Preventing elective surgery cancellations

The ballooning number of elective surgery cancellations is not a new issue, especially in rural and regional communities where patients have long struggled to access essential surgeries, AMA Queensland President Dr Maria Boulton told 4BC Radio. "The people who have those surgeries sometimes need a hospital bed, and if there's not a hospital bed for them to go to, then the surgery might be cancelled as well."

Transcript: AMA Queensland President, Dr Maria Boulton, 4BC Radio, Drive with Peter Gleeson, Tuesday 14 May 2024

Subjects: AMA Queensland Surgical Wait List Roundtable

PETER GLEESON: The LNP has been banging its fists on the table today trying to pin the blame on Labor for the ballooning number of elective surgery cancellations. They say that wait lists and bed shortages are to blame for the 5,134 elective surgery cancellations, 705 of which came in the first two months of this year. Now if you’ve been one of those cancelled jobs, I’d love to hear from you on 133 882.

Anyway, the Shadow Health Minister Ros Bates reckons the Queensland Government has seriously dropped the ball, unable to improve the capacity of our hospitals or address the growing problem with fatigue among our nurses and doctors. Now we know it's been a big problem for the State Government, going right back to the start of the pandemic, and every time the LNP raises it, the State Government and the incumbent Health Minister this time, of course being Shannon Fentiman, they declare the concerns as either false or a beat up.

So where does the truth lie? Are our politicians to blame or are there more factors adding to the mess? Now to help bring some sense to the matter, it's a very good afternoon to Dr Maria Boulton who of course, is the President of the Australian Medical Association of Queensland. Dr Boulton, thanks for your time.

DR MARIA BOULTON: Good afternoon.

PETER GLEESON: What's your read on these figures? Is any one minister to blame? You know, where do you think the real truth lies in this?

DR MARIA BOULTON: These have been issues for quite some time now, and AMA Queensland set up a Ramping Roundtable in 2021 to look at issues with ramping at hospitals. One of the recommendations that we made at the time was that hospitals should run at 90 per cent capacity,  so that when there are surges, like what happens when there are cases of viruses doing the rounds or people in the staff who are unwell, then the staff that are left behind can cope with the usual workings of the hospital and all the lists etc, and all the people that need to be taken care of.

What we find in reality is that most of our hospitals run at 100 per cent capacity, if not more, so that there's no leeway. So, if there's sick staff members or if there's a surge in COVID or RSV or influenza like we're experiencing now, there's really no capacity to take on extra load. If there's no hospital beds available, for example, then that means that sometimes they may look at the elective surgery list. The people who have those surgeries sometimes need a hospital bed, and if there's not a hospital bed for them to go to, then the surgery might be cancelled as well.

PETER GLEESON: So that's the reason that we're getting these cancellations. We've got an upsurge, obviously in flu cases, possibly COVID cases, and because there's no hospital beds, they effectively say we can't actually do this surgery.

DR MARIA BOULTON: Correct. And I guess that's the safe thing to do. The issue is that then those patients have been waiting for a long time on those elective surgery lists. And we know that these surgeries, even though they're called elective, they are essential. You know, these are people who are waiting on a knee replacement, for example, or a cataract surgery, things that they need to do to get back to their normal life. They've been waiting for a long time and it's very, very frustrating for them.

That is why AMA Queensland is convening another roundtable, and this time it's on the surgical wait list, because we know it's a big issue. We know that it's a particularly bigger issue when you go out of the southeast corner and out of the Cairns region. In a lot of other areas in Queensland we see that those wait lists are much longer than in the metro areas.

So, we're bringing together a panel of doctors who work throughout Queensland, not just in surgery but other hospital departments to try and make some recommendations that we will present to the government of the day and hope that they will be funded so that patients get some relief.

PETER GLEESON: Million-dollar question, Maria. How do we get the system back on track?

DR MARIA BOULTON: Well, our main priority at the moment is workforce, and it's really important, number one, that we actually are doing everything possible to support our current workforce. We don't want people to leave because they're not feeling supported, because they're not getting enough time to recover when they're fatigued. It's really important that we hang on to them, but we also need to recruit some more.

We need to ensure that there's enough people coming into Queensland, that we're an attractive destination to work at, that we're providing all those brilliant training pathways so that if you're a medical student now, then you can become a specialist and stay and work in Queensland. And we also need to ensure that all those supports are even greater when it comes to regional and rural areas. We know that all those communities already have issues when it comes to access to housing and childcare and that is something that needs to be supported as well. But workforce is number one, two and three.

We also need to ensure that we are training enough. So, we are supporting the call to train more medical students, opening up more medical student placements in our Queensland universities to ensure that we have more doctors into the future. And it's not just doctors. We know that there are workforce shortages with nursing staff and allied health staff, it's across the board. So, workforce and ensuring that those brilliant people that we have working out there at the moment, who go above and beyond day in, day out, are getting the support that they need.

PETER GLEESON: This one is obviously pretty close to you. Reports today say that only one in 10 students graduating from medicine degrees in 2023 said that they actually wanted to become a GP. Are you worried about the pipeline of doctors coming through?

DR MARIA BOULTON: It is a worry, and not just because of the expected fallout that will have in a few years. I’m a proud GP, and honestly there’s no better specialty, because you have the privilege of looking after someone. Sometimes I’ll look after a pregnant woman who has a baby, and I will look after that baby for years.

We also look after multiple generations of family, and we look after people that come to us with mental health issues. And to see how they change when they’re feeling better and engaging back in work and with their family is just so special.

That’s why we’re calling for the State Government to increase supports for doctors who want to become GPs, to look at incentivising them to join GP training in the same way that Victoria has done, and we know that has had a very positive effect there. And ensure that we’re supporting those doctors to become GPs as we know – where would communities be without their GP? Particularly in rural and remote communities when often that GP will also deliver babies, they will provide anaesthetic and emergency care. I could not imagine a world without them.

PETER GLEESON: No, you guys do an amazing job. There’s no doubt about that. Just quickly, federal budget today, $8.5 billion for health and Medicare including $227 million for 29 new Urgent Care Clinics nationwide. How much of a help will that be and are we getting the adequate amount of resourcing for health and Medicare in this country right now?

DR MARIA BOULTON: I haven't read the details yet because I've been with patients, but the reality is that a few extra Urgent Care Clinics are not going to cut it. And really, especially in Queensland, which is such a decentralised state, we need patients everywhere to be funded to access their GP. And the Federal Government needs to seriously look at the Medicare rebates. They have not kept up with the cost of providing the services. We estimate that you need two-and-a-half times what people are receiving at the moment so that they can access their GP without an out-of-pocket expense. When you look at Queensland, wouldn't it be better to have funding go to every GP so that every patient out there receives that benefit, rather than a handful of Urgent Care Clinics that just don't cut the mustard when it comes to ensuring that every Queenslander has access to that high quality level of care?

PETER GLEESON: Dr Maria Boulton, President of the Australian Medical Association of Queensland, thank you so much for your time today.



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