Restarting of elective surgery and Surgery Connect contracts
With a spirit of cooperation and to continue advocating for a safe, fair return to elective surgery, AMA Queensland hosted its fourth webinar this week with Queensland Health and Queensland’s largest private hospital providers.
The webinar provided members with news of the latest developments in public-private negotiations as well as proposed timelines for the stepped reinstatement of elective surgeries.
Queensland Health’s Acting DDG and Chief Clinical Information Officer Prof Keith McNeil attended the webinar to address members’ questions and concerns in real time, while representatives from the Mater, Ramsay Health, St Vincent’s, Uniting Health Care, and Cura Day Hospitals advised of issues and processes at their facilities as they worked towards resuming normal activities.
WEBINAR RECORDING
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Wednesday 20 May 2020
RESUMPTION OF ELECTIVE SURGERY ACTIVITY
Late Wednesday, Queensland Health Director-General Dr John Wakefield advised by letter that the State Government had determined that private hospitals in Queensland could return to up to 100 per cent of normal elective surgery activity, subject to availability of PPE.
Stage 1 of the resumption would see up to 50 per cent of normal surgical activity levels immediately and up to 75 per cent from June 1. A move to 100 per cent would occur when safe and possible to do so, depending on availability of PPE and other equipment and with the continuing adherence to social distancing measures.
A WIN FOR AMA QUEENSLAND - SURGERY CONNECT RATES
In the letter, the DG advised that, due to the growing waiting list across the State and because “private operators had largely been unable to reach agreements with private specialists on remuneration”, Queensland Health had determined that “Surgery Connect contracts should be used as the vehicle for all referrals of public work to private hospital providers”.
In April, AMA Queensland urged doctors not to sign the contracts and strongly advocated for doctors to be paid above the State Government’s original offer of the Medicare Benefits Schedule fee, indicating that a fee-for-service model, as has been utilised in the Surgery Connect model, was the most appropriate model, rather than the lower offer of fee for time rates.
We welcome Queensland Health’s decision to provide fair and reasonable rates to private doctors whose services will be used to assist the public system in reducing its waiting lists which have increased dramatically since COVID-19 restrictions were imposed.
We recognise that the Surgery Connect model is also not perfect and some conditions and remuneration, especially for anaesthetists and pathologists, are worthy of future discussion when the COVID-19 pandemic has settled further.
CONCERNS
However, as Prof Keith McNeil said during the webinar “the devil is in the details”, and AMA Queensland remains concerned about the lack of clarity on whether there will be a forced allocation of time for public work, as the new contracts with private providers reserve the option for up to 50 per cent of elective surgery capacity to be allocated to public patients. A further concern is the failure of Queensland Health to include a date or process for expiration of the new contracts with doctors. Further clarity is also required on whether idle capacity can be used for private patients, if it’s not used by public patients.
These are very significant issues that must be resolved fairly without disadvantaging doctors and we continue to urge you to read very carefully any contracts you are provided and to seek advice from AMA Queensland, if you have any concerns. It remains imperative that no doctor is shackled to a poor arrangement longer-term and we stand firm to defend the profession against any exploitative behaviour at this difficult time for us all.
With the blow out in both public and private waiting lists over the past two months, AMA Queensland is also calling for an immediate resumption of intermediate lists in the public system.
NEXT STEPS
All private operators will be having urgent meetings with Queensland Health in the coming days to seek clarification regarding the latest announcements.
AMA Queensland will update you again when additional information is to hand.
We are mindful of the need to preserve the real and perceived benefits of private health insurance among patients, to support doctors as they try to rebuild their practices and to always retain the independence of doctors in decision-making and the supremacy of the doctor-patient relationship in all healthcare.
In the meantime, please contact us on covid19@amaq.com.au or call us on (07) 3872 2222, if you have any further concerns regarding the distribution of work in your facility.