Rural and regional hospitals are bracing for a perfect storm

October 29, 2021

Opinion editorial by Tom Symondson, CEO of the Victorian Healthcare Association. This article was first published in The Age on 28 October 2021


From 6pm this Friday, Melbournians will finally be free to leave the city and head to some of the beautiful places regional Victoria is so famous for. Places like the Great Ocean Road, Phillip Island and the mighty Murray River. It’s an exciting time for all of us after so long locked down. But as Victoria becomes one this weekend, healthcare workers in rural and regional areas are bracing for a perfect storm.

Every December, our regional hospitals prepare for their populations to swell by up to 15 times. This brings with it a major jump in seasonal injuries; picture the overconfident bushwalkers with busted knees or backs, the adventurous kids (and adults) suffering from heat stroke after a long day at the beach, the forgetful road tripper who leaves their medication at home and suffers a relapse in an unfamiliar town – the predictable list goes on. And that’s before we get to the increase in heart attacks, stroke and other acute issues that inevitably follow such massive inflows of visitors.

And this year, COVID-19 will be in the mix, too. The Burnet Institute predicts our summer holidays will coincide with peak COVID-19 related hospital admissions across the state. Up until now, this demand has been steadily rising in Melbourne’s hospitals whilst the regions have largely been spared. But as the great summer migration begins, this will change. And the recent outbreaks in Mildura and Shepperton show just how quickly this virus can put a choke-hold on a regional town, putting unimaginable pressure both on health services and other critical infrastructure such as supermarkets.

Earlier this month, we brought together dozens of rural and regional health service executives to discuss their preparedness for a summer like no other. They spoke of issues such as availability of personal protective equipment, ageing infrastructure, and ventilation concerns. But one issue stood head and shoulders above all the others: workforce.

The executives spoke about the unsustainable levels of exhaustion and burnout among nurses, doctors and other workers who have spent the past 20 months fighting COVID-19, many without a meaningful break. They spoke of the additional strain on workers in bushfire affected regions, many of whom are still suffering the effects of trauma from the appalling fires of the past few years and yet are preparing to do it all over again as this year’s fire season fast approaches.

They detailed rising rates of staff absence due to physical and mental illness and occasions when they, the executives, were forced to work night shifts caring for patients because there was literally nobody left to call in. Anyone concerned about the mental image of a hapless bureaucrat caring for patients need not worry – these executives are experienced healthcare professionals and they know what they’re doing. But they still have to turn up the next day to keep running the show.

A shortage of healthcare workers in rural and regional areas is nothing new, but it has been made so much worse by the pandemic. Our closed borders have put a stop to skilled migration which has historically provided so many of our healthcare workers. And the flood of cashed up sea and tree-changers has made affordable accommodation for workers rarer than hen’s teeth in many towns. This means that even if we can attract nurses and doctors to our regions, they may have to resort to long and expensive stays in hotels while they secure a home locally, or give up trying and move back to the city.

The Victorian Government has promised to import 1000 healthcare workers to reduce a shortage across the state, and it’s investing in initiatives such as rest and recovery spaces and on-site counselling to offset the risk of burn out. These are great investments, but 1000 workers won’t be enough to solve the problem. This month, there were more than 300 healthcare jobs advertised in Victoria’s south-west region alone. Multiply that across the state and you can understand why this issue is front of mind for our health sector leaders.

Public hospital staff are used to working hard, under difficult circumstances and they are generally there for altruistic reasons which is partly why they have kept going for so long, despite the strains of COVID-19 and horrific bushfires made worse by climate change.

But there is a genuine fear in the system that our workers are running out of steam. Government talks very consistently about the need to support them, but the blunt reality is that no amount of investment in worker wellbeing programs can fix the chronic shortage of psychologists, counsellors and mental health workers needed to implement them in regional areas overnight.

So, as you plan your getaway this year, think about the things you can do to stay safe and well at your destination. Remember to pack your medication. If you feel unwell, get a COVID test and don’t travel. Hard as it might be, try not to go too crazy with the adventure sports, the partying or the booze. And last but definitely not least – get vaccinated!

Because if you’re unlucky enough to need an ambulance, GP or emergency department, there’s a very good chance you’ll encounter a stressed and stretched service. And you will almost certainly be cared for by a healthcare worker sweating under the weight of heavy, hot protective gear who can only dream of the time that they will be the ones on holiday.