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

Genevieve Jacobs 6 December 2018 57

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?

What’s Your opinion?

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57 Responses to
Why can’t the government sort out ED waiting times?
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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 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 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 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 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.

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 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 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.

9:10 pm 06 Dec 18

Because people go when not needed, go see a GP

    9:53 pm 06 Dec 18

    Mark Piper many cant afford to so they lob at the hospital. Fix the bulk billing, the hospital problem is solved.

    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

    10:56 pm 06 Dec 18

    Thinus Van Rensburg not actually true.

    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

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...

    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

    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.

    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

    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..

8:39 pm 06 Dec 18

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

Lucy Baker 8:17 pm 06 Dec 18

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

8:04 pm 06 Dec 18

This statistic gets blown out of proportion by those who use the ED as a drop in centre for runny noses and sprained toes. If it's not an emergency then go to your GP or local Medical Centre. Don't forget that ED's not only have front entry for walk ins but they have an ambulance entry as well. Watch that door for a while and then complain that your runny nose is more important!

    2:06 pm 07 Dec 18

    Wayne Weaver people go to ED because they can't afford the Drs bills. I don't think they downplay the urgency of real emergencies, but we have to look at the reason why there are so many people walking in. ACT needs more bulk billing doctors..

8:01 pm 06 Dec 18

Canberra needs to take on bulk billing. Many people go to ED because they cannot afford to pay for a doctor. I prefer to go to doctor first because I have friends who are nurses and it’s their biggest gripe... those who come in who should be at the doctors surgery instead.

    11:52 pm 06 Dec 18


    A/H Bulk billed Home Doctor

    10:51 am 07 Dec 18

    Chad Wick often booked out very early in the evening.

    4:15 pm 07 Dec 18

    Racheal Green there are now 3 walk in clinics in Canberra that are open incredibly long hours, and free. We have used them plenty of times and it’s always virtually empty in them.

    6:12 pm 07 Dec 18

    Casey Barton I am aware of the clinics as I have used them but plenty of people don’t know much about them either.

7:24 pm 06 Dec 18

Staff are wonderful, no complaints . But, I did leave at 3.30 am without my hand being stitched. After 5 hours and the terrific staff giving me pain killers, I decided I was over it. There was heaps of people still coming in - Mums and babies - who I could see were more urgent than myself ( we arrived about 9.00)

7:24 pm 06 Dec 18

I’ve been there Cat 2 and had to wait three hours plus in agony and no one cared. Waiting room is awful.

    10:44 pm 06 Dec 18

    Big call that no one cared. Perhaps it was just that no one was working in a system that could support them to help.

6:40 pm 06 Dec 18

I have to say the staff are awesome. I had to rush my partner to Emergency a few months ago and they couldn't do enough.

6:39 pm 06 Dec 18

Shame on the Barr Government. A big 'Thank you" to the wonderful staff.

    9:48 pm 06 Dec 18

    Doris Andrews most of you muppets keep voting them in? You reap what you sow

    9:15 am 07 Dec 18

    Vivien Muñoz Durret Yet the ACT health system is the most well funded in the country. More per person is spent on health in the ACT than anywhere else. The issues are not about funding. The issues are about better management and also people turning up at emergency because they won't pay for a GP and there are not enough bulk billing GPs in Canberra.

    9:55 am 07 Dec 18

    Tony Morris I did not vote for them. Please do not name call.

    10:12 am 07 Dec 18

    Justin Watson yes. Totally agree

6:31 pm 06 Dec 18

I have never had an issue with wait times at ED at TCH to be honest. They need to triage and yes someone more in need than yourself will be seen before you. If more people used the walk in centres and GP for more minor issues the wait times would decrease. Several times we have presented at the ED and havn't even sat down, taken straight through because we go there when it is an emergency

6:18 pm 06 Dec 18

More staff required. Kudos to current staff who do a great job 👏👏 under trying circumstances

bj_ACT 5:23 pm 06 Dec 18

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.

miffed 3:14 pm 06 Dec 18

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?

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