Patients face longer delays as ‘perfect storm’ set to hit stressed public hospitals
Patients face increasingly lengthy waits for hospital care as the Federal Government squeezes funding despite rising demand, creating a “perfect storm” for the nation’s hospitals, AMA President Associate Professor Brian Owler has warned.
As Prime Minister Tony Abbott prepares to meet with State and Territory leaders tomorrow, the AMA’s annual Public Hospital Report Card, released today, shows that, despite the best efforts of doctors and other health professionals, who are working increasingly efficiently and effectively, hospitals are struggling to meet the needs of an expanding and ageing population.
In a clear sign of a system under stress, the national median waiting time for elective surgery has remained stuck at historically high levels.
For the fourth year in a row, patients waited an average of 36 days for elective surgery in 2013-14, almost 10 days longer than they were a decade earlier.
Meanwhile, less than 80 per cent of category 2 patients were admitted within the clinically recommended time of 90 days last financial year, well short of the national target.
Evidence of the strain on public hospitals is set to add to the pressure on Mr Abbott when he meets the nation’s premiers and chief ministers at the Council of Australian Governments in Canberra tomorrow.
Treasury has admitted that Commonwealth funding cuts unveiled in last May’s Budget and December’s Budget update will strip $57 billion from public hospitals between 2017-18 and 2024-25.
The cuts have outraged the premiers who, led by NSW Premier Mike Baird, intend to press Mr Abbott at the COAG meeting to restore the funds.
A/Professor Owler said the States and Territories were facing “a huge black hole in public hospital funding after a succession of Commonwealth cuts”.
“The hospital funding blame game is back, and bigger than ever. Public hospitals and their staff will be placed under enormous stress and pressure, and patients will be forced to wait longer for their treatment and care,” he said. “Funding is clearly inadequate to achieve the capacity needed to meet the demands being placed on public hospitals.”
A/Professor Olwer warned that “a perfect storm” was building ahead of new, lower indexation arrangements for Commonwealth public hospital funding due to come into effect from 2017-18 that will reduce funding from its already inadequate levels, further hampering performance and undermining patient care.
“State and Territory Governments, many of which are already under enormous economic pressures, will be left with much greater responsibility for funding public hospital services,” he warned. “Performance against benchmarks will worsen and patients will suffer. Waiting lists will blow out.”
The AMA said the situation in the nation’s public hospitals was already even worse than the data in the Report Card suggested.
It said official figures disguised the true length of delays that elective surgery patients faced because they only started to count waiting time from when the patient saw their specialist, rather than from the time of referral by their GP.
“This means that the publicly available elective surgery waiting list data actually understate the real time people wait for surgery,” the Report said. “Some people wait longer for assessment by a specialist than they do for surgery.”
Much of this is due to an inadequate number of beds and the staff to serve them.
The AMA’s analysis has found that hospitals have proportionately far fewer beds than they did 20 years ago, contributing to lengthy waits in emergency departments and for elective surgery.
The number of beds per 1000 people fell to just 2.57 per cent in 2012-13, down from 2.62 the previous year, and shows no sign of improving.
Among those most likely to need hospital care, the picture is just as bleak. The number of beds for every 1000 Australians aged 65 years and older has reached a record low of 17.5, a massive 56 per cent decline since the early 1990s.
“Public hospital capacity is not keeping pace with population growth, and is not increasing to meet the growing demand for services,” the report said.
A/Professor Brian Owler said the results showed that, even before the latest massive Federal Government funding cuts bite, public hospital performance was already being hit by inadequate resources.
In last year’s Budget, the Government announced measures that will rip $20 billion out of hospital funding in coming years, including the renunciation of spending guarantees and cut in funding indexation to the inflation rate plus population growth. These cuts were compounded late last year by a further $941 million reduction in spending over the next four years.
A/Professor Owler warned the funding cutbacks would entrench sub-par hospital performance.
“If it proceeds with its savings measures, the Commonwealth will lock in hospital funding and capacity at the inadequate levels demonstrated by current performance,” the AMA President said. “Without sufficient funding to increase capacity, public hospitals will never meet the targets set by governments, and patients will wait longer for treatment.”
The Government has argued budget cuts are necessary because health spending is growing unsustainably.
But A/Professor Owler said total health expenditure actual shrunk in 2012-13, and Commonwealth support was now “well short of [what is needed] to position public hospitals to meet increasing demand”.
The AMA Public Hospital Report Card 2015 can be viewed at the AMA website: ama.com.au