Annual report 2017/18: Disclosure and compliance

Audit Opinion

Auditor General

INDEPENDENT AUDITOR'S REPORT

To the Parliament of Western Australia

WA COUNTRY HEAL TH SERVICE

Report on the Financial Statements

Opinion
I have audited the financial statements of the WA Country Health Service which comprise the Statement of Financial Position as at 30 June 2018, the Statement of Comprehensive Income, Statement of Changes in Equity, Statement of Cash Flows for the year then ended, and Notes comprising a summary of significant accounting policies and other explanatory information.

In my opinion, the financial statements are based on proper accounts and present fairly, in all material respects, the operating results and cash flows of the WA Country Health Service for the year ended 30 June 2018 and the financial position at the end of that period. They are in accordance with Australian Accounting Standards, the Financial Management Act 2006 and the Treasurer's Instructions.

Basis for Opinion
I conducted my audit in accordance with the Australian Auditing Standards. My responsibilities under those standards are further described in the Auditor's Responsibilities for the Audit of the Financial Statements section of my report. I am independent of the Health Service in accordance with the Auditor General Act 2006 and the relevant ethical requirements of the Accounting Professional and Ethical Standards Board's APES 110 Code of Ethics for Professional Accountants (the Code) that are relevant to my audit of the financial statements. I have also fulfilled my other ethical responsibilities in accordance with the Code. I believe that the audit evidence I have obtained is sufficient and appropriate to provide a basis for my opinion.

Responsibility of the Board for the Financial Statements
The Board is responsible for keeping proper accounts, and the preparation and fair presentation of the financial statements in accordance with Australian Accounting Standards, the Financial Management Act 2006 and the Treasurer's Instructions, and for such internal control as the Board determines is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error.

In preparing the financial statements, the Board is responsible for assessing the agency's ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the Western Australian Government has made policy or funding decisions affecting the continued existence of the Health Service.

Auditor's Responsibility for the Audit of the Financial Statements
As required by the Auditor General Act 2006, my responsibility is to express an opinion on the financial statements. The objectives of my audit are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor's report that includes my opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with Australian Auditing Standards will always detect a material misstatement when it exists.

Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of the financial statements. As part of an audit in accordance with Australian Auditing Standards, I exercise professional judgment and maintain professional scepticism throughout the audit. I also:

  • Identify and assess the risks of material misstatement of the financial statements, whether due to fraud or error, design and perform audit procedures responsive to those risks, and obtain audit evidence that is sufficient and appropriate to provide a basis for my opinion. The risk of not detecting a material misstatement resulting from fraud is higher than for one resulting from error, as fraud may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal control.
  • Obtain an understanding of internal control relevant to the audit in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the agency's internal control.
  • Evaluate the appropriateness of accounting policies used and the reasonableness of accounting estimates and related disclosures made by the Board.
  • Conclude on the appropriateness of the Board's use of the going concern basis of accounting and, based on the audit evidence obtained, whether a material uncertainty exists related to events or conditions that may cast significant doubt on the agency's ability to continue as a going concern. If I conclude that a material uncertainty exists, I am required to draw attention in my auditor's report to the related disclosures in the financial statements or, if such disclosures are inadequate, to modify my opinion. My conclusions are based on the audit evidence obtained up to the date of my auditor's report.
  • Evaluate the overall presentation, structure and content of the financial statements, including the disclosures, and whether the financial statements represent the underlying transactions and events in a manner that achieves fair presentation.

I communicate with the Board regarding, among other matters, the planned scope and tiniing of the audit and significant audit findings, including any significant deficiencies in internal control that I identify during my audit.

Report on Controls

Opinion
I have undertaken a reasonable assurance engagement on the design and implementation of controls exercised by the WA Country Health Service. The controls exercised by the Health Service are those policies and procedures established by the Board to ensure that the receipt, expenditure and investment of money, the acquisition and disposal of property, and the incurring of liabilities have been in accordance with legislative provisions (the overall control objectives).

My opinion has been formed on the basis of the matters outlined in this report.

In my opinion, in all material respects, the controls exercised by the WA Country Health Service are sufficiently adequate to provide reasonable assurance that the receipt, expenditure and investment of money, the acquisition and disposal of property and the incurring of liabilities have been in accordance with legislative provisions during the year ended 30 June 2018.

The Board's Responsibilities
The Board is responsible for designing, implementing and maintaining controls to ensure that the receipt, expenditure and investment of money, the acquisition and disposal of property, and the incurring of liabilities are in accordance with the Financial Management Act 2006, the Treasurer's Instructions and other relevant written law.

Auditor General's Responsibilities
As required by the Auditor General Act 2006, my responsibility as an assurance practitioner is to express an opinion on the suitability of the design of the controls to achieve the overall control objectives and the implementation of the controls as designed. I conducted my engagement in accordance with Standard on Assurance Engagements ASAE 3150 Assurance Engagements on Controls issued by the Australian Auditing and Assurance Standards Board. That standard requires that I comply with relevant ethical requirements and plan and perform my procedures to obtain reasonable assurance about whether, in all material respects, the controls are suitably designed to achieve the overall control objectives and the controls, necessary to achieve the overall control objectives, were implemented as designed.

An assurance engagement to report on the design and implementation of controls involves performing procedures to obtain evidence about the suitability of the design of controls to achieve the overall control objectives and the implementation of those controls. The procedures selected depend on my judgement, including the assessment of the risks that controls are not suitably designed or implemented as designed. My procedures included testing the implementation of those controls that I consider necessary to achieve the overall control objectives.

I believe that the evidence I have obtained is sufficient and appropriate to provide a basis for my opinion.

Limitations of Controls
Because of the inherent limitations of any internal control structure it is possible that, even if the controls are suitably designed and implemented as designed, once the controls are in operation, the overall control objectives may not be achieved so that fraud, error, or noncompliance with laws and regulations may occur and not be detected. Any projection of the outcome of the evaluation of the suitability of the design of controls to future periods is subject to the risk that the controls may become unsuitable because of changes in conditions.

Report on the Key Performance Indicators

Opinion
I have undertaken a reasonable assurance engagement on the key performance indicators of the WA Country Health Service for the year ended 30 June 2018. The key performance indicators are the key effectiveness indicators and the key efficiency indicators that provide performance information about achieving outcomes and delivering services.

In my opinion, in all material respects, the key performance indicators of the WA Country Health Service are relevant and appropriate to assist users to assess the Health Service's performance and fairly represent indicated performance for the year ended 30 June 2018.

Matter of Significance
The Under Treasurer approved the removal of the following indicator as an audited key performance indicator (KPI):

  • Percentage of Emergency Department patients seen within recommended times (major rural hospitals)

The approval was conditional on its inclusion as an unaudited performance indicator in the Annual Report and that it be reinstated as an audited KPI following the implementation of a. new Emergency Department data collection system. A new system had not been developed at 30 June 2018. Consequently, the KPI has not been included in the audited KP ls for the year ended 30 June 2018. My opinion is not modified in respect of this matter.

Emphasis of Matter
Attention is drawn to the effectiveness indicator "Proportion of elective wait list patients waiting over boundary for reportable procedures". The notes to this indicator explain that comparative information has not been reported because of errors in the data used to calculate this KPI in 2016-17. My opinion is not modified in respect of this matter.

The Board's Responsibility for the Key Performance Indicators
The Board is responsible for the preparation and fair presentation of the key performance indicators in accordance with the Financial Management Act 2006 and the Treasurer's Instructions and for such internal control as the Board determines necessary to enable the preparation of key performance indicators that are free from material misstatement, whether due to fraud or error.

In preparing the key performance indicators, the Board is responsible for identifying key performance indicators that are relevant and appropriate having regard to their purpose in accordance with Treasurer's Instruction 904 Key Performance Indicators.

Auditor General's Responsibility
As required by the Auditor General Act 2006, my responsibility as an assurance practitioner is to express an opinion on the key performance indicators. The objectives of my engagement are to obtain reasonable assurance about whether the key performance indicators are relevant and appropriate to assist users to assess the agency's performance and whether the key performance indicators are free from material misstatement, whether due to fraud or error, and to issue an auditor's report that includes my opinion. I conducted my engagement in accordance with Standard on Assurance Engagements ASAE 3000 Assurance Engagements Other than Audits or Reviews of Historical Financial Information issued by the Australian Auditing and Assurance Standards Board. That standard requires that I comply with relevant ethical requirements relating to assurance engagements.

An assurance engagement involves performing procedures to obtain evidence about the amounts and disclosures in the key performance indicators. It also involves evaluating the relevance and appropriateness of the key performance indicators against the criteria and guidance in Treasurer's Instruction 904 for measuring the extent of outcome achievement and the efficiency of service delivery. The procedures selected depend on my judgement, including the assessment of the risks of material misstatement of the key performance indicators. In making these risk assessments I obtain an understanding of internal control relevant to the engagement in order to design procedures that are appropriate in the circumstances. I believe that the evidence I have obtained is sufficient and appropriate to provide a basis for my opinion.

My Independence and Quality Control Relating to the Reports on Controls and Key Performance Indicators
I have complied with the independence requirements of the Auditor General Act 2006 and the relevant ethical requirements relating to assurance engagements. In accordance with ASQC 1 Quality Control for Firms that Perform Audits and Reviews of Financial Reports and Other Financial Information, and Other Assurance Engagements, the Office of the Auditor General maintains a comprehensive system of quality control including documented policies and procedures regarding compliance with ethical requirements, professional standards and applicable legal and regulatory requirements.

Matters Relating to the Electronic Publication of the Audited Financial Statements and Key Performance Indicators
This auditor's report relates to the financial statements and key performance indicators of the WA Country Health Service for the year ended 30 June 2018 included on the Health Service's website. The Health Service's management is responsible for the integrity of the Health Service's website. This audit does not provide assurance on the integrity of the Health Service's website. The auditor's report refers only to the financial statements and key performance indicators described above. It does not provide an opinion on any other information which may have been hyperlinked to/from these financial statements or key performance indicators. If users of the financial statements and key performance indicators are concerned with the inherent risks arising from publication on a website, they are advised to refer to the hard copy of the audited financial statements and key performance indicators to confirm the information contained in this website version of the financial statements and key performance indicators.

[Image: Caroline Spencer signature (PDF only)]

CAROLINE SPENCER
AUDITOR GENERAL
FOR WESTERN AUSTRALIA
Perth, Western Australia
J.O September 2018

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Certification of financial statements

WA COUNTRY HEALTH SERVICE CERTIFICATION OF FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2018

The accompanying financial statements of the WA Country Health Service have been prepared in compliance with the provisions of the Financial Management Act 2006 from proper accounts and records to represent fairly the financial transactions for the financial year ending 30 June 2018 and financial position as at 30 June 2018.

At the date of signing we are not aware of any circumstance which would render the particulars included in the financial statements misleading or inaccurate.

[Mr John Arkell signature (PDF only)]
MR JOHN ARKELL
CHIEF FINANCE OFFICER
WA COUNTRY HEALTH SERVICE
19 September 2018

[Professor Neale Fong signature (PDF only)]
PROFESSOR NEALE FONG
CHAIR WA COUNTRY HEALTH SERVICE BOARD
19 September 2018

[Mr Alan Ferris signature (PDF only)]
MR ALAN FERRIS
BOARD MEMBER
WA COUNTRY HEALTH SERVICE BOARD
19 September 2018

Financial statements

Statement of Comprehensive Income

For the year ended 30 June 2018

 Note2018
$000
2017
$000
COST OF SERVICES
Expenses
Employee benefits expense
3.1 1,002,713 958,399
Fees for visiting medical practitioners 3.2 85,859 84,071
Patient support costs 3.2 381,124 398,039
Finance costs 7.2 138 199
Depreciation and amortisation expense 5.1, 5.2 74,005 77,016
Asset revaluation decrement 5.1 17,566 54,218
Loss on disposal of non-current assets 5.1 3,406 1,338
Repairs, maintenance and consumable equipment 3.3 49,200 48,147
Other expenses 3.3 165,559 161,643
Total cost of services   1,779,570 1,783,070
INCOME
Revenue
Patient charges 4.4 67,187 68,996
Commonwealth grants and contributions 4.2 484,181 467,570
Other grants and contributions 4.3 95,652 102,849
Donation revenue   551 637
Other revenue 4.5 22,589 23,738
Total revenue   670,160 663,790
Total income other than income from State Government   670,160 663,790
NET COST OF SERVICES   1,109,410 1,119,280
INCOME FROM STATE GOVERNMENT
Service appropriations 4.1 948,805 943,451
Assets assumed 4.1 (67) 43
Services received free of charge 4.1 55,373 56,107
Royalties for Regions Fund 4.1 71,723 86,489
Total income from State Government   1,075,834 1,086,090
DEFICIT FOR THE PERIOD   (33,576) (33,190)
OTHER COMPREHENSIVE INCOME/(LOSS)
Items not reclassified subsequently to profit or loss
Changes in asset revaluation reserve   - -
Gains/(losses) recognised directly in equity   - -
Total other comprehensive income   - -
TOTAL COMPREHENSIVE INCOME/(LOSS) FOR THE PERIOD   (33,576) (33,190)

Refer also to note 2.2 'Schedule of Income and Expenses by Service'.
The Statement of Comprehensive Income should be read in conjunction with the accompanying notes.

Statement of Financial Position

As at 30 June 2018

 Note2018
$000
2017
$000
ASSETS
Current assets
Cash and cash equivalents 7.3 18,173 18,949
Restricted cash and cash equivalents 7.3 25,342 37,369
Receivables 6.1 23,647 23,752
Inventories 6.3 5,157 5,270
Prepayments 6.3 4,328 5,067
Total Current Assets   76,647 90,407
Non-Current Assets
Restricted cash and cash equivalents 7.3 7,463 3,840
Amounts receivable for services 6.2 748,497 674,420
Property, plant and equipment 5.1 1,916,214 1,777,418
Intangible assets 5.2 17,338 13,941
Total Non-Current Assets   2,689,512 2,469,619
Total Assets   2,766,159 2,560,026
LIABILITIES
Current Liabilities
Payables 6.4 116,019 119,198
Borrowings 7.1 1,779 1,701
Provisions 3.1 143,401 131,606
Other current liabilities   52 22
Total Current Liabilities   261,251 252,527
Non-Current Liabilities
Borrowings 7.1 1,865 3,644
Provisions 3.1 27,885 26,405
Total Non-Current Liabilities   29,750 30,049
Total Liabilities   291,001 282,576
NET ASSETS   2,475,158 2,277,450
EQUITY
Contributed equity 9.9 2,541,924 2,310,640
Reserves   - -
Accumulated deficit   (66,766) (33,190)
TOTAL EQUITY   2,475,158 2,277,450

The Statement of Financial Position should be read in conjunction with the accompanying notes.

Statement of Changes in Equity

For the year ended 30 June 2018

 Note2018
$000
2017
$000
CONTRIBUTED EQUITY 9.9    
Balance at start of period   2,310,640 -
Transfer of net asset by owners   - 2,196,393
Transactions with owners in their capacity as owners:      
Capital appropriations   27,781 20,439
Royalties for Regions Fund   206,831 94,506
Other contributions by owners   695 2
Distributions to owners   (4,023) (700)
Balance at end of period   2,541,924 2,310,640
RESERVES
Asset Revaluation Reserve
Balance at start of period   - -
Comprehensive income/(loss) for the period   - -
Balance at end of period     -
ACCUMULATED SURPLUS
Balance at start of period   (33,190) -
Deficit for the period   (33,576) (33,190)
Balance at end of period   (66,766) (33,190)
TOTAL EQUITY
Balance at start of period   2,277,450 -
Total comprehensive income/(loss) for the period   (33,576) (33,190)
Transactions with owners in their capacity as owners   231,284 2,310,640
Balance at end of period   2,475,158 2,277,450

The Statement of Changes in Equity should be read in conjunction with the accompanying notes.

Statement of Cash Flows

For the year ended 30 June 2018

 Note2018
$000
Inflows
(Outflows)
2017
$000
Inflows
(Outflows)
CASH FLOWS FROM STATE GOVERNMENT
Service appropriations   874,584 855,497
Capital appropriations   26,080 18,815
Royalties for Regions Fund   278,554 180,995
Net cash provided by State Government   1,179,218 1,055,307
Utilised as follows:
CASH FLOWS FROM OPERATING ACTIVITIES
Payments
Employee benefits   (997,236) (938,947)
Supplies and services   (604,092) (636,892)
Receipts
Receipts from customers   64,412 70,696
Commonwealth grants and contributions   484,181 467,570
Other grants and contributions   95,653 102,849
Donations received   521 622
Other receipts   26,532 21,795
Net cash used in operating activities 7.3 (930,029) (912,307)
CASH FLOWS FROM INVESTING ACTIVITIES
Payments
Purchase of non-current physical assets   (258,369) (149,067)
Net cash used in investing activities   (258,369) (149,067)
Net increase / (decrease) in cash and cash equivalents   (9,180) (6,067)
Cash and cash equivalents at the beginning of the period   60,158 -
Cash and cash equivalents transferred in from abolished entity   - 66,225
CASH AND CASH EQUIVALENTS AT THE END OF PERIOD 7.3 50,978 60,158

The Statement of Cash Flows should be read in conjunction with the accompanying notes.

Notes to the Financial Statements

For the year ended 30 June 2018

Note 1: Basis of preparation

WA Country Health Service is a WA Government entity and is controlled by the State of Western Australia, which is the ultimate parent. It is a not-for-profit entity (as profit is not its principal objective).

A description of the nature of its operations and its principal activities have been included in the 'Overview' which does not form part of these financial statements.

These annual financial statements were authorised for issue by the Accountable Authority of the WA Country Health Service on 19 September 2018.

Statement of compliance

These general purpose financial statements have been prepared in accordance with:

  1. The Financial Management Act 2006
  2. The Treasurer's Instructions
  3. Australian Accounting Standards including applicable interpretations
  4. Where appropriate, those AAS paragraphs applicable for not-for-profit entities have been applied.

The Financial Management Act 2006 and the Treasurerʼs Instructions take precedence over the Australian Accounting Standards. Several Australian Accounting Standards are modified by the Treasurer's Instructions to vary application, disclosure format and wording. Where modification is required and has had a material or significant financial effect upon the reported results, details of that modification and the resulting financial effect are disclosed in the notes to the financial statements.

Basis of preparation

These financial statements are presented in Australian dollars applying the accrual basis of accounting and using the historical cost convention. Certain balances will apply a different measurement basis (such as the fair value basis). Where this is the case the different measurement basis is disclosed in the associated note. All values are rounded to the nearest thousand dollars

Judgements and estimates

Judgements, estimates and assumptions are required to be made about financial information being presented. The significant judgements and estimates made in the preparation of these financial statements are disclosed in the notes where amounts affected by those judgements and/or estimates are disclosed. Estimates and associated assumptions are based on professional judgements derived from historical experience and various other factors that are believed to be reasonable under the circumstances.

Contributed equity

AASB Interpretation 1038 Contributions by Owners Made to Wholly-Owned Public Sector Entities requires transfers in the nature of equity contributions, other than as a result of a restructure of administrative arrangements, to be designated by the Government (the owner) as contributions by owners (at the time of, or prior to, transfer) before such transfers can be recognised as equity contributions. Capital appropriations have been designated as contributions by owners by TI 955 Contributions by Owners made to Wholly Owned Public Sector Entities and have been credited directly to Contributed Equity.

The transfers of net assets to/from other agencies, other than as a result of a restructure of administrative arrangements, are designated as contributions by owners where the transfers are non-discretionary and non-reciprocal.

Note 2: WA Country Health Service outputs

How WA Country Health Service operates

This section includes information regarding the nature of funding the WA Country Health Service receives and how this funding is utilised to achieve its objectives. This note also provides the distinction between controlled funding and administered funding:

  • WA Country Health Service objectives - Note 2.1
  • Schedule of Income and Expenses by Service - Note 2.2

2.1 WA Country Health Service objectives

Mission

WA Country Health Serviceʼs purpose is to improve country peopleʼs health and wellbeing through access to quality services and by supporting people to look after their own health.

WA Country Health Service is predominantly funded by Parliamentary appropriations.

Services

The key services of WA Country Health Service are:

1. Public Hospital Admitted Services
The provision of healthcare services to patients in major rural hospitals that meet the criteria for admission and receive treatment and/or care for a period of time, including public patients treated in private facilities under contract to WA Health. Admission to hospital and the treatment provided may include access to acute and/or subacute inpatient services, as well as hospital in the home services. Public Hospital Admitted Services includes teaching, training and research activities provided by the public health service to facilitate development of skills and acquisition or advancement of knowledge related to admitted services. This Service does not include any component of the Mental Health Services reported under Service four “Mental Health Services”.

2. Public Hospital Emergency Services
The provision of services for the treatment of patients in emergency departments of major rural hospitals, inclusive of public patients treated in private facilities under contract to WA Health. The services provided to patients are specifically designed to provide emergency care, including a range of pre-admission, post-acute and other specialist medical, allied health, nursing and ancillary services. Public Hospital Emergency Services includes teaching, training and research activities provided by the public health service to facilitate development of skills and acquisition or advancement of knowledge related to emergency services. This Service does not include any component of the Mental Health Services reported under Service four “Mental Health Services”.

3. Public Hospital Non-admitted Services
The provision of major rural hospital services to patients who do not undergo a formal admission process, inclusive of public patients treated by private facilities under contract to WA Health. This Service includes services provided to patients in outpatient clinics, community based clinics or in the home, procedures, medical consultation, allied health or treatment provided by clinical nurse specialists. Public Hospital Non-Admitted Services includes teaching, training and research activities provided by the public health service to facilitate development of skills and acquisition or advancement of knowledge related to nonadmitted services. This Service does not include any component of the Mental Health Services reported under Service four “Mental Health Services”.

4. Mental Health Services
The provision of inpatient services where an admitted patient occupies a bed in a designated mental health facility or a designated mental health unit in a hospital setting; and the provision of non-admitted services inclusive of community and ambulatory specialised mental health programs such as prevention and promotion, community support services, community treatment services, community bed based services and forensic services. This Service includes the provision of state-wide mental health services such as perinatal mental health and eating disorder outreach programs as well as the provision of assessment, treatment, management, care or rehabilitation of persons experiencing alcohol or other drug use problems or cooccurring health issues. Mental Health Services includes teaching, training and research activities provided by the public health service to facilitate development of skills and acquisition or advancement of knowledge related to mental health or alcohol and drug services. This service includes public patients treated in private facilities under contract to WA Health.

5. Aged and Continuing Care Services
The provision of aged and continuing care services and community based palliative care services. Aged and continuing care services include programs that assess the care needs of older people, provide functional interim care or support for older, frail, aged and younger people with disabilities to continue living independently in the community and maintain independence, inclusive of the services provided by the WA Quadriplegic Centre. Aged and Continuing Care Services is inclusive of community based palliative care services that are delivered by private facilities under contract to WA Health, which focus on the prevention and relief of suffering, quality of life and the choice of care close to home for patients.

6. Public and Community Health Services
The provision of healthcare services and programs delivered to increase optimal health and wellbeing, encourage healthy lifestyles, reduce the onset of disease and disability, reduce the risk of long-term illness as well as detect, protect and monitor the incidence of disease in the population. Public and Community Health Services includes public health programs, Aboriginal health programs, disaster management, environmental health, the provision of grants to non-government organisations for public and community health purposes, emergency road and air ambulance services, services to assist rural based patients travel to receive care, and statewide pathology services provided to external WA Agencies.

7. Small Rural Hospital Services
Provides emergency care & limited acute medical/minor surgical services in locations 'close to home' for country residents/visitors, by small & rural hospitals classified as block funded. Include community care services aligning to local community needs.

2.2 Schedule of income and expenses by service                                              

 Public Hospital Admitted Services 2018
$000
Public Hospital Admitted Services 2017
$000
Public Hospital Emergency Services 2018
$000
Public Hospital Emergency Services 2017
$000
Public Hospital Non-Admitted Services 2018
$000
Public Hospital Non-Admitted Services 2017
$000
Mental Health Services (a) 2018
$000
Mental Health Services (a) 2017
$000
COST OF SERVICES
Expenses
Employee benefits expense 363,315 338,701 160,562 163,968 63,147 62,841 86,005 82,686
Fees for visiting medical practitioners 43,639 43,351 20,599 18,485 9,193 8,423 378 2,104
Patient support costs 125,477 134,308 32,280 36,077 20,482 17,088 3,934 4,863
Finance costs 81 91 22 54 12 22 - -
Depreciation and amortisation expense 30,767 27,024 9,610 13,010 4,829 5,855 207 515
Asset revaluation decrement 6,851 41,709 1,230 1,869 527 913 351 50
Loss on disposal of non-current assets 2,306 453 559 144 345 119 0 68
Repairs, maintenance and consumable equipment 18,345 16,383 5,811 6,855 3,269 3,031 2,252 2,343
Other expenses  41,201 48,698 16,912 24,203 7,136 11,108 26,090 19,854
Total cost of services 631,982 650,718 247,585 264,665 108,940 109,400 119,217 112,483
Income
Patient charges 19,381 19,214 1,618 1,674 17,335 15,818 307 455
Commonwealth grants and contributions 199,127 179,861 54,609 56,644 34,207 34,381 25,754 22,995
Other grants and contributions 2,216 1,970 2,278 2,262 1,211 940 83,677 81,031
Donation revenue 270 316 115 64 15 44 13 23
Other revenue 7,674 3,793 2,923 1,683 2,112 363 1,514 830
Total income other than income from State Government 228,668 205,154 61,543 62,327 54,880 51,546 111,265 105,334
NET COST OF SERVICES 403,314 445,564 186,042 202,338 54,060 57,854 7,952 7,149
INCOME FROM STATE GOVERNMENT
Service appropriations 370,360 378,866 157,575 185,454 47,529 53,630 - 502
Assets assumed 38 36 (26) 1 (4) - (12) -
Services received free of charge 19,718 20,843 7,704 8,335 3,390 3,455 3,710 3,540
Royalties for Regions Fund 4,314 17,947 13,564 7,177 1,870 2,975 688 3,048
Total income from State Government 394,430 417,692 178,817 200,967 52,785 60,060 4,386 7,090
DEFICIT FOR THE PERIOD (8,884) (27,872) (7,225) (1,371) (1,275) 2,206 (3,566) (59)

(a) Includes services in addition to those provided under agreement with the Mental Health Commission for specialised admitted patients and community mental health.

The Schedule of Income and Expenses by Service should be read in conjunction with the accompanying notes.

 Aged and Continuing 2018
$000
Aged and Continuing 2017
$000
Public and Community 2018
$000
Public and Community 2017
$000
Small Rural 2018
$000
Small Rural 2017
$000
Total 2018
$000
Total 2017
$000
COST OF SERVICES
Expenses
Employee benefits expense 95,025 98,812 115,656 108,377 119,003 103,014 1,002,713 958,399
Fees for visiting medical practitioners 205 162 794 642 11,051 10,904 85,859 84,071
Patient support costs 17,174 24,793 147,083 145,155 34,694 35,755 381,124 398,039
Finance costs - - 1 1 22 31 138 199
Depreciation and amortisation expense 2,575 2,837 3,787 6,373 22,230 21,402 74,005 77,016
Asset revaluation decrement 878 581 3,162 (864) 4,567 9,960 17,566 54,218
Loss on disposal of non-current assets 22 218 22 99 152 237 3,406 1,338
Repairs, maintenance and consumable equipment 3,019 4,142 3,830 4,864 12,674 10,529 49,200 48,147
Other expenses 18,754 13,536 31,918 28,586 23,548 15,658 165,559 161,643
Total cost of services 137,652 145,081 306,253 293,233 227,941 207,490 1,779,570 1,783,070
Income
Patient charges 11,997 12,565 12,982 15,780 3,567 3,490 67,187 68,996
Commonwealth grants and contributions 43,994 54,128 24,989 8,686 101,501 110,875 484,181 467,570
Other grants and contributions 1,819 2,124 4,049 4,541 402 9,981 95,652 102,849
Donation revenue 18 51 39 68 81 71 551 637
Other revenue 2,667 2,598 2,770 12,458 2,929 2,013 22,589 23,738
Total income other than income from State Government 60,495 71,466 44,829 41,533 108,480 126,430 670,160 663,790
NET COST OF SERVICES 77,157 73,615 261,424 251,700 119,461 81,060 1,109,410 1,119,280
INCOME FROM STATE GOVERNMENT
Service appropriations 64,090 49,662 227,679 212,619 81,572 62,718 948,805 943,451
Assets assumed (12) 1 (30) 2 (21) 3 (67) 43
Services received free of charge 3,700 3,786 9,529 9,227 7,622 6,921 55,373 56,107
Royalties for Regions Fund 6,440 18,656 18,308 26,586 26,539 10,100 71,723 86,489
Total income from State Government 74,218 72,105 255,486 248,434 115,712 79,742 1,075,834 1,086,090
DEFICIT FOR THE PERIOD (2,939) (1,510) (5,938) (3,266) (3,749) (1,318) (33,576) (33,190)

The Schedule of Income and Expenses by Service should be read in conjunction with the accompanying notes.

Note 3: Use of our funding

Expenses incurred in the delivery of services

This section provides additional information about how WA Country Health Service's funding is applied and the accounting policies that are relevant for an understanding of the items recognised in the financial statements. The primary expenses incurred by WA Country Health Service in achieving its objectives and the relevant notes are:

 Notes2018
$000
2017
$000
Employee benefits expense 3.1(a) 1,002,713 958,399
Employee benefits expense 3.1(a) 1,002,713 958,399
Employee benefits provisions 3.1(b) 171,286 158,011
Patient support costs 3.2 466,983 482,110
Repairs, maintenance, consumable equipment and other expenses 3.3 214,759 209,790

3.1(a) Employee benefits expense

 2018
$000
2017
$000
Salaries and wages 927,098 885,996
Superannuation - defined contribution plans 75,615 72,403
  1,002,713 958,399

Salaries and wages

Salaries and wages comprise of all costs related to employment including the value of the fringe benefits to employees plus the fringe benefits tax component, the value of superannuation contribution component of leave entitlements and redundancy

Superannuation expenses

The Government Employees Superannuation Board (GESB) and other fund providers administer public sector superannuation arrangements in Western Australia in accordance with legislative requirements. Eligibility criteria for membership in particular schemes for public sector employees vary according to commencement and implementation dates.

The superannuation expense recognised in the Statement of Comprehensive Income comprises employer contribution to the Gold State Superannuation Scheme (GSS), the West State Superannuation Scheme (WSS), the GESB Super Scheme (GESBS), or other superannuation funds. The employer contribution paid to the GESB in respect of the GSS is paid back to the Consolidated Account by the GESB.

The GSS is a defined benefit scheme for the purposes of employees and whole-of-government reporting. However, it is a defined contribution plan for agency purposes because the concurrent contributions (defined contributions) made by WA Country Health Service to GESB extinguishes WA Country Health Service's obligations to the related superannuation liability.

The WA Country Health Service has no liabilities under the Pension Scheme or the GSS. The liabilities for the unfunded Pension Scheme and the unfunded GSS transfer benefits attributable to members who transferred from the Pension Scheme, are assumed by the Treasurer. All other GSS obligations are funded by concurrent contributions made by WA Country Health Service to the GESB.

Employment on-costs expenses (workers compensation insurance) are included at note 3.3 'Repair, maintenance, consumable equipment and other expenses'.

3.1(b) Employee benefits provisions

Provision is made for benefits accruing to employees in respect of salaries and wages, annual leave, time off in lieu leave and long service leave for services rendered up to the reporting date and recorded as an expense during the period the services are delivered.

 2018
$000
2017
$000
Current
Employee benefits provisions
Annual leave (a) 64,774 61,864
Time off in lieu leave (a) 31,189 24,860
Long service leave (b) 44,025 42,083
Gratuities 1,226 935
Deferred salary scheme (c) 2,187 1,864
  143,401 131,606
Non-current
Employee benefits provisions
Long service leave (b) 27,198 25,910
Gratuities 687 495
  27,885 26,405
  171,286 158,011

(a) Annual leave liabilities and time off in lieu leave liabilities are classified as current liabilities as WA Country Health Service does not have an unconditional right to defer settlement of the liability for at least 12 months after the end of the reporting period.

Assessments indicate that actual settlement of the liabilities is expected to occur as follows:

 2018
$000
2017
$000
Within 12 months of the end of the reporting period 77,449 69,251
More than 12 months after the end of the reporting period 18,514 17,473
  95,963 86,724

The provision for annual leave and time off in lieu leave is calculated at the present value of expected payments to be made in relation to services provided by employees up to the reporting date.

(b) Unconditional long service leave provisions are classified as current liabilities as WA Country Health Service does not have an unconditional right to defer settlement of the liability for at least 12 months after the end of the reporting period.

Pre-conditional and conditional long service leave provisions are classified as non-current liabilities because WA Country Health Service has an unconditional right to defer settlement of the liability until the employee has completed the requisite years of service.

Assessments indicate that actual settlement of the liabilities is expected to occur as follows:

 2018
$000
2017
$000
Within 12 months of the end of the reporting period 11,718 11,254
More than 12 months after the end of the reporting period 59,505 56,739
  71,223 67,993

The provision for long service leave is calculated at present value as WA Country Health Service does not expect to wholly settle the amounts within 12 months. The present value is measured taking into account the present value of expected future payments to be made in relation to services provided by employees up to the reporting date. These payments are estimated using the remuneration rate expected to apply at the time of settlement, and discounted using market yields at the end of the reporting period on national government bonds with terms to maturity that match, as closely as possible, the estimated future cash outflows.

(c) The provision for the deferred salary scheme relates to WA Country Health Service's employees who have entered into an agreement to self-fund an additional twelve months leave to be taken in the fifth year of the agreement. Deferred salary scheme liabilities are classified as current liabilities as WA Country Health Service does not have an unconditional right to defer settlement for at least 12 months after the end of the reporting period.

Assessments indicate that actual settlement of the liabilities is expected to occur as follows:

 2018
$000
2017
$000
Within 12 months of the end of the reporting period 538 416
More than 12 months after the end of the reporting period 1,649 1,448
  2,187 1,864

Key sources of estimation uncertainty – long service leave

Key estimates and assumptions concerning the future are based on historical experience and various other factors that have a significant risk of causing a material adjustment to the carrying amount of assets and liabilities within the next financial year.

Several estimates and assumptions are used in calculating the WA Country Health Serviceʼs long service leave provision. These include:

  • Expected future salaries rates
  • Discount rates
  • Employee retention rates; and
  • Expected future payments

Changes in these estimations and assumptions may impact on the carrying amount of the long service leave provision.

Any gain or loss following revaluation of the present value of long service leave liabilities is recognised as employee benefits expense.

3.2 Patient support costs

 2018
$000
2017
$000
Fees for visiting medical practitioners 85,859 84,071
Medical supplies and services 80,038 84,287
Domestic charges 10,320 9,818
Fuel, light and power 30,690 28,788
Food supplies 10,670 10,927
Patient transport costs 93,452 94,011
Aboriginal health services 36,367 35,685
Pathology services 41,557 46,749
Purchase of health care services 13,845 12,794
Purchase of outsourced medical services 28,526 26,680
Purchase of other outsourced services 25,192 27,921
Grant payments 10,467 20,379
Total patient support costs 466,983 482,110

Patient support costs are recognised as an expense in the reporting period in which they are incurred. The carrying amounts of any materials held for distribution are expensed when the materials are distributed.

3.3 Repairs, maintenance, consumable equipment and other expenses

 2018
$000
2017
$000
Repairs, maintenance and consumable equipment

Repairs and maintenance
29,617 25,570
Consumable equipment 19,583 22,577
Total repairs, maintenance and consumable equipment expenses 49,200 48,147
Other expenses
Communications 5,107 4,614
Computer services 2,049 2,858
Workers compensation insurance 13,935 14,985
Other employee related expenses 29,190 26,162
Insurance 6,161 5,125
Legal expenses 506 294
Motor vehicle expenses 5,110 4,357
Operating lease expenses 27,298 29,441
Printing and stationery 4,067 4,163
Doubtful debts expense 1,514 4,018
Purchase of outsourced services 21,095 18,014
Shared services costs 31,799 26,536
Other 17,728 21,076
Total other expenses 165,559 161,643

Other operating expenses generally represent the day-to-day running costs incurred in normal operations.

Repairs and maintenance costs are recognised as expenses as incurred, except where they relate to the replacement of a significant component of an asset. In that case, the costs are capitalised and depreciated.

Doubtful debt expense is recognised as the movement in the provision for doubtful debt. Please refer to note 6.1.1 'Movement of the allowance for impairment of receivables'.

Shared services costs represent the value of services related to Information technology, Human resources, Supply and Finance provided by the Health Support Services; and pathology service provided by Pathwest during the financial year. These services are provided free of charge and the corresponding revenue is reflected under Services Provided Free of Charge.

Note 4: Our funding sources

How we obtain our funding

This section provides additional information about how WA Country Health Service obtains its funding and the relevant accounting policy notes that govern the recognition and measurement of this funding. The primary income received by WA Country Health Service and the relevant notes are:

 Notes2018
$000
2017
$000
Income from State Government 4.1 1,075,834 1,086,090
Commonwealth grants and contributions 4.2 484,181 467,570
Other grants and contributions 4.3 95,652 102,849
Patient charges 4.4 67,187 68,996
Other revenue 4.5 22,589 23,738

4.1 Income from State Government

Appropriation received during the period:

 2018
$000
2017
$000
Service appropriation (a) 948,805 943,451
  948,805 943,451

Assets transferred from/(to) other State government agencies during the period: (b)

 2018
$000
2017
$000
Medical equipment from East Metropolitan Health Services 24 10
Medical equipment from Child and Adolescent Health Services 104 -
Plant and equipment from Child and Adolescent Health Services 6 -
Medical equipment to Health Support Services (201) 33
Total assets transferred (67) 43

Services received free of charge from other State government agencies during the period: (c)

 2018
$000
2017
$000
Department of Finance - government accommodation 92 80
North Metropolitan Health Service (PathWest) 23,482 29,491
Health Support Services 31,799 26,536
Total services received 55,373 56,107

Royalties for Regions Fund:

Regional Community Services Account: (d)

 2018
$000
2017
$000
Regional Workers Incentives Allowance Payments 7,878 7,974
Ear, Eye and Oral Health 1,872 531
Expand the ear bus program Fitzroy Kids Health 616
-
-50
Patient Assisted Travel Scheme 11,009 10,742
Regional Palliative Care 500 1,250
Meet and Greet Program 200 -
Royal Flying Doctor Service 2,792 7,899

Regional Infrastructure Headworks Account: (d)

 2018
$000
2017
$000
Pilbara Health Partnership (Asset Investment) 2,860 3,099
Renal Dialysis Service Expansion 920 511
Busselton ICT
Southern Inland Health Initiative
- District Medical Workforce Investment Program (Stream 1)
915
18,599
-
30,421
- District Hospital Investment Program (Stream 2) - 5,159
- Residential Aged and Dementia Care Investment Program (Stream 6) 5,222 14,146
- Telehealth Investment Program (Stream 5) 4,750 4,707
- District Medical Workforce Investment Program (NEW) 13,590 -
Total Royalties for Regions Fund 71,723 86,489
Total income from State Government 1,075,834 1,086,090

(a) Service appropriations are recognised at fair value in the period in which WA Country Health Service gains control of the appropriated funds. WA Country Health Service gains control of appropriated funds at the time those funds are deposited in the bank account or credited to the ʻAmounts receivable for servicesʼ (holding account) held at Treasury.)

Service appropriations fund the net cost of services delivered (as set out in note 2.2). Appropriation revenue comprises the following:

  • Cash component; and
  • A receivable (asset).

The receivable (holding account – note 6.2) comprises the following:

  • The budgeted depreciation expense for the year; and
  • Any agreed increase in leave liabilities during the year.

(b) Transfer of assets: Discretionary transfers of assets (including grants) and liabilities between State government agencies are reported under Income from State Government. Transfers of assets and liabilities in relation to a restructure of administrative arrangements are recognised as distribution to owners by the transferor and contribution by owners by the transferee under AASB 1004. Other non discretionary non-reciprocal transfers of assets and liabilities designated as contributions by owners under TI 955 are also recognised directly to equity.

(c) Services received free of charge or for nominal cost, are recognised as revenues at the fair value of those services that can be reliably measured and which would have been purchased if they were not donated.

(d) The Regional Community Services Accounts and the Regional Infrastructure and Headworks Account are sub-funds within the over-arching ʻRoyalties for Regions Fundʼ. The recurrent funds are committed to projects and programs in WA regional areas and are recognised as revenue when WA Country Health Service gains control on receipt of the funds.

4.2 Commonwealth grants and contributions

 2018
$000
2017
$000
Recurrent
National Health Reform Agreement via the Department of Health (a) 376,330 369,449
National Health Reform Agreement via the Mental Health Commission (a) 24,909 21,839
Multi Purpose Service Units 29,547 28,850
Home and Community Care Program 10,560 10,361
Other 30,834 24,556
Capital
Bringing Renal Dialysis & Support Services Closer 9,000 8,000
Strengthening Regional Cancer Services 3,000 2,000
Other 1 2,515
  484,181 467,570

(a) Activity based funding and block grant funding is received from the Commonwealth Government under the National Health Reform Agreement for services, health teaching, training and research provided by local hospital networks (Health Services). The funding arrangement established under the Agreement requires the Commonwealth Government to make funding payments to the State Pool Account from which distributions to the local hospital networks (Health Services) are made by the Department of Health and Mental Health Commission.

4.3 Other grants and contributions

 2018
$000
2017
$000
Recurrent
Mental Health Commission - service delivery agreement 71,386 67,885
Mental Health Commission - SSAMHS 5,546 5,753
WA Alcohol and Drug Authority - Community Drug Service Team & other programs - 4,875
Mental Health Commission - Community drug and alcohol service 4,821 -
Disability Services Commission - Community aids and equipment program 2,655 2,991
Other 11,244 11,893
Capital
Onslow Health Service Redevelopment - 9,452
  95,652 102,849

Grant income arises from transactions described as:

  • Non reciprocal (where WA Country Health Service does not provide approximate equal value in return to a party providing goods or assets (or extinguishes a liability); or
  • Reciprocal (where WA Country Health Service provides equal value to the recipient of the grant provider).

The accounting for these are set out below.

For non-reciprocal grants, WA Country Health Service recognises revenue when the grant is receivable at its fair value as and when its fair value can be reliably measured.

Contributions of services are only recognised when a fair value can be reliably determined and the services would have been purchased if not donated.

For reciprocal grants, WA Country Health Service recognises income when it has satisfied its performance obligations under the terms of the grant.

Grants can further be split between:

  • eneral purpose grants
  • Specific purpose grants

General purpose grants refers to grants which are not subject to conditions regarding their use. Specific purpose grants are received for a particular purpose and/or have conditions attached regarding their use.

4.4 Patient charges

 2018
$000
2017
$000
Inpatient bed charges 26,379 26,218
Outpatient charges 40,808 42,778
  67,187 68,996

4.5 Other revenue

 2018
$000
2017
$000
Services to external organisations 7,481 9,666
Use of hospital facilities 2,493 1,997
Rent from commercial properties 755 876
Rent from residential properties 325 203
Staff and boarders' accommodation 7,984 8,254
Home and Community Care client fees 1,680 1,713
RiskCover insurance premium rebate 666 142
Other 1,205 887
  22,589 23,738

Revenue on provision of services is recognised by reference to the stage of completion of the transaction.

Note 5: Key assets

Assets WA Country Health Service utilises for economic benefit or service potential

This section includes information regarding the key assets WA Country Health Service utilises to gain economic benefits or provide service potential. The section sets out both the key accounting policies and financial information about the performance of these assets:

 Notes2018
$000
2017
$000
Property, plant and equipment 5.1 1,916,214 1,777,418
Intangible assets 5.2 17,338 13,941
Total key assets   1,933,552 1,791,359

5.1 Property, plant and equipment

 Land
$000
Buildings
$000
Buildings under const.
$000
Site Infra.
$000
Leasehold improv.
$000
Computer equip.
$000
Furniture and fittings
$000
Motor vehicles
$000
Medical equip.
$000
Other plant
and equip.
$000
Other works in progress
$000
Artworks
$000
Total
$000
Year ended 30 June 2018
1 July 2017

Gross carrying amount
100,941 1,259,933 187,814 187,938 1,175 4,539 2,084 770 39,480 6,960 5,080 70 1,796,784
Accumulated depreciation - - - (9,892) (304) (658) (171) (520) (6,926) (895) - - (19,366)
Carrying amount at start of period 100,941 1,259,933 187,814 178,046 871 3,881 1,913 250 32,554 6,065 5,080 70 1,777,418
Additions - 537 225,576 153 - 165 1,006 593 6,752 2,120 4,656 5 241,563
Transfers from/(to) other reporting entities (2,256) (1,072) - - - - - - (73) 6 - - (3,395)
Transfers between asset classes - 82,610 (91,282) 9,560 - 1,328 (313) - 392 812 (3,328) - (221)
Other disposals - (2,690) - (597) - - (15) - (78) (26) - - (3,406)
Revaluation increments/(decrements) (16,398) (1,168) - - - - - - - - - - (17,566)
Impairment losses - - - - - - - - - - - - -
Impairment losses reversed - - - - -   - - - - - - -
Depreciation - (52,382) - (10,277) (304) (1,372) (170) (251) (6,324) (1,116) - - (72,196)
Write-down of assets (5) - (3,593) - - (406) (283) - (283) (22) (1,391) - (5,983)
Carrying amount at 30 June 2018 82,282 1,285,768 318,515 176,885 567 3,596 2,138 592 32,940 7,839 5,017 75 1,916,214
Gross carrying amount 82,282 1,285,768 318,515 196,987 1,176 5,627 2,478 1,363 46,161 9,844 5,017 75 1,955,293
Accumulated depreciation - - - (20,102) (609) (2,031) (340) (771) (13,221) (2,005) - - (39,079)
  82,282 1,285,768 318,515 176,885 567 3,596 2,138 592 32,940 7,839 5,017 75 1,916,214
Year ended 30 June 2017
1 July 2016

Transferred from abolished entity
123,827 1,309,648 79,748 186,329 1,175 1,280 2,050 697 33,502 4,228 6,259 181 1,748,924
Carrying amount at start of period 123,827 1,309,648 79,748 186,329 1,175 1,280 2,050 697 33,502 4,228 6,259 181 1,748,924
Additions   51 148,295 - - 2,926 396 31 5,986 1,185 1,576 - 160,446
Transfers from/(to) other reporting entities (698) - - - - - - - - - - - (698)
Transfers between asset classes - 39,446 (40,229) 1,612 - 327 (313) 42 388 1,575 (2,756) (111) (19)
Other disposals - (930) - (15) - - (43) - (326) (24) - - (1,338)
Revaluation increments/(decrements) (22,188) (32,030) - - - - - - - - - - (54,218)
Impairment losses - - - - - - - - - - - - -
Impairment losses reversed - - - - - - - - - - - - -
Depreciation - (56,252) - (9,880) (304) (651) (177) (520) (6,996) (899) - - (75,679)
Write-down of assets - - - - - - - - - - - - -
Carrying amount at 30 June 2017 100,941 1,259,933 187,814 178,046 871 3,882 1,913 250 32,554 6,065 5,079 70 1,777,418
Gross carrying amount 100,941 1,259,933 187,814 187,938 1,175 4,539 2,084 770 39,480 6,960 5,080 70 1,796,784
Accumulated depreciation - - - (9,892) (304) (658) (171) (520) (6,926) (895) - - (19,366)
  100,941 1,259,933 187,814 178,046 871 3,881 1,913 250 32,554 6,065 5,080 70 1,777,418

Information on fair value measurements is provided in Note 8.3

Initial recognition

Items of property, plant and equipment and infrastructure, costing $5,000 or more are measured initially at cost. Where an asset is acquired for no or nominal cost, the cost is valued at its fair value at the date of acquisition. Items of property, plant and equipment and infrastructure costing less than $5,000 are immediately expensed direct to the Statement of Comprehensive Income (other than where they form part of a group of similar items which are significant in total).

Assets transferred as part of a machinery of government change are transferred at their fair value.

The cost of a leasehold improvement is capitalised and depreciated over the shorter of the remaining term of the lease or the estimated useful life of the leasehold improvement.

Subsequent measurement

Subsequent to initial recognition of an asset, the revaluation model is used for the measurement of land and buildings.

Land is carried at fair value and buildings are carried at fair value less accumulated depreciation and accumulated impairment losses.

All other property, plant and equipment are stated at historical cost less accumulated depreciation and accumulated impairment losses.

Land and buildings are independently valued annually by the Western Australian Land Information Authority (Valuations and Property Analytics) and recognised annually to ensure that the carrying amount does not differ materially from the assetʼs fair value at the end of the reporting period.

Land and buildings were revalued as at 1 July 2017 by the Western Australian Land Information Authority (Valuation and Property Analytics). The valuations were performed during the year ended 30 June 2018 and recognised at 30 June 2018. In undertaking the revaluation, fair value was determined by reference to the market value for land: $31.334 million (2017: $42.90 million) and buildings: $68.604 million (2017: $64.328 million). For the remaining balance, fair value of buildings was determined on the basis of current replacement cost and fair value of land was determined on the basis of comparison with market evidence for land with low level utility (high restricted use land).

Revaluation model:

1. Fair Value where market-based evidence is available:

The fair value of land and buildings is determined on the basis of current market values determined by reference to recent market transactions.

2. Fair value in the absence of market-based evidence:

Buildings are specialised or where land is restricted: Fair value of land and buildings is determined on the basis of existing use.

Existing use buildings: Fair value is determined by reference to the cost of replacing the remaining future economic benefits embodied in the asset, i.e. the current replacement cost.

Restricted use land: Fair value is determined by comparison with market evidence for land with similar approximate utility (high restricted use land) or market value of comparable unrestricted land (low restricted use land).

When buildings are revalued, the accumulated depreciation is eliminated against the gross carrying amount of the asset and the net amount restated to the revalued amount.

Significant assumptions and judgements: The most significant assumptions and judgements in estimating fair value are made in assessing whether to apply the existing use basis to assets and in determining estimated economic life. Professional judgement by the valuer is required where the evidence does not provide a clear distinction between market type assets and existing use assets.

5.1.1 Depreciation and impairment

Charge for the period

 2018
$000
2017
$000
Depreciation
Buildings 52,382 56,252
Site Infrastructure 10,277 9,880
Leasehold improvements 304 304
Computer equipment 1,372 651
Furniture and fittings 170 177
Motor vehicles 251 520
Medical equipment 6,324 6,996
Other plant and equipment 1,116 899
Total depreciation for the period 72,196 75,679

As at 30 June 2018 there were no indications of impairment to property, plant and equipment.

All surplus assets at 30 June 2018 have either been classified as assets held for sale or have been written-off.

Please refer to note 5.2.1 for guidance in relation to the impairment assessment that has been performed for intangible assets.

Finite useful lives

All property, plant and equipment having a limited useful life are systematically depreciated over their estimated useful lives in a manner that reflects the consumption of their future economic benefits. The exceptions to this rule include assets held for sale, land and investment properties.

Depreciation is calculated on a straight line basis, at rates that allocate the assetʼs value, less any estimated residual value, over its estimated useful life. Estimated useful lives for the different asset classes for current and prior years are:

  • Buildings - 50 years
  • Site infrastructure - 50 years
  • Leasehold improvements - Shorter of the lease term and useful life
  • Computer equipment - 4 to 10 years
  • Furniture and fittings - 10 to 20 years
  • Motor vehicles - 2 to 10 years
  • Medical equipment - 3 to 20 years
  • Other plant and equipment - 4 to 30 years

The estimated useful lives, residual values and depreciation method are reviewed at the end of each annual reporting period, and adjustments made where appropriate.

Land and artworks, which are considered to have an indefinite life, are not depreciated. Depreciation is not recognised in respect of these assets because their service potential has not, in any material sense, been consumed during the reporting period.

Impairment

Non-financial assets, including items of property, plant and equipment, are tested for impairment whenever there is an indication that the asset may be impaired. Where there is an indication of impairment, the recoverable amount is estimated. Where the recoverable amount is less than the carrying amount, the asset is considered impaired and is written down to the recoverable amount and an impairment loss is recognised.

Where an asset measured at cost is written down to its recoverable amount, an impairment loss is recognised through profit or loss.

Where a previously revalued asset is written down to its recoverable amount, the loss is recognised as a revaluation decrement through other comprehensive income.

As WA Country Health Service is a not-for-profit entity, the recoverable amount of regularly revalued specialised assets is anticipated to be materially the same as fair value.

If there is an indication that there has been a reversal in impairment, the carrying amount shall be increased to its recoverable amount. However this reversal should not increase the assetʼs carrying amount above what would have been determined, net of depreciation or amortisation, if no impairment loss had been recognised in prior years.

The risk of impairment is generally limited to circumstances where an assetʼs depreciation is materially understated, where the replacement cost is falling or where there is a significant change in useful life. Each relevant class of assets is reviewed annually to verify that the accumulated depreciation/amortisation reflects the level of consumption or expiration of the assetʼs future economic benefits and to evaluate any impairment risk from declining replacement costs.

5.1.2 Revaluation decrements
 2018
$000
2017
$000
Land 16,398 22,188
Buildings 1,168 32,030
  17,566 54,218
5.1.3 Loss on disposal of non-current assets
 2018
$000
2017
$000
Net proceeds from disposal of non-current assets:
Property, plant and equipment
- -
Carrying amount of non-current assets:
Property, plant and equipment
3,406 1,338
Net loss 3,406 1,338

Realised and unrealised losses are usually recognised on a net basis. These include losses arising on the disposal of noncurrent assets and some revaluations of non-current assets.

Losses on the disposal of non-current assets are presented by deducting from the proceeds on disposal the carrying amount of the asset and related selling expenses. Losses are recognised in profit or loss in the statement of comprehensive income.

Selling expenses (e.g. sales commissions netted from WA Country Health Service's receipts) are ordinarily immaterial.

5.2 Intangible assets

 Computer software
$000
Works in progress
$000
Total
$000
Year ended 30 June 2018
1 July 2017
Gross carrying amount 14,441 837 15,278
Accumulated amortisation (1,337) - (1,337)
Carrying amount at start of period 13,104 837 13,941
Additions - 5,101 5,101
Transfers between asset classes 1,771 (1,550) 221
Amortisation expense (1,809) - (1,809)
Write-down of assets - (116) (116)
Carrying amount at 30 June 2018 13,066 4,272 17,338
Year ended 30 June 2017
1 July 2016
Transferred from abolished entity 7,642 2,119 9,761
Carrying amount at start of period 7,642 2,119 9,761
Additions 2,582 2,916 5,498
Transfers between asset classes 4,217 (4,198) 19
Amortisation expense (1,337) - (1,337)
Carrying amount at 30 June 2017 13,104 837 13,941

Initial recognition

Acquisitions of intangible assets costing $5,000 or more and internally generated intangible assets costing $5,000 or more that comply with the recognition criteria as per AASB 138.57, are capitalised.

Costs incurred below these thresholds are immediately expensed directly to the Statement of Comprehensive Income.

Intangible assets are initially recognised at cost. For assets acquired at no cost or for nominal cost, the cost is their fair value at the date of acquisition.

An internally generated intangible asset arising from development (or from the development phase of an internal project) is recognised if, and only if, all of the following are demonstrated

(a) The technical feasibility of completing the intangible asset so that it will be available for use or sale;

(b) An intention to complete the intangible asset and use or sell it;

(c) The ability to use or sell the intangible asset;

(d) The intangible asset will generate probable future economic benefit;

(e) The availability of adequate technical, financial and other resources to complete the development and to use or sell the intangible asset; and

(f) The ability to measure reliably the expenditure attributable to the intangible asset during its development.

Costs incurred in the research phase of a project are immediately expensed.

Subsequent measurement

The cost model is applied for subsequent measurement of intangible assets, requiring the asset to be carried at cost less any accumulated amortisation and accumulated impairment losses.

5.2.1 Amortisation and impairment

Charge for the period

 2018
$000
2017
$000
Computer software 1,809 1,337
Total amortisation for the period 1,809 1,337

As at 30 June 2018 there were no indications of impairment to intangible assets.

WA Country Health Service held no goodwill or intangible assets with an indefinite useful life during the reporting period. At the end of the reporting period there were no intangible assets not yet available for use.

Amortisation of finite life intangible assets is calculated on a straight line basis at rates that allocate the assetʼs value over its estimated useful life. All intangible assets controlled by WA Country Health Service have a finite useful life and zero residual value. Estimated useful lives are reviewed annually.

The estimated useful lives for each class of intangible asset are:

  • Computer software: 5 - 10 years

Computer software that is an integral part of the related hardware is recognised as property, plant and equipment. Software that is not an integral part of the related hardware is recognised as an intangible asset.

Impairment

Intangible assets with finite useful lives are tested for impairment annually or when an indication of impairment is identified. The policy in connection with testing for impairment is outlined in note 5.1.1.

Note 6: Other assets and liabilities

This section sets out those assets and liabilities that arose from WA Country Health Service's controlled operations and includes other assets utilised for economic benefits and liabilities incurred during normal operations:

 Notes2018
$000
2017
$000
Receivables 6.1 23,647 23,752
Amounts receivable for services 6.2 748,497 674,420
Other assets 6.3 9,485 10,337
Payables 6.4 116,019 119,198

6.1 Receivables

 2018
$000
2017
$000
Current
Patient fee debtors 13,100 15,425
Other receivables 2,902 4,566
Allowance for impairment of receivables (4,428) (9,001)
Accrued revenue 6,117 7,848
GST receivable 5,956 4,914
Total receivables 23,647 23,752

WA Country Health Service does not hold any collateral or other credit enhancements as security for receivables.

Receivables are recognised at original invoice amount less any allowances for uncollectible amounts (i.e. impairment). The carrying amount of net trade receivables is equivalent to fair value as it is due for settlement within 30 days.

6.1.1. Movement of the allowance for impairment of receivables
 2018
$000
2017
$000
Reconciliation of changes in the allowance for impairment of receivables:
Balance at start of period 9,001 -
Transfer in from abolished entity - 5,946
Doubtful debts expense 1,514 4,018
Amounts written off during the period (6,149) (921)
Amounts recovered during the period 62 (42)
Balance at end of period 4,428 9,001

The collectability of receivables is reviewed on an ongoing basis and any receivables identified as uncollectible are written-off against the allowance account. The allowance for uncollectible amounts (doubtful debts) is raised when there is objective evidence that WA Country Health Service will not be able to collect the debts.

6.2 Amounts receivable for services (Holding Account)

 2018
$000
2017
$000
Non-current 748,497 674,420
Balance at end of period 748,497 674,420

Amounts receivable for services represent the non-cash component of service appropriations. It is restricted in that it can only be used for asset replacement or payment of leave liability.

WA Country Health Service receives funding on an accrual basis. The appropriations are paid partly in cash and partly as an asset (holding account receivable). The accrued amount receivable is accessible on the emergence of the cash funding requirement to cover leave entitlements and asset replacement.

6.3 Other assets

 2018
$000
2017
$000
Current
Supply inventories 2,259 2,120
Pharmaceutical inventories 2,638 2,735
Other inventories 260 415
Prepayments 4,328 5,067
Balance at end of period 9,485 10,337

Inventories are measured at the lower of cost and net realisable value. Costs are assigned on a weighted average cost basis.

Inventories not held for resale are measured at cost unless they are no longer required, in which case they are measured at net realisable value.

Prepayments are payments in advance of receipt of goods or services or that part of expenditure made in one accounting period covering a term extending beyond that period.

6.4 Payables

 2018
$000
2017
$000
Current
Trade payables 19,290 31,632
Accrued expenses 82,091 65,121
Accrued salaries 14,628 22,430
Accrued interest 10 15
Balance at end of period 116,019 119,198

Payables are recognised at the amounts payable when WA Country Health Service becomes obliged to make future payments as a result of a purchase of assets or services. The carrying amount is equivalent to fair value, as settlement is generally within 30 days.

Accrued salaries represent the amount due to staff but unpaid at the end of the reporting period. Accrued salaries are settled within a fortnight of the reporting period end. WA Country Health Service considers the carrying amount of accrued salaries to be equivalent to its fair value.

Note 7: Financing

This section sets out the material balances and disclosures associated with the financing and cashflows of WA Country Health Service.

 Notes
Borrowings                                                                                                                           7.1
Finance costs                                                                                                                       7.2
Cash and cash equivalents                                                                                                  7.3
Reconciliation of cash 7.3.1
Reconciliation of operating activities 7.3.2
Commitments 7.4
Non-cancellable operating lease commitments 7.4.1
Capital commitments 7.4.2
Other expenditure commitments 7.4.3

7.1 Borrowings

 2018
$000
2017
$000
Current
Department of Treasury loans (a)
1,779 1,701
Non-Current
Department of Treasury loans (a)
1,865 3,644
  3,644 5,345

7.2 Finance costs

 2018
$000
2017
$000
Interest expense (a) 138 199
  138 199

(a) All loans payable are initially recognised at fair value, being the net proceeds received. Subsequent measurement is at amortised cost using the effective interest rate method. Interest incurred are expensed as finance costs.

7.3 Cash and cash equivalents

7.3.1 Reconciliation of cash
 Notes2018
$000
2017
$000
Cash and cash equivalents   18,173 18,949
Restricted cash and cash equivalents (a) Royalties for Regions Fund 8.1 1,141 1,428
Capital grant from the Commonwealth Government (b)   16,512 12,180
Patient receipts under section 19 (2) of the Health Insurance Act 1973   4,838 4,062
Bequests   763 774
Capital funding from external sources   - 17,391
Mental Health Commission Funding (note 9.7)   234 955
Other   1,854 579
Accrued salaries suspense account (c)   7,463 3,840
Balance at end of period   50,978 60,158

(a) Restricted cash and cash equivalents are assets, the uses of which are restricted, by specific legal or other externally imposed requirements.

(b) Unspent funds from the Commonwealth Government are committed to projects and programs in WA regional areas.

(c) Funds held in the suspense account for the purpose of meeting the 27th pay in a reporting period that occurs every 11th year. This account is classified as non current for 10 out of 11 years.

For the purpose of the statement of cash flows, cash and cash equivalent (and restricted cash and cash equivalent) assets comprise cash on hand and short-term deposits with original maturities of three months or less that are readily convertible to a known amount of cash and which are subject to insignificant risk of changes in value.

7.3.2 Reconciliation of net cost of services to net cash flows used in operating activities
 Notes2018
$000
2017
$000
Non-cash items
Net cost of services   1,109,410 1,119,280
Depreciation and amortisation expense 5.1.1, 5.2.1 (74,005) (77,016)
Asset revaluation decrement 5.1.2 (17,566) (54,218)
Loss from disposal of non-current assets 5.1.3 (3,406) (1,338)
Interest paid by Department of Health   (144) (204)
Donation of non-current assets   30 14
Services received free of charge 4.1 (55,373) (56,107)
Write down of property, plant and equipment Net assets transferred in that are expensed 5.1, 5.2 (6,099)
-
(11,305)
Adjustment for other non-cash items   (2) (2)
Increase/(decrease) in assets
Receivables   (105) 1,328
Inventories   (113) (284)
Prepayments   (739) 1,935
(Increase)/decrease in liabilities
Payables (a)   (8,554) (3,938)
Current provisions   (11,795) (4,625)
Non-current provisions   (1,480) (1,205)
Other current liabilities Other non-current liabilities   (30)
-
(8)
-
Net cash used in operating activities   930,029 912,307

(a) Note that the Australian Taxation Office (ATO) receivable/payable in respect of GST and the receivable/payable in respect of the sale/purchase of non-current assets are not included in these items as they do not form part of the reconciling items.

The mandatory application of AASB 2016-2 Amendments to Australian Accounting Standards – Disclosure Initiative: Amendments to AASB 107 imposed disclosure impacts only. WA Country Health Service is not exposed to changes in liabilities arising from financing activities, including both changes arising from cash flows and non-cash changes.

7.4 Commitments

The commitments below are inclusive of GST where relevant.

7.4.1 Non-cancellable operating lease commitments

Commitments for minimum lease payments are payable as follows:

 2018
$000
2017
$000
Within 1 year 8,616 8,907
Later than 1 year and not later than 5 years 5,312 6,469
later than 5 years 43 33
  13,971 15,409

Operating leases are expensed on a straight line basis over the lease term as this represents the pattern of benefits derived from the leased properties.

Operating lease commitments predominantly consist of contractual agreements for office accommodation and residential accommodation. The basis of which contingent operating leases payments are determined is the value for each lease agreement under the contract terms and conditions at current values.

7.4.2 Capital commitments

Capital expenditure commitments, being contracted capital expenditure additional to the amounts reported in the financial statements, are payable as follows:

 2018
$000
2017
$000
Within 1 year 78,339 252,743
Later than 1 year and not later than 5 years 40,512 114,125
later than 5 years - -
  118,851 366,868
7.4.3 Other expenditure commitments

Other expenditure commitments contracted for at the end of the reporting period but not recognised as liabilities, are payable as follows:

 2018
$000
2017
$000
Within 1 year 176,993 162,608
Later than 1 year and not later than 5 years 61,096 109,390
later than 5 years 949 5,955
  239,038 277,953

Judgements made by management in applying accounting policies – operating lease commitments

WA Country Health Service has entered into a number of leases for buildings for branch office accommodation. Some of these leases relate to buildings of a temporary nature and it has been determined that the lessor retains substantially all the risks and rewards incidental to ownership. Accordingly, these leases have been classified as operating leases.

Note 8: Risks and Contingencies

This note sets out the key risk management policies and measurement techniques of WA Country Health Service.

 Notes
Financial risk management 8.1
Contingent assets 8.2.1
Contingent liabilities 8.2.2
Fair value measurements 8.3

8.1 Financial risk management

Financial instruments held by WA Country Health Service are cash and cash equivalents, restricted cash and cash equivalents, loans and receivables, payables, and borrowings. WA Country Health Service has limited exposure to financial risks. WA Country Health Service's overall risk management program focuses on managing the risks identified below.

(a) Summary of risks and risk management

Credit risk

Credit risk arises when there is the possibility of WA Country Health Service's receivables defaulting on their contractual obligations resulting in financial loss to WA Country Health Service.

The maximum exposure to credit risk at the end of the reporting period in relation to each class of recognised financial asset is the gross carrying amount of those assets inclusive of any allowance for impairment as shown in the table at Note 8.1(c) ʻFinancial instruments disclosuresʼ and Note 6.1 ʻReceivablesʼ.

Credit risk associated with WA Country Health Service's financial assets is minimal because the main receivable is the amounts receivable for services (holding account). For receivables other than Government, WA Country Health Service trades only with recognised, creditworthy third parties. WA Country Health Service has policies in place to ensure that sales of products and services are made to customers with an appropriate credit history. In addition, receivable balances are monitored on an ongoing basis with the result that WA Country Health Service's exposure to bad debts is minimal. At the end of the reporting period there were no significant concentrations of credit risk.

Liquidity risk

Liquidity risk arises when the agency is unable to meet its financial obligations as they fall due.

WA Country Health Service is exposed to liquidity risk through its trading in the normal course of business.

WA Country Health Service has appropriate procedures to manage cash flows including drawdown of appropriations by monitoring forecast cash flows to ensure that sufficient funds are available to meet its commitments.

Market risk

Market risk is the risk that changes in market prices such as foreign exchange rates and interest rates will affect WA Country Health Service's income or the value of its holdings of financial instruments. WA Country Health Service does not trade in foreign currency and is not materially exposed to other price risks. WA Country Health Service's exposure to market risk for changes in interest rates relate primarily to the long-term debt obligations.

WA Country Health Service's borrowings are with the Department of Treasury and are at variable interest rates with varying maturities. Other than as detailed in the interest rate sensitivity analysis table at Note 8.1(e), WA Country Health Service is not exposed to interest rate risk because the majority of cash and cash equivalents and restricted cash are non-interest bearing and it has no borrowings other than the Treasurerʼs loans.

(b) Categories of financial instruments

The carrying amounts of each of the following categories of financial assets and financial liabilities at the end of the reporting period are:

 2018
$000
2017
$000
Financial assets
Cash and cash equivalents 18,173 18,949
Restricted cash and cash equivalents 32,805 41,209
Loans and receivables (a) 766,188 693,259
Total financial assets 817,166 753,417
Financial Liabilities
Financial liabilities measured at amortised cost 119,663 124,543
Total financial liability 119,663 124,543

(a) The amount of loans and receivables excludes GST recoverable from the ATO (statutory receivable).

(c) Ageing analysis of financial assets

 Carrying amount
$000
Not past due and not impaired
$000
Not past due and impaired
$000
Past due but not impaired: 1 - 3 months
$000
Past due but not impaired: 3 months to 1 year
$000
Past due but not impaired: 1 - 5 years
$000
Past due but not impaired: More than 5 years
$000
Impaired financial assets
$000
2018
Cash and cash equivalents 18,173 18,173 - - - - -  
Restricted cash and cash equivalents 32,805 32,805 - - - - -  
Receivables (a) 17,691 11,126 - 2,758 3,268 539 1  
Amounts receivable for services 748,497 748,497 - - - - -  
  817,166 810,601 - 2,758 3,268 539 1 -
2017
Cash and cash equivalents 18,949 18,949 - - - - -  
Restricted cash and cash equivalents 41,209 41,209 - - - - -  
Receivables (a) 18,839 12,656 - 2,827 2,661 694 2  
Amounts receivable for services 674,420 674,420 - - -   -  
  753,417 747,234 - 2,827 2,661 694 2 -

(a) The amount of receivables excludes the GST recoverable from ATO (statutory receivable).

(d) Liquidity risk and interest rate exposure

The following table details WA Country Health Service's interest rate exposure and the contractual maturity analysis of financial assets and financial liabilities. The maturity analysis section includes interest and principal cash flows. The interest rate exposure section analyses only the carrying amounts of each item.

Interest rate exposure and maturity analysis of financial assets and financial liabilities

 Interest rate exposure: Weighted average  effective interest rate
%
Interest rate exposure: Carrying amount
$000
Interest rate exposure: Fixed interest rate
$000
Interest rate exposure: Variable interest rate
$000
Interest rate exposure: Non- interest bearing
$000
Nominal Amount
$000
Maturity dates: Up to 1 month
$000
Maturity dates: 1-3 months
$000
Maturity dates: 3 months to 1 year
$000
1-5 years
$000
Maturity dates: More than 5 years
$000
2018
Financial Assets - 18,173 - - 18,173 18,173 18,173 -   - -
Cash and cash equivalents Restricted cash and cash equivalents - 32,805 - - 32,805 32,805 32,805 - - - -
Receivables (a) - 17,691 - - 17,691 17,691 17,691 - - - -
Amounts receivable for service - 748,497 - - 748,497 748,497 - - - - 748,497
Financial Liabilities   817,166 - - 817,166 817,166 68,669 - - - 748,497
Payables - 116,019 - - 116,019 116,019 116,019 -   - -
Department of Treasury Loans 3.06% 3,644 - 3,644 - 3,819 158 315 1,419 1,927 -
    119,663 - 3,644 116,019 119,838 116,176 315 1,419 1,927 -
2017
Financial Assets                      
Cash and cash equivalents                 18,949 - - 18,949 18,949 18,949 -   - -
Restricted cash and cash equivalents   41,209 -   41,209 41,209 41,209        
Receivables (a)  -  18,839 - - 18,839 18,839 18,839 - - - -
Amounts receivable for service  -  674,420 - - 674,420 674,420 - - - - 674,420
Financial Liabilities   753,417 - - 753,417 753,417 78,997 - - - 674,420
Payables  -  119,198 - - 119,198 119,198 119,198 -   - -
Department of Treasury Loans 3.18% 5,345 - 5,345 - 5,532 151 303 1,362 3,716 -
    124,543 - 5,345 119,198 124,730 119,349 303 1,362 3,716 -

(a) The amount of receivables excludes the GST recoverable from ATO (statutory receivable).

(e) Interest rate sensitivity analysis

The following table represents a summary of the interest rate sensitivity of WA Country Health Serviceʼs financial assets and liabilities at the end of the reporting period on the surplus for the period and equity for a 1% change in interest rates. It is assumed that the change in interest rates is held constant throughout the reporting period.

 Carrying amount
$000
-100 basis points: Surplus
$000
-100 basis points: Equity
$000
+100 basis points: Surplus
$000
+100 basis points: Equity
$000
2018
Financial Liabilities
Department of Treasury Loans 3,644 36 36 (36) (36)
Total Increase/(Decrease)   36 36 (36) (36)
2017
Financial Liabilities
Department of Treasury Loans 5,345 53 53 (53) (53)
Total Increase/(Decrease)   53 53 (53) (53)

8.2 Contingent assets and liabilities

Contingent assets and contingent liabilities are not recognised in the statement of financial position but are disclosed and, if quantifiable, are measured at nominal value.

Contingent assets and liabilities are presented inclusive of GST receivable or payable respectively.

8.2.1 Contingent assets

At the reporting date, WA Country Health Service is not aware of any contingent assets.

8.2.2 Contingent liabilities

The following contingent liabilities are excluded from the liabilities included in the financial statements:

 2018
$000
2017
$000
Litigation in progress:
Pending litigation that are not recoverable from RiskCover insurance and may affect the financial position of WA Country Health Service. 1,212 269
Number of claims 6 13
Contaminated sites
Estimated cost to remediate contaminated and suspected contaminated sites reported to the Department of Water and Environmental Regulation. 70 70

Under the Contaminated Sites Act 2003, WA Country Health Service is required to report known and suspected contaminated sites to the Department of Water and Environmental Regulation (DWER). In accordance with the Act, DWER classifies these sites on the basis of the risk to human health, the environment and environmental values. Where sites are classified as contaminated – remediation required or possibly contaminated – investigation required, WA Country Health Service may have a liability in respect of investigation or remediation expenses.

Public holiday time off in lieu (PH TOIL)

Due to an inconsistent interpretation of the employee industrial awards and configuration of the payroll system, it has been identified by the Health Support Services (HSS) that incorrect calculations of Public Holiday Time off in Lieu (PH TOIL) have occurred at WA Country Health Service. A system resolution has been implemented for the nursing cohort and the net effect of this ($3.6m) has been adjusted for in the employee benefits provisions (Note 3.1(b)) in these financial statements. HSS has commenced work on calculating the impact of the inconsistent interpretation on other employee classes that also earn PH TOIL; however, the impact on these employee classes cannot as yet be reliably estimated.

Hospital cladding

WA Country Health Service has conducted a review of its hospitals that have aluminium composite panels (ACPs), following concerns about the potential fire risks associated with the use of some ACP cladding products. The review has identified three sites where ACPs may not meet the requirements of the building code of Australia. The cladding at these sites will undergo additional testing to determine the need for remediation work. Any costs associated with potential remediation work at these sites has not been reliably estimated.

8.3 Fair value measurement

(a) Fair value hierarchy

AASB 13 requires disclosure of fair value measurements by level of the following fair value measurement hierarchy:

1) quoted prices (unadjusted) in active markets for identical assets (level 1).
2) input other than quoted prices included within level 1 that are observable for the asset either directly or indirectly (level 2); and
3) Inputs for the asset that are not based on observable market data (unobservable input) (level 3).

 Level 1
$000
Level 2
$000
Level 3
$000
Fair value at end of period
$000
Assets measured at fair value 2018
Land
Vacant land
- 2,817 - 2,817
Residential - 28,517 - 28,517
Specialised Buildings
Residential
-
-
-
68,604
50,948
-
50,948
68,604
Specialised - - 1,217,164 1,217,164
  - 99,938 1,268,112 1,368,050
Assets measured at fair value 2017
Land
Vacant land
- 3,550 - 3,550
Residential - 39,350 - 39,350
Specialised Buildings
Residential
-
-
-
64,328
58,041
-
58,041
64,328
Specialised - - 1,195,605 1,195,605
  - 107,228 1,253,646 1,360,874
(b) Valuation technique to derive Level 2 fair values

Level 2 fair values of land and buildings are derived using the market approach. Market evidence of sales prices of comparable land and buildings in close proximity is used to determine price per square metre.

(c) Fair value measurements using significant unobservable inputs (Level 3)
 Land
$000
Buildings
$000
2018
Fair value at start of period 58,041 1,195,605
Additions (including transfer from works in progress) - 82,887
Revaluation increments/(decrements) recognised in Profit or Loss (5,383) (3,205)
Transfers from/(to) Level 2 (a) 170 (4,649)
Disposals (1,880) (2,590)
Depreciation expense - (50,884)
Fair value at end of period 50,948 1,217,164
2017
Fair value at start of period - -
Fair value transferred from abolished entity 68,148 1,231,848
Additions (including transfer from works in progress) 2 39,377
Revaluation increments/(decrements) recognised in Profit or Loss (9,409) (20,028)
Disposals (700) (930)
Depreciation expenses - (54,662)
Fair value at end of period 58,041 1,195,605

(a) Represents residential accommodation buildings constructed in previous period and reflected at cost for which market values were provided in 2017/18.

Valuation processes

There were no changes in valuation techniques during the period.

Land (Level 3 fair values)

Fair value for restricted use land is based on comparison with market evidence for land with low level utility (high restricted use land). The relevant comparators of land with low level utility is selected by the Western Australian Land Information Authority (Valuations and Property Analytics) and represents the application of a significant Level 3 input in this valuation methodology. The fair value measurement is sensitive to values of comparator land, with higher values of comparator land correlating with higher estimated fair values of land.

Buildings (Level 3 fair values)

Fair value for existing use specialised buildings is determined by reference to the cost of replacing the remaining future economic benefits embodied in the asset, i.e. the current replacement cost. Current replacement cost is generally determined by reference to the market observable replacement cost of a substitute asset of comparable utility and the gross project size specifications, adjusted for obsolescence. Obsolescence encompasses physical deterioration, functional (technological) obsolescence and economic (external) obsolescence. Valuation using current replacement cost utilises the significant Level 3 input, consumed economic benefit/obsolescence of asset which is estimated by the Western Australian Land Information Authority (Valuations and Property Analytics). The fair value measurement is sensitive to the estimate of consumption/obsolescence, with higher values of the estimate correlating with lower estimated fair values of buildings.

Basis of valuation

In the absence of market-based evidence, due to the specialised nature of some non financial assets, these assets are valued at Level 3 of the fair value hierarchy on an existing use basis. The existing use basis recognises that restrictions or limitations have been placed on their use and disposal when they are not determined to be surplus to requirements. These restrictions are imposed by virtue of the assets being held to deliver a specific community service.

Mandatory application of AASB 2016-4 Amendments to Australian Accounting Standards - Recoverable Amount of Non-Cash- Generating Specialised Assets of Not-for-Profit Entities has no financial impact for the WA Country Health Service as it is classified as not-for-profit and regularly revalues its specialised property, plant and equipment assets. Therefore, fair value of the recoverable assets is expected to be materially the same as fair value.

Note 9: Other disclosures

This section includes additional material disclosures required by accounting standards or other pronouncements, for the understanding of this financial report.

 Notes
Events occurring after the end of the reporting period 9.1
Future impact of Australian standards issued not yet operative 9.2
Key management personnel  9.3
Related party transactions  9.4
Related bodies 9.5
Affiliated bodies  9.6
Special purpose accounts 9.7
Remuneration of auditors 9.8
Equity 9.9
Supplementary financial information 9.1
Explanatory statement 9.11
Administered trust accounts 9.12

9.1 Events occurring after the end of the reporting period

There were no events occurring after the reporting period which had significant financial effects on these financial statements.

9.2 Future impact of Australian Accounting Standards not yet operative

WA Country Health Service cannot early adopt an Australian Accounting Standard unless specifically permitted by TI 1101 Application of Australian Accounting Standards and Other Pronouncements or by an exemption from TI 1101. Where applicable, WA Country Health Service plans to apply the following Australian Accounting Standards from their application date.

  Operative for reporting periods beginning on/after
AASB 9

Financial Instruments

This Standard supersedes AASB 139 Financial Instruments: Recognition and Measurement, introducing a number of changes to accounting treatments.

WA Country Health Service has not yet determined the application or the potential impact of the Standard.

01 Jan 2018
AASB 15

Revenue from Contracts with Customers

This Standard establishes the principles that WA Country Health Service shall apply to report useful information to users of financial statements about the nature, amount, timing and uncertainty of revenue and cash flows arising from a contract with a customer. The mandatory application date of this Standard is currently 1 January 2019 after being amended by AASB 2016- 7.

WA Country Health Service's income is principally derived from appropriations which will be measured under AASB 1058 and will be unaffected by this change. However, WA Country Health Service has not yet determined the potential impact of the Standard on ʻGrants and contributionsʼ revenues. In broad terms, it is anticipated that the terms and conditions attached to these revenues will defer revenue recognition until WA Country Health Service has discharged its performance obligations.

01 Jan 2019
AASB 16

Leases

This Standard introduces a single lessee accounting model and requires a lessee to recognise assets and liabilities for all leases with a term of more than 12 months, unless the underlying asset is of low value.

Whilst the impact of AASB 16 has not yet been quantified, WA Country Health Service currently has commitments for $ 13.971 million worth of non cancellable operating leases which will mostly be brought onto the Statement of Financial Position. Interest and amortisation expense will increase and rental expense will decrease.

01 Jan 2019
AASB 1058

Income of Not-for-Profit Entities

This Standard clarifies and simplifies the income recognition requirements that apply to not for profit (NFP) entities, more closely reflecting the economic reality of NFP entity transactions that are not contracts with customers. Timing of income recognition is dependent on whether such a transaction gives rise to a liability or other performance obligation (a promise to transfer a good or service), or a contribution by owners, related to an asset (such as cash or another asset) received by an entity. WA Country Health Service anticipates that the application will not materially impact appropriation or untied grant revenues.

01 Jan 2019
AASB 1059

Service Concession Arrangements: Grantors

This Standard addresses the accounting for a service concession arrangement (a type of public private partnership) by a grantor that is a public sector entity by prescribing the accounting for the arrangement from the grantorʼs perspective. Timing and measurement for the recognition of a specific asset class occurs on commencement of the arrangement and the accounting for associated liabilities is determined by whether the grantee is paid by the grantor or users of the public service provided. WA Country Health Service has not identified any public private partnerships within scope of the Standard.

01 Jan 2019
AASB 2010-7

Amendments to Australian Accounting Standards arising from AASB 9 (December 2010) [AASB 1, 3, 4, 5, 7, 101, 102, 108, 112, 118, 120, 121, 127, 128, 131, 132, 136, 137, 139, 1023 & 1038 and Int 2, 5, 10, 12, 19 & 127]

This Standard makes consequential amendments to other Australian Accounting Standards and

Interpretations as a result of issuing AASB 9 in December 2010.

The mandatory application date of this Standard has been amended by AASB 2012-6 and AASB 2014-1 to 1 January 2018. Other than the exposures to AASB 9 noted above, WA Country Health Service is only insignificantly impacted by the application of the Standard.

01 Jan 2018
AASB 2014-1

Amendments to Australian Accounting Standards

Part E of this Standard makes amendments to AASB 9 and consequential amendments to other Standards. These changes have no impact as Appendix E has been superseded and WA Country Health Service was not permitted to early adopt AASB 9.

01 Jan 2018
AASB 2014-5

Amendments to Australian Accounting Standards arising from AASB 15

This Standard gives effect to the consequential amendments to Australian Accounting Standards (including Interpretations) arising from the issuance of AASB 15. The mandatory application date of this Standard has been amended by AASB 2015-8 to 1 January 2018. WA Country Health Service has not yet determined the application or the potential impact of the Standard.

01 Jan 2018
AASB 2014-7

Amendments to Australian Accounting Standards arising from AASB 9 (December 2014)

This Standard gives effect to the consequential amendments to Australian Accounting Standards (including Interpretations) arising from the issuance of AASB 9 (December 2014). WA Country Health Service has not yet determined the application or the potential impact of the Standard.

01 Jan 2018
AASB 2015-8

Amendments to Australian Accounting Standards - Effective Date of AASB 15

This Standard amends the mandatory application date of AASB 15 to 1 January 2018 (instead of 1 January 2017). It also defers the consequential amendments that were originally set out in AASB 2014-5. There is no financial impact arising from this Standard.

01 Jan 2018
AASB 2016-3

Amendments to Australian Accounting Standards – Clarifications to AASB 15

This Standard clarifies identifying performance obligations, principal versus agent considerations, timing of recognising revenue from granting a licence, and, provides further transitional provisions to AASB 15. WA Country Health Service has not yet determined the application or the potential impact when the deferred AASB 15 becomes effective from 1 January 2019.

01 Jan 2018
AASB 2016-7

Amendments to Australian Accounting Standards – Deferral of AASB 15 for Not-for-Profit Entities

This Standard defers, for not-for-profit entities, the mandatory application date of AASB 15 to 1 January 2019, and the consequential amendments that were originally set out in AASB 2014-5. There is no financial impact arising from this standard.

01 Jan 2018
AASB 2016-7

Amendments to Australian Accounting Standards – Australian Implementation Guidance for Not for Profit Entities

This Standard inserts Australian requirements and authoritative implementation guidance for notfor- profit entities into AASB 9 and AASB 15. This guidance assists not-for-profit entities in applying those Standards to particular transactions and other events. There is no financial impact.

01 Jan 2019

9.3 Key management personnel

WA Country Health Service has determined that key management personnel include cabinet ministers, board members and senior officers of WA Country Health Service. WA Country Health Service does not incur expenditures to compensate Ministers and those disclosures may be found in the Annual Report on State Finances.

Compensation of members of the accountable authority
 20182017
Compensation Band
$          0 - $ 10,000 1 1
$  40,001 - $ 50,000 7 7
$  70,001 - $ 80,000 1 1
  9 9
 2018
$000
2017
$000
Short-term employee benefits 344 342
Post-employment benefits Other long-term benefits Termination benefits 33
-
-
32
-
-
Total remuneration of members of the accountable authority 377 374

The short-term employee benefits includes salary and travel allowances incurred by WA Country Health Service in respect of the accountable authority.

Compensation of Senior officers

The number of senior officers other than senior officers reported as members of the Accountable Authority, whose total fees, salaries, superannuation, non-monetary benefits and other benefits for the financial year, falling within the following bands are:

 20182017
Compensation Band ($)    
$  10,001 - $ 20,000 1 -
$  60,001 - $ 70,000 1 1
$120,001 - $130,000 - 1
$140,001 - $150,000 - 1
$150,001 - $160,000 - 1
$160,001 - $170,000 - 1
$170,001 - $180,000 1 1
$180,001 - $190,000 - 3
$190,001 - $200,000 2 -
$200,001 - $210,000 4 2
$210,001 - $220,000 2 1
$220,001 - $230,000 1 1
$230,001 - $240,000 4 -
$240,001 - $250,000 - 1
$250,001 - $260,000 - 1
$260,001 - $270,000 3 -
$290,001 - $300,000 - 1
$320,001 - $330,000 - 1
$440,001 - $450,000 1 -
$460,001 - $470,000 1 1
$480,001 - $490,000 - 1
  21 19
 2018
$000
2017
$000
Short-term employee benefits 3,888 3,529
Post-employment benefits 421 355
Other long-term benefits 434 247
Termination benefits - 173
Total remuneration of senior officers 4,743 4,304

The short-term employee benefits includes salary, motor vehicle benefits, district and travel allowances incurred by WA Country Health Service in respect of senior officers.

9.4 Related party transactions

WA Country Health Service is a wholly owned public sector entity that is controlled by the State of Western Australia. Related parties of WA Country Health Service include:

  • all cabinet ministers and their close family members, and their controlled or jointly controlled entities;
  • all senior officers and their close family members, and their controlled or jointly controlled entities;
  • other departments and statutory authorities, including related bodies, that are included in the whole of government consolidated financial statements (i.e. wholly-owned public sector entities);
  • associates and joint ventures of a wholly-owned public sector entity; and
  • the Government Employees Superannuation Board (GESB).
Significant transactions with Government-related entities

In conducting its activities, WA Country Health Service is required to transact with the State and entities related to the State. These transactions are generally based on the standard terms and conditions that apply to all agencies. Significant transactions include:

 2018
$000
2017
$000
Income from State Government - Service appropriations (Note 4.1) 948,805 943,451
Equity contribution (Note 9.9):
- capital appropriations from State Government 27,781 20,439
- equity injections from Royalties for Regions Fund 206,831 94,506
Services received free of charge (Note 4.1):
- corporate services from Health Support Services 31,799 26,536
- pathology services from North Metropolitan Health Service (PathWest) 23,482 29,491
Income from Royalties for Regions Fund (Note 4.1) 71,723 86,489
Commonwealth grant funding received under the National Health Reform Agreement (Note 4.2):
- via the Department of Health 376,330 369,449
- via Mental Health Commission 24,909 21,839
Other grant funding received from the Mental Health Commission (Note 4.3) 82,127 73,638
Insurance payments to the Insurance Commission and Riskcover fund 20,195 20,375
Remuneration for services provided by the Auditor General (Note 9.8) 570 604
Material transactions with other related parties
 2018
$000
2017
$000
Superannuation payments to GESB 70,741 69,823
Transactions with key management personnel

Outside of normal citizen type transactions with WA Country Health Service, there was no other related party transactions that involved key management personnel and/or their close family members and/or their controlled (or jountly controlled) entities.

9.5 Related bodies

A related body is a body which receives more than half its funding and resources from WA Country Health Service and is subject to operational control by WA Country Health Service.

WA Country Health Service had no related bodies during the financial year.

9.6 Affiliated bodies

An affiliated body is a body which receives more than half its funding and resources from WA Country Health Service but is not subject to operational control by WA Country Health Service.

WA Country Health Service had no affiliated bodies during the financial year.

9.7 Special purpose accounts

Mental Health Commission Fund (WA Country Health Service) Account

The purpose of the special purpose account is to receive funds from the Mental Health Commission, to fund the provision of mental health services as jointly endorsed by the Department of Health and the Mental Health Commission, in the WA Country Health Service, in accordance with the annual Service Agreement and subsequent agreements.

The special purpose account has been established under section 16(1)(d) of the Financial Management Act.

 2018
$000
2017
$000
Balance at start of period 955 1,013
Add Receipts:
Service delivery agreement
State contributions 82,127 74,257
Commonwealth contributions 24,909 21,839
  107,036 96,096
Less Payments (107,757) (96,154)
Balance at end of period 234 955

9.8 Remuneration of auditors

Remuneration paid or payable to the Auditor General in respect of the audit for the current financial year is as follows:

 2018
$000
2017
$000
Auditing the accounts, financial statements controls, and key performance indicators 570 604
9.9 Equity

The Western Australian Government holds the equity interest in WA Country Health Service on behalf of the community. Equity represents the residual interest in the net assets of WA Country Health Service.

Contributed equity

 2018
$000
2017
$000
Balance at start of period 2,310,640 -
Transfer of net assets from owners - 2,196,393
Contributions by owners  
Capital appropriations (a) 27,781 20,439
Royalties for Regions Fund – Regional Infrastructure and Headworks 206,831 94,506
 Account Transfer of net assets from other agencies (b):    
Land transferred from Department of Land 695 2
  235,307 114,947
Distributions to owners  

Transfer of net assets to other agencies (b):  
Land transferred to the Health Ministerial Body (2,951) -
Residential buildings transferred to the Health Ministerial Body  (1,072)  -
Land in Wickham transferred to the City of Karratha  - (700)
  (4,023) (700)
Balance at end of period 2,541,924 2,310,640

(a) Treasurer's Instruction (TI) 955 'Contributions by Owners Made to Wholly Owned Public Sector Entities' designates capital appropriations as contributions by owners in accordance with AASB Interpretation 1038 'Contributions by Owners Made to Wholly- Owned Public Sector Entities'.

(b) AASB 1004 'Contributions' requires transfers of net assets as a result of a restructure of administrative arrangements to be accounted for as contributions by owners and distributions to owners.

TI 955 designates non-discretionary and non-reciprocal transfers of net assets between state government agencies as contributions by owners in accordance with AASB Interpretation 1038. Where the transferee agency accounts for a non-discretionary and nonreciprocal transfer of net assets as a contribution by owners, the transferor agency accounts for the transfer as a distribution to owners.

9.10 Supplementary financial information

(a) Write-offs

During the financial year, $ 6.306 million (2017: $ 1.397 million) was written off WA Country Health Service's receivables under the:

 2018
$000
2017
$000
The accountable authority 6,306 1,397
The Minister  - -
Executive Council  - -
  6,306 1,397
(b) Losses through theft, defaults and other causes
 2018
$000
2017
$000
Losses of public money and property through theft or default - 4
Amount recovered    
Net losses - 4
(c) Gifts of public property
 2018
$000
2017
$000
Gifts of public property provided by WA Country Health Service - 8

9.11 Explanatory statement

All variances between estimates (original budget) and actual results for 2018, and between the actual results for 2018 and 2017 are shown below. Narratives are provided for key major variances, which are generally greater than:

  • 5% and $25.0 million for the Statements of Comprehensive Income and Cash Flows, and
  • 5% and $25.0 million for the Statement of Financial Position.
9.11.1 Statement of Comprehensive Income variances
 Variance noteEstimate 2018
$000
Actual 2018
$000
Actual 2017
$000
Variance between estimate and actual
$000
Variance between actual results for 2018 and 2017
$000
COST OF SERVICES
Expenses
Employee benefits expense (a) 947,890 1,002,713 958,399 54,823 44,314
Fees for visiting medical practitioners   82,349 85,859 84,071 3,510 1,788
Patient support costs (b) 339,678 381,124 398,039 41,446 (16,915)
Finance costs   149 138 199 (11) (61)
Depreciation and amortisation expense   74,050 74,005 77,016 (45) (3,011)
Asset revaluation decrement (c) - 17,566 54,218 17,566 (36,652)
Loss on disposal of non-current assets   - 3,406 1,338 3,406 2,068
Repairs, maintenance and consumable equipment   37,219 49,200 48,147 11,981 1,053
Other expenses (d) 211,438 165,559 161,643 (45,879) 3,916
Total cost of services   1,692,773 1,779,570 1,783,070 86,797 (3,500)
Income
Patient charges   66,045 67,187 68,996 1,142 (1,809)
Commonwealth grants and contributions (e) 426,525 484,181 467,570 57,656 16,611
Other grants and contributions   99,184 95,652 102,849 (3,532) (7,197)
Donation revenue   519 551 637 32 (86)
Other revenue   33637 22589 23738 (11,048) (1,149)
Total Revenue   625,910 670,160 663,790 44,250 6,370
Total income other than income from State Government   625,910 670,160 663,790 44,250 6,370
NET COST OF SERVICES   1,066,863 1,109,410 1,119,280 42,547 (9,870)
INCOME FROM STATE GOVERNMENT
Service appropriations   934,426 948,805 943,451 14,379 5,354
Assets assumed   - (67) 43 (67) (110)
Services received free of charge (f) 29,739 55,373 56,107 25,634 (734)
Royalties for Regions Fund (g) 102,698 71,723 86,489 (30,975) (14766)
Total income from State Government   1,066,863 1,075,834 1,086,090 8,971 (10256)
DEFICIT FOR THE PERIOD    - (33,576) (33,190) (33,576) (386)
OTHER COMPREHENSIVE INCOME/(LOSS)
Items not reclassified subsequently to profit or loss 
Total other comprehensive income    -  -  -  -  -
TOTAL COMPREHENSIVE INCOME/(LOSS) FOR THE PERIOD    - (33,576) (33,190) (33,576) (386)
9.11.2 Statement of Financial Position variances
 Variance noteEstimate 2018
$000
Actual 2018
$000
Actual 2017
$000
Variance between estimate and actual
$000
Variance between actual results for 2018 and 2017
$000
ASSETS
Current Assets
Cash and cash equivalents   14,958 18,173 18,949 3,215 (776)
Restricted cash and cash equivalents   37,520 25,342 37,369 (12,178) (12,027)
Receivables (x) 19,227 23,647 23,752 4,420 (105)
Inventories   5,269 5,157 5,270 (112) (113)
Prepayments   5,067 4,328 5,067 (739) (739)
Total Current Assets   82,041 76,647 90,407 (5,394) (13,760)
Non-Current Assets
Restricted cash and cash equivalents   7,680 7,463 3,840 (217) 3,623
Amounts receivable for services (h) 748,471 748,497 674,420 26 74,077
Property, plant and equipment (i) 2,002,976 1,916,214 1,777,418 (86,762) 138,796
Intangible assets   13,941 17,338 13,941 3,397 3,397
Total Non-Current Assets   2,773,068 2,689,512 2,469,619 (83,556) 219,893
Total Assets   2,855,109 2,766,159 2,560,026 (88,950) 206,133
LIABILITIES
Current Liabilities
Payables   114,283 116,019 119,198 1,736 (3,179)
Borrowings   1,779 1,779 1,701 - 78
Provisions   131,607 143,401 131,606 11,794 11,795
Other current liabilities   22 52 22 30 30
Total Current Liabilities   247,691 261,251 252,527 13,560 8,724
Non-Current Liabilities
Borrowings   1,865 1,865 3,644 - (1,779)
Provisions   26,405 27,885 26,405 1,480 1,480
Total Non-Current Liabilities   28,270 29,750 30,049 1,480 (299)
Total Liabilities   275,961 291,001 282,576 15,040 8,425
NET ASSETS   2,579,148 2,475,158 2,277,450 (103,990) 197,708
EQUITY
Contributed equity   2,611,949 2,541,924 2,310,640 (70,025) 231,284
Accumulated deficit   (32,801) (66,766) (33,190) (33,965) (33,576)
TOTAL EQUITY   2,579,148 2,475,158 2,277,450 (103,990) 197,708
9.11.3 Statement of Cash Flows variances
 Variance noteEstimate 2018
$000
Actual 2018
$000
Actual 2017
$000
Variance between estimate and actual
$000
Variance between actual results for 2018 and 2017
$000
CASH FLOWS FROM STATE GOVERNMENT
Service appropriations   860,227 874,584 855,497 14,357 19,088
Capital appropriations (j) 59,681 26,080 18,815 (33,601) 7,265
Royalties for Regions Fund (k),(l) 342,625 278,554 180,995 (64,071) 97,559
Net cash provided by State Government   1,262,533 1,179,218 1,055,307 (83,315) 123,911
Utilised as follows:            
CASH FLOWS FROM OPERATING ACTIVITIES
Payments
Employee benefits (a), (m) (947,891) (997,236) (938,947) (49,345) (58,288)
Supplies and services (n), (o) (640,944) (604,092) (636,892) 36,852 32,800
Receipts
Receipts from customers   66,045 64,412 70,696 (1,633) (6,284)
Commonwealth grants and contributions (e) 426,525 484,181 467,570 57,656 16,611
Other grants and contributions   99,184 95,653 102,849 (3,531) (7,197)
Donations received   519 521 622 2 (101)
Other receipts   33,637 26,532 21,795 (7,105) 4,738
Net cash used in operating activities   (962,925) (930,029) (912,307) 32,896 (17,722)
CASH FLOWS FROM INVESTING ACTIVITIES
Payments
Purchase of non-current physical assets (p), (q) (299,608) (258,369) (149,067) 41,239 (109,302)
Receipts
Proceeds from sale of non-current physical assets   -   -   -
Net cash used in investing activities   (299,608) (258,369) (149,067) 41,239              (109,302) (109,302)
Net increase / (decrease) in cash and cash equivalents   - (9,180) (6,067) -9,180 -3,113
Cash and cash equivalents at the beginning of the period   60,158 60,158 -  - 60,158
Cash and cash equivalents transferred from other sources   - - 66,225  - (66,225)
CASH AND CASH EQUIVALENTS AT THE END OF PERIOD   60,158 50,978 60,158 -9,180 -9,180
Significant variances between estimates and actuals for 2018 and/or between actuals for 2018 and 2017

(a) Employee benefits expense

The variance between current year estimate and actual is primarily attributable to various new and ongoing services for which funding
was not included in the initial estimates but were the subject of subsequent budget allocations throughout the year and at Mid-Year
Review. These included increased funding for Commonwealth funded programs ($37.6m) including multi purpose services, trachoma
services, aged, respite and home care for which funding agreements had not been finalised at the time of the initial 2017-18 budget, as
well as additional $8.6m for mental health, drug and alcohol programs.

(b) Patient support costs

The variance between current year estimate and actual is primarily due to expenditure associated with various continuing and new
services that were not included in the initial Estimates but were the subject of subsequent budget adjustments, including various
Commonwealth funded programs for which funding agreements had not been finalised at the time of the initial 2017-18 budget. In
addition, actual patient support costs include the value of services received at less than full cost from Pathwest, which had not been
included in the initial budget, but was the subject of a budget adjustment during the financial year ($23.0m).

(c) Asset revaluation decrement

The variance between current and last year actuals in asset revaluation decrement is a direct result of changes in land and building
valuation undertaken by the Western Australian Land Information Authority (Valuation and Property Analytics).

(d) Other expenses

The variance between current year estimate and actual is largely due to approved budgets in the initial estimates held pending
reallocation to other Health entities, and budget adjustments throughout the year and at Mid Year Review.

(e) Commonwealth grants and contributions

The variance between current year estimate and actual is primarily due to revenues for various continuing and new Commonwealth
funded services that were not included in the initial Estimates but were the subject of subsequent budget adjustments ($37.6m) such as
multi purpose services, trachoma services, aged, respite and home care, for which funding agreements had not been finalised at the
time of the initial 2017-18 budget. In addition, $19.0m of Commonwealth capital grants were received during the year for renal dialysis,
cancer care and Newman Health Redevelopment projects, with a corresponding budget Adjustment received at Mid Year Review.

(f) Services received free of charge

The variance between current year estimate and actual is due to revised estimates of the value of services received free of charge from
Health Support Services ($2.3m) with a corresponding budget adjustment received during the year, and the recognition of the value of
services received at less than full cost from Pathwest which had not been included in the initial budget but was the subject of a budget
adjustment during the financial year ($23.0m).

(g) Royalties for regions fund (Income)

The variance between current year estimate and actual is due to reconfiguration and recashflowing of Royalties for Regions programs
during the financial year. Variances included reprofiling and recashflowing for Southern Inland Health Initiative's medical workforce and
residential aged care programs ($14.8m), Turquoise Coast Health Initiative ($4.0m), Goldfields Emergency Telehealth ($2.7m) North
West Health Initiative ($3.3m) and various other programs ($6.2m) as detailed in the 2017-18 Mid Year Review and the 2018-19 State
budget documentation .

(h) Amounts receivable for services

Amounts receivable for services represents the non-cash component of service appropriations that support asset replacement or the
payment of leave liability. The variance between current and last year actuals is attributable to the increase in accrual appropriation for
depreciation and amortisation expenses.

(i) Property, plant and equipment

The variance between current and last year actuals is due to additions to capital projects including major infrastructure such as
Karratha Health Campus, Onslow Redevelopment and various Southern Inland Health Initiative capital projects, offset by reduction
through depreciation ($72.1m) and asset revaluation decrement ($17.6m).

(j) Capital appropriations

The variance between current year estimate and actual is due to delays in construction and achievement of project milestones for
various capital works projects which have been recashflowed during the 2017-18 Mid Year Review and the 2018-19 State Budget.

(k) Royalties for regions fund (cash flow)

The variance between current year estimate and actual is due to reconfiguration and recashflowing of the Royalties for Regions
programs during the financial year. Variances included reprofiling and recashflowing for Southern Inland Health Initiative 's medical
workforce and residential aged care programs ($14.8m), Turquoise Coast Health Initiative ($4.0m) and Goldfields Emergency
Telehealth ($2.7m), Karratha Health Campus development ($22.1m) and various other programs ($10m) as detailed in the 2017-18
Mid Year Review and the 2018-19 State budget documentation.

(l) Royalties for regions fund (cash flow)

The variance between current and last year actuals is due to higher funding received for various capital projects under the Southern
Inland Health Initiative ($79.7m) and the Karratha Health Campus development ($45m). This is offset by lower amounts received in
2017-18 for various hospital investment programs, residential aged and dementia care services, as well as a one-off payment to the
Royal Flying Doctor Services for the purchase of an aeroplane in 2016-17 ($5.1m).

(m) Employee expenses (cash flow)

The variance between current and last year actuals is due to the combined effect of increased FTE associated with new and expanded
services and changes to industrial awards for which budgets were provided in the initial 2017-18 Service Agreement or during the
financial year.

(n) Supplies and Services

The variance between current year estimate and actual is due to a combination of:
(i) the reconfiguration and recashflowing of the Royalties for Regions programs during the financial year. Variances included reprofiling
and recashflowing for Southern Inland Health Initiative 's medical workforce and residential aged care programs ($14.8m), Turquoise
Coast Health Initiative ($4.0m) and Goldfields Emergency Telehealth ($2.7m), North West Health Initiative ($3.3m) and various other
programs ($6.2m) as detailed in the 2017-18 Mid Year Review and the 2018-19 State budget documentation,
(ii) lower than budgeted expenditures on Hepatitis C antiviral drugs ($4.7m), and
(iii) the net effect of various other factors ($1.2m).

(o) Supplies and services

The variance between current and last year actuals is attributable to a combination of one off expenditures in 2016-17, including
Southern Inland Health Initiative [projects, grants to Royal Flying Doctor Service for replacement aircraft and medical equipment
replacements], together with reduced expenditures on drugs (particularly Hepatitis C antivirals).

(p) Payments for purchase of non-current physical assets

The variance between current year estimate and actual is due to the recashflow of Karratha Health Campus development ($22.1m),
and delays in construction and achievement of project milestones, adjustments to the Asset Investment Program and recashflowing of
various capital projects during the 2017-18 Mid Year Review and 2018-19 State Budget.

(q) Payment for purchase of non-current physical assets

The variance between current and last year actuals is primarily due to increased payments for various infrastructure projects including
the Karratha Health Campus development, Onslow Redevelopment and various Southern Inland Health Initiative capital projects.

9.12 Administered trust accounts

Funds held in these trust accounts are not controlled by WA Country Health Service and are therefore not recognised in the financial statements.

WA Country Health Service administers trust accounts for the purpose of holding patients' private moneys.

A summary of the transactions for these trust accounts is as follows:

 2018
$000
2017
$000
Balance at the start of period 1,187 1,205
Add Receipts 891 1,270
  2,078 2,475
Less Payments (1,075) (1,288)
Balance at the end of period 1,003 1,187

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Certification of key performance indicators

WA COUNTRY HEALTH SERVICE CERTIFICATION OF THE KEY PERFORMANCE INDICATORS FOR THE YEAR ENDED 30 JUNE 2018

We hereby certify the key performance indicators are based on proper records, are relevant and appropriate for assisting users to assess the WA Country Health Service’s performance and fairly represent the performance of the Health Service for the financial year ending 30 June 2018.

[Image (PDF only]: Professor Neale Fong signature]
PROFESSOR NEALE FONG
CHAIR
WA COUNTRY HEALTH SERVICE BOARD

[Image (PDF only]: Mr Alan Ferris signature]
MR ALAN FERRIS
BOARD MEMBER
WA COUNTRY HEALTH SERVICE BOARD

19 September 2018

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Key performance indicators

Section index

Outcome 1: Public hospital based services that enable effective treatment and restorative healthcare for Western Australians

  • Unplanned hospital readmissions of public hospital patients within 28 days for selected surgical procedures
  • Proportion of elective wait list patients waiting over boundary for reportable procedures
  • Hospital infection rates
  • Survival rates for sentinel conditions
  • Percentage of admitted Aboriginal and Non-Aboriginal patients who discharged against medical advice
  • Percentage of live-born term infants with an Apgar score of less than seven at five minutes post delivery
  • Rate of total hospital readmissions within 28 days to an acute designated mental health inpatient unit
  • Percentage of contacts with community-based public mental health non-admitted services within seven days post discharge from and acute public mental health inpatient unit
  • Average admitted cost per weighted activity unit
  • Average Emergency Department cost per weighted activity unit
  • Average non-admitted cost per weighted activity unit
  • Average cost per bed-day in specialised mental health inpatient units
  • Average cost per treatment day of non-admitted care provided by public clinical mental health services

Outcome 2: Prevention, health promotion and aged and continuing care services that help Western Australians to live healthy and safe lives

  • Response times for emergency air-based patient transport services
  • Percentage of patients who access emergency services at a small rural or remote Western Australian hospital and are subsequently discharged home
  • Average cost per bed-day for specialised residential care facilities, flexible care (hostels) and nursing home type residents
  • Average cost per person of delivering population health programs by population health units
  • Cost per trip of patient emergency air-based transport, based on the total accrued costs of these services per the total number of trips
  • Average cost per trip of Patient Assisted Travel Scheme (PATS)
  • Average cost per rural and remote population (selected small rural hospitals)

Outcome 1: Effectiveness Indicators

Unplanned hospital readmissions within 28 days for selected surgical procedures

Rationale

After successful hospital stay, the most important task for WA public hospital patients and staff is preparing for a successful discharge home. Tracking the number of patients who experience unplanned readmissions to WA health system hospitals within 28 days for selected surgical procedures, assists in assessing the quality of hospital services provided to the community. Unplanned readmissions are those readmissions where the principle diagnosis and readmission interval indicate that the readmission may be related to the care provided by the hospital in an index surgical episode of care. This indicator measures readmissions to a public hospital (the hospital of the original admission or another public hospital) or as a public patient in Contracted Health Entities (CHEs).

Readmission rate is considered a global performance measure, as it potentially points to deficiencies in the functioning of the overall healthcare system. Good intervention and appropriate treatment, together with good discharge planning will decrease the likelihood of unplanned hospital readmissions. A low unplanned readmission rate suggests that good clinical practice is in operation within our health system, and lessons can be learnt from a higher than target unplanned readmission rate through the creation of a variety of improvement strategies.

The surgeries selected to be measured by this indicator have a risk associated with post-surgery complications. Good discharge plans can help to decrease the likelihood of unplanned hospital readmissions, by providing patients with the care instructions they need after a hospital stay and by helping patients recognise symptoms that may require immediate medical attention.

Target

The 2017 targets can be seen in the below table:

Surgical ProcedureTarget
a) Knee replacement ≤26.2
b) Hip replacement ≤17.2
c) Tonsillectomy & adenoidectomy ≤61.0
d) Hysterectomy ≤41.3
e) Prostatectomy ≤38.8
f) Cataract surgery ≤1.1
g) Appendicectomy ≤32.9

Results

The 2017 rate of unplanned readmissions within 28 days to a country hospital for selected surgical procedures can be seen in Table 13.

Table 13: Unplanned hospital readmissions within 28 days for selected surgical procedures, 2017

Surgical Procedure2016
(per 1,000)
2017
(per 1,000)
Target
a)   Knee replacement 22.6 37.9 ≤26.2
b)   Hip replacement 36.7 21.8 ≤17.2
c)   Tonsillectomy & adenoidectomy 46.2 61.6 ≤61.0
d)   Hysterectomy 33.8 15.8 ≤41.3
e)   Prostatectomy 89.3 40.4 ≤38.8
f)   Cataract surgery 3.9 0.4 ≤1.1
g)   Appendicectomy 41.2 39.2 ≤32.9

Data Source: Hospital Morbidity Data System (HMDS)

WACHS has met target for Hysterectomy and Cataract Surgery, with all other procedure readmission rates not meeting target. The low number of cases may lead to significant fluctuation in year on year results as evidenced by the raw numbers of procedures followed by readmission:

  • Knee Replacement = 10 readmissions from 264 procedures
  • Hip Replacement = 6 readmissions from 275 procedures
  • Tonsillectomy & adenoidectomy = 22 readmissions from 357 procedures
  • Prostatectomy = 4 readmissions from 99 procedures
  • Appendicectomy = 30 readmissions from 766 procedures

If patients experience issues or symptoms following surgery, readmission is often the safest option especially in rural or remote areas where the distance between a patient's place of residence and access to health services can be considerable. All readmission cases are individually reviewed to ensure appropriate care.

Proportion of elective wait list patients waiting over boundary for reportable procedures

Rationale

Elective surgery refers to planned surgery that can be booked in advance as a result of specialist assessment resulting in placement on the elective surgery waiting list. Waiting lists are actively managed by hospitals to ensure all patients are treated in clinically appropriate timeframes. Patients are prioritised based on their assigned clinical urgency category:

  • Category 1 – procedures that are clinically indicated within 30 days
  • Category 2 – procedures that are clinically indicated within 90 days
  • Category 3 – procedures that are clinically indicated within 365 days

On 1 April 2016, the WA health system introduced a new state-wide performance target for the provision of elective services. The new target requires no patient (0%) on the elective waiting lists wait longer than the clinically recommended time for their procedure, according to their urgency category.

Reportable cases are defined as all waiting list cases that are not listed on the Elective Services Wait List Data Collection (ESWLDC) Commonwealth Non-Reportable Procedure List. This list is consistent with the Australian Institute of Health and Welfare (AIHW) list of Code 2 (other) procedures that do not meet the definition of elective surgery. It is also includes additional procedure codes that are intended to better reflect the procedures identified in the AIHW Code 2 list.

Target

The 2017-18 target is 0% which is aligned to the WA state-wide performance target.

Results

In 2017-18, the proportion of elective wait list patients waiting over boundary for reportable procedures did not meet target any category (see Table 14).

Table 14: Proportion of elective wait list patients waiting over boundary for reportable procedures, 2017-18

Category2017-18
(%)
Target (%)
Category 1 within 30 days 8.7 0
Category 2 within 90 days 9.4 0
Category 3 within 365 days 4.8 0
Total 5.5 0

WA Country Health Service identified errors in the data used to calculate this KPI in 2016-17 and part of 2017-18. Due to the extent and impact of these errors, WACHS has removed the results section for this KPI from the 2016-17 Annual Report published on the WACHS website, and therefore no comparative period reporting is provided in the 2017-18 Annual Report. An erratum for the 2016-17 Annual Report has also been tabled in Parliament. The organisation is putting stringent measures in place to ensure and maintain accurate reporting of this KPI in the future.

WA Country Health Service is currently undertaking a project involving senior clinicians and health administration staff to improve the accuracy and consistency of referral documentation, and improve the use of business intelligence tools to support the monitoring and management of the elective waiting list. A program of control self-assessment on compliance is also being undertaken across the WA Country Health Service.

Hospital infection rates (healthcare-associated staphylococcus aureus bloodstream infections (ha-sabsi) per 10,000 occupied bed-days in public hospitals)

Rationale

Staphylococcus aureus bloodstream infection (SABSI) is a serious infection that may be associated with the provision of healthcare. Staphylococcus aureus is a highly pathogenic organism and even with advanced medical care, infection caused by this organism is associated with prolonged hospital stays, increased healthcare costs and a marked increase in morbidity and mortality – mortality estimated at 20-25%.

HA-SABSI is generally considered to be preventable adverse events associated with the provision of healthcare.

This KPI has been selected for inclusion as it is a robust KPI of the safety and quality of WA public hospitals, and aligns to the principle of increased transparency and accountability of performance information provided to the public. A low or decreasing HA-SABSI rate is desirable and a target for WA based on historical data has been set.

Target

The 2017 target is ≤ 1.0 per 10,000 bed days.

Results

The rate of HA-SABSI Infection per 10,000 occupied bed days met target as seen in Table 15.

Table 15: Hospital infection rates (healthcare-associated Staphylococcus aureus bloodstream infections (HA-SABSI) per 10,000 occupied bed-days in public hospitals, 2017

 2017
(per 10,000)
Target
(per 10,000)
Infection Rate 0.64 ≤ 1.0

WACHS participates in the WA Health Healthcare Associated Infection
Surveillance in Western Australia Healthcare Facilities (HISWA) program of
mandatory surveillance of a range of healthcare associated infections (HAI),
including HA-SABSI.

All instances of HA-SABSI are thoroughly investigated to determine the cause
of infection. Information on infection rates is discussed at the peak WACHS
infection prevention and control committee to help inform understanding of
WACHS HAI risks and the need to develop or revise processes to reduce
risks to patients. WACHS has standardised processes across regions for
the documentation and observation of peripheral intravenous devices often
associated with HA-SABSI.

Survival rates for sentinel conditions

Rationale

This indicator measures a hospitals’ performance in relation to restoring the health of people who have suffered a sentinel condition-specifically a stroke, acute myocardial infarction (AMI) or fractured neck of femur (FNOF). For these conditions, a good recovery is more likely when there is early intervention and appropriate care on presentation to an emergency department and on admission to hospital.

These three conditions have been chosen as they are particularly significant for the healthcare of the community and are leading causes of death and hospitalisation in Australia. Patient survival after being admitted for one of these three sentinel conditions can be affected by many factors that include diagnosis, the treatment given or procedure performed, age, co-morbidities at the time of admission and complications which may have developed while in hospital. Hospital survival indicators, including this KPI, are considered screening tools as they are not definitively diagnostic of poor quality care and/or safety.

Target

The 2017 targets can be seen in the below table:

Age GroupStroke (%)AMI (%)FNOF (%)
0-49 Years 94.3 99.2 N/A
50-59 Years 92.4 98.9 N/A
60-69 Years 92.8 98.1 N/A
70-79 Years 89.5 96.1 98.9
80+ Years 80.9 91.7 95.3

Results

During 2017, survival rates for stroke met target for all age cohorts (see Table 16). Low number of cases can lead to significant fluctuation in results. Across all age cohorts, WA Country Health Service reported 50 deaths attributed to stroke out of 635 episodes. This is an overall survival rate of 92.1%.

Table 16: Survival rates for sentinel condition: Stroke, 2017

Age Group2016 (%)2017 (%)Target (%)
0-49 Years 95.8 100 ≥ 94.3
50-59 Years 100 97 ≥ 92.4
60-69 Years 92.3 95.9 ≥ 92.8
70-79 Years 92.9 96.5 ≥ 89.5
80+ Years 84.1 85.2 ≥ 80.9

Note: Due to low number of cases within some age categories, care should be taken when considering fluctuations in results.

Data Source: Hospital Morbidity Data System (HMDS)

WACHS has a standardised clinical care pathway for stroke, developed in line with best practice standards.

Survival rates for Acute Myocardial Infarction (AMI) for 2017 also met target performance for the 0-49 Years, 50-59 Years, 60-69 Years and 70-79 Years age cohorts. WACHS did not meet target for the 80+ years cohort (see Table 17). WA Country Health Service reported 16 deaths attributed to AMI out of 500 episodes, representing an overall survival rate of 96.8%.

Table 17: Survival rates for sentinel condition: Acute Myocardial Infarction (AMI), 2017

Age Group2016 (%)2017 (%)Target (%)
0-49 Years 100 100 ≥ 99.2
50-59 Years 100 100 ≥ 98.9
60-69 Years 94.7 100 ≥ 98.1
70-79 Years 94.7 96.8 ≥ 96.1
80+ Years 90.7 90.1 ≥ 91.7

Note: Due to low number of cases within some age categories, care should be taken when considering fluctuations in results.

Data Source: Hospital Morbidity Data System (HMDS)

WACHS has a standardised chest pain pathway, designed in line with best practice clinical standards, which promotes sound escalation processes for patients diagnosed as having an acute myocardial infarction.

Table 18: Survival rates for sentinel condition: Fractured Neck of Femur (FNOF), 2017

Age Group2016 (%)2017 (%)Target (%)
70-79 Years 100 100 ≥ 98.9
80+ Years 95.8 96 ≥ 95.3

Note: Due to low number of cases within some age categories, care should be taken when considering fluctuations in results.

Data Source: Hospital Morbidity Data System (HMDS)

WACHS utilises a standardised Falls Risk Assessment and Management Plan (FRAMP) in which patients are clinically reviewed and assessed for potential falling, and appropriate mitigation strategies are employed to reduce the likelihood of a fall occurring.

Patients presenting with a FNOF are at greater risk of developing delirium whilst an inpatient which adversely affects health outcomes. In 2018 WACHS is implementing a comprehensive cognitive impairment project which includes increasing the awareness of delirium and improving the recognition and response to patients with cognitive impairment.

Percentage of admitted Aboriginal and non-Aboriginal patients who discharged against medical advice

Rationale

Patients who leave hospital against medical advice (also called DAMA or discharged against medical advice) have been found to cost the health system 50% more than the cost of patients who are discharged by physicians.

WA health system public hospitals employ a range of initiatives to ensure patients receive timely, understandable information regarding their treatment options and the importance of continuing to receive care in the hospital setting, if clinically appropriate. These initiatives include supporting the delivery of culturally secure health services to Aboriginal people.

This new KPI will assist in measuring the success of these initiatives and provides a measure of the safety, quality and cultural security of the services provided.

Monitoring this indicator will enable identification of performance improvement opportunities, as well as the collaborative and effective addressing of the underlying factors in achieving an equitable treatment outcome for Aboriginal patients.

Target

The 2017 target is ≤ 0.77%.

Results

The 2017 Discharge Against Medical Advice (DAMA) rate did not meet target (see Table 19).

Table 19: Percentage of admitted Aboriginal and Non-Aboriginal patients who discharged against medical advice (DAMA), 2017

                                                                                                                    

Cohort2017 (%)
Aboriginal 5.2
Non-Aboriginal 0.8
Total 1.7
Overall target: ≤ 0.77

Data Source: Hospital Morbidity Data System (HMDS)

WACHS revised and updated clinical guidance on DAMA in June 2018 (the Discharge Against Medical Advice Policy and associated medical record form). This has provided increased information for clinicians to support reducing the occurrence of DAMA, in particular among Aboriginal and Mental Health patients (who are statistically more likely to DAMA). The Policy includes a risk based approach to managing follow up with patients who DAMA.

Percentage of live-born term infants with an Apgar score of less than seven at five minutes post delivery

Rationale

This indicator provides an outcome measure of a baby’s physical health immediately after birth.

The Apgar score is an assessment of an infant’s health at birth based on breathing, heart rate, colour, muscle tone and reflex irritability. An Apgar score is applied at one, five and possibly ten minutes after delivery to determine how well the infant is adapting outside the mother’s womb. Apgar scores range from zero to two for each condition with a maximum total score of ten. The higher the Apgar score the better the health of the newborn infant.

The outcome measure can lead to the development and delivery of improved care pathways and interventions to improve the health outcomes of Western Australian infants.

The indicator also aligns to the National Core Maternity Indicators (2016) Health, Standard 02/02/2018.

Target

The 2017 target is ≤ 1.8%.

Results

In 2017, the percentage of live-born term infants with an Apgar score of less than seven, five minutes post-delivery met target, seen in Table 20.

Table 20: Percentage of live-born term infants with an Apgar score of less than seven at five minutes post delivery, 2017

 2016 (%)2017 (%)Target(%)
Liveborn Term Infants Apgar1.51.6≤ 1.8

Data Source: Midwives Notification System

The WA Country Health Service Midwifery Advisory Forum, in collaboration with the WA Country Health Service Clinical Advisory and Patient Safety Obstetrics and Gynaecology group, has updated the policy for Recognition and Response of Acute Deterioration in the Newborn at Clinical Risk. This policy now includes newly identified risk factors which contribute to newborn compromise at birth. The policy includes clear pathways for the ongoing management of newborns known to be at clinical risk at birth and at risk of clinical deterioration after birth. WACHS has also recently established a Neonatal and Paediatric Leadership group across rural and remote WA to address newborn and neonatal clinical care delivery issues. This will support staff and patients within WA to ensure the best outcomes for mothers and newborns.

Rate of total hospital readmissions within 28 days to an acute designated mental health inpatient unit

Rationale

A designated metal health inpatient unit or acute mental health inpatient unit may see patients readmitted after completion of a previous admission. Readmission rate is considered to be a global performance measure as it potentially points to deficiencies in the functioning of the overall mental healthcare system.

While multiple hospital admissions over a lifetime may be necessary for someone with ongoing illness, a high proportion of readmissions shortly after discharge may indicate that inpatient treatment was either incomplete or ineffective, or that follow-up care was not adequate to maintain the patient’s recovery out of hospital. These readmissions mean that patients spend additional time in hospital and utilise additional resources. A low readmission rate suggests that good clinical practice is in operation. This indicator is reported at the facility at which the initial admission occurred rather that the facility at which the patient was readmitted.

By measuring and monitoring this indicator key areas for improvements can be identified. This in turn can facilitate the development and delivery of targeted care pathways and interventions, which can aim to improve mental health and quality of life of Western Australians.

Target

The 2017 target is ≤ 12%.

Results

In 2017, the rate of total readmissions within 28 days to an acute designated mental health inpatient unit did not meet target (see Table 21).

Table 21: Rate of total hospital readmissions within 28 days to an acute designated mental health inpatient unit, 2017

 2017 (%)2018 (%)
Total Hospital Readmissions 17.2 ≤ 12

Data Source: Hospital Morbidity Data System (HMDS)

WACHS has identified that due to limited options for supported step down or sub-acute accommodation in rural and remote WA, readmissions may be in the only option for some patients. People with an Emotionally Unstable Personality Disorder (EUPD), also known as borderline personality disorder, experience repeated crises. They are encouraged to return to Emergency Departments and receive short term re-admissions prior to the emotional crises escalating (which may otherwise result in increased self-harming behaviours).

WACHS Mental Health ensures that readmissions are monitored closely and occur where clinically appropriate and not as the first solution. Intensive post discharge follow up continues to be offered to patients however readmission will occur for highly complex patients, including those with a mood disorder.

Percentage of contacts with community-based public mental health non-admitted services within seven days post discharge from an acute public mental health inpatient unit

Rationale

In 2014-15 there were 4 million Australians (17.5%) who reported having a mental or behavioural condition. Therefore, it is crucial to ensure effective and appropriate care is provided not only in a hospital setting but also in the community.

Discharge from hospital is a critical transition point in the delivery of mental health care. People leaving hospital after an admission for an episode of mental health illness have heightened levels of vulnerability and, without adequate follow up, may relapse or be readmitted. This KPI measures the performance of the overall health system in providing continuity of mental health care.

A responsive community support system for persons who have experienced a psychiatric episode requiring hospitalisation is essential to maintain their clinical and functional stability and to minimise the need to hospital readmissions. Patients leaving hospital after a psychiatric admission with a formal discharge plan, involving linkages with public community based services and support, are less likely to need avoidable readmissions.

The standard underlying the measure is that continuity of care involves prompt community follow-up in the vulnerable period following discharge from hospital. Overall, the variation in post-discharge follow up rates suggest important differences between mental health systems in terms of their practices.

Target

The 2017 target is ≥ 75%.

Results

In 2017, contacts with community-based public mental health non-admitted services within seven days post discharge from an acute public mental health inpatient unit met target (see Table 22).

Table 22: Percentage of contacts with a community-based mental health non-admitted service within seven days post discharge, 2017

 2016 (%)2017 (%)Target(%)
Post-discharge community-based
contacts
67.5 75.6 ≥75

Data Sources: Mental Health Information System, Hospital Morbidity Data System (HMDS)

Throughout the last twelve months the WACHS regions have consistently met the target of 75 percent. Improved communication between the Mental Health Inpatient Units and the Community Mental Health teams has contributed to increased rates of follow up. The Mental Health services attempt to follow up all patients discharged but not all patients can be contacted within the seven day time frame. Patients may be difficult to contact for various reasons. Some patients when discharged do not want further contact and refuse to engage with the Mental Health Service. Others may decline to attend or not show up for appointments. Consumers may be lost to the service, not contactable or may have moved out of the area.

Outcome 1: Efficiency Indicators

Average admitted cost per weighted activity unit

Rationale

This indicator is a measure of the cost per weighted activity unit compared with the Health Service Provider’s Health Service Allocation Price (HSAP) set each year in the WA Activity Based Funding (ABF) Operating Model.

The measure ensures that a consistent methodology is applied to calculating and then measuring the performance of Health Service Providers (HSPs) against the funding they receive through the Government Budget Statement and subsequent Service Agreements and the activity delivered by each Hospital site (reported at an aggregate entity level). It is imperative that efficiency of this service delivery is accurately monitored and reported.

Target

The target for average admitted cost per weighted activity unit is $7,285. This target differs from the state (aggregated) target of $6,868 as outlined in the 2017-18 Budget Statements Budget Paper No. 2-Volume 1. The target set in Budget Paper 2 excluded Teaching, Training and Research (TT&R) Programs and PathWest Resources received free of charge (RRFoC) (excluding direct charges to HSPs captured under the existing fee for service model). The 2017-18 WACHS Annual Report target of $7,285 reflects the target published in Budget Paper 2, adjusted for these items.

Results

In 2017-18, the average admitted cost per weighted activity unit (WAU) met target, as can be seen in Table 23.

Table 23: Average admitted cost per weighted activity unit (WAU), 2017-18

 2017-18 ($)Target ($)
Average admitted cost / WAU $6,119 $7,285

Data Sources: OBM Allocation Application, Oracle 11i Financial System, Hospital Morbidity Data System (HMDS)

WA Country Health Service inpatient activity is generally less acute and specialised, as more complex patients are typically referred to metropolitan health services. This results in a lower cost per nWAU result for inpatient activity.

Average Emergency Department cost per weighted activity unit

Rationale

This indicator is a measure of the cost per weighted activity unit compared with the Health Services Provider’s Health Service Allocation Price (HSAP) set each year in the WA Activity Based Funding (ABF) Operating Model.

The measure ensures that a consistent methodology is applied to calculating and then measuring the performance of Health Service Providers (HSPs) against the funding they receive through the Government Budget Statements and subsequent Service Agreements and the activity delivered by each hospital site (reported at an aggregated entity level). It is imperative that Emergency Department service provision is continually monitored to ensure the efficient delivery of safe and high quality care.

Target

The target for average Emergency Department (ED) cost per weighted activity unit is $7,043.

This target differs from the state (aggregated) target of $6,642 as outlined in the 2017-18 Budget Statements Budget Paper No. 2-Volume 1. The target set in Budget Paper 2 excluded Teaching, Training and Research (TT&R) Programs and PathWest Resources received free of charge (RRFoC) (excluding direct charges to HSPs captured under the existing fee for service model). The 2017-18 WACHS Annual Report target of $7,043 reflects the target published in Budget Paper 2, adjusted for these items.

Result

In 2017-18, the average emergency department cost per weighted activity unit (WAU) did not meet target, as seen in Table 24.

Table 24: Average Emergency Department (ED) cost per weighted activity unit (WAU), 2017-18

 2017-18 ($)Target ($)
Average ED cost / WAU $7,292 $7,043

Data Sources: OBM Allocation Application, Oracle 11i Financial System, Emergency Department Data Collection (EDDC)

Average non-admitted cost per weighted activity unit

Rationale

The indicator is a measure of the cost per weighted activity unit compared with the Health Service Provider’s Health Service Allocation Price (HSAP) set each year in the WA Activity Based Funding (ABF) Operating Model.

The measure ensures that a consistent methodology is applied to calculating and then measuring the performance of Health Service Providers (HSPs) against the funding they received through the Government Budget Statements and subsequent Service Agreements and the activity delivered by each hospital site (reported at an aggregated entity level). It is imperative that efficiency of this Service delivery is accurately monitored and reported.

The indicator is a measure of the cost per weighted activity unit compared with the Health Service Provider’s Health Service Allocation Price (HSAP) set each year in the WA Activity Based Funding (ABF) Operating Model.

Target

The target for average non-admitted cost per weighted activity unit is $7,160.

This target differs from the state (aggregated) target of $6,738 as outlined in the 2017-18 Budget Statements Budget Paper No. 2-Volume 1. The target set in Budget Paper 2 excluded Teaching, Training and Research (TT&R) Programs and PathWest Resources received free of charge (RRFoC) (excluding direct charges to HSPs captured under the existing fee for service model). The 2017-18 WACHS Annual Report target of $7,160 reflects the target published in Budget Paper 2, adjusted for these items.

Result

In 2017-18, the average non-admitted cost per weighted activity unit (WAU) met target (see Table 25).

Table 25: Average Non-Admitted cost per weighted activity unit (WAU), 2017-18

 2017-18 ($)Target ($)
Average Non-Admitted cost / WAU $6,035 $7,160

Data Sources: OBM Allocation Application, Oracle 11i Financial System, Non-Admitted Patient Activity and Wait List (NAPAAWL) Data Collection

Outpatient activity is predominately allied health and nursing services, with less specialist outpatient services, resulting in a lower cost per nWAU.

Average cost per bed-day in specialised mental health inpatient units

Rationale

Specialised mental health inpatient units provide patient care in authorised hospitals and designated mental health units located within hospitals. In order to ensure quality care and cost effectiveness, it is important to monitor the unit cost of admitted patient care in specialised mental health inpatient units. The efficient use of hospital resources can help minimise the overall costs of providing mental healthcare and enable the reallocation of funds to appropriate alternative non admitted care.

Target

The target for average cost per bed-day in specialised mental health inpatient units is $1,713.

This target differs from the target of $1,646 as outlined in the 2017-18 Budget Statements Budget Paper No. 2. The target set in Budget Paper 2 excluded Teaching, Training and Research (TT&R) Programs and PathWest Resources received free of charge (RRFoC) (excluding direct charges to HSPs captured under the existing fee for service model). The 2017-18 WACHS Annual Report target of $1,713 reflects the target published in Budget Paper 2, adjusted for these items.

Result

In 2017-18, average cost per bed-day in specialised mental health inpatient units did not meet target, as seen in Table 26.

Table 26: Average cost per bed-day in specialised mental health inpatient units, 2017-18

 2017-18 ($)Target ($)
Average Non-Admitted cost / WAU $6,035 $7,160

Data Sources: OBM Allocation Application, Oracle 11i Financial System, BedState

Changes to the Outcome Based Management (OBM) allocations for Mental Health services have resulted in refinement of overhead costs to inpatient mental health services, resulting in a decrease in average cost compared to 2016-17.

Average cost per treatment day of non-admitted care provided by public clinical mental health services

Rationale

Efficient functioning of public community mental health services is critical to ensure that finite funds are used effectively to deliver maximum community benefit. Services provided by public community-based mental health services include assessment, treatment and continuing care.

Community mental health services consist of a range of community-based services such as emergency assessment and treatment, case management, day programs, rehabilitation, psychosocial, and residential services. The aim is to provide the best health outcomes for the individual through the provision of accessible and appropriate community mental health care. This indicator gives a measure of the cost effectiveness of treatment for public psychiatric patients under public community mental healthcare (non-admitted / ambulatory patients).

Target

The 2017-18 WA Country Health Service Target is $542.

Result

In 2017-18, WA Country Health Service average cost per treatment day of non-admitted care provided by public clinical mental health service did not meet the target as can be seen in Table 27.

Table 27: Average cost per treatment day of non-admitted care provided by public clinical mental health services, 2017-18

 2017-18 ($)Target ($)
Average cost / treatment day of non-admitted care provided by public clinical mental health services $591 $542

Data Sources: OBM Allocation Application, Oracle 11i Financial System, Mental Health Information Data Collection

Outcome 2: Effectiveness Indicators

Response times for emergency air-based patient transport services (percentage of emergency air-based inter-hospital transfer meeting the statewide contract target response time for priority 1 calls)

Rationale

To ensure Western Australians receive the care and medical transport services they need, when they need it, WA Country Health Service has entered into a contractual relationship to deliver emergency air-based patient transport services to the WA public. This collaboration ensures that patients have access to an effective aeromedical and inter-hospital patient transfer service to ensure the best possible health outcomes for patients requiring urgent medical treatment through rapid response.

Response times for patient transport services have a direct impact on the speed with which a patient receives appropriate medical care and provide a good indication of the efficiency and effectiveness of patient transport services. Adverse effects on patients and the community are reduced if response times are reduced.

Calls are assigned a priority (1 to 3) by the service provider, to ensure that conflicting flight requests are dealt with in order of medical need and to allow operations coordinators to task aircraft and crews in the most efficient means possible to meet these needs. The priority system in place is as follows:

  • Priority 1 refers to life-threatening emergencies, where the flight departs in the shortest possible time (subject to weather and essential safety requirements).
  • Priority 2 refers to urgent medical transfer, where the flight departs promptly with flight planning requirements met on the ground.
  • Priority 3 refers to elective transfer, where flight tasked to make best use of resources and crew hours.

Through surveillance of this measure over time, the effectiveness of patient transport services can be determined. This facilitates further development of targeted strategies and improvements to operational management practices aimed at ensuring optimal restoration to health for patients in need of urgent medical care.

Target

The 2017-18 target is ≥ 80% sourced from the WA Health System Service Agreement.

Results

In 2017-18, WA Country Health Service did not meet the target as can be seen in Table 28.

Table 28: Response times for emergency air-based patient transport services, 2017-18

 2017-18 (%)Target (%)
Percentage of priority 1 calls meeting target response time 78.9 ≥ 80

Data Source: Service Agreement Reports provided to WACHS

In 2017-18, there was an increase in the total number of patients transported state-wide, which had an impact on response times given available service resources.

WA Country Health Service continues to actively engage with the contracted provider in emergency air-based inter-hospital transfers to ensure the best care is provided to rural and remote communities.

Percentage of patients who access emergency services at a small rural or remote Western Australian hospital and are subsequently discharged home

Rationale

Small country hospitals provide emergency care services, residential aged care services and limited acute medical and minor surgical services in locations ‘close to home’ for country residents and the many visitors to the regions.

The ability to access emergency services in line with the WA Health Clinical Services Framework at these facilities is a clear community expectation. Accessing services with the outcome of returning home, where clinically justified, rather than transferring to another facility, demonstrates effective service delivery closer to home.

Target

The 2017-18 target is 92%.

Results

In 2017-18, WA Country Health Service did not meet the target as can be seen in Table 29.

Table 29: Percentage of patients who access emergency services at a small rural or remote WA hospital and are subsequently discharged home, 2017-18

 2017-18 (%)Target (%)
Percentage of patients discharged home 90.4 92

Data Source: Emergency Department Data Collection (EDDC)

Increases in admissions and transfer to other health services from small hospitals occurred in 2017-18, contributing to the lower than target result. The health needs of the patient are the top priority in any decision on treatment location.

Outcome 2: Efficiency Indicators

Average cost per bed-day for specialised residential care facilities, flexible care (hostels) and nursing home type residents

Rationale

The WA Country Health Service provides long-term care facilities for rural patients requiring 24 hour nursing care. This healthcare service is delivered to high and low dependency residents in nursing homes, hospitals, hostels and flexible care facilities, and constitutes a significant proportion of the activity within WA Country Health Service jurisdictions where access to nongovernment alternatives is limited.

Target

2017-18 target is $321.

Results

In 2017-18, average cost per bed-day for specialised residential care facilities, flexible care (hostels) and nursing home type residents did not meet target as seen in Table 30.

Table 30: Average cost per bed-day for specialised residential care facilities, flexible care (hostels) and nursing home type residents, 2017-18

 2016-17 ($)2017-18 ($)Target ($)
Average cost per bed-day $526 $557 $321

Data Sources: OBM Allocation Application, Oracle 11i Financial System, Occupied Bed Day (OBD) Data Warehouse

Performance in this indicator can be variable based on demand for aged care residential placements. There is a community expectation that residential aged care facilities operated by the WA Country Health Service will remain open and maintained, regardless of occupancy. In 2017-18, WA Country Health Service led residential care facilities reported over 10,000 less bed days compared to 2016-17, which impacted on the unit (bed day) cost of service delivery.

Average cost per person of delivering population health programs by population health units

Rationale

Population health units support individuals, families and communities to increase control over and improve their health. With the aim of improving health, population health works to integrate all activities of the health sector and link them with broader social and economic services and resources by utilising the WA Health Promotion Strategic Framework 2017–2021. This is based on the growing understanding of the social, cultural and economic factors that contribute to a person’s health status.

Target

The 2017-18 WA Country Health Service target is $233.

Results

In 2017-18, average cost per person of delivering population health programs by population health units did not meet target as per Table 31.

Table 31: Average cost per person of delivering population health programs by population health units, 2017-18

 2016-17 ($)2017-18 ($)Target ($)
Average cost per person for population health $294 $374 $233

Data Sources: OBM Allocation Application, Oracle 11i Financial System, EpiCalc

Refinement to the WA Health Outcome Based Management (OBM) structure has resulted in a change to the allocation of costs to this area, including the inclusion of nursing post costs which were previously reported under a separate Key Performance Indicator. This has resulted in an increase in population health program reported expenditure for 2017-18.

Cost per trip of patient emergency air-based transport, based on the total accrued costs of these services per the total number of trips

Rationale

To ensure Western Australians receive the care they need, when they need it, strong partnerships have been forged within the healthcare community through a collaborative agreement between the WA Country Health Service and the contracted service provider. This collaboration ensures that patients have access to an effective emergency air-based transport service that aims to ensure the best possible health outcomes for patients requiring urgent medical treatment and transport services.

Target

The 2017-18 target is $7,235.

Results

In 2017-18, the cost per trip of patient emergency air-based transport based on the total accrued costs of these services per the total number of trips met the target, as seen in Table 32.

Table 32: Cost per trip of patient emergency air-based transport, 2017-18

 2017-18 ($)Target ($)
Cost per trip of emergency air-based transport $7,121 $7,235

Data Sources: OBM Allocation Application, Oracle 11i Financial System, Service Agreement Reports provided to WACHS

Average cost per trip of Patient Assisted Travel Scheme (PATS)

Rationale

The WA health system aims to provide safe, high-quality healthcare to ensure healthier, longer, and better quality lives for all Western Australians. The Patient Assisted Travel Scheme provides a subsidy towards the cost of travel and accommodation for eligible patients travelling long distances to seek certain categories of specialised medical care. The aim of the Patient Assisted Travel Scheme is to help ensure that all Western Australians can access safe, high-quality healthcare when needed.

Target

The 2017-18 target is $377.

Results

In 2017-18 the average cost per trip of Patient Assisted Travel Scheme (PATS) did not meet target, as per Table 33.

Table 33: Average cost per trip of Patient Assisted Travel Scheme (PATS), 2017-18

 2016-17 ($)2017-18 ($)Target ($)
Average Cost per trip of PATS $438 $440 $377

Data Sources: OBM Allocation Application, Oracle 11I Financial System, Secure Health Record Exchange (SHaRE) PATS On Line

The 2017-18 target was based on realisation of non-hospital savings, including in PATS expenditure. While maintaining costs at levels relatively consistent with prior years, WACHS was unable to achieve these savings. WACHS remains committed to supporting access to specialist care for rural and remote patients, including where patients may be required to travel long distances to receive specialist medical services.

Average cost per rural and remote population (selected small rural hospitals)

Rationale

The WA health system aims to provide safe, high-quality healthcare to ensure healthier, longer and better quality lives for all Western Australians.

Small rural hospitals provide an essential level of access to services for rural and remote communities. These hospitals have relatively low patient activity and have high fixed costs therefore it is appropriate to measure efficiency based on population numbers as opposed to unit of patient activity.

In the calculation of this indicator, ‘rural and remote’ population has been calculated using the total WA Country Health Service population.

Target

The 2017-18 target is $390.

Results

In 2017-18, average cost per rural and remote population (selected small rural hospitals) did not meet target (see Table 34).

Table 34: Average cost per rural and remote population (selected small rural hospitals), 2017-18

 2017-18 ($)Target ($)
Average Cost per rural and remote population $401 $390

Data Sources: OBM Allocation Application, Oracle 11i Financial System, EpiCalc

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Ministerial Directives

Treasurer’s Instruction 903 (12) requires disclosing information about Ministerial directives relevant to the setting of desired outcomes or operational objectives, the achievement of desired outcomes or operational objectives, investment activities and financial activities.

The WA Country Health Service did not receive any Ministerial directives related to this requirement.

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Summary of Board and committee remuneration

The total annual remuneration for each Board or committee is listed below in Table 35. For details of individual Board or committee members, please refer to Appendix 2.

Table 35: Summary of State Government Boards and committees within the WA County Health Service in 2017-18

Board/committee nameTotal remuneration ($)
WA Country Health Service Board $376,254
SUB TOTAL $376,254
Medical Advisory Committees
Albany Hospital Medical Advisory Committee $0
Blackwood Hospital Medical Advisory Committee $600
Bunbury Hospital Medical Advisory Committee $4,288
Busselton Hospital Medical Advisory Committee $1,667
Central Great Southern Medical Advisory Committee $2,970
Denmark Medical Advisory Committee $1,584
Donnybrook Hospital Medical Advisory Committee $0
Eastern Medical Advisory Committee (Wheatbelt) $2,986
Geraldton Medical Advisory Committee $0
Margaret River Medical Advisory Committee $1,260
Plantagenet-Cranbrook Medical Advisory Committee $1,210
Southern District Medical Advisory Committee $1,277
Warren District Hospital Medical Advisory Committee $818
Western Medical Advisory Committee (Wheatbelt) $0
SUB TOTAL $18,661
District Health Advisory Councils
Blackwood District Health Advisory Council $1548
Broome District Health Advisory Council $0
Bunbury District Health Advisory Council $870
Central Great Southern District Health Advisory Council $5682
East Kimberley District Health Advisory Council $1980
East Pilbara District Health Advisory Council $678
Eastern District Health Advisory Council (Wheatbelt) $2694
Gascoyne District Health Advisory Council $0
Geraldton District Health Advisory Council $940
Goldfields District (Kalgoorlie) Health Advisory Council $2970
Kununurra / Wyndham and Surrounding Communities District Health Advisory Council $3060
Leschenault District Health Advisory Council $204
Lower Great Southern District Health Advisory Council $900
Midwest District Health Advisory Council $1320
Naturaliste District Health Advisory Council $0
South East (Goldfields) District Health Advisory Council $0
Southern Wheatbelt District Health Advisory Council $0
Warren District Health Advisory Council (Wheatbelt) $3379
West Pilbara District Health Advisory Committee $0
Western Wheatbelt District Health Advisory Committee $6783
SUB TOTAL $33,008
TOTAL $427,923

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Other financial disclosures

Pricing Policy

The National Health Reform Agreement sets the policy framework for the charging of public hospital fees and charges. Under the Agreement, an eligible person who receives public hospital services as a public patient in a public hospital or a publicly contracted bed in a private hospital is treated 'free of charge'. This arrangement is consistent with the Medicare principles which are embedded in the Health Services Act 2016 (WA).

The majority of hospital fees and charges for public hospitals are set under Schedule 1 of the Health Services (Fees and Charges) Order 2016 and are reviewed annually. The following informs WA public hospital patients fees and charges for:

Nursing Home Type Patients

The State charges public patients who require nursing care and/or accommodation after the 35th day of their stay in hospital, providing they no longer need acute care and they are deemed to be Nursing Home Type Patients. The total daily amount charged is no greater than 87.5 per cent of the current daily rate of the single aged pension and the maximum daily rate of rental assistance.

Compensable or ineligible patients

Patients who are either 'private' or 'compensable' and Medicare ineligible (overseas residents) may be charged an amount for public hospital services as determined by the State. The setting of compensable and ineligible hospital accommodation fees is set close to, or at, full cost recovery.

Private patients (Medicare eligible Australian residents)

The Commonwealth Department of Health regulates the Minimum Benefit payable by health funds to privately insured patients for private shared ward and same day accommodation. The Commonwealth also regulates the Nursing Home Type Patient 'contribution' based on March and September pension increases. To achieve consistency with the Commonwealth Private Health Insurance Act 2007, the State sets these fees at a level equivalent to the Commonwealth Minimum Benefit.

Veterans

Hospital charges of eligible war service veterans are determined under a separate Commonwealth-State agreement with the Department of Veterans' Affairs. Under this agreement, the Department of Health does not charge medical treatment to eligible war service veteran patients, Instead, medical charges are fully recouped from the Department of Veterans' Affairs.

The following fees and charges also apply:

  • The Pharmaceutical Benefits Scheme regulates and sets the price of pharmaceuticals supplied to outpatients, patients on discharge and for day admitted chemotherapy patients. Inpatient medications are supplied free of charge.
  • The Dental Health Service charges to eligible patients for dental treatment are based on the Department of Veterans' Affairs Fee Schedule of dental services for dentists and dental specialists. Eligible patients are charged the following co-payment rates:
    - 50 per cent of the treatment fee if the patient holds a current Health Care Card or Pensioner Concession Card
    - 25 per cent of the treatment fee if the patient is the current holder of one of the above cards and receives a near full pension or an allowance from Centrelink or the Department of Veterans' Affairs.

There are other categories of fees specified under Health Regulations through Determinations, which include the supply of surgically implanted prostheses, Magnetic Resource Imaging services and pathology services. The pricing for these hospital services is determined according to their cost of service.

Capital works

Completed

Table 36: Capital works completed in 2017-18

Project NameEstimated Total Cost in 2017–18 $ '000)
Albany Regional Resource Centre- Redevelopment Stage 1 168,262
Enhancing Health Services for the Pilbara in Partnership With Industry 7,338
Point of Care Network for Pathology Testing 771
Regional Health Administrative Accommodation 1,534

In Progress

Table 37: Capital works in progress in 2017-18

Project NameEstimated Total Cost in 2017–18 ($ '000)Reported in 2016–17 ($ '000)Variance ($ '000)Expected Completion Date2016–17 and 2017-18 variation to cost explanation (>=10%)
Albany Hospice Car Park 4 748 815 -67 Completed  
Broome Regional Resource Centre - Redevelopment Stage 1 42,000 42,000 - Completed  
Bunbury, Narrogin and Collie Hospitals - Pathology Laboratories Redevelopment 4 6,851 6,924 -73 December 2018  
Busselton Health Campus 4 115,202 115,233 -31 Completed  
Carnarvon Aged Care 2 11,577 16,577 -5,000 TBA See footnotes
Carnarvon Health Campus Redevelopment 25,666 25,666 - Completed  
Country - Staff Accommodation- Stage 3 1,4 27,422 26,972 450 Completed  
Country - Staff Accommodation- Stage 4 1,4 8,128 8,513 -385 Completed  
Country - Transport Initiatives 3,228 3,228 - TBA  
District Hospital Upgrade - Paraburdoo, Roebourne, Derby Community Health 3,700 - 3,700 TBA New project
District Hospital Upgrade - Tom Price Hospital Redevelopment 5,250 - 5,250 TBA New project
East Kimberley Development Package 4 38,597 38,593 4 Completed  
Eastern Wheatbelt District (Including Merredin) Stage 1 7,881 7,881 - December 2018  
Esperance Health Campus Redevelopment 1,4 31,871 32,841 -970 Completed  
Harvey Health Campus Redevelopment 4 12,858 12,855 3 Completed  
Hedland Regional Resource Centre - Stage 2 4 136,215 136,308 -93 Completed  
Kalgoorlie Regional Resource Centre - Redevelopment Stage 1 4 57,461 57,086 375 August 2018  
Karratha Health Campus - Development 4 207,131 206,892 239 July 2018  
Newman Health Service Redevelopment 2, 4 47,433 59,570 -12,137 April 2019 See footnotes
Onslow Health Service Redevelopment 4 41,723 41,798 -75 November 2018  
Remote Indigenous Health 4 24,053 20,736 3,317 May 2019 See footnotes
Renal Dialysis and Support Services 4 46,796 47,390 -594 Various  
Southern Inland Health Initiative - Integrated District Health Campuses Stream 2 2,4 163,743 153,728 10,015 Various  
Southern Inland Health Initiative - Primary Health Centres 2,4 32,659 38,664 -6,005 Various See footnotes
Southern Inland Health Initiative - Small Hospitals & Nursing Posts 102,444 102,445 -1 Various  
Southern Inland Health Initiative - Telehealth 5,530 5,530 - Various  
Strengthening Cancer Services - Geraldton Cancer Centre 4 3,930 4,062 -132 Completed  
Strengthening Cancer Services - Narrogin Cancer Centre 2,000 2,000 - December 2018  
Strengthening Cancer Services - Northam Cancer Centre 3,500 3,500 - December 2018  
Strengthening Cancer Services - Regional Cancer Patient Accommodation 4 4,392 4,498 -106 Various  
Upper Great Southern District (including Narrogin) Stage 1 10,497 10,497 - December 2018  
WA Country Health Service Picture Archive Communication System
- Regional Resource Centre
6,273 6,273 - Completed  
Wheatbelt Renal Dialysis 4 1,950 1,967 -17 December 2018  

Notes:

a) The above information is based upon the:
i 2017-18 published budget papers.
ii 2016-17 published budget papers.

b) Completion timeframes are based upon a combination of known dates at the time of reporting.

c) Projects listed above as 'completed' may still be in the defects period.

d) The footnotes that apply to individual projects are:
1. Transfer of funding between projects.
2. Royalties for Regions Funding changes.
3. Impacted as part of Whole of Government Capital Audit.
4. 2017/18 Budget excludes amounts that will not be capitalised, therefore the ETC may vary from that
reported in the 2016/17 Budget.

Staff development

The WA Health Recruitment, Selection and Appointment Policy and Procedure is contained within the WA Health Employment Framework and provides the requirements and standard processes specific to recruitment, selection and appointment, secondment, transfer and temporary deployment. WA Country Health Service is committed to ensuring the timely recruitment of skilled candidates to vacancies in regional areas.

WA Country Health Service is committed to building a strong, skilled and growing Aboriginal health workforce across all levels in the organisation. A key strategy to increase the Aboriginal workforce in the WA health system is through the application of Section 51 (s.51) of the Equal Opportunity Act 1984. WA Country Health Service has applied the s.51 provision to advertising and recruitment strategies throughout the trial period from March 2017 – December 2018.

WA Country Health Service provides a learning and development framework that ensures the delivery of safe, high quality and consumer-centred care services. This is achieved by supporting and facilitating learning programs that enables the development and maintenance of professional skills. Ongoing skills development and learning assists us to attract and retain a competent workforce that is aligned with service needs. Strategies implemented during 2017-18 include a review of mandatory training requirements. Learning Frameworks are now available that provide the workforce with role specific training and skill development. The Framework areas include Nursing and Midwifery, Healthcare Support staff, Managers, Allied Health and Emergency Management roles. The use of a consistent Learning Management System enables an organisation wide governance approach to the management, publication and reporting of training and development. Enhancement to governance practices ensures cost effective delivery of training of programs.

The WA Country Health Service continues to expand its use of the innovative Statewide Telehealth Service to provide staff in regional and remote locations access to metropolitan specialists delivering training to support clinical skills development.

Industrial relations

Responsibility for industrial relations is delineated by an Industrial Relations Policy MP 0025/16 established under the Employment Policy Framework issued by the System Manager (the Chief Executive Officer of the Department of Health) pursuant to section 26 of the Health Services Act 2016.

The Department of Health as System Manager is responsible for WA health system-wide industrial relations matters including negotiation and registration of industrial instruments. WA Country Health Service is responsible for the application of the WA Public Sector legislative and regulatory frameworks regulating employment and industrial relations, management of misconduct matters, representation and advocacy in industrial tribunals and courts, engagement with unions and other external stakeholders in industrial matters.

A new industrial agreement for hospital support workers was negotiated and in-principle agreement reached for hospital salaried officers. There was no significant industrial disputation in the year under review.

Workers compensation

The WA Workers’ Compensation system is a scheme established by the State Government and exists under the statute of the Workers’ Compensation and Injury Management Act 1981.

The WA Country Health Service has an injury management system to assist employees who are injured in the workplace. This system has an early intervention focus within an environment where it is normal practice for employees to return to productive duties as soon as medically appropriate. In 2017-18, a total of 296 workers’ compensation claims were made (see Table 39).

Goverment building contracts

WA Health Works Procurement Policy stipulates that all works over $2 million are coordinated by the Department of Finance, Building Management and Works (BMW).

In collaboration with a number of Group Training Organisations, the Apprentice management program (a business unit of BMW) manages the placement of apprentices with host employers undertaking government building and construction. BMW reports compliance with the Government building training policy in their annual report.

Table 39: Number of WA Country Health Service workers’ compensation claims in 2017-18

Employee categoryNumber of claims in 2017–18
Nursing Services/Dental Care Assistants 114
Administration and Clerical 44
Medical Support 17
Hotel Services 106
Medical (salaried) 0
Site Services 15
Total 296

Note: For the purposes of the Annual Report, Employee categories are defined as:

  • administration and clerical – includes administration staff and executives, ward clerks, receptionists and clerical staff
  • medical support – includes physiotherapists, speech pathologists, medical imaging technologists, pharmacists, occupational therapists, dieticians and social workers
  • hotel services – includes cleaners, caterers, and patient service assistants
  • site services – includes handypersons, security officers, store people and electricians.

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Governance disclosures

Contracts with senior officers

At the date of reporting, no senior officer or Board member, or firms of which senior officers or Board members are members, or entities in which senor officers or Board members have substantial interest, had any interests in existing or proposed contracts with the WA Country Health Service other than normal contracts of employment service.

Unauthorised use of credit cards

WA Health uses Purchasing Cards for purchasing goods and services to achieve savings through improved administrative efficiency and more effective cash management. The Purchasing Card is a personalised credit card that provides a clear audit trail for management.

WA Health credit cards are provided to employees who require it as part of their role. Credit cards are not for personal use by the cardholder. Should a cardholder use a credit card for personal purposes, they are required to submit a Notice of Non-Compliance (Form 625-3) to the accountable authority within five working days of becoming aware of the transaction and refund the total amount of expenditure.

There were 30 transactions in the period where credit cards were inadvertently used for personal purposes. All transactions were refunded before the end of the reporting period.

Table 40: Credit card personal use expenditure in 2017–18

Credit card personal use expenditure1 July 2017 to 30 June 2018
Aggregate amount of personal use expenditure for the reporting period $2,084.47
Aggregate amount of personal use expenditure settled by the due date (within five working days) $1,906.14
Aggregate amount of personal use expenditure settled after the period (after five working days) $178.33
Aggregate amount of personal use expenditure outstanding at the end of the reporting period. $0.00

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Other legal disclosures

Annual estimates

In accordance with Section 40 of the Financial Management Act 2006, the WA Country Health Service has submitted Annual Estimates to the Minister at an appropriate time during the financial year, as determined by the Treasurer.

Advertising

In accordance with section 175Z of the Electoral Act 1907, WA Country Health Service incurred a total advertising expenditure of $72,432 in 2017-18 (see Table 41). There was no expenditure in relation to advertising agencies, polling or direct mail organisations.

Table 41: Summary of WA Country Health Service advertising for 2017-18

Summary of advertisingAmount ($)
Advertising agencies $0
Market research organisations $5,500.00
Polling organisations $0
Direct mail organisations $0
Media advertising organisations $66,932.16
Total advertising expenditure $72,432.16

The organisations that provided advertising services and the amount paid to each are detailed in Table 42.

Table 42: Organisations that provided advertising services

Person, agency or organisation nameAmount ($)
Advertising agencies
Total $0
Market research organisations
West Coast Field Services $5,500.00
Total $5,500.00
Polling organisations
Total $0
Direct mail organisations
Total $0
Media advertising organisations
Adcorp Australia Ltd $9,898.29
Advanced Traffic Management Pty Ltd $2852.00
Carat Australia Media Services $39,319.41
Crana Plus $4,090.91
Health Communication resources Ltd $3,649.00
Total $63,333.64

Note: Values of less than $2,500 are not listed although the amount is included in the total.

Disability Access and Inclusion Plan

Our Disability Access and Inclusion Plan 2015-2020 was developed in consultation with our consumers, staff and key stakeholders to provide strategies for the WA Country Health Service to support increased independence, opportunities and inclusion for people with disability.

The plan outlines our priorities over a five-year period and builds upon our past achievements. WA Country Health Service continues to meet our commitment to ensuring that people with disability have the same opportunities to fully access the range of health services, facilities and information available in the public health system, and to participate in public consultation. Amongst a range of inclusion activities, we do this by:

  • ensuring that all capital works projects comply with the minimum access, egress and amenity levels set out in the Building Code of Australia, and all infrastructure improvements and redevelopments are undertaken with a view to universal access.
  • providing information to staff who are arranging events that will ensure that events are accessible to people with disabilities.
  • providing disability awareness training as a recommended module of the WA Country Health Service induction program for all staff.
  • ensuring people can provide feedback in a range of ways, including by the Patient Opinion website, an independent online consumer feedback platform which has accessibility functions.
  • ensuring that information on patient rights and responsibilities, and feedback options are displayed at WA Country Health Service sites and that information can be made available in alternative formats.
  • facilitating the use of interpreters to improve access to information for people who have difficulty speaking, hearing, seeing and/or reading, or who speak limited English.

In accordance with the Disability Services Act 1993, a progress report has been submitted to the Disability Services Commission outlining our progress against the priorities set out in the plan.

You can download a copy of our Disability Access and Inclusion Plan 2015-2020.

Compliance with Public Sector Standards and ethical codes

The WA Country Health Service values and encourages quality, integrity and justice, and we strive to ensure these values are represented in all that we do.

The WA Country Health Service is committed to complying with the Public Sector Standards in Human Resource Management (the Standards), the Western Australian Public Sector Commission’s Code of Ethics and WA Health Code of Conduct. WA Country Health Service raises awareness of these Standards and Code of Conduct and Ethics by providing information to new employees as part of induction and orientation programs; by including a compliance statement in all Job Description Forms; through mandatory training in Accountable and Ethical Decision Making, Aboriginal Cultural Awareness eLearning programs and the Management Development Program; through policies and procedures; and by publishing information in newsletters, on Notice Boards and on our intranet.

Human resource officers provide a range of consultancy and advisory services to managers and employees to ensure they are aware of and manage their responsibilities in relation to the Standards, together with processing services provided by Health Support Services (payroll and recruitment). Centralised oversight of the recruitment and selection process, including notification of the outcome of recruitment processes ensures that all applicants are provided information about their rights to claim a breach of the Standards.

Complaints alleging non-compliance with the Code of Ethics or Code of Conduct are reviewed, investigated and monitored by WA Country Health Service Industrial Relations in consultation with Human Resources.

Applications made for breach of Standards review, the outcome of claims, and number of complaints relating to non-compliance with the ethical codes is provided in Table 43 (next page).

Table 43: Summary of Breach of Standards Claims 2017-18

(i) Total claims (include all claims lodged whether resolved internally or referred to the Public Sector Commission)

Recruitment selection and appointmentTransfersSecondmentPerformance managementRedeploymentTerminationTemporary deployment (acting)Grievance ResolutionTotal
Claims lodged 2017-18 10             3 13
Claims carried over from previous financial year 1               1
Total claims handled in 2017-18 11             3 14

(ii) Outcome of claims handled

Recruitment selection and appointmentTransfersSecondmentPerformance managementRedeploymentTerminationTemporary deployment (acting)Grievance ResolutionTotal
Withdrawn in agency 3             2 5
Resolved in agency 1               1
Still pending in agency 1             1 2
Referred to OPSSC 6               6
Total claims handled in 2017-18 11             3 14

Freedom of Information

The Western Australian Freedom of Information Act 1992 gives all Western Australians a right of access to information held by the WA Country Health Service. The types of information held by the organisation include:

  • reports on health programs and projects
  • briefings for Minister for Health, Board and executive staff
  • health circulars, policies, standards and guidelines
  • health articles and discussion papers
  • newsletters, magazines, bulletins and pamphlets
  • health research and evaluation reports
  • epidemiological, survey and statistical data/information
  • publications relating to health planning and management
  • committee meeting minutes
  • administrative correspondence
  • legislative reporting and compliance documents
  • health infrastructure records
  • financial and budget reports
  • staff personnel records
  • patient records created from episodes of care

Members of the public can access some of the above information from the WA Country Health Service website. Members of the public who do not have internet access can obtain hard copy documents for free or a nominal fee outside of the Freedom of Information process.

Access to information under the Freedom of Information Act 1992 must be made in writing and can be lodged via email, sent by post or delivered in person. The written request must provide sufficient detail to enable the application to be processed, including contact details and an Australian address for correspondence.

In the case of an application for amendment or annotation of personal information it is required that the request include:

  • detail of the matters in relation to which the applicant believes the information is inaccurate, incomplete, out-of-date or misleading
  • the applicant’s reasons for holding that belief
  • detail of the amendment that the applicant wishes to have made.

For applications seeking non-personal information there is a fee payable at the time of submission.

The WA Country Health Service has a Freedom of Information coordinator for each region. Contact details, including postal and email addresses can be sourced from the Healthy WA website.

All requests for information can be granted, partially granted or may be refused in accordance with the Western Australian Freedom of Information Act 1992. The applicant can appeal if dissatisfied with the process, the reasons provided and in the event of an adverse access decision.

For the year ended 30 June 2018, WA Country Health Service dealt with 3,207 applications for information, of which 2,887 applications were granted full or partial access and 86 were refused (Table 44).

Table 44: Applications for information under the Freedom of Information Act 1992 (WA)

Applications for information under the Freedom of Information Act 1992 (WA)
Number of applications carried over from 2016-17 145
Number of applications received in 2017-18 3,062
Total applications active in 2017-18 3,207
Number of applications granted – full access 1,031
Number of applications granted – partial or edited access 1,856
Number of applications withdrawn by applicant 69
Number of applications refused 86
Number of applications in progress 154
Other applications 11
Total applications dealt with for 2017-18 3,207

Recordkeeping plans

WA Country Health Service has an agency-specific Recordkeeping Plan and supporting framework approved by the State Records Commission, which address the geographic challenges of country WA. This includes information on the recordkeeping system(s), record archiving and disposal arrangements, policies, practices and processes that comply with the State Records Act 2000.

Resources, advice and guidance regarding corporate recordkeeping are made available to all staff through the intranet, staff newsletters and training sessions. Strategies to ensure employees are aware and comply with the Recordkeeping Plan include online recordkeeping and awareness and systems training. In 2017-18, 3500 employees completed the mandatory online Recordkeeping Awareness training course, which is included in the WA Country Health Service induction program. The efficiency and effectiveness of the training program is reviewed on a regular basis via trainee feedback and assessments. Regular communication with end users of recordkeeping system is maintained through targeted training sessions including 'tip of the week' emails and ‘master classes’ for specific user groups. In addition, improved reporting has been implemented to ensure that managers have timely access to compliance information.

In 2017-18 a review of the WA Country Health Service Recordkeeping Plan commenced and is due for submission to the State Records Office in August 2018. The review will include findings on the programs evaluation, including organisation-wide survey, individual site assessments, adoption analysis and learning program surveys.

Across the WA Country Health Service, over 750,000 records were created in the Electronic Documents and Records Management Systems (EDRMS) during 2017-18. Over 600 users completed the EDRMS training program in 2017-18.

Substantive equality

The WA Country Health Service is committed to substantive equality for Western Australians living in the regions through the implementation of the WA Health Policy Framework for Substantive Equality. Our commitment to recognising the diversity of our employees, consumers and other stakeholders is reflected in our organisational values, and reflected in our policies and procedures.

WA Country Health Service is committed to ensuring people with disability, their families and carers are not discriminated against. This includes providing strategies to increase independence, opportunities and inclusion for people with disability and detailed strategies are outlined in the WA Country Health Service Disability Access and Inclusion Plan 2015–2020.

A key focus for the organisation in contributing towards substantive equality is improving the health outcomes of Aboriginal people through a coordinated approach to the planning, funding and delivery of Aboriginal health programs, and the development of a workplace environment that values the employment and retention of Aboriginal employees.

An exciting achievement this year has been the State Government’s commitment to long term funding of Aboriginal health programs that are improving the health and wellbeing of Aboriginal people. The investment provides certainty of funding for programs across the state that support child and maternal health; sexual health education and support; tackling smoking; cancer screening; chronic disease prevention and treatment; improving access to mental health services; as well as promoting a healthy lifestyle and wellbeing. The commitment offers welcomed security for the Aboriginal health workforce and safeguards the long-term sustainability of Aboriginal health programs delivered in partnership with communities, non-government organisations, Aboriginal Community Controlled Health Organisations and other specialist providers.

A key focus for the organisation is to contribute towards substantive equality for Aboriginal people. In 2017-18 we have contributed to substantive equality in the following ways:

  • Continuing to implement the Aboriginal Mentorship Program.
  • Appointment of Regional Aboriginal Health Consultants in the Midwest and Kimberley, and currently recruiting Regional Aboriginal Health Consultants to the remaining five regions.
  • Continued implementation of the WA Country Health Service Aboriginal Entry Level Employment Program.
  • Provided face to face cultural awareness training for executive and other staff located in WA Country Health Service central office.
  • Implemented the Aboriginal Health Practitioner pilot project in the Kimberley region.
  • Produced a promotional video to promote Aboriginal employment within the WA Country Health Service.
  • Employed 413 Aboriginal people (as at the end of April 2018), equating to 4.4% of our workforce. This is above the 3.2% target set by the Public Sector Commission for WA Health.
  • As of 30 June 2018, 84% of WA Country Health Service employees had completed the Department of Health’s mandatory Aboriginal Cultural eLearning Package.
  • Expanded the Country Health Connection Meet and Greet service to provide services from 6.00am to 10.00pm Monday to Friday and as required on the weekends.
  • Commenced development of a WA Country Health Service Aboriginal Health Strategy which will outline how the organisation will work across all regions, directorates and departments to improve service access and delivery for Aboriginal people to reduce health inequities.
  • Continued our longstanding participation and support of a range of state and national forums such as the Statewide Aboriginal Health Network and WA Aboriginal Health Partnership Forum and continued our engagement with key agencies and partners such as the Commonwealth Department of Health, WA Primary Health Alliance, Rural and Remote West and the Aboriginal Health Council of WA.

Occupational Safety, Health and Injury Management

Commitment to occupational safety, health and injury management

The WA Country Health Service is committed to providing a safe workplace and achieving high standards in safety and health for its employees, contractors and visitors. To achieve this the organisation has in place an integrated risk management approach to occupational safety and health that is underpinned by policies and procedures in accordance with the Occupational Safety and Health Act 1984, the Occupational Safety and Health Regulations 1996 and the Code of Practice on Occupational Safety and Health in the Western Australian Public Sector 2007. WA Country Health Service has a published Occupational Safety and Health Statement of Commitment and an Occupational Safety and Health Policy.

The WA Country Health Service takes a proactive approach to “best practice” occupational safety and health by establishing clear policies, goals and strategies and monitoring systems, developing preventative programs, and articulating employee responsibilities. Occupational safety and health objectives, policies, strategies and staff responsibilities are available to all staff through HealthPoint and occupational safety and health intranet pages.

Hazard and risk management processes include the use of Safety Risk Report forms, workplace inspections, risk assessments and job hazard analysis. Consultation on safety and health matters occurs with safety and health representatives and the formation of safety and health committees and OSH performance is improved by establishing measurable objectives and targets through OSH planning activities.

Compliance with occupational safety, health and injury management

WA Country Health Service provides a comprehensive injury management service to support injured workers and facilitate the development and implementation of return to work programs. This service is guided by the requirements of both the Workers’ Compensation and Injury Management Act 1981 and the Workers’ Compensation Code of Practice (Injury Management) 2005.

Injury Management Coordinators manage the injury management systems and are accessible to staff and managers. They develop and assist in the implementation of return to work programs, and report on recovery progress. Claims management processes including claims lodgment and processing, early intervention, and ongoing claims supervision is conducted by both occupational safety and health staff and Injury Management Coordinators to ensure high levels of support are provided to injured workers and their managers.

Employee consultation

All regions within the WA Country Health Service facilitate occupational safety and health management and consultation through:

  • the election of occupational safety and health representatives;
  • the establishment of regional occupational safety and health committees and strategic occupational safety and health groups;
  • hazard/incident reporting and investigation;
  • routine workplace inspections;
  • resolution of issues process; and
  • the implementation of regular audits, risk assessments and control measures to prevent incidents occurring.

Regional occupational safety and health committees meet regularly to discuss and resolve occupational safety and health issues. These processes facilitate communication with management on occupational safety and health issues and support hazard and incident reporting. This ensures issues are formally recognised and actions are communicated back to the employee and occupational safety and health representative.

Employee rehabilitation

WA Country Health Service has a dedicated injury management system which enables systematic management of workers' compensation claims and the provision of injury management services that are administered in accordance with the Workers' Compensation and Injury Management Act 1981.

Injury management services are provided to support the development of return to work programs for staff with a work-related injury or illness. The organisation adopts a case management approach involving the WA Country Health Service Injury Management Coordinator, the injured worker and their treating medical provider to facilitate the early and safe return to work of injured workers.

Return to work performance is reported to the WA Country Health Service Executive on a quarterly basis. Employee rehabilitation programs also extend to non-compensable injuries where there is a risk of exacerbating factors and/or a requirement to provide expert advice to facilitate the employee's safe return to work.

Occupational safety, health assessment and performance indicators

The annual performance reported for the WA Country Health Service in relation to occupational safety, health and injury for 2017-18 is summarised in Table 45.

Table 45: Occupational safety, health and injury performance 2015-16 to 2017-18

MeasureActual Results 2015-16Actual Results 2016-17Actual Results 2017-18Results against target: TargetResults against target: Comments
Number of Fatalities 0 0 0 0 Target achieved
Lost time injury (LTI) and/or disease incidence rate 2.35 2.56 2.73 0 or 10% reduction Target not achieved
Lost time injury and/or disease severity rate 39.32 32.98 42.00 0 or 10% reduction Target not achieved
Percentage of injured workers returned to work:
i) Within 13 weeks N/A 57.2% 47% 70% Target not achieved
ii) Within 26 weeks 69.80% 69.40% 51% 80% Target not achieved
Percentage of managers trained in occupational safety, health and injury management responsibilities 30.60% 86% 88% Greater than or equal to 80% Target achieved

In the 2017/18 period there was a decrease in the number of Workers’ Compensation claims lodged, however of those lodged, there was an increase in severe cases compared to the prior period. WACHS will undertake proactive risk mitigation in the areas of Manual Handling and Stress incidents to achieve LTI and Severity rate improvement.

Note: Performance is based on a three-year trend and as such the comparison base year is two years prior to the current reporting year (ie. current year is 2017/18 and comparison base year is 2015/16).

Senior officers

Senior officers and their area of responsibility for the WA Country Health Service as at 30 June 2018 are listed in Table 46.

Table 46: WA Country Health Service senior officers

Area of responsibilityTitleNameBasis of appointment
WA Country Health Service Chief Executive Mr Jeffrey Moffet Term contract
Operations Chief Operating Officer Mr Shane Matthews Term contract
*Innovation and Development Executive Director Ms Melissa Vernon Acting
Nursing and Midwifery Executive Director Ms Marie Baxter Term contract
Medical Services Executive Director Dr Anthony Robins Term contract
Business Services Executive Director Mr Jordan Kelly Term contract
Mental Health Executive Director Ms Paula Chatfield Term contract
Health Programs Executive Director Ms Margaret Denton Acting
Regional Operations Regional Director Goldfields Ms Geraldine Ennis Substantive
Regional Operations Regional Director Great Southern Mr David Naughton Term contract
Regional Operations Regional Director Kimberley Ms Rebecca Smith Term contract
Regional Operations Regional Director Midwest Mr Jeffrey Calver Term contract
**Regional Operations Regional Director Pilbara Ms Margi Faulkner Term contract
Regional Operations Regional Director Southwest Ms Kerry Winsor Substantive
Regional Operations Regional Director Wheatbelt Mr Sean Conlan Term contract
Office of the Chief Executive Director Ms Tracy Rainford Substantive
Finance Director Mr John Arkell Substantive
Infrastructure Director Mr Robert Pulsford Substantive
Aboriginal Health Strategy Area Director Mr Russell Simpson Substantive

Note:

*Ms Melissa Vernon was Acting Chief Operating Officer Strategy and Reform until 31/12/2017 and is no longer filled.

**The position of Regional Director Pilbara was held by Mr Ron Wynn up until 14/07/2017. Margi Faulkner was appointed to the role on 07/08/2017.

*** The position Executive Director Workforce was filled by Mr Marshall Warner until 18/08/2017 and is no longer filled (the position has been abolished). The position of Executive Director Public Health and Ambulatory Care was temporarily held by Ms Margaret Denton until 22/07/2018 and is no longer filled

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