Waiting lists mask true time to surgery: AMA

States and territories are failing to publish the data needed to address the delays in elective surgery.

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“Hidden waiting lists” are preventing elective surgery patients from making informed decisions about their care, while funding to address the problem is not prioritised because its scale is unknown, according to a new AMA report. 

Released this morning, the report – titled Shining a light on the elective surgery ‘hidden’ waiting list – reveals “a total mishmash of data,” AMA president Steve Robson told ABC News Breakfast. 

“Hidden” waiting lists cover the period between the GP’s referring a patient to a specialist and the time they get to attend the specialist consultation. They contrast with the “official” waiting list, which refers to time to surgery after receiving a specialist referral. 

And while the report claims “waiting times to see the general practitioner are low”, since these times are increasing the problem will likely be compounded. 

The report’s more egregious statistics include:  

• In Victoria, a patient will wait more than 900 days for an urgent neurosurgery appointment (target 30 days)  

• In Queensland, a patient will wait more than 150 days for an urgent gastroenterology or rheumatology appointment (target 30 days) 
• For non-urgent appointments (target 365 days) in Queensland and Victoria, waiting times for ophthalmology, orthopaedic, and plastic/reconstructive appointments are all more than 700 days in both states 
• The average waiting time in Tasmania was 101.2 days for urgent patients (target 30 days).  

A further problem is that the quantity and quality of publicly available data on public hospital outpatient waiting times varies significantly between states and territories.  

NSW, the Northern Territory and the ACT don’t even publish data on waiting times. 

“Inconsistent reporting of outpatient waiting times has several implications,” the report says, “including: patients are not fully informed of the actual waiting time for essential elective surgery in the public hospital; it is impossible to compare performance between states and territories; and the scale of the problem at a national level is unknown, which means funding to address the problem is not prioritised. 

“The full picture on time waited for public hospital elective surgery, however, requires the inclusion of the time a patient waits to see a specialist in a public hospital outpatient clinic before they are assessed and added to the elective surgery waiting list.” 

The report breaks down waiting times across the states and territories. 

• Victoria In the latest reporting period (April-June 2022), 90 per cent of urgent patients were seen within 45 days for their first appointment (target 30 days), and non-urgent within 375 days (target 365 days). 82.2 per cent of urgent and 89.7 per cent of non-urgent of patients were seen within the recommended waiting time. 
• Queensland In the latest reporting period (April-June 2022), 90 per cent of urgent patients were seen within 62 days (target 30 days), semi-urgent within 280 days (target 90 days), and non-urgent within 492 days (target 365 days). Only 68 per cent of urgent, 54 per cent of semi-urgent and 80 per cent of non-urgent patients are currently waiting within the recommended waiting time. 

• Western Australia At the end of December 2017, the median waiting time for a first appointment (WA combines reporting for urgent, semi-urgent, and non-urgent patients) was 8.78 months. The median waiting time has gradually increased from 5.92 months in December 2012. 
• South Australia In the latest reporting period (January-March 2022), the median waiting time for an appointment (SA combines reporting for semi-urgent and non-urgent patients) was 7.1 months, and the maximum waiting time was 27.2 months. 
• Tasmania In the latest reporting period (as of 31 July 2022), the average waiting time was 101.2 days for urgent patients (target 30 days), 349.2 days for semiurgent patients (target 90 days), and 536.2 days for non-urgent patients (target 365 days). 
• NSW, Northern Territory, Australian Capital Territory have no publicly available data. 

According to the AMA, the Australian Institute of Health and Welfare is currently working with jurisdictions on the future publication of outpatient waiting times.