Regional emergency departments a 'basket case of mania', doctor warns

Regional emergency departments are overcrowded and risking patient safety, doctors say Mon 10 Aug 2026 at 5:30am In short: The Australian Medical Association says five regional Victorian hospitals are showing signs of system failure, while doctors on the ground say they are at breaking point. Regional Victorians are facing far longer wait times than Melburnians when they go to an emergency department, government hospital data shows. What's next? The state government said it is supporting Victoria's health service with "record investment and new solutions". Victoria's most dysfunctional and dangerous emergency departments are in regional areas, health department data shows. The quarterly statistics on the state's public hospitals include tracking of emergency department (ED) stays 24 hours or longer, an indicator of pressure on hospital resources. There were about 3,300 patients across the state admitted to emergency from January to March this year who stayed there for at least 24 hours. Of these patients, 2,330 patients, or 70 per cent, were in regional and rural hospitals, with the highest numbers in Ballarat, Albury (which services many Victorians) and Bendigo. By comparison, between January and March 2025, 1,900 patients stayed 24 hours or more in Victorian EDs. Of these, 1,300, or 69 per cent, were in regional and rural hospitals. The health department's performance target is zero patients spending more than 24 hours in the ED. A report by the Victorian Auditor-General's Office from 2024 said the health department set that target in 2011, along with a goal of 81 per cent of all emergency patients staying in an ED for four hours or less. The report noted the goal had been "consistently missed" and that in 10 years from 2013 to 2023 there had been a "significant increase in the number of patients exceeding a 24-hour stay". Doctors on the ground in some of the state's worst-performing EDs in regional Victoria say unsustainable levels of pressure on staff are the new normal, and it is affecting patient safety. From today, public hospital doctors statewide are starting industrial action over pay and conditions. In regional Victoria, doctors can choose from a variety of measures such as not responding to work-related emails from hospital management and displaying campaign material as part of the industrial action. Multiple ED staff have spoken to the ABC about their concerns on the condition of anonymity, for fear of losing their jobs. Patients wait 40 hours Ballarat Base Hospital ED doctor David* said patients having to wait more than 40 hours in ED for a bed on the ward "wasn't uncommon". He said it was normal for ED patients to overflow into corridors or unmonitored waiting rooms, where there was a risk they could deteriorate. "I've seen people who have waited in this waiting room then require emergency surgery,"David said. The doctor said he had seen stroke patients being treated in the corridor in full view of others, depriving them of dignity. David said another doctor had told him of a recent incident where an intern assessed a patient as having a headache and gave them pain relief. The patient then suffered a bleed to the brain. "Often because of how busy it is, [senior doctors] don't get to lay eyes on that patient … they're just trusting what is said [by a junior]," David said. "Should the intern have that much pressure to see patients independently? Of course not. "Everyone's doing the best to cope in a system that is like a pressure cooker. "We're understaffed, underfunded." David said he felt "defeated" by his job and was considering leaving medicine. Another Ballarat ED doctor described the emergency department as a "basket case of mania" while yet another ED doctor said management's efforts to address staff burnout in the Ballarat ED were misguided. "We don't need someone to tell us how to identify burnout. We're the literal definition of burnout,"they said. No privacy Kevin Harper has worked in the healthcare industry for more than 40 years, and has visited ED departments regularly with his partner, who has a long-term health condition. Mr Harper said the Ballarat ED has not grown in size to accommodate the growing population. "I heard the senior nurse discussing with one of the triage staff where they could possibly put beds into corridors to make them not just a waiting space, but a treatment space as well," he said. "So you're hearing confidential information being discussed, bloods are being taken, ECGs all in the corridor without any curtains or privacy at all." A Grampians Health spokesperson acknowledged "some patients who require admission to [Ballarat Base] hospital may experience extended waits for an inpatient bed". "The safety of patients and staff is our highest priority," the spokesperson said. "We will never turn anyone away, so when we experience periods of extremely high demand, there may not be a bed or private bay immediately available." The spokesperson said population growth was "contributing to increased demand for healthcare services" and noted that the "pressures" in the Ballarat ED "reflect broader challenges being felt across healthcare systems nationally". "Sustained pressure on the healthcare system can be challenging for our workforce," the spokesperson said. "Supporting our workforce remains a key priority, and we continue to invest in staff wellbeing initiatives and workforce development." 'Who's going to die first?' At Albury Hospital, which treats a lot of Victorians from the state's north-east region, an ED clinician said there was a constant worry about "who's going to die first?". "You're gambling with the next decision that you make," the clinician said. "You can't meet all the needs of everyone who's asking for help and it does feel like a war zone at times. "[There's] definitely a feeling of helplessness. "We're in constant need of beds." It was a similar story at Mildura Base Hospital, according to a clinician who said patients often spent longer than 24 hours in ED. They said it was common to treat patients in chairs and other temporary, non-private areas, and that junior doctors dealt with complex presentations with little or no supervision. "I have enormous respect for the staff who keep trying to make the system work under this immense, sustained pressure," the clinician said. "I do feel like it's getting more and more normalised, the level of strain these staff are getting." An Albury Wodonga Health spokesperson said they recognised "that periods of increased demand place significant pressure on our workforce and would like to acknowledge the dedication, professionalism and resilience of our staff". They said all patients "receive timely, high-quality emergency treatment to minimise time spent waiting". Mildura Base Hospital has been contacted for comment. A complete standstill Warrnambool Base Hospital declared a code yellow from July 27 to 29, meaning the hospital was grappling with a sustained period of high demand. A health worker from the hospital said that during the internal escalation, many patients waited in the emergency department for more than 24 hours. "It was a complete standstill," they said. "There was one patient who had an entire three-day admission in our emergency observation unit. "We usually try and get people out within four hours." The worker said the intensive care unit was full at one point, and nurse-to-patient ratios were not being met. "It's basically luck that nothing horrendous happened," they said. The worker said the influx of patients was partly driven by a lack of doctor availability in the region, with some patients facing wait times of six weeks to see a GP. The lack of available aged care spaces was also a factor, they said. "People can't see GPs in the community to get their health under control, and they don't have nursing home beds to go to at the other end." The worker said they were concerned by the hospital's focus on moving people out of ED, as they believed it prioritised clearing space over patient care. "It starts putting the focus on the wrong thing, because the shift goes from patient care and patient safety to getting people out, which is a dangerous mindset shift," they said. The worker said healthcare staff bore the brunt of the increased demand on regional and rural hospitals, which was coupled with insufficient funding and resources. "It literally breaks [healthcare workers], and that's going to be the next sort of crisis,"they said. South West Healthcare's chief operating officer Alex Demidov rejected the worker's claims. "Patient care was not compromised at any point during the code yellow, our staffing was at full complement, and our intensive care unit operated at mandated nurse-to-patient ratios throughout," he said. Long stays should be a 'never event' Australian Medical Association (AMA) Victoria president Simon Judkins said ED stays of more than 24 hours disproportionately affected regional and rural hospitals, and it was "a real signal [of] a high level of dysfunction". "We don't see 24-hour stays at the Alfred [in Melbourne],"Dr Judkins said. He said an eight-hour stay in an ED was a sign of a system under stress and operating over capacity. "If you extrapolate that out to 24 hours that indicates a highly dysfunctional system," he said. Dr Judkins said the AMA had worked with state and federal governments to classify an ED stay of 24 hours or more as a "never event". "So, we're aiming for zero, and now we've got thousands of patients across the state," he said. Dr Judkins said the lack of places to refer patients in regional areas, such as aged care homes, was exacerbating the ED problem. "That whole system becomes log jammed, the hospital's filled up," Dr Judkins said. "We don't have the beds, and that all just flows back, back into emergency department over-crowding and ambulances ramping." Dr Judkins said he had heard recently Bendigo Hospital ED staff had turned up to work on a Monday morning to find 30 patients in the ED waiting for transfer to other wards. "It guarantees that anybody who turns up with a stroke, anybody who turns up with a heart attack, anybody who turns up with a trauma, there'll be a delay to care," he said. A spokesperson for Bendigo Health said it "continues to experience periods of high demand across our emergency and inpatient services". "Our staff are working closely across the health service to manage patient flow and ensure patients receive the care they need as quickly and safely as possible," the spokesperson said. AMA Victoria calling for urgent intervention AMA Victoria is calling on the state government to end "unsafe delays and improve transparency" in regional and rural hospitals, and to fund the modernisation of administrative systems in regional hospitals to help speed up processes. "A lot of our regional hospitals still don't even have electronic medical records," Dr Judkins said. The AMA also wants solutions to workforce shortages through investment in specialist training and gaps in access to care, and is calling for a parliamentary inquiry into regional and rural healthcare. "It just seems it's a political football … and nobody's really come up with a long-term plan about how we're actually going to address it,"he said. Speaking to the ABC just before health minister Harriet Shing's recent resignation, Dr Judkins said she had listened to him "sometimes". He was disappointed, he said, after sending Ms Shing a letter on July 9 about concerns with patient safety at Ballarat Base Hospital ED asking for her intervention. He did not receive a response. The state government said it was supporting Victoria's health service with "record investment and new solutions". "We know how frustrating it is when faced with long ED wait time," a spokesperson said. "During the busy winter flu season, Victorians should always consider alternative options like the Virtual Emergency Department or Urgent Care Clinics if their condition is not life-threatening."