Patient care must not be compromised by bureaucratic benchmarks
Every three months, the residents of NSW are given a status update on the performance of their state's public health system.
The quarterly Bureau of Health Information report paints a picture of how the system is functioning, from the number of ambulance call-outs to wait times in emergency and how long the average patient stays at hospital.
Of particular interest since the pandemic – and covered exhaustively by the Herald – has been the elective surgery waitlist, which rose to record lengths when COVID-19 precautions caused the postponement of thousands of non-urgent operations.
In the 2023 state election, NSW Labor ran on a platform of reducing the elective surgery waitlist, announcing a surgical taskforce to investigate ways to clear the list, sparing patients from the poor health outcomes that can come from waiting longer than recommended for life-changing operations, including hip and knee replacements, eye surgery, and cardiothoracic procedures.
By the end of that year, the number of patients overdue for surgery had declined to pre-pandemic levels.
But, as the Herald reported following the release of the latest BHI quarterly data in March, the number of patients overdue for elective surgery in NSW public hospitals tripled between the end of 2023 and the end of 2024.
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While nowhere near the 18,000-person waitlist left after NSW's Delta lockdown in late 2021, such a sharp upward trend in the number of people waiting too long for operations has not been seen outside of periods of pandemic restrictions. Eye surgeries, joint replacements and tonsillectomies were the procedures with the largest backlogs.
Doctors speaking about the release of those figures put the increase down to staff shortages and budget cuts. But, as Herald health editor Kate Aubusson reports today, doubts have been cast over whether the pressure to meet KPIs at some hospitals had led to surgeries being strategically categorised, so they did not appear as overdue on the books.
Among the allegations made by doctors at Sydney's RPA and Westmead hospitals, which follow an ABC investigation into similar behaviour at Orange Hospital last month, are that hospitals have been effectively refusing patients because they will not be able to perform their surgery within the recommended timeframe, or changing the categories of patients.
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Vaccine coverage for influenza sits at just 24.24 per cent nationally and 14 per cent for those under the age of 50. The take-up of COVID boosters has also dropped away significantly in people aged 75 and over, falling from 38 per cent to 32 per cent in the past 12 months. The Australian Medical Association says people need to prioritise conversations with their GP about vaccination against both conditions as well as the similarly widespread respiratory syncytial virus, especially those at greatest Australia's RSV immunisation program has achieved a 57 per cent reduction in hospitalisations among infants, saving the state's health system up to $6.9 million in hospital costs. AMA President Danielle McMullen says its success highlights the power of evidence-based prevention. "These results show what's possible when we get vaccination right, with more babies being kept out of hospital because their parents chose to protect them," she said on Saturday. "The timing could not be more critical with RSV cases climbing since the start of 2025 and children under five most at risk." Dr McMullen says the drop in COVID and flu jab rates is alarming."New COVID-19 strains continue to circulate leading to increased hospitalisations, making regular boosters essential for maintaining protection against severe illness," she said. "We are particularly concerned by (influenza) vaccination rates among Aboriginal and Torres Strait Islander communities, which have declined across all age groups." The national RSV prevention program offers free maternal immunisation and targeted infant protection, while annual influenza jabs provide strong protection, with more than 98 per cent of this year's circulating strains matching vaccine components."The evidence is clear, vaccines work," Dr McMullen said. "But vaccines sitting in fridges don't save lives. We need people to pay attention, particularly parents of young children and older Australians." With a marked dip in immunisation rates for flu and COVID-19, Australians are being urged to get the jab before winter sets in. Vaccine coverage for influenza sits at just 24.24 per cent nationally and 14 per cent for those under the age of 50. The take-up of COVID boosters has also dropped away significantly in people aged 75 and over, falling from 38 per cent to 32 per cent in the past 12 months. The Australian Medical Association says people need to prioritise conversations with their GP about vaccination against both conditions as well as the similarly widespread respiratory syncytial virus, especially those at greatest Australia's RSV immunisation program has achieved a 57 per cent reduction in hospitalisations among infants, saving the state's health system up to $6.9 million in hospital costs. AMA President Danielle McMullen says its success highlights the power of evidence-based prevention. "These results show what's possible when we get vaccination right, with more babies being kept out of hospital because their parents chose to protect them," she said on Saturday. "The timing could not be more critical with RSV cases climbing since the start of 2025 and children under five most at risk." Dr McMullen says the drop in COVID and flu jab rates is alarming."New COVID-19 strains continue to circulate leading to increased hospitalisations, making regular boosters essential for maintaining protection against severe illness," she said. "We are particularly concerned by (influenza) vaccination rates among Aboriginal and Torres Strait Islander communities, which have declined across all age groups." The national RSV prevention program offers free maternal immunisation and targeted infant protection, while annual influenza jabs provide strong protection, with more than 98 per cent of this year's circulating strains matching vaccine components."The evidence is clear, vaccines work," Dr McMullen said. "But vaccines sitting in fridges don't save lives. We need people to pay attention, particularly parents of young children and older Australians."
