Shining a light on the elective surgery ‘hidden’ waiting list

The ‘hidden’ waiting list is the time it takes to see a specialist in a public hospital outpatient clinic. These consultations often result in patients being added to the elective surgery waiting list.  

While elective surgery waiting times are reported nationally each year by the Australian Institute of Health and Welfare (AIHW), the is no national reporting for outpatient appointment waiting times. While some jurisdictions individually report this data, the quantity and quality of publicly available data varies significantly between states and territories, with some states not reporting on it at all. This is why it is referred to as the ‘hidden’ waiting list.  

Demonstrated in this report, many patients are waiting months and even years for an outpatient appointment, to only be put on another waiting list to receive surgery. Patients are therefore not fully informed of the actual waiting time for elective surgery, and the system cannot be resourced properly as the scale of the problem is unknown.  

The AMA has been calling for public hospital outpatient appointment waiting times to be published for years, as without it there is no transparency of how long public patients are waiting for treatment. The AIHW is currently working with jurisdictions towards a future publication on outpatient waiting times. A national recovery plan however is needed now that factors in improving wait times for outpatient appointments and elective surgeries and establishing enough capacity to meet the population demand while factoring in repeat waves of COVID-19 infections into the future.  

The AMA’s solution for public hospital reform and Clear the Hospital Logjam campaign proposes a new funding agreement be established between the Commonwealth Government and state/territory government, that:  

• Improves performance by reintroducing funding for performance improvement.  

• Expands capacity for public hospitals through additional funding for extra beds and staff.  

• Addresses demand for out-of-hospital alternatives, prioritising programs that work with general practitioners to address avoidable admissions and readmissions.   

• Increases the Commonwealth Government’s contribution to 50 per cent for activity, with removal of the 6.5 per cent cap on funding growth. State and territory governments would reinvest the 5 per cent of ‘freed-up’ funds to improve performance capacity.