annual report 2017-18 - parliament of victoria · 2018-09-19 · than it should be.” said monash...

Annual Report 2017-18

2 Monash Health Annual Report 2017-18

Our vision & valuesVision Exceptional care, outstanding outcomes.

Purpose To deliver quality, patient-centred healthcare and services that meet the needs of our diverse community

Our Values(iCARE)

• Integrity

• Compassion

• Accountability

• Respect

• Excellence

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ContentsOur care at a glance 4

Report of the Chair of the Board and Chief Executive 6

The Year in review 9

Innovation 12

Capital works 16

Our people 22

Our community 27

The Monash Health Foundation 28

A journey starts with one small step 31

Our sites, services and staff 32

Operational structure 34

Jessie McPherson Private Hospital 36

Clinical governance report 39

Environmental sustainability report 40

Our Board of Directors 42

Members of the Board of Directors 45

Statutory compliance 48

Disclosure index 50

Attestations 52

Statement of Priorities - Part A 53

Statement of Priorities - Part B 56

Statement of Priorities - Part C 60

Financial summary 62

Financial statements and explanatory notes 66


Our care at a glance In 2017-18

Total Episodes of care*(3.6m in 2016-17) (40,293 in 2016-17)

(1m in 2016-17)

(1.2m in 2016-17)

(10,162 in 2016-17)

(260,786 in 2016-17)

(220,913 in 2016-17)

(54,495 in 2016-17)

(224,460 in 2016-17)

Paediatric Admissions

Pathology Tests

Outpatient Services

Births

Total Hospital Admissions

Emergency presentations

Ambulance Arrivals

Mental health

3,915,202 40,987

1,043,936

1,453,333

10,027

259,958

226,315

58,858

287,624

* Excludes: Surgical Operations, Total Hospital Admissions, Babies, Ambulance arrivals, and Paediatric Admissions.

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We improve the health of our community through:• Prevention and early intervention

• Community-based treatment and rehabilitation

• Highly specialised surgical and medical diagnosis, treatment and monitoring services

• Hospital and community-based mental health services

• Sub-acute, aged care and palliative care programs

• Research, education and teaching the next generation of healthcare professionals

• Regional and state-wide specialist services.

Monash Health is proud to provide healthcare to one quarter of Melbourne’s population, across the entire life-span from newborn and children, to adults, the elderly, their families and carers.


Report of the Chair of the Board and Chief Executive

The Monash Health Translational Precinct (MHTP), an alliance between Monash Health, Monash University and Hudson Institute of Medical Research, had 1135 active research projects in FY 2017-18, with $15.3 million new funds from the National Health and Medical Research Council to ensure life-changing medical research is brought to the bedside. Innovative projects, such as home-based cancer treatments and use of virtual reality to alleviate anxiety in our youngest consumers are just two examples of the new thinking fuelling our work.

Growing to meet Victoria’s healthcare needsIn FY 2017-18, Monash Health achieved many Australian and Victorian firsts, providing the latest equipment, procedures and services to consumers. We are now one of only two 24-hour endovascular clot retrieval services in Victoria; providing stroke victims with a better chance of survival. The use of 3D modelling and a new generation scanner to assess musculoskeletal disease are just some of the amazing innovations we made available to consumers this year. The treatment of breast cancer through intraoperative radiotherapy has significantly improved our patients’ experience.

We are well underway with the implementation of an Electronic Medical Record, which is Monash Health’s biggest technology-based transformation and due to “go live” early 2019. It will provide clinicians with access to timely information about the people they are caring for, and

assist them in making decisions with better evidence. For consumers, this means safer, higher quality care.

We also progressed our capital works projects substantially, as we continue to plan for Victoria’s changing and expanding healthcare needs. Design consultants began work on our Victorian Heart Hospital - Victoria’s first standalone heart hospital that will bring together clinical practice and research and innovation.

We continue to deliver our Casey Hospital expansion project to schedule, with the main inpatient tower construction works progressing well; new theatres and Central Sterile Services Department on track for completion by the end of September 2019 and the site’s new front entrance building will open in late 2018. A key focus of 2018-19 will be detailed operational and budget planning.

Likewise, service and capital planning for the expansion of Pakenham Health Centre commenced in 2017-18 and will continue in 2018-19, to ensure it is well placed to meet growing demand for community-based services in the south eastern growth corridor of Melbourne.

Planning for the expansion of Monash Medical Centre’s emergency department commenced in 2017-18. This will enable the establishment of dedicated children’s emergency and mental health areas and improve traffic flows at the main entrance, thereby improving access to the hospital. Construction will commence in 2018-19.

Welcome to the Monash Health 2017-18 Annual Report

Providing exceptional careMonash Health provides care to a quarter of all Victorians at every stage of their life. With the health and well-being of so many people in our hands, we strive to provide excellence in patient care. Our Transforming Care Program has this exact goal in mind, and we made significant progress this year. We are working to ensure our systems and our people align at every stage.

Monash Health successfully achieved accreditation in 2017, against the National Safety and Quality Health Service Standards. Surveyors acknowledged our achievements and continued growth.

We celebrated the one year anniversary of the opening of the Monash Children’s Hospital school reflecting our commitment to patient care beyond the healthcare environment, and recognising the essential role that education plays in our young peoples’ lives. We are immensely proud that this initiative will help to keep our young consumers connected to learning opportunities and the social aspects of attending school.

Translating research into better patient outcomesMonash has achieved significant progress in research during FY 17-18, with widespread recognition of our people and our achievements. The work of our researchers and clinicians in pursuit of improved patient outcomes, is possible through the many partnerships we have in place.

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A fond farewell for our Chair of the BoardThis year marked the final chapter of a longstanding relationship with Monash Health for our Board Chair, Ms Barbara Yeoh AM.

Barbara has been an outstanding leader at Monash Health since 2009, guiding the organisation with calm determination through significant periods of change and growth. Barbara’s leadership has inspired our Board and Executive to commit to patient-focussed care and an ethos of continuous improvement. Barbara has remained dedicated to providing strong governance, with a focus on quality and safety. She is a leader who inspires by example and who is generous with her personal and professional support. Monash Health wishes her all the very best for the future.

Mr Dipak Sanghvi has taken up the role of Chair of the Board as of 1 July, having served on the Board for three years already.

Engaging with our community

This year, our Community Advisory Committee members co-designed an improvement project to enhance emergency department patient experience. Other initiatives, such as the introduction of our integrated model for responding to elder abuse, reflect our belief in extending care beyond hospital walls and working together with consumers and their families to achieve the best possible outcomes.

Our Primary Care and Population Health Advisory Committee is likewise progressing Monash Health’s Chronic Disease Strategy Implementation Plan. Once complete, this strategy will support community health and community healthcare providers to deliver diabetes, oral health, and management of advanced chronic non-malignant disease and palliative care in our community.

The development of an Equity and Inclusion strategy was completed in 2017-18 and sets out the principles and a program to promote and ensure respect for all individuals irrespective of their personal beliefs, identity and choice of expression. The supporting action plan will be implemented in 2018-19.

Defining our strategic directionIn 2017, we began the process of developing Monash Health’s 2023 strategic plan. This is a critical time for the organisation, as we define and focus our efforts over the next five years.

Throughout the past 12 months, we listened to our community, our employees and our partners to understand what matters most to them, and what they believe we should aspire to achieve.

Our 2023 strategic plan, describes our commitment to the relentless pursuit of excellence in our care, teaching and research, as well as the core principles and priorities to achieve our shared vision for the future. The plan will be published in FY 2018-19.

AcknowledgementsMonash Health works with many organisations and individuals to provide excellence in care. We acknowledge and thank the Victorian Government, Department of Health and Human Services and Federal Government for supporting us to serve our diverse and growing community.

We extend grateful thanks to our Board Members and Executive for their leadership. To all Monash Health employees and volunteers, thank you for your work and the wonderful contribution you make every day to the health and well-being of consumers. And to our community, we thank you for your feedback which provides us with rich insights into how we can improve.

Andrew Stripp Chief Executive

Dipak Sanghvi Chair of the Board of Directors

Dipak Sanghvi Chair of the Board of Directors

Andrew Stripp Chief Executive

Barbara Yeoh AM Chair of the Board of Directors (to 30 June 2018)


Journeys of Inspiration and Hope book and exhibition launchThe stories and experiences of people affected by an acquired brain injury were shared at the launch of a new book and art exhibition Journeys of Inspiration and Hope in October.

The book is a collation of stories from clients of the Monash Health Acquired Brain Injury: Slow to Recover (ABI: STR) program, which has been providing care to clients for 21 years.

The event was held in the Art Space at Monash Medical Centre, with around 70 consumers and families in attendance. The event was opened by Chief Executive Andrew Stripp, who reported that the program was launched in 1996 to provide for the very specific needs of those with severe to profound head injuries.

Over that time, the program has helped more than 400 people to meet their rehabilitation goals.

ABI: STR Program client Scott Harris and his mother Marissa

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The year in review

“In Ruth’s case the valve was also leaky and of most concern was that her aorta — the main pipe that attaches that valve to the body — was a lot bigger than it should be.” said Monash Heart cardiologist Dr Siobhan Lockwood.

At thirty eight weeks pregnant her obstetrician Dr Annie Kroushev, from Jessie McPherson Private Hospital induced her and in September Ruth finally gave birth to healthy baby Aeva.

“Seeing this gorgeous healthy looking girl was just amazing,” Mrs Staniscia said. “Even though it was a difficult pregnancy we felt so well looked after.”

Delivering exceptional patient care

Monash Health shines in National Standards accreditationMonash Health successfully achieved accreditation in October, against the National Safety and Quality Health Service Standards.

Twenty-two Australian Council on Healthcare Standards surveyors travelled across our health service speaking with staff, consumers and families. Many areas of Monash Health performed strongly and received particular commendation from surveyors. Monash Health is now accredited to October 2020.

From patient to work experience In 2017, Ashlene had surgery at Monash Health to fix a valve in her heart, after it was discovered she was suffering from a congenital heart condition where blood was leaking and going the wrong way.

She celebrated her 14th birthday in hospital and was so impressed with the care she received that she has now changed her career aspirations and wants to be a paediatric nurse.

“The experience was lovely, even though I was stuck at the hospital. Now I’m really enjoying seeing the other side of hospital life,” she said.

In 2018 Ashlene spent a week of work experience with the Monash Heart team, chatting to consumers, seeing what happens in a catheter lab, and helping out nurses on ward tours.

Ruth welcomes a baby girl Ruth Staniscia gave birth to a healthy baby girl at Monash Health in December, after being told her heart condition could make pregnancy very risky.

Ruth learned in late 2016 she had a congenital heart defect, bicuspid valve disease. Her heart has two leaflets on her aortic valve, instead of three like most people. This valve controls the one-way flow of oxygen-rich blood from the heart back into the body. Her condition means her heart was working overtime and some blood was flowing the wrong way.

Becoming pregnant could have resulted in an enlarged artery in her heart rupturing, threatening her life and her baby’s.

Delirium and dementia initiative launched After months of careful planning, the Monash Health Delirium and Dementia Initiative was launched in the general medicine wards at Monash Medical Centre in July.

The initiative is being introduced across Monash Health to provide high-quality care for consumers with cognitive impairment, and improve staff experience in supporting these consumers. The approach uses a tailored framework, focusing on a number of principles of care throughout the patient journey.

A key resource for the initiative is Monash Health’s new Cognition Clinical Lead, Bri Walpole. Bri will be based on the wards, helping staff to implement the principles of care and problem-solving with the team to provide safe and high quality care for consumers with cognitive impairment.

Staff are being asked to be alert to the risk of delirium and the risk factors that can precipitate or predispose it; be aware that consumers with cognitive impairment are at increased risk of harm (e.g. falls, pressure injuries) in hospital; partner with consumers, families and carers to provide person-centred care and attend education sessions.


In the lead up to the event, Hayley had been in bed for almost a week after undergoing surgery and that day was her first out of bed.

Hayley’s mum Sharlene said she was absolutely blown away by the effort everyone had gone to for the girls.

“It’s so wonderful to see all of their school friends here, the staff made cakes and the Starlight Captains painted their nails,” she said, “thank you.”

Starlight Express Room opens at Monash Children’s Hospital In October, Monash Health officially opened the Starlight Express Room at Monash Children’s Hospital.

The Starlight Express Room and Starlight Captains play a vital role in bringing fun, happiness and laughter to consumers and their families every day.

Monash Health Chief Executive Andrew Stripp said Monash Children’s Hospital has been a proud partner with Starlight for many years. “This is a space for children to forget that they’re in hospital; to be children, not consumers,” he said.

“The Starlight Captains help to support children when they are in hospital, providing a range of activities and distractions to improve their experience.”

We are incredibly grateful to the Starlight Captains, staff, volunteers, supporters and ambassadors to have this amazing space in our hospital.”

Monash Health safely welcomes quadrupletsIn January Monash Health safely delivered a set of quadruplets, following a 30-week and one day gestation period.

Mariam Hussaini and her husband Mohammed had always dreamed of having a family, after moving to Australia from Afghanistan in 2012.

Mariam has been under the care of our Women’s & Newborn program since she was three months pregnant, with the wellbeing of Mariam and babies carefully monitored by a team of staff.

“Each of the four babies had their own team, and everyone knew which team they belonged to,” said Monash Health Director of Neonatology Dr Charles Barfield.

All four boys were delivered safely by caesarean section.

Named Elyas and Almaas (identical twins) and Rayan and Shayan (fraternal twins), all four were born healthy and progressed so well that they were able to go home in early April.

Kidsafe Victoria opens Community Centre at Monash Children’s Hospital

The Victorian Minister for Families and Children, the Hon Jenny Mikakos MP opened Kidsafe Victoria’s new Community Centre at Monash Children’s Hospital in August.

Monash Health Chief Operating Officer, Martin Keogh said Monash Children’s Hospital is proud to work alongside Kidsafe Victoria to support them in education and advocacy that prevents injuries to children.

“We treat over 30,000 children every year at this hospital, and many of them are here because of unintentional injuries and accidents,” he said.

“The Kidsafe Children’s Injury Prevention Hub will be an asset for Monash Children’s Hospital, for our staff, parents, consumers and visitors.”

Erica Edmands, President of Kidsafe Victoria said the opening of the new Child Injury Prevention Centre was made possible by many sponsors and is a major milestone for Kidsafe Victoria.

“The location at the Monash Children’s Hospital will provide parents, carers, hospital staff and early childhood services with central access to lifesaving information,” she said.

“The new Centre will increase opportunities to expand Kidsafe Victoria’s interaction with the community, as well as facilitate injury prevention initiatives in partnership with Monash Children’s Hospital.”

Cassy and Hayley celebrate a very special school formal

For many teenagers, the school Formal is the biggest event of the social calendar.

School friends, Cassy and Hayley were both devastated that they couldn’t attend their formal last week.

Monash Children’s Hospital Occupational Therapist, Larissa said she didn’t want the girls to miss out on the important occasion.

“When the girls told me they were missing out on their Formal I thought – why can’t we bring the Formal to them?” she said.

Larissa and her team worked to pull together a celebration the girls would never forget. Cassy and Hayley had grins from ear to ear and enjoyed party food, beautiful outfits, dancing, great music, and most importantly, lots of friends.

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Baby Harry goes home after 176 daysFor first time parents Belinda and Ivan Campbell, it was concerning when their baby needed to come into the world extremely early on 28 March 2017 at just 27 weeks, weighing just 730 grams.

As a nurse, Belinda knew it was essential to have her baby delivered in a hospital with a Neonatal Intensive Care Unit (NICU) after she was diagnosed with preeclampsia.

Baby Harry has gone through a lot to survive his first six months of life.

With severe lung complications, he had to spend many weeks on a ventilator on life support and later underwent surgery.

But he proved to be a fighter.

At the time Monash Health’s neonatologist, Dr Atul Malhotra said, “as one of the first, sickest and most delicate consumers to be moved into the new Monash Newborn service on 19 April, it took ten specially trained staff to move him across.”

“Harry has done great in the last few months, he is a little trooper.”

Belinda and Ivan have a unique perspective of NICU life, having spent time in the old unit before being part of the move.

“The new NICU is light, spacious and so comfortable. We are so grateful to the wonderful care we have received at Monash Children’s Hospital,” said Belinda.

We can report little Harry was able to leave hospital and go home in September.

Monash Medical Centre celebrates 30 years Current and past staff came together to celebrate the 30th anniversary of Monash Medical Centre in September. Memories and stories of the hospital’s past were shared between the 200 guests during the celebratory event with an historical exhibition on display.

Among many great memories, the event reunited Jessica Bailey and her parents Susan and Michael with the doctor who delivered the first baby - Jessica - at Monash Medical Centre,

Dr Paul Shekleton. Professor Richard Harper, interim Director MonashHeart and Emeritus Professor of Cardiology took the audience through the journey of creating a cardiology service for the south east, which has resulted in MonashHeart being the largest cardiovascular service provider in Victoria. Jennine Harbrow, Acting Operations Director Monash Health Community, shared her experience as a senior nurse over this period.

Since its inception Monash Medical Centre has cared for more than two

million people, helped to deliver close to 120,000 babies and supported hundreds of thousands of Victorian families through difficult times.


Innovation

Symptom and urgent review clinicA symptom and urgent review clinic for oncology patients began at Dandenong Hospital.

Funded with a Department of Health and Human Services competitive grant, the clinic runs four days a week and consists of advanced practice nurse in oncology, Gurpreet Grewal, and experienced oncology pharmacist, Chihao La, with oncologists support.

Supportive care clinics are a pillar of modern oncology services. The objective of the clinic is to provide practical support to consumers receiving cancer treatment so that toxicities can be identified early and effectively managed.

It is expected that pre-emptive management will reduce emergency department and hospital presentations and allow consumers to maintain their independence and quality of life. Appropriate consumers are identified by clinicians including doctors, nurses, and allied health staff.

planning and outcome of her corrective surgery. The technology has also enhanced the educational experience for medical staff and students.

The novel project, led by Monash Health Consultant Paediatric and Neonatal Surgeon, Mr Ram Nataraja, who is also Director of Surgical Simulation and a Senior Lecturer at Monash University, was also published in the Journal of Paediatrics and Child Health.

Mr Nataraja’s team constructed a 3D model of the patient’s cyst, a rare congenital enlargement of the bile ducts. Mr Nataraja said the child had a straight forward uncomplicated post-operative recovery with no operative complications and has remained well since her surgery.

Transforming care across Monash HealthMonash Health is undergoing a whole of hospital transformation, to provide the best possible care and experience for consumers.

In the 2017/18 financial year the Transforming Care program has:

• Encouraged and supported all employees to speak up regarding any safety concerns.

• Allocated $18.1m towards replacement of medical equipment.

• Continued to embed clinicians as managers and leaders in the health service.

• Invested $2.6m in nursing leadership, to ensure nurse managers were able to allocate their time in accordance with clinical and management priorities, rather than working within nurse ratios.

• Commenced the organisation-wide multi-day bed reconfiguration; to assist patient flow assist patient flow, and reduce the moving of people once admitted to an inpatient ward.

• Improved the ability of clinical teams to communicate patient-related task requests and evenly distribute workload over night by implementing the electronic Smartpage system.

3D printing an education tool for surgical trainees and medical students In May, a team at Monash Health and Monash University created the first 3D printed model of a three-year-old patient’s abnormal biliary tree and choledochal cyst, to improve the

• Attracted $172,379 in competitive funding for the 2017 Victorian Telehealth Specialist Clinic Funding Project, to improve access to adult specialist clinics for regional and rural consumers in collaboration with Gippsland Health Services.

• This enabled, for example, the first adult telehealth conference between Casey Haematology Clinic, a Gippsland patient and a local GP clinic; saving the patient a 14+ hour round trip. See story below.

• Commenced roll out of an electronic referral triage system to replace paper processes and eliminate the risk of lost referrals in specialist clinics.

• Commenced relocation of paediatric and high safety risk adult clinics to fit-for-purpose specialist consulting clinic space.

• Implemented a specialist consulting data dashboard, to enable transparency and allow staff to make data-driven decisions.

• Introduced multidisciplinary inpatient ward based leadership teams, to support local areas to support ward performance and deliver patient centred care at the local level.

• Implemented prioritised patient care pathways and investigations framework, to enable safe and direct patient admissions from our emergency departments to inpatient wards.

• Improved ambulance offload processes in our emergency departments. This saved over 250 hours in ‘Ambulance Victoria in corridors time’ from November to December 2017, which significantly decreased the time ambulances were off the road.

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Establishing key community links to support function is a vital aspect of this clinic. The clinic is staffed by Dr Ranjana Srivastava, an oncologist who trained at the University of Chicago’s award-winning geriatric oncology clinic and Dr Irene Wagner, a geriatrician with extensive experience in managing dementia, behavioural issues, and the broader community needs of the elderly. They are supported by a range of hospital-based and community allied health services.

Monash Children’s Hospital School officially opened The Victorian Premier, the Hon Daniel Andrews MP and Minister for Education the Hon James Merlino MP officially opened the Monash Children’s Hospital School in October.

Welcomed to Monash Children’s Hospital by school Principal, Colin Dobson, the Premier and Minister visited young people as they worked alongside teaching staff.

The school is run by the Department of Education, with teachers delivering classes throughout the hospital, including at students’ bedsides, in small activity rooms, and in central ward areas. There will soon also be four purpose-designed classrooms and a specialist art room.

Classrooms feature hot desk areas and are equipped with cameras and the latest technology to enable students to virtually connect with teachers and classmates at their regular school, and with their families at home.

Telehealth pilot program saves John 14 hour commuteGippsland-based John Bailey was delighted with Monash Health’s pilot adult telehealth service, after he was invited to participate in the program in June.

John’s specialist appointments previously required a time commitment of more than 14 hours, including travel to Casey Hospital and back from Bruthen, a small town 20 minutes’ drive east of Bairnsdale.

In the past, appointments have meant a 4:30am wakeup and the hassle of car, train, and bus travel.

“People don’t really understand the stress and anxiety that causes, because you don’t know the bus lines, or the train might be delayed or you end up on the wrong line. And there’s only so many magazines you can read!”

Often, John would end up getting back home to Bruthen after 10pm at night.

During the consultation, John spoke to his specialist via a phone and web connection at his local medical clinic, and was able to be home again in just 90 minutes.

“It was fantastic,” John said. “It felt like I was sitting in the room, sitting across the table with the doctor. You could see his face and speak to him as if he was there. It was all very personable and easy.”

John was able to travel to his local clinic in Bairnsdale, the Macleod Street Medical Centre.

Practise Manager at the centre, Mr Wayne Howlett, liaised with Monash Health to ensure a private consultation room and the technology required.

“Wayne had everything ready to go, and the Macleod Street Medical Centre were really helpful,” John said.

John was ‘virtually’ checked in as a Monash Health patient at the Casey Specialist Consulting Clinic. After a private consultation, including immediate pathology requests and blood samples taken locally, John was able to make the short drive home again.

“For people in the region, this will save us hours and hours of travel just to see a specialist that we otherwise may not have access to,” John said.

“It was really excellent; a 20 minute drive that I’m used to, and I even had time to get my shopping done!”

John’s GP also received a detailed letter after the appointment for any follow-up.

Geriatric oncology clinic now open Monash Health Department of Oncology, in collaboration with Southern Metropolitan Integrated Cancer Service, announced the opening of our first Geriatric Oncology Clinic at Dandenong Hospital in February.

The clinic places the focus on the whole patient, and includes collaborative patient management by a geriatrician, an oncologist, and allied health professionals.

Every patient undergoes a comprehensive geriatric assessment, which identifies otherwise hidden problems including malnutrition, cognitive impairment, frailty, and social vulnerability. The information allows clinicians, consumers and families to tailor cancer treatment in a way that allows elderly consumers to benefit from modern therapies, while protecting them from risks.


24/7 Endovascular Clot Retrieval service saving stroke patients Victorian stroke victims now have a better chance of survival, with a new clot retrieval service improving stroke survival rates.

Monash Medical Centre joined The Royal Melbourne Hospital as the state’s only 24/7 Endovascular Clot Retrieval hospitals. The service enables consumers to be transported for rapid treatment no matter where the patient is located.

In 2017/2018, 112 patients received endovascular clot retrieval compare to 70 patients in 2016/2017. In 2017 we performed 91 retrievals. In the first seven months of 2018 we had already performed 83 cases and we estimate about 130-150 cases will be performed in 2018.

First published by Nine News, 17 September 2017.

A 30-minute heart disease test is being trialled by MonashHeart doctors A 30-minute test for coronary artery disease aims to cut the number of invasive investigations consumers have to undergo to get their diagnosis confirmed.

The single test, which uses a patient’s CT scan to make a 3D model of the heart arteries and simulate blood flow, is designed to be faster with less potential side effects than current techniques.

MonashHeart Interventional Cardiology Fellow, Dr Abdul Rahman Ihdayhid said when a patient was suspected of having clogged arteries, they usually had a CT scan. While it could highlight narrowing in these small tubes, he said that without further invasive tests, the cardiac CT could not say how blood flow to the heart was affected.

Not all clogged arteries require a stent or bypass surgery and in some cases medication is sufficient.

New generation bone scanner first in Australia A new generation scanner to assess musculoskeletal disease was made available to Monash Health consumers in March.

The XtremeCT-II measures bone density and quantifies the three-dimensional microarchitecture of bones (including 3D bone microstructure, tendons, cartilage, joints, muscle, fat and vascular calcification) at the highest resolution and precision currently available.

“The XtremeCT-II is the only one of its kind in Australia and will allow cutting edge musculoskeletal research both domestically and internationally,” Research Fellow, Dr Ayse Zengin said.

There are only two of these scanners in the world—the other is in China. The XtremeCT-II will be available as a research platform for researchers, clinicians and surgeons, ensuring collaboration between health care professionals.

Head, Department of Medicine, School of Clinical Sciences at Monash Health, Professor Peter Ebeling, AO, heads up the Bone and Muscle Research Group at Monash University. Prof Ebeling anticipates using a low-radiation method for high-resolution imaging of bone, muscle and joints will enhance understanding of musculoskeletal conditions, enabling effective preventative and treatment strategies.

Virtual reality to distract children during medical proceduresClinicians at Monash Children’s Hospital and Monash University are conducting a research study using virtual reality — an interactive computer system that can be ‘seen’ when wearing a headset and smartphone — to help distract consumers from procedures in our pathology and emergency departments.

Current pain management techniques, such as local anaesthetic cream or distraction is inadequate for some children and may result in the need for restraints and/or sedation.

Young consumers can now explore a virtual ocean and interact with friendly sea life, all while a doctor is performing medical procedures, including venepuncture or the inserting an intravenous cannula. These procedures can often be upsetting for children and family members.

“The current gold standard for measuring blood flow is an angiogram,” Dr Ihdayhid said.

“It’s done in the catheter lab where we put a specialised pressure wire down someone’s coronary artery and measure the blood flow. It’s an invasive procedure associated with potential side effects, discomfort to the patient, and considerable cost to the health system.”

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Trial provides treatment at home for cancer patients The Hospital in the Home program was involved in a trial of a new way of treating cancer patients deemed at low risk of febrile neutropenia, a complication of chemotherapy usually treated with antibiotics.

Until recently, consumers were treated as inpatients with IV antibiotics. Consumers now have the option of being safely treated in their own environment; shown to have great benefits for consumers and carers, and efficiencies for healthcare providers.

The project was first trialled at the Peter MacCallum Cancer Centre, where it found inpatient length of stay was reduced from four days to less than one day.

The program brings together several departments at Monash Health and collaboration and education among staff and departments is expected to provide great benefits to consumers.

L-R: Andre Levak, Low Risk Febrile Neutropenia Coordinator, Rhonda and Vicki McLeod, Oncology Nurse Practitioner.


Moorabbin Hospital – refurbished imaging and outpatient areas We were delighted to welcome The Hon Jill Hennessy MP, Victorian Minister for Health and Ambulance Services, and Mr Nick Staikos MP, Member for Bentleigh, to Moorabbin Hospital in November, to visit newly-refurbished diagnostic imaging and outpatient areas.

The $16.2 million capital project has already made a significant difference to the way Moorabbin Hospital cares for consumers.

Capital works A new MRI machine and PET CT scanning technology have begun to operate at the site, with enhanced facilities for the imaging team. The outpatients’ area has also been improved, with additional consultation suites and a naturally-lit, more open environment.

Casey Hospital expansion progresses on scheduleCasey Hospital is poised to deliver even more services to one of the fastest growing areas in Melbourne’s south-east. Funded by the Victorian Government, construction began in 2017, in conjunction with the Department of Health and Human Services and Plenary Group, and the project has reached a number of milestones in FY 2017-18.

The main inpatient tower construction works are progressing well and will be handed over in stages. The new theatres and Central Sterilising

Supply Department is a major project milestone and is on track for completion by the end of September 2019.

A number of internal refurbishment works will commence over coming months to create a new pharmacy and expand pathology services. The site’s new front entrance building is due to open in September 2018. The front entrance building will provide new retail areas for the site and also accommodate Monash University. Expansion is needed to ensure that Casey Hospital has the capacity and services needed to provide the residents of Casey and Cardinia with quality care at their local facility, given the unprecedented growth in this area and the need for increased specialised services. Construction is expected to be completed in 2019.

Pet therapy puppy Abby visits a young patient at Monash Children’s Hospital.

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The total project is projected to cost $543 million, and the new hospital will have 195 beds, with the capacity to provide 2000 cardiac surgeries each year, 13,500 cardiac catheterisation laboratory procedures and 108,000 consultations and outpatient appointments.

Happy 1st birthday Monash Children’s Hospital!On 19 April Monash Health celebrated the first birthday of Monash Children’s Hospital (MCH). Staff and consumers came together to join in activities and entertainment, including an animal farm, face painting and a teddy bear hospital.

Channel 9 was there to capture all the fun, as Monash celebrated its first year of operations. The MCH is only the second dedicated paediatric tertiary hospital in Victoria, and focusses on providing state-of-the-art facilities and care in a child-friendly environment.

Victorian Heart Hospital development $320m funding boost The Victorian Government announced in December it will invest an additional $320 million to build the Victorian Heart Hospital, Victoria’s first standalone heart hospital that will bring together clinical practice and research. In FY 2017-18 design consultants were appointed and design has commenced, with construction scheduled to commence later in 2018.

The newest hospital for Monash Health is due for completion in 2022. Project partners Monash University will have embedded researchers within the facility, allowing cutting-edge research to directly benefit consumers.

Monash Medical Centre opens new state-of-the-art angiography facility Monash Medical Centre now offers more consumer emergency treatment, after opening our new innovative, state-of-the-art treatment facility in June.

Professor Timothy Buckenham, Interventional Radiologist said that in 2017, Monash Health treated 2400 consumers with a comprehensive range of procedures to diagnose or treat consumers with cerebrovascular disease, kidney disease, sepsis, bleeding, aneurysms, and cancer.

The new Biplane Angiography Suite is equipped with a new-generation image-guided therapy platform, capable of performing a wide range of routine and minimally-invasive catheter-based procedures in the interventional lab.

Neuro-Interventional Radiologist and Head of Endovascular Clot Retrieval, Professor Ronil Chandra said the new facility is a major improvement for patient care at Monash Health and will increase capacity to provide lifesaving treatment to consumers across the south east of Victoria.

The new Azurion Biplane Angiography imaging platform is one of the first of its kind installed in Australia, featuring substantial hardware and software upgrades.


Research and partnerships

found if radiation was delivered at the time of surgery to remove the tumour, it was as effective as standard external radiation.

The trial and introduction of the therapy into standard care practices, means Victorian women with early, low-risk breast cancer are among the first in the world to have access to intra-operative radiation therapy, which could revolutionise cancer treatment by allowing it to be completed in one day.

Consumers previously required up to 25 hospital visits to complete their treatment.

Intra-operative radiotherapy offers women with early stage breast cancers another therapeutic option, a better patient experience and a more rapid return to normal activity. The technique delivers radiation to a more targeted area through a balloon in the resection cavity, which spares organs and tissue from radiation.

Aspirin and the mysteries of preeclampsia

A Monash Health researcher involved in world-first research is spreading the word about a simple solution to a potentially-deadly condition.

Monash Health Translation Precinct The Monash Health Translation Precinct (MHTP) partnership aims to be a world leader in translational research, generating innovative scientific discoveries and revolutionising clinical care in a dynamic and collaborative environment.

The MHTP is a partnership between Monash Health, Hudson Research Institute and Monash University. MHTP is also a critical component of Monash Partners Academic Health Science Centre. Through these partnerships, leading researchers have direct access to clinicians and consumers, enabling scientific breakthroughs to reach the bedside more effectively than ever before.

Areas of focus within the MHTP include:

• Cancer

• Neurosciences

• Endocrinology

• Inflammation

• Women’s, Children’s, and Reproductive Health.

Breast cancer: Single dose of radiation replaces daily treatment A single nine-minute dose of radiation therapy delivered during breast cancer surgery has replaced three to five weeks of daily treatment at Monash Health. Intra-operative radiotherapy was trialled in 2017-18 at Moorabbin Hospital, together with Peter MacCallum Cancer Centre. The trial

Our research visionTo be a health service that integrates excellence in clinical services, education and research. Monash Health provides a supportive and dynamic environment for health care professionals to conduct world-class clinical and translational research that drives improved clinical practice.

Dr Daniel Rolnik was part of a team of researchers whose ground-breaking research was published in June’s edition of the prestigious New England Journal of Medicine. The large study screened almost 27,000 women in six countries, revealing aspirin is an effective treatment for preventing preeclampsia.

Preeclampsia is a major cause of maternal and infant death around the world. It is often unclear what causes preeclampsia, with treatment options often limited once the condition has developed.

Dr Rolnik found improved screening and a simple daily dose of inexpensive aspirin could dramatically reduce the incidence and mortality numbers.

He observed a 60 per cent reduction in the development of preterm preeclampsia in women taking a low dose of aspirin during pregnancy, compared to the placebo group, and more than 80 per cent reduction in preeclampsia requiring delivery before 34 weeks.

Monash Health doctors invent bidirectional cannula to save limbs and livesMonash Health clinicians led a collaboration of Australian organisations to solve a global medical problem that will save lives around the world.

A ‘bidirectional cannula’ device was developed by three Monash Health and Monash University clinicians. It is likely to significantly reduce complication rates around the world during certain types of heart surgery procedures.

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In FY 2017-18:

374Clinical drug or device trials implemented

229Quality improvement and service activities registered

In 2017/18:

$15.3+ million In National Health and Medical Research Council (NHMRC) funding awarded to Monash Health and Monash Health Translation Precinct partners.

470New research projects approved by Monash Health Human Research Ethics Committee

1,135Active research projects.

In 2017:

$20+ million In funding for commercially sponsored clinical trials by leading pharmaceutical and biotechnology companies for national and international clinical research.


The device has been designed, engineered, and tested in Australia. The clinical trials of the device was made possible by a generous grant from the Victorian Government.

The device is used to connect consumers to a heart-lung machine through a large artery at the top of the leg. Clinical trials of the device at the Alfred Hospital, led by Associate Professor Silvana Marasco, have yielded very favourable results.

The new device has shown tremendous promise in reducing the risk of leg ischaemia (lack of oxygen supply), a potentially serious complication that can occur during heart surgery and in consumers requiring artificial cardiac support in intensive care units.

A world-first treatment for pelvic organ prolapse Monash Health has collaborated with Hudson Institute of Medical Research on a world-first approach to treating pelvic organ prolapse.

With lab research underway, clinical trials are expected to begin in the next three to five years.

A new bio-construct created by combining stem cells from the lining of a woman’s own uterus will be used to restore quality of life to women with pelvic organ prolapse, and to prevent the condition from occurring in younger women.

Pelvic organ prolapse is a lifelong, potentially debilitating condition, predominantly caused by the impact of childbirth. It affects an estimated one in four women, and around one in two women aged over 50.

Associate Professor Anna Rosamilia, head of the Pelvic Floor Unit at Monash Health says “It’s exciting to be part of a research team looking at new treatment options for pelvic organ prolapse which use degradable scaffolds and the woman’s own mesenchymal endometrial stem cells. Theoretically this should translate into better healing than currently available options but the technology needs further vigorous testing to establish its place.”

It’s hoped this new technique will trick the body or modify its immune response to promote healing rather than scarring, which will help to repair the damage.

World’s largest clinical trial in follicular lymphoma providing hope An international collaborative study, including researchers at Monash Health and Monash University, has shown that follicular lymphoma patients treated with a therapy known as obinutuzumab, in combination with chemotherapy, leads to significant improvements in how the disease is controlled.

Published in the prestigious New England Journal of Medicine in October, the results from the largest ever follicular lymphoma clinical trial revealed that consumers treated with a combination of chemotherapy and obinutuzumab had their disease under control for one and a half times longer than the standard treatment with chemotherapy and rituximab.

The Gallium study was the largest clinical trial ever conducted in follicular lymphoma, comparing the safety and effectiveness of two different anti-lymphoma antibodies (rituximab and obinutuzumab), in combination with chemotherapy for consumers with previously untreated follicular lymphoma.

1202 consumers — including 30 at Monash Health, the largest recruitment site in Australia—were randomly selected to receive chemotherapy with rituximab or chemotherapy with obinutuzumab.

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MonashHeart and Monash University research wins trifecta of prizes

MonashHeart interventional cardiology fellow and Monash University PhD candidate Dr Abdul Ihdayhid was recognised for his ground-breaking research into coronary artery disease, receiving two highly prestigious awards in Perth in August. The two awards follow on from Dr Ihdayhid’s Young Investigator Award in July, at the Society of Cardiovascular Computed Tomography in Washington D.C.

Dr Ihdayhid was awarded the highly regarded Ralph Reader Prize at the annual scientific meeting of the Cardiac Society of Australia & New Zealand as well as the prestigious Geoff Mews Memorial Fellows’ Prize at the Australia & New Zealand Endovascular Therapies Meeting for his research into assessing the functional significance of coronary artery disease.


Our people

Monash Health farewells Board Chair Barbara Yeoh AMOn 27 June, more than one hundred people from Monash Health community came together to farewell our Board Chair, Barbara Yeoh AM.

Monash Health Chief Executive Andrew Stripp said how extremely fortunate Monash Health has been to have Barbara guiding the organisation through so many changes over the past nine years.

The event included a video, with special words from Chief Executive Andrew Stripp, Board Member Charles Gillies, Wurundjeri Elder Margaret

Gardiner, Professor Euan Wallace AM, Moorabbin Hospital Ladies Auxiliary President Pat Huggins OAM, Director of Nursing Hospital in the Community, Monash Health Community and Allied Health Jennine Harbrow, and the Minister for Health the Hon. Jill Hennessy MP.

Ms Hennessy said, “Barbara has done extraordinary things for Monash Health and for the entire community. She’s a champion for patients, she’s a champion for diversity, and she’s a champion for the workforce. We have been so lucky to have had her service.”

Andrew Stripp said, “Barbara has made an extraordinary commitment to health care, but I think one of her other achievements is her humanity and commitment to patient care and experience.”

Concluding the event, Barbara took the time to say thank you and farewell. She shared a quote from Winnie the Pooh, “How lucky am I to have something that makes saying goodbye so hard.”

Staff recognised at Monash Health awards

The Monash Health Awards is a chance to celebrate, recognise, and congratulate staff for outstanding work. Each year, nominations are received from across the organisation, in 12 award categories. Submissions exemplify excellence, innovation, quality, safety, and leadership.

In FY 2017-18, Monash Health hosted two separate award ceremonies; in August 2017 and June 2018.

Aboriginal Graduate and Cadetship Program wins national awards Aboriginal Graduate and Cadetship Program Coordinator, Judy Clayton, and Aboriginal Health Midwife and Aboriginal Graduate and Cadet

Congratulations to the winners of the 2017 and the 2018 Monash Health Awards:In 2017: Associate Professor Peter Poon, Jeff Chen, Janelle Finn, Dr Ramini Shankumar, Michelle Ravesi, Jacquie McBride, Alyce Cuman, Katrina Clarke, Annette Bezzant, Associate Professor Ronil Chandra, Dr Hashrul Rashid, General Medicine Unit, Accountable Care team, Dandenong Hospital, Fiona McAlinden, and Helen Stubbs.

In 2018: Jeff Chen, Dr Michael Gordon and the Early in Life Mental Health Service, Dr Atul Malhotra and The Stem Cell BPD Team, Associate Professor Peter Poon and The Supportive Chronic Conditions Care Team, Jacquie McBride, Kate Plowright, Dr Ramini Shankumar and The Dental Health Services team, Dr Christina Johnson and The Monash Doctors Education team, Dr Jacquie Taylor and The Monash Newborn Team, Anne Marie Hadley and the Patient eXperience Team, and Associate Professor Michelle Giles.

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Support Officer, Tracey Stephens, recently attended the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) conference on the Gold Coast to receive a partnership award and Sally Goold Award for individual excellence in nursing.

The CATSINaM Partnership Award is presented to organisations that actively establish culturally respectful, committed, and successful partnerships between their members and other organisations. This was awarded to the Monash Health Aboriginal Graduate and Cadetship program for its organisation-wide commitment to increasing the number of Aboriginal nurses and midwives employed within our service and for ensuring Aboriginal staff have access

to a range of career development and employment opportunities.

Tracey Stephens was also presented with the Sally Goold Award for individual nursing and/or midwifery excellence that recognises her achievements as an Aboriginal midwife who has made substantial contributions to the nursing and midwifery profession, and the health of Aboriginal and Torres Strait Islander Australians.

Length of Service awards celebrate our staff and volunteers In November, Monash thanked our many staff and volunteers at the annual Length of Service Awards. Over 540 certificates were presented throughout the day, a testament to our dedicated and passionate people.

Staff completing 10, 15, 20, 25, 30, 35, and 40 years of service were acknowledged, together with volunteers completing five years or more of service. One volunteer, Carlene Powell, was honoured for achieving an amazing 50 years of service with Monash Health.

People Matter Survey results In 2017, almost 3400 staff, or 31 per cent of our total employees, took the time to share their views as part of the People Matter Survey. In 2018, the response rate more than doubled to 4 per cent.

Release of the full 2018 results is pending, however the 2017 results presented excellent feedback, including: most staff believe the work they do is important, more staff observed managers driving a safety-centred culture, where patient care errors are handled appropriately, and more people report that they work in a fair and inclusive workplace.

Full results for 2017 were rolled out during the year at our People Matter Forums.

Using creative strategies to enhance patient wellbeing As part of the Monash Health Delirium and Dementia Initiative, a dedicated group of medical, allied health and nursing staff found creative ways to support patient care in the acute general medical units at Monash Medical Centre.

From left, Board member and in-coming Board Chair, Dipak Sanghvi, Board Member, Dandenong and District Aborigines Co-operative Ltd., Margaret Gardiner and Chief Executive Officer, Dandenong and District Aborigines Co-operative Ltd., Andrew Gardiner.


People with dementia and delirium are more vulnerable to falls and pressure injuries. Hospitals are unfamiliar environments, which often disrupt usual routines and can be disorientating. To meet the challenge of providing meaningful activities and engagement for people with a cognitive impairment in hospital, the general medical teams developed a dementia and delirium resource library.

A bake sale raised approximately $1300 to support patient wellbeing and engagement and helped to fund ‘dementia-safe’ sensory and tactile resources such as gel mats, a ‘plumber’s mate’ and magnetic building blocks. Other resources include reminiscence cards and a toss-and-talk ball activity to build on person-centred care, which can foster social and physical skills and collaboration between consumers, their family and the multidisciplinary team.

A range of ‘fidget blankets’ has also been created; used to provide sensory and tactile stimulation. People with dementia and other forms of cognitive impairment often find comfort in having something to keep their hands busy, especially those staying in an unfamiliar environment like a hospital. Fidget blankets can help people feel calm while keeping them occupied.

Monash Health hosted first Schwartz Round (19 Oct) Monash Health hosted its first Schwartz Round in November. The Schwartz Rounds are a multidisciplinary forum, where clinical and non-clinical staff can discuss social and emotional issues that arise in caring for consumers.

The program comes from The Schwartz Center for Compassionate Healthcare, an independent, non- profit organisation with more than 425 healthcare members in the US, Canada, Australia and New Zealand. The Centre was founded by Ken

Residential in Reach: Thinking outside the box - Highly Commended

Category: Secretary’s Award for improving integration of care for consumers with chronic and complex conditions

Oncopain Clinic: Provision of multidisciplinary rapid access cancer pain assessment and management - Finalist .

Schwartz, days before his death from cancer in 1995. His experience as a patient drove him to establish the organisation with the mission to promote compassionate care so that consumers and their caregivers relate to one another in a way that provides hope to the patient, support to caregivers and sustenance to the healing process.

In 2017, Monash Health became a member of the Schwartz Centre. A Schwartz Rounds Planning Committee, chaired by Associate Professor Andrew Block was then created to oversee all future rounds.

Dr Anjali Dhulia, Director Medical Services, said the program provided an important opportunity for staff to reflect on their experiences as caregivers.

“The Schwartz Rounds bring doctors, nurses and allied health caregivers as well as non-clinical staff together to discuss the human side of healthcare,” Dr Dhulia said.

“The purpose of Rounds is to understand the challenges and rewards that are central to providing care, not to solve problems or to focus on the clinical aspects of patient care.”

Monash Health recognised in the 2017 Victorian Public Healthcare Awards

The Victorian Public Healthcare Awards recognise and celebrate excellence, dedication and innovation in public health, health services and service initiatives that deliver informed and effective health care. Areas that received acknowledgement included:

Category: Excellence in CALD health

The GP Engagement Initiative: Building capacity in primary healthcare to respond to refugee health needs – Highly Commended

Category: Excellence in public sector aged care

A new world for nursing recruitment at Monash Health Monash Health began a six-month trial of a Centralised Recruitment Model (CRM) for all nursing and midwifery roles. With well over 7000 nursing and midwifery staff working at Monash Health, the CRM represents a collaborative new way of managing the recruitment of permanent and fixed-term nursing and midwifery roles. Clinical hiring managers have partnered with a dedicated recruitment specialist to support them in the end-to-end recruitment process.

The CRM partnership has helped to ensure only the best talent is recruited; more quickly and at a lower cost. The model also gives back valuable time to our clinical nursing hiring managers to provide exceptional care and an enhanced patient experience

Professors David Kissane, AC and Barbara Workman, AC recognised in Australia Day honoursProfessor David Kissane, Head of Department of Psychiatry, School of Clinical Sciences at Monash Health and Professor Barbara Workman Service Director for Rehabilitation and Aged Care at Monash Health were made Companions of the Order of Australia in the 2018 Australia Day Awards.

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Professor Barbara Workman received this award for her significant service to geriatric and rehabilitation medicine, as a clinician, academic and educator, and as a leader in the provision of aged care services.

Professor Kissane received his honour in recognition for his contribution to psycho-oncology and palliative medicine, as an educator, researcher, author and clinician, and through executive roles with a range of national and international professional medical bodies.

Diana Egerton-Warbuton inducted into Victorian Honour Roll of Women Associate Professor Diana Egerton-Warburton was inducted into the Victorian Honour Roll of Women in 2018.

Currently the Director of Emergency Research and Innovation at Monash Health, Diana has worked for almost three decades in Victorian emergency departments. She has trained and mentored a new generation of emergency medicine specialists and is passionate about developing women in leadership roles. She is Associate Professor with the School of Clinical Sciences at Monash University and the National Drug Research Institute at Curtin University. She has also advised Victorian and Commonwealth governments on alcohol and drug policy.

Diana’s research has always focussed on patient needs, with a particular interest in reducing alcohol harm. Diana served as President of the Australasian Society for Emergency Medicine from 1997 to 2000, where she was an advocate for the non-specialist workforce and recognised for her teaching, training, research, and public health achievements.

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Our community

Refugee Week 2018 In June we celebrated Refugee Week, which raises awareness about issues affecting refugees and recognises the valuable contribution refugees make to Australian society.

The theme of this year’s Refugee Week is #WithRefugees.

Monash Health has a long-standing commitment to improving the health of asylum seekers and refugees across Melbourne’s south-east. This is most strongly reflected in Monash Health’s multidisciplinary refugee service, Refugee Health and Wellbeing, located in Dandenong.

After years of working closely with local refugee communities, Refugee Health and Wellbeing has become familiar with stories of the tragic circumstances that bring asylum seekers and refugees to Australia. However, we have also experienced the many ways that refugee communities embrace new opportunities with strength, resilience, and determination through countless stories of success.

Refugee Week was a way for the organisation to reflect on the diverse journeys of others, consider our personal roles in creating a fair, just, and inclusive society, and celebrate the diversity that makes Australia a vibrant and culturally-rich nation.

Monash Health Annual General Meeting More than 100 people attended the 2017 Annual Meeting in November. Monash Health Board Chair Barbara Yeoh delivered the opening address, followed by a detailed account of the achievements and successes of the organisation presented by Chief Executive Andrew Stripp.

Mr Stripp reported on the organisation’s clinical, operational, safety, capital and financial results, including Monash Health meeting all of its service delivery targets within its 2016-17 operating budget of $1.7 billion.

Mr Stripp also shared patient stories and our progress on organisational-wide priorities, such as patient experience, response to family violence, aboriginal health, sustainability initiatives, research and innovation. He also spoke about opportunities and guiding principles as Monash Health develops its new strategic plan.

Keynote speaker was Dr Beth Wilson AM. A lawyer by training, Dr Wilson is an expert in mental health and a passionate consumer rights advocate. Dr Wilson spoke about Monash Health’s duties to its consumers, including the recently produced ‘Statutory duty of candour’, which recommends legislation which would ensure consumers and their families are told when and why things go wrong with their care.

Committed volunteer goes above and beyond Dayawati Lal has been volunteering at Dandenong Hospital since 2013. Originally from Fiji, it is part of Dayawati’s culture and Hindu beliefs to give back to the community in which she lives.

Dayawati is one of the first friendly faces you see when entering Dandenong Hospital, she provides important directions and guidance to consumers and their visitors. She also spreads hope and happiness with the delivery of flowers to the wards on Tuesday mornings.

But Dayawati wanted to do even more for Monash Health consumers. She came to her shift one afternoon with the funds to purchase a wheelchair. “I wanted to give something useful to the people who need help moving around the hospital,” she said.

We thank Dayawati and all of our committed volunteers who generously give their time to help consumers and their families.

Integrated Model for Responding to Elder Abuse at Monash Health In December, Monash Health launched a project to deliver an Integrated Model for Responding to Elder Abuse. The new model focusses on identifying and responding as part of a whole of health approach to elder abuse using a family centred approach, which engages both the person being abused and the person responsible.

This new initiative is a 12-month project funded by the Department of Health and Human Services through the Elder Abuse Prevention and Response Unit. The department has funded five trial sites throughout Victoria.

The integrated model of care includes four key components: workforce training, an Elder Abuse Prevention Response liaison officer, counselling and mediation (including financial counselling), and an elder abuse prevention network. Monash Health has partnered with like-minded organisations to help us achieve this, including St Vincent’s Hospital, the Bouverie Centre and FMC Mediation, and Counselling Victoria.


The Monash Health FoundationThe Monash Health Foundation partners with the community through philanthropy to support the incredible work of Monash Health.

Generous giving from individuals, organisations, and passionate fundraisers has enabled the purchase of state-of-the-art equipment, investment in research and provided additional comfort and wellbeing programs for consumers and their families.

Thank you to every person, family and organisation that has helped make a difference to our consumers through generous donations.

2018 has been a great year as we have built on the successful events of the past, forged new partnerships and strengthened our community of philanthropy. Through the launch of the Imagination Appeal we have reached new donors and inspired many to continue their support.

We are particularly grateful to the people, groups and organisations who have supported Monash Health through direct gifts or by dedicating their time and energy to organising extraordinary events that have lasting impact:

• The inaugural Premier’s Golf Day was held in support of the Monash Children’s Hospital NICU. Over $400,000 was raised to purchase new equipment including a state-of-the-art transportation cot. The event was supported by Victoria’s property development community and was attended by the Honourable Daniel Andrews MP, Premier of Victoria along with cricket legends Ian Botham and Dean Jones.

• Bailey’s Golf Day has raised over $3 million to fund paediatric oncology fellows at the Monash Children’s Hospital Cancer Centre.

• The 2nd annual My Room Footy Show Telethon was held in August. Funds raised by My Room have been committed to support a Clinical Research Training program,

Dietetics, Physiotherapy, a 3D pain distraction system, and patient families undergoing long term treatment.

• Lincoln and Veronique Wulff and the Dandelion Wishes Gala Committee for their ongoing dedication and commitment to paediatric health, now in its third year, the annual gala has raised over $1.2 million for the Monash Children’s Hospital. Funds from this year’s event purchasing an echocardiograph for the Paediatric Intensive Care Unit.

• The Friends of the Children Foundation who continue to support the Monash Children’s Hospital through their fundraising and involvement in The Walk for Monash Children’s Hospital which raised nearly $200,000 this year.

• Richard Lim and the Cambodian community came together to celebrate the inaugural Lim’s Pharmacy Charity Dinner Dance raising over $100,000 for Monash Health and Monash Children’s Hospital.

• The annual Monash CF Foundation Charity Golf held at Cheltenham Golf Club, led by Felicity Stretch and her dedicated volunteers raised over $12,600. The funds support the Cystic Fibrosis service at Monash Children’s Hospital and Monash Health which treats over 230 kids & adults with Cystic Fibrosis.

• Jennifer Herbert who is currently undergoing treatment for cancer, wanted consumers in the public health system to have the same options for treatment as those in private hospitals. Jennifer has inspired generosity from others and raised an amazing $81,000 to purchase two scalp cooling machines that preserve a patient’s hair during chemotherapy.


Acknowledgment65km for Cystic Fibrosis Committee

ALH Group Pty Ltd

Amgen Australia Pty Ltd

Anna Marsenovic

Anna Wang

Anthony Bellgrove

Anthony Caligiuri Director – Mt Atkinson Holdings

ANZAPP Vic

ASL Real Estate

Bailey’s Day

BankVic

Beletti Restaurant Cafe Bar

Berwick Opportunity Shop

Blueways Group

BMF Construction

Boston Scientific

Brent and Jessica Cameron on behalf of Brooke Cameron

Cambodian Community MCH Fundraising Event

Camp Quality

Cancer Council Victoria

CEPIA – Cardiac Electrophysiology Institute of Australasia

Chain Reaction

Channel 9

Children’s Cancer Foundation

Chobani

City of Casey

Collier Charitable Fund

Cystic Fibrosis Community Care

Dandelion Wishes Gala Committee

Effie Atkins’ Dr Hope

Estate of Doris and Rupert Joseph

Estate of EC Blackwood

Estate of Ernest Finlay Burns

Estate of John Frederick Wright

Estate of John Lambrick

Estate of Lindsay James Baldy

Estate of Martin and Isobel McLoughlin

Estate of Maxwell John Bradford

Estate of Muriel Bradley

Estate of Eva Tidswell

Estate of William and Mary Levers & Sons Maintenance Fund

Estate of William Macrow

Exclusive Networks

First State Super

Freemasons Foundation Victoria

Friends of the Children Foundation

Giac Hoang Pagoda

HESTA Superfund

Indimax Productions

INKA Surgical Instruments

Jennifer Herbert

John Kilpatrick

John Plumridge – MAW Civil Pty Ltd

Julie Biggar

K Henzen

KARL STORZ Endoscopy Australia

Kaspersky Lab

Kids with Cancer Foundation Australia

Lady Marigold Southey AC

Lim’s Parmacy

Lincoln & Veronique Wulff

Lions Club of Clarinda

Lions Club of Dandenong Supper – District 201V5

Lions Club of Waverley

Lotus Oaks Development

Louis and Lesley Nelken Trust Fund

Mary MacKillop Foundation

Maxxia

Mazda Foundation

McGrath Foundation

Medical Indemnity Protection Society (MIPS)

Medtronic Australasia Pty Ltd

Melbourne Racing Club Foundation

Mercedes-Benz Berwick

Miei Fiori

Moller Family Foundation

Monash Cystic Fibrosis Foundation

Monash Plastic & Reconstructive Surgery

Monash University

Moorabbin Hospital Ladies Auxiliary

Moose Toys

Mr Rolf Burggraaff

My Room

Paragon Financial Group

Patterson Cheney

Pellicano Property & Constructions

Premier’s Golf Day

Redkite

Rombotis Event Trust

Rotary Club of Endeavour Hills

Rubbermaid (Newell Brands)

Sam Polimeni

Scleroderma Victoria Inc.

Scottish Pacific

Sparkling Car Wash

Spicer Thoroughbreds

Stihl Shop Ferntree Gully

Stockwood Building Group

Thai Hoa Long

The Appu Family

The Flinders Group (Tass & Tina Arhon and Steve Panopoulos)

The Foundation for Aids Research (amfAR)

The Garry White Foundation

The Honda Foundation

The Miranda Foundation

The Monash Kids Support Group

The Ricky Taylor Foundation Inc.

The Teo Chew Chinese Assoc. of Vic.

The Walt Disney Company

The Wood Family

Thi Ly

Tom and Margo Hartley

Unicharm Australasia

Watsons

Yan Wo Tong Chinese Medicine Centre

Zagame Automotive Group.

Thank you The Monash Health Foundation acknowledges the generosity of all the people who have supported the work of Monash Health throughout the year.

In particular, we extend our gratitude to those who have raised funds in celebration of a special occasion or have given a gift in memory of a loved one.

Our auxiliary members have, as always, worked tirelessly to raise funds for Monash Health. The extraordinary commitment from this wonderful group of people to support our Monash Health consumers continues to inspire generosity from our community.

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A journey starts with one small step

of life for their children. This was the driving factor and the motivation to work tirelessly to raise money to support research into CF.

Cystic fibrosis is a complicated disease, it primarily effects the lungs and digestive system and there is currently no cure.

Monash Health provides lifetime care for over 200 adults and children with cystic fibrosis. Every year, an average of eight newly diagnosed babies are referred to Monash Health’s Cystic Fibrosis clinic.

Funds raised from the 2017 event have funded three research projects we hope will have a lasting impact on the lives of these consumers.

• Studying the impact of DNase with early stage lung disease to decrease inflammation and infection. This project has the potential to improve the long-term outcome in children with CF

• Investigating the effect of an innovative treatment to improve sinus symptoms, quality of life,

After significant planning and organisation, Susan Biggar, Julie Noorman and Kathy Ryan, (all CF Mums) launched ‘65km for Cystic Fibrosis’ (www.65kmforcf.com.au), a 65km endurance walk to raise funds for research. The event exceeded their own expectations both in terms of participation and fundraising.

As parents of children living with CF, these extraordinary mums know the value of research to improve the quality

Seven years ago, three mums decided to make a difference and raise funds to support vital research into cystic fibrosis (CF).

and the amount of infections for people living with CF and sinus disease

• Develop the optimal, patient-centred model of care for people with cystic fibrosis Related Diabetes.

The small but amazing team continue their unwavering commitment to the cause, raising over $600k since 2013 and funding more than 10 research projects.

The team has now been joined by Sue Emery and Phil Ryan which has seen the event grow in its participation rates and success, remarkably raising over $147,000 in 2018. The Committee will work with health care professionals, researchers, and the CF community to determine priority projects for consideration with funding from this year’s event.

In 2016, the team was awarded the Premier’s Volunteer of the Year, Dame Elisabeth Murdoch Award for Teamwork, for their inspiring contribution.

It is truly inspirational to witness and support such dedicated fundraisers.Matthew Hannan, Monash Health Foundation

‘65km for Cystic Fibrosis’ Committee members, from left, Julie Noorman, Susan Biggar, Kathy Ryan and Sue Emery.


Monash Health provides services to almost a quarter of metropolitan Melbourne’s population. We also play a significant role in providing regional and state-wide specialist services in Victoria.

Casey Hospital Casey Hospital is a 273-bed hospital serving one of the fastest growing areas in Melbourne’s south-east. Services include an emergency department, general medical, mental health, rehabilitation, surgical and ambulatory care services, maternity, and a special care nursery. The hospital is a provider of paediatric services for Monash Children’s Hospital and gives access to the leading cardiac services of MonashHeart.

Cranbourne Centre Cranbourne Centre provides a range of same-day acute and subacute services including surgery, renal dialysis, specialist consulting services, regional ophthalmology services and mental health services. It also provides the local community with access to community health services and a community rehabilitation centre.

Dandenong Hospital Dandenong Hospital is a 573-bed acute hospital providing a wide range of health services to the people living and working in Dandenong and its surrounding areas. The hospital provides a number of general and specialist services. These services include general medical and surgical, an intensive care unit, MonashHeart cardiac care centre, rehabilitation and aged care services, pathology, radiology, maternity unit, special care nursery, children’s services, outpatients, day chemotherapy, home haemodialysis, mental health services, and allied health services. Dandenong Hospital also provides

specialist services including orthopaedic, plastics, vascular, facio-maxillary, gynaecology, respiratory, and infectious diseases.

Kingston Centre Kingston Centre is a 213-bed subacute facility specialising in high-quality rehabilitation, functional restoration, transitional care and aged mental health. The highly regarded rehabilitation program focuses on restoring function after illness or injury with the full range of allied health services provided to adults of all ages. The centre provides specialist services for older people including aged care assessment, cognitive dementia and memory services. It also offers a Falls and Balance Clinic, Pain Clinic, clinical gait analysis, and continence service. It is at the forefront of research into movement and gait disorders, aged mental health and geriatric medicine.

Monash Medical Centre Clayton Monash Medical Centre Clayton is a 640-bed teaching and research hospital, providing a comprehensive range of specialist surgical, medical, allied health and mental health services to the community.

Specialist units include coronary care, intensive care and neonatal intensive care.

The hospital is designated a national provider of renal and pancreatic transplants, and statewide provider of Thalassemia and children’s cancer services.

Our sites, services and staff

It is the base for MonashHEART, a centre of excellence in cardiac assessment, treatment and research; and Monash Children’s, Hospital.

Uniquely offering maternity and newborn services integrated on the one site, Monash Medical Centre provides one of Victoria’s largest women’s health services. It is also renowned for men’s health services.

Moorabbin Hospital

Moorabbin Hospital is a 147-bed hospital incorporating Monash Cancer Centre, one of Victoria’s leading cancer treatment centres, and operating in partnership with Peter MacCallum Cancer Centre. The hospital also offers elective surgery, short-stay care and dialysis. Home to Victoria’s first Patient Simulation Centre, the hospital plays a major role in the education and training of undergraduate and postgraduate medical students, nurses, and allied health professionals. The hospital hosts the Southern Melbourne Integrated Cancer Services and is a centre for research, and in particular, a major contributor to cancer-related research.

Monash Children’s Hospital Monash Children’s Hospital (MCH) is a network of paediatric healthcare services across three sites – the main Clayton campus (co-located with Monash Medical Centre), together with satellite sites at Dandenong and Casey Hospitals.

MCH has Victoria’s largest Neonatal Intensive Care Unit and provides leading paediatric services in rehabilitation, oncology, paediatric intensive care unit, and palliative care.

Our sites

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Our servicesMonash Health provides more than 250 uniquely integrated community and hospital-based services focusing on improving the health of our community through:

• Prevention

• Early intervention

• Community-based treatment and rehabilitation

• Highly specialised surgical and medical diagnosis, treatment and monitoring services

• Hospital and community based mental health services

• Comprehensive aged care programs

• Aged residential services

• Palliative care.

Aged residential care and targetted programsAged residential care is provided at: Allambee Nursing Home; AG Eastwood Hostel; the Kingston Centre (Cheltenham); Chestnut Gardens Aged Care (Doveton); Yarraman Nursing Home (Noble Park); and Mooraleigh Hostel (East Bentleigh), collectively providing 249 aged and aged mental health residential beds. Comprehensive aged care programs are provided across our acute and community based services, including aged mental health, and our aged and community care program (Dandenong).

Community-based rehabilitation services Community rehabilitation services are provided from centres at Kingston, Clayton, Doveton, Springvale, Dandenong, Cranbourne and Pakenham and in clients’ homes through the Rehabilitation in the Home services.

Community services Community services are provided across the catchment. Our staff are located across 11 major sites (Cranbourne Centre and Mundaring Drive, Cockatoo, Doveton, Kingston, Berwick, Clayton, Pakenham, Parkdale, Springvale, and Thomas Street, Dandenong). A range of services are provided at each site by multi-disciplinary teams of allied health workers including physiotherapists, podiatrists, occupational therapists, dieticians, our services counsellors, speech pathologists, nurses, health promotion practitioners, and exercise physiologists. Co-located services include dialysis, dental, pregnancy care clinics, and adult mental health. We also facilitate group programs to support respite, social inclusion, and improved health. Some of our services are targeted at specific populations in our community and are led by experienced staff in these fields. This includes aged care, Aboriginal health, refugee health, youth and other vulnerable groups. Self-management is central to our care - we aim to empower and prepare clients to manage their health and healthcare across all levels of the care continuum. Community Support Options provide personalised services to assist people who are aged or have a disability to remain in their own homes. Respite services are also provided to support carers.

Hospital and community-based mental health services Mental health services are provided through hospital and community-based facilities. Our services for children, youth and adults experiencing mental health issues include: the Monash Health Drug and Alcohol Service; a telephone psychiatric triage service; community and inpatient perinatal, child and youth services; crisis assessment and treatment teams and enhanced crisis assessment and treatment teams; consultation liaison psychiatry; psychological medicine; mental health Hospital in the Home, community care teams; mobile support and treatment services; acute inpatient care; secure extended care services; perinatal infant service including an inpatient unit; eating disorders services; gender dysphoria services, prevention and recovery care services; and community residential and rehabilitation services.

Hospital in the Home Hospital in the Home operates a ‘140-bed’ virtual acute ward from consumers’ homes or residential care facilities. In-home care is provided by medical and nurse practitioners to people who require acute care, but can safely receive it in their home environment.


Operational structure

Executive Director Innovation, Patient Safety & Experience / Chief Medical Officer

Erwin Loh

Clinical Programs

• Pathology

• Pharmacy

• Radiology

Other

• Medical Workforce

• Appointment

• Credentialing

• Medical Education

• Library

• Simulation Centre

• Patient Experience Office

• Patient Safety, Innovation & Strategy

• Business Intelligence

• Centre for Clinical Effectiveness

• Clinical Analytics

• Clinical Governance

• Innovation & Redesign

• Strategy & Planning

Executive Director Residential Care & Support Services/ Chief Nursing & Midwifery Officer

Cheyne Chalmers

Clinical Programs

• Residential Care

• Campuses

• Hostels & Nursing Homes

Other

• Monash Bureau

• Nursing & Midwifery

• Education & Workforce

• Security

• Support Services

Executive Director Research Strategy

Erwin Loh (interim)

Clinical Trials

• Monash Health

• Translation Precinct (MHTP)

• Research Governance

• Research Strategy

Chief Operating Officer

Martin Keogh

Clinical Programs

• Acute Medicine, Subacute & Community

• Children’s

• Mental Health

• Specialty Medicine, Cancer & Intensive Care

• Surgery & Interventional Services

• Women’s & Newborn

Campuses

• Casey Hospital

• Community Sites

• Cranbourne Centre

• Dandenong Hospital

• Kingston Centre

• Monash Medical Centre & Monash Children’s Hospital

• Moorabbin Hospital

Other

• Emergency Management & Business Continuity

• Health Information Services

• Patient Flow Unit

Executive Director Financial Services / Chief Financial Officer

Stuart Donaldson

• Budget

• Clinical Costing

• Finance

• Payroll

• Revenue

Chief ExecutiveAndrew Stripp

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Executive Director Information Development

Emilio Pozo

• Information Technology Services

• Electronic Medical Record

Executive Director People & Culture

Karen Lowe

• Diversity & Inclusion

• Employee Development

• Employee Health & Wellbeing

• Employee Relations

• People & Culture

• Recruitment & Retention

• Occupational Health & Safety

Executive Director Capital & Infrastructure

Geoff McDonald

• Biomedical Engineering

• Capital

• Engineering

• Infrastructure

• Property

Executive Director Communications & Engagement

Louise Kanis

• Public Relations

• Communications

• Government & community relations

• Media relations

• Internal and corporate communications

• Brand & marketing

• Web and digital communication

• Project communication

Executive Director Corporate Services & Governance / Chief Legal Officer

Katherine Lorenz

• Audit

• Compliance

• Corporate Governance

• Fraud Control

• Freedom of Information

• Insurance

• Legal Services

• Medicolegal

• Commercial

• Employment

• Procurement

• Retail

• Risk

• Monash Health Foundation

Office of the Chief ExecutiveStuart Cavill (Acting) – Chief Allied Health Officer

Amanda Nolan – Executive Advisor Business

Sara Golubenko – to June 2018 – Reform: Executive Advisor Chief Executive


Jessie McPherson Private Hospital

This affiliation also provides Jessie McPherson Private Hospital consumers access to world-renowned research and teaching facilities.

Jessie McPherson Private Hospital provides quality healthcare for people in Melbourne, regional Victoria, interstate, and overseas. As one of only a few private hospitals to provide tertiary level services in Victoria, Jessie McPherson Private Hospital has preferred provider agreement status with all major health funds.

Jessie McPherson Private Hospital offers specialist services including cardiology, cardiothoracic surgery, neurosurgery, vascular, gastro-sciences, general medicine and respiratory, high acuity maternity and neonatal services.

The co-location of the hospital with Monash Medical Centre provides consumers with access to a wide range of additional services and facilities such as pharmacy, pathology and diagnostic imaging.

Jessie McPherson Private Hospital is a 103-bed tertiary level private hospital and a subsidiary of Monash Health. The hospital is proud to have a team of highly skilled and dedicated staff and is equipped with some of the best medical facilities in Victoria.

Safe patient care is the number one priority at Jessie McPherson Private Hospital and processes are in place to provide the best patient outcomes. The hospital’s ‘Point of Care Goals’ were developed following input from Jessie McPherson Private Hospital staff and consumers about what constitutes safe and quality care. These goals reflect what consumers’ value about healthcare access and delivery, and how this translates into exceptional care, for every patient, every time.

Jessie McPherson Private Hospital is one of a select few private hospitals accredited as a TAVI Hospital, this means that we are able to offer an alternative to open heart surgery for aortic stenosis patients.

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A rapid recovery for Brendan

After developing symptoms, Brendan’s doctor picked up on a problem with his heart and he was referred to MonashHeart Interventional Cardiologist, Dr Ben Dundon.

finding himself out of breath doing everyday tasks like walking up a hill. It became increasingly worse.

Brendan was then considered for a TAVI procedure and admitted to Jessie McPherson Private Hospital in November 2017. The procedure was carried out the following day in the MonashHeart Cath Lab and Brendan was home by Friday and back at work the following week.

Brendan has since returned to all the activities he enjoys.

Dr Dundon’s assessment confirmed Brendan required coronary angioplasty, and he then had a stent inserted at the MonashHeart Cath Lab followed by a stay on the Cardiac Ward at Jessie McPherson Private.

Whilst the stent improved his symptoms, Dr Dundon informed Brendan his aortic valve was not functioning as it should and may require treatment in the near future.

Over the course of 2017, Brendan noticed his condition worsening, he was struggling to remain active,


Our staff

As an equal opportunity employer, Monash Health is committed to a fair and non-discriminatory workplace that maximises the talent, potential and contribution of all employees. We act with fairness, dignity and empathy for each other and for consumers.

We value honesty, openness and taking responsibility for our performance. We aim for and recognise innovation, quality and professionalism. All our staff remain firmly committed to our iCare values: integrity, compassion, accountability, respect, and excellence.

We are continuing our commitment to conducting safety inspections with participation from Health and Safety Representatives and management. We are working to ensure ongoing consultation and engagement at all levels of Monash Health to continuously improve our occupational health and safety performance.

Staff numbers

We are continuing our commitment to conducting safety inspections with participation from HSRs and management to ensure consultation and engagement at all levels of Monash Health. All new initiatives seek to ensure Monash Health continuously improves occupational health and safety performance.

Occupational violence statistics

2016-17 2017-18WorkCover accepted claims with an occupational violence cause per 100 FTE

0.37 0.35

Number of accepted WorkCover claims with lost time injury with an occupational violence cause per 1,000,000 hours worked

2.17 1.71

Number of occupational violence incidents reported

850 1327

Number of occupational violence incidents reported per 100 FTE

7.83 11.47

Percentage of occupational violence incidents resulting in a staff injury, illness or condition

4.71 38.43*

* In previous years the percentage of occupational violence lost time injuries (LTIs) resulting in a staff injury, illness or condition were reported. This year the value includes all incidents not just LTIs.

WorkCover claimsNumber of standard claims by year

17 -18

16 -17

15 -16

14 -15

13 -14

12 -13

11 -12

10 -11

09 -10

08 -09

07 -08

171 177 148 176 130 166 166 151 152 165 174

Definitions For the purposes of the statistics the following definitions apply:

Occupational violence – any incident where an employee is abused, threatened or assaulted in circumstances arising out of, or in the course of their employment;

Incident – an event or circumstance that could have resulted in, or did result in, harm to staff;

Accepted WorkCover claims – accepted WorkCover claims that were lodged in 2017-18;

Lost time – at least one shift lost due to a work related injury or illness;

Injury, illness or condition – this includes all reported harm as a result of an incident, regardless of whether the employee required time off work or submitted a claim.

Our staff continue to provide quality health care to our community.

Labour category

June YTD**

FTE*

June Current month

FTE*

2017 2018 2017 2018

Nursing Services 4,799 4,968 4,970 5,111

Admin. & Clerical 1,624 1,698 1,681 1,771

Medical Support Services 1,102 1,179 1,145 1,233

Hotel & Allied Services 958 1,029 990 1,050

Medical Officers 186 188 191 192

Hospital Medical Officer 978 1,054 1,015 1,079

Sessional Med. Officers 324 348 330 373

Ancilliary Support Serv. 948 1,016 987 1,042

Grand Total 10,919 11,480 11,309 11,852

* Full-time equivalent (FTE) staff at Monash Health and Jessie McPherson Private Hospital as at 30 June 2018.

**Average monthly FTE for financial year.

Occupational health and safety statement Monash Health is committed to providing a safe and healthy working environment for our employees, contractors, volunteers and the public and we take all reasonable steps to control hazards and minimise risk of injury.

This year we have focused on the strategic approach of managing health and safety in the workplace with the development of our OHS Strategy 2018 – 2023 and the Action Plan for 2018/2019. For the first time lead and lag OHS targets have been established for Monash Health and will be reported monthly to all levels of the organisation.

Monash Health has continued with a proactive and supportive approach to occupational health and safety with a focus on support in the workplace. A series of eLearning modules have been developed for all staff and managers to increase awareness and provide guidance in completing tasks safely.

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Clinical governance reportMonash Health is a public health service; a body corporate established under Section 65P of the Health Services Act 1988, as amended in 2005 and listed in Schedule 5 of that Act.

Excellence is our standard Our Clinical Governance Framework outlines the structure and processes, leadership, and culture that are in place and the outcomes monitored to ensure we provide accountable, safe, effective, efficient patient-centred care underpinned by continuous improvement.

It is based on the Victorian Clinical Governance Framework (June 2017) and the Australian Safety and Quality Framework for Healthcare (December 2010).

Key quality indicators are available on dashboards customised for each ward, unit and program and prominently displayed on quality boards in all wards.

The health service performance against pre-determined quality indicators are tracked and reported monthly to Clinical Council, Monash Health Executive, and the Monash Health Board.


We recognise the compelling link between greenhouse gas emissions, climate change, and the resultant impact on our environment.

Monash Health has committed to actively contribute to the implementation of the Victorian Government’s policy to be net zero carbon emissions by 2050 and improve environmental sustainability.

Eco Champions CommitteeThe Monash Health Eco Champions Committee has represented Monash Health at the Victorian Green Health Round Table and Australian Nursing and Midwifery Federation Sustainability Conference.

Environmental sustainability reportMonash Health is committed to reducing our ecological footprint. Sustainability is one of the priorities of our 2018-23 Strategic Plan.

The Committee meets bimonthly with a comprehensive and growing representation inclusive of clinical and non-clinical staff.

Their outcomes this year include:

• Highlighting sustainability initiatives to encourage staff participation as well as to support sustainability messaging

• Regular contributions to the internal staff newsletter, keeping communications contemporary and relevant

• Development of training materials and displays to support staff education and promotion of environmental sustainability

• Running Keep a Cup drives to further encourage staff to reduce the amount of disposable cups used in our facilities

• Our retail providers continue to offer a discount to those staff who bring their own mug

• Engineering continues to roll out our LED lighting program

• Implementation of a building analytics program for Monash Children’s Hospital to ensure early detection of any Heating, Ventilation and Air Conditioning faults

• Employment of an energy performance management consultant to conduct a level 2 energy audit for Monash Medical Centre and Dandenong Hospital. This audit will identify any opportunities to improve our energy consumption for these facilities.

The Minister for Health and Ambulance Services, The Hon Jill Hennessy MP, is the responsible Minister.

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Bicycle Facilities Monash Health has invested to encourage our staff to ride to work by installing /maintaining a number of bike parking facilities and changing facilities. These include but are not limited to:

• Undercover and secure bike parking for 78 bikes at Monash Medical Centre

• Curved hoops at Casey Hospital near the Emergency Department. These are also available for the public

• Bike racks at Moorabbin and Dandenong Hospitals.

Cleaning without chemicalsOur Infection Control and Support Services team presented our ‘cleaning without chemicals’ approach to the New South Wales branch of the Australian Nursing and Midwifery Federation. The session provided nurses and midwifes with information on the program, how to make the change, and the benefits to using this system. The session received great feedback.

Recycling initiativesMonash Health continues to explore opportunities to increase our recycling rate. Despite changes to the recycling waste industry Monash Health still managed to recycle 1,104 tonnes of waste. This is equates to around 25% of all waste generated across Monash Health.

In addition Monash Health utilizes reusable sharps containers which saves between 10-15 tonnes of plastic going into landfill per year.

Our Dandenong and Clayton sites diverted 1.4 tonnes of single use instruments from our clinical waste stream. These are removed free of charge by a local metal recycler.

Grass roots initiativesPassionate staff drive local sustainability efforts in their areas or sites to raise awareness and contribute to the reduction of our environmental impact. Some of the staff-led activities this year included:

• Staff continuing to self-nominate to become sustainability champions in their own areas

• Our theatres continue to review the content of their prepacked theatre packs to eliminate any unnecessary items and reduce waste. They have been successful in reducing the number of hand towels in each pack that were otherwise thrown out

• Our Central Production Kitchen which produces over 7,500 meals per day, five days per week continued to work with their suppliers to reduce the amount of packaging coming into the facility switching from recyclable cardboard boxes to reusable plastic food crates for meat deliveries

• Dandenong Theatre is now recycling their PVC – oxygen masks and plastic tubing

• Paper reduction is supported by an ever expanding electronic access system to information/forms and learning materials. We have continued to roll QR readers for attendance records for training and meetings

• The Asset Sales Program is now in its 5th year. The program has recycled thousands of items, including kitchen, cleaning, workshop, audio visual, IT, medical and laboratory equipment that would otherwise have been waste disposed of in landfill.

Installation of hand dryersAn initiative to install hand dryers into high use public and staff toilets has commenced. These hand dryers are very energy efficient and result in a number of benefits including reducing the amount of paper hand towels used. This initiative also improves the presentation of our bathrooms with no hand towels being left on the floors, reducing slip hazards.

Garden MaintenanceThe gardens at Monash Health are maintained by our engineering department to ensure consumers, visitors and staff are able to enjoy the beautiful and relaxing garden spaces. This year our engineering department has engaged an arborist to ensure our trees are well maintained.


Our Board of DirectorsThe Board of Directors of Monash Health is appointed by the Governor-In-Council on the recommendation of the Minister for Health and Ambulance Services in accordance with the Health Services Act 1988.

Functions of the Board of Directors

The functions of the Board are:

• To monitor the performance of Monash Health

• To recommend the appointment of and determine the employment terms (including remuneration) of a Chief Executive

• To oversee the management of Monash Health and monitor the performance of the Chief Executive

• To develop statements of priorities and strategic plans for the operation of Monash Health and monitor their compliance

• To develop financial and business plans, strategies and budgets to ensure accountable and efficient provision of health services by Monash Health and its long-term financial viability, as well as to ensure they are adhered to

• To establish and maintain effective systems to ensure that health services meet the needs of the community served by Monash Health and that the views of users and providers of health services are taken into account

• To ensure that Monash Health operates within its budget and that its systems accurately reflect its financial position and viability

• To ensure effective and accountable systems are in place to monitor and improve the quality and effectiveness of health services provided by Monash Health

• To ensure any problems identified with the quality or effectiveness of the health services provided are addressed in a timely manner and that Monash Health continuously strives to improve the quality of the health services it provides and to foster innovation

• To develop arrangements with other agencies and health service providers to enable effective and efficient service delivery and continuity of care

• To establish the organisational structure, including the management structure, of Monash Health

• To establish and ensure the effectiveness of a Finance Committee, an Audit Committee, a Quality Committee, and other committees considered appropriate

• To facilitate health research and education and any other functions conferred on the Board by or under the Act.

Board committees The following committees support the functions of the Board of Directors:

Quality Committee

The purpose of the Quality Committee is to support the Board’s function of providing strategic leadership in relation to the clinical governance of quality and safety at Monash Health. It serves to ensure, on behalf of the Board, that the following broad objectives are fulfilled:

• Effective and accountable systems are in place to monitor and improve the quality and effectiveness of health services provided by Monash Health

• Any problems identified with the quality or effectiveness of the health services provided are addressed in a timely manner

• Ensure Monash Health continuously strives to improve the quality of the health services it provides and to foster innovation.

Audit Committee

The role of the Audit Committee is to advise the Board of Directors on audit matters and matters relating to the financial, accounting and legislative compliance, and the operational effectiveness and efficiency of Monash Health.

The committee also advises the Board on the level of business risk or exposure to which Monash Health might be subject and oversight of internal and external audit activities.

Membership of the committee includes:

• John Thomson Member 1 July 2016 to 30 June 2018

• Charles Gillies Member 1 July 2016 to 30 June 2018

• Sarah Ralph Member 2 March 2016 to 30 June 2018

• Jorden Lam Member 2 March 2016 to 30 June 2018.

Remuneration Committee

The principal role of the Remuneration Committee is to advise the Board of Directors on matters relating to the organisation’s remuneration policies and practices. In addition, the Remuneration Committee provides oversight with respect to succession planning for the Chief Executive and senior executive positions.


Aboriginal Health Strategic Partnership Committee

The Aboriginal Health Strategic Partnership Committee operates under the authority of the Monash Health Board of Directors and the Dandenong and District Aborigines Co-operative Limited Board of Directors. The Aboriginal Health Strategic Partnership Committee commenced in 2012 and was followed by a signing of the Statement of Intent and a Memorandum of Understanding between the two organisations.

The purpose of the Aboriginal Health Strategic Partnership Committee is to ensure a collaborative partnership between the Dandenong and District Aborigines Co-operative Limited and Monash Health.

The intent is to ensure that by working closely together we are able to better meet the health and wellbeing needs of our local Aboriginal and Torres Strait Islander communities.

The Aboriginal Health Strategic Partnership Committee shall:

• Ensure accountability and leadership in relation to all Aboriginal and Torres Strait Islander health matters

• Ensure a respectful and collaborative relationship between Monash Health and the Aboriginal and Torres Strait Islander community

• Oversee the implementation of the Monash Health Reconciliation Action Plan and Employment Plan

• Identify shared strategic opportunities and projects

• Monitor the Monash Health Aboriginal Health Data Report and relevant data from the Dandenong and District Aborigines Co-operative Limited

• Support the Aboriginal Health Working Group to achieve their goals.

During FY 2017-18, the committee has focussed on a few key priorities: Improving maternity and emergency care for Aboriginal and Torres Strait Islander people. Increasing Aboriginal employment at Monash Health has also been another key priority as we have a 2 per cent Aboriginal and Torres Strait Islander employment target.

Finance Committee

The role of the Finance Committee is to advise the Board of Directors on financial matters and to assist in the oversight of financial performance.

The Finance Committee reviews and makes recommendations to the Board regarding financial strategy, financial policies, annual operating and capital budgets, cash flow and business plans to ensure alignment with key strategic priorities and performance objectives.

Community Advisory Committee

The role of the Community Advisory Committee (CAC) is to provide direction and leadership to integrate consumer, carer, and community views into health services operations and strategic policy development; and to identify and advise the Board of Directors on priority areas and issues requiring a consumer, carer and/or community perspective.

The last 12 months have been a period of change for the committee saying goodbye to a number of committee members including Peter McDonald, Halina Gwizdzil, Catherine Rampant, Reg Shelly, Judy Little, Peter Vant Hooft and Debbie Williams (Board member). We also welcomed a new chair Lynda Condon and new committee members Zuben Rustomjee, Julie Noorman, Shabnam Safa, and Emma Burt. Continuing on the committee are Sharon Harris, Pauline Hopkins and Betty Wilderman (Vice Chair). The CAC has appreciated the enormous support from the Board Chair Barbara Yeoh and her commitment to consumer engagement at Monash Health.

Key Achievements

• Successfully supported Monash Health through the National Standards Accreditation process. Members were integral in National Standards planning, preparation and survey meeting with auditors to discuss the role and extent of consumer engagement and contributions to the many committees and working parties across the organisation

• Engaged in the development of equity and inclusion definition for Monash Health

• Commenced work around the review of the consumer participation framework following engagement from Safer Care Victoria who is developing a new state-wide framework

• Contributed to the strategic plan consultation process giving valuable feedback during key milestone points that have been incorporated into the plan

• Providing feedback into the proposed Monash Health Volunteer Ward Ambassador program

• Realignment of consumer representation on all of the organisations Clinical Governance Committees following the introduction of a new program structure.

• Currently co designing an improvement project to enhance the experience of consumers in the Emergency Department

• Completed CAC governance training

• Drove the development of a new Consumer Advisor Orientation / On boarding program.

Primary Care and Population Health Advisory Committee

The Primary Care and Population Health Advisory Committee provides strategic advice to the Board of Directors on matters specific to the primary care and population health of our local community. Membership comprises primary care and academic partners in our region and members of the Monash Health Board and management.

The committee has a particular focus on improving the health status of our community across focus areas such as the hospital primary care interface, models of care for high risk community members, health promotion, and, primary care research and education. In addition, there is a focus on the health and wellbeing of vulnerable groups such as refugees, Aboriginal and Torres Strait Islanders and culturally and linguistically diverse communities.

The Primary Care and Population Health Advisory Committee has continued to provide strong leadership to the development and implementation of Monash Health’s Chronic Disease Strategy Implementation Plan. This work builds on a foundation set in initial action areas of diabetes; chronic respiratory disease; management of advanced stage chronic disease; and oral health. Implementation of the strategy involves small collaborative cross-sector pilots in each area, bringing back key themes and learnings to inform initiatives to scale, and ultimately our healthcare system as a whole.

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Members of the Board of Directors

Ms Barbara Yeoh AMBSc (Hons), FAICD

• Chair, Monash Health Board• Chair, Remuneration Committee• Member, Finance Committee• Chair, Board Quality Committee,

June 2017• Member, Aboriginal Health Strategic

Partnership Committee

Term of appointment: July 2009 - 30 June 2018.

Ms Barbara Yeoh has more than 30 years experience as a director in both

Mr Charles GilliesBSc/BA, MBA, SF Fin, GAICD

• Chair, Finance Committee• Chair, Audit Committee• Member, Kitaya Holdings Board

Pty Ltd*

Term of appointment: July 2011 - current.

Mr Charles Gillies is co-founder of Jolimont Global Mining Systems which specialises in investing in mining technology companies.

Ms Debbie WilliamsFAICD, MBA, ME, BCom, GradDip in Health Services Management

• Chair, Primary Care and Population Health Advisory Committee

• Member, Community Advisory Committee

the public and private sectors across a broad range of industries. She is currently a Member of the AHPRA Agency Management Committee, Deputy Chair of the Victoria State Emergency Service and Deputy Chair of the Civil Aviation Safety Authority Audit Committee. Ms Yeoh is also a Principal Associate of Phillips KPA, specialist advisers to the education sector.

In 2015, Ms Yeoh was inducted into the Victorian Honour Roll of Women and received the CEO Magazine Chairperson of the year award which encompasses the public, private and not for profit sectors.

These companies compete in fast-moving, highly competitive global technology markets. As an active investor himself his approach has been to work closely with management to develop a plan to create economic value. He has been Director and Chairman of a number of technology and investment companies and has worked closely with CEOs and management teams, developing strategies and setting objectives and performance targets.

*Kitaya Holdings Pty Ltd operates Jessie McPherson Private Hospital.

Term of appointment: July 2009 - June 2018.

Ms Debbie Williams is a strategy consultant who brings extensive experience in healthcare management, corporate governance, business strategy development, mental health management and financial management. Ms Williams is President of Toy Libraries Australia.


Mr Dipak Sanghvi

• Member, Primary Care and Population Health Advisory Committee

• Member, Finance Committee• Member, Kitaya Holdings Board Pty

Ltd, March 2018 to June 2018

Term of appointment: June 2016 - current.

Ms Heather ClelandMBBS, FRACS (Plas)

• Member, Quality Committee

Term of appointment: July 2016 - current.

Ms Heather Cleland is a Plastic Surgeon who is currently head of the state-wide Victorian Adult Burns Service at the Alfred Hospital. In addition to clinical practice and service development, she is actively involved in clinical education, training, and

Ms Jorden LamLLM, LLB, BCom, GradDipLP, GAICD, SA Fin.

• Member, Audit Committee• Member, Community Advisory

Committee

Term of appointment: October 2016 - current.

Ms Jorden Lam is the Company Secretary & General Counsel at HESTA Super Fund, and also serves on the Board of BreastScreen Victoria and the Policy Committee of Women

Mr Dipak Sanghvi is a pharmacist who owns five pharmacies in Victoria. He is currently Chair of Member Benefits Australia Pty Ltd. Previous positions held include: President of the Pharmacy Guild Victoria Branch during 2006-2011, Chair of Gold Cross Products and Services Pty Ltd, Chair of Return of Unwanted Medicines, being a Board member of Guild Insurance and Superannuation, and Meridian Lawyers; as well as several other board positions in the community and pharmaceutical industry.

in Super. She has also previously served on the Community Advisory Committee for Ambulance Victoria. She is experienced in the development and implementation of corporate governance frameworks, regularly advises on director and trustee duties and is passionate about achieving high standards of governance practice in organisations. Ms Lam has previously practiced as a commercial lawyer with several leading firms, advising corporations across a range of complex matters. In 2015 she was a recipient of the Australian Financial Review’s “Young Executive of the Year Award”.

research. She has been instrumental in establishing the clinical quality Burns Registry of Australia and New Zealand, and chairs its steering committee. She is a Board member of the Australian and New Zealand Burns Association and Past President. She has served on various departmental and professional committees, and is a member of the Donor Tissue Bank Committee of the Victorian Institute of Forensic Medicine, member of the Court of Examiners of the Royal Australasian College of Surgeons and an Adjunct Senior Lecturer at Monash University.

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Dr Misty JenkinsBSc (Hons), PhD, MAICD

• Member, Quality Committee• Member, Aboriginal Health Strategic

Partnership Committee

Term of appointment: November 2016 - current.

Dr Misty Jenkins is a NHMRC fellow, biomedical scientist and laboratory head at Walter and Eliza Hall Institute for Medical Research, where she researches cellular immunology and new immunotherapies for cancer. Dr Jenkins has previously held postdoctoral positions at The

Ms Sarah RalphBA, LLB, LLM

• Member, Audit Committee• Member, Primary Care and

Population Health Advisory Committee

Term of appointment: November 2016 - current.

Ms Sarah Ralph is a partner of global law firm, Norton Rose Fulbright. Ms Ralph has practiced in employment

Emeritus Professor Hatem Salem AMMB, ChB (Mosul, Iraq), FRACP, FRCPA, MRCP (UK) MD (Monash), LRCP, MRCS.

• Chair, Quality Committee

Term of appointment: 1 August 2017 - current.

Hatem Salem is an Emeritus Professor at Monash University. Prior to this, Professor Salem was the Head of the Academic Department of Clinical Haematology at Monash University and the Head of Clinical Haematology at the Alfred Hospital. He served as President of Asia Pacific Society of Thrombosis and Haemostasis and past president and Executive Director of the

Universities of Cambridge and Oxford, and The Peter MacCallum Cancer Centre in Melbourne. Dr Jenkins was awarded the L’Oreal for Women in Science Fellowship (2013), was Tall Poppy of the year (2015) and won the Westpac/Australian Financial Review Top100 Women of Influence award (2016). In addition to her research career, Dr Jenkins brings experience in governance as a Director and Deputy Chair of The National Centre for Indigenous Genomics at ANU, previous Director of the Aurora Education Foundation, Ambassador for the Poche Centre for Indigenous Health and Chair of NHMRC Project Grant Review Panels.

and labour law for over 20 years and leads the firm’s national government practice. Ms Ralph regularly acts for public and private sector employers in complex employment matters including in the health sector. Ms Ralph’s experience includes working in government and the private sector in strategic and legal roles. Ms Ralph is a volunteer member of the Youth Support and Advocacy Service (YSAS) Risk and Audit Committee. Ms Ralph brings her experience in people management, corporate governance, and risk management to the Board.

Australasian Society of Thrombosis and Hemostasis. He is a senior Counsellor of the International Society of Thrombosis and Haemostasis.

In 2005, his vision and ability to develop leading clinical and research programs was recognised by the Victorian Government’s Public Healthcare Award, where he was the recipient of the Health Minister’s Award for Outstanding Individual Achievement.

In 2010, Professor Hatem Salem was awarded the Member of the Order of Australia (AM) for service to medicine in the field of haematology as a clinician, educator and researcher and also through the establishment of the Australian Centre for Blood Diseases.


Statutory complianceCarers Recognition Act 2012Monash Health is committed to partnering with and empowering our consumers.

We understand that our consumers, their families and carers need to play an active role in their own healthcare and in helping us improve the quality and safety of our services.

We take all practicable measures to ensure our employees and agents reflect the care relationship principles in developing, providing or evaluating support and assistance for persons in care relationships.

The Monash Health Consumer and Community Participation Policy provides an organisation-wide framework describing our approach to embedding relationship centred care and partnerships in our culture, recognising that everyone in the organisation has an impact on patient, family, carer and consumer experience.

Partnering with Consumers for an Exceptional Patient Experience education is mandatory for all new Monash Health staff both clinical and non-clinical. Our learning tools draw particular attention to the needs of carers and families.

Monash Health reports on how we engage with our consumers, their families and carers in the annual Quality of Care Report. That report is available on our website: http://www.monashhealth.org/page/monash_health_quality_account

There are no disclosures required to be made under the Carers Recognition Act 2012.

Compliance with the Building Act 1993Monash Health facilities are managed through site inspections, risk assessments and audits. Contracts are in place to maintain Essential Safety Measures and annual compliance audited by independent Registered Building Surveyors.

Building standards and condition assessmentsThe condition of our buildings is assessed through site inspections and condition audits by architects and consultant engineers on an ‘as needed’ basis. Fire audits and risk assessments are undertaken by consultant fire engineers to comply with the Department of Health and Human Services Fire Risk Management Guidelines Series 7.

Recommendations from fire audits are actioned through a series of projects developed in conjunction with the Department of Health and Human Services to maintain a high degree of fire safety. All bed-based facilities are audited on a five-yearly cycle.

Fire safety auditsThe five-yearly fire safety audit of Monash Health’s 12 bed based facilities was completed in June 2018.

Essential safety measures maintenanceContracts are in place to maintain all Essential Safety Measures elements at sites owned by Monash Health. Audits were performed at these sites by registered Building Surveyors to ensure compliance with Essential Safety Measures Maintenance regulations.

Action plans to rectify defects identified during the audits are currently in place. In accordance with regulatory requirements, service and maintenance records are kept to enable completion of an annual Essential Safety Measures Report for all properties owned by Monash Health. This provides confirmation that all Essential Safety Measures are operational at the required level of performance for the safety of these facilities.

Risk assessmentVictorian Managed Insurance Authority (VMIA) conducts site risk assessments (SRS) at Monash Medical Centre, Moorabbin Hospital, Kingston Centre, and Dandenong Hospital.

Risk treatment options generated from the SRS are monitored through action plans until they are completed.

Freedom of Information Act 1982Summary of requests received under the Act from 1 July 2017 to 30 June 2018.

Other (no documents found) 15Other (not proceeded with) 25Application fee not paid 0Not yet finalised 90Exemptions cited – total 230

Clause:

25 125A(5) 330(1) 1832(1) 633(1) 11933(2)(A) 333(4) 133(4)(a) 035(1)(a) 035(1)(b) 5638 24

http://www.monashhealth.org/page/monash_health_quality_account



49

Fees and charges

Application fees collected $40,271.20Application fees waived $12,439.20Copy charges collected $66,987.00Copy charges waived $7,640.30

Initial decision makersRachael Gillies, Release of Information Manager; Maija Dimits, Health Information Manager; Elaine Elliott, Health Information Manager; Monika Bosnich, Health Information Manager; Tammy O’Connor, Senior Corporate Counsel; and Elle Bethune, Corporate Counsel.

National Competition PolicyMonash Health continued to comply with the Victorian Government’s Competitive Neutrality Policy. In addition, the Victorian Government’s Neutrality Pricing Principles for all relevant business activities have been applied by Monash Health since 1 July 1988.

Protected Disclosures Act 2012 Monash Health has a procedure for protected disclosures and matters of this nature are referred to the Independent Broad-based Anti-Corruption Commission. Information is included in the ‘Patients & Visitors/Concerns and compliments’ section of the Monash Health Internet site for external parties and internally our staff policies and procedures provide direction for staff.

Safe Patient Care Act 2015Monash Health has no matters to report in relation to its obligations under section 40 of the Safe Patient Care Act 2015.

Victorian Industry Participation Policy Act 2003 The following information for contracts commenced and/or completed in the financial year must be disclosed under the Victorian Industry Participation Policy (VIPP) Act 2003 (Refer to FRD 25C Local Jobs First-Victorian Industry Participation Policy Disclosures in the Report of Operations):

• Two contracts valued at $22M were commenced but not completed in the financial year for which a VIPP Plan was required;

• Six contracts valued at $22.1M were commenced but not completed where a VIPP Plan was not required (due to nil to limited contestability)

1. Four are local by nature; and

2. Two are international by nature;

• Eight conversations were held with the Industry Capability Network that correspond with the registration and issue of an Interaction Reference Number.

Additional information available on request In accordance with FRD 22H, Monash Health confirms the items listed below have been retained by Monash Health and are available to the relevant Ministers, Members of Parliament and the public on request (subject to the freedom of information requirements, if applicable):

a. Declarations of pecuniary interests have been duly completed by all relevant officers;

b. Details of shares held by senior officers as nominee or held beneficially;

c. Details of publications produced by the entity about itself, and how these can be obtained;

d. Details of changes in prices, fees, charges, rates and levies charged by the Health Service;

e. Details of any major external reviews carried out on the Health Service;

f. Details of major research and development activities undertaken by the Health Service that are not otherwise covered either in the report of operations or in a document that contains the financial statements and report of operations;

g. Details of overseas visits undertaken including a summary of the objectives and outcomes of each visit;

h. Details of major promotional, public relations and marketing activities undertaken by the Health Service to develop community awareness of the Health Service and its services;

i. Details of assessments and measures undertaken to improve the occupational health and safety of employees;

j. A general statement on industrial relations within the Health Service and details of time lost through industrial accidents and disputes, which is not otherwise detailed in the report of operations;

k. A list of major committees sponsored by the Health Service, the purposes of each committee and the extent to which those purposes have been achieved;

l. Details of all consultancies and contractors including consultants/contractors engaged, services provided, and expenditure committed for each engagement.


Disclosure indexThe Annual Report of Monash Health is prepared in accordance with all relevant Victorian legislation. This index has been prepared to facilitate identification of the Department’s compliance with statutory disclosure requirements.

Legislation Requirement Page reference

Charter and purpose

FRD 22H Manner of establishment & relevant Ministers 39, 40

FRD 22H Purpose, functions, powers and duties 2 & 5

FRD 22H Initiatives and key achievements 6 & 7

FRD 22H Nature and range of services provided 28

Management and structure

FRD 22H Organisational structure 34 & 35

Financials and other information

FRD 10A Disclosure index 50 & 51

FRD 11A Disclosure of ex-gratia expenses 131

FRD 21C Responsible person and executive officer disclosures 52

FRD 22H Application and operation of Protected Disclosure 2012 49

FRD 22H Application and operation of Carers Recognition Act 2012 48

FRD 22H Application and operation of Freedom of Information Act 1982 48, 49

FRD 22H Compliance with building and maintenance provisions of Building Act 1993

48

FRD 22H Details of consultancies over $10,000 63

FRD 22H Details of consultancies under $10,000 63

FRD 22H Employment and conduct principles 38

FRD 22H Information and Communications Technology Expenditure 63

FRD 22H Major changes or factors affecting performance 67

FRD 22H Occupational violence 38

FRD 22H Operational and budgetary objectives and performance against objectives

56-57

FRD 22H Summary of the entity’s environmental performance 40, 41

FRD 22H Significant changes in financial position during the year 62

51

Legislation Requirement Page reference

FRD 22H Statement on National Competition Policy 49

FRD 22H Subsequent events 130

FRD 22H Summary of the financial results for the year 62

FRD 22H Additional information available on request 49

FRD 22H Workforce Data Disclosures including a statement on the application of employment and conduct principles

38

FRD 25C Victorian Industry Participation Policy disclosures 49

FRD 103F Non-Financial Physical Assets 94

FRD 110A Cash flow statements 74

FRD 112D Defined Benefit Superannuation Obligations 91

SD 5.2.3 Declaration in report of operations 52

SD 5.1.4 Financial Management Compliance Attestation 52

Other requirements under Standing Directions 5.2

SD 5.2.2 Declaration in financial statements 68

SD 5.2.1(a) Compliance with Australian accounting standards and other authoritative pronouncements

69-70

SD 5.2.1(a) Compliance with Ministerial Directions 68

Legislation

Freedom of Information Act 1982 48 & 49

Protected Disclosure Act 2012 49

Carers Recognition Act 2012 48

Victorian Industry Participation Policy Act 2003 49

Building Act 1993 48

Financial Management Act 1994 52

Safe Patient Care Act 2015 49


Data Integrity I, Andrew Stripp certify that Monash Health has put in place appropriate internal controls and processes to ensure that reported data accurately reflects actual performance. Monash Health has critically reviewed these controls and processes during the year.

Andrew Stripp Chief Executive Monash Health 17 August 2018

Conflict of Interest I, Andrew Stripp, certify that Monash Health has put in place appropriate internal controls and processes to ensure that it has complied with the requirements of hospital circular 07/2017 Compliance reporting in health portfolio entities (Revised) and has implemented a ‘Conflict of Interest’ policy consistent with the minimum accountabilities required by the VPSC. Declaration of private interest forms have been completed by all executive staff within Monash Health and members of the board, and all declared conflicts have been addressed and are being managed. Conflict of interest is a standard agenda item for declaration and documenting at each executive board meeting.


Compliance with Health Purchasing Victoria (HPV) Health Purchasing Policies I, Andrew Stripp certify that Monash Health has put in place appropriate internal controls and processes to ensure that it has complied with all requirements set out in the HPV Health Purchasing Policies including mandatory HPV collective agreements as required by the Health Services Act 1988 (Vic) and has critically reviewed these controls and processes during the year.


Financial Management Compliance attestation I, Mr Dipak Sanghvi, on behalf of the Board certify that Monash Health has complied with the applicable Standing Directions of the Minister of Finance under the Financial Management Act 1994 and Instructions.

Mr Dipak Sanghvi Chair, Board of Directors Melbourne 17 August 2018

AttestationsResponsible bodies declarationsIn accordance with the Financial Management Act 1994, I am pleased to present the report of operations for Monash Health for the year ending 30 June 2018.

Mr Dipak Sanghvi Chair, Board of Directors Melbourne 17 August 2018

53

Health Service DeliverablesStatus indicator Comment

Help people stay healthy by completing the Monash Health Integrated Health Promotion Plan to improve alignment of health promotion activities, including our refugee health services and therefore health outcomes for disadvantaged population groups through improved collaboration of organisations across Monash Health’s catchment area.

Achieved The Integrated Health Promotion Plan is complete and was submitted to the Department of Health and Human Services.

Build healthy neighbourhoods by establishing a regional Chronic Disease coalition with community partners including Primary Health Networks, general practice, community health and consumers in line with the Monash Health Chronic Disease Strategy.

Achieved In partnership with representatives of South Eastern Melbourne Primary Care Partnership and Southern Health Connect progress is underway against work plan milestones.

Target health gaps by continuing the implementation of Health Links – Chronic Care (Monash Watch) and evaluate to inform the future platform of service delivery.

Achieved The Health Links – Chronic Care (Monash Watch) evaluation report is complete.

Development of a Victorian Integrated Care Model will be undertaken in consideration of the Health Care Home Trial in south east Melbourne, in partnership with the South Eastern Melbourne Primary Health Network.

Reduce state-wide risks by implementing a Family Violence Education Plan in Monash Health’s emergency departments to improve support for victims of family violence; initially measured by the number of staff trained to respond.

Achieved Family Violence Education Plan is implemented in Monash Health’s emergency departments.

234 Emergency Department staff have received family violence education comprising 42 registrars and 192 nurses. A comprehensive training program continues.

Ensure fair access by establishing a contemporary elective surgery model of care including implementing pre-procedural care that is standardised and transparent in delivery, reducing the number of consumers whom are: on the elective surgery waitlist; and, on the elective surgery waitlist longer than their clinically recommended time.

In progress The new peri-operative co-ordinator model practices consistently across all specialties and the Treatment in Turn and Prioritisation of Review work is complete. The time taken to treat consumers continues to decrease.

The redesign program of work will continue in 2018-19.

Improve timely access to care by implementing a standardised model of care across Monash Health emergency departments, focusing on upfront senior decision making and timely progression of care to improve the number of emergency consumers whom are: transferred from ambulance to emergency department within clinically recommended time; and, seen within the clinically recommended time.

In progress The Prioritising Patient Care Pathway has been implemented and the Upfront Senior Decision Making model is in the process of implementation across all three emergency departments.

Ambulance Victoria offload performance has progressively improved since the beginning of the year, as has the number of presentations seen within clinically recommended triage times.


Statement of Priorities - Part A



Ensure fair access by developing and commencing implementation of a specialist consulting clinics redesign plan to ensure that clinics run efficiently and effectively, increasing the number of consumers who attend their first appointment within the recommended time.

In progress Specialist Consulting redesign work is well underway, including: minimising risks associated with delays to care through redesigning e-referral management; clinic demand and capacity planning; improved data management and reporting; and, significant expansion of the telehealth specialist consulting program.


Improve access by enhancing partnerships with residential care facilities to provide optimal in home care with a view to provide better care and prevent unnecessary emergency department admissions.

Achieved In partnership with South Eastern Melbourne Primary Health Network a new model was implemented to coordinate aged care services between hospital and aged care facilities.

Monash Health has increased its outreach services to residential aged care in alignment with Department of Health and Human Services mandatory reporting and HIP guidelines.

Plan and invest in the redesign of the Monash Medical Centre emergency department to provide appropriate segregation for adult, paediatric and mental health patients.

Achieved The design is progressing on schedule for the construction work to be tendered in early 2019.

Plan and invest in commencing construction of the Casey Hospital expansion, in line with the construction program.

Achieved Construction work is on track for the project to be completed in late 2019.

Unlock innovation by implementing an emergency department interactive dashboard to increase visibility of patient flow across Monash Health.

Achieved The emergency department Power Business Intelligence interactive dashboard is operational across the three Monash Health emergency departments.

Unlock innovation by further developing the Mental Health Hospital In the Home service provided through Casey Hospital.

Achieved Hospital in the Home activity for the Casey sector of Monash Health increased by greater than 25% in 2017-18.

Improve the traffic flows at Clayton through a redesign in collaboration with Vic Roads and local council.

Achieved The traffic redesign has been approved by VicRoads and the City of Monash. Design documentation is on schedule for tender in early 2019.

Unlock innovation by increasing access to care, teaching and research through the Monash Children’s Telesurgery Service to regional operating theatres and emergency departments at Latrobe Regional Hospital, Central Gippsland Health Service and Bairnsdale Regional Health Service.

Achieved The Monash Children’s telehealth service has increased access to care, teaching and research by increasing the number of telesurgery specialities, the number of consults, the number of calls to people’s homes, and the support provided in the Gippsland region by general practitioners, paediatricians, and allied health practitioners.

Strengthen the workforce by establishing interdisciplinary ward leadership teams to enhance local quality and safety improvement initiatives and the oversight of routine clinical practice.

Achieved The new ward governance model has commenced across Monash Health sites, with leadership teams formed, and program and ward quality and safety dashboards, available on both the quality boards in place in all wards and on the electronic quality and safety dashboards accessible via the intranet.

55


Strengthen the role and leadership of nurse managers through allocation of additional management time and education and training.

Achieved Nurse managers of 24 hour 7 day services have transitioned to full-time management positions. A new governance structure for all nurse managers is established and ongoing education and support is in place.

Strengthen the workforce by developing a five-tier education strategy to address occupational violence and aggression incidents (and implement): online training for managers to address bullying and inappropriate behaviour; and, online training for all employees which includes processes for reporting patient and employee safety concerns and escalation.

Achieved The occupational violence and aggression strategy, work plan and training are developed and accessible to all employees.

Prevent avoidable harm by developing and implementing a formal online training package to educate staff members that have patient contact on their obligations to report patient safety concerns, as measured by the number of staff trained and an increase in the number of reported incidents.

In progress Implementation of the Department of Health and Human Services training is in progress, and will continue into 2018-19.

Partner with consumers to put quality first by addressing priorities arising from the outcomes of the Victorian Healthcare Experience Survey:

• Discharge planning: Transition hospital to home: Implement “My Passport” and Teach Back training across adult inpatient wards and paediatrics.

In progress The rollout of “My Passport” and Teach Back training was completed for 24 wards across Monash Health, and will continue into 2018-19.

• Environment: Implement redesigned ward upgrade and cleaning programs for adult inpatient wards at Monash Medical Centre.

Achieved Redesigned ward upgrades and cleaning programs for adult inpatient wards at Monash Medical Centre were completed.

• Food services: Develop and implement a plan to address key drivers of the patient food experience, to commence implementation at Monash Medical Centre.

In progress The plan is developed and implementation has commenced in accordance with the work plan.


Statement of Priorities BHigh Quality and Safety indicator

Target2017-2018

Result

Accreditation

Compliance with NSQHS Standard accreditation Full Compliance Achieved

Infection prevention and control

Compliance with Hand Hygiene Australia program >=80% 81%

% of Health care worker immunised for influenza >=75% 78.0%

Patient experience

Victorian Healthcare Experience Survey - Percentage of positive patient experience reponses Quarter1

>=95% 88.4%


>=95% 89.6%


>=95% 85.6%

Victorian Healthcare Experience Survey - Percentage of positive responses to questions on discharge care Quarter1

>= 75% 70.4%


>= 75% 72.3%


>= 75% 68.5%

Victorian Healthcare Experience Survey - Patients perception of cleanliness Quarter1

>= 70% 59.2%


>= 70% 59.8%


>= 70% 58.0%

Healthcare associated infections

Number of patients with surgical site infection No outliers Not Achieved

ICU CLABSI (central line-associated blood stream infection) per 1000 line days - Clayton

Nill 0.70

ICU CLABSI (central line-associated blood stream infection) per 1000 line days - Dandenong

Nill 0.00

SAB rate (Occupied Bed days) <=1 per 10,000 0.6

57

Target2017-2018

Result

Adverse events

Number of sentinel events Nill 10

Mortality – number of deaths in low mortality DRGs2 Nill 0.02%

Mental Health

Percentage of adult inpatients who are readmitted within 28 days of discharge <=14% 13.6%

Rate of seclusion events relating to an acute admission - all age groups <=15 per 1000 8.1

Rate of seclusion events relating to a child and adolescent acute admission <=15 per 1000 16.1

Rate of seclusion events relating to an adult acute admission <=15 per 1000 9.9

Rate of seclusion events relating to an aged acute admission <=15 per 1000 0.1

Percentage of child and adolescent patients who have post-discharge follow-up within seven days

>=75% 91.3%

Percentage of adult patients who have post-discharge follow-up within seven days >=75% 88.3%

Percentage of aged patients who have post-discharge follow-up within seven days >=75% 98.5%

Continuing care

Functional independence gain from admission to discharge, relative to length of stay>=0.39(GEM)* 0.48

>=.65(Rehab) 0.79

Governance, leadership and culture - % of Staff with positive response to questions

Staff with an overall positive response to safety culture question >=80% 90%

I am encouraged by my colleagues to report any patient safety concerns I may have >=80% 95%

Patient care errors are handled appropriately in my work area >=80% 94%

My suggestions about patient safety would be acted upon if I expressed them to my manager

>=80% 91%

The culture in my work area makes it easy to learn from the errors of others >=80% 87%

Management is driving us to be a safety-centred organisation >=80% 93%

This health service does a good job of training new and existing staff >=80% 82%

Trainees in my discipline are adequately supervised >=80% 83%

I would recommend a friend or relative to be treated as a patient here >=80% 91%


Target2017-2018

Result

Emergency Care

Emergency - Casey Hospital

Percentage of ambulance patients transferred within 40 minutes >=90% 76.0%

Percentage of Triage Category 1 emergency patients seen immediately 100% 100.0%

Percentage of Triage Categories 1-5 emergency patients seen within clinical recommended times

>=80% 64.2%

Percentage of emergency patients with length of stay less than 4 hours >=81% 70.8%

Number of patients with a length of stay in the emergency department greater than 24 hours

0 2

Emergency - Monash Medical Centre




>=80% 60.0%



0 5

Emergency - Dandenong Hospital




>=80% 67.6%



0 7

Elective Surgery

Percentage of Urgency Category 1 elective patients removed within 30 days 100% 100%

Percentage of urgency category 1, 2 and 3 elective patients admitted within clinically recommended timeframes

>=94% 86.4%

% patients on the waiting list who have waited longer than clinically recommended time for their respective triage category

<=5% 11.5%

Number of patients on the elective surgery waiting list (end of June2018) <=5,050 5,859

Number of Hospital Initiated Potponements per 100 scheduled admissions <=8/100 7.6%

Number of patients admitted from the elective surgery waiting list – annual total 32,200 29,067

Access and timelines

59

* GEM is Geriatric Evaluation and Management

Target2017-2018

Result

Specialist Clinics

Percentage of urgent patients referred by a GP or external specialist who attended a first appointment within 30 days

100% 50.3%

Percentage of non-urgent patients referred by a GP or external specialist who attended a first appointment within 365 days

>=90% 96.5%

Financial sustainability

Target2017-2018

Result

Finance

YTD Operating Result ($m) $0.00 $0.04

Trade creditors <60 days 47 days

Patient fee debtors <60 days 43 days

Public & private WIES 3 performance to target 100% 95.4%

Adjusted Current asset ratio >=0.7 0.5

Number of days with available cash >=14 days 11 days


Statement of Priorities CActivity and Funding

2017-18 Activity Achievement

Acute Admitted

WIES Public 156,400

WIES Private 15,975

WIES (Public & Private) 172,375

WIES DVA 579

WIES TAC 740

WIES TOTAL 173,694

Acute Non-Admitted

Home Enternal Nutrition 4,245

Home Renal Dialysis - Home ABF 167

Radiotherapy Non Admitted Shared Care 138

Specialist Clinics - Public 223,703

Home Perinatal Nutrition 157

Subacute and Non-Acute Admitted

Subacute WIES - Rehabilitation Public 2,678

Subacute WIES - Rehabilitation Private/TAC/Workcover 442

Subacute WIES - GEM Public 1,809

Subacute WIES - GEM Private/TAC/Workcover 316

Subacute WIES - Palliative Care Public 408

Subacute WIES - Palliative Care Private 51

Subacute WIES - DVA 60

Transition Care - Occupied Bed days 17,331

Transition Care - Home day 10,176

61

2017-18 Activity Achievement

Subacute Non-Admited

Health Independent Program - Public 194,152

Aged Care

Residential Aged Care 33,524

HACC - Service Time Hours 51,594

Mental Health ( Occupied Beddays) and Drug Services

Mental Health Ambulatory 158,019

Mental Health Inpatient - Available bed days 58,725

Mental Health Inpatient - Secure Unit 16,384

Mental Health Residential 44,984

MH - Subacute 14,929

Drug services 1,771

Primary Health

Community Health/Primary Care Program -Service Time Hours 95,009

Other

NFC- Pancreas Transplants 14

Health Workforce 562


2018 2017 2016 2015 2014

Private 40 46 48 50 43

Transport Accident Commission - - - - -

Victorian WorkCover Authority (VWA) 67 98 96 127 117

Nursing Home 41 38 37 28 26

<30 days

31-60 days

61-90 days

>90 days

2017-18

2016-17

2015-16

2014-15

2013-14

Private 1,839 675 67 238 2,818 4,401 4,029 3,652 3,652

Transport Accident Commission

- - - - - - - - -

Victorian WorkCover Authority (VWA)

211 46 60 134 452 352 530 160 160

Nursing Home 346 63 33 121 563 642 801 650 538

Total 2,574 1,544 440 835 3,833 5,394 5,361 4,930 4,350

Average collection days

Inpatient debtors ageing

2018 $’000

2017 $’000

2016 $’000

2015 $’000

2014 $’000

Total Revenue 1,882,391 1,850,870 1,751,695 1,512,402 1,450,332

Total Expenses 1,877,401 1,754,104 1,647,800 1,528,277 1,428,992

Net Result for the Year (inc. Capital and Specific Items)

15 107,457 103,895 -15,875 21,340

Retained Surplus/(Accumulate Deficit) 127,978 133,689 32,982 -67,073 -50,995

Total Assets 1,813,045 1,715,387 1,591,476 1,420,199 1,405,432

Total Liabilities 583,887 522,107 505,698 463,422 433,922

Net Assets 1,229,158 1,193,280 1,085,778 956,777 971,510

Total Equity 1,229,158 1,193,280 1,085,778 956,777 971,510

Summary of financial results

63

Disclosure

Details of Information and Communication Technology (ICT) expenditure

The total ICT expenditure incurred during 2017-18 is $54.6 million (excluding GST) with the details shown below:

BAU ICT Expenditure

Total (excluding GST)

($’000)

Non-BAU ICT Expenditure Total = A+B

(Excluding GST) ($’000)

Operational Expenditure

A (Excluding GST) ($’000)

Capital Expenditure B (Excluding GST)

($’000)

$30,135 $24,479 $241 $24,238

2017-18 Disclosure of Consultancy Expenditure

Details of consultancies (under $10,000)

In 2017-18, there were 28 consultancies where the total fees payable to the consultants were less than $10,000. The total expenditure incurred during 2017-18 in relation to these consultancies is $117,288 (excluding GST).

Details of consultancies (valued at $10,000 or greater)

In 2017-18, there were 23 consultancies where the total fees payable to the consultants were $10,000 or greater. The total expenditure incurred during 2017-18 in relation to these consultancies is $1,587,973 (excluding GST). Details of these consultancies are listed below.

Consultants 2018 2017 2016 2015 2014

Consultants’ cost ($) 1,587,973 1,228,225 996,437 1,265,500 2,051,811

Total number of consultants 51 107 140 80 115


ConsultantPurpose of Consultancy

Start date

End date

Total approved

project fee ($’000)

Expenditure 2017-2018

($’000)

Ernst & Young Internal Audit and FBT Services

1/07/17 30/06/18 669 669

Press Ganey Associates Pty Ltd

Inpatient Surveying Consulting 1/07/17 30/06/18 187 187

Senateshj Information technology consulting

1/07/17 30/06/18 88 88

Pharmconsult Pty Ltd Consulting on Pharmacy 1/07/17 30/06/18 68 68

Madison Cross Australia Pty Ltd

Consulting for Organisational Growth and Development

1/07/17 30/06/18 58 58

Health Connexion Consulting for Transition Support Unit

1/07/17 30/06/18 54 54

Innovative Thinking It Unit Trust

Information technology consulting

1/07/17 30/06/18 52 52

The Ideal Consultancy Pty Ltd

Marketing Consulting 1/07/17 30/06/18 47 47

Mkm Health Pty Limited Information technology consulting

1/07/17 30/06/18 45 45

Cetec Pty Ltd Workplace safety review 1/07/17 30/06/18 45 45

Francis Group Consultants Aust Pty Ltd

Project consulting 1/07/17 30/06/18 44 44

Carney Associates Strategic Planning consulting 1/07/17 30/06/18 36 36

Opturion Pty Ltd Information technology consulting

1/07/17 30/06/18 34 34

Pitcher Partners Information technology consulting

1/07/17 30/06/18 30 30

Aquaklar Analytical Supplies

Workplace safety review 1/07/17 30/06/18 23 23

Alison Evans Consulting Strategic Planning consulting 1/07/17 30/06/18 18 18

Simpply Information technology consulting

1/07/17 30/06/18 16 16

65

AdvertisingMonash Health made no expenditure in Government advertising.

Car parkingMonash Health complies with the Department of Health and Human Services hospital circular on car parking fees and details of car parking fees and concession benefits can be viewed at: https://www2.health.vic.gov.au/about/news-and-events/hospitalcirculars/circ0515

Monash Health’s car parking fees and concession benefits can be found at: www.monashhealth.org

ConsultantPurpose of Consultancy

Start date

End date

Total approved

project fee ($’000)

Expenditure 2017-2018

($’000)

Hardes And Associates Consulting for Organisational Growth and Development

1/07/17 30/06/18 15 15

Novoture Pty Ltd Workplace Culture Review 1/07/17 30/06/18 14 14

Margaret Charlton Consulting for Organisational Growth and Development

1/07/17 30/06/18 13 13

Disability Services Consulting

Insurance Scheme Review 1/07/17 30/06/18 13 13

Cwh Mediation & Workplace

Workplace Review 1/07/17 30/06/18 10 10

Hambleton Family Trust Workplace Review 1/07/17 30/06/18 10 10

https://www2.health.vic.gov.au/about/news-and-events/hospitalcirculars/circ0515

https://www2.health.vic.gov.au/about/news-and-events/hospitalcirculars/circ0515

http://www.monashhealth.org

Financial statements and explanatory notes


Independent Auditor’s Report To the Board of Monash Health

Opinion I have audited the consolidated financial report of Monash Health (the health service) and its controlled entities (together the consolidated entity), which comprises the:

• consolidated entity and health service balance sheet as at 30 June 2018 • consolidated entity and health service comprehensive operating statement for the year then

ended • consolidated entity and health service statement of changes in equity for the year then ended • consolidated entity and health service cash flow statement for the year then ended • notes to the financial statements, including significant accounting policies • board member's, chief executive's and chief financial officer's declaration.

In my opinion, the financial report presents fairly, in all material respects, the financial position of the consolidated entity and the health service as at 30 June 2018 and their financial performance and cash flows for the year then ended in accordance with the financial reporting requirements of Part 7 of the Financial Management Act 1994 and applicable Australian Accounting Standards.

Basis for Opinion

I have conducted my audit in accordance with the Audit Act 1994 which incorporates the Australian Auditing Standards. I further describe my responsibilities under that Act and those standards in the Auditor’s Responsibilities for the Audit of the Financial Report section of my report.

My independence is established by the Constitution Act 1975. My staff and I are independent of the health service and the consolidated entity in accordance with the ethical requirements of the Accounting Professional and Ethical Standards Board’s APES 110 Code of Ethics for Professional Accountants (the Code) that are relevant to my audit of the financial report in Victoria. My staff and I have also fulfilled our other ethical responsibilities in accordance with the Code.

I believe that the audit evidence I have obtained is sufficient and appropriate to provide a basis for my opinion.

Board’s responsibilities for the financial report

The Board of the health service is responsible for the preparation and fair presentation of the financial report in accordance with Australian Accounting Standards and the Financial Management Act 1994, and for such internal control as the Board determines is necessary to enable the preparation and fair presentation of a financial report that is free from material misstatement, whether due to fraud or error.

In preparing the financial report, the Board is responsible for assessing the health service and the consolidated entity’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless it is inappropriate to do so.

69

2

Auditor’s responsibilities for the audit of the financial report

As required by the Audit Act 1994, my responsibility is to express an opinion on the financial report based on the audit. My objectives for the audit are to obtain reasonable assurance about whether the financial report as a whole is free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes my opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with the Australian Auditing Standards will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of this financial report.

As part of an audit in accordance with the Australian Auditing Standards, I exercise professional judgement and maintain professional scepticism throughout the audit. I also:

• identify and assess the risks of material misstatement of the financial report, whether due to fraud or error, design and perform audit procedures responsive to those risks, and obtain audit evidence that is sufficient and appropriate to provide a basis for my opinion. The risk of not detecting a material misstatement resulting from fraud is higher than for one resulting from error, as fraud may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal control.

• obtain an understanding of internal control relevant to the audit in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the health service and the consolidated entity’s internal control

• evaluate the appropriateness of accounting policies used and the reasonableness of accounting estimates and related disclosures made by the Board

• conclude on the appropriateness of the Board's use of the going concern basis of accounting and, based on the audit evidence obtained, whether a material uncertainty exists related to events or conditions that may cast significant doubt on the health service and the consolidated entity’s ability to continue as a going concern. If I conclude that a material uncertainty exists, I am required to draw attention in my auditor’s report to the related disclosures in the financial report or, if such disclosures are inadequate, to modify my opinion. My conclusions are based on the audit evidence obtained up to the date of my auditor’s report. However, future events or conditions may cause the health service and the consolidated entity to cease to continue as a going concern.

• evaluate the overall presentation, structure and content of the financial report, including the disclosures, and whether the financial report represents the underlying transactions and events in a manner that achieves fair presentation

• obtain sufficient appropriate audit evidence regarding the financial information of the entities or business activities within the health service and consolidated entity to express an opinion on the financial report. I remain responsible for the direction, supervision and performance of the audit of the health service and the consolidated entity. I remain solely responsible for my audit opinion.

I communicate with the Board regarding, among other matters, the planned scope and timing of the audit and significant audit findings, including any significant deficiencies in internal control that I identify during my audit.

MELBOURNE 20 August 2018

Ron Mak as delegate for the Auditor-General of Victoria


Monash Health Annual Report 2017/2018

Note Consolidated Consolidated

2018 2017$'000 $'000

Revenue from operating activities 2.1 1,776,667 1,667,804 Revenue from non-operating activities 2.1 3,709 2,759 Employee expenses 3.1 (1,299,663) (1,210,884) Non salary labour costs 3.1 (19,151) (16,447)

Supplies and consumables 3.1 (262,011) (268,549) Commercial activities 3.1 (62,215) (54,898) Other expenses 3.1 (137,384) (119,897) Share of net result of associates and joint ventures accounted for using the equity method 87 147 Net result before capital and specific items 39 35

Capital purpose income 2.1 101,928 180,160 Depreciation and amortisation 4.3 (77,310) (67,063) Specific expenses 3.3 (372) (667) Finance costs 3.4 (3,547) (3,739) Finance costs - self funded activity 3.4 (1,670) (1,734) Bad and doubtful debts expense 3.1 (2,762) - Expenditure using capital purpose income 3.1 (11,316) (10,226)

4,951 96,731 Net result after capital and specific items 4,990 96,766

Other economic flows included in net resultRevaluation of long service leave (4,975) 10,691 Total other economic flows included in net result (4,975) 10,691

Net result for the year 15 107,457

Other comprehensive incomeItems that will not be reclassified to net resultChanges in property, plant and equipment revaluation surplus 8.1a 35,000 - Total other comprehensive income 35,000 -

Comprehensive result 35,015 107,457

This Statement should be read in conjunction with the accompanying notes.

Monash HealthComprehensive Operating Statement For the Financial Year Ended 30 June 2018

71


Note Consolidated Consolidated2018 2017$'000 $'000

Current assetsCash and cash equivalents 6.2 160,932 116,009 Receivables 5.1 42,771 47,582 Inventories 5.2 17,320 15,742 Prepayments 2,087 2,893 Total current assets 223,110 182,226

Non-current assetsReceivables 5.1 90,917 81,717 Investments accounted for using the equity method 4.1 4,099 4,012 Property, plant and equipment 4.2 1,490,954 1,443,956 Intangible assets 4.4 3,965 3,476 Total non-current assets 1,589,935 1,533,161 TOTAL ASSETS 1,813,045 1,715,387

Current liabilitiesPayables 5.4 90,222 81,217 Borrowings 6.1 7,781 6,161 Provisions 3.5 320,839 279,912 Other current liabilities 5.3 15,044 12,619 Total current liabilities 433,887 379,909

Non-current liabilitiesBorrowings 6.1 85,797 83,418 Provisions 3.5 64,204 58,780 Total non-current liabilities 150,001 142,198 TOTAL LIABILITIES 583,887 522,107 NET ASSETS 1,229,158 1,193,280

EQUITYProperty, plant and equipment revaluation surplus 8.1a 676,545 641,545 Restricted specific purpose surplus 8.1a 20,715 14,953 Contributed capital 8.1b 403,920 403,093 Accumulated surpluses 8.1c 127,978 133,689 TOTAL EQUITY 1,229,158 1,193,280


Balance SheetFor the Financial Year Ended 30 June 2018

Monash Health


Mon

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73


Note Consolidated Consolidated

2018 2017$'000 $'000

CASH FLOWS FROM OPERATING ACTIVITIESOperating grants from Government 1,528,862 1,441,631 Capital grants from Government 52,966 118,650 Patient fees received 139,195 115,194 Private hospital fees received 47,517 47,929 Donations and bequests received 7,407 1,791 GST received from ATO 35,101 38,016 Recoupment from private practice for use of hospital facilities 12,987 11,696 Interest and Investment income received 3,710 2,759 Other receipts 36,178 53,102 Total receipts 1,863,923 1,830,768

Employee expenses paid (1,268,805) (1,213,970) Payments for supplies and consumables (282,833) (292,088) Finance costs (1,670) (1,734) Other payments (231,562) (211,354) Total payments (1,784,870) (1,719,146)

NET CASH FLOW FROM OPERATING ACTIVITIES 8.2 79,053 111,622

CASH FLOWS FROM INVESTING ACTIVITIESPurchase of intangibles, property, plant and equipment (44,908) (72,109) NET CASH FLOW USED IN INVESTING ACTIVITIES (44,908) (72,109)

CASH FLOWS FROM FINANCING ACTIVITIESRepayment of car park loan (1,647) (1,048) Loan from government 10,000 - NET CASH FLOW USED IN FINANCING ACTIVITIES 8,353 (1,048)

NET INCREASE IN CASH AND CASH EQUIVALENTS HELD 42,498 38,466 Cash and cash equivalents at beginning of year 103,390 64,925

CASH AND CASH EQUIVALENTS AT END OF FINANCIAL YEAR6.2 145,888 103,390


Cash Flow Statement For the Financial Year Ended 30 June 2018

Monash Health


Notes to the Financial Statements Monash Health Annual Report 2017/2018

Its principal address is: 246 Clayton RoadClayton, Victoria 3168

Objectives and Funding

Note 1: Summary of Significant Accounting Policies

These annual financial statements represent the audited general purpose financial statements for Monash Health and its controlled entities for the year ended 30 June 2018. The report provides users with information about Monash Health’s stewardship of resources entrusted to it.

(a) Statement of Compliance

These financial statements are general purpose financial statements which have been prepared in accordance with the Financial Management Act 1994 and applicable AAS, which include interpretations issued by the Australian Accounting Standards Board (AASB). They are presented in a manner consistent with the requirements of AASB 101 Presentation of Financial Statements .

The financial statements also comply with relevant Financial Reporting Directions (FRDs) issued by the Department of Treasury and Finance, and relevant Standing Directions (SDs) authorised by the Minister for Finance.

Monash Health is a not-for-profit entity and therefore applies the additional paragraphs applicable to "not-for-profit" Health Services under the AASBs.

The financial statements are prepared on a going concern basis (refer to Note 8.11 Economic Dependency).

Accounting policies are selected and applied in a manner which ensures that the resulting financial information satisfies the concepts of relevance and reliability, thereby ensuring that the substance of the underlying transactions or other events is reported.

All amounts shown in the financial statements have been rounded to the nearest thousand dollars, unless otherwise stated. Minor discrepancies in tables between totals and sum of components are due to rounding.

The accounting policies have been applied in preparing the financial statements for the year ended 30 June 2018, and the comparative information presented in these financial statements for the year ended 30 June 2017.

These financial statements are presented in Australian dollars and the historical cost convention is used unless a different measurement basis is specifically disclosed in the note associated with the item measured on a different basis.

Monash Health’s overall objective is to provide quality, patient-centred health care that meets the needs of the community through a vision of exceptional care, outstanding outcomes, key strategic goals of putting patients first, driving innovation, partnering strategically, leading in sustainable healthcare as well as to improve the quality of life for Victorians.

Monash Health is predominantly funded by accrual based grant funding for the provision of services.

(c) Basis of Accounting Preparation and Measurement

The annual financial statements were authorised for issue by the Board of Monash Health on 17 August 2018.

(b) Reporting Entity

The financial statements include all the controlled activities of Monash Health.

A description of the nature of Monash Health’s operations and its principal activities is included in the report of operations, which does not form part of these financial statements.

75


Goods and Services Tax (GST)

The financial statements are prepared in accordance with the historical cost convention, except for:

● Non-current physical assets which, subsequent to acquisition, are measured at a revalued amount being their fair value at the date of the revaluation less any subsequent accumulated depreciation and subsequent impairment losses. Revaluations are made and are reassessed when the indices are published by the Valuer-General Victoria to ensure that the carrying amounts do not materially differ from their fair values;

Judgements, estimates and assumptions are required to be made about the carrying values of assets and liabilities that are not readily apparent from other sources. The estimates and underlying assumptions are reviewed on an ongoing basis. The estimates and associated assumptions are based on professional judgements derived from historical experience and various other factors that are believed to be reasonable under the circumstances. Actual results may differ from these estimates.

● Superannuation expense (refer to Note 3.6 Superannuation);

Note 1: Summary of Significant Accounting Policies (continued)

Consistent with the requirements of AASB 1004 Contributions contributed capital and its repayment are treated as equity transactions and, therefore, do not form part of the income and expenses of Monash Health.

Monash Health operates on a fund accounting basis and maintains three funds: Operating, Specific Purpose and Capital Funds. Monash Health's Capital and Specific Purpose Funds include unspent donations and receipts from fund-raising activities conducted solely in respect of these funds.

The financial statements, except for the cash flow statement, have been prepared using the accrual basis of accounting. Under the accrual basis, items are recognised as assets, liabilities, equity, income or expenses when they satisfy the definitions and recognition criteria for those items, that is, they are recognised in the reporting period to which they relate, regardless of when cash is received or paid.

Income, expenses and assets are recognised net of the amount of associated GST, unless the GST incurred is not recoverable from the Australian Taxation Office (ATO). In this case the GST payable is recognised as part of the cost of acquisition of the asset or as part of the expense.

Cash flows are presented on a gross basis. The GST components of cash flows arising from investing or financing activities which are recoverable from, or payable to the ATO, are presented as operating cash flow.

Commitments and contingent assets and liabilities are presented on a gross basis.

(c) Basis of Accounting Preparation and Measurement (continued)

Additions to net assets which have been designated as contributions by owners are recognised as contributed capital. Other transfers that are in the nature of contributions to or distributions by owners have also been designated as contributions by owners.

● The fair value of assets other than land is generally based on their depreciated replacement value.

Revisions to accounting estimates are recognised in the period in which the estimate is revised and also in future periods that are affected by the revision. Judgements and assumptions made by management in the application of AAS that have significant effects on the financial statements and estimates relate to:

● The fair value of land, buildings and plant and equipment (refer to Note 4.2 Property, Plant and Equipment);

● Employee benefit provisions are based on likely tenure of existing staff, patterns of leave claims, future salary movements and future discount rates (refer to Note 3.5 Employee Benefits in the Balance Sheet).

Receivables and payables are stated inclusive of the amount of GST receivable or payable. The net amount of GST recoverable from, or payable to, the ATO is included with other receivables or payables in the Balance Sheet.



Intersegment Transactions

(d) Principles of Consolidation

These statements are presented on a consolidated basis in accordance with AASB 10 ConsolidatedFinancial Statements :

• The consolidated financial statements of Monash Health includes all reporting entities controlled by Monash Health as at 30 June 2018.

● Kitaya Holdings Pty Ltd.

Transactions between segments within Monash Health have been eliminated to reflect the extent of Monash Health's operations as a group.

• The parent entity is not shown separately in the notes.

Where control of an entity is obtained during the financial period, its results are included in the Comprehensive Operating Statement from the date on which control commenced. Where control ceases during a financial period, the entity’s results are included for that part of the period in which control existed. Where entities adopt dissimilar accounting policies and their effect is considered material, adjustments are made to ensure consistent policies are adopted in these financial statements.

Entities consolidated into Monash Health reporting entity by virtue of the existence of congruent objectives, exposure to variable returns and significant management control include:

Note 1: Summary of Significant Accounting Policies (continued)

• Control exists when Monash Health has the power to govern the financial and operating policies of an organisation so as to obtain benefits from its activities. In assessing control, potential voting rights that presently are exercisable are taken into account. The consolidated financial statements include the audited financial statements of the controlled entities listed in Note 8.10 Controlled Entities.

77

Notes to the Financial StatementsMonash Health Annual Report 2017/2018

Note 2: Funding delivery of our services

Structure2.1 Analysis of revenue by source2.2 Assets received free of charge or for nominal consideration

Monash Health's overall objective is to deliver programs and services that support and enhance the wellbeing of all Victorians.

To enable Monash Health to fulfil its objective it receives income based on parliamentary appropriations. Monash Health also receives income from the supply of services.


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ams

as d

efin

ed in

the

Age

ncy

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rmat

ion

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agem

ent

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tem

(AIM

S)

guid

elin

es.

For

clin

ical

sup

port

, in

fras

truc

ture

and

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nd d

iagn

ostic

labo

rato

ry

and

med

ical

ser

vice

s, F

ull T

ime

Equi

vale

nt (

FTE)

has

bee

n us

ed t

o al

loca

te r

even

ue a

cros

s th

e pr

ogra

ms.

The

Dep

artm

ent

of H

ealth

and

Hum

an S

ervi

ces

mak

es c

erta

in p

aym

ents

on

beha

lf of

Mon

ash

Hea

lth.

Thes

e am

ount

s ha

ve b

een

brou

ght

to a

ccou

nt in

det

erm

inin

g th

e op

erat

ing

resu

lt fo

r th

e ye

ar b

y re

cord

ing

them

as

reve

nue

and

expe

nses

.

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mit

ted

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on

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dm

itte

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RA

C (

incl

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tal

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h)

Pri

mary

Healt

h

79


Note 2.1: Analysis of revenue by source (continued)

Revenue recognitionIncome is recognised in accordance with AASB 118 Revenue and is recognised as to the extent that it is probable that the economic benefits will flow to Monash Health and the income can be reliably measured at fair value. Unearned income at reporting date is reported as income received in advance. Amounts disclosed as revenue are where applicable, net of returns, allowances and duties and taxes.

Government Grants and other transfers of income (other than contributions by owners)In accordance with AASB 1004 Contributions , government grants and other transfers of income (other than contributions by owners) are recognised as income when Monash Health gains control of the underlying assets irrespective of whether conditions are imposed on Monash Health’s use of the contributions. Contributions are deferred as income in advance when Monash Health has a present obligation to repay them and the present obligation can be reliably measured.

Indirect contributions from the Department of Health and Human Services • Insurance is recognised as revenue following advice from the Department of Health and Human Services.• Long Service Leave (LSL) – Revenue is recognised upon finalisation of movements in LSL liability in line with the arrangements set out in the Department of Health and Human Services Hospital Circular 04/2017.

Patient feesPatient fees are recognised as revenue on an accrual basis.

Private practice fees Private practice fees are recognised as revenue at the time invoices are raised.

Revenue from commercial activitiesRevenue from commercial activities such as car park and property rental income are recognised on an accrual basis and commercial laboratory medicine is recognised at the time invoices are raised.

Donations and other bequestsDonations and bequests are recognised as revenue when received. If donations are for a special purpose, they may be appropriated to a surplus, such as the specific restricted purpose surplus.

Dividend revenue Dividend revenue is recognised when the right to receive payment is established. Dividends represents the income arising from Monash Health's and its controlled entities' investments in financial assets.

Interest revenue Interest revenue is recognised on a time proportionate basis that takes in account the effective yield of the financial asset, which allocates interest over the relevant period.

Other incomeOther income includes recoveries for salaries and wages, non-property rental and external services provided.



Note 2.1: Analysis of revenue by source (continued)

Category Groups

Monash Health has used the following category groups for reporting purposes for the current and previous financial years.

Admitted Patient Services (Admitted Patients) comprises all acute and subacute admitted patient services, where services are delivered in public hospitals.

Mental Health Services (Mental Health) comprises all specialised mental health services providing a range of inpatient, community based, residential, rehabilitation and ambulatory services which treat and support people with a mental illness and their families and carers. These services aim to identify mental illness early and seek to reduce its impact through providing timely acute care services and appropriate longer-term accommodation and support for those living with a mental illness.

Non Admitted Services comprises acute and subacute non admitted services, where services are delivered in public hospital clinics and provide models of integrated community care, which significantly reduces the demand for hospital beds and supports the transition from hospital to home in a safe and timely manner.

Emergency Department Services (EDs) comprises all emergency department services.

Aged Care comprises a range of in home, specialist geriatric, residential care and community based programs and support services, such as Home and Community Care (HACC) that are targeted to older people, people with a disability, and their carers.

Primary and Community Health comprises a range of home based, community based, primary health and dental services including health promotion and counselling, physiotherapy, speech therapy, podiatry and occupational therapy services.

Residential Aged Care including Mental Health (RAC incl. Mental Health) referred to in the past as psychogeriatric residential services, comprises those Commonwealth-licensed residential aged care services in receipt of supplementary funding from the department under the mental health program. It excludes all other residential services funded under the mental health program, such as mental health funded community care units and secure extended care units.

Other Services excluded from National Health Care Agreement (NHCA) (Other) comprises services not separately classified above, including: public health services such as laboratory testing, blood borne viruses / sexually transmitted infections clinical services, Kooris liaison officers, immunisation and screening services, drugs services including drug withdrawal, counselling and the needle and syringe program, disability services including aids and equipment and flexible support packages to people with a disability, community care programs including sexual assault support, early parenting services, parenting assessment and skills development, and various support services. Health and community initiatives also fall in this category group.

81


Consolidated Consolidated2018 2017$'000 $'000

During the reporting period, the fair value of assets received free of charge, was as follows:

Medical Equipment 136 713

TOTAL 136 713

Medical Equipment was gifted from various donors.

Note 2.2: Assets received free of charge or for nominal consideration

The revenues and assets recognised as a result of such transactions shall be measured at the fair value of resources received.

Fair value of assets and services received free of charge or for nominal consideration

Resources received free of charge or for nominal consideration are recognised at their fair value when the transferee obtains control over them, irrespective of whether restrictions or conditions are imposed over the use of the contributions, unless received from another Health Service or agency as a consequence of a restructuring of administrative arrangements. In the latter case, such transfer will be recognised at carrying amount. Contributions in the form of services are only recognised when a fair value can be reliably determined and the services would have been purchased if not received as a donation.



Note 3: The cost of delivering our services

This section provides an account of the expenses incurred by the hospital in delivering services and outputs. In Note 2, the funds that enable the provision of services were disclosed and in this note the cost associated with provision of services are recorded.

Structure3.1 Analysis of expenses by source 3.2 Analysis of expense and revenue by internally managed and restricted specific purpose funds3.3 Specific expenses3.4 Finance costs3.5 Employee benefits in the balance sheet3.6 Superannuation

83

Not

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8

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Note 3.1: Analysis of expenses by source

Net gain/(loss) on non-financial assets

a) revaluation gains/(losses) of non-financial physical assets. (Refer to Note 4.2 Property, plant and equipment; andb) net gain/(loss) on disposal of non-financial assets.

Expenses are recognised as they are incurred and reported in the financial year to which they relate.

• Wages and salaries; • Fringe benefits tax; • Leave entitlements; • Termination payments; • Workcover premiums; and • Superannuation expenses.

Employee expenses Employee expenses include:

Grants and other transfers These include transactions such as grants, subsidies and personal benefit payments made in cash to individuals.

Other operating expenses Other operating expenses generally represent the day-to-day running costs incurred in normal operations and include:

a) Supplies and consumables Supplies and services costs are recognised as an expense in the reporting period in which they are incurred. The carrying amounts of any inventories held for distribution are expensed when distributed. b) Fair value of assets, services and resources provided free of charge or for nominal

considerationContributions of resources provided free of charge or for nominal consideration are recognised at their fair value when the transferee obtains control over them.

c) Borrowing costs of qualifying assets In accordance with the paragraphs of AASB 123 Borrowing Costs applicable to not-for-profit public sector entities, Monash Health continues to recognise borrowing costs immediately as an expense, to the extent that they are directly attributable to the acquisition, construction or production of a qualifying asset.

Net gain/(loss) on non-financial assets and liabilities includes realised and unrealised gains and losses as follows:

Any gain or loss on the disposal of non-financial assets is recognised in the period of disposal.

85


Note 3.1: Analysis of expenses by source (continued)

Net gain/(loss) on financial instrumentsNet gain/(loss) on financial instruments includes:

b) disposals of financial assets and derecognition of financial liabilities.

Amortisation of non-produced intangible assets

Other gains/(losses) from other economic flows

De-recognition of financial liabilities

a) realised and unrealised gains and losses from revaluations of financial instruments at fair value;

Intangible non-produced assets with finite lives are amortised as an ‘other economic flow’ on a systematic basis over the asset’s useful life. Amortisation begins when the asset is available for use that is when it is in the location and condition necessary for it to be capable of operating in the manner intended by management.

Other gains/(losses) include:a) the revaluation of the present value of the long service leave liability due to changes in the bond rate movements, inflation rate movements and the impact of changes in probability factors; andb) transfer of amounts from the reserves to accumulated surplus or net result due to disposal or derecognition or reclassification.

A financial liability is derecognised when the obligation under the liability is discharged, cancelled or expires.



Consolidated Consolidated Consolidated Consolidated2018 2017 2018 2017$'000 $'000 $'000 $'000

Commercial ActivitiesPrivate Practice and Other Patient Activities 19,954 20,324 23,522 23,349 Laboratory Medicine 2,289 2,195 2,289 2,300 Diagnostic Imaging 12,149 12,159 12,227 12,163 Property - - 119 116 Other:-Bequests and Donations 1,478 1,014 2,530 1,789 -Breastscreen service 4,466 4,184 4,169 4,234 -Cardiology 8,359 8,043 9,987 10,144 -Special Purpose Funds 8,980 8,744 13,444 12,239

Other ActivitiesFundraising and Community Support 217 768 107 470 Research and Scholarship 8,425 5,766 8,720 7,452 Other 3,344 1,701 3,248 3,145 TOTAL 69,661 64,898 80,362 77,401

Note 3.2: Analysis of expense and revenue by internally managed and restricted specific purpose funds

Expense Revenue

87


Note 3.3: Specific expenses


Specific ExpensesVoluntary Departure Packages 372 667 Total Specific Expenses 372 667

Note 3.4: Finance costs


Finance Costs - Self Funded Activity 1,670 1,734 Finance Charges - Finance Leases i 3,547 3,739

Total Finance Costs 5,217 5,473

Finance costs include:

• amortisation of discounts or premiums relating to borrowings;

i Construction and fit out of Casey Hospital was funded as a Public Private Partnership under a Project Agreement between the State of Victoria and Progress Health Pty Ltd. This amount represents the interest payments made during the financial year.

• interest on bank overdrafts and short-term and long-term borrowings (interest expense is recognised in the period in which it is incurred);

• amortisation of ancillary costs incurred in connection with the arrangement of borrowings; and

• finance charges in respect of finance leases recognised in accordance with AASB 117 Leases .



Note 3.5: Employee benefits in the balance sheet


Current ProvisionsEmployee Benefits i

Accrued Days Off- unconditional and expected to be settled wholly within 12 months ii 4,326 3,895 Annual Leave- unconditional and expected to be settled wholly within 12 months ii 77,929 69,393 - unconditional and expected to be settled wholly after 12 months iii 13,154 11,527 Long Service Leave- unconditional and expected to be settled wholly within 12 months ii 19,886 18,413 - unconditional and expected to be settled wholly after 12 months iii 136,833 122,527 Accrued wages and salaries 41,664 30,041

293,792 255,796 Provisions related to Employee Benefit On-CostsUnconditional and expected to be settled within 12 months ii 10,733 10,890 Unconditional and expected to be settled after 12 months iii 16,314 13,226

27,047 24,116

Total Current Provisions 320,839 279,912

Non-Current ProvisionsEmployee benefits i 57,912 53,053 Provisions related to employee benefit on-costs 6,292 5,727 Total Non-Current Provisions 64,204 58,780

Total Provisions 385,043 338,692

(a) Employee Benefits and Related On-Costs

Current Employee Benefits and related on-costsUnconditional long service leave entitlements 173,747 156,155 Annual leave entitlements 101,102 89,821 Accrued wages and salaries 41,664 30,041 Accrued days off 4,326 3,895 Non-Current Employee Benefits and related on-costsConditional long service leave entitlements iii 64,204 58,780 Total Employee Benefits and Related On-Costs 385,043 338,692

Notes:

ii The amounts disclosed are nominal amounts.iii The amounts disclosed are discounted to present values.

i Employee benefits consist of amounts for accrued days off, annual leave and long service leave accrued by employees, not including on-costs.

89


Note 3.5: Employee benefits in the balance sheet (continued)Consolidated Consolidated

2018 2017Movements in provisions $'000 $'000

Movement in Long Service Leave:Balance at start of year 214,935 206,012 Provision made during the year- Expense recognising employee service 41,379 25,204 Settlement made during the year (18,363) (16,281) Balance at end of year 237,951 214,935

Employee Benefit Recognition

Provisions

Salaries and Wages, Annual Leave and Accrued Days Off

Long Service LeaveThe liability for LSL is recognised in the provision for employee benefits.

The components of this current LSL liability are measured at:

Termination Benefits

On-Costs Related to Employee Expense

Undiscounted value – if the health service expects to wholly settle within 12 months; and

Unconditional LSL is disclosed in the notes to the financial statements as a current liability, even where the Monash Health Service does not expect to settle the liability within 12 months because it will not have the unconditional right to defer the settlement of the entitlement should an employee take leave within 12 months. An unconditional right arises after a qualifying period.

Liabilities for salaries and wages, annual leave and accrued days off are all recognised in the provision for employee benefits as ‘current liabilities’, because Monash Health does not have an unconditional right to defer settlements of these liabilities.

Provisions are recognised when Monash Health has a present obligation, the future sacrifice of economic benefits is probable, and the amount of the provision can be measured reliably.

The amount recognised as a liability is the best estimate of the consideration required to settle the present obligation at reporting date, taking into account the risks and uncertainties surrounding the obligation.

Provision is made for benefits accruing to employees in respect of wages and salaries, annual leave and long service leave for services rendered to the reporting date as expense during the period of the services are delivered.

Present value – where the health service does not expect to settle a component of this current liability within 12 months.

Conditional LSL is disclosed as a non-current liability. Any gain or loss following revaluation of the present value of non-current LSL liability is recognised as a transaction, except to the extent that a gain or loss arises due to changes in estimations e.g. bond rate movements, inflation rate movements and changes in probability factors which are then recognised as other economic flows.

Provision for on-costs, such as workers compensation and superannuation are recognised together with provisions for employee benefits.

Termination benefits are payable when employment is terminated before the normal retirement date or when an employee decides to accept an offer of benefits in exchange for the termination of employment.



Note 3.6: Superannuation

Consolidated Consolidated Consolidated Consolidated2018 2017 2018 2017$'000 $'000 $'000 $'000

Defined benefit plans:State Superannuation Fund 550 539 39 60 First State 3,417 3,290 237 365 Unisuper 369 298 29 24

Defined contribution plans:First State 54,447 46,453 4,266 5,246 Hesta 48,348 36,963 3,763 4,734 VicSuper and Other 2,087 1,606 335 198 Total 109,218 89,149 8,669 10,627

The amount charged to the Comprehensive Operating Statement in respect of defined benefit superannuation plans represents the contributions made by Monash Health to the superannuation plans in respect of the services of current Monash Health staff during the reporting period. Superannuation contributions are made to the plans based on the relevant rules of each plan, and are based upon actuarial advice.

Superannuation contributions paid or payable for the reporting period are included as part of employee benefits in the Comprehensive Operating Statement of Monash Health.

The name, details and amounts expensed in relation to the major employee superannuation funds and contributions made by Monash Health are disclosed above.

Defined contribution superannuation plans

Monash Health Services does not recognise any unfunded defined benefit liability in respect of the plans because the hospital has no legal or constructive obligation to pay future benefits relating to its employees; its only obligation is to pay superannuation contributions as they fall due. The Department of Treasury and Finance discloses the State's defined benefits liabilities in its disclosure for administered items.

Defined benefit superannuation plans

Employees of Monash Health are entitled to receive superannuation benefits and Monash Health contributes to both defined benefit and defined contribution plans. The defined benefit plans provides benefits based on years of service and final average salary.

Contribution Outstanding at Year End

Paid Contribution for the Year

In relation to defined contribution (i.e. accumulation) superannuation plans, the associated expense is simply the employer contributions that are paid or payable in respect of employees who are members of these plans during the reporting period. Contributions to defined contribution superannuation plans are expensed when incurred.

91


Note 4: Key Assets to support service delivery

Structure4.1 Investments accounted for using the equity method4.2 Property, plant and equipment4.3 Depreciation and amortisation4.4 Intangible assets

The hospital controls infrastructure and other investments that are utilised in fulfilling its objectives and conducting its activities. They represent the key resources that have been entrusted to the hospital to be utilised for delivery of those outputs.



Note 4.1: Investments accounted for using the equity method

2018 2017 2018 2017Name of Entity % % $'000 $'000

Associates

Monash Health Research Precinct Pty LtdProperty Investment Australia 20.33 20.33 4,099 4,012

(a) As at 30 June 2018, the fair value of Monash Health's interest in Monash Health Research Precinct Pty Ltd was based on its share of the company's net assets which is a level 3 input in terms of AASB 13 Fair Value Measurement.

(b) The financial year end date of Monash Health Research Precinct Pty Ltd is 31 December. This was the reporting date established when that company was incorporated. For the purpose of applying the equity method of accounting, the financial statements of Monash Health Research Precinct Pty Ltd have been used, and appropriate adjustments have been made for the effects of significant transactions between that date and 30 June 2018.

PrincipalActivity

Country of Incorporation

Ownership Interest Published Fair Value

93


Note 4.2: Property, plant and equipment

(a) Gross carrying amount and accumulated depreciation

Consolidated Consolidated

2018 2017$'000 $'000

Land - Land at Fair Value 222,022 187,022 Total Land 222,022 187,022

Buildings - Buildings at Fair Value 676,088 676,088 Less Accumulated Depreciation (120,453) (94,463)

555,635 581,625

- Buildings at Cost 461,591 429,989 Less Accumulated Depreciation (49,291) (30,350)

412,300 399,639

Total Buildings 967,935 981,264

Plant and Equipment - Plant and Equipment at Fair Value 57,559 43,092 Less Accumulated Depreciation (23,814) (18,440) Total Plant and Equipment 33,745 24,652

Medical Equipment - Medical Equipment at Fair Value 160,752 146,511 Less Accumulated Depreciation (94,766) (82,683) Total Medical Equipment 65,987 63,828

Computers and Communication Equipment - Computers and Communication Equipment at Fair Value 20,089 16,746 Less Accumulated Depreciation (16,681) (13,685) Total Computers and Communication Equipment 3,408 3,061

Furniture and Fittings - Furniture and Fittings at Fair Value 11,766 3,619 Less Accumulated Depreciation (2,750) (1,402) Total Furniture and Fittings 9,016 2,217

Motor Vehicles - Motor Vehicles at Fair Value 2,219 2,366

Less Accumulated Depreciation (2,213) (2,353) Total Motor Vehicles 6 13

Cultural Assets - Cultural Assets at Fair Value 2,792 2,792 Total Cultural Assets 2,792 2,792



(a) Gross carrying amount and accumulated depreciation (continued)

Consolidated Consolidated

2018 2017$'000 $'000

Assets Under ConstructionAssets Under Construction at Cost 55,820 60,379 Software Under Construction at Cost 31,217 12,364 Total Assets Under Construction 87,037 72,743

Leased Assets Contracted under PPP Agreement - Leased Buildings at Fair Value 154,011 154,011 Less Accumulated Depreciation (58,632) (52,136)

95,379 101,875

- Leasehold Improvements at Cost 1,448 1,448 Less Accumulated Depreciation (547) (511)

901 937

- Leased Motor Vehicles 6,583 5,799 Less Accumulated Depreciation (3,858) (2,248)

2,725 3,551

- Plant and Equipment at Fair Value 164 164 Less Accumulated Depreciation (164) (164)

- - - Medical Equipment at Fair Value 6,495 6,555 Less Accumulated Depreciation (6,495) (6,555)

- - - Computers and Communication Equipment at Fair Value 305 305 Less Accumulated Depreciation (305) (305)

- -

- Furniture and Fittings at Fair Value 12 12 Less Accumulated Depreciation (12) (12)

- -

Total Leased Assets 99,005 106,363

TOTAL PROPERTY, PLANT AND EQUIPMENT 1,490,954 1,443,956

(i) Casey Hospital commenced operation during the year of 30 June 2005. Construction and fit out of Casey Hospital was funded as a Public Private Partnership under a Project Agreement between the State of Victoria and Progress Health Pty Ltd. Monash Health is responsible for operating Casey Hospital and has recognised the leased asset and associated interest bearing liabilities (Note 6.1). The State of Victoria is obligated to fund quarterly service payments due to the Project Agreement for the life of that agreement, a period of up to 25 years.

95

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as b

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on

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. Th

e ef

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ive

date

of th

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s at

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ir fai

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. Th

e la

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requ

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a fur

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201

8. T

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s ap

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Note 4.2: (c) Fair value measurement hierarchy for assets

Balance at 30 June 2018 Level 1 (i) Level 2 (i) Level 3 (i)

Land at fair value - Non-Specialised Land 47,085 47,085 - Specialised Land 174,937 174,937 Total Land at Fair Value 222,022 47,085 174,937

Buildings at fair value - Specialised Buildings 555,635 - 555,635 Total Buildings at Fair Value 555,635 - 555,635

Plant and Equipment at Fair Value 33,745 - 33,745 Medical Equipment at Fair Value 65,987 - 65,987 Computers and Communication Equipment at Fair Value 3,408 - 3,408 Furniture and Fittings at Fair Value 9,016 - 9,016 Cultural Assets at Fair Value 2,792 2,792 - Motor Vehicles at Fair Value 6 - 6

Total Property, Plant and Equipment 892,611 - 49,877 842,734

Balance at 30 June 2017 Level 1 (i) Level 2 (i) Level 3 (i)

Land at fair value - Non-Specialised Land 39,514 39,514 - - Specialised Land 147,508 147,508 Total Land at Fair Value 187,022 39,514 147,508

Buildings at fair value - Specialised Buildings 581,625 - 581,625 Total Building at Fair Value 581,625 - 581,625

Plant and Equipment at Fair Value 24,652 - 24,652 Medical Equipment at Fair Value 63,828 - 63,828 Computers and Communication Equipment at Fair Value 3,061 - 3,061 Furniture and Fittings at Fair Value 2,217 - 2,217 Cultural Assets at Fair Value 2,792 2,792 Motor Vehicles at Fair Value 13 13

Total Property, Plant and Equipment 865,211 - 42,306 822,905

Notei Classified in accordance with the fair value hierarchy

Fair value measurement at endof reporting period using:

Carryingamount as at 30 June

2018

Carryingamount as at 30 June

2017

Fair value measurement at endof reporting period using:

97

Not

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Notes to the Financial Statements


Note 4.2 (e): Fair value determination

Asset class Types of assets Expected fair value level

Likely valuation approach

Significant inputs (Level 3 only)(c)

In areas where there is an active market:

- Vacant Land - Land not subject to restrictions as to use or sale

Land subject to restriction as to use

- Cost per square metre

- Useful life

Active resale market available Level 2 Market approach n.a.


- Useful life


- Useful life

- Cost per unit

- Useful life


- Useful life

- Cost per unit

- Useful life

There were no changes in valuation techniques throughout the period to 30 June 2018.

InitialRecognition

SubsequentMeasurement

VehiclesNo active resale market available Level 3

Depreciated replacement cost approach

The estimates and underlying assumptions are reviewed on an ongoing basis.

All property, plant and equipment for which fair value is measured or disclosed in the financial statements are categorised within the fair value hierarchy.

For the purpose of fair value disclosures, Monash Health has determined classes of assets on the basis of the nature, characteristics and risks of the asset and the level of the fair value hierarchy as explained above.

In addition, Monash Health determines whether transfers have occurred between levels in the hierarchy by reassessing categorisation (based on the lowest level input that is significant to the fair value measurement as a whole) at the end of each reporting period.

For the purpose of fair value disclosures, Monash Health has determined classes of assets and liabilities on the basis of the nature, characteristics and risks of the asset or liability and the level of the fair value hierarchy as explained above.

The Valuer-General Victoria (VGV) is Monash Health’s independent valuation agency.

Items of property, plant and equipment are measured initially at cost and subsequently revalued at fair value less accumulated depreciation and impairment loss. Where an asset is acquired for no or nominal cost, the cost is its fair value at the date of acquisition. Assets transferred as part of a merger are transferred at their carrying amounts.

The cost of a leasehold improvement is capitalised as an asset and depreciated over the shorter of the remaining term of the lease or the estimated useful life of the improvements.

Theoretical opportunities that may be available in relation to assets are not taken into account until it is virtually certain that any restrictions will no longer apply. Therefore, unless otherwise disclosed, the current use of these non-financial physical assets will be their highest and best uses.

Land and buildings are recognised initially at cost and subsequently measured at fair value less accumulated depreciation and accumulated impairment loss.

Consistent with AASB 13 Fair Value Measurement , Monash Health determines the policies and procedures for recurring property, plant and equipment fair value measurements, in accordance with the requirements of AASB 13 and the relevant FRDs.

Medical equipment (a)

Non-specialised Land Level 2 Market approach n.a.

Specialised buildings (a)Specialised buildings with limited alternative uses and/or substantial customisation

Level 3Depreciated replacement cost approach

Market approach Community Service Obligations Adjustments Specialised Land Level 3

Depreciated replacement cost approach

Plant and equipment (a)Specialised items with limited alternative uses and/or substantial customisation

Level 3Depreciated replacement cost approach

Specialised items with limited alternative uses and/or substantial customisation

Level 3

(b) AASB 13 Fair Value Measurement provides an exemption for not for profit public sector entities from disclosing the sensitivity analysis relating to ‘unrealised gains/(losses) on non-financial assets’ if the assets are held primarily for their current service potential rather than to generate net cash inflows.

Computers and Communication Equipment (a)

Any type Level 3Depreciated replacement cost approach

Furniture and Fittings Any type Level 3Depreciated replacement cost approach

(a) Newly built/acquired assets could be categorised as Level 2 assets as depreciation would not be a significant unobservable input (based on the 10 per cent materiality threshold).


Notes to the Financial Statements


Note 4.2 (e): Fair value determination (continued)

Fairvaluemeasurement

Considerationofhighestandbestuse(HBU)fornon‐financialphysicalassets

use from its past use;

Valuationhierarchy

Identifyingunobservableinputs(level3)fairvaluemeasurements

Non‐SpecialisedLand,Non‐SpecialisedBuildingsandCulturalAssets

• Evidence that suggests that the asset might be sold or demolished at reaching the late stage of an asset’s life cycle.

Monash Health uses valuation techniques that are appropriate for the circumstances and where there is sufficient data available to measure fair value, maximising the use of relevant observable inputs and minimising the use of unobservable inputs.

All assets and liabilities for which fair value is measured or disclosed in the financial statements are categorised within the fair value hierarchy.

Unobservable inputs are used to measure fair value to the extent that relevant observable inputs are not available, thereby allowing for situations in which there is little, if any, market activity for the asset or liability at the measurement date. However, the fair value measurement objective remains the same, i.e., an exit price at the measurement date from the perspective of a market participant that holds the asset or owes the liability. Therefore, unobservable inputs shall reflect the assumptions that market participants would use when pricing the asset or liability, including assumptions about risk.

Assumptions about risk include the inherent risk in a particular valuation technique used to measure fair value (such as a pricing risk model) and the risk inherent in the inputs to the valuation technique. A measurement that does not include an adjustment for risk would not represent a fair value measurement if market participants would include one when pricing the asset or liability i.e., it might be necessary to include a risk adjustment when there is significant measurement uncertainty. For example, when there has been a significant decrease in the volume or level of activity when compared with normal market activity for the asset or liability or similar assets or liabilities, and Monash Health has determined that the transaction price or quoted price does not represent fair value.

Monash Health develops unobservable inputs using the best information available in the circumstances which includes its own data. In developing unobservable inputs, Monash Health begins with its own data and makes adjustments to this data if reasonably available information indicates that other market participants would use different data or data unique to Monash Health exists that is not available to other market participants.

For non-specialised land and non-specialised buildings, an independent valuation was performed by the Valuer-General Victoria to determine the fair value using the market approach. Valuation of the assets was determined by analysing comparable sales and allowing for share, size, topography, location and other relevant factors specific to the asset being valued. An appropriate rate per square metre has been applied to the subject asset. The effective date of the valuation is 30 June 2014.

Level 3 fair value inputs are unobservable valuation inputs for an asset or liability. These inputs require significant judgement and assumptions in deriving fair value for both financial and non-financial assets.

Non-specialised land, non-specialised buildings and cultural assets are valued using the market approach. Under this valuation method, the assets are compared to recent comparable sales or sales of comparable assets which are considered to have nominal or no added improvement value.

• Evidence that suggests the current use of an asset is no longer core to requirements to deliver Monash Health’s service obligation; and

Fair value is the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date.

Judgements about highest and best use must take into account the characteristics of the assets concerned, including restrictions on the use and disposal of assets arising from the asset’s physical nature and any applicable legislative/contractual arrangements.

In accordance with paragraph AASB 13.29, Monash Health assumes the current use of a non-financial physical asset is its HBU unless market or other factors suggest that a different use by market participants would maximise the value of the asset.

Therefore, an assessment of the HBU will be required when the indicators are triggered within a reporting period which suggest the market participants would have perceived an alternative use of an asset that can generate maximum value. Once identified, Monash Health engages with VGV or other independent valuers for formal HBU assessment.

These indicators, as a minimum, include:

External factors:

• Changed acts, regulations, local law or such instrument which affects or may affect the use or development of the asset;

• Changes in planning scheme, including zones, reservations, overlays that would affect or remove the restrictions imposed on the asset’s

101


Note 4.2 (e): Fair value determination (continued)

SpecialisedLandandSpecialisedBuildings

PlantandEquipment

RevaluationsofNon‐CurrentPhysicalAssets

Specialised land includes Crown Land which is measured at fair value with regard to the property’s highest and best use after due consideration is made for any legal or physical restrictions imposed on the asset, public announcements or commitments made in relation to the intended use of the asset. Theoretical opportunities that may be available in relation to the assets are not taken into account until it is virtually certain that any restrictions will no longer apply. Therefore, unless otherwise disclosed, the current use of these non-financial physical assets will be their highest and best use.

Plant and equipment (including medical equipment, computers and communication equipment and furniture and fittings are held at carrying amount (depreciated cost). When plant and equipment is specialised in use, such that it is rarely sold other than as part of a going concern, the depreciated replacement cost is used to estimate the fair value. Unless there is market evidence that current replacement costs are significantly different from the original acquisition cost, it is considered unlikely that depreciated replacement cost will be materially different from the existing carrying amount.

The market approach is used for specialised land and specialised buildings although it is adjusted for the community service obligation (CSO) to reflect the specialised nature of the assets being valued. Specialised assets contain significant, unobservable adjustments; therefore these assets are classified as Level 3 under the market based direct comparison approach.

The CSO adjustment is a reflection of the valuer’s assessment of the impact of restrictions associated with an asset to the extent that is also equally applicable to market participants. This approach is in light of the highest and best use consideration required for fair value measurement, and takes into account the use of the asset that is physically possible, legally permissible and financially feasible. As adjustments of CSO are considered as significant unobservable inputs, specialised land would be classified as Level 3 assets.

For Monash Health, the depreciated replacement cost method is used for the majority of specialised buildings, adjusting for the associated depreciation. As depreciation adjustments are considered as significant and unobservable inputs in nature, specialised buildings are classified as Level 3 for fair value measurements.

An independent valuation of Monash Health ’s specialised land and specialised buildings was performed by the Valuer-General Victoria. The valuation was performed using the market approach adjusted for CSO. The effective date of the valuation is 30 June 2014.

In June 2018 a managerial valuation was carried out in accordance with FRD 103F to revalue the land to its fair value.

Revaluation surplus is not transferred to accumulated funds on de-recognition of the relevant asset, except where an asset is transferred via contributed capital.

In accordance with FRD 103F, Monash Health's non-current physical assets were assessed to determine whether revaluation of the non-current physical assets was required.

There were no changes in valuation techniques throughout the period to 30 June 2018.

For all assets measured at fair value, the current use is considered the highest and best use.

Non-current physical assets are measured at fair value and are revalued in accordance with FRD 103F Non-CurrentPhysical Assets . This revaluation process normally occurs every five years, based upon the asset's Government Purpose Classification, but may occur more frequently if fair value assessments indicate material changes in values. Independent valuers are used to conduct these scheduled revaluations and any interim revaluations are determined in accordance with the requirements of the FRDs. Revaluation increments or decrements arise from differences between an asset’s carrying value and fair value.

Revaluation increments are recognised in ‘Other Comprehensive Income’ and are credited directly to the asset revaluation surplus, except that, to the extent that an increment reverses a revaluation decrement in respect of that same class of asset previously recognised as an expense in net result, the increment is recognised as income in the net result.

Revaluation decrements are recognised in ‘Other Comprehensive Income’ to the extent that a credit balance exists in the asset revaluation surplus in respect of the same class of property, plant and equipment.

Revaluation increases and revaluation decreases relating to individual assets within an asset class are offset against one another within that class but are not offset in respect of assets in different classes.



Note 4.3: Depreciation and amortisationConsolidated Consolidated

2018 2017$'000 $'000

DepreciationBuildings 43,072 39,893 Plant & Equipment 5,460 3,567 Medical Equipment 12,831 11,319 Computers and Communication Equipment 3,017 1,819 Furniture and Fittings 1,351 285 Motor Vehicles 7 8 Leased Assets i 8,161 7,841 Total Depreciation 73,899 64,732

AmortisationIntangible Assets 3,411 2,331 Total Amortisation 3,411 2,331

Total Depreciation and Amortisation 77,310 67,063

2018 2017Buildings

– Structure Shell Building Fabric 45 to 70 45 to 70 years– Site Engineering Services and Central Plant 22 to 30 22 to 30 years– Fit Out 22 to 30 22 to 30 years– Trunk Reticulated Building Systems 22 to 30 22 to 30 years

Plant & Equipment 3 to 10 years 3 to 10 yearsMedical Equipment 3 to 10 years 3 to 10 yearsComputers and Communication 3 years 3 yearsFurniture and Fitting Up to 10 Up to 10 yearsMotor Vehicles 4 years 4 yearsLeased Buildings 45 Years 45 YearsIntangible Assets 5 years 5 years

(i) Of the balance disclosed under 'Depreciation Leased Assets', $6.5m ($6.5m 2017) relates to leased buildings contracted under a PPP arrangement.

As part of the building valuation, building values were separated into components and each component assessed for its useful life which is represented above.

All buildings, plant and equipment and intangible produced assets that have finite useful lives are depreciated. Depreciation begins when the asset is available for use, which is when it is in the location and condition necessary for it to be capable of operating in a manner intended by management.

Depreciation is generally calculated on a straight line basis, at a rate that allocates the asset value, less any estimated residual value over its estimated useful life. Estimates of the remaining useful lives and depreciation method for all assets are reviewed at least annually, and adjustments made where appropriate. This depreciation charge is not funded by the Department of Health and Human Services. Assets with a cost in excess of $1,000 are capitalised and depreciation has been provided on depreciable assets so as to allocate their cost or valuation over their estimated useful lives.

Intangible produced assets with finite lives are depreciated as an expense on a systematic basis over the asset’s useful life.

The following table indicates the expected useful lives of non-current assets on which the depreciation charges are based.

103


Note 4.4: Intangible assets


Intangible Produced Assets - Software 34,088 30,188 Less Accumulated Amortisation (30,123) (26,712)

Total Intangible Assets 3,965 3,476

Consolidated$'000

Balance at 1 July 2016 4,912Additions 895 Amortisation (refer Note 4.3) (2,331) Balance at 1 July 2017 3,476Additions 3,900 Amortisation (refer Note 4.3) (3,411) Balance at 30 June 2018 3,965

Reconciliation of the carrying amounts of intangible assets at the beginning and end of the previous and current financial year:

Intangible assets represent identifiable non-monetary assets without physical substance such as computer software. Intangible assets are initially recognised at cost. Subsequently, intangible assets with finite useful lives are carried at cost less accumulated amortisation and accumulated impairment losses. Costs incurred subsequent to initial acquisition are capitalised when it is expected that additional future economic benefits will flow to Monash Health.

Expenditure on research activities is recognised as an expense in the period in which it is incurred.



Note 5: Other assets and liabilities

This section sets out those assets and liabilities that arose from the Monash Health's operations.

Structure5.1 Receivables5.2 Inventories5.3 Other liabilities5.4 Payables

105


Note 5.1: Receivables


CURRENTContractual

Inter Hospital Debtors 1,799 1,698 Trade Debtors 5,708 5,807 Patient Fees 18,914 22,259 Accrued Revenue - Other 16,789 10,597 Amounts Receivable from Governments and Agencies i - 6,394

Less Allowance for Doubtful DebtsTrade Debtors (218) (308) Patient Fees (3,071) (2,448)

39,921 43,999 Statutory

GST Receivable 2,850 3,583 2,850 3,583

TOTAL CURRENT RECEIVABLES 42,771 47,582

NON CURRENTStatutory

Long Service Leave - Department of Health and Human Services 90,917 81,717

TOTAL NON-CURRENT RECEIVABLES 90,917 81,717 TOTAL RECEIVABLES 133,688 129,299

(a) Movement in the Allowance for doubtful debts


Balance at beginning of year 2,756 2,550 Increase in allowance recognised in net result 533 206 Balance at end of year 3,289 2,756

(b) Nature and extent of risk arising from receivables

i Terms and conditions of amounts receivable from the Department of Health and Human Services vary according to the particular agreement with the Department.

Refer to Note 7.1(a) for the nature and extent of credit risk arising from contractual receivables.



Note 5.1: Receivables (continued)

Receivables consist of:

Trade debtors are carried at nominal amounts due and are due for settlement within 30 days from the date of recognition. Collectability of debts is reviewed on an ongoing basis, and debts which are known to be uncollectible are written off. A provision for doubtful debts is recognised when there is objective evidence that the debts may not be collected and bad debts are written off when identified.

Receivables are recognised initially at fair value and subsequently measured at amortised cost less any accumulated impairment. Trade debtors are carried at nominal amounts due and are due for settlement within 30 days from the date of recognition.

In assessing impairment of statutory (non-contractual) financial assets, which are not financial instruments, professional judgement is applied in assessing materiality using estimates, averages and other computational methods in accordance with AASB 136 Impairment of Assets .

• Contractual receivables, which includes mainly debtors in relation to goods and services, loans to third parties, accrued investment income, and finance lease receivables; and

• Statutory receivables, which includes predominantly amounts owing from the Victorian Government and Goods and Services Tax (GST) input tax credits recoverable.

Receivables that are contractual are classified as financial instruments and categorised as loans and receivables. Statutory receivables are recognised and measured similarly to contractual receivables (except for impairment), but are not classified as financial instruments because they do not arise from a contract.

107


Note 5.2: Inventories


At Cost:

Pharmaceuticals 7,961 6,160 Medical and Surgical Consumables 7,336 7,939 General Stores 559 525 Pathology 1,464 1,118

TOTAL INVENTORIES 17,320 15,742

Inventories include goods and other property held either for sale, consumption or for distribution at no or nominal cost in the ordinary course of business operations. It includes land held for sale and excludes depreciable assets.

Inventories held for distribution are measured at weighted average cost, adjusted for any loss of service potential. All other inventories are measured at the lower of cost and net realisable value.

Inventories acquired at no cost or for nominal consideration are measured at current replacement cost at the date of acquisition.

The bases used in assessing loss of service potential for inventories held for distribution include current replacement cost and technical or functional obsolescence.

Cost is assigned to high value, low volume inventory items on a specific identification of cost basis.



Note 5.3: Other liabilities


CURRENTMonies Held in Trust - Patient Monies Held in Trust 219 211 - Accommodation Bonds (Refundable Entrance Fees) 14,825 12,408 Total Other Liabilities 15,044 12,619

Represented by the following assets:Cash Assets 15,044 12,619 TOTAL 15,044 12,619

109


Note 5.4: PayablesConsolidated Consolidated

2018 2017$'000 $'000

CURRENTContractualTrade Creditors 30,323 29,604 Accrued Expenses 31,562 24,311 Amounts payable to doctors 544 544 Superannuation Accrual 8,669 10,566 Prepaid revenue - Department of Health and Human Services 5,608 - Other 13,516 16,192 TOTAL PAYABLES 90,222 81,217

Contractual payables are classified as financial instruments and are initially recognised at fair value, and then subsequently carried at amortised cost. Statutory payables are recognised and measured similarly to contractual payables, but are not classified as financial instruments and not included in the category of financial liabilities at amortised cost, because they do not arise from a contract.

Payables consist of:

• Contractual payables which consist predominantly of accounts payable representing liabilities for goods and services provided to Monash Health prior to the end of the financial year that are unpaid, and arise when Monash Health becomes obliged to make future payments in respect of the purchase of those goods and services. The normal credit terms for accounts payable are usually nett 30 - 35 days.


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111


Note 6: How we finance our operations

This section provides information on the sources of finance utilised by Monash Health during its operations, along with interest expenses (the cost of borrowings) and other information related to financing activities of Monash Health.

This section includes disclosures of balances that are financial instruments (such as borrowings and cash balances). Note: 7.1 provides additional, specific financial instrument disclosures.

Structure6.1 Borrowings 6.2 Cash and cash equivalents6.3 Commitments for expenditure



Note 6.1: BorrowingsConsolidated Consolidated

2018 2017$'000 $'000

CURRENTAustralian Dollar Borrowings– Finance Lease Liability i 5,600 5,048 – TCV Loan ii 1,181 1,113 – Advances from Government iii 1,000 - Total Australian Dollars Borrowings 7,781 6,161

Total Current 7,781 6,161

NON CURRENTAustralian Dollar Borrowings– Finance Lease Liability i 51,945 56,229 – TCV Loan ii 26,008 27,189 – Advances from Government iii 7,844 - Total Australian Dollars Borrowings 85,797 83,418

Total Non-Current 85,797 83,418

Total Borrowings 93,578 89,579

(a) Maturity analysis of borrowingsPlease refer to Note 5.4 for the ageing analysis of borrowings.

(b) Defaults and breachesDuring the current and prior year, there were no defaults and breaches of any of the borrowings.

i During the year ended 30 June 2005, Casey Hospital commenced operation. Construction and fit out of Casey Hospital was funded as Public Private Partnership under a Project Agreement between the State of Victoria and Progress Health Pty Ltd. Monash Health is responsible for operating Casey Hospital and has recognised the leased asset (Note 4.2) and associated interest bearing liabilities. The State of Victoria is obligated to fund quarterly service payments due under the Project Agreement for the life of that agreement, a period of up to 25 years.

ii During the year ended 30 June 2010, Monash Health entered into a loan agreement with the Treasury Corporation of Victoria to fund $19.6m improvements required to the car park at the Clayton site. The loan is repayable over 22 years with repayments being made quarterly.

During the year ended 30 June 2014, Monash Health made a further drawdown under the existing loan arrangement with the Treasury Corporation of Victoria to fund $13.5m improvements required to the car park at the Clayton site. The loan is repayable over 20 years with repayments being made quarterly.

iii During the year ended 30 June 2018, the Department of Health and Human Services granted an interest free loan of $10m to Monash Health. The loan is repayable over 10 years with repayments being made annually.

113


Note 6.1 Borrowings (continued)

(c) Finance lease liabilities

2018 2017 2018 2017Finance leases $'000 $'000 $'000 $'000Casey Hospital Public Private Partnership Lease

Repayments in relation to finance leases are payable as follows:Not later than one year 6,592 6,592 3,399 3,199 Later than one year but not later than 5 years 26,370 26,370 15,871 14,933 Later than 5 years 41,752 48,345 34,553 38,891

Other finance lease liabilities payablei

Not later than one year 2,276 1,969 2,201 1,849 Later than one year but not later than 5 years 1,555 2,475 1,521 2,405 Minimum lease paymentsii 78,546 85,751 57,545 61,277 Less future finance charges (21,001) (24,474) - - TOTAL 57,545 61,277 57,545 61,277

Included in the financial statements as:Current borrowings lease liabilities 5,600 5,048 Non-current borrowing lease liabilities 51,945 56,229

57,545 61,277

Finance Leases

Entity as lessor

Entity as lessee

Leasehold Improvement

Borrowings

Minimum future lease payments (i)

Present value of minimum future lease

payments

i Other finance lease liabilities include obligations that are recognised on the Balance Sheet.

Monash Health does not hold any finance lease arrangements with other parties.

ii Minimum future lease payments include the aggregate of all base payments and any guaranteed residual.

The weighted average interest rate implicit in the finance lease is 6.07% (2017: 6.07%).

All borrowings are initially recognised at fair value of the consideration received, less directly attributable transaction costs. Subsequent to initial recognition, borrowings are measured at amortised cost with any difference between the initial recognised amount and the redemption value being recognised in the net result over the period of the borrowing using the effective interest method. Fair value is determined in the manner described in Note 7.1.

A lease is a right to use an asset for an agreed period of time in exchange for payment. Leases are classified at their inception as either operating or finance leases based on the economic substance of the agreement so as to reflect the risks and rewards incidental to ownership.

Leases of property, plant and equipment are classified as finance leases whenever the terms of the lease transfer substantially all the risks and rewards of ownership to the lessee. All other leases are classified as operating leases, in the manner described in Note 6.3 Commitments for expenditure.

Finance leases are recognised as assets and liabilities at amounts equal to the fair value of the lease property or, if lower, the present value of the minimum lease payment, each determined at the inception of the lease. The lease assets under the PPP arrangement are accounted for as a non-financial physical asset and is depreciated over the term of the lease. Minimum lease payments are apportioned between reduction of the outstanding lease liability, and the periodic finance expense which is calculated using the interest rate implicit in the lease, and charged directly to the Comprehensive Operating Statement. Contingent rentals associated with finance leases are recognised as an expense in the period in which they are incurred.

The cost of leasehold improvements are capitalised as an asset and depreciated over the remaining term of the lease or the estimated useful life of the improvements, whichever is the shorter.



Note 6.2: Cash and Cash Equivalents


Cash on Hand 74 74 Cash at Bank i 160,858 115,935 Total Cash and Cash Equivalents 160,932 116,009

Represented by:Cash as per Cash Flow Statement 145,888 103,390 Cash for Monies Held in Trust (refer to Note 5.3) - Cash at Bank 15,044 12,619 Total Cash and Cash Equivalents 160,932 116,009

Cash and cash equivalents recognised on the Balance Sheet comprise cash on hand and in banks, deposits at call and highly liquid investments (with an original maturity date of three months or less), which are held for the purpose of meeting short term cash commitments rather than for investment purposes, which are readily convertible to known amounts of cash and are subject to insignificant risk of changes in value. For cash flow statement presentation purposes, cash and cash equivalents include any bank overdrafts, which are included as liabilities on the Balance Sheet.

i $7.6m (2017: $7.9m) relates to funding from the Commonwealth Department of Health and Human Services for the Monash Health Translation Precinct.

115


Note 6.3: Commitments for expenditureConsolidated Consolidated

2018 2017$'000 $'000

a) Commitments other than public private partnerships

Capital Expenditure CommitmentsPayable:Plant and equipment 29,987 37,728 Total Capital Expenditure Commitments 29,987 37,728

Operating Commitments Payable:Contracted services 100,074 108,854 Total Operating Commitments 100,074 108,854

Lease Commitments Commitments in relation to leases contracted for at the reporting date - cancellable 33,814 36,180 Total Lease Commitments 33,814 36,180

Total Commitments other than Public Private Partnerships 163,875 182,762

All amounts shown in the commitments note are nominal amounts inclusive of GST.

Commitments for future expenditure include operating and capital commitments arising from contracts. These commitments are disclosed by way of a note at their nominal value and are inclusive of the GST payable. In addition, where it is considered appropriate and provides additional relevant information to users, the net present values of significant individual projects are stated. These future expenditures cease to be disclosed as commitments once the related liabilities are recognised on the balance sheet.

Service concession arrangementsMonash Health sometimes enters into certain arrangement with private sector participants to design and construct or upgrade assets used to provide public services. These arrangements are typically complex and usually include the provision of operational and maintenance services for a specified period of time. These arrangements are often referred to as either public private partnerships or service concession arrangements (SCAs). The State of Victoria is obliged to fund Quarterly Service Payments due under the Project Agreement for the life of that Agreement, a period of up to 25 years. Monash Health expects that it will continue to operate and control Casey Hospital at the expiry of the lease. The building has been componentised into 4 major asset classes, of which their estimated useful lives are between 22 to 70 years.These SCAs usually take one of two main forms. In the more common form, Monash Health pays the operator over the period of the arrangement, subject to specified performance criteria being met. At the date of commitment to the principal provisions of the arrangement, these estimated periodic payments are allocated between a component related to the design and construction or upgrading of the asset and components related to the ongoing operation and maintenance of the asset. The former component is accounted for as a lease payment in accordance with the lease policy (See Note 6.1). The remaining components are accounted for as commitments for operating costs which are expensed in the comprehensive operating statement as they are incurred.



Note 6.3: Commitments for expenditure (continued)Consolidated Consolidated

2018 2017(b) Public Private Partnerships i, ii $'000 $'000

Commissioned Public Private Partnerships - CaseyHospital Nominal Value Nominal Value iii

PPP operations and maintenance commitmentNot later than one year 11,211 6,244 Later than 1 year and not later than 5 years 21,597 27,734 Later than 5 years 60,147 65,221 Total PPP operations and maintenance commitment 92,954 99,199

Capital commitments iv

Not later than one year 9,187 8,973 Later than 1 year and not later than 5 years 39,101 38,147 Later than 5 years 70,391 80,531 Total capital commitments 118,678 127,652

TOTAL COMMITMENTS FOR PUBLIC PRIVATE PARTNERSHIPS 211,633 226,850

Amounts shown are exempt from GST.


(c) Commitments payable

Capital Expenditure CommitmentsLess than 1 year 23,570 23,175 Longer than 1 year but not longer than 5 years 6,417 14,552 Total Capital Expenditure Commitments 29,987 37,728

Operating CommitmentsLess than 1 year 35,701 30,213 Longer than 1 year but not longer than 5 years 64,370 61,766 5 years or more 3 16,875 Total Operating Commitments 100,074 108,854

Lease Commitments Less than 1 year 7,588 7,612 Longer than 1 year but not longer than 5 years 15,512 15,252 5 years or more 10,714 13,316 Total Lease Commitments 33,814 36,180

Public Private Partnership Commitments (commissioned)i

Less than 1 year 20,398 15,218 Longer than 1 year but not longer than 5 years 60,698 65,881 5 years or more 130,537 145,751 Total Public Private Partnership Commitments 211,633 226,850

Total Commitments 375,508 409,612

Less GST recoverable from Australian Tax Office (17,132) (15,562)

Total Commitments 358,376 394,050

iv The capital commitments include both interest and principle repayments based on the Treasury Corporation of Victoria PPP model as provided by DHHS. The finance lease liability disclosed in Note 6.1 presents the principle component of the capital commitment, as minimum future lease payments.

i The present values of the minimum lease payments for commissioned Public Private Partnerships (PPP) are recognised on the Balance Sheet and are not disclosed as commitments.ii The year on year reduction in the nominal amounts of the other commitments reflects the payments made.iii The prior year amounts have been updated to reflect the Department of Treasury and Finance commitments and are now comparable to the current year disclosure.

117


Note 7: Risks, contingencies and valuation uncertainties

Monash Health is exposed to risk from its activities and outside factors. In addition, it is often necessary to make judgements and estimates associated with recognition and measurement of items in the financial statements. This section sets out financial instrument specific information, (including exposures to financial risks) as well as those items that are contingent in nature or require a higher level of judgement to be applied, which for Monash Health is related mainly to fair value determination.

Structure7.1 Financial instruments 7.2 Contingent assets and contingent liabilities



Note 7.1: Financial instruments

(a) Financial instruments: categorisation

ContractualFinancialAssets -

Receivables

ContractualFinancial

Liabilities at Amortised

Cost TotalConsolidated2018 $'000 $'000 $'000Contractual Financial AssetsCash and cash equivalents 160,932 - 160,932 Receivables - Trade debtors 5,490 - 5,490 - Other receivables 34,431 - 34,431 Total Financial Assets i 200,853 - 200,853

Financial LiabilitiesPayables - 90,222 90,222 Borrowings - 93,578 93,578 Other financial liabilities - Accommodation bonds - 14,825 14,825 - Other - 219 219 Total Financial Liabilities i - 198,844 198,844

ContractualFinancialAssets -

Receivables

ContractualFinancial

Liabilities at Amortised

Cost TotalConsolidated2017 $'000 $'000 $'000Contractual Financial AssetsCash and cash equivalents 116,009 - 116,009 Receivables - Trade debtors 5,499 - 5,499 - Other receivables 38,500 - 38,500 Total Financial Assets i 160,008 - 160,008

Financial LiabilitiesPayables - 81,217 81,217 Borrowings - 89,579 89,579 Other financial liabilities - Accommodation bonds - 12,408 12,408 - Other - 211 211 Total Financial Liabilities i - 183,415 183,415

Financial instruments arise out of contractual agreements that give rise to a financial asset of one entity and a financial liability or equity instrument of another entity. Due to the nature of Monash Health's activities, certain financial assets and financial liabilities arise under statute rather than a contract. Such financial assets and financial liabilities do not meet the definition of financial instruments in AASB 132 Financial Instruments: Presentation .

i The carrying amount excludes statutory receivables (i.e. GST receivable and DHHS receivable) and statutory payables (i.e. Revenue in Advance and DHHS payable).

119

Notes To the Financial Statements Monash Health Annual Report 2017/2018

Note 7.1: Financial instruments (continued)

(b) Net holding gain/(loss) on financial instruments by category

Net Holding Gain/(Loss) Total

Consolidated2018 $'000 $'000Financial Assets

Cash and Cash Equivalents i 2,807 2,807 Investment - Term Deposit 524 524

Financial Assets - Receivables i (2,713) (2,713)Total Financial Assets 618 618 Financial Liabilities

Financial Liabilities at Amortised Cost ii (54) (54)Total Financial Liabilities (54) (54)

2017Financial Assets

Cash and Cash Equivalents i 1,867 1,867 Investment - Term Deposit 1,038 1,038 Receivables i (2,189) (2,189)Total Financial Assets 716 716Financial Liabilities

Financial Liabilities at Amortised Cost ii (378) (378)Total Financial Liabilities (378) (378)

Categories of financial instruments

Offsetting financial instruments: Financial instrument assets and liabilities are offset and the net amount presented in the consolidated balance sheet when, and only when, Monash Health has a legal right to offset the amounts and intends either to settle on a net basis or to realise the asset and settle the liability simultaneously.

· receivables (excluding statutory receivables); and

Financial liabilities at amortised cost are initially recognised on the date they are originated. They are initially measured at fair value plus any directly attributable transaction costs. Subsequent to initial recognition, these financial instruments are measured at amortised cost with any difference between the initial recognised amount and the redemption value being recognised in profit and loss over the period of the interest bearing liability, using the accrual method. Monash Health recognises the following liabilities in this category:· payables (excluding statutory payables); and· borrowings (including finance lease liabilities).

· term deposits

i For cash and cash equivalents and receivables, the net gain or loss is calculated by taking the movement in the fair value of the asset, the interest revenue, plus or minus foreign exchange gains or losses arising from revaluation of the financial assets, and minus any impairment recognised in the net result.

ii For financial liabilities measured at amortised cost, the net gain or loss is calculated by taking the interest expense measured at amortised cost.

Receivables and cash are financial instrument assets with fixed and determinable payments that are not quoted on an active market. These assets are initially recognised at fair value plus any directly attributable transaction costs. Subsequent to initial measurement, receivables are measured at amortised cost using the accrual method (and for assets, less any impairment). Monash Health recognises the following assets in this category:· cash and deposits



Note 7.1: Financial instruments (continued)

(b) Net holding gain/(loss) on financial instruments by category

Derecognition of financial liabilities: A financial liability is derecognised when the obligation under the liability is discharged, cancelled or expires.When an existing financial liability is replaced by another from the same lender on substantially different terms, or the terms of an existing liability are substantially modified, such an exchange or modification is treated as a derecognition of the original liability and the recognition of a new liability. The difference in the respective carrying amounts is recognised as an ‘other economic flow’ in the Comprehensive Operating Statement.

· has transferred substantially all the risks and rewards of the asset; or· has neither transferred nor retained substantially all the risks and rewards of the asset, but has transferred control of the asset. Where Monash Health has neither transferred nor retained substantially all the risks and rewards or transferred control, the asset is recognised to the extent of Monash Health’s continuing involvement in the asset.Impairment of financial assets: At the end of each reporting period, Monash Health assesses whether there is objective evidence that a financial asset or group of financial assets is impaired. All financial instrument assets, except those measured at fair value through profit or loss, are subject to annual review for impairment.

The allowance is the difference between the financial asset’s carrying amount and the present value of estimated future cash flows, discounted at the effective interest rate. In assessing impairment of statutory (non-contractual) financial assets, which are not financial instruments, professional judgement is applied in assessing materiality using estimates, averages and other computational methods in accordance with AASB 136 Impairment of Assets .

Reclassification of financial instruments: Subsequent to initial recognition and under rare circumstances, non-derivative financial instruments assets that have not been designated at fair value through profit or loss upon recognition, may be reclassified out of the fair value through profit or loss category, if they are no longer held for the purpose of selling or repurchasing in the near term.

Some master netting arrangements do not result in an offset of balance sheet assets and liabilities. Where Monash Health does not have a legally enforceable right to offset recognised amounts, because the right to offset is enforceable only on the occurrence of future events such as default, insolvency or bankruptcy, they are reported on a gross basis.

Derecognition of financial assets: A financial asset (or, where applicable, a part of a financial asset or part of a group of similar financial assets) is derecognised when:· the rights to receive cash flows from the asset have expired; or· Monash Health retains the right to receive cash flows from the asset, but has assumed an obligation to pay them in full without material delay to a third party under a ‘pass through’ arrangement; or· Monash Health has transferred its rights to receive cash flows from the asset and either:

121

Notes To and Forming Part of the Financial Statements Monas Health Annual Report 2017/18

Note 7.2: Contingent assets and contingent liabilities


Contingent LiabilitiesQuantifiableBackdated EBA Awards - 2,900 Total Quantifiable Contingent Liabilities - 2,900

All amounts shown in the contingents note are nominal amounts inclusive of GST.

At 30 June 2018, there were no contingent assets (2017: $0)

Contingent assets and contingent liabilities are not recognised in the Balance Sheet, but are disclosed by way of note and, if quantifiable, are measured at nominal value. Contingent assets and contingent liabilities are presented inclusive of GST receivable or payable respectively.



Note 8: Other disclosures

This section includes additional material disclosures required by accounting standards or otherwise, for the understanding of this annual report.

Structure8.1 Equity8.2 Reconciliation of net result for the year to net cash flow from operating activities8.3 Responsible persons disclosures8.4 Remuneration of executives 8.5 Related parties8.6 Remuneration of auditors8.7 Ex-gratia payments 8.8 AASBs issued that are not yet effective8.9 Events occurring after the balance sheet date8.10 Controlled entities8.11 Economic dependency

123


Note 8.1: EquityConsolidated Consolidated

2018 2017$'000 $'000

(a) SurplusesProperty, Plant and Equipment Revaluation Surplus

Balance at the beginning of the reporting period 641,545 641,545 Revaluation increment - Land 35,000 - Balance at the end of the reporting period* 676,545 641,545

* Represented by: - Land 158,864 123,864 - Buildings 516,917 516,917 - Cultural assets 447 447 - Motor vehicles 317 317

676,545 641,545

Restricted Specific Purpose SurplusBalance at the beginning of the reporting period 14,953 8,203 Transfer from accumulated surplus 5,762 6,750 Balance at the end of the reporting period 20,715 14,953

Total Surpluses 697,260 656,498

(b) Contributed CapitalBalance at the beginning of the reporting period 403,093 403,048 Capital contribution received from Victorian Government 827 45 Balance at the end of the reporting period 403,920 403,093

(c) Accumulated SurplusesBalance at the beginning of the reporting period 133,689 32,982 Net result for the year 15 107,457 Transfers to restricted specific purpose surplus (5,762) (6,750) Prior year adjustment 36 -

Balance at the end of the reporting period 127,978 133,689

Total equity at end of year 1,229,158 1,193,280

Contributed Capital

Specific Restricted Purpose Surplus

The asset revaluation surplus is used to record increments and decrements on the revaluation of non-current physical assets.

A specific restricted purpose surplus is established where Monash Health has possession or title to the funds but has no discretion to amend or vary the restriction and/or condition underlying the funds received.

Consistent with Australian Accounting Interpretation 1038 Contributions by Owners Made to Wholly-Owned Public Sector Entities and FRD 119A Contributions by Owners , appropriations for additions to the net asset base have been designated as contributed capital. Other transfers that are in the nature of contributions to or distributions by owners that have been designated as contributed capital are also treated as contributed capital.

Transfers of net assets arising from administrative restructurings are treated as contributions by owners. Transfers of net liabilities arising from administrative restructures are to go through the Comprehensive Operating Statement.

Property, Plant and Equipment Revaluation Surplus




Net result for the period 15 107,457

Non-cash movements:Depreciation and amortisation 77,310 67,063 Provision for doubtful debts 533 206 Adjustment Prior year capital contribution 11 - Share of net results in associates (87) (147) Net movement in finance lease i (3,198) (2,172) Government non cash funding for hospital expansion (44,380) (61,905) Adjustment of non current portion of loan to present value (1,155) -

Movements included in investing and financing activitiesNet gain from disposal of non-financial physical assets 342 271

Movements in assets and liabilities:Change in operating assets and liabilities (Increase)/Decrease in Receivables 54 (6,963) (Increase)/Decrease in Prepayments 806 422 Increase/(Decrease) in Payables 9,005 (14,158) Increase/(Decrease) in Provisions 41,375 24,165 (Increase)/Decrease in Inventories (1,578) (2,617)

NET CASH INFLOW FROM OPERATING ACTIVITIES 79,053 111,622

Note 8.2: Reconciliation of net result for the year to net cashFlow from operating activities

i Funded by and payments made by the Department of Health and Human Services to Monash Health.

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Governing BoardsMs Barbara Yeoh (term expired 30 June 2018)Ms Debbie Williams (term expired 30 June 2018)Mr Charles GilliesMs Heather ClelandMr Dipak SanghviMs Jorden LamDr Misty JenkinsMs Sarah RalphProf. Hatem SalemAccountable OfficersMr Andrew Stripp

Remuneration of Responsible PersonsThe number of Responsible Persons are shown in their relevant income bands.

2018 2017Income Band No. No.$0 - $19,999 - 3$20,000 - $29,999 - 2$30,000 - $39,999 8 5$70,000 - $79,999 1$420,000 - $429,999 - 1$460,000 - $469,999 1 -Total numbers of Responsible Persons 10 12

$854,638 $770,504

1/07/2017 - 30/6/20181/07/2017 - 30/6/2018

1/07/2017 - 30/6/2018

Responsible Ministers: The Honourable Jill Hennessy, Minister for Health, Minister for Ambulance ServicesThe Honourable Martin Foley, Minister for Housing, Disability and Ageing, Minister for Mental Health

1/07/2017 - 30/6/2018

1/07/2017 - 30/6/20181/07/2017 - 30/6/20181/07/2017 - 30/6/20181/07/2017 - 30/6/2018

Note 8.3: Responsible persons disclosuresIn accordance with the Ministerial Directions issued by the Minister for Finance under the FinancialManagement Act 1994 , the following disclosures are made regarding responsible persons for the reporting period.

Period

1/07/2017 - 30/6/2018

Parent

1/07/2017 - 30/6/20181/07/2017 - 30/6/2018

Total remuneration received or due and receivable by ResponsiblePersons from the reporting entity amounted to:

1

1/07/2017 - 30/6/2018

Amounts relating to the Governing Board Members and Accountable Officer are disclosed in the Monash Health's controlled entities financial Statement. Amounts relating to responsible Ministers are reported within the Department of Parliamentary Services' Financial Report as disclosed in Note 8.5 Related Parties.



Note 8.4: Remuneration of executives

Executive Officers' Remuneration

Remuneration of executive officers

2018 2017$ '000 $ '000

Short-term benefits 2,351 2,173 Post-employment benefits 213 202 Other Long-term benefits 74 45 Total remuneration 2,638 2,420

Total number of executives 9 12 Total annualised employee equivalent i 9 8

The number of executive officers, other than Ministers and Accountable Officers, and their total remuneration during the reporting period are shown in the table below. Total annualised employee equivalent provides a measure of full time equivalent executive officers over the reporting period. Remuneration comprises employee benefits in all forms of consideration paid, payable or provided in exchange for services rendered, and is disclosed in the following categories:

Short-term Employee Benefits Salary and wages, annual leave or sick leave that are usually paid or payable on a regular basis, as well as non-monetary benefits such as allowances and free or subsidised goods or services.

Post-employment Benefits Pensions and other retirement benefits paid or payable on a discrete basis when employment has ceased. Other Long-term Benefits Long service leave, other long-service benefit or deferred compensation.

Parent

Total Remuneration

(i) Annualised employee equivalent is based on working 38 ordinary hours per week over the reporting period.

Remuneration of Kitaya Holding Pty Ltd's executive officers is disclosed in the company's financial statements.

127


Note 8.5: Related parties

Key Management Personnel Position TitleMonash HealthMs Barbara Yeoh (term expired 30 June 2018) Board MemberMs Debbie Williams (term expired 30 June 2018) Board MemberMr Charles Gillies Board MemberMs Heather Cleland Board MemberMr Dipak Sanghvi Board MemberMs Jorden Lam Board MemberDr Misty Jenkins Board MemberMs Sarah Ralph Board MemberProf. Hatem Salem Board MemberMr Andrew Stripp Chief Executive

Kitaya Holding Pty Ltd's KMPs are disclosed in the company's financial statements

Significant transactions with government-related entities

The Department of Health and Human Services granted an interest free loan of $10m to Monash Health during the year ended 30 June 2018. The loan is repayable over 10 years with repayments

Expenses incurred by Monash Health in delivering services and outputs are in accordance with HealthPurchasing Victoria requirements. Goods and services including procurement, diagnostics, patient meals and multi-site operational support are provided by other Victorian Health Service Providers on commercial terms.

Professional medical indemnity insurance and other insurance products are obtained from a Victorian Public Financial Corporation.Treasury Risk Management Directions require Monash Health to hold cash (in excess of working capital) and investments, and source all borrowings from Victorian Public Financial Corporations.

The compensation detailed below excludes the salaries and benefits the Portfolio Ministers receive. The Minister’s remuneration and allowances is set by the Parliamentary Salaries and Superannuation Act 1968 , and is reported within the Department of Parliamentary Services’ Financial Report.

Monash Health has two loan agreements with Treasury Corporation of Victoria for $19.6m and $13.3m with amounts borrowed repayable over 22 and 20 years respectively. At 30 June 2018, the total amount due to the Treasury Corporatiion of Victoria in relation to these loans was $27.2m.

The Board of Directors and the Chief Executive of Monash Health and it's controlled entities are deemed to be KMPs.

Monash Health received funding from the Department of Health and Human Services of $1,451 million (2017: $1,384 million).

KMPs are those people with the authority and responsibility for planning, directing and controlling theactivities of Monash Health and its controlled entities, directly or indirectly.

Monash Health is a wholly owned and controlled entity of the State of Victoria. Related parties of the hospital include:• All key management personnel (KMPs) and their close family members;• Cabinet ministers (where applicable) and their close family members; and• Controlled entities • All hospitals and public sector entities that are controlled and consolidated into the whole of stateconsolidated financial statements.



Note 8.5: Related parties (continued)

Parent Parent2018 2017$ '000 $ '000

Compensation of Key Management PersonnelShort-term Employee Benefits 779 701 Post-employment benefits 62 59 Other long-term benefits 14 11

Total i 855 771

Transactions with KMPs and Other Related Parties

Controlled Entities Related Party Transactions

2018 2017$ '000 $ '000

Rental income received from its controlled entity 1,149 1,132 Contracted Goods and Services provided to its controlled entity 24,228 24,918

Amounts owing at balance date Amount owing to controlled entity 13,188 14,239

Outside of normal citizen type transactions with the Department of Health and Human Services, all other related party transactions that involved KMPs and their close family members have been entered into on an arm's length basis. Transactions are disclosed when they are considered material to the users of the financial report in making and evaluation decisions about the allocation of scare resources.

Kitaya Holdings Pty Ltd operates Jessie McPherson Private Hospital. Monash Health is reimbursed by its controlled entity, Kitaya Holdings Pty Ltd, for the provision of goods and services required to run the private hospital. The fee includes charges for labour, power, food, cleaning and other services. All transactions are conducted on normal commercial terms and conditions.

The aggregate amounts brought to account in respect of the following types of transactions were:

i KMPs are also reported in Note 8.3 Responsible Persons

Given the breadth and depth of State government activities, related parties transact with the Victorian public sector in a manner consistent with other members of the public e.g. stamp duty and other government fees and charges. Further employment of processes within the Victorian public sector occur on terms and conditions consistent with the Public Administration Act 2004 and Codes of Conduct and Standards issued by the Victorian Public Sector Commission. Procurement processes occur on terms and conditions consistent with the Victorian Government Procurement Board requirements.

There were no related party transactions with Cabinet Ministers required to be disclosed in 2018.

There were no related party transactions required to be disclosed for Monash Health Board Members and Chief Executive in 2018.

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Note 8.6: Remuneration of auditors

2018 2017$000 $000

Victorian Auditor-General's OfficeAudit of financial statement 335 326

TOTAL REMUNERATION OF AUDITORS 335 326



Note 8.7: Ex gratia payments

There have been no ex gratia payments made during the financial year (2017: $0).

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Note 8.8: AASBs Issued that are not yet effective

Standard Summary

Applicableforannualreportingperiodsbeginningon

Impactonpublicsectorentityfinancialstatements

AASB9FinancialInstruments 1January2018 Theassessmenthasidentifiedthattheamendmentsarelikelytoresultinearlierrecognitionofimpairmentlossesandatmoreregularintervals.TheinitialapplicationofAASB9isnotexpectedtosignificantlyimpactthefinancialpositonhowevertherewillbeachangetothewayfinancialinstrumentsareclassifiedandnewdisclosurerequirements

AASB2014‑1AmendmentstoAustralianAccountingStandards[PartEFinancialInstruments]

AmendsvariousAASstoreflecttheAASB’sdecisiontodeferthemandatoryapplicationdateofAASB9toannualreportingperiodsbeginningonorafter1January2018,andtoamendreduceddisclosure requirements

1January2018 ThisamendingstandardwilldefertheapplicationperiodofAASB9tothe2018‐19reportingperiodinaccordancewiththetransitionrequirements.

AASB2014‑7AmendmentstoAustralianAccountingStandardsarisingfromAASB9

AmendsvariousAASstoincorporatetheconsequentialamendmentsarisingfromtheissuanceofAASB9.

1 January 2018 The assessment has indicated that there will be no significant impact for the public sector.

AASB15RevenuefromContractswithCustomers

ThecoreprincipleofAASB15requiresanentitytorecogniserevenuewhentheentitysatisfiesaperformanceobligationbytransferringapromisedgoodorservicetoacustomer.NotethatamendingstandardAASB2015‑8AmendmentstoAustralianAccountingStandards–EffectiveDateofAASB15 hasdeferredtheeffectivedateofAASB15toannualreportingperiodsbeginningonorafter1January2018,insteadof1January2017

1 January 2018 The changes in revenue recognition requirements in AASB 15 may result in changes to the timing and amount of revenue recorded in the financial statements. The Standard will also require additional disclosures on service revenue and contract modifications.

Amendsthemeasurementoftradereceivablesandtherecognitionofdividendsasfollow:

The assessment has indicated that there will be no significant impact for the

public sector. Trade receivables, that do not have a significant financing component, are to be measured at their transaction price at initial recognition. Dividends are recognised in the profit and loss only when:

o the entity’s right to receive payment of the dividend is established;o it is probable that the economic benefits associated with the dividend will flow to the entity; and

o the amount can be measured reliably.

AASB2015‐8AmendmentstoAustralianAccountingStandards–EffectiveDateofAASB15

ThisstandarddefersthemandatoryeffectivedateofAASB15from1January2017to1January2018.

1 January 2018 This amending standard will defer the application period of AASB 15 for for‐profit entities to the 2018‐19 reporting period in accordance with the transition requirements.

ThisStandardamendsAASB15toclarifyrequirementsforidentifyingperformanceobligations,principalversusagentconsiderationsandthetimingofrecognisingrevenuefromgrantingalicence

The assessment has indicated that there will be no significant impact for the public sector, other than the impact identified for AASB 15 above.

Theamendmentsrequire: a promise to transfer to a customer a good or service that is ‘distinct’ to be recognised as a separate performance obligation; for items purchased online, the entity is a principal if it obtains control of the good or service prior to transferring to the customer; and for licences identified as being distinct from other goods or services in a contract, entities need to determine whether the licence transfers to the customer over time (right to use) or at a point in time (right to access).

AASB2014‑5AmendmentstoAustralianAccountingStandardsarisingfromAASB15

AASB2016‐3AmendmentstoAustralianAccountingStandards–ClarificationstoAASB15

1 January 2018

1 January 2018

Certain new Australian accounting standards have been published that are not mandatory for the 30 June 2018 reporting period. The Department of Treasury and Finance assesses the impact of all these new standards and advises Monash Health of their applicability and early adoption where applicable.

As at 30 June 2018, the following standards and interpretations had been issued by the AASB but were not yet effective. They become effective for the first financial statements for reporting periods commencing after the stated operative dates as detailed in the table below. Monash Health has not and does not intend to adopt these standards early.

ThekeychangesintroducedbyAASB9includesimplifiedrequirementsfortheclassificationandmeasurementoffinancialassets,anewhedgingaccountingmodelandarevisedimpairmentlossmodeltorecogniseimpairmentlossesearlier,asopposedtothecurrentapproachthatrecognisesimpairmentonlywhenincurred.



Note 8.8: AASBs Issued that are not yet effective (continued)

Standard Summary



AASB2016‐7AmendmentstoAustralianAccountingStandards–DeferralofAASB15forNot‐for‐ProfitEntities

ThisstandarddefersthemandatoryeffectivedateofAASB15fornot‐for‐profitentitiesfrom1January2018to1January2019.

1 January 2019 This amending standard will defer the application period of AASB 15 for not‐for‐profit entities to the 2019‐20 reporting period.

AASB2016‐8insertsAustralianrequirementsandauthoritativeimplementationguidancefornot‐for‐profit‐entitiesintoAASB9andAASB15.

ThisstandardclarifiestheapplicationofAASB15andAASB9inanot‐for‐profitcontext.Theareaswithinthesestandardsthatareamendedfornot‐for‐profitapplication include:AASB9Statutoryreceivablesarerecognisedandmeasuredsimilarlyto�inancialassets

AASB16Leases ThekeychangesintroducedbyAASB16includetherecognitionofmostoperatingleases(whicharecurrentlynotrecognised)onbalancesheetwhichhasanimpactonnetdebt.

1January2019 Theassessmenthasindicatedthatmostoperatingleases,withtheexceptionofshorttermandlowvalueleaseswillcomeontothebalancesheetandwillberecognisedasrightofuseassetswithacorrespondingleaseliability.

Intheoperatingstatement,theoperatingleaseexpensewillbereplacedbydepreciationexpenseoftheassetandaninterestcharge.

AASB1058IncomeofNot‐for‐ProfitEntities

AASB1058standardwillreplacethemajorityofincomerecognitioninrelationtogovernmentgrantsandothertypesofcontributionsrequirementsrelatingtopublicsectornot‐for‐profitentities,previouslyinAASB1004Contributions.TherestructureofadministrativearrangementwillremainunderAASB1004andwillberestrictedtogovernmententitiesandcontributionsbyownersinapublicsectorcontext,

1January2019 Thecurrentrevenuerecognitionforgrantsistorecogniserevenueupfrontuponreceiptofthefunds.ThismaychangeunderAASB1058,ascapitalgrantsfortheconstructionofassetswillneedtobedeferred.Incomewillberecognisedovertime,uponcompletionandsatisfactionofperformanceobligationsforassetsbeingconstructed,orincomewillberecognisedatapointintimeforacquisitionofassets.

AASB1058establishesprinciplesfortransactionsthatarenotwithinthescopeofAASB15,wheretheconsiderationtoacquireanassetissignificantlylessthanfairvaluetoenablenot‐for‐profitentitiestofurthertheirobjective

Therevenuerecognitionforoperatinggrantswillneedtobeanalysedtoestablishwhethertherequirementsunderotherapplicablestandardsneedtobeconsideredforrecognitionofliabilities(whichwillhavetheeffectofdeferringtheincomeassociatedwiththesegrants).Onlyafterthatanalysiswoulditbepossibletoconcludewhetherthereareanychangestooperatinggrants.

Theimpactoncurrentrevenuerecognitionofthechangesisthephasingandtimingofrevenuerecordedintheprofitandlossstatement.

AASB15•The“customer”doesnotneedtobetherecipientofgoodsand/orservices;•The“contract”couldincludeanarrangemententeredintounderthedirectionofanotherparty;•Contractsareenforceableiftheyareenforceablebylegalor“equivalentmeans”;•Contractsdonothavetohavecommercialsubstance,onlyeconomicsubstance;and•Performanceobligationsneedtobe“sufficientlyspecific”tobeabletoapplyAASB15tothesetransactions

ThisStandardamendsAASB9andAASB15toincluderequirementstoassistnot‐for‐profitentitiesinapplyingtherespectivestandardstoparticulartransactionsandevents.

AASB2016‐8AmendmentstoAustralianAccountingStandards–AustralianImplementationGuidanceforNot‐for‐ProfitEntities

1January2019

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Note 8.8: AASBs Issued that are not yet effective (continued)

Standard Summary



AASB1059ServiceConcessionArrangements:Grantor

1January2019 ForanarrangementtobeinscopeofAASB1059allofthefollowingrequirementsaretobesatisfied:besatisfied:•Operatorisprovidingpublicservicesusingaserviceconcessionasset;•Operatormanagesat‘leastsome’ofpublicservicesunderitsowndiscretion;•TheStatecontrols/regulates:oWhatservicesaretobeprovided;oTowhom;andoAtwhatprice•Statecontrolsanysignificantresidualinterestintheasset.

Ifthearrangementdoesnotsatisfyalltheaboverequirementstherecognitionwillfallundertherequirementsofanotherapplicableaccountingstandard.

2.EconomicInfrastructure:APPPthatisbasedonuserpaysmodel:•Operatorfinancesandconstructstheinfrastructure;•Statedoesnotpayforthecostoftheconstruction;and•Operatorchargesassetusersandrecoversthecostofconstructionandoperationforthetermofthecontract.

CurrentlythesocialinfrastructurePPPsareonlyrecognisedonthebalancesheetatcommercialacceptance.Thearrangementwillneedtobeprogressivelyrecognisedasandwhentheassetisbeingconstructed.Thiswillhavetheimpactofprogressivelyrecognisingthefinancialliabilityandcorrespondingassetastheassetisbeingconstructed.

For economic infrastructure PPP arrangements, that were previously not on balance sheet, the standard will require recognition of these arrangements on balance sheet. There will be no impact to net debt, as a deferred revenue liability will be recognised and amortised over the concession term.

Thisstandardappliestoarrangementsthatinvolveanoperatorprovidingapublicserviceonbehalfofapublicsectorgrantor.Itinvolvestheuseofaserviceconcessionassetandwheretheoperatormanagesatleastsomeofthepublicserviceatitsowndirection.Anarrangementwithinthescopeofthisstandardtypicallyinvolvesanoperatorconstructingtheassetusedtoprovidethepublicserviceorupgradingtheassetsandoperatingandmaintainingtheassetsforaspecifiedperiodoftime.

TheStatehas2typesofPPPs:1.SocialInfrastructure:APPPthatrequiresthegovernmenttomakepaymentstotheoperatoruponcommencementofservices:•Operatorfinancesandconstructstheinfrastructure;andState pays unitary service payments over



Note 8.9: Events occurring after the balance sheet date

There have been no significant events after reporting date.

Assets, liabilities, income or expenses arise from past transactions or other past events. Where the transactions result from an agreement between Monash Health and other parties, the transactions are only recognised when the agreement is irrevocable at or before the end of the reporting period.Adjustments are made to amounts recognised in the financial statements for events which occur between the end of the reporting period and the date when the financial statements are authorised for issue, where those events provide information about conditions which existed at the reporting date. Note disclosure is made about events between the end of the reporting period and the date the financial statements are authorised for issue where the events relate to conditions which arose after the end of the reporting period that are considered to be of material interest.

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Note 8.10: Controlled entities

Name of entity Country of incorporation Equity Holding

Kitaya Holdings Pty Ltd Australia 100%(trading as Jessie McPherson Private Hospital)

CONTROLLED ENITITES CONTRIBUTION TO THE CONSOLIDATED RESULTS

2018 2017

Kitaya Holdings Pty Ltd 100% 100%



Note 8.11: Economic dependency

Monash Health is wholly dependent on the continued financial support of the State Government and in particular, the Department of Health and Human Services.

The Department of Health and Human Services has provided confirmation that it will continue to provide Monash Health adequate cash flow support to meet its current and future obligations as and when they fall due for a period up to September 2019.

The hospital’s current asset ratio improved slightly but continues to be below an adequate short term position (2018: 0.51 and 2017: 0.48) while cash generated from operations fell to a surplus of $79m from $112m in 2017. Cash reserves increased to $160m from $116m in 2017. A letter confirming adequate cash flow was also provided in the previous financial year. The financial statements have been prepared on a going concern basis.

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Corporate Office 246 Clayton Road, Clayton

t 03 9594 6666 e [email protected] www.monashhealth.org

ABN 82 142 080 338

annual report 2017-18 - parliament of victoria · 2018-09-19 · than it should be.” said monash...

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