A leaked internal review has revealed regional Queensland's only public high-risk maternity service is understaffed and under-resourced, causing delays that could put mothers and babies at risk.
The independent review obtained by the ABC was commissioned by Townsville Hospital in 2021, in response to growing concerns its Maternal Fetal Medicine (MFM) unit could not meet surging demand.
Conducted by Brisbane-based specialist Glenn Gardener, the review was finalised in November 2022.
The unit, established in 2014, is the only clinic of its kind outside Queensland's south-east corner.
It manages the highest-risk and most complicated pregnancies and is under extra pressure amid the state's ongoing maternity crisis.
Dr Gardener's report found the unit's workforce — which was centred around just two certified MFM specialists — could not meet current or future maternity healthcare needs.
"This has led to documented delays in the care of high-risk pregnant women," Dr Gardener wrote in the review.
"Increased waiting times for women [have] attendant risks of adverse pregnancy outcomes and potential medico-legal consequences."
Townsville Hospital and Health Service said it was reviewing the report.
High-risk pregnant woman lodges complaint
The ABC has obtained a complaint to the Townsville MFM by a 27-year-old Central Queensland patient who had to wait weeks for a recommended scan due to a backlog of cases.
The mother, who was diagnosed with a fetal growth restriction, was referred to Townsville for growth scans.
"I am concerned that further delaying my treatment could be detrimental to the health of my child," she stated in her first complaint to the hospital earlier this month, seen by the ABC.
She attempted to contact the hospital again in the weeks that followed, after she received no response.
"The health system is failing me and my unborn child," her second email said.
"Am I just another woman in the healthcare system with an unborn child that will go unnoticed?"
The Townsville Hospital and Health Service said the complaint had been successfully resolved.
"Ensuring our patients are supported throughout their care with us is, and remains, our priority," chief executive Keiran Keyes said.
Ten years of warnings
The mother's concerns were referred to the MFM's director David Watson, whose response revealed the extent of the unit's backlog.
"We have 54 referrals to be triaged and seen in the next few weeks," Dr Watson's response to the complainant said.
"There were in excess of 15+ referrals needing more urgent assessment [than the complainant] ... this occurs multiple times every week in Townsville MFM.
"We have identified these issues multiple times over [the] past ten years.
"We don't have the capability to meet the MFM demand for north, western and central Queensland."
Regional Queensland maternity crisis
According to Dr Watson's response, the strain on the MFM has, in part, been caused by absorbing patients from other Queensland regional areas that no longer have easy access to obstetrics specialists.
Regional Queensland is grappling with a worsening maternity health crisis and gaps in vital obstetrics positions.
The Gladstone and Biloela hospitals have been on birthing bypass for months, while birthing services have not been provided at Weipa hospital since the 1990s and at the Cooktown facility since February last year.
"[We are] inadequately resourced to meet the current demand for our referral base, especially as some obstetrics and gynaecology units in north Queensland are in crisis and are asking for as much help as we are able to provide," Dr Watson's response to the complainant said.
The National Association of Specialist Obstetricians and Gynaecologists president Gino Pecoraro is calling for federal intervention in Queensland's maternity health system.
"We've seen that the state government's response in Gladstone was to simply tell women to drive down to Rockhampton," Dr Pecoraro said.
"What that resulted in was increasing pressure on the doctors working in Rockhampton, and I was told that a number of doctors there then simply had enough and left that service."
Maternity domino effect arrives Townsville
In 2021, 451 pregnant women were transferred to the specialist unit from health services from Mackay to Mt Isa, and from the Townsville catchment.
Dr Gardener's review found the two MFM specialists in Townsville serviced more births than any other unit in Australia or New Zealand, "with some of the highest rates of perinatal morbidity and mortality in the country."
"The number of pregnancies serviced per MFM specialist … is almost double that of their south-east Queensland counterparts," it said.
Despite the overload, Townsville's MFM unit only operates two and a half days a week, due to "an acute shortfall" in staff, the review found.
Dr Pecoraro said the burden on public hospitals like Townsville was also due to the increasing unaffordability of private obstetric care.
"Almost certainly there will be women who need this highly expert service that aren't getting access to it in a timely manner, and that can have very real negative impacts on their health and the health of their pregnancies," he said.
Townsville Hospital reviewing MFM unit
Dr Gardener made eleven recommendations, including investing in more staff to allow the MFM to operate five days a week and a purpose-designed clinic.
The Townsville Hospital and Health Service chief executive Keiran Keyes said no specific incident triggered the review.
"Based on feedback from our staff and the community, there are increased workforce pressures being felt across northern Queensland due to the increasing demand for specialist MFM care, which is why it's essential we plan for the future now," he said.
"This [review] was a proactive step by health service management as part of best practice planning to cater for the future growing demands of our region."
A Queensland Health spokesperson said the department was holding a forum next Thursday to explore maternity workforce solutions.
