Doctors are demanding an emergency roundtable meeting to discuss Queensland's maternity crisis amid fears mothers' and babies' lives will be at risk in the Gladstone region until the city's birthing bypass is lifted.
Gladstone Hospital in Central Queensland has been on maternity bypass for more than six months and Biloela Hospital, 120 kilometres inland from Gladstone, is also on a birthing bypass because of a shortage of specialist doctors.
It means women in the region cannot give birth locally, unless by elective caesarean in Gladstone, and they must drive, or be transported, to another hospital, usually Rockhampton, before or when they are in labour to deliver their babies.
Gladstone and Biloela have no private maternity services.
Beaudesert Hospital, 70 kilometres south-west of Brisbane, has also been on obstetric bypass four times in the past month.
Together Union senior vice-president and recently retired anaesthetist Sandy Donald described maternity services in central Queensland as particularly "outrageous and dangerous".
"Someone should be hanging their head in shame about what's happening in Gladstone," Dr Donald said.
"It should have an obstetric service."
Gladstone is a city of about 60,000 people. Before the bypass, about 600 babies were born there every year.
Dr Donald said three obstetricians recently left Rockhampton Hospital, placing extra pressure on birthing services in central Queensland.
He said two of the obstetricians left because of excessive workloads, burnout and "getting really dangerous transfers from Gladstone" more than 100km away — about an hour and 20 minutes by road.
"They didn't feel safe and they didn't think the patients were safe," Dr Donald said.
"There have definitely been transfers with high risk to the mother and/or baby. I have spoken to a specialist who believes that avoidable deaths are absolutely guaranteed if the current system continues."
'This is a medical emergency'
National Association of Specialist Obstetricians and Gynaecologists president Gino Pecoraro said the situation had become so dire an emergency roundtable was needed, with input from Premier Annastacia Palaszczuk and Queensland Health Minister Yvette D'Ath, to formulate long-term solutions.
He called for representatives of Queensland Health, the Australian Medical Association, the federal government, Medicare, the private hospital sector, business, the medical insurance industry and unions to be involved.
"This is a medical emergency," Dr Pecoraro said. "This is more than just an embarrassment for the Palaszczuk government.
"If we don't do something about this now … more maternity units will close — and once they close, they won't reopen.
"The opportunity exists for Queensland, with the help of the federal health department and the private hospital sector, to hone a model that can be used to solve an issue which is happening all around Australia.
"The public sector alone simply cannot handle all the demands."
Dr Pecoraro said that without adequate plans to maintain good maternity services into the future, it would become harder to attract doctors to obstetrics.
"If, all of a sudden, young doctors just keep hearing about obstetric disasters … they will stop applying to train in this area, because there's plenty of other areas where they can go," he said.
Expectant women nervous about situation
The Gladstone maternity bypass has left expectant women living in the region feeling stressed.
Gladstone disability support worker Michelle Williams, 39, who is due to give birth in the next fortnight, said the prospect of something going wrong was terrifying.
"That's my worst fear. It's devastating," she said.
The mother-of-two said if she had known about the Gladstone Hospital bypass before deciding to expand her family, she might have waited.
"This pregnancy was planned … I didn't even factor [the chance of a bypass] in," Ms Williams said.
"It's supposed to be the most rewarding time of your life but the extra stress it's causing drives you crazy basically."
She is due to travel to Rockhampton this weekend to see if specialists there can turn her baby, who is currently in a breech position.
Calls for an emergency roundtable come less than four years after a task force handed down a report into rural maternity services in Queensland, with then-state health minister Steven Miles pledging to concentrate on mothers' preferences to deliver their babies closer to home.
At the time, Mr Miles said he would require hospital and health services to obtain ministerial approval for changes to regional birthing services to ensure everything possible was done to keep maternity units open.
Recruitment proving particularly difficult
The Queensland Rural Maternity Task Force, chaired by patient safety specialist John Wakefield, found the rate of babies born before arriving at hospital had more than doubled since 2000, with the highest rates for women who lived between one and two hours from maternity services.
Dr Wakefield became Queensland Health director-general within months of the report being handed down in 2019, pledging to prioritise regional and remote maternity services in his time in the role.
But the COVID-19 pandemic hit in January 2020 and Dr Wakefield's reign as director-general ended in mid-last year – about the same time the Gladstone Hospital went on maternity bypass.
In a recent letter to doctors' groups, obtained by the ABC, Queensland Health's new director-general, Shaun Drummond, said the health sector was experiencing workforce challenges nationally, including a significant shortage of obstetricians.
"The recruitment and retention of obstetricians into regional Queensland is proving particularly difficult," Mr Drummond said.
"Queensland Health is working with clinician leaders and other stakeholders to implement a range of immediate and short-term initiatives to stabilise our workforce.
"Included in these strategies is the ability to support locum-equivalent rates for Queensland Health-employed specialist obstetricians able to support short-term rotational deployments."
But Dr Pecoraro said Queensland Health was offering $2,000 a day for obstetric locums to work at Gladstone Hospital, whereas NSW regional maternity units such as at Orange Base Hospital and Goulburn Base Hospital had been offering locums $3,000 and $3,500 a day respectively.
Central Queensland Hospital and Health Service (CQHHS) chief executive Emma McCahon said Gladstone Hospital had been unable to secure the services of the specialist doctors needed to provide safe and sustainable birthing services "like many jurisdictions around Australia".
"The safety of mothers and babies is the reason we have made the tough decision to put Gladstone Hospital on bypass for birthing services," she said in a statement.
"We are committed to reintroducing normal birth services at the hospital as soon as we have a safe and sustainable roster of suitably qualified doctors, including obstetric specialists.
"This also includes using general practitioner obstetricians who are appropriately trained, qualified and credentialed."
'The time for talk is over'
Dr McCahon said CQ Health had recruited four more obstetricians who were expected to start work this year, but she gave no time frame on when, or if, the Gladstone Hospital maternity bypass would be lifted.
"In the meantime, we are continually engaging with locum agencies to try to source suitably qualified staff to fill vacancies," she said.
While doctors are calling for an emergency round-table to develop a blueprint for better birthing services across the state, Queensland Nurses and Midwives' Union secretary Beth Mohle said: "The time for talk is well and truly over."
"Why don't we just concentrate on working together to solve the problems rather than just talking about it," she said.
"We all know what the issues are. We just need to get on and act.
"We're going to have to look at different things in terms of supporting specialists to undertake their training and bonding them to different areas."
Ms Mohle described the issue as a "distribution" problem.
"It's not that we haven't got enough obstetricians. They just don't want to go to Gladstone or other rural locations outside of metropolitan areas," she said.
"We've got to change their mindset."
In a statement late yesterday, Ms D'Ath said the state government had engaged with stakeholders, including the AMA's Queensland branch and the federal government, to investigate potential solutions which could include extra training places and fast-tracking accreditation of international specialists.
She did not answer a question relating to whether the Queensland government would call a roundtable meeting on the state's maternity services.
