Elective surgery progress often goes unnoticed

In 2008 the Government made a deliberate decision to increase elective surgery operations overall and to ensure our program focussed on reducing the number of patients who had been waiting too long for their operations. This was the right thing to do for patients and has indeed been a success. The number of people who have been waiting more than a year for surgery has halved to its lowest level in eight years.

This strategy has had its drawbacks for although the number of operations performed each year has increased significantly so has the median waiting time which is a performance measure of an elective surgery system. It is unfortunate that the quality of our public hospital system is too often measured by the elective surgery median waiting time. This is but one of a number of measures used to evaluate the success of our elective surgery program and in fact one of dozens of measures that assess the overall quality of health care provided through our hospitals. Elective surgery is part of the public hospital story but it is not the whole story. It makes up just 17 percent of the inpatient activity of our hospitals. In addition to the 11,336 elective surgery procedures provided each year, another 6,500 people have emergency operations and tens of thousands more receive care that does not involve surgery at all. For instance, there are another 80,000 inpatient episodes each year, 112,000 emergency department presentations and 350,000 outpatient occasions of service.


Given the interest in elective surgery, however, I am today releasing a new ACT Surgery Report Card as part of my commitment to leading an open and transparent government. It is another tool for reporting to the community our progress against our key priorities. Health is one of those priorities and the community will be able to use this Report Card to track our progress in elective surgery each quarter and see how we measure up against our targets and make progress towards them.


The Report Card for June/July 2011 shows that we have made significant inroads in reducing the number of people on the waiting list and the times people are waiting. While there is still work to be done, it shows clearly that our investment is paying off with more people than ever before having operations each year. In fact, the increase in operations has far outstripped population growth, with a 65 percent increase in surgical procedures compared to a 16 percent increase in population since 2000-01. The current waiting list is at its lowest level since 2003 and in just 18 months the number of people waiting longer than clinically recommended has halved. A fixation on the median waiting time does unfortunately mean that these good results, the achievements of our doctors and nurses, are often overlooked.


It is incredibly difficult to compare elective surgery performance across jurisdictions. There are a number of peculiarities unique to the ACT health system. Here in the ACT we have just two hospitals in which to provide elective surgery. Both of these hospitals also perform emergency work which does affect our capacity to continue to deliver more and more surgery. Most other states have dedicated elective surgery centres able to focus on elective work without the interruptions that occur with emergency surgery.


We also have the highest levels of private health insurance and yet one of the lowest rates of use which does affect demand on the system. However, this is also a clear indicator that people have confidence in our public health system.


A third of our elective surgery patients come from New South Wales which impacts on the resources available to ACT patients and our capacity to deliver more surgery to Canberrans. No other state or territory has to plan for this proportion of patients from across the border.


Bearing all this in mind, the way forward must be multi-faceted and does involve the cooperation of other health providers. Firstly, there must be clear role delineation between our two hospitals with Calvary Public Hospital increasingly becoming the specialist elective surgery centre for the ACT, freeing up The Canberra Hospital to focus on emergency work. We are currently discussing this with Calvary and seeking their agreement to it.


The future must also include better utilisation of the new hospital sitting just across the border in Queanbeyan. If we are to be a true regional health provider, Queanbeyan Hospital must factor in to our planning, whether that results in the ACT using the available theatres in Queanbeyan to treat NSW patients or NSW resourcing Queanbeyan Hospital to provide a greater range of services to its own patients thereby taking pressure off Canberra’s hospitals. Following a meeting with my NSW counterpart Jillian Skinner, both the ACT and NSW health departments are now working on possible options for further collaboration and are due to report back within months.


Thirdly, the Government will continue to look to the private sector where it is efficient to do so, as it has done over the past year with 250 operations already provided through the private sector.


Alongside these options, we must continue to pursue preventative health measures as our population ages and the prevalence of chronic disease increases. The burden of disease is already increasing pressure on our health system despite the ACT being home to one of the healthiest communities in Australia.


The community can rest assured that those people who need surgery the most and those who have been waiting the longest will be prioritised. Canberrans can also have confidence in our overall public health system which provides excellent outcomes for patients. I hope this new Report Card will give the community that confidence and the assurance that the Government is on the right path.


You can read the report card by following this link http://www.health.act.gov.au/publications/reports/act-surgery-report-card-june-july-2011