GP clinic closures can't continue

Transcript: AMA Queensland President, Dr Maria Boulton, 4BC, Mornings with Bill McDonald, Tuesday 24 October 2023

Subjects: Urgent Care Clinics, Satellite Hospitals

BILL MCDONALD:   The Australian Medical Association Queensland President Maria Boulton joins me this morning. There are two stories that I wanted to get across for you today, both about government initiatives to ease pressures on our health sector. Are they actually working? When I was reading through them, I thought, yep, okay, sounds good, but I want to know if the rubber is hitting the road. And Maria, thanks for speaking to us today.

Can we start with these urgent care clinics in Queensland that are funded by the federal government and are open to take pressure off emergency departments? We just had one open in Woolloongabba supposed to take pressure off the Mater, Queensland Children's and the PA, and there's one in Murrumba Downs and Browns Plains as well, I believe. They're supposed to be open 14 hours a day, but currently only open 12 hours. What's happening? Are they working?

DR MARIA BOULTON:   Good morning, Bill. It's not enough. And that's the reality, that when you look at the immense need and how many people actually attend general practice and hospitals every day, and when you consider how decentralised a state Queensland is, a handful of urgent care clinics in a handful of suburbs is not going to cut it. While we do welcome any investment in healthcare, what would have made more sense to us is for investment to go to everyone's GP, whether you live in Charleville, Proserpine or Brisbane, so that you can have access to your GP when you need it. We know that after-hours can be a tricky time and we have been calling for extra funding for GP clinics to be open in that after-hours time. And it seems that the urgent care clinics that are currently open don't open in those hours. When you look at GP clinics, there's some that are open till 6pm, some till 7pm, some till 10pm. But what would have been much more useful is to have a service open outside of those hours, which doesn't seem to be something that the urgent care clinics are open at the moment.

BILL MCDONALD:   So is it a bit deceptive to say that this is making a real difference? I know you said you don't want to be critical and you welcome any sort of input and assistance from the government, but is it a little bit disingenuous to say that it's making a big difference?

DR MARIA BOULTON:   I don't think it will in the long term. In the long run, it's just too little of an investment. It definitely recognises the fact that GP services can't be done just on bulk billing rates because the funding going into the urgent care clinics is additional to what the Medicare rebates are. But once again, that funding would have been better to go to your GP. And the reason why that's important is because patients are far better off seeing their GP clinic that knows them, knows their history so that they can have that continuity of care rather than going to someone they don't know who may not be able to follow them up, for example.

When it comes to healthcare, you look at Australia compared to the rest of the world, we have one of the best GP systems in the world. Instead of funding that so we can continue to provide the excellent care we do provide, it seems that governments are intent on funding these Band-Aids that just won't be accessible to everyone.

BILL MCDONALD:   And on the timing, the 14 hours a day and currently only open 12, is it hard to get staff? Why are they only open for and not for longer?

DR MARIA BOULTON:   Look, I can't comment on that. But we know that workforce is really tight at the moment and that's across all health workforces, be it nurses, receptionists, doctors, allied health, pharmacists. They’re suffering from the same pressures that the rest of the system is suffering from. And it's not a pressure that is just Queensland. It's also the rest of Australia and in fact the rest of the world.

That's why we've been calling for the state government to produce a comprehensive workforce plan so that we understand exactly how short we are, how much workforce we need in all the different areas in Queensland, but also our future needs for 10 years’ time because we want to make sure that we're training enough people and recruiting enough people so that these healthcare services can remain open.

BILL MCDONALD:   We're coming into an election year. We've talked about a lot, nearly 12 months out. Are you expecting it to be a prime opportunity for the urgent health needs to be addressed? I imagine there'll be a lot of promises being made. Are you expecting that you'll get an ear and we will see the dial shift in terms of what both sides will be looking to offer to fix and remedy the health situation in Queensland and the hospitals?

DR MARIA BOULTON:   Most definitely. We've seen both sides really recognise the importance of healthcare and the urgent need to do something about it. The issue with general practice is that Medicare rebates are federally funded, so it's not just up to the state, but I'm sure that Queenslanders would appreciate the state stepping up and supporting their access to their GP.

We've had many conversations with our new Health Minister and also the Leader of the Opposition, and we've discussed the need to ensure that general practice is well funded to provide that collaborative multidisciplinary care that we do, especially not just in metro areas but also regional, rural and remote areas.

I just heard today there's a GP clinic in Rockhampton that has closed down. Last week it was a clinic in the Sunshine Coast, at a time when this cannot happen. We cannot continue losing GP clinics because what we'll see then is that people won't be as well and we'll see more people end up in hospital.

BILL MCDONALD:   Yeah, well of course we're going to 4RO in Rocky, so it'll be interesting to hear if there's anyone impacted by the closing of that clinic.

While we've got you, Maria, turning attention to the state-funded satellite hospitals as well that's been getting a bit of attention in the media. And early data shows that the Ripley and Redlands satellite hospitals cared for more than 4,600 people from August 30 to October 15. At the same time, Ipswich and Redland Hospital emergency departments are showing a drop in presentations. Early data also showed patients treated at the satellite hospitals were in and out in about 90 minutes. The average length of stay was about one hour and 40 at Ripley, an hour and 33 at Redlands. Satellite hospitals at Kallangur, north of Brisbane, Tugun on the Goldie, they're set to open in the coming weeks. Eight Mile Plains in Brisbane's south and Bribie Island in 2024. Are these satellite hospitals helping?

DR MARIA BOULTON:   I think it's the same issue as the urgent care clinics. The satellite hospitals were set up to reduce ambulance ramping and the figures that were released focus on Category 4 and Category 5 patients. They're not the patients that are actually causing the backlog in EDs.

What's happening in the emergency departments is that they're seeing an increase in presentations of people with urgent conditions, for example, chest pain and stroke, and then when ED try to shift them to a hospital bed, there's no hospital beds to shift them into. So then the amazing ED personnel are left caring for those patients for longer. And then when an ambulance comes with another patient with chest pain, they can't get that patient off onto a bed because there are no beds available.

When you speak to my emergency colleagues, what they'll tell you is that it's not people who come in with sore ears, coughs and colds who are causing the issues, who are causing ramping, it's the lack of hospital beds and the lack of workforce. And here we are again, workforce. The Premier has announced 2,500 new hospital beds that are going to be opening in the next five years. We welcome that announcement, but the big issue there is that we'll also need the workforce to staff those beds. Once again, you have to look at the system as a whole.

We put together a Roundtable in AMA Queensland looking at the ramping issues in ED. One of our recommendations was an increase in beds. There were other recommendations made that haven't been fully taken up or funded yet that need to be looked at because we know that they are going to make a big difference when it comes to ramping.

And then on the other end, we know that a good investment into general practice and supporting patients access their GPs when they need to, particularly those vulnerable people who can't afford the out-of-pocket gaps, then we know that by keeping those people in touch with their GP, we know that they'll stay healthy and they'll have less need of a hospital bed.

BILL MCDONALD:   Yeah, it makes a lot of sense. Thanks very much for your time. We always appreciate it.