{"id":1029,"date":"2025-09-23T09:22:00","date_gmt":"2025-09-22T23:22:00","guid":{"rendered":"https:\/\/ruralhealth.org.au\/partyline\/?p=1029"},"modified":"2025-09-23T09:29:09","modified_gmt":"2025-09-22T23:29:09","slug":"opinion-piece-should-local-government-be-responsible-for-funding-delivering-health-services","status":"publish","type":"post","link":"https:\/\/ruralhealth.org.au\/partyline\/opinion-piece-should-local-government-be-responsible-for-funding-delivering-health-services\/","title":{"rendered":"Opinion Piece: Should Local Government be responsible for funding & delivering health services?"},"content":{"rendered":"\n

Let me set the scene with a real-world example of commercial realities that directly impact a small remote aboriginal town called Warburton in Western Australia. <\/p>\n\n\n\n

Situated in the Shire of Ngaanyatjarraku, a population of 511, located 1,494 kms north-east of Perth, and 288 kms from the Northern Territory border, this community is strategically well positioned on the Great Central Road.<\/p>\n\n\n\n

Mobility is a key determinant, and the cost of diesel fuel provides a stark and compelling example of the cost-of-living pressures for Warburton resident; a town that is largely welfare dependent. Diesel fuel in Perth sits around $1.85 per litre while the cost of diesel in Warburton sits around $3.15 per litre i.e. >70%. Food and other essential items are priced well over that in metropolitan Perth largely due to the high cost of freight transport.  For this community cost of living pressures are a constant lived reality.<\/p>\n\n\n\n

The closest hospital is in a small town called Laverton, 560km to the southwest. The nearest regional hospital lies either 1050km north-east in Alice Springs or alternatively 920km south-west in Kalgoorlie-Boulder. There is a community-controlled government funded health service that operates a community health centre.  Other external health providers such as the RFDS provide a vital aerial medical evacuation service and a free mobile dental service to Warburton residents.<\/p>\n\n\n\n

Small rural towns across Australia like Warburton are facing the greatest impacts of medical workforce shortages and Local Governments are feeling the increased pressure to find innovative and creative ways to provide medical services, engage the right staff and funding thereof.<\/p>\n\n\n\n

Recruiting the right health professionals with the appropriate skills is a constant challenge.<\/p>\n\n\n\n

Affected local governments generally source funding from their annual budget which means that ratepayers wear the cost.  Given that many small rural local governments struggle to finance basic community services, the additional finance impost of medical services weighs heavily on them. Indeed, small local governments rightly argue that funding medical services within their towns is not their responsibility, nor is it core business, and funding is rightly State and Federal Government responsibility. Pleas for funding support generally land on deaf ears resulting in those local governments having to fund between $500,000 and $1million per annual to support basic medical services.<\/p>\n\n\n\n

In Western Australia there are several examples where small local governments are having to source and fund medical services.  The Shires of Quairading, Coolgardie and Dundas are three small WA local governments struggling to find a sustainable medical delivery model.<\/p>\n\n\n\n

The inequity between metropolitan Perth stands in stark contrast to that of small rural towns.  This inevitably leads to a loss of community confidence and morale thus leading to a loss of population.  Moreover, those who continue to live in small rural towns are required to travel great distances to access medical services and this comes a great personal cost.<\/p>\n\n\n\n

Whilst mobile medical and telehealth services attempt to fill the gaps, having medical staff residentially based in a town is manifestly more desirable. <\/p>\n\n\n\n

Health outcomes, particularly for aboriginal people living in small remote communities, are very poor and the corresponding increase in health costs and reduced standard of living is significantly compromised.  What this means is that the shortage of health service provision is a significant health risk for those people, aboriginal and non-aboriginal alike.<\/p>\n\n\n\n

Health workforce gaps can be attributed to the lack of private and public health workforce availability, coupled with the lack of availability of suitable and affordable housing, contribute to a multi-edged conundrum.<\/p>\n\n\n\n

A \u201cone fits all\u201d model of health service provision, whilst desirable for government, is unworkable in the rural context.  Indeed, each local government has its own set of extraordinary circumstances in which it operates and exists, leading to the need for specific models of health service delivery that will meet their community\u2019s needs and aspirations.<\/p>\n\n\n\n

In essence, many small local governments are having to deal with market failure in the delivery of medical services. Government reluctance, or inability, to fill health service gaps, leads to local government having little choice other than to assume responsibility for the delivery and funding of those services.<\/p>\n\n\n\n

Piecemeal approaches such as training local people within those small communities to undertake certain medical support services, whilst altruistic, is generally not sustainable.<\/p>\n\n\n\n

Resource poor small local governments struggle to understand how health systems work and therefore rely on external expertise to guide them; this comes at an additional expense.  Notwithstanding, one approach might be that those local governments, who wish to provide medical services, forge relations with medical schools within their geographic reach that are willing and able to work with them to better understand the rural health landscape and provide evidence-based solutions to those local governments.<\/p>\n\n\n\n

In summary, local governments that are committed to providing health services to their communities ought to be applauded, however they need support. Ratepayers are having to wear the costs and responsibility when that is clearly not their remit. Therefore, government must act urgently to address the health crisis in the bush to abate the worsening health outcomes for those Australians who choose to live in rural and remote Australia.<\/p>\n

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