WA's health system is making progress on reducing its elective surgery waitlist from its COVID peak, by scheduling some surgeries on weekends among other measures, but is struggling to bring down the number of patients waiting longer than the recommended time.
Among them is Karen Boyd, who the ABC first spoke to in June.
Six months later, she is still in pain having waited for surgery on her spine for around a year and a half now.
"It does make me sad because I know that I do need surgery and I know that I would have a better quality life once I had this surgery done," Ms Boyd said.
Her surgery is classed as category three, meaning it should happen within a year.
But she is still yet to receive any indication of when she will go under the knife.
After elective surgeries were cancelled a number of times during the pandemic, the waitlist had blown out to a peak of 33,206 cases in May.
That has fallen over the last few months, to sit at 28,079 in October, the most recent month for which data is available.
But despite that success, the government has been unable to make headway on tackling the issue of patients waiting longer than the recommended time.
That measure peaked in June at 6,894 cases — but remains not too far off at 6,542 in October.
'Secret waitlist'
The Australian Medical Association's (AMA) Mark Duncan-Smith said those figures were almost certainly an under-representation of the number of people waiting for surgery.
"There's a secret waitlist," Dr Duncan-Smith said.
"Which is actually the waitlist to get in to see a specialist in the first place, to then actually get on the waitlist for surgery."
The WA president of the AMA said issues with elective surgery largely came down to a lack of capacity within the hospital system.
"The ability to do elective surgery is directly related to the number of beds available," he said.
"The McGowan government, I do not think, has an adequate plan to deal with the problem with high capacity, which requires significantly more beds.
"Western Australia started the pandemic with the lowest number of hospital beds per head of population of any state or territory in Australia.
"Health care professionals are sick and tired of trying to deal with ramping, with cancellations of surgery, with poor service to patients, because we've got one hand tied behind our backs as we try to fight these problems."
Wait times 'deeply distressing'
The opposition's health spokesperson, Libby Mettam, said anytime patients were waiting for longer than the recommended time was "deeply distressing".
"This leads to acuity issues, as well as other impacts on the overall cost of the healthcare system, and the wellbeing of WA patients," she said.
Of the 500 beds the state government has promised the health system over the last year, almost all have been delivered.
The extra beds have frequently been sold as the equivalent of an additional tertiary hospital being added to the system.
A spokesperson for Health Minister Amber-Jade Sanderson pointed to new data from the Australian Institute of Health and Welfare (AIHW) which showed that over the last financial year, most WA patients were waiting only slightly longer than the national average for surgery.
"WA Health continues to actively work to reduce elective surgery waitlists following the short pause on bookings for elective surgery during the peak of the COVID pandemic, the one-off National Day of Mourning for Queen Elizabeth II and the ANF's industrial action," the spokesperson said.
"Each of the health service providers is doing what they can to safely reduce elective surgery waitlists including, for example, additional theatre lists and scheduling some surgeries on the weekend."
The AIHW data also showed WA patients faced the second-longest median wait time in emergency departments, with only half of ED patients seen "on time".
"These figures should be of no surprise given going into COVID we had the lowest number of public beds per capita," Ms Mettam said.
"The McGowan government [had] been cutting corners on health in their first term in office, and it's leading to a range of damning statistics.
"Whether it's ambulance ramping, emergency department wait times or elective surgery waits or admission figures.
"It all points to a government who are not putting the patients of WA first."
Last month was the worst November on record for ambulance ramping in the state, with paramedics stuck waiting outside hospitals for a total of 5,767 hours – equivalent to 240 days.
Waiting game
Ms Boyd said while system pressures continued to impact many like her on a daily basis, it was frustrating to be left in the dark about when her surgery will go ahead.
She said the only updates she received came when she called for them.
"If I had've realised it was going to be this long, we could have gone into private cover, waited the 12 months and I could have been looking at around about now seeing a surgeon and having surgery within months of seeing that surgeon," she said.
"Now I'm stuck, and even if we do go private I'm still waiting another 12 months."
But the prospect of the relief the surgery will bring keeps her hopeful.
"Once I have the fusion done I'll be back to hopefully a normal kind of life where I can do what I used to do," she said.
"Day-to-day chores, just going out and enjoying life again without having this constant pain, looking tired, feeling tired, and the pain itself."
