Victoria's Hospital Crisis Leaves Patients Waiting

More than half of Victoria’s emergency department patients wait over four hours for treatment. Ambulances can sit outside hospitals for hours, patients still on their stretchers. At least 10 to 15 ambulances are ramped outside hospitals on any night, Victorian Ambulance Union acting secretary Olga Bartasek said. “Paramedics are being told they’re not going to be able to get their patient off the stretcher for anywhere between two and eight hours.”

The delay falls on patients, paramedics and hospital staff, while the health system’s institutions make decisions about beds, staffing and care pathways. At St Vincent’s Hospital in Melbourne, emergency physician Dr Joanne Henry said staff saw 150 to 160 patients each shift, compared with about 100 a day in past years. Every crowded waiting room has a human face.

The cost of waiting

A woman in her 80s arrived at St Vincent’s with signs of heart failure. Staff gave her oxygen, treated her and transferred her to intensive care. Nearby, a young man who had taken methylamphetamine, commonly known as ice, and GHB had life-threatening metabolic acidosis. Dr Rex Gavan told him, “Just try and relax, mate,” and, “It’s OK. You’re all right, mate. You’re in the emergency department.”

Between January and October this year, St Vincent’s treated 43,171 patients, more than 1,400 above the same period in 2024. The Australasian College of Emergency Medicine warned that frail, elderly patients were left in corridors to deteriorate as they waited for beds. Associate Professor Mark Putland, the college’s Victorian branch chair, said the state’s health system was at a tipping point.

The Victorian Agency for Health Information reported that more than half of patients waited over four hours for emergency treatment. Between April and June this year, 3,786 people spent longer than 24 hours in an emergency department, up from 3,336 in the previous quarter. Australian Medical Association Victoria president Simon Judkins said hospitals were treating patients who needed urgent care in corridors because they lacked beds.

At Austin Hospital, staff treated more than 300 patients in one day, the highest daily number reported there since the thunderstorm asthma event that killed 10 Victorians a decade ago. Some patients went to nearby Warringal Private Hospital and paid hundreds of dollars to be seen sooner. Its staff treated almost twice their usual number of patients. When public capacity runs short, people needing care can pay the price.

Promises from the top

The Victorian government said it would unveil a $1.5 billion plan on Sunday to cut emergency department waiting times by up to 20 per cent. If re-elected, it would expand 12 hospital emergency departments by 25 per cent, including Melbourne’s Alfred Hospital, the state’s major trauma centre. The plan calls for 1,500 health workers, including 750 more nurses, and 250 additional beds over the next four years.

Those promises depend on re-election. The strain is already clear in the figures: in September, The Age reported that 20 emergency beds at the Royal Children’s Hospital would stay unused after a redevelopment scheduled for completion in November because of staffing shortages. The government later committed an additional $66 million to staff the beds.

The Coalition offered its own election pledges: more beds, upgrades including at Mildura Base Public Hospital, and 24-hour Protective Services Officers in emergency departments. It also pledged $1.27 billion to halve the public elective surgery waitlist by transferring thousands of public hospital patients to private hospitals. The proposal sends public patients into private facilities; it doesn’t erase the waiting list or the crowded public departments staff describe.

A system stretched at every door

St Vincent’s director of emergency services Dr Jonty Karro said delays also arise when patients need residential aged care or National Disability Insurance Scheme support before they can leave hospital. “You can’t get people out of the hospital until they have somewhere to go,” he said. St Vincent’s and Austin hospitals have geriatrician teams who work with emergency clinicians to assess older patients and direct them to homes, aged-care facilities or rehabilitation.

At Austin, associate nurse unit manager Ellen Bradbury said she had not seen the department so stretched in her 15-year career. “Most days, we don’t even have time to get to the toilet or take breaks.” She said some patients couldn’t afford to see a GP, contributing to longer waits and emergency department stays. The hospital introduced a dedicated ambulance offload area to shorten paramedics’ wait and give patients a quieter place to wait for assessment.

Dr Jocelyn Howell said Austin’s patient surge was about 20 per cent above a typical day and involved more seriously ill and complex patients. “Our patients are so much more complex, they have a much higher acuity, and they are taking us much longer to deal with,” she said. At St Vincent’s, Karro described people arriving in “absolute crisis.” Institutions offer plans and new processes; people waiting, working through shifts without breaks and paying privately when they can face the shortage now.