14th NRHC Recommendation

We call on state and federal governments to stop regionalisation of health services in the bush and move to reestablish local ownership models that promote collaboration as the mechanism to assist communities control service design, delivery and development to its citizens.
Rural Communities are being significantly weakened by regionalisation as the answer to improving service quality, safety and efficiency. Regionalisation leads to the loss of the voice of the local expert/community, relies on transportation and impacts each local communities economic base and future. International research has proven regionalisation is not the solution to improving the health of rural Australians.

Recommendation Type: 


I would be interested to explore the definition of regionalisation. Is the suggestion that every town, regardless of size, offer the same, full range of health services? I would recommend considering the work of Thomas, Humphreys and Wakerman on defining "minimum" PHC services, which includes some differentiation by population size. I think we need to consider a more nuanced recommendation, that considers a service planning approach that seeks to maximise the upsides of both regionalisation and localisation, and supports transparent decision making in this space, in partnership with local communities.

I work as a CEO in Rural Victoria and having worked in leadership in WA QLD and Vic I find that having a skilled local health board is the greatest model for working with the community and developing appropriate ranges of services, regionalization as in QLD or NSW causes loss of the truly local voice and add layers of bureacratic speak to the health agenda of a community. In my mind the right question is how to move service to communities not people to centralized big services - of course organisations need to ensure high quality safe care and work within a capability framework but in reality a local governance system can contribute greatly to this instead of a missing in action regionalised governance model- we should also be renumerating community members for being on a health board