6 key findings in AMA hospital report card

Medical politics

By Michael Woodhead

13 Mar 2018

The AMA has again sounded the alarm about a worsening crisis in public hospital capacity in its report card for 2018.

Launching the report on 9 March, AMA president Dr Michael Gannon said the government’s own performance figures showed that public hospitals were failing to keep pace with demand from an ageing population needing more complex care.

And with Federal government funding levels for public hospitals stagnant or falling, key measures of capacity such as bed numbers were going backwards.

Here are some key findings from the report:

  1. The ratio of hospital beds per 1000 population over 65 has almost halved from 30 in 1992-3 to 16.9 in 2015-16, and continues to decline.
  2. Median waits for elective surgery continue to increase, topping 38 days in 2016-17.
  3. More than one in ten Category 2 patients do not receive elective surgery within the clinically recommended time of 90 days.
  4. ‘Hidden’ waiting lists mean that many patients wait longer for assessment by a specialist after GP referral than they do for surgery.
  5. Current levels of hospital funding from the Commonwealth continue to stagnate and the funding guarantees for 45% of costs depend on State and Territories meeting the remaining 55%.
  6. Punitive new hospital funding agreements that take effect on 1 July 2018 will dock funding for ‘avoidable’ readmissions and intensify the spiralling decline in hospital capacity.

Dr Gannon said the key message is that public hospitals need adequate and stable long term funding, which can be linked to better performance and care co-ordination in a practical way.

Also speaking at the launch, AMA vice president Dr Tony Bartone, a Melbourne GP,  said there was a need for greater transparency on hidden waiting lists, to reveal the waiting times for specialist assessment.

“What I’m seeing more and more is that patients are required to wait months, sometimes 12 months or more, to see the specialist in outpatients to be put onto the elective surgery list,” he said.

“If we look at orthopaedics, [or] urology, that can be upwards of 18 months or two years for some assessments in outpatients. Gastroenterology – sometimes scopes in that specialty can take upwards of 12 months or more.”

“For example, if we’re looking at orthopaedics, if we’re looking at a knee joint that is painful, it’s the pain that I’m managing. It’s the additional medications that they don’t need to take. It’s the delayed outcome. So they’ve got other conditions that I’m trying to manage – their diabetes, their heart disease, they can’t exercise. So this is all compounding in the end and leading to worse outcomes. It’s not giving them the quality of care that they deserve in our society.

“This is not what we would expect from a first order health society … It’s selling our patients short, and we really need to ensure that the funding that allows the access continues to be implemented and increased sufficiently to allow timely access.”

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