ACT HEALTH
Objectives
ACT Health aims to increase the community’s capacity for healthy living by planning, providing and purchasing quality community based health services, major trauma and tertiary health care, 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.
2007‑08 Priorities
Strategic and operational initiatives to be pursued in 2007‑08 include:
•	achieving the efficiencies and reforms that will bring ACT hospital costs closer to the national average;
•	full commissioning of the new sub acute and non-acute facility at Calvary Public Hospital, comprising psycho-geriatric beds and transitional/rehabilitation beds;
•	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 our care delivery systems through the Access Improvement Program;
•	providing additional elective surgery episodes through the commissioning of a tenth operating theatre at The Canberra Hospital for five days per week;
•	implementation of the Human Papillomavirus (HPV) Vaccination Program in the ACT, designed to reduce instances of cervical cancers;
•	enhancing the Territory’s capacity to manage and respond to communicable disease outbreaks and emerging communicable disease threats;
•	extending the existing health services for marginalised and disadvantaged young people to the Belconnen/Gungahlin and Tuggeranong areas;
•	establishing a cross-agency team that will provide intensive support and assertive case management to at-risk children and families; and
•	reducing the waiting times for people on the dental restorative waiting list.

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; and
•	a system of care and support that improves the quality of life for vulnerable groups.
Estimated Employment Level
	2006‑07
Est.  Outcome	2007‑08
Budget	
Staffing (FTE)	4,128	4,171	

Output Classes
	Total Cost1	Government Payment for Outputs	
	2006‑07
Est. Outcome
$’000	2007‑08
Budget
$’000	2006‑07
Est. Outcome
$’000	2007‑08
Budget
$’000	
Output Class 1:
Health and Community Care	762,809	801,774	598,525	628,455	
Output 1.1: Acute Services	499,897	520,666	355,703	366,510	
Note:
1.	Total cost includes depreciation of $15.932 million in 2006‑07 and $17.220 million in 2007‑08. 
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	
	2006‑07
Est. Outcome
$’000	2007‑08
Budget
$’000	2006‑07
Est. Outcome
$’000	2007‑08
Budget
$’000	
Output 1.2: Mental Health Services	51,280	55,193	49,718	53,942	
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	
	2006‑07
Est. Outcome
$’000	2007‑08
Budget
$’000	2006‑07
Est. Outcome
$’000	2007‑08
Budget
$’000	
Output 1.3: Community Health Services 	99,921	101,271	92,285	95,399	
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 are also 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	
	2006‑07
Est. Outcome
$’000	2007‑08
Budget
$’000	2006‑07
Est. Outcome
$’000	2007‑08
Budget
$’000	
Output 1.4: Public Health Services	23,791	24,577	22,460	23,432	
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	
	2006‑07
Est. Outcome
$’000	2007‑08
Budget
$’000	2006‑07
Est. Outcome
$’000	2007‑08
Budget
$’000	
Output 1.5: Cancer Services	21,327	23,900	16,333	18,870	
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	
	2006‑07
Est. Outcome
$’000	2007‑08
Budget
$’000	2006‑07
Est. Outcome
$’000	2007‑08
Budget
$’000	
Output 1.6:
Aged Care and Rehabilitation Services	30,631	36,106	28,392	31,932	
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 facilitating 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	
	2006‑07
Est. Outcome
$’000	2007‑08
Budget
$’000	2006‑07
Est. Outcome
$’000	2007‑08
Budget
$’000	
Output 1.7:
Early Intervention and Prevention	35,962	40,061	33,634	38,370	
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;
•	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.
•	providing screening services for children who are entering substitute and kinship care, to increase the early identification and intervention of health issues; and
•	reporting the number of females screened for cervical abnormalities (total screened and number of women in the target age group of 20-69 years).

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 to 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.
	2006‑07
Targets	2006‑07
Est. Outcome	2007‑08
Target	
The Canberra Hospital	<0.7%	0.8%	<0.7%	
Calvary Public Hospital	<0.46%	0.5%	<0.46%	

Strategic Indicators cont.
2.	Rate of unplanned hospital readmission
The proportion of people separated from hospital that 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.
	2006‑07
Targets	2006‑07
Est. Outcome	2007‑08
Target	
The Canberra Hospital	2.0%	2.0%	2.0%	
Calvary Public Hospital	1.0%	1.0%	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 emboli are to some extent avoidable through the use of appropriate prophylaxis.
	2006‑07
Targets	2006‑07
Est. Outcome	2007‑08
Target	
The Canberra Hospital	<1.0%	1.0%1	<1.0%	
Calvary Public Hospital	<1.0%	0.2%1	<1.0%	
Note:
1.	The small numbers of people captured by these indicators can result in an apparent negative result.  However, the estimated outcomes for 2006‑07 are within acceptable margins.

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.  
	2006‑07
Targets	2006‑07
Est. Outcome	2007‑08
Target	
The Canberra Hospital	0.5%	0.8%	0.5%	
Calvary Public Hospital	0.1%	0.09%	0.09%	

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 upon which consumers and carers are represented.

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	1.69	1.85	
DMFT Index at 12 years	1.38	0.95	
Source: Child Dental Health Survey 2001 (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	(Vic) 77.9	
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.  The figures above show an increase in life expectancy at birth in the ACT since the 2006‑07 Budget, up 0.5 years for females and up 0.4 years for males.  The Government aims to maintain this result.

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

Source: National Health Survey 2001

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 2001

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 6.8 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 receive care within 48 hours.

Strategic Indicators cont.

Radiotherapy access times cont.
Percentage of all radiotherapy patients who receive care 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.  The Government aims to maintain this reduction in youth smoking with the objective of reaching 13 per cent in 2008.  The national rate in 2005 (latest available data) was 9 per cent.

Strategic Indicators cont.
Strategic Indicator 19
Universal newborn hearing screening
Newborn hearing screening
The Government provided funding in 2004-05 to expand the Newborn Hearing Screening Program to cover all babies who meet the criteria for screening.  The Newborn Hearing Screening Program will extend beyond the public system to include babies born in ACT private hospitals.  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
Increase in the number of women who have their cervical cytology results forwarded to the cervical cytology register annually (up to 34,000 in 2007‑08).  This level of reporting of cervical screens provides an indication of the effectiveness of early intervention health messages.
Strategic Indicator 21
Emergency department timeliness
Waiting times for treatment by triage category
The proportion of Emergency Department presentations who are treated within clinically appropriate timeframes.
Triage Category	2006‑07
Est. Outcome	2007‑08
Target	Long term
Target	
One (resuscitation seen immediately)	100%	100%	100%	
Two (emergency seen within 10 mins)	75%	80%	80%	
Three (urgent seen within 30 mins)1	50%	60%	75%	
Four (semi-urgent seen within 60 mins)1	50%	60%	70%	
Five (non-urgent seen within 120 mins)	83%	85%	85%	
Note:
1.	Target for category three and four for 2007‑08 is below the long term target due to current level of performance in these triage categories.  The impact of the Access Improvement Program will result in a gradual return to at/or above target performance for these triage categories.  

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).

Accountability Indicators
	2006‑07
Targets	2006‑07
Est. Outcome	2007‑08
Target	
Output Class 1: Health and Community Care	
Output 1.1: Acute Services	
				
Patient activity				
a.	Cost weighted patient separations	68,940	71,300 	73,400 1	
b.	Non-admitted occasions of service	234,000	234,000	241,000	
c.	Percentage of category one elective surgery patients who receive surgery within 30 days of listing	95%	91%	95%	

This provides an indication of the responsiveness of the hospital system to those in urgent need of elective surgery.
	
Notes:
1.	Reflects estimated growth in inpatient activity (approx 3 per cent) over 2007‑08.  Cost weights are presented using National Public Hospital Cost weights Round 9 applied to Australian Revised Diagnostic Resource Groups version 5.0.

Output 1.2 Mental Health Services	
				
Patient activity				
a.	Admitted patient separations 	1,200	1,140	1,1001	
b.	Adult services 	153,000	162,000	170,0001	
c.	Children and youth services	34,680	33,500	34,680	
d.	Older persons’ services	12,640	11,600	12,640	
e.	Psychogeriatric services bed days 	n/a	n/a	4,4242	

This provides an indication of the number of services provided by Mental Health ACT.

f.	Supported accommodation bed occupancy rate	95%	92%	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.

g.	The proportion of clients seen at an ACT Health community facility during the 7 days post discharge from the inpatient services	75%	75%	75%	

his provides an indication of the effectiveness of Mental Health ACT in providing an integrated response to the needs of its clients.

h.	Percentage of clients with outcome measures completed	60%	58%	65%	

This provides a data platform for analysis of the appropriateness and effectiveness of mental health services in ensuring that client needs are met.
				
Note:
1.	Reflects continuation of trend in reduction of inpatient services with a corresponding increase in community based services.
2.	This is a new measure in 2007‑08.

Accountability Indicators cont.
	2006‑07
Targets	2006‑07
Est. Outcome	2007‑08
Target	
Output Class 1: Health and Community Care	
Output 1.3: Community Health Services	
a.	Number of opioid treatment clients with management plans	450	570	570	

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	16 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.  The increase in mean waiting times for 2006‑07 is a result of the establishment of a single waiting list for all types of services.

c.	Proportion of offenders and detainees in Quamby and the Belconnen Remand 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 hospitals	91,000	92,500	95,600	

This provides an indication of the level of allied health services provided to hospital based patients by Community Health.

e.	Number of nursing (domiciliary and clinic based) occasions of service	88,000	76,0001	70,8002	
f.	Number of allied health regional services (occasions of service)	26,000	23,600 1	20,0002	
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%	
h.	Proportion of clients discharged from ACT Public Hospitals to a Community Health Program who have a completed discharge plan	50%	30%3	30%	
				
Note:
1.	The lower than expected outcome for 2006‑07 is related to changes in counting arrangements during 2006‑07.  From February 2007, only direct occasions of services are counted.  Previously, direct and indirect occasions of service were included in the total.  The new reporting method is more consistent with national reporting practice. 
2.	The 2007‑08 target is based on a full year’s activity with the new counting methods.
3.	This indicator refers only to discharge plans undertaken by the Link team.  The move to more integrated discharge planning processes means that discharge plans are now managed by all clinicians involved in a patent’s care (nurses, doctors, allied health professional).  This has resulted in a decrease in the amount of discharge planning undertaken by the Link team as a proportion of the total.  A more comprehensive discharge planning indicator will be developed for 2008‑09.

Accountability Indicators cont.
	2006‑07
Targets	2006‑07
Est. Outcome	2007‑08
Target	
Output Class 1: Health and Community Care	
Output 1.3: Community Health Services (cont.)	

Mean waiting time form referral to service delivery, for Allied Health Priority One clients by service type (Nutrition, Occupational Therapy, Physiotherapy, Podiatry and Social Work) 1	2 working
days	n/a	n/a	
Mean waiting time from referral to service delivery, for Allied Health Priority Two clients by service type: 1				
i.	Nutrition	3 weeks	n/a	n/a	
ii.	Occupational Therapy	15 weeks	n/a	n/a	
iii.	Physiotherapy	10 weeks	n/a	n/a	
iv.	Podiatry	6 weeks	n/a	n/a	
v.	Social Work	2 weeks	n/a	n/a	
				
Note:
1.	Accurate information against these indicators is not able to be provided at this point in time.  It is expected that information systems and data collection processes will be in place to capture and measure this data in time for inclusion in the 2008‑09 Budget.

	2006‑07
Targets	2006‑07
Est. Outcome	2007‑08
Target	
Output Class 1: Health and Community Care	
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%	90%1	80% 1	
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%	
				
Note:
1.	The 2006‑07 estimated outcome continues to be above target due to education and enforcement activities undertaken by the Health Protection Service.  However, this level of compliance is not expected to be maintained due to new legislative requirements for smoking in enclosed public places and anticipated changes to food safety requirements under the Food Act, 2001.
Accountability Indicators cont.
Output 1.5: Cancer Services	
				
Patient activity				
a.	Cost weighted admitted patient separations	3,200	3,050 1	3,040 1	
b.	Non‑admitted occasions of service	37,800	38,900 1	40,400 1	

The number of hospital based services provided to clients.  This provides 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%	100%	100%	
d.	Waiting time between the making of an appointment and the breast screen is less than 28 days	90%	92%	90% 2	

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.  This provides an indication of the effectiveness of the service in providing timely advice to women on the results of their breast screen.
	
Notes:
1.	The change to the estimated outcomes and targets for 2007‑08 is due to the change in the counting of ancillary services provided to bone marrow transplant recipients.  The aftercare provided to these patients was recorded as inpatient care up to February 2007.  From that date, this care has been recorded as an outpatient occasion of service, reflecting the type and nature of care provided.  This has resulted in an drop in inpatient care and a corresponding increase in outpatient services.
2.	The target remains at the national rate of 90 per  cent.

	2006‑07
Targets	2006‑07
Est. Outcome	2007‑08
Target	
Output Class 1: Health and Community Care	
Output 1.6: Aged Care and Rehabilitation Services	
				
Patient activity				
a.	Cost weighted admitted patient separations	3,180	3,020 1	3,110	
b.	Non‑admitted occasions of service	1,550	1,250 2	1,550 2	
c.	Sub‑acute service – episodes of care	710	490 3	920 3	
d.	Sub‑acute service – occupied bed days	10,600	7,020 3	13,870 3	

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.	The drop in inpatient cost weighted separations in 2006‑07 is related to the opening of the sub and non-acute services at Calvary Public Hospital.  This new service provides greater options for treating clinicians to provide care in the most appropriate environment for a patient’s needs.
2.	The drop in the estimated outcome for 2006‑07 is due to delays in recruitment of rehabilitation specialists. Recruitment action is now completed and activity is expected to rise as a result.  
3.	The lower than expected outcome for 2006‑07 is related to a later than expected completion of the new sub-acute facility on the Calvary Hospital site.  The new facility began taking patients in March 2007 and will gradually increase to its capacity as demand for services grow.
Accountability Indicators cont.
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%	

The proportion of coverage for the primary immunisation schedule, measured at 1 year of age, in accordance with the Australian Childhood Immunisation Register.

Breast Screening				
b.	Total breast screens	12,000	12,000	12,000	
c.	Number of breastscreens for women aged 50-69	9,950	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	20%	28%	25%	
e.	Proportion of children aged 0-14 who are entering substitute and kinship care within the ACT who attend the Child at Risk Health Unit for a health and wellbeing screen	80%	80%	80%	

Changes To Appropriation
Changes to Appropriation - Departmental						
 	2006-07	2007-08	2008-09	2009-10	2010-11	
Government Payment for Outputs	Est. Out.	Budget	Estimate	Estimate	Estimate	
 	$'000	$'000	$'000	$'000	$'000	
						
2006-07 Budget	592,119	624,234	663,049	704,424	704,424	
						
2007-08 Budget Policy Adjustments 						
Wage Outcome - Salaried Medical Officers	4,520	 - 	 - 	 - 	 - 	
Aged Care and Rehabilitation - Service Enhancement	 - 	2,500	2,563	2,627	2,693	
Growth in Demand for Acute Care Capacity	 - 	3,000	3,090	3,183	3,278	
Growth in Cancer Services	 - 	500	513	526	539	
Growth in Demand for Elective Surgery	 - 	2,500	2,575	2,652	2,732	
Increased Critical Care Capacity	 - 	1,200	1,236	1,273	1,311	
Integrated Prevention for Chronic Disease	 - 	500	536	551	566	
Increased Costs in Provision of Blood and Blood Products	 - 	300	600	900	1,200	
Mental Health Service Enhancement	 - 	3,000	3,090	3,180	3,280	
Population Health Surveillance and Communicable Disease Control	 - 	425	540	554	571	
Expanded Youth Health Services	 - 	260	533	546	560	
Women and Children Detox Program	 - 	50	52	53	54	
Targeted Support for At Risk Children and Families	 - 	500	513	526	539	
Dental Health Program - Restorative Waiting List Reduction	 - 	400	416	433	450	
Implementation of the Human Papillomavirus (HPV) Vaccination Program in the ACT	2,217	4,431	1,658	706	706	
Base Funding Envelope Offset	 - 	(15,362)	(16,464)	(17,085)	(17,854)	
						
2007-08 Budget Technical Adjustments						
Revised Indexation Parameters	 - 	(151)	(323)	(505)	13,231	
Community Sector Indexation	 - 	60	62	64	387	
Continuation of Growth Funding	 - 	 - 	 - 	 - 	33,780	
Rollover - COAG Diversion	(927)	927	 - 	 - 	 - 	
Rollover - Australian Immunisation Agreement	(500)	500	 - 	 - 	 - 	
Rollover - Public Health Outcomes Funding Agreement	(118)	118	 - 	 - 	 - 	
Rollover - Pathways Home Funding	(117)	117	 - 	 - 	 - 	
Shared Services Centre SLA Adjustment	 - 	600	593	601	612	
Australian Government Funding for HACC, AHCA, AIA and ACAP 	840	1,752	861	871	890	
Transfer of Community Services Grants to DHCS	 - 	(491)	(509)	(528)	(548)	
Decreased Notional Superannuation Contribution Rates	 - 	(3,415)	(2,265)	(1,499)	(694)	
Linear Accelerator Procurement and Replacement (reclassify Lease to Capital Purchase)	 - 	 - 	(550)	(550)	(550)	
						
2007-08 Budget	598,034	628,455	662,369	703,503	752,157	

Changes to Appropriation - Territorial						
 	2006-07	2007-08	2008-09	2009-10	2010-11	
Payment for Expenses on Behalf of Territory	Est. Out.	Budget	Estimate	Estimate	Estimate	
 	$'000	$'000	$'000	$'000	$'000	
						
2006-07 Budget	4,865	640	640	640	640	
						
2007-08 Budget Technical Adjustments						
Capital Upgrades Indexation	 - 	18	35	52	70	
						
2007-08 Budget	4,865	658	675	692	710	

Changes to Appropriation - Departmental						
 	2006-07	2007-08	2008-09	2009-10	2010-11	
Capital Injections	Est. Out.	Budget	Estimate	Estimate	Estimate	
 	$'000	$'000	$'000	$'000	$'000	
						
2006-07 Budget	18,198	14,910	3,610	3,710	3,710	
						
2007-08 Budget Policy Adjustments 						
Dental Health Program - Restorative Waiting List Reduction	 - 	60	 - 	 - 	 - 	
Adult Mental Health Acute Inpatient Unit	 - 	2,290	 - 	 - 	 - 	
Clinical Equipment for Calvary Hospital	 - 	956	1,321	1,223	 - 	
High Secure Mental Health Inpatient Unit	 - 	1,200	 - 	 - 	 - 	
Neonatal Intensive Care Unit	 - 	795	 - 	 - 	 - 	
New Multistorey Car Park - The Canberra Hospital	 - 	6,500	22,500	 - 	 - 	
Linear Accelerator Procurement and Replacement	 - 	3,200	 - 	 - 	3,500	
						
2007-08 Budget Technical Adjustments						
Rollover - Linear Accelerator Procurement and Replacement	(5,170)	5,170	 - 	 - 	 - 	
Rollover - TCH Extra Car Parking (Yamba Drive)	(550)	550	 - 	 - 	 - 	
Rollover - Fire Systems Upgrade (Phase 1)	(600)	600	 - 	 - 	 - 	
Capital Upgrades Indexation	 - 	88	170	254	340	
						
2007-08 Budget	11,878	36,319	27,601	5,187	7,550	

2007‑08 Capital Works Program
Departmental
 	Estimated	Estimated	2007‑08	2008-09	2009‑10	Expected 	
	Total	Expenditure	Financing	Financing	Financing	Completion 	
	Cost 	Pre 2007‑08				Date  	
 	$’000	$’000	$’000	$’000	$’000	 	
							
Forward Design							
							
Adult Mental Health Acute Inpatient Unit	2,290		2,290			Jun 2008	
High Secure Mental Health Inpatient Unit	1,200		1,200			Jun 2008	
Neonatal Intensive Care Unit 	795		795			Jun 2008	
							
Total Forward Design	4,285		4,285				
							
New Capital Works							
							
New Multistorey Car Park - The Canberra Hospital	29,000		6,500	22,500		Jun 2009	
							
Total New Works	29,000		6,500	22,500		 	
							
Capital Upgrades							
							
Building Refurbishment and Upgrades	1,593		1,593				
Electrical, Lift and Major Plant 	Upgrades	1,240		1,240				
Environment and Safety	75		75				
OH&S and Access	390		390				
							
Total Capital Upgrades 	3,298		3,298				
	 	 	 		 	 	
Total New Capital Works	36,583		14,083	22,500		 	
							
Works in Progress							
							
The Canberra Hospital							
Linear Accelerator Procurement and 	Replacement	18,700	930	16,870	400	500	Jun 2010	
Extra Car Parking (Yamba Drive)	1,950	1,400	550	-	-	Sep 2007	
Fire Systems Upgrade (Phase 1)	2,600	2,000	600	-	-	Sep 2007	
							
Total Works in Progress	23,250	4,330	18,020	400	500	 	
							
 Total Departmental Capital Works	59,833	4,330	32,103	22,900	500	 	

Territorial 
	Estimated	Estimated	2007‑08	2008-09	2009‑10	Expected 	
	Total	Expenditure	Financing	Financing	Financing	Completion 	
	Cost 	Pre 2007‑08				Date  	
	$’000	$’000	$’000	$’000	$’000		
							
Capital Upgrades							
							
Building Refurbishment and Upgrades	350		350				
Electrical, Lift and Major Plant Upgrades	308		308				
							
Total Capital Upgrades	658		658				
							
 Total Territorial Capital Works	658		658	-	-	 	

Commonwealth Grants
The major Commonwealth payments for which the Portfolio has responsibility are:
Name of Grant	Activities Funded by Grant	2007‑08
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.	119,287	
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.	11,920	
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.	3,531	
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.	7,764	
High Cost Drugs	Provision of highly specialised drug therapies under the National Health Act 1953.	10,049	
Aged Care Assessment Program	Funding is provided to support Aged Care Client Assessments undertaken by the Aged Care Assessment Team.	686	
Youth Health Services	Funding of a range of innovative health services for homeless youth in the ACT.	59	

Total	153,296

ACT Health	
Operating Statement	
  2006‑07			  2006‑07	   2007‑08		  2008-09	  2009‑10	  2010-11		
    Budget			Est.Outcome	   Budget	   Var	  Estimate	   Estimate	  Estimate		
    $'000			   $'000	   $'000	    %	   $'000	    $'000	   $'000		
		Income								
		Revenue								
592,119		Government Payment for Outputs	598,525	628,455	5	662,369	703,503	752,157		
127,954		User Charges - Non ACT Government	126,054	136,084	8	142,244	148,718	151,797		
2,426		User Charges - ACT Government	2,426	1,934	-20	1,983	2,032	2,062		
8,845		Grants from the Commonwealth	9,675	10,049	4	10,437	10,840	11,060		
228		Interest	228	228	-	228	228	228		
4,701		Other Revenue	8,970	8,927	..	9,150	9,377	9,284		
686		Resources Received free of charge	1,000	1,025	3	1,050	1,075	1,100		
736,959		Total Revenue	746,878	786,702	5	827,461	875,773	927,688		
		Gains								
769		Other Gains	569	588	3	603	618	623		
769		Total Gains	569	588	3	603	618	623		
737,728		Total Income	747,447	787,290	5	828,064	876,391	928,311		
		Expenses								
318,465		Employee Expenses	327,568	348,605	6	368,531	395,052	424,259		
55,296		Superannuation Expenses	55,899	53,604	-4	56,021	58,101	60,290		
203,070		Supplies and Services	204,276	214,816	5	224,405	234,998	245,909		
15,682		Depreciation and Amortisation	15,932	17,220	8	18,191	18,191	18,191		
9,482		Cost of Goods Sold	9,482	10,074	6	10,685	11,335	12,045		
146,273		Grants and Purchased Services	144,951	153,875	6	161,506	169,650	178,190		
2,952		Other Expenses	4,701	3,580	-24	3,663	3,758	3,858		
751,220		Total Ordinary Expenses	762,809	801,774	5	843,002	891,085	942,742		
-13,492		Operating Result	-15,362	-14,484	6	-14,938	-14,694	-14,431		

ACT Health	
Balance Sheet	
    Budget			Est.Outcome	   Planned		   Planned	   Planned	   Planned		
as at 30/6/07			as at 30/6/07	as at 30/6/08	   Var	as at 30/6/09	as at 30/6/10	as at 30/6/11		
   $'000			   $'000	    $'000	    %	    $'000	    $'000	    $'000		
		Current Assets								
9,561		Cash	13,382	12,564	-6	11,532	10,506	9,480		
27,937		Receivables	22,396	22,396	-	22,396	22,396	22,396		
5,686		Inventories	6,553	6,553	-	6,553	6,553	6,553		
1,016		Other	1,013	1,013	-	1,013	1,013	1,013		
44,200		Total Current Assets	43,344	42,526	-2	41,494	40,468	39,442		
		Non Current Assets								
3,000		Investments	3,000	3,000	-	3,000	3,000	3,000		
387,984		Property, Plant and Equipment	383,282	412,026	7	429,741	426,210	424,347		
12,595		Intangibles	10,660	10,987	3	9,993	9,028	8,063		
3,693		Capital Works in Progress	4,482	4,482	-	4,482	4,482	4,482		
407,272		Total Non Current Assets	401,424	430,495	7	447,216	442,720	439,892		
451,472		TOTAL ASSETS	444,768	473,021	6	488,710	483,188	479,334		
		Current Liabilities								
19,403		Payables	28,812	28,012	-3	27,212	26,412	25,612		
1,250		Interest Bearing Liabilities	0	0	-	0	0	0		
18		Finance Leases	449	2,249	401	2,955	2,249	2,955		
50,827		Employee Benefits	82,622	85,407	3	88,161	90,915	93,669		
3,271		Other	4,110	4,110	-	4,110	4,110	4,110		
74,769		Total Current Liabilities	115,993	119,778	3	122,438	123,686	126,346		
		Non Current Liabilities								
696		Interest Bearing Liabilities	530	530	-	530	530	530		
21		Finance Leases	1,267	2,327	84	1,142	2,327	1,142		
32,033		Employee Benefits	4,303	5,876	37	7,427	8,979	10,531		
32,750		Total Non Current Liabilities	6,100	8,733	43	9,099	11,836	12,203		
107,519		TOTAL LIABILITIES	122,093	128,511	5	131,537	135,522	138,549		
343,953		NET ASSETS	322,675	344,510	7	357,173	347,666	340,785		
		REPRESENTED BY FUNDS EMPLOYED								
343,478		Accumulated Funds	322,200	344,035	7	356,698	347,191	340,310		
475		Reserves	475	475	-	475	475	475		
343,953		TOTAL FUNDS EMPLOYED	322,675	344,510	7	357,173	347,666	340,785		

ACT Health	
Cash Flow Statement	
  2006‑07			  2006‑07	   2007‑08		  2008-09	  2009‑10	  2010-11		
    Budget			Est.Outcome	   Budget	   Var	  Estimate	   Estimate	  Estimate		
    $'000			   $'000	   $'000	    %	   $'000	    $'000	   $'000		
		CASH FLOWS FROM OPERATING ACTIVITIES								
		Receipts								
592,119		Cash from Government for Outputs	598,034	628,455	5	662,369	703,503	752,157		
130,641		User Charges	128,741	138,018	7	144,227	150,750	153,859		
228		Interest Received	228	228	-	228	228	228		
8,845		Grants Received from the Commonwealth	9,675	10,049	4	10,437	10,840	11,060		
40,212		Other Revenue	44,281	44,511	1	44,745	44,991	44,904		
772,045		Operating Receipts	780,959	821,261	5	862,006	910,312	962,208		
		Payments								
370,081		Related to Employees	378,816	397,851	5	420,248	448,847	480,243		
203,185		Related to Supplies and Services	204,077	214,591	5	224,153	234,722	245,608		
146,273		Grants and Purchased Services	144,951	153,875	6	161,506	169,650	178,190		
47,176		Other	47,676	48,650	2	49,340	50,089	50,900		
766,715		Operating Payments	775,520	814,967	5	855,247	903,308	954,941		
5,330		NET CASH INFLOW/(OUTFLOW) FROM OPERATING ACTIVITIES	5,439	6,294	16	6,759	7,004	7,267		
		CASH FLOWS FROM INVESTING ACTIVITIES								
		Payments								
30,845		Purchase of Property, Plant and Equipment	33,238	42,431	28	33,940	11,765	14,391		
30,845		Investing Payments	33,238	42,431	28	33,940	11,765	14,391		
-30,845		NET CASH INFLOW/(OUTFLOW) FROM INVESTING ACTIVITIES	-33,238	-42,431	-28	-33,940	-11,765	-14,391		
		CASH FLOWS FROM FINANCING ACTIVITIES								
		Receipts								
18,198		Capital Injection from Government	11,878	36,319	206	27,601	5,187	7,550		
188		Receipt of Transferred Cash Balances	188	0	-100	0	0	0		
18,386		Financing Receipts	12,066	36,319	201	27,601	5,187	7,550		
		Payments								
0		Distributions to Government	13,276	0	-100	0	0	0		
0		Repayment of Finance Lease	250	1,000	300	1,452	1,452	1,452		
0		Payments of Transferred Cash Balances	67	0	-100	0	0	0		
0		Financing Payments	13,593	1,000	-93	1,452	1,452	1,452		
18,386		NET CASH INFLOW/(OUTFLOW) FROM FINANCING ACTIVITIES	-1,527	35,319	#	26,149	3,735	6,098		
-7,129		NET INCREASE/(DECREASE) IN CASH HELD	-29,326	-818	97	-1,032	-1,026	-1,026		
18,440		CASH AT BEGINNING OF REPORTING PERIOD	42,708	13,382	-69	12,564	11,532	10,506		
11,311		CASH AT THE END OF THE REPORTING PERIOD	13,382	12,564	-6	11,532	10,506	9,480		
Notes to the Budget Statements
Significant variations are as follows:
Operating Statement
•	government payment for outputs:
–	the increase of $6.406 million in the 2006‑07 estimated outcome from the original budget is due to medical officers Enterprise Bargaining Agreement (EBA) funding ($4.520 million) and increased Commonwealth specific purpose payments ($3.057 million) mainly associated with the Human Papillomavirus (HPV) vaccination program.  These are partially offset by programs deferred to 2007‑08 ($1.171 million); and
–	the increase of $29.930 million in the 2007‑08 Budget from the 2006‑07 estimated outcome is mainly due to wage increases ($16.128 million), indexation ($4.796 million), growth and new initiatives ($15.362 million), the full year effect of prior year initiatives ($6.763 million) and increased Commonwealth specific purpose payments ($1.822 million).  These are partly offset by savings ($6.443 million), the effect of 2006‑07 Budget savings ($3.360 million), lower deferred programs from prior years ($0.968 million), the transfer of grant funding to the Department of Disability, Housing and Community Services ($0.491 million) and decreased notional superannuation contribution rates ($3.415 million).
•	
user charges – non ACT Government:  
–	the decrease of $1.9 million in the 2006‑07 estimated outcome from the original budget is related to a reclassification of revenue between user charges and other revenue; and
–	the increase of $10.030 million in the 2007‑08 Budget from the 2006‑07 estimated outcome is due to increased private patient revenue, the full year impact of the second Magnetic Resource Imaging (MRI) machine and revenue associated with the new CT scanner, increased cross border revenue and general indexation.
•	user charges – ACT Government:  the decrease of $0.492 million in the 2007‑08 Budget from the 2006‑07 estimated outcome reflects the transfer of the Victim Support Services (VSS) program to the Department of Justice and Community Safety.
•	grants from the Commonwealth:  the increase of $0.830 million in the 2006‑07 estimated outcome from the original budget and the increase of $0.374 million in the 2007‑08 Budget from the 2006‑07 estimated outcome, relates to increased reimbursement for highly specialised drugs used at The Canberra Hospital.
•	other revenue:  the increase of $4.269 million in the 2006‑07 estimated outcome from the original budget relates to the reclassification of revenue from user charges – non ACT Government, new third party revenue including Commonwealth transition care agreement funding and increased pharmaceuticals reimbursements from the National Capital Private Hospital.
•	resources received free of charge:  the increase of $0.314 million in the 2006‑07 estimated outcome from the original budget relates mainly to recognition of legislative services provided by the Parliamentary Counsel’s Office for the first time.
•	employee expenses: 
–	the increase of $9.103 million in the 2006‑07 estimated outcome from the original budget relates to medical officers pay outcomes ($4.789 million), reallocation of growth funding ($3.450 million), an adjustment to Shared Services Centre billing ($0.375 million), third party funded programs ($0.272 million) and Commonwealth funded specific purpose programs ($0.217 million); and
–	the increase of $21.037 million in the 2007‑08 Budget from the 2006‑07 estimated outcome largely relates to wage increases ($18.761 million), increased staffing requirements resulting from growth and new initiatives ($7.641 million), the full year impact of prior year initiatives ($0.770 million) and Commonwealth funded specific purpose programs ($0.254 million).  These are partially offset by the full year impact of Shared Services Centre implementation and associated savings ($3.725 million) and other savings ($3.222 million).
•	superannuation expenses: 
–	the increase of $0.603 million in the 2006‑07 estimated outcome from the original budget relates mainly to medical officers pay outcomes; and
–	the decrease of $2.295 million in the 2007‑08 Budget from the 2006‑07 estimated outcome mainly relates to decreased notional superannuation contribution rates.
•	supplies and services: 
–	the increase of $1.206 million in the 2006‑07 estimated outcome from the original budget relates to Commonwealth specific purpose programs mainly in connection with the HPV vaccination program ($2.840 million), increased highly specialised drug and pharmaceutical costs ($1.595 million) and other third party funded programs ($0.340 million).  These are largely offset by the reallocation of growth funding ($2.2 million), deferred programs ($0.735 million), an adjustment to Shared Services Centre billing ($0.428 million) and changes to leasing arrangements for motor vehicles ($0.250 million); and
–	the increase of $10.540 million in the 2007‑08 Budget from the 2006‑07 estimated outcome mainly relates to indexation ($5 million), growth and new initiatives ($4.799 million), the full year impact of the Shared Services Centre implementation ($3.019 million), Commonwealth funded specific purpose programs ($1.568 million), the full year impact of prior year initiatives ($1.556 million) and deferred programs ($0.735 million).  These are partially offset by savings ($3.222 million), the full year effect of 2006‑07 Budget savings ($1.890 million) and changed accounting treatment for vehicles leases ($0.750 million).
•	depreciation and amortisation:  the increase of $1.288 million in the 2007‑08 Budget from the 2006‑07 estimated outcome relates mainly to changes to leasing arrangements for motor vehicles ($0.750 million) and depreciation on completed prior year capital works projects.
•	cost of goods sold:  the increase of $0.592 million in the 2007‑08 Budget from the 2006‑07 estimated outcome relates to increased sales of supplies to other ACT and regional hospitals.
•	grants and purchased services: 
–	the decrease of $1.322 million in the 2006‑07 estimated outcome from the original budget relates to programs deferred to 2007‑08 ($0.927 million) and the reallocation of growth funding ($1 million).  This is partially offset by increased non-government organisation (NGO) payments funded from third party revenue ($0.605 million); and
–	the increase of $8.924 million in the 2007‑08 Budget from the 2006‑07 estimated outcome mainly relates to growth and new initiatives ($2.216 million), the full year impact of prior year initiatives ($3.536 million), indexation ($1.888 million) and deferred programs from 2006‑07 ($0.927 million).
•	other expenses: 
–	the increase of $1.749 million in the 2006‑07 estimated outcome from the original budget relates mainly to a one-off building write-off ($0.999 million), land transfer ($0.250 million) and the increase in resources received free of charge in relation to legislative services provided by the Parliamentary Counsel’s Office ($0.314 million); and
–	the decrease of $1.121 million in the 2007‑08 Budget from the 2006‑07 estimated outcome relates mainly to a one-off building write-off and a land transfer in 2006‑07, which will not occur in 2007‑08.

Balance Sheet
•	cash and cash equivalents:  the increase of $3.821 million in the 2006‑07 estimated outcome from the original budget reflects information technology project roll overs.
•	receivables:  the decrease of $5.541 million in the 2006‑07 estimated outcome from the original budget reflects a lower than planned NSW cross border receivable.
•	property, plant and equipment:  
–	the decrease of $4.702 million in the 2006‑07 estimated outcome from the original budget relates to higher than planned works in progress, other delays in capital projects and write-off and transfer of land and a building; and
–	the increase of $28.744 million in 2007‑08 Budget from the 2006‑07 estimated outcome relates to new and existing capital works projects, including the linear accelerator procurement and replacement and The Canberra Hospital multistorey car park.
•	current - payables:  the increase of $9.409 million in the 2006‑07 estimated outcome from the original budget reflects the 2005‑06 audited outcome and relates to higher levels of accrued expenses mainly associated with information technology charges.
•	current - interest bearing liabilities:  the decrease of $1.250 million in the 2006‑07 estimated outcome from the original budget reflects the changed accounting treatment for unpresented cheques.
•	current - finance leases:  the increase of $0.431 million in the 2006‑07 estimated outcome from the original budget and increase of $1.8 million in the 2007‑08 Budget from the 2006‑07 estimated outcome relates to the changed leasing arrangements for motor vehicles.
•	current - employee benefits:  the increase of $31.795 million in the 2006‑07 estimated outcome from the original budget reflects the ACT Accounting Policy requirement to classify unconditional long service leave as current employee benefits.  The change in policy is attributable to advice received regarding the interpretation of the Australian Accounting Standards.
•	non current - finance leases:  the increase of $1.246 million in the 2006‑07 estimated outcome from the original budget and increase of $1.060 million in the 2007‑08 Budget from the 2006‑07 estimated outcome relates to the changed leasing arrangements for motor vehicles.
•	non current - employee benefits:  the decrease of $27.730 million in the 2006‑07 estimated outcome from the original budget reflects the ACT Accounting Policy requirement to classify unconditional long service leave as current employee benefits. The change in policy is attributable to advice received regarding the interpretation of the Australian Accounting Standards.

ACT Health	
Statement of Income and Expenses on Behalf of the Territory	
  2006‑07			  2006‑07	   2007‑08		  2008-09	  2009‑10	  2010-11		
    Budget			Est.Outcome	   Budget	   Var	  Estimate	   Estimate	  Estimate		
    $'000			   $'000	   $'000	    %	   $'000	    $'000	   $'000		
		Income								
		Revenue								
4,865		Payment for Expenses on behalf of Territory	4,865	658	-86	675	692	710		
720		Taxes Fees and Fines	577	591	2	613	635	650		
133,928		Grants from the Commonwealth	137,035	143,247	5	146,391	152,679	159,886		
139,513		Total Revenue	142,477	144,496	1	147,679	154,006	161,246		
		Gains								
0		Total Gains	0	0	-	0	0	0		
139,513		Total Income	142,477	144,496	1	147,679	154,006	161,246		
		Expenses								
4,865		Grants and Purchased Services	4,865	658	-86	675	692	710		
134,648		Transfer Expenses	137,612	143,838	5	147,004	153,314	160,536		
139,513		Total Ordinary Expenses	142,477	144,496	1	147,679	154,006	161,246		
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 30/6/07			as at 30/6/07	as at 30/6/08	   Var	as at 30/6/09	as at 30/6/10	as at 30/6/11		
   $'000			   $'000	    $'000	    %	    $'000	    $'000	    $'000		
		Current Assets								
100		Cash	214	214	-	214	214	214		
200		Receivables	86	86	-	86	86	86		
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	
  2006‑07			  2006‑07	   2007‑08		  2008-09	  2009‑10	  2010-11		
    Budget			Est.Outcome	   Budget	   Var	  Estimate	   Estimate	  Estimate		
    $'000			   $'000	   $'000	    %	   $'000	    $'000	   $'000		
		CASH FLOWS FROM OPERATING ACTIVITIES								
		Receipts								
4,865		Cash from Government for EBT	4,865	658	-86	675	692	710		
720		Taxes, Fees and Fines	577	591	2	613	635	650		
133,928		Grants Received from the Commonwealth	137,035	143,247	5	146,391	152,679	159,886		
487		Other Revenue	487	64	-87	64	64	64		
140,000		Operating Receipts	142,964	144,560	1	147,743	154,070	161,310		
		Payments								
4,865		Grants and Purchased Services	4,865	658	-86	675	692	710		
487		Other	487	64	-87	64	64	64		
134,648		Territory Receipts to Government	137,612	143,838	5	147,004	153,314	160,536		
140,000		Operating Payments	142,964	144,560	1	147,743	154,070	161,310		
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		
100		CASH AT BEGINNING OF REPORTING PERIOD	214	214	-	214	214	214		
100		CASH AT THE END OF THE REPORTING PERIOD	214	214	-	214	214	214		
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 decrease of $4.207 million in the 2007‑08 Budget from the 2006‑07 estimated outcome relates to the completion of capital works programs for the sub and non-acute inpatient facility ($3.450 million), plant and building upgrades ($0.2 million) and the sterilising facility ($0.575 million).  These are partially offset by indexation on the remaining capital upgrades funding ($0.018 million).
•	taxes fees and fines:  the decrease of $0.143 million in the 2006‑07 estimated outcome from the original budget relates to the transfer of tobacco licensing to the Department of Justice and Community Safety ($0.092 million) and the cessation of smoke free places licensing ($0.051 million).
•	grants from the Commonwealth:
–	the increase of $3.107 million in the 2006‑07 estimated outcome from the original budget relates mainly to increased funding for the Australian Immunisation Agreement ($2.890 million), Aged Care Assessment program ($0.166 million) and the Australian Health Care Agreement ($0.065 million); and
–	the increase of $6.212 million in the 2007‑08 Budget from the 2006‑07 estimated outcome largely relates to increases in the Australian Health Care Agreement ($6.190 million), the Australian Immunisation Agreement ($2.911 million) and Home and Community Care program ($0.931 million).  These are partially offset by removal of the Illicit Drug Diversion funding ($1.3 million) and the Pathways Home program ($2.6 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 variances are the same as those identified for ‘taxes fees and fines’ and ‘grants from the Commonwealth’.

Health and Community Care	
Operating Statement	
  2006-07			  2006-07	   2007-08		  2008-09	  2009-10	  2010-11		
    Budget			Est.Outcome	   Budget	   Var	  Estimate	   Estimate	  Estimate		
    $'000			   $'000	   $'000	    %	   $'000	    $'000	   $'000		
		Income								
		Revenue								
592,119		Government Payment for Outputs	598,525	628,455	5	662,369	703,503	752,157		
127,954		User Charges - Non ACT Government	126,054	136,084	8	142,244	148,718	151,797		
2,426		User Charges - ACT Government	2,426	1,934	-20	1,983	2,032	2,062		
8,845		Grants from the Commonwealth	9,675	10,049	4	10,437	10,840	11,060		
228		Interest	228	228	-	228	228	228		
4,701		Other Revenue	8,970	8,927	..	9,150	9,377	9,284		
686		Resources Received free of charge	1,000	1,025	3	1,050	1,075	1,100		
736,959		Total Revenue	746,878	786,702	5	827,461	875,773	927,688		
		Gains								
769		Other Gains	569	588	3	603	618	623		
769		Total Gains	569	588	3	603	618	623		
737,728		Total Income	747,447	787,290	5	828,064	876,391	928,311		
		Expenses								
318,465		Employee Expenses	327,568	348,605	6	368,531	395,052	424,259		
55,296		Superannuation Expenses	55,899	53,604	-4	56,021	58,101	60,290		
203,070		Supplies and Services	204,276	214,816	5	224,405	234,998	245,909		
15,682		Depreciation and Amortisation	15,932	17,220	8	18,191	18,191	18,191		
9,482		Cost of Goods Sold	9,482	10,074	6	10,685	11,335	12,045		
146,273		Grants and Purchased Services	144,951	153,875	6	161,506	169,650	178,190		
2,952		Other Expenses	4,701	3,580	-24	3,663	3,758	3,858		
751,220		Total Ordinary Expenses	762,809	801,774	5	843,002	891,085	942,742		
-13,492		Operating Result	-15,362	-14,484	6	-14,938	-14,694	-14,431