Regional access to elective surgery unfair, harmful

Transcript: AMA Queensland Immediate Past President, Dr Maria Boulton, ABC Radio Capricornia, mornings with Jeremy Jones, Tuesday 17 September 2024

Subject: Elective surgery in Central Queensland

JEREMY JONES: What is the situation facing those needing elective surgery in Central Queensland? AMA Queensland has convened a new roundtable to examine growing elective surgery wait times in regional and rural areas and identify practical, affordable actions the government can take to address inequalities in access. Dr Maria Boulton is a former AMA Queensland President. She's with you now to explain the problem and how they hope to improve outcomes. Maria, thanks for joining us. How does Central Queensland fare when it comes to wait times?

DR MARIA BOULTON: Good morning. It seems that Central Queensland, from data we know that it fares much worse than, for example, the southeast corner and the Cairns region. We know that the wait times for elective surgery are much higher than in those other areas. For example, currently in Central Queensland, there are over 3,000 people waiting for elective surgery, which is actually up by more than 20 per cent from last year. When you compare it to other regions in Queensland, it's by far the worst.

We also know that there's almost a thousand patients waiting longer than the clinical recommended time for their surgery, which is up almost 65 per cent from the same period last year. In other areas of Queensland, that number has actually gone down. So Central Queensland is certainly faring far worse than the rest of the state, which is a real concern, particularly when we know how many people live in those areas. Queensland is the most decentralised state, and it is really essential that all health services reach all Queenslanders, and this is why AMA Queensland called a Surgical Wait List Roundtable because we were hearing reports, not from not just from our members who work all over Queensland, but also from patients who were alarmed at these statistics.

JEREMY JONES: And what are the impacts for someone waiting for elective surgery?

DR MARIA BOULTON: Elective surgery is not optional. Often, it's someone who may be waiting for a knee or a hip replacement so that they can go back to work. It may be someone who may be waiting for hernia surgery from a painful hernia or somebody who may be waiting for a cataract to be operated on so that they can see. So, it's different to emergency surgery as it doesn't need to be performed within 24 hours, but it's still essential. So, the impact can be quite profound.

It may be that patients are waiting for longer in pain, they may not be able to return to work, they may be relying on pain medication, or their condition may worsen because of the amount of time that they're waiting. And there are so many people waiting longer than is clinically recommended which is not ideal and it's not fair. It's really not fair for somebody to be living that long with a problem that we know can be fixed by surgery.

JEREMY JONES: On the fairness of it then, the wait times here are longer. Why is it that other areas are shorter? What are they doing that means that they can have elective surgery sooner?

DR MARIA BOULTON: With Central Queensland there are issues to do with funding. The funding is not the same as other areas. For some reason, some areas in Central Queensland don't qualify as rural as other areas, which we're calling for a change because we need more funding to go into Central Queensland.

Also, there's always been issues with workforce and getting healthcare workers to go to those areas. It's a real shame. I lived in Mackay for 10 years and it was truly a wonderful place to live and raise a young family. But clearly there's not enough being done by Queensland Health, by the government, to attract and retain workforce to those areas when we know that they are beautiful places to live in. There's many reasons for that. We know that there's a workforce shortage affecting not just Queensland, but the whole of Australia and even the entire world.

There's also been a lack of planning for workforce shortages. We wouldn't be in this position had the planning been where it needed to be. We also need to recruit more to those areas. We need to ensure that medical students are training in those areas and that they're able to complete their speciality training in Central Queensland so that they're more likely to stay in those areas. We also need to ensure that the workforce that's currently there is well supported so that they stay in those areas. We hear far too often, problems with rostering and how some people are working in excess of 24 hour shifts repeatedly because of workforce shortages, and people just don't last if that's the conditions that they're working in. So, the conditions need to improve, the workforce planning needs to improve. Also, healthcare workers are affected by the same issues that everybody else is. They’re affected by the lack of accommodation, lack of jobs for their partners, all those things also come into play. The difference being that health is so critically important.

JEREMY JONES: Maria, you touched on there about areas that weren't classified as rural. Can you tell us, do you think if they were classified as rural, those elective wait times would go down?

DR MARIA BOULTON: Well, there is some structural reform to be done when it comes to funding and that is one of them - ensuring that these areas are classified accordingly so that they attract that funding. The other one is the way that funding is distributed. At the moment it's activity-based funding, but if there's no activity of a certain type in an area, then that funding isn't there to attract someone to provide that activity. So, it really needs a whole change to ensure that there is enough funding there so that we can attract enough of those services to that area and retain them in those areas because we need longevity above all. We've got some short-to-medium term solutions, but we also have some longer-term solutions, and we need to ensure that whatever's happening now doesn't get repeated again.

JEREMY JONES: That's really interesting though. So, with the rural classification, would there be areas here that aren't rated rural that then have longer wait times than those that are rated rural in other regions of Queensland?

DR MARIA BOULTON: Correct. So, there are there are different ratings of rurality and funding. We know that Central Queensland doesn't attract the same funding than other areas and yet there is so much need there, particularly when it comes to workforce.

JEREMY JONES: As we approach the state election, are you aware of what the parties’ stances are? Is this something that could be looked at in the coming election?

DR MARIA BOULTON: I've heard both leading parties discuss what their priorities are and we know that health is up in the top three. And so it should be because it is so important. We know that it's been a burning issue for some time, and particularly when it comes to, for example, the maternity crisis that really was impactful on Central Queensland. I'm not sure on what specifics they're going to be electioning on, but certainly this pivotal work from our roundtable is something that we will be sharing with them, similarly to when we shared all the findings and recommendations from our emergency Ramping Roundtable. We have seen most of those recommendations receive funding.

We hope that the recommendations from this Surgical Wait List Roundtable Action Plan also receive the funding, because we've put together an amazing group of clinicians from all over Queensland from all different specialities. They include anaesthetics, surgery, general practice, and these are people on the front line who know exactly what the problems are and have made some excellent practical recommendations.

JEREMY JONES: Well, Maria, a big thank you for joining us on the show this morning.

DR MARIA BOULTON: Thank you.

JEREMY JONES: Dr Maria Boulton with you there, former AMA Queensland President. I thought that was particularly interesting there, the rural classifications and what that can mean for an area when it comes to funding.