Ms ROSOL – Thank you. A question about the Elective Surgery Action Plan, because we were talking about it earlier. Great news to hear that there was an increase in the number of surgeries completed over that four years. I note that in the last 12 months that we have figures for up on the dashboard, there’s been an increase in the waiting list of 1107, or a 14 per cent increase in the number of people waiting for surgery.
In the previous four‑year plan, there was $156.4 million invested in that elective surgery plan over the four years. The new plan’s supported by $70 million over four years, so a significant decrease in the funding. How will you be able to repeat what you did in the past with increasing the number of surgeries, when demand is increasing and the amount of money that you’re investing into the plan is decreasing?
Mrs ARCHER – Thank you. Yes, well, as you have said, we have just tabled our new Elective Surgery Plan today with the intention of continuing to drive down those waiting lists, and recognising that yes, demand for services does continue to grow. We have seen that demand continue to grow. We’re taking action to try and manage that growing demand.
That is an important part, and that also goes, I think, to the calls we have made to the federal government, who are asking Tasmania, and all states, to reduce their health demand, which is quite extraordinary, in some ways. At the same time, also they often introduce policy initiatives that actually increase demand on our elective surgery waiting lists. That is another reason why we are calling on the federal government to give regard to this in relation to the National Health Reform Agreement. The focus is on reforming the services and delaying the need for elective surgery, and avoiding people having to present. I might ask the Secretary if he wants to make more comments.
Mr WEBSTER – Thanks, minister, and through you. The original four years was a base, if you like. We’ve built systems and procedures, and we’ve built a network across the state around elective surgery and surgery generally, all funded through that initial four years. The second four years is about then maintaining that base, so therefore we need less funding to achieve the same outcome over the next four years. That’s the first thing, but secondly, the wait list has gone up, but that’s on the back of our success that we’re having with outpatients. That’s because we’re seeing record numbers of people through outpatients, but also because of our e‑referrals, it’s easier to make a referral, we’re getting more referrals and we’re seeing more people and that is increasing the numbers going on to the waitlist.
Ms ROSOL – Doesn’t that indicate more people need surgery, so you should be putting more funding into it? I’m just trying to understand this cut from $156 million to $70 million over the four years. It sounds like what you’re saying is, the federal government should be giving us more, so we’re just putting the $70 million in, and they should do more. How are you going to keep up with demand if you have more people going through outpatients, more people needing surgery and coming in, but you’re putting less money into it?
Mr WEBSTER – Through you, minister. As I said, it’s not actually a cut as in we’ve spent all of that money in the first four years in individual surgeries, it was spent on processes and systems and things like that. Now, the funding is adequate to maintain the high levels that we’ve achieved. Demand funding comes through the NHRA, hopefully, we can sign a new one that allows us to continue to grow surgery overall, over the period, but this is, if you like, a top‑up to that, to make sure that we’re going beyond the demand funding in elective surgeries, in recognition of the fact that we need to get the waitlist down. The minister went through in a previous answer, our rate of admissions around surgeries, et cetera. What we’re trying to do is maintain the high level, but also keep pace with demand, through the demand funding in addition to –
Ms ROSOL – It’s not adding up in my head; if it’s increased by 1000 over the last year, but systems are in place for it to function better, it’s just kind of not quite fitting.
CHAIR – We will move to the next question, unless you have anything more to add.
Mrs ARCHER – I can add a little further to that, that there are reforms in the new four‑year plan to support the service sustainability, by improving utilisation of existing capacity to increase supply and changing the models of care, to optimise care pathways. Some of those reforms will be implemented by modernising systems and technology; process mapping and redesign; virtual care and digital platforms; creating more connected and accessible surgical care experience; strengthening non‑surgical care pathways to give people more options for managing their health before surgery is needed; expanding access to early intervention and conservative treatment; improving referral pathways; and supporting people to prepare well for surgery, by embedding evidence‑based prehabilitation and preoperative optimisation programs; and improving surgical pathways.
Chair, just before we move on, I think the Secretary and his team also have a response for the vacancy committee question about positions declined in this financial year and have a breakdown.
Mr WEBSTER – Through you, minister. This financial year it’s 8.5 and last financial year was 5.5.
Ms ROSOL – I just want to go back to the Elective Surgery Four-Year Plan. In the previous four year plan, there were performance measures in there and I can’t see any performance measures in here. I’m just wondering what your goal is for surgery waiting lists each year or at the end of the four years, how you will be measuring the success of this plan and if you have anything that you could table or share with us about how you will be measuring progress on this plan, please.
Mrs ARCHER – Broadly, we would like to see continued progress in driving down elective surgery waiting lists. I think we can all agree that’s what success would look like. But I might throw it to Dale for some further information.
Mr WEBSTER – Through you, minister. In line with moving it into an ongoing businesses situation, the targets are now set through the Tasmanian Health Service Annual Service plan, which is a document issued by the minister to the Health service to say this is what you must deliver, so that’s how it’s reflected into the future.
Ms ROSOL – So are you able to share here what your wait list target would be for the end of the new four-year plan at all please or if it’s something you could provide on notice?
Mr WEBSTER – Through you, minister. There’s a number of measures, the first of which is the number of patients waiting over boundary and there’s a target there, the average overdue wait time for those waiting beyond the recommended time for elective surgery, number of patients waiting that went on to the list prior to 30 June 2023.
The patients seen within clinically recommended timeframes and the number is in a different part of the document near the measures. There it is. So, under our priority five, the number of missions, elective surgery 21,930 is our target for this year and that under elective surgery also including endoscopies and we’ve got it targeted 13,073 for this financial year.
Ms ROSOL – So the goal for the waiting list at the end of the year, do you have that figure available also?
Mr WEBSTER – Through you, minister, that’s not in the Service plan.
Ms ROSOL – Is that something we could take on notice please?
Mrs ARCHER – Yes, possibly. It would depend on demand, but it probably goes without saying that our goal is that Tasmanians can access the healthcare that they need as soon as possible.
Ms ROSOL – Yes, which is a great goal, but I just know there’s been figures attached to that in the past, do just interested to know what they are now.
Just moving to HR processes we’ve talked about vacancy control and you’ve talked quite a bit about recruitment within the Department of Health. We’ve been hearing lots of reports about recruitment delays within the department where it’s taking for some positions up to six months for a position to be filled – and that’s the position’s advertised, interviews are conducted, there’s a successful applicant and then it sits in HR and doesn’t get processed and the position doesn’t get filled and just some questions around that. Given HR delays are leaving positions vacant for long periods, is the Department of Health using those delays as a form of vacancy control and as a way of managing positions and saving money.
Mrs ARCHER – No, would be my short answer to that, but the Secretary will be able to give you some information around how those processes are managed.
Mr WEBSTER – Through you, minister. On the question of does it save us money, it in fact costs us money to have those delays because it inevitably ends up in agency nurses, locums or agency allied health professionals. For the first time this year, the Tasmanian Health Service Service Plan actually sets a target for recruitment at 40 business days, because we do accept that the delays that we’ve been experiencing in our recruitment process, et cetera, are unacceptable, so we’ve focused on it.
As I said, the minister has set, through the Service Plan, a target of 40 working days for this financial year for us to get to. I would say to you that we then need to work on getting it down lower than that, but there have been significant delays. Some of that is due to the processes being inconsistent across the state, because of the way that THS has been apart together, those sorts of things. Some of it relates to delays in recruitment; for instance, we’ve been very successful in international recruitment, but that then has a delay built into it because we need to source visas and things like that; again, with interstate applicants, there’s delays as well in relocation and things like that. All of those things we need to actually get rid of in our system, to get down to that 40 days because it costs us money.
Mrs ARCHER – Chair, I would just like to clarify on my previous answer, if that’s all right. In relation to my answer to Ms Haddad’s; the funding for The Bubble is an infrastructure grant delivered through the Department of Health, the others are interest-free loans delivered through the Department of State Growth.
In relation to the General Practise Sustainability and Viability Initiative, $2 million per year was allocated in the 2024-25 state budget for four years. Round one has already been awarded and round two is planned to occur later in 2025-26.
