Question One - Funding for Eating Disorders
Amy:
The federal government has announced $26.9 million over four years for the treatment of eating disorders, including funding for working in partnership with states and territories to explore opportunities to establish additional eating disorder day programs. Of the $9.2 million in the federal government’s announcement which is unaccounted for, what has been allocated to the Queensland government for eating disorder day programs and how will these funds be spent?
Answer from Director-General of Queensland Health:
Specifically in relation to eating disorders, I can say that the government has invested $10.1 million over five years, with $7.1 million of that going to adults; $3 million of that going to child and youth eating disorder services, largely delivered through the Queensland Children’s Hospital; and $1.4 recurrent funding for the specialist child and youth eating disorder day program. Some $500,000 has also been allocated to expand Eating Disorders Queensland, which is an NGO that I am sure you will be aware of, to deliver specialist eating disorder services for people aged over 16, their families and carers. That is state funding. Specifically in relation to your question about federal funding, I do not have that to hand. I am happy, with the minister’s agreement, to see if we can find that information out during the course of this session.
Question Two - Public pregnancy termination services
Amy:
How many hospital and health service facilities provide public pregnancy termination services rather than partnering with private providers?
Answer from Director-General of Queensland Health:
Obviously, the decriminalisation of termination of pregnancy has led to changes in the way that the public health system has responded to the needs of women requesting termination of pregnancy. We work very closely with stakeholders, and our advice was that women prefer, in the main, to have access to those services in discreet settings and outside of our major public hospitals.
Along those lines, as you are aware, we have made arrangements to support those women presenting for termination of pregnancy to access that service, under our cost, largely with partners in the non-government sector. The vast majority of terminations of pregnancy, from a surgical or procedural perspective — between the 9,000 and 10,000 mark per year — are done in the private and NGO sector.
The role of the public hospital system in the termination of pregnancy tends to be in what we would call a therapeutic termination of pregnancy. Services for those cases, which tend to be much later in the pregnancy and are associated with foetal abnormality or with serious illness in the mother — for example, the mother may get cancer or a serious disease and have to make an incredibly difficult decision — can only really be provided in our level 6 hospitals. They would tend to be the Royal Brisbane and Women’s Hospital and one or two other services providing level 6 fetomaternal units. That situation has not changed and those numbers are very small, as you would imagine. Basically, we operate one Queensland health system across the board, so wherever the woman presents in that scenario they will be referred and supported into our level 6 services, which would be Townsville or the Royal Brisbane and Women’s Hospital.
Question Three - Rural maternity services
Amy:
The Rural Maternity Taskforce Report was released in 2019. It made six recommendations for rural maternity services in Queensland. What work has occurred in order to progress the implementation of these recommendations?
Answer from Director-General of Queensland Health:
I am really proud of the work across Queensland Health. Stakeholders including midwives, our rural doctors particularly, our Indigenous health workers and the rural health services have worked very hard with the department to progress the recommendations of the Rural Maternity Taskforce. What we can be most proud of, I believe, is the commitment to establish level 3 maternity services in Weipa. That is a recurrent investment of $8.1 million. We anticipate that that service will be up and running from next financial year.
What does that mean? What does level 3 maternity service mean? As we talked before about the Torres and Thursday Island, what it means is that that service in Weipa will be able to provide 24/7 services to the women of Weipa and the western cape and of course significantly change the lives of Aboriginal and Torres Strait Islander peoples in that western cape who currently have to go to Cairns. Obviously high-risk birthing will still, in conjunction with Weipa, have to be undertaken at a bigger centre. That means that those midwives and those fantastic rural doctors, who are generalists but are specialists in anaesthetics and in obstetrics, are the ones who essentially can deliver those services with those support staff in Weipa, and I think that is a tremendous uplift. It will also, as a by-product of that, create a lot more other services into that western cape area. I think that is a massive uplift when it occurs, and it has already been committed to. The business case is done and it is in its implementation phase.
Since 2014 we have also established or re-established birthing services in Cooktown, in Ingham and in Beaudesert, and I have already talked about Weipa. That is the first thing—that is, birthing services or better birthing services and better access for rural women. It is not just about having medical services; the evidence is very clear that women want to have continuity of carer as part of pregnancy. For example, whilst in Chinchilla it has been a challenge to manage the 24/7 medical service, the team that supports the midwifery group practice there and provides that continuity of carer, including all through pregnancy and including supporting that woman and travelling with them to Dalby to birth, has received exceptionally positive feedback from women there. So it is not just about birthing at all costs in a facility; it is also about the sorts of services that we can provide and that women want. Safety is obviously critical. Not every rural town has the volume of demand that would allow for us to safely provide services and ensure the staff maintain their training and experience, so I think we also have to be realistic. Coming back to the point of what was recommended in the task force report, it was very much to say a framework that was developed to really help communities work through that with their health service but also a range of other things including investment in training and support for staff.
Finally, and I think it has already been referred to in a previous question, the final recommendation really pertained to the governance and attention paid to rural services in Queensland. As a consequence of that recommendation, I established the office of rural health, which is a very small entity based in Townsville but has links into Cairns and also into Toowoomba to join up legacy services. I am proud to say that that is really making a difference I think. It brings rural health care and rural communities to a seat at the decision table—the top table of Queensland Health—so, again, I am proud of that. In answer to your question, a lot has happened. I should also mention that in this budget as part of the plan First Nations birthing has received funding to be able to deliver on that plan as well, and that was another part of that task force report.
Question Four - Ambulance services
Amy:
How many ambulance stations in Queensland are there where there is a single paramedic at work? Do you have data on cases where an individual paramedic has arrived at an incident and they have then had to call for another ambulance or the Fire Service?
Answer from Commissioner of Queensland Ambulance Services:
I will get you the exact number. We deliver services in Queensland very differently to most other states. In fact, we would be the only ambulance service that actually delivers permanent services in towns like Aramac and Karumba—you name it—all of those very small towns. There has been a view with government for a long time that these services are very important to those communities and that we should continue to have permanent services. Some of those locations do
employ at a minimum two staff and many of them have volunteer networks within the community. With two staff, you will get an overlapping day in the middle. It is pretty much a single response that is augmented by volunteers.
One of the things that I think we do exceptionally well in Queensland is we work with other emergency services very closely. It is not unreasonable that fire will help us on some occasions, and that happens in a lot of small communities. In saying that, if you look at the support we provide to fire at standbys and things like that, we provide a workplace health and safety arrangement with them to make sure that they are safe and we check them over when they are done. We do all those sorts of things, so one sort of knocks out the other. That is how we do it in Queensland. I think into the future we will need to look at auxiliary type models—probably similar to fire—and how we provide those services. In terms of the actual number, as the minister said before, we provide services from 302 locations, and 83 of them are what we would call a category 2 station.
Amy:
Is there any data on when a single paramedic has had to call for other services?
Answer from Commissioner of Queensland Ambulance Services:
We have a mobile service, do not get me wrong. The ambulances will go from town to town or suburb to suburb if you are in Brisbane. That is why I say that we use volunteers. If you are in Aramac—and that seems to be getting a run today—it is 66 kilometres from Barcaldine. It is not as simple as getting someone to run up the road for 66 kilometres. That is why the officer-in-charge in those locations is able to help. Do we keep data on that? No.