In November 2019 we published our latest report on the results of the financial audits in the health sector. We included the Department of Health and 16 hospital and health services (HHSs) in this report.
The sector has continued to improve year end processes, and more HHS provided quality statements in a timely manner. It was great to see the quality of their draft financial statements remained high.
Overall, controls were in place to enable health entities to prepare reliable financial statements. However, we made new recommendations to improve controls and processes. Common areas for improvement were compliance with procurement policies and procedures, and maintenance and management of the replacement of buildings and medical equipment.
The sector is facing an ongoing challenge to maintain financial sustainability while ensuring patients are not waiting longer for care than clinically recommended. In 2018–19, eight HHSs reported operating deficits (one more than last year), despite only three having budgeted for an operating deficit. The operating deficits in five of these HHSs predominantly resulted from the board-approved investment of prior year surpluses into non-recurrent projects, such as the integrated electronic medical records.
Increasing demand and costs for healthcare services are impacting on the long-term sustainability of the HHSs. At some HHSs, staff numbers are growing faster than activity, putting upwards pressure on their cost to deliver services.
The HHSs have $11.35 billion in property, plant and equipment assets, and there is growing anticipated maintenance for these assets. This maintenance, estimated at $893 million as at 30 June 2019, is likely to put additional pressure on the sector’s long-term sustainability.
Actions for entities
Each of our reports to parliament now includes ‘action items’ that audit committees and senior management can use to perform a health check.
We've provided four action points for consideration:
Queensland health entities should continue to ensure that they are allocating enough time and resources early in the financial year to complete the asset valuation and asset accounting processes before year end.
Audit committees should continue to regularly review the status of outstanding audit issues and ensure the risks are addressed in accordance with agreed timelines.
Entities have outstanding audit recommendations they still need to address. Some will use the new finance system—implemented in August 2019—to refine manual controls and processes to address weaknesses. The implementation of the new system will be a focus area for our 2019–20 audits.
Queensland health entities should strengthen their controls and processes by acting on outstanding audit recommendations. Where possible, the entities should use the functionality of the new finance system to effectively and efficiently act on these recommendations.
Queensland health entities should continue to prioritise high-risk maintenance, and the hospital and health services should work with the department to find ways to mitigate the operational, clinical, and financial risks associated with anticipated maintenance.
Our new dashboard for HHS data
You can see the financial results of the HHSs in our new data visualisation format here. The dashboard allows you to compare the financial results and some financial metrics of your HHS against others. Check it out!