Qld Health’s ‘dangerous’ ultimatum to emergency department medics sparks outrage

Doctors and nurses have been left outraged at an “unfair” new directive they say will blow up patient care across the state.

Nurses’ Professional Association of Queensland Kara Thomas said there was pressure to manipulate numbers. Photo: Lucas Salvatori.

Frontline emergency department medics across the state have been directed to turnover patients within 24 hours or hospital funding will be lost, sparking outrage from already overwhelmed doctors and nurses who say the “beat the clock” pressure will blow up patient care and encourage data concealment.

The directive from Queensland Health warns that from July 1 if patients stay longer than 24 hours the responsible Health and Hospital Service will not receive the activity-based payment for that patient.

“Linking emergency department funding to arbitrary 24-hour targets is a very dangerous practice,” Dr Duncan Syme, president of the Australian Medical Professionals Society said.

“Bureaucratic KPIs are pressuring staff to manipulate data, reclassify patients and rush decisions, not to improve patient care but to avoid funding penalties. That’s not medicine. That’s not safe healthcare. That’s mismanagement,” he said.

But Queensland Health insists there is no pressure being placed on clinicians and that the target is aimed at prioritising patient care as a patient’s condition is at greater risk of deteriorating the longer they stay in ED.

There are about 400,000 public ED presentations in Queensland each year. In May 2025, 910 stays were longer than 24 hours.

Nurses’ Professional Association of Queensland president Kara Thomas. Photo Steve Pohlner

But the president of the Nurses’ Professional Association of Queensland Kara Thomas told the Sunday Mail that nurse members report that they have already been pressured to manipulate those numbers by stashing patients in short stay areas, behind curtains and in corridors caused by ongoing bed block.

“When things go wrong, it’s never the executive policy decision-makers who are held accountable. It’s the individual clinicians left carrying impossible workloads under unsafe policies. That blame shift is not just unfair, it’s dangerous,” Dr Syme said.

Ms Thomas said that the July 1 directive is a violation of clinical independence and a betrayal of professional standards.

“If the emergency department is already operating over its funded-bed capacity and

both the hospital and mental health units are bed blocked, where exactly do you

propose these patients go? Push them from ED corridors to ward corridors?” Ms Thomas has asked Health Minister Tim Nicholls and Queensland Health Director General David Rosengren in an email.

Minister for Health and Ambulance Services Tim Nicholls. Picture: Liam Kidston

“We have received consistent and alarming reports from frontline staff that the ED admission

process has been intentionally altered in recent weeks to stop the 24-hour clock as soon as a

patient nears breach,” she said.

“There is now widespread panic to transfer these patients, still awaiting a ward bed, into the short stay and overflow unit, solely to protect funding. These patients remain inappropriately housed in short stay while awaiting ward admission. This practice could be described as data concealment.”

A Queensland Health spokesman said that the directive from July 1 is consistent with a long-established funding models, adopted by health jurisdictions across the nation, in which funding is adjusted for hospital activity linked with avoidable adverse outcomes.

“This does not change the commitment to prioritising patient safety because patients will only be discharged if it is clinically safe to do so,” he said.

Originally published as Qld Health’s ‘dangerous’ ultimatum to emergency department medics sparks outrage