Public hospitals 'struggling' to meet demand as fed funding declines
The federal government needs to increase public hospital funding as public hospitals across the country struggle to meet patient demand and COAG performance targets, AMA President, Dr Steve Hambleton said in a recent statement.
The AMA Public Hospital Report Card 2014 released last week provides consistent analysis of public hospital activity over time.
This year, for the first time, the Report Card takes into account commonwealth funding information from the National Health Funding Pool Administrator (NHFPA).
Dr Hambleton said the new data shows a decline in federal funding for public hospitals from what was promised over the reporting period.
"The NHFPA data indicates that the previous federal government contributed $134 million less to public hospitals in 2012-13 than its Mid-Year Economic and Fiscal Outlook (MYEFO) commitment for that year," he said.
"This data shows that some states were worse off, which is counter to the commonwealth's commitment in Clause 15 of the National Health Reform Agreement (NHRA) that no State or Territory would be worse off under the Agreement.
"The AMA is very concerned that the 2013-14 MYEFO document shows that the current Federal Government is now planning to spend around $400 million less on public hospitals over the next three years compared to the planned expenditure set out in the 2012-13 MYEFO document.
"We call on the new government to restore federal funding to at least the originally committed NHRA levels to help public hospitals around the country to meet their performance targets and provide timely and quality care for the community."
The AMA Public Hospital Report Card 2014 shows only marginal improvement in public hospital performance against the performance benchmarks set by all Governments.
No state or territory met the target for 2012-13 under the National Partnership Agreement on Hospital and Health Workforce Reform for 80 per cent of emergency department Category 3 patients being seen within clinically recommended triage times.
Dr Hambleton said that public hospitals need more funding to produce greater capacity as the ageing population and more people suffering complex and chronic conditions place heavy burdens on our public hospitals.
"When judged against key capacity and performance measures, the Australian public hospital system is struggling to meet the clinical demands being placed on it.
"This is not the time for public hospital funding cuts. Now is the time to invest in our public hospitals as part of an overall health strategy.
"The AMA recognises that the long-term focus for Australia's healthcare system should be on primary care to keep people well and out of hospital.
"But, until that can be achieved, our public hospitals must have the capacity to provide treatment efficiently and effectively to people needing acute care."
Key findings of the AMA Public Hospital Report Card 2014 include:
- bed numbers per 1000 of the 65 and over population have remained largely unchanged;
- nationally, only 68 per cent of emergency department patients classified as urgent were seen within the recommended 30 minutes. This is a small improvement over 2011-12. If this rate of improvement were to continue, we could be on track to achieve 2012's target in 2018;
- for calendar year 2012, only WA met (in fact exceeded) the interim National Emergency Access Target. NSW, Vic and the NT did not even meet their baseline for this performance target in 2012.
- nationally, median waiting times for all elective surgery have increased over the last ten years. In 2012-13, the national median waiting time remained unchanged at 36 days, meaning no improvement over the last three years.
- the number of public hospital elective surgeries performed in 2012-13 across Australia was 673,316. This was an increase of around 1.8 per cent over the number of elective surgery admissions in 2011-12 (661,710); and
- 2.7 per cent or 18,180 of the patients admitted for elective surgery in 2012-13 waited for more than a year for their elective surgery.
Dr Hambleton said the full story about waiting times for elective surgery in Australia's public hospital system still remains hidden.
"There are people who are waiting to see a specialist to be assessed for surgery who are not counted in waiting list data," Dr Hambleton said.
"The clock only starts on waiting times for elective surgery when a patient has seen a specialist and is booked for surgery.
"The AMA is calling on COAG to include the hidden waiting list in official data."
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