The Australian Government needs to do much more than extend the Office of the National Rural Health Commissioner to tackle the disproportionately greater number of poor health outcomes experienced by rural and regional healthcare patients.
The government announced last week (June 12) that it will introduce legislation to expand the office it established in 2017 by appointing deputy commissioners. It will also appoint a new commissioner.
The government’s focus on rural and regional health through its ‘Stronger Rural Health Strategy’ is welcome but report after report shows it is sorely needed.
In September last year a damning ABC’s 4 Corners investigation – Health Hazard – shared the stories of patients who had died or suffered significant disability as a result of the care they received at their local regional hospital. Their injuries were preventable. Our health system failed them. The program prompted an outpouring of similar stories from many regional communities. After the 4 Corners’ report, some regional NSW doctors called for a state inquiry into regional healthcare, which has been ignored.
When the commissioner’s office was appointed I predicted, sadly, that progress would be slow. The Commission’s big achievement – in two and a half years – has been to bring the Royal Australian College of General Practitioners and the Australian College of Rural and Remote Medicine together to agree to develop a national framework for the Rural Generalist medical specialty and a pathway for rural generalists. This is only one of the many rural health workforce issues.
It is important we have public data to monitor performance too. We still have agencies such as the National Health Performance Authority refusing to release national data on death rates and adverse events in hospitals. In the United States and England, this information is available to the public – by postcode – at the touch of a button.
Governments – state and federal – need a proper, data based strategy with more funding to improve rural healthcare.
The strategy needs to tackle the reality for regional patients. They experience poorer access to health services and they have to travel considerable distances to access services. The number of available doctors, including specialists, is considerably lower in rural and regional areas. Generalists are often performing specialised practices with far less experience (and therefore skill) than those in the city.
A 2019 Australian Institute of Health and Wellbeing (AHIW) report showed that the rate of potentially avoidable death increases from 94 per 100,000 people in the major cities to 129 in regional areas. The AIHW’s 2019 Rural And Remote Health report shows that people living in rural and remote areas have higher rates of hospitalisations, disease, mortality, injury and poorer access to, and use of, health services, compared with those living in metropolitan areas.
As a regionally-based health and medical lawyer, I see first-hand the impact of disproportionately poor health resourcing for rural and regional residents. I see too many negligence cases and inquests involving avoidable death and serious injury. I also see the benefit that legal action brings to garner focus on improved standards of professional responsibility and patient safety.
A Rural Health Commission is needed to tackle the issues impacting rural and regional healthcare, and quickly.