Public Hospital Report Card 2024

Australian Capital Territory

AMA ACT President’s Introduction

Dr Walter Abhayaratna

President, AMA ACT

Once again, the AMA Public Hospital Report Card shows that ACT Public Hospitals are performing below the standard our community should expect.  This is happening despite the tireless efforts of our hospital staff and the highest proportion of public hospital funding coming from any State or Territory Government.

The ACT continues to struggle under the ‘four-hour rule’, with only 48 per cent of emergency department presentations being completed in less than the requisite four hours. This result has been in decline for almost a decade now. ACT residents deserve better. While it’s little comfort to know that public hospital performance is down across the country, it does show just how much pressure all our public hospitals are under.

On a more positive note, the integration of North Canberra Hospital into Canberra Health Services presents an opportunity to better coordinate our public hospital services, and that prospect gives some hope that better, more streamlined services will result.  While this has not yet materialised in the Report Card data, we will be watching closely to see any resultant impact on care from better integrated hospitals.

2024 is an election year in the ACT and we look forward to a vigorous and policy-driven debate about our local healthcare system. However, one thing we do know, is that a decade of Walk-In-Centres has not improved the ACT’s public hospital emergency waiting times, and change is needed.

Disappointingly, the ACT Government does not seem to appreciate that the continued funding of fragmented care, and the imposition of a payroll tax on medical practices will result in increased utilisation of emergency departments, as the cost of care in the community for those with chronic diseases increases. In turn, this will result in more pressure on our hospitals, and an increase in high-cost, hospital-based care that should have been provided earlier and at a lower cost in the community.

The long-term solution must include better integration of care for patients with chronic diseases so that higher value care can be provided in the community. The challenge for all of us is that this will require a re-organisation of the Territory’s fragmented healthcare resources in order to better support general practice.

The lead up to this year’s election will also see the opening of the Canberra Hospital Expansion with all the excitement and challenges that go with it. It’s to be hoped that the new facility will provide a much needed boost to our hard-working staff and play an important role as the ACT seeks to turn around its public hospital performance.

Key Takeaways

In 2022-23, the ACT was the worst performer in two key metrics. Figure 6 demonstrates the fall in Category 2 planned surgery patients admitted on time in the ACT. The territory also remains the worst “four-hour rule” performer for the fifth year in a row, as a record low of 47 per cent of emergency visits are completed within four hours or less.

Table 1: ACT performance 2022-23 compared to the previous year

Cat 3 ED on time 4 Hour Rule Median Surgery wait Cat 2 Surgery wait

Table 2: ACT performance 2022-23 compared to national average (below or above)

Cat 3 ED on time 4 Hour Rule Median Surgery wait Cat 2 Surgery wait

Emergency department performance - ACT

The ACT remains the worst performing jurisdiction under the “four-hour rule”, with a record low of 48 per cent of emergency department visits being completed within four hours during 2022-23. Although the percentage of Category 3 emergency department patients being seen within the recommended time has improved for the fourth year in a row, the ACT’s figure sits at 41 per cent, 17 per cent below the national average. Note that data was not available for 2015-16.

Figure 3: Percentage of Category 3 (urgent) ED patients seen within the recommended time of under 30 minutes - ACT

Figure 4: Percentage of ED visits completed in four hours or less - ACT

Planned surgery performance - ACT

While the overall median waiting time for planned surgery sits right on the median (representing the ACT’s best performance when compared to national standards), the percentage of Category 2 planned surgery patients being admitted within the recommended time has fallen from 81 per cent to 49 per cent in just six years, the worst in the country.

Figure 5: Median waiting time for planned surgery (days) - ACT​

Figure 6: Percentage of Category 2 planned surgery patients admitted within the recommended (90 days) - ACT​

Public hospital expenditure – ACT

Figure 7: Per person average annual per cent increase in public hospital funding by government source (constant prices) - ACT​

2011-12 to 2021-22 2011-12 to 2016-17 2016-17 to 2021-22
Commonwealth 3.19% 5.59% 0.31%
ACT Government 0.59% -2.71% 3.90%

Figure 8: Public hospital funding, per person, by government source (constant prices) - ACT​

Note that the most recent public hospital funding data is from 2021-22. In the ACT, the territorial government takes on the largest proportion of public hospital funding of any jurisdiction, where 65 per cent of per person funding comes from the territory, and only 35 per cent by the federal government. ​