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Regional Care And Chronic Pain

Australia is a vast and beautiful country, but for those who need Regional care coping with chronic pain, accessing appropriate medical care poses huge challenges.  The following article covers the subject in depth.

Rural patients deserve better health care. We just need to be brave and implement change.

By Jack Archer –¬†Posted¬†

If you live in rural and remote Australia, your access to health care remains well below the standard that citizens of one of the richest nations on Earth should expect.

Rural and remote areas experience serious health workforce shortages, despite having a greater need for medical services.

Lower rates of cancer screening and higher rates of potentially preventable hospital stays are just some of the issues people in the regions face.

The outcome is lower life expectancy and higher rates of illness and disease.

It is a key issue that drives people to move away from rural and remote areas, undermining progress for these economies and communities.

For those of us who don’t live the reality, this stream of facts and stories can be tiring. It can seem like just another unfortunate thing in the world that can’t be changed.

But if you look a little harder, you can see this isn’t really true. In fact, many of the answers are right in front of us.

A masked nurse adjusts their blue plastic glove in an operation room.

More could be done to utilise nurses’ skills.(Rawpixel: Chanikarn Thongsupa)

How tech creates opportunities

New technologies are opening up exciting opportunities for better access to quality care each day.

Artificial intelligence is assisting isolated healthcare workers to collect information for a rapid diagnosis without specialist training.

There are also new initiatives identifying ways to resolve chronic workforce shortages across the sector.

The small town of Glen Innes in rural New South Wales, which suffers from serious health workforce shortages, recently secured two new local general practitioners, a pharmacist, an exercise physiologist, a diabetes educator, a nurse practitioner and a speech pathologist in just six months.

They did this by embracing the emerging Attract Connect Stay initiative that helps communities lead the way in finding, welcoming and retaining new health workers.

Despite the workforce shortages, there is already the same or a stronger presence of nurses per person in rural and remote areas.

Generic shot of a nurse testing unidentified patient's blood sugar.

Specialist nurses in regional areas could ease the burden on the healthcare system.(ABC: Emma Wynne)

The opportunities to enable these nurses to do more and to make their practice more rewarding and impactful are significant.

For example, overseas evidence shows that nurse practitioners are able to provide 67-93 per cent of all primary care services if given the scope of practice and access to funding similar to Medicare.

At present, these skilled specialist nurses who can diagnose and prescribe for many illnesses, and work closely with specialist doctors to provide complex care, are thin on the ground.

By investing in more nurse practitioner positions in rural and remote areas and expanding their scope of care we could make a big, big impact on rural health problems.

Telehealth improves access to care.

Last, but certainly not least, is the role that telehealth now plays in rural and remote health care.

The pandemic finally gave government the push to make telehealth more widely available, with enduring benefits for people in rural and remote areas in terms of access to care.

These are all great examples of the change that is possible.

Man sits at desk looking at laptop screen, woman is displayed on screen

Telehealth is now a vital tool to deliver health care in regional Australia. (Supplied)

There are many others, and they should all give us real hope for the future.

But the reality is that, aside from the telehealth rollout, these are fragile green shoots, good options or just one-off pilots that prove change is possible, but don’t make it so.

Real change needs a long-term investment combined with a system-wide commitment to innovation and change.

The foundation for making this happen is moving to equitable Medicare spending for rural and remote communities.

A rapid analysis of the latest data* on national health spending reveals that the Medicare Benefits Scheme (MBS) spent about $290 less per person in small rural towns and remote areas than in major cities over the previous financial year.

Category

2021 population

Medicare benefits July 2021‚ÄďDecember 2022

Benefits per person

Metropolitan

16.5 million

$11.3 billion

$684

Regional centres

2.1 million

$1.3 billion

$617

Large rural towns

1.5 million

$944 million

$626

Medium rural towns

923,000

$571 million

$618

Small rural towns

1.7 million

$989 million

$586

Remote communities

271,000

$109 million

$405

Very remote communities

180,000

$55.5 million

$309

*Source: Department of Health and Aged Care, Medicare quarterly statistics

In total, this equates to more than $600 million each year that is not being spent on Medicare benefits for rural and remote Australians, mostly because they can’t access the services they need.

This gap is not new.

In 2014‚Äď15,¬†the National Rural Health Alliance found that the underspend through the MBS was $374 less for remote residents¬†compared with people in metropolitan areas.

The recurring underspend should be invested in an ongoing innovation fund, with the states, private sector and philanthropists challenged to match the commitment.

Over a 10-year period, this equity-based approach to funding could generate billions of dollars to invest in trialling new ways of delivering health services at scale and then rapidly rolling out the innovations that work.

It would be a game changer for rural and remote health.

The government is looking at widespread changes to Medicare right now.

If the reforms include a commitment to the equality of spending for rural and remote Australians, we could have things up and running and be investing in real change within 12 months.

Let’s not wait for another pandemic to make major positive changes in rural and remote health.

Time to be brave and make it happen.

Jack Archer is an advisor on regional development issues and former chief executive of the Regional Australia Institute.

Another article covering the subject

 

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