Australian Rural & Regional News asked some further questions about the report of Mark Genovese, CEO of Westfund, answered below.
Westfund, Media Release, 2 November 2023
The ‘Westfund Regional Health Gap Report’ shows that access to healthcare remains an ongoing issue for Australians in regional areas, with half (49 per cent) of respondents considering the wait time to see their GP unreasonable, some having to wait up to six weeks to get an appointment, and many having to travel more than two hours for an in-person consultation with specialists.
The report was commissioned by Australia’s leading regional not-for-profit private health insurer, Westfund Health Insurance, and developed in partnership with Insight Actuaries, to shed light on the current state of disease prevalence and healthcare access in regional Australia. The report used claims data over a seven-year period from 66,000 patients across eight regional locations (Mudgee, Orange, Dubbo, Bathurst, Lithgow, Wollongong, Mackay, and Townsville).
Despite 1 in 4 Australians living in rural or regional areas, official data confirms that remote areas have 7 times fewer specialists compared with major cities. The Westfund report reveals that access to ancillary service providers (non-GP healthcare professionals, including dentists, optometrists, physiotherapists, podiatrists, and psychologists) is limited across all locations, with places like Mudgee (14 providers per 1000 members) and Bathurst (27 providers per 1000 lives) being at the bottom of the list when it comes to the access.
The limited access to the healthcare system in regional areas is clearly impacting the long-term health of those who live there. The report shows that among members who are at medium or high risk of adverse health events, many also have a known chronic condition (such as mental health conditions, cancer, obesity, or diabetes), especially in Townsville (43 per cent), and Wollongong (32 per cent).
The Westfund Report represents a bigger, systematic access issue that needs to be addressed by all stakeholders, including the Gov, healthcare providers and health funds.
“Around 7 million people, or nearly one-third, of Australians live in rural and remote areas. We know that they often find it more difficult to access both GP and non-GP specialist care, have higher rates of hospitalisations, deaths and injury, and overall poorer health outcomes than those living in metropolitan areas. Targeted strategies to increase the number of health care professionals, across all areas, are needed to address the ongoing maldistribution of doctors, nurses, and allied health professionals to work toward reversing this inequity”
: Dr RT Lewandowski, President of the Rural Doctors Association of Australia (RDAA)
Read the report and fact sheet.
Questions from Australian Rural & Regional News
Australian Rural & Regional News asked some further questions of Mark Genovese, CEO of Westfund.
ARR.News: Are there general trends shown by the data that were not previously known or suspected?
Mark Genovese: The challenges regional and rural communities face when it comes to GP shortages and access to care are well known. This is only part of the story however. What we learned was that the needs of regional Australia are unique and wide-ranging – from the geographical differences in disease prevalence to the regional areas with glaring gaps in access and availability of health services. We also explored the longtail impacts of the COVID-19 pandemic, delayed screening and early intervention – particularly when it comes to mental health – which we see as a growing risk to the health of Australians.
ARR.News: The data was from Westfund members only and the report acknowledges this. How might this limit conclusions drawn from the data and action based on this data?
Mark Genovese: Geographical factors play an important role in health outcomes when it comes to access to care, but so too do lifestyle, socioeconomic and environmental factors. 55 per cent of the Australian population has private health insurance which represents those that value and can afford the private system. What’s so interesting is how diverse the needs of our membership are. No region is created equal and by conducting research like the Westfund Regional Health Gap Report, we can not only highlight the health gap gaps for Australia’s regions but start to quantify and solve for them.
ARR.News: Tailoring services to address particular needs of specific areas. How do you see that the specific initiatives for specific areas might be advanced in such a way that this could make a real difference to the wider community in these areas? Will you be taking action on this?
Mark Genovese: It’s about being efficient and effective with health spending. Everyone is experiencing budget pressures while health needs continue to increase. By having a clear understanding of the health needs of the community, we can target preventive strategies. This is a much more effective and cost-efficient approach than treating people when they get sick.
For example, from our research we saw the prevalence of skin cancer in locations such as Mackay and Lithgow coupled with a lack of services to screen patients. We partnered with a national skin check provider to roll out a skin check program in the locations prioritised by our member’s needs. In one location, 57 per cent of members who went through the pilot were referred on to a GP, 1 in 3 were told to seek follow up urgently and 11 per cent had never had a skin check. Something as simple as skin screening can save lives and improve health outcomes for our communities.
ARR.News: Digital health care. Provided connectivity problems in regional and remote areas can be addressed (and that is no small issue itself), do you see this as a potential gamechanger for regional health? Do you have more details at this stage as to what this might involve and how to achieve it? Could this be progressed at local council/ community level?
Mark Genovese: Digital health has to be part of the solution for regional Australia. It doesn’t replace the need for many in-person services, but for some individuals and some treatment, it provides options that previously weren’t there. For example, we partnered with THIS WAY UP to make their online mental health programs available to our members anytime and anywhere. Their programs aren’t suitable for everyone, so we’re also exploring telehealth partnerships to open up access for one-to-one sessions with providers previously inaccessible. It’s not going to be the entire solution but it will go a long way in helping to address the access and availability challenges for regional Australia. We’re also looking at ways we can utilise our Care Centre network to facilitate face to face and digital services for those in the community who need a bit more support.
The more we do in the space the more we learn how education and health literacy is so important. This ranges from making healthy lifestyle decisions to understanding the role and use of digital health. Anything that can be done to support education at the community level is important.
ARR.News: Could there be a greater role for carers and providers other than doctors to fill some gaps? If so, what is needed to progress this?
Mark Genovese: In short, yes. We believe that to solve this issue the health system must think broader in how we can provide access to services – online and through qualified health care providers. We are looking to partner with GPs by working with them to provide services that support their role as the primary physician. For mental health – Westfund was quick to broaden the providers available for members to claim treatment with, including social workers and counsellors as well as psychologists. Next year we’ll be adding mental health nurses as well as expanding benefits for our online mental health programs. Our recent skin check pilot saw us working with certified clinical nurses. And we’re exploring opportunities with local pharmacists to see what’s possible using their physical footprint. This does not replace the need for specialist GPs, but it does provide options to access preventive services or support the management of chronic conditions.
