Public Hospital Report Card 2024


AMA TAS President’s Introduction

Dr John Saul

President, AMA Tasmania

There's no hiding that this year's AMA Public Hospital Report Card paints a concerning picture of national performance, with four key metrics showing disappointing averages.​

While there have been slight improvements in Category 2 elective surgery and median waiting times, Tasmania lags, ranking among the worst-performing states across all critical indicators, including emergency department and planned surgery wait times.​

These results highlight areas that demand urgent attention. We know that the ongoing decline in performance is affecting the morale of our doctors and their healthcare colleagues, pose a risk to the reputation of Tasmania's healthcare system, and potentially hinder urgently needed recruitment efforts.​

Although bed and access blocks aren't the sole obstacles, they represent significant challenges within the public system. They contribute to ambulance ramping, prolonged elective surgery wait times, and extended emergency department stays, disrupting patient flow and limiting surge capacity. Moreover, an overburdened outpatient waiting list and delays in accessing pathology and radiology results compound these issues, creating a perfect storm of challenges.​

Addressing these issues requires sustained investment in beds, resources, and infrastructure. Our members' insights, those working in the wards, theatres, and emergency departments, are invaluable in navigating these challenges. They offer experienced perspectives on the system's pressures and successes, and the government needs to listen.​

More than cosmetic improvements and masterplans will be required; we require systemic changes for long-term efficiency and sustainability. ​

The state government can only do so much. We need governments of all levels to work together to invest in public hospitals, primary care, older person care, disability services, and a Medicare system that keeps pace with the economic climate. We urge the government to carefully consider these findings and collaborate on meaningful solutions to address the pressing challenges facing Tasmania's public hospital system.

Key Takeaways

Despite moving out of last place in two metrics by improving their results in both Cat 2 and median planned surgery waiting times, Tasmania remains one of the worst performing states overall, sitting below the national average in all four key performance indicators.

Table 1: Tasmania 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: Tasmania 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 - Tasmania

Tasmania’s ability to treat and discharge Emergency Department patients within the recommended timeframe is well below average. Only 44 per cent of category 3 patients are seen within the recommended timeframe, a major fall from the 66 per cent figure of ten years ago. Meanwhile, Tasmania’s performance sits close to the bottom of the scorecard when it comes to the “four hour rule”, with only 51 per cent of ED visits being completed within four hours or less.

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

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

Planned surgery performance - Tasmania

Despite positive improvements meaning that Tasmania moved out of last place in both planned surgery metrics, performance remains below average in both areas. The median waiting time for planned surgery is four days longer than the national average, and the proportion of Category 2 patients admitted on time is 12 per cent below the national average.

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

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

Public hospital expenditure - Tasmania

Figure 7: Per person average annual percent increase in public hospital funding by government source (constant prices) - Tas

2011-12 to 2021-22 2011-12 to 2016-17 2016-17 to 2021-22
Commonwealth 3.62% 5.79% 0.89%
Tasmania Government 3.34% 4.42% 1.69%

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

The most recent public hospital funding data is from 2021-22. In Tasmania, most public hospital funding (58 per cent) comes from the state government. This is largely in line with the national average of 59 per cent, as state and territory governments continue to take on most of the funding burden for our public hospital system.