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Elective Surgery - the Financial Whipping Boy

The Australian reported last week that patients in several states were made to wait for common elective procedures such as cataract removals// and knee and hip replacements for much longer periods than they used to.

The average wait for a cataract removal has risen from 168 days to 218 days in NSW and from 152 to 176 days in Victoria. Almost one-third of patients in NSW and in the Northern Territory have waited more than a year for knee replacements.

According to health professionals and economists the public hospital system seems to be struggling to cope with the increasing medical demands of their aging population. Surgical waiting lists only prove that public system hospitals are miserably failing to properly manage their busy emergency departments as well as their elective surgery lists.

In surgical waiting lists elective cases usually have to take a back seat. While balancing a hospital budget also, usually emergency surgeries get preference over elective surgeries.

Several states have proposed to remove elective surgery as a responsibility of public hospitals. In November, the Government plans to open a $90 million facility to perform elective surgery on public patients.

In South Australia the government developed two operating theatres on the grounds of the Flinders Medical Centre specifically to perform elective eye operations. The number of elective eye procedures increased from 566 in 1999-00 to 1521 in 2004-05.

. Last year the NSW Government launched plans to revitalize the system by redirecting some elective patients from large hospitals to smaller hospitals as well as the government linked funding for the number of elective procedures each hospital performed. As a result they have become equipped with a series of important performance indicators such as the number of operations hospitals do thereby payment is made for work done rather than waiting list targets.

Private hospitals are also enlisted to get through the longest waiting lists. However this would probably damage the already crippled public system, according to some. Diverting staff to private hospitals or these elective surgery centres would leave public hospitals understaffed.


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