Crisis point: Sick kids inundate EDs as hospital system buckles

Queensland emergency departments are being inundated with sick kids and adults, with as much as 30 per cent more needing hospital care as access to bulk-billing GPs becomes scarce. SEE HOW BAD IT IS WHERE YOU ARE

There’s been a surge in the number of children presenting to Queensland’s emergency departments amid the soaring cost of living and struggle to find GPs who bulk-bill.

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Families struggling to cope with cost-of-living pressures and a lack of bulk-billing doctors are being blamed for a surge in the number of children presenting to Queensland’s emergency departments.

The state’s biggest paediatrics units – Queensland Children’s Hospital and Prince Charles Hospital – both saw increases by as much as 30 per cent in almost every category of patient according to the latest hospital performance data for January, February and March.

Queensland emergency departments divide patients into categories from one to five, with category one patients representing the most severe illnesses or injuries and category five the least urgent.

Regional centres like Mackay, Toowoomba, Rockhampton saw increases in every category of patients aged 14 years and under, with Mackay seeing a whopping 100 per cent increase in category two patients seeking medical attention.

Townsville University Hospital had a 44 per cent surge in Category two children (516) and 34 per cent for Category three, Ipswich Hospital saw a 41 per cent jump in category two (920) and 32 per cent in category four (1046) while Sunshine Coast University Hospital had a 22 per cent increase in category two (720) and 60 per cent in category five (80).

Gold Coast University Hospital had spikes across nearly all categories including a 79 per cent jump in category five patients (95) while Logan and Cairns Hospitals also surged across all categories.

Over half a million people presented to the state’s emergency departments in the last quarter with Health Minister Shannon Fentiman blaming the high numbers on population growth and difficulties in people being able to get into a GP or find one that has bulk-billing. 

“Clearly we have huge population growth here in Queensland, and yes, we have a primary care system that was neglected for many, many years by the federal government,” she said.

“If you talk particularly to people in regional Queensland, it is very difficult to find a GP appointment and it’s expensive because not many of them are bulk-billing.

“So people wait, and they don’t go and see their GP, they don’t get access to primary health care in their community, they get sicker and then they present in an emergency department.”

Health Minister Shannon Fentiman tours the new Caboolture Satellite Hospital. Picture: Liam Kidston

Australian College of Rural and Remote Medicine president Dr Dan Halliday said the federal government’s decade-long resistance to thawing the freeze on Medicare rebates had forced the hand of many GPs to ditch bulk-billing, including to children and pensioners.

He said it was a misconception that all GPs bulk-billed children 16 and under, with this decision entirely up to each individual practice or GP.

“We know that if you do provide good quality primary care, that you actually reduce the presentations and admissions to the emergency departments,” Dr Halliday said.

“Bulk-billing in certain areas is on its knees, and in some areas that it’s ceased altogether, which is an absolute shame.”

Dr Halliday estimates treating a Category 4 or 5 patient in a Queensland hospital ED typically costs about $250 to $500, a cost borne by the Queensland Government.

Australian Medical Association Queensland president Maria Boulton said studies done interstate on the reasons families visited emergency found it was because they wanted access to bulk-billed services immediately.

She said the current waves of Covid, influenza and RSV circulating through the community will place even more strain on hospitals.

“We know that respiratory illness doesn’t respect business hours. We know that the Medicare rebates for people to access their GPs outside of hours is not where it should be, and that’s why it’s so important for the Federal Government to raise those rebates for patients,” she said.

From November a $5.7 billion boost for general practice in the recent federal budget will see the incentive paid to doctors who bulk-bill certain patients, like seniors and children, triple.

But Royal Australian College of General Practitioners Dr Bruce Willett said he feared that without a permanent moratorium on payroll tax for GPs, the Medicare reform would just be eaten up in payroll tax.

“It was actually really rare for children not to get bulk-billed, but the rebate got down to the stage where (it was no longer viable),” he said.

“I think the federal government’s increase of the bulk-billing incentive for kids will really have a big impact but the payroll tax will eat into that really quickly.”

He said the issue of payroll tax “sucking money” out of Medicare affected every state and territory in the country and needed to be taken to national cabinet.

Ms Fentiman committed to continuing to work with GPs to see how her government could help support them during a press conference on Saturday.

“But I do want to say that Queensland is the only state that has introduced a moratorium on payroll tax for GPS, no other state has introduced that moratorium … but here in Queensland, that moratorium is in place to the middle of 2025 because we recognise the pressure that our GP services are under,” she said. 

But Dr Boulton said the best way that the state government could alleviate the pressure was a permanent moratorium on payroll tax.

“The amnesty doesn’t apply to new practice, so a practice anywhere in Queensland will be liable to pay the patient tax when they see their doctor, which we know is not fair,” she said.

“The evidence is very clear that if governments support patients accessing their GP, those patients will be healthier and they’re less likely to visit the hospital and it will reduce the strain on hospitals.”

Federal Health minister Mark Butler had spruiked the introduction of 58 Medicare Urgent Care Clinics at GP clinics and health centres to take pressure off “overwhelmed emergency departments”.

More than $350m over the next five years is to be spent establishing the 58 Medicare UCCs at GP clinics, community health centres, and Aboriginal Community Controlled Health Services across Australia.

But last week Department of Health first assistant secretary in the primary care division Simon Cotterell said in “some cases” it was not going to be “possible or necessary” to have all the clinics opened the full range of extended hours, particularly in rural areas.