Susi Tegen, Chief Executive, National Rural Health Alliance
With a renewed mandate in hand, the Albanese Government and its new Cabinet will have no barriers for further delay to implement the many health, disability and ageing sector reviews, reforms and recommendations it worked on with stakeholders in its first term of government.
The Government has a renamed Cabinet for Health, Ageing and Disability with Minister for Health and Ageing and Minister for Disability and the National Disability Insurance Scheme Mark Butler, and Assistant Minister for Rural and Regional Health Emma McBride. Also importantly, other Ministers and Assistant Ministers for Indigenous Health, National Disability Insurance Scheme, Aged Care and Seniors, and Mental Health and Suicide Prevention will work alongside Minister Butler.
This group has been elected and tasked to now act decisively and equitably to fix a broken health, disability, and aged care system that continues to fail the more than 7.3 million Australians residing outside our major cities, whose productivity keeps Australia’s economy afloat.
For too long, rural, regional and remote communities have been stuck on the wrong side of a widening health and care access gap, despite being innovative with solutions — and the time for positive action is here. They have been an area of need for too long.
The National Rural Health Alliance (NRHA) will continue working with the government to provide solutions and options, to solve systemic and environmental issues that cripple the delivery of care.
Grassroots collaboration and action will send a strong message to the 30 per cent of Australia’s population. The 7.3 million Australians living in rural and remote areas don’t need more consultations. They need a government that will implement the solutions that have already been developed, debated, and recommended.
NRHA worked closely with the first-term Albanese Government on several reviews, most of which have now presented their recommendations. The Unleashing the Potential of our Health Workforce: Scope of Practice Review, the Strengthening Medicare Measures, the National Medical Workforce Strategy, and the Australian Digital Health Workforce Strategy have provided solutions and recommendations that would help narrow the gap between rural and urban Australia when it comes to healthcare accessibility. These include single employer models, infrastructure and housing support for medical and health students wishing to train in rural areas, block or blended funding where Medicare bulk billing fails, multidisciplinary care models like PRIM-HS, collaboration with local government, tourism and other industries to deliver care and health providers working to their full scope in hub and spoke outreach sites.
Now, the government must work with communities and put those findings into practice — on the ground, with real investment where the market is non-existent or has failed, where communities must travel excessive distances for services. Rural communities are ready and able.
While we acknowledge the important and consistent work undertaken by the Department of Health and Aged Care in the last three years, rural Australians need more than incremental improvements and pilots. The Minister for Health, Ageing and Disability understands that pilots and trials are no longer needed. Communities need a system that sees them, that understands that their needs are different from those in the cities, and that solutions come from the grassroots. They need a system that is coordinated, transparent, flexible, and equitably funded.
Current models of care designed with urban settings in mind are failing rural communities, resulting in great underspends and re-distribution of funding away from the regions. Without a clear and properly funded National Rural Health Strategy, the inequities between urban and rural Australia will persist and worsen. We are calling for the implementation of a National Rural Health Strategy to align Commonwealth, State, and Territory investment across health, aged care, and disability services in rural Australia, led and coordinated by the National Rural Health Commissioner.
The Labor government’s promise of improved Medicare bulk billing is welcome, but it’s not suitable for many rural communities where the market has failed or there is no competition, as there is no profit, resulting in communities having to fundraise many hundreds of thousands of dollars to keep a service. It also does not address the fundamental need for infrastructure investment to support practice growth and place-based care in rural areas. Instead, we advocate for flexible, place-based, block funding models that can genuinely support rural primary care, attract multidisciplinary teams, and deliver quality care for complex and chronic conditions in regions which are often forgotten.
We are also concerned by the distribution of Urgent Care Clinics (UCCs). While intended to ease the great pressure on emergency departments, which in urban cases has met this goal, many of the 50 new UCCs are located in metropolitan areas. This deepens the divide in investment, doesn’t build on those clinicians currently supporting rural communities and overlooks the higher burden rural Australians already face: greater distances to care, poorer health outcomes, lack of public transport, higher costs, and limited services. This issue has been exacerbated by floods, droughts and fires, causing havoc and disastrous consequences to health, wellbeing and security of communities.
True equity and parity require recognising and addressing these disparities. Distribution levers for funding and infrastructure must be recalibrated to prioritise rural communities and their unique challenges, including those posed by damaging climate impact and natural disasters.
We applaud the government’s formal recognition of Rural Generalism as a general practice specialty. Rural health and medical students need greater opportunities to study and train in rural settings, from university entry through to clinical placement. Indeed, Indigenous health and medical students must be more supported to develop their health-related careers in regions, which need them most. These pipelines are essential for building a workforce that stays in rural communities for the long term. The initiative will result in positive long-term outcomes.
The opportunity is here. With political will and a bold, coordinated strategy, this government can set a new standard for rural health. We must  build on initiatives towards  universal health and healthcare, disability and ageing services for all, a system which is the envy of many countries around the world.
This is particularly so in rural Australia where health, disability and care of the ageing overlap.
The NRHA, its 54 members, community of Friends and Allies and grassroots stakeholders are ready to work together with the Ministers and Government to ensure that healthcare equity is not just a goal, but a reality no matter the postcode.
