AMA demands more on hospitals

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The AMA says it is unclear whether a slowdown in the rate of public hospital elective surgery admissions is due to patients being pushed onto "hidden" waiting lists or the result of patients using private hospitals for their elective procedure.

The association has used the release of its Public Hospital Report Card to call on the major political parties to make a "meaningful election promise" to increase funding to public hospitals.

AMA President, Dr Tony Bartone, said the report card paints a "depressing picture of overstretched hospitals and patients waiting longer for their care."

Dr Bartone said that the ability of hospitals to cope with increasing patient demand is in decline.

“Public hospitals are a vital pillar of our world-class health system, but neglect and underfunding are dooming them to failure,” said Dr Bartone.

Federal government funding to the states and territories for public hospitals is budgeted to increase by around $30 billion over the five years from 2020 to 2025. Labor has committed to increasing that funding by an additional $2.8 billion over the same period.

According to the AMA, between 2012-13 and 2016-17, public hospital separations rose at an average annual rate of 4.5 per cent. 

Federal government funding to public hospitals has grown at around that level and is budgeted to grow at an average annual rate of almost 5 per cent over the years to 2022-23.

“Emergency treatment times for ‘urgent’ patients have gone backwards in most States and Territories. None have performed substantially better than last year," said Dr Bartone. 

“The picture for elective surgery is not much better, with most jurisdictions performing worse or remaining static."

He added, “Compared to last year, elective surgery admissions per 1,000 population actually went backwards by 1.5 per cent nationally, and backwards in every jurisdiction bar two."

A recent report from the Australian Institute of Health and Welfare (AIHW) showed a substantial jump in the number of public hospital admissions funded by private insurers.

According to the report, private health insurance-funded hospitalisations increased from 8.2 per cent of hospitalisations in 2006–07 to 13.9 per cent in 2015–16 - an average annual increase of 9.6 per cent.

A report commissioned by private health insurer HBF also found wait times for elective surgery are on average much longer in public hospitals compared to private hospitals.

The report is based on data from the AIHW, the WA Department of Health and newly obtained private hospital data, and compared the end-to-end journey for an elective surgery patient in both parts of the health system.

The report found the average wait time between the first GP appointment and the first specialist appointment varied significantly between WA-based public and a selection of private hospitals.

The median wait time was just 0.5 months at the private hospitals, compared to almost 6 months at Royal Perth Hospital and 10 months at the Sir Charles Gairdner Hospital.

There was also a significant difference between hospitals when it came to the median time between the decision to treat with surgery and admission to hospital for surgery.

For knee replacements, the median wait time was just 0.75 months at the private hospitals, compared to almost 7.7 months at Royal Perth Hospital and 4 months at the Sir Charles Gairdner Hospital.

A challenge in making any comparison and assessment is that currently the ‘wait time’ reported by the AIHW in reports such as the Elective Surgery Waiting Times report refers only to the time between placement on the waiting list and admission to surgery - omitting the first part of the journey.