Doctors warn elective surgery backlog will push patients into emergency surgery and poorer prognosis

MedTech News: The number of people waiting for elective surgery across public hospitals is swelling and is expected to reach more than 500,000 by mid-year if no action is taken by governments.  

Australian Medical Association (AMA) President, Professor Steve Robson, said the AMA’s latest report Addressing the elective surgery backlog shows a system under enormous pressure and struggling to meet demand.  

“Recently state premiers have talked about the dire state of the health system and the need for urgent action through National Cabinet — this report highlights a key part of the system that’s struggling,” Professor Robson said.  

“Our analysis shows hospitals can’t meet demand or the recommended timeframes for surgeries and it’s only going to get worse without intervention. There’s currently an estimated elective surgery backlog of 306,281 patients nationally and this will grow to more than 500,000 by the end of the financial year if something isn’t done,” Professor Robson said. 

Elective surgeries are not optional. They are surgeries that address life-threatening conditions as well as conditions that impact quality of life. Delays will result in patients presenting with more advanced illness and poorer prognosis, and patients being pushed into emergency surgery.

“It’s relieving pain, it’s allowing people to see, it’s allowing people to hear, It’s allowing people to move and allowing people to work. So apart from the compassionate side of this, we need to get every Australian back at the top of their game in the current situation,” Professor Robson commented.

Australia needs a national plan now to address the growing and increasingly critical backlog of elective surgeries, with an immediate injection of funds required.  

“This plan needs to be funded by both states and territories and the federal government and backed by long-term funding commitments that deliver permanent expanded workforce and increased capacity to deliver services in our public hospital system,” Professor Robson said.

The AMA’s analysis shows Victoria makes up the largest percentage of the backlog (134,950 patients, or 44 per cent of the backlog) together with New South Wales (77,845 patients, or 25% of the backlog). Queensland and Western Australia account for around 10% of the backlog each. 

According to Professor Robson, there are a series of system problems at the moment. In the first instance, it’s even difficult to get in to see a specialist at a public hospital. There is an enormous hidden waiting list. Once people see a specialist and are scheduled to have a procedure or an operation in our public hospitals, are hospitals are in logjam at the moment and it’s extremely difficult to get the resources. The beds, the nurses, the doctors – all the resources in a hospital needed for surgery, and things are getting worse by the day.

The AMA is calling for a new funding agreement between the state and territories and the Commonwealth that includes an upfront advance payment provided by the Commonwealth to support state and territory governments to expand their capacity, including workforce, to address the elective surgery backlog. 

“This should reduce the backlog of hospital outpatient appointments by providing funding to state and territory governments or directly to health services to assist in expanding the number of public outpatient appointments​,” Professor Robson said. 

“We also need to see data on waiting lists, including the hidden waiting list, reported more regularly and transparently across all jurisdictions to ensure the health system can be appropriately managed and patients are receiving the right care at the right time. This isn’t happening now.”  

The activity-based funding and delivery of public hospital services is governed by the National Health Reform Agreement (NHRA). The AMA continues to campaign through its Clear the Hospital Logjam  campaign for the existing funding agreement – which ends in 2025 – to be replaced with one that includes 50-50 funding and scrapping the 6.5% cap on funding growth with state and territory governments reinvesting the 5% of ‘freed-up’ funds to improve performance capacity. ​ 

“The big problem with activity-based funding is hospital resources don’t let them do the activity at the moment. So we need to move forward from these artificial caps on the way things work. We need proper funding and resourcing, and we need an injection of cash urgently if we’re going to get anywhere near dealing with this incredible backlog.

“As we look to Britain and the catastrophe in the National Health Service (NHS), it’s a grim warning for Australia. The NHS has had years of decreased investment, and we want to make sure that that situation does not develop here,” noted Professor Robson.

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