Robin Osborne looks at the latest report card on Northern Rivers hospitals.

In a statement issued after the release of the latest Bureau of Health Information Healthcare Quarterly report (covering April-June 2023), the Northern NSW Local Health District (NNSWLHD) said its hospitals continued to make significant progress on their planned surgery wait lists.

For example, the overdue list was reduced by over 50 per cent, while 95.8 percent of all urgent planned surgery was performed on time in the second quarter of this year. A total of 3,676 planned surgeries were performed across the region throughout the quarter, an increase of 8.1 per cent over the same quarter last year. 

This good news aside, the wording of the statement remained cautious. 

Note how the word highlighted in red, would, had it appeared, have greatly improved the following sentence, the opening one in the LHD’s media release of 6 September: ‘Public hospitals across Northern NSW Local Health District (NNSWLHD) continued to perform well amid sustained high activity…’

So, on balance, we learn that the hospitals did actually perform, as opposed to being the Yes, Minister kind of facilities that have no patients, but the question remains about whether they could have done better. 

The short answer is that of course they could, but so could every business we rely on, whether daily, like telcos, energy providers and supermarkets, or infrequently, like… Qantas.

To be fair, our hospitals are not doing the medical equivalent of losing people’s luggage, or cancelling services at short notice with little explanation. Well, to use that word again, not too much of the latter.

When it comes to emergency departments, this being the other key measurable criterion of hospital performance, regional facilities were recorded to have bettered NSW average standards across the board. Well done! 

Total attendances for the quarter numbered 54,626, with more than seven in 10 patients (73.5 per cent) starting treatment on time, exceeding the NSW state average of 65.8 per cent. Almost eight in 10 patients (78.5 per cent) were transferred from ambulance to ED staff within the 30-minute benchmark, which was also better than the state average (74.1 per cent). 

The majority of patients (72.6 per cent) left the ED within four hours, also better than the NSW average (56.7 per cent). 

‘We want to make sure that patients are being seen as quickly as they can be in our hospitals, but we also know that many patients could receive more appropriate care in other settings,’ the NNSWLHD Chief Executive, Tracey Maisey said. 

Given that this is code for, largely, GP care, the numbers are worth considering.

According to Mrs Maisey, ‘Around half (49.4 per cent) of all presentations to our EDs this quarter were for the least urgent triage categories four and five.’

This means that more than 27,000 presentations (somewhat less in actual patient numbers, given multiple presentations) might have been treated more appropriately if, a) after-hours care was available to them, b) they could have found a bulk billing practice, and/or, c)  could have afforded gap payments. 

Rightly, Mrs Maisey continued ‘to remind everyone to support us by saving emergency departments and ambulances for saving lives,’ and directed those with an illness or injury that is not serious or life-threatening to call Healthdirect Australia for a 24-hour telephone health advice.

The next question is whether that alternative is properly filling the gap. There are two ways to answer, the first depending on whether you’re a federal politician or a state one, i.e. which jurisdiction picks up the tab. The other is whether you’re a patient. To my knowledge, minimal customer satisfaction feedback has been sought, or at least, publicised, about the Healthdirect experience. 

Hospital-wise, the relatively new kid on the block, Byron Central Hospital, with 5,304 ED attendances, outstripped Ballina, which recorded 4,440. No doubt it parallels the Ballina Byron Gateway Airport traffic – more people heading off to “the Bay”.

The figures seem a lot for three months, but Grafton Base had 6,942 (presentations, not individual people) through its ED, surpassed locally by Lismore Base with 9,931. 

The numerical winner, not surprisingly, was The Tweed Hospital, due to move to a new site early next year, which registered 13,846 ED attendances. Located in a population growth spot, with a regular clientele from across the Queensland border, TTH recorded 80.6 per cent of ED patients starting their treatment on time (NSW average: 61.1 per cent).

It was also noted that 70.2 percent of patients exited within four hours of arriving, which is good news when you need to attend a place where you perhaps shouldn’t be, and don’t necessarily know whether it is performing well, even if it is indeed performing.