In meetings last week with Ministers Dutton and Nash, the National Rural Health Alliance reiterated the principles which must inform the size, management and functions of the new Primary Health Networks (PHNs) to take over next year from Medicare Locals.
Tim Kelly, Chairperson of the NRHA, said that the tenders soon to be let for the new bodies must lay the basis for ongoing and effective collaboration between a primary care sector that needs to be further strengthened, and the acute or hospital system.
"Adherence to three principles can ensure the success of the new organisations," Dr Kelly said.
"First, the PHNs must be tailored to regional circumstances. The ones covering rural, regional and remote areas must be governed by local clinicians, patients and health services managers - country people who have well-grounded, lived experience of the challenges facing their communities and a genuine understanding of what might be tackled. The rural PHNs must be for, by and through local people - not driven by Canberra or the other capital cities.
"A city-based governing body will struggle to have a real grasp of the needs of small, more isolated towns like Coober Pedy or Kalumburu, or know 'what works best' within the challenging service, workforce and financial constraints which communities like these face. It simply wouldn't work."
"Secondly, in terms of both their functions and their governance, the PHNs covering rural and remote communities must be strongly multi-professional. This has to be the case to reflect the fact that primary care in those areas may or may not be centred around a GP but is always provided by a team, including nurses, allied health professionals, Aboriginal health workers and pharmacists.
"Thirdly, the groups or organisations that win the tenders for development of the non-metropolitan PHNs must have the contacts, the will and the capacity to collaborate with Aboriginal and Torres Strait Islander people and their community controlled health services."
The process of establishing the new PHNs must have confidence in the capacity of clinicians and service managers in rural and remote areas to continue to develop innovative responses to the special challenges they face. And arrangements for the PHNs must very soon become clear so that clinicians and managers currently involved with services provided through rural Medicare Locals have the confidence to stay in rural areas.
"This time around we want the arrangements to stick," Dr Kelly said. "For this to be the case in rural, regional and remote areas, the local community must support and understand the new structures and functions. People in more remote areas cannot rely on arrangements managed from their capital city."
Contacts: Tim Kelly – Chairperson: 0438 011 383
Gordon Gregory – Executive Director: 02 6285 4660