Today’s article in The Age- "Trapped and dying: Victoria’s worst hospital for emergency department waits" - is confronting and deeply concerning. However, we must be clear: the blame does not lie with dedicated emergency department (ED) staff who continue to do everything they can under immense pressure.
This is a system-wide crisis, not an ED problem. It’s important to distinguish between the symptoms- dangerously long waits and patient distress- and the underlying causes: chronic underfunding, understaffing, and inadequate capacity, particularly impacting rural and regional Victorian hospitals.
AMA Victoria strongly believes that such headlines risk obscuring the true story. ED clinicians and staff are not responsible for hospital bed shortages, ambulance ramping, or inadequate patient flow beyond their departments. Yet, they suffer moral injury and significant personal distress when the system fails their patients and communities.
The real issue is access block- the systemic failure to move patients from emergency departments into appropriate inpatient care within a reasonable timeframe. This is not a new problem. It has affected Victorian hospitals for decades and remains a persistent barrier to timely, safe care. Our recent submission to the Victorian Parliamentary Inquiry into Ambulance Services reinforced this message: ambulance ramping, ED overcrowding, and excessive wait times are all interconnected symptoms of a broader health system under strain. The inability to admit patients from the ED into hospital wards is not just a logistical issue. It reflects deep structural pressures on hospital capacity, workforce, and system coordination.
The AMA has consistently advocated for clear, evidence-based solutions. These include a sustained and strategic increase in public hospital bed numbers, supported by the workforce required to staff them. We need better workforce planning, rural and regional incentives, safer conditions, and meaningful steps to retain and attract healthcare professionals. Investment must also extend beyond hospital walls: strengthening general practice, expanding community-based services, improving aged care access, and resourcing mental health and disability support are all essential to reducing unnecessary pressure on emergency departments.
It is also worth emphasising that regional hospitals continue to fall well behind when it comes to investment in IT infrastructure. Many still rely on paper records and fax-based communication, which contributes to significant delays and inefficiencies, prolonging patient stays and delaying access to care. Closing this digital gap is essential to improving system performance and patient flow.
Dr Simon Judkins, AMA Victoria’s new President, and himself a regional Emergency Medicine Director, has identified tackling access block and hospital overcrowding as core priorities. Simon knows firsthand the strain placed on regional hospitals, where staffing gaps are harder to fill, transfer options are fewer, and communities are more vulnerable when the system fails.
This issue isn’t new. The solutions aren’t mysterious. We know what needs to be done- the missing piece is consistent government commitment and funding to address underlying structural issues in Victoria’s health system.
AMA Victoria stands with our ED colleagues, especially those in rural and regional areas, and calls on the Victorian Government to move beyond rhetoric and commit to real, long-term investment to finally break the hospital logjam.