The importance of broadband for rural health and rural communities cannot be overstated, says Professor Lesley Barclay, head of the Northern Rivers University Department of Rural Health in northern NSW.
But there is also a need to redesign rural health services, she says. The Independents need to know that improving rural health is not all about having “more”, whether doctors, nurses or dollars. It’s also about doing differently and better.
Lesley Barclay writes:
It is good to see that rural and remote health issues might get a guernsey in the upcoming political scene. It has been wonderful, quite frankly, to hear these issues canvassed by the three Independents.
I note that Dr Jenny May from the National Rural Health Alliance and Dr Nola Maxfield, Rural Doctors Association President are making the most of this opportunity.
There are issues that are different for those of us living in rural or remote Australia.
As I sat in a village on the north cost of New South Wales on Sunday trying to work on my computer but not being able to down load or work effectively because of slow speeds, I thought of rural-based colleagues who run business or creative arts activities who are disenfranchised by this.
However, the National Broadband network and its capacity to enable specialist consultations makes this inconvenience for me, or a lack of business opportunity for friends, pale into insignificance.
It would be wonderful to have better diagnosis and treatment for the 30% of Australians who are long distances from highly skilled specialists who are needed for diagnosis and treatment of their less common ailments.
We need to lobby for creative workforce solutions for skills shortages in rural areas. This does not just mean we need more!
With small numbers of people living long distances from each other, we need clever thinking in linking skills sets. For example, the connecting and utilisation of Aboriginal health workers and nurses or nurse practitioners with GPs and acute care services as a network of care focussed on what the patient needs.
Again, communication links will help with this as we are starting to see already, but a NBN can help again with photos, test results etc being transmitted readily between us.
Birthing is another area where we have seen the closure of rural services without consideration of the impact of this – despite Australian published evidence of their safety for healthy women and babies. We now have women giving birth on the road and families suffering great expense as women have to spend weeks in a regional centre waiting for birth.
The other issue I would like the Independents to think about is helping us educate communities about how their own small hospitals fit into a contemporary health system.
The local hospitals built with great energy and commitment are still important but in a new role. For example if one has a heart attack you do need to go to a regional hospital for care.
However, if you are aged and require nursing home attendance, if you are dying and require palliative care, or are undergoing rehabilitation after major surgery this could well be provided locally.
It does mean however changing the nature of the local services and looking at how these services can be supported by a network of care, local GP or nurse practitioner.
It means closing small emergency departments if there is no resident doctor on site. It does mean working with ambulances and air evacuation for acutely ill people and no longer imagining that all care can be provided in a small country town.
This may be hard to understand but it is a vital step in reworking rural health care for this century.
As a rural and remote researcher, I also would put in a plea to look at studies that meet the needs of health service redesign, better delivery of services and building rural capacity in ways that make sense.
Much of this requires new thinking and innovation that is different from urban areas where most of the limited amount of health service research gets done.