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NSW cataract patients waiting 71 days longer post-COVID 

The Australian Society of Ophthalmologists (ASO) has criticised major public hospitals in New South Wales for operating at 20% capacity or less, contributing to a wait time blow out for ophthalmic patients who now spend 330 days on average before receiving an operation.

Ophthalmology patients within the NSW public health system are waiting the longest for elective surgery than any other specialty, the latest Bureau of Health Information Healthcare Quarterly report reveals, with the median wait time for cataract surgery alone ballooning to 343 days.

Ashish Agar.

In the three months to September 30, ophthalmologists performed 10,298 procedures in the public system, with just 66% of those on time. This is a 32% drop from the same quarter last year when 98% were delivered within the recommended timeframe.

The 330-day median wait time for an ophthalmic procedure is a 98 day increase on the same period in 2019 and the largest rise among all medical specialties.

Of the 8,426 cataract procedures performed in the September quarter, the median wait time was 343 days – the fourth-worst of all common procedures and 71 days longer than last year.

In the September quarter, ophthalmology patients waited longer for surgery than any other speciality in state-run NSW hospitals.

There was also a major rise in the number of ophthalmology patients waiting longer than clinically recommended (365 days), which swelled from 52 patients in the September 2019 quarter to a staggering 1,444 this year. Most were awaiting cataract procedures, which rose from 40 patients in 2019 to 1,268.

ASO president Associate Professor Ashish Agar said although there was a hangover from the shutdown on elective surgery earlier this year, some public hospitals were only operating at 20% or less of their usual ophthalmic capacity.

He said this was contributing to ophthalmology’s unfavourable statistics. It also wasn’t conducive to the purpose of a work-sharing agreement struck with private hospitals to create greater overall capacity to clear the COVID-19 backlog.

Ophthalmology was the bottom-ranked speciality in terms of the proportion of surgeries delivered on time in the September quarter.

“Most ophthalmic surgery in Australia is done in day and private surgeries so there is a lot of experience, skill and potential there to really help reduce waiting lists, and we certainly support those initiatives,” he said.

“But that shouldn’t be at the expense of the public hospital surgery being wound back to an almost token-like level. My concern is that we are far from addressing the backlog, and there is a risk of us going backwards, particularly if some of these major hospitals don’t restore their previous levels of public hospital surgery because then we haven’t got a hope in catching up.”

Agar said the public system was already struggling pre-pandemic, and the system needed more capacity now – not less.

The median wait time for cataract surgery increased by 71 days when compared with the 2019 September quarter.

“The last thing patients need is a system that’s going to push them even further back,” he added.

From July to September, 2,171 elective surgical procedures were contracted to NSW private hospitals, representing 3% of all elective surgical procedures performed.

NSW Government has ‘lost control’

NSW Health Deputy Secretary Ms Susan Pearce told the Sydney Morning Herald that, given all non-urgent surgery was suspended during the shutdown, procedures with larger cohorts would experience significant waiting times when the program recommenced fully in July.

Susan Pearce.

“It should be noted patients scheduled for non-urgent surgeries are able to be re-categorised by their own specialist to a more urgent category, if their clinical condition required their surgery to be conducted sooner than initially planned,” she said.

Overall, she believed the figures showed the health system is recovering well from nationally imposed restrictions.

“Almost 100% of urgent surgery was performed on time (99.8%) and more elective surgical procedures were performed this quarter, than in any other quarter over the last five years,” Pearce said.

“We needed to act decisively to address the impact of a pause in non-urgent surgeries on our waiting lists that was introduced Australia-wide in March, which we did and are continuing to do.”

The figures show public hospitals performed almost 65,000 elective surgeries in the July to September quarter, up by 2,581 or 4% on the same quarter in 2019, when there was no COVID-19.

Despite the public waiting list sitting at 95,000 at the end of September, Pearce noted this had been reduced from the end of June when this figure was 101,000.

Labor health spokesman Mr Ryan Park said the government had lost control of the wait-list.

“The record-long waitlists are a result of a decade of neglect and under-resourcing,” he said in a statement.

“It has little to do with the elective surgery suspension earlier this year. Quarter after quarter, we have seen blowouts and backlogs and nothing being done to address it.”

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