Public hospitals in state of emergency
AMA President, Dr Michael Gannon, said recently that inadequate funding has consigned Australia’s public hospitals – and all the dedicated health professionals who work in them – to a constant state of emergency.
Launching the AMA's 2017 Public Hospital Report Card in Sydney this morning, Dr Gannon said that, against key measures, the performance of our public hospitals is virtually stagnant, or even declining.
"To put it bluntly, public hospital performance against these measures across all States and Territories is woeful," Dr Gannon said.
"But this is not the fault of the highly-skilled and hard-working doctors, nurses, and other health professionals and hospital workers who work around the clock caring for patients, and who are being asked to do more with less year after year.
"Our over-stretched and over-stressed public hospitals are suffering because of inadequate and uncertain Commonwealth funding, which is choking public hospitals and their capacity to provide essential services."
The AMA Report Card shows that, across 48 key measures, there were 40 ‘fails' and only three positives, with five ‘no scores' because the data was not provided.
The positives include:
- small improvements in elective surgery admissions for Category 2 urgent patients (admission in 90 days) in Victoria and Queensland in 2015-16, though both States failed to meet their targets; and
- an improvement of three days in the median time Northern Territory patients wait to be admitted for elective surgery.
Dr Gannon said that these isolated improvements are welcome, but the bigger picture for public hospitals is bleak.
"Bed number ratios have remained static," Dr Gannon said.
"Emergency department (ED) waiting times for Urgent patients (patients who should receive care within 30 minutes) have worsened and, in most cases, remain well below the target set by governments to be achieved by 2012-13.
"NSW alone achieved the target for ED patients as a single group across all triage categories, while still falling short of the target for patients in the Urgent category.
"The percentage of ED patients treated in four hours has not changed over the past three years (since 2013-14), and is well below target.
"Elective surgery waiting times have worsened, and treatment times have only improved marginally.
"Public hospital performance has not improved overall against the performance benchmarks set by all Governments.
"Without sufficient funding to increase capacity, public hospitals will never meet the targets set by governments, and patients will wait longer for treatment," Dr Gannon said.
Dr Gannon said the additional Commonwealth funding announced at the Council of Australian Governments (COAG) meeting in in April 2016 of $2.9 billion over three years was welcome, but inadequate.In contrast, data published by the independent Parliamentary Budget Office (PBO) shows that funding under the original National Health Reform Agreement would have delivered $7.9 billion in additional public hospital funding to June 2020, compared to funding by CPI indexation and population growth (as announced in the 2014-15 Budget).
"Public hospitals are at the core of our healthcare system, and much loved and respected by the Australian people," Dr Gannon said.
"Our public hospitals are the training ground for the future medical workforce.
"They are the first port of call for emergency care.
"They are the safety net for the people who can't afford private health insurance.
"They are the place where innovation and new treatments, which continue to enhance the extraordinary gains in medical science and for patient outcomes, are developed.
"Public hospitals require sufficient and certain funding to deliver these essential services. The Commonwealth must work with the States and Territories to reach an agreed long-term strategy to fund public hospitals appropriately," Dr Gannon said.
The AMA Public Hospital Report Card 2017 has been compiled using information from:
- Australian Institute of Health and Welfare, Australian Hospital Statistics: Hospital resources 2014-15; Australian Hospital Statistics 2015-16: emergency department care; Australian Hospital Statistics 2015-16: elective surgery waiting times; Health Expenditure Australia 2011-12, 2012-13, 2013-14 and 2014-15.
- Commonwealth Budget documents, Budget Paper No. 3 2013-14, 2014-15, 2015-16 and 2016-17; and Mid-Year Economic and Fiscal Outlook (MYEFO) 2012-13, 2013-14, 2014-15, 2015-16 and 2016-17.
- Council of Australian Governments (COAG) Reform Council, National Partnership Agreement on Improving Public Hospital Services: Performance Report for 2013 (NEAT and NEST targets).
The AMA Public Hospital Report Card 2017 is at https://ama.com.au/ama-public-hospital-report-card-2017