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Five years on from Westmead Hospital’s billion-dollar redevelopment, its emergency department has recorded the worst wait times and ambulance ramping in NSW.
One in 10 Westmead patients spent almost 22 hours in the emergency department, more than double the time clocked up a decade ago despite only a small rise in the number of patients, the latest Bureau of Health Information (BHI) data revealed.
NSW patients spent less time in the ED than patients in most other Australian states and territories in 2024-25, and were more likely to complete their emergency treatment within four hours.
But at Westmead, just 41.5 per cent of patients started their treatment on time in January to March, down from 59.6 per cent in the same quarter in 2016, and significantly below the 68.4 per cent treated on time statewide. In the same time, the number of patients presenting to the ED rose 1100, although many required more urgent care.
NSW Health Minister Ryan Park defended Westmead, and said it faced challenges including population growth: “It’s right in the eye of that storm.”
A Westmead emergency nurse not authorised to speak publicly said clinicians at the hospital felt helpless in the face of excessive wait times due to a lack of flow from the ED into other departments.
“You know that [patients] need care that you can’t provide in the waiting room, but you can’t get them in, you can’t get them a bed, you can’t get them the care that they deserve,” the nurse said.
Ten years ago, 94 per cent of ambulance arrivals at Westmead were transferred from paramedics to emergency staff within half an hour. That figure had dropped to 60 per cent, while across the state, 80.5 per cent of ambulance arrivals were seen within 30 minutes in January to March.
A spokesperson for Western Sydney Local Health District said in a statement that while overall presentations were stable, Westmead ED had the highest number of patients requiring urgent care of any hospital in NSW.
These include resuscitation patients (categorised as T1), who need treatment immediately or within two minutes for presentations like a heart attack, and emergency (T2) patients, whose conditions are imminently life-threatening and require treatment within 10 minutes, such as those with chest pain or difficulty breathing.
The hospital treated 25 per cent more T2 patients in January to March 2026 than they did a decade ago, but 5.3 per cent less than the same quarter last year.
Across the state, emergency T2 cases were up 70 per cent compared to 2016. Campbelltown Hospital in Sydney’s south-west had nearly three times as many T2 presentations compared to the same quarter in 2016, but treats more than 70 per cent of its patients on time.
Australasian College for Emergency Medicine NSW branch chair Dr Rachael Gill said emergency departments statewide had experienced a reduction in less-urgent patients, suggesting “investment in community-based alternatives is beginning to bear fruit”.
However, she said the college remained concerned about the rise in the number of critical patients spending “far too long” in emergency. “The system’s most vulnerable patients deserve better,” she said.
Westmead’s 14-storey-high Central Acute Services Building (CASB) – opened in 2021 by the Berejiklian government – was billed as the “centrepiece” of the Westmead Health Precinct redevelopment, costing more than $1 billion. It features two new EDs (adult and children’s), 25 digital operating theatres, and more than 300 patient rooms.
Park said Westmead serviced “a large catchment area for north-western Sydney, [which] hasn’t seen the expansion in hospital services for some time”.
He said the Minns government’s investment in Rouse Hill Hospital – due to open in 2029 – and more beds at Blacktown and Mount Druitt would ease the pressure.
The NSW hospital system is under record strain from a growing and ageing population with complex chronic conditions, which has led to unprecedented demand on ambulances and almost 95 per cent of hospital beds occupied.
Paramedics responded to 387,000 incidents in January to March, the highest number recorded for that quarter since the BHI began reporting in 2010.
Park said there were 1300 hospital beds across NSW occupied by patients who are medically ready to be discharged but awaiting a federal government-funded place in an aged care or NDIS program – people his office refers to as “Commonwealth patients”.
Shorter wait times for surgeries
Planned surgery wait times improved across NSW, with 82.2 per cent of elective surgeries performed on time, up almost 4 per cent compared to the same quarter last year.
About 92,300 patients were on the wait list in the January to March quarter, 8.3 per cent fewer than the same period in 2025.
The state is increasingly relying on private hospitals to clear public surgery waitlists, with more than 2500 planned procedures performed in private facilities, up from 926 in the first quarter of 2025.
Australian Medical Association NSW president Dr Fred Betros said: “If the public hospital system hasn’t got the capacity to do that extra work, the question is why? Where’s the funding, and where are the resources?”
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