Senator the Hon Bridget McKenzie chaired the seventh Rural Health Stakeholder Roundtable.
Agenda Items – 28 March 2019 meeting
- National Rural Generalist Pathway;
- Work of the National Rural Health Commissioner;
- Work of the Distribution Working Group (DWG);
- Mid-Year Economic and Fiscal Outlook (MYEFO) measures designed to strengthen rural GP telehealth; and
- A demonstration of the Health Demand and Supply Utilisation Patterns Planning (HeaDS UPP) tool.
The National Rural Generalist PathwayFollowing an announcement at the 15th National Rural Health Conference, funding to commence a National Rural Generalist Pathway was discussed at the Roundtable. This four year, $62.2 million policy initiative includes: implementation of coordination units to support rural generalist trainees; an expansion of the Rural Junior Doctor Training Innovation Fund by around 50 full-time equivalent places; and funding to assist the process of seeking recognition of Rural Generalism as a Specialised Field within the Specialty of General Practice. Funding for an evaluation of the effectiveness of the Pathway is also included.
Roundtable members welcomed the announcement. The following discussion focused on the importance of cultural safety, the crucial role of GP college support for trainees, and the capacity for transition between the Rural Generalist Pathway and other medical training programs. Roundtable members also discussed options for supporting the rural allied health workforce, using the medical pathway as a model, while noting the particular challenges facing rural allied health.
National Rural Health CommissionerRoundtable participants thanked the Commissioner for his work developing advice to Government on a National Rural Generalist Pathway. The Commissioner updated the Roundtable on his next tranche of work, developing advice on improving access to allied health services in rural, regional and remote areas of Australia. This work will include a literature review, a discussion paper, and a final advice paper containing recommendations to the Minister. The final advice paper will be provided to the Minister responsible for rural health in October 2019.
Members of the Roundtable outlined issues of access and quality in Australia’s rural allied health care sector that the Commissioner could focus on in his report to Government. This included the current lack of allied health data; issues surrounding the credentialing of allied health professionals; limited rural placements for allied health students; and issues of market failure.
Distribution Working GroupThe Roundtable was updated on the final two meetings of the DWG, which took place on 21 September 2018 and 16 November 2018. The work of these final two meetings included finalising recommendations for updating the District of Workforce Shortage (DWS) system, considering mechanisms to encourage a more equitable distribution of health workforce and endorsing the updated Modified Monash Model.
The Department of Health updated Roundtable members on the decision to rename the DWS to Distribution Priority Areas (DPA) to better reflect that its primary purpose is one of distribution to areas of need. Roundtable members were also informed the DWG will continue to meet under a new name, the Distribution Advisory Group (DAG). The DAG have been asked to review the current specialist DWS once the data is available.
Members of the Roundtable discussed the transition from the Remoteness Areas classification method to the Modified Monash Model (MMM) when determining areas of workforce shortage. Stakeholders emphasised the importance of adequate communication to ensure members were aware of potential changes in rurality status. The Department undertook to discuss with the Australian Institute of Health and Welfare the use of MMM, rather than the Remoteness Areas classification method it currently employs, when determining areas of medical workforce shortage.
MYEFO Telehealth MeasuresThe Department updated the Roundtable on MYEFO measures designed to improve access to care for people living in rural areas through the creation of eight new MBS telehealth items. These measures will apply to people living in MM6-7 from 1 November 2019, and are expected to provide an additional 200,000 services per year. Patients are required to have received three face-to-face consultations from a single provider in the past year as evidence of an existing clinical relationship.
Discussion at the Roundtable centred on the difficulties of ensuring patients receive three face-to-face consultations with the one practitioner before accessing the announced telehealth measures. Participants requested further consultation with Government to ensure the measures improve health outcomes in rural areas. The variability of regional areas was stressed, as was the notion that these measures must avoid a one-size-fits all model for telehealth services in MM6-7.
Demonstration of the HeaDSUPP toolThe Department provided the Roundtable with a demonstration of a beta version of the HeaDSUPP tool. The tool provides information on Australia’s medical workforce, including geographical spread and the density of medical practitioners per specified area. This demonstration included an overview of the tool’s capabilities; the data it uses; the tool’s implications for workforce planning; and additions that would be made to complete the final version of the tool.
A question-and-answer session followed this demonstration. Roundtable members were supportive of the tool, and stressed the importance of adding nursing, dental and other allied health services to future updates.
Roundtable MembershipThe Roundtable is chaired by the minister responsible for rural health. Membership includes a number of peak bodies representing the rural health workforce and the National Rural Health Commissioner.
Members in attendance for the 28 March 2019 meeting were:
- Allied Health Professions Australia
- Australian College of Rural and Remote Medicine
- Australian Dental Association
- Australian Medical Association
- Australian Rural Health Education Network
- Congress of Aboriginal and Torres Strait Islander Nurses and Midwives
- Federation of Rural Australian Medical Educators
- Indigenous Allied Health Australia
- National Rural Health Alliance
- National Rural Health Commissioner
- National Rural Health Student Network
- Royal Australian College of General Practitioners
- Rural Doctors Association of Australia
- Rural Health Workforce Australia
- Services for Australian Rural and Remote Allied Health
- Pharmaceutical Society of Australia
- Australian Indigenous Doctors’ Association
- National Aboriginal and Torres Strait Islander Health Worker Association