The Australian National E-Health Transition Authority (NEHTA) (The peak government e-health entity) released its 2005-06 Annual Report a couple of days ago. It is an impressive 24 page document that is clearly designed to let us know as little as possible about what is going on. A good two pages are wasted, at least, on the smiling faces of the directors and CEO for example – rather than some useful information (Indeed we get two identical photos of the chairperson – just different sizes!).
The document contains riveting information on the organisational structure of NEHTA, two puff pieces (from the chairperson and CEO) saying what a success it has been so far, two and a half pages outlining all the stakeholders who have been “engaged with”, and a two page 2006 – 6 update of all the projects they are undertaking.
The rest of the document gives is a graph of the exponential recruitment process (to now about sixty people) and two pages of guff on directorial movements and changes.
It then concludes with the usual statements of audit independence and a “concise financial report” – the real report seems to be secret – and an auditors statement that the accounts are unqualified and accurate. (This takes seven pages with only two pages of figures provided).
The 24 page report thus provides a totally inadequate two page report on what NEHTA has achieved with the almost $10 million it has spent this financial year.
Those interested can access the report at the following URL.
http://www.nehta.gov.au/component/option,com_docman/task,cat_view/gid,92/Itemid,139/
As with all such documents it is not what is in the document, but what is left out that really matters.
Left out is enunciation of any real e-Health Vision or Strategy for Australia.
Left out is any indication of how the interoperation between the Private (read the GP, investigative and Specialist sectors), and the Public Health System is going to or could be made to work.
Left out are any performance measures and any statements as to how NEHTA is performing against these benchmarks.
Left out is any analysis of the business risks faced by NEHTA – especially those around not being able to get funding for the Shared Electronic Health Record and what would then be done with all this work.
Left out is any clear forward plan as to just what is to be delivered and when – with a staff of 38 then and 60 now – most having project management skills – one wonders why? (All there are a statements that some things have to be done by mid 2008 and others by mid 2009 – all a long way off compared with the pace we see in the US and the UK right now!)
Left out is any explanation of just what a little over $1.7 million spent on administration has achieved. Given that the total operational expenses were a little over $9 million it would seem a lot was spent administering.
Left out is any listing of, or rationale for the selection of, the clinicians and consumer representatives who have been consulted with a small number of time.
Left out is any evidence of a single improved clinical outcome or improved information flow to result from NEHTA’s two years of work so far.
Left out is why $7 million plus of member contributions were not spent this financial year. Work in this are is urgent and the opportunity cost of inactivity is high. Why so slow to get moving when the funds are available?
Left out is an explanation of the $4.5 million in receivables at the end of the year which is mostly members contributions owing. Seems some States are not paying promptly?
Among the interesting tit-bits to be found in the report are the following quotes:
“The company operates predominantly in one business and geographical segment being the development of methods to electronically collect and securely exchange health information throughout Australia.” (p21). Its nice to know what they are meant to be doing at least!
“The full financial report is available to Members free of charge upon request.” (p20). That means we want to keep the public away I would suggest – the members being the jurisdictional CEOs are to be the only ones who know what is going on!.
“NEHTA believes it is exempt from income tax as a public authority for the purposes of s.50-25 of the Income Tax Assessment Act 1997. This assessment will be confirmed by an application for a private ruling from the Australian Taxation Office during the 2006 - 07 financial year.” (p20). One is amazed this has not been sorted out by this – but delay is consistent with the apparent slowness of the organisation getting ramped up in general.
“The company’s major liability of trade and other payables ($3,086,023) comprises goods and services tax payable on member contributions and general trade payables.” I really wonder why NEHTA would pay GST on its member contributions – they are grants from State to Federal Governments are they not?
I know bureaucrats thrive on letting nothing out that could result and any controversy or criticism – but this so called “Annual Report” has set a new bar for obfuscation and concealment.
NEHTA is a publicly funded entity which has now expended well over $20 million in its initial and now corporate manifestations. The public is entitled to a much clearer statement of just what has been achieved and what is planned in my view.
The total lack of any sense of the need to provide more than the scantiest accountability or openly discuss and consult on future plans and directions is amazingly arrogant and borders on a scandal.
David.
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