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‘Not the time to point fingers’: GPs push back against hospital ramping blame
Queensland’s Deputy Premier has said the hospital crisis is being exacerbated due to ‘GPs declining to see people with respiratory illnesses’.
Queensland Deputy Premier Steven Miles says GPs are contributing to ambulance ramping at the state’s hospitals. (Image: AAP)
Prominent RACGP figures have strongly contested a claim made by the Queensland Deputy Premier Steven Miles that GPs are contributing to ambulance ramping at the state’s hospitals.
Mr Miles, who previously worked as the state’s health minister, this week said there had been ‘an absolute collapse in primary healthcare’.
‘[There are] lots and lots of people who can’t get to see a GP [and] even if they have a regular GP, many GPs are declining to see people with respiratory illnesses, sometimes before they get a COVID test, sometimes not at all, and that is driving lots and lots more people to our emergency departments,’ he told reporters on Wednesday.
He said that delays in obtaining care are causing many people to develop more acute illness and then go to over-stretched emergency departments as a result.
However, RACGP Rural Chair Dr Michael Clements, who practises in Townsville, said it is not the first time that the State Government has looked to shift blame for significant hospital ramping and overcrowded emergency departments.
‘The issue of ambulance ramping is not new,’ he told newsGP. ‘It has been happening, and getting worse over several years, including before the pandemic began.’
Last year, GPs were also forced to defend themselves against similar attacks from Queensland’s then Chief Health Officer Dr Jeanette Young, as well as claims made by Victorian Liberal Democrat MP David Limbrick.
But with the pandemic still raging and Queensland averaging roughly 6000 new COVID cases each day, Dr Clements says health professionals need to work together and blaming primary care is unhelpful.
‘Now is the time for Queensland Health to work with GPs that have been supporting the hospitals during their shutdowns, and not to point fingers and blame them for not working hard enough,’ he said.
RACGP President Adjunct Professor Karen Price is of the same view.
‘Never before has the family doctor been so important, and yet we are facing a future where the long-term sustainability of general practice care is in jeopardy and GPs are being blamed for an over-stretched hospital system,’ she said.
‘Now is not the time to throw blame at GPs and general practice teams, we are doing our best in very challenging circumstances and need the full support of all levels of government.’
Dr Clements also highlighted a Queensland Health inquiry report on primary healthcare released earlier this year, saying 40 of the 44 recommendations blamed the Federal Government for current healthcare challenges.
‘There were lots of submissions for the inquiry giving options to Queensland Health for help, including the RACGP submission suggesting how they could work with GPs better,’ he said.
Dr Clements said GPs are doing their best to deal with a rising number of upper respiratory tract infections and COVID-19 cases, alongside other tasks such as vaccination and looking after patients who are unable to be seen in hospital clinics.
‘General practices are dealing with things over the phone wherever possible to keep the waiting rooms safe for those vulnerable patients who need face to face [care],’ he said.
‘Most coughs and colds do not need antibiotics and so GPs have been able to manage these symptoms well remotely.
‘We are seeing patients with upper respiratory tract infections face-to-face where possible after triage.
‘Some practices are not well set up for this though, and neither federal nor state governments have given any extra support for PPE and the costs of making sure everyone stays as safe as possible.’
He also said many patients are finding GPs charging out-of-pocket fees as the Medicare rebate is no longer accepted by an increasing number of practices.
‘Our members have been reporting patients walking out after finding out about new fees and choosing to wait in ED for free rather than pay a gap,’ he said.
The state’s current Health Minister Yvette D’Ath warned on Wednesday that Queensland is likely to see its worst flu season in a decade.
Queensland Health separately confirmed to newsGP that 475 patients had been admitted to hospitals in the state due to influenza since the beginning of April, with 30 of those going to ICU.
Back in 2019 there were 68,148 confirmed cases of the disease in the state with 264 deaths.
According to the Department of Health, there were 511 COVID patients in Queensland hospitals at the time of publication on 19 May, including 16 in ICU.
After Mr Miles’ remarks, Ms D’Ath made a more conciliatory reference to primary care, highlighting how GPs
are ‘working tirelessly’ to Nine Newspapers.
She said staff shortages due to COVID infections are having an impact on an already stretched hospital system. There are reportedly more than 1600 staff currently isolating.
A GP shortage in the state is also contributing to the problem, she said, suggesting that retiring GPs could leave aged care residents without proper access to primary care.
‘So what do they do?’ Ms D’Ath said. ‘The staff pick up the phone to the Queensland Ambulance Service and ask for an ambulance to take that person to hospital because they don’t have qualified staff and they no longer are being serviced by GPs in their area.’
She said there were 520 long-stay patients in Queensland hospitals who did not need treatment but required an NDIS or aged care package.
Dr Clements said the Australasian College for Emergency Medicine (ACEM) as well as the Australian Medical Association Queensland are clear that hospital underfunding is at the root of the current issues.
Last year, an ACEM statement directly
addressed the suggestion that primary care was contributing to a worsening situation at hospitals.
‘These pressures are also not the result of “GP type” patients presenting to the ED, which is a public narrative still being frustratingly peddled,’ they said.
‘Such patients presenting to emergency departments are relatively straightforward to treat and do not require significant resources nor admission to hospital.’
Instead, ACEM called for urgent investment in beds and staffing,
a plea reiterated this week.
‘The current hospital crisis has not been caused by COVID-19. COVID merely exposed and worsened existing issues,’ a spokesperson said.
‘The system pressures that lead to ambulance ramping, emergency department overcrowding, bed block and worsening health outcomes have been growing for decades. We have been calling for help with these issues for just as long.’
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