Doctors have raised concerns about another regional hospital obstetric unit, as a leaked letter reveals Queensland Health is considering a new "workforce rotational model" amid unprecedented vacancies in maternity services.
Together Queensland senior vice-president Dr Sandy Donald, a retired anaesthetist, said the union was worried birthing services at Innisfail Hospital "may be interrupted" after speaking to unhappy doctors in the Far North Queensland town, about 90 kilometres south-east of Cairns.
Dr Donald said he had been in discussions with Cairns and Hinterland Hospital and Health Service (CHHHS) senior management this week about the retention of GP obstetricians — doctors with training in general practice and obstetrics — at Innisfail Hospital.
"They indicated that they would urgently investigate and see what they can do," he said.
It comes as Gladstone and Biloela hospitals remain on a birthing bypass and staffing issues threaten to derail plans to resume delivery of babies at Cooktown Hospital and to establish a birthing service at Weipa Hospital.
The CHHHS acting chief executive, Jeremy Wellwood, insisted Innisfail Hospital's birthing rosters were "covered" but admitted its maternity unit was trying to fill an obstetric vacancy.
"We acknowledge that obstetric doctors are in short supply nationally and are therefore using a number of strategies to manage this vacancy," Dr Wellwood said.
"This includes recruiting doctors returning from maternity leave, sourcing locums, as well as reducing the obligation for obstetric doctors to do emergency medicine, thereby reducing fatigue leave.
"We are participating in state-wide plans to improve medical staffing, including improving accommodation for locum cover and increasing training opportunities."
Queensland Health proposes new 'workforce rotational model'
A leaked letter, obtained by the ABC, provides details of a March 2 forum at the Queensland State Library in Brisbane.
The letter outlines a Queensland Health proposal of a new "workforce rotational model" to be discussed at the forum, called to identify any issues and barriers and to seek a consensus on the immediate, short-term and long-term solutions to maternity workforce issues.
A pilot program under development at the Royal Brisbane and Women's Hospital will recruit extra obstetric specialists to travel to and from regional centres to support their maternity units, when needed.
The program is expected to be up and running by mid-year.
"The Department of Health and Hospital and Health Services are responsible for providing maternity services that are safe, of high quality, culturally capable and meet the needs of women, infants and their families," the leaked letter said.
"Hospital and Health Services have recently experienced unprecedented workforce vacancies that have created challenges in the delivery of maternity services."
The Australian Medical Association Queensland and the Rural Doctors Association of Queensland have been invited to attend along with other peak bodies, "leading clinicians, health care executives … and unions".
Dr Donald said he expected Together Queensland representatives to be involved, although he had not yet received an invitation.
National Association of Specialist Obstetricians and Gynaecologists' president Gino Pecoraro said he felt vindicated after last month demanding an emergency round table meeting to discuss the maternity crisis, particularly in central Queensland where the Gladstone and Biloela hospitals have been on a birthing bypass for months.
Dr Pecoraro late yesterday renewed calls for Premier Annastacia Palaszczuk to attend the March 2 forum to show she understands "the importance of the issue to the people of Queensland".
Ensuring services across Queensland 'always going to be difficult'
The Rural Doctors Association of Queensland (RDAQ) also recently called for the urgent re-establishment of a rural maternity implementation oversight committee.
RDAQ president Matt Masel, a GP obstetrician in Goondiwindi, about 350 kilometres south-west of Brisbane, said little progress had been achieved since the release of recommendations by a rural maternity task force in June 2019.
"The inequity confronting rural and remote women has only widened, now with some larger regional centres on bypass or at risk of closure," Dr Masel said.
"I haven't seen the work that I was expecting to come out of the task force really roll on, and I'm loathe to say it's all just about COVID.
"It's staffing. It's workforce. That comes down to recognising the need to put significant resources into training and retaining and providing leave for that workforce."
Dr Masel said the RDAQ had received a "brief overview" from Health Minister Yvette D'Ath about the proposed new "workplace rotational model".
"It represents a state-wide lever that Queensland Health, as the system manager, can utilise to support birthing in any hospital and health service across Queensland," he said.
"RDAQ believes this type of model would need oversight by a state-wide committee.
"We've been calling for something along these lines … recognising this will require more recruiting, more incentives, and more resources. Birthing services are too important to do anything otherwise."
Queensland Nurses and Midwives' Union secretary Beth Mohle welcomed the forum, describing workforce issues as the health system's biggest challenge "in terms of delivery of safe services".
"Workforce is what keeps me awake at night — how we actually sustain our workforce," Ms Mohle said.
"Being able to deliver services safely across such a decentralised and diverse state as Queensland is always going to be difficult.
"We need to design services that meet the needs of those diverse communities. They need to be designed with them, not for them. That's the key."
News of the forum comes as Gladstone Hospital reintroduced 24/7 cover for obstetric emergencies this week.
But resumption of full maternity services is unlikely until at least mid-year, with Gladstone women in labour still being transported to Rockhampton to give birth.
