Des Houghton: Why bureaucratics are ruining Queensland’s health sector

One of the state’s most respected doctors has spoken out against bullying government bureaucrats in Queensland hospitals.

One of the state’s most respected doctors has spoken out against bullying government bureaucrats he blames, in part, for leaving our hospitals at the point of collapse.

Dr Phillip Kay, 71, the director of emergency medicine at the Princess Alexandra Hospital for 23 years, said there was regular political interference by “the people in suits”, who endangered patient safety.

The suits even tried to “terminate” his career for speaking out about failures in the hospital and health service. “The bureaucrats are more focussed on the budget than they are on clinical care,” said Kay.

“When I was at PA the senior people were ripped into and abused and bullied by corporate office for spending money on people who
were sick.

Emergency medicine specialist says bureuacrats are destroying Queensland’s health system. Picture: AAP Image/Steve Pohlner

“They refused to fund stuff. They don’t pay the hospitals properly. They manipulate the system to control the cash going out.

“If you shrunk Queensland Health down, there would be hundreds of millions of dollars spare to build beds.

“The money is going to salaries; it is not going to infrastructure.”

Kay has seen hospital extensions built “all over the place” with no new staff to run them.

“You are supposed to do that with the same number of people, but that doesn’t work,” Kay said.

He favours decentralisation, with hospitals run not by distant bureaucrats but by hospital professionals who know where to throw the money.

And Kay praised the efforts of independent union supremo Graeme Haycroft who is campaigning for massive pay rises for nurses to be funded by money saved by tearing down the multi-layered bureaucracy. Haycroft’s Red Union hub commissioned a study that shows there are more bureaucrats to nurses in Queensland than just about anywhere else in the world.

Said Kay: “Services wise, you could work out a new system of treating patients without getting permission from the bureaucrats and corporate office. And they fundamentally don’t know what is going on. They are in
an ivory tower. They don’t live in the real world.

“The bureaucracy is full of people doing planning and statistics and reports and stuff that was useless.

“My computer was full of reports every day. I just deleted them because they were a waste of time. They were often out of date, or they were wrong, or just not relevant. People are getting paid 180 grand to write these reports.

“It’s nonsense. It’s overmanaged. It’s ridiculous (and) it’s dangerous.’’

“The clinician to administration ratio is wrong. I think in the private sector it is five to one. I think in the public sector it is almost one to one.

“I know there are too many bureaucrats. And they don’t produce anything of real value.

“They soak millions and millions and millions out of the system that should be going to the front line.

Dr Phil Kay was the director of emergency medicine at Brisbane’s PA hospital for more than two decades. Picture: Steve Pohlner

“There is a critical shortage of nurses both publicly and privately. There are private hospital beds laying empty because they can’t get nurses to staff them.’’

Kay spoke out to support Chris May, another emergency medicine specialist who said successive governments ignored warnings that hospital services were in decline due to bad planning decisions stretching back to the Goss government.

Dr May, the former executive director of all the emergency departments in the Metro North Hospital and Health Service said it would take at least a decade to repair Queensland’s broken hospital system that suffers bed block and clogged emergency departments. Kay agrees.

“More and more Queenslanders will die in ambulances on the ramp as people can’t get into emergency departments,” Kay said.

Ramping is a sign our public hospitals will soon collapse, he said.

“It has already started, not frequently but on a fairly regular basis. It will get worse as the population ages.”

He had spent his career arguing with the people in suits who did not listen to the clinicians who warned of bed block.

Kay caused uproar by publishing an opinion piece in 2010 accurately predicting a crisis in emergency medicine. He was howled down by political apparatchiks who set about to undermine him.

“They tried to terminate me for writing it. They didn’t do it formally; there were a lot of behind-the-scenes phone calls.’’

Someone in the office of then Premier Anna Bligh had requested his personal file, one health department executive told him.

“They had a go, yeah.’’

However Kay survived when clinicians rallied to support him.

Next, he campaigned for years for funding to expand PA.

However, said PA extensions came “10 years too late”. He said there was some optimism when Kevin Rudd became prime minister. As the Director-General of the Office of Cabinet in the Goss government, Rudd understood the problems facing hospitals better than most.

“Kevin Rudd came up with the idea that he was going to give the Canberra money directly to the hospitals and not give it to Queensland Health,” Kay said.

“Queensland Health fought to the death to stop that because they knew controlling the hospitals was the reason for their existence.’’