President and CEO Update - June

Professor Chris Perry OAM, AMA Queensland President and Dr Brett Dale, CEO

June has seen us responding to the Queensland State Budget and highlighting the wins and gaps for health in the state. While we are on the cusp of potential COVID restrictions, we cannot forget that June also saw an escalation in media attention for emergency department ramping and access block as well as major changes to COVID-19 vaccinations. Read our June update to learn more about the advocacy we have conducted for members this month.

COVID-19

The current COVID-19 clusters pose a high risk for further outbreaks throughout Australia. It is sensible that the Queensland Government has mandated mask wearing for the next two weeks and we hope this will be enough to curb the spread of COVID-19 but further restrictions may be necessary to keep our community safe.

All health care settings must now operate in the ‘moderate’ risk category with escalated use of personal protective equipment (PPE). This ruling is necessary but we need to ensure all health care workers, including GP clinics and their staff, have the support they need, which means access to adequate PPE supplies and fit-testing. We need meaningful action from the State and Federal Governments to ensure GPs and all frontline health workers are protected and can continue to care for our community.

GPs to administer Pfizer

In early June, GPs were invited to register their interest to administer the Pfizer vaccine. We had been lobbying for this over many months, ever since the storage advice for Pfizer was updated to allow one month in a normal fridge, paving the way for GPs to administer this vaccine. It is expected that all participating general practices will be given the opportunity to administer Pfizer by October 2021 and a limited number may be invited to start from July in areas of need. This was a hard-fought crucial step forward that will allow GPs to vaccinate more members of the community, which is even more important given the changes to the AstraZeneca vaccine.

Changes to AstraZeneca guidelines

On 23 June, the Australian Technical Advisory Group on Immunisation (ATAGI) lifted the age guidelines for the AstraZeneca vaccine from patients 50 years and over, to 60 years and over. This sudden change caught GPs by surprise and threw COVID-19 vaccine clinics into chaos with high cancellation rates, no-shows, wastage of vaccines and a significant drop in public confidence in the vaccine program.

We recognise the COVID-19 vaccination program will continue to adjust in line with international and national data and we welcome the ATAGI’s vigilance and guidance. However, the process of notifying GPs and the public of changes to vaccine guidelines must adjust. The current reactive system give GPs no time to understand new information, provide advice to patients and change existing bookings and systems in their practices. GPs need to have advance warning so they can continue to provide the best advice to their patients and effectively deliver COVID-19 vaccinations.

It is also imperative for the Federal Government to invest in a major public health campaign across all channels and mediums to restore confidence in the vaccine program and help GPs with the heavy lifting of allaying concerns and promoting the benefits of vaccination against COVID-19.

Medicare COVID consultations flawed

On the same day the AstraZeneca changes were announced, the Federal Government revealed new Medicare items for longer GP consultations to provide advice to patients on COVID-19 vaccinations. This was the result of significant advocacy over several months by the AMA with the Prime Minister and the Minister for Health. We welcomed the new items initially but the devil is in the detail.

The consultation is required to occur just before a patient receives the jab. However, the vast majority of patients want to discuss COVID-19 vaccines with their GP well in advance of receiving a dose. GPs have also told us that most patients book a regular consult and then have a COVID-19 discussion as a ‘tag on topic’ taking between 5 – 10 minutes on top of their scheduled appointment. In addition, most GPs are holding vaccine clinics on a given day and specific timeframe to ensure maximum efficiency, no wastage of their small allocation of vaccines, and appropriate supervision of patients post-vaccine. Consultations discussing COVID vaccines are most difficult during these vaccine clinics.

Finally, the new items force GPs to bulk bill the consultation to which we are opposed. The bulk billing rates set by the Federal Government fall woefully short of the true cost of delivering quality primary care to the community and hinder the ability for GPs to sustain viable businesses.

The new Medicare items show a complete lack of understanding in how GPs are delivering COVID vaccines on the ground. Read our full statement on this issue and our commitment to continue to advocate for changes that truly reflect the needs of the medical profession to deliver high quality health care to our community.

Queensland State Budget Response

The Queensland Government produced a health budget focussed on bricks and mortar rather than patient care and the wellbeing of doctors. While we welcome the $2 billion Hospital Building Fund, we need innovation and investment to find solutions that will address access block now. We need to move patients through the hospital system and stop the ramping crisis that is crippling Queensland. Not only do we need hundreds more staff in intensive care, mental health and general wards, we must also recognise the difficult conditions doctors and all frontline health workers are experiencing and invest in their care and support.

Rural Queensland also missed out on support in this budget with no allocation for specialist maternity care, mental health and pain management services. There was no additional funding for palliative care, underwhelming investment in Indigenous health and no training for much needed addiction medicine specialists.

Read our media response to the State Budget.

Ramping Round Table

We held our first AMA Queensland Ramping Round Table on 16 June, convening a group of diverse health experts from across Queensland to develop new ideas and solutions to address access block in our hospitals. Not only do we need more beds but also we must use the beds we have more efficiently.

The Chair, Dr Kim Hansen said there was no shortage of practical ideas that could be rolled out now and over the longer-term. Some of the key ideas the group flagged in the initial meeting include:

• measuring patient flow through the hospital system and not just emergency department wait times;
• establishing access and flow committees in hospitals that are focussed on patient movement and care through the hospital system;
• maintaining hospital capacity at 90 per cent to leave room for patients to be admitted into wards; and
• better processes for patients to access care in the community rather than in a hospital bed e.g. nursing home placements, scans, and reviews.

The 10- member group will bring on additional expertise as needed and plan to meet again in the next month. A clear timeline for recommendations will be developed including short, medium and long-term goals. We look forward to working with Queensland Health and the Government to help provide solutions out of our current ramping crisis.

Read more about the Ramping Round Table.

Every Dr Needs a GP campaign

The AMA Queensland Board identified the need to encourage doctors to take care of their own health and devised the Every Dr Needs a GP campaign. It can be tricky for a doctor to be a patient and for a doctor to be comfortable treating another doctor, but the reality is, every doctor needs a GP to provide objective health advice and support.

Our campaign includes a guide on how to find a GP, testimonials from our Board and Council, as well as an In Conversation webinar Dr Jennifer Schafer from Doctors’ Health in Queensland. Doctors, like most people, delay getting a GP until they are sick, which makes it difficult to find the right person when your decision-making capacity is at its lowest. We are encouraging every doctor to have a GP as a part of their regular health care, so you can access support and advice that you trust, when you need it most.

Read more about the campaign.

Pay rises for hospital doctors

ASMOFQ and AMA Queensland have secured two wage increases for Queensland Health-employed doctors over the next six months. From 1 July 2021, doctors will obtain a 2.5 per cent pay increase. This is a delayed pay rise postponed during the COVID-19 outbreak. ASMOFQ maintained pressure on the Queensland Government to deliver this wage increase as promised. An additional wage increase of 2.5 per cent will also occur from 1 January 2022 as a part of a new deal secured by ASMOFQ.

Read more about this strong result for doctors working in Queensland hospitals.

Minimum wage increased

The Panel of the Fair Work Commission has decided to increase the minimum modern award rates of pay by 2.5 per cent. For the health care sector, this increase will take effect from 1 July 2021 and impacts employees covered by industry modern awards, such as the Nurses Award 2010 and the Health Professional and Support Services Award 2020.

Our Workplace Relations Team is currently updating our Pay Rates Summary for 2021-22 that will be available before 1 July 2021.

Read more about this important change for those in private practice.

Queen’s birthday honours

A number of distinguished AMA Queensland members were recognised in the Queen's birthday honours on 14 June.

• The Reverend Dr Cecilie Lander has received an AM for significant service to paediatric medicine, and to the Anglican Church of Australia.
• The Reverend Dr Meryn Lander has also received an AM for significant service to paediatric medicine, and to the Anglican Church of Australia.
• Recently retired Dr Charles Steadman received an AM for significant service to tertiary medical education, and to gastroenterology.
• Professor Claire Jackson received an AM for significant service to primary health reform, and to general practice medicine.
• Dr Amanda Dines received an OAM for service to medicine.

Doctor Q interviews Health Minister

You will have received the winter edition of Doctor Q where we interviewed the Queensland Health Minister, The Hon. Yvette DÁth MP, on the crisis facing emergency departments around the state. Other feature articles include breaking down the aged care recommendations and meeting our newly elected Board and Council. We are always keen to hear your feedback so please let us know if you have any suggestions for content and articles you would like to see in our flagship magazine. Please email your suggestions to amaq@amaq.com.au. 

Read the Winter Doctor Q.

  

Around the state

We have been busy in June travelling throughout Queensland to meet with members and understand the needs of doctors across our vast state. Here's a snapshot of our member engagement.

    

Photos left to right: Meeting with Board member Dr Nick Yim and Cr Darren Everard, Deputy Mayor Fraser Coast, while in Hervey for Fraser Coast LMA; Prof Chris Perry and partner attending the Indian Medical Association Annual Dinner;

  

Photos left to right: Prof Chris Perry speaking at the Rural Doctors Association Queensland Conference; Attending the Brisbane LMA.