More than a third of patients in five of Sydney's major hospitals are failing to be treated in emergency departments within four hours, new figures show.
Despite huge improvements in waiting times at some hospitals over the past two years, the state has once again failed to meet targets requiring patients to leave emergency on time. And experts say the upcoming $55 billion federal budget cuts to hospital funding combined with new GP co-payments could undermine recent improvements and drive overburdened hospitals backwards.
Australasian College for Emergency Medicine President Anthony Cross said the only way patients could be treated quickly was if the whole hospital was funded and run effectively.
"That means the ambulance system has to work, the emergency department has to work, there has to be adequate aged care and rehabilitation beds," he said. "Despite all the flaws in the four-hour rule it … has clearly focused everyone on ensuring the whole healthcare system is functioning effectively."
Dr Cross said the federal government devolving control of hospitals to the states could make dealing with overcrowding even more difficult, as states tried to fix the same problem in different ways.
AMA President Brian Owler said he suspected the removal of federal incentives to meet targets would only reduce the likelihood of hospitals meeting their benchmarks.
The Bureau of Health Information report released on Thursday shows that from January to March more than 600,000 people visited NSW public hospital emergency departments, a 2 per cent jump compared to the same time last year.
About 73 per cent of patients left emergency departments within four hours, up from 66 per cent last year, but still falling far short of the 81 per cent target.
Liverpool, Westmead and Campbelltown Hospitals were among the worst performers, with almost 40 per cent of patients not completing their emergency stay within the four-hour target.
Health program director at the Grattan Institute, Stephen Duckett, estimated that about 300,000 fewer patients than expected will visit their GP once the co-payment is introduced. ''A proportion of these will decide to visit a NSW emergency department which will further reduce the chance of meeting the targets and could have a significant effect on waiting times.''
Labor health spokesman Andrew McDonald said a combination of the busy winter period and the proposed co-payment could cause a ''collapse to the system''.
The new figures show that while about 97 per cent of people are getting surgery on time, some patients are still waiting more than six months.
Median waiting times for ear, nose and throat surgery are now 153 days. Gynaecology, urology and prostate surgery waits increased between seven to 10 per cent.
''NSW still has the longest waiting times for elective surgery in Australia and close to the longest in developed countries,'' said Dr McDonald. ''A 302-day median wait time for a knee replacement is just unacceptable.''
But Health Minister Jillian Skinner said the public hospital performance has reached record highs, with patients being treated faster than ever despite surging demand. She said although reward funding for reaching targets in 2014 and 2015 has been scrapped from the federal budget, NSW Health will ''ensure elective surgery and emergency department performance continues to improve'' according to benchmarks.