Budget gives ‘no crumbs of hope for our rural health workforce’

The New Zealand Rural General Practice Network is remaining optimistic about the future of rural health despite the lack of focus it received in yesterday’s Budget announcement.

Network Chief Executive Dr Grant Davidson says that this is frustrating given the attention Health Minister Andrew Little gave to primary and community care in his opening speech at the National Rural Health Conference only three weeks ago.

“Was that the same Minister that spoke at our conference on the Health Reforms and the focus on primary and community care? Because this just hasn’t been reflected in this Budget,” he says.

“The Budget once again refers to the ‘post code lottery where the treatment you get is determined by where you live,’ but there is nothing in it to address the challenges that close to 20% of the population who have a Rural Delivery postcode face in getting the health care they need.”

The Network has long been advocating for targeted interprofessional rural health training to tackle the rural health workforce crisis. Minister Little has acknowledged the stressed, over-worked and under-staffed state of the rural health workforce, but he has not acted on the workforce’s proposal for rural training hubs which he has had ‘under consideration’ since his appointment.

Dr Davidson says “I know Budget 2021 will be demoralising for all rural health workers. They will see no answers to a sustainable funding model or a commitment to training our future rural health workforce in it.”

“This workforce issue is vital to the future of rural communities. Those communities will struggle to thrive if there are no skilled health professionals there to look after them and their whānau” he says.

While the announcement has been disappointing, the Network acknowledges that the Budget does address and action some of the social determinants of health.

The Network appreciates that increasing benefits and providing more housing and warmer, healthier homes, will have positive impacts on the health and wellbeing of our rural communities.

“We need to ensure that this money flows towards our rural communities where there are higher populations of Māori and higher levels of social deprivation.”

The Māori Health Authority received positive attention in Budget 2021 with $98M announced for its establishment and $127M for initial commissioning of services for Māori. The Network is optimistic that this will improve access to healthcare for Māori and especially, rural Māori.

Dr Davidson says the significant investment in this budget for DHBs and more hospital infrastructure seems more of the same, rather than the focus on localities and primary care that the Minister pointed to in the reforms.

The extra $10M announced for the deployment of 5G in rural areas is a small concession for the Network who have been pushing for improvements to rural broadband to increase connectivity for rural communities and access to telehealth initiatives.

The Network remains optimistic and committed to an appropriate response to its calls to action around workforce, funding, digital and a rural health plan.

The opportunities to address these issues lie in the decisions yet to be made around the detail and roll out of the new health reforms, which the Network is eagerly awaiting.

Dr Davidson has high hopes for the provision in the budget to trial 5-6 locality networks for health service delivery and is pushing for one of these to be a specific rural locality.

“My view is that we need to focus on piloting a locality based on a collection of rural health providers working in rural and remote communities. We want to prototype how the rural locality will run, be integrated with rural Māori community services while still having access to specialist services and hospitals in urban areas.”

While Budget 2021 has been disheartening for the Network, Dr Davidson is determined to see change happen.

“It feels like we are constantly pushing against the tide when we shouldn’t be. The tide should be flowing with us to help address the health inequities for those living rurally,” he says.

“I am optimistic that there is positive change to come for rural health, and we will continue to advocate loudly on behalf of rural communities until our voices are heard.”