Health Services in Rural Areas

Hansard & Papers " Legislative Assembly " 26 February 2008 " Full Day Hansard Transcript " Item 14 of 47 "
Health Services in Rural Areas
About this Item
Speakers - Torbay Mr Richard
Business - Private Members Statements, PRIV

HEALTH SERVICES IN RURAL AREAS
Page: 5418

Mr RICHARD TORBAY (Northern Tablelands-Speaker) [1.58 p.m.]: It is no exaggeration to say that the delivery of health services both in this State and nationally is at crisis point. I do not want to dwell on recent incidents highlighting these problems: members know them well through the sensational media reports of recent times. In reality they indicate a system that is stretched at the seams, handicapped by a bloated bureaucracy and held to ransom by militant medical professional associations. The situation in rural areas is just as critical as it is in the major cities. We, too, have ageing infrastructure compounded by a shortage of doctors and specialists, nurses and allied health professionals. In addition there is isolation and the distances country people have to travel to access specialist treatment. Dentists are scarce and public dentistry is underfunded. There is virtually no public transport in some areas and the various Federal and State funded transport schemes that exist are not coordinated and often do not meet specific community needs.

In the Northern Tablelands we have two positive initiatives that are making a difference in smaller communities. We hope they will overcome some of the difficulties in recruiting doctors to rural areas. Cooperation between the Federal and State governments has delivered us the very successful multipurpose service hospitals to accommodate long-stay, aged-care patients and acute and community health services under the one roof. We have them operating successfully in Emmaville, Guyra and Walcha, with buildings underway for further hospitals of this model in Bingara, Tingha and Warialda. Because the conditions in these hospitals are so modern and efficient, it is becoming easier to recruit doctors and other staff to work in them-not easy, but a little easier.

The initiative upon which many country people are pinning their hopes is the new Rural Medical School at the University of New England, in conjunction with the University of Newcastle. It opened this year with 62 enrolments for its five-year program; and touring the facilities, it is a magnificent achievement by all concerned. More than 60 undergraduates will be enrolling each year and spending the greatest proportion of their clinical education in large and small rural and regional hospitals. Statistics indicate that after they graduate students more often than not choose to remain in the areas in which they studied.

Attracting specialists is much more difficult outside the metropolitan centres. A collective culture encourages them to work in close proximity to each other. The rationale, which has some validity, is that they can retain and update their skills more effectively by working in teams, and that the prestige and pay scales available in the bigger cities are much more attractive. In our area this is equally true. Specialists tend to gather in the larger centres, and since the start-up of the Rural Medical School they have been a little easier to recruit. The Hunter New England Area Health Service has proposed a hub and spoke or outreach model to share the specialist services across the tablelands area. Some centres like Inverell are trying to recruit a general practitioner [GP] surgeon to replace the retired surgeon they lost almost four years ago. While a recruiting process continues, surgeons from Armidale and Glen Innes will be regularly visiting Inverell hospital.

In my view a hub and spoke model can be more flexible, with each centre concentrating on one specialist area and becoming the hub for other centres. Attracting specialists to meet this model is a problem at present, but it should be considered as a real alternative. It is all very well to have a hub and spoke structure, but public transport services must be addressed to make it work effectively. At present, with so many specialist services based in the larger centres, it is necessary for transport disadvantaged to have access to reliable transport. I urge the Government to address this issue with some urgency. In terms of infrastructure, we need new and upgraded hospitals in Armidale, Glen Innes, Inverell and Tenterfield. The existing hospitals do not meet the demands of modern management practices.

Some upgrading has occurred and new services such as renal dialysis have been introduced over the past few years, but now a major strategic overhaul is needed. With closer cooperation between the State and Federal Governments, and the Federal health Minister undertaking a review of rural health services, there is a real opportunity to tailor services to meet the specific needs of rural and regional communities. In my view, this should be led by a regional health authority to manage State, Federal, local government and private sector funding and initiatives. This would save money, cut back on bureaucracy and provide conditions conducive to local management, recruiting and making the most of the services of doctors, specialists, dentists, nurses and allied health professionals in areas outside the Sydney Basin.