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Community Affairs Legislation Committee - 15/02/2012 - Estimates - HEALTH AND AGEING PORTFOLIO - Australian Institute of Health and Welfare

Australian Institute of Health and Welfare

Ms Halton : We took two questions earlier in the day that I would like to provide some answer for, and I have one piece of advice for Senator Boyce, which is that Torres Strait Island is OHP, which outcome 14. The first of the two questions was: what was the process by which the department identified the spike in suicide rates in Mt Isa? I am advised that the department is a member of a Regional Health Forum, which includes health service providers in Mt Isa and the lower gulf. The forum met on 21 September 2011. The service providers pulled information that indicated there was a possible spike in suicides/attempted suicides at that time.

The second question was: was there a suicide prevention specialist in Mt Isa prior to the spike in suicide numbers? I am advised that Queensland Health, as we know being the primary provider of mental health services in Mt Isa, has Mt Isa based staff, including relevant mental health counselling qualified staff and people who are trained in that respect. Particularly relevant to the question is the fact that a suicide prevention working group, which includes clinicians, has been operating in Mt Isa since 2009.

Senator FIERRAVANTI-WELLS: I have some follow-up questions, Ms Halton, in relation to the role of Preventative Health Taskforce members, the Intergovernmental Committee on Drugs, the National Drug Research Working Group, alcohol policy, and the National Alliance for Action on Alcohol. I will deal with those in the population health area.

Ms Halton : Policy questions, except of course those questions specifically directed to the preventative health agency, are a matter for the program 1 officers specifically.

Senator FIERRAVANTI-WELLS: Mr Kalisch, table 2 of your annual report 2010-11, notes the performance indicator data supplied for 2008-09 and 2009-10 for COAG reporting. I tried to ask these question yesterday in COAG and was referred to here. In relation the performance indicator data supplied for COAG reporting, your 2010-11 annual report states that specifications were endorsed for 79 indicators, yet data was only supplied for 48. Can you give me the reason for this?

Mr Kalisch : Often it takes a bit of time between when the data is specified and when it is collected and then reported. The COAG Reform Council has a process whereby we supply data to the Productivity Commission. The Productivity Commission verifies that the data is robust and it is provided to the CRC. They then go through a process of analysing it, providing it to jurisdictions, and then receiving comments before they publish it. So there is often a time lag between the time the data is supplied and published.

Senator FIERRAVANTI-WELLS: Who is responsible for the supply of the data?

Mr Kalisch : Initially, we provide data for a fair number of the indicators. Also, the ABS supplies other data from its survey and census material.

Senator FIERRAVANTI-WELLS: Bearing in mind what you have said, is there a reconciliation—if I can put it that way—when all the data comes in so that there is a true reflection of that data? Also, what do you do to address this issue you have just raised with me?

Mr Kalisch : We work with the COAG Reform Council and with the Productivity Commission around the data specifications that need to be improved for following years and around the collection of data and its insertion in national minimum data sets. That is then conveyed and discussed with jurisdictions at regular Commonwealth-state meetings. We get their commitment to make those enhancements and improvements to their data supply to us. Once the data comes to us we compile it, verify it, quality assure it and provide it to the Productivity Commission, and then it goes through the whole process again.

Senator FIERRAVANTI-WELLS: So at any given time that is probably not an accurate reflection?

Mr Kalisch : It is an ongoing process in terms of further improvement year by year. We are at the moment looking at having a conversation with the Productivity Commission and the COAG Reform Council and with jurisdictions around opportunities for further improvements in the coming years.

Senator FIERRAVANTI-WELLS: So that it is all done within a time frame and, therefore, when it is reported it accurately—

Mr Kalisch : So that there is an understanding of when that can be reported and so that we make as much progress as we can.

Senator FIERRAVANTI-WELLS: On page 90 of your annual report 2010-11 there is an item ' Performance against planned outputs in 2010-11'. It really goes to the late supply of National Registration and Accreditation Scheme data. Why was this data not supplied?

Mr Kalisch : As you are probably aware, there was a change to the way in which information was received on health registered occupations with the establishment of the new agency.

Senator FIERRAVANTI-WELLS: So it was caught up in the establishment.

Mr Kalisch : Yes. It has taken some time for them to provide us with usable data. We have now received data that we believe is of sufficient quality and we are analysing it at the moment in a number of the key occupations. We look forward to publishing something very soon.

Senator FIERRAVANTI-WELLS: So you will be publishing better data for 2010-11 shortly. Is that the case?

Mr Kalisch : Yes.

Senator FIERRAVANTI-WELLS: Was it a short-term glitch?

Mr Kalisch : I would call it a transition arrangement—as it moves from one system of data collection to probably what is a more robust registration arrangement.

Senator FIERRAVANTI-WELLS: On page 71 of the annual report, under the heading 'Hospitals information improvement unit', I understand it is responsible for the development of indicators reported on the MyHospital web site.

Mr Kalisch : Yes.

Senator FIERRAVANTI-WELLS: Have these indicators been accepted by all state and territory governments?

Mr Kalisch : There is a process in train to expand and improve the number of indicators that are on the MyHospital site. As you might recall we have just published information on Staphylococcus aureas bacteraemia—that was late last year—for every hospital. That drew upon the information that was provided by jurisdictions to us on a jurisdiction by jurisdiction basis, but we also then received the information by-hospital against the national benchmark. Further understandings have been reached between health ministers for further information to be going up on the MyHospital site in coming months. We are in the process of doing that.

Ms Halton : Coincidentally, as we speak I am reading an email about the hand hygiene data.

Mr Kalisch : It is looking good.

Senator FIERRAVANTI-WELLS: Do all the states and territories comply with the reporting requirements relating to timeliness and content?

Mr Kalisch : Sadly, no. Unfortunately that is the case, but over the last 12 months we have also introduced data quality statements in our reports and against our data sets. These indicate where there are some issues that we have identified with the consistency, the standardisation, the quality and the timeliness of the information we have received from jurisdictions, so users are well aware of the data—and it is data consistency and data quality.

Senator FIERRAVANTI-WELLS: There is obviously a problem with consistency of reporting across the states.

Mr Kalisch : It is an issue that is much better in the health, community services and disability and housing areas, because there is at least some focus on standardisation and setting good definitions. At the institute we publish those nationally accepted definitions on our METeOR facility, which provides a publicly available set of the national data standards. Also, we do look carefully at what jurisdictions supply to us against those standards.

Senator FIERRAVANTI-WELLS: Can you explain to me why the MyHospital web site provided elective surgery waiting times for 2010-11 but admissions for 2009-10?

Mr Kalisch : In 2010-11, for elective surgery and emergency departments we get earlier information on those two pieces of information. We publish those by-jurisdiction in around October or November. Most of the other data for hospitals for admitted patient care is reported around April of the subsequent year. So it is really around the timing in which we receive the data and process it.

Senator FIERRAVANTI-WELLS: State governments often have more timely information on their web sites than is available on MyHospital. Is there going to be some process where the MyHospital site will better match the timelines of data published by the states?

Mr Kalisch : I would hope that over time we would not only improve the timeliness of information on the MyHopstial site, but also in terms of the broader reporting on hospitals by-jurisdiction and nationally. There are some opportunities for states and territories to provide data to the AIHW on a quicker basis and potentially on a quarterly basis. That would enable us to report it in a more timely fashion.

Senator FIERRAVANTI-WELLS: How many hits has the MyHospital web site had by month, quarter or year since it commenced? Also, how much will the MyHospital web site cost to operate in this financial year and over the forward estimates?

Mr Kalisch : The total cost for the MyHospital web site to 30 November 2011 has been $4,477,735. I cannot give you exactly what date this is taken from but since launch on 10 December 2010 I have a figure of 520,000 visitors to the MyHospital web site, with more than 2.3 million page views.

Senator FIERRAVANTI-WELLS: And you will take on notice the operating of the costs over the forward estimates?

Mr Kalisch : The costs over the forward estimates do depend on the nature of the work and the nature of how it is going to be expanded. So I am not sure that we have a good sense of that. We have certainly given you an indication of how much it has cost to date. That has been a fair bit of, I suppose, the development infrastructure of the basic site. But there has also been work that has been required on the specification of the different indicators that are on the site. For example, we are working with the Commission on Safety and Quality in Health Care around a number of those indicators. That will be of benefit to the MyHospitals site in terms of information that can be reported there. But it will also be of benefit to the commission with their surveillance activities.

Senator BOYCE: Mr Kalisch, I was actually looking at your publication on welfare in 2011 today and noted that people under 14 and people over 65 are considered vulnerable. Given that with the ageing of the population, given that the pension age is going to move, and given that people are being encouraged to work past that age, have you had any discussions with the ABS or anyone else around whether 65 is any longer an appropriate time to start measuring retirement and vulnerability, so to speak?

Mr Kalisch : Perhaps I can preface this by talking about some work that I did a number of years ago in labour markets and the perspective on older workers. At that stage, excuse me, colleagues, the definition we used for older workers was 45 and above.

Senator BOYCE: It has shifted in living memory.

Mr Kalisch : It has shifted in living memory, and I would have to say that 65 is looking particularly young. The other dimension is that, obviously on a more serious note, where the information is available from the ABS and from other survey sources, it is useful to actually break down that 65 and above group into much smaller categories. For example, 85 and above might be a useful category to focus on in some instances, particularly in terms of looking at, say, the aged care population.

Senator BOYCE: But are there any formal discussions about using another age?

Mr Kalisch : I suppose we try and balance up two things. One is the reliability of the information—if you can actually break it down towards other age categories, which we do as much as possible. But the second one is also on presentation and whether it does make sense to break down those age categories. We utilise the ABS information and will seek more detailed tables from them where that is available and where the information is robust enough to lead to that outcome.

Senator BOYCE: Thank you. Thanks, Chair.

CHAIR: There being no other questions on AIHW, thank you, Mr Kalisch. Now we will move to the Australian National Preventative Health Agency.