The other shameful gap Australia needs to close: the city-country health divide .




We are talking about a problem that has remained unsolved for at least a generation, and it is likely to get worse due to the recent onslaught of drought, floods and fire.


Why is the rural health crisis so intractable?

The conventional thinking goes like this: the distribution of doctors determines the availability of care. If rural residents have less access to healthcare, we can fix the problem by getting more doctors to live in rural and remote Australia.

This hasn’t worked to date. What we should not be doing is putting more and more resources into current processes in the expectation that things will get better.

There is no argument the healthcare needs to be where the patient is living. But healthcare is one of the few antiquated methods we have of service delivery.  In rural and remote areas, patients often travel long and costly distances to get to a town to see a doctor. They may then need to return for tests, and again to be told their test results, and again for referral to a specialist, and then to pick up prescriptions.

Is it surprising that optimal results are not achieved.

What if – instead of investing billions of extra dollars to do more of the same – we spent that money to change a broken system. Because we have the technology.

Let’s equip patients who live in towns without doctors with the know-how and the communications technology to put themselves at the centre of the healthcare model. We can make more use of home-monitoring of patients – blood pressure or glucose levels, for example, which can be transmitted in real time to a GP or specialist.

At the University of New England, we have a SMART Farm program, which monitors soil quality in fields all the way down to the health of a poultry flock. Remotely.

Every town may not have a doctor, but they may have a pharmacist, paramedic or a nurse. Let’s equip those health workers with the capacity to liaise with a GP or specialist in the nearest hospital, to sit with the patient while they have a telemedicine conference to discuss what is wrong.


If there was ever a problem that could benefit from investment in digital technology, rural health is it.

The Australian Medical Association is pushing the federal government to radically change the way Medicare funds GP visits. It wants patients to enrol with one general practice that would get block funding for their ongoing care. This gets over the entrenched idea that healthcare can be dispensed in 15-minute time slots.

Or even – and here’s the kicker – that healthcare always needs to be dispensed by a doctor.

More doctors in the bush would be wonderful, but let's not continue to make rural health contingent on us being able to get them to live there. If ever it was time to think outside the box, it is now.

Professor Rod McClure is director of the the University of New England’s Virtual Health Network and dean of its faculty of medicine and health, where Professor Jane Conway is associate dean.

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