At the same time, median waiting time was 46 days and 6.4 per cent of patients waited more than a year for surgery, so access remains uneven. Public hospitals continue to face ambulance ramping, bed blocking and long emergency department stays.

If you work in the medical sector, you see these pressures every day. For senior roles, the pressure shows up in different ways: harder recruitment, higher turnover, more scrutiny and less time to lead.

This insight looks at where public hospitals sit in 2025 and what that means for senior appointments across medicine, nursing, and allied health.

1. Where Public Hospitals Stand In 2025

National performance data from the Report on Government Services 2025 confirms the picture many clinicians already feel. Activity is up, demand is persistent and performance varies widely by state and region.

Key points from 2023–24:

• More elective surgery is being completed, but waiting times remain long for some specialties and some hospitals.
• Emergency departments continue to experience long stays, particularly for patients who need a bed on a ward. Bed access blocks affect ambulance ramping and flow.
• Governments are investing in urgent care clinics and out of hospital care to relieve pressure, but the impact will take time.

The result for you is a workplace where expectations keep rising, even if resources and workforce headcount do not keep pace.

2. Workforce Shortages and Maldistribution

The single largest pressure point in 2025 is the health workforce itself.

National data shows:

• Ongoing shortages across nursing, medicine and allied health, with strong evidence of maldistribution between metropolitan and regional areas.
• Rural and remote hospitals struggle to retain nurses, midwives and allied health professionals. Survival in role drops sharply after about two years, which creates a constant recruitment cycle.
• Remote workforce issues include high burnout and high turnover, which increases recruitment costs and erodes organisational memory.

At the senior level, this takes several forms:

• Fewer experienced candidates who are willing to relocate to regional and remote sites.
• Difficulty filling roles that combine clinical leadership, management and on call demands.
• Loss of senior staff to private providers, locum work or interstate roles with higher pay and more manageable rosters.

If you are responsible for senior recruitment, you are competing in a small and tired market.

3. An Ageing Senior Workforce and Succession Risk

Another feature of 2025 is the age profile of the medical workforce.

Several sources highlight that a large share of senior doctors and general practitioners are in late career. There is concern that additional regulatory or administrative burden could encourage earlier retirement and reduce capacity further. 

For public hospitals this means:

• A pipeline problem for Head of Department, Director of Medical Services, Clinical Director and equivalent roles.
• Reliance on a small group of experienced clinicians who carry heavy leadership, teaching and clinical loads.
• Limited time to develop the next generation of leaders before current senior staff step back or retire.

If your hospital does not have structured succession planning, you will feel this as sudden gaps, rushed acting appointments and repeated recruitment rounds.

4. Industrial Pressure, Culture and Trust

Industrial action and public criticism are more visible in 2025.

Recent examples include:

• Health staff in Tasmania taking strike action over pay, retention and workload, citing the loss of staff to mainland and private sectors.
• Senior doctors and staff at Albury Wodonga Health publicly raising safety concerns, workforce stress and loss of confidence in leadership.

These events may be local, but the themes are national.

For senior appointments, this has several implications:

• Candidates now scrutinize culture more closely than salary alone. They ask about psychological safety, how conflicts are handled and how leadership responds to risk.
• Boards and health departments are more cautious about hiring. They expect visible alignment with governance standards, codes of conduct and consumer engagement.
• New senior leaders walk into environments where historical issues, public campaigns or unresolved grievances are still active.

If you are interviewing for a senior role, you know culture questions now go both ways. If you are hiring, you need a credible story on culture, not only a position description.

5. Specific Pain Points in Senior Recruitment

Across Australia, public hospital leaders report recurring issues when filling senior posts.

a. Very tight candidate pools

• Key specialties such as emergency medicine, psychiatry, anaesthetics and critical care can be extremely hard to fill in some locations.
• Many qualified clinicians prefer fractional appointments combined with private work, which complicates full time leadership roles.

b. Competition with private and locum markets

• Senior doctors can often earn more, or work more flexibly, in private hospitals, day procedure centers or locum roles.
• Public sector enterprise agreements limit how far you can move on salary alone. This pushes you to compete on non-financial factors such as training, research and lifestyle.

c. Complex role design

• Roles often combine service management, workforce planning, medical administration and still expect a clinical load.
• Job descriptions can be vague about authority, reporting lines and protected time for leadership tasks.
• Without clear authority, senior appointees struggle to deliver change, which then affects retention.

d. Rural and regional leadership

• Smaller hospitals need clinical leaders who are both generalists and able to manage relationships with larger referral centers.
• Isolation, schooling for children and partner employment remain major barriers to recruitment and retention.

6. What this means for you if you work in the sector

If you are a senior doctor, nurse, allied health professional or manager in the public system, these trends affect your daily work and your career decisions.

You may recognise some of the following:

• Acting in leadership roles for long periods without clarity on permanency.
• Taking on extra governance or performance tasks at the same salary level.
• Limited administrative support, which leaves you spending clinical time on rosters, data and reports.
• Burnout risk that comes from being the person everyone looks to, while your own support is thin.

If you are involved in recruitment, you may feel that every appointment now needs far more effort, from market mapping and relocation support through to onboarding and mentoring.

7. Practical Actions For 2025 Senior Appointments

The broader policy settings are important, but you still have levers at hospital or health service level. Below are practical steps you can take in 2025.

a. Redesign roles around realism

• Strip out tasks that do not have to sit with the senior clinician. Use experienced managers or project staff for operational follow up where possible.
• Protect nonclinical time in the contract and in actual rosters. Candidates now want to see this in writing.
• Be explicit about authority. Clarify what the role can decide on beds, theatre time, staffing and models of care.

b. Invest in retention, not only recruitment

• Identify your critical senior people and ask what will keep them for the next three to five years. Often this is support, team stability, or flexibility rather than a pure pay issue.
• Fund leadership coaching, peer support groups or protected time for professional development.
• Watch early warning signs, such as repeated unfilled vacancies in a unit, rising complaints, or locum dependence.

c. Build local succession pipelines

• Identify mid-career clinicians with leadership interest and offer structured development, such as deputy roles, secondments or project leadership.
• Use acting roles deliberately, with clear objectives and support, rather than as a holding pattern.
• Partner with universities and colleges to position your site as a training and research hub where possible.

d. Strengthen your recruitment process

• Shorten decision timelines. Prolonged internal steps often cost you preferred candidates who accept other offers.
• Provide a single point of contact for candidates, especially those considering relocation or overseas applicants navigating Australian registration.
• Be transparent about challenges. Senior candidates expect honesty about workload, performance pressures and any recent public issues.
• Use an experienced Search consultancy firm that can do most of the heavy lifting and make candidate selection so much easier.

e. Recognise regional and rural realities

• Offer practical relocation support, such as help with schooling options, housing and partner employment networks.
• Consider flexible models, including fly in fly out, multi-site roles or shared appointments with larger centers, where safe and feasible.
  

8. How Senior Leaders Can Shape A Better 2025

While many of the structural issues sit with governments, senior clinicians and managers still have influence inside their own services.

You can:

• Use your voice on local committees and statewide advisory groups that shape workforce and funding decisions.
• Model reasonable expectations about after hours work, availability and email culture.Support colleagues who raise safety or culture issues in good faith, so that the organisation learns rather than defends.
• Partner with consumer representatives so that service redesign is clinically and community informed.

If you work in public hospitals, the pressure in 2025 is real. At the same time, there is appetite for new workforce models, stronger leadership and more honest conversations about what is sustainable. Senior appointments sit at the centre of that shift. Getting them right is now a core strategy issue, not an administrative task.

If you would like a consultation on any of the matters discussed in this article then feel free to reach out to your consultant at Predictus Search who will be delighted to help.