What are the problems in rural health service delivery and what can we do about them?
For decades, the Australian Government has been wrestling with how to “fix the rural health problem”. Long‐standing problems of workforce shortages and maldistribution, difficulties with recruitment and retention, and inadequate access to, and availability of, appropriate services persist.1 These contribute to the poor health status of many non‐metropolitan Australians, especially Aboriginal and Torres Strait Islander populations, despite the fact that governments spend millions of dollars annually on specific rural and remote health programs.2
The full article is accessible to AMA members and paid subscribers. Login to read more or purchase a subscription now.
Please note: institutional and Research4Life access to the MJA is now provided through Wiley Online Library.
- 1. Mason J. Review of Australian government health workforce programs. Canberra: Australian Government Department of Health; 2013. http://www.health.gov.au/internet/publications/publishing.nsf/Content/work-review-australian-government-health-workforce-programs-toc (viewed Feb 2019).
- 2. Australian Institute of Health and Welfare. Australia's health 2018 (Australia's health series no. 16; Cat. No.AUS 221). Canberra: AIHW; 2018. https://www.aihw.gov.au/reports/australias-health/australias-health-2018/contents/table-of-contents (viewed Feb 2019).
- 3. Australian Health Ministers Conference. National rural health strategy. Canberra: Australian Government Publishing Service; 1994. http://ruralhealth.org.au/sites/default/files/healthy-horizons/national%20rural%20health%20strategy%2C%20march%201994.pdf (viewed Feb 2019).
- 4. Kwan MMS, Kondalsamy‐Chennakesavan Ranmuthugala G, et al. The rural pipeline to longer‐term rural practice: general practitioners and specialists. PLoS ONE 2017; 2017(12): e0180394.
- 5. Playford D, Ngo H, Gupta S, Puddey IB. Opting for rural practice: the influence of medical student origin, intention and immersion experience. Med J Aust 2017; 207: 154–158. https://www.mja.com.au/journal/2017/207/4/opting-rural-practice-influence-medical-student-origin-intention-and-immersion
- 6. McGrail MR, Russell DJ, Campbell DG. Vocational training of general practitioners in rural locations is critical for the Australian rural medical workforce. Med J Aust 2016; 205: 216–221. https://www.mja.com.au/journal/2016/205/5/vocational-training-general-practitioners-rural-locations-critical-australian
- 7. Buykx P, Humphreys J, Wakerman J, Pashen D. Systematic review of effective retention incentives for health workers in rural and remote areas: towards evidence‐based policy. Aust J Rural Health 2010; 18: 102–109.
- 8. Thomas SL, Wakerman J, Humphreys JS. Ensuring equity of access to primary health care in rural and remote Australia: what core services should be locally available. Int J Equity Health 2015; 14: 111.
- 9. Wakerman J, Humphreys JS, Wells R, et al. Primary health care delivery models in rural and remote Australia: a systematic review. BMC Health Serv Res 2008; 8: 276.
- 10. Humphreys JS, Wakerman J, Wells R, et al. “Beyond workforce”: a systematic solution for primary health service provision in small rural and remote communities. Med J Aust 2008; 188: S77–S80. https://www.mja.com.au/journal/2008/188/8/beyond-workforce-systemic-solution-health-service-provision-small-rural-and
- 11. National Rural Health Alliance. Australia's health system needs re‐balancing: a report on the shortage of primary care services in rural and remote areas. Canberra: NRHA, 2011. http://ruralhealth.org.au/document/australias-health-system-needs-re-balancing-report-shortage-primary-care-services-rural-and (viewed Feb 2019).
- 12. Zhao Y, Russell DJ, Guthridge S, et al. Cost impact of high staff turnover on primary care in remote Australia. Aust Health Rev 2018. https://doi.org/10.1071/ah17262. [Epub ahead of print]
- 13. Reeve C, Wakerman J, Humphreys JS, et al. Strengthening primary health care: achieving health gains in a remote region of Australia. Med J Aust 2015; 202: 483–487. https://www.mja.com.au/journal/2015/202/9/strengthening-primary-health-care-achieving-health-gains-remote-region-australia
- 14. Buykx P, Humphreys JS, Tham R, et al. How do small rural primary health care services sustain themselves in a constantly changing health system environment? BMC Health Serv Res 2012; 2: 81.
- 15. Carey TA, Sirett D, Wakerman J, et al. What principles should guide visiting primary health care services in rural and remote communities? Lessons from a systematic review. Aust J Rural Health 2018; 26: 146–156.
- 16. Humphreys JS, Wakerman J. Primary health care in rural; and remote Australia: achieving equity of access and outcomes through national reform. A discussion paper for the national health hospitals reform commission. 2008. https://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;query=Id%3A%22library%2Fjrnart%2FTAAS6%22 (viewed Feb 2019).
- 17. Humphreys J, Wakerman J. Learning from history: how research evidence can inform policies to improve rural and remote medical workforce distribution. Aust J Rural Health 2018; 26: 329–334.
Online responses are no longer available. Please refer to our instructions for authors page for more information.
John Wakerman receives funding from the Australian Government Department of Health, the Northern Territory Government Department of Health and the Medical Research Future Fund through the Central Australian Academic Health Science Centre.
No relevant disclosures.