6 December 2018

Why can't the government sort out ED waiting times?

| Genevieve Jacobs
Join the conversation

Canberra emergency waiting times remain the worst in the country according to the latest figures. File photo.

Despite years of effort directed at trying to solve the problem, Emergency Department waiting times in Canberra remain the worst in the country, according to the latest figures. Elective surgery waiting lists are also poor on a national basis, with many patients waiting more than a year.

According to the Australian Institute for Health and Welfare, 72 per cent of people nationally presenting to emergency departments were seen ‘on time’ for their urgency (triage) category for the year until June. But this varied substantially, ranging from 80 per cent of patients seen ‘on time’ in New South Wales to just 49 per cent in the ACT.

The figures come on the back of years of problems with emergency waiting times, dating back a decade or more. In recent times, ACT Health’s newly-appointed director general departed the role just three days after it was publicly announced and before a major restructuring, and the Canberra Hospital failed to meet multiple accreditation criteria in March.

Speaking on ABC Radio this morning, health minister Meegan Fitzharris acknowledged that the emergency waiting times were unacceptable, but said that the new Canberra Health Service model is only two months old and that “you can’t change everything overnight”. The government had invested in elective surgery outcomes, supporting GPs and active planning for two new walk-in centres in Weston Creek and the Inner North.

But University of Canberra academic and health policy specialist Professor Laurie Brown said that while the quality of ACT healthcare is good, “it seems like the Health Directorate itself is highly dysfunctional. I’m not talking about individual leaders but overall there’s been a number of issues over a number of years.

“So who is doing their job in arguing for the necessary resources, and why haven’t greater resources been provided as a result? The emergency waiting times are an indication of broader policy failure that’s ongoing. The issues are well known, there’s nothing new about any of this.”

Professor Brown says that Canberra’s rapid population growth is not an excuse for a failure in resourcing. “The reality is that Health, alongside all the other areas of government, will have detailed population forecasts. They have a fairly good idea of what the population growth will be for the next five to ten years and they can engineer scenarios. I can’t see what’s unexpected.”

Professor Brown agrees that the walk-in centres have been a success and that they’re a health care model that’s worth pursuing. But she wonders whether there’s still opposition in the community to using the centres as the first point of contact.

“If you need out-of-hours primary care, where do you go? Most Canberrans would struggle to think of a GP they could go to for an emergency. Yes, you could choose the walk-in clinic but for many people, your immediate thought is that you need a doctor and that you’ll only find one of them at the hospital,” she said.

Professor Brown believes that we don’t need a new hospital, but better use of the facilities that we have. “You could easily improve some of the bottlenecks by providing greater resources. You could open more operating theatres, get more surgeons or practitioners, nursing staff and then start cutting down some of the long waiting lists. It’s really a question of economics: where should the ACT budget be spent?

“If you think about it, this is not a short-term problem. This has been on agenda for many years, so there’s an ongoing problem. Given that situation, why are there still such major difficulties? Where is the political and organisational failure to address these issues?”

Why do you think it’s so hard to sort out Canberra’s emergency department waiting times?

Join the conversation

All Comments
  • All Comments
  • Website Comments
Capital Retro6:09 pm 08 Dec 18

The walk -in clinics are free – no doubt about that, but they can’t be compared to an $80 less rebate visit to a GP because the services offered are poles apart.

There have been several articles in the media stating the costs of running the walk-ins are very high and the value for money isn’t justified.

I don’t know how much they claim back from Medicare for each visit but it wouldn’t (or shouldn’t) be the $37.60 that is given as a rebate for a GP visit which usually involves getting a prescription.

And when we talk about “free”, remember the money comes from the taxpayer and not from the money that grows on trees at the arboretum.

Capital Retro8:40 am 07 Dec 18

I would prefer to consult with my usual GP all the time and I don’t mind paying the $40.00 “gap” but getting an appointment is a 2 -3 day wait and his surgery hours are only 9 – 5 during the week and not at weekends.

The only other “choice” when some actual treatment is required is the ED at our public hospitals. Waiting time at the walk-ins is now about 2 hours so may as well go straight to ED.

Is it true that the emergency waiting room is full of people who should be at their GP instead of the Emergency Room?

I don’t know myself and I haven’t seen the data on emission status. But three Nurses and a Doctor that I trust, think that this common view is not actually the world case.

The people who work in ED, think that it is Government mismanagement, years of inadequate funding growth and poor internal organisation is the key to the ongoing failures. .

Is there anyone who can give Riotactors some on the ground honest feedback? Not just their experience of an occasional visit or their warped.view that everyone else in the Emergency Room is less sick then themselves?

My experience, both personally and an elderly mother who has been hospitalised through Emergency maybe 5 times in past 2 years is we have been seen reasonably quickly 15-25 mins despite reasonably full waiting rooms.

Says to me the triage system as identified most of the others there to be a lower priority. Which seems to me to suggest that maybe their illnesses are not ED worthy.

A neighbour of ours used to take her baby to ED at least once a month just because the child was sick. And thought it strange when we had children that at the first cough or runny nose we didn’t do the same rather we took them to the doctor.

I guess that is why I’m calling for the data. For every positive story you hear (such as for you and your mother), you hear at least five negative stories including people dying or suffering terribly, because they weren’t attended to in an adequate amount of time.

AIHW see the detailed admission data and medical reasons for the patient being in ED and say that Canberra Hospitals are performing badly in comparison to other Jurisdictions.

I just want to know the truth, not the spin from either the Government or the Doctors who ard at opposite ends of the scale.

petunia petal10:32 pm 06 Dec 18

A lot of people commenting here without first hand experience of working in the ED. How do you know its due to people not opting to pay GP fees? Do they have enough beds open? prob not. Is too much of the hospital $ going towards exec salaries and bureaucrats as opposed to clinicians/beds? We need to listen to staff (not to politicians or exec staff) and not presume we know what the issues are. The hospital clearly has problems.

Adding to the problem are the people who initially see their GP and are told they need a scan/x-ray/blood test. This involves a cost that they do not want to pay, so they turn up at E.D. stating their GP says they need further investigation so they want to be seen here and have it organised through the hospital so that it will be free.

I have a strong suspicion that the government’s fondness for the walk-in centres has more to do with commitments made to the nurses’ union than its health care effectiveness or efficiency merits.

Any evidence of this?

The wait time in the walk-in clinics is appalling as well.

Every time I’ve been to a Nurse walk in Centre, I’ve been recommended that I will need to go to a Doctor at Emergency if the situation doesn’t stabilise.

People in a ‘perceived’ Emergency situation want a Doctor and Emergency Resources not a nurse. I think there is an obvious flaw in the Nurse Walk in Model that is supported by the low use data for the service But hey I’m not a Health Expert.

I agree with the comment from Miffed, that Professor Brown needs to stop continually giving us opinions on issues in the Press and Media and start giving us some supporting data, proper analysis and well articulated evidence.

Could either Prof Brown or The Minister point us towards any proper scientific analysis proving that the walk in clinics is a success? Or even were needed?

There was one review done years ago and it was scathing. Despite this more Clinics were opened.

The last time any data was released by ACT Health was over two years ago and this showed most patients presented during normal business-hours, one clinic with multiple staff saw less people than a single GP would and the costs were five times more to tax payers than seeing a GP.

And every single clinic is within walking distance of existing Bulkbilling GP clinics with extended trading hours.

Please Genevieve, explain to me how this can be defined as a success?

Daily Digest

Want the best Canberra news delivered daily? Every day we package the most popular Riotact stories and send them straight to your inbox. Sign-up now for trusted local news that will never be behind a paywall.

By submitting your email address you are agreeing to Region Group's terms and conditions and privacy policy.