Should Indigenous patients get faster emergency care than others? This hospital is changing the rules

When you’re sitting in an emergency department, every tick of the clock feels like an eternity.

But what if your wait wasn’t just determined by your symptoms—but by decades of inequality embedded deep in the healthcare system?

One Melbourne hospital has taken a bold step to change that, sparking both praise and outrage across the country.

St Vincent’s Hospital in Melbourne has introduced a groundbreaking policy ensuring Indigenous patients are seen within 30 minutes of arrival—a move designed to close long-standing healthcare gaps but one that’s become a lightning rod for political debate.

The hospital, which treats more First Nations patients than any other in Victoria—around 5 per cent of all presentations—introduced the rule in April 2024.

Under the new system, Indigenous patients automatically receive a minimum category-three triage, meaning they must be seen within half an hour.

Crucially, the policy doesn’t let Indigenous patients skip ahead of more critical cases—it simply ensures their care isn’t delayed beyond that 30-minute mark.

Nationally, data suggests Indigenous and non-Indigenous Australians have similar emergency wait times—typically between 18 and 20 minutes in recent years.

But St Vincent’s decision wasn’t based solely on averages—it was about tackling deeper, systemic problems in healthcare access.

Indigenous Australians attend emergency departments roughly twice as often as non-Indigenous Australians—25 visits per 1,000 people compared to 13 per 1,000.

This higher rate is often linked to limited access to primary healthcare, especially in rural and regional communities.

Even more concerning, Indigenous Australians leave hospital against medical advice at rates up to 30 times higher than non-Indigenous people—especially Aboriginal men aged 25 to 44.

Experts believe this is connected to past negative experiences and ongoing cultural safety issues in the healthcare system.

Research from St Vincent’s showed that when Indigenous patients were seen within an hour, they were more likely to remain engaged with their treatment.

This finding supports national research showing that having Indigenous Liaison Officers and Aboriginal Health Workers in hospitals improves patient outcomes and reduces early discharges.

Healthcare experts also stress that consistent triage practices are vital for fair treatment and that hospitals should regularly audit triage scores across populations to ensure equity.

However, the new policy has not been without controversy.

Victoria’s Shadow Health Minister Georgie Crozier called it ‘discrimination’, arguing that ‘triaging of patients should be done on medical need, not based on the colour of your skin.’

Critics see it as unfair preferential treatment, but supporters point out that it doesn’t bypass medical urgency—it simply corrects systemic delays that previously left Indigenous patients waiting longer.

The debate comes as Victoria prepares to implement Australia’s first state treaty legislation, with some opponents linking the hospital’s move to broader treaty discussions, though health experts note that equity initiatives like this have been developing for years.

Beyond the headlines, the policy reflects a stark truth—Indigenous Australians face preventable hospitalisations at nearly three times the rate of other Australians.

St Vincent’s says the approach aligns with national safety and cultural standards under the Closing the Gap framework, which calls for culturally safe healthcare practices.

The hospital reports that since the policy’s rollout, waiting times between Indigenous and non-Indigenous patients have become nearly identical, without affecting overall emergency department flow.

The controversy highlights a deeper question—what does true healthcare equity look like?

While critics frame the policy as unfair, advocates say it’s a necessary correction to historical disadvantages.

Emergency medicine training now includes modules on bias in triage and cultural considerations, acknowledging that equity sometimes requires targeted approaches for different groups.

St Vincent’s has even received a Victorian Public Healthcare Award for the initiative, recognising that ‘First Nations patients are now seen more promptly than non-Indigenous patients’—a milestone supporters argue is both overdue and essential.

If you’re interested in seeing how hospital wait times can affect real patients, there’s another story that highlights this issue in a striking way.

It details a patient’s two-hour ordeal in an emergency department, revealing how systemic delays can create stressful and potentially dangerous situations.

Reading this story can provide more context on why policies aimed at reducing wait times, like the one at St Vincent’s, are so important.

Read more: ‘Degrading and stressful’: Patient's two-hour hospital ordeal reveals healthcare system flaw

Can targeted healthcare policies truly close long-standing gaps—or will they always stir controversy in a system built on 'equal treatment' that hasn’t always been equal in practice?