Wednesday, March 01, 2023

Queensland Audit Office reveals huge spike in ambulance and specialist doctor wait times

More than 100,000 Queenslanders are waiting to see a specialist doctor — a surge of 80 per cent in seven years — and ambulance officers spent more than 134,000 hours in a year sitting with patients on ramps at emergency departments.

The concerning reality of the state’s health system has been laid bare in the latest Auditor General report, who also flagged delays to the delivery of critical hospital bed and budget blowouts.

In the 2021/22 financial year, the number of long waits for specialist outpatient services — which is patients waiting to see a specialist doctor — surged by 80 per cent to about 104,000 people.

The disturbing spike adds another layer of concern to the ballooning elective surgery wait list which The Courier-Mail revealed this week rose to nearly 60,000, given the more than 100,000 waiting to see a doctor could further squeeze surgery delays.

Queensland Health introduced a new strategy in 2015 to improve management processes and allow patients to access treatment within clinically recommended time.

But the Queensland Audit Office said the total number of patients waiting to see a specialist in the last financial year was “significantly higher” than when the department introduced the Specialist Outpatient Strategy in mid-2015.

“In 2021–22, the total number of long waits increased by 80 per cent due to Covid-19 impacts on system capacity,” Auditor-General Brendan Worrall wrote.

The delays have also caused a knock-on effect to the ultra-long waiting list — where patients have waited more than two years for an initial specialist outpatient appointment — which Mr Worrall said would grow further if the backlog of wait times more broadly was not improved.

“Ultra-long waits continued to decrease until 2019, but have increased again over the last three years,” the Auditor General wrote.

“Of the 2481 patients waiting more than two years for an appointment as of 1 July 2022, there were none for category 1; 634 for category 2; and 1847 for category 3.

“The large increase in long waits and reduced system capacity will place pressure on ultra-long waits if specialities are unable to clear the backlog of long waits quicker than when new referrals come in.”

Mr Worrall also noted the growing demand on the Queensland Ambulance Service (QAS), including for the most urgent of patients.

“The time it takes ambulance crews to transfer patients into the care of emergency departments increased significantly in 2021/22,” he wrote in his audit into health services in Queensland.

“If patient transfer takes longer than 30 minutes, the extra time is considered ‘lost’ time for QAS.

“In 2021/22, QAS lost approximately 134,155 hours – a 20 per cent increase compared to 2020–21.”

A performance target for patient off-stretcher time to have 90 per cent of patients transferred into emergency departments was not achieved in the past eight years.

“The percentage of patients transferred off stretchers in less than 30 minutes has shown a significant downward trend in the past five years,” Mr Worrall wrote, noting the further pressure placed on the system from the Covid-19 pandemic.

“Hospitals have adopted new infection control measures, such as social distancing and personal protective equipment, which have increased treatment time and affected patient flow.

“Several Queensland hospitals also provide Covid-19 fever clinics from their emergency departments.”

Health experts have warned authorities will struggle to improve ramping times and overstretched emergency departments without boosting the bed capacity in the system.

Mr Worrall said ageing health infrastructure needed to be replaced and expanded given the continual surge in the state’s population coupled with its ageing demographic.

But he warned the state government was unlikely to deliver on its commitments to deliver 2200 additional beds through building three new hospitals and expanding existing facilities, flagging delays and budget blowouts.

“The sector will face challenges in achieving the desired outcomes from the capital investment program, with current market conditions placing considerable pressure on costs and shortages in materials and labour creating risks around timing,” Mr Worrall wrote.

“Related operational costs will need to be included in future budgets to ensure these assets can be effectively and efficiently used.”


Mandatory psychiatry training flagged for doctors

This sounds about right. 10 weeks should be enough to learn all there is to learn about psychiatry

Every doctor trained in Queensland would complete a mandatory placement in psychiatry within two years of graduating, under a bold plan to help junior doctors better deal with patients experiencing mental health issues.

The Royal Australian and New Zealand College of Psychiatrists is calling on the Queensland Government to introduce an eight- or 10-week psychiatry term in a bid to better support doctors who are already bearing the brunt of the woefully under-resourced mental health sector.

Today The Courier-Mail continues its series examining the state of Queensland’s health system, and with mental health accounting for a significant amount of all emergency department presentations and up to 70 per cent of all visits to the GP, it continues to be a major area of concern.

Patients who need to see a psychiatrist in Queensland can expect to wait between six and 12 months and the wait to see a child psychiatrist is at least 12 months.

Despite this doctors frequently report feeling underprepared to deal with mental illnesses with very little of their studies dedicated to the vital area.

The college’s Queensland branch chair Professor Brett Emmerson said mandatory training would go a long way to improving knowledge and confidence of people to be able to deal with mental health, as well as reducing the stigma of it.

The Courier-Mail understands the Department of Health has met with RANZCP to and is keen to consider the proposal.

Minister Health and Ambulance Services Yvette D’Ath said her government had the biggest investment in mental health Queensland had ever seen – $1.6 billion over five years.

“Our record investment in the budget delivers the funding over five years to improve mental health, alcohol and other drug services which means more beds, dedicated services, increased crisis responses, suicide prevention initiatives and a package dedicated toward First Nations peoples,” she said.

Research undertaken in 2018 by the Australasian College for Emergency Medicine found that mental health patients frequently waited longer than other patients with a similar severity of physical illness before being treated – often due to a lack of specialist mental health staff.

Professor Emmerson said the decision for mandatory postgraduate training for medicine graduates moving from one year to two years would give the time needed to introduce mandatory mental health terms.

The Royal Australian and New Zealand College of Psychiatrists is also creating a Diploma of Psychiatry that doctors could opt to complete, to broaden their knowledge.

The diploma would aim to help doctors assessed patients presenting with new mental health problems, manage risk in relation to patients who may harm themselves or others, start therapeutic care or prescribe appropriate medication.


‘It’s lifesaving for men’: Why blokes need more mates

Men’s difficulty in forming friendships is at a crisis point and is contributing to a sense of social isolation and poor quality of life, experts say.

While women’s friendships tend to flourish throughout life, the struggle for men to form solid friends begins in adolescence and continues into adulthood, according to the head of youth mental health organisation Batyr, Nic Brown.

“If we look at male suicide, for every nine suicides that happen daily in Australia, seven are men, and a significant part of that is the inability to have important conversations early enough to avoid getting to that point,” Brown says.

“Less than 40 per cent of young men are reaching out for support. They so often don’t feel they have the friendships to have the conversations that are needed.”

The language around articulating feelings can also be part of the challenge for men, compared to women and girls who, Brown says, are more enabled to converse in that way.

“It’s the difference between being told to man up when you’re a boy and being asked what’s wrong when you’re a girl,” he says.

Clinical psychologist and Movember director of mental health training Zac Seidler says the research clearly shows men don’t prioritise social relationships, particularly after the age of 18.

“This is when women are forming and strengthening relationships but men, around the same time, go to university and focus on achieving to be a good provider, to find a mate as a reflection of self-worth,” Seidler says.

“Friendships, while important in high school, fall away at this point and continue on that path so you end up with a vacuum. So many men are reliant on their partner to tend to social relationships so, when that central relationship breaks down, there’s a serious breakdown in all the relationships for men.

“Friendship is fundamentally lifesaving for men. It has to be put front and centre because this is very serious and has been for a long time, but it requires a vulnerability for the man to say ‘I need you’.”

Male pride is more likely to prevent men from initiating contact or letting a friendship drop away if the invitations stop. “We need to find ways to encourage emotional disclosure among other men and this must start very early in life,” he says.

Happiness Institute psychologist Dr Tim Sharp says social isolation is an epidemic, particularly for men, and he believes we’re all part of the solution. “We’re not just dealing with men’s attitudes and may need to look at their partners or women around them and wider society,” Dr Sharp says.

“There are mixed messages. We’re trying to get the message out that it’s important for men to speak out. Just as we go to a mechanic when our car is in trouble, we need to seek help when we’re struggling emotionally, but there’s also a subtle message to stop complaining.

“The most important thing when it comes to health and wellbeing is to have at least one person you can be open with. This isn’t 100 Facebook friends. It’s the really intimate ones, we call them 3am friends where, if something goes wrong, you can call at any time of day and they’ll listen and offer constructive support.”

Psychologist Stephen Brown says friendship is just as important to men as a job and family in having stable mental health and a good quality of life.

“It’s what keeps men on the highway, not drifting off,” Brown says. “A male has to have his own interests and that needs to be encouraged. I don’t think men are being as encouraged to go out there and this leads to caution and a lack of confidence.”

Once part of a vibrant friendship circle, life circumstances, including a divorce and two moves interstate for work, left Guy Thompson with just a few friends he considers close enough to “have your back”.

But busy schedules for everyone means the group only get together every couple of months, leading Thompson to develop Crewmen, an app that matches men with others that share similar interests and encourages them to meet face-to-face to develop a sense of camaraderie and mateship.

“Everybody wants to do more things with their mates but, when you have only got a small pool of mates to catch up with, finding the right time is really hard,” he says.

“Having a wider circle means more opportunities for catch-ups with people that have the same hobbies and are on the same page.”

Thompson says surviving challenging times without a strong group of mates is tough, but sometimes it’s the happiest moments that can cause the greatest sense of loneliness.

“Having good mates allows you to celebrate achievements and milestones in your life,” he says.

“For me, it’s like what’s the point in achieving things if you don’t have anyone to celebrate with? Without that, those achievements can seem like they don’t even exist.”


Wood veneer is both "Green" and attractive

It's common in cheap furniture but is probably the best when solid wood is too dear -- which it often is these days. I prefer laminated wood, which is something of a halfway house

The current Federal Government continues beating a path toward reducing carbon emissions, passing climate change bills as recently as September 2022.

The Australian emissions reduction target of 43 per cent and net zero emissions by 2050 is now enshrined in legislation, but the Architecture 2030 report found the built environment generates 40 per cent of annual global CO2 emissions, from construction elements such as steel, concrete, glass and plastics.

As we build or renovate our homes, we can all seek products that will help, not hinder a greener future – while naturally still looking drool-worthy.

Sometimes a bad reputation just clings to a product decades after its quality has improved beyond belief. An unfair rap has certainly proved hard for timber veneers to shake.

The word “veneer” itself suggests fakery, when in fact it is such a genuine material made from a natural, renewable resource – unlike laminates which are truly synthetic and arguably responsible for the unfair maligning of the real thing.

Melbourne-based architect with the award-winning sustainable architecture and design practice Breathe, Madeline Seawall is a strong advocate for using beautiful veneers at every opportunity. “Designing sustainably means choosing the material that is most suitable for every application,” Seawall says.

“We love using timber veneers instead of hardwood door panels for joinery because it is such an efficient use of a precious resource,” she says, urging Australian Forest Stewardship Council certified timber only.

Imagine sitting back in your lounge, looking at the finishes about you and delighting in the uniqueness. Those wormholes, swirls and burls all signify nature’s dateless design.

Ancient art

Veneers were originally the go-to material for furniture makers as a solution to expanding and contracting solid wood. The practice dates to Ancient Egypt, where wood was the same precious resource it is today.

Flash forward and the word veneer still has some people baulking, but here’s a reality check: timber veneers in 2023 are beautiful, sustainable, remarkably pliant and responsible for some of the best design breakthroughs this century.

Plus they’re made of actual timber, glued to inexpensive particle board backing. Wood slices for veneer use can be as thin as 0.5mm thickness. According to the Timber Veneer Association of Australia, one cubic metre of timber can generate 1000 sqm of veneer. If you had to buy 1000 sqm of solid Queensland red cedar, you’d have to sell the Bentley.

And if you’re looking for the newest products in the range, go to Elton Group and let your eyes dance across their range of WoodWall products – which can be applied as easily as wallpaper. Wow. If you do use veneers in your own home, not only are you smart, you’ll join the fine company of some of this country’s greatest designers.

Fine figures

Wood is an excellent sustainable building product that looks cool and contemporary while at the same time being warm and welcoming.Have you visited Sydney’s Qantas First Class Lounge? Well, neither have I (though I live in hope), but the pictures of it are fabulous.

How about the Margaret Court Arena? Sydney’s Knox Grammar? The Melbourne School of Design?

The range of available timbers boggles the mind. From imported ash styles to Australian Huon pine, there seems to be a “figure” (or surface pattern) that works for every design concept.




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