Vision for Australia's Health

Pillar 2: Public hospitals

Public hospitals that are funded to provide high-quality and timely care

The provision of timely elective and emergency treatment in public health systems is crucial in ensuring patients receive the care they need while minimising costs for both patients and the healthcare system. Investing in timely treatment can prevent the need for more costly medical interventions, as patients are less likely to develop complications or other associated health conditions that may require more expensive surgeries, extended hospital stays, or readmissions to hospital. Additionally, investing in hospital programs that support the timely discharge of patients from hospitals or provide out-of-hospital care can generate savings as well as reduce the burden on hospitals.82

Goals Policy enablers Measures of success
2.1: Patients requiring outpatient care, emergency treatment, hospital admission and planned surgery are treated within the clinically recommended timeframe.
  • In addition to existing reporting, national, consistent, and public reporting of:
    • patient off-stretcher times (the time taken for patients to be transferred off an ambulance stretcher into a hospital emergency department)
    • waiting times for hospital outpatient appointments (the time between referral and outpatient appointment, often referred to as the hidden waiting list)
    • the number of days patients who are clinically eligible for discharge are waiting in hospital for aged-care or disability services (often referred to as exit block).
  • Implementation of national, consistent, and public reporting.
  • Introduction of funding for performance improvement.
  • Improvements in hospital performance.
  • Funding to address the growing elective surgery backlog.
  • Reduction in the number of patients waiting for elective surgery.
  • Funding and programs to support timely discharge of patients who are clinically eligible for discharge but are waiting for aged-care or disability services.
  • Reduction in the number of patients waiting in hospital for aged-care or disability services.
  • Funding to improve transport between healthcare settings.
  • Reduction in the time waiting for transport between healthcare settings.
2.2: Strengthened communication between public hospitals and general practices.
  • Hospitals follow best practice, with timely, full discharge summaries to general practices.
  • Increase in proportion of discharge summaries that meet best practice standards.
  • Integration of clinical systems between hospitals and the community to facilitate information sharing.
  • Successful integration of clinical systems.
2.3: Prevention of avoidable admissions and readmissions to reduce the burden on public hospitals.
  • Governments fund community-based programs to prevent avoidable admissions and readmissions, including programs that involve general practice, residential aged-care facilities, Aboriginal Community Controlled Health Services, out-of-hospital care, and disability services.
  • Reduction in avoidable hospital admissions and readmissions.
2.4: Patients have genuine and informed choice regarding being treated as a private patient in a public hospital.
  • A consistent approach to enable patients to elect to be treated as a private patient in a hospital, including appropriate consent and choice.
  • Patients use their private health insurance for admitted care, where appropriate and is their choice.
  • Increase in hospitals using best-practice approaches to treating private patients in public hospitals.
2.5: Public hospitals provide a safe and supportive work environment for all staff as part of delivering safe patient care. For more information see the AMA Position Statement Safe, healthy and supportive work environments for hospital doctors 2023.
  • Hospitals and health services are required to annually report on incidents, frequency, remediation taken to embed best-practice response, and cultural change in the workplace.
  • Increase in hospitals and health services annually reporting.
  • Review of the National Safety and Quality Health Service (NSQHS) Standards to require health services to provide for and promote the health, safety, and wellbeing of those staff within the workplace (including the psychosocial health, safety and wellbeing of staff).
  • Adoption of evidence-based risk-management approaches in the NSQHS Standards to address psychosocial hazards in the workplace.
  • Implementation of policies and procedures that support psychosocial health, safety, and wellbeing. • Measurement against key performance indicators.
2.6: Enhanced continuity of care and community support for patients with mental health issues.
  • Expand hospital bed capacity and design to accommodate the acute mental healthcare needs of patients, reducing excessive waiting times in emergency departments.
  • Increase investment in the healthcare workforce, including psychiatrists and GPs, to provide longitudinal and coordinated care across general practice, community care, and hospitals.
  • Increase in patient access to mental health services.
  • Reduction in emergency department mental health presentations.
2.7: Patients can access high-quality public hospital services in regional, rural, and remote areas.
  • Public hospitals in regional, rural, and remote areas are well resourced (both infrastructure and workforce) to meet the needs of communities (see Goal 5.20 for further details).
  • Improvements in the performance of regional, rural, and remote hospitals.
  • Investment in infrastructure to support seamless communication between regional, rural, and remote hospitals and metropolitan centres.
  • Improvements in the communication between regional, rural, and remote hospitals and metropolitan centres.