Why listening to communities is key to better rural healthcare
Improving health services in rural and regional NSW is complex, but giving country communities a genuine voice in the decisions that affect them is a good place to start.

Healthcare and access to services continues to be a pain point for rural and regional NSW – not enough healthcare professionals, hospital access, mental health support, maternity services … among the issues flagged by frustrated communities. There’s now a new call-to-action on this enormously complex – and critical – issue and one of the state’s largest advocacy groups for non-metropolitan NSW is helping raise its profile.  

The Country Women’s Association (CWA) of NSW had its beginnings in 1922 in response to the health care needs of rural and regional NSW, and in the years its members have continued to champion the cause. The Association has now thrown its support behind the ‘Better Care, Closer to Home’ Alliance’s Rural Health Action Plan, developed by Independent Member for Wagga Wagga Dr Joe McGirr and now supported by dozens of organisations around the state.

The Plan is based on the recommendations of the NSW Legislative Assembly Select Committee on Remote, Rural and Regional Health, which Dr McGirr chaired, and features six calls to action: a GP guarantee for every town; the restoration of rural maternity services; reducing the substantial cost of locums; embedding community input in health decisions; an independent commissioner for rural health; and the integration of hospitals, GPs, councils and community care.  

At the recent Bush Summit in Dubbo, healthcare featured prominently when it came to the most pressing priorities for rural and regional communities. This is certainly not news; the fact the CWA of NSW was calling for more support more than a century ago speaks to that. But, what is new about Dr McGirr’s six-point plan is its perspective, in that it’s rethinking the way things are currently done, rather than trying to chart a whole new course. And, it’s based on the experience of those who have the most to win, and lose, from future healthcare reforms.

The NSW Legislative Assembly Select Committee on Remote, Rural and Regional Health was established to inquire into and report on health outcomes and access to health and hospital services in rural, regional and remote NSW, and tabled its final report in May last year. When it conducted its inquiries, the committee travelled all around the state, hearing the first-hand of experiences of those in country communities. The stories and views of those who addressed committee members was sometimes harrowing, but always heartfelt and honest.

They felt let down and believed where they live shouldn’t determine their health outcomes. But they were also grateful to be heard, and appreciated the chance to speak to the committee directly. Those who couldn’t do it in person submitted their views in writing. Dr McGirr’s six-point plan is based on the recommendations from the inquiry, and one of the key issues it reflects is that while everyone who shared their views with the inquiry was grateful to be heard, they felt they had no voice when it came to decisions that ultimately had an impact on the care they received.

And this is one of the main focuses of the Better Care, Closer to Home Rural Health Action Plan: bringing communities to the table and giving them a say on planning and decision-making. No-one’s saying fixing our healthcare system is simple or easy. The issues are many and very complex, with no single cause and no single cure, but surely a more collaborative approach is a good place to start.

Dr McGirr and his supporters are quick to point out that their plan is not about throwing a lot more money at the issues, it’s about rethinking current processes and resource allocation to achieve better outcomes. Greater consultation with country communities doesn’t need to cost a lot of money; it just needs recognition the current system is failing and a will to listen and turn things around.