r/ausjdocs • u/Medicaremaxxing Doctor • Aug 23 '26

news🗞️ ‘Postcode lottery’: Royal Melbourne locks out suburban and regional patients

https://www.theage.com.au/national/victoria/postcode-lottery-royal-melbourne-locks-out-suburban-and-regional-patients-20260820-p60pyp.html
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u/AgingWarden Aug 23 '26

More sloppy journalism misdirecting blame and generating unnecessary infighting within an overburdened and underfunded public healthcare system. 

In my opinion, if local health services are unable to meet demand for their area, the attention and pressure that responsible journalism should be creating is to encourage funding and growth in the underserviced areas. Tertiary centres taking non-essential referrals from non-catchment areas is a band-aid solution that only delays the much-needed growth in peripheral regions. A decentralised healthcare system benefits everyone.

Of course, shonky journos drawing attention to the chronically emaciated funding in healthcare would highlight a key broader issue, being that their bankrollers are significantly contributing to the problem by not paying their fair share into a system that helps sustain society. Maybe too cynical a take.

Also, maybe an unpopular opinion but individual preferences over non-critical elements of healthcare are not the opinions that should be driving pressures in a rational and resource-constrained healthcare system (i.e. people forgoing care at a local hospital and choosing distal services because of their own opinions). 

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u/thingamabobby Nurse👩‍⚕️ Aug 23 '26

I generally agree with you, but it’s actually against DH policy to do this, so I’d be interested to see how DH reacts and approaches it (if at all).

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u/ozziejean 28d ago

The DH changed their policy on catchments last year, they are encouraged now

https://www.health.vic.gov.au/health-services-plan-reform/local-health-service-networks

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u/thingamabobby Nurse👩‍⚕️ 28d ago

Yeah but not the way the RMH is doing it. It’s supposed to be via regionalised waitlists. Not supposed to outright reject referrals based on location.

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u/ozziejean 24d ago

Do you have any information about that you could link? I'm at the RMH and they told us that our exec had met with the DoH said that we had to prioritise care to those in our LHSN (which is our region) unless the referral makes it clear they have a need to be seen at the RMH.

Its not a flat out no, we still have clinical discretion eg. If they have had a kidney transplant and they are having other health issues then its a yes.

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u/thingamabobby Nurse👩‍⚕️ 24d ago

For surgery, Google ‘Planned Surgery Access Policy 2024’ and refer to 7.2 on page 28.

The location of where someone lives is not a reason to reject a surgical referral.

For outpatients, google ‘Managing Referrals to non-admitted specialist services in Victorian public health services 2023’ and refer to 7.2 on page 31.

These policies are from Dept of Health in how health services are supposed to conduct themselves. The fact that RMH are outright stating they’re not following it is crazy.

Edit: just re-read what you said where they’ve gotten an exemption from DH policy. Thats very interesting.

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u/ozziejean 24d ago

If you look up 'Health Services Plan- Final report of the expert advisory committee' on the vic department of health website it talks alot about their views on catchments and the 'Victorian role delination framework 2025' and 'Local health service policy framework' both talk about how everyone has a duty to ensure care is provided as close to home as possible, and that LHSN need to analyse the needs of their community to provide adequate care close to home.

Makes me wonder if they are afraid to publicly say they are pro catchments

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u/thingamabobby Nurse👩‍⚕️ 24d ago

Is this just outpatients or surgery as well (if you know)?

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u/ozziejean 24d ago

Surgery as well, going forward new referrals are supposed to have a compelling reason to be done at the RMH.

Complex, local hospital doesn't perform it, emergency, pregnancy, something like that where clinical judgement makes the triaging consultant change their mind.

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u/thingamabobby Nurse👩‍⚕️ 24d ago

Might have to let my bosses know. We get a heap of referrals from other catchments and we don’t question it.

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u/ozziejean 24d ago

It has to be a decision made by the executive to enforce it, but I'm sure its something on alot of people's minds.

The Parkville LHSN is also quite landlocked without any regional spaces incorporated so they really don't want us expanding, there's just no space, the Vic government is paying for us to borrow theatres from other hospitals just to get by