Stepping towards a National Rural Health Commissioner

Friday, 31 March 2017
Australian Parliament House

During the election last year, the Coalition announced their intent to appoint a National Rural Health Commissioner.  This was met with enthusiasm by the rural health sector as a vehicle to drive the urgent work required to improve the health and wellbeing of the seven million people living in rural and remote Australia.

The Alliance strongly supports the establishment of the Rural Health Commissioner and the great opportunity this offers. We are keen to see the legislation passed as soon as possible. We also think the legislation could be enhanced to drive further change over the longer term.

The effort and resources required to see real improvements in rural and remote Australia need a long-term commitment.  The legislation in its current format provides for a Rural Health Commissioner for only three years.  Ideally, the position would be active for a longer period to give rural health issues sustained attention and investment.  Australia’s Assistant Minister for Health, Dr David Gillespie MP, has indicated that he is inclined to lend his support to an extension of the role past its current funding period which runs to mid 2020.  We expect this will be formalised through government-sponsored amendments to the legislation.

The legislation to establish the position of the Commissioner is now before Parliament and most of the discussion is focused on the scope of the role of the Commissioner and the length of the appointment.  The legislation initially included the Commissioner's role as primarily being to establish a national Rural Generalist Pathway for GPs.

Minister Gillespie has advised that, while the development of the pathways will be the commissioner's first priority, the needs of nursing, dental health, pharmacy, Indigenous health, mental health, midwifery, occupational therapy, physical therapy and other allied health stakeholders will also be considered.

“Health-care planning, programs and service delivery models must be adapted to meet the widely differing health needs of rural communities and overcome the challenges of geographic spread, low population density, limited infrastructure and the significantly higher costs of rural and remote health-care delivery,” the Minister said.

“In rural and remote areas, partnerships across health-care sectors and between health-care providers and other sectors will help address the economic and social determinants of health that are essential to meeting the needs of these communities. The commissioner will form and strengthen these relationships, across the professions and for all the communities.”

Other amendments at the request of Cathy McGowan, the Independent Member for Indi, included: 

1) ensuring that the Commissioner consult with rural and remote consumers,
2) the Commissioner consider the affordability of health services in rural and remote Australia and
3)  that the  final report from the Commissioner be tabled in each House of Parliament.

The Senate is now examining the legislation.  To follow the progress see this link http://www.aph.gov.au/Parliamentary_Business/Bills_Legislation/Bills_Search_Results/Result?bId=r5796 . 

We anticipate that the legislation will be amended in the Senate and hopefully passed either today (31 March 2017) – with an extra day of sitting – or during the Budget sitting in early May.  If the legislation is amended in the Senate, it will need to then be agreed by the House of Representatives.  So we have some way to go before recruitment of the inaugural National Rural Health Commissioner can proceed.

Having said that, the Alliance is hopeful that an appointment will be made by the end of the financial year.