Wait list alarm

A REVIEW of Tasmania's health system has called for urgent action to improve the state's ``deeply concerning'' elective surgery wait, suggesting that hospitals are deliberately overlooking long-waiting patients.

The Commission on Delivery of Health Services in Tasmania's interim report reveals a health system burdened by poor leadership, bad behaviour, unviable services and an ``alarmingly high'' number of overdue patients on waiting lists.

Released by state and federal governments yesterday, the report said hospitals were not prioritising long-waiting elective surgery patients, instead focusing on others who hadn't exceeded the recommended waiting time.

The commission said that complex elective surgery cases were being overlooked in favour of category 1 cases and minor day-procedures.

``This `cherry picking' of less complex cases leads to inequity of access to surgery, with data showing some people are waiting more than five years,'' the report said.

It said faults in wait list auditing and management were clear in previously-released figures showing that of the Tasmanian patients who waited more than a year for surgery, 57.4 per cent left the waiting list because they were ``not contactable'', or dead.

The commission recommended that Tasmanian Health Organisations adopt a ``treat-in-turn'' policy for scheduling surgery and that they monitor and report elective surgery consistently and transparently.

The report also endorsed the separation of elective and emergency surgery, as pledged by the state government.

But it said that while funding boosts helped reduce backlogs of care, it did not reduce demand, and Tasmania needed a longer-term elective surgery plan.

The report said fundamental reform was required across the health system if it was to become affordable and sustainable.

It added that clinical redesign was needed to address elective surgery issues, serious problems with patient access to care, and avoidable hospital presentations.

At Launceston General Hospital last financial year, more than 50 per cent of people presenting to the emergency department stayed more than eight hours before getting a bed, and 43.8 per cent of presentations were for potentially avoidable GP-type illnesses. 

But the report said significant improvements could not happen without cultural change, with poor leadership, bad behaviour and long-standing cultural attitudes ``at the core of Tasmania's inability to achieve both effective governance and sustainable change in its health system''.

``The move to three Tasmanian Health Organisations appears to have acted, in effect, to further legitimise dangerous and undisciplined behaviour within the system,'' the report said.

``A measure of scrutiny provided by the daily realities of working within a statewide system has been lost, and some poor work practices have been shielded within the THOs.''

Health Minister Michael Ferguson said he was appalled by some of the findings.

 ``The commission's report outlines the major changes needed to ensure that the Tasmanian health system meets the needs of patients, ending excessively long waiting times for elective surgery and inefficient and wasteful practices,'' he said.

``These findings of the commission are a matter of great concern to me - as I am sure they are to all Tasmanians.''

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