And the State’s ambulance service recorded 112,000 hours of  “lost time” – when a patient spends more than 30 minutes on an ambulance stretcher waiting for a bed. This is up 76 per cent from the previous year.

The Auditor-General’s report into the Health Department and its 16 hospital and health services, tabled on Thursday, says that whilst the short-term financial position of the sector improved in 2021-21, other problems in relation to ambulance ramping, leave balances and hotel quarantine debts need to be fixed.

And it notes that whilst the combined operating result of $33 million compared to an $82 million loss in 2019-20, this was partly due to the Federal Government guarantee of funding due to the Covid-19 pandemic.

In November 2020, all health staff were given two days of pandemic leave, aside from their normal leave.

The auditor’s report says that at June 30, 2021, 49 per cent of staff had not taken any of their pandemic leave.

“This indicates the health workforce is under significant stress and the extra leave provided has not been used due to the increasing demands on it. Failure to take leave during the pandemic will lead to a fatigued workforce and the increasing demands will become unsustainable,” the audit report says.

And the number of unused recreation leave hours has increased 7.8 per cent compared to the previous year, something which the auditor also warns will impact the wellbeing of staff.

“The wellbeing of the workforce is a significant issue that could impact on the sustainability of the health sector. This will be a major challenge for the Department of Health when Queensland’s borders open in December 2021.

“It is important to have enough hospital beds to manage the demand. It is even more important that we have a highly energised health workforce to cope with the risk of a Covid-19 outbreak. High leave balances indicate the workload of our health workers may be unsustainably high.”

The audit report also contains details of the $179.4 million of hotel quarantine fees. In 2020-21, $82.5 million of this was not yet invoiced, due to a lack of staff resources.

And the department recognised $54.5 million in doubtful debts, including $21.4 million which the department estimated may not be recoverable and may have to be written off from the $82.5 million not yet invoiced.

The audit report says that the Department of Health should arrange another entity to manage hotel quarantine debts, allowing it to focus on provision of health care instead of debt recovery.

In relation to the Ambulance Service, the audit report says there is increasing demand for services and the time taken to transfer patients into the care of emergency departments has increased significantly in the past five years.

In 2020-21, the QAS lost about 112,000 hours, waiting longer than 30 minutes for patients to be taken into hospital beds.

“Overcrowded emergency departments affect ambulance services. If an overcrowded emergency department is unable to receive more patients, ambulance services are not able to transfer them.” the report says.