Victorian Auditor-General's Office

Audit summary

Victoria’s public hospitals bought more than $1.6 billion of goods and services in 2010–11, their second largest cost after salaries and wages, accounting for almost 15 per cent of expenditure. Such a significant outlay of public funds means procurement activity should demonstrate integrity, transparency and value-for-money.

Health Purchasing Victoria (HPV) is the central procurement agency for the public hospital sector. Set up in 2001 under the Health Services Act 1988 (the Act), it was expected to improve hospital system effectiveness by:

Procurement Practices in the Health Sector

Body
This audit examined whether procurement practices in the public health sector deliver best value, and are conducted with probity and transparency. It examined the Department of Health, Health Purchasing Victoria and four public hospitals. It covered clinical and non-clinical procurement and reviewed the implementation of past recommendations from this office and the Ombudsman.

Appendix A. Audit Act 1994 section 16—submissions and comments

Introduction

In accordance with section 16(3) of the Audit Act 1994 a copy of this report was provided to audited health services and the Department of Health with a request for submissions or comments.

The submissions and comments provided are not subject to audit nor the evidentiary standards required to reach an audit conclusion. Responsibility for the accuracy, fairness and balance of those comments rests solely with the agency head.

4 Access to woman-centred care

At a glance

Background

Once assured of safe care, women want choice, continuity of care and control of their pregnancy.

Conclusion

Access to woman-centred care is variable. Women are experiencing greater control of their maternity care. However, less than half of them are experiencing continuity of care and the lack of comprehensive, accessible information contributes to poor understanding of the maternity system.

3 Access to maternity services

At a glance

Background

Timely, high quality maternity care during pregnancy supports women to give their babies the healthiest possible start in life.

Conclusion

Women attending the hospitals we audited in metropolitan growth areas do not have equitable access to maternity services as there is a demand and supply mismatch. This is projected to increase with population growth. The Department of Health has, however, now begun collecting data on the timeliness of access to antenatal care to inform service improvement.

2 Planning for maternity services

At a glance

Background

The Department of Health is responsible for health service planning, including maternity services, at the state level, while health services plan locally.

Conclusion

The department has limited information about the capacity and provision of maternity services in Victoria which makes the identification of service gaps and making informed planning decisions problematic. Work is underway, with the department mapping existing maternity services.

1 Background

1.1 Introduction

After a period of decline, birth numbers in Victoria began to rise from 2001, creating an increased demand for maternity services. Services came under pressure especially in Melbourne's growth areas. Sunshine Hospital, which services some of the fastest growing communities such as Brimbank and Melton, has the third highest number of births in the state.

Figure 1A shows the 16 per cent increase in births from 2000–01 to 2009–10.

Figure 1A

Births in Victorian public hospitals, 2000–01 to 2009–10

Audit summary

Background

Healthy outcomes for women and their babies are dependent on adequately resourced maternity facilities and an appropriately skilled workforce. Maternity services are a core part of healthcare delivery, representing 5 per cent of all public hospital admissions and 17 per cent of state-funded hospital outpatient appointments. Responsibility for the delivery of antenatal care, or care during pregnancy, is shared between the Victorian Department of Health and the Commonwealth.

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