Together condemns government’s attack on the health system

Posted February 11, 2014 by Together Queensland

Together is condemning the government’s attack on the health system, Secretary Alex Scott said today.

“This government is trying to misrepresent a very significant report into terms of the problems within the health system to introduce a radical attack on the ability of Queensland doctors to stand up for the Queensland community and Queensland patients.

“There are clearly deep problems in relation to rights of private practice arrangements that existed for a number of years within Queensland Health,” Mr Scott said.

“Our union and other unions have argued strenuously for 8 years to improve the system to ensure appropriate accountability and ensure that there is transparency about the pay and conditions of doctors in our system.”

Mr Scott said it is unfortunate a tiny minority of less than 10 doctors facing investigation over a government report about health are now being used as an excuse for radical health system changes that will generate a hospitals crisis.

“Queensland well knows the importance of well trained doctors. We need to have the best doctors possible in Queensland,” Mr Scott said.

“Ask anybody in Bundaberg about what happens if you don’t have our best doctors.

“Over the last 10 years we have been able to recruit some of the best doctors in the health system and Queensland now has possibly the best medical workforce in the world.”

Mr Scott said because of the rorts claims suggested regarding a handful of doctors the government is seeking to introduce radical contracts to silence the ability of doctors to stand up for patients and stand up for the community.

“This government doesn’t want to listen to doctors, doesn’t want to listen to health professionals, and doesn’t want to listen to patients,” Mr Scott said.

“Unfortunately the attack that this will generate on doctors will result in a mass exodus of doctors from the health system and we will go back to the bad old days where we don’t attract the best doctors in the world and we struggle to fill doctors’ vacancies in regional Queensland.

“There needs to be change but the government needs to be honest about the system, it needs to listen to its workforce rather than sack its work force, it needs to abandon its attempt to introduce one sided contracts to silence doctors.

“The Queensland community trusts their hospitals, they trust their doctors, they trust their nurses they trust their health practitioners.

“The government needs to understand what the reality is. They need to listen to the health practitioners and the doctors rather than trying to silence them.

“This government is trying to manipulate the budgets and the waiting lists rather than listening to the most important people in the system, who are the patients.

“And the patients need to have doctors standing up and fighting for their rights.

“The contracts being contemplated by this government will drive out our best doctors overseas and interstate which will see a crisis in coming months in our health system.

“There is a problem with rights of private practice, we have seen that for the last 10 years.

“The government can’t misrepresent the current problems. The problems that exist of $800 million are not about rorting the system, they are about the system itself.”

Mr Scott said the amount of rorting as has been suggested by individual doctors is less than 10 in the current report.

“But that is being misrepresented by the minister, by the government, to hand more power to bureaucrats to take power away from doctors, to take power away from patients,” Mr Scott said.

“And in coming weeks and months if this government doesn’t reverse its current course we will see a crisis of mass resignations from the health system as our best doctors start working for hospitals that listen to them, where they can put patients ahead of budgets and that will be somewhere other than Queensland.”

Mr Scott said the rorting as has been suggested in the government report is a tiny minority.

“We know that from the capacity of most doctors, who don’t have access to private practice, who work in accident and emergency, if you work as an anaesthetist you don’t have the ability to do private practice,” Mr Scott said.

“So there’s two questions about the rorting system. One is a fundamental problem with the system which we have argued against for 8 years and that’s the $800 figure. This shouldn’t be called an allowance, it should be called salary.

“There is only a tiny minority of people who are double dipping by working in the private sector and the public sector and not appropriately charging back to the government the cost of private practice.

“The Audit only identified less than 10 of those.

“And we know from the amount of money being paid to doctors that the amount, the total income, is only a tiny minority of the possible cases available.

“The government is trying to use the problems within the system to introduce radical changes to silence doctors.

“The silencing of those doctors will mean patients lose and the community lose and we will also see a mass exit of doctors.

“So this government is trying to use a smoke screen of its auditor general’s report to completely misrepresent the true state of affairs in relation to the hours of work for doctors, the private practice arrangements for doctors.

“At the end of the day this government is also saying that the health pay roll system should be more trusted than the doctors in terms of what is going on.

“We know health is broken. We know the health payroll system is broken. We know the HR practices are broken.

“We also know the more we listen to doctors the more we listen to nurses the more we listen to health practitioners the better off the community will be.

“This government is trying to do the exact reverse. They want to give more power to health bureaucrats, more power to Charlotte Street and less power to the people who really care about the hospitals, and really care about the patients.

“That is our doctors and our health practitioners.

“If they introduce these one sided contracts that they can change at any time in the future we are going to see a mass exodus of our best doctors to overseas and interstate and we will go back to the bad old days where Queensland can’t attract the best and can’t attract enough doctors particularly in regional Queensland. And we would strongly encourage the minister and every regional MP to go back and read the last royal commission, read the inquiry into Bundaberg and find out what they are about to reintroduce.

“If there aren’t enough doctors, if you can’t attract the best doctors the people who are going to suffer is the Queensland community.

“Our hospitals will be cheaper but they will be worse.

“One major problem with the contract, it’s a contract like nowhere else in Australia, it’s a contract that the doctor has to sign with the government and the government can change any part of that contract at any time they like in the future.

“It provides no certainty. Secondly the contract is designed to allow for doctors to be dismissed by bureaucrats whenever they like if they make decisions which are bad for budgets.

“Every time a doctor makes a decision which is good for a patient it’s bad for a budget.

“The contracts are designed to reduce the power of doctors in the hospital system and maximise the power of the bureaucrats.

“And thirdly, the contracts are designed to remove fatigue leave and annualise the salaries to try and make sure that the government and hospitals can work doctors for as long as they like without a financial penalty which means doctors will work longer and longer shifts.

“We know that that will mean that doctors will be working tired which will mean that their judgement is impaired.

“Fatigue leave is vitally important for doctors to make sure that the health bureaucrats don’t run shift on shift which is what they used to do in the old days which means that doctors are overtired and aren’t providing the best possible care.

It’s about stripping away the power of doctors, it’s about silencing them on budgetary and patient care decisions, and that’s why doctors who have the opportunity of working interstate or overseas will go somewhere where they have the basic rights of any other worker.

“You sign up to a contract, you have a guarantee that contract won’t change unilaterally at the whim of the employer.”

Mr Scott says there are approximately 5000 doctors in the public health system including 3500 permanent.

There’s absolutely no evidence of wide scale rorting as has been implied in the smokescreen of what the minister said today and said last year as he tries to demonise doctors.

“The report is accurate but it’s being misrepresented, to say that there is wide scale problems, yes there are problems with health payroll, yes there are problems with pay slips in hospitals and hours of work and such.

“That’s true of doctors, nurses, everybody, that’s not rorting the system that’s health is just bereft of process.

“In terms of people actively going out and lining their own pockets at the expense of Queensland taxpayers and the Commonwealth tax payers, there is only a very small minority of cases that have been identified after 3 different reports.

“Those people identified should be sent to jail and should have the full face of the law in relation to them but that’s only am absolute tiny minority.

“The $800 million, is those people who are talking about being offered an allowance as part of their salary, that was never a rort, that was the system.

“There was only a handful, literally a handful (at the centre of claims they) rorted the system.

“The government is now trying to penalise all doctors and silence all doctors based on an absolute handful of cases.

“The actual majority are now being punished and by punishing those people they are going to force doctors out of Queensland and it’s the Queensland community that’s going to suffer because the health bureaucracy is trying to use this process as a way of silencing internal criticism from doctors about the problems in the health system.

“The problem goes back to when it was first introduced following the Caboolture problems at accident and emergency over 10 years ago. Peter Beattie tried to give doctors a large pay rise and hide it from the rest of the health workforce. So they called it an allowance. That allowance was never going to be possible. It was introduced for accident and emergency doctors initially and expanded. Accident and emergency doctors don’t have ability to have private practice.

“So the fundamental problem has always been there. We have been arguing for 8 years to have a change and brought back into salary with this government and under the previous government.

“Both governments refused because they didn’t want to see salaries going up.

“So that is a fundamental problem at one level, but then there’s (suggestions of) a rort by individuals at another level.

“Individual rorts should be stopped and people should be prosecuted, health should get its act together so it can catch these people.

“The problem is they don’t have accurate payroll systems, they don’t have accurate time sheets.

“Some of the problems also identified in the report include the districts ripping off the head office.

“So health is a basket case but the absolute minority of rorters should go to jail, should be forced to pay back the money but they shouldn’t be used as an excuse to try and silence doctors from having clinical conversations in the hospitals standing up for patients because that will result in a mass exodus.

“The minister will give you one figure, $800 million and he will not be able to confirm how much of that is actual individual rorting versus how much is a problem with the system.

“The $800 million figure is the amount of allowance, what’s called Option A allowance, paid to all doctors.

“And the problem was that the government of the day said if you go and get private practice rather than take that income yourself we will give you an allowance.

“The vast majority of doctors couldn’t do private practice but they were still getting the allowance.

“That was the false statement put forward to have the excuse for the pay rise.

“Accident and emergency and all those groups are never going to be able to earn income.

“That’s what the auditor general KPMG said with $800 million that’s supposed to be cost neutral, it wasn’t cost neutral, it was a pay rise.

"It was a tiny minority of those specialists who can work in the public sector and private sector seeing private patients and not giving the money back that there should be.

“The government can’t tell you a figure on that, they have identified less than 10 in their report.

“But you would also be able to follow through the tax system who those people are because they were making millions of dollars, those people should have the full face of the law against them.

“But that is not to say that the $800 million has anything to do with the suggested rort.

“We think some of them are over a million dollars from what the government has said.

“The government knows how many people they pay and how much they are making so they don’t want to give an accurate figure on how much of the $800 million is the standard structural problem…

“They can’t tell because health systems are so corrupted and wrong in terms of the health payroll and time sheets and everything else.

“The government has absolutely no idea what the size of the problem is.

“We know from talking to doctors that it’s an absolutely tiny minority.

“But they are trying to confuse and misrepresent this report.

“They would be able to make significant amounts of money more than they should be.

“Some of them legitimately were making large amounts of money.

“A handful of doctors were making a huge amount of money out of it, an obscene amount of money out of it. But the vast majority, the $800 million, the 3500 doctors in the system were getting paid what they were promised as a pay rise to make sure we could attract the best doctors. When Peter Beattie introduced this after Caboolture, after Bundaberg, we started attracting more doctors, increasing the numbers and getting the best In the world. That’s because they increased their salaries significantly to do that but they called it an allowance. By calling it an allowance they have then gone to the attorney general and said ‘You work in accident and emergency why haven’t you generated a hundred thousand dollar allowance.' That person can’t because they have no right of private practice.

“That’s the structural problem, that’s not a rort. That’s a problem we have been arguing for 8 years should be changed, it should become part of salary. The government wants to say here’s $800 million, here’s this problem over here, but we also have a handful of people over here and don’t want to give out the figures but use the bargaining process to try to introduce contracts which are going to silence the ability of doctors to stand up for patients because they don’t want doctors spending the budget in the way that it should be spent.

“It’s all about shifting power back to Charlotte Street. It’s the pay system.

“And the Auditor General’s report is based on saying the pay system is right.

“We can’t find time sheets, we can’t find pay structures.

“Nobody can find the time sheets and pay structures in Queensland Health.

“We are told it’s a disaster one day and today we are told it’s the basis for saying there’s rorts.

“There is problems in reporting, the health system should be improved, we shouldn’t have districts ripping off head office but head office is also ripping off Canberra.

“The whole thing about private practice is completely inappropriate to start with because the private practice is all about trying to get Canberra to pay for hospitals and not Brisbane.

“So there’s a fundamental problem about cost shifting from start to finish.

“At the end of the day we need to be paying our doctors appropriately, that’s why we had the allowance brought in in the first place.

“But trying to put them on individual contracts which are unlike any other in Australia and can be unilaterally changed by the employer at any point in time, that can result in a doctor being sacked for putting a patient ahead of the budget will mean that we will have a mass exodus of doctors in the coming months ahead and we will go back to the bad old days where Queensland can’t attract the best doctors in the world which we currently have.

“The money will be rolled over into contracts and there will be some improvements in relation to individual assessments in terms of the accident and emergency they are not supposed to be generating income. Some of that will be dealt with.

“The contracts don’t reduce people’s take home pay, what it’s about is silencing them and reducing their power.

“They are in contracts at the moment, they are trying to introduce contracts, and we are saying the contracts they are introducing are fundamentally flawed and we will see a mass exodus of doctors across the state.

“The government negotiated a collective agreement for doctors 2 years ago and they had all these things rolled into the agreement, now they are saying they have got to introduce these individual contracts where we can sack you without notice or without reason, we can change your contract without any negotiation afterwards and at the end of the day you will be required to put the budget ahead of patients.

And that’s what’s going to see all our doctors who have the option of going and working interstate or overseas having a mass exodus if this government goes down this path because Charlotte Street and the health bureaucrats want to silence our doctors and the minister is running their lines for them.


Authorised Alex Scott, Secretary, Together.
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