Public hospital picture far from rosy: New report exposes five years of decline

Australians continue to suffer as a result of a logjammed public hospital system, with emergency department (ED) and planned surgery waiting times remaining at some of the worst levels on record.

The Australian Medical Association’s 2025 Public hospital report card, to be launched today in Sydney, shows some modest improvements in public hospital performance, but performance remains markedly worse than it was just five years ago.

AMA President Dr Danielle McMullen said she welcomed the improvements, including a small drop in the median waiting time for planned surgery and an increase in the total number of public hospital beds available.

“We are glad to see some good news in this report card, however, there is no escaping the reality that Australia’s public hospitals remain critically logjammed,” Dr McMullen said.

“While the total number of public hospital beds available has increased, when we consider the ageing population, the number of available beds per 1000 Australians aged over 65 is stagnant at 14.3 – the lowest on record.”

The grim level of capacity in public hospitals is taking a significant toll on doctors, who are working harder under increasingly challenging conditions – and without adequate government investment to support them.

Ahead of the launch of the report card in Sydney today, AMA NSW President Dr Kathryn Austin said the data presented in the report card would come as no surprise to staff in NSW public hospitals, with doctors being asked to do more with less.

“We have an exhausted workforce operating on budgets and staffing levels from seven years ago,” Dr Austin said. “It is becoming increasingly difficult to recruit and retain medical staff in NSW. This is untenable and, sadly, patients who should be at the centre of our health system are the collateral damage.”

NSW retains the unwanted title of the longest median surgery wait time in the country, demonstrating the urgent need to clear the state’s planned surgery backlog.

The AMA’s report card also shows just 55% of ED presentations across Australia were completed within the benchmark target of four hours in 2023–24, marking the eighth consecutive annual fall in performance for this metric.

A third of all ED patients triaged as “emergency” (category two) were not seen within the recommended 10-minue time frame, up from a quarter five years earlier. Category two presentations include chest pain of a cardiac nature, severe respiratory distress or acute stroke.

The proportion of category two planned surgery patients undergoing surgery within 90 days has fallen from 83% five years ago to 71% in 2023–24. However, this is a 6% improvement from the previous financial year. Category two surgeries include heart valve replacements and operations to address congenital cardiac defects.

For the remaining 29% of patients, the average wait has become “extremely long and potentially dangerous”, according to the report. In these cases, the average wait time exceeds twice the recommended timeframe, with patients in Victoria waiting an average of 297 days, in Western Australia 206 days, in South Australia 184 days, in Tasmania 290 days, and in the ACT 215 days.

“…there is still a very long way to go to reverse the long-term trends,” Dr McMullen said.

While funding for public hospitals is gradually increasing, performance continues to decline, and a disproportionate funding burden continues to fall on state and territory governments.

Dr McMullen further added, “In the lead-up to this year’s federal election, we are calling on all politicians and political parties to prioritise our health system, including our hospitals.

“While recent investment from the federal government and action to address issues in some states and territories is welcome; the delay to a new National Health Reform Agreement (NHRA) was disappointing. The federal government’s promised investment, originally estimated at $13 billion, into our public hospitals is little more than a nice idea if states and territories fail to reach an agreement with the federal government.

“The need for a new fit-for-purpose agreement has never been greater – for both doctors and their patients.”

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