While the wait for a Government continues, here is the advice that the National Rural Health Alliance gave the independents last week:
“The NRHA proposes that interested parliamentarians seek a formal written commitment that the new Government should:
1. Plan and deliver broadband access to homes and businesses throughout the nation.
Fast broadband is essential for e-health, commerce, business, education, connectivity and recreation. The price will be affordable for consumers, irrespective of their location and the technology used. Function will determine required speed eg e-health requires sufficient speed to sustain real time transmission of accurate images for telemedicine.
Reporting requirement: Annual report to Parliament, against a detailed budget and timeline.
2. Bi-partisan approach to Indigenous wellbeing.
In government, provide the Party in opposition with the opportunity to confirm a bipartisan approach to national inter-government work to improve the state of health and wellbeing of Australia’s Aboriginal and Torres Strait Islander peoples.
Reporting requirement: Annual report to Parliament.
3. A fair share of the extra money that is to be spent on hospitals.
Require States and Territories to deliver a measurable and fair share of the extra money to be spent on hospitals (beds, emergency departments, elective surgery, subacute care, mental health etc) in rural and remote areas. The extra resources may at times be better directed to acute care facilities that are not ‘hospitals’ (eg MPSs) and to services that are ‘better than hospital beds’ (eg hospital in the home).
This commitment includes confirmation that block funding (not activity-based) will be provided to smaller hospitals. The quantum of block funds will allow for the service obligations of smaller hospitals and the number of people (weighted by health need and socio-economic status) served by them.
Reporting requirement: A report in each year of the government’s term – by region (major city, regional, rural, remote) – and stepped action if the evidence shows that there is not a fair rural share in year one.
4. A new pool and allocation system for health infrastructure.
Create a new pool of resources for health infrastructure (including the GP Superclinic program, REID, the RMIF and the commitments made in the election campaign to augment infrastructure in general practices) and a new process for allocating resources from the pool. Allocations would be made on the basis of demonstrated need for such infrastructure, rather than by government decision (in the case of GP superclinics) and through competitive grant applications (in the case of REID and RMIF). In the first term of the new Government, allocations would be made through a formula managed by the Australian Institute of Health and Welfare. The formula would comprise data on access to a GP and other primary care professionals, socioeconomic status and population health data. Allocated resources would go to the health facility best able to provide improved services – not necessarily general practice.
Reporting requirement: A report each year assessing the allocation of these funds by region (major city, regional, rural, remote).
5. Commit to continue health reform.
Continue health reform, working closely with the States and Territories, ensuring rural and remote areas gain greater local fundholding and performance measurement, permitting ‘place-based’ planning and delivery of health services. The reform should include the establishment of new primary care organisations (along the lines of Medicare Locals envisaged by the Rudd/Gillard Government) and decentralisation of the control of groups of hospitals (along the lines of Local Hospital Networks). These new organisations should be ‘local’ and in more remote areas flexible enough to establish a single integrated entity for both acute and primary care. Wherever communities of interest and patient flows suggest it, the primary care and/or acute care entity should cross existing state and regional boundaries.
Reporting requirement: There will be a public annual report each year on progress with these reforms, with analysis by region (major city through to very remote).
6. Extra effort in oral health care.
Provide significant additional resources for public oral health services, through a Commonwealth dental health program, along the lines of the previous such program, and through practical measures (eg scholarships, HECS reimbursement) to improve the oral health workforce.
Reporting requirement: A public report each year on the number of people in various categories (Indigenous, low income, health care card holder, rural and remote residents) who do not receive oral healthcare and on the availability of oral health staff.
7. Build the rural and remote health workforce.
A package of measures to further build and redistribute a health workforce to rural, regional and remote areas, resulting in greater equivalence of support across all health professional groups. The package would include:
- support (as outlined in the election campaign) for practice nurses, nurse practitioners and dental scholarships;
- a specific focus on the oral health service workforce, with the establishment of a foundation (training) year for new dental graduates; HECS reimbursement for rural service by dentists and oral therapists and hygienists; [see above re a new public dental health program];
- new Medicare items for telehealth consultations with more specialised clinicians, to be accessed by GPs, practice nurses or nurse practitioners in towns where there is no doctor (see a above).
Reporting requirement: A public annual report each year on progress with these measures, with analysis by region (major city through to very remote).
These seven measures would significantly improve the social, economic and health status of rural, regional and remote Australians.”