From people being resuscitated in waiting rooms to people waiting years for elective surgery, Australia’s health system is crumbling and some say it was entirely predictable.
In February 2020, Mal Gregory was diagnosed with a severely arthritic and deteriorating left hip joint, and was in need of a hip replacement.
COVID-19 was just emerging as a serious threat to the world, but Mr Gregory’s GP referred him to a hospital in Queensland and he was put on a waiting list.
He stayed on the waiting list for years, even after lockdowns ended and Australia moved forward and tried to live alongside COVID-19.
It was in September 2022 when Mr Gregory got the hip replacement he needed, after he wrote to the state government explaining his situation.
He suffered a lot during those years in limbo.
“My mobility obviously just got worse and I couldn’t stand [or] walk without every step being painful,” he told The New Daily.
Waiting for his surgery, he not only suffered physical pain that affected his work, but his marriage broke down, he began having suicidal thoughts and began self-medicating.
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Hospitals in strife across Australia
It’s not just people waiting for elective surgery who are being affected by Australia’s crumbling system.
The “chronic underfunding” of public hospitals is impacting everyone.
The Australian Medical Association has released its analysis of Australia’s public hospitals.
Only three of 201 delivered care within the recommended time frames, which is down from 15 the previous year.
Dr Sarah Whitelaw is the AMA’s Emergency Medicine representative and works in a Melbourne hospital. She paints a grim picture of what patients can expect and what doctors and nurses are seeing.
She told The New Daily a significant number of senior staff at hospitals are leaving the field knowing that despite their best efforts, they cannot give their patients adequate care.
Around the country, emergency departments are beyond capacity, there’s an increase in ambulance ramping, hospital beds are unavailable when needed, and there are continued workforce shortages.
“There isn’t a region in Australia that’s unaffected by this,” Dr Whitelaw said.
“It’s not a state problem. It’s not isolated to one geographic area. It’s just right across Australia.”
Patient harm
For many in the emergency department, including patients and loved ones, it’s the worst day of their lives, Dr Whitelaw said.
For her, and many others working in hospitals, being there, doing what they are trained to do, is a privilege.
“It is not the stress of delivering emergency care or excellence in emergency management that is the problem,” she said. Instead, it’s the system.
Although Mr Gregory witnessed a system in crisis, he only had positive things to say about the hospital staff, praising them for their empathy and expressing his concern for their wellbeing.
Dr Whitelaw said it’s important people understand what patient harm looks like.
“It looks like resuscitating people in waiting rooms and in corridors. It looks like elderly people being forced to sit in plastic chairs in the waiting room for many, many hours,” she said.
“It looks like people trying to give IV antibiotics for pneumonia on a chair in the waiting room and it looks like people being in pain for hours because they can’t be given pain-relief injections safely when they’re not in a cubicle that’s being looked after by appropriate safe healthcare staff.”
Dr Whitelaw says patients are suffering because the system does not allow healthcare workers to do their job properly.
This is made worse when she hears that it really “isn’t that bad” in political spaces, when she knows just how bad it is.
Issues started long before COVID
There’s no denying the pandemic put pressures on healthcare systems all over the world.
But Dr Whitelaw said the issues that are plaguing the system were apparent long before COVID-19 and since about March 2020, she and her colleagues predicted this is where Australia would be.
Over the past 10 years, there has been a steady increase of about 3 per cent of people needing emergency department care.
“So if you draw that straight line across the last decade, and you kind of ignore the variations through 2020-2021, the demand is entirely predictable,” she said.
People are sicker and more are requiring ambulance transfers and Dr Whitelaw noted more people are therefore sick and dealing with complications because their elective surgeries were delayed.
She said it’s frightening to think that in 12 months time, Australia’s healthcare system could be in a state similar to Britain’s NHS.
“We can do this when the acute waves reside, but we need to invest in our health system,” she said.
“We can do it. We can live with COVID, but you can’t live with COVID if you don’t to prepare your health system to do so and we just haven’t.”
What can be done?
There is an acknowledgment of the crisis within primary care, but Dr Whitelaw says there needs to be more awareness about what is happening in hospitals.
On Friday, national cabinet will meet and AMA president Professor Steve Robson hopes ministers will discuss ways to tackle the issue.
“We want ministers to tackle the backlog of surgeries that we estimate will top half a million at the end of June, because it’s devastating for every person waiting and dealing with months and months of pain,” he said.
He said it was unlikely hospitals will be able to expand their capacity to address the backlog without intervention.
The AMA is also calling for a new national plan, to help state and territory government expand hospital capacity, including the workforce.
Professor Robson also wants the federal government to up its share in hospital funding to 50 per cent and remove the annual cap on activity.
“We need to change the way we fund our public hospitals and we need to change our performance measures so that they reward excellent patient care and patient outcomes, not just volume,” Dr Whitelaw said.
The AMA’s logjam finder allows people to put in their postcode to see how hospitals in their area rank. In addition to this, the AMA is calling on people to reach out to their local MP and express their concerns.
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