CQ maternity crisis a medical emergency

Transcript: AMA Queensland President, Dr Maria Boulton, RN Breakfast with Hamish Macdonald, Monday 16 January 2023

Subject: Central Queensland maternity crisis

HAMISH MACDONALD:   A lot happens in the weeks, months leading up to having a baby. Setting up the cot, of course, packing a hospital bag, perhaps a sitter on standby for the other children in the family. But for many women in Central Queensland, they're also factoring in a 100 kilometre-plus car trip and a stay away from home with birthing services no longer available in the regional centres of Gladstone and Biloela. Dr Maria Boulton is President of the Australian Medical Association in Queensland. Also here is the Green Senator Penny Allman-Payne. Welcome both of you to Breakfast. Good morning, Dr Boulton, what's led to this? What's changed within the medical services in this part of Queensland that’s led to all of the headlines we're reading about?

DR MARIA BOULTON:   We've seen a lack of support for maternity services in regional and rural areas in the last few years. In Gladstone, the reason that we're in the situation that we're in is that in 2018, the private service closed. At the time, Queensland Health was told that this would put undue stress on the public service. And that's exactly what happened. They had some workforce issues. Gladstone went on maternity bypass, so did Biloela, and that's putting extra pressure on Rockhampton, which is 100 kilometres north.

HAMISH MACDONALD:   Just before you proceed, what does maternity bypass mean?

DR MARIA BOULTON:   It means that women can't safely deliver in those hospitals that are on bypass. So if you are pregnant and are due to have a baby in say, February, you will have to deliver that baby in Rockhampton, so travel the 100 kilometres by road and deliver there rather than delivering at the Gladstone Hospital.

HAMISH MACDONALD:    I've read in some of the press over the weekend as well, though, that some women are essentially being forced to have caesareans booked and planned in order to deal with some of the uncertainties around this.

DR MARIA BOULTON:   And that's really concerning. Caesarean sections are there for a reason, because sometimes it's the only way to safely deliver a baby. However, to have a caesarean section forced on you and I guess women, you know, when you're travelling 100 kilometres, who's going to look after your other children? Who's going to look after your accommodation costs? When are you going to actually travel to Rockhampton to wait for this baby to come? And to have women choose or elect to have a caesarean section for no other reason other than the hospital services in your town are closed, it's not good enough.

HAMISH MACDONALD:    But do you understand that to be correct, that those reports are true?

DR MARIA BOULTON:   I’ve only heard what's been reported in the media. I haven't actually spoken to patients on the ground to verify it.

HAMISH MACDONALD:     Senator, you're from Queensland. I understand you've also got family, personal experience with this issue. What happened?

SENATOR PENNY ALLMAN-PAYNE: Yes, thanks Hamish. I live in Gladstone, where we have had no maternity services for six months now. My elder daughter actually was a high-risk pregnancy three years ago, and she couldn't get the care that she needed then. Knowing that she couldn't get the care that she needed, she had to move away from Gladstone. And so she's been away for three-and-a-half years while she has her family, and she's only just come back.

But we have women here who are having to leave because they are pregnant. That is an untenable decision for women to have to make. We're a community that makes a significant contribution to the Queensland economy, and it's absolutely appalling that women here can't get the services that they need to birth safely.

HAMISH MACDONALD:   What do you mean by pregnant women are being forced to leave? As in, move for the period of their pregnancies?

SENATOR PENNY ALLMAN-PAYNE:   Yes, I can tell you stories of women who have decided to actually leave Gladstone on a permanent basis while they have their families because it's not safe for them. We have women here at the moment who are having to make choices about leaving in the months leading up to giving birth.

Women here are stressed. I mean, it's one thing to say that you can book in for an elective Caesar - and that is happening here. But you know, babies don't always come on time, things don't go to plan. We've also got women who have gotten in the car and driven to Rockhampton Hospital early in their labour because they don't want to leave it too late, and then they get to Rocky hospital and they tell them that they're not far enough into labour to be admitted to the hospital. And so they're having to find places to stay. This is really untenable. And as I said, it's been going on for six months now, and the government really needs to do something about this and quick.

HAMISH MACDONALD:   When you say the government, the Queensland State Government?

SENATOR PENNY ALLMAN-PAYNE:    Yes, absolutely. Our local member here is the Minister for Regional Development. We've recently had the Prime Minister and Minister Bowen and all their Labor colleagues here announcing how Gladstone is going to be the centre for renewable energy transition and all the opportunities that brings, and it certainly does. But the industry is telling me that they can't attract workers here because they know that they can't get the health services that they need.

I was a teacher at the high school here until six months ago when I was elected. I can tell you now that we have difficulty attracting teachers to Gladstone because young women know that they can't birth safely here. And if they transfer here and they want to start a family, they can't do that. So apart from the fact that this is a huge issue for women who are currently pregnant, you go to the shopping centre, and you're not hearing women talking about how excited they are that they're about to start their family when they're pregnant. What you're hearing is how stressed they are about what is to come. And we all know that women who are stressed during pregnancy are at much greater risk of having adverse outcomes for both them and their child.

HAMISH MACDONALD:   Usually, I think, Senator, there's around about 600 babies born in the Gladstone area each year, so it's not a small number. Is there a sense of fear amongst these women and families that they're actually not safe?

SENATOR PENNY ALLMAN-PAYNE:    Absolutely. As I said, the level of stress amongst the women here who are pregnant is really high. And you know, this is a time of life when people should be absolutely excited and looking forward to the fact that they're about to either start a family or add to their family, and instead they are scared and stressed. And in a town of 60,000 people, that's totally unacceptable.

HAMISH MACDONALD:   Dr Maria Boulton, doesn't this speak, though, to broader issues within the health system in Queensland and particularly regional Queensland?

DR MARIA BOULTON:   Yes, most definitely. And what we see time and time again is a lack of planning, a lack of leadership, a lack of resources and funding and this ever pressing need for workforce. And the situation in Gladstone, we travelled there last year, we spoke to women who'd had to go through having a baby during the bypass. They were in tears. The worst thing you can have when you're pregnant - I mean, it's already a stressful time - is the lack of certainty as to where you're going to deliver your baby.

HAMISH MACDONALD:   But so what does the Queensland Government say women should do? What's their response to this, Maria Boulton?

DR MARIA BOULTON:   So when we spoke to these patients on the ground, they kept asking during their pregnancies ‘where am I going to deliver?’. They were told very little until about 37 weeks when they were told that they would have to travel to Rockhampton, and, and it was a very stressful time.

The Queensland Government has told us they're recruiting like mad to try and increase the workforce in central Queensland. I'm not too sure where they're at with that. But we know that it's also creating a lot of pressure in Rockhampton Hospital. Rockhampton is dealing with hundreds of extra deliveries on top of the deliveries that they already deal with, and they've had staff specialists leave. And that is creating a pressure push in that last hospital.

This is terrible, and it is a medical emergency that should not be happening. It should not be happening in a population of 60,000 people like Gladstone, with 600 births a year.

HAMISH MACDONALD:   We did approach Glenn Butcher, the Gladstone MP, minister in the State Government to speak to us, Penny Allman-Payne, I understand that he had said that if the maternity services weren't returned, he might consider his position. Should he?

SENATOR PENNY ALLMAN-PAYNE:   Look, I think that the Queensland Labor Government is responsible for this. Whether it's Glenn Butcher, whether it's the Health Minister, the government has the capacity to make decisions to change this situation quickly.

I mean, they keep talking about recruitment. But as Dr Boulton said, retention has also been an issue as well. So what is it about the circumstances and the working conditions of the people that we previously had that were not being met, that meant that they haven't stayed?

There are lots of people who want to come and live and work in Gladstone. They like to use this rhetoric that it's really hard to get people into the regions. It's a great place to live, people love living and working here. My son-in-law is actually a health professional who can't work here. He has had to resign from or take leave from his job in Brisbane with the state health system, because they don't offer the specialty here that he has that is greatly needed.

They want to be here, there are other workers who want to be here, but if they don't provide the services that people need, people aren't going to come and stay. So it's really that circle that if they don't fix this, it's going to have flow-on effects. So it's going to be even harder to recruit and retain people.

I might point out too that we're in the middle of a quite a severe weather event. So all those women in Gladstone at the moment who are being told that they need to drive to Rockhampton, if they need to go today or in the next few days, they're not only going to be on the road, but they're going to be in driving rain. This is just unacceptable.

HAMISH MACDONALD:   Senator Penny Allman-Payne and Dr Maria Boulton from the Australian Medical Association Queensland, thanks both of you for your time.