Restrictions on elective surgery and the recent state-wide Code Brown which halted elective surgery saw waiting lists increase but in giving evidence to the state's Pandemic Declaration Accountability and Oversight Committee's Review of Pandemic Orders hearing earlier this month Grampians Health chief executive Dale Fraser said the case numbers should be back to original levels this year.

"Our elective surgery list here is marginally up on where it was two years ago but not materially up. So we are quite confident that once we are over the restrictions we will bounce back rather quickly with regard to our pre-COVID surgical program," he told the committee.

But he warned that some of the cases still waiting for surgery were more complex cases that would impact on operating theatre time and demand for beds.

Mr Fraser said activity in category three surgery, the least urgent cases, had slowed substantially throughout the pandemic.

"Our target for the cat(egory) threes has moved from I think an average of 304 days to 350 days ... cat(egory) two numbers have moved from the high 70s to the low 90s.

"Our pre-pandemic elective surgical waiting list numbers were at 1254, and ... today our number is at 1415."

"The one challenge we have had, which is going to cause a challenge for us coming back, is that we have maintained a focus on some volume. So what we are coming back to now is more complex work, so the impact on theatre time and demand for beds and so forth will require us to work more logistically on how we get that workload through. We have done a lot more of the easier work throughout the process in the last couple of years, but now we are left with some of the more complex cat twos and cat threes."

Mr Fraser said about 60 per cent of surgical work at BHS is emergency surgery.

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BHS was able to maintain capacity for elective surgery during much of the pandemic through its relationships with St John of God hospital and other regional providers.

"We have continued to have capacity to have surge surgery or surge demand being met by St John, and that has been managed throughout the last whole two years, so we have had capacity here. They at various times have done surgery for us to maintain capacity along the way to ensure that we met appropriate time lines.

"We also have ongoing relationships with the Ballarat Day Procedure Centre to do day-case surgery for us, but beyond that we have had an ongoing program for a number of years now whereby we have had arrangements with other public hospitals around us - work being done at Daylesford and work being done at Maryborough, Ararat and other locations.

"We have used a network approach to ensure that rather than patients coming to us here at Ballarat, if you have a condition that is able to be safely managed at those facilities and you live in those areas, then we create an arrangement whereby we contact those organisations to provide the care. They come off our waiting list, but the service is actually provided in those various locations."

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