A Perth teaching hospital's cardiothoracic surgery unit descended into crisis-level staffing shortages, forcing the management of critical surgical cases to grind as overworked surgeons were rotated off duty. Freedom of Information documents released to the Sydney Morning Herald detail the challenges that gripped Sir Charles Gairdner Hospital's department throughout 2024 and 2025.
The cardiothoracic surgery unit treats some of the most complex cases: heart disease, lung conditions, and major vessel repairs. Yet the department has struggled to maintain adequate surgeon coverage. Hospital records show the unit operates with just one full-time and three sessional surgeons, a configuration that leaves little margin when illness or exhaustion pulls staff away.
When surgeons became overextended, the hospital's only response was to stand them down, effectively removing them from the schedule. This created a vicious cycle: reducing their workload in the short term meant cancellations and delays for waiting patients. The documents reveal internal frustration about the situation, with staff noting the unsustainability of the arrangement.
Sir Charles Gairdner Hospital is one of Australia's leading teaching tertiary hospitals, located in Nedlands in Western Australia's medical precinct. It serves as the regional referral centre for cardiothoracic work across northern metropolitan Perth and beyond. The pressure on its surgical teams reflects a broader collapse in Australia's specialist workforce.
The healthcare system faces a genuine dilemma. Cardiothoracic surgery requires years of training, and the pathway to becoming a fully qualified surgeon is arduous. Australia has historically relied on a pipeline of motivated trainees willing to spend a decade or more learning the craft. But burnout, driven by pandemic-era pressures and chronic understaffing, has thinned the ranks. One senior cardiothoracic surgeon at the hospital, Jurgen Passage, left Sir Charles Gairdner in mid-2023 to move to Fiona Stanley Hospital and later to private practice, reflecting a pattern seen across the public system where experienced specialists migrate to better-resourced settings or exit public medicine entirely.
The hospital has attempted to recruit replacement surgeons. A registrar position in cardiothoracic surgery was advertised with an appointment pool running until November 2025, with positions not commencing until 2026. Yet filling these gaps takes time, and gaps that open today cannot be closed retroactively.
The question facing hospital administrators is not unique to Perth. Across Australia, specialist departments report the same predicament: too much work, too few trained staff, and an insufficient pipeline to replace those who leave. Some argue the solution lies in training more specialists domestically and removing regulatory barriers for overseas-trained surgeons. Others point to the need for better rostering practices and workplace cultures that retain experienced staff rather than driving them away.
What is clear is that standing down overstretched surgeons is a symptom, not a solution. It delays care for patients waiting for critical heart and lung surgery. It does nothing to address the fact that cardiothoracic surgery has become a speciality struggling to attract and keep the talent it requires. Until Australia invests systematically in surgical workforce planning and creates conditions that retain experienced practitioners, hospitals like Sir Charles Gairdner will continue improvising with inadequate staffing.