From the Journal Associates
The rural and remote health workforce of the future
Rural health and remote health are different. You can-not simply tweak and rebadge a metropolitan health service and expect it to function effectively in a rural and remote community. It follows that the workforce for rural and remote health services also needs to be different and attuned to their communities’ needs.
One of the priority recommendations of the 14th National Rural Health Conference recognised this issue by identifying the need for:
a long-term commitment to rural health workforce
scholarships, including expansion of regionally-based training pathways;
broadening the rural generalist pathway to embrace
the full rural and remote health professional work-force, including allied health professionals;
active investing in training and support for health
managers who are at the front line of change and performance of health systems; and
the Australian Commission on Safety and Quality in
Healthcare to work with remote stakeholders to develop and secure funding to implement national stan-dards for remote health worker safety and security. Australia is now producing significant numbers of medical graduates, but the maldistribution of the med-ical workforce is increasing. These graduates find work in outer metropolitan, inner and outer regional communities; very few choose to work in remote and very remote communities. Inequity of access in those remote areas is increasing.1
Doctors are crucial to the delivery of comprehensive primary health care and the implementation of system
reforms such as Health Care Homes. Without
increased numbers of nurses, dentists and allied health providers, potentially preventable hospitalisations and the massive differences in health outcomes – such as were reported in The Second Australian Atlas of
Healthcare Variation2
– will continue. The success of the Health Care Homes initiative in rural and remote communities depends on access to the broad range of health care services and providers that are necessary to ensure optimal outcomes.
It is clear that the appointment of the National Rural Health Commissioner will see a renewed emphasis on the development of the rural generalist pathway for medical practitioners. Alliance members strongly argue that unless there is a broadened rural generalist pathway for all rural and remote health pro-fessionals, we will continue to see poor health out-comes, particularly in remote communities.
Developing the rural and remote health workforce of the future needs long-term government commitment involving all jurisdictions in addition to the ongoing work of educational institutions, scholarship pro-grams, training providers and communities. Current progress in regional communities must extend to the needs of remote communities.
It is important to reconsider how we choose and train the rural and remote workforce of the future. Training closer to home – including postgraduate training – broadens the potential pool of people will-ing to consider health careers. Delivery of education and training closer to home removes the extra barrier that relocation costs can impose. Regional and remote health education and training hubs using new technol-ogy can help.
For many rural and remote communities, health, disability care, aged and community services are the jobs of the future. To capitalise on this, workforce planning needs to engage communities to identify future local needs and plan to source, educate and train the workforce locally as far as possible. New scopes of practice, developed with professional bodies, and new, possibly more generalist roles, will support health professionals working in settings changing rapidly in response to improved communication tech-nologies. Place-based solutions to meet local health needs are the way of the future and should be expanded to include the local health workforce and its needs.
Fiona Brooke
Senior Policy Officer National Rural Health Alliance
1http://aihw.gov.au/workforce/medical/additional/, Supplementary Table 23, accessed 6 July 2017.
2http://acsqhc.maps.arcgis.com/apps/MapAndAppGallery/index.html?appid=fd3b04ebe3934733b7ecb8514166c08f, accessed 6 July 2017.
doi: 10.1111/ajr.12383 ©2017 National Rural Health Alliance Inc.
Aust. J. Rural Health(2017)25,254
