Federal budget found wanting

Subject: Federal Budget

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ALEX EASTON:   In the Federal Coalition's budget last March, the Australian Medical Association had pitched a series of ideas that were designed basically to fix the health system in Australia. Some of those would cost the government money, such as increased funding for general practice or the establishment of an independent authority to oversee the private health sector. One to split health funding 50-50 between the states and the Commonwealth would rearrange existing health funding structures and one of them, a tax on sugary soft drinks, would've made the government money while reducing health impacts of things like obesity and type two diabetes.

The coalition didn't go for any of that in March, but last night, the nation's medicos got a chance to do over when the new Treasurer, Jim Chalmers handed down his first budget. Dr Maria Boulton is the President of the Australian Medical Association Queensland. Dr Boulton, thanks so much for joining us. Did the new Labor government pick up on any of those proposals that the previous government had rejected?

DR MARIA BOULTON:   Good morning. They picked up on a few but not enough, and we're deeply concerned.

I've been in this role for about five months now and I've travelled to Rocky, Gladstone, Toowoomba, and I've been in many hospitals in those areas and I don't believe that there's enough in this budget to address the issues that are affecting Queenslanders when it comes to ramping, when it comes to bed access block, when it comes to the elective surgery wait list, and also with the woeful Medicare rebates as they stand for patients to access medical services.

They did address some issues that we've been advocating for. So, for example, there is funding there to bring registered nurses into aged care facilities. We've been pushing for that for some time. There is some funding to try and increase the rural health workforce, not a lot, but there is some in there, and there's also some funding for First Nations health.

So there were some positives, but it needed a bigger vision to address the issues that are affecting us at the moment.

ALEX EASTON:   One of the ones that looked like it was designed to deal with the long wait times that people have just to get in to see a GP was $235 million for 50 urgent care clinics around the country, which would be places where people could go with non-emergency cases. I don't know where they would all be, but obviously, Australia's a big place and 50 is going to be spread relatively thin. Is that something that would make any difference?

DR MARIA BOULTON:   We believe it won't because, as you said, there's only 50 of them.  We've been advised that they will be located near large hospitals, so basically rural and remote Australia misses out. We haven't seen a lot of the detail when it comes to it and we don't understand why that funding wouldn't go to patients accessing their own GP. Why would you need to build separate clinics when there's GPs out there already set up who already look after their patients and why that funding wasn't given to the patients to access their own GP?

So once again, the devil is in the detail, where we need to see that detail and we've been asking for it for some time now, but just looking at the number, 50, that's not going to go far enough.

ALEX EASTON:   A fairly similar criticism that was made of the GP Super Clinics idea that was rolled out, I think under the Rudd government. Is this basically a revival of the super clinics with a different name?

DR MARIA BOULTON:   Yeah, it seems that way. And once again, it's nonsensical when you have many GP clinics who already operate seven days a week, already operate after hours and many others who would be keen to do so if the funding was there to be able to offer those services.

ALEX EASTON:   If that $235 million was directed towards GPs to try and free up space in the existing GP network, would that make any difference?

DR MARIA BOULTON:   To be honest, it would be a drop in the ocean. It's not a lot. When you divide it amongst all the people who have GP consultations every year because all that money eventually goes to the patient, and if it goes to Medicare rebates, that's the patient rebate. We would need a little bit more than that, but it would be a good start. And it would also be acknowledging that relationship that the patient has with their own GP or their own GP clinic.

ALEX EASTON:   Of the various opportunities that the government had to address issues in healthcare in the budget last night, what's the biggest missed opportunity do you think?

DR MARIA BOULTON:   The biggest missed opportunity was increasing funding to our hospitals. We have been asking for a 50-50 split of funding, so we have been asking for the federal government to increase their funding by another five per cent to hospitals.

We know that hospitals at the moment are in crisis. We know that COVID hasn't helped, and we know that a lot of the patients who are coming into hospitals are actually patients who need a hospital bed, so these are category one patients, and we know from Queensland Health that there's been a rise in these patients.

These patients are people who are having a heart attack or a stroke, people who actually need a hospital bed. And this was a real missed opportunity. The Federal Government should have invested more in our hospitals.

And this is not an issue just in Queensland. It’s across Australia. We also know that there are workforce issues and that's why we needed the increase in funding as well.

ALEX EASTON:   Part of that 50-50 split that the AMA and a lot of the state governments, including Queensland have been asking for as well, I gather is about the Federal Government having had for quite a few years now, a 6.5 per cent cap on how much it will let its hospital spending grow. And there's concern that the growth in the cost of running the hospitals will far outstrip that 6.5 per cent, and that extra cost just gets shifted onto the states. How big a problem is that?

DR MARIA BOULTON:   If you're a Queenslander waiting on an ambulance to be admitted into emergency, it's a huge problem. And doctors and nurses and everyone is working in emergency departments are doing what they can with the system that they have. But they will tell you time and time again that they need an urgent increase in funding because there's only so long that they can cope with this.

It's really stressful. So we hear from doctors who will spend a whole shift at work and not see one patient in a bed. They'll spend the whole shift seeing patients on stretchers or they'll see them in an ambulance. There are also patients who are waiting in excess of 24 hours in an emergency bed to be admitted into a hospital bed because there's not enough hospital beds.

So this is a real issue and it's happening already, and I just don't understand why there wasn't more funding allocated to fight this.

ALEX EASTON:   You're hearing from Dr Maria Boulton from the Australian Medical Association Queensland.

I suppose one thing is this year's budget is unusually late. You don't usually see budgets coming out late October, so presumably if the next one goes on schedule, we're looking at a wait of about maybe six months or so before we are doing this whole budget thing again, which means the AMA broadly has six months to campaign for these reforms. What kinds of things should we be expecting to see from the AMA and AMA Queensland over the next few months leading up to the next budget?

DR MARIA BOULTON:   So the AMA is fiercely campaigning to increase funding for our hospitals. We're also fiercely campaigning to reform Medicare. We know that the Medicare rebates are more suited to short consultations, whereas patients nowadays come in with complex problems that take longer and they deserve to be able to spend longer with their doctors.

We also know that there's an increase in mental health issues, so we will continue to campaign so that patients can have access to those Medicare rebates so that they can have those longer consultations with their doctors.

We'll also continue to make sure that whatever money was in this budget, so the money that was allocated to aged care, First Nations health, etc, that that money is used appropriately.

I still think that there needed to be more for our rural workforce. We know that it's not only an issue of recruiting health workforce to our remote and rural regions, but also they need accommodation. They need support for their families. We need to do a little bit better there, so we will continue to push for those.

ALEX EASTON:   All right. Dr Maria Boulton, thank you so much for your time this morning.