From the outset, I want to congratulate and thank all our dedicated hospital doctors, nurses and healthcare workers who have carried such a burden during the pandemic. These tireless workers kept our hospitals going as we experienced our first major COVID-19 waves.
Queensland went from seven COVID deaths in the first year of the pandemic to more than 2,800 by March 2023. We have gone through stages of having close to 1,000 COVID patients in our overstretched hospitals and hundreds of doctors furloughed with infection or as close contacts. Even now, we still have more than 200 COVID patients in hospital.
The Queensland government listened to our Ramping Roundtable and pledged 2,500 new hospital beds in the 2022-23 budget. But the majority of these beds will not come online for years, and there is no workforce strategy to recruit the staff needed to run them. We needed these beds yesterday.
In this light, it is disappointing but understandable to see decreases in Category 3 Urgent patients being seen within the recommended time and in ED visits being completed within four hours.
We need the Queensland government to urge their federal Labor colleagues to agree to a fairer share of state-federal funding for public hospitals and increase the federal share to 50 per cent. Maybe then we will see our waiting lists start to ease.
Queensland is facing several real pressure points. We have a population the size of Denmark in an area 40 times the size. Recruiting and retaining staff in regional Queensland is becoming increasingly difficult in both hospitals and general practice.
It’s a very long drive between hospitals in regional Queensland, particularly if you have a medical emergency.
We have multiple maternity units closed or on bypass across the state. Obstetricians are choosing to work as locums in New South Wales due to demand and poor conditions in Queensland, and then get labelled as ‘greedy’ by the state government.
At the same time, our state government is introducing proposals that only make regional practice less attractive. Allowing pharmacists in North Queensland – everywhere from the north and west of Mackay – to autonomously diagnose and prescribe for a range of conditions is a dangerous experiment with patient health that will only deter GPs from moving to regional towns, putting more stress on our hospitals.
Changing the interpretation of payroll tax for private practitioners will force general practices to close or pass the costs on to patients. Bulk billing is already a thing of the past, and the new urgent care clinics being established by the federal Labor government will have the perverse effect of putting existing after-hours practices out of business.
Australian Institute of Health and Welfare data show that in 2021-22 year, the volume of emergency presentations at Queensland public hospitals increased by 17.5 per cent, averaging around 5,171 daily presentations in 2020-21, compared to 4,401 presentations per day in 2019-20.61,62 In 2021-22 the daily number of ED presentations in Queensland was 5,117, a slight increase compared to the year before, meaning that the pressure on EDs in Queensland continues.63
Percentage of Triage Category 3 (Urgent) emergency department patients seen within recommended time (< 30 minutes) - Queensland
In 2021-22, 60 per cent of patients visiting emergency department in Queensland and triaged as Category 3 were seen within the recommended 30 minutes. This is a drop of five percentage points compared to the year before.
Source: The State of our Public Hospitals (DOHA 2004-2010). Australian Institute of Health and Welfare (AIHW). Emergency department care 2010-2021-22
Percentage of emergency department visits completed in four hours or less - Queensland
In the same reporting period, 61 per cent of emergency department visits were completed in four hours or less.
Source: Australian Institute of Health and Welfare (AIHW). Emergency department care (2011-12 to 2021-22): Australian hospital statistics.
Note: National emergency access targets were abolished with effect from 1 July 2015
Similar to other jurisdictions, Queensland started to ease its COVID-19 restrictions in the last quarter of 2021. Following the announcement of “Quarter of a billion-dollar planned surgery blitz” by the Queensland Premier in 2020,64 the median wait time in Queensland improved in 2021-22.
Median waiting time for elective surgery (days) - Queensland
Median wait time for planned surgery in Queensland in the 2020-21 reporting period was 36 days, improvement by 6 days compared to the year before, and 11 days longer than the best performing State, Victoria.
Source: Australian Institute of Health and Welfare (AIHW). Planned surgery data cubes (2001-02 to 2006-07): Australian hospital statistics. Australian Institute of Health and Welfare (AIHW). Planned surgery waiting times (2007-08 to 2021-22): Australian hospital statistics
Category 2 patients
Percentage of Category 2 planned surgery patients admitted within the recommended time (90 days) Queensland
77 per cent of patients on the Category 2 planned surgery waiting list were seen within the recommended 90 days in Queensland. This is an 8 per cent drop compared to previous year, and a drop of 15 percentage points compared to the pre-pandemic 2018-19.
Source: The State of Our Public Hospitals (DoHA 2004-2010) FOI request reference 253-1001 lodged June 2011. 2011-12 estimate based on State and Territory Government published data; State and Territory data for 2012 calendar year published by Australian Institute of Health and Welfare (AIHW) National emergency access and planned surgery targets 2012: Australian hospital statistics. Australian Institute of Health and Welfare (AIHW) Planned surgery waiting times 2013-14 to 2021-22: Australian hospital statistics
2010-12 data not available
Public hospital funding
The most recent public hospital funding data is 2020-21, so it is affected by COVID19 response.
Commonwealth and Queensland government per person funding for public hospitals (constant prices)
Source: Australian Institute of Health and Welfare (AIHW) 2022, Health Expenditure Australia: 2008-09 to 2019-20 viewed 10 February 2022 https://www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure-australia-2019-20/contents/main-visualisations/overview
Per person average annual per cent increase in public hospital funding by government source (constant prices)
|2008-09 to 2012-13
|2013-14 to 2017-18
|2018-19 to 2020-21
|2008-09 to 2020-21
61 Australian Institute of Health and Welfare 2021. Australian Hospital Statistics: Emergency Department care 2019-20 viewed 2 August 2021 https://www.aihw.gov.au/reports-data/myhospitals/intersection/activity/ed
62 Australian Institute of Health and Welfare 2022. Australian Hospital Statistics: Emergency Department care 2020-21 viewed 1 Feb 2021 Table 2.2 https://www.aihw.gov.au/getmedia/0d0d6cbf-e764-4a89-a71a-b03c5156235d/Emergency-Department-Care-2020-21.xlsx.aspx
63 Australian Institute of Health and Welfare 2022. Australian Hospital Statistics: Emergency Department care 2020-21 viewed on 16 February 2023 Table 2.2.