Elective surgery backlog 'serious'

Tuesday, 17 August 2021

Elective surgery backlog 'serious'
A significant number of patients are waiting for elective surgery, 18 months after the first COVID-19
enforced shut down of procedures. It will be some time before the backlog can be addressed, says
Australian Private Hospitals Association CEO Michael Roff.

"We estimated there were 340,000 episodes of care "missing" from private hospitals in 2020. Taking into
account the six months to the end of June, we now estimate that figure has fallen to 290,000, but it will still
take a considerable amount of time to work through these cases.

"This is a serious situation for those affected patients and the healthcare system. These are surgeries and
other treatments that have been deferred but they will need to be done at some stage and include
procedures like total knee and hip replacements or cataract surgery that impact a patient's ability to move
around or to see," he said.

The latest data released today by the Australian Prudential Regulation Authority (APRA) shows there were
978,797 episodes of care in private hospitals during the three months to the end of June. This is more than
the previous quarter but will still not make up the gaps in health care need created by the various
lockdowns around the country.

The data also shows a 0.1 percentage point increase in private health insurance membership in the
quarter, and year-on-year data shows an increase with an additional 245,189 people with hospital cover
compared with 30 June 2020. It is encouraging that more people will have access to private hospitals so we
can address the surgery backlog when the COVID situation settles.

The APRA data shows funds held over by private health insurers to fund elective surgery that could not
take place during the pandemic – deferred claims liability – stands at $1.4 billion. Private health insurers
have not made good on their promise to return these funds to members – only $400 million has been
handed back in this quarter.

"This inaction on the part of insurers needs to be addressed. The Australian Competition and Consumer
Commission has suggested* these 'deferred claims' which have not been used to address the elective
surgery backlog should be taken into consideration when the Health Minister considers premium increases.

"The APRA report indicates health insurers doubled their profit to $1.5 billion in the 12 months to the end of
June. Therefore, the Minister should look very closely at any insurer trying to increase their premiums while
still holding onto large amounts of their member's money in the form of deferred claims," Mr Roff said.

-ENDS*ACCC report to the Australian Senate July 2019-June2020
Media contact: Frith Rayner, Director Communications and Marketing, 0413 971 999
Level 3 /11 National Circ, Barton ACT 2600. PO Box 4502, Kingston ACT 2604. [T] 02 6273 9000 [F] 02 6273 7000
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