Victorian Auditor-General’s report
1 September 2010

Sustainable Farm Families Program

Audit summary
Victorians in rural and remote areas generally have poorer health than those in major cities, with higher rates of mortality, disease and health risk factors. They have less access to primary health-care services and are less likely to adopt preventative health practices. They are also likely to wait longer before seeing a doctor.
Farming families as a group in rural communities have a culture of self-reliance, independence and stoicism in adversity. These attitudes may make them resilient in tough times and possibly less inclined to use health services.
The Department of Primary Industries (the department) has funded the Sustainable Farm Families (SFF) program since 2007 in an attempt to close the gap in the health differential and to support farmers during the protracted drought.
The program is a series of annual workshops over three years, where participants receive information and advice about health issues relevant to farming and rural populations. Attendees also get free annual health assessments and take part in focus groups and action planning. The program is based on the idea that information will lead to behaviour changes that improve health.
The audit examined whether the SFF program has been effective in improving the health and wellbeing of farming families. It reviewed:
·	the program’s rationale and planning 
·	its implementation
·	evidence of its effectiveness.
Conclusions
Participants report that they have learned from the program and have changed their behaviour as a result. This is borne out by clinical indicators that show their health is improving. Together these indicate the SFF program is effective in improving participants’ health. However, it is too early to know whether positive health outcomes will be sustained.
While the SFF program is effective, better targeting and tighter financial control is needed to be assured that the program is efficient.
Findings
The department had a sound basis for funding the SFF program as a drought assistance measure. The SFF program, developed by Western District Health Service, Hamilton (WDHS), had been piloted previously and had early positive results. 
Agricultural industry groups partnering with the department and WDHS have successfully recruited farmers and their families into the program. Retention rates are above expectations, but participation rates are starting to fall.
The department did not prioritise locations most in need of the program. The onus was on local health agencies or industry groups to recognise the need and apply to run the program in their area.
A high proportion of participants were referred for additional medical attention after their health assessments. Program results indicate its effectiveness—participants are more knowledgeable about their health after attending and their clinical health indicators improve from the first to second year. At-risk males and females had the highest rates of improvement.
The department has a strong, positive relationship with the program developer WDHS. The department’s project management in non-budget matters is satisfactory but it should strengthen oversight of spending and financial reporting by WDHS.
Recommendations
Number	Recommendation	Page	
1.	The Department of Primary Industries should research why participants drop out, to identify any issues with the Sustainable Farm Families program’s content or delivery.	16	
2.	The Department of Primary Industries should develop alternative service providers to deliver the Sustainable Farm Families program so the scale of the program is not limited by the program developer’s capacity.	16	
3.	The Department of Primary Industries should strengthen oversight of Western District Health Service’s expenditure and financial reporting.	16	
4.	The Department of Primary Industries should regularly evaluate the Sustainable Farm Families program to assure that it continues to meet its intended outcomes and assess whether the positive health results are sustainable.	22