Patients in pain on waiting lists

Transcript: AMA Queensland President, Dr Maria Boulton, ABC Brisbane, Mornings with Rebecca Levingston, Monday 5 September 2022

Subjects: Elective surgery surgery and specialist outpatient waiting lists

REBECCA LEVINGSTON:   Are you waiting on elective surgery right now? What are you waiting for? And how long have you been waiting? You are not alone. Right now hundreds of thousands of Queenslanders are waiting for an initial appointment at one of Queensland Health's specialist outpatient clinics. At the end of June, there were over 50,000 people waiting for elective surgery. And of that number over 7,000 had been waiting longer than clinically recommended. Dr Maria Boulton is President of AMA Queensland. She's also a GP in Brisbane. Dr Boulton, good morning.

DR MARIA BOULTON:   Good morning, Rebecca.

REBECCA LEVINGSTON:   The pandemic seems like an obvious point as to why there's so many on a wait list. Is that that number acceptable, hundreds of thousands waiting for an initial appointment?

DR MARIA BOULTON:   No, it isn't. And as a GP, we look after these patients until they have that surgery, and we're the ones that can see what pain and suffering they're in. These are people waiting for surgeries that need to happen. They're not optional. They're people who need a hip or a knee replacement. They're people who have cataracts. They're people who need their tonsils out. So for example, if by the time you need a hip or a knee replacement, you're in pain every day, and to prolong that pain and suffering is really awful for those patients.

REBECCA LEVINGSTON:   When did wait list times become an issue?

DR MARIA BOULTON:   They were an issue before the pandemic. We knew that our hospitals were already stretched prior to the pandemic. But certainly over the last two and a half years, we've had instances where elective surgeries have been postponed. At the moment we have an issue where GPs received a letter from Queensland Health stating that referrals to outpatients, category three referrals to outpatient departments would be postponed as well. So there's people that need to be seen by a specialist. We know that those referrals are taking longer at the moment. Then they get seen by a non-GP specialist and then get put onto a surgical list. So it's kind of like a double wait list to get the treatment that they need.

REBECCA LEVINGSTON:   How long's an average wait time for something like a hip or knee replacement?

DR MARIA BOULTON:   It really depends across jurisdictions, but I've got, for example, a patient who's waiting for her gallbladder to be removed because she has gallstones. And her wait time, she got told would be 12 months, but it does vary. Every hospital will have a different load on their wait list and will have a different wait time. And it would vary across the hospitals.

REBECCA LEVINGSTON:   Dr Boulton, Queensland Health says they completed 32,300 elective surgeries in the quarter up until June. They say that's a nearly 40 per cent increase in elective surgery activity compared to the previous quarter. Is that reason for optimism?

DR MARIA BOULTON:   Look, I'm glad that they're doing as much - well, I hope they're doing as much as they possibly can. I know that staff that are working in those surgical units are doing the best they can to get through the lists. But we also know that there are reports where there's not enough staff in some areas. We know that there's not enough hospital beds. And try saying that to all the other people who are still waiting to get those surgeries. So I think we need to do better, I think we need to do more, and it's going to be a really difficult situation because really what the hospital system needs is more staff. And we know that the rest of Australia's in the same predicament at the moment so it is going to take a little bit of time to get through that. But we just also have to think about that individual person. It doesn't really matter to my lady who's waiting for her gall bladder to come out how many surgeries Queensland Health performed in the last quarter. It really doesn't matter to her and her suffering.

REBECCA LEVINGSTON:   Dr Maria Boulton, President of AMA Queensland, also a GP in Brisbane, can you confidently say that everyone is getting surgery in a timeframe that doesn't have detrimental long-term effects to them?

DR MARIA BOULTON:   No. We know that there are hospitals that are falling behind that recommended timeframe and so what happens then is that a patient is not seen within that recommended timeframe. That has effects on that patient. Mental health effects, of course, because if you're in pain for a prolonged period of time, that's not great for your mental health. But also it may make that surgery a little bit more difficult. Say, for example, with my lady and the gallstones, we know that gallstones can move, we know that they can block the duct that comes out of your pancreas, and it can cause pancreatitis, which is quite serious and people can end up in intensive care. But we know for a fact, we know that the Sunshine Coast Hospital, for example, is behind where they need to be. There was an article today on ABC Online stating that and we know that it's an issue in other hospitals as well.

REBECCA LEVINGSTON:   Can I just ask, just in trying to understand some of the figures as well, there are 167,000 surgical patients and another 100,000 medical patients on the list, what's the difference between those two?

DR MARIA BOULTON:   So I guess the surgical patients would be people waiting for a procedure. For example, it could be a hip or a knee replacement. It could be tonsils. It could be cataracts. The 100,000 on the medical list could be someone who's waiting to see a cardiologist or someone waiting to see an endocrinologist or a rheumatologist for example. So, people who don't necessarily need a surgical procedure but still need that specialist input above what the GP can provide.

REBECCA LEVINGSTON:   And then the figures go on to say at the end of June there were 57,900 people waiting for elective surgery in Queensland, close to 7,500 waiting longer than clinically recommended as you've identified. You said more staff are needed to help tackle the issue. Where are they going to come from?

DR MARIA BOULTON:   Yeah, it's a really great question and it is something that we have raised with Queensland Health. We know that at the moment we are very pressured for staff. We're also worried about, there's this great announcement about 2,500 new hospital beds over the next six years. But for every hospital bed, you need 10 staff members. So we're also worried about where those staff members are going to come from. We have asked to see a plan about staffing hospitals. We don't want to the hospital system to pull staff from the already short-staffed primary care system either. So it's going to be a challenge for them and we'd like to see what they're doing about it.

REBECCA LEVINGSTON:   What's your advice, Dr Boulton, to people who are waiting and in pain and are hearing these tens of thousands of people on the wait list?

DR MARIA BOULTON:   Yeah, look, it's a really awful, awful spot to be in. And these are people that have nowhere else to go. And we made that very clear to Queensland Health at a meeting in the last month saying, you cannot reject our referrals. You must accept them because these people have nowhere else to go but the public system. There's nowhere else for these people to be referred to. We cannot perform those procedures anywhere else.

So what my advice would be to those patients is that your GP will always be there to help you. And certainly if things get worse, you need to make contact with your GP. We can't do much about the waiting list, as much as we would like to, but we certainly continue to fight for their right to have surgery.

REBECCA LEVINGSTON:   Appreciate your time this morning, Dr Boulton. Thanks so much.