Emergency department waiting times: $1.5 billion for staff and beds, and no word on the queue

On 25 October, at the launch of Victoria's election campaign in Geelong, Premier Ben Carroll promised $1.5 billion over four years. Emergency department waiting times at targeted hospitals would fall by up to 20 per cent. The announcement specifies 1,500 additional health workers, 750 of them nurses, and 150 extra hospital beds, most opening next year. It names no patient flow program, no virtual care expansion and no triage technology.

The evidence on what moves emergency department waiting times points exactly where the pledge is silent. Victoria already runs a virtual emergency department statewide that has kept 81.5 per cent of its patients out of a physical ED. The state's Timely Emergency Care program attributes measured improvements to data-driven operational management across 22 hospitals. And the international evidence on AI triage, while observational, consistently shows faster time to initial care. None of the three appears in the pledge, or anywhere in the 94-claim promise ledger this state's campaign has so far produced.

What the $1.5 billion buys

The pledge targets the hospitals where the waits are worst. The Herald Sun counts 12; the ABC's breakdown lists five Melbourne hospitals (the Alfred, the Austin and the Royal Children's among them) plus 10 regional hospitals, including Bendigo and Ballarat Base. Staffing at the targeted hospitals rises by 25 per cent, on the Herald Sun's reading, with the 1,500 extra workers and 250 beds carrying the expansion.

The premier's own statement framed the stake personally: “We've waited in an ED with our daughter many times — nothing's more stressful.” The Victorian branch of the Australian Medical Association welcomed the commitment. Its president, Simon Judkins, said the commitment responds to “the unacceptable delays many Victorian patients are currently experiencing”. He added that emergency departments and their staff are “under enormous pressure”, and that the entire emergency healthcare pipeline should be reviewed.

The reporting itself shows the blur. Several outlets put 25 per cent on the story; that figure is the ED expansion and staffing increase. The waiting-time reduction is up to 20 per cent. Our own promise ledger first recorded the claim with those two numbers swapped, and corrected it a week later against the campaign-launch reporting. The numbers everyone can check (dollars, workers, beds) and the number that matters to the person in the waiting room (minutes) are different things, and only one of them has a stated path.

How long patients wait now

Patients wait longer than they did before the pandemic. In 2024-25, half of Australian ED presentations completed within 3 hours and 48 minutes, about 47 minutes longer than in 2020-21, on Australian Institute of Health and Welfare data. Half of patients were seen within 18 minutes; 90 per cent within the hour.

Victoria tracked the national four-hour departure rate through the 2010s, fell deeper through the pandemic (52 per cent at the 2022-23 trough against 56 nationally), and by 2024-25 sat at 53 per cent, 18 points below its 2015-16 peak. The national rate fell over the same span from 73 to 53. (Chart data: AIHW MyHospitals, measure MYH0005, extracted 31 October 2026.)

Reporting on Victorian Agency for Health Information data states that more than half of the state's ED patients now wait more than four hours. The Victorian Auditor-General found few hospitals meet the 81 per cent four-hour target in the Statement of Priorities. It also found the Department of Health “has not sufficiently monitored ED performance and has not held hospitals to account for under performance”. Regional Victoria carries the worst of it. The AMA named five regional hospitals showing signs of system failure, and regional doctors described patients waiting more than 40 hours in emergency departments as not uncommon.

Emergency-category patients, the sickest band short of resuscitation, were seen within the clinically recommended time 83 per cent of the time in 2011-12; that share bottomed at 55 per cent in 2021-22 and had recovered to only 64 per cent by 2024-25. Urgent-category patients trace the same arc: 72 per cent, then 58, then 69. (Chart data: AIHW MyHospitals, measure MYH0010, extracted 31 October 2026.)

The Herald Sun ran the pledge's own arithmetic against it: a 20 per cent reduction at the Alfred lands near 101 minutes, marginally better than a year ago. Productivity Commission data, the paper notes, has Victoria treating the most urgent patients substantially worse than a decade ago.

What measurably moves ED waiting times

Three levers measurably move emergency department waiting times: virtual care, patient flow and triage. Victoria owns two of them and is not promising the third.

Virtual emergency care is the largest measured diversion lever, and Victoria owns it. The state-wide VVED has consulted more than 300,000 patients since October 2020 and averages over 600 presentations a day. Its peer-reviewed outcomes, published in The Lancet Western Pacific, show 81.5 per cent of patients did not attend a physical emergency department within 48 hours of a virtual consultation. In May 2025 the service averaged 737 video calls a day, and 79.4 per cent of patients referred by paramedics received virtual care on scene rather than transport, freeing ambulances back to the road. No party's pledges mention it.

Patient flow is the government's own working answer. The Timely Emergency Care 2026 program works the whole patient journey, arrival to discharge, across 22 hospital sites plus Ambulance Victoria. Its components are unglamorous and measured: afternoon discharge planning huddles, optimised ward rounding, transit lounges, ED-to-ward process agreements, and data-driven operational management. The program's own summary: “Across our health system patients are being seen faster, having treatment decisions made quicker, and getting back home earlier.” The $1.5 billion pledge neither extends nor funds this program; the words patient flow appear nowhere in the announcement.

The AI triage evidence is the youngest and the thinnest, and it consistently favours the technology. A scoping review of 29 studies found machine learning models consistently outperformed conventional triage systems at discrimination. A quality improvement study across three US emergency departments covered 174,648 visits. After an AI triage tool was deployed, median time to initial care fell from 12 minutes to 8, and sensitivity for critical-care patients rose from 78.8 to 83.1 per cent. A Canadian health technology review links AI triage to patients receiving care faster and leaving the ED sooner. The caveats are real: the studies are observational, the strongest of them flags temporal confounding, and no Australian emergency department deployment surfaced in preparing this article.

What the silence costs

The pledge will be judged on waiting times: the ledger's resolution rule tests the outcome, not the mechanism. The Coalition's contrasting pledges have the same shape: exit lounges at 10 hospitals to free up beds, 25,000 extra surgeries a year through private hospitals, a Bairnsdale emergency department expansion, Protective Services Officers at seven hospitals. Voters can picture staff and beds; a data-driven operational management program is harder to announce and harder to picture.

The distinction changes nothing for the patient. For the people running hospitals, it decides whether the new staff can work at full capacity. Staff and beds take years to convert into minutes: a nurse hired in 2028 reaches full ward productivity later still. Flow programs and virtual care convert in quarters; that is where the government's own program already works. A health system that gets 1,500 workers and no flow investment buys capacity it cannot fully use. The four-hour problem in Victorian EDs is substantially a whole-of-hospital problem, as the Auditor-General's and the program's own findings both say.

The May 2027 budget checkpoints

The first checkpoint is the May 2027 budget, where the pledge must decompose into lines. Three things to look for: whether any appropriation names flow programs, virtual care expansion or triage systems, or whether the whole $1.5 billion splits into capital and staffing; what happens to the VVED, whose own annual agreement flags expansion planning; and whether Timely Emergency Care 2026 continues past its current sites, with its measured outcomes still publishing.

The election sets the funding agenda; the technology agenda is already running in the 22 hospitals in the program, with or without a pledge that names it. If your service is deciding what to build while the campaign runs, the evidence above is the checklist. Talk to us about what the flow and virtual care evidence means for your stack.

Sources

Media: ABC News, “Labor pitches $1.5 billion plan to slash emergency wait times”, 25 October 2026. Herald Sun, Shannon Deery, “Labor's $1.5bn ED fix: can it cut Victoria's wait times?”, 26 October 2026. Sydney Morning Herald, “Carroll kicks off re-election campaign in Geelong”, 25 October 2026.

Studies and data: The Lancet Western Pacific, “Outcomes of a state-wide virtual emergency department in Victoria”, 2026. Victorian Virtual Emergency Department, 2025-26 Annual Agreement. Emergency Medicine Australasia (PMC), “From concept to reality: development and evolution of a virtual emergency department”, 2024. AIHW, Emergency department care: time spent in emergency departments, 2024-25. Victorian Auditor-General, Efficiency and Effectiveness of Hospital Services: Emergency Care. health.vic, Timely Emergency Care 2026. 2 Minute Medicine, summary of an AI triage quality improvement study across three US emergency departments, 2026. Scoping review, “Use of Artificial Intelligence in Triage in Hospital Emergency Departments”, 2024. Canadian Journal of Health Technologies, “Technologies to Address Wait Times in the Emergency Department”.

Internal: Airteam, Victorian Promise Ledger, frozen baseline 28 October 2026.