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Public hospitals stretched by rising demand

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Public hospitals are not keeping pace with the growth in demand for their services, underlining AMA concerns that they be spared from any cuts in tonight’s Federal Budget.

Australian Institute of Health and Welfare figures show there has been a steady decline in public hospital capacity in recent years, particularly in the face of increasing demand from an ageing population.

Analysis of the data by the AMA shows that the number of public hospital beds available for every 1000 people in the crucial 65 years and older age group – where demand is greatest – has tumbled by almost 43 per cent past two decades, from more than 30 in 1992-93 to 17.8 in 2012-13.

Total bed numbers fell by 234 last financial year and, across the population as a whole, the number of beds per 1000 people slid down to 2.59. The ratio has not improved since 2009-10.

AMA President Dr Steve Hambleton said the results showed public hospitals were being starved of the resources needed to meet the growth in demand.

“We have maintained roughly the same bed to population numbers over recent years, while there has been increasing demand for hospital services,” Dr Hambleton said. “This is why public hospital waiting times are long. Our public hospitals need greater support and funding, not cuts.”

The Institute’s figures show that the public system still provides the bulk of hospital care – almost 60 per cent of the 9.4 million hospital admissions in 2012-13 were in the public sector, and more than two-thirds of the 28 million patient days reported by the nation’s hospitals were in the public system.

But growth in demand for private hospital services is outstripping that for the public system, particularly for elective and non-acute care.

Between 2008-09 and 2012-13, private hospital admissions for palliative care, rehabilitation, health maintenance and other subacute and non-acute services grew by almost 14 per cent a year, compared with 8.2 per cent in the public system.

Over the same period, private admissions for non-surgical and non-emergency care grew by 6.4 per cent, compared with 4.2 per cent in public hospitals, and same-day admissions in private facilities increased by 5 per cent a year, compared with 3 per cent in the public system.

Furthermore, almost 1.4 million of the 2 million elective surgery admissions in 2012-13 were in private hospitals.

Dr Hambleton said that, in contrast to public hospitals, the private system had increased its bed capacity since 2009-10 to keep pace with the growth in demand.

The difference was highlighted by AIHW figures showing that total recurrent spending on public hospitals (in constant price terms) grew by an average of 4.7 per cent a year between 2008-09 and 2012-13, compared with an annual average of 12.2 per cent among private hospitals.

The surge in private hospital care has caused some to warn that a two-tiered health system is developing in which those that can afford it are able to circumvent lengthy queues for surgery in public hospitals by getting treatment in the private system.

Consumers Health Forum spokesman Mark Metherell told the Sydney Morning Herald that the majority of people who did not have private health insurance were unable to avoid waiting for elective surgery.

Adrian Rollins