Aged care needs trained staff

Transcript: AMA Queensland President, Dr Maria Boulton, ABC Capricornia, Breakfast with Paul Culliver, Tuesday 6 September 2022

Subjects:   GPs in aged care, Gladstone Hospital maternity unit closure

PAUL CULLIVER:   When it comes to living in aged care, there's some pretty basic things that you'd think you'd need to live a happy and safe life. You want to be fed well, you want to be kept company, you want some good activities, access to visit your family and friends and have them visit you, and, of course, your medical needs should be looked after. Those, of course, are going to be met by visits by GPs and nurses.

For the last 12 months or so, Access Aged Care has provided that service to a number of aged care facilities in Rockhampton and also Bundaberg. But now, they're pulling out. They say the costs are going too high because quite simply they cannot source GPs locally. Now, that probably rings true for you, given we know we just don't have enough GPs in Central Queensland right now. But if you're living in an aged care facility, well, where are you left to go when it comes to getting the proper medical care you need?

Dr Maria Boulton is the AMA Queensland President. Dr Maria Boulton, good morning to you.

DR MARIA BOULTON:   Good morning, Paul.

PAUL CULLIVER:   Just how crucial are services like this, having GPs and nurses come into aged care to provide those services?

DR MARIA BOULTON:   We know that they are really, really important because people living in aged care facilities, not everyone, but a lot of them will have serious health conditions. It's very difficult for them at times to leave those facilities to go and see a doctor at a clinic or go to a hospital to get care. If we can provide the care within that facility, it's a much better outcome for those residents.

PAUL CULLIVER:   Reading between the lines there, if there's not a different service that's going to come in and replace what is being provided here and they're going to pull out from about mid-September, that's what they're faced with, with having to go and book in and get GP visits and leave the place that they live?

DR MARIA BOULTON:   Yeah, basically. But from my understanding, I know that our primary health network locally is trying to work and find a solution and try to force some local GPs to go and visit the facilities. But the issue is that the entire of the health workforce is under a lot of strain at the moment, and this is putting pressure in areas, especially that I'd say vulnerable people, like aged care residents.

We have been talking about this issue for a long time. We know that there was a royal commission into aged care, and we know that these residents deserve better. We know that they don't have access to staff ratios, for example. When you have a child in daycare, there's a ratio between carers and the children in daycare, but it's not the same if you're in aged care. There's no nurse-to-resident ratio. It seems to me that that's really important because you do need trained staff, you do need registered nurses to be able to care for those residents. You need trained nurses to be able to deliver those medications and also know when to call the doctor and when to call the ambulance.

Then the GP comes on top of that as well. We know that GPs have never been adequately resourced to go into aged care facilities. We've been asking for them to be resourced so that this can't continue to happen. Unfortunately, it's the vulnerable residents that miss out in the end.

PAUL CULLIVER:   Yeah. It seems to me that any kind of short-term fix that you might put in is going to pull at something else. It's almost a zero sum game, in a sense. You're either paying a whole lot more for locums, which is obviously making your costs rise, or you're using more local GPs, which we just don't have any great ample supply when it comes to appointments and all of the strain they're under. Just any which way you cut it, someone's losing out here or we're putting more strain on the system, it seems.

DR MARIA BOULTON:   Yeah, most definitely. We know that there's all these new hospitals being built across Queensland in the next six years, or 2,500 new hospital beds, but that's going to drain staff from areas that are already short of staff. So it's really, really important that Queensland Health look at that. I know that they're having a health workforce summit at the end of September. We're definitely, definitely asking to see some long-term solutions that are not just quick Band-aids. They do come up with interesting Band-aid solutions at times. In the end, people in aged care facilities, what they need is they need doctors and they need registered nurses that can care for them.

PAUL CULLIVER:   Yeah. I suppose for people listening and people that have loved ones and people that do live in aged care facilities that might be concerned about this, about the future of the healthcare that they might receive in their facility I suppose, what are those conversations that they should be having with their provider?

DR MARIA BOULTON:   Yeah. I think it's asking the provider what sort of staffing they have, how many registered nurses they have on shift, whether there's a registered nurse there 24/7, what the visiting doctors are like, how often do they visit, and what happens if those doctors, for example, have to go away or get sick? Where's the cover for that? It will vary between regions. I live in Brisbane Metro, and I know that if one of the doctors can't go to an aged care facility, one of the other doctors will cover, or there is a hospital service that will send someone to that aged care facility at short notice. But these are not services that are available all through Queensland, which they should be.

Many of us are going to end up in aged care facilities with chronic disease, and honestly, and it is in the interest of Queensland Health to be able to care for those patients at those facilities, because otherwise, those residents end up in hospitals. We don't want residents to be moving around. We want them to be kept comfortable. We want them to be kept as independent as possible. It's really sad. We see residents going to some facilities, and they don't get any physio, they don't have access to occupational therapy, all those services that will keep them mobile and independent for longer. Then their condition deteriorates, which is really sad to see.

PAUL CULLIVER:   Dr Maria Boulton is your guest this morning, the AMA Queensland President. It's now been two months that Gladstone has been on maternity bypass, of course expectant mothers having to travel to Rockhampton. It was just late last week that we also learned that the Biloela maternity would be on bypass for some time, through till September 10 is our current advice as to when it will come off bypass. But, of course, that's all adding extra strain to Rockhampton birthing services. Dr Maria Boulton, I just wonder what you make of the current situation and just how much strain that is putting on the services here in Central Queensland.

DR MARIA BOULTON:   Oh, it's extremely concerning. We know that there are 600 births in Gladstone a year. At the moment, it's Rocky that's managing those, and we know that Rocky also has staff shortages. So you have an already very busy unit trying to also deliver for another town.

I was talking to a doctor in the area, and they used to work in a regional area in another state and they said that the services that they had access to in that region were way more than what they have access in Queensland. We knew that this was going to be a problem when the private maternity services closed a few years ago, and we knew that that was going to place more strain on public services. This is exactly what happened.

We have met with Queensland Health and we have written to them and we have asked for them to come up with an urgent solution to this. The reply that we've had is that they are trying to frantically recruit doctors to the area. They're also trying to see whether they can have doctors fly in to the area to sort it out because it's just not good enough, 600 births.

It's not just obstetrics, it's also gynaecology. So people who have, for example, abnormalities in their cervix, for example, have to travel to Rockhampton to get those assessed. With a population in the hundreds of thousands, it's just not good enough.

PAUL CULLIVER:   Dr Maria Boulton, really appreciate your time today. Thank you.