Proper funding can cure our ailing health system

Doctors have been warning the health department of the imminent collapse of maternity services for two years, writes Dr Gino Pecoraro.

A lack of specialists at Gladstone Hospital has forced women to travel to Rockhampton to give birth.

It is telling, that acting Premier, Dr Steven Miles only arranged an “urgent” meeting with the health Minister and director-general of health after embarrassing press drew attention to the failings of the health department.

Doctors (myself included) have been warning the health department of the imminent collapse of maternity services for two years. The root cause of this collapse was the closure of the private maternity unit in Gladstone. This led to the private specialists previously living and working in Gladstone moving out.

New information released suggests that Queensland Healthwould not allow those doctors to work delivering their private mothers in the public hospital, Of course those doctors had no other choice but to pack up and leave forcing all women to present to the public hospital. In time the public unit collapsed forcing women to travel to Rockhampton which has also had 3 of its 4 specialists resign. This pattern can be expected to continue to the next region unless something is done urgently.

Health Minister Yvette D'Ath. Picture: NewsWire / Sarah Marshall

Gladstone had the specialist staff but their ill treatment by the health department led to them fleeing. This cannot be stressed enough. Any so called solution relying on expensive fly in fly out locums or conscripting doctors from Brisbane for enforced terms won’t survive long term. Not in the least because the daily locum rates offered by Queensland Healthare half of what locums can get if they offer their services in other states facing similar issues.

What is needed is retention as well as recruitment. Recruitment will be difficult as long as the carrot of private practice is unavailable.

For this situation to be resolved, we need the federal government to become involved. The feds need to fix private insurance so that it is affordable and covers the cost of treatment. Women wanting health insurance that covers reproductive issues are forced to pay double the rate that men do in a federal government sanctioned gender discrimination perpetrated by the health insurance industry. This needs to be dealt with and pregnancy included in all policies, the same as male reproductive health care is. Both Medicare and private health insurance patient rebates need to increased to fix the stagnation that the freeze caused, and ongoing appropriate indexation to health care costs needs to be enshrined in legislation.

Obstetrics is a challenging medical specialty to enter. It has one of the longest training programs of 6 years after medical school and junior doctor training. It has less than favourable hours with extensive after hours, weekend and public holiday commitment, has the highest rate of litigation against doctors and obstetricians have the highest suicide rates of medical practitioners.

Dr Gino Pecoraro. Picture: Glenn Hunt/The Australian

Attracting obstetricians isn’t just about money although we know that paying rates does attract more highly trained staff. Look to the mining industry for an example where engineers, electricians and plumbers can be paid as much as 3 times what their city counterparts do. There isn’t a desperate shortage of highly trained workers in arguably much less salubrious locations and this wage increase must explain at least some the reasons why.

New legislation passed in Queensland means that a doctor under investigation can now be publicly named and shamed. This is often a career ending experience for a doctor and even if found innocent (as 70% are) the stress they face is real. These sorts of adversarial investigations are responsible in part for the higher than average suicide rate obstetricians face.

The state department can surely help by offering attractive packages for specialists to move to Gladstone and allow them the right of private practice in the public hospital but the federal government needs to lift its game as well and save private obstetrics before it completely collapses.

This issue is not unique to central Queensland. The exact same scenario is playing in regional areas all over Australia. Minister D’Ath is in a position to broker a solution with her federal counterparts that can be used as a template for this issue nationally. All that is required is the political will and adequate funding for what is an essential service.

Dr Gino Pecoraro is president of the National Association Of Obstetricians and Gynaecologists

Originally published as Proper funding can cure our ailing health system