Current projections of the growing burden on NSW public hospitals may be underestimated, the Australian Medical Association has warned before Tuesday's state budget announcement.
Hospital emergency departments have had a record increase in presentations, with 672,000 visits between January and March 2016, the Bureau of Health Information reported.
The data also shows a 10 per cent increase in triage category 1 (immediately life-threatening) cases from the previous quarter.
The jump was cause for concern, as Triage 1 cases usually increase like clockwork by just 1 or 2 per cent quarter on quarter, Australian Medical Association NSW branch president Brad Frankum said.
"It is alarming and surprising. Certainly if this is a sustained rise it will place a lot of extra pressure on emergency departments. Time will tell," Professor Frankum said.
Though triage 1 and triage 2 (imminently life-threatening) cases make up just 13 per cent on all emergency presentations, Prof Frankum said the sudden increase could be a warning sign that current projections of rising demand on hospital services are underestimated.
"The numbers look small but these patients require an enormous amount of resources," he said.
"If this trend continues, not only will we have more presentations, but more presentations of sicker patients, which will inevitably put pressure on the whole hospital.
"Sicker patients require more services, more high-end, intensive care, emergency surgeries that could potentially divert resources that could make dealing with other patients harder as well," he said.
Funding uncertainty from the federal government in the coming decades will put further strain on state government coffers to meet the rising demand on the health system.
A three-year interim measure separates the hospital system from an impending funding black hole of more than $50 billion nationally during the next decade, after both major federal parties failed to deliver a plan to help ease the burden of rising hospital bills beyond the next term of government.
Elective-surgery wait lists had ballooned to a record 74,351 patients, the BHI report found, and ABS figures released in 2015 showed the number of available beds in NSW public hospitals was decreasing compared with the size of the population.
Health funding has floated near 27-28 per cent of the total state budget during the past decade, with every treasurer increasing funding just over 5 per cent every year.
But the 2014-15 budget paper cited the growth in health costs was about 6 per cent, suggesting the current level of funding growth won't keep up with the rise in health costs.
Health economists have suggested anything less than an increase of 7 per cent would be a cut in real terms, taking into account the growing population, the so-called grey tide of ageing Australians, wage increases and the cost of new medical technologies.
Health economist Stephen Duckett at the Grattan Institute said the budget would need to meet growth during the next five years and outline strategies to try to reduce the demand on hospital services.
Allocating funding for hospital redevelopment, such as Westmead hospital's planned $100 million allocation in the next budget, will be accompanied by appropriate funding for staffing and other resources, Dr Duckett said.
"[Treasury] have to be guaranteeing with the money they are putting into capital they are budgeting for the recurrent expenditure of operating the facilities," he said.
"They also need to make sure they are meeting the demands of new medical technologies and IT and so on."
Beyond hospital funding, the budget needs to allocate funding to support primary care, treating chronic illness in the community, and dental services to keep people out of hospitals, he said.
NSW Health said performance in the state's public hospitals remained stable despite the increasing numbers of people attending emergency departments every year.
The time-to-treatment performance was better than the national average in all triage categories, and NSW was the only state to meet the target for all triage categories, a spokesperson said.
Mental health funding boost
The NSW government will invest $1.8 billion in mental health funding in the 2016-17 budget, an increase of $106 million on last year.
The budget will support the government's decade-long mental health reform to better shift the balance from hospital to community-based care, so that people with a mental illness can live well.
Minister for Mental Health Pru Goward said NSW is reforming mental health to build a world-class, community-based mental healthcare system.
"The new investment in this year's budget continues to support the delivery of inpatient services and includes a focus on community mental health, supporting young people and suicide prevention," Ms Goward said.
