Professional News 2008

February 2008

Auditing rural health: only the beginning

One of the benefits of the recent federal election is that many politicians visited parts of Australia beyond their own electorates and unfamiliar to them. This provided the opportunity for members of the Australian community to share concerns and offer insights into the unique challenges faced by their communities. On one such visit to rural Queensland Prime Minister Rudd announced that, since rural industries were central to Australia’s economic future, ensuring access to health services for people in rural and remote Australia was vital. As a means of addressing this, the government plans to audit the rural and remote health workforce, examine the reasons for workforce shortages, and investigate a range of options for attracting and retaining health professionals in rural Australia.

This is welcome news. If health outcomes in rural and remote Australia lag behind those of metropolitan communities, and if access to health care is considered a basic human right, then surely all Australians (not just those who live within easy reach of services) deserve access to essential health services.

Significant shortages of nurses and midwives in rural Australia exist (the ANF estimates 5,400 additional nurses and 600 additional midwives are needed just to meet basic healthcare needs).

Of all the health professions, nurses are by far the most evenly geographically dispersed in rural and remote Australia. This confirms that nurses are more than willing to undertake the unique challenges of rural and remote health care. Governments must realise that nurses, as a group, provide a solution to improving access to health services and addressing poor health outcomes in these areas. Many very remote communities already rely solely on nurses to provide their health service. Improving working conditions for nurses who have demonstrated a commitment and willingness to practice in rural and remote areas would assist in workforce retention.

A lack of sufficient support also makes it hard for nurses in rural and remote communities. Action to address the inequity in incentives currently available to health professionals would help, such as: better access to locum support; more rural and remote clinical placements; improving access to professional development and upskilling opportunities; and models of care that support multidisciplinary practice. The role of nurse practitioners, too long overlooked by governments due to medical opposition, also deserves far greater support and application.

So while rural and remote communities should benefit from some of the insights gained from this audit, counting the numbers of health professionals needed to deliver services is only part of the process of providing safe, evidence based care in rural and remote areas. Further work is needed to look at how sustainable, meaningful, change can be achieved. Rural and remote nurses (and their colleagues) struggling to provide services urgently need something to be done.

Fiona Armstrong
ANF Senior Federal Professional Officer