This week's report from the Grattan Institute (Access all areas) about primary care in rural and remote areas has created substantial interest. The report deals with critical issues and shines a spotlight on the serious workforce inequities in many rural and remote areas.
The report under-states the difference between rural and remote circumstances, with some of its solutions not taking account of the quite different models of care that operate in remote areas. Models of primary care not based on fee-for-service medicine are the norm in remote areas.
The NRHA welcomes the prospect of multidisciplinary health care models as long as they are well-evidenced and sustainable. Nurses, Aboriginal Health Workers, allied health professionals and paramedics are in a great position to contribute more, with the shortage of positions in rural and remote areas being one of the main barriers. The Grattan Institute's report is too dismissive of efforts to recruit and enhance the rural health team with these existing professionals.
Any health professional is more likely to remain in a rural area if they are of rural origin, have had access to positive rural undergraduate or postgraduate experience and have a job or work opportunity. Australia needs to invest more heavily in multifaceted strategies along the training and work pipeline for doctors, nurses, allied health professionals and others.
In addition, the NRHA wants to see rural health professionals better connected: with each other, with off-site professionals, and with patients. For this reason the NRHA is adamant about the need for high speed broadband at equivalent cost and an electronic health record.
The NRHA would like to see much further extension of workforce initiatives to allied health, nursing and other professional groups. This will mean long lead times and patience on behalf of those evaluating such programs.
Extended scopes of practice for pharmacists in primary care will have to be carefully negotiated, and subject to evidence and appropriate credentialing and registration.
There is no 'quick fix' for improved access to primary care in rural and remote areas, but Access all areas provides a useful insight into some of the critical issues.
Dr Lesley Barclay - Chair: 0412 282 801