The best laid plans of departments and ministers will continue to go awry without a national rural health strategy to guide workforce planning, according to the RDAA.
Rural Doctors Association of Australia president Dr Raymond ‘RT’ Lewandowski III is stuck on a million-dollar question – how many nurses, doctors and allied health professionals do we need to train to serve Australia’s rural communities?
Without a national rural health strategy, he contended, this question will go unanswered.
“We know the direction we need to head in – we need to get more services, and we need to get more professionals providing those services,” he told The Medical Republic.
“But let’s say we need five, and we train four.
“Well, guess what? We’re never going to get where we’re going.”
With rural and remote Australia set to be the testing ground for new initiatives as per the Scope of Practice Review, the future of the healthcare system will be heavily influenced by how well-equipped the rural health system is.
Australia has had rural health strategies in the past. The most recent form was the Stronger Rural Health Strategy released in 2019.
The strategy itself is a collection of individual initiatives working toward themes of teaching, training and retaining rural healthcare staff, rather than a single document with set goals.
“Investing money in a strategy rather than fixing piecemeal potholes makes a lot of sense,” Dr Lewandowski said.
Previous attempts to gauge how many doctors and healthcare workers are missing from the bush have used flawed methods, according to the North Queensland-based rural generalist.
Just counting the number of vacant positions, for instance, assumes that the original number of positions was enough to meet community need.
“You will find reports saying we need this, or we need that,” Dr Lewandowski said.
“What a lot of them do is these kind of straw polls and they’ll see how many positions exist in a place and how many are filled, and then presume that the vacancies are the need.
“Obviously that’s not the case, because a lot of places don’t even have vacancies because they’ve never even created the positions.”
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Other models assume that the per capita ratio of GPs that is appropriate in the city holds true for the bush or that population demographics are consistent across the country.
“You might plan to need one GP per 800 people, for instance, but that presumes that you have the 800 people that are alive right now today [forever],” Dr Lewandowski said.
“In 20 years, if we keep going as we’re going, our 800 people will be older people with a higher demand on the healthcare service, which means you’ll actually need more GPs per capita.
“Where rural falls over is that, oftentimes, they come up with a strategy and say, ‘nationwide, here’s what we need’ … but in a rural population you’ll need more GPs per capita to get the same services you would in a city, because GPs in rural areas tend to provide more services.”
The RDAA has also confirmed that former ACRRM president Dr Sarah Chalmers has been elected president.
She won’t start in the role until the next RDAA AGM, in late 2025.
