Experts call for overhaul of Qld’s stressed health system amid ramping crisis

Premier Annastacia Palaszczuk admits Queensland's health system is "stretched", but says it wasn't struggling "as much" before the COVID-19 pandemic struck. 

Annastacia Palaszczuk has defended Queensland's under pressure health system, saying it wasn't struggling "as much" before the COVID-19 pandemic struck. 

But she conceded it was being "stretched", with the first step to address the number of aged care residents in hospital beds. 

"At the moment we have a lot of staff that have to be diverted to be doing not just the testing (COVID-19) but also the vaccinations," she said. 

"There's a whole lot of other issues that our health professionals are working on at the moment

which is not necessarily what they would normally do in their core business day to day."

Ms Palaszczuk said Queensland wasn't the only jurisdiction experiencing demand. 

"We are fortunate at the moment that Queenslanders are able to get surgeries done, that our emergencies are able to look after our most sick, because in other parts of the world, the health systems are collapsing due to COVID," she said. 

"I think step number one needs to be, we need to look at the number of aged care residents that are actually in hospital beds.

"I think they need to be prioritised to get out into suitable aged care accommodation."

Spruiking the proposed seven satellite hospitals, the Premier said the government had set up a "special committee" to prioritise the facilities.

And she said people needed to be seeing GPs as regularly as possible, but acknowledged there were financial constraints.

"Honestly sometimes that pay barrier is a big deterrent for a lot of people who don't have a lot of money to make ends meet," she said.  

"We need to make sure that our emergencies are kept free for emergency situations."

It comes after experts called for an overhaul of the stressed health system as a major lack of beds feeds a hospital ramping crisis that emergency department staff say is threatening lives.

Professionals from across the system have called for a doubling of beds on major campuses, federal funding of private health insurance and nurses empowered to discharge patients and care for them in the community in a slew of reform ideas.

>> MAJOR REFORM FOR SICK SYSTEM: YVETTE D’ATH

Ambulances ramped at the Royal Brisbane and Women’s Hospital. File picture: David Clark

They spoke to The Courier-Mail as about 40 per cent of patients brought to hospitals via ambulance sit ramped at EDs, and the state’s longest-serving health director-general Professor Robert Stable admits “we got it wrong” when planning for bed growth in the 1990s.

Dr Stable said the population had increased 62 per cent since 1994 but beds had grown by 24.5 per cent, despite the ageing population using hospitals “a lot more”.

He said a “serious review” was needed of all aspects of the system as he called for government-subsidised health insurance to take more advantage of private beds and take pressure off public hospitals.

Dr Stable, who served between 1996 and 2004, also fired off at the wasteful, “artistic extravagance” of new infrastructure and said work practices and labour costs – which equals 74 per cent of the health budget – must be canvassed in the review.

“The costs of operating Queensland Health needs to be reduced,” he said.

Australasian College for Emergency Medicine President John Bonning said access block, ED crowding and ambulance ramping posed unacceptable risks and must be urgently addressed.

He said a person arriving at an access-blocked ED was “10 per cent more likely to die within the next seven days than a person who arrives at an ED that is not access blocked”.

“It is a matter of life and death,” he said.

Australasian College for Emergency Medicine president John Bonning.

“The significant increasing pressures hospital emergency departments are currently under cannot be written off as a blip or post-pandemic surge.

“In reality this is a continuation and an exacerbation of trends we have been seeing for years.”

He said it wasn’t about “patients who should have gone to their GP instead”.

“Emergency clinicians are tired of the bogus public narrative, so popular with politicians and bureaucrats, which blames these issues on ‘GP type’ patients,” he said.

“Such arguments miss the point, and fail to address the root systemic causes of access block.”

Dr Bonning said there needed to be adequate inpatient beds, staff and processes to improve patient flows and measured, accountable targets for improving ramping access block and admissions.

“In many communities, the ED is the only health service available after-hours, so we would also like to see the rest of the health system operating at more patient-centred hours,” he added.

AMA Queensland president Dr Chris Perry wants a “doubling of beds” at major tertiary hospitals the PA, RBWH, Townsville and Toowoomba and the Gold Coast and Sunshine Coast university hospitals and more at Ipswich, Cairns, Rockhampton, QEII and Logan hospitals.

“If you want to stop ramping, you’re going to have to start to build,” he said.

“They haven’t kept up with population increases and life expectancy is going up almost every year and the cost of keeping people comfortable and happy is a huge amount,” he said.

And Dr Perry backed calls for a subsidising of private health to encourage its take up and retention, accusing federal governments of “sponging off private patients” for years.

“I think the federal government has been using private insurance and the money of private patients to make health care for them cheaper,” he said.

AMA Queensland president Dr Chris Perry says the capacity of regional hospitals – like the SCUH – must also increase.

“If they’re helping to fund private schools, they’re still saving money.

“It makes sense to put a reasonable amount of money into private health.

“Otherwise it costs them more if people aren’t putting their own money into it.”

UWU national ambulance co-ordinator Fiona Scalon said discharging a patient was limited to the availability of doctors and registrars.

“It’s an historical, professional issue that doctors are the only people who can make the decision to discharge someone, even though there are other highly qualified staff,” she said.

She said a lack of free health care outside the hospital system was a problem as people called ambulances when they should be at a medical centre.

“When the service is losing on average 400 hours per day to resources being delayed at hospital it leaves the system very thin on the ground,” she said.

“The budgeted increases in staffing over the next four years will not address this.”

Queensland Nurses and Midwives’ Union secretary Beth Mohle said governance structures where people were held to account and public reporting were vital.

And she championed new models of care focused on patients, rather than a “conveyor belt” of care.

One example was community nurses that could deliver services in people’s homes, she said.

“There are incredible, passionate, innovative, creative people working in our health system,” she said.

“They just need to be empowered to get on with it and deliver services that will improve outcomes for patients.

“We don’t need consultants to tell us what to do.”

Originally published as Experts call for overhaul of Qld’s stressed health system amid ramping crisis