Comments from Queensland Health’s new director-general have sparked fresh concerns that the state will bring in unregulated healthcare workers.
Queensland Health is in hot water over the potential role of physician assistants once again, after new director-general Dr David Rosengren expressed a willingness to consider a place for the role to help alleviate workforce shortages.
This is just the latest flare in the Queensland physician assistant saga, which kicked off in July 2024 when a leaked business case surfaced online proposing that the Sunshine Coast Hospital and Health Service increase its current PA workforce from three full-time equivalent roles to 16.
That proposal does not appear to have been progressed, although the state does currently employ six PAs across three health districts.
In an interview with the ABC, Dr Rosengren said his new workforce strategy would include examining how other healthcare providers may work within the system and confirmed that this including considering a bigger role for PAs.
“To ensure our clinical workforce operates at maximum scope of practice, we are exploring opportunities to grow our traditional workforce while also innovating and adapting alternative models of service delivery,” he told TMR.
“This approach reflects a global trend, as health systems worldwide evolve to meet increasing demands, and we cannot afford to be left behind.”
While the PA role has existed for decades in various forms and locations, it has become headline news in the United Kingdom over the last few years.
The debate over whether PAs – who generally do a two-year degree – have a place in the National Health Service has threatened to split one of the world’s oldest medical colleges, spurred legal challenges and seen the British Medical Association GP committee vote in favour of phasing out the role.
Although it is unclear yet how committed Queensland Health is to finding a place for PAs, Dr Rosengren’s comments were enough for the Royal Australasian College of Physicians to publicly call for a thorough consultation process.
“Everybody’s a bit taken by surprise,” RACP president Professor Jennifer Martin told TMR.
“We know that when we introduce a new group into the workforce, it does actually have quite a number of effects on patient flow, patient referrals and on clinical governance.”
Whether Queensland introduces a bigger role for PAs or not, one of Professor Martin’s chief concerns is the message that floating the idea sends to younger doctors and medical students.
“We’re worried that all the other solutions haven’t been considered,” she said.
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“We do know there’s quite a bit of loss from the medical workforce at the moment – even young doctors, which never used to be the case, are leaving and not going back to medicine.
“We’re just wondering why we would invest all that training into young doctors and then not support them.”
It’s not just doctors who are set against the idea, either; the Queensland Nurses and Midwives Union has also joined the opposing chorus.
“Broadly speaking it is a highly unnecessary and risky move that would cost Queenslanders dearly, with evidence out of the United Kingdom highlighting patient safety risks associated with the physician assistant role” QNMU secretary Sarah Beaman said.
Australian Salaried Medical Officers’ Federation Queensland president Dr Hau Tan also questioned how the workforce situation could be so dire that a solution like bringing in physician assistants is on the table when at least one hospital in the state has cut four anaesthetic registrar positions in the last year.
“These were college accredited anaesthetic training positions … it just doesn’t make sense,” Dr Tan told TMR.
“And I guess it shows the dyssynchrony not just within Commonwealth and the state, but within Queensland Health.”
GP Dr Nick Yim, AMA Queensland president, told TMR that its biggest concern was that there is no training pathway for PAs in Australia – nor has there been one for several years.
“At the same time [physician assistants] are not registered under AHPRA, such as with other healthcare professionals,” he said.
While a future plan for the workforce is needed, the AMAQ president said, it should not come at the cost of patient safety or junior doctor training opportunities.
