I am delighted to be writing my one and only editorial for Partyline as the National Rural Health Alliance’s Interim Chief Executive Officer. The Alliance is going through a period of transition after the retirement of Foundation CEO Gordon Gregory who led the Alliance for 23 years. It is an honour to head up the Alliance for this interim period while our Board finds exactly the right person to support the rural health sector into the future. So watch this space for a ‘hello’ from the new CEO very soon.
It is an exciting time here in Canberra as we get ready to welcome a raft of new (and old) Members of Parliament to our nation’s capital. Building relationships with these important decision makers is critical. The Alliance will focus on ensuring that the Government and parliamentarians understand our role in supporting the best health for rural and remote Australians.
We saw health become a focus of post-election analysis. We will work to continue focussing attention on rural and remote health and wellbeing on behalf of all of you who live and work in rural and remote communities.
Health workforce shortages mean that the universal entitlement of Medicare is not delivering on its fundamental tenet of universal access in rural and regional Australia. The spend per individual through the Medicare Benefits Schedule (MBS) in remote areas is 60 per cent less than that spent in major cities ($536 in remote areas, compared to $910 in major cities in 2014-15). The harsh reality is that what does not exist (health professionals) cannot be paid for, which is why we see this Medicare underspend in rural and remote Australia.
Given the paucity of health professionals and services in rural and remote areas there are some options which need to be supported over the next few years:
Lower the demand for health services.
The benefits of a healthy lifestyle including good nutrition and exercise are clear. However, many small rural and remote communities face higher costs for healthy food. The Alliance will release a report on food security later in the year which will shine a light on this important issue.
Smoking rates are still higher in rural and remote communities. We are finalising a research paper to highlight the lack of progress being made in reducing smoking rates in rural and remote areas when compared to the city.
Help people travel to health services.
Patient travel has always been a significant issue for people who live in rural and remote communities and cannot rely on affordable public transport options. This is a particularly big issue for patients who require multiple treatments in distant regional centres or in the city.
Use technology to connect people to services.
There are pockets of excellence in using telemedicine to help connect rural and remote people with distant health practitioners and services. However, a national strategy is needed to ensure that we are not seeing a repetition of the rail gauge problem (where systems and infrastructure cannot work together). We desperately need national leadership and a national telehealth strategy. The Digital Health Agency, recently set up by the Australian Government, gives an opportunity for us to advocate for a national strategy.
These options, which could make such a difference in the lives of rural and remote Australians, should be part of a National Rural Health Plan, but the last Plan was developed in 2011, five years ago now.
A joint Commonwealth and States/Territories framework is vital given the complementary responsibilities of both jurisdictions. The soon to be appointed Rural Health Commissioner could oversee the development of such a Framework.