Health funding going backwards

The NSW Government will point to this Budget as a record investment in health.

But the truth is this a disaster for patients.

Health funding has gone backwards despite record activity.

With health inflation (hospital and medical services) at 4.9 per cent, this Budget is funding growth at only 4.2 per cent.

It is extraordinary that this Budget fails to keep pace, despite extra Commonwealth funding and the mandated wage increase for nurses and midwives.

Nurses and midwives do essential work and deserve to be properly valued. They are critical to patient care, and no hospital can function without them.

But the NSW Government cannot seriously claim this as a Budget boost when almost 30 per cent of health funding is going towards wage increases it was forced into paying by the Industrial Relations Commission.

Nor can the NSW Government point to hospital infrastructure announcements as though they are all new answers to the pressure facing patients. Most of the infrastructure projects in today’s Budget were announced by the previous government. New hospitals and upgraded facilities matter, but infrastructure announcements alone do not treat patients.

Patients do not need a record figure on paper. They need a health system with enough doctors, nurses, beds, theatres, outpatient clinics and support services to deliver safe and timely care.

That is where the Budget falls short.

The NSW Government has promised 9,000 additional health workers, including paramedics, nurses and allied health staff. That sounds significant, but the key question remains unanswered: how many of them will be doctors?

The NSW Government must clearly explain how many doctors will be recruited, where they will work, what specialties they will cover, when they will start, and whether they will be enough to safely open the new beds, emergency departments, theatres and services being announced.

That is not a minor detail. It is the central question.

A new hospital without doctors is not a health service. A new emergency department without doctors will not reduce waiting times.

As a surgeon in western Sydney, I see the impact of this pressure on the front line. I see patients waiting too long for care, doctors and clinical teams stretched too thin, and hospitals trying to manage demand they were never properly resourced to meet.

Doctors across NSW are already treating more complex patients, carrying unsafe workloads and working in a system stretched beyond capacity. Emergency departments remain under enormous pressure. Patients are waiting too long for surgery. Regional communities continue to struggle to attract and retain the medical workforce they need.

Against that background, any Budget that promises new services must also explain how those services will be safely staffed. The medical workforce is not interchangeable. Doctors diagnose, make complex decisions, perform procedures, lead clinical teams, manage risk and carry responsibility for patients when the system is under pressure.

If doctors are missing from the Budget detail, patients should be worried.

The latest Bureau of Health Information figures show why this matters. Ambulance call-outs and arrivals were again the highest on record since reporting began in 2010. Treatment started on time for only 68.4 per cent of emergency department patients. Almost 80,000 patients spent more than 12 hours in an emergency department in just three months.

That is not a system under control. It is a system under strain.

The NSW Government may point to elective surgery activity and claim progress. But more than 92,000 patients remained on the elective surgery waiting list at the end of March, including almost 4,000 who had waited longer than clinically recommended.

These are people waiting in pain, living with reduced mobility, reduced independence and reduced quality of life. They are not statistics. They are patients whose lives are on hold.

The number of elective surgeries contracted to private hospitals has also almost tripled in a year. There is nothing wrong with using private hospitals to help patients receive care sooner. But the NSW Government cannot outsource pressure to the private system and pretend the public hospital system has been fixed.

The deeper problem is that NSW is still responding too late.

There is also no clear funding announcement in today’s Budget for preventative health to keep people out of hospital in the first place. That is a serious omission from a government that purports to want to fix the health system.

NSW cannot keep waiting until patients are sick enough to need an emergency department or hospital admission before the system takes them seriously.

Without proper investment in prevention, chronic disease management, specialist outpatient clinics and early intervention, hospitals will continue to carry pressure they were never designed to absorb.

A patient who cannot access care early may end up in an emergency department. A patient who cannot access a public outpatient clinic may deteriorate and require admission. A patient who waits too long for surgery may become more complex, more costly and harder to treat.

That is bad for patients, bad for doctors and bad for the Budget.

AMA (NSW) is not criticising investment in nurses and midwives. They deserve fair pay and respect. But a hospital system cannot function safely unless the entire clinical workforce is planned for and supported.

That includes doctors.

Patients need hospitals that are built, opened and safely staffed. They need emergency departments with enough doctors to treat them in time. They need theatres that can operate, wards that can function and outpatient clinics that reduce delays.

They need prevention that keeps them well, not a system that waits until they become seriously unwell.

Until those questions are answered, this Budget remains a record health spend without the workforce plan needed to deliver real change.

Big numbers may make headlines.

But doctors treat patients.

And NSW patients need to know the Government has a real plan to put enough doctors where they are needed most.