International recruitment of doctors

Transcript: AMA Queensland President, Dr Maria Boulton, ABC Radio Brisbane, Mornings with Kate O’Toole, Tuesday 21 June 2022

Subjects: Overseas recruitment of doctors, state budget

KATE O'TOOLE:   If you've been to the doctor or if you've been to the hospital, perhaps you've noticed how flat strapped medical staff have been. You've seen it in the news too. They've been feeling the pressure. The Queensland Government recently announced an international campaign to fill key roles in the healthcare sector, so international nurses and doctors will be recruited under this plan. It's all to help the struggling healthcare sector. Maria Boulton is the AMA Queensland President, which is the voice for Queensland doctors. How severe is the shortage of doctors in Queensland, Dr Boulton? Good morning.

MARIA BOULTON:   Good morning. For us in Queensland, it's also an issue of maldistribution. We are a large state and it's often difficult to get any workforce through to the rural and remote regions. Also, a particular concern of AMA Queensland is the fact that we know that there's not enough hospital beds. So we are asking for more hospital beds in today's state budget. However, we do realise that there's going to need to be staff to staff those hospital beds. So we're also looking into the future so that whatever initiative or whatever funding goes to find sustainable workforce that can cover the entire of the state.

KATE O'TOOLE:   That is something that has been flagged, but just in terms of why it's so hard to ensure an adequate distribution of doctors in Queensland, will recruiting more doctors fix that problem?

MARIA BOULTON:   I think it's a two-pronged approach. Queensland rural and remote and regional areas always rely on international medical graduates. A large percentage of the doctors there are international medical graduates. Part of it is the fact that, during COVID, there's been very little travel. Some people were very reluctant to leave their countries to come here. The other part is retaining them. A lot of these doctors come under a moratorium where they have to stay in the rural, remote region for 10 years. Then at the end of those 10 years, they don't stay. They come to metro areas. I guess it's supporting them so that when they arrive, a) they have the training, the capacity, but they're also supported, that the whole family feels supported. That goes for anyone who goes to those areas. I mean, you're talking about mining. The mining industry is the same. We need to not just support the healthcare worker, but also their partner, their children, so that they can form some roots in those areas and stay there long-term.

KATE O'TOOLE:   So if you were to pick out a place in Queensland where you could give us an example of the shortage, is there an area which is in particular need?

MARIA BOULTON:   Look, it varies. You're also talking about growth corridors as well, such as Springfield Lakes and North Lakes, for example. It varies. We're working very closely with Health Workforce Queensland to try and get some real data. That's the thing. We all have to base our plans on real data, and they have some excellent data that can be used to help with all this reform. The other issue we're looking at is medical students. Are the medical student placements, is it enough? Do we need more medical students being trained at that level so that at the other end of the spectrum, we have lots of doctors for all those regions?

KATE O'TOOLE:   The Queensland Premier Annastacia Palaszczuk has tweeted this morning that included in today's budget will be “the largest investment in new hospitals and hospital beds in Queensland's history”. Is that encouraging? Are you aware of any of the details of this?

MARIA BOULTON:   It's encouraging. I'll be at the budget briefing today. So I can't wait to see the detail. Obviously, the devil is always in the detail, but it's not just about throwing money out there, but actually talking to people on the ground, talking to doctors, nurses etc, to ensure that all that funding, all those beds go to where they are needed.

KATE O'TOOLE: Also, this increase often has a lag time, right? I mean, if you take that quote literally and say the largest investment in new hospitals, a new hospital, there's a long lead time in that, right?

MARIA BOULTON:   Yeah, look, absolutely. Sometimes what happens is, and what we've seen in the past, is by the time a new hospital is built, it already doesn't have enough beds. So there needs to be capacity moving into the future. We're getting a lot of migration into Queensland and a lot of people who are retiring into Queensland, so sometimes, they will be older people with chronic illness and that increases the burden on the hospital system. We need to ensure that there's enough capacity to be able to deal with that. We also need to deal with, I mean, COVID's here to stay, right? We're going to be have to be able to deal with whatever COVID throws at us and ensure that our emergency departments can cope with that and that has to be planned so, so well and in such detail, and I do encourage the government to make sure that they involve stakeholders in all that planning, because it is important that all the money that is spent, I mean, money is so hard to find nowadays, right, that all that money gets spent appropriately.

KATE O'TOOLE:   How common is it for Queensland to recruit internationally for medical professionals?

MARIA BOULTON:   It's quite common, it happens commonly. It just has been slowed down due to the COVID pandemic. When I used to work in Mackay, I worked with excellent surgeons that came from the UK or South Africa, for example. I mean, everyone has to go through checks and balances to ensure that they have the adequate training. Once again, I'm a GP and just because you have someone with a medical degree doesn't mean that you can put them into general practice and expect them to be able to do everything that a GP does. They need to go through adequate training and exams etc, so that the community is safe and they're getting the best care possible.

KATE O'TOOLE:   We have had a text through this morning underscoring the importance of mental health and that ought to be, that funding for mental health needs to be considered in today's budget also?

MARIA BOULTON:   Yeah, and that's one of the priority points that we asked for, because once again, I'm a GP. We see a lot of mental health. The pandemic has just exacerbated that and mental health doesn't get as much funding as other illnesses. So for example, when you're looking at Medicare rebates, the rebates for someone who has a mental health issue is not as much as someone who needs a procedure or has a chronic disease. We also know that there's a huge waiting time for people to access specialised services and GPs will continue to see that patient, but sometimes we do need those specialised services and we'll continue seeing them until they get in. But I've been on the phone on Friday, for example, I've got an adolescent patient who needs to be seen by a psychiatrist. I made dozens of phone calls to try and get them in quickly somewhere. I was faced with "sorry, we're not taking any new patients" or "sorry, we have a six month wait list". That's just not good enough when you have someone who's suffering.

KATE O'TOOLE:   So while we wouldn't expect, obviously you're not going to expect in a state budget there to be any difference to the Medicare rebate, what could happen?

MARIA BOULTON:   We'd like to see a bit of investment. All areas of the healthcare system have been neglected. This was a problem before the COVID pandemic. COVID has just exacerbated it. What we'd like to see from the state is the states are responsible for hospitals, but there is a lot of collaboration to be had with primary care and there's certain areas that they could fund in primary care. But today, we're expecting a lot of that funding to go to hospitals. In Queensland now, we have a Labor state government and a Labor federal government. So that excuse of "that is a federal issue, that is a state issue", we hope we don't hear anymore because they need to work together.

KATE O'TOOLE:   But something practical, is that a matter of saying "we're going to add more psychiatrists to hospitals", which is something that they can control? Is that the type of solution that you're looking for, or something different?

MARIA BOULTON:   Yeah. But they could add more adolescent mental health beds. They could add more adult mental health beds. They could fund more staff to staff those beds. They could provide funding for patients who get discharged from hospital to see their GP within seven days. We know that if patients get discharged and they see their GP within that week, they have less of a bounce back into hospital, thus reducing the stress on the emergency departments. So there are some practical points that could be applied.

KATE O’TOOLE:    Thank you so much for speaking with us this morning. Dr Maria Boulton, AMA Queensland President.

21 June 2022

CONTACT: media@amaq.com.au 0419 735 641