'Everything's on hold': Patients caught in surgery backlog

Some days, Kelly-Ann says she can barely get out of bed, the pain in her face is so bad.

"It's like a constant burning sensation, right through the top of my mouth into my nose … right through my gums," she said.

The nerve damage is the lasting effect of multiple surgeries, some of those delayed, to fix a problem with her jaw.

She is now waiting for elective surgery to help numb that pain, but has been waiting for two years, and has seen further cancellations in that time.

"I've become socially withdrawn, because I can't feel what my mouth's doing, so you know, I don't like to eat in front of people," she said.

"I'm a single mum, I've got two kids, two young kids, and they find it difficult to understand that mum's in pain."

Tasmania's elective surgery waitlist is around 9,500 people long; 57 per cent of people are seen within clinically recommended time frames.

Funding for health will increase year on year in the state budget, rising by 8 per cent over four years, thanks to extra federal money.

However, inflation is forecast at 11 per cent over that same period, resulting in a funding decrease in real-world terms.

And in order to meet its budget, the Health Department will also be required to find $702 million in efficiency cuts over four years.

Health Minister Bridget Archer said the government is investing in the health system, and the efficiencies are about delivering a sustainable health system.

Despite that, parliamentarians and health stakeholders have raised concerns about the impact of the cuts and subsequent service delivery for Tasmanians.

Ms Webb said the health system already is not working for her.

"They've pulled money out, they've put money in — I can't see any improvements anyway,"

she said.

Long wait for crucial results

Penny* had a double mastectomy in early May after finding out she had an aggressive form of breast cancer.

She is still waiting for pathology results to see if the cancer has spread to the rest of her body.

"Pretty … pretty, anxious. I'm very unsure and uncertain,"

she said.

Penny said she had been told the wait for results, which will determine her treatment, could be six to 10 weeks in total.

"I feel like everything's on hold … until I have some level of certainty about what, what the next few months will look like from a medical point of view," she said.

"I don't know the science of it, but I don't think anxiety is probably good for recuperation or, you know, fighting back."

She said she considered sending her samples interstate for testing, and was told the results would take one to two weeks in the New South Wales system.

Penny said having seen the Tasmanian health system close up, she said she was dismayed by the budget's funding for health services.

"It's probably the staff that are going above and beyond that are kind of holding a place together," she said.

"Some of our decision makers need to spend some time in the Royal [Hobart Hospital] and just see where the gaps are and just recognise that it does need more money and resourcing."

The Department of Health said it would not comment on individual cases, but that it understood the frustration that cancelling elective surgery caused for patients.

It also said the department was committed to improving timely access to pathology, and was in the process of recruiting for four additional full-time pathologist positions.

Savings to focus on bureaucracy

Last week, health secretary Dale Webster said the department was "targeting revenue collection", by ensuring it collected money owed from private health insurers or Medicare.

"We have actually employed additional officers … they're specific revenue officers to make sure that we're collecting this revenue," he told a parliamentary committee.

He also pointed to removing "duplication".

"In changing the way we order pharmaceuticals for our pharmacies, we have made $3 million in savings,"

Mr Webster said.

"That is about having different contracts that deliver pharmaceuticals on a just-in-time basis, rather than holding stock ourselves which then expire."

The state budget pointed to decreasing locum and agency costs and a revised executive structure as measures to help meet the $702 million target.

It said the Health Department will be "prioritising frontline services and improving service delivery outcomes".

Mr Webster said there was "unlikely" to be a mass staff lay-off, as the department's high turnover rate meant it could redeploy in areas of need.

Efficiencies must be fed back into system, AMA says

Australian Medical Association Tasmania president Michael Lumsden-Steel said the health system "was no longer working for the Tasmanian population".

He agreed there were efficiencies to be found in the health system and that the bureaucracy had become bloated.

"There's an increasing level of people I call "the clipboard holders" that have essentially been created into positions driven by governance requirements, structural requirements, reporting requirements, or other outcomes from investigations.

He estimated the cost of staff spending time on mandatory training per year was $30 million.

"Where we find efficiencies, that must be put into programs to improve outcomes, and must be put in programs to improve patient access,"

he said.

*Penny's name has been changed for privacy.