Page 4336 - Week 14 - Wednesday, 27 November 2013
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In early 2012 work was undertaken by Canberra Hospital to review the way that schedules and management of their elective surgery waiting lists were done, with the principal intent being to maximise—this is information for Mr Hanson—the number of people who have their surgery on time, something he has also criticised the health department for, and to reduce the number of people waiting too long for surgery, another thing he has criticised year-in, year-out the Health Directorate for.
So a new system was put in place. In Canberra Hospital, more category 2 patients are having their surgery within 70 days; so one would think that that is a good thing. They are actually stopping patients becoming long waits; another good thing. This approach has reduced the number of category 2 patients on the waiting list who are waiting too long for their procedure. The method and results at Canberra Hospital are in keeping with the objectives of national health reform and the ACT’s objectives for management of elective surgery.
However, Calvary had continued to manage the waiting list by always booking the longest waiting patients to receive their surgery first. The evidence shows that as fewer people have their surgeries on time, the number of long-waiting patients remains static. This is because an approach of this nature means that there is a concentrated effort only on moving long-wait patients. Then as they are removed for surgery, other patients on the list become long waits.
The management of the health system and health care should be dynamic and should require continual evaluation and realignment based on evidence. The evidence we have shows that an approach that has a more concentrated focus on increasing the numbers of patients who have their surgery on time actually greatly assists in also reducing the number of patients who wait too long for their surgery.
Despite what some of the conspiracy theorists are actually arguing, it is not borne out by the facts. The facts are that the number of people waiting too long for their surgery—I think Mr Hanson just said, “Waiting on the waiting list forever”—is actually the lowest it has been in several years both at Canberra and Calvary hospitals.
Calvary were directed to implement this change, because we have one public health system. We contract Calvary to provide public health services. Without a letter from the Director-General of Health, they were not going to implement this change. The letter went to them in August. It actually took two months for the VMOA to raise this issue. I had been expecting it to raise its head in August, but it took two months for it to come out, by which time the changes had been put in place.
Indeed, performance against the targets has improved and the numbers of people waiting too long for care continues to decline. This is what is not well understood. The longer you just focus on removing the long-wait patients off the list, the more long-wait patients you get because the people who have just joined the list never get access to surgery. This is actually providing that balance to the management of the list.
Prior to putting the changes in, Calvary was recording monthly timeliness results for category 2 patients of 41 per cent to 54 per cent. Since implementing the change,
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