Victoria announces $1.5 billion COVID catch-up plan

The state government is vowing to ramp up surgical activity to record levels as part of a $1.5 billion hospital blitz to clear a massive backlog of elective surgery built up over the pandemic.

In a significant pre-election health pitch, acting Premier James Merlino on Sunday promised elective surgeries would be cranked up to 125 per cent of their pre-pandemic levels, with an extra 40,000 in 2023, building up to 240,000 every year from 2024.

But the push – needed to tackle huge waiting lists built up over the past two years – will not come cheaply, costing as much as $1.5 billion, spread over about seven years.

While the state’s leading medical colleges and health unions have welcomed the plan, they warn Victorian healthcare workers are beyond exhausted and time was needed to train the significant number of staff required for the elective surgery blitz.

It will see Victorian hospitals operating at night and on weekends. And in an extraordinary move, Frankston Private Hospital will effectively be taken over by the state government to be run as a public surgery centre, with the ability to handle up to 9000 public patients a year from 2023.

The idea is that there will be no emergency department to divert healthcare workers, allowing the new facility to focus on tackling the backlog of elective surgery patients built up over the past two years.

Elective surgery waiting lists have blown out at hospitals around Melbourne, forcing thousands of people to wait beyond clinically recommended times for all but the most urgent surgeries.

At the end of the December quarter, 80,000 people in Victoria were waiting for surgery, but there are fears this number has swelled even higher in recent months.

The elective surgery push follows a warning from Health Minister Martin Foley on Saturday that the Omicron BA.2 sub-variant could lead to “several hundred” extra hospitalisations a day in Victoria. New modelling suggests case numbers will peak later this month.

In a statement, the Royal Melbourne Hospital said its elective surgery waitlist had increased by 15.9 per cent over the last six months. “We understand this has a significant impact on our community and anticipate returning to pre-pandemic levels in July 2022.”

As part of the plan, two new operating theatres will be set up at the Frankston Private Hospital by early next year.

Australian Medical Association Victorian president Roderick McRae said the plan was a “considered and proportionate response” giving hope to thousands of Victorians who had deteriorated or been left in chronic pain for years on the waitlist for elective surgery.

But he warned the situation in hospitals, where emergency departments were currently being pushed to the brink, would worsen before it got better.

“This is only a medium-term solution and there has to be some profound, long-term recruitment into the state’s health system, including everything from doctors, to nursing and midwifery staff, ambulance officers and allied health staff… the whole shooting match is needed,” Dr McRae said.

“We are going to be battling chronic staffing shortages for the foreseeable future.”

The Royal Australasian College of Surgeons said it was a step in the right direction, but implementing it would be complex given the time needed to train hundreds of staff.

“We’ve also got to have the staff available,” a spokesman for the college said on Sunday. “We’ve got to remember that we have an exhausted workforce and must keep their welfare in mind.”

Australian Nursing and Midwifery Federation Victorian branch secretary Lisa Fitzpatrick backed the plan and said it would help ensure people could access treatment within clinically recommended timeframes.

“This plan, once implemented, will yield more sophisticated and accurate data collection, provide unprecedented coordination by having designated elective surgery hubs, and includes workforce expansion and specialisation that is already underway,” she said.

The government is promising to spend $475 million to boost the number of same-day surgeries across the hospital system, with increased “twilight and after-hours work”, as well as theatre improvements to increase efficiency.

It is pledging to spend $548 million treating public patients in private hospitals and claims that will mean an extra 51,300 people will receive non-urgent surgery by the middle of 2024.

“Rapid access hubs” will be set up across metropolitan public hospitals to perform specific surgeries such as hernia repairs, cataract surgeries and joint replacements, allowing specialist staff using specialised equipment to perform more surgeries each day.

The first eight of these hubs will be set up over the next year at St Vincent’s on the Park, Broadmeadows Hospital, Heidelberg Repatriation Hospital, the Royal Women’s Hospital, Werribee Mercy Hospital, Sandringham Hospital, the Peter MacCallum Cancer Centre, and one in regional Victoria.

While Victorian Healthcare Association chief executive Tom Symondson welcomed the plan, he warned it was critical that public hospitals had the final say on how much elective surgery they can safely perform.

“Public hospitals continue to battle a severe shortage of healthcare workers and high rates of burnout among staff who are facing unpredictable emergency demand as we head into our first winter with both flu and COVID-19 circulating in the community,” Mr Symondson said.

A new “chief surgical adviser” will be appointed to help run the blitz, working with a Surgery Recovery Taskforce offering clinical advice.

The government is also promising $80 million to “upskill” more than 1000 nurses and theatre and sterilisation technicians, and help train an extra 400 perioperative nurses and recruit 2000 skilled healthcare workers from overseas.

The government will also spend $20 million on an equipment fund.

It follows a heated stoush between the states and the federal government over the carve-up of health funds.

In February, The Age revealed NSW and Victoria are demanding up to $20 billion to tackle the “extreme pressure” placed on the system by the COVID-19 pandemic, including a 50-50 split between the states and the Commonwealth on hospital funding.

Opposition health spokeswoman Georgie Crozier said Premier Daniel Andrews had two years ago promised $1.3 billion “to avoid the exact situation we are now in”.

“Two years later, Labor still won’t say where that money has gone or how bad our healthcare crisis actually is,” she said.

“Today’s announcement is too little, too late for a system in crisis.”

With Sumeyya Ilanbey

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