Transcript - ABC Radio - New Health Minister

Transcript: AMA Queensland President, Dr Maria Boulton, ABC Brisbane, Breakfast with Craig Zonca and Loretta Ryan, Thursday 18 May 2023

Subjects: Ministerial reshuffle, private health insurance, payroll tax

LORETTA RYAN:    Queensland Health is riddled with high profile issues - ambulance ramping, the maternity crisis in central Queensland - closer to home, the conditions patients and staff are living and working in at the PA Hospital spinal unit.

CRAIG ZONCA:    Maria Boulton is the President of the Australian Medical Association in Queensland. Dr Boulton, good morning to you.

MARIA BOULTON:    Good morning, Craig and Loretta.

CRAIG ZONCA:    What do you think about what you've heard so far and a change in Health Minister for Queensland?

MARIA BOULTON:    I guess our first step is to thank Minister D’Ath for working with us. We always found her genuinely interested in the problems that are facing Queenslanders and she did make some good steps towards addressing some of the crisis we're facing. But in reality there is a lot of work to be done, not just in the hospital system but also in primary care.

For example, in the hospitals, the area that needs urgent focus is the maternity crisis affecting central Queensland. I heard someone say the other day that there are other units that are also hanging on by a thread and literally one resignation away from closing down. So it's really essential that the new minister pays close attention to this, goes and speaks to the people working in those areas and ensures that there's enough work being done to not only retain people in those areas, but also recruiting people to work in those communities, so that women have safe, multidisciplinary, collaborative care when they need to deliver their babies. That's just one crisis in the hospital system.

CRAIG ZONCA:    I was going to say that's one of a list of issues that we have written down on our piece of paper in front of us too. I just want to pick up on a point you mentioned there. You say other units are on a thin wedge as well. When you say other units are you referring to other maternity services in the state?

MARIA BOULTON:    Correct. Other maternity services through the state. We are a very big state and our maternity services are very reliant on not just obstetricians and anaesthetists and midwives, but also GP obstetricians and GP anaesthetists as well. At the moment we are short of just obstetricians, it's dozens. So there's 40 full-time equivalent vacancies for obstetricians in Queensland Health that need to be filled. And I bet it's just as many when it comes to GP obstetricians. That needs to be urgently addressed and turned around.

That's where this workforce plan comes in. For some reason we're in this situation that we shouldn't be in. That's why people in state government need to work through a workforce plan to ensure that we have enough health workforce, not just in cities, but also rural and remote and regional and not just doctors, but nurses. And that plan needs to also include aged care, which we know is struggling to find nurses, primary care, NDIS and, you know, things like pharmacies, allied health, et cetera.

CRAIG ZONCA:   With a change in minister though, the problems still remain. I know the state government might paint it as a fresh start, but any minister is effectively relying on the advice that they get from their DG and bureaucrats, don't they?

MARIA BOULTON:    That's correct. And that's where we need to look at how that level of leadership is also functioning to ensure that it's doing the best it can for our Queensland population, and not just seeking advice from the DG and the deputy DGs, but also the medical representative bodies, the consumer groups as well, the nurses’ union, midwives et cetera also helps.

And also getting on the ground - last year I visited Rockhampton and Gladstone to see firsthand what's going on and to speak to women who delivered under the bypass just to try and understand the issues. So, so just getting around and seeing what people actually need. And also, at the moment many health care workers feel very scared about speaking out, so ensuring that they have the protections available so that they feel safe to raise their issues and not fear for their jobs.

LORETTA RYAN:    Looking at the cabinet reshuffle, particularly affecting health, with Shannon Fentiman expected to get Health Minister - Maria Boulton, how often do you actually sit down with the minister and are you planning to try and set up a meeting straight away?

MARIA BOULTON:    Yes. AMA Queensland meets regularly with health ministers and other stakeholders and we have a set meeting. We represent thousands of doctors and we also represent the needs of the community. So we have meetings with the Health Minister, we have meetings with the Assistant Health Minister, we also have meetings with Queensland Health leadership teams and other stakeholders and that's something on our regular agenda. And we will be looking to meet with the new minister as soon as they are appointed.

If it is Minister Fentiman, we've worked with her in the past on drug law reform and I've also spoken to her at various occasions. So we already have that relationship to build on around some of the other issues.

CRAIG ZONCA:    Around some of the other issues, you’ve talked about maternity services, workforce issues. The other story that is constantly in the headlines is that of ambulance ramping and getting people through emergency departments. What's the biggest change in your mind, Maria Boulton, that could happen to have the most impact?

MARIA BOULTON:    Workforce. It all comes back to workforce. We know we've had the announcement - and this is something that the new minister is going to have to build on - of the 2,500 new beds through Queensland and every bed needs 10 healthcare workers to staff it. We know that workforce is really strained at the moment and we know that there needs to be a lot more work to ensure that the current workforce is retained and supported. We don't want them leaving.

But also recruiting more workforce and ensuring that we're training enough doctors, nurses, pharmacists, allied health to fulfil our needs. That is the one key issue.

I know that there's many doctors out there that would work more if they were funded to do so. And so there's this underemployed population out there that could be utilised better, especially now that we're in crisis. But workforce is the key.

LORETTA RYAN:     Maria Boulton, before we let you go, just another issue. Private health premiums are rising for millions of Australians in about two weeks’ time. Are you concerned what effect this might have on public hospitals if people drop out of the private system?

MARIA BOULTON:    Absolutely. And this is what triggered the Gladstone maternity crisis. It was the fact that the private maternity services closed down because people started dropping their private insurance. As a woman, if you want maternity to be covered, you have to pay a much higher premium. And that's why it's so important for private insurance to be affordable, but also sustainable so that we can continue to offer those services.

Not enough young people are taking private insurance up. Private insurance, when it comes to, for example, elective surgeries, they do a lot of the heavy lifting, but it needs to be affordable, and every dollar that we spend in premiums needs to be spent in the best way so that we get the better health outcomes.

The other issue with the new minister, and it's something I have to mention, is payroll tax. Not only are people going to have to pay more for their private insurance premiums, but once this amnesty goes away about and come 2025, patients will have to pay payroll tax to access their GP. It's nonsensical, and this also needs to be removed. Otherwise people will be faced with higher fees when they see their GP, which will undo some of the announcements that we've just heard in the federal budget. So this will need to be addressed by the new Health Minister.

CRAIG ZONCA:    It sounds like that first meeting you have with Shannon Fentiman, if everything we've heard is true and she does take that portfolio, it's going to be a long meeting. Maria Boulton, we look forward to discussing the outcomes from it when it does occur.