As Christmas approaches, there is one gift that would mean so much to the 6.7 million people who live in rural, regional and remote Australia.
That is better access to health care. This requires a sustainable workforce, including doctors, nurses, oral health workers, managers and allied health professionals.
To assist in making this Christmas wish come true, the National Rural Health Alliance recommits itself to working closely with the Federal Government, and particularly with Peter Dutton, Minister for Health, and Senator Fiona Nash, Assistant Minister for Health.
Recent reviews have charted a way forward for action to improve the health workforce in rural and remote areas. Lost in the Labyrinth? (published in March 2012) dealt with overseas trained doctors; the Senate Report on Factors affecting the supply of health services and medical professionals in rural areas was published in August 2012; and in May 2013 there was the report of the independent Review of Australian Government Health Workforce Programs.
Senator Nash was herself closely involved with the second of these and, in effect, its recommendations are a ready-made plan for an improved rural and remote health workforce.Action on such a plan would go a long way to making health care more accessible for rural people. It will also strengthen the program support provided to nurses and allied health professionals while retaining GPs at the heart of the primary care team.
The Senate Report of August 2012 supported changes to the ASGC-RA system for defining rurality, something which Minister Nash will hopefully act on early in the new year.
It also noted that aiming for equal numbers of health professionals per 100,000 people was not the answer. Other issues such as accessibility, higher disease burdens and poorer health outcomes in more remote areas need to be taken into account.
The Report charged Rural and Regional Health Australia (in the Department of Health) with the collection of robust and meaningful data on rural health and with the task of developing a strategy to address the gaps in research and knowledge affecting rural health service delivery.
It also called for an expansion of rural generalist programs and for the Commonwealth Government, education providers and the medical profession to work together to ensure there are sufficient rural placements for junior doctors in their pre-vocational and vocational years.
The Report makes the case for greater equivalence of government support across the professions - something of great importance to the Alliance - and recommended that the HECS reimbursement scheme be extended to nurses and allied health professionals.
The Report proposed "meaningful sanctions" on universities that fail to meet the enrolment targets in place to ensure fair representation of students from rural and remote areas in medical courses. It argued that universities, professional Colleges and regulatory bodies should make every effort to ensure it is easier for health professionals to be recruited and trained locally – which will improve the likelihood that they will remain and practise in their local area.
It proposed that rural GPs who provide training to pre-vocational and vocational students should not be financially disadvantaged and should have additional locum support to cover the time spent delivering training. This would ensure rural training experiences for a greater number of early career health professionals.
The Report also had a recommendation on the provision of affordable housing for rural health workers, proposing that a coordinated accommodation strategy be developed.
It is to be hoped that Minister Nash is planning to act on these proposals from the Senate Report with which she was closely involved. In so doing the Minister will have the strong support of the National Rural Health Alliance and the people of rural and remote Australia.
Together we look forward to celebrating happier, healthier Christmases for many years to come.
Tim Kelly, Chairperson 0438 011 383
Gordon Gregory, Executive Director 02 6285 4660