President and CEO Update- April 2021

In the past month we have continued to advocate for doctors in Queensland across a number of key issues including COVID-19 vaccinations, safety in hospitals and bed shortages and more. Read our report outlining key activities delivered in April.

Scorecard

We are delighted to launch the AMA Queensland Scorecard that outlines our key achievements and results delivered in the first quarter of 2021. It provides a visual overview of our extensive work to advance and improve the medical profession in Queensland and support doctors in the delivery of exemplary health care for the community. Take a look at our scorecard now. LINK

Media engagement

Strategic media advocacy continues to be a significant part of our work for members to elevate major issues in the public domain, educate the community and influence government. 

Our proactive media engagement on the crisis facing public hospital emergency departments was a major media item this week. AMA Queensland member and Australian College for Emergency Medicine spokesperson, Dr Kim Hansen, said the situation was the worst emergency doctors had seen. We must thank Dr Hansen for her outstanding media advocacy this week and expert opinion that helped us elevate this issue in the public’s eyes and place pressure on government to act now.

Read our media release - Overloaded hospitals are a ticking time bomb.

We also issued a media statement that welcomed the Australian Government’s promise of medical equipment and supplies to help India, as it faces an unimaginable COVID crisis. This initial pledge is a sensible start but the scale of the outbreak is staggering and will need an ongoing commitment of help and support. Thank you to former AMA Queensland President Dr Dilip Dhupelia for his leadership in this important global issue.

Read our media release - Doctors urge Australia to do more

The worldwide shortage of essential sterilisation wrap, Kimguard, was another key media issue for AMA Queensland. We have called on investment and collaboration between the State Government, manufacturing and startup sector to develop solutions to meet this community and industry need. Incentivising local manufacturers and startups to fill the shortage could kick-start ideas and solutions that capitalise on a global business opportunity.

Read our full media statement - Investment needed to stem surgical supply shortage

Ministerial and Government Advocacy

We met with the Honourable Minister Di Farmer MP, Minister for Employment and Small Business and Minister for Training and Skills Development, to discuss support for our members who operate businesses and private practices. GP and non-GP specialist practices are often overlooked when the State Government offers support to small businesses. There is understandably a focus on the health care contributions that our members’ practices make to communities but they also deliver other public benefits. These businesses make significant direct and indirect contribution to local economies through employment of staff and the procurement of local services.

At our meeting, we spoke about the opportunity to support growth, business mentoring and the education and training of both clinical and administrative staff. The Minister was very receptive and a follow up meeting has been organised to discuss how the Department of Employment, Small Business and Training (DESBT) could deliver programs and services targeted to support medical practices. This could be across the broad range of programs within DESBT including those aimed at assisting small businesses and vocational education and training opportunities. We will continue this discussion to achieve strong, practical outcomes for our members.

Voluntary Assisted Dying

The Queensland Law Reform Commission has stated they will now provide the draft voluntary assisted dying (VAD) legislation on 26 May to both Parliament and stakeholders. There will be a two-week window to provide feedback and a public hearing is also likely to occur but no date has been announced yet. VAD is of course an emotive debate for our community. Our priority is to ensure there are adequate protections in place for the vulnerable in our community and that doctors rights are secured. We will respond to the legislation in alignment with our members’ views as outlined in our survey and continue to keep members updated.

Read the results of our VAD member survey. 

COVID-19 Vaccination Program

Role of GPs

We continue to lobby the Federal Government to ensure GPs remain the central method for vaccine distribution. Australia’s GP-led primary care system is different to many other countries and provides a uniquely Australian option for vaccine distribution. To date, the GP program has significantly sped up the roll-out, with a large service footprint and easy access for patients. We know GPs offer a safe clinical environment, including post vaccine monitoring that is not comparable in pharmacy, shopping centres, or other possible mass vaccination venues. GPs draw on a significant track record of administering millions of flu vaccinations annually, showing capability to administer large vaccine volumes quickly. Our preference is that all interested GPs should be allocated doses but recognise this is dependent on adequate and consistent supply, which continues to be the most significant barrier to the program’s success. We will continue to advocate for GPs and pressure the Federal Government to modify the program as needed to ensure GPs are adequately utilised and supported in the COVID-19 vaccine roll-out.

2a and flu shots

We welcomed the announcement from National Cabinet to bring forward phase 2a of the COVID vaccine program. People over 50 will be able to access COVID vaccines at GPs from 17 May. We will continue to make sure this message is well communicated and also emphasise the need for the community to book in for flu jabs. Influenza is a major risk to public health and we are outlining this danger in our media relations and explaining the timing of 14 days between COVID and flu vaccines. 

Informed decisions on safety vs risk

The rare but deadly blood-clotting risks associated with the AstraZeneca vaccine shows that due care and consideration is needed before administering this vaccine. We continue to support the latest evidence-based, scientific advice from the Therapeutic Goods Administration and the Australian Technical Advisory Group on Immunisation, that studies the evolving international vaccine data and as well as local information. The updated advice on the preferred use of the Pfizer vaccine for people under 50, has negatively impacted the speed and efficacy of the vaccine roll-out as well as public confidence. Anecdotally, GPs reported a 30 per cent cancelation rate when the change in AstraZeneca advice was released.

While it is good news that an additional 20 million Pfizer vaccines have been secured, the delivery will not occur until the second half of the year that creates a significant delay in vaccinating and protecting our community. It is therefore vital that people under 50, particularly health workers and those at risk, make an informed COVID-19 vaccine decision understanding the risks and benefits pertinent to their individual circumstances. It is important to note that the AstraZeneca vaccine remains highly effective at preventing death and severe illness among people who have contracted COVID-19 and the incidence of the reported blood-clotting syndrome is very rare. We are urging Queenslanders to speak to a GP who knows their medical history to provide individual advice in relation to COVID-19 vaccines.

Read our media release. Worried about COVID vaccine? Talk to your GP

Our members are also reporting that once the risks and benefits of AstraZeneca are explained to patients, they predominantly proceed with the vaccination. However, this understandably takes more time. We are continuing to advocate for the MBS item to be adjusted to recognise the extra time spent assuring patient consent. Read our advocacy with the Prime Minister. 

Our Workplace Relations team is delivering a free webinar for members with advice on how to streamline the patient consent process. Learn how to create efficiencies, cut costs and where possible, equip staff with communication techniques to better handle patient anxiety. Jump on board and register for our webinar scheduled for Thursday 13 May from 6.00pm – 7.00pm. Register now. 

Indemnity risks

Some GPs remain worried about medical indemnity coverage for providing advice to patients about AstraZeneca as well as for its administration. We have been repeatedly and categorically assured by Medical Defence Organisations (MDOs) that doctors are covered by their policies and MDOs are providing this same advice to their members in the strongest terms. Vaccine manufacturers have also been indemnified by the Commonwealth.

While medical indemnity coverage is not an issue of itself, we have been in ongoing discussions with the Commonwealth about the potential long-term implications of the vaccine roll-out. While the available vaccines appear incredibly safe, based on trial and real-world data, we do not know what impact future claims might have on reinsurance arrangements and indemnity premiums. This uncertainty needs to be removed. In recognition of our concerns, the Commonwealth has given written assurance that it will take further steps to protect and support health professionals if the vaccination roll-out gives rise to an unusual number of patient claims. While this guarantee is welcome, we still do not have enough detail about what mechanisms it would use and the exact circumstances that would see the Commonwealth act on this. 

We are calling for more clarity and measures to ensure that, as far as possible, GPs are not drawn into future vaccine-related litigation and will continue to lobby the Federal Government for adequate protection.

Industrial relations - fighting for the safety of health workers

On 30 March we ran a media campaign with our industrial relations partner, the Australian Salaried Medical Officer Federation Queensland (ASMOFQ), on the need for fit-testing and COVID vaccinations for all frontline doctors and health workers at risk of contracting COVID-19. The campaign was guided by our survey findings that showed 70 per cent of respondents had not been fit-tested for the P2/N95 face masks used when treating COVID patients and 43 per cent had not yet received their first COVID-19 vaccination. 

This campaign secured a directive from the Chief Health Officer, Dr Jeannette Young, stating that any Queensland Health employee who has direct contact with a positive COVID-19 patient is required: to wear a P2/N95 face mask; have had appropriate fit-testing completed; and must be vaccinated. We welcome this directive but know it is not being delivered.

ASMOFQ joined a recent Queensland Nurses and Midwives Union dispute before the Queensland Industrial Relations Commission (QIRC) that was investigating the adequacy of fit-testing. This dispute built on a commitment that ASMOFQ secured from Queensland Health last year that it would deliver a consistent program of fit-testing for personal protective equipment for frontline staff. However, this week, Queensland Health presented an audit to the QIRC that revealed major inconsistencies and gaps in fit-testing being conducted by Hospital and Health Services. ASMOFQ President Dr Hau Tan said many doctors and nurses are still not fit-tested, and this places them at risk.

Read more on our advocacy to secure safety for health workers - Doctors and nurses join forces to demand safety

Task substitution

There has been an increase in medical task substitution over the last 12 months. We have written to Minister D’Ath outlining our position and concerns that task substitution will result in increased risk to public safety, a reduced standard of quality care and lead to reduced confidence in the health system. Specific examples were highlighted including ENT specialist referrals being seen by an audiologist; endoscopy and colonoscopy performed by nurses; mid-wife led maternity serviced without obstetrician oversight in rural and remote communities; physiotherapists prescribing S4 and S8 medications in emergency departments; and pharmacists prescribing antibiotics for UTI without clinical assessment and diagnostic support. While we support collaborative multi-disciplinary health care, we are opposed to task substitution including people working outside their scope of training and believe this creates a risk of inappropriate care, may harm public safety and effects quality of access to basic health care needs and specialist care. We will continue to lobby the State Government to rectify the inappropriate practice of task substitution.

Read our Position Statement on Task Substitution.

Queensland Doctors’ Community

We are delighted to see an increase in conversations last month on our member-platform, Queensland Doctors’ Community. We encourage all members to continue to initiate and join discussions that are important to them on QDC, our go-to platform to gain insights on key issues for our members. We appreciate your honesty and candour on QDC and will continue to listen to members and respond to questions and concerns raised on the platform.