Tuesday’s planned tongue surgery was supposed to leave three-year-old Madoc breathing a little easier.
Instead, he returned home after the procedure was postponed for the second time in 10 months. A surgeon at the Westmead children’s hospital told his distraught mother, Kelsey Boivin, that it could not go ahead as there were no ICU beds left.
Madoc has Beckwith-Wiedemann syndrome – a condition that has caused him to develop an oversized tongue and has resulted in health issues including sleep apnea, which leads to him waking up about 20 times an hour.
“The surgery was to try and help open up his airway because he doesn’t breathe well,” Boivin said.
Madoc is one of tens of thousands of people across New South Wales waiting for elective surgeries due to compounding impacts of the pandemic, including the mass furloughing of staff and the summer pause on surgery when Omicron cases surged.
In December, there were 94,807 people on the elective surgery waitlist.
Experts predict that number would have increased since then and want to see state and federal governments act now to speed up the return to normal functioning.
Madoc’s surgery was first planned for last June, after spending time on the waiting list. A new date was set when elective surgeries resumed this year.
Boivin pulled Madoc’s older brother, six-year-old Beau, out of school so that no one contracted Covid before the long-awaited procedure. Boivin organised help and took time off work.
“You plan your whole life around that – you do the PCR test three days before, jump through all of the hoops and then it doesn’t happen,” Boivin said.
“It’s a massive life thing – emotionally, financially, everything, trying to get ready for it each time.”
A spokesperson for the Children’s hospital at Westmead said it had dealt with a “significant number” of trauma and emergency cases on Monday evening that affected ICU and surgical capacity – at a time when more than 200 staff were in isolation.
“The decision to reschedule non-urgent surgery is never made lightly and only applies in cases where it has been deemed clinically safe and appropriate,” the spokesperson said.
The president of the Australian Medical Association, Dr Omar Khorshid, has repeatedly raised concerns about the affects of ballooning wait times for surgeries.
“As that waiting time blows out to beyond a year, then there’s a very, very severe impact on those individuals lives and the lives of their families,” he said, citing concerns over prolonged times for some people on pain management drugs and people being forced to take time off work.
Korshid predicted a “disaster” in winter, due to a likely rise in flu cases, further spread of Covid and severe staff burnout.
“It paints a pretty worrying picture for this upcoming winter,” he said.
He said the federal government should take a leadership role to sort out the issue, which is being felt in every state and territory.
“It’s going to be a real challenge to actually catch up, because our system doesn’t have the capacity to do more,” he said.
“While some short-term measures are warranted to try and get on top of the surgical waiting lists, we also have to look at the longer term picture of what is the correct capacity for our public hospital system going forward.”
This week the Victorian government announced a $1.5bn investment to reduce the elective surgery waitlist by boosting capacity by a quarter, with 40,000 extra surgeries to take place in the next year.
But Korshid said “doctors and nurses don’t grow on trees”, and a plan like that would require workforce planning.
The Royal Australasian College of Surgeons NSW chair, Payal Mukherjee, said there should be a longer term vision from governments and expressed concern about workforce issues after two years of interrupted learning.
“We have to keep making sure that training is not disrupted … it doesn’t just have the issue of stress and burnout on the junior workforce but it has an impact on workforce supply,” she said.
The ear, nose and throat surgeon said high numbers of Covid cases had also made it hard to get through daily surgery lists, as many patients were testing positive right before their appointments.
“That unpredictability – not even being able to use the resources that we have efficiently – that has a huge impact,” Mukherjee said.
Staffing shortages are also wrecking havoc, with 4,424 NSW healthcare workers in isolation as of Monday.
NSW Health is looking to partner with private hospitals as a possible short term solution, according to the head of the Australian Private Hospitals Association, Michael Roff.
“There is a working group that’s been set up by the department with the private hospitals in [the] state to look at a sort of framework for using private hospitals to address some of that public backlog,” he said.
Roth said that could be part of the solution, but there should also be work done at a federal level to make it easier to hire medical professionals from overseas.
NSW Health said it is continuing to use a “staged approach to increasing surgical activity in public hospitals” to balance the needs of people having access to surgery with the affects of the ongoing pandemic.
A spokesperson said progress was being made in the arrangements with private hospitals over elective surgery to reduce “reliance on temporary suspensions of non-urgent surgery in managing future waves of Covid-19”.
“NSW Health thanks the community for its patience during this challenging period and remains committed to ensuring non-urgent elective procedures that were delayed during the temporary suspensions are performed as quickly as possible,” they said.
For patients like Madoc, the wait continues.
“There’s no way to quantify or qualify what this delay might mean for him,” Boivin said.
“We know that there are policies in place to prioritise the most urgent need, but we’ve had over 500 days waiting, of waking up 20 times an hour every night.”
