The waiting time for elective surgery in a public hospital has increased in news ahead of this 12 months’s federal budget. This is a kind of non-emergency surgery that involves all the pieces from cyst removal to hip substitute.
The Australian Medical Association (AMA), a strong medical lobby group, has called on the federal government to commit the funds over A$2 billion inside two years to shorten the waiting time for elective surgery.
Although the Albanian government committed this week to spend more on public hospitalsa big reduction in waiting time for elective surgery will not occur in the near future.
Why waiting lists matter
Australians are wait longer for elective surgeries in public hospitals than ever before. Almost every tenth is waiting more than a 12 months.
Factors placing greater burden on the health care system include an aging population and the increasing incidence of chronic diseases. However, public hospitals cannot sustain with our growing health care needs.
Long waiting times may not concern many Australians with private medical insurance; the waiting time for treatment in a personal hospital is way shorter. For example, you possibly can wait more than a 12 months for cataract surgery in a public hospital. But you’ll likely wait less than a month but in a personal hospital.
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For more than half For Australians not receiving care in a personal hospital, waiting times for elective surgery in public hospitals matter.
Longer waits mean more suffering for patients and potentially worse surgical outcomes. AND UK study found that longer waits were related to worse health outcomes after hip and knee substitute surgery, but not after varicose vein surgery and hernia surgery.
More troubling is that longer waits reflect the public hospital system under loadpotential precursor worse quality of health care.
What caused the latest backlog?
Since 2020, the pandemic has been largely accountable for the increase in waiting times. Lockdowns and the suspension of elective surgeries have created a backlog that public hospitals are struggling to atone for. After restrictions were eased, hospitals weren’t prepared for this to the point in demand.
It could be fallacious to blame COVID for all our wait time woes. They were unacceptably long before Covid-19 and that is what happened increased in just about all states and territories five years before the pandemic. It would even be inappropriate to blame the aging population and chronic diseases. Both are predictable and mustn’t have come as a surprise to governments.
Waiting times in public hospitals are long as governments and health care managers have tried to reorganize their resources. This is probably going due to staffing shortages of nurses, specialists and surgeons, but in addition to complexity. Healthcare reform is difficult and requires improving the quality of care they froze just in time.
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The best way to reduce waiting time
An in depth international overview paints a a grim picture to ready-made solutions. Changing the way patients on the waiting list are handled has had mixed results. No interventions were found to reduce demand for elective surgery or increase supply.
In Australia, waiting lists for elective surgery are managed by public hospitals based on guidelines and three urgent categories (urgent, semi-urgent and non-urgent) set by the federal government.
Creating a care pathway more effective by redesigning how patients are allocated to urgent categories and withholding low-value care can reduce wait times. It may additionally be helpful to assign waiting patients to public hospitals where waiting times are shorter, slightly than to a neighborhood hospital.
One unique approach which will provide lessons for Australia is: from England almost 20 years ago. The maximum waiting time for elective surgery has been reduced from 18 months to 18 weeks between 2004 and 2008.
Success it began with the creation of a national goal, with the support of the Prime Minister, whose personal priority was shorter waiting times.
The UK government has invested more in infrastructure, increased the number of healthcare staff, modified clinical practice by moving some practices from inpatient to outpatient care, and closely monitored waiting times. Publicly reporting hospital performance and allowing patients to select a public hospital for elective surgery helped match supply and demand.
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Importantly, the directors of public hospitals were there held accountable for achieving goal waiting times. Public hospitals got greater autonomy if targets were met, and chief executives were threatened with dismissal if targets weren’t met.
Unfortunately, since then the waiting time for elective surgery in England has increased significantly. The standard of 18 weeks has recently been achieved in 2015. This reflects historically low growth in healthcare financing following the global financial crisis, persistent arrears due to the epidemic, and more recently Strokes by consultants and young doctors.
Will we shorten waiting times in the near future?
A big reduction in waiting times in Australia is unlikely any time soon. Reorganizing health care resources, constructing infrastructure (e.g. latest operating rooms), developing latest care processes and filling staff shortages will take time.
State, territory and federal governments must first make reducing waiting times a national priority as part of the next National Health Reform Agreement (an agreement between the Australian Government and all state and territory governments on roles and responsibilities in health care).
In the meantime, steps ought to be taken to reduce waiting times. The Mid-term review The National Agreement on Health Reform has advisable upfront funding to reduce the backlog of elective surgeries post-Covid.
To further reduce waiting times, more funding will be needed. Just throwing money at state and territory governments could be reckless. This is a structural problem, not something that may be solved by a single budget.
