President and CEO update February 2023

Payroll tax amnesty

The Australian described it as “one of the quickest about-faces in political memory” but in reality the Queensland Treasurer’s decision to announce a payroll tax amnesty for GPs took more than a year of hard work and persistence by AMA Queensland.

Our requests to meet the Treasurer went unanswered from November 2021 until this month. The Premier, the Treasurer and the Health Minister repeatedly denied any changes in tax law interpretation following rulings in NSW, and the Queensland Revenue Office (QRO) refused to provide us with written advice on why GPs were being hit with retrospective bills going back five years.

These bills were coming at a time when practices were already closing due to financial strain. Practices that had been fully compliant were suddenly facing bills in the thousands and millions of dollars with no warning or explanation.

In late December, the QRO finally confirmed the interpretation of tax laws had changed. It provided a public ruling on the new tax and gave us a commitment to limit audits to 1 July 2021 onwards. While this gave some relief to practices, the public ruling made it clear the government considers GPs who rent space in clinics to be employees.

We called for this to be raised at February’s National Cabinet. On the morning of National Cabinet, after sustained media pressure, the Treasurer announced an amnesty – two-and-a-half years to either restructure their business model or build up the resources to pay the new tax from mid-2025, conveniently after the next state election.

While we welcome the compromise, this is not a long-term solution. Practices will have no choice but to start charging patients more now so they can afford their tax bills in the future.

We are continuing to advocate for an exemption for general practice. When a patient goes to a public hospital, that service is payroll tax-exempt for a very good reason – healthcare is an essential need. Patients deserve to have access to their GPs in the same way.

We will also work with our state and federal counterparts for a sustainable national solution. GPs in Tweed Heads face the same pressures as their Gold Coast counterparts.

Read more about our advocacy, including our correspondence with the State Treasurer and the Queensland Revenue Office.

Medicare reform and pharmacy prescribing

The federal government’s Strengthening Medicare taskforce report was released after National Cabinet. Our federal colleagues were part of the taskforce and many of the report’s recommendations focus on proposals identified in the AMA’s Modernise Medicare campaign.

These include improved funding for the Workforce Incentive Program and support for after-hours GP services.

We were disappointed there were no further funding announcements from National Cabinet. We continue to advocate for urgent funding for patients to access their GPs, to alleviate ramping and to address the elective surgery wait lists. This cannot wait until the May federal budget.

We were also disappointed the federal Minister flagged his support for allowing pharmacists to autonomously diagnose, treat, and prescribe and sell medications beyond their level of training and experience.

We’ve seen the adverse health outcomes of the urinary tract infection (UTI) pharmacy prescribing pilot for Queensland women, and we are continuing to fight against the North Queensland pilot that’s due to start this year.

We are working with our federal colleagues to press for urgent, sustainable reforms to Medicare.

Maternity services

The Central Queensland maternity crisis has shone a light on regional workforce pressures and the parlous state of private obstetrics across not just the state but the nation.

The Queensland Government has listened to our advocacy and relaxed its locum restrictions on Queensland Health employees. We are also optimistic that Queensland Health is actively recruiting to fill workplace shortages.

However, full maternity services in Central Queensland will not return until mid-2023 at the earliest when three international medical graduates are due to arrive.

We are heartened to see a record intake of junior doctors starting work in Queensland hospitals this year. However, this is simply the natural movement of medical graduates into the workforce and not the result of any state government action.

It is vital that Queensland Health develops a long-term workforce strategy that looks at recruitment and retention simultaneously. It is not enough to recruit doctors to rural and regional areas – we have to find ways to keep them there.

Ramping

Ramping and bed block in our public hospitals continue to be a major focus in 2023, with two new AMA reports showing the increased stresses on emergency departments and elective surgery wait lists.

Queensland is not alone – these issues are affecting all states and territories and have been building up for decades.

The AMA Hospital Exit Block report found about 250,000 patient days in public hospitals Queensland hospitals had the highest number of patient days attributed to patients waiting to be discharged into residential aged care in 2020-21 – close to 100,000.

It also found 245 NDIS-eligible patients in Queensland public hospitals in November 2022 who were ready for discharge but with nowhere to go.

The Australian Public Hospitals in Logjam report, released to coincide with National Cabinet, analysed the emergency department and elective surgery performance of 201 public hospitals around the nation.

It found only three were delivering care within recommended timeframes, down from 15 last year. No Queensland hospital met the recommended timeframes.

Our hospitals and healthcare staff have been under unprecedented pressure throughout the pandemic. We are seeing the impact of scans and treatments that were delayed during COVID lockdowns.

Our Ramping Roundtable action plan lays out the steps the government must take to resolve these issues and build a sustainable health system.

Fraser Coast Health Conference

We have partnered with The University of Queensland and the Fraser Coast Regional Council to hold the inaugural Fraser Coast Health Conference in Hervey Bay on 25-26 February.

This conference – spearheaded by AMA Queensland Vice President, Dr Nick Yim – gives medical and nursing students, doctors in training and international medical graduates the opportunity to see what the Fraser Coast offers in career and lifestyle.

Along with highlighting the region’s three Ls – location, lifestyle and liveability – the conference will cover issues including geographic narcissism during medical education and training, managing challenging patients and families, and the diverse pathways available through general practice.

The conference is now sold out, but we look forward to hosting the conference on the beautiful Fraser Coast. 

Australia Day honours

Congratulations to Drs John W. Cox and Vernon Moo, who received Medals of the Order of Australia on Australian Day.

Dr Cox is a Toowoomba-based consultant paediatrician who served on numerous roles for AMA and AMA Queensland, including the National Private Practice Committee, AMA Queensland Council, Ethics Committee, Aboriginal and Torres Strait Islander Committee, Public Health Committee and representing Toowoomba and Darling Downs on Council. Dr Cox has been President and member of the Toowoomba and Darling Downs Local Medical Association and a member of the Gene Regulating Authority of Australia.

Dr Moo is a Brisbane-based anaesthetist who works as a senior visiting specialist at the Princess Alexandra Hospital and privately through Gabba Anaesthesia. He has practised in Australia, the UK and Antarctica and has volunteered for more than 50 missions with Interplast Australia and New Zealand, Operation Smile and other charities. He has also served in the Royal Australian Navy on peacekeeping and humanitarian operations.

There’ll be more on Dr Moo in the Autumn edition of Doctor Q.

Doctorportal Learning

The Australian Medical Council (AMC) has approved Doctorportal Learning Pty Ltd, a wholly-owned subsidiary of AMA (WA), for initial accreditation to deliver a CPD home service to all eligible doctors around the nation.

Trading as CPD Home, the new service will launch in March 2023 and will be available nationally to all doctors who are required by the Australian Health Practitioner Regulation Agency (Ahpra) to participate in an accredited CPD program.

This includes all Australian-registered medical specialists (regardless of whether they are already a fellow of a college), international medical graduates, PGY2+ trainees and non-vocationally registered doctors.

This is an example of how AMAs around Australia are working together as a federation for the benefit of members.

The Medical Board of Australia’s statement in full is available at https://www.medicalboard.gov.au/News/2023-01-20-new-accredited-CPDhome.aspx