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Health experts warn delays on elective surgery may have compounding effects on the health system

Troy Patten’s life for the last two years has been more isolated than most.

The 58-year-old has been waiting for a hip replacement, and the risk of catching COVID-19 just when he might finally have his surgery scheduled is not one he’s willing to take.

“All I do is sit by the phone and wait for someone to let me know I can have my life back and give me a hip replacement,” he told 7.30 at his home in regional Victoria.

Like thousands of Australians, Mr Patten’s operation has been delayed due to repeated shutdowns of elective surgery to take pressure off the strained healthcare system.

He currently relies on a walking stick and said he struggles with day-to-day tasks. He’s also had to stop working, and can’t pursue hobbies, like doing up cars, which he’s passionate about.

Despite this, his surgery is considered non-urgent. He was told in July 2020 that it should happen within 365 days – two years later, he’s still waiting.

Man sitting down with a laptop in front of him showing a picture of a car.
Troy Patten can’t pursue his hobbies, like fixing up cars, because he’s in too much pain while waiting on a hip replacement.(ABC News: Daniel Fermer)

“It’s got to the point where it’s not ‘am I in pain?’, it’s ‘how much?'” he said.

“Everything in my whole life is in a state of flux.

“Everything’s half-finished and everything’s in the process of getting done because I just do bits and pieces here and there and try to get the best out of what I have for the day.”

But it’s the toll on his family life he has struggled with the most.

“It’s just surviving now and it’s missing out [on the] grandkids, being able to hold my grandkids,” Mr Patten said.

“I had one of my grandkids on the weekend want to sit on my knee and I couldn’t.

“It’s things like that people just take for granted.”

Waiting lists blowing out across the nation

In Victoria, there were 87,000 people on the waitlist for elective surgery at the end of June – that’s an increase of 21,000 in a year.

In a statement, a spokesperson for the Victorian Department of Health said $1.5 billion was being spent to get on top of the backlog and improve capacity in the future.

“Health services work closely with all patients to reschedule any postponed procedures as soon as possible and provide them with alternative supports while waiting for treatment,” they said.

But the problem is far from limited to that state.

Empty bed at Royal Brisbane and Women's Hospital
Continuing pressure on hospitals and staff shortages have seen elective surgery waitlists blow out across the country. (ABC News: Chris Gillette)

There were more than 100,000 people on the list in New South Wales at the end of March, nearly 19,000 of whom were overdue.

The West Australian list has grown by 10 per cent in the last year to 33,000.

Tasmania’s waitlist has improved by about 2,000 in the last year, down to 9,400 in June.

In Queensland, there are almost 58,000 on the list, 7,500 of which are overdue.

The federal Department of Health told 7.30 in a statement: “The Commonwealth provides a significant proportion of spending on the Australian health system to states and territories … and is committed on working with states and territories on longer-term health reforms of the health system to reduce pressure on hospitals.”

“All health ministers realize there are challenges and pressures facing the state and territory health and hospital systems and are working in partnership to consider a number of long- and short-term measures to ease pressure on hospitals.”

The president of the Australian Medical Association Queensland, Maria Boulton, said just because someone’s surgery is considered “non-urgent” (recommended to be completed within a year) does not mean their injury or illness has no profound impact on their quality of life.

Woman with medium length brown hair wearing a black printed top and red jacket.
Maria Boulton says elective surgeries shouldn’t be considered optional for those on the waiting list.(ABC News: Michael Lloyd)

“It’s important to understand that surgery is not optional,” she said.

“These are people that are in pain, these are people that are having effects into their activities of daily living… it’s also causing a lot of stress to them.

“You don’t know what’s going to happen if they have to wait on a waitlist for that long — are they ending up in an emergency? Will that surgery then become an emergency surgery?

“It’s not fair that they’re waiting for so long for a procedure in such a state.”

‘My fear is that my life will change dramatically’

Dianne Hill, from Brisbane, has been waiting 13 months now for cataract surgery, which she was recommended to have within a year.

While she is managing, she said she was worried about what would happen if her condition deteriorated.

A woman wearing a black top with a scarf and black-framed glasses.
Dianne Hill has been waiting over a year for cataract surgery in Queensland.(ABC News: Michael Lloyd)

“I can drive still, but I’m on the cusp, so I’m very concerned… I’m on my own, single, no-one to look after me,” she said.

“I am having issues. I can’t read instructions … I’ve got a magnifying glass I have to use.

“I’m still lucky I can get out and about and keep up with some of my hobbies and activities … my fear is that my life will change dramatically.”

A spokesperson for Queensland Health said in a statement $15 million was being spent to tackle waitlists.

“All hospital and health services (HHS) continue to prioritize clinically safe care for patients who require emergency surgery, the sickest patients will always be seen first,” they said.

System in need of reform

Jeffrey Braithwaite from the Australian Institute of Health Innovation was part of a team of researchers who looked into how to improve elective surgery waitlists in the first year of the pandemic.

He said there were a number of things that needed to be considered.

“Prioritising people on the list and really looking at where it is that we would provide the best value care for conditions,” he said.

“We could optimize the public and private hospital nexus … the public hospitals are often jam-packed, and under huge pressure — sometimes the private system has some capacity.”

He and Dr Boulton agree that delaying elective surgeries would also eventually put pressure on other parts of the health care system.

Man wearing a white shirt with black suit jacket and glasses standing in front of a bookcase.
Jeffrey Braithwaite says it will take a variety of measures to get on top of waitlists. (ABC News: Kathleen Calderwood)

“You can say a simple hip replacement is not as urgent as some cardiac surgery — that may well be true,” Professor Braithwaite said.

“However, to what extent is the hip not being replaced going to create huge effects for that person not being able to work, to be deteriorating over time, to not be mobile at all?

“[And then there will] be a much bigger set of problems [and] comorbidities coming into the health system six months later because we didn’t tackle them to start with.”

For Troy Patten, he’s just desperate to get his life back.

Man sitting outside next to a motorbike holding a walking stick.
Troy Patten has had to remain isolated at his home in regional Victoria while he waits for a hip replacement.(ABC News: Daniel Fermer)

“It’s hard on the mental state,” he said.

“Am I not worthy? Am I worthy? All these things go through your head.

“Then you start thinking they’re just going to throw me away and they’re finished with me — where I have a lot more to give.”

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