Modern Australian

Private hospitals get grace period before freeze on non-urgent elective surgery

  • Written by Michelle Grattan, Professorial Fellow, University of Canberra

National cabinet on Wednesday night decided to extend the deadline for the suspension of non-urgent elective surgery undertaken at private hospitals.

Earlier in the day Scott Morrison announced the suspension, that applies to both public and private hospitals and is designed to free up resources as hospitals prepare to deal with the full impact of COVID-19.

The measure, which covers only category 1 and some “exceptional” category 2 surgery would be apply “until further notice”.

It was originally to come into force on Wednesday night but the private hospitals are getting another week before the cut off date.

Patients awaiting elective surgery are placed by their doctor in one of three categories

  • Category 1 – Needing treatment within 30 days. Has the potential to deteriorate quickly to the point where the patient’s situation may become an emergency

  • Category 2 – Needing treatment within 90 days. Their condition causes pain, dysfunction or disability. Unlikely to deteriorate quickly and unlikely to become an emergency

  • Category 3 – Needing treatment at some point in the next year. Their condition causes pain, dysfunction or disability. Unlikely to deteriorate quickly.

Morrison said cancelling some elective surgery would “preserve resources including protective equipment” to help both public and private health services for COVED-19.

He said this had “already largely been implemented for category 1 and category 2 and what this means is a further scaling back of those elective surgeries in Category 2.”

Australian Medical Association president Tony Bartone said the AMA supported the ban. “Doctors will ensure that patients who have their surgery delayed are looked after and given the best medical advice.”

The national cabinet on Wednesday night also agreed to widen the criteria for eligibility for COVID-19 testing.*

Meanwhile, Victorian premier Daniel Andrews warned there would be a “stage three” of the response to the virus – after the national cabinet on Tuesday agreed to further shut downs - although he said we were not there yet.

Andrews reiterated it was vital people follow the health and social distancing advice. He said the Centrelink queues were heartbreaking but “what we don’t want is queues for people who need a machine to help them breathe.

"We cannot have people queuing for intensive care beds – that will mean they will die,” he said.

“If we have a situation where this virus fundamentally gets away from us, we will have thousands of people who will only survive if they can breathe with the assistance of a machine.

"And we will not have enough machines, nurses and doctors to provide that care. I’m not sure whether I could make it any clearer than that. If you need further evidence, turn on your TV. Have a look what’s going on in Italy.”

Morrison has also formed a COVID-19 Co-ordination Commission to advise on cushioning the virus’s economic impact, bringing together efforts to mitigate the effects.

Morrison said: “This is about working cooperatively across private-to-private and public-to-private networks to unlock resources, break bottlenecks and fix problems so Australian families, businesses and communities are supported through the challenging months ahead.”

It will be headed by Neville Power, former CEO of Fortescue Metals Group, with a board of commissioners with backgrounds in business, government, and the not-for-profit sector.

They include former Labor minister Greg Combet, former secretary of the health department Jane Halton, former managing director of Toll Holdings Paul Little, EnergyAustralia managing director Catherine Tanna and former Telstra CEO David Thodey (deputy chair), who headed the recent inquiry into the federal public service. Representation from the not-for-profit sector is yet to be announced.

The secretaries of the Prime Minister’s department (Phil Gaetjens) and Home Affairs (Mike Pezzullo) are also on the commission.

Morrison said the commission was “about mobilising a whole-of-society and whole-of-economy effort”.

He told a news conference he had rung Power and “I simply said, Nev, I need you to serve your country”.

Morrison admitted what he has been reluctant to say before – that there are differences in the national cabinet. Stressing its fundamental unity, he said, “Sure, there may be the odd time where there might be a bit of difference at the edge. But I can tell you in my entire working life, in public life, I have never seen the states and territories work together like they are working together right now.

"It is all of our preference to keep that consistency and common action together as much as is possible. But we also need to recognise that in some places, states and territories are in different situations to other parts of the country.” He instanced the Northern Territory, with its remote communities.

It has been NSW and Victoria which have been the most forward-leaning on issues, notably schools.

NSW on Wednesday announced tough action to crack down on “reckless social gatherings”.

Police will be able to issue $1,000 on-the-spot fines for individuals and $5,000 for corporations that do not comply with ministerial directions. For example if a person organised or took part in a bootcamp of more than the permitted ten people they could be fined.

Police will no longer need a warrant to arrest someone breaching a public health order. This follows NSW legislation to increase police powers passed Tuesday.

National Cabinet agreed to an Australian Health Principal Protection Committee (AHPPC) recommendation to expand the current coronavirus testing criteria to include testing people with fever or acute respiratory infection in:

1. all health workers

2. all aged/residential care workers

3. geographically localised areas where there is elevated risk of community transmission as defined by the local public health unit

4. where no community transmission is occurring, high risk settings where there are two or more plausibly-linked cases, for example:

- aged and residential care

- rural and remote Aboriginal and Torres Strait Islander communities

- detention centres/correctional facilities

- boarding schools

- military bases (including Navy ships) that have live-in accommodation.

Authors: Michelle Grattan, Professorial Fellow, University of Canberra

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