The National Rural Health Alliance (the Alliance) is pleased to have the opportunity to comment on Issues Paper 2 of the Scope of Practice Review. Given the Department of Health and Aged Care will be consulting directly with our members and Friends of the Alliance via the verbal consultation sessions in June, we have taken this opportunity to provide an overarching written response in lieu of completing the survey questions.
The Alliance represents 51 member organisations encompassing healthcare professionals, health and wellbeing providers, educators, researchers, the Aboriginal and Torres Strait Islander health sector and rural health students. The Alliance is committed to improving the health and wellbeing of the 30 per cent of the population (more than seven million people) living in rural, remote and regional (hereafter rural) communities.
At the population level, people residing in rural Australia have poorer health than their metropolitan counterparts. They experience a higher prevalence of multiple health risk factors, rate more poorly against the social determinants of health, and have reduced access to health, disability and aged care services. Consequently, rural people experience a greater burden of disease, higher rates of morbidity and mortality, and have a lower life expectancy.1 Maldistribution of the health workforce in rural Australia, as well as the tyranny of distance and higher costs, play a significant part in the reduced access to services rural people are faced with.
We are cognisant of the opportunity this review provides to enable change at the individual, organisational and health-system level, with the potential to improve health workforce satisfaction and retention, access to high quality care close-to-home, and ultimately reduce the inequity in health outcomes experienced by rural people. We acknowledge the strong focus and many references to the rural health sector within Issues Paper 2 and agree with the statement that “in rural and remote areas, the impact of issues relating to scope of practice were determined through the evidence to be overall more profound, due to issues of workforce constraints, distance, and specific local community needs”. We highlight and reiterate the astute comment that follows, noting that rural and remote regions are “a key priority for reform”.
Our overarching assessment of the options for reform is that it would be pertinent to take some immediate steps which are realistic and will achieve the intended aims with broad sector agreement, flexibility in guidelines to suit communities, and appropriate investment of resources. Additionally, it would be prudent to ensure that policies put forward do not risk adding unnecessary bureaucracy or create additional regulation of scope of practice, as these consequences would create additional burden, adding further barriers to workforce and access to services by patients.