As celebrations marking the 90th year of Royal Flying Doctor Service (RFDS) operations wind down, the Flying Doctor has looked ahead to 2028 to ensure their services remain competitive and efficient, optimally targeted and designed to meet the needs of a changing population in rural and remote Australia.
The RFDS Research and Policy Unit has released a new research paper that asks: In 10 years’ time, as we mark our centenary, what services should the RFDS be providing?
This has been answered by analysing projected population, health status and health workforce trends in rural and remote Australia to identify key service gaps and inform recommendations for future RFDS service priorities.
The findings of this paper also have a broader purpose in the policy conversation on health service planning for rural and remote parts of Australia. The report identifies the best areas for investment in future health care services by governments, service providers, communities and the RFDS.
The Australian population is estimated to be 29.4 million by the year 2028, growing at approximately 1.4 per cent per year, and with the population of remote areas predicted to grow steadily at 0.2 per cent per year over the next decade.
The number of Australians living with at least one chronic disease is estimated to increase from 11.8 million in 2018 to 13.8 million by 2028. Cancer, disorders of mental health and cardiovascular disease (CVD) are predicted to be the most prevalent chronic diseases. Consistent with current trends, those in rural and remote areas are expected to be impacted most by these growing rates.
There was a 3.7 per cent per year increase from 2003 to 2011 in disability-adjusted life years (DALYs) lost due to neurological diseases, such as dementia and Alzheimer’s. It is expected that without further prevention measures the prevalence of these diseases will continue to increase.
Pathology, imaging and pharmaceuticals are together expected to reach 17.2 services per patient per year in 2027–28 as compared to 13.3 services in 2007–08. This increase reflects the growing burden of chronic disease.
Data presented in the report indicates that in the next decade there will be significant shortages of essential health services, such as general practitioners, physiotherapists, pharmacists and psychologists in rural and remote Australia
The clinical perspective survey undertaken to inform this report showed that the availability of primary health care was perceived as generally adequate. This indicates that progress has been made in response to renewed interest and policy intervention in rural and remote health since the early 1990s. Nonetheless, there were specific areas that were deemed as having limited or poor provision, including services for dental health, mental health and diagnostic imaging.
Participants indicated that more resources should be invested into health literacy education, to the provision of mental health services, and to improving health infrastructure.
It is predicted that with the decentralisation of health networks, the closure of regional hospitals and an increasingly ageing population suffering from complex and age-related illness, the demand for RFDS inter-hospital transfers by air and road transport will grow significantly throughout the next ten years. RFDS Victoria and Central Operations increasing their transfers by road from 12,000 in 2012 to 70,342 in 2018. This trend is predicted to continue.
RFDS primary health care (predominantly GP and nursing clinics) services will need to evolve and, with an ageing population, the RFDS and other health service providers should prepare to respond to more complex and age-related illnesses. Furthermore, the RFDS may need to increase provision of physiotherapy, mental health, pharmacy and diagnostic imaging services in rural and remote areas.
In summary, the report projects that over the next decade, on a population basis, there will continue to be significantly fewer services in country areas as compared to our major cities. Similarly, workforce provision will also continue to be significantly lower in rural and remote than metropolitan areas. At the same time the disease burden due to cancer, CVD and disorders of mental health in rural and remote areas is expected to continue surpassing that of metropolitan areas.
Consequently, there will need to be: additional health prevention and early intervention activities; enhanced primary health care services and treatment services to respond to increases in chronic disease; and support and incentives for clinicians working in the bush.
Services of the RFDS will continue to be in high demand throughout the next ten years, with expected growth in multidisciplinary primary health care and outreach programs involving specialists, allied health, mental health, dental and telehealth services to rural and remote areas.
For a full copy of the research paper go to www.flyingdoctor.org.au/what-we-do/research.