Bridging the health divide: The hidden costs of rural living

For many Australians, a visit to the doctor is as simple as booking an appointment and driving a few minutes to a clinic. But for residents of rural and remote communities in WA, a 185km one way drive is the reality when local governments don’t step into supplying GPs.

“In the city, there’s competive income opportunities for doctors. In rural towns the GPs are predominantly on their own, long hours, covering hospital shifts and it’s a lot more of a challenge to get doctors to our community” says Shire of Gnowangerup President Kate O’Keefe.

A February 2025 position paper, Provision of Remote GP Services, released by the alliance of the Shires of Gnowangerup, Jerramungup, Kojonup, Lake Grace, Narembeen, and Ravensthorpe — lays bare the stark reality: access to healthcare in regional and remote Western Australia is not only a logistical challenge but also a financial strain on local governments.

The report highlights a chronic shortage of general practitioners (GPs) and increasing market rates in remote areas, a problem exacerbated by inadequate financial incentives, professional isolation, and the high cost of operating medical practices in sparsely populated regions. The consequences of not having accessible GPs has disproportionate outcomes for those living in the regions. Life expectancy in remote Australia is up to seven years lower than in urban areas, and rates of chronic diseases like high blood pressure (20% in remote communities vs. 16.5% state average) and obesity (38.9% vs. 29.7%) are significantly higher. The level of State and Federal investment in this area does not reflect the difference in health outcomes.

With fewer doctors available, residents must travel long distances—sometimes over 130 kilometers—to access basic primary health care. Shire of Lake Grace residents in Lake King must travel 184 kilometers to reach the nearest doctor, without the option of public transport available to them. The lack of local GPs has led to an over-reliance on hospital emergency departments, where over 50% of presentations in rural WA are non-urgent cases that could have been handled by a GP.

In an effort to bridge the gap left by insufficient Commonwealth and State funding, local governments have been diverting significant portions of their ratepayer funds towards attracting and retaining GPs through offering cash incentives, housing, vehicles, and fully-equipped medical facilities.

The report’s six local governments collectively contribute over $1.475 million annually to ensure their residents have access to a GP. The financial burden is unsustainable, particularly given that these funds are being drawn away from other essential services. The Shire of Narembeen alone contributes $305,000 annually—16% of its total ratepayer income—to ensure continued GP services.

In response to the GP shortage, telehealth has been touted as a potential solution. While virtual consultations can provide some relief, the report warns against over-reliance on this approach. Telehealth cannot replace physical examinations, nor can it provide emergency interventions. Intermittent telehealth providers lack the local knowledge necessary to offer personalised care, particularly for Indigenous patients with complex medical needs. Moreover, telehealth threatens to divert funding from rural communities to metropolitan centers, deepening the divide between urban and remote healthcare access. The report highlights concerns that telehealth dependency could erode rural health services over time, ultimately discouraging doctors from relocating to these areas.

The report’s local government authors are calling on the Commonwealth and State Governments to commit to a sustainability payment of $4.425 million over a three-year pilot period to help fund GP services within their communities. This investment would alleviate the financial burden on local governments, seeing ratepayer funds redirected to essential services while still maintaining critical primary healthcare access.

The message from these communities is clear: healthcare should not be a postcode lottery. “If we don’t get involved, we would not have a GP” says President Kate O’Keefe.