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

Genevieve Jacobs 6 December 2018 54

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?

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54 Responses to Why can’t the government sort out ED waiting times?
Sue Owens Sue Owens 7:59 pm 10 Dec 18

There are plenty of bulk billed Drs The national Health co op bulk bill & they have about 8 outlets across Canberra with more to open in the future

    Cass Proudfoot Cass Proudfoot 9:40 am 11 Dec 18

    Canberra has the lowest level of bulk billing in Australia and people do put off trips to the doctor due to cost.

Kim Hooper Kim Hooper 10:14 pm 09 Dec 18

more clinical staff and more resources, ...trim the upper eschalons...🤨

Rodney TatStan Rodney TatStan 8:03 pm 09 Dec 18

Well if there was equal workplace mental health benefits then maybe people could see face to face counsellors rather than emergency department.


Capital Retro Capital Retro 6:09 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.

Cass Proudfoot Cass Proudfoot 10:57 am 07 Dec 18

People who aren't that sick aren't really the problem. There is a triage system to sort out the urgent cases from the barely sick. Something else is going wrong in our hospital system to cause the delays in seeing the urgent and serious cases.

Stephen Page-Murray Stephen Page-Murray 10:15 am 07 Dec 18

Waited 7 hours at Calvary. Later that night they admitted that I’d “fallen through the cracks”. At least the Muslim female doctor that saw me was top notch.

Capital Retro Capital Retro 8:40 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.

Jackie White Jackie White 8:30 am 07 Dec 18

How about a lack of bulk billing doctors in Canberra, and the sad fact of a growing population and one fewer hospital than 20 years ago?

Joanne Hagan Joanne Hagan 8:24 am 07 Dec 18

I recently had an excellent experience with emergency and the hospital itself. I was however, very disappointed in what I saw people presenting with as "emergencies ". Try seeing a GP or walk-in centre first people! And learn the definition of "emergency ". I really feel for the staff, as it must be so frustrating for them

Julia Graczyk Julia Graczyk 6:32 am 07 Dec 18

I presented to Emergency at TCH a few months ago. It was a genuine emergency. I was seen within minutes and sent up to the Emergency ward almost immediately. The staff there were incredibly responsive, helpful and caring. They saved my life that day. I really couldn't imagine getting better care.

Elective surgery waiting lists on the other hand. Don't get me started. The waiting times for some procedures are mind boggling.

    Margaret Freemantle Margaret Freemantle 3:00 pm 07 Dec 18

    Julia Graczyk this can only be addressed by another hospital. We want to grow the population but not the healthcare.

Ursula Gamal Ursula Gamal 11:05 pm 06 Dec 18

Because senior management are no clinicians but a bunch from the private sector imported to trim any fat. Instead they trimmed healthcare in general.

bj_ACT bj_ACT 10:53 pm 06 Dec 18

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?

    JC JC 9:12 pm 08 Dec 18

    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.

    bj_ACT bj_ACT 6:14 pm 09 Dec 18

    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 petal petunia petal 10:32 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.

Julie Donda Julie Donda 10:09 pm 06 Dec 18

Because too many people use it as a doctors surgery.

I’ve never had to wait long because the handful of times either myself or a family member has been there is due to a “Accident or Emergency”.

Thank you to all the staff in A&E for your hard work.

knuckles knuckles 9:48 pm 06 Dec 18

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.

Ian Ian 9:48 pm 06 Dec 18

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.

Mark Piper Mark Piper 9:10 pm 06 Dec 18

Because people go when not needed, go see a GP

    Thinus Van Rensburg Thinus Van Rensburg 10:45 pm 06 Dec 18

    Tony there is plenty of bulkbilling available in Canberra. Every single walk in clinic has at least one bulkbilling clinic within walking distance from it and some of these operate at the exact same hours as the walk in clinics

    Samantha Morgan Samantha Morgan 10:56 pm 06 Dec 18

    Thinus Van Rensburg not actually true.

    Margaret Freemantle Margaret Freemantle 2:59 pm 07 Dec 18

    Thinus Van Rensburg bad luck if you have a serious condition- a lot of people have and walk in clinics staff know nothing about complex issues. The government is in denial of the problems- a new hospital instead or more trams NOW

Nada Krstin Nada Krstin 9:10 pm 06 Dec 18

Agree with all the above comments....people are using ED for minor ailments instead of Walk-In Centres (which by the way are bulk billed) or visiting their GP. This is very frustrating for those that have had to attend ED with something that is actually an 'emergency' and are exposed to excruciating long waits - not the staff or hospital's fault ....

But I do take on board that many attend ED because they don't want to pay for the GP appointment (selfish), or cannot truly afford to...

    Thinus Van Rensburg Thinus Van Rensburg 10:42 pm 06 Dec 18

    Nada bulkbilling involves Medicare - $37 From Federal taxes. The walk-in clinics attracts no Medicare funding. Every single person seen there, and most are for the common cold, cost ACT taxpayers $190.

    Nothing is free - our taxes pay for it all

    Samantha Morgan Samantha Morgan 10:55 pm 06 Dec 18

    Thinus Van Rensburg well why is it that Brisbane health care far exceeds the ACT? Something is very wrong with the ACT system.

    Thinus Van Rensburg Thinus Van Rensburg 5:58 am 07 Dec 18

    Yes. There is somethin* seriously wrong with ACT Health. However life expectancy and quality of life in the ACT is still better here than in any other State

    Nada Krstin Nada Krstin 8:16 pm 11 Dec 18

    Thinus Van Rensburg thanks for enlightening. However I would still prefer that more people used the Walk-In Centres for minor ailments than to clog up the ED - leave the ED to attend with chronic and actual emergency issues.

    The Walk-In Centres are managed by full time staff that ACT Taxpayers pay for wages (happily from my end) - regardless whether the public attend or not..

Emanuel Margaronis Emanuel Margaronis 8:39 pm 06 Dec 18

The lack of bulk billing GPs in the ACT is clogging up ED.

    Thinus Van Rensburg Thinus Van Rensburg 10:43 pm 06 Dec 18

    Emanuel that is simply untrue.

    Emanuel Margaronis Emanuel Margaronis 12:00 pm 07 Dec 18

    Thinus Van Rensburg Ok thanks....I stand corrected.🤨

    So tell me where are people that can’t afford to pay for a $80 visit to at a GP going....maybe a magical witch doctor?

    Casey Barton Casey Barton 4:16 pm 07 Dec 18

    Emanuel Margaronis the walk in clinics are free....

    Tarz Lam Tarz Lam 6:56 pm 07 Dec 18

    This is incorrect. The National Health Co-op offers bulk billing at its multiple sites and I can always get an appointment when I need one.

Lucy Baker Lucy Baker 8:17 pm 06 Dec 18

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

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