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Envisioning equitable health care in rural Australia
By Kathya de Silva, Media and Communications Officer, National Rural Health Alliance
Source: APNA Primary Times Summer 2022-23 (Volume 22, Issue 2)
The National Rural Health Alliance (the Alliance) is the peak body for rural health in Australia, with a vision of healthy and sustainable rural, regional and remote communities. We aim to advance the wellbeing of the 7 million people living and working in rural Australia.
The Alliance’s influence is uniquely strengthened by the composition and breadth of its membership, which has increased to 46 this year. We welcome the Australian Primary Health Care Nurses Association as one of our newest members and look forward to building a strong partnership with this respected organisation.
Our diverse membership includes representation from the Aboriginal and Torres Strait Islander health sector, health professional organisations, health service providers, consumers, health educators and students. The Friends of the Alliance membership is made up of other individuals and organisations interested in equitable and accessible health care in rural Australia.
We aim to fulfil our vision by identifying priority needs and promoting appropriate action; undertaking or commissioning research; disseminating relevant information and knowledge; providing feedback to governments on the health impact of their policies and services; encouraging stronger organisations and population groups to recognise and support those who are vulnerable; developing strategic alliances; and undertaking resourced project and contract work.
The Alliance produces evidence-based policy to help inform advocacy work that is driven through representations in national committees and policy submissions.
The Alliance is currently advocating for two key policy platforms. One is the advancement of a new National Rural Health Strategy with an integrated implementation plan, including a revised framework to evaluate its effectiveness.
The Alliance has urged the Australian Government to deepen its commitment to improving the health and wellbeing of rural Australians through a strategy that embeds workforce, models of care, training pathways and research.
The Alliance’s former Chief Executive Officer Dr Gabrielle O’Kane’s comments at the 16th National Rural Health Conference, held in August 2022, resonated the need for a comprehensive national strategy.
‘We can’t tinker around the edges and need to do things differently. We need to adapt to the changing landscape. We need to commit to new models of care which are bottom up and new ways of funding as rural communities are different from the metropolitan,’ Dr O’Kane said.
Dr O’Kane added that the Alliance estimates a $4 billion deficit in rural health funding per annum.
‘We suspect that the deficit in spending takes into account the lower uptake in health services in rural areas. The burden of disease is excessive in rural areas compared to metropolitan areas. Therefore, we need to spend more to bring it down to the same level,’ Dr O’Kane said.
A new model of health-care delivery
The other major policy framework by the Alliance, to advance rural healthcare delivery, is supporting a concept of rural area community-controlled health organisations. The concept aims to overcome many of the barriers to recruitment and retention of a skilled and flexible workforce.
‘We can’t tinker around the edges and need to do things differently. We need to adapt to the changing landscape. We need to commit to new models of care which are bottom up and new ways of funding as rural communities are different from the metropolitan.’ – Dr Gabrielle O’Kane, former CEO of the Alliance
Developed in consultation with health-sector stakeholders, the model understands the difficulties of operating in rural environments and the diminishing financial viability of many primary health care services.
This concept would require a different funding model to support primary health care that includes multidisciplinary teams and care services that meet the unique needs of communities.
The Alliance has received positive feedback about the need for this kind of model in rural communities. The concept has been included in several key national-level policy documents and widely referenced in the media. However, the implementation of a place-based model, such as this, needs commitment from government and at the grassroots level.
The Alliance has also produced evidence-based resources for the rural health sector such as the Rural Health Workforce Mapping Tool, which demonstrates disparities in the health workforce across rural areas of Australia. With this, users can search health workforce details by federal electoral division, local government area, or national-level Modified Monash Model geographic classification.
In addition, the Rural Health in Australia Snapshot 2021 provides comprehensive and detailed facts and figures about the rural health system and the health status of people living outside major cities.
We also produce fact sheets on issues relating to health care in rural areas, such as cancer, mental health, suicide and the health workforce. We contribute through input and full submissions to a range of government and other inquiries, where we can advocate for the health needs of rural Australia.
The events hosted by the Alliance are a key element of its mission to bridge health-care gaps, encouraging engagement and discussion of issues in the sector.
The National Rural Health Conference is held every 2 years, alternated with the Rural and Remote Health Scientific Symposium, enabling all stakeholders from the health sector to demonstrate latest evidence, voice concerns and give recommendations. These events highlight the benefits of working rurally and discuss the best approaches to providing health-care services in rural areas.
‘Rural and remote communities are not just smaller urban communities but require different models of care and funding.’ – Dr Stephen Gourley, Alliance Deputy Chair
The 16th National Rural Health Conference was held in August 2022 in Brisbane, and the 9th Symposium will take place in 2023.
In wrapping up the latest conference, the Alliance Deputy Chair, Dr Stephen Gourley, said the overarching theme of feedback was that ‘rural and remote communities are not just smaller urban communities but require different models of care and funding’.
Two short videos sharing the reflections of delegates are available on the Alliance’s website.
The Alliance has an effective communications strategy to disseminate information and feature programs undertaken by health sector organisations and community leaders to bring health-care dividends to rural communities.
The Australian Journal of Rural Health (AJRH) is a peer-reviewed online journal published on behalf of the Alliance by Wiley. It features papers from Australian and international researchers, as well as clinician researchers, providing research information, policy articles, commentary and letters pertinent to health care in rural areas. It is listed in Thomson Reuters Journal Citation Rankings with an impact factor of 2.060 (2021). We celebrate its 30th anniversary this year.
The AJRH has opened a Call for Abstracts for an upcoming Special Issue: Children and young people’s (ages 0–24) health and wellbeing in rural and remote communities.
This Special Issue calls for papers to explore how children and young people are faring in rural and remote communities and what their experiences of health and wellbeing are. The submission deadline is 23 December 2022.
Articles featured in the Special Issue will be set as ‘free to read’ for a promotional period. Australian or New Zealand researchers may be eligible to publish articles as Open Access with no transactional charges.
Partyline is the flagship online magazine of the Alliance, published four times a year, with contributions from individuals and organisations across Australia. This is another vehicle through which the Alliance provides space to rural voices. The latest Issue #80 on rural women’s health and wellbeing was published on 23 September 2022. Partyline has also called for submissions for its upcoming Issue #81, which will explore mental health issues in rural Australia.
The Build ‘Em Up podcast, supported by nbnTM, features inspirational stories from rural leaders who work to improve the health and wellbeing of their communities. We have aired 18 episodes so far, with the last featuring feedback from delegates to the 16th National Rural Health Conference.
The BushWire is our monthly email newsletter that reaches over 13,500 individuals and organisations around Australia.
Through these initiatives, the Alliance is committed to making rural voices heard and we look forward to engaging partnerships from the sector to improve the health and wellbeing of all Australians.
National Rural Health Alliance resources
National Rural Health Alliance (NRHA) official website: www.ruralhealth.org.au
Australian Journal of Rural Health: www.ruralhealth.org.au/ajrh
NRHA flagship online magazine, Partyline: www.ruralhealth.org.au/partyline
NRHA, ‘Rural health in Australia snapshot 2021’: www.ruralhealth.org.au/rural-health-australia-snapshot
NRHA, ‘Rural health workforce mapping tool’: www.ruralhealth.org.au/mapping-tool