Tasmania's population is expanding and ageing, and we still, albeit tenuously, retain the luxury of achieving a balance of highly skilled and dedicated staff who excel at personalised care more akin to community-sized hospitals; chances are the cardiologist on staff knows the patient's oncologist as well as their GP, and so on.
While all of us in health care know the enormous benefits of this for both staff and patients, once again, we find ourselves at a crucial crossroads, and this time the wrong turn could have grave consequences.
We must ensure Tasmania's three main public hospitals are sufficiently resourced to navigate the nuanced balance of gold-standard patient care while at the same time providing opportunity for our doctors.
COVID shone a light on our healthcare system like no other time during my career in medicine; every level of government appealed to us all to stay at home and stay safe and help our hospitals arm themselves for the tsunami of patients anticipated, and by doing this, we were assured that we would all, hospital systems especially, come out better for it on the other side.
This is quite different from the reality we are now facing in our public hospitals, with a largely burnt-out workforce, access, and bed block at all-time highs, blown out wait times whether it's for planned surgery or specialist appointments and morale and recruitment and retention at the lowest I've ever witnessed.
If the predicted COVID-protected hospital environment had worked, the figures we see in this year's AMA public hospital report would be measurably different.
Only 43 per cent of patients in Triage Category 3 in Tasmania were seen within the recommended time in the 2021-22 reporting period, a drop of six per cent compared to the previous year.
We saw a further drop in our emergency department presentations completed within four hours by seven per cent compared to the pre-pandemic 2018-19.
As for planned surgery, Category 2 planned surgery wait times during 2021-22 median wait in Tasmania was 62 days, the longest wait time in Australia and 37 days longer (over an extra month longer) than the best-performing state, granted this is a slight improvement compared to the year before; however, as it's only by three days, it's just not enough to celebrate.
In the Category 2 planned surgery, where patients are admitted within the recommended time (90 days), we saw only 42 per cent of patients on the Category 2 planned surgery waiting list seen within the recommended timeframe. At the same time, pleasingly, this is a six per cent improvement compared to the year before; for clarity, Tasmania has been the worst-performing state in this area yearly since 2013-14, with these minor improvements being achieved by short-term funding injections rather than the long term planned investment with strategic surge capacity allowances built-ins that are needed.
In Tasmania, in 2022, over 57,000 patients were waiting to see a specialist in the public health system for their medical conditions. That includes patients with urgent referrals waiting over 880 days (nearly three years) to see a specialist, such as a neurosurgeon.
In 2020-21 there was an increase in public hospital expenditure per person in terms of both state and federal funding, with the Tasmanian government investing $1,678.00, a significant increase compared to the year before ($1,375.05) and the federal government investing $1,230.00 and while we have no recent data available on this, it shows we are somewhat heading in the right direction.
With emergency department wait times and bed block unrelenting, it is no surprise that our doctors are at the end of their tether when little seems to have changed or the ad hoc measures put in place are quickly overtaken by demand growth. The government needs to implement sustainability.
For Tasmania's public hospitals, workforce issues must remain our primary focus, recruiting medical staff, from interns to consultants. The time is right now for Tasmania while we are still small enough that we can afford to experiment with new patient care models by developing innovative policies and hospital systems that are sufficiently resourced and flexible enough to grow with the population.