Victorians are waiting up to four years to access specialist care in the state’s public hospitals, triggering a state government overhaul that will create regional waitlists and use AI to flag urgent cases.
Under the changes, which have been outlined in a new Department of Health report, more specialist appointments would be shifted to nurses to take pressure off doctors.
Review appointments deemed unnecessary would also be cut to improve access for patients in greater need, and virtual care would be expanded.
The plan is a response to an unprecedented influx of patients seeking public specialist care, driven by the cost-of-living crisis and soaring private doctors’ fees.
The report highlighted the case of a four-year-old who waited more than 12 months for an ear, nose and throat assessment, while falling behind in their development. Rural patients spoke of having to drive five hours for an appointment, only to face carpark fees of up to $70.
Health Minister Harriet Shing said too many Victorians were waiting too long or struggling to navigate the complex system.
“That’s why this reform is vital – it will mean quicker access, clearer communication, and more options for patients and their families,” she said.
Rising fees for private specialists – which grew by 73 per cent between 2010 and 2025 – and the cost-of-living crisis have pushed more patients into the public system.
This has led to a surge in demand, with referrals to specialist care in public hospitals increasing by an average of 460,000 per year between 2020/21 and 2024/25, while appointments rose by 250,000 per year.
While most patients requiring urgent appointments were seen swiftly, some patients waited up to 1460 days, or four years, for a routine appointment at a vascular clinic.
“Extended wait times are stressful and worrying for patients and can increase the risk of conditions becoming more complex and needing even more intensive and expensive care, including admissions to hospital,” the report said.
The report also identified waste: 11 per cent of public specialist appointments (600,000 per year) were not attended.
Professor Ben Thomson, the Department of Health’s chief surgical adviser, said there had been little reform in outpatient clinics over the past 80 years.
“Pockets of innovation and reform are happening in Victoria, but nothing centrally coordinated at present,” he said.
He hopes the changes improve wait times and access for patients.
He is particularly interested in the proposal to boost access to virtual care and allow patients to decide when and if they need a review appointment. Only one in five specialist appointments are for new patients, with the remainder reserved for review appointments.
He said many of these review appointments were booked by default, and some were unnecessary.
For parents caught in the middle of these delays, the wait can be agonising.
Lavengamalie Malagaoma became concerned about her son Michael’s hearing when he was two years old. He had constant ear infections and wasn’t responding to his name.
The mother-of-six from Kings Park in Melbourne’s north-west took him to a local hearing clinic and he was told he had a blockage that needed to be seen by an ENT specialist. A referral was sent to the ENT, but four years passed, and the family never heard anything.
“It was frustrating,” she said. “He wouldn’t respond, he wouldn’t listen. It was because he couldn’t hear. He couldn’t sleep because he was crying.”
About two years ago, Michael’s ear worsened and after he was taken to Sunshine Hospital’s emergency department, he was referred to their Audiology Advanced Practice Paediatric Ear (AAPPEAR) Clinic.
The service employs audiologists who conduct diagnostic assessments of children’s ears. Some children are discharged without needing to see an ENT specialist, while others are referred for routine or urgent appointments.
Michael was swiftly seen by the clinic’s audiologists, who referred him to an ENT who recommended grommets. The grommets were placed in the now eight-year-old’s ears about a year ago.
“He can hear better,” Malagaoma said. “His confidence, friendships and learning has improved.”
The recent state budget included $16 million to deliver 45,000 more specialist clinic appointments for children and young people.
It also included $8 million to create and pilot a new service for GPs and patients to get specialist advice without the need for a referral.
Associate Professor David Fuller, chair of Paediatric Clinical Network, said it was common for children with learning, behaviour and development issues to wait more than 18 months for an initial assessment.
“It is challenging for clinicians when you get referrals and you can’t see the patients any earlier,” said Fuller, who is also a paediatrician at Barwon Health and a member of the blueprint’s expert advisory group.
“You know the impact of an untreated condition can be long-term.”
His health services recently started publishing wait times for clinics so patients have more transparency.
He said the blueprint would help maximise existing resources while redesigning the system so it worked better for patients.
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