Millions wasted as Australian public hospital waiting lists grow

Patients are waiting longer than ever for elective surgery, even though state governments have collectively wasted an additional $200 million a year on trying to fix the problem. Waiting times increased most significantly in NSW, Victoria and the ACT, while Queensland and South Australia showed some improvement. Figures obtained by The Australian from state and territory governments reveal that there were 143,000 patients across Australia needing elective surgery. And on average they waited longer for common procedures such as cataract removals and knee and hip replacements in 2004-05 than they did in the previous year.

The average wait for a cataract extraction jumped from 168 days to 218 days in NSW and from 152 to 176 days in Victoria. A third of patients in NSW and the Northern Territory waited for more than a year for a knee replacement. Ten per cent of patients in NSW and the ACT waited more than 600 days to have knee surgery and more than 400 days for a hip replacement. Tasmania, which had the longest waiting times last year, was the only state that would not release figures for 2004-05.

Australian Society of Orthopaedic Surgeons national chairman Gary Speck said state governments were wasting millions of dollars every year on non-essential services and paperwork. "Spending the money more appropriately would be a good start," Dr Speck said. "A lot of money is spent putting up new buildings and on administration, rather than being spent at the coalface." He said many patients suffered for years before they were placed on the official waiting lists. "There is a waiting list to get an appointment to see a specialist and, in some parts of Victoria, that could take 15 months," Dr Speck told The Australian. "Once they finally get to see a specialist, patients then wait another nine to 12 months before they have the surgery, so people needing hip and knee replacements often wait more than two years."

The executive director of the Health Services Association of NSW, James McGillicuddy, said that state governments were reluctant to invest in long-term strategies to restructure the public health system. Mr McGillicuddy said elective surgery should be removed, or dramatically reduced, from public hospitals that ran busy emergency departments, and relocated to designated public health organisations dedicated to elective surgery. "The current situation, where elective surgery is done in existing public hospitals, is unworkable and will lead to longer waiting lists as the population becomes older and demand for elective surgery increases," he said. "This proposal would involve increased investment in public health infrastructure, but in the long run it would pay dividends to both the Government and reduce waiting times for elective surgery."

Mr McGillicuddy said private hospitals were also struggling to meet elective surgery demand. Forty-three per cent of Australians have private health insurance, but the 33 per cent increase in premiums during the past five years has forced many younger members to dump their health cover.

A spokesman for Victorian Health Minister Bronwyn Pike said an elective surgery centre would be opened on the grounds of Melbourne's The Alfred hospital in November to reduce pressure on the public hospital. "The $90 million centre, which is still part of the public hospitals, will have staff and beds dedicated to elective surgery only," she said. "It was designed to deal with the problem of elective surgery having to be prioritised in amongst the emergency demands."

A spokeswoman for NSW Health Minister John Hatzistergos said the Government was focusing on reducing the number of patients waiting longer than a year. "The long wait list has dropped from over 10,500 in February 2005 to 3400 in February 2006," she said.

However, Elizabeth Feeney, chairwoman of the Australian Medical Association's hospital practice committee (NSW), said the continued closure of operating theatres during public holidays would hamper efforts to reduce waiting times. "Ten years ago, hospitals used to close for a week between Christmas and New Year, but now some close for up to eight weeks over Christmas and three weeks over Easter to cut costs," Dr Feeney said. "To have all that money invested in equipment and instruments and only use it for three-quarters of a year is not what a business would do. "If BHP shut for a few months a year that would seem pretty odd."

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ANOTHER BRILLIANT SUCCESS FOR BRITAIN'S NHS

Hospital cleaning products may actually help a diarrhoea-causing bug to survive and spread, researchers claim. Some strains of Clostridium difficile became more resistant when exposed to two cleaning agents used in hospitals. Elderly patients are most at risk from Clostridium difficile, the major cause of hospital-acquired diarrhoea, with tens of thousands contracting it each year.

Researchers from Leeds General Infirmary and the University of Leeds treated the strains with five cleaning products. All the strains produced more spores when exposed to two chemicals that did not contain bleach. If a bug has more spores it means it may be able to survive for longer periods in hospitals. Professor Wilcox said: "These bacteria can form spores which survive for months or even years in the environment, in spite of hospital cleaning regimens. "We have shown that some commonly used hospital cleaning and disinfectant agents not only fail to kill bacteria, they actually promote spore formation."

In 2004, Department of Health figures showed there were 44,488 cases of the bug in those aged over-65. Clostridium difficile is not as deadly as the superbug MRSA but it has led to several deaths. Careful use of antibiotics and being able to isolate infected patients are two of the things that help to stop it spreading.

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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