Solving our biggest healthcare problems

There are no quick fix solutions to the ambulance ramping or elective surgery problems, rather, our health system needs long-term, strategic support from the government, incoming AMA Queensland President Dr Nick Yim told 4BC Radio. "We want to ensure that we do have a world class health care system in Queensland, regardless of whether you live at Coolangatta or Brisbane, or north of Cairns or out to Mount Isa. We want to ensure that all Queenslanders get the right amount of care."

Transcript: Incoming AMA Queensland President, Dr Nick Yim, 4BC Radio, Mornings with Bill McDonald, Monday 20 May 2024

Subjects: Solutions to ambulance ramping

BILL MCDONALD: I Just had a look back to check how many and who some of the Health Ministers have been over the three terms of the Labor Government here in Queensland. Cameron Dick, who's currently the Treasurer and Deputy Premier, Steven Miles, current Premier, Yvette D'Ath of course, and now Shannon Fentiman. So, there's been a roll call of superstars in the Labor ranks that have had a crack at health. And here we are today, and this is just another chapter in a pretty miserable book when it comes to the system.

We've been talking about the myriad of chronic issues in our health system. There are no quick fixes for them, and anyone tasked with solving them certainly has their work cut out for them, no doubt about that. Like my next guest, the newly elected President of the Australian Medical Association Queensland, Dr Nick Yim. Good morning, Nick. Nice to talk to you.

DR NICK YIM: Good morning.

BILL MCDONALD: Congratulations on the new role. Now, I believe you're sharing, in this is a bit of a departure.

DR NICK YIM: It's an exciting role. It's always an honour to represent Queensland doctors and also to ensure the health of Queenslanders. But there are, as you mentioned, going to be challenges moving forward.

BILL MCDONALD: So, what do you make of the ambulance ramping numbers reached over the weekend – a record high?

DR NICK YIM: The ambulance ramping numbers are, to a certain extent, no surprise. We have seen over the past five years an increase in population in Queensland and our population in Queensland is ageing. At the same time, our chronic diseases are increasing.

AMA Queensland, from what we are seeing, we do want to conduct some more groups to consult with. One of the key aspects is elective surgeries. We know that many Queenslanders are waiting longer on elective surgery wait lists. So, we are conducting a Surgical Roundtable to get ideas on the board so we can see how we can ensure those Queenslanders get those operations in a timely fashion.

BILL MCDONALD: Where do you see, I know the population is growing and there's obviously issues with aged care, and Shannon Fentiman the Health Minister has made that clear. How do you see it getting resolved?

DR NICK YIM: There is no one quick fix. Moving forward we don't need band aid solutions, we need a long-term investment strategy for the health care of Queenslanders. At AMA Queensland, we are working with governments to ensure that there is a long-term workforce plan that includes recruitment and retention strategies, and also to ensure that there's training opportunities for those doctors coming through. We are seeing that, for example, less and less medical students are keen to enter the realm of general practice, and general practice is one of the key aspects of preventative care, to keep our population well and to keep patients out of hospitals.

BILL MCDONALD: What's the problem in the hospitals? Is that a shortage of nurses and doctors, is that why they're getting ramped, and they can't be seen? Is it a shortage of beds or is it a bit of both?

DR NICK YIM: I think it's a bit of both. As I mentioned, workforce is one issue. So that just doesn't apply to doctors, that also includes nursing staff, administration staff and this is occurring across the whole country. We are not immune to that in Queensland.

The other element, as you mentioned, is probably the flow. So, we are seeing that it's challenging for people when they do arrive at the emergency department to flow through the hospital and ultimately be discharged, and that could be discharging back into the patient's home or back into, say, an aged care facility. Those are all the aspects that we do need to work on moving forward.

BILL MCDONALD: So the long-term patients are with aged care, that's another sector that's struggling as well for retention and just to stay viable. How do you see that one playing out? Because I guess if you can get older patients out of hospital, it will ease up. It's a flow on effect, isn't it?

DR NICK YIM: Absolutely, there's no one solution. One of the things that we're hearing from our members, from staffing across aged care sectors and the hospital staff, is obviously the wellbeing of the healthcare workers. We need to ensure that the workers are safe, that we are looking after their work hours and their mental health as well. As you can imagine, if the healthcare workers aren't well, they can't look after the patients in need. So, it's a multifaceted aspect that we need to look after.

BILL MCDONALD: Anecdotally, we always hear a lot about how bloated the public service is and how big the health department is, and there's more bureaucrats than there are frontline staff. Is that something that you would speak to? Would you agree that there needs to be a focus on the other way around?

DR NICK YIM: I think one of the key aspects, and this is where we do commend the State Government for [inaudible] the AMA Queensland Surgical Wait List Roundtable, is that we are getting front line staff, frontline doctors into the mix to get their ideas, to get their visions, so we can assist the Queensland public to reduce those elective surgery wait times. At the same time to reduce some of the regional inequities. We want to ensure that we do have a world class health care system in Queensland, regardless of whether you live at Coolangatta or Brisbane, or north of Cairns or out to Mount Isa. We want to ensure that all Queenslanders get the right amount of care.

BILL MCDONALD: Why are they still having to have roundtables when surely there's been enough discussions and enough meetings and enough talk about this? It just sounds like another talkfest to have roundtables.

DR NICK YIM: I think we all need to get into a centralised approach. You're absolutely right, we need action, we need investment, and ultimately, we need to ensure that both sides of government are working towards the future, and that future is the health of all Queenslanders.

BILL MCDONALD: What about, you’re a GP as well, so just on a related topic, why are we seeing the rates of bulk billing decline so rapidly?

DR NICK YIM: Yes, I'm a GP, I work in the regional town of Hervey Bay. What we are seeing is the continued gross underfunding or the lack of funding for the patient Medicare rebates. It's one of those situations where we know that if we invest in preventative care, we keep patients well. Prevention is better than a cure, so if we can keep them out of hospital, we don't need to utilise the more expensive hospital care. It's something we have been working with the Federal Government to ensure that the patient Medicare rebate stays up to scratch, and it just hasn't been kept up to scratch.

BILL MCDONALD: On the ambulance ramping again, I was saying earlier that the ambos have been great to be able to maintain their response times, but some of them are ramping for two plus hours. Is that running the risk that at some stage something's going to give somewhere? While there's ambulances ramped, someone's going to miss out. There's going to be a patient that's going to sadly, not get treatment in time. Something's got to give somewhere, hasn't it?

DR NICK YIM: That's the greatest risk that we face. We know our paramedics are working their butts off, they're working really hard. Likewise, the nurses, allied health, pharmacists. We are hearing that the whole healthcare system workforce is under pressure. These are the reasons why we work with our State Government at AMA Queensland, to give them what we're hearing from the front line, what we're hearing from our members, to ensure the health of our communities.

BILL MCDONALD: Have you had any discussions, or will you have any discussions with the state opposition who obviously could be forming government, possibly, if they win the election at the end of the year?

DR NICK YIM: We have always been working closely with the state opposition and the current government. Those are the things that we want to work with, and we do want to work on. One of the big issues is the payroll tax in general practice which is ultimately putting pressures on patients with increased fees, and we also know that the cost of living is rising as well. These are some things that we are working on along with workforce, training and also incentives to recruit and retain the health profession in Queensland.

BILL MCDONALD: All right, well you've got a big job ahead of you and it's an election year as well, so I wish you all the best.

DR NICK YIM: Thank you very much, looking forward to further chats with you.

BILL MCDONALD: Yes, that'd be great. Thank you very much. Dr Nick Yim, one half of the new Presidency of the AMA Queensland. He certainly does have a busy time ahead of him and we'll be having plenty of chats, no doubt, over the next couple of months and certainly beyond October.


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