Today we have the release of a report card on the state of the Australian Public Hospital system released by the Australian Medical Association (AMA).

The clear message of this report is that there is no evidence of substantial progress towards achievement of any of the national targets that have been agreed by the Council of Australian Governments (COAG) as part of health reform.

The report highlights that there has been far too much political focus on “backroom issues” such as fighting over funding responsibilities and pricing hospital services and little focus on the systems overall capacity to deliver a quality service.

Some of the more disappointing findings (that are no surprise to many of us) include:

  • the number of public hospital beds has been slashed by almost 70 per cent since the mid–1960s.
  • in 2010–11, there were only 18.9 hospital beds for every 1,000 people over the age of 65 – a decrease of 1.6 per cent since 2009–10.

This is despite the demand on healthcare of an ageing population and increase in chronic diseases requiring complex care.

  • The continuing decline in bed numbers means that public hospitals, particularly the major metropolitan teaching hospitals, are commonly operating at an average bed occupancy rate of 90 per cent or above.
  • Official statistics relating to the time patients are waiting for elective surgery are fudged.
    Waiting times are counted from the time a patient sees a specialist and is referred for surgery. NOT from the time a patient is referred by their own doctor to see the specialist. And we all know how long those waiting lists are.
  • The report shows that the number of administrative staff (as a % of total hospital staff) has actually increased despite a commitment by governments to deliver healthcare reforms without increasing bureaucracy.

And the percentage of Emergency Department Triage Cat 3 patients (urgent patients that should have treatment commenced within 30 minutes) that are seen within the recommended time:

  • New South Wales: 71%
  • Victoria: 72%
  • Queensland: 63%
  • Western Australia: 52%
  • South Australia: 70%
  • Tasmania: 64%
  • Australian Capital Territory (my home): 50%
  • Northern Territory: 49%

This is bad.

What is much worse remains un-tracked in this report. The  length of time these category 3 patients are actually waiting before they are seen.

The report concludes:

Health reform, as defined and constructed by governments, has failed to deliver direct improvements in the capacity of public hospitals to meet the clinical demands and performance targets placed on them. This is sobering given the energy and money that has been spent by governments and the health care sector to implement the reforms.

Real health reform for patients, doctors, nurses, and allied health professionals means more resources at the hospital bedside to deliver timely, safe and quality health care [bold mine].

Right now, all I can do is shake my head.

You can download the report to read for yourself: Public Hospital Report Card 2013

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