants from the Commonwealth:  the decrease of $153.610 million in the 2009-10 Budget from the 2008-09 estimated outcome relates to the transfer of Commonwealth grant revenue to the Department of Treasury due to the Federal Financial Reforms.
•	grants and purchased services:  the increase of $1.707 million in the 2009-10 Budget from the 2008-09 estimated outcome relates to the Capital Works program at Calvary Public Hospital.
•	transfer expenses:  the decrease of $153.588 million in the 2009-10 Budget from the 2008-09 estimated outcome relates to the transfer of Commonwealth grant revenue to the Department of Treasury due to the Federal Financial Reforms.