President and CEO update September 2022
With virtually all COVID public health precautions lifted, governments at all levels appear to have declared the pandemic over and back to business as usual. At the same time, the death of our reigning monarch had unforeseen impacts on our health system with the sudden public holiday.
Ambulance ramping rates show no signs of improvement and the Queensland Health Workforce Summit on 27 September provided no real solutions. A whole-of-healthcare system approach was needed - instead the summit focused on Queensland Health and ignored general practice, aged care and disability care.
Rather than investing in the medical workforce, the state government appears determined to press on with experiments to allow pharmacists to act as de facto GPs with minimal training. Under the North Queensland Pharmacy pilot, which will be rolled out next year, pharmacists will be allowed to autonomously diagnose and treat conditions after 120 hours of practice learning. The Queensland Government continues to support this experiment despite clear evidence from our survey and our members showing the UTI pharmacy prescribing pilot report was flawed and the trial caused harm to patients.
Our annual survey of junior doctors has revealed the impact COVID is taking on the future of our profession, with almost 60 per cent worried about making a fatigue-induced mistake and only one-quarter satisfied with the standard of training they are receiving. While we were disappointed with the Health Workforce Summit, our advocacy for a mental health and wellbeing summit for doctors and medical students has paid off with a date set for 17 November.
COVID health precautions lifted
September began with the announcement that daily reporting of COVID statistics would be wound back, that the blanket COVID-19 vaccine mandate for private healthcare workers would be lifted, and isolation periods for positive cases would be cut from seven to five days.
It ended with the decision to scrap mandatory mask wearing on public transport and end mandatory isolation altogether.
AMA Queensland is continuing to advocate for consistent and clear health information about the pandemic. More than 2,000 Queenslanders have died with the virus. We cannot become complacent. We have raised the need for support for private practices and doctors to set the protocols needed to protect their team and patients without the fear of vexatious complaints.
Read the ABC interview transcript featuring Dr Nick Yim.
National Day of Mourning
The sudden death of Queen Elizabeth II had unexpected consequences for our health system when a public holiday was declared at short notice for 22 September.
The Queen was the only monarch most Australians had known and it was appropriate to mark her passing. However, the lack of clarity about what the public holiday meant for patients who had elective surgery and hospital outpatient appointments on that day was disappointing and distressing.
Figures released earlier in September showed that more than 50,000 Queenslanders were waiting for elective surgery – hip or knee replacements, cataract surgery, endometrial operations, gall bladder operations.
AMA Queensland wrote to Queensland Health and rang Ministerial offices seeking clarity for patients with procedures booked for 22 September - with no success.
We gave advice to private practices about the workplace implications of choosing to open on the public holiday.
On the other side of the nation, WA Health confirmed that 60 per cent of elective surgeries went ahead as planned on the public holiday, with 271 procedures cancelled. We have yet to see Queensland Health figures.
Read some of our member and media activities:
- National Day of Mourning implications for private practice
- Public holiday arrangements unclear
- Patients still in limbo about public holiday
Ramping
New figures continue to show the stress our hospitals and healthcare system are under, with ambulance ramping blowing out to almost eight hours and patients waiting longer than 24 hours to be admitted to a mental health bed.
The figures coincided with the height of the state’s third Omicron wave and flu season in July, but there are few indications of any significant improvements.
Separate Queensland Ambulance Service figures released under Right to Information laws showed at least 20 people died and seven needed to be revived in a 16-month period as overworked paramedics could not respond in time.
This is not a reflection on ambulance officers – it is a reflection of a broken system. AMA Queensland President Dr Maria Boulton has visited numerous hospitals in regional and metro areas and had the opportunity to speak to doctors on the ground and listen to their concerns.
We are hearing a lot of blame between the federal and state governments, but we need real changes to end the hospital logjam and bed block that is clogging up our emergency departments and leading to ambulance ramping.
Read the transcripts of Dr Maria Boulton's Today Show interview and 4CA interview.
UTI prescribing trial
The Queensland Government’s urinary tract infection (UTI) pharmacy prescribing pilot became permanent on 1 October 2022, meaning pharmacists across the state will be able to autonomously diagnose, treat, and prescribe and sell antibiotics for the condition.
Health Minister Yvette D’Ath quietly tabled in parliament the executive order enabling the change on 27 September, but did not mention it at the Queensland Health Workforce Summit she attended that same day.
We remain concerned about patient safety, as doctors identified at least 240 cases of patient complications from the pilot, including misdiagnoses and hospitalisations, when we surveyed them earlier this year.
Unlike clinical trials, this trial did not include a mechanism for doctors to report harms. We asked QUT, which managed and implemented the UTI pilot, for details of the pathway for doctors and patients to report adverse outcomes.
QUT has now advised doctors to report their concerns to the Office of the Health Ombudsman (OHO).
The Queensland Government has just announced the proposed North Queensland pharmacy prescribing pilot, based on the UTI pilot, will commence next year. This pilot would allow pharmacists to autonomously diagnose and treat serious conditions, including respiratory diseases and skin conditions, without any medical oversight or consultation.
Dr Elise Witter, a GP trainee in North Queensland, outlined her concerns with the North Queensland pilot in an article.
Get the latest information at our Stop North Queensland Pharmacy Pilot advocacy page.
Resident Hospital Health Check
Our seventh annual Resident Hospital Health Check, released in September, found that Queensland’s junior doctors are increasingly concerned that overwork and fatigue may lead to them making medical mistakes.
The survey of doctors in training at Queensland hospitals found that almost 60 per cent were concerned about making a clinical error due to fatigue caused by hours worked, up from 51 per cent last year and 48 per cent in 2020.
A total of 719 junior doctors responded to the annual survey from AMA Queensland’s Committee of Doctors in Training (CDT) and ASMOFQ (Australian Salaried Medical Officers’ Federation Queensland), which compares the junior doctor experience and staff wellbeing in public hospitals around the state.
The steady increase in concern about possible fatigue-induced clinical errors highlights the toll COVID has taken on the medical profession and the failure of hospital authorities to take enduring action on both the hours worked and the quality of formal and bedside teaching and training.
The survey attracted wide media interest across the state and nationally, and we took the results to the Queensland Health Workforce Summit on 27 September. We will reinforce the message at the Mental Health and Wellbeing Summit planned for 17 November.
- Explore the report.
- Read the statewide and region-specific media releases.
- Read the press conference transcript.
QScript update
Following months of AMA Queensland advocacy, Queensland Health has acknowledged the high levels of concern among doctors and other health practitioners about QScript.
While we support the intentions of QScript, it is clear that its implementation has been difficult. Queensland Health’s post-implementation survey has found concerns about legal liability and dissatisfaction with QScript’s performance and responsiveness.
Queensland Health has now confirmed it is considering policy changes to address these concerns that may require legislative amendment.
This means the current arrangements will continue for a further 12 months, with Queensland Health monitoring, educating and encouraging (but not mandating) doctors to use QScript. Queensland Health has confirmed AMA Queensland will be consulted on the proposed policy and legislative changes after this period.
Read more about the QScript update.
Paracetamol restrictions
The Therapeutic Goods Administration (TGA) is considering restrictions on the sale of paracetamol in supermarkets and pharmacies, including smaller package sizes and age restrictions.
An independent report commissioned by the TGA found about 50 Australians die every year from intentional paracetamol overdose and hundreds more are hospitalised with liver injury. The rate of intentional overdose was highest among adolescents and young adults, particularly women.
The AMA supports the TGA’s consultation on the proposals. Used properly, paracetamol is an effective and safe pain reliever, but we need regulations in place to limit supply and restrict package sizes, particularly where there is no intervention from a healthcare professional.
The TGA consultation is open for submissions until 14 October 2022.
- Read more about the TGA review.
- Read a transcript of Dr Nick Yim's ABC interview.
IMG Survey
We ran an online survey in September to better understand the unique challenges facing international medical graduates (IMGs) in Queensland.
We thank the hundreds of IMGs who took time to complete the survey. Your responses will help our IMG Working Group to provide expert advice and recommendations to the AMA Queensland Council.
IMGs face complex obstacles in recruitment, training, professional development and everyday practice, and AMA Queensland is committed to clearing as many of these as we can.
Read more about our IMG survey.
Aged care
A major aged care services provider, Access Aged Care, withdrew from providing GPs and nurses to aged care facilities in Rockhampton and Bundaberg, leading to extra strain on local services.
GPs are not adequately resourced to go into aged care facilities. We are constantly advocating at the state and federal level for staff-to-patient ratios in nursing homes and proper resourcing for GPs to continue to care for patients after they move into residential aged care facilities.
People in aged care are among our most vulnerable and they deserve the best care. They need doctors and registered nurses to care for them.
Many of us will end up in aged care facilities with chronic disease and it is in Queensland Health’s interest to be able to care for us in those facilities. Otherwise we will end up in hospital emergency departments and bed block will become even worse.
Read the transcript of Dr Maria Boulton's interview with ABC Capricornia.