Hundreds of millions of health dollars are wasted paying highly skilled staff to do tasks less qualified workers could do, a report says.

Hospitals could save $430 million and treat an extra 85,000 patients a year if doctors, nurses and physiotherapists devolved simple tasks to assistants, according to the Grattan Institute.

The think tank's head of health policy, Stephen Duckett, said too many hospital staff did not use their training and skills fully because their time was taken up with straightforward work.

Though doctors have traditionally been fiercely protective of their role as gatekeepers of care, the institute believes specialist nurses could do endoscopies and administer anaesthetics.

Both procedures are among the most common in hospitals and the institute argues appropriately qualified nurses could do routine cases as well as specialists.

In the case of endoscopies, nurses would do them only when a patient was referred by a doctor or it was routine screening.

As a start, nurses should be trained to provide sedation to low-risk patients who stayed conscious during a procedure.

Further training could be provided to nurses to administer general anaesthetic to patients for surgery with a low risk of death, such as tonsillectomies or cataract removal.

Another option put forward was to expand the use of nursing assistants for basic tasks such as bathing, feeding and moving patients to free up highly trained registered nurses.

The institute estimates 15 per cent of a registered nurse's time is taken up with these tasks.

The report also suggests physiotherapists and occupational therapists hand over duties to assistants. It says a physiotherapist on average earns $78,000 and an assistant $30,000 less.

Dr Duckett said many of the recommendations were standard practice overseas, such as in the US and Britain. "Staffing takes up about 70 per cent of a hospital's spending," he said.

The West Australian

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