Health inquiry report disappointing

Transcript: AMA Queensland Vice President, Dr Bav Manoharan, 4BC, The Scott Emerson Drive Show, Monday, 11 April 2022

Subjects: Queensland health crisis inquiry; hospital ramping

SCOTT EMERSON:    Now, time and again, we have seen the headlines about Queensland's crippling health system and 4BC Drive listeners, you've texted me, you've spoken to me about what you see are the problems with the hospital system. You've talked about the fact that you couldn't get an ambulance when you call for one, or if you are in an ambulance, you had to wait two, three, four hours while ramping outside the hospital, all those code yellows. We've heard about what's happening at hospitals where there's no beds for patients. There are real problems out there, but you think, oh, well, the government called an inquiry into this. But they rigged the inquiry. What they said was, "Oh, we want you to look at the Queensland health system, but only the kind of areas that the Federal Government is responsible for." And of course it came back with a whole series of recommendations for the Federal Government.

So look, I think it's a bit of a crock, this inquiry. I think we need a proper investigation, not just one that's very politically biased. Well, that's my view at least. Let's hear from the AMA, what do they think about the Queensland health system and what inquiry would they like to hear? We're joined now by the AMA Queensland Vice President, Dr Bav Manoharan, and he's on the line now. Bav, good to have you back on 4BC Drive.

BAV MANOHARAN:    Thanks Scott. Thanks. It's good to be back and look, you're absolutely right. There were 40 recommendations in that report and only four of them were to be actioned by the Queensland government, 36 for the federal government. So it's a little bit interesting with the timing with the federal election as well.

SCOTT EMERSON:    Oh, I know. Interesting. The fix was in, Bav, I have to say, coming out just ahead of time. Look, that's the thing that frustrates me about this. I think clearly there are problems in Queensland Health and no particular party has ever been immune from having problems in Queensland Health. We know that health's a very difficult thing to deal with and you've had good ministers and bad ministers, but there's always things you can improve, but when you say you're going to have an inquiry, I said, "I thought it was rigged. I thought it looked like it was fixed." I mean, did you have the confidence in this inquiry when the health minister comes out and says, "We want to have an inquiry, but we're going to only look at the commonwealth issues, not the state issues?"

BAV MANOHARAN:    When AMA Queensland engaged in this inquiry and we gave evidence as part of it, we really thought it was an opportunity for us to really consider what Queenslanders needed for their health care system and an opportunity to perhaps look at real ways to fix all the issues. I mean, hospital ramping, surgical wait lists, and all of these have been issues for such a long time. And you're right. It's not been one specific government. We know that health is always a very difficult portfolio and there's so many different players in that space and it's a service that always requires a lot of money and it's $22 billion in the last state budget. It's a big slice of our expenditure.

But when we saw the report, it was really disappointing. It really just smacks of blame shifting and it's blame shifting at the eve of an election. So you can't help but think that it's designed by a state Labor government to assist the federal opposition Labor as part of the election campaign. We’re a little bit disappointed.

SCOTT EMERSON: It sounds from what you're saying, Bav, it's not really worth the paper that it's written on. If there was an inquiry, a proper inquiry, I think there should be a proper inquiry that looks at the whole system and doesn't blame shift as you just said then, what kind of issues do you think from the state responsibility, because obviously this inquiry was rigged to look at just federal issues, what are the kind of state responsibility areas do you think an inquiry should look at?

BAV MANOHARAN: Yeah. Look, well, let's perhaps look at the good or the messaging in this report that I think we can agree with. One is, when we talk about public hospital funding, there's this talk about 50/50 between the state government and the federal government to fund public hospitals. At the moment, Queensland does 55 per cent and the commonwealth 45 per cent.

So we absolutely agree that they should be looking at parity. We should really be looking at increasing that commonwealth support, but we don't want the state to reduce their commitment. There's issues around Medicare and so the Medicare rebates for our GPs and other specialists in the community, that hasn't gone up for decades and hasn't really kept that with CPI. So these are small businesses, they're hiring staff, admin staff, nurses, and other people to work in their practices to help deliver care and they can't keep up with their cost of delivering that high quality care when the rebates haven't gone up as well.

So those are federal issues and we need to make sure that's clear, they're issues the commonwealth has to work on. But where Queensland's been letting the ball drop is around the hospital ramping. So AMA Queensland had a ramping roundtable and we came up with some very clear and realistic steps to talk about hospital bed block and ramping.

SCOTT EMERSON: We've spoken to [AMA Queensland President] Chris Perry about the ramping and the roundtable and look, I thought when you were talking about that previously with the AMA here on 4BC Drive, good to have a roundtable to talk about this. It's one of the issues that a lot of our listeners, Bav, do call in about and say, "Look, we are concerned about it", because I think they're worried that if they call an ambulance, they want it to arrive on time and they want to be able to get to the hospital as quickly as possible. Did this inquiry examine the issue of ramping?

BAV MANOHARAN: No, I don't think it really goes anywhere near it or there's no adequate response to it at all. As we're heading into winter months and your callers will be worried about this as well and your listeners going to be worried about this, there's going to be a surge of flu. There might be another COVID variant. If all of our hospitals are blocked because of that, how do they get their routine elective surgeries and other health care needs met? Where is the redundancy in our hospital system? We're operating well over 100 per cent. So we need the hospitals to be operating at 90 per cent, so patients can get seen on time, but also if there is a surge, if there is other things happening in the world like a pandemic, that we can respond to that.

SCOTT EMERSON: Well, look, I think it's one of the big issues out there, ramping there. We mentioned previously on the show about code yellows at hospitals. So what would the AMA like to see now? Would they like to see a new inquiry, an unbiased inquiry into this and are you hopeful that could happen?

BAV MANOHARAN: Well, other inquiries might shed some more light if it had very specific terms of reference and it was very tailored towards solutions, but there's already a lot of information out there. There's the roundtable and there's a lot of experts have commentated on this and I think what we need to see is a strategy from Queensland Health. We need a strategy about how we're going to manage the workforce issues. There's just not enough doctors and nurses and other health professionals in the system to go around, unless we invest in it now.

We need to invest in training pipelines and that's not a Commonwealth issue unless you're talking about university spots, it's actually around a strategy in Queensland. We're different from a lot of the other states. We're a big state, with a decentralised population. How are you going to attract young people to do their training and then go work out in a region? I think that's what we need to be working on here. We haven't seen any of that and it's a little bit disappointing, because we need another 1,500 new beds, but you can't just plonk a bed into a hospital and expect that someone's going to be seen in it or cared for in it. You actually need the workforce to go with and that has to come from a strategy and that's not going to be solved before the election, that's a multi-year, multi-decade strategy. We just haven't seen that.

SCOTT EMERSON: AMA Queensland Vice President Bav Manoharan. Great to have you on 4BC Drive this afternoon.