The recent parliamentary inquiry into health and hospital services in rural, regional and remote NSW painted a shameful picture of a system in crisis.
It was shocking that such disparity in health services and outcomes could exist in Australia in 2022.
The health of people living outside our cities is compromised by persistent staff shortages, the fragmented nature of health provision, poor resourcing and the necessity of travelling vast distances for specialist treatment.
Like other parts of the state, the New England North West (NENW) has low general practitioner-to-patient ratios and routinely relies on a revolving door of visiting locums.
It's unsustainable, not to mention impossible for maintaining continuity of quality health care.
But we have a solution that could address many of the problems identified by the parliamentary inquiry, at least in part, if only the state and federal government saw fit to stop being seduced into believing that we should continue to do things the way they have always been done.
Now is the time to invest in innovative solutions that drive a paradigm shift in the delivery of health care in rural and remote settings.
The New England Virtual Health Network (NEViHN) is a model that uses new digital technologies to support place-based face-to-face care to improve health outcomes - the big bottom line - and, in doing so, pioneers the education of health professional students in the small communities that need them most.
NEViHN was developed by the University of New England (UNE) in partnership with the Hunter New England Local Health District (LHD) and the Hunter New England and Central Coast Primary Health Network (PHN), so it has the backing of those with skin in the game.
It's no longer good enough to accept that by living outside metropolitan areas we must wait months to see a GP, travel vast distances for specialist care or, in the case of many First Nations peoples, be too fearful to use the public health system at all.
The results are deadly. This isn't histrionics. It's fact.
Studies have shown that health professionals who are from, or educated in, a rural, regional or remote area are much more likely to stay on once they have completed their training.
NEViHN would enable future doctors, nurses, pharmacists, psychologists and social workers to study for 12 months or more, well supervised, in interdisciplinary groups in something akin to a community apprenticeship.
What clinical experience students don't access face-to-face is supplemented by simulated experiences in place or at central hubs (such as the Tablelands Clinical School), and technology-enhanced learning via NEViHN's "virtual hospital" - a compendium of virtual patients developed by UNE.
As COVID proved, telehealth and virtual care allow us to effectively engage metropolitan-based specialists in patient treatment, saving those sick people considerable travel, expense and discomfort.
The Royal Australian College of General Practitioners, Australian College of Rural and Remote Medicine, the Australian Medical Association and National Rural Health Alliance have all endorsed the important role technology has to play in our health system.
Rather than replacing the bedside clinician, digital technologies give us the opportunity to enhance the care clinicians deliver face-to-face and support the wellbeing of the health practitioners themselves.
As Dr Nigel Lyons, Deputy Secretary, Health System Strategy and Planning Division, NSW Health, told the inquiry, the focus of telehealth and virtual care is for on-the-ground clinicians to have "access to information, to have backup from people who have got expertise and capability to help them deliver optimal care to their patients in the environment in which they work".
The appointment of a patient advocate or "navigator" as part of the NEViHN model will help patients to navigate this new virtual terrain.
We urgently need to introduce smarter solutions to bridge the rural divide and tackle the entrenched workforce and operational challenges in providing health care in the bush.
Delivering on the recommended parliamentary inquiry reforms in meaningful and sustainable ways will demand it.
By creating a network of regional, rural and remote health professionals and better supporting them, we believe that NEViHN will help to retain the staff we spend so much time and effort training.
The networked model will assist practitioners to achieve some semblance of work-life balance, to take leave when required, access important continuing professional development, and even go on holidays.
This is imperative for a healthy workforce and can only be healthy for patients and communities, too.
Almost a month since the inquiry handed down its 44 damning recommendations, there has been little suggestion of how they might be achieved.
And a follow-up inquiry to check on progress is now less than two years away.
In our inherently conservative health sector, where tradition tends to trump innovation, radical change is desperately needed to overhaul care outside our cities.
We are going to need all manner of brilliant ideas in addition to NEViHN, but without trialling new solutions like it now, the health of people in rural, regional and remote NSW will worsen, fast.
I, for one, want to be part of the solution.- Professor Jennifer Williams
I, for one, want to be part of the solution.
Professor Jennifer Williams is Dean, Faculty of Medicine and Health University of New England and an Emergency Physician and was recently part of a panel event 'The Future of Rural Health' with Australia's Rural Health Commissioner, Professor Ruth Stewart in Tamworth.
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