Skerritt and McGinty on waiting lists
March 10, 2006
The following is a transcript from ABC Radio.
Liam Bartlett
... are blowing out again in the worst possible way. According
to a report in "The West Australian" this morning, in the past
three months, the waiting list at Sir Charles Gairdner for urgent
surgery has increased 13%.That means, according to this report,
nearly half of all patients waiting for urgent surgery at Charlie's
wait longer than is medically desirable. At Royal Perth Hospital,
41% of urgent patients waited longer than clinically desirable,
at Fremantle Hospital it was 24% and 20% at Princess Margaret Hospital.
To discuss this, we are joined this morning by the Health Minister,
Jim McGinty. Minister, good morning.
Jim McGinty
Good morning Liam.
Liam Bartlett
And also, Dr Paul Skerritt who is State President of the AMA.
Doctor, good morning to you.
Paul Skerritt
Good morning Liam.
Liam Bartlett
Mr McGinty, to you firstly, this is a pretty frightening set of
figures.
Jim McGinty
Well, it is a frightening article in "The West" Liam because
it is completely wrong. It is one of the most appalling pieces
of journalism that I have ever seen. The truth about our elective
surgery position at the moment is this, that we have got the lowest
number of people ever recorded on our Wait Lists at the moment,
it is just over 13,000 people. That is unacceptable, but it is
the lowest ever recorded. Now that is what the story should have
been, not the misleading story that ultimately appeared. We have
also got dramatically falling waiting times for people. The average
waiting time for people waiting for elective surgery has fallen
by a month in the last year. I am pleased that we are making some
progress here.
Liam Bartlett
But these figures about the amount of people waiting longer than
is clinically desirable, you are saying that these figures are
wrong?
Jim McGinty
Yes. What we've got is the number of people who are waiting
longer than is clinically desirable is falling here in Western
Australian and has been for the last 12 months.
Liam Bartlett
Are you in agreeance with this Doctor?
Paul Skerritt
We always like to give credit where it is due and some of the
figures do show some improvement, but really, there isn't a tinkering
around the edges range, there is a range of 10% against 10,000
or 13,000 as the Minister has said, so the advice is that they
are going down but the problem is still very substantial. Longer
than clinically desirable is a particularly worrying figure in
any case that anybody is waiting longer than is clinically desirable.
You know, being in pain is one thing but where the illness is likely
to deteriorate during that time is something much more serious.
Liam Bartlett
Well that is what stands out, doesn't it? I mean it's a terrible
situation, it is essentially saying that people are medically being
put at risk.
Paul Skerritt
That's right and that should be zero. Now it is not going to
be able to be accomplished in a very short time, but we really
need longer term planning to lessen these waiting lists. It is
no good having programs to arrest them and every so often having
a burst to try and drop the waiting list times and unfortunately
the only solution is to have more beds, which we appreciate from
the Government's point of view, is a very expensive one.
Liam Bartlett
But the Minister has just given the newspaper report a swift
bash around the ears. Do you agree with that criticism?
Paul Skerritt
I think it was essentially correct in that certainly my part
in that was that the improvements were fairly minor. But the problem
is, is how reliable these figures are and they are all quite amenable
to interference at an administrative level, it is very easy to
put the wind up administrators and get them to use their various
devices to change these figures. Two of them that are particularly
notable are the figures for Joondalup and Peel as privatised facilities
aren't included, so that would certainly boost the numbers overall.
And as the Auditor General pointed out, we don't have the figures
for people who haven't even got on the waiting list yet, who are
on the waiting list to get on the waiting list.
Liam Bartlett
It's the waiting for the waiting list.
Paul Skerritt
That's right and it was the Auditor General saying that there
was not way of working out those figures, estimating that there
may be as many as 30,000 people so you can be in a position for
waiting for a year for an appointment and then being put on a waiting
list for however long that might be.
Liam Bartlett
Well I know there are long lists at Charlie's for that sort of
thing.
Paul Skerritt
Yes.
Liam Bartlett
Minister, let's just find out where your criticism of this particular
story is, because I mean this is obviously essential for Western
Australian taxpayers. Sir Charles Gairdner Hospital, it says the
waiting list for urgent surgery has increased from 35% to 48%.
Jim McGinty
Can I just run through very quickly Liam what the true figures
are. The number of people waiting on the list that's published,
is in the last 6 months has fallen from over 14,000 down to 13,020
people. That is a very significant reduction, it is 1,000 less
people waiting for their surgery now. It is still too high but
we're heading in the right direction there. The waiting time has
fallen by 20%. In June of last year, the average waiting time was
5.26 months for across the board elective surgery. In June of this
year, we have managed to reduce that down to 4.3 months.
Liam Bartlett
Yes, but it says that, this report says that. It concentrates
on what we have just agreed is a terrible situation and that is
people waiting longer than is clinically desirable, so can we just
focus on those figures please.
Jim McGinty
The percentage of people waiting for longer than is clinically
desirable is falling. If I can give you the figures here, it is
still unacceptably high and I agree with Dr Skerritt there, but
we should be aiming at nobody waiting longer than is clinically
desirable, but we have got to deal with the situation as we find
it and we are making, I believe, significant progress. The percentage
of people waiting overall who are waiting longer that is clinically
desirable is about 30%. Now that hedges down from where it was
six months ago at something like 34% so all of these matters are
heading in the right direction and that is substantially the product
of an injection of $10 million into addressing those people who
have been waiting for a very long period for their surgery. If
I can say, December last year, we had 3,200 who had been waiting
for longer that 500 days for their elective surgery. Today, that
figure is just over 1,000 so we have had an enormous reduction
in that level. Now these figures are always dynamic in the sense
that they are constantly changing but we are going to be putting
in a lot more effort over the next month or two to drive them down
to historically low levels and hopefully we will enjoy the support
of the medical profession and the broader community in doing that.
Liam Bartlett
You haven't told me that those published figures for Sir Charles
Gairdner Hospital are wrong.
Jim McGinty
The Sir Charles Gairdner figures as I understand it, are wrong.
I haven't got a complete range of figures here but it would be,
there might be the odd glitch in the system but overall, the percentage
of people waiting for their surgery waiting longer than clinically
desirable, is falling throughout the system.
Liam Bartlett
Is the waiting list at Sir Charles Gairdner for urgent patients
up to 48%?
Jim McGinty
It would surprise me if that were the case Liam.
Liam Bartlett
But you can't tell me today definitively no. JM Well the information
that I have got is that the number of people waiting longer than
clinically desirable is falling and I am pleased to see that trend,
but to answer your questions specifically in relation to a particular
hospital, no I can't but it would surprise me if Sir Charles Gairdner
Hospital was bucking the trend.
Liam Bartlett
It says that at Royal Perth Hospital, 41% of urgent patients
waited longer than clinically desirable. At Fremantle Hospital,
it was 24% and 20% at Princess Margaret. Are those figures correct?
Jim McGinty
Look I don't have the precise figures in front of me Liam,
they are posted up on the website, people can check them from there.
Liam Bartlett
Because you see, you being correct is very important isn't it
because your Government said you would fix this and that is at
the top end. These figures signify the top end, the important end
and at that end, it is getting worse.
Jim McGinty
Well I don't think it is Liam. It is as simple as that. All
of the global figures that I have seen for the system as a whole,
now there might be one hospital that has gone up and everyone else
has gone down. The real area of concern here is the fact that today
we have, while still unacceptable, the best set of figures in relation
to election surgery that we have had for a long time and there
are improvements in every category.
Liam Bartlett
Dr Skerritt, what can we do to get these waiting lists for urgent
surgery down?
Paul Skerritt
Well firstly we need to know that the waiting lists are accurate.
I think that is an important thing. We are not talking about enormous
cuts, we are talking about something like a 10% cut. Now if we
extrapolate that to the future and if the population remains the
same and if we didn't have an ageing population, that would mean
the next ten years trying to eliminate the waiting list and that
is certainly not satisfactory. The planning needs to accommodate
the fact that Western Australia has an increasing population, particularly
has an increasing elderly population that draws on health services
and we need to do better than the improvement . . I always like
to give credit where it is due and cutting down the figures is
fine, but that rate is not sufficient and we need to get the waiting
list down to nothing. Now maybe a council of perfection to get
the whole global figures down nothing but certainly longer than
clinically desirable should be very close to zero. And it is not
just a matter of doing something urgently to fix it, there needs
to be something sustainable over a long period of time.
Liam Bartlett
Well that's the whole point, isn't it? I mean, let's just keep
concentrating here on the top end of the problem, the urgent category.
If you are waiting for surgery and it is classified as urgent,
that is clinically desirable, shouldn't that list be as close to
zero as possible?
Paul Skerritt
Well I would certainly think so, without a moment's doubt.
Liam Bartlett
Minister, you bag this report in the paper but you have given
me absolutely no proof - no facts as to why any of it is wrong.
Jim McGinty
Well can I say in addition to what I have already told you
that the percentage and the number of people waiting for longer
than is clinically desirable is falling in all categories, that
is category 1, 2 and 3. The long wait patients have fallen from
3,200 down to just over 1,000 and that is a result of a specific
initiative designed to address those issues and we are going to,
in the next few months, be announcing further initiatives which
will again bring down those figures. The most telling statistic
in all of this Liam is the fact that we have got a record low for
the number of people on the elective surgery waiting list. Now
surely some credit is due for that.
Liam Bartlett
Dr Skerritt thinks that the number of public patients waiting
for surgery at places like Joondalup and Peel Health Campus should
be included in these figures, do you agree with that?
Jim McGinty
I, I ...
Paul Skerritt
Absolutely. North Metropolitan has already got the worst figures
which bothers me as I live in that area and I don't want to get
sick with a serious condition and have to wait for a long period
of time. Joondalup Health Campus is a substantial provider so there
is not reason why those figures can't be included - they are certainly
available.
Jim McGinty
Can I say, I agree completely with that and I have instructed
the Health Department in future that those privately managed public
hospitals should also be included. The only reason they haven't
been is historical and I believe they should be so what we will
see is the total number of teaching hospitals, secondary hospitals
and the privately managed public hospital figures all published
collectively so that that will do away with any scope for manipulation
of those figures as between the different classes of hospitals.
Liam Bartlett
When will those figures be included Minister?
Jim McGinty
I have instructed about a month ago that that be done so I
should imagine in the next published figures we will see them all
put out there together Liam.
Liam Bartlett
We will leave it there. Thank you both for your time this morning.
Paul Skerritt
Great pleasure Liam.
Jim McGinty
Thank you.
Liam Bartlett
Minister Jim McGinty, Minister for Health and the State President
of the AMA, Dr Paul Skerritt.
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