Canberra's public health system has been the thorn in the government's side over the last term of government - and many years before that.
The troubled system's wait times regularly compare poorly to interstate counterparts, while Canberra Hospital has been struggling for years to overcome poor culture and bullying.
In 2018, the hospital was given three months to pick up its game after a disastrous interim accreditation report by the Australian Council on Healthcare Standards.
There has been a huge churn of health department executives and the department was restructured into two organisations.
The government eventually brought in a new chief executive of Canberra Hospital it believed would be able to turn the culture around.
Many departments in Canberra Hospital are frequently stretched to or near capacity - perhaps most notably the mental health unit.
The emergency department waits are often seen as a product of bed block - patients stuck in ED waiting for a bed in another department - as well as a shortage of beds in the ED itself.
Meanwhile the long awaited $500 million Canberra Hospital expansion - previously called SPIRE - will not be open until 2024 at the earliest.
So why does Canberra lag behind the rest of the country?
ACT emergency departments' performances have been below the national average since about 2004, according to the Australian Medical Association's latest report card.
It's a similar story for elective surgery.
But in the last few years, it's dramatically declined further.
For example, the latest national figures, which included Canberra Hospital and Calvary Public Hospital, showed ACT's median emergency department wait time was the worst in the country at 50 minutes.
The next worst jurisdiction was Western Australia at 28 minutes.
The association's ACT president, Antonio Di Dio, said a combination of factors led to ACT's poor performance.
"The way forward has to involve improving the culture, supporting the staff and committing to an improved funding model to meet the unique demands of the ACT," he said.
"Absent these things, it is hard to see significant improvement in the ACT's performance in the near future."
Dr Di Dio thinks the ACT government needs to invest more in the territory's health services, contending that real levels of funding have been falling.
But Grattan Institute health economist Stephen Duckett said money was not the answer, it just came down to making a more efficient system.
He said as well as performing badly on key indicators like emergency wait times, the ACT also struggled on cost efficiency measures.
"Basically, the health system needs to have a focus on performance improvement and accountability and efficiency," Dr Duckett said.
"Interestingly, the Liberal Party says 'we will put more money into the system'.
"But the system has already got too much money.
"The ACT government should be saying to the health system. 'You have to work out how you can improve within the existing budget'."
He said the poor outcomes in hospitals could also be due to deficiencies or underfunding in community-based services.
Before the coronavirus pandemic, Health Minister Rachel Stephen-Smith said the department's plan to improve patient flows at Canberra Hospital would eventually improve emergency wait times.
"We know this is probably going to take some time to deliver a significant change in outcomes in the data but what we are seeing is real changes being made within the Canberra Hospital in relation to the timely care strategy," Ms Stephen-Smith said.
The government and Canberra Hospital management has said Canberra faces unique challenges because it is a small jurisdiction and can't be easily compared to other states for that reason.
But Dr Duckett said ACT's size and high density of the population meant it should actually be a lot easier to run a health system.
"There is no reason that people in the ACT should be waiting any longer than people in other jurisdictions," he said.
A long-awaited hospital expansion
Promises for a fancy new Canberra Hospital began almost a decade ago when Katy Gallagher was chief minister.
Labor was planning an $800 million redevelopment of the tower block, but it was ditched by Gallagher in 2013, saying she wasn't sure if it was needed.
In the weeks before the 2016 election, Labor again promised a major Canberra Hospital expansion - this time a $500 million redevelopment called SPIRE.
The party said the hospital would be delivered by 2022, but that has since blown out to 2024.
The scope and site location has changed significantly since the announcement.
Chief Minister Andrew Barr has defended the delays, saying they came due to changes made during consultation.
"This is a case of 'we're damned if we do, damned if we don't," he said earlier this year.
"If we hadn't have engaged with the community, if we hadn't sought to alter designs to reflect the issues that were brought to us, we would be accused of ramming something through."
But Dr Di Dio said that excuse simply wasn't good enough.
"I think it's an extraordinary excuse," he said.
"If you promise to deliver something at a particular time, part of the delivery is the consultation process.
"If you don't think you can deliver it in time don't promise it."
Whose health policy is better?
Both major parties have announced their major health policies in the lead up to the October 17 election.
The Canberra Liberals have promised to add eight extra hybrid operating theatres into the Canberra Hospital expansion and tweak the design.
They say the project wouldn't face further delays and haven't disclosed how much extra it would cost.
The party has also promised to churn through 70,000 elective surgeries in the next four years - 10,000 more than what Labor has promised.
They say they can halve emergency and elective surgery wait times over the next four years if elected.
Labor meanwhile has promised to build an extension the the University of Canberra Rehabilitation Hospital to add day surgery theatres.
It will also significantly expand the territory's nurse-led walk-in centres, with five extra clinics across the territory on offer.
Dr Di Dio said he couldn't back one party's platform over the other.
On the one hand Labor was promising to expand the network of walk-in centres, which are loathed by GPs as expensive and ineffective.
On the other hand,the Liberals had not been upfront about how they would deliver their promises.
"I don't think the Liberals have genuinely given us how they're going to pay for everything," he said.
"The statement, halving waiting times, sounds terribly appealing, but I'm not sure that I can approve of it unless I can have some kind of evidence that there is a pathway and some detail to explain how they're going to do that."
