CBD walk-in health clinics a missed opportunity

Transcript: AMA Queensland President, Dr Nick Yim, ABC Brisbane, Mornings with Steve Austin, Tuesday 2 July 2024

Subject: $46 million nurse-led walk-in centres and regional health

STEVE AUSTIN: The Queensland AMA, as you may have heard, has directly attacked the state government's policy of walk-in health clinics in the central business district of this city, saying they're not efficient and they’re in places that doesn't need them - the city. Now, you know that there is a health workforce crisis. The nurses’ union, the QNWU, the Queensland Nurses and Midwives Union, earlier on this year expressed concern about the health workforce crisis and called for more nurses to be employed. And at the time, after the state government budget, they said a commitment to more nurses and midwives is not a silver bullet to fixing the workforce crisis, quote unquote.

So let's go to the Australian Medical Association's Queensland President, Dr Nick Yim. The AMA has obtained freedom of information emails in other states that appear to indicate that the style of health clinic in the CBD is vastly more expensive to run. Dr Yim, good morning to you. You say the CBD walk-in health clinics don't make sense? Why not?

DR NICK YIM: From AMA Queensland's perspective, this is clearly a missed opportunity. With $46 million being invested in these walk-in clinics in a metropolitan area in the middle of the CBD when there's already four GP practices on Adelaide Street, a further 15 within walking distance and I guess another 50 within three kilometres, it seems like - when we're looking at the regional and rural areas - it definitely feels like a missed opportunity.

STEVE AUSTIN: So the central business district of Brisbane is already well serviced, if not saturated by health centres or health clinics?

DR NICK YIM: With the number of general practices in that area compared to other areas, I think we would say that there's a significant supply of healthcare professionals.

STEVE AUSTIN: My guest is Dr Nick Yim. If that's the case, why has the state government felt there was a need for walk-in health centres if there's already a saturation of health centres or medical centres in Brisbane City?

DR NICK YIM: I think we do have to acknowledge that across the whole of state of Queensland, also across the country, there is a challenge of access to healthcare. But that is further accentuated in the rural and regional areas, and we would always open communications with the state government to develop strategies to ensure the health of our communities and our population.

STEVE AUSTIN: So, Nick Yim, what you're telling me is the state government is exacerbating a problem. They're putting health centres in an area that's already over-serviced by health centres and starving the places that don't have enough health centres of what they need.

DR NICK YIM: What I'm saying is currently the investment into healthcare, it is quite confusing. We've got this recent announcement of the walk-in clinics, we've got the satellite hospitals, we've got the urgent care clinics. Ultimately, our health workforce is stretched. Where are we going to find this workforce to supply this? Essentially, we know that general practice, GPs, they keep our patients well, they keep patients out of hospital. And preventative care is key.

STEVE AUSTIN: My guest is Dr Nick Yim from the Australian Medical Association Queensland. The AMA has obtained emails under Freedom of Information laws that examined this model in other states. What did it reveal, Nick Yim?

DR NICK YIM: With regard to these models, they have been trialled and tested in the ACT and they have been shown to be more costly. On average it cost the taxpayers approximately $200 per consultation, to taxpayers, as opposed to, say, in a GP clinic, $40. And this is not actually looking at data of how many of those patients were potentially redirected to emergency departments.

STEVE AUSTIN: Have you raised this with the Health Minister, Shannon Fentiman?

DR NICK YIM: We haven't raised this one in particular, but previous models, when they were suggested prior to the budget, we have spoken to the Health Minister about.

STEVE AUSTIN: So you spoke to the Health Minister prior to the budget. What about the nurses’ union? Because the nurses’ union also is on a similar trajectory, not exactly the same as you are. They also express a concern about the health workforce crisis in Queensland. The state government did promise in the budget to try and fund or find more health workers in Queensland.

DR NICK YIM: All the peak bodies, including allied health, nurses, have big, big concerns about the workforce of healthcare professionals across the state of Queensland. Ultimately, we don't need shuffling of seats, we need to have appropriate investments in the areas that's already got the infrastructure.

I guess the key thing is, one of these models, hypothetically, why didn't they invest that $46 million within existing general practice to essentially keep the doors open? At the same time, we also know that in regional and rural areas, some places may not even have a general practice.

STEVE AUSTIN: Like for instance where? Where should they have invested the $46 million instead of the already well-serviced CBD of Brisbane?

DR NICK YIM: To give you an idea, in country towns such as Clermont, some of the general practices unfortunately have had to close. We know that some areas have only a single GP. So one of those areas, for example, they would love to get maybe a doctor come across to help them out. So those are some of the investments that can be beneficial.

STEVE AUSTIN: Nick Yim, the $46 million for these walk-in health clinics, it's already been allocated. We did invite the Health Minister Shannon Fentiman onto the program and the nurses’ union. Unfortunately, neither of them are available at this stage. That may change down the track. Is this in any way an attack on the nurses’ union or the nurses themselves, Nick Yim?

DR NICK YIM: Absolutely not. For example, I work in a general practice in Hervey Bay. We have a lot of nurses. We work in a very collaborative team-based environment. That's the same as my colleagues in the hospital. They work very well collaboratively with the nursing team, and that's key.

I think the key thing here is this is taxpayers’ dollars. We need to ensure this investment is used wisely because it's finite. We have a health workforce shortage, and we need to ensure that workforce is distributed across the state appropriately.

STEVE AUSTIN: Finally, we have the satellite hospitals. In fact, the dizzying array of both Commonwealth and state funded health centres or health clinics is actually getting hard to keep a track of. Can you just break it down for me? So we have the satellite hospitals, which are not actually hospitals, and they don't have emergency departments. We will have these health clinics in the city. Can you break it down for me as to what the state and what the Commonwealth is responsible for? Can you say?

DR NICK YIM: It is getting very confusing, isn't it? I'm even struggling to keep up, and I can't imagine how your listeners are trying to keep up. I think the key thing here is we need to ensure that your listeners do have a regular GP or GP practice. They’re key for preventative care, they’re key to keep you well and keep patients out of hospitals. When people are very unwell, in those emergency life-threatening situations, they need to present to an emergency department.

STEVE AUSTIN: Okay, not a satellite hospital.

DR NICK YIM: No, not a satellite hospital. They only have their set resources, and that information is on the Queensland Health website.

STEVE AUSTIN: I appreciate your time. Thanks very much.