The stress on NSW hospitals is real, and should be taken seriously

Going to hospital isn’t exactly anyone’s idea of a good time. But the idea of seeking care while ill or injured only to find those treating you are harried, overworked, stressed and at greater risk of making medical errors will fill many with dread.

This is increasingly the case for patients at NSW hospitals. Bed block is widespread, and the latest Bureau of Health Information data revealed on Wednesday that hospitals are failing new wait-time targets set by the state government in the face of a record number of patients needing emergency and urgent medical care.

While the statewide picture is grim, health editor Kate Aubusson reveals that alarm bells are sounding loudly at one of the most controversial institutions: the Northern Beaches Hospital.

Emergency department and wards are described as chronically under-resourced, and clinicians have accused SafeWork NSW of failing to act on repeated warnings over unsafe workloads for junior doctors. They have sent a list of concerning incidents, from surgical and medical consults going unanswered for days, to registrars working unsupervised, falsified rosters and more than 100 electronic tasks – some of them time-critical – that were uncompleted by the end of the shift.

Understaffing is not unique to Northern Beaches Hospital, as Wednesday’s data showed one in three emergency department patients waited too long for treatment. There were some bright spots in Wednesday’s data, such as they are. More ED patients started treatment on time (65.7 per cent – up 2 percentage points from the same quarter in 2024), and there was less ambulance ramping – 79.3 per cent of patients were transferred from paramedics to ED staff within 30 minutes.

But Northern Beaches Hospital has been a problem since before its doors opened, and the flawed public-private partnership model it operates under has led to constant friction among staff, its operator Healthscope, and the government. The controversy reached its zenith with the high-profile deaths of two young children.

Add to the mix that Healthscope’s parent entities are in receivership, there have been pay disputes for public sector doctors, nurses and psychiatrists, and the government has left the door open to taking over the entire hospital. Combined, this is a recipe not only for a never-ending game of passing the blame, but also a potential disaster for patients.

The Australian Salaried Medical Officers Federation NSW has warned that extreme fatigue among registrars, often working without the appropriate oversight of senior specialists, has created “high-risk lone worker scenarios” and “elevated risk of clinical error”.

The hospital’s Medical Staff Council president, ASMOF member Dr Keith Burgess, said junior doctors were carrying the worst of the burden but stressed that the bulk of the risk was not life-threatening. Instead, the greater risk was patients were receiving suboptimal care.

“This is a good hospital doing good work on the sweat of the staff going above and beyond what they have to do in a public system,” Burgess said.

But the warning is real, and one that should be taken seriously.

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