Yesterday over 100 people concerned with healthcare services in rural, regional and remote areas came together from around Australia to discuss the implications of national health reform for rural health services and outcomes. They were attending a Policy Think Tank convened in Canberra by the National Rural Health Alliance (NRHA) and the Australian Healthcare and Hospitals Association (AHHA).
Participants expressed a sense of uncertainty about the shape of the reforms and their ultimate impact on rural and remote areas that have highly diverse communities and needs. In particular, the role of Medicare Locals and their relationships with Local Hospital Networks remain unclear.
The major test of the reforms will be how well these new entities can deliver the services expected of them - in many areas over huge geographical distances. Performance measures need to be finely tuned to measure access to care and changes to health outcomes resulting from the work of Medicare Locals, Hospital Networks and Multi-Purpose Services (MPSs).
Those at the meeting called on Governments to improve communications to ensure that the structure and intentions of the reforms are clear to both the healthcare sector and rural communities. At this stage, many healthcare professionals feel disengaged from the process and morale is being affected. In particular there needs to be greater certainty about the funding to be available for Medicare Locals, block-funded smaller hospitals and MPSs.
A flexible workforce is a key to maintaining necessary levels of service in rural and remote areas. Participants called for a greater focus on training generalists in medicine, nursing and allied health, and incorporating them appropriately into integrated health care teams. There is scope for graduate and vocational students to contribute more to rural service provision as part of their training – with benefits for patients and existing clinicians, as well as the trainees themselves.
For healthcare organisations to deliver rural and remote services that suit local needs in an effective and efficient way, Governments must have a flexible attitude to funding and operating guidelines. Services should have the ability to pool funding from different sources and to share workforce and facilities with other parts of the health, aged care and community sector.
Participants want to see a measured approach to implementation of national health reform, with clear priorities agreed, flexibility in adoption to meet local needs, and more information and communication between all parties improved. Above all, those at the meeting emphasised the need for reforms in train to enhance patient-focused care in rural and remote areas.
Terrie Paul - Australian Healthcare & Hospitals Association: 02 6162 0780
Gordon Gregory - Executive Director, National Rural Health Alliance: 02 6285 4660