Queensland’s hospital system is buckling under the weight of a preventable crisis: over 1,100 acute beds are blocked by patients who no longer need hospital care, aged care, mental health, and NDIS patients with nowhere to go.

This is not a staffing issue.

This is not a resource allocation issue.

This is a catastrophic failure of policy and planning.

These blocked beds are costing taxpayers almost $1 billion a year and the equivalent of taking the entire Royal Brisbane and Women’s Hospital, and Bundaberg Base Hospital out of action. The consequences are deadly: ambulance ramping, delayed surgery, early discharges, increasing occupational violence, double-bunking, corridor nursing, and wards crammed beyond safe capacity.

At the same time, the federal government, under the direction of Prime Minister Albanese, is pushing to reduce health spending while adding over one million migrants a year to Australia’s population. These new arrivals will inevitably rely on our already overstretched health infrastructure. It’s as though the Prime Minister believes our workforce are magical healers who can do more with less. Frankly, this sounds like a legitimate mediscare campaign.

And the worst part? No one seems to have a plan.

‘We’re always bed-blocked with patients waiting on nursing home or NDIS placements. There’s never enough security. We’re dealing with violent dementia patients and behavioural issues constantly. We don’t have enough staff to manage them, and we often can’t get a special. It’s killing nurses, it breaks your heart. The skill mix is poor, wards full of juniors, and nurses are doing double shifts and overtime just to keep it going.’ – Qld nurse

‘Sometimes patients are literally placed in the corridor while we’re being pushed to discharge someone quickly, just to avoid an ED breach. If the discharge falls through, that patient is stuck in the hallway.’ – Qld nurse

The Human Toll on Staff and Patients

At the heart of this mess are frontline nurses, midwives, and health workers. We are seeing levels of burnout, PTSD, and psychological injury increasing like never before. These professionals are working double shifts, missing breaks, being assaulted, and expected to cope.

And what’s fuelling this? Patients who shouldn’t even be in the hospital.

‘I’ve been kicked, punched, scratched, spat at and that’s just this week. These are dementia patients we can’t discharge because no aged care facility will take them.’ – nurse, Queensland

Hospitals are becoming de facto aged care homes, mental health facilities, and disability units, yet many are not resourced or trained for this. A substantial number of blocked beds are occupied by violent, high-acuity dementia patients, high needs mental health, or complex NDIS cases rejected by providers due to their care needs or because there are simply no beds.

‘I was spat on by a patient and threatened with rape. I did the paperwork. Nothing happened. The sign on the wall says ‘zero tolerance’, but that’s just a sticker. It means nothing.’ – QLD nurse

‘We are also having wandering cognitive impaired patients left on the ward for long periods who refuse cares and are an extreme infection risk. They are often impossible to clean up and walk around dripping waste.’

These patients need specialist care in properly funded and purpose-built facilities. Instead, they are being warehoused in public hospitals, putting other patients and nurses at risk.

Federal Failure, State Punishment

The federal government is failing to deliver on aged care beds, home care packages, or NDIS housing. The data shows we need over 26,000 new aged care beds in Queensland by 2036. But nothing is moving.

And instead of fixing the system, the Queensland government is punishing hospitals in an attempt to reduce the budget.

On July 1 this year, two new policies were introduced threatening to cut activity-based funding for emergency departments if:

A patient is ramped for more than 2.5 hours.
A patient remains in ED for more than 24 hours.

But where exactly are these patients meant to go?

There are no beds. Over 10 per cent of Queensland’s acute beds are blocked. And many of these are filled by high-need, high-risk patients who can’t go home and can’t be placed.

This policy is not just short-sighted. It’s dangerous. It forces hospitals to make unsafe decisions just to meet KPIs.

‘Patients discharge early only to represent sicker.’ – Emergency Department nurse

‘24hr ED rule puts a lot of pressure on wards to have over census beds, converting patient lounges into beds wards, and the number of toilets/showers per patient is not appropriate.’ – Qld nurse

‘Our ward is being forced to take an ‘over-sensus’ patient just to stop the 24-hour ED breach. We end up understaffed and over patient ratio. Patients are put in bays with no oxygen, no suction, sometimes no proper bed for 12 hours.’

‘Patients are discharged early because there are no beds and ED can’t breach 24 hours. We’re putting patients in corridors, waiting rooms, even side rooms with AINs doing obs and praying they don’t need admission. It’s all to avoid breaching.’

The Collapse of Private and Public Balance

This pressure is compounded by a collapse in the private sector. Cuts to maternity care, after-hours surgery, and rural private hospitals mean more people are flooding the public system. Meanwhile, Queensland Health pressures patients to provide private health details to bill their insurers, for care delivered in an overcrowded public ward, putting upward pressure on premiums.

This is a slippery slope. As the cost of living climbs, more people drop private cover, sending even more onto a public system teetering on collapse.

‘My ward has 36 beds and we have 42 patients. No staff increase. We are told to ‘make it work’.’ QLD nurse.

What Needs to Happen

We need political will.

We need:

• Thousands more aged care and NDIS beds and home care packages now, not in years to come.
• Specialist step-down units for dementia and complex NDIS patients.
• More mental health beds.
• Increased security for high-risk patients.
• Mass recruitment and retention with wage reform and staff safety guarantees.
• Greater preventative care
• We need a return to locally autonomous hospitals.

We cannot treat our nurses like cannon fodder. We cannot punish EDs for ramping and delayed discharge when there’s nowhere for patients to go. And we cannot accept that a billion dollars a year in wasted hospital beds is just ‘how it is’.

‘We’ve lost too many good nurses. They’re leaving in droves. And the ones who stay? We cry in the shower and go back in again.’ – Regional hospital nurse

Conclusion

Queensland’s frontline health workers are breaking. And unless governments act, both federal and state, our hospitals will reach a point, if we are not already there, where they simply cannot function effectively and people die.

We need beds. We need staff. And we need real leadership.

Kara Thomas, President, Nurses Professional Association of Queensland (NPAQ)