ACT Health's spending on consultants and contractors has more than tripled in the past four years, rising from $5.5 million in 2012-13 to $18 million in 2015-16.
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The directorate's latest annual report showed a significant $8 million rise in expenditure on "consultants and contractors" last fiscal year to $18 million, up from $10 million in 2014-15.
It said that increase was mainly due to the wide-ranging $11.9 million "System Innovation Program", which aims to save money and increase efficiencies to re-direct the savings found to other areas of the health system.
That innovation program was signed off by Chief Minister and Treasurer Andrew Barr last year, with a single $11.9 million "capital injection" to health's coffers to fund it.
While the total cost of the innovation program has raised some eyebrows in Canberra's health sector, many agree with the intentions behind it, given the ACT's reputation as having the most costly and inefficient hospital system in the country.
It is unclear what specific initiatives the savings could be re-directed to, but it could include boosting preventative health programs, given the government's agenda to expand efforts in the community and help reduce the pressure on the hospital system.
The annual report also said the $8 million rise was partly due to "ICT contractor costs" that were "incorrectly accounted for as prepaid expenses in prior years".
Overall, the expenditure on consultants and contractors rose from $5.5 million in 2012-13 to $7.2 million in 2013-14 and continued rising to $10 million in 2014-15 and $18 million in 2015-16.
Much of the expenditure over those four years has also been attributed to IT contractors in previous annual reports, amid efforts to improve clinical management and record-keeping systems.
A Fairfax Media analysis of "notifiable invoices" ACT Health awarded between July 2015 and December 2016, for contracts worth more than $25,000, shows at least $5.1 million spent on "contractors" and "consultants".
The analysis did not include those contracts awarded through the wider tender system and covers a longer period than the 2015-16 fiscal year, so does not directly accord with the total $18 million spent in 2015-16.
Similarly, the register does not show two other major contracts issued to Ernst and Young last year totalling more than $700,000 for two system-wide reviews of clinical services and community health issued through the tenders system, among other contracts awarded through the tender system.
But it does show where some of the money is being spent, including that two of the nation's biggest consultancy companies, often used by the federal bureaucracy, scored contracts with ACT Health in the months between July 2015 and November 2016.
It shows PriceWaterhouseCoopers Australia was the biggest recipient of contracts recorded on the register in that period, scoring at least $1,149,367 worth of work.
Others contracts on the register included Baxter Healthcare, which received $514,904 worth of contracts in that period; Ernst and Young, which received $299,102 worth of work and West Australian firm Kamareja, which received $289,455 in contracts.
The register also shows Canberra firm Callida Consulting winning $180,546 worth of work; Oakton Contracting and Recruitment securing at least $126,165 of contracts, and Dexler Education Australia receiving $118,085 of work.
It also shows ACT Health's senior leadership has sought the perspectives of multi-national consultants, including awarding a $72,930 contract to global advisory house Protiviti.
The directorate also awarded two contracts worth a total of $65,191 to Washington DC-based The Advisory Board Company, a specialist health consultancy that touts its services as helping improve the quality of patient care and "efficiency" in hospital and health systems.
The invoices recorded on the register also contracted work sourced from universities, NSW Health and the NSW Cancer Institute, reflecting the nature of the ACT health system and its role providing services to much of the wider southern NSW region.
It is unclear what the breakdown between how much was spent on "consultants" and "contractors" as only an aggregated figure is provided in annual reports.
ACT Health was unable to respond to questions about the rise in spending before deadline.
