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15 Aug 2019


The 2019 AMA Public Hospital Report Card, which was released to great effect early in the May election campaign, has become reality television with regular news headlines of underfunding, ambulance ramping, and long patient waits.

The public hospital crisis has been rolling out on the evening news across most States and Territories in the months since the election.

The Report Card painted a picture of hospitals and staff under enormous pressure, and patients waiting too long for care, and it is all true – an awful reality.

The figures show that public hospital performance was worse in 2017-18 (the most recent data) compared to the previous year on most measures. No jurisdiction improved performance across all indicators. 

These are not the signs of a public hospital sector in good shape.

Clearly, doctors and nurses are bearing the brunt of this stress. They are caring for more patients than ever before as populations rise rapidly, especially aged and chronic disease populations, which further increase the demand.

A persistent and ever-increasing lack of resources is often being masked by headlines of a record flu season, which is demanding a large share of overstretched services.

There is no denying that when governments underfund, they are making a specific choice to constrain the supply of public hospital services. We all know what the consequences of these scenarios are. I see it daily in my practice, as do most doctors.

Public hospital capacity is determined by funding. Public hospitals can’t provide faster access to elective surgery unless they are funded to pay for extra theatre sessions, extra ward beds, extra nurses, and extra specialists.

Ambulance ramping and long waits in emergency departments will not be resolved unless public hospitals have enough money and ward beds with appropriately skilled staff to accept seriously ill patients after they are ready to transition from the expert care of the emergency physicians.

We can’t have a hospital system that is stretched so tight that scheduled elective surgery is cancelled because ward beds are needed by seriously ill patients who unexpectedly present in emergency.

Our public hospitals are struggling and require commensurate additional funding to not just cater for the increasing demand, but to provide innovative caring and treatment conditions to assist in meeting the growing demand.

They need to be assisted to more effectively deal with the new care needs of the changing illness populations, and work as part of a coordinated care team in our health system.

The AMA is sick of hearing the Commonwealth blame the States for funding cuts when the Commonwealth has its own funding cuts built into the indexation formula. States should not complain if they are not contributing their share.

The political blame game must stop.

Both levels of government need to stop the political games and start funding public hospitals to meet demand for public hospital services.

They must help our public hospitals improve the quality of their care, rather than just the quantity of work each staff member must carry.

And they must support our medical and health staff with the resources they need, so they can care for all of us.

Our hardworking doctors, nurses, and health professionals, like all Australians, do not deserve any less.


Published: 15 Aug 2019