http://www.heraldsun.com.au/news/more-news/hospital-waiting-list-pain-to-get-worse/story-fn7x8me2-1226237797257
4800+ patients added to the hospital waiting lists in those hospitals where records being kept (not including smaller country hospitals – eg Kilmore, Seymour)
9500 less surgery being done
And this is despite $13 billion being spent on health last year in Victoria
With the ageing population, the demand for surgery will only get worse.
One needs to look at how theatre efficiencies can be increased.
I would propose that one small step to the solution could be to look if an additional case can be done in each public hospital theatre each day. This would help reduce the numbers on the waiting lists. This would require flexibility on the part of the booking office, day ward, patients, medical staff, nursing staff and admin. But this can be done. There is usually enough spare time during a day’s operating list where the theatre is used to fit in a short case – eg carpal tunnel, skin cancer, gastroscopy, colonoscopy and even a simple hernia repair. All that is needed is a common desire to reduce the waiting lists as much as possible. Without fear that this will mean the budget to the hospital will be cut the next year etc
In Victoria, 157,073 patients had elective surgery last financial year, but 182,462 were added to the waiting list.
Ninety per cent of Victorian patients had surgery within 182 days, and the median waiting time was 36 days.
http://www.theage.com.au/victoria/hospitals-behind-in-national-rating-20111129-1o571.html#ixzz1f6CHlkpb
This means that there were additional 25000 patients being added to the waiting list last financial year in Victoria alone…how will this waiting list be reduced?
The capacity is there – eg if one increases the hours theatres are utilized – extending lists to 6-8pm on weekdays, Saturday lists but the costs are prohibitive…esp with a cash-strapped Victorian government
Will the waiting lists for surgery here continue to rise like the US debt as the population ages and more surgical options are available?
Unlike the US debt, there is no QE solution…
Problems we face:
1. Increasing population
2. Increasing percentage of patients from elderly age group…people do get sick eventually even with the best of care – such is life…
3. Budget pressures on hospitals leading to inefficient use of theatre times eg some hospitals do not allow cases after 11am or 4pm on morning or afternoon lists in case of theatre overruns; prolonged theatre closures over Easter and Xmas(to reduce hospital costs)
4. Lack of surgical beds….more and more presssure on beds for medical patients, more patients in hospital waiting for nursing home beds
Overall, I am not optimistic… although there are steps that may help.
Hopefully with the promise of transparency, we will get a true picture of:
1. Waiting lists for patients to surgical outpatients
2. Waiting lists for surgery in smaller country hospitals – these are not normally reported, hospital not required to collect the data
3. Waiting lists to see specialists privately in hospitals without public outpatient clinic
I was just referring a patient to surgical outpatients at a tertiary hospital in Melbourne(too high risk to be operated on in the country) – was asked to tick the urgency for the outpatient consultation…Cat 1 (within 30 days) Cat 2(30-90 days) Cat 3….
Once the patient gets the appointment and sees the specialist there(or the registrar or intern) – they will then be put on another waiting list for their surgery ..again Category 1 , 2 and 3
(and the patient’s wait did not just begin when the patient saw me…he had been waiting for a few weeks for an appointment to see me, prior to that he had to have some investigations..and also wait 1-2 weeks to see his GP…and again 1-2 weeks to see his GP again for the referral to me)
Sometimes, I find it incredible that there is so much waiting in the health system despite the amount of money the government pours in (perhaps a lot is wasted on various levels of bureaucracy/administration) … This seems to be one big weakness of our health system.
Due to budget constraints, one of the most efficient public hospital in Victoria is rapidly building up a waiting lists for its local patients to have surgery.
(This hospital is not WIES funded – but bulk funded) The CEO is under pressure from the DHS to balance the budget.
Steps taken:
1. Cut down on theatre days – ie closing longer over Xmas and New Year and also for Easter ie 4-6 weeks closure
2. Reduce operating time for whole day sessions – finishing by 3:30pm instead of 5pm
3. Not allowing patients to be put on standby (even if the list can finish early) – the are often patients who fail to turn up for their schedule surgery
Other steps:
1. Limiting access to surgery to patients from local postcodes
Unfortunately patients in suburds who are just out of the area suffer – longer waiting lists at other hospitals
Patients who have moved out of the area but still see the local GPs are not able to access the hospital
Patients from other areas – will increase the waiting lists of their local hospitals
2. Encouraging patients to use their private insurance and getting surgeons to increase number of private cases in their lists(however this will only be successful if there is a short waiting list …I don’t believe that public patients should be deferred if their case is urgent in order to operate on a private patient in a PUBLIC HOSPITAL)
In the long-term, this will only add to the state wide waiting lists for elective surgery…true every hospital needs to balance the budget. But when the facility is available, the theatre staff are available not using the theatres to its full efficiency is really a waste of resources. Building new hospitals is not the only answer..more importantly theatre services should be fully funded to function at its capacity.