Right time for rural cri­sis fo­cus

The loom­ing fed­eral poll is be­ing seen as the best chance for years to se­cure pledges from the main par­ties to fix rural health, re­ports Health ed­i­tor Adam Cress­well

The Weekend Australian - Travel - - Health -

THE 1700 res­i­dents of Bara­dine and its hin­ter­land in north-west­ern NSW need lit­tle con­vinc­ing that there is a cri­sis in rural health. The town, be­tween Tam­worth and Wal­gett, lost its only re­main­ing GP two months ago, af­ter the doc­tor con­cerned found him­self burned out by the stress of look­ing af­ter so many pa­tients with­out med­i­cal back-up.

‘‘ It’s dev­as­tat­ing,’’ says Paul Wangmann, owner of the town’s newsagency. ‘‘ My wife got sick last week — we rang (the nearby towns of) Coon­abarabran and Coon­am­ble, and they both said it was a three-day wait to see the doc­tor.

‘‘ My wife just toughed it out at home. But it’s af­fected morale in the town — there are a lot of el­derly peo­ple who need to get scripts, and if they run out of pills they get very wor­ried.’’

The area health ser­vice has ar­ranged for a locum doc­tor to be avail­able, but so far avail­abil­ity has been patchy. Wangmann says the locum was only avail­able for 11/ days this

2 week, and none last week. The locum doc­tor is ex­pected to be re­placed with a fresh fill-in doc­tor ev­ery two weeks, so pa­tients have to retell their his­to­ries each time they see the new physi­cian. And this isn’t a one-off. Coon­abarabran and Coon­am­ble, both sev­eral hours’ drive away, have them­selves both lost doc­tors: Coon­am­ble is one doc­tor short, and Coon­abarabran re­cently lost two trainees.

Al­though sud­denly no longer hav­ing a doc­tor around in case of med­i­cal emer­gency is alarm­ing for af­fected res­i­dents, who now find them­selves with fewer op­tions for med­i­cal care, sto­ries like this are hardly new.

What is new is that a num­ber of med­i­cal, nurs­ing and other health pres­sure groups are now sens­ing right now to be an un­miss­able op­por­tu­nity to wring con­ces­sions from politi­cians vy­ing to win the loom­ing fed­eral elec­tion.

There was a time when it was hard to imag­ine a se­nior Gov­ern­ment min­is­ter go­ing near a con­fer­ence to ham­mer out so­lu­tions to a rural health ‘‘ cri­sis’’, be­cause that would im­ply they agreed the sit­u­a­tion amounted to a cri­sis — re­spon­si­bil­ity for which would in­evitably be at­trib­uted, at least in part, to the Gov­ern­ment.

But the rules change when a fierce elec­tion bat­tle looms.

Deputy Prime Min­is­ter Mark Vaile not only at­tended, but opened, a ‘‘ rural health cri­sis sum­mit’’ held in Can­berra this week by the Aus­tralian Med­i­cal As­so­ci­a­tion, which dis­cussed the fac­tors strain­ing rural health re­sources and the mea­sures needed to fix it.

In his speech to the sum­mit, Vaile, who is also leader of the Na­tion­als and Min­is­ter for Trans­port and Re­gional Ser­vices, did not speak of a cri­sis or ad­mit there was one. But he did say that rural health care de­liv­ery ‘‘ presents con­tin­u­ing chal­lenges’’, and the prob­lems had ‘‘ built up over time and can­not be fixed overnight’’.

Ac­cord­ing to Vaile, who at­tended as rep­re­sen­ta­tive of both the Gov­ern­ment and health min­is­ter Tony Ab­bott, the prob­lems of rural health are caused by many things out­side the Gov­ern­ment’s con­trol (such as the pref­er­ence of doc­tors to work in the cities and the age­ing of the med­i­cal work­force and the pop­u­la­tion as a whole) and the Gov­ern­ment has re­sponded with poli­cies that will bear fruit in the medium to long term.

Th­ese in­clude dou­bling the num­ber of med­i­cal stu­dents by 2012 and es­tab­lish­ing bonded stu­dent places, re­quir­ing doc­tors who qual­ify un­der the scheme to work in the bush for a des­ig­nated pe­riod.

But there are many in the rural sec­tor who think what­ever is be­ing done is in­suf­fi­cient.

The AMA’s own po­si­tion, sum­marised in its Bridg­ing the Gap doc­u­ment re­leased at the sum­mit, em­pha­sises the short­fall in health ser­vices in rural ar­eas, even though nearly 7 mil­lion Aus­tralians live in the re­gions.

Its pol­icy doc­u­ment re­leased this week points out there are about 3300 ad­di­tional deaths an­nu­ally in rural ar­eas than would be ex­pected if mor­tal­ity was at the same level as seen in the ma­jor cities.

The doc­u­ment spells out a num­ber of mea­sures the AMA wants the ma­jor par­ties to com­mit to ahead of the elec­tion, in­clud­ing re­build­ing rural hospi­tal in­fra­struc­ture, and bet­ter fund­ing deals for the bush through the next round of Aus­tralian Health Care Agree­ments due to be signed next year.

Sev­eral of the rec­om­men­da­tions also fo­cus Con­tin­ued inside — Page 19

Pic­ture: Kelly Barnes

So near, yet so far: Peter Ris­ch­bi­eth a doc­tor an easy hour’s drive from Ade­laide, says his town of Murray Bridge needs two GP ob­ste­tri­cians and a doc­tor able to per­form cae­sarean sec­tions

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