The Rural Heath Crisis

  • NSW has a higher proportion of people living in a rural or regional area than any other State or Territory, but one of the lowest rates of medical practitioners in rural areas;
  • according to the Australian Bureau of Statistics (ABS) the number of people living outside of capital cities will increase by 26% or 2 million people by 2025;
  • the number of older people in rural and regional Australia will also grow, significantly increasing the demand for health and medical services at a time when there is a growing shortage of doctors and health professionals.
  • rural and regional Australians have access to around half the number of doctors per person compared to our capital cities, particularly general practitioners (GPs) and GPs with procedural skills.
  • they have access to fewer than half the number of audiologists, speech pathologists, pharmacists, radiographers, occupational therapists, psychologists per person and only a little over half the number of dentists, dieticians and nutritionists, physiotherapists and podiatrists per person.
  • the Rural Doctors Association of Australia (RDAA) estimates there is a current shortfall of 1,800 rural doctors today.
  • according to a 2010 survey by RDAA, 62% of rural Australians are experiencing a significant shortage of health professionals in their area; 52% of rural Australians are waiting one or more weeks for a routine appointment with their GP; 18% are waiting more than three weeks to see a GP; and, 63% were not able to receive a variety of health services in the past year because of a shortage or absence of health professionals in their area;
  • an Australian Institute of Health and Welfare (AIHW) report released in January 2011 found that people in rural and remote Australia have significantly less access to health services due in large part to a chronic shortage of doctors and other health professionals in rural areas.  Lower rates of utilisation of health services in rural areas means that rural Australians receive $2 billion less in health services each year than they would receive if major city rates of expenditure had applied.
  • rural and regional Australians have poorer health outcomes, higher rates of chronic disease and higher death rates from preventable disease than people in capital cities.
  • a 2010 AIHW study found that around 4,600 rural Australians died unnecessarily between 2004 and 2006 because of where they live.
  • despite the desperate need for more doctors in rural Australia, fewer than 13% of medical graduates want to practice in rural areas and only 13% of these want to become a GP.
  • a 2008 study found that only 4.29% of medical graduates from two Queensland medical schools entered practice in a rural area;
  • as a result, over the last 10 years there has been a 4% decline in the number of Australian medical graduates in rural practice;
  • the situation is worse in NSW, despite the fact that it a higher proportion of people living in rural areas compared to many other States and Territories.
  • the rural health workforce crisis is only going to get worse. According to Health Workforce Australia we need to create at least 350 additional medical student places every year if we are to meet current and future demand for health services.  With rural Australia already experincing chronic doctor shortages and higher rates of illness and death, it is essential that the majority of these places are filled by rural students studying at a rurally based University.
  • while rural and regional Australians make up 36% of the population, medical schools are only required to enrol of 25% of their students from rural areas.  Yet a 2010 report from the Federal Government's Medical Training Review Panel found that only six medical programs met the 25% requirement, with a number of other medical schools not participating in the program at all;
  • overseas trained doctors now make up 41% of doctors working in rural and regional Australia with a recent report by Rural Health Workforce Australia (RHWA) concluding that ... the growth in rural and remote GP numbers [over the past 11 years] has come almost exclusively from international medical graduates' (2008).
  • with increased retirements of rural doctors, on current trends overseas trained doctors will make up more than 50% of the rural medical workforce within the next ten years.
  • despite hundreds of millions of dollars of investment in programs run by metropolitan medical schools to increase the number of rural doctors and other health professionals, there is no evidence that they are making a big enough impact. The latest independent review of the Rural Clinical School (RCS) program for example concluded that, despite multi-million dollar investments, there is ... no definitive answers to whether RCSs in Australia have (or have not) yielded higher rates of rural practice among participating students (2009).
  • Existing strategies have had more than 10 years to prove they are increasing the number of rural doctors and health professionals to a level appropriate to meet demand. Yet, rural Australians continues to experience chronic shortages of health practitioners and unacceptably high levels of chronic illness and unnecessary deaths.