Six year specialist wait times spark need for reform

Some Australians are languishing on waiting lists for longer than six years to see crucial specialists including neurosurgeons, ear, nose and throat surgeons, and immunologists in parts of the country, as a prominent doctor warns people could die while waiting for care.

The data only tells part of the story, as there is no comprehensive information available revealing the true extent of waiting times for public and private specialists in Australia.

Known as the “hidden” wait list, specialist outpatient waiting times only detail the lengthy waits for an initial specialist appointment in the public system — not the period of time from that appointment to subsequent ones or elective surgery.

They reveal that in Victoria, some people are waiting more than eight years to see ear, nose and throat surgeons, and longer than seven years to see immunologists and dermatologists.

In Tasmania, some are waiting longer than six years to see neurosurgeons, while in parts of South Australia, doctors such as gastroenterologists and ophthalmologists come with lists as long as five years.

“The word heartbreaking comes up after 50 years as a doctor to think that we’ve got to this stage,” he said.

“For some problems, you can wait quite a period of time.

“This is not what Australians were told their health system was going to be.”

Below you can look at wait times in your state, noting the figures are not directly comparable across jurisdictions as they are measured differently.

The data compares actual wait times to the recommended wait times of 30 days for urgent (category 1) conditions, 90 days for semi-urgent (category 2) conditions and 365 days for non-urgent (category 3) conditions.

New South Wales, the Australian Capital Territory, the Northern Territory and Western Australia do not currently publish this data.

Few other treatment options available

For the past two years, Linsey Daly-Vincent has been waiting for an initial appointment with a public gynaecologist in Sydney.

The 37-year-old has endometriosis, an often debilitating condition where tissue similar to the lining of the uterus grows outside of the uterus.

“It’s been insanely frustrating,” she said.

“The public waiting system — it’s kind of put me on the backburner, and it’s like as if they’ve just forgotten about me.

“I’ve been in quite extreme, chronic pain to the point where I have had to take days off work, I’ve ended up in hospital twice because of it, sometimes the pain makes me throw up.”

As people such as Linsey struggle to access care, some specialists say demand for their services has never been greater.

Western Sydney paediatrician and former state Labor MP Dr Andrew McDonald said he had been forced to close his books to new patients because he simply could not see all the children who needed help.

“In the 33 years I’ve worked in Campbelltown, it’s never been as hard for a parent whose child needs to see a paediatrician,” he said.

“Thirty years ago, these children were seen. You cannot now find a paediatrician to see your child for love nor money.”

He said the children he was turning away were left with little other treatment options.

“They either don’t get care, they wait on waiting lists forever, or they fall through the cracks,” Dr McDonald said.

“And if nothing happens, the cracks will continue to widen.”

Need to re-imagine healthcare

Dr Jacqueline Small from the Royal Australasian College of Physicians (RACP) said demand for specialists was being driven by an ageing population and the increasing prevalence of chronic illnesses, meaning more people needed specialists than ever before.

But training places for the next generation of doctors are limited, tied to funding and teaching capacity.

“There’s been a range of issues that have emerged, particularly through COVID, but it’s really been the tipping point for the health system with increasing demand, and difficulties in meeting the demands of people with complex health problems,” she said.

“The models of care aren’t set up to deal with these types of complexities. We need to re-imagine the health system and create new models of care that are better connected.”

Dr Small also called for nationally consistent information about specialist wait times, to better understand the problem.

“One of the big concerns we have is there actually isn’t good, widely accessible data about waitlists for public outpatient clinics across Australia, but also data on what’s happening in the private health system,” Dr Small said.

Fixing the system ‘not rocket science’

Describing the solution to specialist waiting times as “straightforward,” Prof. Stewart called on the federal government to urgently boost funding to public hospitals, so they can better resource outpatient specialist clinics, and increase training positions.

“We cannot keep calling Medicare a safety net with these big holes in it. These are huge rips in the basic fabric of Medicare, and the time has now come to fix it,” he said.

In a statement, federal Health Minister Mark Butler conceded long wait times had a “serious detriment” to people’s health, arguing the federal government was focused on boosting the health workforce, and was reviewing the five-year agreement on public hospital funding between the Commonwealth and states and territories.

The ABC also approached the states which publish data for comment.

They argued they were working to improve waiting lists and specialist shortages, with some pointing to significant improvements in outpatient waiting times.

In the lead-up to the 2019 election, federal Labor promised it would set-up a permanent policy-making body called the Australian Health Reform Commission, flagging improved access to public specialists as an early priority.

It ultimately abandoned the policy ahead of the 2022 election, but Professor Stewart said the body was urgently needed.

He said if nothing changed, more people would fall through the cracks.

“It will progressively get worse,” he said.