An inquiry into delays at NSW public hospital emergency departments continues after the health minister rejected the testimony of doctors who described conditions at a western Sydney hospital as "Third World".
The parliamentary inquiry into the impact of ambulance ramping and access blocks on hospital emergency departments has already heard from experts detailing long wait times.
One doctor, James Tadros, told the inquiry on Wednesday conditions at his workplace were "Third World".
"Well they want to go and work in the Third World then," Health Minister Brad Hazzard told reporters on Thursday.
"Those doctors who spoke are very good in their own areas ... but it doesn't necessarily mean they're good at managing an entire health system."
The Australian Medical Association (AMA) has recommended making Mr Hazzard's job easier by removing funding caps and increasing federal funding for state hospitals to a 50-50 split.
The union has made it clear to state and federal health ministers that better funding will provide better outcomes, AMA NSW president Michael Bonning told the hearing on Friday.
"It has been front and centre," Dr Bonning said.
"If hospitals and states are penalised for wanting to deliver more care that is effective, timely and appropriate, then what we see ... is growing lists of people who are waiting for access to care, or access to waiting lists."
Improvements in elective surgery and emergency wait times should also receive funding again, and additional funds should be allocated for more beds and staff.
Payroll tax exemptions could help address general practitioner shortages and out-of-hospital care alternatives could avoid unnecessary hospitalisations, the AMA recommended.
The elective surgery backlog has also led to thousands of people not receiving treatment in the advised time.
The AMA noted Bureau of Health Information data showed a more than ninefold increase in the pandemic.
There were 18,748 patients waiting for surgery, who had waited longer than clinically recommended at the end of June, compared with 2037 in March 2020.
"It has a significant detriment and drawdown on our ability to provide health care because many of those patients will now require more ongoing health care than they would have required otherwise," Dr Bonning said.
Elective surgery was halted to preserve capacity in the state's hospitals, but the wider pandemic health response prevented many people requiring hospitalisation, Royal North Shore Hospital senior emergency physician Liz Swinburn told the hearing.
"We thought we needed heaps more beds than we did," Dr Swinburn said.
"Hopefully, this is an opportunity to look at other ways of doing things," she said.
Patients could be discharged from hospitals and free up beds quicker if they could collect prescribed medication from a chemist or have them home delivered, rather than waiting for a hospital pharmacist, Dr Swinburn suggested.
Pharmacists largely missed out on increased funding during the pandemic, Society of Hospital Pharmacists of Australia policy and advocacy head Jerry Yik told the hearing.
However, they could play a role in reducing emergency wait times.
Sutherland Hospital has invested in an emergency medicine pharmacist which can prevent some people requiring hospitalisation, Mr Yik told the hearing.
There were about 400,000 medication-related presentations to emergency departments and 250,000 admissions that followed, Mr Yik said.
While doctors and nurses were busy, pharmacists could detect adverse drug reactions and other medication-related issues.
"If you've got a pharmacist there they can actually find out what the issue is and then resolve it from the ED and get them out of the ED in under four hours," Mr Yik said.
The hearing continues.
