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Playing the waiting game (Ballarat Courier, opinion editoral)
By Dr Harry Hemley.
Around 3,000 of the Victorians currently on elective surgery waiting lists will still be waiting for their surgery in twelve months when the 2010 Victorian election results reveal the state’s future leader.
For these patients, the twelve-months-plus wait for surgery to reduce their pain and disability will seem like a lifetime.
For the future leader, twelve months is not long enough to fix the myriad of problems and shortages that cripple our health system. But it is long enough to come up with a compelling, long-term plan to put an end to long waits for care at Ballarat Base Hospital and throughout the public hospital system.
The quality of care at Victorian public hospitals is high but so is the level of dissatisfaction at long waits for emergency care and elective surgery. Ballarat Health’s patient satisfaction has dropped from 97 per cent in 2006 to 79 per cent this year - understandable, given that long waits lead to poorer outcomes and greater risk of complications.
Increasing the number of beds is the single most important measure needed to ease the pressure on our public hospitals. When hospitals run beyond 85 per cent occupancy, there is no flexibility to deal with fluctuations in demand and patients are forced to wait.
There are fewer beds now per capita than there were a decade ago. As Victoria’s population grows, ages and develops higher levels of chronic disease, shortages will become critical and plugging holes will no longer be an option.
We need an extra 187 beds each year just to keep up with current capacity levels but to catch-up to 2003 levels we need a hefty bed rise of 600 first. It won’t be cheap but it is vital to reducing the lengthy waits.
At the end of the last financial year 3,000 Victorians were still on the waiting list for non-urgent surgery, but it is unclear how many Victorians were on hidden waiting lists.
Patients can wait for 12 months or more for an outpatient clinic appointment. This initial wait to see a specialist in an outpatient clinic is not reported by the government and does not count towards the total waiting time.
For example, a patient waiting for a hip replacement might wait 12 months to see an orthopaedic surgeon in an outpatient clinic, plus another 18 months on the elective surgery waiting list. Instead of reporting the actual wait of 30 months, the government only reports on the final 18 months.
If a patient and their doctor don’t know how long they will have to wait, they can ’t make informed decisions about their treatment options, let alone decisions about living arrangements, organising carers and taking time off work.
It is difficult to know just how dire our outpatient clinic system is. Victoria’s future health plan must include adequate reporting systems so we can pinpoint the long waits and direct resources into reducing these waits.
I hope the election health plans on both sides provide solutions to allow doctors, nurses and allied health practitioners to treat local patients within clinically recommended times well beyond the next election cycle.
Dr Harry Hemley is President of AMA Victoria
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