A key session at the National Rural Health Conference, starting in Adelaide on Sunday, will address the social and economic determinants of health, and initiatives to ensure rural and remote Australia receives its fair share of resources.
In the preview below compiled by Marge Overs, who is reporting on the conference for Croakey, the session’s three speakers give a taste of their presentations. And National Rural Health Alliance Executive Director Gordon Gregory explains why the session is one not to be missed.
Building regional capacity
Paul Rosair, Director General, Department of Regional Development and Lands, WA
WA’s Royalties for Regions program requires 25% of mining royalties to be spent outside of Perth.
It aims to build regional communities through building capacity, retaining benefits in the communities, improving services, attaining sustainability, expanding opportunity and growing prosperity.
The Southern Inland Health Initiative is a primary example of the capacity for Royalties for Regions to deliver key project outcomes for regional WA.
The project will provide a direct, significant and tangible increase in medical and other clinical services across the Southern Inland area, ensuring the sustainability of emergency and acute inpatient services outside of the metropolitan area.
Over the next five years, $240 million will be invested into the health workforce and the provision of health services; and a $325 million invested in a capital works program.
Delivering community-based primary health care in comprehensive and integrated models of service is essential to address the health issues for rural people, especially for the elderly, vulnerable groups, Aboriginal people, mental health, parental and child health.
The medical model is a first for hospitals in rural WA, allowing communities access to safe and sustainable emergency medical care, while providing an emphasis on the importance of primary health.
Royalties for Regions funding through the Southern Inland Health Initiative means that residents of country towns and surrounding areas have improved access to emergency medical care 24 hours a day, seven days a week.
Promoting economic participation
Jan Ferguson, Managing Director, Ninti One Limited: Cooperative Research Centre for Remote Economic Participation for Remote Economic Participation (CRC-REP)
CRC-REP is a partnership of more than 50 bodies, including the Australian Government, four state and territory governments, non-government organisations, universities, private businesses and industries including mining, pastoralism and tourism.
Thirty per cent of its membership comes from Aboriginal organisations and communities.
It is focused on delivering solutions to the economic challenges that affect remote Australia and providing practical responses to the complex issues that can restrict full economic participation in such areas.
Despite remote Australia’s significant contribution to our national wealth, notably with 60% of the nation’s mining platforms operating in remote Australia, remote Australians continue to have lower incomes, lower employment rates, lower education and poorer health outcomes than the rest of Australians.
Addressing remote inequity in health and life expectancy urgently requires new approaches to change the social determinants of health for remote Australians.
Our community development work and extensive research agenda contribute to addressing these issues.
This includes successfully working with small and micro-businesses; carrying out participatory action research to understand and articulate the measures for success; the development of remote technologies that improve the profitability of livestock management; creating opportunities in bush products, tourism and cultural activities, and positively influencing government policies.
Our recent work at Ntaria in central Australia show that our Aboriginal Community Research program is an innovative and unique way of working with communities to achieve unprecedented successes in terms of community engagement, development, employment and policy formulation outcomes.
National leadership required
Rob Oakeshott MHR, the Member for Lyne
In Australia there is a long-standing inequity in health funding between those who live in the major cities and those who live in rural and regional areas.
Rebalancing this situation was one of the elements of the agreement signed between myself and Tony Windsor and the Prime Minister in 2010.
Our agreement has resulted in a number of funding wins for rural health and hospitals, including $1.8 billion for rural and regional health infrastructure, with more than 100 hospitals and health centres in rural and regional Australia being rebuilt or upgraded as a result.
Despite these wins, much more needs to be done.
Further real progress will require firm and prudent national decisions on community services, welfare and potentially the tax system – especially at a time when significant expectations have been raised in areas such as disability services and education.
Some of the work to improve equity in the funding of services for rural and remote areas can be led by parliamentary committee work. This must result in higher standards of accountability in the public sector, including effective oversight by the Auditor-General.
National leadership can also be exercised through upstream issues impacting on health and wellbeing, such as the Constitutional Recognition of Indigenous Peoples, and work to minimise violence against women and girls.
Our rural health network in Australia is one of the best, if not the best, in the world. The multidisciplinary, contemporary medicine approach is proving itself, and data are showing rapid improvements throughout the country in previously entrenched poor health data.
Governments have a willing and able partner in the field of rural health. More resource support, as well as listening more to experts in the field, will see further improvement and the continued building of health equity in Australia.
A window of opportunity
Gordon Gregory, Executive Director of the National Rural Health Alliance
Given the work of the Senate Committee and the establishment of the new Social Determinants of Health Alliance, there is a window of opportunity for Australia to focus as much as it ought to on the social and economic determinants of health.
In both its concurrent and plenary sessions, the 12th Conference will deal with a range of upstream issues, such as the state of governance in remote regions; fly-in fly-out services and other issues affecting the health of people in mining towns; neighbourhood cohesion and the impact on the health of women; food security; and managing natural hazards to minimise their impact on the health of people in rural and remote areas.
Where the social determinants of health in rural and remote areas are concerned, nothing is more important than the basic capacity of a region to provide its people with gainful employment, income, housing and a sustainable way of life.
Despite the neutral sounding word, ‘regions’ are sets of people’s home communities: where they live, bring up their families, recreate and work.
If the region or the smaller community in it does not have jobs, there will not be local education; and education is, globally, the most important determinant of health outcomes overall.
The plenary session in which Rob, Paul and Jan will speak will provide a national, Western Australian and regional focus on the fundamental issue of how regions can be assured of their fair share of public services and infrastructure, and other resources.
Some of the focus will be on a ‘royalties for regions’ approach, which sees explicit transfer of resources from those that are rich in primary industries and earning capacity to those that are less so.
Given the so-called two-speed (or multispeed?) economy in rural and remote areas of Australia, the policies to be considered in this session will be important in determining the future for many people.
Previous Croakey articles on the 12th NRHC
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