Doctors and nurses are warning that Australia's healthcare system is buckling under the pressure of record levels of COVID-19 hospitalisations, staffing shortages and long-term funding issues.
Australia made international headlines this week as COVID-19 hospitalisations hit record highs on Monday with 5,433 cases, eclipsing the 25 January record of 5,390 people.
As of Wednesday, there were 5,571 people in hospital with COVID-19, including 165 in intensive care units.
Gabriel Blecher is deputy director of emergency medicine at Monash Health in Melbourne and has seen first-hand the impact of COVID-19 on the hospital system as an emergency physician.
'Nurses are leaving us faster than we can hire'
"I think a lot of people are unaware of how bad it is until they actually need to seek care," Dr Blecher told SBS News.
"There doesn't seem to be an uproar amongst the general public because it's a small proportion that seek help and suffer all the problems of the system.
"Until they come into an emergency department, or are trying to make an appointment with anyone, or call an ambulance, they wouldn't realise how bad things are."
Dr Blecher said healthcare workers are struggling and "sick of working in hospitals".
"Nurses are leaving us faster than we can hire,” he said.
“Every area in the hospital we've got deficits. We're funded for however many people and we can't recruit up to that number … There aren't enough doctors and nurses or allied health … there's a shortage everywhere.”
ANMF Tasmania secretary Emily Shepherd. Source: SBS News / Sarah Maunder
Emily Shepherd, secretary of the Australian Nursing and Midwifery Federation's (ANMF) Tasmanian branch, said nurses had been "extremely patient over the two years of the COVID-19 pandemic, working at 200 per cent with inadequate resources".
She said the strike had "sent a message to the government" that it's time "to provide nurses and midwives with the staff and resourcing that they need to be able to provide safer quality care".
Gordon, a registered nurse at Royal Hobart Hospital, said "nurses shouldn't have to come to work and be forced to work 18-hour shifts because there aren't enough nurses to safely staff our ward".
"I think that the COVID pandemic has escalated and made those things, made the situation a bit worse, but those things have been happening for years," he said.
"And I think it is really important that we come out here today, we've got to do something differently because the government isn't listening. It's not trying to fix our health system effectively."
Gordon says COVID-19 has exacerbated long-term issues with the hospital system. Source: SBS News / Sarah Maunder
Shortage of overseas workers
Hospitals are “competing for a limited number of staff”, and Dr Blecher said a shortage of overseas workers wasn't helping.
“A lot of other countries have a lot of overseas staff, we haven't been doing that much. In the medical field, we used to have lots of UK and Irish doctors come over and work and that's been cut right back because of lack of travel availability,” he said.
“So everyone's burnt out. No-one's feeling great and rested and energetic and happy, to be honest.”
Following the election in May, the Australian government announced a to address the “enormous burden” on health services.
“We need to replenish our health and aged care workforce, ensuring we are identifying, training and recruiting doctors and nurses for Australia,” the government said.
The package focuses on three main areas including, supporting workers, “expanding Australian capacity”, and “expanding the overseas-trained healthcare workforce”.
Dr Blecher said the package is “absolutely not” sufficient to address the current and long-term problems with Australia’s healthcare system.
“The whole system needs to be redesigned. You can't just put a few more doctors or nurses into the system ... it simply won’t fix the problem,” he said.
Record COVID-19 hospitalisations are simply the “straw that broke the camel’s back” of a healthcare system that has been in disrepair for years, he said.
“The health system has not been in a good way for years … and it’s just getting worse and worse in terms of care needs going up, ageing population, more people needing health care, and not really anything being put into place to deal with that,” he said.
“There's a lack of investment over the last few decades really.”
SBS News has contacted the federal Department of Health for comment.
Hospitals face COVID-19 ‘marathon’ as winter bites
This winter is proving an especially challenging time for the healthcare system with more staff off work due to both COVID-19 and flu, coupled with record levels of COVID-19 hospitalisations.
Australia’s hospitals are enduring a “long period of intense pressure” due to COVID-19, resulting in “staff that haven't had enough downtime in order to survive”, Deakin University epidemiologist Catherine Bennett said.
“It means that winter is a much more difficult time to deal with, and it's going to be almost impossible if we're going to continue to have high rates over winter,” Professor Bennett said.
I think that's the real challenge that this is, you know, operating as a sprint, when we're in something that's much more like a marathon.Catherine Bennett
Creating a “surge” workforce to deal with staff shortages and record hospitalisations is difficult “in a system that's clearly under pressure”, she said.
Building surge capacity through measures such as delaying elective surgery brings its own issues.
“That then leaves you with a catch up on your elective surgery, which if you don't have a real downtime after a wave, then you're trying to catch up in a time where it's really not that different from where you were a month or two ago, and you're doing that catch-up and then you're into the next wave before you you really get back on, and maybe even deferring surgery again, as we are seeing in some settings,” Professor Bennett said.
“So I think that's the real challenge that this is, you know, operating as a sprint, when we're in something that's much more like a marathon.”
Whether or not Australia will continue to see high levels of COVID-19 hospitalisations each winter remains to be seen, Professor Bennett said.
“We may not need long-term solutions that cater for that level of [COVID-19] exposure, it might be that this does contract, and we don't see anything quite the same by the time we get to next winter. But it's really hard to know how you build a [healthcare staff] surge capacity,” she said.
Short-term solutions include encouraging recently-retired healthcare workers to return to work, as well as recruiting overseas workers, Professor Bennett said.
The risk of losing qualified healthcare workers due to burnout is a long-term threat to Australia’s healthcare system, she added.
