Addressing the rural health gap in Victoria

October 25, 2022

Almost a quarter of Victorians live in rural and regional Victoria. While living in rural and regional areas comes with great benefits – including social indicators associated with good mental and physical health – according to other health indicators, rural Victorians are also more likely to experience poorer health outcomes than metropolitan Victorians.

Comprehensive healthcare is essential to disease prevention, early intervention, and chronic disease management – and rural Victorians deserve the same level of access to high-quality care as Victorians living in metropolitan Melbourne or a regional hub.

The operational challenges that rural health services face are compounded by social, economic and geographic disadvantage, adding to the disparity in health outcomes for rural Victorians.

Rural health services are doing the best they can with the resources they have to deliver high-quality care to their local communities. But they need more support – that’s why the VHA is calling on the government to level the playing field.

 

Rural Regional Roundtable network

The VHA’s quarterly Rural Regional Roundtable virtual roundtable series aims to support rural and regional hospitals’ immediate and long-term preparedness and resilience. At past meetings we have been articulating the systemic challenges impacting the sector, including workforce and infrastructure. Attendees were invited to summarise the key challenges faced by the sector, explore policy solutions, and prioritise the VHA’s advocacy agenda for the Victorian election and beyond.

In April 2022, the VHA developed a report exploring the complex challenges of workforce by drawing on both academic evidence and the collective insights of over 50 senior leaders from across health services in rural and regional Victoria. This report outlines the chronic and unique workforce challenges faced by rural and regional health services that are exacerbated by geographical location and scale of service. Challenges include housing availability, flexible workforce models, and competitive remuneration which create added complexity to recruitment and retention.

 

Effective use of workforce

On 23 October 2022, ABC News covered an innovative rural initiative in which a paramedics are deployed to target older people in the community who are not connected to healthcare. The story featured the voices of Sunraysia Community Care CEO,  Simone Heald, and Ebonee Dowdy, one of two community paramedics working in the district as part of a pilot program based on a Canadian model which found after 10 years at 100 locations, there was a 20 per cent decrease in ambulance call-outs, an increase in service user’s quality of life, and reduced chronic disease risk factors.

While all the other health professions are in short supply, there are actually 6,500 more trained paramedics in Australia than there are ambulance positions, according to government data. Formerly an Ambulance Victoria paramedic, since July 2022 Ebonee’s role has seen her travel to different community centres in the region each day, meeting locals, delivering health checks and connecting them with other health services. However, due to legislation, community paramedics are currently limited in the scope of healthcare they can offer.

 

State Election Platform

The VHA is seeking nine commitments from the next State Government to support public health and community health services across Victoria. These commitments have been developed through extensive engagement with VHA members – for rural health services, the Rural Regional Roundtable was a key forum to gather and test priority policies. All nine of our election asks are relevant to rural health services and the communities they serve, with three that have a particularly strong rural focus:

We want the next Victorian State Government to increase and expand Victoria’s ‘full scope’ workforce programs to ensure clinical skills and expertise are used in the most effective way. We need to address workforce shortages by using staff to the best of their abilities; this is often called working to ‘full scope of practice’ – working to the full extent of the profession’s recognised skill base and regulatory guidelines.

We want the next Victorian State Government to fully fund rural urgent care centres so that no Victorian will have to pay for emergency care. Urgent care centres are a vital health resource, delivering urgent and emergency care to rural communities. But there is often an out-of-pocket expense attached.  Currently, if a Victorian presents to an urgent care centre, they may have to pay a Medicare fee – yet if they were in a regional hub or metropolitan area, they could attend an emergency department for free.

We want the next Victorian State Government to create a Health Infrastructure Maintenance Fund to provide expert support, maintenance, and regulatory compliance. Ensuring the basic running of our facilities is critical to the delivery of healthcare. While the Victorian Government dedicated $2.5 billion to health infrastructure in the last Budget, only $55 million was dedicated to maintaining the current asset base. Health services tell us they are having to use money intended for upgrades just to meet basic compliance requirements.

Without these commitments from government, rural health services will continue to be disproportionately affected by workforce shortages, ageing infrastructure and inadequate funding – with poorer health outcomes for local communities.

 

Read our election documents:

VHA State Election Platform 2022 – Response, recovery and reform: delivering the healthcare system Victorians deserve

Election position paper – Addressing the rural health gap