Reflections on AMA National Conference

Transcript: AMA Queensland President, Dr Maria Boulton, ABC Regional Drive with Annie Gaffney, Wednesday, 3 August 2022

Subjects: AMA National Conference, GP funding, NQ Pharmacy Experiment

ANNIE GAFFNEY:   What do a bunch of doctors talk about when they get together at their National Conference? Plenty, it seems. Last weekend was the AMA's National Conference and our Queensland President, Dr Maria Boulton was there. I spoke with her earlier and asked her what some of the big ticket items on the agenda at last week's conference were.

DR MARIA BOULTON:   The AMA National Conference was really great opportunity to get members of the AMA together to discuss national and state issues. And some of the big ticket items and some of these were actually acknowledged by our Minister Mark Butler, were the need of reform for general practice funding, so that patients are able to access their GPs in the future. Also, we discussed the North Queensland Pharmacy trial, which is affecting us in Queensland. We also discussed the way that we have responded to the COVID threat in Australia and what needs to be done moving forward.

We also discussed a big issue that affects us all, which is climate change. And also how to promote gender equity in our health leadership. So, unfortunately some of the sessions were concurrent, so I wasn't able to attend all of them in person, but I will certainly be catching up on the ones that I wasn't able to attend.

ANNIE GAFFNEY:   So, let's dig into some of those topics a little. Tell us about the funding reform for GP practice. What was proposed?

DR MARIA BOULTON:   So, we know that Medicare rebates have not kept up with the increase in costs to provide medical services. And we have seen many practices close in the last few years, and we've now seen a large corporate practice actually close down because of viability issues. And that large corporate had a lot of practices in rural and remote regions, which is really catastrophic when you think about the fact that GPs in those areas provide not only general practice care, but also deliver babies, provide obstetrics. So, it's really a crucial time. And we're also facing the fact that less medical graduates are actually wanting to become GP, and they were issues that we raised with Health Minister Butler. And I guess the great thing about him attending the conference online was that he was able to listen to our concerns. He did say that he's committed to ensuring that general practice remains viable into the future, and he's also very committed to ensuring that there are enough GPs in the future as well. And we discussed the Medicare task force that has been set up federally. And I know that they have had a couple of meetings already, where all this funding reform is firmly on the table.

ANNIE GAFFNEY:   How hopeful are you, after that conference, that there is going to be some change in relation to increasing Medicare rebates? I mean, this issue has been going on for years. Doctors have been calling on the government to do something about it and it just seems to be rinse and repeat.

DR MARIA BOULTON:   Yes. Correct. But Mark Butler did reiterate that he was fairly committed to ensuring that there's a quick turnaround on this. And there's already $750 million committed to general practice over the next five years, which we know is just not enough, but it's a start. And we need to ensure that that money goes to where it's needed most and where it's going to make the most difference to patient outcomes, to ensure that it is patients that enjoy the benefits, rather than be lost in bureaucracy. And we will continue to push for that.

ANNIE GAFFNEY:   When it comes to the fact that not enough doctors want to graduate into general practice, that they're instead choosing to specialise because there's less stress for them potentially in terms of running a GP practice, with the Medicare rebates not covering their expenses at that level for staffing, et cetera, not keeping pace with the increased costs that GPs are facing, was there any discussion, Dr Boulton, about incentivising the move for doctors into general practice? Was there any kind of move in that direction from the government?

DR MARIA BOULTON:   Most definitely. We discussed providing incentives for junior doctors to go into general practice, but also to go into general practice in rural and remote areas. We know that when you're looking at a carrot-vs-stick approach, carrots work best, but we also know that general practice needs to be, given it's the amazing place that it is and no other career where you can actually look after four generations of the same family, no other career where you can deliver a baby, do a skin check on someone, help someone with depression, help someone through pregnancy and then vaccinate their baby.

When I did medical university now more than 20 years ago, about half of medical graduates would go into general practice. The number this year was only 16 per cent, which if you look in the future in the next 10, 12 years, what that'll mean is that it'll mean less GPs in areas where GPs are badly needed. And we know that GPs are the bedrock of primary care. We provide the most healthcare in the country. Without a good general practice workforce and without a healthy general practice, the rest of the system will collapse. So, there was a lot of commitment, both from Minister Mark Butler, but also the Shadow Minister for Health, to ensure that the general practice remains viable.

ANNIE GAFFNEY:   Dr Maria Boulton is my guest this afternoon. She's the President of the AMA in Queensland. Tell us a little bit about the response to the COVID pandemic moving forward. What was the approach there?

DR MARIA BOULTON:   The approach was to have a listen to what's been the overseas experience and what's been happening in Australia. And I guess from a general practice point of view, we heard how GPs have actually provided the bulk of COVID vaccine. GPs have administered more than 31 million COVID vaccines. We are also administering the flu vaccines and this year we've done more than 10 million. So, basically GPs have done more than 40 million vaccines in the last 12 to 18 months. And we've done it with very little funding and we've done it after hours, so that we can continue to care for our patients. So, there was a lot of respect paid to GPs, but also our colleagues in hospitals who have been at the front line.

There was acknowledgement that the health workforce is fatigued. So, whatever funding reform happens in the future needs to consider the fact that the workforce is fatigued and we need that funding urgently, but we also don't need to put any more bureaucracy on that funding because it needs to get to patients as soon as possible. We recognise the importance of communication between the hospital system, but also general practice. We know that COVID has required an entire health system response. We also acknowledge the fact that our hospitals were overstretched coming into COVID, so COVID has just exacerbated a lot of the issues that the hospitals were already seeing.

And that is why we're in the situation we're in with cancellation of elective surgeries, postponement of outpatient appointments, and the ramping that's happening in our emergency departments at the moment. And there was a lot of discussion about that and the need to ensure that moving forward, there is some capacity in our hospital system to ensure that. And I think it's only a matter of time before the next COVID wave comes, and we need to be able to ensure that we can cope with that without having to put patient care at risk.

ANNIE GAFFNEY:   And climate change is another really interesting one that was also on the agenda. What was talked about there in that sense in our health?

DR MARIA BOULTON:    Climate change is really interesting because it is something that has unfortunately taken a back step because of COVID. And it is also something that we have raised with Queensland Health through AMA Queensland. And the fact is that we know that climate change... So for example, if our air is not clean, we know that it has terrible effects on people's health. We know that in Queensland, our air quality is not as great as other states and territories, and we'd like to see more done in this space. We did have a chat to Queensland Health, and there are some ongoing programs within Queensland Health.

So, for example, looking at alternative power, alternatives such as solar power, but also seeing where the waste from the hospital can go, whether it can be recycled, et cetera. But it's a really, really important issue. And there's a lot of very passionate doctors and of course, community members, who realise that climate change does affect our health and that something needs to be done for the future.