Australian Medical Association’s Public Hospital Report Card: Cook passes buck to Canberra after dire result

Roger Cook has tried to pass the buck to Canberra after the dismal state of WA’s public hospitals was laid bare in a damning report. The Australian Medical Association’s Public Hospital Report Card, released on Friday, exposed a public health system woefully under-delivering on planned surgery waits and emergency care. The report confirmed just 32 per cent of patients requiring urgent treatment were seen on time in emergency departments in 2023-24. This was the nation’s worst result. And the average wait for patients who had planned surgery for procedures such as heart valve replacement was not admitted within the recommended time was described as “alarmingly high”, at 206.3 days. They are recommended to take place within 90 days. The Premier pointed the finger at Canberra, blaming a lack of bulk-billing for the issue. “Our primary healthcare system in Western Australia is particularly challenged at the moment, (with) the lowest bulk-billing rates,” he said. “It’s not surprising that (category) three presentations are challenging our EDs because people say, ‘I can’t afford to go to my GP, therefore I’m going to go to my local hospital’, and that puts our hospitals under pressure.” The Australasian Triage Scale describes category three as “potentially life‑threatening”, with assessment and treatment recommended to start within 30 minutes. AMA WA president Michael Page hit back at Mr Cook’s suggestion, saying it was “absolutely not” the reason for lengthy ED waits. “The types of patients that are waiting and waiting and waiting in our EDs are not waiting because there’s not enough GPs. They’re waiting because there’s not enough beds in the hospitals,” Dr Page said. “There is the potential for a condition to deteriorate whilst a patient is in the emergency department waiting room, so there is a clinical risk there and that’s why those target times exist.” Dr Page said the AMA report highlighted a “nationwide problem of public hospital capacity”. “It’s not confined to Western Australia, and that’s not an excuse for Western Australia’s Government — current and future — to accept that what we’ve got is good enough because it’s similar to other States,” he said. “It actually just indicates that, around the country, governments have failed to think long-term about the health needs of the country.” Mr Cook tried to take the heat off WA’s poor performance by pointing to the State being the best for patients completing ED presentation in less than four hours. But the AMA report itself said this “points more to falling national performance than WA’s strength”. The State dropped to 59 per cent in 2023-24 for patients seen within the four-hour time frame, compared to 75 per cent in 2019-20. “The decline in performance for this metric is worryingly consistent across Australia. Concerningly, no jurisdiction saw more than 60 per cent of ED presentations completed within four hours,” the report said. Mr Cook said the commitment by the Albanese Government to bolster bulk billing with a $7.9 billion injection into Medicare would help improve ED response times. “Lifting bulk-billing rates means that people can go to their GP more often so they don’t get very sick before going to a hospital, but also they can afford to go to the GP, which means they won’t need to go to a hospital just to save that money,” he said. But Dr Page maintained this was a furphy, saying the state of WA’s hospitals was not the fault of GPs. “Of course we need more general practitioners, but it’s not because GPs are less able to bulk bill that our wards are full of patients today,” he said. Mr Cook said his Government had increased public hospital bed numbers by 800, before spruiking election commitments like upgrades to emergency departments at Royal Perth Hospital and St John of God Midland Hospital. He conceded wait times at RPH would not improve quickly, however, as upgrades wouldn’t begin until 2026. “Obviously, rebuilding the hospitals does take time. It’s an important observation, but it’s all part of that continuum of work that happens under a Labor Government,” he said. Public health has been firmly in the spotlight during the election campaign, with The West Australian this week revealing a Perth father died as he waited 27 minutes for an ambulance while in cardiac arrest. Health Minister Amber-Jade Sanderson initially stayed quiet over the 39-year-old man’s death, with Mr Cook on Thursday defending her silence — saying he spoke for Ms Sanderson as the “CEO” of government. But Ms Sanderson provided comment shortly afterwards and committed to meeting with the man’s family. On Friday, WA Liberal leader Libby Mettam said if Mr Cook was the CEO of healthcare — he deserved to be “sacked”. “The difference between us and Labor is Labor is not seeing health as a priority,” she said. “If Roger Cook is the CEO of health, it’s a CEO that deserves to be sacked. No organisation would put up with the outcomes that we have seen under this CEO.” Greens MLC Brad Pettitt said the consequences of the current health system operating this way could be disastrous. “This actually is a disaster waiting to happen, because there is a real danger that if we’re not seeing those key ED patients on time . . . these people will end up in a much worse situation or with terrible consequences,” he said.