AMA President Dr Steve Hambleton, Doorstop, AMA Public Hospital Report Card and Queensland Hospital Contracts
Transcript: AMA President, Dr Steve Hambleton, Doorstop, Royal Brisbane Hospital
Subject: AMA Public Hospital Report Card 2014 and Queensland Hospital Contracts
STEVE HAMBLETON: Thank you ladies and gentlemen. Thank you for coming here today to the launch of the AMA 2014 Public Hospital Report Card.
The AMA is accessing the latest information we can get to actually report back to the public and to governments on how our public hospitals are functioning. The measurements that we use, and we've used longitudinally over the last couple of year, are the emergency access targets. That is how many people in category three, that's the urgent category, gets seen within in 30 minutes. Sadly, there's not been much improvement.
Marginal improvement to 68 per cent is not good enough. The target for this year was meant to be 80 per cent. If we increase it at the rate that we're increasing, it'll take us six more years to get to that 80 per cent target, and that means that our emergency departments are under pressure.
We also look at the elective surgery targets, and we are looking at the average wait for elective surgery around the country and we're looking at 36 days, and there's been no improvement for the last three years. And that tells us that, again, our hospitals are under pressure. We need to make sure that we actually sufficiently invest in infrastructure so we can get those targets met.
Now, the third thing we've looked at this year is actually the funding for hospitals. We've now examined the funding against what was promised to be delivered in our public hospital sector. And around the country, looking at the last Government, there was $136 shortfall in the spend by the last Government over what they promised. Sadly, we looked at the current Government's estimations in the Mid Year Economic Fiscal Outlook and there's $400 million short over the next three years.
So, it's very disturbing that we've got these figures showing our hospitals are under pressure, and yet the funding may not be there. So this is not the time to cut funding and we're calling on the Government to make sure they spend all the money that they were proposing to spend on our public hospitals.
QUESTION: How's Queensland fairing?
STEVE HAMBLETON: Queensland actually stands out in a couple of areas. We certainly have the lowest elective surgery waiting times in the country, and that's really pleasing, but the figure that we see is only part of the wait. The other half of the wait is actually the time between the referral from the GP and getting to the specialist in the hospital. That's what GPs need to measure.
It is being published by Queensland and we call on the other states to publish those figures, but it's got to be easily accessible by both doctors and patients, otherwise we don't have meaningful answers. Now, whether we can compare that 27 days in Queensland with 36 days in other states is very difficult, because we all measure things very differently. But Queensland is doing well there.
Now, emergency access times in Queensland have shown an improvement. We see 68 per cent in our documents, but in the last year there has been a significant improvement, and that's because the Government is engaged with the doctors and looked at system redesign. This is a principle that we urge other governments to do. It's very important to work with your workforce.
QUESTION: WA has also shown some improvement, along with, you say, Queensland. What do we owe that improvement to?
STEVE HAMBLETON: Well, look, I think the improvement fairly and squarely has not been more dollars, it has not been in more beds, because we know the bed numbers have not gone up. The improvement is because of engagement of the staff. It's a whole of hospital reform. When management and staff work together in a very constructive arrangement, we can look at system design, we can redesign things that work better for patients, and we can get the outcomes.
It works. WA showed it can work first up. Queensland has adopted some of those principles. And I guess we're concerned that we need to maintain that engagement with the staff, because if we do the opposite, you're going to get the opposite outcome.
QUESTION: So are you saying that it's not necessarily more funding that's needed, it's more engagement?
STEVE HAMBLETON: Well, absolutely saying that we need better engagement with our staff, we need to look at the systems that we're using, we need to use the expertise of the staff in the system to actually redesign that, but we also need that funding. We need to make sure that Federal Government spends what it has promised. We need to make sure that the state governments invest in infrastructure.
The number of beds per person over the age of 65 has not changed year after year, and if you think about it, they're the ones that are using our public hospital sector. I can have my contract changed so that there can be changes in salary, changing in working conditions. And, as a father, as someone with kids in school, with mortgages, that doesn't work for me and it wouldn't work for the people of Queensland, or the doctors of Queensland.
Doctors can move around. You know, health service or illness is the same across the world. So we can move with it. We don't want to move - we like working here. But you don't criticise us for producing the best report card across Australia.
QUESTION: How will these contracts affect patient care?
JOHN FRASER: Well our hope obviously is that we don't affect patient care, but if you are being punished for delivering the best report card it's really not engaging your work force. People can move, people can leave the public system, people can move out of state. The trainees that we depend on for the next five years won't come up and it'll be seen as a pariah in the health service.
So we really need to see - this is not just about today and tomorrow, it's about the next generation of Queensland. And we want to provide them, when we leave the health service, with a great system. And I really worry that this document that's been forced upon the doctors will not provide that.
QUESTION: Would you be prepared to take industrial action?
JOHN FRASER: It's been discussed. I think as a medic we try very, very hard to avoid that because our first and foremost thought it the patient. What we'd really like to do is speak to the Government and say let's sit back down at the table, let's engage us, let's see that you've got the best report card in Australia. Work with us rather than against us, and then together we can provide the best healthcare for the people of Queensland.
14 February 2014
CONTACT: John Flannery 02 6270 5477 / 0419 494 761
Kirsty Waterford 02 6270 5464 /0427209753
Published: 14 Feb 2014