Victorian public hospital system needs long-term fix

The peak body for emergency medicine in Australia says solutions to fix a struggling Victorian public hospital system need to be more sophisticated than just focusing on time-based targets.

A recent AMA Public Hospital Report Card showed longer waiting times for patients in emergency departments.

“We know as emergency departments get busier patient risk increases, mortality goes up, we also see the level of staff burnout increase as well as those leaving,” Australasian College for Emergency Medicine (ACEM) President Dr Simon Judkins said.

“However, what is needed is not a focus on ‘fixing the numbers’, rather a plan to address inherent problems in the healthcare system.

“For example, ACEM’s own guidelines which spell out how many senior medical staff need to be employed by hospitals in their emergency departments to provide proper care, are not being used as a standard in Victoria. Better planning for immediate and longer term recruitment and retention of health experts is a must.

“In addition, many emergency departments have not been able to keep up with the huge growth in ambulance arrivals and patients self-presenting. There is no doubt that many of our units and hospitals just aren’t big enough to cater for this significant and ongoing expansion in patient numbers.”

ACEM has also been outspoken about resources available to provide quality care to people who present to emergency departments with mental health crises – they are getting substandard care, waiting sometimes days and having to be sedated and restrained because of the lack of mental health staff and mental health beds, but have limited choices due to the lack of appropriate services in the community.

Highlighting this crisis in mental health care, a recent report by the Victorian Auditor‐General showed that that Victoria’s mental health bed base needs to grow by 80 per cent over the next decade to reach levels of service provision of other Australian jurisdictions.

ACEM Victoria Faculty Chair Dr Shyaman Menon said: “Patients who present to an emergency department in a mental health crisis are mostly likely to have a prolonged stay within the emergency department, some of them waiting for more than 24 hours for definitive care.

“While we welcome recent initiatives by the Andrews Government like the Emergency Department Crisis Hub at Geelong and other emergency departments, the role out of new mental health models-of-care needs to be state-wide.

“More importantly, let’s adequately resource community services so that people with mental health conditions can be managed earlier in their disease process in their homes so that they never reach crisis point and need to come to hospital.

“Community services that respond to aged care, homelessness, family violence and drug and alcohol use need to be funded, too.”

Dr Menon added: “ACEM welcomes its continued involvement with the Department of Health and Human Services to work collaboratively in improving the delivery of emergency care to the Victorian public.”


ACEM is the peak body for emergency medicine in Australia and New Zealand, responsible for training emergency physicians and advancement of professional standards.

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