Elective surgery ‘hidden wait list’ horror

Huge backlogs at outpatient clinics have left some patients unable to gain an initial appointment with a specialist for several years.

Mal Gregory, with his daughter Tegan Bonsey. Mal had to wait 2½ years in extreme pain for an outpatient appointment at Redcliffe Hospital. Picture: Jamila Toderas

Public patients are sometimes waiting three or even four times as long for elective surgery than is reported in official state government figures due to a huge backlog at outpatient clinics that has left some patients unable to gain an initial appointment with a specialist for several years.

The enormous delays for appointments at outpatient clinics is dubbed the “hidden waiting list” by the Australian Medical Association, which says the true waiting times for elective surgery in the public system are often far longer than publicly reported, with deteriorating patients being left in pain and desperate.

Until they have seen a specialist for an initial appointment, public patients are not placed on government elective surgery waiting lists, which have blown out around the country due to the pandemic from levels that were high even beforehand. But patients have frequently been waiting many months or even years to see specialists before being placed on elective surgery waiting lists.

AMA President Steve Robson.

A new report compiled by the AMA reveals shocking blowouts in outpatient wait times for some specialties, prompting calls for an urgent plan to tackle the backlog, which is far larger than state governments are reporting. The report will fuel tensions over hospital funding, with state governments and doctors pushing for the commonwealth to continue funding 50 per cent of hospital costs, as it has during the pandemic, beyond December 30 and to scrap a cap that limits the federal government’s contributions to increased costs to 6.5 per cent. The issues will be pushed by the states as national cabinet meets on Friday.

The AMA’s new report shows some patients deemed non-urgent are waiting as long as 1400 days to see a specialist at an outpatient clinic in Victoria, and 700 days in Queensland. Waiting times for ophthalmology, orthopaedic, plastic and reconstructive surgery appointments are all over 700 days for some patients in both states.

Shockingly, Victoria reported that 90 per cent of patients requiring an urgent appointment with a neurosurgeon were seen within 930 days – meaning at least one patient requiring urgent neurosurgery waited as long as 930 days for an initial appointment with a specialist when the target time frame is 30 days.

In Queensland, patients with urgent gastroenterological conditions waited 150 days for an initial appointment, 120 days longer than the target time.

And the average waiting time in Tasmania for outpatient appointments was over 100 days, more than triple the target.

Mal Gregory. Picture: Jamila Toderas

However, the picture is incomplete as some states, including NSW, do not publish any data on outpatient clinic wait times, and the data is inconsistently reported by states.

“These hidden figures are a scandal that affect hundreds and thousands of patients and impact a health system already in logjam,” AMA president Steve Robson said. “Patients, many of them in pain, aren’t just waiting years for surgery, sometimes they are waiting years just to see a specialist who can get them on the official surgery waiting list.

“During this wait, they often develop other health issues … which further affects their quality of life and ends up costing the system more.”

Hospitals across the country have been struggling to catch up since elective surgery was halted in many states due to Covid-19. Latest Australian Institute of Health and Welfare data reveals the number of patients waiting more than a year for elective surgery almost tripled in 2020-21.

Many would have waited months or years just to get on a wait list, such as Queensland man Mal Gregory, who needed a hip replacement but had to wait 2½ years in extreme pain for an outpatient appointment at the orthopaedic clinic at Redcliffe Hospital before finally being seen in August.

“Time kept ticking away and my hip was getting worse,” Mr Gregory says. “I was struggling to walk, we’re talking very high-level pain upon walking, I was walking with a constant severe, crippling limp. I became quite severely limited in terms of what I could do. It was a struggle to get in and out of the car. The pain was waking me up every night.”

At the beginning of this year, having already waited two years for an appointment with a specialist, Mr Gregory was told to expect to wait a further 18 months. “It sent me on a real skid down into personal hell,” he said. “No one, not even my wife, knows how close I got to actually planning to end my life.”

Just as Mr Gregory had begun making plans to withdraw $25,000 from his superannuation to pay for private surgery, he was told he had been allocated a surgery date. It came after he began publicly lobbying on waiting lists and wrote a piece for a newspaper on the issue. He had his hip replacement this month.

Just a week after surgery, he was able to walk his daughter down the aisle at her marriage ceremony. “To be able to stand there and just see her, she was just absolutely gorgeous, I had a smile as wide as a Cheshire cat, you just couldn’t take it off me.”

Mr Gregory said official data would show his surgery had taken place within time frames, but if the hidden waiting list was reported, the real wait time was almost three years. “The waiting lists are false,” he said.

The AMA is calling for “total transparency” on the number of people awaiting care from public hospitals.

“Elective surgery waiting times are reported nationally each year, but these numbers don’t reflect the time someone waits to see the specialist in an outpatient clinic,” Professor Robson said. “How can any system properly operate or be properly managed if we don’t know how many patients are waiting for care? How can we possibly know how many doctors, nurses and beds we need if we have inconsistent and unreliable data?”

The Australian Institute of Health and Welfare is working with state jurisdictions to include outpatient waiting data in officially reported figures.