AMA is Calling to Unlock the Public Hospital Logjam

The Concerning Outlook on the Public System

Australia’s public hospital system is facing a crisis that can no longer be ignored. Chronic underfunding by federal, state, and territory governments has steadily eroded hospital performance, resulting in dangerous delays, unacceptable patient outcomes, and widespread system strain. Every day, the unfortunate reality is that Australians are dying while waiting for treatment. Patients requiring essential surgeries endure years on waiting lists, ambulances are ramped outside overwhelmed hospitals, and exhausted staff work in increasingly unsafe conditions.

The most recent Australian Medical Association (AMA) Public Hospital Report Card highlights the scale of the issue. Only 61 percent of patients requiring urgent attention in emergency departments are seen within the clinically recommended 30 minutes. 40 percent of patients spend more than four hours waiting in emergency departments, while only 71 percent of Category 2 surgical patients are treated within the recommended 90 days. These figures represent an alarming deterioration over just a few short years. Category 2 procedures — such as heart valve replacements — are not elective luxuries; they are essential, life-preserving interventions.

While there has been some short-term progress, with slight improvements in emergency triage and an increase in the number of available public hospital beds, the overall trajectory remains grim. Compared to five years ago, performance across almost every metric has worsened markedly. Australia’s population continues to grow and age, placing even more pressure on a system already struggling to meet basic demand. The number of available hospital beds per 1,000 Australians over the age of 65 has plummeted to 14.3 — less than half the capacity available in the early 1990s. Without decisive investment and reform, hospital crowding, ambulance ramping, surgical waitlists, and staff burnout will only worsen.

However, it’s worth noting that the problem is not simply about resources; it is also about the structure of hospital funding itself. The current model, largely based on the number of procedures performed, is no longer fit for purpose. It fails to account for the ageing population, the growing burden of chronic disease, and the urgent need to invest in prevention and community-based alternatives to hospital care.

AMA Funding Solution to our Hospital Crisis

The AMA has proposed a comprehensive four-point plan to address the crisis. First, the government must reintroduce funding for performance improvement initiatives that actively reverse the decline in hospital standards. Tying funding to measurable improvements in elective surgery waiting times and emergency department performance is essential if we are to restore public confidence in our health system. Second, hospital capacity must expand significantly. This requires not only more beds but also the appropriate staffing levels needed to support them, ensuring that hospitals can meet both everyday demand and surge requirements during periods of crisis.

Third, there must be real investment in community-based alternatives to hospital care. Many patients currently occupying hospital beds could be better cared for through preventative programs, chronic disease management, or coordinated general practice support. Funding and scaling up these alternatives will ease the burden on hospitals while delivering better patient outcomes. Finally, governments must commit to a new National Health Reform Agreement that provides significantly increased matched funding from both federal and state levels. The AMA’s detailed model calls for an additional $12.5 billion in federal investment and $15.3 billion from state and territory governments between 2025–26 and 2028–29.

The Outlook without Change

The consequences of failing to act are stark. If we do nothing, the number of hospital beds relative to population size will continue to decline, admissions and emergency presentations will grow, and waitlists for elective surgery will balloon. Emergency departments will become more overcrowded, ambulance ramping will escalate, and staffing shortages will intensify. Patients will wait even longer for life-saving treatments, while healthcare workers will continue to suffer unsustainable levels of burnout. As they say, “we’ve seen this movie before”, and know all too well that when the unthinkable burnout consumes our front-line, we won’t have the resources to get them back on their feet when they need it most. 

Local Change Brings Federal Backing

In the face of this, doctors across Australia have an essential role to play. Advocacy must become part of our professional responsibility. Medical professionals are uniquely placed to speak with authority about what is happening inside our hospitals. Sharing the realities — respectfully, but honestly — with patients, the media, and politicians can help build the public and political will for change.

Doctors should also actively engage with professional organisations like the AMA that are leading the push for reform. Supporting campaigns, signing open letters, participating in advocacy initiatives, and attending public forums will strengthen the collective voice calling for action. Within hospitals, clinicians can contribute by championing innovations that improve patient flow, supporting models of out-of-hospital care, and participating in data collection that documents unmet needs and system pressures.

There is also a crucial educational role for doctors to play in the community. Many Australians remain unaware of the crisis facing their health system. By helping patients and families understand the connection between funding, wait times, staffing shortages, and health outcomes, doctors can drive grassroots demand for reform.

Finally, in the lead-up to the federal election, doctors — and the broader healthcare community — must vote with health at the forefront of their minds. Political leaders must be held accountable for the health policy platforms they present. Our votes, our voices, and our stories have the power to shape national priorities.

Australia’s public hospitals are a vital cornerstone of our society. They are meant to guarantee that every person, regardless of wealth, has access to essential healthcare. That promise is now at risk. But there is an opportunity before us to change course. The new National Health Reform Agreement can lay the foundation for a stronger, more equitable, and more resilient hospital system — but only if we fight for it.

The AMA has provided a clear roadmap, read about this and find out more here:
https://www.ama.com.au/clear-the-hospital-logjam