Why surgeries could be cancelled across Australia from next week

Australia’s public health system is at risk of “coming to a grinding halt” due to an unprecedented shortage of intravenous fluids.

The Australian Medical Association has warned of a need to boost onshore medical manufacturing, saying hospital surgeries could be cancelled as soon as next week.

Veterinarians have also been told to conserve supplies.

Intravenous fluids contain saline and other additives and are used in medical care for both humans and animals.

Manufacturing issues and unexpected increases in demand are behind a global shortage which is likely to continue through 2024, according to the Therapeutic Goods Administration.

While health workers are trying to find workarounds, this is not a long-term solution as Australia is reliant on overseas medical suppliers, Royal Australasian College of Physicians president Jennifer Martin said.

“The current situation is safe (but) it’s not ideal, it is causing a lot of extra work,” she told AAP.

Australia feels supply issues more than other countries, she said.

“We actually import over 90 per cent of our medications from predominantly China and India, we don’t manufacture much in Australia,” Martin said.

“We have a generic industry that’s pretty small, but essentially it means that we’re really at the behest of the global community because we’re sort of at the bottom of the supply chain.”

Several state health departments have warned of supply disruptions or have created a stock buffer.

Australian Medical Association president Steve Robson said imminent shortages flagged by local health authorities were yet to be experienced but could have huge implications across the health sector.

“The health system potentially could come to a grinding halt next week if intravenous fluid isn’t available,” Robson said.

He said he would not perform planned surgeries next week if fluids are not available, and warned the supply shortage was “unprecedented”.

“That would affect every surgeon, every anaesthetist and every patient awaiting surgery in the country. That has potentially bigger implications than the COVID restrictions,” he said.

“It would affect anaesthesia, surgery, chemotherapy, emergency departments, managing people with acute infectious illness in hospital ... (and) pediatric intensive care.”

NSW Health issued a safety alert in mid-July over critical shortages for up to three weeks and said stock was being carefully managed, while Victoria is aware of the issue but hasn’t had any disruption to patient care.

Tasmania has established a “small buffer” of high-volume lines and raised concerns with the TGA more than 18 months ago, a health department spokesperson said.

“Given the potential implications for the delivery of hospital services, the department continues to advocate for the issue to be addressed at a national level,” the spokesperson said.

The situation in the ACT is “rapidly changing” with stock monitored daily and the public health service, ambulance and private hospitals sharing supplies as required, according to a spokesperson.

South Australia Health statewide incident controller Wayne Champion said stock was being conserved “out of an abundance of caution” but the state had adequate supply.

Authorities in the Northern Territory, Queensland and Western Australia have not reported any impacts.

Australian Veterinary Association president Sally Colgan said vets were conscious of the issue and finding alternative solutions.

“Veterinarians are being advised that they need to manage their supply and they need to manage their use of fluids so that they can conserve the fluids that they have,” she said.

The Therapeutic Goods Administration has allowed multiple overseas-registered alternative saline fluids to be imported in an effort to increase supply as they continue working with state and territory authorities.

“The TGA is also liaising with the three Australian suppliers of IV fluid products ... to monitor the situation and address any regulatory barriers to supply,” a spokesperson said.