Just about any public hospital doctor or patient in Western Australia can tell you with great certainty, and without reference to any hard data, that we are in the midst of a crisis of access to care. Patients are waiting hours to get through the front door of the emergency department, half a day to be seen by a doctor, months for high-priority elective surgery, and years for outpatient appointments.
During our state election campaign through the beginning of 2025, we have asked the two major parties to show some ambition, some vision to build the capacity of our health system; at the very least, to acknowledge that our public system is drastically short of capacity and indicate a willingness to build bricks and mortar hospital beds and train more doctors locally to meet our current need and anticipate our future need, which will only grow.
We have heard some good initiatives pitched by both sides that could improve efficiency and reduce demand on the system, but not yet that ambition to build real capacity. AMA WA will continue to draw the public’s attention to the real danger that we face of ending up with an increasingly two-speed system, where those who can afford to go private receive care when and where they need it, and those who can’t languish in an interminable queue.
Key Takeaways
In 2023–24, WA has remained the poorest performer in the percentage of category 3 ED patients seen on time at a worryingly low 32 per cent. Minor improvements in planned surgery waiting mean WA’s performance sits right on the national average, with much improvement required to return to pre-COVID levels.
Figure 1: Western Australia’s performance 2023‒24 compared to the previous year
| Cat 3 ED on time |
4-hour rule |
Median surgery wait |
Cat 2 surgery wait |
| = |
❌ |
✔️ |
✔️ |
Figure 2: Western Australia’s performance 2023‒24 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 - Western Australia
Although performance has fallen year on year, WA was the best-performing state in regard to the “four-hour rule”. This title points more to falling national performance than WA’s strength, as WA’s performance has fallen from 75 per cent to 59 per cent of patients completing their ED presentation within four hours.
Meanwhile, WA has maintained the position of lowest proportion of Category 3 (urgent) patients seen within the recommended time of 30 minutes, with only 32 per cent of these patients being seen on time, a figure that is 29 per cent below the national average.
Figure 3: Percentage of Category 3 (urgent) ED patients seen within the recommended time of under 30 minutes — WA
Figure 4: Percentage of ED visits completed in four hours or less — WA
Planned surgery performance - Western Australia
WA’s planned surgery performance saw a slight improvement in 2023–24 along both metrics measured by the AMA, although performance remains far below historical averages. The percentage of Category 2 planned surgeries admitted within the clinically recommended time sits equal to the national average at 71 per cent, which despite being an improvement on the year prior, represents a 12 per cent drop from 2019–20. Despite this, the average wait time for each patient that has not been admitted within the clinical timeframe is alarmingly high at 206.3 days for Category 2 (recommended to occur within 90 days) and 522.6 days for Category 3 (recommended to occur within 365 days).
Figure 5: Median waiting time for planned surgery (days) - WA
Figure 6: Percentage of Category 2 planned surgery patients admitted within the recommended (90 days) — WA
Public hospital expenditure – Western Australia
Figure 7: Per person average annual percentage increase in public hospital funding by government source (constant prices) — WA
|
2012‒13 to 2022‒23 |
2012‒13 to 2017‒18 |
2017‒18 to 2022‒23 |
| Federal |
3.57% |
4.58% |
2.58% |
| WA Government |
2.39% |
0.06% |
4.76% |
Figure 8: Public hospital funding, per person, by government source (constant prices) — WA
The most recent public hospital funding data is from 2022‒23. Western Australia has increased its public hospital spending after a long decline in per-person expenditure and is now spending $2,015 per person on public hospitals. This equates to 63 per cent of total spending on public hospitals, with 37 per cent coming from the federal government in 2022–23.
