2025 Public Hospital Report Card

Australia’s public hospitals are a crucial part of our health system. But for years they have been in logjam — a logjam that’s led to increasing wait times for essential surgeries and longer waits for patients in our emergency departments (EDs). 

The Australian Medical Association’s annual Public Hospital Report Card — published since 2007 — has recorded a steady decline in public hospital performance year-on-year, with last year’s report detailing the worst performance in the history of the report.

This year there is some good news. The most recent data shows improvements compared to 2022–23 including: improvements in the percentage of patients triaged as emergency being seen on time; the proportion of category 2 planned surgery patients being seen on time; a drop in the median waiting time for planned surgery; and an increase in the number of public hospital beds available.

But the picture is far from rosy with performance during 2023–24 remaining markedly worse than it was just five years ago across all states and territories.

The results reflect what I hear from my emergency department colleagues: every day our public hospital EDs are overcrowded and under-resourced. Between 2014–15 and 2019–20, the percentage of ED presentations completed within four hours or less fell from 73 per cent to 69 per cent. Five years later in 2023–24, just 55 per cent of ED presentations across Australia were completed within the benchmark target of four hours.

These are not patients with cuts and bruises. ED patients who are triaged as Category 2, “emergency”, should be assessed and begin receiving treatment within 10 minutes. These are patients presenting with chest pain (likely of cardiac nature), severe respiratory distress, or acute stroke. Despite seeing a three per cent improvement compared to last year, a third of all patients triaged as “emergency” were still not seen on time, up from a quarter five years earlier. 

Patients continue waiting too long for essential surgery. These are patients in pain, sometimes unable to work, or care for their loved ones — to live normal lives. The longer people wait for surgery, the more they are exposed to unnecessary pain, unnecessary time away from their work and social lives, and a greater the chance their condition gets worse. 

By way of example, the percentage of category two patients having their surgery on time (within 90 days) has fallen from 83 per cent to 71 per cent in five years. Category two planned surgery procedures include heart valve replacements and surgeries to address congenital cardiac defects. These are not patients who can afford to wait. 

It’s encouraging to see there’s been some short-term improvements when we compare this report with the last one. But there is still a very long way to go.

The number of beds available for every 1,000 Australians aged over 65 remains at the record low number of 14.3, less than half of the capacity in the early 1990s. Australia’s population continues to grow and age, with older patients spending much longer in hospital once they are admitted. Without increased investment in our health system by both state and federal governments, capacity will continue to fall, and our already overworked hospital staff will continue to be impacted, with increasing rates of burnout.

In the lead-up to this year’s federal election, we are calling on all politicians and political parties to prioritise our health system, including our hospitals. While recent investment from the federal government and action to address issues in some states and territories is welcome; the delay to a new National Health Reform Agreement was disappointing. The need for a new fit-for-purpose agreement has never been greater — for both doctors and their patients.