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People in rural areas have poorer access to health care and lower life expectancy.

Rural areas are becoming increasingly reliant on international medical graduates, with up to 50 per cent of doctors in rural areas having been recruited from other countries. This is not a sustainable strategy for our health system.

The next Government must ensure that strategies are employed to recruit and retain doctors with the right skills in rural areas; otherwise, access to medical care for patients in rural Australia will continue to deteriorate.

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Quality health care in rural areas depends on a well-distributed and well-trained medical workforce that works in effective collaborative arrangements with other health care professionals.

The lack of access to quality facilities, services, and doctors is a key barrier to improving the health and wellbeing of rural communities. Health care in rural areas depends on a strong GP workforce and a viable public hospital system. Without access to quality public hospital facilities, doctors cannot maintain their procedural skill levels, and the opportunity to train new doctors in rural areas is greatly diminished, leaving many communities with no doctors or too few doctors.

Rural patients deserve a health system that provides them with access to a doctor – a system that does not seek to substitute doctors with other health care workers.

Not all rural communities can sustain more specialised health services. In these situations, patients need to know that the system has well- funded, patient assisted travel schemes to support them to travel to where treatment can be provided.

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To address rural workforce shortages, Governments have tried a number of initiatives, including bonded medical school places.

These schemes seek to conscript doctors rather than build a workforce that wants to be part of the rural community for the long term. These schemes seek to conscript doctors rather than build a workforce that wants to be part of the rural community for the long term.

The 2009-10 Federal Budget also included modest additional funding to support rural workforce incentives. However, the extra funding falls well short of what is needed to address current workforce shortages in a meaningful way.

A 2007 Senate Inquiry into existing patient assisted travel schemes highlighted the inadequacy of current arrangements to support the health-related travel of rural patients and recommended several reforms, including increased government funding.

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To attract and retain a medical workforce with the right skill set for rural practice, the next Government must:

• Implement the AMA/RDAA Rural Workforce Package, which would provide further enhancements to rural isolation payments and rural procedural and emergency/on-call loadings;
• Develop and implement, in consultation with the AMA and specialist colleges, a new funding program to support and encourage more ‘generalist’ training so that we have more doctors with the right skills for rural practice; and
• Discontinue the bonded medical places scheme and expand existing incentive schemes that offer HECS relief and scholarships.

To help patients access more specialised care, the next Government also needs to ensure that there is a significant improvement in patient assisted travel schemes so that they provide reasonable assistance for travel and accommodation costs. These arrangements should be nationally consistent and their administration and funding must be transparent and accountable.

There must also be investment in telemedicine technology and services.

* For a full pdf version of the Key Health Issues for the 2010 Federal Election click here