The New South Wales (NSW) Parliamentary Inquiry Report issued last week documented the repeated testimonies of individuals and families let down by lack of access to healthcare in rural and remote areas. The College welcomed the 22 findings and 44 recommendations to support positive solutions. Of particular relevance to ACRRM were recommendations related to:

• implementing the single employer model for General Practice and Rural Generalist trainees across rural, regional, and remote NSW 
• overhauling the Visiting Medical Officer (VMO) model to ensure viability, and  
• expanding rural and remote GP training positions and support.  

Other key recommendations related to appropriate telehealth models, improved state-Commonwealth coordination, a review rural maternity services, and strengthening Aboriginal workforce representation. 

ACRRM’s submission and testimony to the Inquiry were quoted extensively throughout the report. The role and contribution of Rural Generalists across rural and remote NSW was discussed at length and the Report recognises general stakeholder support for the Rural Generalist model of care.
 
For further information or to provide feedback for the College on the Inquiry and its outcomes, please contact our policy team at policy@acrrm.org.au. 

Further information...

The Inquiry was the most extensive of its kind ever conducted in New South Wales. The Committee held 15 public hearings, received 749 submissions, and conducted two site visits. Throughout the inquiry, the committee heard repeatedly about individuals and families let down by the health system. The Committee Chair, Hon Greg Donnelly, MLC notes that the current situation cannot and should not be seen as acceptable.

The Report included pertinent patient testimonies:

“At what point did it become acceptable to have a multipurpose service open for business with an emergency and ambulance sign out the front and no doctor inside the walls? It is false advertising. It fills the community with false hope that they will receive appropriate care should they need it when in fact that could not be further from the truth. The system is failing.”

“Recently the cook from the hospital was forced to sit with a patient in a care park outside our facility who had had a stroke…. there was no ambulance in town to provide back up assistance”

“It is extremely difficult to get an appointment to see a doctor in Moree. There are two medical practices, wait times for an appointment at either of them is typically three to six weeks if one is available”

The Report notes that the issues faced by rural, regional, and remote residents of NSW are: 

• Linked to workforce challenges – shortages in some areas are at critical levels, with clinical staff facing unsustainable working hours, poorly coordinated recruitment and retention strategies, inadequate remuneration and lack of resources.
• Complicated by the shared responsibilities between Commonwealth and State governments and their inability to achieve effective structural reform. There is an urgent need for ministerial intervention to establish clear governance arrangements and a strategic plan for health reform. The Committee Chair noted that governance ultimately underpins many of the issues highlighted by the Report. 
• Exacerbated by services failing to align with community need – services such as oncology, palliative care, allied health, ambulance services and telehealth do not always accord with community need, and more must be done to ensure that regardless of postcode, services can be viably run in rural, regional and remote areas so residents can seek, access and receive treatment in a timely and cost effective manner.
• Perpetuated by the fragmented nature of health care provision outside metropolitan areas – patients are currently getting lost in a vast and complicated system, and improved communication and coordination between services is required to improve patient outcomes.
• For Aboriginal and Torres Strait Islander peoples, the evidence demonstrates that factors such as discrimination, racism, poor experiences with healthcare professionals, lack of transport and lack of affordable and culturally appropriate healthcare services are discouraging people to seek medical assistance.