On behalf of the AIHW Board, I am pleased to present the AIHW’s annual report for 2019–20.
The board and I have been incredibly impressed by the dedication of the AIHW’s staff in responding to the COVID-19 pandemic. Staff have supported the National Incident Room and AIHW data have contributed to the considerations of the Prime Minister, the Minister for Health and the Chief Medical Officer in their policy responses to COVID-19. This exemplifies our purpose to create authoritative and accessible information and statistics that inform decisions and improve the health and welfare of all Australians. Among the tragedy and terrible effects of COVID-19 in Australia and around the world, it gives me enormous pride to commend the tremendous efforts of the AIHW.
Unsurprisingly, COVID-19 dominated our March and June board meetings, which were held via teleconference. We paid particular attention to our strategic risk profile and performance reports in exercising the board’s oversight of the AIHW in responding to the pandemic while striving to meet our strategic goals.
On 11 September 2019, I had the honour of hosting the Minister for Social Services, Senator the Hon. Anne Ruston, to launch our flagship report Australia’s welfare 2019 at Parliament House. This was the first release of a flagship report in a new format that included improved online functionality, allowing users better interaction with data presented.
The board recognises the importance of community trust in the AIHW in holding large data assets that contain sensitive personal information. We take our role seriously in oversighting policies and practices to keep these data safe and secure from growing cyber threats. This focus on community trust also requires us to continue delivering our services to a high standard while also investing in technologies to deliver new and enhanced service offerings in a changing data landscape.
I gratefully accepted the opportunity to be reappointed as AIHW Board Chair by the Minister for Health, the Hon. Greg Hunt, MP, for another 3 years. I also welcomed the reappointment of our 3 members nominated by state and territory health ministers—Dr Zoran Bolevich, Ms Christine Castley and Ms Marilyn Chilvers. These appointments provide the board with stability and continuity not seen for a number of years. I thank all members for their useful contributions to board discussions and decisions. On behalf of the board, I also thank the members of the AIHW Ethics Committee for their advice and support in managing the complex issues around access to sensitive data and the linkage of multiple data sets.
The achievements in this annual report reflect the authentic and visionary leadership of the Chief Executive Officer, Mr Barry Sandison, and his outstanding guidance to the executive team and the staff of the AIHW. I thank each and every one of them for their dedication, commitment and passion in one of the most challenging periods in our history. Under Mr Sandison’s stewardship, the AIHW has grown its data and analytical capabilities in traditional and new topic areas, presented publications in more innovative, dynamic and interactive formats, and provided expanded data and information services in collaboration with governments and the research community.
In 2020–21, we will maintain focus on efficiency and building partnerships with our stakeholders to achieve our vision of stronger evidence, better decisions and improved health and welfare. The AIHW Board will commence a review of our strategic directions with the aim of cementing the pathway to retain the AIHW as the leader in health and welfare information in Australia.
Mr Barry Sandison
It has been an incredibly challenging year in 2019–20. Like much of Australia, work at the AIHW was impacted firstly by the national bushfire crisis and then the COVID-19 pandemic. Despite these challenges, we continued to deliver our products and services while supporting Australia’s response to the pandemic.
Data are playing an increasingly powerful role in informing policy and research in health and welfare in Australia. We saw growth in demand for data linkage and customised data services.
Due to the Australian Public Service cap on staffing levels, we have continued to rely on employing contract staff to meet our business requirements. By the end of June 2020, 32.3% of our active staff were contractors.
We embraced a flexible approach in response to the COVID-19 pandemic. We provided staffing support to the Department of Health as requested, shifted our resources internally, put some work on hold to take on new work and increased demand for some services.
A number of our highly qualified epidemiologists and statistical staff were deployed to the National Incident Room, the Department of the Prime Minister and Cabinet (PM&C) and a few state and territory health departments to support policy responses to the pandemic.
In compliance with decisions of the National Cabinet and advice from the Australian Public Service Commission, we introduced social distancing measures to support our staff maintain a safe and healthy workplace and we enabled the majority of staff to work from home. Our capacity to support remote working arrangements increased from 40 to 240 staff. Results of a survey showed that 95% of staff felt the measures kept them safe and 84% believed the changes enabled them to work productively.
To ensure that policymakers had access to credible and comparable data to inform the COVID-19 response in key areas, we developed rapid and flexible approaches to data collection and analysis. For example, the AIHW received hospital capacity and activity data from all state and territory governments and shared this across all jurisdictions via an interactive online dashboard. We also assisted the Department of Health to monitor crucial mental health-related data from a range of sources to report directly to the Prime Minister.
2019–20 Australian bushfires
Unprecedented fires burned across south- eastern Australia over the 2019–20 bushfire season and caused devastation of the natural and built environment. Our staff were directly impacted by threats to, or loss of, their property or that of their families and by the effects of dense smoke in Canberra and Sydney. We put measures in place to minimise smoke in buildings to maintain healthy air quality.
Though it will take many years for all of the health and other impacts to become apparent, we began a project to examine the immediate effects of air quality on health in different locations and points in time using Pharmaceutical Benefits Scheme data, emergency department attendances in New South Wales, over-the-counter Ventolin purchases and visits to primary health-care services. The report will include interactive content and summarise findings from other available information related to bushfires and health.
Australia’s welfare 2019 was launched on 11 September 2019 by the Minister for Social Services, Senator the Hon. Anne Ruston.
We presented Australia’s health 2020 to the Minister for Health, the Hon. Greg Hunt, MP, on 30 June and released it on 23 July. We delayed its release to include a key article on COVID-19.
Highlights for 2019–20
Other key achievements included:
establishing the Housing Data Dashboard—a one-stop-shop for housing and homelessness data, bringing together over 20 national data sets, and around 7.5 million data points into a single interactive dashboard environment
commencing the new national suicide information system and working with jurisdictions to establish registers to improve the timeliness of data
partnering with the Attorney-General’s Department to provide data analysis for the Independent Review by the National Commissioner for Defence and Veteran Suicide Prevention
The contract with an external provider to replace METeOR was terminated and plans are now underway to develop it in-house in 2020–21 (see Our services).
After a few small errors were discovered in released data, we commissioned a systemic review of our product development process (see Independent review of product development). The Quality Management Framework is being redeveloped and a new plan to improve the handling of errors has been introduced.
The last 4 years
Since I started at the AIHW in 2016, I am proud of the tremendous progress made by the Institute in entrenching its position as the leader in health and welfare statistics in Australia. This has been reflected in the growth in our total revenue from $57.8 million in 2016–17 to $86.7 million in 2019–20,
Following an independent review of the AIHW conducted in 2015, we worked with the Department of Health to transform many of our processes and enhance engagement with stakeholders. These reforms have enabled us to improve our timeliness and responsiveness, and facilitate efficient growth in the AIHW’s suite of products and services.
We invested in our capability to link multiple, complex data sets. For example, we developed the National Integrated Health Services Information Analysis Asset (NIHSI AA) linking hospitals data with the Medicare Benefits Schedule, Pharmaceutical Benefits Scheme, Repatriation Pharmaceutical Benefits Scheme, residential aged care and the National Death Index data. Containing 12 billion recorded events, the NIHSI AA demonstrates the value of linking data safely and securely to allow greater analysis of the patient journey through the health system. Work to develop the National Disability Data Asset is now well underway which, when completed, will provide a better understanding of how people with a disability are supported through services, payments and programs.
I would like to thank all members of the AIHW Board I have worked with during this period for their strategic guidance of the AIHW.
Most of all, I am privileged to lead an organisation of highly qualified, talented and motivated people who have a strong culture of collaboration and commitment to excellence in delivering products and services on a wide range of health and welfare topics.
Outlook for 2020–21
COVID-19 reinforced the need for timely reporting. Our key priority for 2020–21 will be to review our own work processes and continue to work with our data suppliers to develop ways to improve our capability to present data more quickly.
We will continue improving our flexible approach to managing our work commitments, meeting new demands and keeping our staff safe during the COVID-19 pandemic. Some staff will also be relocated into a new building at 9 Thynne Street, Bruce, next door to our current main building. This relocation will consolidate our longer term accommodation needs in Canberra.
The forthcoming release of 'A burning issue: short-term health impacts of the 2019–20 Australian bushfires', co-funded by the Department of Agriculture, Water and the Environment, will improve our understanding of the effects of bushfires on health. A web page on Environmental health will also be established on the AIHW’s website which will enable the provision of new data in 2021.
We will build on our strong and established relationships with the Australian Government and state and territory agencies to improve access to data. All governments recognise the importance of high-quality data to improve the evidence base for decision making and the AIHW is well placed as a trusted strategic partner to facilitate improved data sharing between agencies.
To achieve our goals in 2020–21, we will continue to work with all our partners in health and community services across Australia to maintain our role as a leading national agency for information and statistics.
The AIHW undertook a range of activities in response to the COVID-19 pandemic. This highly contagious disease, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported in China in late 2019, with serious impacts in Australia beginning in March 2020. Some routine work was reprioritised so that resources and specific skills could be diverted to focus on urgent COVID-related activities. We also supported the secondment of 17 staff members to the Department of Health, PM&C, ACT Health and NSW Health to contribute their expertise on COVID-related projects.
Most AIHW data collections and associated releases have established schedules for collection, analysis and reporting. To ensure that decision makers had access to credible and comparable data to inform the Australian Government’s response to the COVID-19 pandemic, we adopted a rapid and flexible approach to receiving hospital capacity and activity data from all state and territory governments and shared these data across all jurisdictions via an interactive dashboard.
This approach included emergency department, admitted patient and elective surgery information and data from the new Critical Health Resource Information System. This system was developed by the Australian and New Zealand Intensive Care Society, Ambulance Victoria and Telstra Purple. It covers intensive care unit capacity and activity. These data enabled daily monitoring of the impact of COVID-19 and associated restrictions on the hospital system.
We assisted the Department of Health to curate, analyse and report COVID-19 mental health-related activity data. These data were reported to the Prime Minister via the Department of Health and PM&C. Data included Medicare Benefits Schedule, Australian Government-funded helplines, headspace and suicide information from 3 states. Public reporting of the mental health helpline activity presented a unique opportunity to provide more comprehensive information on the support provided by the Australian Government to Australians experiencing mental health issues.
We also supported the World Health Organization (WHO) to develop key standards and classifications to standardise the counting of cases and improve international comparisons.
We were guided by the advice on local restrictions provided by the Australian Government, the Department of Health, Safe Work Australia, the Australian Public Service Commission and state and territory governments.
To support the wellbeing of our people, we established flexible work arrangements for all staff, which included the introduction of new technology to support working-from-home arrangements. In March, approximately 75% of staff began working from home in some capacity. Many of the staff who remained working in an AIHW office were on a roster to reduce the number of staff in the office at any point in time. Due to the number of COVID-19 cases in New South Wales, we temporarily closed our Sydney office on March 23. A small number of staff have since resumed working in that office. Staff were provided access to use their work-based equipment at home, and home workstation assessments were undertaken to support ergonomic health and safety. Of our active staff, 342 (67%) now have formal arrangements to work from home in some capacity.
The shift to staff working from home strained AIHW remote services. We utilised remote access through Citrix for 40 concurrent users and directed access for approximately 150 staff through the provision of laptop computers. We also had to adapt to new methods of delivering outcomes to stakeholders while managing risks.
We reviewed our strategic risk profile in relation to information and communication technology (ICT) services that had previously restricted the use of mail on mobile telephones and expanded use of GovTeams to effectively collaborate and deliver outcomes. We designed and deployed a new remote access solution within 3 weeks that increased the capacity and functionality of remote access to enable staff operating remotely to utilise data analytics tools. This increased our connection capability from 40 to 240 users with increased bandwidth capacity to enable these connections.
We were advised of, and accepted, the associated increase in ICT risk with the rapid release of technologies and manage the ongoing risks, including the rollout of improved services during the pandemic. We increased communications with staff to address security, change and the requirements for new services.
During the critical COVID-19 period from March to mid-June 2020, we maintained a standard of 139 concurrent connections during a standard workday, and suffered no significant outages on the new remote access solution. Although there was evidence of increased targeting of the AIHW, no cyber security breaches were identified during the period.
Overall productivity and wellbeing over this period indicate potential for longer term flexibility for staff choosing to work at home or at the office. Considerations might include the different ways staff work together, such as increased use of instant messaging applications and videoconferencing. These factors will influence priorities for future ICT projects, such as our project management systems and developing an improved information management strategy.
In May 2020, we conducted a pulse survey to assess how staff coped with the changes made to our working environment since March 2020. It had a response rate of 74% and the overall results were very positive: more than 90% of respondents had worked from home; 95% felt effective changes were implemented to maintain their safety; 84% agreed adjustments assisted them to continue to work productively; and 76% agreed that they continued to feel connected to their work group while working from home.
In line with the government’s 3-stage approach to relaxing restrictions in June, we began a voluntary, gradual return of staff to our offices. Stage 1 saw the gradual return of up to 50% of staff during June. To ensure the health and safety of staff working from an AIHW office, we implemented safety measures in line with government and health advice, including:
promoting physical distancing and maintaining strong personal hygiene
limiting the number of people who can occupy meeting rooms
providing hand sanitiser and spray disinfectant in all communal areas and meeting rooms
undertaking additional professional cleaning
replacing face-to-face meetings with teleconferences or videoconferences.
We also continued to promote the Employee Assistance Program and share resources and information to support all staff to remain COVID safe.
Calendar of significant events
Launch of the Housing Data Dashboard
Launch of Australia’s welfare 2019
Reappointment of Mrs Louise Markus as the AIHW Board Chair
February – June
Supported Australia’s response to COVID
Provision of Australia’s health 2020 to the Minister for Health
We have 20 performance indicators underpinning our 5 strategic goals. Details of our integrated performance framework and strategic goals are in Our performance. Progress reports on our performance are provided to our Executive Committee and the AIHW Board each quarter.
We achieved 15 of our 20 indicators in 2019–20 . The impact of COVID-19 necessitated a shift of resources to meet immediate internal organisational priorities and to assist with the Australian Government’s response to the pandemic which had some impact on our performance. Detailed information on our performance is in Our performance
Performance measure achievement by strategic goal
Number of measures
Leaders in health and welfare data
Drivers of data improvements
Expert sources of value-added analysis
Champions for open and accessible data and information
Trusted strategic partners
Our environmental performance
Across all our offices in Canberra and Sydney, we decreased our electricity consumption by 15%, paper consumption by 40% and toner cartridge use by 27% compared with 2018–19. These decreases build on our 2018–19 results and can be partly attributed to fewer staff being physically located in the office following implementation of our COVID-19 restrictions. Detailed information on our environmental performance is provided at Accommodation.
Our financial performance
Our total revenue for 2019–20 was $86.7 million, which represents an increase of $8.7 million from 2018–19. Most of this increase was due to a large rise in fee-for- service work. Our financial result for the year was a deficit of $946,000. More information on our financial performance is provided at Our financial performance and in Financial statements.
About the AIHW
Stronger evidence, better decisions, improved health and welfare.
Australian Institute of Health created within the Commonwealth Department of Health
Australian Institute of Health established by legislation as an independent Commonwealth statutory authority
First edition of Australia’s health
Welfare functions added and name changed to the Australian Institute of Health and Welfare
First edition of Australia’s welfare
Ethics Committee enabled in the AIHW Act
Accredited as an Integrating Authority to undertake linkage of sensitive Commonwealth data
Reporting of the Performance and Accountability Framework transferred to the AIHW following the closure of the National Health Performance Authority
AIHW Act amended to enhance the composition of the AIHW Board and streamline operations
Data and information provided to support the Australian Government’s response to COVID-19
Our functions are set out in section 5 of the AIHW Act. The role of the AIHW is to:
assist the collection and production of, health- and welfare-related information and statistics
conduct and promote research into Australians’ health and their health services
develop specialised standards and classifications for health, health services and welfare services
publish reports on its work
make recommendations to the Minister for Health on prevention and treatment of diseases and improvement and promotion of the health awareness of Australians
provide researchers with access to health- and welfare-related information and statistics, subject to confidentiality provisions.
To create authoritative and accessible information and statistics that inform decisions and improve the health and welfare of all Australians.
Our work provides governments, key stakeholders and the broader Australian community with valuable evidence and insights about key issues affecting the health and welfare of Australians.
In pursuing our vision, we draw on our independence and our expertise in health and welfare to strive for excellence in all we do. We also uphold the Australian Public Service (APS) values.
Impartial: We are apolitical and provide the Government with advice that is frank, honest, timely and based on the best available evidence.
Committed to service: We are professional, objective, innovative and efficient, and work collaboratively to achieve the best results for the Australian community and the Government.
Accountable: We are open and accountable to the Australian community under the law and within the framework of Ministerial responsibility.
Respectful: We respect all people, including their rights and their heritage.
Ethical: We demonstrate leadership, are trustworthy, and act with integrity, in all that we do.
Our strategic goals
We continued to apply and strengthen our capabilities to be: leaders in health and welfare data; drivers of data improvements; expert sources of value-added analysis; champions for open and accessible data and information; and trusted strategic partners.
We will engage nationally and internationally with authorities in our domain to develop, promote and deliver quality standards, systems and processes for collecting, curating and linking health and welfare data.
Drivers of data improvements
We will build on our trusted status to identify and respond to gaps and opportunities in multisource health and welfare data holdings. We will support our partners to develop and capture the data required to inform national priorities.
Expert sources of value-added analysis
We will harness and enhance our capabilities in the health and welfare domains to turn data and information into knowledge and intelligence. We will translate this evidence to provide insight into patterns, trends and outcomes, including how these compare across organisations, regions and internationally.
Champions for open and accessible data and information
We will leverage emerging technology and enhance our products and services in order to provide data and information tailored to diverse access, timeliness and quality requirements. We will support our partners in making their data accessible while protecting privacy.
Trusted strategic partners
We will foster strategic partnerships and engage collaboratively with stakeholders to deliver program-specific expertise and enable others to achieve their strategic goals.
Overview of governance
Overview of governance
AIHW is a corporate Commonwealth entity under the Public Governance, Performance and Accountability Act 2013 (PGPA Act) and is a body corporate with separate legal entity from the Commonwealth.
A 12-member board, chaired by Mrs Louise Markus, is the accountable authority of the AIHW. The AIHW Board sets our strategic directions and is responsible for fulfilling its functions under the AIHW Act (see Variable).
The AIHW Act and the Australian Institute of Health and Welfare (Ethics Committee) Regulations 2018 establish our Ethics Committee and set out its functions and membership (see Variable).
Portfolio and ministerialoversight
The AIHW is a Commonwealth corporate entity in the Health portfolio. We are accountable to the Australian Parliament through the Minister for Health, the Hon. Greg Hunt, MP.
We provide the minister our corporate plan, annual report and other relevant information as required by the PGPA Act.
The Minister for Health, and other relevant ministers in the Australian Government and state and territory governments, have embargoed access to our products prior to release.
The second half of 2019–20 was impacted by COVID-19. Information on how we managed our work, people and ICT systems is provided in a special article on our COVID-19 response.
We continue to see growth in our externally- funded projects. Our project revenue increased by $7.6 million to $50.3 million in 2019–20.
Mental health and suicide prevention remain national priorities. We received funding in the 2019–20 budget to create a new national suicide information system. We worked with jurisdictions to establish and use state- and territory-based suicide registers to improve the timeliness of data on suspected suicides to improve suicide-prevention interventions. We will continue to collaborate with stakeholders to build national ambulance data into the National Suicide and Self-Harm Monitoring project.
As at 30 June 2020, the AIHW had 507 active staff (permanent, non-ongoing and temporary) based in Canberra and Sydney.
The demand for access to data continues to grow. While the number of data downloads remained relatively stable compared with 2018–19, we continued to see growth in our data linkage work and requests for customised data.
We continue to build our data assets. We currently have 165 data sets with 9 new data assets approved by our Ethics Committee.
We continued to invest in transforming our ICT infrastructure despite the disruptions caused by COVID-19. This investment supports our data analytics capacity and the management of our data assets. ICT transformation will continue to be a priority in 2020–21.
We renewed our focus on stakeholder engagement. Our stakeholders are important to us as groups to whom we are accountable, who fund us and to whom we target our products and provide services. Further information on our stakeholders and how we engaged with them is provided in Our stakeholders .
We undertook 3 activities during 2019–20 to better understand our stakeholders and their needs: a broad survey of perceptions, products used and preferred ways of engaging; focus groups to gauge community trust in the AIHW; and a targeted survey of organisations using the Specialist Homelessness Information Platform (SHIP). As well, in a review undertaken by Mr Peter Harper, former Australian Bureau of Statistics (ABS) deputy statistician, stakeholders in government were consulted on how we can more effectively engage with them.
The AIHW collaborates closely and maintains effective partnerships with many individual government entities, universities, research centres, non-government organisations and individual experts. Our major stakeholders include:
the Australian Parliament, the Australian Government and its departments and agencies and the people of Australia
the Minister for Health as our responsible minister
state and territory governments and their departments
health, welfare and housing service providers and non-government organisations
consumers of health, welfare and housing services
the research community.
The AIHW has a role in information sharing with a number of international organisations, such as the WHO and the Organisation for Economic Co-operation and Development (OECD). We also have informal collaborative arrangements with other international agencies and bodies, such as the Canadian Institute for Health Information (CIHI) and the International Group for Indigenous Health Measurement.
We assisted the WHO in developing internationally agreed standards and classifications for COVID-19 to standardise the counting of cases and improve international comparisons. Our CEO communicated regularly with the CIHI CEO, Mr David O’Toole, and other CIHI staff via videoconference and regularly shared information with them in relation to COVID-19.
Former AIHW director receives WHO award
Professor Richard Madden was presented with an award by the WHO for Lifetime Achievement in the WHO-Family of International Classifications in Banff, Canada, in October 2019. Professor Madden was the director of the AIHW from 1996 to 2006.