The Auditor General's Public Sector Performance Report for 2005 was a follow-up to the 2001 performance examination.The re-look at Life Matters: Management of Deliberate Self- Harm in Young People compared the care given in hospital emergency departments and community health services with medical guidelines.

The examination found the Department of Health (DoH) has made limited progress in addressing 2001 recommendations...

• Not all patients presenting with deliberate self-harm at hospital EDs receive psychiatric attention (but the DoH is increasing the number of mental health clinicians to deal with this problem).
• The DoH does not actively monitor compliance with the National Mental Health Standards and cannot demonstrate it has introduced minimum service specifications.
• Different referral and collaborative care protocols have been implemented across individual health services, affecting the efficiency and effectiveness of care.
• The online clinical information system (PSOLIS) has not been implemented to assist service planning and monitoring.

The Auditor General's look at the regulation of child care services revealed that in 2005, an estimated 38% of children <6 yrs and 15% < 13 yrs use child care services - that's >70,000 children each week.

Child care services must be licensed under the Community Services Act 1972. The legislation sets minimum standards for the care of children and the Department for Community Development (DCD) is responsible for licensing a child care provider and making sure they meet standards.

Adverse findings were:

• DCD's assessment of staff numbers and qualifications at centres needs improvement - 31% of new centres were not checked within six months of commencement. DCD also uses a staffing formula that in 30% of cases tested, resulted in fewer staff than required by regulation.
• Non-compliance by child care services with regulations (that do not constitute an immediate risk to the child) is common. The Department does not classify these in order to determine when prosecution, suspension or revocation of a licence is applicable.
• DCD's investigation of complaints and allegations into child maltreatment can be complex and time consuming. Opportunity for improvement was noted. Complaints relating to health and safety, child care activities and administration took on average 111 days to resolve, while 43% of investigations into child maltreatment allegations took between 91-231 days to resolve.