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Elective surgery during the COVID-19 pandemic 

COVID-19 outbreaks and lockdowns have led to long waiting lists for elective surgeries like hip replacements and cataract operations.

hospital operating theatre
Last updated: 06 January 2022
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Need to know

  • Many elective surgeries have been cancelled due to COVID-19 outbreaks and lockdowns
  • Public hospital waiting lists have increased for surgeries like hip and knee replacements, cataract operations or breast reconstruction after breast cancer
  • Even cancer and coronary heart surgeries can get delayed and doctors are warning that some patients' conditions may deteriorate in this time

The COVID-19 pandemic has brought healthcare systems around the world to the brink. 

Some elective surgery was stopped in public and some private hospitals due to lockdowns which means public hospital waiting lists have increased, and some patients have been waiting for surgery for several years.

Delays can even affect some coronary heart surgeries, early stage cancer surgeries and reconstructive surgeries after breast cancer. Doctors are concerned some patients' conditions may deteriorate because of the delay.

What is elective surgery?

If surgery is called 'elective' it just means it's not emergency surgery and is not immediately needed to save your life.

"There is a misconception that 'elective' refers to unnecessary surgeries, such as cosmetic procedures. But elective surgeries are vastly comprised of surgeries that are necessary, for example, the majority of cancer surgeries are considered elective surgery," says Stephen Mason, CEO Australian Patients Association.

You may be in a life-threatening situation if your surgery is delayed too long, and it's possible that you can become disabled while waiting, like for a hip or knee replacement surgery, or your ability to enjoy and live your life could be severely limited, like if your eyesight worsens while waiting for cataract surgery.

There are three categories of elective surgery.

  • Category 1 (urgent) – admission is recommended within 30 days as your condition can deteriorate and could become an emergency and possibly life-threatening. Examples include urgent cancer operations, a breast lump or skin lesion, limb amputations or urgent heart surgery.
  • Category 2 (semi-urgent) – admission is recommended within 90 days as the condition can cause pain and disability but is unlikely to become an emergency. Examples include hernia and kidney stone surgery.
  • Category 3 (non-urgent) – admission is recommended within the next year as the condition causes pain or disability but doesn't have the potential to become an emergency. Examples include cataract surgery and breast reconstruction after breast cancer.

General surgery is the most common elective surgery, followed by urological surgery. The most common elective surgeries are:

  • cataract surgery 
  • cystoscopy (an endoscopy to find problems with the urinary tract or bladder such as stones, infection or cancer).

How long are public hospital waiting lists?

In 2019–20 about 690,000 patients were admitted to surgery from public hospital waiting lists according to the Australian Institute of Health and Welfare, and elective surgery waiting lists increased during 2020.

The number of admissions from waiting lists was about 9% lower than the year before due to the cancellation of elective surgery during lockdowns. In comparison, between 2014–15 to 2018–19 these admissions had increased by about 2% on average per year.

If you have private health insurance, you can have a shorter wait time by selecting your own doctor and having your surgery in a private hospital.

To make sure you're getting the best value cover, we've built a tool that lets you compare health insurance policies from dozens of health funds, big and small, member-owned and nonprofit (without sponsored results like other comparison sites).

What can you do if your surgery was cancelled?

Get in contact with your surgeon and check if your surgery can be rescheduled. If your condition worsens, it's very important to let your surgeon know.

When elective surgery starts again after a lockdown, specialists and hospitals may select patients based on:

  • how urgent their condition is – your category 3 surgery may become a category 2 if your condition has changed
  • location – hospitals that treat a high number of COVID-19 patients will have more limited availability for elective surgery
  • type of surgery – day surgery is often preferred to procedures requiring post-operative care, especially if care in an ICU may be required.

It could also be worth asking your surgeon if there are other options that can help you until your surgery, like physiotherapy in the case of a sports injury.

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