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In preparing the report we have visited over one dozen metropolitan and non-metropolitan public hospitals to speak with a full range of hospital personnel including senior managers and administrators, senior clinical staff, registrars and hospital waiting list booking staff. During these visits hospital staff gave willingly of their time to relate to us the way in which their hospital managed waiting lists. Moreover, we put the recent allegations about waiting list manipulation to hospital staff and sought their responses.

We were also fortunate to have had the benefit of the comprehensive information gathered for the Clinical Categorisation Project, chaired by Mr Brian Collopy AM, which was of great assistance.

In summary we found no evidence that urgent patients are being denied access to public hospitals due to waiting list manipulation or any other reason. In fact hospitals have rightly focussed their attention on patients with the highest clinical priority despite the pressures of an increasing workload.

The Panel believes that some instances of inappropriate recategorisation from Category Two (semi-urgent ) to Category Three (non-urgent) have occurred. This is sporadic and infrequent and the Panel found no evidence of systematic gaming.

Hospitals and their medical and nursing staff have been coping admirably but with difficulty under increasing cost and demand pressures. More and more patients require admission in the public system for reasons including an ageing population, declining rates of private health insurance coverage and natural demand growth. The medical staff we interviewed were strongly of the view that there are currently insufficient resources to meet the clinical demands placed upon the system.

The increasing demands on hospitals have driven a number of changes in clinical surgical practice. These changes affect undergraduate and postgraduate medical education and have important implications for the future. The role of hospitals in medical education must therefore be urgently addressed.

Staff need to be rewarded with a new and more positive bonus scheme which takes the increasing workload into account.

The Review also makes some significant recommendations to address the need for better communication at all levels, and in particular with patients on waiting lists.

We are satisfied that the findings in our report satisfactorily address the terms of reference, and trust that our recommendations are seen as being constructive and achievable.