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Crisis in the provinces: Time for a NZ Rural Health Commissioner?

Contributor:
Fuseworks Media
Fuseworks Media

Frustration over chronic workforce shortages, poorer health outcomes and unequal access to healthcare is mounting for the group representing around 30 of the country’s leading rural health, business and agricultural organisations.

The Rural Health Alliance Aotearoa New Zealand (RHAANZ) meets in Wellington tomorrow for the organisation’s 4th RuralFest, an annual day-long event to discuss and formalise a formal policy ‘wish-list’ to take to parliament the following day (Thursday) for a series of unique, high-access meetings with the Health Minister and MP’s from other political parties.

A fresh call for New Zealand’s first ever stand-alone Rural Health Commissioner to champion the needs of all non-urban New Zealanders, is likely to be one pressing government ‘call to action’ from RHAANZ members.

"It’s time the health of 600 thousand New Zealanders, our country’s second largest city, was given far more equity" says RHAANZ council member and GP Dr Chris Henry. "I’m looking forward to asking RHAANZ members to take a sector-wide view of the need for a Rural Health Commissioner, to advocate for the health rights of all rural New Zealanders".

An alarming inequity of access and outcomes, a growing burden of mental health need and a system which continues to fail Maori - RHAANZ says it’s a situation even a government-commissioned report of New Zealand’s health system calls "simply unacceptable".

"Heather Simpson’s interim Health and Disability System Review clearly states that rural communities are currently forced to make do with an unacceptable level of service accessibility" says Dr Henry. "Her report talks of a rural health service near crisis, desperately in need of form, structure and a clear and consistent strategy for delivering rural health services. A Rural Health Commissioner would take leadership of all these urgent issues, push for policy change, accountability and ensure policies are followed-through".

RHAANZ says Australia clearly recognised the importance of an over-arching health voice for its rural population by establishing its own Rural Health Commissioner role two years ago. He credits the Australian government with having the foresight to establish the position and believes it is equally needed here, as both countries share similar problems.

"It would be a great solution for New Zealand" says Professor Worley. "What’s now been realised in Australia is that a complete and comprehensive pathway is needed for rural health. My role’s about brokering collaboration and articulating where the gaps are in the system. I’m doing that by listening and reflecting on what I hear, and it’s given people hope that finally, someone is listening, and that workable solutions are going to have support".

Professor Worley says one major success so far has been agreement for a National Rural Generalist Pathway for trainee doctors. Once established, existing Australian medical schools will develop rural campuses where students spend their entire medical training, a move, when linked seamlessly to rurally-based junior doctors and registrar training, that’s expected to produce up to 350 extra fully qualified rural doctors for Australia each year, with over 3500 students and doctors living and learning in rural Australia at any one time.

RHAANZ member groups represent not just rural GP’s, hospitals, nursing and allied health workers, but social services, district councils, farmers, forestry workers and agribusiness.

"Until now, many of our proposed solutions have been discussed but not necessarily heard, with progress too slow, especially in dealing with critical workforce shortages" says Dr Henry. "The constant headlines tell the story, whether it be inequitable access to diagnostic tests and surgery, closures of rural maternity services or alarming rates of suicide and mental health sparked by isolation, fatigue, burn-out and stress. There’s a sense that while government understands the issues, it hasn’t quite grasped the urgency of the situation".

The closures of six rural primary maternity units nationwide over the past five years; Justice Ministry provisional data showing 20 farmers lost their lives to suicide last year alone; and news that the country’s Mobile Surgical Bus regularly struggles to find enough nurses to support surgery at most of the 24 rural locations it visits, are just a few examples of issues requiring urgent attention.

RHAANZ says it has however been heartened that many previous RuralFest priorities have been actioned by government.

"Last year, for the first time, the Health Minister’s Letter of Expectation to all twenty of the country’s District Health Boards urged them to make the needs of their rural patients a priority as part of the new Rural Proofing policy" says Dr Henry. "Otago University researcher Dr Garry Nixon has also now been awarded a Health Research Council grant to define a clear and consistent definition of the term ‘rural’. This basic data is desperately needed to more accurately target future funding and policy decisions. Health Minister David Clark has also announced a scoping project to establish Rural Health Training Hubs.

"While this shows the government is willing and prepared to listen, it’s frustrating to see patients struggling to access equitable healthcare and suffering adverse health outcomes just because they choose to live rurally" says Chris Henry. "My hope is that RHAANZ members use this year’s RuralFest to discuss whether the time is right to now take the Rural Health Commissioner issue to parliament, in an effort to improve the health of all New Zealanders, whether town or country".

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