Some Australians are languishing on waiting lists for longer than six years to see crucial specialists including neurosurgeons, ear, nose and throat surgeons, and immunologists in parts of the country, as a prominent doctor warns people could die while waiting for care.
The ABC has analysed public specialist outpatient waiting times across Australia, with the figures revealing some Australians are waiting longer than two years for urgent appointments with brain surgeons, despite the recommended time frame of 30 days.
The data only tells part of the story, as there is no comprehensive information available revealing the true extent of waiting times for public and private specialists in Australia.
Known as the "hidden" wait list, specialist outpatient waiting times only detail the lengthy waits for an initial specialist appointment in the public system — not the period of time from that appointment to subsequent ones or elective surgery.
They reveal that in Victoria, some people are waiting more than eight years to see ear, nose and throat surgeons, and longer than seven years to see immunologists and dermatologists.
In Tasmania, some are waiting longer than six years to see neurosurgeons, while in parts of South Australia, doctors like gastroenterologists and ophthalmologists come with lists as long as five years.
Professor Graeme Stewart from the Westmead Institute for Medical Research described the figures as "unconscionable".
"The word heartbreaking comes up after 50 years as a doctor to think that we've got to this stage," he said.
"If they're not dying while they're waiting, the delay may alter the outcome to be the difference between life and death.
"This is not what Australians were told their health system was going to be."
Below you can look at wait times in your state, noting the figures are not directly comparable across jurisdictions as they are measured differently.
The data compares actual wait times to the recommended wait times of 30 days for urgent (category 1) conditions, 90 days for semi-urgent (category 2) conditions and 365 days for non-urgent (category 3) conditions.
New South Wales, the Australian Capital Territory, the Northern Territory and Western Australia do not currently publish this data.
Victoria
Below are the routine first appointment waiting times state-wide between October-December 2022 at the 90th percentile, which is the time it takes to see 90 per cent of patients. We have selected the top-10 longest waits at the 90th percentile.
Specialty |
Overall state wait time |
Health service with longest wait |
|---|---|---|
Hepatobiliary and Pancreas |
1,005.2 days or 2.75 years |
Melbourne Health 1,005.8 days or 2.76 years |
Ear, Nose and Throat Surgery |
819 days or 2.24 years |
Austin Health 3,270.2 days or 8.96 years |
Orthopaedics |
769.10 days or 2.11 years |
Mercy Health 2,070.8 days or 5.67 years |
Plastic surgery |
741.70 days or 2.03 years |
Northern Health 1,334 days or 3.65 years |
Ophthalmology |
631 days or 1.73 years |
Austin Health 1,378.4 days or 3.78 years |
Dermatology |
616 days or 1.69 years |
Austin Health 2,622 days or 7.18 years |
Immunology |
534 days or 1.46 years |
Austin Health 2,793 days or 7.65 years |
Urology |
470.90 days or 1.29 years |
Bendigo Health 1,573.10 days or 4.3 years |
Rheumatology |
467.7 days or 1.28 years |
St Vincent's Health 1,739.6 days or 4.77 years |
Gynaecology |
454 days or 1.24 years |
Western Health 1,068 days or 2.92 years |
A spokesperson for the Victoria government said in a statement that timely outpatient appointments were central to patients' long-term care needs and recovery.
"Even in the face of record demand driven by COVID, staff furloughing and deferred care — the most urgent patients always received care within the clinically recommended time," they said.
"Our $12 billion Pandemic Repair Plan is all about training and recruiting more staff, upgrading and building new hospitals and delivering more planned surgery – all of which will move patients through the system quicker, including outpatient services.
"We know there are shortages across Australia both in the public and private system, which us why we’re working with health services to improve their triage and referral processes, investing in training more specialists and boosting appointment numbers."
Tasmania
Below are the indicative 75th percentile waiting times in days across the Southern, North West and Northern Regions as at February 28, 2023. The 75th percentile is the time it takes to see 75 per cent of patients. We have selected the 10 specialties with the longest waits based on the non-urgent category.
Specialty |
Urgent condition wait time |
Semi-Urgent condition wait time |
Non-urgent condition wait time |
|---|---|---|---|
| Neurosurgery (Southern Region) | 898 days or 2.46 years |
1,741 days or 4.77 years |
2,546 days or 6.98 years |
Gastroenterology (Northern Region) |
385 days |
1,820 days or 4.99 years |
2,163 days or 5.93 years |
Orthotic prosthetic services (Southern Region) |
251 days |
1,118 days or 3.06 years |
1,929 days or 5.28 years |
Respiratory (Northern Region) |
157 days |
1,386 days or 3.8 years |
1,784 days or 4.89 years |
Urology (Northern Region) |
37 days |
1,191 days or 3.26 years |
1,694 days or 4.64 years |
Neurology (Northern Region) |
378 days |
1,091 days or 2.99 years |
1,596 days or 4.37 years |
Ear Nose and Throat Clinic (Northern Region) |
41 days |
441 days or 1.21 years |
1,565 days or 4.29 years |
Colorectal (Northern Region) |
80 days |
920 days or 2.52 years |
1,519 days or 4.16 years |
Vascular (Northern Region) |
77 days |
744 days or 2.04 years |
1,511 days or 4.14 years |
Plastic Clinic (Northern Region) |
16 days |
581 days or 1.59 years |
1,478 days or 4.05 years |
A spokesperson from the Tasmanian Health Department said the department acknowledged the impact difficulties recruiting specialists in Tasmania had on outpatient waiting times.
"The demand for neurosurgical services in Tasmania has been increasing, whilst also being a particularly challenging area for recruitment with a limited number of neurosurgeons available. Unfortunately, this can result in extended wait times for these patients," they said.
"We understand the effect long waits can have on patients’ lives and we work collaboratively with patients and general practitioners to ensure patients are appropriately prioritised according to their level of clinical urgency and can access an outpatient appointment as soon as possible.
"To address these challenges, we are transforming the way outpatient services are delivered in Tasmania to better meet the needs of our community, improve waiting times and reduce waiting lists to sustainable levels."
South Australia
The below shows the maximum waiting times for routine (category 2) and non-urgent (category 3) who have not been given an appointment date as at December 31, 2022. We have selected the 10 specialties with the longest maximum waits based on both categories.
Specialty |
Hospital |
Maximum waiting time |
|---|---|---|
Opthalmology |
Flinders Medical Centre |
60 months or 5 years 57 months or 4.75 years 56 months or 4.67 years |
Ear, nose and throat (ENT) |
Lyell McEwin Hospital The Queen Elizabeth Hospital Modbury Hospital |
60 months or 5 years 57 months or 4.75 years 53 months or 4.42 years |
Plastic and reconstructive surgery |
Flinders Medical Centre The Queen Elizabeth Hospital Royal Adelaide Hospital |
60 months or 5 years 58 months or 4.83 years 52 months or 4.33 years |
Gastroenterology |
Flinders Medical Centre Lyell McEwin Hospital The Queen Elizabeth Hospital |
60 months or 5 years 54 months or 4.5 years 50 months or 4.17 years |
General surgery |
Flinders Medical Centre |
60 months or 5 years |
Urology |
Flinders Medical Centre The Queen Elizabeth Hospital Lyell McEwin Hospital |
59 months or 4.92 years |
Neurology |
Royal Adelaide Hospital The Queen Elizabeth Hospital Flinders Medical Centre |
58 months or 4.83 years 57 months or 4.75 years 46 months or 3.83 years |
Orthopaedics |
The Queen Elizabeth Hospital Lyell McEwin Hospital Flinders Medical Centre |
58 months or 4.83 years 55 months or 4.58 years 47 months or 3.92 years |
Endocrinology |
Royal Adelaide Hospital Flinders Medical Centre The Queen Elizabeth Hospital |
58 months or 4.83 years 47 months or 3.92 years 35 months or 2.92 years |
Vascular surgery |
Flinders Medical Centre Royal Adelaide Hospital Lyell McEwin Hospital and Modbury Hospital |
58 months or 4.83 years 27 months or 2.25 years 16 months or 1.34 years |
SA Health said the latest report showed South Australians were being seen faster for outpatient appointments at public hospitals.
"The specialist outpatient waiting time quarterly report shows a total of 65 speciality outpatient services at South Australian metropolitan hospitals have reduced overall maximum waiting times to between two weeks to 33 months, compared with the last quarterly report," it said.
"All hospitals have met the initial goal of having no patient wait more than five years for an appointment by 31 December, 2022."
"We’re working as a system to continue to improve and make sure all South Australians can access the health care they need in a timely manner," SA Chief Medical Officer Dr Michael Cusack said.
"There have been significant inroads made, particularly over the last 12 months."
Queensland
Below are the 90th percentile waiting times for patients in days across total categories for October-December 2022. We have selected the 10 specialties with the longest waits at the 90th percentile across all categories.
Specialty |
Wait time |
|---|---|
Ear, nose and throat |
725 days |
Ophthalmology |
507 days |
Surgical other |
489 days |
Pain management |
487 days |
Paediatric surgery |
455 days |
Rheumatology |
431 days |
Neurology |
420 days |
Paediatric medicine |
384 days |
Orthopaedic |
363 days |
Vascular surgery |
350 days |
In a statement, Queensland Health's Director-General Shaun Drummond said the state's health system was facing increased pressure, driven by a growing and ageing population, the increasing burden of chronic conditions, workforce challenges, lack of access to GPs and declining health cover.
"The significant international workforce shortage, particularly of key medical specialists, continues to be the greatest obstacle to the delivery of sustainable health services across the nation," he said.
"We are working hard to meet growing demands while prioritising the safety and wellbeing of staff.
"We are employing an additional 9,475 frontline health staff across Queensland (between 2020 and 2024), including an extra 1,500 doctors over the next four years which will further help to support Queensland's growing healthcare needs.
Few other treatment options available
For the past two years, Linsey Daly-Vincent has been waiting for an initial appointment with a public gynaecologist in Sydney.
The 37-year-old has endometriosis, an often debilitating condition where tissue similar to the lining of the uterus grows outside of the uterus.
"It's been insanely frustrating," she said.
"The public waiting system — it's kind of put me on the backburner, and it's like as if they've just forgotten about me.
"I've been in quite extreme, chronic pain to the point where I have had to take days off work, I've ended up in hospital twice because of it, sometimes the pain makes me throw up."
As people such as Linsey struggle to access care, some specialists say demand for their services has never been greater.
Western Sydney paediatrician and former state Labor MP Dr Andrew McDonald said he had been forced to close his books to new patients because he simply could not see all the children who needed help.
"In the 33 years I've worked in Campbelltown, it's never been as hard for a parent whose child needs to see a paediatrician," he said.
"Thirty years ago, these children were seen. You cannot now find a paediatrician to see your child for love nor money."
He said the children he was turning away were left with little other treatment options.
"They either don't get care, they wait on waiting lists forever, or they fall through the cracks," Dr McDonald said.
"And if nothing happens, the cracks will continue to widen."
Need to re-imagine healthcare
Dr Jacqueline Small from the Royal Australasian College of Physicians (RACP) said demand for specialists was being driven by an ageing population and the increasing prevalence of chronic illnesses, meaning more people needed specialists than ever before.
But training places for the next generation of doctors are limited, tied to funding and teaching capacity.
"There's been a range of issues that have emerged, particularly through COVID, but it's really been the tipping point for the health system with increasing demand, and difficulties in meeting the demands of people with complex health problems," she said.
"The models of care aren't set up to deal with these types of complexities. We need to re-imagine the health system and create new models of care that are better connected."
Dr Small also called for nationally consistent information about specialist wait times, to better understand the problem.
"One of the big concerns we have is there actually isn't good, widely accessible data about waitlists for public outpatient clinics across Australia, but also data on what's happening in the private health system," Dr Small said.
"Quite a lot of health care in Australia is provided in the private health system and we really don't have any grasp on what's happening there."
Fixing the system 'not rocket science'
Describing the solution to specialist waiting times as "straightforward," Professor Stewart called on the federal government to urgently boost funding to public hospitals, so they can better resource outpatient specialist clinics, and increase training positions.
"We cannot keep calling Medicare a safety net with these big holes in it. These are huge rips in the basic fabric of Medicare, and the time has now come to fix it," he said.
In a statement, federal Health Minister Mark Butler conceded long wait times had a "serious detriment" to people's health, arguing the federal government was focused on boosting the health workforce, and was reviewing the five-year agreement on public hospital funding between the Commonwealth and states and territories.
The ABC also approached the states which publish data for comment.
They argued they were working to improve waiting lists and specialist shortages, with some pointing to significant improvements in outpatient waiting times.
In the lead-up to the 2019 election, federal Labor promised it would set-up a permanent policy-making body called the Australian Health Reform Commission, flagging improved access to public specialists as an early priority.
It ultimately abandoned the policy ahead of the 2022 election, but Professor Stewart said the body was urgently needed.
He said if nothing changed, more people would fall through the cracks.
"It will progressively get worse," he said.
"But it's bad enough as it is. It doesn't have to get worse for people to take notice that we have to act now."
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