Gulf between city and rural healthcare sparks call for new funding model

Three years into the federal government’s 10-year Stronger Rural Health Strategy, regional patients are still waiting six weeks for a GP appointment and longer for a specialist as country towns struggle to attract doctors, a Senate inquiry heard last month. Doctors who gave evidence at the rural healthcare inquiry described burnout and 12-hour days as patients unable to get a GP appointment flooded small regional hospitals.


In a pre-budget submission to the government, the NRHA called for a new model of healthcare in the bush with block funding for local health organisations to hire medical professionals such as GPs, nurses, midwives, dentists, paramedics and pharmacists.

Rural Area Community Controlled Health Organisations would be modelled on Aboriginal Community Controlled Health Organisations, which have operated since the1970s and were recently lauded by Prime Minister Scott Morrison for their role in protecting Indigenous Australians from COVID-19.

“If rural health services don’t exist, people cannot access the health care they need,” NRHA chief executive Gabrielle O’Kane said. “Lack of services means rural people utilise Medicare and the pharmaceutical benefits scheme at a much lower rate, which results in an expenditure shortfall in rural and remote areas.”

Dr O’Kane said the proposed model would overcome the barriers to attracting and retaining a rural health workforce by providing secure, ongoing employment with a single or primary employer, with conditions such as holiday pay.


Rolling out 30 of the proposed RACCHOs would cost the federal budget $314 million over four years, the alliance said in its submission.

The federal government spent $98 billion on health in the last financial year.

Rural Health Minister David Gillespie said he was “acutely aware of the workforce challenges in our health workforce” and was working to boost the number of health practitioners in the bush.

“Block funding would be a limiting move as it means restricting Medicare funding to a defined amount,” Dr Gillespie said. “The current system is demand-driven.”

But Dr O’Kane said this was misleading as “you can’t claim a Medicare rebate if there’s no doctor to see.”

“It’s not demand-driven if there’s no supply,” she said.

Dr Gillespie said more than 700 GPs and 700 nurses had moved to the bush since the government launched its Stronger Rural Health Strategy.

“Further measures we have been working on will be announced in the weeks and months ahead,” he said.

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