Doctors and surgeons are urging state and federal governments to address a backlog in elective surgeries, but nurses in Victoria say the surgery pause should continue to give an “exhausted workforce” some reprieve.
The Australian Medical Association (AMA) and the Royal Australasian College of Surgeons (RACS) both supported state governments that postponed elective surgeries to dedicate resources to Covid-19 and prevent virus patients from overwhelming public hospitals. But in a joint statement, the AMA and RACS said: “This approach is increasingly unsustainable.
“An urgent plan is needed to restore reasonable and acceptable access to elective surgery, as well as a long-term funding arrangement to ensure this backlog is cleared,” the statement said.
The AMA president, Dr Omar Khorshid, said blanket suspensions of elective surgery should be used only as a last resort.
“The fact that these are still happening points to the failure of governments to properly invest in public hospital capacity, as well as a failure to undertake the necessary planning needed to avoid this outcome,” he said.
The surgeries cancelled by governments have largely been “category three” surgeries – operations that need to occur within one year or for conditions that may cause pain but aren’t expected to rapidly deteriorate – and some “category two” surgeries, which are conditions causing pain or disability and need to occur within 90 days.
The RACS president, Dr Sally Langley, said these surgeries were not “optional”.
“For many patients waiting in line in pain to have a critical operation, the delays in surgery can be devastating,” she said. “Further, the lack of screening procedures has resulted in patients presenting with more advanced cancers, and in some cases, it has dramatically altered their prognosis.”
The AMA and RACS want elective surgery to resume as a priority in both private and public hospitals so that surgeons can start catching up on missed operations.
On 7 January the New South Wales government announced non-urgent elective surgery would be suspended. On Tuesday, the premier, Dominic Perrottet, announced that from 7 February, non-urgent elective surgery requiring an overnight stay would return to 75% capacity in private hospitals, and up to 75% of pre-pandemic activity levels at public hospitals in regional and rural NSW where they were able to do so.
In Victoria, non-urgent elective surgeries have been suspended until mid-February.
The Victorian branch of the Australian Nursing and Midwifery Federation urged the premier, Daniel Andrews, to maintain the pause as planned, despite growing pressure from doctors and surgeons.
The federation’s acting secretary, Paul Gilbert, said the pause had provided a surge workforce that could be redeployed at a time when nurses were exhausted and there were critical shortages in aged care homes especially.
“In a crisis, it is smart not to use up all your reserves and private hospital nurses and doctors are a surge workforce under the code brown declaration that may well be needed over the next few weeks.”
Asked about Gilbert’s comments on Wednesday, Andrews said the government would take a cautious approach before announcing anything. But he added: “We think it is possible to resume some services in a staggered way, in a balanced, cautious way, and we’ll make further announcements about that soon.
“We’ll make the announcements when we’ve listened, when we’ve got all that feedback and when we have determined how it is we will recommence those services, and nothing will be done that isn’t safe.
“It’s not an easy decision, it’s not lightly made to limit the number of services that are offered across the system. We’ll get those services back up and running as fast as we possibly can and, of course, we’ll listen to our workforce when it comes to making those important decisions.”
The Australian Healthcare and Hospitals Association acting chief executive, Kylie Woolcock, said governments also needed to invest funding into the health system, including for digital transformation, to address the range of care deferred and delayed through the pandemic.
While surgeries had been affected, data reported by the Productivity Commission on Tuesday revealed decreasing participation in cancer screenings nationwide throughout the pandemic.
“These drops in screening will result in people being diagnosed when cancer is at a more advanced stage, when it is more difficult to treat and result in worse prognoses,” Woolcock said.
