Tamworth GP Jenny May appointed to powerful panel to be 'part of the solution' to damning findings of rural health inquiry

Professor Jenny May will sit alongside Walcha pharmacist Anna Barwick on the powerful new Regional Health Ministerial Advisory Panel.

Both will be charged with advising the state government on how to respond to a damning inquiry into the state's rural health system, which found that rural people have "greater premature deaths when compared to their counterparts in metropolitan areas".

That was just one of the findings of the years-long 'health outcomes and access to health and hospital services in rural, regional and remote New South Wales' report, released in May.

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In a surprise move, the state government released its response to the inquiry on Thursday, months earlier than its end-of-year deadline.

Minister for regional health Bronnie Taylor said on Thursday, that the government had drawn a "line in the sand" and committed the state to support 41 of the 44 recommendations of the parliamentary inquiry in full, or in principle.

"It is my absolute priority to ensure that, no matter where you live in our state, you have access to the health services that you need and deserve," she said.

But the government won't back a recommendation to create an independent Health Administration Ombudsman, or conduct an additional inquiry into the state's mental health system, and has yet to promise to adopt a government-wide approach to healthcare.

It's also unclear what change will happen to the state's much-maligned GP visiting medical officer (VMO) model, which pays local doctors in private practice to work in the local public hospitals in many small towns.

It has been criticised for being overly stingy compared with lucrative locum work available for out-of-town doctors, with a local MP and local doctors declaring the system is in "crisis" and "a pending disaster".

Professor Jenny May is both the Director of the University of Newcastle Department of Rural Health, which is based in Tamworth, and a GP with decades of experience.

On Thursday, she was announced as one of 15 doctors, nurses, academics and local councillors appointed to the state government's new advisory panel, which will advise the minister, and the health bureaucracy, on strategies to improve regional healthcare. The body will be led by Richard Colbran, CEO of the NSW Rural Doctors Network.

Professor May put her hand up for the ministerial advisory panel because "you can either be a part of the solution or part of the problem".

"I want to be part of the solution."

She's long been an advocate of giving medical training to rural people in the towns they live in, the "grow your own" or "train and retain" model.

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She said she's hopeful that the state government will be able to bring a range of solutions to bear on the health system's key challenge; workforce shortages.

"I'm very hopeful that the advisory body will have the opportunity to look at package solutions [for medical training]," she said.

"That's with the understanding that there's no one specific strategy that will change everything. We've been guilty of wanting an easy fix, and I think managing rural health services in 2022 is a bit of a wicked problem and we need to be prepared to think about multiple approaches."

She said she's "realistic" that the body is on a journey towards improved healthcare, and will not solve all problems forever, for everyone. It's not the first, and probably won't be the last health inquiry, she said.

"I'm in the process and I fervently believe in the outcome," she said.

"This is one way of shining a lens, a very helpful lens, on some of the challenges that we know exist. And I hope that there is a groundswell of support to work towards a more sustainable long term solution."

Walcha's Anna Barwick has worked as a pharmacist for more than 15 years, in private, public and aged care systems. She also helped develop PharmOnline, a telehealth service which aims to connect homes with pharmacy services, and said the panel should look to similar high-tech solutions to resolve some systemic problems.

She said she wasn't daunted by the level of challenge revealed by the rural health inquiry's finding that there had been premature deaths in rural areas - she put her hand up for the job because she wants to make a difference.

"To me it's an opportunity to improve that and reverse that," she said.

"It's time to not make excuses any more and to look at options and look at new innovations so that that [preventable deaths] doesn't happen any more."

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The body will be responsible for advising the minister on how to develop a new regional health plan, to be released later this year.

Minister Taylor said the body would play an "integral role in the NSW Government's work to improve health outcomes"

"A key focus of the panel will be to identify and outline a broader vision and action plan for strengthening the rural and regional health system in NSW," she said.

Both North West representatives believe the body will have to investigate either reform or outright replacement for the GPVMO system.

Both stressed that no solution could be, as Ms Barwick put it, "one size fits all".

Northern Tablelands MP Adam Marshall said the VMO model simply "doesn't work" in the modern health system.

He said the health minister ought to scrap the model entirely and employ doctors directly in public hospitals in outpatient clinics.

"It only works when you have a large pool of general practitioners in the community," he said.

"In parts of the region, and more broadly across regional NSW, it doesn't work because there are no GPs in a community, or if there are they're not wanting, for various reasons, to work in a hospital.

"So the VMO model might have worked 20 or 30 years ago when every community had abundant numbers of general practitioners willing to work in a hospital, but now we don't.

"You don't need to take my word for it. That's why most of our hospitals are staffed by locum doctors, not by VMOs."

The state government committed to undertake a review of the "working conditions, contracts and incentives" of GPs working as visiting medical officers and a review of the state-wide system of credentialing for those doctors so that the system is more consistent and streamlined.

Minister Taylor committed to implement 41 of 44 recommendations on the rural health inquiry.

In fact, several have already been implemented, starting with her own appointment as a specific minister responsible for the local health districts covering the rural parts of the state, including the Hunter New England area.

As a result of the Thursday commitment, the state government will work with the federal government to develop a 10-year rural and remote medical and health workforce recruitment and retention strategy - if the Commonwealth is committed to investing in it.

The state will also up funding to increase rural intern positions, expand programs to train and upskill GPs in rural areas, and shift medical scholarships towards a more "grow your own" approach in rural areas, credentialing rural students to serve as doctors for their own communities.

"One of the priority outcomes [for the NSW health workforce plan 2022-2032] calls for building a pipeline of future job-ready graduates particularly in rural and remote areas," the government response reads.

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Labor shadow minister for health Ryan Park, said the government was responsible for "years of understaffing" and had governed a "broken" system, leading to the damning response from the health inquiry.

He committed the party to implement the inquiry's recommendations, if they were able to form government after the next election, in March next year.

"Our health system was under pressure long before COVID arrived in this country," he said.

"The rural and regional health inquiry shone a light on areas that people in the city couldn't believe was occurring. That shouldn't have been allowed to take place. We shouldn't have needed an inquiry for that to be highlighted and remedied and fixed. It's up to ministers to be listening to communities and I think communities were saying a long time before COVID that they were at breaking point, particularly in regional and rural areas."

Greens MLC Cate Faehrmann, who sat on the parliamentary committee responsible for the inquiry, said the government was crossing its fingers that the health crisis would be solved just by throwing money at the problem.

"It was unfortunate that my recommendation to include nurse to patients ratios wasn't included in the final report, particularly given nurses and midwives have been on strike today calling for ratios," she said.

Ms Faehrmann said the health system would remain "dangerously understaffed" until the government guaranteed safe staffing levels.

"The lack of support for a mental health inquiry is also concerning. It was extremely apparent throughout the inquiry that the mental health system is just as, if not even more, dysfunctional as the health system in regional, rural and remote NSW," she said.

The state has committed to hire 3,800 additional nursing staff, a major recommendation of the inquiry, and increase the number of highly-skilled nurse practitioners available in the state.

It will also help develop shared medical record systems with PHNs, and employ a geriatric nurse in more hospitals.

It has not committed to implement nurse-to-patient ratios, a step which was not recommended in the inquiry.

It also didn't commit to three recommendations the inquiry did make.

It "noted" a recommendation for a mental health inquiry, for a specialist health ombudsman and that it adopt a 'health in all policies' approach like the South Australian government.

The government said a specific health ombudsman wouldn't be required, and would just duplicate the work of the existing NSW Ombudsman. The mental health inquiry would "duplicate the recent past examinations" of the same system, and possibly allocate resources away from the health system, it said in its response.

There will be a review of progress on the original recommendations published in May 2024, the second anniversary of the release of the inquiry.

The government budgeted to spend billions employing thousands of new staff, improving rural incentives, improving palliative care and doubling the Isolated Patients Travel and Accommodation Assistance Scheme, all recommendations.

The Regional Health Ministerial Advisory Panel will consist of 15 people: Anna Barwick, Karen Booth, Jo Caldwell, Leone Crayden, Rick Firman, Louise Fox, Laura Hand-Ross, Warren Kealy-Batemean, Ken Keith, Jennifer May, Georgina Rosee, Ayman Shenouda, Meg Austin, Anna Windsor and Richard Colbran.

Tamworth MP Kevin Anderson said the local pair would provide local knowledge and ensure the region's voice is heard.

"Both Anna Barwick and Professor May are well respected leading health professionals who know better than anyone the issues we face when it comes to healthcare in our region," Mr Anderson said.

"They are passionate about improving health outcomes for our communities and I know their strong voice will be critical to improving outcomes in the New England North West."

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