Rural Health Minister "I absolutely share the goals and aspirations of the NRHA"

Thursday, 12 April 2018
Rural Health Minister Bridget McKenzie addressing the #6rrhss
Rural Health Minister Bridget McKenzie addressing the #6rrhss

Senator Bridget McKenzie, Federal Rural Health Minister, recently gave the Alliance a large public tick of approval.

"Growing up in country Victoria, I share the goals and vision of the National Rural Health Alliance," she told a packed auditorium at the recent 6th Rural and Remote Health Scientific Symposium #6rrhss.

Senator McKenzie talked of the need to build a sustainable health workforce in our regions. 

" We need to build and create a sustainable health workforce in our regions ... that we have people that want to, that enjoy, that are prepared to deliver high-quality health services to those living outside capital cities," the Minister said.

"We can't run away from what the research tells us about what works. When students complete the majority of their training in a regional setting, they are more likely to stay in the country to practice."

"It, too, means offering incentives for doctors and other health professionals to live and work in country areas, so they can know what we all inherently know and believe: that it's not a bad thing to live, work and grow up in rural and regional areas."

Senator McKenzie also addressed Closing the Gap targets, and while halving the gap in child mortality is on track, the gap in life expectancy between Indigneous and non-Indigenous Australians - now at 10 years - is not.

"In a first world country as wonderful as Australia, it is simply unacceptable that we still have a life expectancy gap between Indigenous and non-Indigenous Australians of around 10 years," she said. 

"Closing the Gap requires intergenerational commitment and investment, and is the responsibility of the whole health sector. It also requires a commitment to economic empowerment. If we look at the determinant around health outcomes, it is around median income levels. It is around educational attainment. So we need to be working right across government and community to ensure that all those factors, causal factors impacting on health outcomes are being addressed."

National Rural Health Alliance CEO Mark Diamond thanked the Minister for attending, and emphasised the quality of presentations overall.

"The Symposium, once again, provided an essential service for the sector.  The latest research findings, about some of the most difficult challenges facing rural and remote health," he said.

"We look forward to next year's 15th National Rural Health Conference in Hobart to tackle some of these issues and many more."

 

The text of the Minister's speech follows. 

You can hear her speak on our Youtube channel.

 

Senator Bridget McKenzie

Deputy Leader of The National Party

Minister for Rural Health

 

KEYNOTE SPEECH - 6th Rural and Remote Health Scientific Symposium

12 April 2018

E&OE – Check against delivery

Thank you very much. It gives me great pleasure to be with you and amongst you this morning. I'd like to acknowledge the traditional custodians of the land, the Ngunnawal people and pay my respects to elders past and present. I want to acknowledge the warm welcome you all received yesterday by Matilda House, who spoke about pathways or the Murrah, and I think the concept of pathways, the Murrah, has a lot of value for everything that you're discussing here, and a lot that we all come together to achieve on behalf of rural and regional Australia in the rural health context.

Thanks Jennifer, for your kind introduction. For those of you that don't know who the Vixens are, they're the Victorian netball team, but indeed, obviously at the moment we're all barracking for Australia, and it was a particular delight to see them beat the Kiwis yesterday. So I'll be looking forward to some gold medals there over the weekend.

Look, it's great to be here as part of the sixth Rural and Remote Health Scientific Symposium. Your plenary session this morning is on Closing the Gap, and my colleague, the Minister for Indigenous Health Ken Wyatt is unfortunately unable to attend today, but he does send his best wishes.

I'll have something to say shortly about the Australian Government's absolute commitment, particularly through Ken as the minister responsible, and Nigel Scullion, my Senate leader, to improving health outcomes for Australia's First People. But can I start by saying as someone that was born and bred in country Victoria, I absolutely share the goals and aspirations of the National Rural Health Alliance. It's a great privilege and my deep honour to serve the 7 million Australians who don't live in capital cities, who live in rural and regional Australia, and it's my job to develop and implement policies that improve their health and wellbeing.

People living in rural and regional Australia make an enormous contribution to our nation that often goes unrecognised or acknowledged, to our economy, to our cultural identity and our national character. They deserve the same access to high-quality healthcare services as those living in capital cities, and I know every single one of you in the room today is committed to that outcome, and I'm focused on working with you to improve the capacity, the quality and distribution of health services to ensure the sector gets the attention and resources it deserves and needs to deliver on our joint mission.

The Coalition Government has a clear plan to improve health outcomes in rural and regional Australia. It's multi-pronged, and comprises of a strategic and long-term commitment. If people living in country areas are to have access to health services comparable to those living in major centres, we need to build and create a sustainable health workforce in our regions. Number one: A, B, C, D and E for me is to actually ensure that we have people that want to, that enjoy, that are prepared to deliver high-quality health services to those living outside capital cities. It means making it easier for young people, such as the young school leavers from Western New South Wales, or the Goldfields of Western Australia, to complete their medical training without having to move to a capital city.

The evidence tells us - we're all science-based here, including myself - the evidence: we can't run away from what the research tells us about what works. When students complete the majority of their training in a regional setting, they are more likely to stay in the country to practice. It, too, means offering incentives for doctors and other health professionals to live and work in country areas, so they can know what we all inherently know and believe: that it's not a bad thing to live, work and grow up in rural and regional areas.

We're focused as a government on creating the settings to make this possible. We're supporting the health workforce and investing in areas to address health issues that specifically affect those people living in rural and regional areas.

Our rural communities are incredibly resilient. We know that, but I get a little tired of people using that as an excuse not to back us, but we're not unbreakable, I think, is probably what we always need to follow that sentence with. Droughts, flood, isolation, can test the most seemingly unbreakable of spirits. And so, as a government, we're investing in mental health for people living in rural and regional areas and utilising technology and innovative approaches to overcome the tyranny of distance.

As part of this, we're investing in a range of initiatives to make it easier for people in country areas to find the pathway – a Murrah – to be more active, to have healthier lifestyles. Not just eating healthy food and making healthy choices, but making it easy for them to connect into physical activity and sports, because what we do know: sport and physical activity does assist our physical health, but increasingly, the body of research around its impact on our mental health is overwhelming. So we need to ensure that Australians are finding physical activity that they can connect with. This will give Australians in rural areas, particularly younger Australians, the tools they need to make the choices to lead longer and happier lives.

I know following my address you'll have a discussion about improving the health outcomes for Aboriginal and Torres Strait Islander people. If you look back over the past 10 years the Closing the Gap framework has been in place, there has been plenty to celebrate, but there are still many challenges to overcome. As this year's Closing the Gap report notes, Aboriginal and Torres Strait Islander people, on average, are living longer than ever before, and factors contributing to the gap, such as death from circulatory disease - heart attack and stroke - are going down.

I don't, though, wish to overstate the progress that's been made, but the Closing the Gap target to halve the gap in child mortality is on track to be met this year with the rate falling 35 per cent since 1998. It's quite incredible.

The key target to close the gap in life expectancy by 2031 is not on track, although Indigenous mortality rates have declined by 14 per cent since 1998. In a first world country as wonderful as Australia, it is simply unacceptable that we still have a life expectancy gap between Indigenous and non-Indigenous Australians of around 10 years.

Closing the Gap requires intergenerational commitment and investment, and is the responsibility of the whole health sector. It also requires a commitment to economic empowerment. If we look at the determinant around health outcomes, it is around median income levels. It is around educational attainment. So we need to be working right across government and community to ensure that all those factors, causal factors impacting on health outcomes are being addressed.

On Tuesday, Minister Wyatt gave a keynote address on Aboriginal health to the Centre of Independent Studies in Sydney. He acknowledged the progress being made, but spoke extensively about the coordination and effort required to combat debilitating and deadly conditions. He said - and I quote - we need to be fully committed to sitting down and listening, hearing what's being said, making the changes needed to improve outcomes, and continuing to invest in programs at a local level.

The Commonwealth Government is committed to funding organisations across the country that provide comprehensive primary healthcare to Aboriginal and Torres Strait Islander clients. We're investing in around 180 such organisations, and of these, around 140 are Aboriginal community-controlled health organisations; some of which I'm sure are represented here at the symposium, and are integral, alongside Indigenous leaders, to overcoming health challenges. The health of First Australians is everyone's business. Together we must celebrate the milestones, but it is crucial we continue to look carefully at the challenges and the poorer aspects of health which remain.

Twenty years ago, Australians faced a nationwide health workforce shortage. Concerted government efforts, of all persuasions, over the past two decades, have successfully addressed this, and now, there are indications that by 2030 Australia may have as many as 7,000 doctors. But as you all know, rural and regional Australia does have a doctor shortage. Indeed, there are maldistribution issues across the wider health workforce in rural and regional Australia. The Government, through both the Departments of Health and Education, is currently undertaking a comprehensive assessment of the distribution of medical school places and training. This involves considering existing workforce modelling data; two decades of workforce distribution policies, which clearly still have left us with a maldistribution; the expansion of higher education places; and our priority areas to address the uneven spread of medical professionals across regional, rural and remote communities.

This assessment will inform future decision-making. I like to make decisions based on evidence and data, but we need to have it so that we can actually make those decisions. But we're not sitting on our hands, even while we wait for that particular work to be completed.

In the meantime, we're investing over $28 million in 26 medical training hubs across the regions. These are part of the Integrated Rural Training Pipeline and will provide training opportunities for doctors at all stages, from medical school right up through to vocational training. The benefits of investing in these hubs is obvious. More medical students will be able to stay in rural communities instead of being forced to go to big cities, where the bulk of training now occurs. That will allow them obviously to make greater connections and to see a real connection between their current practice in the regions and their training they're receiving.

The government will also fund primary care rotations for interns as part of the rural-based intern year through the Rural Junior Doctor Training Innovation Fund. This will improve local training capacity by looking for innovative ways to train junior doctors in primary care settings and improve the continuity for rural doctor training. And we're also making substantial investments in post-graduate medical training through the Australian General Practice Training Program and the Specialist Training Program, both of which have significant rural training targets.

We know we have to also look at data which underpins all this, and as a result, the government has established the Distribution Working Group to review equitable rural health distribution models and provide advice on how to attract more health professionals into rural areas, and I'll be relying a lot on that particular group's advice over coming months. The recommendations provided by the working group will inform future rural health policy. We are committed to investing in workforce and training opportunities in rural and regional Australia, as it provides doctors from the bush a pathway – a Murrah – to stay in the bush, leading to stronger retention of health professionals and better health outcomes for the community they serve.

In 2016, we as a government made an election commitment to appoint a National Rural Health Commissioner and I'm really pleased to have delivered on this and anyone who's met Paul Worley will just - I mean, hey, the nods right? What an inspired appointment by my predecessor. He is so passionate about delivering in this space. So please, he's your conduit, he's independent and make your voices heard to him, beat a pathway to his door. His highest priority that I've tasked him with has been to deliver a plan for a National Rural Generalist Pathway. This will help to address the serious issue affecting the rural health sector, the lack of access to specialist doctors in rural, regional and remote communities. The appointment of Professor Worley is integral to achieving this outcome and championing rural practice. In February, Professor Worley landed an historic agreement between the Australian College of Rural and Remote Medicine and the Royal Australian College General Practitioners to work together to develop a national framework for a rural generalist medical speciality.

The two colleges will now work together to create the foundations to build a strong, sustainable and skilled national medical workforce to meet the needs of our rural and regional communities. And I know the commissioner will also be working closely this year with other rural health stakeholders, everyone here in the room today, in developing the Rural Generalist Pathway and I really do encourage you all to engage in this. I think this particular partnership and the framework developed from it and the learnings in the process of developing it will inform, I hope, other health professionals to see similar innovative ways to deliver the workforce our communities need.

On Sunday, I had the great pleasure of joining His Royal Highness Prince Charles, not just for the basketball in Cairns as Sports Minister, but indeed to visit the Royal Flying Doctor Service. He was able to dedicate their latest aircraft, the 350C Super King, aptly named Outback Angel. While we were in Cairns, we actually had the opportunity to speak to Lyn French, who's on Gilberton Station in Far North Queensland. We'd sort of set up the teleconference to sort of talk through somebody that uses the Royal Flying Doctor Service. The Royal Flying Doctor Service holds their regular field days at that particular station. So, that was all sort of set up weeks in advance. But it's as if, sort of, like this object lesson that very morning Lyn's daughter had fallen off her horse. Didn't know whether she'd busted some limbs or ribs or shoulder, and had actually been airlifted to Townsville that very morning. So, she was living the experience of how important the Royal Flying Doctor Service was to her family and her community, with His Royal Highness. And obviously he's been off a few ponies himself, and so they were able to share a bit of a joke about getting back on the horse.

But I think that particular experience underlined the importance of the RFDS to the over 330,000 people that they touch every single year. They're running a clinic at the Nullarbor Roadhouse, which I'm dying to go and visit, or psychological mental health services using telehealth for 3am out onto rural stations, which the clinicians in Broken Hill spoke to me personally about. What a fantastic innovation that was, that allowed them to directly speak to people - 3am, getting the help they needed in a really, really timely manner and then follow it up obviously with personal visits, post that critical incident.

For over 90 years, the RFDS has been helping those who live in our communities in the most challenging of circumstances. Ninety years of changing lives, 90 years of saving lives, and it was my great pleasure to see the Prime Minister announce the money we've secured through the Budget process, $84 million just before Easter, which was fantastic. This additional investment will continue the aeromedical services, dental outreach services, and we'll also be able to put more psychologists and mental health nurses on the in areas where they're needed most. Many remote areas and communities rely on this very unique quintessential Australian response to health services in the bush by this iconic organisation.

The last thing I just briefly wanted to touch on was the importance of innovation and technology in the provision of high quality medical services to those living in rural and regional Australia. That video link call to me was an example of being able to use the latest technology to deliver services to people living outside of capital cities. And I also saw that on show in Moranbah in Central Queensland - a mining town, where the local hospital has really been scaled down to really just being a little ED space, if you like - before people can be stabilised and then medevaced to a larger hospital in the region and their use of telehealth services to assist. They all told us this great story- well, the story itself is great. At the time, it's quite traumatic. But a grazier that came in with, like- seriously, was doing the fencing with a a fence post through his leg.

And how did these nurses and health professionals who weren't specialists in that area stabilise this patient so that he could be medivaced to get him help? And they're able to do that by having very high-tech telehealth services, if you like - being able to remotely beam into the specialists in the capital city who just said: no, do this, do that, stitch here, hold that. No, no, no, don't do that. And to stabilise that particular patient and getting the help he needed. So, I’m very, very proud to be part of a government that's seeing an increase in those particular services.

In conclusion, the Australian Government believes all Australians, and me particularly as Deputy Leader of The National Party, that no matter where you live in this great country of ours, you should have access as right of citizenship to high quality and timely health services and we will continue to make significant investments in rural and regional health to further strengthen the system. We'll continue to take a holistic approach to improving health outcomes in country areas, and we are committed to responding to the needs of local communities to ensure that location is not a barrier to accessing high quality healthcare. Thank you very much and I look forward to hearing the outcomes of this symposium.
ENDS