Queensland Health has hundreds of thousands of people waiting for specialist outpatient care
In December, Heather Jacobs learned she would be seen by a specialist cardiology clinic within three months.
She is still waiting.
“I have heart failure and I have angina…and an ischemic heart,” she said.
“It all sounds terrible, but I’m going anyway.
“They want to investigate, because palpitations have started happening, so they’re going to investigate the valves and so on.
“I left from [category] one, two, one more, then two.
“I guess if it was an extremely serious situation, I would get in an ambulance and go to the hospital.
“The problem is that they are so full.”
Heather is one of hundreds of thousands of people waiting for a first appointment at one of Queensland Health’s specialist outpatient clinics, which provide services that don’t require someone to be hospitalized.
There are 167,181 surgical patients and 100,061 other medical patients on the list.
It is sometimes called “the waitlist for the waitlist” because it can include the care people receive before they are booked for elective surgery.
At times during the pandemic, many of these services have been put on hiatus.
Dozens of elective surgeries have also been canceled or postponed over the past two and a half years.
Few can say for sure what the total impact on the system will be.
Even before the pandemic hit, in July 2019, 212,247 people in Queensland were waiting for a first appointment at a specialist outpatient clinic.
What are the waiting lists currently like?
At the end of June, 57,914 people were waiting for elective surgery in Queensland, and 7,560 of them were waiting longer than clinically recommended.
Of these, 266 were Category 1, having a condition that can quickly worsen to the point of an emergency. They are supposed to be seen within 30 days.
Another 3,145 were Category 2 patients, meaning their conditions cause pain, dysfunction or disability and they would need to undergo surgery within 90 days.
4,149 patients were in Category 3, who were due for surgery within a year but had been waiting longer than recommended.
While patients wait for their specialist treatments, monitoring their condition is often the responsibility of their GP.
The Vice President of the Royal Australian College of General Practitioners, Bruce Willett, said there had been a significant increase in the time it took for people to get outpatient appointments.
“It’s always an increased burden to continue to care for, to manage these patients, both in terms of workload – and of course we share our patients’ stress about the wait, and that’s additional psychological burden for patients and GPs,” he said. said.
“I understand that Queensland Health will be working very hard to try to reduce these waiting times.
“Unfortunately, I think it will take six to 12 months to overcome these wait times.”
Eruptions in the southeast and north
Queensland president of the Royal Australasian College of Surgeons, Sanjeev Naidu, said the proportion of emergency surgeries and urgent surgeries – heart surgeries, cancer operations and treatment of trauma such as car accidents – has increased in the for the past five years at least, which is putting pressure on hospitals and the state’s elective surgery program.
“Particularly in South East Queensland and Cairns, volumes have increased due to our growing population,” Dr Naidu said.
“It’s been steadily increasing, but there was a bit of a spike from 2020.
“When you look at the big picture, about 7,500 [long waits]it’s a small percentage.
“However, those long waits are people, and we have to deal with them to the best of our abilities.”
Dr Naidu said Australia used to rely on British nurses to fill vacancies, but said there was also a need for 100,000 staff there.
“We may have beds but we don’t have staff. It’s a big problem in the hospital system as well as in primary health care,” Dr Naidu said.
“Now the staff, they are tired, they are exhausted.
“We have to look after our staff… take care of them because we are not able to recruit easily like we used to.”
Referral of patients to private hospitals
One of Queensland Health’s tools for keeping track of waiting lists is a program called Surgery Connect, which directs public patients to the private system for their procedures.
In the last fiscal year, 9,650 procedures were performed through Surgery Connect, the highest number in the previous three years.
Between mid-2018 and last month, over 30,000 surgeries were performed through Surgery Connect.
UnitingCare Queensland Group Director Michael Krieg said there were waiting lists across the board, with the biggest challenge being available staff.
“The ability for us to reach higher levels is really tested due to workforce constraints,” he said.
The number of UnitingCare employees on sick leave has hovered between 8 and 10 per cent this year, figures similar to sick leave at Queensland Health at the height of the most recent third wave of COVID-19.
UnitingCare hospitals have done about 10% less work than they usually expect over the past two and a half years.
Mr. Krieg said many exhausted employees were unwilling or unable to take on additional work.
“It’s extremely difficult because most private hospitals haven’t made any money at all in the past two years. We need business to be viable,” he said.
“Being able to balance the welfare of staff, our ability to pay for things, the challenges of the whole system, is really difficult at the moment.
“The pressure on our staff in particular has been enormous.”
The national body representing private hospitals, the Australian Private Hospitals Association (APHA), said internal surveys of private hospitals showed around 8,000 nurses were needed to fill positions nationwide.
“The sickest patients will always be seen first”
Queensland Health said this year’s state budget included $15 million to support the delivery of planned long-term care and to tackle waiting lists.
The agency admitted it faced increased pressure, driven by a growing and aging population, COVID, a lack of seniors, disability and primary care and declining private health coverage.
Queensland Health succeeded in increasing the number of elective surgeries in the June quarter by 40% compared to the previous quarter, performing 32,362 elective procedures.
“Queensland has seen three peaks of COVID-19 this year which has also increased the pressure on our healthcare system due to high numbers of hospitalizations as well as a large number of furloughed staff,” said a spokesperson.
Each regional health and hospital service manages its planned care and elective surgeries according to its particular situation.
“The sickest patients will always be seen first,” a Queensland Health spokesperson said.
Another elective surgery blitz?
After a months-long nationwide pause on elective surgery at the start of 2020, the Queensland government spent $250 million on a “blitz” on elective procedures.
In August of that year, then-Health Minister Steven Miles said the long waiting list had fallen to 2,774 patients, despite predictions that that year’s cancellation would see the number about 7,000.
With more than 7,000 patients on long-term waits, Health Minister Yvette D’Ath did not say whether another blitz was planned.
She pointed to the government’s $23.6 billion spent on health in this year’s state budget, which included hospital expansions and thousands of new beds.
“To perform 32,362 surgeries in a quarter so heavily impacted by COVID and influenza is an exceptional effort,” said Ms. D’Ath.
Outpatient waiting lists were the target of major funding when the state government came to power in 2015 – an effort the Auditor General reviewed in a report released late in the year. last year.
This report found that the funding initially cut the waiting list for outpatient specialist appointments in half, but they have been steadily increasing again since 2017.
Between July 2017 and July 2020, the number of patients waiting longer than recommended increased by 72%, and while 36% more first appointments were offered in the five years to June 2021, the number of referrals increased. increased by 53 percent.
The increase in removals was well ahead of Queensland’s population growth of just over 8% over roughly the same period.
“This makes it more difficult to match supply and demand and to actively manage patients to ensure they are on the right track at the right time,” the auditor general’s report said.