Placed-based funding ‘urgently’ needed for rural Aussies

4 minute read

The inequity in health outcomes continues for rural and Indigenous Australians, and the NRHA says not enough is being done.

Place-based investment that responds to local needs is a must to address health inequity for Australia’s seven million rural residents and offset the $6.55 billion health spending deficit, says the National Rural Health Alliance.

Yesterday, the government released the 2024 State of Australia’s Regions report outlining issues faced by rural Australians across all sectors, including health and aged care, and what’s being done to address them.

The report focused on major issues identified at the local level, aligning with the federal government’s Regional Investment Framework.

“As communities outside of our big cities grow, it’s more important than ever that regional people have access to reliable, fit-for-purpose services in their own backyard – from education, health and connectivity,” said Regional Development, Local Government and Territories Minister Kristy McBain in a release.

Speaking to The Medical Republic, chair of the RACGP’s poverty and health special interest groups Dr Tim Senior said the report highlighted what we already know.

“Often, places that have higher needs don’t get as much funding proportionately, and it’s certainly true for rural and remote Australia,” he said.

According to Dr Senior, this discrepancy seemed to be biggest in Medicare funding and hospital care, which was “probably no surprise to anyone”.

In its response to the report, the National Rural Health Alliance said that while it was pleased some “good measures” are in place to bolster rural Australia, including recognising that place-based investment is a necessity, “this is not happening as it needs to in rural health, aged and disability care”.

“Place-based contemporary investment is urgently required to address the unique health challenges of the seven million people in rural Australia,” said the Alliance Chief Executive Susi Tegen.

Ms Tegen added deficits in health spending of $6.55 billion annually demonstrated that we should be directing funding towards rural health professionals who are “underserved, under-supported and not able to meet the minimum level of primary health care compared to urban Australia”, through place-based funding.

“Current funding models still don’t reach the grassroots, resulting in the worst health conditions for rural Australians, she said.

“Medicare is not covering costs of delivery of services in rural Australia, with bulk billing never developed to cover the whole of delivery cost of service to patients.”

Dr Senior seconded the view that tailoring funding to a particular area and communities’ needs would make it more responsive to local needs.

He also highlighted the importance of recognising the “knock-on effects of non-health policy and non-health funding”.

“Frequently rural areas lack services, not just in health but in education, housing availability or transport issues, and particularly in unemployment,” he said.

“These all have a knock-on effect on the people’s health issues.

“If problems are conceived as only a problem of health services, and funding of health services, then actually you end up not solving the problem.

“Because a lot of the problems come from a lack of ability to do cross-agency work with welfare and with housing and with transport which is responsible for so much of people’s health.”

Dr Senior also flagged the benefit of rural community-controlled health services.

“Aboriginal community control has had really successful outcomes,” he said.

“It’s not just about provision of services but about accountability and responsiveness to local community need, and that’s what makes funding effective.”

The NRHA also called for “innovative and flexible options” for specialised providers and healthcare services to provide care in rural areas for people with disabilities.

“Innovative options also need to encourage retraining and disability service providers to work in rural locations so that people with disabilities do not have to rely on telehealth which should only be an aspect of care delivery, not instead of, from metropolitan centres, at exorbitant cost,” said the NRHA.

The alliance will be working with all levels of government to achieve the Regional Investment Framework.

“The report has echoed the Alliance’s concerns that people living in rural areas continue to have shorter life expectancy than those in capital cities with higher levels of disease and injury, reiterating that accessibility to high-quality health and community services across regions is an ongoing challenge with increasing remoteness,” said the NRHA.

“Without housing, education, health and infrastructure working together, rural Australia would be at a greater disadvantage, socially and economically.”

Infrastructure, Transport, Regional Development and Local Government Minister Catherine King reiterated the sentiment.

“These regular reports will support evidence-based decision making through the Government’s Regional Investment Framework – ensuring investments and initiatives across government respond to what the data is showing, and what people in the regions are saying.”

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