Audit objective and criteria

The objective of this audit was to assess the effectiveness of the Department of Immigration and Border Protection’s administration of health services in onshore immigration detention. To form a conclusion against this objective, the ANAO adopted the following high-level criteria:

• Was a robust contract in place to support the effective and efficient delivery of health services?
• Were effective arrangements established to monitor health service provision and manage the contractor’s performance?
• Was health service delivery and contractor performance appropriately monitored?

Conclusion

The department’s administration of health services in onshore immigration detention has been improved by the strengthening of contractual arrangements with the selected provider of health services. The current contract, which was developed by the department based on a strategic analysis of shortcomings that had arisen under earlier contracts, includes: mechanisms to control the risk of over-servicing and uncontrolled cost escalation; clearly defined deliverables; and a performance monitoring regime containing provisions for the application of penalties and incentives. However, to be able to give assurance that contract objectives are being achieved, there is further scope for the department to improve its administration of health service delivery, primarily through strengthening arrangements for monitoring:

• the quality of the health services that are being delivered; and
• key areas of health service delivery risk (such as services to detainees with mental health conditions)