The NSW government spent $74 million over four years on private hospitals doing elective surgeries for the public sector in the Hunter New England Health district.
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The money was spent to reduce the elective surgery backlog, which ballooned in the pandemic when services were suspended with resources directed to fight COVID.
The funding, issued through the government's "collaborative care" program, ended on December 31 last year.
But doctors say "significant issues" remain in completing urgent and non-urgent surgeries in the public system.
Data obtained through GIPA showed that 8620 surgeries were done in the Hunter New England Health district from January 2020 to December 2023, under the program.
The surgeries were done at 14 private hospitals, including Newcastle, Lingard, Lake Macquarie, Charlestown, Warners Bay, Maitland and Hunter Valley.
AMA NSW president Michael Bonning said the program "was needed during the pandemic and in the immediate period following".
"But there should now be a return to this work being done in the public hospital system whenever possible," Dr Bonning said.
Dr Bonning said the NSW government "must adequately fund public hospitals to ensure timely access" to surgery.
He said AMA members stated that "there are significant access issues across the state for doctors seeking to undertake urgent and non-urgent surgery".
Australian Private Hospitals Association chief executive Michael Roff said private hospitals "stepped up" to help the "overstretched public system" during the pandemic.
Mr Roff said there was "still the capacity and willingness in the private sector" to do surgeries for the public system.
"Private hospitals have supported the public system by performing elective surgeries for many years," he said. "With public surgery waiting lists continuing to grow, it makes sense to use the capacity in the private sector. The current negotiations for a new National Health Reform Agreement provide an opportunity for new thinking about how this might work."
He proposed a system where public patients not treated "within the clinically appropriate time" would be entitled to treatment in a private hospital at the state's expense.
A Hunter New England Health spokesperson said the collaborative care contract was a "temporary arrangement put in place to catch up on wait lists, following the pause on elective surgeries during the pandemic".
"Since collaborative care ceased, we've focused on bringing this care back into our own facilities," the spokesperson said.
"We also continue to look at strategies to improve the overall surgical wait list, including streamlining and auditing where possible to improve access to timely care."
This issue has been a controversial one in the Hunter. Surgeons alleged in 2022 that they had been directed to change patients' clinical urgency categories to meet NSW Health's elective surgery benchmarks.
Michael DiRienzo resigned as Hunter New England Health chief executive in February last year. Two months later, Tracey McCosker was appointed to the role.
In a submission last November to the special commission of inquiry into healthcare funding in NSW, Ms McCosker said the collaborative care program had an "unintended consequence". She said workforce issues were "exacerbated by increasing private sector services, leading specialists to prefer private over public employment".
"As a result, we are finding it difficult to recommence elective surgery at our full internal capacity now that collaborative care will end on December 31, 2023."
The HNEH spokesperson said the most recent Bureau of Health Information data for the October to December quarter showed "significant improvements in completing planned surgeries".
It said the district had cut "the overdue wait list by 67.1 per cent", compared to the same quarter in the previous year and had performed "more planned surgeries on time".
"Our district saw an 8.9 per cent increase overall in planned surgeries performed during the quarter, totalling 7210."
The data showed 383 patients in the district had been waiting for surgery longer than recommended, down from a high of 1245 in the pandemic.
And 10,849 patients overall were on waiting lists for surgery in Hunter New England, falling from 12,936 patients at the height of the pandemic.
The government said NSW's overdue planned surgery wait list had been "reduced by 85 per cent" since its surgical care taskforce was established in March last year.
Health Minister Ryan Park said the taskforce was "one of the first things we did after coming into government".
"We've seen a remarkable turnaround," Mr Park said. "There are close to 12,000 less people awaiting an overdue planned procedure. None of this progress would be possible without the dedicated efforts of our clinicians and healthcare workers."
Dr Bonning said work on the elective surgery issue was "well advanced before the establishment of the taskforce".
