A staggering 47,000 West Australians are waiting to see a public hospital specialist to find out if they need surgery, figures reveal.
The number of patients waiting to get appointments at outpatient surgical clinics - the so-called "waiting to waits" - is almost double the State Government's last estimate of 24,000, which it conceded was out of date.
It does not include people waiting to see specialists for treatment such as pain management and the numbers are on top of the 17,000 West Australians already on the official elective surgery waiting list.
It is the first time surgery out- patient waiting lists have been made public in WA and comes after calls from the Australian Medical Association and shadow health minister Roger Cook to make the system more transparent.
The 47,245 referrals waiting at the end of last year included more than 10,000 children needing assessment for surgery at Princess Margaret Hospital.
Overall, the average waiting time to get in to see a specialist is 4.5 months.
The longest waits are at Sir Charles Gairdner Hospital (5.9 months) and PMH (5.2 months).
Health Minister Kim Hames said that though the total number of referred patients shocked him, it was likely only a small number would need surgery because last year just 6.8 per cent of the 255,000 appointments resulted in patients going on the elective surgery waiting list.
He said this suggested only 4500, at the most, of the current referrals would need surgery.
"The number of referrals is higher than we expected but the good news is that the ones actually needing surgery is low," he said.
"But that does raise questions about how we manage them and why some of them are there.
"It suggests some people are being referred for surgery when, in fact, they might need other medical treatment like medication or physiotherapy, so we need to look at that."
Dr Hames believed WA was the first State to publish surgery outpatient waiting lists, which would be updated every six months.
"We're going to work with the AMA to look at how people are referred from GPs and if there is a better way to manage them," he said.
AMA president Richard Choong said he welcomed greater transparency but believed the numbers were underestimated because they did not include referrals at secondary hospitals or non-surgical cases referred to tertiary hospital outpatient clinics.
"This gives a bird's-eye view but we would like to see more detail, including a breakdown of waiting lists for surgical specialties, and we're keen to work with the Government to improve waiting lists and times," Dr Choong said.
"In particular we need to improve the integration between GPs and hospitals so that we don't have all these thousands of patients suffering pain while waiting months for their outpatient appointments."