Coming soon: federal boost for rural health and a new e-health plan

By Stephen Easton

February 22, 2017

The Commonwealth will establish a new Rural Health Commissioner and “redesign” the federally funded network of independent rural health workforce agencies, as it puts the best part of $100 million towards the perennial challenge of getting doctors to work outside metropolitan areas.

The federal government has put aside $4.4 million to get the commissioner up and running, and $93 million for the seven rural health workforce agencies to run new programs designed to attract and retain clinicians and allied health professionals in rural, regional and remote areas.

Assistant Minister for Health Dr David Gillespie said the new programs had been developed in consultation with the rural workforce agencies, which are located in each jurisdiction bar the ACT, and would begin mid-year after “a targeted grants round” to allocate the funding. He said very little about the “redesign” except that “access to essential primary health care, quality of access, and future planning to build a sustainable workforce” would be the focus.

According to Gillespie, the government also wanted “an independent and high-profile advocate for regional, rural and remote health” to provide frank advice on the longstanding challenge. It’s not that there’s a shortage of doctors; quite the opposite, in fact.

We can expect an oversupply of 7000 doctors in Australia by 2030, according to the Department of Health’s 2015 report on the future of the national health workforce. Gillespie, who is a physician himself, said the commissioner would be a “champion” for rural communities and the health professionals that support them. The soon-to-be-appointed commissioner will also consider “nursing, dental health, Indigenous health, mental health, midwifery and allied health needs” outside major population centres, said Gillespie, but will start with the GPs:

“The very first task of the Commissioner will be to develop a National Rural Generalist Pathway, to improve access to training for doctors in regional, rural and remote Australia. Appropriate remuneration for Rural Generalists, recognising their extra skills and longer working hours, will also be under consideration.”

New ways of coaxing more of the health workforce out into the regions was also the Assistant Minister’s key concern when he recently met with the National Medical Training Advisory Network. He said in a statement that federal investment in training programs and incentives would not be enough to adjust the “maldistribution” of medical professionals:

“Having a good distribution of training for medical students is an essential step but once medical students graduate from university, they still have years of training ahead of them. We need to ensure that rural training can continue beyond university.

“At key points in their training and development, the structure of the training system and a lack of advanced regional, rural and remote positions tend to force new doctors back to the cities, where they often settle.”

New digital health strategy on the way

Meanwhile, the efforts of the Australian Digital Health Agency — formerly known as the National E-health Transition Authority — and its new CEO Tim Kelsey to get electronic health records back on track moves into a new phase with a webcast panel discussion that marked the end of consultation on a new “co-produced” National Digital Health Strategy.

The ADHA seems pleased that over 1000 people were online last Monday watching Kelsey and his chief medical adviser Meredith Makeham chat with Department of Health secretary Martin Bowles, Data61 chief Adrian Turner, Australian Institute of Health and Welfare director Barry Sandison and Australian National University vice-chancellor Brian Schmidt. The latest webcast and a transcript is available on the ADHA website.

The consultation process for the new strategy began last October and Kelsey said the ADHA had received survey responses and submissions from about the same number that watched the webcast, over 1000. Kesley took away from this:

“They want more control and access over their health care. They want to trust in the health information and tools available to them.”

The agency has also “engaged with over 3000 consumers, clinicians, health care providers, allied health, researchers, jurisdictions and industry” about the strategy through various workshops, meetings, “town hall” events, forums, and webcasts.

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