A new workforce scheme has drawn the ire of rural doctors in the sunshine state.
In an Australian-first, the Queensland government announced in February that will introduce new legislation to allow experienced paramedics to work in remote hospitals and health services.
Set to take effect from 1 April, the reform has been pitched as a key move to strengthen frontline care and address health workforce shortages in rural and remote regions.
This will allow remote hospital paramedics who are not actively responding to emergencies to work in collaboration with doctors, nurses and Aboriginal and Torres Strait Islander health workers.
Findings from the Crisafulli government’s Workforce Gap Analysis are what prompted the change, with the report highlighting the need for greater rural workforce support along with “no workforce gaps for Queensland Ambulance Service paramedics in South Queensland.”
This reform has drawn criticism from medical advocacy bodies over how it could fragment care in already vulnerable communities.
AMA vice president Associate Professor Julian Rait has claimed that the reform is a misinterpretation of the workforce data.
“This is just smoke and mirrors, really, trying to suggest that somehow that people with far less training can fulfil the same roles,” Professor Rait told The Medical Republic.
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“We’re going to see increasing shortages across all specialties, and you can’t replace everybody with paramedical people or pharmacists.
“You’re going to actually have to ensure that you actually train sufficient medical personnel to fulfil these roles.”
The initiative won some praise from the RACGP for its ability to activate inactive paramedics, but college rural chair Associate Professor Michael Clements said it was indicative of broader workforce planning issues.
“I think that when this kind of program is done for the most needful communities, that this collaborative effort will really work to better that community and increase patient access,” he told TMR.
“What we need to be careful of, though, that we don’t take some of the benefits of these rural and remote communities and then start to try and apply them in different settings where there might be segregation.
“This is a way of formalising and investing in the training for paramedics to understand some of the additional skills that are required in the chronic disease space.”
Both the RACGP and AMA agreed that the risk of this reform lies in the model of care that it will be implemented in.
“There’s no reason why rural communities should have to continue to put up with second best, with role substitution all over the place,” ACRRM president Dr Rod Martin told TMR.
“The problem with governments is they think that because someone’s got a good understanding of many aspects of health and physiology and aspects of pharmacology that they have the very intrinsic skills of integrating someone’s entire health picture.
“It would be the same as expecting to be able to put a doctor in the back of an ambulance and drive them to a crash scene and expect them to do the job as well as a paramedic would.”
