The National Rural Health Alliance (NRHA) welcomes the Government's announcement of the successful bids for Primary Health Networks (PHNs) and understands the care being taken to have the best options in place for those areas where decisions are yet to be confirmed.
For rural PHNs to be successful they must immediately start working with organisations and communities in their catchments to provide the health services needed locally. This means that appropriate financial resources and staff must be available to the service providers - whether they be the PHNs themselves or separate service entities.
"If the rural PHNs have to prove, once again, that their areas have major gaps in service delivery, there will be more uncertainty and more delays," says Gordon Gregory, CEO of the NRHA.
The transition from Medicare Locals to PHNs has already resulted in the loss of some services and staff in more remote areas due to the uncertainty. Such losses have worsened pre-existing service deficits.
One issue of particular concern for rural PHNs is the lack of clarity around what constitutes 'market failure' and under what circumstances PHNs will be able to deliver services themselves, rather than commissioning them from existing services in their catchments. It is important to quickly establish what resources the Government will make available to PHNs working in areas where it has not been possible to sustain commercially viable enterprises in the past.
"Rather than asking rural PHNs to start afresh and collect new data that demonstrate that people are missing out on services, the case for 'market failure' should be transparent and built on existing data and evidence - including from the Medicare Locals in those areas", says Mr Gregory. "If not, there are likely to be delays before rural PHNs have the remit and resources to start delivering the primary care that rural people so urgently need."
Irrespective of which organisations have been chosen to run rural PHNs, if they are to succeed they must embrace four key principles:
- there must be an openness to facilitating ongoing input from local clinicians, patients and health service managers who understand the challenges faced by their community;
- they must be strongly multi-disciplinary to reflect the fact that primary care in rural and remote settings is provided by a range of professionals often working as a team;
- they must be culturally and philosophically equipped to work in close partnership with local rural/remote organisations; and
- there must be the will and capacity to work effectively with Aboriginal and Torres Strait Islander people and their community controlled health services.
The NRHA commits itself to work with PHNs to improve primary care in rural/remote areas.