The Queensland Audit Office’s (QAO) Health 2023 Report has revealed the COVID-19 pandemic’s ongoing impact on healthcare delivery across the state’s health system.
Minister for Health, Mental Health and Ambulance Services, Shannon Fentiman said the Report identifies major challenges facing the public health system, including budgetary pressures, surging demand for services, workforce shortages and rising employee expenses.
“I welcome the Queensland Auditor-General’s report. It helps us identify areas where we can improve and ensure we’re delivering the best possible health care to Queenslanders,” she said.
“The report also speaks to the challenges the system is under, and working to overcome – including demand, supply chain pressures in the infrastructure space, and workforce availability.
“Despite emerging from a global pandemic that heavily impacted our system, Queensland Health has performed exceptionally well.
“We’ve witnessed an 11% increase in services this year compared to an 8 per cent budget increase, demonstrating improved efficiency.
“I acknowledge the ongoing challenges, but I’m confident we’re headed in the right direction.”
The report outlined a record number of elective surgeries had been performed in the audit period, with shorter surgery wait times, increased outpatient appointments and reduced lost ambulance time recorded.
It also found that Queensland Health’s internal controls were effective but identified opportunities for improvement, particularly in rostering and overtime management.
“Queensland Health has already begun addressing some of the issues raised and is committed to making continuous progress,” said Minister Fentiman.
“The Queensland Government’s top priority remains ensuring accessible, high-quality healthcare for all Queenslanders.
“This requires strong infrastructure, accurately and timely staff payments and financial sustainability,” she said.
The audit report acknowledged the complexity of managing the department’s massive workforce of over 125,000 employees across more than 893,000 shifts every fortnight.
In response, Minister Fentiman said Queensland Health has begun reviewing its payroll policies and processes in partnership with Hospital and Health Services (HHS) and relevant unions.
To further enhance its rostering and overtime management, Queensland Health is rolling out an electronic rostering system for its nursing and midwifery workforce by late 2024. This system will be progressively expanded to other occupational groups within the department, the Minister confirmed.
The report also recommended that Queensland Health address inconsistencies in how it calculates its anticipated asset maintenance needs.
The anticipated maintenance required for HHS buildings and equipment has risen by $351 million to $1.448 billion.
A key initiative already addressing this is the Sustaining Capital Program, which will invest $346 million in 2023-24 to improve, renew or replace aging assets.
Enhancing its commitment to efficient asset management, Queensland Health will initiate the Asset Management Uplift project in 2024. This project seeks to centralise governance for all assets across their lifecycles and standardise processes for assessing and predicting maintenance needs, said Ms Fentiman.
The QAO report highlighted that the combined operating deficit of the 16 HHSs in 2022-23 was $68.9 million, representing only 0.34% of their $20 billion budget. Importantly, eight HHSs achieved surplus, the Health Minister said.
Queensland Health’s overall spending exceeded its 2022-23 budget by $1.8 billion (9.9%). This was primarily due to two factors: the need to expand services by 11% due to COVID-19, resulting in additional funding, and construction cost pressures, leading to project overruns.
Health workforce shortages resulted in a $47 million (16%) increase in the cost of frontline contractors to meet service demands.
Staff overtime and sick leave also increased, with a 20% rise in overtime and a 10% increase in sick leave compared to 2021.
While public hospitals saw a 9% increase in specialist outpatient appointments, fewer are being seen within the clinically recommended timeframe.
The report also highlighted that Queensland’s public health system is facing a growing demand for services that significantly outstrips population growth.
This imbalance is evident in the dramatic 12.7% increase in emergency department (ED) presentations since 2018-19, compared to the state’s 6.5% population growth during the same period.
Despite this surge, Queensland boasts the third-best performance in Australia for ED wait times, with 62% of patients admitted or discharged from ED within four hours.
The Queensland Ambulance Service (QAS) has also experienced a significant surge in demand over the past five years. Code 1 (emergency) incidents have increased by 33%.
Despite having the highest demand for ambulance services in Australia, QAS maintains faster code 1 response times than most other jurisdictions, Minister Fentiman said.
