To the Editor: Van Der Weyden is to be congratulated on his editorial about the Bundaberg Hospital scandal.1 He rightly points out that, although these issues have surfaced now in Queensland, the whole of the Australian health system is currently like a time bomb, with other disasters waiting to happen. However, the current health workforce shortage, which underlies many of the problems facing the health system, is not going to be solved by creating more of the same. There needs to be a radical rethink of how we deliver services in different ways, with different types of health practitioners, such as physician assistants, nurse anaesthetists and a range of other health professionals — many of whom already practise in other countries. The editorial did not emphasise, however, the importance of creating “partnerships” between Queensland Health and the universities. The concept of the professor/director, so common now in the southern states of Australia, has not been embraced in Queensland. There are significant opportunities to work together to improve health worker training in the future if this partnership is embraced.

There is also an urgent need for an open debate on what Australians want from their health system and how much they are willing to pay. These are difficult issues and, although other countries such as the United States (Oregon) have attempted to have this community debate in the past, no clear solutions have been forthcoming. The current issues in Queensland, the publication of the Queensland Health Systems Review by Mr Peter Forster2 and the Productivity Commission’s Position Paper on Australia’s Health Workforce3 provide a great opportunity for the government and the community to sit down and have that debate, so that we can plan an appropriate health system for the future.