Ms O’CONNOR – What’s the elective surgery wait-list as at this date?
Mr WEBSTER – It’s on our dashboard and I’m just logging in.
Ms O’CONNOR – Is the dashboard – just remind me – is it real time?
Mr WEBSTER – The elective surgery dashboard is as at the end of the previous month.
Ms O’CONNOR – Alright, so while you’re looking for the most recent figure. In a media release on 7 August this year about elective surgeries, Minister, you seem to blame COVID for driving up the elective surgery waiting list, which at that point was at 12,286.
I’m interested to know why and on what evidence the decision was made to blame COVID. We can agree it has had an impact and a negative impact, not only on individuals but on the system. Who advised you that COVID was to blame for the wait list reaching this peak?
Mrs ARCHER – Certainly, the advice that I have had is that it did have, as you identified, a significant impact on elective surgery, as it had a significant impact right across the health system. I don’t know that it would be reasonable to necessarily – I know it probably generally terms not blame, or not seek to place blame, but really to provide explanation for some of the change in those figures.
Ms O’CONNOR – I could have said you attributed the rise to COVID and where that advice came from on the basis of what evidence?
Mr WEBSTER – The advice came from the department. I was around in those days, and it was due to a number of times where, due to COVID outbreaks within hospitals, et cetera, we actually reduced our elective surgery through COVID to protect consumers and the hospital from further outbreaks. That’s why –
Ms O’CONNOR – Including in the past year, because the 12 August statement suggests that that impact on the system has persisted.
Mr WEBSTER – It peaked at that level and has come down since.
Ms O’CONNOR – When? Sorry, I’m just trying to get this.
Mrs ARCHER – When did it peak?
Mr WEBSTER – My team will let me know that, but the peak was somewhere in 2022.
Ms O’CONNOR – So are you blaming – are you attributing events of 2022 to the waiting list being driven up to 12,286, or is the advice that the system impacts are ongoing and that is why, to this date – so on a contemporary measure if you like – the wait-list problems are being attributed in significant part to COVID?
Mrs ARCHER – The COVID peak of 12,286 was in January 2021, but we’ve also noted that the elective surgery waiting list continues to decrease and is 36 per cent less than that COVID-driven peak in January 2021. That’s in part being driven by the statewide Elective Surgery Four-Year Plan and again that’s what we are seeking to do with our next elective surgery four-year plan, as well.
There are, I think, and Dale may add more to this, but I think there are a range of reasons that drive elective surgery, including screening programs. For example, we’ve seen screening programs contribute to increased demand for elective procedures like endoscopies and the like as well. Did you want to add anymore comments to that?
Mr WEBSTER – Just to give the figure, this is the end of September from the dashboard. The Launceston or Energy Age figure is 3276; Mersey is 652; Northwest Regional is 912; and the Royal Hobart Hospital is 4435. A total at the end of September of 9275. The peak was 12,000. We’ve come down to that figure.
Ms O’CONNOR – In July of 2017, the elective surgery waiting list was at 5403 by March 2020, when COVID hit Tasmania, that number had more than doubled and reached 11,307. In other words, 86 per cent of the waiting-list growth occurred prior to the start of the pandemic. Given that, do you think it was reasonable to attribute the peak being reached to COVID? And are those impacts of COVID still being felt in the system in terms of, and I’m sure they are, in terms of being able to deliver elective surgeries?
Mrs ARCHER – I would just note that also the Australian Institute of Health and Welfare has noted earlier this year that since early 2020, elective surgeries across the country have been affected by disruptions to hospital services that arise from the COVID pandemic. And just to go back to what you indicated, I am not sure we were on the same page there. COVID-driven peak, 12,286 in January 2021.
Mr WEBSTER – A number of factors drive the wait-list – so we’re delivering record number of surgeries, but the wait-list is quite stubborn.
CHAIR – Open the door and they keep coming in.
Mr WEBSTER – The other side of it is that, it is demand driven, but e-referrals has increased the number of outpatient referrals, you know, convenience because we’ve made it easier to actually refer to us, but we’ve delivered a record number of outpatient appointments but that means that the number of patients coming from outpatient appointments onto the surgery list has gone up. As we meet demand, we’re creating demand, is one of the factors.
CHAIR – Can I just indicate that it’s 11:00, we were going to have a break at this time and if people are expecting that we might break and come back to this. We will take a 15 minute break there and be back just after 11:15.
CHAIR – I think you were about to ask another question on 2.1.
Ms O’CONNOR – Elective surgery, that’s right. Thank you, Chair. We were talking earlier about the impact of COVID and potentially other infectious diseases on the system, on admitted services. In the past year, how many outbreaks of infectious diseases, and which diseases, have occurred in each hospital that required a response?
CHAIR – Well, everything requires a response.
Ms O’CONNOR – That required, for example, a new PPE arrangement being put in place. When there’s an outbreak in any health system, there’s a response. How many times did that happen in each hospital in the past year?
Mrs ARCHER – Thank you. Just to clarify that you’re not speaking about disruption to services necessarily?
Ms O’CONNOR – No, because that’s a given.
Mr WEBSTER – I’m just looking across – we don’t have that with us, but we were actually talking about it during the break. This year was in fact a double peak in terms of respiratory disease through winter. We experienced a peak as normal in August and then we had another one in late September into October, so we actually had a large rate of infection across Tasmania, not just COVID –
Ms O’CONNOR – COVID, flu, RSV –
Mr WEBSTER – Yes, and we had a thing called parainfluenza that affected people as well that resulted in some hospitalisations. There were a lot of people who, even though immunised, picked up on that.
Mrs ARCHER – Those are all respiratory illnesses, but there would be presumably – potentially other infections as well.
Mr WEBSTER – We certainly had a number of outbreaks within hospitals, but we haven’t actually collated that as a data set, how many times we had an outbreak in hospital in the last 12 months.
Ms O’CONNOR – Are there so many you can’t count them, or is it simply not something that’s recorded?
Mr WEBSTER – It’s not something that’s recorded directly, but it is actually reported because I get to know about every one of these situations.
Ms O’CONNOR – So it’s recorded somewhere if it’s reported?
Mr WEBSTER – Exactly. That’s right.
Ms O’CONNOR – Where is it recorded?
Mr WEBSTER -Well, through our hospitals, it’s one of the things they monitor. We just don’t have it with us, but we will attempt to get it.
Ms O’CONNOR – You would be happy to take that on notice, would you?
Mrs ARCHER – We can take it on notice, yes.
Mr WEBSTER – Yes.
Ms O’CONNOR – And in terms of a response, if there’s an outbreak on a ward – because let’s face it, the PPE standards are not what they used to be – what is the response on that ward in the case of a highly‑infectious disease?
Mr WEBSTER -There would be closure of that ward to externals, and again the PPE usage would increase within that ward –
Ms O’CONNOR – That’s very reactive.
Mr WEBSTER – but we would then have a closure of that. You talk about reactive, but there is an ongoing assessment of where we use PPE and what level of PPE, related not just to outbreaks but to winter disease that we just spoke about, et cetera. There would be limited visitation, for instance, cohorting if the spread is across more than one location at the hospital. As part of our COVID response during the emergency, we also increase the number of negative‑pressure rooms that are available across the network, in terms of infection –
Ms O’CONNOR – Isolate people.
Mr WEBSTER – so we can isolate, and in negative‑pressure rooms so that there isn’t spread beyond that room, and those sorts of things, so there are a number of initiatives that we put in place.
Ms O’CONNOR – Thank you. Can I ask, have admissions for tuberculosis increased, and what are they now because we’re seeing an increase in tuberculosis around the world?
Mrs ARCHER – Australia has achieved and maintained good tuberculosis control since the mid‑1980s, but challenges remain to progress towards pre‑elimination. In Tasmania, the rate of TB is lower than observed in Australia, approximately 2.1 per 100,000 per annum, that’s 2015 to 2024, compared to 5 to 6 per 100,000 per annum for the same period in wider Australia. While crude notification numbers in Tasmania are low, there has been a small increase in notifications in 2025 year to date. There have been 18 notifications in 2025 year to date, compared to a range of eight to 21 notifications per annum for 2015‑2024; no cases in Tasmania year to date were among those who identify as Aboriginal or Torres Strait Islander, and the majority of TB notifications in Tasmania are among those born overseas in countries with high TB incidence, and among adults aged 15 to 44 years of age.
Ms O’CONNOR – Okay. Can I ask if a patient presents to the emergency department – and I know we will be dealing with emergency department matters soon – but if a patient presents and they are confirmed to have tuberculosis, what happens?
Mr WEBSTER – We might pass that to the Chief Medical Officer.
Prof. ARYA – We have a very rigorous contact‑tracing procedure in our emergency departments, so if anyone who presents with TB or any infectious disease, the contact tracing kicks in immediately. We have a public health unit that then gets involved in tracing all those contacts or potential contacts.
Ms O’CONNOR – And the data that Mr Webster was talking about before, when outbreaks are reported, for example, that is recorded in that public health unit, is it?
Prof. ARYA -Yes. So, any infectious disease – and tuberculosis is a notifiable one – any infectious disease notification is recorded and monitored.
Ms O’CONNOR – Through you, minister, can I ask what other interesting and exotic –
CHAIR – Can we do this under public health?
Ms O’CONNOR – But this is –
CHAIR – Now we’re moving into public health, we will do it there.
Ms O’CONNOR – Yes, we can. Sure.
Mrs ARCHER – Just further on your question about TB, the up‑to‑date and the past counts of rates of cases in Tasmania are also available on the national notifiable diseases dashboard.
Ms O’CONNOR – And just to confirm, if a patient comes in and is confirmed to have tuberculosis, are they isolated within the hospital?
Prof. ARYA – Yes.
CHAIR – Probably in a negative‑pressure room.
Mrs ARCHER – We do have PPE information.
CHAIR – You are happy to table that?
Mrs ARCHER – Yes.
Mr WEBSTER – Yes.
