Pressure on paediatric allergy clinics

REBECCA LEVINGSTON: Are you concerned about the impact of the closure of this allergy group? 

DR MARIA BOULTON: It's always a concern when medical services close. We're seeing the same happening to GP clinics and at the moment there is such demand for medical services and - not just medical actually - psychology, physio, everything. 

The system is quite busy. And what happens when services close is that it puts strain on the rest of the services and it means that patients may have to wait longer to get in to see that practitioner. 

And having listened to your previous caller, I've been through the same with my child. And it's really scary when you have a child who has their first allergic reaction in front of you. And even as a medical professional at the time, it still scared the bejesus out of me. 

REBECCA LEVINGSTON: Do you mind if I ask, what was the situation with your own child? 

DR MARIA BOULTON: Yeah, sure, so my child, who's a teenager now, what happened was she was quite a colicky reflux baby, and. we kind of hadn't worked out why. 
And back then, there wasn't a lot known about food allergies. I mean, I'm talking some time ago now, and it wasn't until she was six months of age when I gave her some formula that, you know, her lips started swelling, her face started swelling, even her ears started swelling. And I was thinking, oh, my goodness, she's allergic to cow's milk protein. And I just didn't know where the reaction was going to stop. 

So I did the right thing. I called the ambulance. Luckily, by the time the ambulance got to my house, it seemed that the reaction was getting much, much less. But, you know, we had a few minutes there where I thought, oh, this kid's going to need adrenaline. It's not something you normally keep at home. 
And you know, the paramedics were incredible. They sat me down. I think they gave me a cup of tea and they said, you know, don't give her any more of that until you speak to your GP. And I said, thank you.

REBECCA LEVINGSTON: So go to your GP, but of course some people do that and presumably, they can either get referred to a private allergy clinic or what about in the public system? Are you aware - is there a wait list for allergy specialists, and in particular, paediatric allergy specialists? 

DR MARIA BOULTON: Yes there is. So there is a public allergy clinic through the Queensland Children’s Hospital, which is fabulous. The issue is, that there is just one and there is a waitlist. 

They do prioritise according to need and urgency and the GP must send a referral in, as GPs we want all our patients to be seen as quick as possible but at the end of the day, the hospital triages. A lot of the time, parents who have the means, and this is where equity of access comes in, right? 

There are parents who are able to pay private who then seek a referral to see if they can get in privately. 

There are fabulous private clinics out there, for some people who are perhaps concerned about trialling their kid on a particular food because they’re allergic to another food, there are some clinics that will bring the parents in so they can do that food trial at the clinic. 

REBECCA LEVINGSTON: Well now there’s one less clinic with Allergy Medical Group closing. They say that thousands of patients, well, they expect inquiries to be in the thousands, I’m not sure of how big their patient base is – it’s not even clear why they’ve had to close. 

Just let me clarify, did you say there’s only one paediatric allergy specialist in Queensland? 

DR MARIA BOULTON: There's one paediatric allergy clinic in the Queensland Children's Hospital, I'm not too sure. I'm sure there's more than one specialist and they always have specialists who are completing their speciality training as well. 

REBECCA LEVINGSTON: Okay. But they may go into private or something like that. So I wonder is this something that is broadly more concerning or, you know, it's particularly traumatic for the family at the centre, but at the moment in south east Queensland, do we have enough resourcing to meet the needs of families with allergies? 

DR MARIA BOULTON: I don't think so. And the reason why I say that is because as a GP I see parents who, for example, there are things that GPs can't do and one of them, and it's really odd because we were able to do it, is to prescribe the specialised formula that some babies need and for whatever reason, the government took that permission off us. So we can't do that initial script. And I've had parents who have, you know, cried in my room because they can't get in anywhere to get that script. And, despite me making lots of phone calls, writing lots of letters, there's still that way list and it's not good enough. 

And I think we've been caught. I mean, there seems to be more allergy presentations And certainly when I had my child, it just didn't seem to be as, um, there didn't seem to be as many. And nowadays we know that 5 - 10 per cent of kids, for example, babies, will have a food allergy. Thankfully, most of them will grow out of it by the age of two. But it's a big number when you think about the number of babies being born in Queensland needing sometimes specialised help. 

The other issue we see sometimes too is EpiPens. GPs can't prescribe the initial script for an EpiPen. It must come from an immunologist and then we can do the continuation script. So, it does place a burden on those specialities and it does mean that patients and parents have to wait which you know you never want to see people waiting ever.