Election must result in better funding for public hospitals

The AMA has used the backdrop of the Federal Election campaign to release its 2019 Public Hospital Report Card and call for greater funding for struggling hospitals.

The Report Card was released over the Easter long weekend and highlights the plight of many public hospitals having to deal with inadequate funding.

In releasing the document, AMA President Dr Tony Bartone said it demonstrated the need for the sector be better resourced, and he called on all major political parties to use the election campaign to promise significant new long-term funding.

He said whichever party forms government after the May 18 election, it should immediately fix the funding shortfall for the nation’s public hospitals.

Dr Bartone said the Report Card painted a depressing picture of overstretched hospitals and patients waiting longer for their care.

The ability of the hospitals to cope with ever-increasing patient demand continues to decline, he said, and it is a trend that will only accelerate unless something is done.

“Public hospitals are a vital pillar of our world-class health system, but neglect and underfunding are dooming them to failure,” Dr Bartone said.

“All our governments have to lift their game, but the leadership and the funding priorities and strategies must come from the Federal Government.

“Our public hospitals need clear and transparent long-term funding arrangements, above and beyond the current formulas.”

Key findings of the Report Card include: static bed ratios for the general population and a 24-year low of hospital beds per 1000 people aged 65 years and older; longer waiting times for patients in emergency departments, with only 64 per cent of urgent presentations seen within the recommended 30-minute timeframe in 2017-18; nationally, more than a third of the almost three million patients who presented to an emergency department in need of urgent treatment waited longer than clinically recommended; and in three of the eight States and Territories, about one in five patients who need elective surgery within 90 days are waiting longer than clinically-recommended.

Emergency treatment times for ‘urgent’ patients have gone backwards in most States and Territories. None have performed substantially better than last year.

Elective surgery is not much better, with most jurisdictions performing worse or remaining static.

“Compared to last year, elective surgery admissions per 1,000 population actually went backwards by 1.5 per cent nationally, and backwards in every jurisdiction bar two,” Dr Bartone said.

“No jurisdiction improved performance across all indicators in our Report Card. The picture should be one of continual improvement. Sadly, it is not.

“This is not what our rapidly growing and ageing population deserves. It is certainly not a base to provide the level and amount of care needed for the increasing complex conditions the community will face in coming years.”

Dr Bartone said public hospitals were the first port of call for emergency care and intensive care. And they are the only place for the sickest of patients who arrive in an emergency who need intensive care or treatment for conditions such as life threatening burns or as a result of car accidents or falls.

But he said there were significant consequences of underfunding public hospitals.

“Every year, the Australian population gets older and sicker,” Dr Bartone said

“It’s no surprise then that public hospitals are treating more patients each year. Between 2012-13 and 2016-17, public hospital separations rose on average 4.5 per cent per annum.

“The number of emergency presentations also rose on average by 2.6 per cent each year over the same period.

“Across all types of public hospital service, the rate of increased demand is outstripping the 1.6 per cent, per annum, rate of population growth.

“Underfunding can lead to increased numbers of deaths for admitted patients, higher levels complications, delayed care, delayed pain relief, and longer length of stay for patients.

“Public hospital capacity is determined by funding. We can’t have a hospital system that is stretched so tight that scheduled elective surgery is cancelled because ward beds are needed by seriously ill patients who unexpectedly present in emergency.

“We can’t have a hospital system that is so under-resourced that primary health care doctors cannot find a hospital bed for their patients who need elective surgery.

“Greater funding is needed to lift the capacity of our hospitals.

“They need the resources to first slow the decline, before they can show significant performance improvements.

“Greater funding is needed to support the highly-skilled, dedicated, and hardworking doctors, nurses, other health professionals, and hospital workers who are asked to do more with less every day.

“And greater funding is needed to ensure that patients can get access to high-quality care when they need it, without long waiting times.”

JOHN FLANNERY and CHRIS JOHNSON

The 2019 AMA Public Hospital Report Card is available at https://ama.com.au/ama-public-hospital-report-card-2019