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Australia’s public hospitals are the backbone of our health system — the places Australians turn to in moments of crisis, vulnerability, and profound need. Yet the findings of the Australian Medical Association’s 2026 Public Hospital Report Card make one thing abundantly clear: our public hospitals remain under severe and sustained strain. Despite the extraordinary efforts of doctors, nurses, and other health workers, the system is struggling to keep pace with rising demand, and patients are feeling the consequences.
This year’s report card shows that while there have been modest improvements in some areas, overall performance is significantly worse than it was a decade ago. The data paints a picture of a system stretched beyond its limits; and emergency departments continue to bear the brunt of this pressure. Just over half of patients now complete their emergency department visit within the nationally agreed four-hour benchmark — the lowest level in ten years. Nearly one in three patients triaged as urgent are still not being seen on time. These are not abstract figures; they represent real people waiting too long for care, often in pain, distress, or uncertainty.
Planned surgery tells a similar story. While median waiting times have improved slightly, Australians are still waiting far longer than they were ten years ago, particularly for medically necessary Category 2 procedures. These delays have real impacts: prolonged pain, delayed return to work, and worsening health outcomes. And although more beds have been added to the system, population growth has effectively wiped out these gains. For older Australians, capacity has fallen to its lowest level on record.
These trends are not the result of a lack of effort by medical practitioners. Quite the opposite. Every day, clinicians are doing everything they can, but they’re working within a system that simply does not have the capacity to meet the needs of a growing and ageing population. The report card reinforces what frontline staff have saying for years: demand has outstripped capacity for far too long.
This year’s report card is particularly significant because it reflects performance before the signing of the new National Health Reform Agreement (NHRA) in January. The AMA welcomed the announcement of the new NHRA as a long-overdue and meaningful shift in the right direction — and a clear win for our long-running Clear the Hospital Logjam campaign. The additional $25 billion in federal funding lifts the artificial growth cap and increases the federal government’s share of hospital funding. These are structural changes the AMA has consistently identified as essential to addressing overcrowded emergency departments, ambulance ramping, and growing surgical backlogs. The agreement also provides states and territories with funding certainty over the next five years, creating the conditions for improved access and performance.
But while the NHRA is a critical step forward, it is not a cure-all. Funding alone will not fix a system that has been under strain for more than a decade. The report card underscores the need for governments to match funding with meaningful reform. That includes reinstating proven performance programs that drive improvements in patient outcomes, ensuring states and territories maintain and increase their own funding effort, and translating new investment into tangible increases in hospital activity. All the funding in the world will not help if it does not result in more patients being seen and treated in a timely and high-quality way.
The NHRA must also shift the national conversation away from aspirational targets and towards measurable improvements. Australians deserve to see real progress — shorter waits for emergency care, timely access to planned surgery, and a hospital system that can meet rising and increasingly complex demand. Clinicians deserve a system that allows them to provide safe, high-quality care without burning out.
The opportunity before us is significant. But the window for action is narrow. Without clear plans from states and territories to expand capacity, increase activity, and rebuild the workforce, the additional funding may not be enough to turn things around.
The AMA will continue to press governments to ensure the NHRA delivers real improvements on the ground. We will continue to advocate for a system that supports the workforce, meets the needs of patients, and restores the performance Australians expect from their public hospitals. And we will continue to publish this report card each year, because transparency matters. Australians deserve to know how their hospital system is performing — and governments must be held accountable for delivering the care their communities rely on.
This year’s report card is a warning, but it is also an opportunity. With the right investment and reform, we can turn this around. Our public hospitals are too important to accept anything less.
Dr Danielle McMullen is the President of the Australian Medical Association.
The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.
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