Sensible decision can reduce stress for pregnant patients in Cairns

Transcript: AMA Queensland President Dr Maria Boulton, 4CA, Mornings with John MacKenzie, Friday 13 October 2023

Subjects: Maternity services in regional Queensland

JOHN MACKENZIE:   This is a little matter that's been bubbling for quite some time - the birthing arrangements with the private hospital closing down access to that particular service. This came yesterday in The Cairns Post under the heading Birth plan a non-starter. It says, ‘Our local Cairns Health Service is yet to receive a formal proposal from a private obstetrician seeking access to deliver babies at the Cairns Hospital, amid calls for the Health Minister Shannon Fentiman to intervene.’

The impending closure of the private hospital's maternity services from November 1 has left expectant mums wanting to birth privately in Cairns without options. Well, the option seemingly is believed to be off to Townsville. It goes on to say, ‘The Cairns Post reported on Tuesday that private obstetricians, Dr Liz Jackson and Dr Anusha Lazzari, had offered their services to the public sector in exchange for the ability to birth private patients at the Cairns or Atherton hospitals.’ That offer appears to have been firmly rebuffed with health service chief executive Leena Singh saying on Tuesday, ‘It's not the role of the health service to ensure private obstetricians could continue operating their business within public hospital infrastructure.’ Adding, ‘All obstetricians were welcome to apply for positions at the health service’. And responding to the report, AMA Queensland President Maria Boulton said, ‘Ms. Fentiman must intervene to allow private specialists to practice in public hospitals to address workforce shortages in regional areas, particularly in maternity units’. This is quite a contretemps, isn't it?

I've got Dr Maria Boulton on the line to present some more information on this. She's the President of the Australian Medical Association Queensland. Maria, good morning.

DR MARIA BOULTON:   Good morning, John.

JOHN MACKENZIE:   This is quite an issue at a time when, of course, expectant mothers are at their wits’ end, thinking, ‘Where am I going to be? Am I going to be here? Am I going to be in Townsville? Am I going to be in the Cairns Hospital?’ Fundamentally, can you give us an overview in language we can all relate to, what's going on here?

DR MARIA BOULTON:   I really feel for those expectant mothers. I spoke to expectant mothers during the Gladstone bypass, and it creates a lot of stress at a time when you should really be enjoying the pregnancy. It was announced that the private hospital in Cairns would cease its maternity services in November and that would leave women who were booked to deliver through the private services having to look at their options of either delivering within the public system in Cairns or traveling to another private hospital to deliver their baby.

Some of the private obstetricians in Cairns have said, ‘We're very aware of the situation that's happening through maternity services in Queensland. We would like to collaborate and help out the public system and provide our services through the public system’. I understand it's not just helping to deliver those women who were booked to deliver privately, but also be part of the health service system to provide on-call support, which happens a lot in Queensland.

I used to work in Mackay and many of the private specialists provided valuable support to the public system. They helped with on-call rosters, they helped with training. It's collaboration that happens everywhere but for some reason in the last few years, we've seen much less of a support from Queensland Health towards those private specialists. At the end of the day what happens is that there's less specialists working in the hospital, which creates strain that we don't need.

JOHN MACKENZIE:   Well, the chief executive seems to be saying, ‘Listen, you can apply for a position at the hospital at our health service’. So, it's ‘apply for a position there or we're not interested in your services’. Is that what the message seems to be?

DR MARIA BOULTON:   I have not spoken recently with the CEO of the HHS, but I don't understand. There is already a visiting medical officer arrangement that-happens in other areas and I don’t understand why that’s not being offered, particularly at a time when we know that Queensland is short of obstetricians. And you know, it's not just obstetricians that make maternity services thrive, but also paediatricians, doctors with anaesthetic skills and also midwives, nurses, everybody. So it takes a team to deliver maternity services safely.

JOHN MACKENZIE:   Do you believe the only way this is going to get sorted out is by approaching the relevant Minister Fentiman?

DR MARIA BOULTON:   We have a meeting with Minister Fentiman next week and certainly it is on our agenda firmly amongst other things that we'll be discussing. But it seems that that's the case. I know there was a call for the private obstetricians to give a proposal to the HHS. I've spoken to one of the private obstetricians, and they're more than happy to meet with the HHS as needed. I'm sure that they've already reached out to the HHS.

It would be great to give these women the opportunity to have the choice as to who delivers their baby. The choice of where their baby gets delivered has been taken away, but they could have choice as to who delivers that baby. And those obstetricians have also said that they will help out in other areas, which is really valuable at a time of workforce shortages.

JOHN MACKENZIE:   You sound as if you're hopeful of a settlement as early as next week.

DR MARIA BOULTON:   I hope so. I just think from the patient perspective, it makes sense. At the end of the day, it's all about the patients. We've been fighting for a solution to the maternity crisis in Queensland, it's going to take some time to solve. And there have been some good initiatives from the Minister. But this is nonsensical, right? You have two specialists who are willing to help at a time of crisis, and why not allow them to help?

JOHN MACKENZIE:   Very well said. Thank you, Maria. Dr Maria Boulton is the president of the Australian Medical Association, Queensland AMA.