14 April 2022

Elective surgery waiting times get thumbs down

COVID-19 Hospitals Political Surgery

Delayed essential procedures and other healthcare mean 'an enormous catchup' awaits.

Deferring elective surgery mustn’t be used again as a lever to unlock capacity in an outbreak, medical advocates say, as it creates serious consequences downstream for health and the workforce.

A study of NSW residents released yesterday has found 80% of respondents to a survey were concerned about the quality of the NSW healthcare system, including 42% who were “extremely concerned”.

That number tops the 34% who were extremely concerned about the economy and the 36% extremely concerned about climate change. The only issues that attracted greater extreme concern were the general cost of living (55%) and housing affordability (53%).

Johnson & Johnson MedTech ANZ commissioned SEC Newgate Research to carry out the study.

While the healthcare system was considered to have performed well in several areas, 60% of respondents rated waiting times for elective surgeries as poor or very poor, making this the lowest-performing issue evaluated.

“Covid has caused a huge backlog in elective surgery,” AMA president Dr Omar Khorshid said at a recent roundtable to discuss the findings.

“There are estimates of around the 120,000 mark of procedures that have been delayed. Now those aren’t just numbers; those are people whose conditions will continue to worsen, people that may not be able to work and contribute to the economy, and for some people that could actually affect their survival.

“We’re going to see the consequences of the deferral of diagnostic tests and we’re going to see the consequences of long covid, which may mean those non-surgical patients continue to push surgery out of our hospitals, further compounding the difficulty of this enormous catch-up that we’ve got to do.

“We have an urgent problem that will be further compounded by the fact that our system lacks the capacity to do more and that includes our private sector. We just don’t have thousands of spare beds and spare staff to be able to deliver more healthcare.”

Associate Professor Payal Mukherjee, NSW chair of the Royal Australian College of Surgeons, said the primary concern should be workforce numbers.

“In NSW, when the systems become totally overwhelmed with covid, it’s not even beds – we just don’t have the workforce. At the peak of Omicron, we had 6000 workers out of the system and then on the back of three years of relentless emergencies and crises, we were also seeing a lot of exodus – healthcare workers choosing not to pursue a career in health.

“When you mention the word ‘capacity’, in my mind that triggers the word ‘workforce’, which is an even worse resource to lose [than equipment] because you can’t replenish that quickly, you can’t throw money at it and suddenly have a workforce.

“[In NSW and other states], elective surgery keeps being used as a lever to increase capacity to allow emergencies to occur.”

The survey also found that 55% of respondents opposed the NSW government’s decision to suspend elective surgery during the Omicron outbreak, with only a quarter (24%) supporting it.

A majority felt delaying Category 1 and 2 surgeries would be unacceptable if there are future covid outbreaks. Attitudes to delaying Category 3 surgeries were more mixed, with similar proportions finding it acceptable and unacceptable.

Four in five respondents felt the health system should be better resourced so covid outbreaks do not lead to the suspension of elective surgeries.

According to Catholic Health Australia CEO Pat Garcia, the strategy to increase capacity by suspending elective surgery so space could be kept free for covid emergencies in private hospitals had proven counterproductive.

“You can’t do that any more,” he said. “In NSW and Victoria, we had whole wards, fully staffed, not being used for months on end, but when we know there is a desperate need to keep elective surgeries ticking along to keep patients safe, keeping whole wards empty for months on end is just not something we can do.

“The capacity does exist within the private hospital system to deal with elective surgeries, we just need to be clever about the way we do it.”

New South Wales, It’s Time to Say My Health Can’t Wait