Editorial - A call for action to improve policies and programs for rural health

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The 14th National Rural Health Conference was once again an outstanding success as judged by the overwhelming positive feedback received from the almost 1,200 people who attended.

The most important and influential event on Australia’s rural health agenda, one of the strengths of the biennial Rural Health Conference is its contribution to setting an agenda for action to improve policies and programs for rural and remote health. The seven key themes arising from the Conference, and the associated recommendations, were presented to the Assistant Minister for Health, the Hon Dr David Gillespie, as part of the closing ceremony for the Conference. The themes are:

  1. development of a dedicated national rural health strategy and associated implementation plan;
  2. action to close the gap in Aboriginal and Torres Strait Islander health and wellbeing;
  3. enabling all children to experience a healthy start in life;
  4. guaranteed access to digital health and high-speed broadband for rural and remote Australia;
  5. build on the value of arts in health;
  6. use research and evidence based practice to achieve better health outcomes; and
  7. building the right health workforce to ensure integrated models of care.

The Alliance is now working with members and other stakeholders on which recommendations and actions should be incorporated into the Alliance workplan for the next two years. However we also would encourage all stakeholders to consider both the priority recommendations coming from the Conference (http://www.ruralhealth.org.au/14nrhc/recommendations) and the full range of recommendations which came from delegates (http://www.ruralhealth.org.au/sharingshed/recommendations).

We need a strong, collective voice, expressed repeatedly and relentlessly at national and local levels if we are to catalyse action.

One of the strongest recommendations emerging from the Conference was the call for a national rural health strategy.

Conference delegates called on Commonwealth, State and Territory Governments and all political parties for urgent non-partisan commitment to a new national rural health strategy and long-term funding for an associated national implementation plan. The strategy and plan should be finalised by June 2018 through broad consultation with the rural and remote sector, including co-design with consumers.

The plan should identify the concrete, on-the-ground building blocks, including funding models needed to bridge the divide in health outcomes for people living outside the major cities of Australia. This should include broadening of the Multi-purpose Services Model (MPS).

A minimum data set of performance indicators (both qualitative and quantitative) should be developed, based on domains identified in consultation with the National Rural Health Alliance, to underpin, inform and evaluate implementation of the plan.

The Alliance, its members and other stakeholders now need to be rigorous in prosecuting the case for the national rural health strategy to become a reality.

At the Conference, Shadow Minister for Health, Catherine King, committed a future Labor government to these recommendations. We are still awaiting a similar commitment from the Coalition.

The Alliance welcomes the fact that legislation to establish a National Rural Health Commissioner has now been passed. This is a significant initiative for rural and remote Australia, and the Federal Government should be congratulated.

However, we need to be realistic about the limitations of the role. This is one person, supported by officers located within the Australian Government Department of Health. Their first priority is to establish a National Rural Generalist Pathway and this will take considerable time and effort.

It is very important that the Commissioner not be seen as the answer to all things rural – and certainly not as a place where serious policy issues about the health and wellbeing of people in rural and remote Australia can be parked until some unknown future date.

By its very nature, a national rural health strategy is not the natural domain of the National Rural Health Commissioner. The Commissioner is a Federal Government position whereas a national strategy requires buy-in from the States and Territories. Hence it needs to be driven across jurisdictions by the Australian Health Ministers Advisory Council and the COAG Health Council.

The Alliance is looking forward to working with and supporting the Commissioner in carrying out his or her duties. More broadly, we are looking at working with all Governments and other stakeholders in the development of a long-overdue national rural health strategy.

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