Urgent overhaul needed: Public hospitals at a level of deterioration not seen in 15 years

MedTech & Diagnostics News: The Australian Medical Association (AMA) has called for an urgent overhaul of the National Health Reform Agreement (NHRA) in order to address the declining public hospital performance impacting patient care.

The AMA is urging all health ministers to work together to address the growing backlog of elective surgeries and the hidden waiting list of patients waiting years to see a specialist.

The demographics of Australia are shifting and the demand for public hospital services is increasing dramatically. Professor Robson reported that only 58% of patients triaged as urgent were seen within 30 minutes and one in three patients staying longer than four hours in EDs due to lack of beds available to admit them.

In the last 30 years, the number of public hospital beds available for people aged over 65 has dropped significantly, from 32.5 beds per 1,000 people to only 14.7.

“We’ve also seen wait times for essential surgeries blow out in the last financial year. It’s wrong to think of these as elective surgeries, they are essential and only 63% of patients referred for semi-urgent planned surgery are being treated within the recommended days. That’s more than one in three patients waiting longer than the clinically indicated time for essential surgeries, often in terrible pain and unable to work.

“Meanwhile, we also have a hidden waiting list with people sometimes waiting years to get in to see a specialist so they can get on to the official waiting list. We estimate that about 100,000 fewer people were added to the essential surgery list in 2021–22 as a result of these delays which shows the hidden waiting list is continuing to grow,” AMA’s President, Professor Steve Robson said.

Most of what was discussed at the National Cabinet meeting on Friday was relating to primary care reform. However, as people with multiple chronic health conditions are much more likely to go through emergency departments and require hospital care, the $2.2 billion package is aimed at making it easier for those patients to access primary care, out-of-hours care to keep them out of hospital, or care that allows them to leave hospitals earlier because care is available in the community.

Professor Robson emphasised that the current way of funding public hospitals is inadequate, and the current review of the NHRA is a chance to act.

“The funding arrangements as they stand are failing Australians and the Premiers and Chief Ministers understand that. We need to look at embedding long term reform in the way hospitals are funded and run that incentivises quality, that incentivises keeping people out of hospital,” said Professor Robson.

The AMA has proposed a new national hospital funding agreement that splits the funding 50/50 and provides hospitals with the resources they need to meet community demand. The AMA urges health ministers to consider this plan and take rapid action to address the hospital logjam.

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