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Victoria has failed to hit its target for monthly elective surgeries needed to clear the COVID-19 backlog, according to a leaked briefing note.
The state is also unlikely to reach its annual goal of 240,000 elective surgeries to reduce the surgery backlog despite its $1.5 billion investment, peak health bodies say.
Victoria announced a major “catch-up” plan after the elective surgery waitlist soared during the pandemic. Credit: Royal Children’s Hospital
As the state government prepares to unveil major reforms next month, the leaked briefing note reveals that Victoria is yet to hit the 20,000 monthly surgeries target.
The Andrews government set an elective surgery target of 240,000 procedures for this financial year as part of its commitment to tackle a surgery waiting list blowout that resulted from lengthy pandemic lockdowns.
A $1.5 billion investment into surgeries such as hip replacements and hand surgeries was designed to “exceed pre-pandemic levels by 25 per cent” and the new figure was expected to be met every year after 2024.
But a presentation provided to public health service leaders in June, seen by The Sunday Age, has shown Victoria needs to deliver 20,000 surgeries a month to hit the target. The best result since the catch-up program began was 18,127 surgeries completed in March.
Nearly 190,000 patients on the waiting list were treated in the last financial year – well short of the “activity target” of 237,000 surgeries, the document stated.
The Australian Medical Association predicts that Victoria will fail to achieve the 240,000 figure because of healthcare worker shortages.
“I anticipate that, unfortunately, we’ll fall short of the target, just as we did last year,” said Dr Jill Tomlinson, Victorian president of the medical association and a plastic reconstructive surgeon.
“It may be that we find that the targets that were announced are not achievable.
Dr Jill Tomlinson says there are high levels of burnout among medical professionals.Credit: Wayne Taylor
“I do wonder if we will find in time that this surgical target is a bit like some of the election commitment targets.”
The program would need productivity to increase to 140 per cent of existing levels and could fall short even if the government outsourced more surgeries to the private sector and the new surgery hubs ran at full capacity, including at weekends, she said.
COVID-19 waves in winter 2022 and at the end of last year were stronger than predicted and the state government says the pressure on the system, alongside the large numbers of staff furloughed during this period, slowed the recovery effort.
“We also need to avoid healthcare worker burnout, which is at a pretty high level,” Tomlinson said.
There were still significant delays in getting people on to a waiting list, to meet a surgeon and to have an operation done, she said.
“That has significant impacts on patients because it means that they have pain and disability … [that they are] having to put up with for much longer periods of time.”
Tomlinson said Victoria was still below some of its targets for emergency department admissions and that the limited workforce posed questions about where to devote resources.
Department of Health officials have spent the past year undertaking consultation for a “reform blueprint” that will be released next month.
Reforms to the surgical system could include finding alternative therapies for those on the waitlist.Credit: Steven Siewert
It will aim to improve elective surgery through major changes, better predicting pressures on the system and preparing a “system-wide” approach, the documents show.
Tomlinson was part of the consultation process last year and said the government could consider alternative pathways to surgery and “role substitution”, where other specialist health professionals such as physiotherapists or occupational therapists pick up clinical responsibilities when safe to do so.
“We also need to ensure that the reforms are considering regional and rural areas because the hubs that have been built are established overwhelmingly in metropolitan areas,” Tomlinson said.
“Improving hospital communication with general practice practitioners is also an important aspect because in-hospital surgical treatment isn’t something that starts and stops at the front door.
“If GPs are more effectively communicated with, then they can both ensure that patients are ready for care at the time that the hospital is ready to deliver the surgical service, plus they can also be better involved in the post-operative care.”
Patrick Lo, chair of the Royal Australasian College of Surgeons in Victoria, said Victoria was making inroads but would face another peak in the waiting list if resources or support were not maintained.
“We can’t now take our foot off the pedal,” he said. “The moment that we stop thinking it is a crisis, then it is only going to be out of control.”
Lo said the medical community was looking deeper into why patients were on the list and what other treatments were available.
Frankston Private hospital is being taken over by the state government to be run as a public surgery centre.
“No one actually wants surgery,” he said.
“But can we look into some other ways of helping them [like] getting physical therapy beforehand or getting diabetes education before they get really sick?”
Lo, a paediatric neurosurgeon, said it was also important to look at how different types of surgery were performing.
The waiting list for his speciality was low, but other areas had waiting times of more than 100 days, so could need more support.
The Victorian opposition’s leader in the Legislative Council and health spokeswoman Georgie Crozier.Credit: Justin McManus
Opposition health spokeswoman Georgie Crozier said Victorians were suffering.
“The failure of Daniel Andrews to meet his own surgery targets means tens of thousands of Victorians are waiting in pain and with their lives on hold for treatment they should have received,” she said.
”These aren’t just numbers on a page, but Victorians who continue to suffer as a result of the ongoing mismanagement of the health system under the Andrews government.“
A Victorian government spokesperson said the state had transformed two private hospitals into public surgery centres and set up 23 patient support units to assist more than 45,000 people on the waiting list.
More than 2500 theatre nurses and technicians had been “upskilled” to provide more workers, and the state was halfway through opening eight “rapid access hubs” for specific procedures.
“We’ve set ambitious targets and we’ve already made some significant headway, with an additional 40,000 surgeries delivered, the waitlist down 20 per cent and surgeries back at pre-pandemic levels – and we expect to see further improvements as we grow to 240,000 surgeries every year,” the spokesperson said.
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