The Queensland Government is forcing the state’s most senior doctors to leave the public health system.
The Queensland Government is attempting to push doctors onto individual contracts that would force our most senior specialists out of the public health system. The contracts would strip away vital working conditions like fatigue management and attack job security – putting the needs of health bureaucrats ahead of those of the Queensland public and our doctors. Queensland can’t afford to lose its top doctors.
Local doctors speak about the devastating impact the State Government's proposed individual contracts would
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There are two different types of diabetes mellitus, type 1 (insulin dependent) and type 2. Around 10-15% of the population who suffer with diabetes are type 1, with around 85-90% suffering with type 2. Diabetes is a condition where an individual has too much glucose in their bloodstream.
Type 1 diabetes occurs when the beta cells within the pancreas are destroyed by the body’s own immune system and cannot produce insulin, a hormone responsible for promoting the absorption of glucose and regulating the blood glucose levels.
Type 2 diabetes occurs when the beta cells become damaged by various lifestyle factors and cannot produce enough insulin, resulting in failure of the body cells to respond adequately to the hormone.
Livewell Rehab in Brisbane is an organisation which provides on-going support, information, factsheets, education workshops, tests and medical treatment which can be accessed in different locations throughout South-East Queensland. The healthcare team is made up of Exercise Physiologists, General Practitioners, Endocrinologists, Diabetes Educators, Ophthalmologists, Podiatrists, Dieticians, Counsellors, Dentists, Exercise Professionals and Aboriginal Health Workers to assist with all aspects of living with diabetes.
Type 1 diabetes management involves replacing the insulin that your body is unable to produce, by having regular injections or by using an insulin pump. The amount and type of insulin needed will vary between individuals, depending on factors such as lifestyle and individual requirements. Your doctor will work with you to make decisions about your care and appropriate management.
Checking of blood glucose levels regularly is an integral part of successful diabetes management, which you can do very simply at home.This enables you to see the effects that food, exercise, medication and illness have on your blood glucose levels and identify any patterns or changes that should be discussed with your doctor. Your doctor will advise you on the correct technique and frequency for self-monitoring.
Following a healthy eating plan is also a key factor in the successful day to day management of type 1 diabetes. It is important to liaise with your dietician or diabetes educator to understand what is the right eating plan for you, to help manage your diabetes and fit with your lifestyle.
There are five food groups which are important to incorporate into your diet. These are:
There are other important factors to consider which help with successful management of the condition, such as portion control, eating at regular intervals, matching insulin to the amount of carbohydrates consumed and eating enough fibre.
Physical activity also plays a vital role in the management of Type 1 diabetes. Before embarking on a high impact fitness regime, discuss what the appropriate type and amount of exercise is for you with your healthcare team. This will depend on your level of fitness and any other existing medical conditions.
The benefits of regular exercise are not only to help your mind and body feel good by maintaining a healthy weight, lowering your blood pressure, reducing your risk of heart disease and reducing stress but it also increases the effectiveness of insulin on your body. Your diabetes healthcare team will advise you about any alterations that may be required to your normal eating and insulin regime, once you begin regular physical activity.
On diagnosis of type 2 diabetes, it is vitally important that good management habits of the condition are established as soon as possible. Although there is no cure for type 2 diabetes, with the right management, it is possible to continue to live a healthy life and in some cases achieve remission. Livewell rehab’s healthcare team are there to support you from the time of diagnosis and throughout your life, providing information, guidance, education workshops, tests and medical treatment, essential to living a full and healthy life with the condition.
Successful management of type 2 diabetes can be achieved largely through leading a healthy lifestyle, with regular physical activity, a nutritious diet and maintaining a healthy weight. Alongside this, it is likely that you will be given tablets by your doctor to help manage your blood glucose levels and some people may also go on to need insulin injections. As with type 1 diabetes, It is also vitally important to regularly check your blood glucose levels at home. Your doctor will advise you on the correct technique and frequency for this and there is also a two hour practical skills workshop, which will show you the best techniques for self-monitoring.
Your dietician or diabetes educator will work with you to establish a nutritious eating plan, including the five important food groups, to help achieve optimal health and maintain blood glucose levels within the target range. There is also a three hour education workshop to help you understand the facts about carbohydrates, how they have an impact on your blood glucose levels and what amount and types of carbohydrates are best for you.
Keeping active on a daily basis is an important factor in staying healthy for anyone, especially for those with type 2 diabetes and it is also an integral part of preventing the condition occurring. It helps to maintain a healthy weight, keep blood glucose levels within the target range, relieve stress, sleep better and also meet new people for friendship and support. Remember to always discuss your exercise plans with your doctor or exercise physiologist to ensure that you are embarking on an appropriate level and type of exercise for your fitness level, which aligns with your lifestyle and other management aspects of your diabetes.
Diabetes Queensland offers a self-management education course, called DESMOND which covers all aspects of living with type 2 diabetes and will help you to understand and manage your condition, while gaining a support network through meeting others with similar experiences.
Every day there is something new that life brings your way that needs to be added to the order of life. Sometimes this is chosen, and other times it seems to be thrust upon you. It’s always a relief when the most important aspects of your life are in order. Having a My Health Record in place is a sure way of staying clear of the chaos and stress caused by the disorder of such vital and personal information but at what cost? The Health Minister, Mr. Greg Hunt, has prioritized this renovation in the healthcare system and calls it ‘My Health Record’.
The My Health Record system is an innovative way to securely store and file your personal medical records. This program will become like a GPS for the history of your health. A typical My Health Record includes the names of your healthcare providers such as specialists, pharmacists, and your general practitioner along with their contact information. As for your personal information, all reports of scans or tests, allergies, medications you have taken, medications you are currently taking, any previous, reoccurring, or current health conditions, hospital discharge summaries, as well as, referral letters from any of your doctors will be a part of a My Health Record file.
Some more delicate information to consider adding to your file from past Medicare date consists of Pharmaceutical Benefits Scheme (PBS) information which is found at the Department of Human Services, Repatriation Schedule of Pharmaceutical Benefits (RPBS) information through the Department of Veterans’ Affairs (DVA), immunisations (only including those listed in the Australian Immunisation Register), and finally, you may record your decisions specifically regarding organ donations. Be sure to include usual and emergency contact details, if you hold an Indigenous, Veterans, or Australian Defense Force status, and either the contact information of your custodian or your advance care plan.
Your doctors will have the capability of accessing your shared health summary for the purpose of better understanding how to continue treating you if, or when, it becomes necessary. This will also help each of your other specific or private practitioners to be on the same page as your regular doctor as they will be able to better understand your history and keep up to date with your current state of health.
A most awful predicament would be to receive a false diagnosis due to the missing puzzle pieces of your health’s tendencies. With this record, Physicians will be able to better track any patterns in your health which may reveal more clear answers on how to direct you down a healthier path. As you first apply for a My Health Record you can add up to two years of your medical history in the file system. The grander the scope of understanding is that you provide, the more precise your treatment will be in curing whatever it may be that ales you. Some healthcare practicioners are wary, we spoke to one sports physiotherapist in Brisbane who was worried not about the overall system’s security but the thousand of weakpoints created for hackers who simply need to get one password from someone with access to the portal.
A My Health Record can be viewed through any device that has the capability of connecting to the internet. There are multiple levels of security to these very personal records, so you can be reassured of your file’s safekeeping. The only people who will have access to your health record will be those to whom you give permission. You have the power to control your security and privacy settings for your records, as well as adjust the details, controls, and notes. It is important to add side notes on allergies, allergic reactions, maintain the access controls to your files, affix custodian details, and review your own information. This file system also has the capability of sending you personalized notifications via SMS or email. Caring for your medical files has never been so easy. All you need to do is notify your doctor during your next appointment saying that you wish to upload your medical information to My Health Record. You are free to withhold uploading any information that you would like to remain private.
This, so far, $2 billion project will be set up for every resident of Australia unless they decide to opt out by October 15, 2018. Currently, over 20,000 signatures have been collected to petition the change of the “opt-out” deadline to an “opt-in” deadline. There have already been millions who have opted out of having a My Health Record as many are concerned about the security level of the overall system. Even some doctors are petitioning for the privacy of their patients. It is not absolutely certain that the system is secure and if there comes a time that you are uncomfortable with the privacy settings you maintain control of those settings. If you care to cancel your My Health Record you may do so at any point in time. This pertains to those who already possess an existing medical file.
Currently, over 5.9 million Australians have taken the step towards the future of medical care organization at its finest and filed a personal My Health Record. When you are ready to apply, go to a myGov account, find for an application form at a Medicare service center, or call the Helpline via 1-800-723-471. For newborns, fill out a Medicare enrolment form. If you are a resident who participated in a trial area in 2016 a My Health Record file will automatically be set up for you. So, if you are ready to finally bring order to your personal medical files then you don’t have to do anything you’ll be moved across, if you value your privacy then it may be worth considering the opt-out option.
The new contracts for the state’s SMOs and VMOs took effect, for those who signed them, at the beginning of this month.
In the end, Queensland doctors won the battle for fairer contracts. The State Government attempted to force us onto contracts that would have completely stripped away our rights and the rights of our patients. But thanks to your commitment to the public health system, we’ve ended up with contracts considerably better than those originally put on the table.
But we know that the current contracts are not perfect and that there will be a continued push from the Government to claw back some of harmful elements we fought hard to have excluded.
We can’t let that happen, which is why the upcoming Contracts Advisory Committee, or ‘CAC’ elections are so crucial.
Elections for the new Contracts Advisory Committee are due to be held over the coming weeks, with ballot papers to be mailed to eligible voters from Monday 8 September. Doctors voted onto this committee will play an important role in the implementation and ongoing review of the contracts
It’s critical that the doctors elected to this committee represent the best interests of the state’s doctors. Without a strong team willing to stand up for the rights of doctors and patients, we are at serious risk of ending up back where we started.
The CAC will be made up of one VMO representative, a metropolitan SMO representative, a regional SMO representative and a rural/remote SMO representative.
The Australian Salaried Medical Officers’ Federation and the Together Union are endorsing the following candidates who have nominated to represent you on the Contracts Advisory Committee.
Dr Suzanne Royle
Dr Suzanne Royle is currently employed half time at The Prince Charles Hospital as a Senior Staff Specialist Paediatrician. She is also a Senior Lecturer at the University of Queensland, mother to two young daughters and the Vice-President of ASMOFQ.
Dr Royle has previously worked as a VMO Paediatrician at the Gold Coast Hospital, and has held academic roles at Griffith University and Imperial College London. Her paediatric training was undertaken at the Mater Children’s Hospital, the Children’s Hospital at Westmead, and the Royal Children’s Hospital in Brisbane.
Dr Suzanne Royle was a key member of the Keep Our Doctors taskforce and was heavily involved in the contract negotiations with the Queensland Government from the outset.
Dr Sandy Donald
Dr Sandy Donald has worked as a specialist anaesthetist at Cairns Hospital since 1995. He is an Executive member of Together Queensland.
Sandy has been advocating for doctors for most of his time in Cairns, including a term as President of the Cairns Senior Medical Staff Association. He represented doctors during each of the three MOCA negotiations and was a key member of the Keep Our Doctors taskforce.
Dr Donald continues to publicly advocate for regional health services generally, with a particular focus on doctors’ rights.
Dr Derek Holroyd
Dr Derek Holroyd is a Rural Generalist based at Proserpine Hospital. He was a QH Rural Bonded Scholar who remained rural after his return of service, which has resulted in a role as Director of Rural Generalist Training with QRGP. Derek is also an examiner for the RANZCOG diploma for GP obstetricians.
Dr Holroyd has been a member of ASMOFQ and RDAQ since 2005, and previously advocated for salaried doctors during the MOCA1 as deputy chair for the Doctors In Training group. He was a RDAQ management committee member for 2006-7.
Associate Professor Mark Ross, MBBS FRACS, Orthopaedic Surgeon
Dr Mark Ross is an Associate Professor of Orthopaedic Surgery in the School of Medicine at The University of Queensland; Director of the Upper Limb Fellowship Programme at the Princess Alexandra Hospital; and a co-director of the Brisbane Hand and Upper Limb Research Institute. He is also the current President of the Queensland Shoulder Surgery Society.
Dr Ross was a key member of the Keep Our Doctors taskforce, representing VMOs in the recent contract negotiations with the QLD Government. He was instrumental in securing fair employment conditions for VMOs in the current contracts.
Please take these endorsements into account when voting for your CAC representative. Queensland doctors deserve to have the best possible team representing us in these important discussions.
Voting on the members of the Contract Advisory Committee or ‘CAC’ will begin on September 8, 2014.
The CAC is designed provide expert advice and recommendations to the Director-General with regard to matters relating to the implementation and strategic review of contracts for SMOs and VMOs.
For a complete overview of the CAC’s role and details of those eligible to sit on the committee click here.
The state’s doctors have very cautiously voted to accept the Government’s improved contracts and have vowed to continue fighting for the rights of Queensland patients.
Of the doctors who voted in the ballot from Together and ASMOF 53 per cent voted in favour of the contracts; 34 per cent voted against; and 13 per cent said they were unsure or abstained.
Australian Salaried Medical Officers’ Federation President Dr Tony Sara said that while doctors have voted to accept the contracts in their current form, there is a very strong desire to continue the fight to improve the conditions in the public health system.
“We’ve come a very long way from the original contracts which completely stripped away the rights of doctors and patients. The contracts are now acceptable to the state’s doctors, but only barely,” Dr Sara said.
“This can’t be considered an overwhelming vote in favour of the Government’s contracts. Doctors fought very hard to get these significant improvements to the contracts that protect the needs of patients. This is the best possible contract we could get from a Government which is seemingly determined to put the needs of bureaucrats ahead of the needs of Queenslanders.
“The state’s doctors are committed to providing the best possible care to the people of Queensland. We won’t let this Government continue to attack the right of patients to have access to the best possible public health care system.
“One thing is very clear in all this – that the State Government has completely lost the trust of the its top doctors and the state’s patients. The onus now is on the Government to rebuild the trust and to work with its Health and Hospital Services to ensure the contracts doctors are provided with live up to their promises.”
There was also overhwleming support from doctors to be part of a campaign to ensure that the next generation of Queensland’s senior doctors are also guaranteed fair and just working conditions.
“Queensland must continue to attract the best and brightest junior doctors if it is to sustain a first class public health care system.” Dr Sara said.
Dr Sara today also expressed his marked disappointment at the overnight sacking of Assistant Health Minister Dr Chris Davis.
“Dr Davis knew the contracts his Government were trying to force through would strip away the rights of patients and doctors, so he did what was right and spoke out against them,” Dr Sara said.
“It’s very disappointing that the Premier has dismissed Dr Davis for standing up for the needs of the Queenslanders.”
If you’re an ASMOFQ SMO or VMO member, make sure you vote in the ballot which was emailed t you at 12.01am on May 6th.