The Hon. J.M.A. LENSINK: I seek leave to make an explanation before asking the minister representing the Minister for Health a question about Metropolitan Domiciliary Care.
The Hon. J.M.A. LENSINK: I had a good opportunity to thoroughly read the annual report of Metropolitan Domiciliary Care for 2002-03, recently tabled in this place.
Metropolitan Domiciliary Care (MDC) is an amalgamation of the four regional metropolitan dom care services and came into being as a new entity on 1 July 2002. Much of the drive for a single service was to reduce duplication, unify services across the metropolitan area and, presumably, for some efficiency gains. The new amalgamated service is of quite significant size. Total revenue for 2002-03 was $59.5 million.
It has a total full-time equivalent of 667.39 and for the year had a total active client number of 11 581, who received a total of 45 724 direct and indirect hours of service—direct being personal care and other forms of assistance and indirect referring to the behind the scenes work such as travel and staff contact with other professionals.
According to the report, the average client receives 3.91 hours of direct service. However, a few calculations lead to some interesting results. If you do a simple division of the total expenses for the year of $52.16 million by the total number of service hours to establish a simple measure of unit cost, that being what it costs to deliver one hour of service to a client, it comes out to $1 140.76. In wondering whether that could possibly be correct and in recognition of the significant equipment distributed by domiciliary care, I excluded all except the largest expense, employee benefits of $37.694 million divided by the number of FTEs, to come up with approximately $56 500 in benefits for the average staff member.
The next calculation was to divide the number of clients by the number of staff, which led to approximately 17 clients for every staff member. Benefits per staff member divided by the number of clients per staff member yields $3 256, which sounds something like the level of funding for a CACP package, or low level support at home. When you divide that last figure by the average service hours per client, you get an hourly rate of all employee benefits for the cost of providing domiciliary care services at a staggering rate of $833 per hour.
The Hon. R.D. Lawson: Repeat that!
The Hon. J.M.A. LENSINK: $833 per hour.
The PRESIDENT: I do not think the Hon. Ms Lensink needs a straight man.
The Hon. J.M.A. LENSINK: I thought that maybe I was wrong, so I recalculated it and took just the wages and salaries (which excludes long service leave, holiday pay and so on) of $32.573 million and divided it by total client hours of 45 724 to reach an hourly rate of $712. At that point, I decided there were no more things that I could exclude in the interest of being fair to MDC. My questions are:
1. How can these costs be justified in light of South Australia’s ageing population and the high demand for services?
2. What efficiency dividends has the merger achieved so far?
3. How many employees are receiving executive level salaries and at what rates; and why were those levels not printed in detail on page 23 as were the number of people on various levels of the nursing award, medical officers award and so on?
4. Has the government considered any restructure that would make domiciliary care more efficient?
5. Will the government consider financial benchmarking with other services in the non-government and private sector in the interests of providing more services for the large number of dollars it receives?
The Hon. T.G. ROBERTS (Minister for Aboriginal Affairs and Reconciliation): I will refer those important questions to the minister in another place and bring back a reply.
An honourable member interjecting:
The Hon. T.G. ROBERTS: Of course I would; it is not my particular area of responsibility.
Monday 16 February 2004
In reply to Hon. J.M.A. LENSINK (1 December 2003).
The Hon. T.G. ROBERTS: The Minister for Health has provided the following information:
1. In 2002-03, Metropolitan Domiciliary Care (MDC) provided a total of 548,693 hours of service. 45, 724 hours was the monthly average for service hours.
2. There has been a 5.8 per cent increase in the total number of service hours provided during 2002-03 in the first year of the newly formed organisation, as compared to 2001-02. Total service hours provided in 2002-03 were 548,693 as compared to 518,574 hours in 2001-02.
3. Only the Chief Executive Officer (CEO) is employed at an executive level salary (EX-B salary classification). As the CEO commenced duty on 2 December 2002 and the salary for this 7 month period to June 2003 did not exceed $100,000, it was not reported separately in the notes to the financial statements.
4. On 1 July 2002, domiciliary care services were recently restructured to create Metropolitan Domiciliary Care. This is realising efficiencies in service delivery. Further efficiency benefits of the restructure are expected during 2004-05.
5. DHS is currently developing financial benchmarking for Metropolitan Domiciliary Care.