5 February 2024

'This is embarrassing': ACT still lags behind the nation for emergency department, elective surgery wait times

| Claire Fenwicke
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Canberra Hospital emergency department ED entrance

Canberra’s poor emergency department wait times have been a sore topic in the Territory for years. Photo: Claire Fenwicke.

The ACT still has the country’s worst emergency department and elective surgery wait times despite slight improvements in the last year.

The latest Productivity Commission’s Report on Government Services for Health showed the ACT was again last when it came to the time between people presenting to the emergency department (ED) and either being discharged or admitted: only 47.9 per cent of patients stayed for four hours or less (including both waiting and treatment times in the department).

This compares to the national average of 55.8 per cent and is worse than the 2021-22 data, which saw 52.4 per cent of Canberra’s patients seen within four hours.

There were improvements in the number of people seen on time in the ED compared to last year, with 41 per cent of ‘urgent’ patients seen within clinically recommended time frames (up from 36 per cent), 51 per cent of ‘semi-urgent’ patients seen on time (up from 46 per cent) and 76 per cent of ‘non-urgent’ patients seen on time (up from 73 per cent).

Overall, there have been improvements in the proportion of patients in the ACT seen on time, an increase from 48 per cent in 2021-22 to 51 per cent in 2022-23, and the median wait time has decreased.

Elective surgery wait times also increased, with 30 per cent of 2022-23 patients not admitted within clinically recommended times, up from 24.6 per cent in 2021-22.

Concerningly, the number of Canberrans avoiding seeing their GP has more than doubled from 3.7 per cent in 2021-22 to 8.1 per cent in 2022-23.

The number of people not filling out their necessary prescriptions due to the expense also rose from 3.3 per cent to 6.8 per cent in the same period.

However, the number of potentially avoidable GP-type presentations to EDs was down from 49,887 to 46,025 for 2022-23.

READ ALSO Belconnen doctor’s registration cancelled after he behaved inappropriately to patients

Health has long been a sore point in the Territory.

Deputy opposition leader and shadow health minister Leanne Castley slammed the statistics as a “disgrace” and “indictment” on the current government.

“Every year the Labor-Greens government has managed the health system, it has performed worse than the national average,” she said.

“This is embarrassing, but more importantly, it has a real impact on Canberrans’ health outcomes.”

Ms Castley accused the ACT Government of “excuses and spin” rather than coming up with solutions that worked.

“Each year we hear new excuses from the Health Minister about what she is doing to fix this crisis and each year she fails to improve the ACT’s ED wait times despite numerous promises,” she said.

“This year, Canberrans will be subjected to more propaganda from the government about everything it is doing in health, but Canberrans know their public health system is failing them.”

READ ALSO Bulk billing rates are up and so are Labor’s spirits

Health Minister Rachel Stephen-Smith acknowledged that while there is room for improvement, every health system across the country was under pressure.

“What this data does not specifically show and what the Canberra Liberals are not willing to acknowledge is that we have continued to see improvements with emergency department performance,” she said.

“The full-year 2022-23 data disguises improvements that were made through the year, with April-June 2023 emergency department figures tabled in the Legislative Assembly last year showing around 60 per cent of patients starting treatment on time.”

Ms Stephen-Smith also stressed ED wait times don’t reflect on the department alone and pointed out several initiatives being implemented by Canberra Health Services to improve processes across the entire hospital system.

These include an ED task force to improve patient flow in and out of the department, the introduction of an ED medical navigator role to support decision-making and flow on a shift-by-shift basis, expanding the acute medicine unit (AMU) and introducing Advanced Practice Nurses to work in the Fast Track area of the ED, focusing on patients triaged as category 4 or 5.

It’s intended their role will be expanded in the coming year to focus on ED-specific protocols.

As for elective surgery wait times, it has previously been outlined that the fire at the former Calvary Public Hospital Bruce’s operating theatres had some impact on the number of procedures being performed.

The last of those theatres came back online late last year.

Monthly performance was also impacted by the launch of the Digital Health Record (DHR) when 11,000 staff needed to be trained in its use.

“Following the launch of DHR, performance has been improving, and we have received very positive feedback from staff and consumers on the benefits of the new system,” Ms Stephen-Smith said.

More data from July to December 2023 is expected to be released in the first part of this year, which Ms Stephen-Smith said would show further improvements in ED ‘seen on time’ numbers.

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“Health Minister Rachel Stephen-Smith acknowledged that while there is room for improvement, every health system across the country was under pressure.”

Same old excuse from RSS, same old excuse from ACT Labor

HiddenDragon10:16 pm 05 Feb 24

The link above to the Productivity Commission website makes for interest reading, and not just in relation to public hospital services.

There are some areas where the ACT does OK or better, but generally no more so than might reasonably be expected given the advantages which this jurisdiction has. Too often, though, particularly when you look at what was happening ten years ago and what is happening now, a picture emerges of no real progress in absolute or relative terms – in some cases things have become worse.

Some of these shortcomings may well be due, at least in part, to patchy leadership from the political level but it is difficult to escape the conclusion that there are systemic problems which go beyond the lopsided nature of politics in the ACT and related lack of genuine accountability.

The ACT Liberals need to address this reality and make a broader case for change than just “trust us, we can do the same things in the same way better than the other lot”.

Jack D’s job is to constantly run a protection racket for ACT Labor. This must get a bit embarrassing when we are consistently at the bottom of the ladder with any Health Service comparison.

You and chewy didn’t answer my questions franky! The Canberra Liberals are considered a joke amongst their state and federal colleagues and the most conservative division of the party in the country. They are a party devoid of any policies and have been in opposition in the ACT for over two decades!

It must get a bit embarrassing and tiresome for you trying to protect the Canberra Liberals. Especially a party that blew up one of our only two public hospitals when they were last in government, not to mention what those ramifications were.

Left with only one public hospital and a run down publicly funded Catholic hospice offering limited services. Canberra Hospital has been pulling the weight ever since for both NSW and ACT patients.

We’re coming last of 7 jurisdictions in many heath care measures and getting worse. But clearly it’s all the opposition’s fault.

Even worse, franky22 – there’s 8 jurisdictions (6 states and 2 territories) of which we are last. However, your point is still valid.

The Olympics motto is: Faster – Higher – Stronger.
But in the ACT it’s: Slowest – Worst – Longest
After 20+ years of Barr-Rattenbury the Labor-Greens the record is:
“ACT has slowest economic and population growth in Australia: CommSec report” (CT 24/10/2022)
“ACT worst in country for aged-care accreditation checks” (CT 21/01/2021)
“ACT public hospital emergency patients have longest wait in the country” (RA 08/11/2021)
The only thing the ACT has achieved ‘Highest’ in is indigenous incarceration rates:
“Jumbunna Institute to lead ACT government’s review of high Indigenous incarceration rates” (ABC 05/02/2024)
But there are still unthinking electors, loyal party cadres and paid spin-doctors who habitually excuse this government’s dismal record, discrediting any alternative.
We get the governance we deserve and if the majority don’t care, accept this record and avoid change then the majority is responsible for past, present and future mediocrity, incompetence and negligence.

Capital Retro12:44 pm 07 Feb 24

You been watching Sky News too? ha ha.

Liberal leader Elizabeth Lee and her deputy Leanne Castley who is shadow minister for just about everything these days, have been noticed hanging around Lonsdale Street in Braddon these past few weeks stirring up angst and division amongst a small number of traders opposed to development in the area.

Mses Lee and Castley are very good at being the smart alecs, shrill in opposing everything and dishing it out to those in Labor. The Canberra Liberals are the most far right division of the party in the country. ED is only part of the huge public health equation. Social and health reforms have been hard fought in this city and vehemently opposed by the Liberals who petitioned their federal colleagues to use their dominant powers to interfere and override our laws.

Ms Castley is recognised as being more conservative than any of her predecessors before her. Her motives in the Assembly have been questioned for their far right and anti-feminism principles. The party’s slavish and active support in appeasing fringe and far-right lobby groups who contribute so much to the party’s coffers is legendary. These include, but not limited to, the Australian Christian Lobby, Right to Life and Advance Australia.

What plans do the Canberra Liberals have for current laws that they previously opposed? LGBTIQA+ rights, safe schools, drug law reforms, voluntary assisted dying, mental health, contraceptive and sexual health services for women just to name a few? The party was fervently opposed to the government’s acquisition and expansion of the Catholic run, publicly funded and run-down Calvary hospital last year despite public support. What are the Canberra Liberals’ plans for the now North Canberra and the Canberra Hospital’s expansion? How will these policies align with the party’s dominant conservative and far right support base?

@JackD I have no idea what you are saying, however it appears to have nothing to do with ED waiting times.

Jack D will do anything to avoid recognising the clear and immense failures in service delivery from the current government.

Ideology is far more important to him than outcomes as can clearly be seen by the above whataboutism word salad.

Maybe goggles and chewy can enlighten me and tell me what policies the Canberra Liberals will be bringing to the table. Not just health policies which take up 31% of the ACT’s budget but education, transport, housing, infrastructure, population growth, public transport, economic development, justice, climate change just to name a few. Msses Lee and Castley are expert at sniping from the sidelines but we have seen nothing from them on what the Canberra Liberals will bring to the table should their party win government at this year’s election.

Better still, maybe goggles and chewy can provide answers to the specific health questions I asked. Those policies which the party has scorned and continue to fight against including North Canberra and Canberra Hospital development, LGBTIQA+ rights, Indigenous health, safe schools, drug law reforms, voluntary assisted dying, mental health, contraceptive and sexual health services for women just to name a few? Ms Castley’s is deputy opposition leader but her motives continue to be questioned for her far right and anti-feminism principles.

How will these policies align with the party’s dominant, conservative and far right support base?

Why bother talking policy when you clearly don’t care about it as evidenced by your constant excuses for the clear policy and service delivery failures of the existing government?

Particularly when your default position is whataboutism about the supposed “far right wing” of the opposition, instead of any kind of balanced assessment.

Jacl D’s mantra:
Progressives good, Conservatives bad. Ad nauseum.

Capital Retro5:06 pm 04 Feb 24

Why not get people to pay? If they can’t pay up front then at least 50% and then the rest on terms. Plenty of “interest free” money from the ACT Government on other stuff.

And they can pay for the medications too. I always offer to pay when I go there – I have to if I see my GP but sometimes the wait for an appointment is just too long. I have to pay “the gap” when I use the hospital and associated services even though I have private insurance.

This notion that we all have a right to “free healthcare” is nonsense. Time to toughen up as the Territory is almost broke.

@Capital Retro
I’m all for those who can afford to pay for health care doing so … however, I understand one of the major ‘numbers’ issues is that the ED is clogged up with people who can’t afford to pay to see a GP so they use the ‘free service instead’.

It’ll solve the ‘numbers’ problem if they charge, but it would also mean these people would have access to no health services whatsoever, which may not be the outcome the health system is seeking.

GrumpyGrandpa6:31 pm 04 Feb 24

Hi CR,
When you are admitted into The Canberra Hospital, they’ll ask if you have Private Insurance. If you have been before, those records will already be on file.

Being a Public Hospital, you are automatically booked-in as a Public Patient and your care in the Hospital is covered by Medicare (paid for by you, through your taxes).

What sometimes happens is that someone will chase you down and ask is you’ll sign some forms, to enable the Hospital to charge your Health Fund for your admission. They try and shame you into it. – if the Private Health Fund pays, it helps us out with our funding.

You are under no obligation to sign those forms.

It will make no difference to your care. You won’t have a choice of doctor, you won’t get a Private room etc.

I find that chasing down those with Private Insurance disgraceful.

All this practice does is push the cost of our Private Insurance 🤔.

People are not expecting free healthcare. They are expecting to be able access a service they have paid for. Most people pay a Medicare Levy (some of us have paid it for 40 years). And before you claim people do anything to minimise their taxes, that simply doesn’t happen, only those with investments or who are self employed can do that easily – wage earners have almost capacity to avoid the Medicare Levy. The promise when it was introduced was the right to be able to access health care when you need it and not just when you can afford it. Maybe the funding formula needs work, but it is wrong to suggest people are looking for freebies.

The problem with your statement is that the Medicare levy does not remotely come close to the about spent on health care through Medicare, so even if we all paid a similar amount, then we aren’t covering it through that payment, the rest being serviced through general revenue.

Well that also comes from taxation you might say, but the level of access to those services does not match up with taxation payments, in fact there’s a more inverse relationship.

Now, I think thats a good thing having a universal health care system, but it’s most certainly not a user pays one, pretty much the opposite.

The current Medicare levy is pitiful megsy! The levy is based on a set percentage of 2% across all income levels above $23,000, or $33,000 for seniors and pensioners. The significant shortfall is paid out of general government expenditure.

Medicare was originally set up in the 1970s to be a publicly funded universal health care insurance scheme operated by the then Social Security Department. It funded most primary health care services. It was a scheme set up to benefit all Australian citizens and permanent residents most in need across most services. It has been scorned, undermined and watered down by successive conservative governments since it was implemented with attempts to abolish it.

Australia’s taxation system needs a total overhaul, particularly NDIS and Medicare which currently benefits the wealthy.

This Labor government should be returning NDIS and Medicare to their rightful place in history and what they were originally intended to be, insurance schemes that benefited all Australians, not just the wealthy and those who seek to rort!

Capital Retro1:27 pm 05 Feb 24

The Medicare levy applies only to taxable income, not all income. I agree that the NDIS is being rorted by the wealthy though.

Jack D. Medicare started in 1984 (not the 70s – that was the old Medibank). I’m not disputing the funding model is not working and needs an overhaul (its interesting that rebates haven’t changed in over a decade, while everyone’s contribution has as a result of indexation of wages).

I was challenging Capital Retro’s claim people were looking for free health care. That is not so and it is unhelpful to try to reduce the debate to that level. Most people actually pay more than they get back. For example, if your income is between 50K & 100K (where most people fall), you will pay between $1,000 & $2,000 a year. If you only see a doctor a couple of times a year, then you have well and truly paid for it.

Yes, the problem comes when people need more serious care than just a GP, but some of the problems with emergency department wait times and/or unmanaged health conditions deteriorating to needing hospital care are happening because people cannot afford to see a GP (despite paying $1-2K per year for the right to do so).

I agree with all of your comments megsy.
The Medicare scheme had its incarnation under the Whitlam government in 1975 as “Medibank”. The Fraser government attempted to abolish the scheme and it was reinstated by the Hawke government in the mid 80s under the name “Medicare”.
Medibank was privatised by the Abbott government in 2014.

It’s a bit meaningless to say most people pay more than they get back on Medicare in any one individual year. It’s an insurance scheme, it wouldn’t work if that wasn’t the case.

But the overall cost of Medicare to the budget is around $2k per adult each year and the total health system around $5k per year.

The median taxable income is only around $60k per year ($1.2k Medicare levy). That amount of Medicare levy doesn’t remotely come close to funding the proportion of Medicare let alone the health system as a whole. And half of all taxpayers are paying even less.

NDIS and Medicare benefits the wealthy, how so

Capital Retro10:22 am 06 Feb 24

They are not means tested.

@Capital Retro
But, the wealthy also have to pay the Medicare levy (admittedly on their ‘declared, not actual, income’) unless they opt for private health cover – which (stretching it a little) is a kind of means testing. Have to defer to you on NDIS as I know nothing about it or the funding model.

Capital Retro5:47 pm 06 Feb 24

A couple of posts have inferred that the “wealthy” arrange their financial affairs so they don’t have to pay any levies. That’s called “tax minimization” not “tax avoidance”.

It would be good if someone well informed on the subject (chewy is good on this matter) could tell us how many “wealthies” actually pay the default Medicare levy in lieu of not getting private health cover.

Capital Retro6:00 pm 06 Feb 24

JS, everyone gets an income in this country. Even the homeless get the full taxpayer welfare that is available to them. How income is spent is the problem. The ones you claim “cannot afford to pay” actually can pay but they choose to prioritize other things instead like cigarettes, a packet of which now costs more than the net price for a doctor’s consultation. Many buy drugs first. Taxpayers fund the health system which is today made up of very well paid “health professionals”, very few of which care for the best outcome for any social group.

Capital Retro,
Everyone pays the Medicare Levy, it is 2% of taxable income.

The Medicare Levy Surcharge is on top of that and very few wealthy people pay it because you only need basic Health Insurance to avoid it. No brainer to make sure you don’t get stung with further tax for no benefit.

@Capital Retro
“The ones you claim “cannot afford to pay” actually can pay but they choose to prioritize other things instead like cigarettes, a packet of which now costs more than the net price for a doctor’s consultation. Many buy drugs first.”
Wow – and you wonder why you get no respect, when you come up with sanctimonious and judgmental generalisations like that.

Capital Retro11:31 am 07 Feb 24

You are repeating what I have already said. So, how many actually pay the Levy surcharge?
Heath Insurance doesn’t cover the cost associated with a GP consultation by the way and not “everybody” pays the levy, in fact that a lot of the people that seek free treatment at TCH are under the taxable income threshold.

Capital Retro,
around 10-15% of people liable pay the Medicare Levy Surcharge, for a number of reasons but mostly because they don’t care or don’t know about the extra tax cost they pay rather than getting cheaper insurance.

“and not “everybody” pays the levy”

Everyone pays the levy based on their taxable income and associated reduction/exemption thresholds. Your other claims about people avoiding doctors fees and wanting to charge at the TCH are pretty nonsensical and would actually result in higher health related costs in the longterm.

Capital Retro12:43 pm 07 Feb 24

Hey JS, I think you should turn off your device and get out in the real world for a change.

Respect, what’s that?

@Capital Retro
Oh I get out into the real world quite a bit, CR, it’s how I know, unlike you, that not everyone who is currently suffering financial hardship and can’t afford to go to the doctor, is a cigarette smoking, drug taking wastrel – I would hazard a guess that a large portion are hard working but low paid people who are struggling to get by on what they earn.

Respect, CR? Well if you decided to forego posting falsehoods and comments denigrating people in financial hardship, you never know, you may actually find, from someone out there, what respect is.

Only last week I went blind in one eye thanks to a detached retina -got examined initially by the opthalmology dept. at Woden hospital but late that night got a call telling me to hot foot next morning to Sydney for treatment – they just don’t have the specialists here for that treatment. Got done in Sydney (outcome still uncertain) but eye doctors in Sydney expressed amazement that (for them) a fairly routine procedure can’t be done in the national capital!

Capital Retro7:40 pm 04 Feb 24

My information is that they have never had resident eye surgeons. At one stage they were flying them in but the ED department didn’t like being told to what to do by out of towners so they don’t come anymore.

There are private eye hospitals in Canberra that handle surgeries and TCH have referred people I know to them – can’t see why they would send you to Sydney.

would have likely referred Kalo to Sydney for public eye surgery as the out-of-pocket expenses for private eye surgeries is quite high.

What is not well understood is that eye surgeons only do certain parts of the eye, not all of it.

My detached retina experience, albeit 23 years ago, was much the same. Going to Sydney Eye Hospital was recommended to me on the basis of you’re better off getting surgery done by a person who does it umpteen times a week versus one who does it a couple of times a month. I went to Calvary on the Saturday morning, got told to go to Sydney which I did Saturday afternoon and was operated on Sunday morning. My eye still works fine all these years later.

Maybe our hospitals are more cautious than others and people stay longer to ensure a good outcome.

Capital Retro1:20 pm 05 Feb 24

I think you will find that the reality is exactly the opposite, Elf.

It’s almost as if they can’t wait to discharge people and this can be fatal for people who have had surgery as blood clotting can occur and a pulmonary embolism can result. I have lost two friends in the last five years after this happened. The partner of one of the victims pleaded with the hospital beforehand not to discharge him just two days after surgery.

The “worst emergency department and elective surgery wait times” in the country! Not a good look in an election year.

“Health Minister Rachel Stephen-Smith acknowledged that while there is room for improvement, every health system across the country was under pressure.”
Yes, minister, but despite the fact that “we have continued to see improvements with emergency department performance”, we still have the worst figures in the country.

If every health system in the country is under pressure, what is Labor’s plan to get us off the bottom? And, all we get from the Deputy opposition leader and shadow health minister Leanne Castley, is outrage! A huge missed opportunity to explain how, when they get into government, the Libs will improve the ACT health system.

Oh it’s going to be a long 9 months!

Who cares !!
We’ve got great LGBTQI artwork in Braddon and more EVs than anywhere else.

Isn’t it ironic that Ms Castley throws in the word propaganda, while spouting propaganda. The figures for the ACT aren’t good, but I’m yet to see any actual plans from the opposition that will make any difference. And I remember the last Liberal govt in the ACT – there were problems with the health system under them too.

Ms Castley, how about less adversarial politics and all sides of the Assembly start working together to find meaningful solutions?

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