Foreword

Under the Public Audit Act 2001, my mandate to review issues of effectiveness and efficiency was extended beyond core central and local government entities. This is the first performance audit in the health sector under the Act.

Audit Offices around the world take a close interest in what their counterparts in other countries are doing. They try to learn from one another and make good use of resources; for example, by sharing approaches to avoid "reinventing the wheel". Through this interest, we noted the success of the report that the United Kingdom National Audit Office published in February 2000 "The Management and Control of Hospital Acquired Infection in Acute NHS Trusts in England". The team for our audit is most grateful to the UK colleagues who worked on that report, for providing material to help us with our audit - including access to their survey, which we amended to reflect the New Zealand context.

In reporting the results of our survey (which form the basis of Volume Two), we decided not to name individual District Health Boards (DHBs) as we expected that, as a result of our report, hospitals would be implementing improvements. We have provided all DHBs with comparative feedback of survey results which we hope they will use to improve infection control practices.

We appreciate the positive response of the health sector to our audit. The idea of patients acquiring an infection as a result of treatment they receive strikes at the core of the health system. We might have expected to encounter some defensiveness among health sector staff. We did not. Instead, we were consistently met with open-minded professionalism from people wanting to continuously improve their clinical practices.

The Ministry of Health and DHB staff have acknowledged our audit as providing a baseline from which to improve infection control practices. I look forward to seeing this commitment applied to achieving the improvements recommended in this report.

K B Brady
Controller and Auditor-General

12 June 2003

Explanatory Notes:

1. Frequent footnote references are made in this report to our survey by questionnaire of DHBs. The blank questionnaire form is available on our web site www.oag.govt.nz under "Publications". All results are taken from a survey population of 21 DHB hospital services unless otherwise stated. The footnotes identify the relevant part of the survey questionnaire by form, question, and part - e.g. F2: Q10, a, b, c refers to Form 2, Question 10, and sub-parts a, b, and c of that question.
2. In this report we have used quotations extracted from DHB survey responses to highlight some issues and/or opinions. The quotations are shown in stylised text boxes.