The hidden secrets of Queensland Health

I swore on the Bible once.

I was giving a statement at a lawyers office, for evidence to be submitted in a trial.  I was taken aback when they pulled out a Bible, and asked if I wanted to swear on it.  I’ve probably seen too many episodes of Matlock, so I associated the process with Hollywood, not our modern legal system.  I never thought I’d be doing it myself.

I swore that I would “tell the truth, the whole truth and nothing but the truth, so help me God.”

Anna Bligh would like Queenslanders to believe during the current election campaign that she is telling the truth.  And in a way, I’m sure she is.  Like when she said that Queensland has the lowest operating waiting lists of all state health departments (http://bit.ly/zQGVbs).  Sure, it’s probably technically correct.  But could she swear on the Bible about the QHealth elective surgery waiting times?  Is she speaking the whole truth, and nothing but the truth?

The AMA Queensland doesn’t think so.  Professor Richard Kidd told the media, “The Premier lied when she said that we had the shortest waiting lists.”

The article went on,

“Dr Kidd said public hospitals were returning thousands of referral letters to general practitioners telling them they could not see their patients in a timely way.
“Those patients don’t get counted on the waiting list,” he said.
Dr Kidd said other patients languished for many years before getting an appointment to a public hospital specialist for assessment, making up the so-called “waiting list to get on the waiting list”.
“We need to talk about the waiting list, the waiting list for the waiting list and the I’m never going to get onto the waiting list, waiting list,” he said.”

Rarely do I agree with the AMA.  By and large, I have found them like an old broken air-conditioner – chewing up lots of resources, making lots of noise, and producing nothing but hot air.  But Richard Kidd publicly confirmed things about Queensland Health that the average Queensland voter wouldn’t hear about.

As a GP on Brisbane’s northside, I struggle with patients every day to find a timely solution to their health needs.  Getting them into the Royal Brisbane or Prince Charles Hospitals are not timely options.  Only the absolutely emergent will get seen within a few days.  Most of my patients would wait 12 months to 18 months depending on the severity and the specialty required.  As Professor Kidd pointed out, most of these people languish on the specialist outpatients waiting list, the so-called “waiting list for the waiting list”.

But even then, it isn’t so much the waiting times that irritate me, but the tricks that the bureaucrats play to keep thinning the numbers.  Like sending letters out to patients asking if they still want to stay on the waiting list.  If the patient doesn’t respond within 7 days, they are taken off the list.  Or 18 month audits of the waiting list that GP’s are expected to complete and return, with the same aim in mind, to thin out the waiting list numbers.   I had to do two of those for one patient I can recall, who suffered for more than two years on the ENT waiting list for the RBH, almost completely deaf while I waited for a specialist to give me advice on how best to manage his condition.

Or, as Professor Kidd also said, I get letters back from the hospitals stating that they will not accept my referrals because my patients will not get seen in a timely manner.  In other words, “we don’t want to see them at all”.  But some people have no other option.  They can’t afford to go to private specialists.  Or, like the children on the long, long wait for speech therapy services, there aren’t enough private practitioners around.

When services are provided, Queensland Health now uses federal funding by bulk-billing Medicare for services rendered.  While that may seem like a win-win for the hospital and the patient, the hundreds of millions of dollars that Queensland Health sucks from the Medicare system is money that could be put towards better General Practice and primary health care – money that could be spent on trying to keep people out of the hospital system in the first place.

When I left the public hospital system in early 2004, I already felt that the system was starting to spiral out of control.  And nothing in the last eight years of Labour government has convinced me that it is getting any better.  If anything, the holes in the error-riddled system binding Queensland Health together have become large and numerous, like an old sponge.  If Campbell Newman wins this election, he will have a tough job on his hands.

If Anna Bligh wins this election, God help us all.  There will certainly be lots of swearing, but not on the Bible.

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