Seven-year wait to see specialist in SA public health system is an improvement on the previous 16-year maximum

Waiting lists for SA’s public health specialists are so long people are dying before getting to see a doctor.

People are waiting up to seven years just for an appointment to see public hospital specialists – but it’s an improvement on wait times in excess of 16 years seen in the past.

New data shows the longest maximum wait for an outpatient specialist appointment for routine or non-urgent patients is now seven years for an ophthalmology consultation at Flinders Medical Centre, followed by 83 months to see a urologist and 81 months for a gastroenterology appointment, both also at FMC.

These waiting times are just for a consultation – if the diagnosis is that the person needs elective surgery, they will then be put on a separate waiting list.

The SA Health data shows many waiting times plummeted under the former Liberal government – and that length of wait is a lottery depending on what hospital wait list you are on.

The Liberals fulfilled an election pledge to publish the data after the former Labor government had claimed it would be too difficult.

The first such report showed that as of March 31, 2018 there were 132 specialties across metropolitan hospitals with a maximum waiting time for an appointment of more than a year, 43 with a wait of more than five years and seven with more than 10 years.

These included 16 years each to see an ENT or plastic and reconstructive doctor at the Royal Adelaide Hospital, or to see a medical oncologist at the Queen Elizabeth Hospital.

As of March 31, 2022, there were 92 specialties with a waiting time for an appointment of more than a year, 24 with a wait of more than five years, and none of more than seven years.

While there is no wait to see some specialists, such cardiothoracic appointments at the RAH or FMC, waiting times varied wildly between hospitals.

There is no wait for a medical oncology appointment at the RAH or Lyell McEwin, but 38 months at FMC.

For cardiology, the maximum wait is 70 months at the RAH, 20 months at the Queen Elizabeth and 13 months at Noarlunga Hospital.

The maximum wait for a dermatology consultation at the RAH is eight months, but 34 months at FMC; for haematology there is no wait at the RAH but 19 months at Lyell McEwin.

Specialties with some of the longest maximum waits at all hospitals for an appointment included ophthalmology, orthopaedics, urology and plastic and reconstructive surgery.

In 2018 The Advertiser reported the case of Michele Clarke of Andrews Farm who was told she faced an 11-year wait to see a Lyell McEwin Hospital urologist.

Her GP has since managed to get her an appointment at the Royal Adelaide Hospital but Mrs Clarke, 53, this week told The Advertiser she is also on a separate waiting list for orthopaedic elective surgery.

“I’ve been waiting three years for a hip replacement with no sign of when it will actually be done, I’m in chronic pan and have had falls so it is affecting my life but what can you do?” she said.

Michele and Bryan Clarke at their Andrew Farms home in 2018. Picture: Dylan Coker

SA Health chief medical officer, Dr Michael Cusack noted there has been a major program to cut appointment waiting time including asking GPs to audit all patients who have been waiting three years or longer in an effort to clear the backlog, a focus on alternative care pathways and putting patients back in GP care after an specialist consultation, rather than clogging the system with ongoing outpatient reviews.

“Covid-19 has been a significant disrupter to the delivery of health services in South Australia’s public hospitals resulting in periods of rescheduling and delay in outpatient services to allow our outpatient workforce to support the COVID-19 response,” he said.

“While every effort is made to avoid delays to outpatient services, some face-to-face appointments may have been postponed, and others conducted through telehealth, in order to reduce the footfall of patients and visitors within our hospitals.”

Dr Cusack said Local Health Networks are continuing to work towards centralised waiting lists to assist with managing access for services between hospitals in the same network.

People are on waiting lists so long they’re dying

Audits of people waiting years for a public hospital appointment have found cases where people have died waiting to see a doctor.

They are taken off the lists, reducing wait time for people behind them.

SA Health chief medical officer Dr Michael Cusack said hospital officials continue to review waiting lists to ensure that they accurately reflect people actually waiting for an appointment.

“As Local Health Networks complete these audits, large reductions in maximum waiting times are realised as people who have already had an appointment or no longer need an appointment are removed from lists,” he said.

He said SA Health is committed to the delivery of quality and timely health care services and is working to reduce outpatient wait times.

Dr Cusack noted since the last quarterly check, 47 specialist outpatient services have reduced maximum waiting times of up to 26 months, with the greatest reduction of 26 months between reporting periods achieved by the Royal Adelaide Hospital in neurosurgery, from 86 months to 60 months.

The data from SA Health reveals both median and maximum wait times for each specialty at each metropolitan hospital.

“RAH Neurosurgery has achieved the greatest reduction in median waiting times from 15 months to 1 month, followed by The Queen Elizabeth Hospital Respiratory, which reduced from 24 months to 9 months,” he said.

“A total of 36 specialist outpatient services have seen a reduction in the overall median waiting times of up to 14 months.

“Overall, the longest maximum waiting time has reduced by six months from 89 months to 83 months between the December 2021 and January 2022 reporting period.

“This represents a continued downward trend in the overall maximum longest waiting time of 192 months reported in March 2018, and is expected to reduce further by the next quarterly report.

“Generally, large increases in waiting times between reporting periods are as a result of patients with previously scheduled appointments returning to a waiting list. The circumstances in which this would occur include cancellation of appointments (either by the patient or the hospital) or if a patient is unable to attend their scheduled appointment. Patients are then returned to the waiting list, maintaining their previous position on the queue. In some circumstances this will significantly increase the maximum waiting time for some clinical services.

“Such circumstances can also contribute to variances in waiting times between hospitals, as can the availability of specific sub-specialist services at each hospital.”