Public treatment in private hospitals and after-hours surgery lists are among the key features of a multi-million-dollar elective surgery blitz recently unveiled by state governments to tackle waiting lists across Australia.
In the face of a growing backlog, the New South Wales, Queensland and Western Australian governments have announced $675 million in combined extra spending to ramp up capacity and ensure postponed cases are treated within clinically-recommended timeframes.
It comes as hospitals across the country continue to gradually reintroduce non-urgent procedures after a month-long suspension on all surgery in April due to COVID-19.
The disruption is estimated to have created a backlog of 400,000 operations in Australia, according to the international CovidSurg Collaborative project. Further highlighting the issue, the Australasian College of Surgeons has said if the hospital system increases weekly surgeries by 20% compared with pre-pandemic activity, it would still take 22 weeks to clear the backlog.
In the largest of the announcements, NSW Health Minister Mr Brad Hazzard said his government would spend an additional $388 million. This would allow public patients to be treated in private hospitals, while public hospitals would also increase capacity.
NSW Health is expected to host a roundtable discussion with public and private health sectors and clinicians within the next month to determine the best way to deliver the plan.
Public hospitals in NSW typically provide around 100,000 emergency surgeries as well as 235,000 elective surgeries a year. Surgical capacity was on track to be reinstated to 75% by the end of June, with the aim of reaching 100% this month.
A year-long backlog
Meanwhile, the Queensland Government has unveiled $250 million in new spending for hospitals to provide non-urgent procedures outside of regular hours.
Deputy Premier and Minister for Health Mr Steven Miles said prior to the pandemic, Queensland Health was delivering strong outcomes for its elective surgery patients, with 94% of Category 1, 2 and 3 patients operated on within the clinically appropriate time.
As of 1 June, there were 52,240 patients ready on elective surgery lists – more than 90% of those were waiting within clinically recommended timeframes.
However, Queensland Health’s modelling indicates more than 7,000 people could be waiting longer than clinically recommended by 1 July as a result of the pandemic.
Queensland Health director general Dr John Wakefield said the funding would allow hospitals to return to pre-COVID levels of elective surgery much sooner than planned, while working through the backlog at a quicker rate.
“This investment will require us to expand over and beyond our usual levels of activity, plus work in partnership with the private sector,” he said.
“It may take up to 12 months to clear the backlog, but could be longer if we have further disruption to our system, such as a second wave of COVID-19 cases.”
Weekend lists
In WA, Premier Mr Mark McGowan said his government would invest $36 million. This would enable the public system to perform approximately 5,800 more elective procedures by the end of the year than was projected before COVID-19.
Western Australian health service providers, which returned to 100% capacity on 15 June, will use a number of strategies to clear the elective surgery waitlists, including twilight and weekend surgery lists, increasing hours of work available to existing staff, and using additional staff.
In recent weeks, approximately 240 additional Category 1 procedures have been performed per week, while approximately 130 additional Category 2 procedures have been performed per week compared to the same period in 2019.
“The significant success of WA’s whole-of-community response to COVID-19 is what has enabled our health system to return to normal sooner than expected, and this blitz will deliver excellent clinical outcomes for patients as well as support our state’s recovery,” McGowan said.
In March, the Victorian Government committed more than $60 million to both public and private hospitals to undertake additional surgery before a predicted peak of the pandemic.
Meanwhile, South Australia Minister for Health and Wellbeing Mr Stephen Wade said that in March 2018 his government inherited an overdue elective surgery list of 1,583.
“We have been investing $45m to bring the overdue list down. By March 2020, we had halved overdue elective surgery. COVID-19 has required a shut down of elective surgery which has tripled overdue elective surgeries,” he said.
