The ACT emergency departments saw thousands more presentations from July to December, and the surge is expected to continue in 2025. Photo: Michelle Kroll.
An unanticipated surge in demand at the ACT’s hospitals has forced the government to inject an extra $227.3 million to maintain services, including sticking with elective surgery targets and not losing the gains that have been made in emergency departments.
The new money will form the centrepiece of next week’s 2024-25 Budget Review, to be revealed by new Treasurer Chris Steel.
Along with a funding injection, the government will seek $27 million in savings this financial year by bringing some of the more expensive elective surgery back into the public sector, risking a brawl with Visiting Medical Officers and locum doctors by changing the way they are paid, and less use of contracted agency nurses.
Health Minister Rachel Stephen-Smith said the growth in demand across hospital departments was part of a national phenomenon driven by a number of factors, including an ongoing post-COVID bump, more people turning up at EDs instead of going to the doctor and an ageing population’s array of chronic conditions.
Ms Stephen-Smith said the ACT’s hospitals were also having to deal with not being able to discharge older patients into aged care and the NDIS, about which the government had been talking to the Commonwealth for some time.
She said that in the first six months of this financial year, Canberra Health Services (CHS) saw 85,000 more patient visits compared to the same period in 2023, a 16 per cent increase (from 528,152 to 612,719).
This included 6000 more emergency department presentations, 6600 more overnight hospital admissions and additional surgeries and procedures, as well as almost 67,000 Walk-in Centre presentations, 5800 more than the same period last year.
This was on top of a 12 per cent growth in 2023-24 in the number of patients moving through the system, including ED presentations, surgeries or specialist appointments.
Ms Stephen-Smith said this demand pressure and a rise in costs amounted to a perfect storm for the budget and the capacity to deliver services.
However, the government was not prepared to cut services or lose the gains it had made, particularly in the EDs.
“Part of the reason that we have made the decision to put this significant additional investment in the Budget in the Mid-Year review is because we don’t want to, having achieved this improvement in performance and having been really successful in undertaking some recruitment, we don’t want to then turn around and say, well, actually, we need to make cuts in order to stay on budget,” Ms Stephen-Smith said.
“Instead, we’re going to make this very significant investment to be able to sustain our services for this year, but we’re also taking some decisions that will result in some savings this financial year.”
Health Minister Rachel Stephen-Smith said the government could not let health services slide. Treasurer Chris Steel will announce the top-up in next week’s Budget review. Photo: Ian Bushnell.
Ms Stephen-Smith said increased capacity and recruitment meant these savings measures would not impact services.
She said the boost to capacity provided by the new theatres in Canberra Hospital’s Critical Services Building and the integration of the former Calvary Public into the Territory system had provided more scale for elective surgeries.
The successful recruitment program for nurses also meant Canberra Health Services could rely less on agency staff.
Ms Stephen-Smith said the change to VMO payment arrangements would be a difficult conversation, but the move from fee-for-service to payment per session was in line with practices in other jurisdictions and would save the CHS money.
She said CHS would also be moving, as much as possible, to have more staff specialists and fewer VMOs.
In 2025, the government will pursue more efficiencies to maintain a sustainable system and continue to focus on reform within CHS to deliver on its Health Services Plan and election commitments.
Ms Stephen-Smith acknowledged that the government would be criticised for underestimating demand and having to find more money in the budget.
“It is true that we didn’t project this amount of demand in the system,” she said.
“We’re in the same mode as many others in that regard, but we have made a choice to prioritise.
“We have made some very clear decisions to continue to prioritise healthcare and the delivery of services for the Canberra community, and that does come at a cost.”
Ms Stephen-Smith said the government could have significantly pulled back on services in the second half of the year to try to come in on budget, impacting areas such as elective surgery.
“We chose not to make that decision, but instead to put some additional resources in while we do a deep dive into how can we deliver this service more efficiently, but also across the Budget – what are we spending on health versus everything else and is this the right decision if it is, how are we going to support that into the future,” she said.
Original Article published by Ian Bushnell on Riotact.
