This post includes:

  • Comments on the Queensland Health budget from the state’s AMA
  • A brief summary of the Qld Health budget papers
  • Analysis by Professor Amanda Lee of QUT, who says the budget means “the greatest dismantling of public and preventative health services in recent Australian history”. More than 60 public health nutritionists, 20 Indigenous nutrition promotion officers and over 70 health promotion experts will lose their jobs in Queensland, she says.

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AMAQ gives the budget a ‘D’

It seems there will be 4,140 FTE redundancies from Queensland Health this year (versus last week’s announcement that 2754 full time equivalent positions, or 4 per cent of the department’s staff, will go).

But AMAQ President Dr Alex Markwell says the budget doesn’t provide enough detail about the cuts: “…we are still in the dark about which health workers will lose their job and when, and how those cuts will directly impact on hospital and health services across 17 regions.

“It is very difficult to see how population and preventative health programs will be delivered with massive cuts to public health units around Queensland. Specialist services such as the Queensland Tuberculosis Control Centre have also been dismantled.”

She said in a statement: “I would mark this health budget a D…for disappointing and disingenuous.”

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Queensland Health budget papers say:

• Under the restructuring of the department, it will shift from a single organisation into a collection of independent entities with decentralised decision making, using a purchaser-provider model. Hospital and Health Services (HHSs) will operate as independent statutory bodies overseen by Hospital and Health Boards, to which the HHS CEOs will report. Qld Health will be the “system manager” responsible for purchasing services from HHSs, as well as for  legislative and governance arrangements and system-wide public hospital service planning and performance.

• Queensland Health needs to improve efficiency as preliminary comparisons from the Independent Hospital Pricing Authority show the cost of delivering public hospital services in Queensland is 11% above the national efficient price (Croakey wonders whether this calculation takes account of Qld’s geography). As part of efficiency savings, Hospital and Health Boards will be encouraged to consider outsourcing for services such as catering, cleaning, security, gardening and general maintenance, and encouraged to work with the private sector in the delivery of aged care and other services. As well, private providers will be engaged to treat patients who’ve had long waits for elective surgery.

• On the spending side, there will be an increase to Patient Travel Subsidy Scheme payments, and the Maternal and Child Health Service will be expanded to provide home visits at 2 and 4 weeks of age, and free consultations at community centres at 2, 4, 6 to 8 and 12 months old. The Government has also committed to increasing medical, nursing and allied health staff on weekends to ensure patients can be treated and discharged without unnecessary delays, and to providing up to an extra 40,000 specialist outpatient appointments. As well, GP Liaison Officers will be funded at 20 public hospitals.

• The Government has promised to release external reports and reviews aimed at guiding system improvements.

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Public health cuts will hit the most vulnerable  

Amanda Lee writes:

With today’s budget news, it’s now clear that the new Queensland government is intent on overseeing the greatest dismantling of public and preventative health services in recent Australian history, yet it’s still trying to argue this will have no effect on health and wellbeing across the state.

At the centre of this argument is a fiction. That is, a misleading distinction between ‘front-line’ and ‘desk’ jobs.

The implication is that the four thousand plus jobs going from Queensland Health contributed little if anything to the health of Queenslanders.

Yet many of the jobs being cut have provided extremely cost- effective health outcomes for the state.

The area of public health I have been involved in – nutrition and physical activity promotion- has a particularly proud record of achievements.

For three of the last four years running, Queensland has been honoured to achieve the Gold Award from the Australian and New Zealand Obesity Society. The award was in recognition of collaborative work that has helped make healthy choices the easiest choices, when it comes to eating well and being physically active.

Such programs improving our social and physical environments are essential to combat growing waist lines – and the related growing prevalence of chronic disease such as type 2 diabetes, heart disease, stroke and some cancers – which are already putting enormous pressure on our ill-health system, as throughout the western world.

As an example, public health nutritionists throughout Queensland have worked hard to combat the gross misinformation about diet and health which swamps our media and the continual battering of advertising that encourages all of us to eat more energy dense foods and drinks high in saturated fat, added sugar and salt.

They have worked tirelessly to improve food supply in childcare and education settings, health facilities and remote communities. An evaluation of the successful Smart Choices program – which supplies healthy food in tuckshops and all aspects of school life across the state – was recently recognized in a European Journal as a world first in terms of its scope and size.

It is preventative health experts who provide the mechanism to respond, when the community says things like “The Government should do something to make it easier for us to be healthy…”

With today’s news, that over 60 public health nutritionists, 20 Indigenous nutrition promotion officers and over 70 health promotion experts will lose their jobs in Queensland, it is the achievements of this workforce that will erode, and with this, the capacity of the Government to tackle chronic disease and promote health and wellbeing.

And it is the most vulnerable people in our state that will suffer. It is difficult to see how the gap in Aboriginal and Torres Strait life expectancy can be closed without Indigenous nutrition workers supporting clinical staff to help mothers feed their infants healthier food, and check growth and development.

Preventive health is not an optional extra. It’s an essential part of any modern evidence-based public health service. It’s not only a type of insurance to help avoid future cost blowouts, it’s a smart, and cost-effective approach to reduce the impact of some of the most country’s most pressing health problems.

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Update, Sept 12:

From the Federal Minister Warren Snowdon