Project Officer: Carmel Brophy PO Box 280 DEAKIN WEST  ACT  2600

Ph: (02) 6285 4660 Fax:  (02)  6285 4670 hcrra@ruralhealth.org.au

ACCESS TO TRANSPORT TO HEALTH SERVICES

Health Consumers of Rural and Remote Australia recognises that there is a discrepancy in the availability of transport to health services between rural and remote consumers and consumers who live in urban areas. Access to transport to health services by people in rural and remote areas should be at a level that facilitates and enables the delivery of quality health care to consumers in rural and remote areas of Australia.

Health Consumers of Rural and Remote Australia recognises also that in some rural and remote areas, available transport services may meet consumer needs but service levels may be impeded for example by lack of consumer information about available services. Alternatively, there are areas where transport for health purposes may not be available.

Health Consumers of Rural and Remote Australia will advocate for

• a range of transport services provided through government funded programs;
• a range of transport services provided through community organisations with the costs subsidised by Commonwealth or State Governments to either the providers of services or the person accessing the transport;
• a range of transport services provided by community organisations and funded by fundraising activities in communities;
• the design of flexible programs to provide financial assistance to subsidise transport to health services;
• the design of co-ordinated programs to facilitate transport to health services to enable optimum use of the services; and
• the availability of information about transport services and financial assistance programs through health service outlets, community organisations and locations where community information is distributed.

This will be achieved through

• bringing to the attention of governments, incidences of consumer requirements and service shortcomings so that changes to existing services can be examined. For example co-ordinating health consultation appointment times and transport arrangements;
• policy development forums informed about transport requirements and shortcomings so that strategies can be included in policy papers to address transport requirements;
• developing an information paper on the issue of transport for health purposes, bringing to the Government's attention the views of consumers.

ACCOUNTABILITY OF EXPENDITURE OF FUNDS

Health Consumers of Rural and Remote Australia will expend its funds in accord with agreed aims and goals of the organisation. Accurate records of expenditure will be available for inspection by members of the organisation and funding bodies.

Health Consumers of Rural and Remote Australia will

• develop the aims and goals of the Strategic Plan and Business Plan having regard for the health and wellbeing of its members and rural and remote consumers generally, the contract obligations from the funding body and the policies of the National Rural Health Alliance;
• ensure money received from the Department of Health and Aged Care is expended to achieve the aims and goals of the Strategic Plan and the Business Plan. Copies of these plans have been lodged with that Department;
• ensure membership subscriptions are expended in accordance with the Strategic Plan and the Business Plan which have been lodged with at Department of Health and Aged Care and funds raised for specific reasons will be acquitted;
• ensure monies raised in response to fund-raising initiatives for specific purposes will be allocated for that specific purpose ; and
• provide records of expenditure for examination by and officers of the Department of Health and Aged Care as required or on request.

Health Consumers of Rural and Remote Australia will achieve this through

• providing ongoing consultation with consumer networks in rural health to develop aims, goals and allocation of expenditure of funds;
• directing funds to projects to raise the profile of the requirements of rural and remote health consumers;
• maintaining up to date financial records and meeting all accounting requirements; and
• ensuring records are available for inspection as required.

1 August 2000

AGED CARE

Health Consumers of Rural and Remote Australia supports the right of people requiring aged care services and accommodation to access those quality services within their communities. The association supports the existence and availability of support services, including respite care, for carers to facilitate the provision of ongoing quality aged care in rural and remote communities.

Health Consumers of Rural and Remote Australia states that

• geographical isolation should not prevent the provision of choices for consumers accessing aged care services;
• appropriate services required by aged people include medical, counselling, allied health professional services, spiritual services and specialised aged accommodation be made available as required;
• care plans for aged persons in rural and remote areas should address issues relating to accessing the range of required services;
• family and carer support are taken into account when developing care options for aged people;
• special requirements for dementia sufferers be considered; and
• access to services should address any transport requirements by visiting immediate family members and friends.

This position will be achieved through

• working with consumers in rural and remote areas to develop aged care accommodation proposals most suitable to their specific requirements;
• working as required with State and Commonwealth government to address aged care issues in rural and remote areas
• developing proposals which will have regard to competing demands for funding for such services; and
• developing proposals which will achieve the best outcomes within available funding limits for aged care services.

Health Consumers of Rural and Remote Australia has a commitment to keep health consumers in rural and remote areas of Australia informed. Information will be up to date, relevant and assist with the long-term goal of improving the general level of health in rural and remote areas.

Health Consumers of Rural and Remote Australia acknowledges that

• the variations in location of health consumers in rural and remote areas mean that traditional and contemporary methods of communication will be used to keep in touch;
• the following methods of communication will be used to keep consumers in rural and remote Australia informed and up to date -
  • paper based information via the mail service;
  • telephone contact;
  • electronic mail as appropriate; and
  • the use of facsimile machine as appropriate;
• there is a significant difference in access levels to communication services by people in rural and remote Australia. Health Consumers of Rural And Remote Australia will continue to bring the concerns of its members to Government and parliament in an effort to improve access to the full range of communication methods;
• access to consumers in rural and remote areas will be by electronic mail wherever possible to reduce the use of paper, in keeping with the environmental impact of the ongoing use of large quantities of paper;
• as long as rural and remote consumers are not accessible via the Internet, all material will be forwarded to them in paper form; and
• having regard to privacy issues, no details of the mailing list will be released to other than government health departments without the permission of those whose names appear on that list.

Health Consumers of Rural And Remote Australia will achieve this through

• the production and distribution through traditional and contemporary methods, of quarterly Health Consumers of Rural And Remote Australia newsletters;
• mailouts of National Rural Health Alliance information;
• maintaining up to date mailing lists of email and personal addresses; and
• maintaining the privacy of those whose details are on the mailing list.

Health Consumers of Rural and Remote Australia, by virtue of its Mission Statement and Objectives, works to ensure that a range of consumers in rural and remote areas is available to represent consumer interests, requirements and views on planning, policy development, implementation and evaluation forums.

Health Consumers of Rural and Remote Australia will

• canvass members to ascertain their willingness and availability to stand for election to the Committee;
• canvass members to ascertain their willingness and availability to represent the varied and different interests of consumers in as many forums as possible;
• encourage non members of the association to take up similar representation opportunities as these arise. However, non-members will be encouraged to join the association as under the terms of the Constitution, non-members are not permitted to speak on behalf of Health Consumers of Rural and Remote Australia. This strategy is intended to strengthen the reputation of the association in the public forum and increase the level of representation it covers;
• provide support to consumers who take on representative responsibilities through Committee members and the project officer
• develop reports on consumer representation activities and distribute these to members via the association's newsletter;
• ensure that information provided on behalf of members is representative of their views, accurate, comprehensive and up to date.

This will be achieved through

• developing and using networks developed by Health Consumers of Rural and Remote Australia to increase its profile and membership;
• maintaining up to date information on representative interests and intentions of the membership of Health Consumers of Rural And Remote Australia; and
• reporting to members on meetings attended by representatives to enable benefits of representation to be recognised and to encourage more consumers to become representatives.

DENTAL HEALTH IN RURAL AND REMOTE AUSTRALIA

POSITION STATEMENT - Health Consumers of Rural and Remote Australia (HCRRA) recognises that sound oral health is vital to ongoing good health. Access to dental services in rural and remote Australia is difficult and, in some places, non-existent. People living in these areas have the right to access affordable dental treatment. Government subsidised dental services, particularly for economically disadvantaged people, is an important priority for people in rural and remote areas.

Health Consumers of Rural and Remote Australia states that

• geographical isolation should not preclude access to affordable dental services;
• oral disease, including dental caries and periodontal disease, are among the most prevalent diseases in the community;
• Indigent and socially disadvantaged people are determined by their poor oral health rather than by their state of dress or even where they live;
• dental health is the least subsidised of all health services and public dental care is not reaching many of the poorest and most in need Australians - while children's dental health is serviced through school dental schemes, adult oral health in Australia is worse than many comparable countries;
• affordable dental services must include preventative, maintenance and remedial treatments; and
• initiatives to address the short supply of dental professionals in non-metropolitan Australia should be developed and implemented immediately.

HCRRA advocates for

• the right of access to affordable dental treatment for those who live in non-metropolitan areas of Australia;
• an extension of Medicare to fund medically necessary dental care as well as for gum and periodontal disease and the repair and replacement of teeth;
• the development and implementation of initiatives to increase access to dental practitioners in non-metropolitan areas.

This will be achieved through

• face to face contact with consumers in non-metropolitan areas to gather evidence to give to Government to support the need for an increase in dental services;
• bringing this disastrous situation to the attention of all levels of Governments at every opportunity;
• taking membership on committees and other policy forums to advocate for an increase in the provision of dental services;
• advocating for an increase in expenditure by the Federal Government on dental health that shows public acknowledgement of the role of dental health in health and well-being more generally;
  
• advocating for the development and implementation of programs designed to increase the number of undergraduate dental health places at universities; and
• advocating for the development and implementation of programs and incentives to increase the number of dental health professionals in non-metropolitan Australia.

HCRRA 4 May 2004

 EQUALITY OF HEALTH STATUS

Health Consumers of Rural and Remote Australia works to remove inequalities in the level of health experienced by people in rural and remote areas. The association recognises that, given the budgetary constraints both of government and individual consumers, it is not possible to provide the same levels of health services to all consumers or for all consumers to access health services to the same level.

Health Consumers of Rural and Remote Australia recognises that the health of people in rural areas is not at the same level of people who live in urban areas and will highlight

• differences in health status to the appropriate government and non-government organisations who work in health policy and health promotion;
• the importance, policies and practices of disease prevention in working toward equality of health status; and
• the unequal status of health with the appropriate government and non government bodies of people in rural and remote areas for consideration when determining health expenditure priorities.

Health Consumers of Rural and Remote Australia will

• draw to the attention of government and non government bodies the concerns and experiences of health consumers in rural and remote areas which demonstrate the lack of equality of health status as well as examples of practices which address this inequality;
• work with consumer organisations as well as government and non-government bodies to prioritise consumer issues;
• work with individuals and community organisations to make best use of all available resources so that needs can be addressed; and
• facilitate information sharing between networks and consumers so that available information and resources are made best use of to achieve healthy outcomes.

Health Consumers of Rural and Remote Australia represents the interests and concerns of all the people in rural and remote Australia equally and without favour.

Health Consumers of Rural and Remote Australia

• states that by virtue of its existence, the organisation has a responsibility to its members and to the wider community to present and represent the issues and concerns of the people of rural and remote Australia;
• encourages membership of its organisation although the organisation represents the interests of all rural and remote health consumers in keeping with Health Consumers of Rural And Remote Australia's mission statement, regardless of their membership status;
• presents the concerns of all rural and remote health consumers to the appropriate government and non government authorities and organisations without favour or prejudice; and
• presents an unbiased case. In no case will the claims of one area be favoured over the claims of another without evidence to support the preferred claim.

Health Consumers of Rural and Remote Australia will achieve this through the

• representation, within its resources, of concerns of all rural and remote consumers to the appropriate government and non government bodies;
• preparation, presentation and dissemination of policy papers which are developed in response to the needs of rural and remote consumers;
• development of networks with other rural and consumer organisations with the aim of consolidating the views and concerns of all of rural and remote consumers, prioritising their issues and representing these to the responsible bodies; and
• provision of information about available services to consumers.

MEN’S HEALTH

POSITION STATEMENT – Health Consumers of Rural and Remote Australia recognises that there is a discrepancy in the levels of health of males and of females. This is especially true of men who live in rural and remote Australia. Health Consumers of Rural and Remote Australia recognises also that the culture, which has developed in parts of Australia is not conducive to men attending to symptomatic illness nor attending to preventative health matters as the need arises.

Health Consumers of Rural and Remote Australia will advocate for

• all practitioners and health related services working towards instilling the notion of self responsibility within the rural male culture;

• the provision of flexible male appropriate rural health services:

• availability, in locations such as sporting clubs, social venues and businesses, of information on health issues and illnesses that research shows impacts on men, including diabetes, heart disease and workplace safety;

• allocation of funding for research and development of a national health strategy for men;

• supporting rural organisations and local governments to provide men’s health and wellbeing information sessions and facilitate the local distribution of men’s health and wellbeing information;

• ensuring that men are appropriately represented on local government committees and organisations providing advocacy for men’s health and wellbeing;

This will be achieved through

• supporting men’s health programs which are designed to raise awareness of preventative health care, to provide steps for treating symptomatic illness and generally to inform men about men’s health and wellbeing issues;

• encouraging health services and providers to meet the needs of rural men by delivering flexible and male appropriate services;

• bringing to the attention of governments, evidence based research that supports the development and implementation of a men’s health strategy along the lines of the women’s health strategy;

• Health Consumers of Rural and Remote Australia adopt a proactive approach in recruit male representation for its committee.

August 2001

POSITION STATEMENT – Health Consumers of Rural and Remote Australia will use its networks and representative opportunities to bring to the attention of policy developers in State and Commonwealth Governments that services for people suffering from mental illness in rural and remote Australia are not at a sufficient level to address the evidence that people in rural and remote areas have higher levels of mental illness than those living in urban areas.

 Health Consumers of Rural and Remote Australia recognises that

• there is evidence that people in rural and remote areas have higher levels of mental illness than those living in urban areas;

• services of the 7.5% of psychiatrists located in rural or remote locations is not an appropriate service level for people who live in rural and remote areas;

• of psychiatrists practising in non-metropolitan areas, 90% are located in major regional centres. This is not an appropriate service level for people who live in rural and remote areas; and

• there are also shortages of clinical psychologists and social workers in rural and remote areas.

Health Consumers of Rural and Remote Australia advocates

• that, wherever possible, consumer representative opportunities in mental health forums be offered to members of Health Consumers of Rural and Remote Australia who have a knowledge and understanding of the issues about mental illness;

• that all efforts to improve the development and implementation of flexible service delivery models that will increase the level of mental health services in rural and remote areas be fully supported by Health Consumers of Rural and Remote Australia;

• that governments acknowledge the implications and potential implications upon access to and delivery of mental health services, which are unintended consequences of policy decisions;

• increased availability, in locations such as schools, sporting clubs, social venues and businesses, of information on mental health issues and available services; and

• HCRRA will use its networks to advocate for increased availability of mental health services in rural and remote Australia.

December 2002

OVERSEAS TRAINED DOCTORS (OTDs) IN RURAL AND REMOTE AUSTRALIA

POSITION STATEMENT - Health Consumers of Rural and Remote Australia demands equal access to services by medical practitioners for people in rural and remote areas. Health Consumers of Rural and Remote Australia acknowledges there is a shortage of general practitioners in areas in Australia, compromising equal access to these services. Health Consumers of Rural and Remote Australia recognises that the initiative of admitting overseas trained doctors to practice in rural and remote areas of Australia has long been important to improve access to general practitioner services for people in rural and remote Australia.

Health Consumers of Rural and Remote Australia will advocate for

• the ongoing placement of OTD's in rural and remote areas as a valuable initiative at a time when there is a national shortage of GPs;
• acceptance of overseas trained doctors, whether they are permanent residents or temporary visitors, as valued health service providers, and not merely a 'resource';
• recognition that the situations of stress and service mean that OTDs require and need an easily accessible and well-functioning network of support while they are practicing in rural and remote Australia;
• the development of strategies to meet the particular challenges for Australia as a host nation, and for country towns as host communities to welcome OTDs, particularly if their cultural norms are more distinct from Australia's. These strategies should address situations such as providing the OTDs and their families with the 'normal' support needed by health professionals in rural and remote areas, including locums, time off, continuing professional development , information technology access
• the development of strategies to address the specific areas in which support is needed for doctors who have trained overseas. For example:
  helping to make the transition from non-medical jobs to general practice and other health work, by enabling them to access the Australian Medical Council (AMC) and State medical registering bodies;
  • access to assistance to prepare for and pass the examinations;
  • increasing the capacity of the accreditation process to admit increased numbers of new overseas trained doctors rather than the limited capacity now available;
  • providing OTDs with valuable information about opportunities for practice;
  • providing cultural, language and practice orientation.
• an 'audit' of currently practising OTDs to ensure they are AMC accredited in order to ensure an appropriate level of skills and safe practice.

Health Consumers of Rural and Remote Australia recognises there are organisations already providing assistance and support in these areas, including Rural Workforce Agencies and Divisions of General Practice. However, the scope and depth of support is inconsistent.

HCRRA 21 April 2004

REPRESENTATION ACTIVITIES BY COMMITTEE MEMBERS

POSITION STATEMENT – Committee members take every opportunity to represent the organisation in forums where a consumer perspective can be presented. Examples of such representation are with the National Rural Health Alliance, Consumers Health Forum and other forums convened by Commonwealth and State Governments. This representation is informed by the policies of Health Consumers of Rural and Remote Australia and the input of its members. Committee members ensure that the association uses its networks and the outcomes from community participation to develop policy and to represent rural and remote area consumer interests, requirements, and views on planning, policy development, and evaluation and implementation forums.

Members of the Committee of Health Consumers of Rural and Remote Australia will

• honour their position as Committee members of Health Consumers of Rural and Remote Australia by publicly acknowledging their auspice and their responsibility to the association they represent;
• participate actively in public forums and community consultations as opportunities arise;
• adhere to the policies of Health Consumers of Rural and Remote Australia, as amended, and bring to the attention of the full Committee shortcomings in areas of policy;
• develop and use community and other networks to inform policy development. Report consumer concerns to the Committee to provide impetus for approaches to Governments;
• provide support to consumers who take on representative responsibilities through Health Consumers of Rural and Remote Australia;
• develop reports on consumer representation activities and distribute these to members via the association’s newsletter.

These things will be achieved through:

• acknowledging the existence, policies and activities of Health Consumers of Rural And Remote Australia at every public opportunity;
• establishing and developing networks at all opportunities to gain information, thus increasing the value of participation in representative forums;
• maintaining up-to-date information on representative interests and intentions of the membership of Health Consumers of Rural And Remote Australia and others; and
• reporting to members on meetings they attend to enable benefits of representation to be recognised and to encourage more consumers to contribute and perhaps become representatives.

1 December 2002 

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