Government doesn’t know if $4m health project worked, state watchdog audit reveals

The state’s watchdog has revealed the Andrews government couldn’t tell if its own state-funded hubs had boosted patients’ access to vital health services.

The government spent more than $4.2m establishing eight clinical hubs and an information hotline between 2017 and 2020. Picture: iStock

The government has no idea whether a multimillion-dollar health program improved patients’ access to — as opposed to just awareness of — vital health services, the state’s watchdog has found.

The Victorian Auditor-General’s Office reviewed women’s access to sexual and reproductive health services and found the health department could not determine if their state-funded hubs had actually boosted access and were “the best use of government resources”.

The government spent more than $4.2m establishing eight clinical hubs and an information hotline between 2017 and 2020, with 11 hubs – costing $150,000 per year – running by 2022.

But the VAGO questioned their locations, finding there are still areas in Victoria where women “cannot readily access” services and that the health department “does not know” if their hubs were “where women most need them”.

The audit and its recommendations, released on Wednesday and accepted by the Health Department, blamed poor performance monitoring measures and data collection as opposed to the hubs’, who offer services including contraception, abortion and sexual health testing.

It found the department did “not fully understand” service demand and gaps; still did not have a “complete list” of providers; and that – even based on the current, available data – hub locations were still inconsistent with “women’s SRH needs”.

The government funds state sexual and reproductive health hubs. Picture: Scott Campbell

The hotline 1800 My Options did improve access to SRH information, the auditor-general found, noting that 85 per cent of calls related to abortion and users reported a better understanding of their rights, options and corrections of misinformation.

But again, VAGO found the department could not determine whether this information had led to “improved access to SRH services”.

The review found Wyndham, Hume, Melton and Whittlesea council areas had a high demand – based on 1800 call data – but no hub, while 15 rural LGAs have less than two registered SRH providers.

Access to abortion services was even more limited, and – as of January 2023 – 17 regional and rural LGAs had no registered medical or surgical termination providers on 1800 My Options.

The audit did not examine recent policy updates – including a new sexual and reproductive health strategy that was based on “extensive consultations … including feedback on the previous strategy’s gaps” and was released in 2022.

The report also noted the department, responding to the performance measures’ criticism, said they did not identify targets “to avoid creating situations” where staff were influenced to recommend one service, for example termination, over another.

But the report said the department had a responsibility to develop “relevant and appropriately worded outcome performance measures” that allow them to measure their services’ effectiveness without influencing patients’ decisions.

The audit made three recommendations to the department including undertaking a “comprehensive” service demand and gap analysis and developing “relevant outcome performance measures” – which measure access as opposed to just awareness – for both hubs and 1800 My Options.

Department of Health secretary Professor Euan Wallace, whose response was included in the report, said he accepted the recommendations.

A health department spokesman said work to implement the recommendation was “already under way” and thanked the Auditor-General for this “important report”.

“We will always support a woman’s right to make her own reproductive choices and will continue to work with Victoria’s health providers on how best to ensure all women can access the services they need,” he said.

“That’s why, as part of the Victorian government’s commitment to give women’s health the focus it deserves, we’ll expand the number of sexual and reproductive health hubs and establish 20 comprehensive women’s health clinics across Victoria, giving Victorian women better access to the care they need.”