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:
•	increase the community’s capacity to live healthily;
•	ensure access to health and community services is fair and equitable;
•	ensure health services in the community are appropriate and of a high quality;
•	meet the health needs of an ageing population;
•	gain best value for the community through promoting efficiency and sound resource management;
•	meet consumers’ needs for services that are better coordinated and integrated;
•	focus on prevention and early intervention throughout people’s lives;
•	improve the good health of the Canberra population and narrow the health gap between the general community and the poor and disadvantaged;
•	strengthen the health of the community through a whole of government approach to health issues, together with community partnerships to develop sustainable social care supports;
•	support an active lifestyle at all stages of people’s lives;
•	improve mental health and reduce the barriers facing people with mental health problems;
•	reduce harm from alcohol and other drug use;
•	ensure quality information drives effective decision making; and
•	build an effective organisation with a skilled, satisfied and accountable workforce.
2005‑06 Highlights
Strategic and operational initiatives to be pursued in 2005‑06 include:
•	providing an additional 20 medical beds in the ACT’s public hospitals with 12 additional beds at Calvary Hospital and 8 additional beds at The Canberra Hospital;
•	implementing an Elective Surgery Reform Program which will overhaul the management of elective surgery in the ACT.  This will ensure those patients with the highest clinical need receive more timely access to surgery, with a reduced likelihood of cancellations.  This will deliver an additional 300 elective surgery episodes in 2005‑06, rising to 400 in 2006‑07;
•	providing additional funding for purchase of medical equipment and occupational health and safety equipment;
•	introducing a digital imaging transmission for film based imaging services through the procurement of an integrated Picture Archival Communication System;
•	developing, establishing, promoting and implementing an ACT wide re-entry and refresher program for nurses;
•	continuing the pilot Intermittent Care Service to test the effectiveness and efficiency of combining health and aged care funding to provide short-term care services for older persons;
•	meeting growth in demand for medical oncology services;
•	establishing Nurse Practitioner positions across ACT Health;
•	strengthening the ACT’s capacity to provide allied health services through the creation of a Certificate Level IV course for Allied Health Assistants; and
•	implementing, enhancing and supporting a range of clinical information technology projects including the national e-health transition authority, mental health information system, laboratory information systems, clinical record information system, shared care system, health provider directory, and electronic referrals.

Output Classes
	Total Cost	Government Payment for Outputs	
	2004-05
Est. Outcome
$’000	2005-06
Budget
$’000	2004-05
Est. Outcome
$’000	2005-06
Budget
$’000	
Output Class 1
Health and Community Care	635  018	671  273	502  509 	533  205	
Output 1.1 Acute Services	429  726	447  104	316  049	328  276	
Output Description
The Government provides public hospital services at The Canberra Hospital and Calvary Public Hospital.  These public hospitals provide the full range of acute care including inpatient, outpatient and emergency department services.  Both hospitals are teaching hospitals in cooperation with the ANU Medical School.  The Canberra Hospital is the major trauma referral hospital for the ACT and surrounding region of NSW.
The key strategic priority for acute services is to deliver timely access to effective, 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 would otherwise experience long waits due to the complexity of their conditions;
•	achieving benchmark performance standards for waiting times for access to elective surgery; and
•	achieving bed occupancy rates of less than 90%.  Occupancy levels of 90% or less contribute to patient safety, reduce access block, ensure efficient work flows and minimise disruptions to elective surgery.
			
	Total Cost	Government Payment for Outputs	
	2004-05
Est. Outcome
$’000	2005-06
Budget
$’000	2004-05
Est. Outcome
$’000	2005-06
Budget
$’000	
Output 1.2 Mental Health Services	43  829	47  578	42  146	45  709	
Output Description
Mental Health ACT provides a range of services in hospitals, community health centres and people’s 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.
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 through reducing excessive waiting times for urgent admissions to acute psychiatric units; and
Output Classes cont.
•	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	
	2004-05
Est. Outcome
$’000	2005-06
Budget
$’000	2004-05
Est. Outcome
$’000	2005-06
Budget
$’000	
Output 1.3 Community Health Services 	89  391	98  647	81  479	90  594	
			
Output Description
Community Health provides a range of community based health service responses across the ACT that meet the needs of many people with chronic conditions and primary health care needs as well as providing valuable pre and post hospital care responses.
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 immediate access to public dental health care in cases of emergency need; 
•	providing health care assessments for people detained in corrective facilities on detention; and
•	working with the acute care sector to ensure effective provision of allied health care to people in hospitals in order to maximise health outcomes.
			
	Total Cost	Government Payment for Outputs	
	2004-05
Est. Outcome
$’000	2005-06
Budget
$’000	2004-05
Est. Outcome
$’000	2005-06
Budget
$’000	
Output 1.4 Public Health Services	23  339	21  007	21  117	19  724	
			
Output Description
Public Health Services provide Government services and purchases services from Non‑Government agencies.  It provides high quality health and community services to the ACT and surrounding region including the supply of blood and blood products.
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.  These priorities include:
•	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.

Output Classes cont.
			
	Total Cost	Government Payment for Outputs	
	2004-05
Est. Outcome
$’000	2005-06
Budget
$’000	2004-05
Est. Outcome
$’000	2005-06
Budget
$’000	
Output 1.5 Cancer Services	15  821	18  517	  11  847	14  275	
			
Output Description
Capital Region Cancer Services provide 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.
			
	Total Cost	Government Payment for Outputs	
	2004-05
Est. Outcome
$’000	2005-06
Budget
$’000	2004-05
Est. Outcome
$’000	2005-06
Budget
$’000	
Output 1.6 Aged Care and Rehabilitation Services	  17  772	21  728	  14  829	18  305	
			
Output Description
The provision of an integrated, effective and timely response to aged care and rehabilitation services for inpatient, outpatient, emergency department, sub‑acute and community based settings.
The key strategic priorities for Aged Care for Rehabilitation Services (ACRS) are:
•	reducing excessive 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 (ACAT). This will assist in facilitating their safe return home with appropriate support, or access to, appropriate supported residential accommodation; and
•	improving discharge planning to minimise the likelihood of readmission, or inadequate support for independent living, following completion of hospital care.

Output Classes cont.
			
	Total Cost	Government Payment for Outputs	
	2004-05
Est. Outcome
$’000	2005-06
Budget
$’000	2004-05
Est. Outcome
$’000	2005-06
Budget
$’000	
Output 1.7 Early Intervention and Prevention	15  140	16  692	15  042	16  322	
			
Output Description
Increasing the focus on initiatives that prevent or intervene early in health care conditions that result in major acute or chronic health 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%;
•	ensuring that the newborn hearing screening program reaches 100% of babies born in the ACT;
•	increasing the proportion of females screened through the BreastScreen Australia program for the target population (aged 50-69 years) to 70%; and
•	reporting the number of females aged 20-69 years screened for cervical abnormalities.

Strategic Indicators
Strategic Indicator 1
Emergency Department access block
Acute Services
Proportion of persons who are admitted via the emergency department who wait more than 8 hours from commencement of treatment to admission in 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 Australian Council on Health Care Standards has defined four key indicators of the quality of hospital services.  These are:
1.	Rate of unplanned return to the operating theatre
	2004‑05
Targets	2004-05
Est. Outcome	2005-06
Target	
The Canberra Hospital	-	0.84%	0.7%	
Calvary Public Hospital	-	0.34%	0.3%	
				
The proportion of people who have an operation who require an unplanned return to the operating theatre within a single episode of care due to complications with their care.  This provides an indication of the quality of theatre and post-operative care.
2.	Rate of unplanned hospital readmission
	2004‑05
Targets	2004-05
Est. Outcome	2005-06
Target	
The Canberra Hospital	-	2.64%	2.5%	
Calvary Public Hospital	-	1.13%	1.1%	
				
The proportion of people separated from hospital who are re‑admitted to hospital within 28 days of their separation due to complications with their care (where the re‑admission was unforseen at the time of separation).  This provides an indication of the effectiveness of hospital-based services in the ACT in the treatment and discharge of persons who receive hospital based care.
Strategic Indictors cont.
3.	Rate of post-operative pulmonary embolism
	2004‑05
Targets	2004-05
Est. Outcome	2005-06
Target	
The Canberra Hospital	-	1.01%	<1%	
Calvary Public Hospital	-	0.95%	<1%	
				
The proportion of people admitted to hospital who experience a pulmonary embolism.  This provides an indication of the quality of care and the effectiveness of the hospital system in meeting the needs of patients.
4.	Hospital acquired infection rate (bacteraemia)
	2004‑05
Targets	2004-05
Est. Outcome	2005-06
Target	
The Canberra Hospital	-	0.72%	0.7%	
Calvary Public Hospital	-	0.1%	0.1%	
				
The proportion of people admitted to hospitals that acquire an infection during their stay.  This provides an indication of the safety of hospital-based services.
Strategic Indicator 3
Reaching the optimum occupancy rate for acute overnight hospital beds
Bed occupancy
Mean percentage of overnight acute hospital beds in use.

This provides an indication of the efficient use of resources available for hospital services.

Strategic Indicators cont.
Strategic Indicator 4
Reducing the usage of seclusion
The number of occasions of seclusion.  This measures the effectiveness of care provided by Mental Health ACT over time in providing services that minimise the need for seclusion.

Use of Seclusion
The number of clients of Mental Health ACT who are subject to seclusion.

Strategic Indicator 5
Increasing consumer and carer participation
The proportion of Mental Health ACT clients with individual care plans incorporating consumer and/or carer comment and signed agreement.

Consumer participation in health care plans
The proportion of Mental Health ACT clients involved in the development of their health care plans.

Strategic Indicators cont.
Strategic Indicator 6
Access to 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 reduce the proportion of mental health clients waiting more than 8 hours for admission to a maximum of 25%.
Strategic Indicator 7
No waiting for access to emergency Dental Health services
Oral Health
Percentage of assessed emergency clients seen within 24 hours.

The proportion of clients assessed with emergency dental health needs who are seen within 24 hours.  This provides an indication of the responsiveness of the dental service to emergency need.
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	1.83	1.56	
DMFT Index at 12 years	1.39	0.84	
			
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 by 2006.
Strategic Indicators cont.
Strategic Indicator 9
Maintenance of the highest life expectancy at birth in Australia
Life expectancy at birth	ACT
	Australia	Next Best State (WA)	
Females	83.3	82.6	82.9	
Males	79.2	77.4	77.9	
Source: Australia’s Health 2004 (Life expectancy 2000-02)

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 Government aims to maintain this result.
Strategic Indicator 10
Reduction in the prevalence of cardiovascular disease in the ACT
Cardiovascular disease
Prevalence of cardiovascular disease - ACT and Australia.

The proportion of the ACT population diagnosed with some form of cardiovascular disease.  This provides an indication of the success of prevention and early intervention initiatives as well as providing an indication of the demand for acute cardiovascular services.  The Government aims to better the Australian average by 2007.

Strategic Indicators cont.
Strategic Indicator 11
Prevalence of diabetes in the ACT
Diabetes
Prevalence of diabetes - ACT and Australia.

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.
Strategic Indicator 12
Reduction in the rate of fractured neck or femur (broken hip)
The reduction or maintenance of the rate of fractured neck or 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
Percentage of semi urgent radiotherapy patients who receive care within 4 weeks.

This provides an indication of the effectiveness of radiotherapy services in meeting the need for urgent services for the people of the ACT.
Strategic Indicator 14
Decrease in death rates for breast and colon cancers
Type of Cancer
	ACT 
Females	ACT
Males	Australian Females	Australian Males	
Breast Cancers	29.9	N/A	24.8	N/A	
Colorectal Cancers	21.7	28.1	19.7	30.5	
1.	Cancer in Australia 2001 (AIHW 2004), Age standardised death rate per 100,000 population	
					
This indicator measures the death rate for breast and colon cancer in the ACT against the rest of Australia.  The Government aims to meet or better the Australian rate.  This provides an indication of the effectiveness of prevention, early intervention and treatment initiatives.

Strategic Indicators cont.
Strategic Indicator 15
Reducing the average length of stay for acute rehabilitation care
Acute Rehabilitation
Average length of stay for acute rehabilitation patients.

This provides an indication of the capacity and effectiveness of sub‑acute and community based services.
Strategic Indicator 16
Improving hospital access times for older persons
Access to aged care inpatient services
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 17
Reducing the waiting times for assessments by the Aged Care Assessment Team
Aged care assessment team
This is measured by the mean waiting time in days between request for, and provision of, assessment by the Aged Care Assessment Team (ACAT).

This provides an indication of the responsiveness of the ACAT team in assessing the needs of clients.
Strategic Indicator 18
Increasing the rate of discharge planning
Discharge planning
Proportion of aged care clients 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 19
Reduction in the youth smoking rate
Youth Smoking
Percentage of persons aged 12-17 years who smoke regularly.

The ACT rate has dropped significantly since 1996 from 20%.  The Government aims to maintain this drop in youth smoking with an objective to reach 13% by 2006.  This indicator provides evidence of the success of prevention and early intervention campaigns.  The national rate in 2001 (latest available data) was 14%.
Strategic Indicator 20
Newborn hearing screening for every baby born in the ACT 
The Government has provided funding to expand the Newborn Hearing Screening Program to cover all babies born in the ACT.  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 21
Number of additions to the cervical screening register  
Increase in the number of additions to the cervical register annually (up to 32,000 in 2005-06 from the target of 30,000 in 2004‑05).  This level of reporting of cervical screens provides an indication of the effectiveness of early intervention health messages.

Accountability Indicators
	2004‑05
Targets	2004-05
Est. Outcome	2005-06
Targets	
Output Class 1
Health and Community Care	
Output 1.1 Acute Services	
				
Patient activity				
a.	Cost weighted patient separations	59  3301	59  3301	61  285	
b.	Non-admitted occasions of service	202  020	210  3202	219  310	
c.	Percentage of category one elective surgery patients who receive surgery within 30 days of listing	95%	92%	100%	
This provides an indication of the responsiveness of the hospital system to those in urgent need of elective surgery.
1.	The 2004-05 target and estimated outcomes have been adjusted to reflect the removal of cost weighted separations for Capital Region Cancer Stream and the Aged and Rehabilitation Care Stream.
2.	The increase in activity in 2004-05 is principally due to increases in imaging services and in part by the transfer of endoscopy services to outpatient care settings within acute care services (+1,000).
Output 1.2 Mental Health Services	
				
Patient activity				
a.	Admitted patient separations	1  400	1  420	1  300	
b.	Adult services	138  800	136  539	140  800	
c.	Children and youth services	24  000	28  660	24  300	
d.	Older persons’ services	12  200	12  071	12  400	
The number of people who use the various community based service responses.  This provides an indication of the volume of care provided by Mental Health ACT.
e.	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.
f.	The proportion of clients seen at an ACT Health community facility during the 7 days post discharge from the inpatient services.  	-	-	75%	
This provides an indication of the effectiveness of Mental Health ACT in providing an integrated response to the needs of its clients.
g.	Percentage of clients with outcome measures completed	-	-	75%	
This provides a data platform for analysis of the appropriateness and effectiveness of mental health services in ensuring that client needs are met.

Accountability Indicators cont.
	2004‑05
Targets	2004-05
Est. Outcome	2005-06
Targets	
Output Class 1
Health and Community Care	
Output 1.3 Community Health Services	
a.	Number of opioid treatment clients with management plans	-	-	450	
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	8 months	8 months	
This provides an indication of the capacity of the adult dental program in meeting the needs of the community.  This provides evidence of the responsiveness of Community Health to clients of the dental program.
c.	Proportion of offenders and detainees in Quamby and the Belconnen Remand Centre with health care assessment plans within 24 hours of detention	-	-	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	85  000	85  000	85  000	
This provides an indication of the level of allied health services provided to hospital based patients by Community Health.
e.	Proportion of new referrals to Community Health aged over 65 years with a completed falls assessment	-	-	60%	
This provides an indication of the responsiveness of Community Health to the needs of its client group.
Output 1.4 Public Health Services	
a.	Samples analysed	7  000	7  000	7  000	
The amount of specimens provided to the Health Protection Service Analytical Laboratory for analyses in connection with legislation enforcement, other services to ACT Government agencies and private activity.
b.	Inspection compliance of licensable, registrable and non-licensable activities	70%	70%	70%	
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%	

Accountability Indicators cont.
	2004‑05
Targets	2004-05
Est. Outcome	2005-06
Targets	
Output Class 1
Health and Community Care	
Output 1.5 Cancer Services	
Patient activity				
a.	Cost weighted admitted patient separations	2  973	3  050	3  140	
b.	Non admitted occasions of service	32  000	33  500	34  400	
The number of hospital based services provided to clients.  This provides an indication of the volume of care provided for hospital based cancer patients.
Breast screening				
c.	Waiting time for results is less than 28 days	-	-	100%	
d.	Waiting time between breast screen and assessment is less than 28 days	-	-	90%	
This gives an indication of 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.
Output 1.6 Aged Care and Rehabilitation Services	
Patient activity				
a.	Cost weighted admitted patient separations	3  153	3  200	3  350	
b.	Non admitted occasions of service	980	1  180	1  290	
This provides an indication of the level of services provided.
c.	Number of people assessed in falls clinics	240	420	420	
This provides an indication of the demand for this service and the effectiveness of aged care services in minimising the fall risks for older people.
Output 1.7 Early intervention and Prevention	
a.	Immunisation coverage for the primary immunisation schedule measured at 1 year of age, in accordance with the Australian Childhood Immunisation Register	91%	91%	91%	
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 screens	12  000	11  200	12  000	
c.	Number of screens for women aged over 50	-	-	9  950	
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 total volume of services as well as providing an indication of the level of services provided to women in the target age group.

Budgeted Financial Results
Section 31 of the Financial Management Act 1996 (FMA) advises that Chief Executives are responsible for achievement of financial results.  For the purpose of Section 31 of the FMA, key budgeted results are specified in the Budget Papers to improve accountability.  An outcome of the increased accountability will be the requirement for Chief Executives to explain material variances from specified budgeted results.
In accordance with Section 31 of the FMA, the following are the key budgeted results for ACT Health:
•	Operating Result ($14.333m deficit) – this measure focuses on the financial performance of ACT Health, and will measure management of expenditure levels within Government funding and own-source revenue limitations.  The budgeted level of deficit mainly reflects depreciation and accrued employee expenses offset by recurrent funding for capital purchases.
•	Current Ratio1 (0.48 to 1) – the current ratio is an indication of the ability to fund short‑term liabilities from short-term assets.  While a generally accepted minimum of 1:1 is desired, given the nature of the Department’s operations and that the majority of its revenue is from Government and received in regular fortnightly instalments, a ratio of 0.48 to 1 is not unreasonable.  Additionally, the Department’s current liabilities of $69.757m include $38.522m for annual leave.  While some leave entitlements are likely to be utilised within the next financial year, the overall level of provisions are expected to remain constant or grow due to the accumulation of new leave by employees.
•	Total Assets ($433.480m) – this measure focuses on ACT Health’s ability to manage its asset base.
•	Total Liabilities ($102.360m) – this measure focuses on maintaining prudent levels of liabilities as required by Section 11 of the FMA.
1	Total current assets / Total current liabilities

Changes to Appropriation
Changes to Appropriation - Departmental						
 	2004-05	2005-06	2006-07	2007-08	2008-09	
Government Payment for Outputs	Est. Outc.	Budget	Estimate	Estimate	Estimate	
 	$'000	$'000	$'000	$'000	$'000	
2004-05 Budget	  489  505	  519  757	  548  660	  572  567	  572  567	
2nd Appropriation						
Wage Negotiations	  8  506	  10  010	  13  654	  13  986	  14  171	
Aboriginal and Torres Strait Islander Dental Health Program	    56	    222	    228	    233	    239	
Children at Risk Assessment Unit	    206	    638	    659	    669	    678	
2005-06 Budget Policy Adjustments						
Elective Surgery	    0	  2  000	  2  050	  2  101	  2  154	
Equipment for Hospitals	    0	  2  000	    0	    0	    0	
Dental Services	    0	    278	    285	    292	    299	
Reform of Community Sector Funding Indexation	    0	    0	    224	    463	    716	
Continuation of Growth Initiative	    0	    0	    0	    0	  12  895	
General Savings	    0	-2  500	-2  500	-2  500	-2  500	
Agency Funded Initiatives						
After Hour GP Service	    0	    350	    359	    369	    377	
Allied Health Assistants	    0	    250	    257	    263	    270	
Care Package - Returning Mental Health Clients	    0	    613	    623	    634	    0	
Clinical IT Package	    0	    800	  1  071	    987	    635	
Falls Prevention	    0	    300	    300	    300	    300	
High needs Children	    0	    465	    630	    650	    670	
Intermittent Care Program	    0	    650	    660	    670	    680	
Nurse Practitioners	    0	    250	    256	    263	    269	
Nurse Re-entry/Refresher	    0	    500	    512	    525	    538	
Pathology Registrar	    0	    100	    100	    100	    100	
Picture Archival Communication System (PACS)	    0	    170	  1  310	  1  686	  1  702	
Quality Infrastructure	    0	    500	    916	    933	    950	
General Savings to be Reinvested	    0	-7  278	-8  412	-7  380	-6  491	
2005-06 Budget Technical Adjustments						
Revised Indexation Parameters	    0	    0	    0	    0	  10  906	
Employer Superannuation Adjustment	    0	    650	    650	    650	    650	
Cross Border Outpatients	    0	-2  000	-2  000	-2  000	-2  000	
Revised Commonwealth Specific Purpose Payments	    556	    939	    320	-1  647	-1  297	
Transfer of Community and Health Services Complaints Commissioner Unit to DJCS	    0	-1  100	-1  131	-1  149	-1  168	
Transfer of Respite Funding (Baptist Community Service) to DDHCS	    0	-205	-210	-215	-220	
Transfer of Healthcall Agreement from DDHCS	    0	    680	    697	    714	    732	
Communication Contract Savings	    0	-147	-218	-218	-218	
2005-06 Capital Works Program - Feasibility Studies	    0	  1  180	    0	    0	    0	
2005-06 Budget 	  498  829	  530  072	  559  950	  583  946	  608  604	

Changes to Appropriation - Territorial	 	 	 	 	 	
	2004-05	2005-06	2006-07	2007-08	2008-09	
Payment for Expenses on Behalf of Territory	Est. Outc.	Budget	Estimate	Estimate	Estimate	
 	$'000	$'000	$'000	$'000	$'000	
						
2004-05 Budget	  15  881	  8  916	  2  772	  2  836	  2  836	
						
2005-06 Budget Policy Adjustments						
2005-06 Capital Works Program - Calvary	    0	  2  200	    575	    0	    0	
Capital Upgrade Program - Calvary	    0	  1  240	    640	    640	    640	
2005-06 Budget Technical Adjustments						
Revised Indexation Parameters	    0	    0	    0	    0	    71	
Rollover - Capital Works - Calvary	-8  455	  6  275	  2  180	    0	    0	
						
2005-06 Budget 	  7  426	  18  631	  6  167	  3  476	  3  547	

Changes to Appropriation - Departmental						
 	2004-05	2005-06	2006-07	2007-08	2008-09	
Capital Injections	Est. Outc.	Budget	Estimate	Estimate	Estimate	
 	$'000	$'000	$'000	$'000	$'000	
						
2004-05 Budget	  29  061	  6  100	    0	    0	    0	
						
2005-06 Budget Policy Adjustments						
2005-06 Capital Works Program	    0	  3  400	  3  980	    0	    0	
Capital Upgrade Program	    0	  2  610	  3  210	  3  210	  3  210	
Agency Funded Initiatives						
Picture Archival Communication System (PACS)	    0	  2  330	  1  418	    0	    0	
2005-06 Budget Technical Adjustments						
Rollover - Capital Works	-7  224	  7  224				
Return of Discontinuing Projects	-5  719	-1  700	    0	    0	    0	
Transfer of 'Junction' Youth Health to Office for Children, Youth and Family Support	-780	    0	    0	    0	    0	
						
2005-06 Budget 	  15  338	  19  964	  8  608	  3  210	  3  210	

Capital Works
Departmental
 	Estimated	Prior	2005-06	2006-07	2007-08	Expected 	
	Total	Year	Financing	Financing	Financing	Completion 	
	Cost 	Expenditure				Date  	
 	$’000	$’000	$’000	$’000	$’000	 	
New Capital Works							
							
New Construction Works							
Departmental							
Refurbish Roof of Old Analytical Lab 	Building – Holder	1  000	-	1  000	-	-	Mar 2006	
Karralika Development Options	400	-	400	-	-	Nov 2005	
							
Mental and Community Health							
Master Planning of Mental and Community 	Health Facilities	300	-	300	-	-	Oct 2005	
							
The Canberra Hospital							
Medical Records Relocation	3  380	-	1  000	2  380	-	Jun 2007	
Fire Systems Upgrade (Phase 1)	2  600	-	1  000	1  600	-	Jun 2007	
Building 1 Tower/Ambulatory Care/Hot 	floor	  500	-	  500	-	-	Oct 2005	
Helipad Relocation/Multi-Storey Carpark	  310	-	  310	-	-	Oct 2005	
Traffic and Parking Review	  70	-	  70	-	-	Oct 2005	
							
Total New Construction Works	8  560	-	4  580	3  980	-	 	
							
Capital Upgrades							
Building Refurbishment and Upgrades	1  210	-	1  210	-	-		
Electrical, Lift and Major Plant Upgrades	  580	-	  580	-	-		
Environment and Safety	  500	-	  500	-	-		
OH&S and Access	  320	-	  320	-	-		
							
Total Capital Upgrades 	2  610	-	2  610	-	-		
	 	 	 		 	 	
Total New Capital Works	11  170	-	7  190	3  980	-	 	
							
Works in Progress							
							
Refurbish Paediatrics	4  050	3  593	  457	  -	  -	Aug 2005	
ANU (Canberra) Medical School - Canberra 	Hospital	12  100	2  700	9  400	  -	  -	Jan 2006	
Howard Florey Building, Holder– 	Supplementary Funding	  417	-	  417	  -	  -	Jan 2006
	
Building 10 Lifts and Dumb Waiter 	Upgrade	  650	  280	  370	  -	  -	Oct 2005	
Orthopaedic Theatre Refurbishment	  470	  80	  390	  -	  -	Jan 2006	
Anatomical Pathology Laboratory 	Refurbishment	  450	  150	  300	  -	  -	Aug 2005	
Imaging Department Reception and Work 	Area	  375	  85	  290	  -	  -	Aug 2005	
Total Works in Progress	18  512	6  888	11  624	  -	  -	 	
							
 Total Departmental Capital Works	29  682	6  888	18  814	3  980	-	 	

Territorial 
	Estimated	Prior	2005-06	2006-07	2007-08	Expected	
	Total	Year	Financing	Financing	Financing	Completion	
	Cost 	Expenditure				Date	
	$’000	$’000	$’000	$’000	$’000		
 New Capital Works	 	 	 	 	 	 	
							
New Construction Works							
							
Calvary Hospital							
Fire Safety Upgrade	1  000	  -	1  000	-	  -	Jun 2006	
Calvary Hospital Sterilising Facility	1  775	  -	1  200	  575	  -	Dec 2006	
							
Total New Construction Works	2  775	  -	2  200	  575	  -	 	
							
Capital Upgrades							
Building Refurbishment and Upgrades	  940	  -	  940	-	-		
Electrical, Lift and Major Plant Upgrades	  300	  -	  300	-	-		
Environment and Safety	-	  -	-	-	-		
OH&S and Access	-	  -	-	-	-		
							
Total Capital Upgrades	1  240	  -	1  240		-	-		
	 	 	 	 	 		
Total New Capital Works	4  015	  -	3  440	575	-	 	
							
Works in Progress							
							
Sub and Non Acute Service – Phase 1	5  150	  830	4  320	-	  -	Oct 2006	
Sub/Non Acute Services Supplementary 	Funding	4  600	-	2  420	2  180	  -	Oct 2006	
Canberra Medical School	1  750	  250	1  500	  -	  -	Feb 2006	
Improvements to Security and Access Control	  460	  410	  50	  -	  -	Aug 2005	
Plant and Building Upgrade	4  192	  500	3  692	  -	  -	Jun 2006	
Electrical and Lift Upgrade	2  678	2  178	  500	  -	  -	Sep 2005	
							
Total Works in Progress	18  830	4  168	12  482	2  180	  -	 	
							
 Total Territorial Capital Works	22  845	4  168	15  922	2  755	-	 	

Commonwealth Grants
The major Commonwealth payments for which the Portfolio has responsibility are:
Name of Grant	Activities Funded by Grant	2005‑06
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.	107  479	
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.	10  215	
National Public Health Outcomes Agreement	Provide 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  397	
Australian Immunisation Agreement	Provision of funding for vaccines listed under the National Immunisation Program, including vaccines for the childhood immunisation program, influenza and pneumococcal vaccines for people aged 65 years and over.	1  435	
Illicit Drug Diversion	This grant program provides early intervention in the criminal justice process and opportunities for individuals to access assessment, with a view to treatment, rather than progress through the criminal justice system. In addition, funding is provided to support needle and syringe programs.	1  260	
High Cost Drugs	Provision of highly specialised drug therapies under section 100 of the National Health Act 1953.	6  500	
Pathways Home Program	Provide rehabilitation/transitional and psycho geriatric services to support persons who have completed an acute hospital episode but require an intensive period of recuperation and rehabilitation in order to successfully return to community living.	2  600	
Aged Care Assessment Team	Commonwealth funds are provided to support ‘assessment’ services for aged people.	492	
Youth Health Services (IHSHY)	Funding of a range of innovative health services for homeless youth in the ACT.	57	

Total	133  435

ACT Health	
Operating Statement	
  2004-05			  2004-05	   2005-06		  2006-07	  2007-08	  2008-09		
    Budget			Est.Outcome	   Budget	   Var	  Estimate	   Estimate	  Estimate		
    $'000			   $'000	   $'000	    %	   $'000	    $'000	   $'000		
		Income								
		Revenue								
492  057		Government Payment for Outputs	503  551	533  205	6	559  950	583  946	608  604		
90  109		User Charges - Non ACT Government	100  341	107  219	7	110  960	112  066	113  387		
3  097		User Charges - ACT Government	2  597	2  508	-3	2  570	2  634	2  666		
5  676		Grants from the Commonwealth	6  876	6  500	-5	6  670	6  844	6  969		
1  147		Interest	1  447	1  236	-15	1  186	1  186	1  186		
5  038		Other Revenue	5  238	5  608	7	5  747	5  889	5  978		
303		Resources Received free of charge	681	664	-2	682	700	723		
597  427		Total Revenue	620  731	656  940	6	687  765	713  265	739  513		
		Gains								
0		Total Gains	0	0	-	0	0	0		
597  427		Total Income	620  731	656  940	6	687  765	713  265	739  513		
		Expenses								
266  475		Employee Expenses	281  776	298  100	6	311  836	322  255	332  049		
34  153		Superannuation Expenses	35  049	37  606	7	38  872	39  387	39  843		
169  975		Supplies and Services	172  441	179  356	4	185  646	193  708	202  362		
14  244		Depreciation and Amortisation	13  500	14  963	11	15  966	16  250	15  987		
5  836		Cost of Goods Sold	7  500	8  032	7	8  182	8  335	8  535		
120  003		Grants and Purchased Services	123  287	130  834	6	139  246	146  368	153  239		
2  261		Other Expenses	2  171	2  382	10	2  440	2  499	2  599		
612  947		Total Ordinary Expenses	635  724	671  273	6	702  188	728  802	754  614		
-15  520		Operating Result From Ordinary Activities	-14  993	-14  333	4	-14  423	-15  537	-15  101		
0		Extraordinary Revenue	-142	0	-100	0	0	0		
102		Extraordinary Expense	350	0	-100	0	0	0		
-15  622		Operating Result	-15  485	-14  333	7	-14  423	-15  537	-15  101		

ACT Health	
Balance Sheet	
    Budget			Est.Outcome	   Planned		   Planned	   Planned	   Planned		
as at 30/6/05			as at 30/6/05	as at 30/6/06	   Var	as at 30/6/07	as at 30/6/08	as at 30/6/09		
   $'000			   $'000	    $'000	    %	    $'000	    $'000	    $'000		
		Current Assets								
1  445		Cash	3  943	4  026	2	3  600	3  174	2  748		
14  731		Receivables	20  593	20  593	-	20  593	20  593	20  593		
4  963		Investments	19  823	1  567	-92	1  193	819	445		
4  827		Inventories	6  006	6  006	-	6  006	6  006	6  006		
1  658		Other	1  289	1  289	-	1  289	1  289	1  289		
27  624		Total Current Assets	51  654	33  481	-35	32  681	31  881	31  081		
		Non Current Assets								
3  000		Investments	3  000	3  000	-	3  000	3  000	3  000		
395  939		Property, Plant and Equipment	360  758	385  202	7	387  349	381  932	375  848		
954		Intangibles	3  513	9  797	179	7  006	4  215	2  475		
3  574		Capital Works in Progress	6  888	2  000	-71	0	0	0		
403  467		Total Non Current Assets	374  159	399  999	7	397  355	389  147	381  323		
431  091		TOTAL ASSETS	425  813	433  480	2	430  036	421  028	412  404		
		Current Liabilities								
19  319		Payables	20  286	19  486	-4	18  686	17  886	17  086		
1  200		Interest Bearing Liabilities	650	650	-	650	650	650		
22		Finance Leases	0	0	-	0	0	0		
43  542		Employee Benefits	44  667	48  230	8	49  696	52  251	54  775		
2  317		Other	4  524	1  391	-69	1  391	1  391	1  391		
66  400		Total Current Liabilities	70  127	69  757	-1	70  423	72  178	73  902		
		Non Current Liabilities								
999		Payables	852	852	-	852	852	852		
66		Finance Leases	39	39	-	39	39	39		
30  195		Employee Benefits	29  306	31  712	8	33  417	34  981	36  524		
31  260		Total Non Current Liabilities	30  197	32  603	8	34  308	35  872	37  415		
97  660		TOTAL LIABILITIES	100  324	102  360	2	104  731	108  050	111  317		
333  431		NET ASSETS	325  489	331  120	2	325  305	312  978	301  087		
		REPRESENTED BY FUNDS EMPLOYED								
332  956		Accumulated Funds	325  014	330  645	2	324  830	312  503	300  612		
475		Reserves	475	475	-	475	475	475		
333  431		TOTAL FUNDS EMPLOYED	325  489	331  120	2	325  305	312  978	301  087		

ACT Health	
Cash Flow Statement	
  2004-05			  2004-05	   2005-06		  2006-07	  2007-08	  2008-09		
    Budget			Est.Outcome	   Budget	   Var	  Estimate	   Estimate	  Estimate		
    $'000			   $'000	   $'000	    %	   $'000	    $'000	   $'000		
		CASH FLOWS FROM OPERATING ACTIVITIES								
		Receipts								
489  505		Cash from Government for Outputs	498  829	530  072	6	559  950	583  946	608  604		
93  206		User Charges	102  938	109  727	7	113  530	114  700	116  053		
1  147		Interest Received	1  447	1  236	-15	1  186	1  186	1  186		
5  676		Grants Received from the Commonwealth	6  876	6  500	-5	6  670	6  844	6  969		
27  161		Other Revenue	27  361	27  681	1	27  820	27  962	28  051		
616  695		Operating Receipts	637  451	675  216	6	709  156	734  638	760  863		
		Payments								
294  865		Related to Employees	314  728	329  737	5	347  537	357  523	367  825		
171  172		Related to Supplies and Services	173  260	179  492	4	185  764	193  808	202  439		
120  003		Grants and Purchased Services	124  332	130  834	5	139  246	146  368	153  239		
30  220		Other	31  794	32  487	2	32  695	32  907	33  207		
102		Extraordinary Payments	350	0	-100	0	0	0		
616  362		Operating Payments	644  464	672  550	4	705  242	730  606	756  710		
333		NET CASH INFLOW/(OUTFLOW) FROM OPERATING ACTIVITIES	-7  013	2  666	138	3  914	4  032	4  153		
		CASH FLOWS FROM INVESTING ACTIVITIES								
		Payments								
44  841		Purchase of Property, Plant and Equipment	24  105	40  803	69	13  322	8  042	8  163		
44  841		Investing Payments	24  105	40  803	69	13  322	8  042	8  163		
-44  841		NET CASH INFLOW/(OUTFLOW) FROM INVESTING ACTIVITIES	-24  105	-40  803	-69	-13  322	-8  042	-8  163		
		CASH FLOWS FROM FINANCING ACTIVITIES								
		Receipts								
29  061		Capital Injection from Government	15  338	19  964	30	8  608	3  210	3  210		
29  061		Financing Receipts	15  338	19  964	30	8  608	3  210	3  210		
		Payments								
27		Repayment of Finance Lease	16	0	-100	0	0	0		
27		Financing Payments	16	0	-100	0	0	0		
29  034		NET CASH INFLOW/(OUTFLOW) FROM FINANCING ACTIVITIES	15  322	19  964	30	8  608	3  210	3  210		
-15  474		NET INCREASE/(DECREASE) IN CASH HELD	-15  796	-18  173	-15	-800	-800	-800		
23  682		CASH AT BEGINNING OF REPORTING PERIOD	41  912	26  116	-38	7  943	7  143	6  343		
8  208		CASH AT THE END OF THE REPORTING PERIOD	26  116	7  943	-70	7  143	6  343	5  543		

ACT Health	
Statement of Changes in Equity	
    Budget			Est.Outcome	   Planned		   Planned	   Planned	   Planned		
as at 30/6/05			as at 30/6/05	as at 30/6/06	   Var	as at 30/6/07	as at 30/6/08	as at 30/6/09		
   $'000			   $'000	    $'000	    %	    $'000	    $'000	    $'000		
319  992		Opening Balance	325  636	325  489	..	331  120	325  305	312  978		
		Accumulated Funds								
-15  622		Operating Result for the Period	-15  485	-14  333	7	-14  423	-15  537	-15  101		
		Reserves								
-15  622		Total Income And Expense For The Period	-15  485	-14  333	7	-14  423	-15  537	-15  101		
		Transactions Involving Equity Holders Affecting Accumulated Funds								
29  061		Capital Injections	15  338	19  964	30	8  608	3  210	3  210		
333  431		Closing Balance	325  489	331  120	2	325  305	312  978	301  087		
Notes to the Budget Statements
Significant variations are as follows:
Operating Statement
•	government payment for outputs:
•	the increase of $11.494m in the 2004‑05 estimated outcome from the original budget  relates to funding for increases in salaries ($8.506m), deferred projects ($2.170m), increased Commonwealth specific purpose payments ($0.556m) and election commitments funded through the 2nd Appropriation ($0.262m); and
•	the increase of $29.654m in the 2005‑06 Budget from the 2004‑05 estimated outcome relates mainly to funding for increases in salaries ($11.726m), indexation ($4.397m), growth funding ($8.369m), 2005-06 new initiatives ($4.278m), full year effect of 2004-05 new initiatives ($4.778m), feasibility studies ($1.180m), full year effect of 2nd Appropriation election commitments ($0.598m), increased employer superannuation ($0.650m), transfer of the Healthcall agreement funding from the Department of Disability, Housing and Community Services ($0.680m) and higher Commonwealth specific purpose payments ($0.548m).  These are offset by general savings ($2.5m), a reclassification of government revenue to capital injection for the picture archival communication system ($2.330m), a reduction to offset expected increases in cross border revenue ($2m) and the transfer of the health complaints office to the Department of Justice and Community Safety ($1.1m).
•	user charges – non ACT Government:  
•	the increase of $10.232m in the 2004‑05 estimated outcome from the original budget relates mainly to higher third party revenue at The Canberra Hospital ($4.7m), increased cross border revenue from NSW ($3.868m) and increased supply activity ($1.664m); and
•	the increase of $6.878m in the 2005‑06 Budget from the 2004-05 estimated outcome relates mainly to further increases in cross border revenue from NSW ($4.034m), indexation ($1.289m), parking revenue ($0.805m) and business development and process redesign in pathology ($0.5m).
•	user charges – ACT Government:  the decrease of $0.5m in the 2004‑05 estimated outcome from the original budget relates mainly to the cessation of the Healthcall agreement ($0.680m) with the Department of Disability, Housing and Community Services (these funds will now be directly appropriated to ACT Health);
•	grants from the Commonwealth:  the increase of $1.2m in the 2004‑05 estimated outcome from the original budget relates to increased pharmaceutical expenses on high cost drugs.  The decrease of $0.376m in the 2005‑06 Budget from the 2004‑05 estimated outcome represents the estimate of likely reimbursements;
•	interest:  the increase of $0.3m in the 2004‑05 estimated outcome from the original budget relates to higher levels of investments held due to deferred Commonwealth projects and the timing of payments for the purchase of plant and equipment and information technology systems.  The reduction in revenue in the outyears relates to the utilisation of those cash balances;
•	other revenue:  the increase of $0.2m in the 2004‑05 estimated outcome from the original budget incorporates donations and other miscellaneous revenue collected by the Department;
•	resources received free of charge:  the increase of $0.378m in the 2004‑05 estimated outcome from the original budget relates to higher levels of legal services received from the Department of Justice and Community Safety (JACS);
•	employee expenses:
•	the increase of $15.301m in the 2004‑05 estimated outcome from the original budget relates mainly to pay rises under the new nursing, medical officer and template (clerical) Enterprise Bargaining Agreements (EBA) ($7.493m), increased activity at The Canberra Hospital funded from higher third party revenue ($4.4m) and cross border revenue ($2.468m), deferred projects from 2003-04 ($0.477m) and 2nd Appropriation funding for election commitments ($0.163m); and
•	the increase of $16.324m in the 2005‑06 Budget from the 2004-05 estimated outcome relates mainly to funding for EBAs ($9.031m), growth funding ($3.2m), new initiatives funded from increased cross border revenue ($2.8m), full year effect of 2004-05 new initiatives ($0.478m), 2nd Appropriation funding for election commitments ($0.336m), 2005-06 new initiatives ($0.144m) and further increased activity at The Canberra Hospital funded from higher third party revenue ($1m).  These are offset by general savings ($0.830m) and the transfer of the health complaints office to the Department of Justice and Community Safety ($0.7m).
•	superannuation expenses:  the increase of $0.896m in the 2004‑05 estimated outcome from the original budget and the increase of $2.557m in the 2005-06 Budget from the 2004‑05 estimated outcome relates mainly to pay rises under the new nursing, medical officer and template (clerical) (EBA);
•	supplies and services:
•	the increase of $2.466m in the 2004-05 estimated outcome from the original budget relates mainly to projects deferred from 2003‑04 ($0.811m), increased activity at The Canberra Hospital funded from higher third party revenue ($0.7m), higher Commonwealth specific purpose payments ($0.556m) and higher resources received free of charge for legal services ($0.378m); and
•	the increase of $6.915m in the 2005-06 Budget from the 2004-05 estimated outcome relates mainly to indexation ($4.3m), growth funding ($1.2m), feasibility studies ($1.180m) and new initiatives ($1m).  These are offset by the transfer of the health complaints office to the Department of Justice and Community Safety ($0.293m) and general savings ($0.075m).
•	depreciation and amortisation:  
•	the decrease of $0.744m in the 2004‑05 estimated outcome from the original budget relates mainly to delays in capital works and the purchasing of medical equipment and information technology systems; and
•	the increase of $1.463m in the 2005-06 Budget from the 2004‑05 estimated outcome coincides with the expected take‑up of these assets.
•	cost of goods sold:  the increase of $1.664m in the 2004‑05 estimated outcome from the original budget relates to increased supply activity with external clients such as Calvary Public and Private Hospitals, John James Hospital and Queanbeyan Hospital.
•	grants and purchased services:
•	the increase of $3.284m in the 2004‑05 estimated outcome from the original budget relates to EBA payrise funding for Calvary Public Hospital ($0.860m), deferred projects ($0.968m), car parking funding for Calvary Public Hospital ($1.4m) and 2nd Appropriation funding for election commitments ($0.056m); and
•	the increase of $7.547m in the 2005‑06 Budget from the 2004‑05 estimated outcome relates mainly to EBA pay rises ($2.695m), growth funding ($3.890m), new initiatives ($1m) and the full year effect of 2004-05 new initiatives ($2.303m).  These are offset by the removal of car parking funding ($1.4m) and savings initiatives ($0.750m).
Balance Sheet
•	cash and investments:  
•	the increase of $2.498m in cash and $14.860m in investments in the 2004‑05 estimated outcome from the original budget relates mainly to unspent Commonwealth specific purpose payments and other deferred projects, deferred purchases of medical equipment and information technology systems; and
•	the decrease of $18.256m in investments in the 2005‑06 Budget from the 2004‑05 estimated outcome relates to the utilisation of these funds for the items referred to above.
•	receivables:  the increase of $5.862m in the 2004‑05 estimated outcome from the original budget is to bring the estimated outcome and outyear figures in-line with the actual outcome for 2003‑04;
•	inventories:  the increase of $1.179m in the 2004‑05 estimated outcome from the original budget reflects the higher than anticipated level of stock held by ACT Health at 30 June 2004;
•	
property, plant and equipment:  
•	the decrease of $35.181m in the 2004‑05 estimated outcome from the original budget relates mainly to deferred medical equipment purchases and delayed capital works projects.  In addition, information technology assets have been reclassified as intangibles; and
•	The increase of $24.444m in the 2005‑06 Budget from the 2004‑05 estimated outcome relates mainly to the catch‑up in equipment purchases ($5.990m), capital works ($7.224m) and completion of capital works in progress ($6.888m).  It also changes the new 2005‑06 capital works program ($4.010m), planned completion of the 2004‑05 program ($4.4m), new initiatives ($4.330m) and recurrent equipment program ($4.599m).  These are offset by depreciation ($14.963m).
•	intangibles:  
•	the increase of $2.559m in the 2004‑05 estimated outcome from the original budget mainly relates to the transfer of information technology assets into this category of assets; and
•	the increase of $6.284m in the 2005‑06 Budget from the 2004‑05 estimated outcome relates to the expected completion of the patient admission system.
•	capital works in progress:  
•	the increase of $3.314m in the 2004‑05 estimated outcome from the original budget relates to delays in the paediatrics refurbishment, the building 10 lifts upgrade, the orthopaedic theatre refurbishment, the anatomical pathology laboratory refurbishment and the imaging department reception and work area refurbishment; and
•	the decrease of $4.888m in 2005‑06 Budget from the 2004‑05 estimated outcome relates to the planned completion of works in progress for capital works projects.
•	current employee benefits:  the increase of $1.125m in the 2004‑05 estimated outcome from the original budget and the increase of $3.563m in the 2005‑06 Budget from the 2004‑05 estimated outcome relates mainly to the higher level of pay rises negotiated for nursing, clerical, professional, technical and health service officers (template agreement) than originally factored into the 2004‑05 Budget.  In addition, a 3% payrise was awarded to medical officers during 2004‑05.
•	other current liabilities:  
•	the increase of $2.207m in the 2004‑05 estimated outcome from the original budget relates to higher than anticipated deferral of Commonwealth specific purpose payments and other deferred projects; and
•	the decrease of $3.133m in the 2005‑06 Budget from the 2004‑05 estimated outcome relates to the utilisation of these funds.
•	non current employee benefits:  the decrease of $0.889m in the 2004‑05 estimated outcome from the original budget reflects the lower than anticipated result from the 2003‑04 audited outcome.  This is offset by increases for higher pay outcomes in the nursing and template (clerical) EBAs than originally factored into the 2004‑05 Budget and the 3% payrise for medical officers.

ACT Health	
Statement of Income and Expenses on Behalf of the Territory	
  2004-05			  2004-05	   2005-06		  2006-07	  2007-08	  2008-09		
    Budget			Est.Outcome	   Budget	   Var	  Estimate	   Estimate	  Estimate		
    $'000			   $'000	   $'000	    %	   $'000	    $'000	   $'000		
		Income								
		Revenue								
15  881		Payment for Expenses on behalf of Territory	7  426	18  631	151	6  167	3  476	3  547		
679		Taxes Fees and Fines	679	695	2	712	728	746		
121  284		Grants from the Commonwealth	121  091	126  935	5	130  504	135  736	136  085		
137  844		Total Revenue	129  196	146  261	13	137  383	139  940	140  378		
		Gains								
0		Total Gains	0	0	-	0	0	0		
137  844		Total Income	129  196	146  261	13	137  383	139  940	140  378		
		Expenses								
15  881		Grants and Purchased Services	7  426	18  631	151	6  167	3  476	3  547		
121  963		Transfer Expenses	121  770	127  630	5	131  216	136  464	136  831		
137  844		Total Ordinary Expenses	129  196	146  261	13	137  383	139  940	140  378		
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 30/6/05			as at 30/6/05	as at 30/6/06	   Var	as at 30/6/07	as at 30/6/08	as at 30/6/09		
   $'000			   $'000	    $'000	    %	    $'000	    $'000	    $'000		
		Current Assets								
284		Cash	289	289	-	289	289	289		
16		Receivables	11	11	-	11	11	11		
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	
  2004-05			  2004-05	   2005-06		  2006-07	  2007-08	  2008-09		
    Budget			Est.Outcome	   Budget	   Var	  Estimate	   Estimate	  Estimate		
    $'000			   $'000	   $'000	    %	   $'000	    $'000	   $'000		
		CASH FLOWS FROM OPERATING ACTIVITIES								
		Receipts								
15  881		Cash from Government for EBT	7  426	18  631	151	6  167	3  476	3  547		
679		Taxes, Fees and Fines	679	695	2	712	728	746		
121  284		Grants Received from the Commonwealth	121  091	126  935	5	130  504	135  736	136  085		
1  517		Other Revenue	498	1  593	220	340	64	64		
139  361		Operating Receipts	129  694	147  854	14	137  723	140  004	140  442		
		Payments								
15  881		Grants and Purchased Services	7  426	18  631	151	6  167	3  476	3  547		
1  343		Other	497	1  593	221	340	64	64		
121  963		Territory Receipts to Government	121  770	127  630	5	131  216	136  464	136  831		
139  187		Operating Payments	129  693	147  854	14	137  723	140  004	140  442		
174		NET CASH INFLOW/(OUTFLOW) FROM OPERATING ACTIVITIES	1	0	-100	0	0	0		
174		NET INCREASE/(DECREASE) IN CASH HELD	1	0	-100	0	0	0		
110		CASH AT BEGINNING OF REPORTING PERIOD	288	289	..	289	289	289		
284		CASH AT THE END OF THE REPORTING PERIOD	289	289	-	289	289	289		

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 $8.455m in the 2004‑05 estimated outcome from the original budget relates to delays in the capital works programs at Calvary Public Hospital; and
•	the increase of $11.205m in the 2005‑06 Budget from the 2004‑05 estimated outcome relates to the deferral of capital works projects and the new 2005‑06 capital works program at Calvary Public Hospital, and increased funding to HealthPACT for indexation and the commencement of the childhood obesity measures, announced in the 2004‑05 Budget.
•	grants from the Commonwealth:  the increase of $5.844m in the 2005‑06 Budget from the 2004‑05 estimated outcome relates mainly to increases in the Australian Health Care Agreement ($5.420m), Home and Community Care ($0.886m) and Illicit Drug Packages ($1.003m), offset by a decrease in the Australian Immunisation Agreement ($1.541m).
•	grants and purchased services:  these variances are the same as those identified above for ‘payment for expenses on behalf of the Territory’.
•	transfer expenses:  these variances relate mainly to the movement identified above for ‘grants from the Commonwealth’.

Health and Community Care	
Operating Statement	
  2004-05			  2004-05	   2005-06		  2006-07	  2007-08	  2008-09		
    Budget			Est.Outcome	   Budget	   Var	  Estimate	   Estimate	  Estimate		
    $'000			   $'000	   $'000	    %	   $'000	    $'000	   $'000		
		Income								
		Revenue								
491  073		Government Payment for Outputs	502  509	533  205	6	559  950	583  946	608  604		
90  109		User Charges - Non ACT Government	100  341	107  219	7	110  960	112  066	113  387		
3  097		User Charges - ACT Government	2  597	2  508	-3	2  570	2  634	2  666		
5  676		Grants from the Commonwealth	6  876	6  500	-5	6  670	6  844	6  969		
1  147		Interest	1  447	1  236	-15	1  186	1  186	1  186		
5  038		Other Revenue	5  238	5  608	7	5  747	5  889	5  978		
259		Resources Received free of charge	681	664	-2	682	700	723		
596  399		Total Revenue	619  689	656  940	6	687  765	713  265	739  513		
		Gains								
0		Total Gains	0	0	-	0	0	0		
596  399		Total Income	619  547	656  940	6	687  765	713  265	739  513		
		Expenses								
265  845		Employee Expenses	281  095	298  100	6	311  836	322  255	332  049		
34  058		Superannuation Expenses	34  952	37  606	8	38  872	39  387	39  843		
169  702		Supplies and Services	172  163	179  356	4	185  646	193  708	202  362		
14  244		Depreciation and Amortisation	13  500	14  963	11	15  966	16  250	15  987		
5  836		Cost of Goods Sold	7  500	8  032	7	8  182	8  335	8  535		
120  003		Grants and Purchased Services	123  287	130  834	6	139  246	146  368	153  239		
2  217		Other Expenses	2  171	2  382	10	2  440	2  499	2  599		
611  905		Total Ordinary Expenses	634  668	671  273	6	702  188	728  802	754  614		
-15  506		Operating Result From Ordinary Activities	-14  979	-14  333	4	-14  423	-15  537	-15  101		
0		Extraordinary Revenue	-142	0	-100	0	0	0		
102		Extraordinary Expense	350	0	-100	0	0	0		
-15  608		Operating Result	-15  471	-14  333	7	-14  423	-15  537	-15  101		

Additional ACT Health Operating Statements
The following operating statements are published to provide an additional level of transparency and accountability into the operations of ACT Health. 
The Canberra Hospital
Operating Statement	
									
2004-05*		 	   2004-05	  2005-06	 	  2006-07	  2007-08	  2008-09	
Budget			Est.Outcome	   Budget	   Var	  Estimate	   Estimate	  Estimate	
$'000		 	    $'000	   $'000	    %	   $'000	    $'000	   $'000	
		Income							
		Revenue							
239  479		Government Payment for Outputs	245  839	256  643	4	266  332	270  325	274  884	
32  457		User Charges - Non ACT Government	37  366	37  530	..	38  468	39  430	40  416	
612		User Charges - ACT Government	612	627	2	643	659	675	
5  676		Grants from the Commonwealth	6  877	6  500	-5	6  663	6  829	7  000	
418		Interest	558	557	..	557	557	557	
3  389		Other Revenue	3  967	3  674	-7	3  766	3  860	3  956	
0		Resources Received Free of Charge	134	134	-	137	141	144	
282  031		Total Revenue	295  353	305  665	3	316  565	321  801	327  632	
		Gains							
0		Total Gains	0	0	-	0	0	0	
282  031		Total Income	295  353	305  665	3	316  565	321  801	327  632	
		Expenses							
154  577		Employee Expenses	164  071	169  690	3	176  478	179  125	181  453	
16  980		Superannuation Expenses	18  976	20  993	11	21  833	22  160	22  448	
109  545		Supplies and Services	112  586	112  827	..	115  648	118  539	121  502	
10  317		Depreciation and Amortisation	10  174	10  174	-	10  674	10  674	10  674	
0		Other Expenses	134	134	-	137	141	144	
291  419		Total Ordinary Expenses	305  941	313  818	3	324  769	330  639	336  222	
-9  388		Operating Result	-10  588	-8  153	23 	-8  204	-8  838	-8  590	

* The 2004-05 Budget figures have been updated to remove the Cancer and Aged Care and Rehabilitation streams, which are no longer reported within The Canberra Hospital.

Calvary Public Hospital
Operating Statement	
									
2004-05*		 	   2004-05	  2005-06	 	  2006-07	  2007-08	  2008-09	
    Budget			Est.Outcome	   Budget	   Var	  Estimate	   Estimate	  Estimate	
    $'000		 	    $'000	   $'000	    %	   $'000	    $'000	   $'000	
		Income							
		Revenue							
3  430		User Charges - Non ACT Government	3  470	3  530	2	3  565	3  601	3  637	
80  819		User Charges - ACT Government	80  747	85  603	6	88  989	92  502	93  704	
5  663		Capital Grants	3  332	15  922	378	3  395	640	640	
320		Interest	340	320	-6	150	100	100	
1  050		Other Revenue	1  251	1  289	3	1  321	1  354	1  388	
3  249		Resources Received Free of Charge	3  249	3  400	5	3  536	3  677	3  825	
94  531		Total Revenue	92  389	110  063	19	100  957	101  874	103  294	
		Gains							
0		Total Gains	0	0	-	0	0	0	
94  531		Total Income	92  389	110  063	19	100  957	101  874	103  294	
		Expenses							
59  397		Employee Expenses	59  287	62  600	6	65  104	67  709	68  589	
5  398		Superannuation Expenses	5  601	5  825	4	6  058	6  300	6  382	
23  914		Supplies and Services	24  599	25  990	6	26  640	27  306	27  988	
3  800		Depreciation and Amortisation	3  559	3  720	5	3  750	4  148	4  546	
92  509		Total Ordinary Expenses	93  046	98  135	5	101  552	105  463	107  506	
2  022		Operating Result	-657	11  928	# 	-596	-3  589	-4  212	

* The Operating Statements published for Calvary Public Hospital this year include Mental Health activity.

Community Health
Operating Statement	
									
2004-05*		 	   2004-05	  2005-06	 	  2006-07	  2007-08	  2008-09	
    Budget			Est.Outcome	   Budget	   Var	  Estimate	   Estimate	  Estimate	
    $'000		 	    $'000	   $'000	    %	   $'000	    $'000	   $'000	
		Income							
		Revenue							
51  303		Government Payment for Outputs	51  375	55  033	7	57  121	58  022	58  911	
1  320		User Charges - Non ACT Government	1  534	1  572	2	1  611	1  652	1  693	
1  868		User Charges - ACT Government	1  790	1  211	-32	1  241	1  272	1  304	
634		Other Revenue	872	895	3	917	940	964	
0		Resources Received Free of Charge	52	52	-	53	55	56	
55  125		Total Revenue	55  623	58  763	6	60  944	61  940	62  928	
		Gains							
0		Total Gains	0	0	-	0	0	0	
55  125		Total Income	55  623	58  763	6	60  944	61  940	62  928	
		Expenses							
36  187		Employee Expenses	38  379	41  070	7	42  713	43  353	43  917	
4  895		Superannuation Expenses	5  573	5  875	5	6  110	6  202	6  282	
13  244		Supplies and Services	12  059	12  241	2	12  547	12  861	13  182	
217		Depreciation and Amortisation	178	178	-	178	178	178	
1  664		Grants and Purchased Services	0	0	#	0	0	0	
0		Other Expenses	52	52	-	53	55	56	
56  207		Total Ordinary Expenses	56  241	59  416	6	61  601	62  648	63  616	
									
-1  082		Operating Result	-618	-653	 -6	-657	-708	-688	

* The 2004-05 Budget figures have been updated to remove the Cancer and Aged Care and Rehabilitation streams, which are no longer reported within Community Care.	

Mental Health ACT
Operating Statement	
									
2004-05*		 	   2004-05	  2005-06	 	  2006-07	  2007-08	  2008-09	
    Budget			Est.Outcome	   Budget	   Var	  Estimate	   Estimate	  Estimate	
    $'000		 	    $'000	   $'000	    %	   $'000	    $'000	   $'000	
		Income							
		Revenue							
35  446		Government Payment for Outputs	38  741	40  129	4	41  560	42  276	43  000	
401		User Charges - Non ACT Government	401	411	2	421	432	443	
5		Other Revenue	5	5	-	5	5	5	
35  852		Total Revenue	39  147	40  545	4	41  986	42  713	43  448	
		Gains							
0		Total Gains	0	0	-	0	0	0	
35  852		Total Income	39  147	40  545	4	41  986	42  713	43  448	
		Expenses							
22  722		Employee Expenses	23  770	24  976	5	25  975	26  365	26  707	
2  933		Superannuation Expenses	3  039	3  188	5	3  316	3  365	3  409	
6  253		Supplies and Services	7  416	7  692	4	7  884	8  081	8  283	
		Depreciation and Amortisation	162	162	-	162	162	162	
4  438		Grants and Purchased Services	5  265	5  014	-5	5  139	5  268	5  400	
36  346		Total Ordinary Expenses	39  652	41  032	3	42  476	43  241	43  961	
									
-494		Operating Result	-505	-487	4 	-490	-528	-513	

* The 2004-05 Budget figures have been updated to only show direct Mental Health ACT expenditure.  This presentation is consistent with other Divisional Operating Statements published for ACT Health.