❓ Mr. Sutherland asks the Minister for Health to compare WA's elective surgery and emergency services with Queensland's, following a fact-finding delegation. The Minister details differences in data collection and service provision, highlighting areas for potential improvement and concerns about national comparisons.
AnsweredQoN 104Legislative Assembly
QuestionView source ↗
HEALTH
SYSTEM — ELECTIVE SURGERY AND EMERGENCY SERVICES
104. Mr M.W. SUTHERLAND to the Minister for Health:
The minister recently led a delegation of health
professionals to Queensland to study elective surgery and emergency services in
Queensland's public health service. Can the minister inform the house
how WA's provision of services in these areas compares with those of
Queensland and whether he observed any initiative that should be used in the WA
health system?
SYSTEM — ELECTIVE SURGERY AND EMERGENCY SERVICES
104. Mr M.W. SUTHERLAND to the Minister for Health:
The minister recently led a delegation of health
professionals to Queensland to study elective surgery and emergency services in
Queensland's public health service. Can the minister inform the house
how WA's provision of services in these areas compares with those of
Queensland and whether he observed any initiative that should be used in the WA
health system?
AnswerView source ↗
I thank the member for the question.
Mr P.B. Watson :
Congratulations on your grandchildren!
Dr K.D. HAMES : I
thank members. Members might note that I asked for this question early on
because I intend to leave the chamber as soon as I have finished the answer. I
am a grandfather for the fourth time. A baby boy was born at 1.37 pm at St John
of God hospital; so that is number four—a bit more to go yet!
I went to Queensland recently with a delegation of health
experts from Western Australia.
Mr M. McGowan interjected.
Dr K.D. HAMES :
Members talk about grandfather's day; it is good to be a grandfather.
We are trying to diversify the ethnicity of our clan, so the surname will not
be Hames. It is Croatian: Cucic. We are trying to get some hybrid vigour!
We had a very interesting trip to Queensland. The reason we
went to look at Queensland's health system was that there were some
suggestions that its waiting list performance was better than Western Australia's.
Of course we have some targets to reach that have dollars attached to them, so
we wanted to look at how Queensland's system was operating to see what
we could do better. We found two interesting things. One is that the way
Queensland's system works its numbers is slightly different from the way
it is done in WA, and there are some lessons to be learnt from that. Another is
that Queensland does particularly well with category 1 cases. I will explain
one of the ways in which that is done. When a patient attends a hospital in WA
but cannot have surgery for medical reasons on that day—for example,
the patient has a fractured tibia with a lot of swelling and doctors must wait
24 to 48 hours for that to settle—we do not count that as waitlist
surgery; we count it as acute surgery and the patient returns in two to three
days. Queensland counts that as waitlist surgery, because the patient is
waiting, and of course he or she is seen within two days; therefore, that is
very good for the number of category 1 cases being seen within the appropriate
time. That significantly increases Queensland's figure for category 1
patients and therefore might be a good methodology for making sure we reach our
targets.
The second reason is Queensland's waitlist surgery
target. We have a problem with our category 2 waitlist being higher than it
should be and its target not being met. One reason for that is we have a couple
of surgeons who do bariatric surgery—largely putting in gastric sleeves—and
those patients are listed as category 2 even though the number done is minimal
and the wait time is generally about 12 months. That puts the number of all our
category 2s out of whack. Queensland's health service does not include
those at all because it does not do that sort of surgery in its public system.
That means we have a lot of trouble reaching our target and Queensland does not
even have them on its list. I will therefore raise issues such as these with
the new federal Minister for Health, Hon Tanya Plibersek, and I will point out
the different methodologies between the states so that Western Australia is not
penalised because we have a different system.
Queensland's health service has major problems with
ramping, and in fact the four-hour rule is coming in. However, whereas 70-odd
per cent of patients in WA are admitted, managed and/or discharged from
hospital within four hours, the figure at the Queensland hospital we visited
was 16 per cent. Between 50 and 60 per cent of patients were waiting longer
than eight hours for a bed; whereas our figure is down to between five and 10 per
cent. Its ambulance ramping queues are about three times the size of our
queues. In some hospitals in Queensland—not all—many patients
stay out in the ambulance instead of getting into hospital, We in Western
Australia therefore struggle to get a patient in category 3 or 4 seen by a
doctor in the appropriate time once the patient presents to an emergency
department, while Queensland does not even put them on the list until they have
spent half an hour or an hour outside in an ambulance waiting to get into
hospital. That is not something, I might add, that we intend to copy. We need
to make our system work better. Queensland expressed severe concern that it
cannot meet what are called the NEAT and NEST targets. NEAT is the national
emergency assistance target, which is the four-hour rule, and NEST is the
national elective surgery target, which is the time in which a patient gets
surgery. Queensland says it is impossible to do them both at once and that it
is like sailing to Vanuatu at the same time as sailing to Fiji—that is
on the Queensland side of the Pacific Ocean.
I pointed out to them that in Western Australia we are in
fact meeting both those targets concurrently. But they do have some good things
to do. Their acute surgical unit, something we have at Fremantle but not yet at
other hospitals, is working exceptionally well. They have a program of first
on, first off for waitlist surgery, which means that rather than surgeons
picking and choosing the latest patients they want to see along the way, they
have to see them as they come on the list. That means that rather than the list
being spread over 12 to 14 months, all those patients are seen within six
months. I think there are things for us to learn. We are putting those new
plans in place, and with the acute surgical unit and acute medical units that I
am also insisting be put into our hospitals, it will allow us to do even better
than the national emergency assessment targets we are meeting at present. Thank
you, Tony, for your indulgence; I apologise that I shall now depart.
Mr P.B. Watson :
Congratulations on your grandchildren!
Dr K.D. HAMES : I
thank members. Members might note that I asked for this question early on
because I intend to leave the chamber as soon as I have finished the answer. I
am a grandfather for the fourth time. A baby boy was born at 1.37 pm at St John
of God hospital; so that is number four—a bit more to go yet!
I went to Queensland recently with a delegation of health
experts from Western Australia.
Mr M. McGowan interjected.
Dr K.D. HAMES :
Members talk about grandfather's day; it is good to be a grandfather.
We are trying to diversify the ethnicity of our clan, so the surname will not
be Hames. It is Croatian: Cucic. We are trying to get some hybrid vigour!
We had a very interesting trip to Queensland. The reason we
went to look at Queensland's health system was that there were some
suggestions that its waiting list performance was better than Western Australia's.
Of course we have some targets to reach that have dollars attached to them, so
we wanted to look at how Queensland's system was operating to see what
we could do better. We found two interesting things. One is that the way
Queensland's system works its numbers is slightly different from the way
it is done in WA, and there are some lessons to be learnt from that. Another is
that Queensland does particularly well with category 1 cases. I will explain
one of the ways in which that is done. When a patient attends a hospital in WA
but cannot have surgery for medical reasons on that day—for example,
the patient has a fractured tibia with a lot of swelling and doctors must wait
24 to 48 hours for that to settle—we do not count that as waitlist
surgery; we count it as acute surgery and the patient returns in two to three
days. Queensland counts that as waitlist surgery, because the patient is
waiting, and of course he or she is seen within two days; therefore, that is
very good for the number of category 1 cases being seen within the appropriate
time. That significantly increases Queensland's figure for category 1
patients and therefore might be a good methodology for making sure we reach our
targets.
The second reason is Queensland's waitlist surgery
target. We have a problem with our category 2 waitlist being higher than it
should be and its target not being met. One reason for that is we have a couple
of surgeons who do bariatric surgery—largely putting in gastric sleeves—and
those patients are listed as category 2 even though the number done is minimal
and the wait time is generally about 12 months. That puts the number of all our
category 2s out of whack. Queensland's health service does not include
those at all because it does not do that sort of surgery in its public system.
That means we have a lot of trouble reaching our target and Queensland does not
even have them on its list. I will therefore raise issues such as these with
the new federal Minister for Health, Hon Tanya Plibersek, and I will point out
the different methodologies between the states so that Western Australia is not
penalised because we have a different system.
Queensland's health service has major problems with
ramping, and in fact the four-hour rule is coming in. However, whereas 70-odd
per cent of patients in WA are admitted, managed and/or discharged from
hospital within four hours, the figure at the Queensland hospital we visited
was 16 per cent. Between 50 and 60 per cent of patients were waiting longer
than eight hours for a bed; whereas our figure is down to between five and 10 per
cent. Its ambulance ramping queues are about three times the size of our
queues. In some hospitals in Queensland—not all—many patients
stay out in the ambulance instead of getting into hospital, We in Western
Australia therefore struggle to get a patient in category 3 or 4 seen by a
doctor in the appropriate time once the patient presents to an emergency
department, while Queensland does not even put them on the list until they have
spent half an hour or an hour outside in an ambulance waiting to get into
hospital. That is not something, I might add, that we intend to copy. We need
to make our system work better. Queensland expressed severe concern that it
cannot meet what are called the NEAT and NEST targets. NEAT is the national
emergency assistance target, which is the four-hour rule, and NEST is the
national elective surgery target, which is the time in which a patient gets
surgery. Queensland says it is impossible to do them both at once and that it
is like sailing to Vanuatu at the same time as sailing to Fiji—that is
on the Queensland side of the Pacific Ocean.
I pointed out to them that in Western Australia we are in
fact meeting both those targets concurrently. But they do have some good things
to do. Their acute surgical unit, something we have at Fremantle but not yet at
other hospitals, is working exceptionally well. They have a program of first
on, first off for waitlist surgery, which means that rather than surgeons
picking and choosing the latest patients they want to see along the way, they
have to see them as they come on the list. That means that rather than the list
being spread over 12 to 14 months, all those patients are seen within six
months. I think there are things for us to learn. We are putting those new
plans in place, and with the acute surgical unit and acute medical units that I
am also insisting be put into our hospitals, it will allow us to do even better
than the national emergency assessment targets we are meeting at present. Thank
you, Tony, for your indulgence; I apologise that I shall now depart.
Explore WA Government Data
Search the full archive in the free dashboard, or query programmatically via API.
Explore more
Government Gazette
Appointments, regulatory notices, planning changes.
Hansard
Debates, questions, speeches and sentiment.
Tabled Papers
Reports and documents tabled in Parliament.
Committees
Committee profiles and recent reports.
Regulations
Subsidiary legislation with filters and summaries.
Bills
Proposed laws and parliamentary progress.
Acts
Current WA legislation and summaries.
Explanatory Memoranda
Bills with EMs (text/PDF) available.
Members
MP profiles, party breakdown and rankings.
Pollie Rankings
Data-driven rankings across 19 categories.
Amendment Chains
Track how schemes and regulations evolve over time.