Too many people waiting for healthcare

Transcript: AMA Queensland President, Dr Maria Boulton, ABC North Queensland, Mornings with Susan Graham-Ryan, Monday 22 April 2024

Subject: AMA Public Hospital Report Card

SUSAN GRAHAM-RYAN: Surgery wait times are at an all-time high and emergency departments are facing pretty severe delays. The state of the country's public hospitals has been revealed in the Australian Medical Association's Report Card, and it looks like our healthcare system is in need of some pretty urgent care itself. Queenslanders are facing the longest wait times for planned surgeries on record, and our emergency departments are not faring much better, prompting the AMA to call for urgent action across the country. President of AMA Queensland Dr Maria Boulton says while the results are disappointing, they're also not surprising. She joins me now, good morning.

DR MARIA BOULTON: Good morning.

SUSAN GRAHAM-RYAN: So, start by giving us a bit of an overview of the current state of public hospitals in Queensland, particularly those in the regions.

DR MARIA BOULTON: What we've been seeing in Queensland, and this is something that is widely reported by our members, is that there's too many people waiting for healthcare. There's two types of healthcare that get delivered in hospitals. Some of it is emergency care and some of it is people waiting to be seen in outpatients and be booked for that surgery. And when you look at Queensland, we are the most decentralised state. And sadly, people outside of the big metro areas, for example, if you look at the area between the Sunshine Coast and Townsville, they're waiting far longer than people in Cairns or in the South-East for elective surgery. And elective surgery is not optional, it could be someone who's waiting for a hip or a knee replacement who's in pain every day. It's surgery that must happen and yet they're waiting far longer than their big metro counterparts.

SUSAN GRAHAM-RYAN: So, let's have a look at what some of the positives are in terms of the Report Card for Queensland. What are some of the positives or the rays of hope that you see in this report?

DR MARIA BOULTON: The AMA puts out an annual Public Hospital Report Card that looks at financial years. The latest one looks at 2022-23. And Queensland, when you compare it to the rest of the country, is not the best performer and not the worst performer. We come somewhere in the middle.

There was a slight improvement of 2 per cent of people who are waiting to be seen in emergency who are category three, which means they're not the most urgent, but that's only 2 per cent. So, 62 per cent of people were seen within the clinical recommended time versus 60 per cent in the year prior.

But when you compare that to the people who are waiting in excess of four hours in emergency departments to be seen, there was a deterioration there. And when you look at all the figures, it seems that since the reports have been running, most of the figures have actually declined. So, it seems that hospital performance is just declining over time, albeit with small little exceptions here and there.

SUSAN GRAHAM-RYAN: What are the causes for the worsening, do you think?

DR MARIA BOULTON: There's a few different causes. One is the lack of investment in healthcare, so basically our hospitals need more funding. We need more workforce, as we know that there are workforce shortages, which tend to be more extreme outside of the big metro area. We're also seeing a lack of investment in general practice. General practice is the key to keeping people healthy and out of hospital, and if the investment isn't there, then more people end up in hospital.

In Queensland, we've got an ageing population, as does the rest of Australia. People are presenting with more complex chronic conditions. Also, we've seen a lot of people move to Queensland and why wouldn't you, right? It’s such a lovely state to live in. So, there's a lot of different things that are creating this. But unless we have some urgent funding, unless we have some urgent attention to our workforce, and that means supporting the workforce that's already there, but also ensuring we're recruiting and training enough for our requirements and our future requirements, things will get worse.

SUSAN GRAHAM-RYAN: Obviously, we have a state election coming up, so that will be something that you're, I guess, having a conversation with all of the parties. Now, what would you like to see prioritised if we're going to use a similar model to the report card and how hospitals triage patients? What are the key areas we need to be prioritising right now?

DR MARIA BOULTON: AMA Queensland is establishing a Surgery Wait list Roundtable, where we will work with doctors who are working all through Queensland in making recommendations for exactly this. How do we reduce the number of people waiting on surgical wait lists? The work of that roundtable will be ready in a few months, and we would like to see those recommendations prioritised.

We've also released our Advocacy Priorities for the next three years and No.1 on our list is workforce. Without workforce, nothing happens. And if it wasn't for the brilliant work that our healthcare workers do now, we would be in a much worse shape. So, it is really important that we support our current workers, but also ensure that we're training enough. We'd like to see a comprehensive workforce plan, and that needs to include not just public hospitals, but also private hospitals, NDIS, aged care, and primary care. And we'd also like to see some urgent investment into general practice so that we have enough GPs to keep people healthy and out of hospital.

I guess our main priority for the election is for the government to release some incentives to help doctors make that decision to train as a GP rather than stay in the hospital system, because we know we need more GPs, particularly outside of those metro areas where GPs are so essential to each community.

SUSAN GRAHAM-RYAN: What can we do to improve that consistency and that access to care in regional, rural and remote parts? How can we improve that healthcare in those areas?

DR MARIA BOULTON: Workforce is really essential, and with workforce, it's really tricky because when you look at health, it's not just the State Government that is involved, but also the Federal Government. And, really, patients don't care where the funding comes from. If they have a health issue, they just want it looked at as fast as possible. This is where State and Federal Governments need to work together and ensure that patients do have access to that GP care and that patients have access to that hospital care.

The other issue that's affecting our communities is maternity. So, we know that there's a lot of maternity units that have closed or have gone on bypass. And, once again, we need urgent attention into those, but funding incentives to attract people to the regions. The workforce also is affected by the same issues that affects the rest of the workforce, which is lack of accommodation, lack of employment for families and partners and childcare. So, they're the things that if you address, not only will it help healthcare workers, but it will help other areas of business as well.

SUSAN GRAHAM-RYAN: How hopeful are you that the that this Report Card into the future might look a bit more positive, because we know that the Commonwealth Government has said that they will increase funding to hospitals?

DR MARIA BOULTON: There is a new arrangement being discussed that will start in 2025. So, there is some hope there. The issue is that 2025 is a long way away yet and we do need that urgent investment now to deal with the backlog in surgeries. So, I'm always hopeful and we do have a state election in Queensland, and I know that it's one of the top three issues. When you talk to Queenslanders about what's important in this upcoming state election, health is one of the top three. So hopefully if we continue to advocate in this space, hopefully governments will step up and listen and we'll get more funding, we'll get more workforce and hopefully that will result in better care for Queenslanders.

SUSAN GRAHAM-RYAN: Dr Maria Boulton, President of the Australian Medical Association Queensland, thank you very much for your time this morning.