Budget must deliver for primary healthcare

Big-spending hospital builds and more ambulance officers are welcome, but this week’s state budget must also deliver for primary healthcare and general practice.

“It’s great having new hospitals and more ambulances, but it would be more practical and cost-effective to invest in keeping people out of emergency departments and hospital beds in the first place,” AMA Queensland President Dr Nick Yim said.

“We don’t want to see the Queensland Government make the same mistakes their federal counterparts did in the May budget.

“Federal Labor missed the opportunity to make real changes to Medicare, tackle critical GP shortages and address cost of living pressures in the health system.

“We don’t want to see the state government go the same way, particularly in an election year.

"The government has promised to invest in more ambulance officers. This will boost response times and we support it. But if we don’t have beds in our hospital wards for patients who need to be admitted and staff to operate them, we are just going to see more ambulance ramping.

“We have bed block in our hospitals because we have 1,000 patients who are well enough to be discharged but cannot because they are waiting for aged care places or NDIS packages.

“We are seeing patients being readmitted to emergency departments because they have not been able to get the care they need like vital elective surgery or follow-up treatment and preventative health services with a regular GP.

“There must be systems integration between hospitals and general practice to facilitate effective patient handover and referrals of patients to their GP and allied health care teams. Patients who see their GP within seven days of hospital discharge are much less likely to be readmitted.

“We commend the state government for trialling our Patient Care facilitators proposal, which funds practice nurses to coordinate care for newly-discharged patients. This should be rolled out statewide.

“Doctors, nurses and other healthcare professionals are delivering exceptional care to Queenslanders under trying circumstances.

“There is a mindset that healthcare should be free. For that to become a reality, governments at all levels must invest more in general practice and primary care.

“Primary care is the most cost-effective form of healthcare. Hospital care is the most expensive and we should be investing in keeping people well and healthy in the community and out of hospitals.

“We also don’t have enough staff in our hospitals. We are getting new hospital beds but without the staff to operate them, we can’t put patients in them. We have to recruit, train and retain more doctors, nurses and allied health practitioners.

“Our workforce is fatigued from overwork and we need real change, or something’s going to give.”

The AMA Queensland Budget Submission 2024-25 identifies 14 priority areas for attention including workforce, wellbeing, preventative health, climate and sustainability, and women’s and First Nations health. It can be read here.

Background:

AMA Queensland is calling for:

• An exemption from payroll tax for payments to contracted medical practitioners to strengthen affordability for patients and ongoing viability for all medical practices
• GP recruitment incentives for GPs and practice nurses, including expansion of the $20K-70K relocation incentives to all interstate and international GPs
• Improved International Medical Graduate (IMG) recruitment, orientation and training pathways to increase Queensland’s attractiveness to IMGs
• GP training incentives, including $40K trainee grants for medical graduates to train as GPs and for GPs to upskill and maintain skills crucial for regional Queensland (e.g. anaesthetics, obstetrics, mental health and paediatrics)
• Reinstatement of the Prevocational General Practice Placements Program (PGPPP), a six-week practical program to expose and attract interns to general practice
• State-funded medical student places in Queensland universities to help fill the shortfall in Commonwealth Supported Places
• Investment in line with the Tasmanian Liberals’ GP Guarantee, including $100K GP HECS contributions for new GPs that work in regional and rural areas for 5 years and up to $250K p/annum for practices to strengthen and sustain their viability and service offering (e.g. through expanded telehealth and after hours services and capital upgrades)
• Expansion of the Patient Care Facilitator pilot (currently being trialled in Logan and Ipswich) to ensure patients see their GP within seven days of discharge to reduce hospital readmissions
• Formal collaboration mechanisms between Queensland Health and general practice to advise on policy reform and integrate systems to improve continuity of care for all patients, including establishment of a 0.5FTE senior executive GP liaison role within Queensland Health
• Investment in voluntary assisted dying programs in regional and rural Queensland, particularly funding for longer GP consultations and practitioner travel to patients living outside of larger centres
• Funding for pilot programs in environmental and climate sustainability in 10 GP clinics (five metro, five rural/remote)
• A voluntary suicide register to identify the true rate of suicidal ideation in the LGBTQIASB+ community.