Hospital staff deserve safe, fair working conditions

Transcript: AMA Queensland President, Dr Maria Boulton, ABC Brisbane, Drive with Kelly Higgins-Devine and guest host Ellen Fanning, Monday 29 April 2024

Subjects: AMA Queensland Budget Submission, hospital safety and bulk billing

ELLEN FANNING: The Australian Medical Association of Queensland is calling on the State Government to make our public hospitals safer for both staff and patients. It claims hospital staff are being overworked to the point of exhaustion. Dr Maria Boulton the President of the Australian Medical Association of Queensland joins me now. Thanks for your time.

DR MARIA BOULTON: Good afternoon, Ellen.

ELLEN FANNING: Now this is your wish list for the state budget, and I imagine that it would contain, you know, dollar signs and billions and all the rest of it, but a big part of it is about wage theft. I was struck, Maria, at the huge case in New South Wales, junior doctors, they're all coming together and winning the largest underpayment claim in Australian history – $230 million for unpaid overtime. But you would remember when you were a junior doctor, this has just been the way it is. You work the excess hours, and you don't put in for the overtime.

DR MARIA BOULTON: It's been quite a long time since I was a junior doctor 20 years ago, but certainly at the time, some of the units I worked in did discourage us from putting in the extra hours that we worked. I used to work in a regional hospital, a very, very busy hospital, and the number of overtime hours I had to do was incredible. And it's sad to see that there are still junior doctors who really have to fight to have those hours counted. The hours that they deserve to get paid for, and hours that often they don't have any choice but to work because there is no one else to do that work.

ELLEN FANNING: And that's the first dot point in the Queensland Budget Submission for this year from the AMA, excessive workloads and inadequate resourcing. So how does that become systemic? I mean, I can imagine somebody saying – look, there was a terrible accident that’s occurred, and would you mind staying a few more hours in accident and emergency? But what sorts of things are doctors being asked to do?

DR MARIA BOULTON: The main things we're seeing being reported by our members is members working excessive hours, very long shifts, sometimes 24 hours, and very little downtime. And it does become systemic in that they're doing it over and over again, and it happens for a number of reasons. The lack of workforce, sometimes if some team members are away sick there's not enough leeway to cover those team members. And that's why we have always called for hospitals to run at 90 per cent capacity, to leave room for that surge, and to cover for people who are also sick and can't come into work.

I think there's just an inadequate number of doctors working in our hospital system and whether you speak with junior doctors or a doctor in training or a senior medical officer, we continue hearing again and again, particularly in regional and rural areas, that there's just not enough doctors. And we're not alone, we know that there are workforce pressures in the entire of the healthcare industry. There are not enough nurses, allied health workers, pharmacists, particularly in regional and rural areas, which in Queensland is really important because we are so decentralised.

ELLEN FANNING: So, when you read that the lead plaintiff in New South Wales in that historic underpayment claim, $230 million New South Wales is going to have to pay out to junior doctors who are underpaid over 10 years. The lead plaintiff, Dr Amireh Fakhouri, says she'd work 100 hours a week, no overtime. She'd often leave a car at work and take the bus home because she didn't think she was safe to drive home. When you look at the AMA's annual survey that says more than half of junior doctor’s fear making a clinical error due to fatigue, is that the situation in Queensland?

DR MARIA BOULTON: It's a very similar situation in Queensland when it comes to the number of hours that our doctors are working and the pressure that they're under. They do a brilliant job and without our brilliant healthcare workers, we wouldn't be in the situation we are in, we would be much worse. It's because of the altruism of those healthcare workers that our patients receive the quality care that they receive. But certainly, it is concerning, and certainly it's like a pilot. There is a reason why pilots don't fly when they're fatigued, there is a reason why there should be fatigue leave, and there is a reason why people need to stick to the hours that they're rostered and not work excess hours.

ELLEN FANNING: You call it altruism, some people call it exploitation. My guest is Dr Maria Boulton President of the Australian Medical Association of Queensland, talking about the AMA’s wish list for the forthcoming Queensland budget.

The other elements you're looking at are trying to ensure that recent medical graduates, overseas trained doctors, don't quit. Trying to ensure that doctors, including First Nations doctors and healthcare workers stay working in the system. What sorts of workforce incentives do you want to see there?

DR MARIA BOULTON: We'd like to see more workforce incentives. There are already a few that the Queensland Government has started up, but we need to do more. For example, for our First Nations doctors. Unfortunately, 30 per cent of First Nations doctors quit, and considering that they only make up 2 per cent of the workforce, it's not enough. They need all the support they can get, and there are some programmes that do support them quite well. One is run out of the Townsville Hospital and we're seeking funding to ensure that programme gets rolled out across other hospitals.

We're also seeking incentives for doctors to go into GP speciality training. When I was a medical student, half of the cohort wanted to become a GP. Now that number is less than 15 per cent and there are many reasons for it. But one of the reasons is when you enter GP training, your salary does drop a lot. And we're just looking for parity and we're looking for those doctors also to be offered maternity leave, sickness leave, study leave, all those things that their hospital colleagues do enjoy. We hope that by offering those incentives to those doctors, more doctors will be GPs, as has happened in Victoria where they have had similar incentives.

ELLEN FANNING: We've also seen some new Medicare data released today showing GP bulk billing rates are up more than 2 per cent since the Federal Government tripled incentives in November. Is that what success looks like?

DR MARIA BOULTON: It's what partial success looks like. When you look at the bulk billing incentives, they don't apply to everyone, they only apply to young people under the age of 16, older Australians, and people on healthcare cards, for example. There are too many people that miss out. A rise of 2.2 per cent in Queensland versus when you look at the Productivity Commission saying that more people than ever are putting off medical care due to the cost issues, it’s not far enough. That’s why we’re calling for the actual Medicare rebate, so that rebate that everybody receives to see their doctor, to be increased, because it just hasn’t kept up. It does mean that people are putting off their medical care at a time when people are choosing between food, petrol and scripts. We know that it's difficult at the moment, we know that people above all need access to see their GP.

ELLEN FANNING: Final question, is there a risk that if the Queensland Government doesn’t listen to the AMA on questions like… and indeed senior doctors who are members of the AMA don’t listen, say to the junior doctors – oh I did it, I overworked and you will too. If we don’t listen to these junior doctors and these people in rural and remote areas, we could see class actions like they’ve seen in New South Wales and indeed in Victoria where the health system ends up paying for it in the end, hundreds of millions of dollars.

DR MARIA BOULTON: Indeed, and I guess that was money that was owed to those junior doctors and I’m glad that they have had a chance to receive some compensation for it. But I think long gone are the days where people should be saying – oh this is the way I did it. I have a child that wants to be a doctor, and I certainly hope that by the time that she starts working in a hospital, conditions are far better. These are very resilient individuals. People who get into medicine work very hard to get their medical degree. They're very resilient, they just get beaten down by the system and they deserve a safe and supported work environment like everybody else does.

ELLEN FANNING: Thank you so much for your time. Dr Maria Boulton President of the Australian Medical Association of Queensland.

DR MARIA BOULTON: Thank you.