Festive season - office closure

This has been another bruising year for the community, for patients, for doctors and for all healthcare workers. We’ve battled shortages of staff and PPE, vaccine anxiety, vaccine scepticism and, eventually, vaccine complacency.

As we head into 2023, our COVID death toll is more than 2,300. This pandemic is not over, but the public and political mood has changed. Federal COVID funding for our public hospitals will end this year. Lockdowns and mask mandates are things of the past. We are now treating COVID like influenza and other respiratory illnesses – relying on people to take personal responsibility.

Rest assured that AMA and AMA Queensland will continue to advocate on behalf of the entire profession and our patients as we enter post-pandemic 2023.

COVID-19

Throughout 2022, we advocated at the state and federal level for doctors and patients for the best decisions and protections from COVID. We secured dedicated pathways for GPs to access PPE supplies, and certainty around protocols for treating COVID patients in the community.

We arranged priority COVID PCR testing for private practice doctors, their staff and families when Queensland Health refused our request to do the same. We are grateful to the private pathology companies who facilitated this state-wide, particularly earlier in the year when the lines for PCR testing were massive and wait times for results were long. We advocated for the provision of fit testing for private practice and their staff, resulting in some PHNs and Metro North providing this service.

We also sorted out the private flu vaccine rebates when the free flu vaccine announcement was made via the media. Unlike other states, GP clinics were able to claim the rebate from Queensland Health at the start of the campaign.

We supplied constant, near real-time updates to members on Queensland Health public health notifications, and provided guidance to practices on how to fulfil ethical and professional duties while managing unvaccinated patients. We successfully advocated for Medicare rebates for COVID telehealth services to be extended, and for a new Medicare item for antiviral management.

We prevented legislative changes that would have allowed pharmacists to prescribe COVID antivirals.

We convinced the federal government to reinstate pandemic leave from mid-July for casual workers who might otherwise have gone to work, further spreading the virus and, with ASMOFQ, persuaded Queensland Health to allow employees to access pandemic leave immediately.

We delivered COVID Care Packages to 1,000 doctors in public hospitals and 19 private practices to thank members across the state for their tireless efforts during the pandemic.

Into 2023, we will continue to advocate for the strongest protections possible for doctors, healthcare workers and the community as we move into a new phase of the pandemic.

Pharmacy prescribing pilots

We are continuing to fight against dangerous plans to allow pharmacists to autonomously diagnose and prescribe for medical conditions. Unfortunately, this year the urinary tract infection (UTI) pilot became a permanent part of our health system, despite the pilot’s evaluation showing hundreds of cases of misdiagnoses and women needing to seek further medical treatment. It took months of pressure from AMA Queensland for the government to release the evaluation. We are continuing to pursue Queensland Health and the Queensland University of Technology (QUT), which designed and evaluated the pilot, for explanations about inaccuracies and unsubstantiated claims made in the evaluation.

Disappointingly, other states are following in our flawed footsteps and considering similar trials.

The Queensland government appears determined to press ahead with the North Queensland pharmacy prescribing pilot, based on the ‘success’ of the UTI pilot. AMA Queensland was part of the North Queensland pilot’s steering committee, but quit early this year when the full scope of the pilot became clear.

Through our advocacy, we have been able to delay the pilot’s start and reduce the number of serious medical conditions covered from 23 to 17. We continue to advocate against this pilot.

Payroll tax

We are aware many general practices are being audited by the Queensland Revenue Office (QRO) following a tribunal ruling in New South Wales that found GPs in one practice were employees, incurring payroll tax for the practice.

With the RACGP, we are continuing to negotiate with the QRO and are seeking to meet with the Treasurer to get clarity for practice owners. We are asking for an exemption from payroll tax for private medical practices, similar to the exemption for public hospitals and some private hospitals, or a moratorium while practices ensure they comply with the new interpretation of the law.

Voluntary Assisted Dying

We have been working with the state government on the implementation of the Voluntary Assisted Dying (VAD) scheme, which commences on 1 January 2023. Doctors still have many questions about how the VAD scheme will operate, eligibility criteria and practitioner applications.

AMA Queensland has a VAD information page that is regularly updated. Go to ama.com.au/qld/campaigns/voluntary-assisted-dying

Mental health and wellbeing

We are happy to report an important step in AMA Queensland’s long-running battle to better protect our doctors.

The Queensland Government will amend the Hospital and Health Boards Act 2011 to make Hospital and Health Services (HHS) and their boards responsible for staff wellbeing and for promoting a culture that supports health, safety and wellbeing.

We have advocated strongly for these changes, which are similar to laws introduced in South Australia.

Health Minister Yvette D’Ath flagged her intention to introduce these amendments at the November Health Workforce Mental Health and Wellbeing Summit, which was held as a result of AMA Queensland advocacy.

We are heartened by these positive actions to look after our health workforce, particularly their emotional wellbeing and cultural safety. These changes acknowledge that their work can pose unique risks to their wellbeing.

Medicare

This year we have seen a steady stream of attacks on GPs as Medicare fails to keep pace with the rising cost of delivering healthcare and doctors can no longer afford to bulk bill. The ABC and major newspapers accused doctors of completely unsubstantiated claims of rorting $8 billion a year from Medicare, and state ministers blamed emergency department wait times on GPs.

At the same time Queensland and other jurisdictions are rolling out pharmacy prescribing pilots that will risk patient safety and undermine the doctor-patient relationship.

With our federal colleagues, we are campaigning to Modernise Medicare to make it fit for purpose. This call has been echoed in a Grattan Institute report which calls for a complete overhaul of Medicare.

GPs are seeing far more complex issues now than when Medicare was set up, including mental health issues that need much longer than the standard consult, but Medicare does not recognise the need for long medicine.

Federal Health Minister Mark Butler has admitted that general practice is in the worst shape it’s been in during the 40 years of Medicare, with bulk billing rates dropping from 88.4 per cent late last year to 83.4 per cent in September 2022.

Minister Butler has asked his department for more information about the state of bulk billing. We will be lobbying to ensure this further information leads to real reform.

Public hospitals

We had a win this year with the state government implementing many of the recommendations of our Ramping Roundtable Action Plan, including the budget promise to deliver 2,500 new hospital beds and 9,000 additional healthcare workers.

Unfortunately, many of these beds will not be online for several years when they were needed yesterday.

We continue to call for urgent action to address major concerns at our hospitals, including Redland Hospital, the only metropolitan Queensland Health hospital without an intensive care unit (ICU)/critical care unit, 24/7 general surgical services, and inpatient orthopaedic services.

Members have contacted us with their concerns about ambulance ramping, hospital bed block and delays in transferring patients to other hospitals.

We are raising our concerns about obstetrics and gynaecology services, particularly in Central Queensland where the Gladstone and Biloela maternity units have been on bypass for months, and those flow-on effects at Rockhampton and other hospitals around the state.

We will continue to advocate for action for our public hospitals, including for the federal government to reinstate 50-50 hospital funding with the states and territories.

The year ahead

We have a lot of work ahead of us in 2023.

We have a new Opioid Stewardship Roundtable, a new Committee of Consultant Specialists, and a new international medical graduate (IMG) working group to address the unique stresses and challenges for this vital part of the medical workforce.

We are seeking federal AMA advocacy for a new stepdown registration for senior active doctors, and will continue to advocate for a modernised Medicare, ending hospital logjam and bed block, and for safety and protection from COVID for all healthcare workers.

The AMA Queensland Board, Council and secretariat staff would like to wish all our members a very happy festive season. We know not all of you will get a break over the holidays, but we hope you get to spend some time with loved ones and get some much-needed rest at some stage.