Sick rural sector prepares for diagnosis

·3-min read

Nurse Pen McLachlan says she has many horror stories about working in a rural hospital.

There is one about a cook sitting with a stroke patient in the Condobolin Hospital car park, in western NSW, while the two nurses on duty were busy in the emergency department.

There is another about an elderly man in the final hours of his life, whose family cleaned and cared for him in the absence of palliative care.

A nurse agreed to come in to work "out of the goodness of her heart" to shower the man. He died on the bathroom floor, where his daughter said her final goodbye.

"Where do we start to fix it and how do we start to fix it? Because it is a bloody big problem," Ms McLachlan told the NSW parliamentary inquiry into rural healthcare last year.

After 720 written submissions and 15 hearings over the course of a year, the inquiry is due to table its report to state parliament as early as Thursday.

Ms McLachlan's evidence crystallised the frustrations faced by rural communities, where hospitals are without doctors, recruiting GPs is near impossible, and many health services have been centralised to regional cities.

That's the picture in the Griffith region, where local MP Helen Dalton says hospitals do not have permanent doctors, and ambulances are used to ferry patients to the bigger hospital at Wagga Wagga.

Ms Dalton hopes the grim evidence aired during the inquiry leads to cooperation between the state and federal governments.

Broad action is needed to address structural issues that prevent doctors and nurses working in the bush, like housing shortages and low pay, she says.

"It's hard to get somebody from Sydney to come out here and take up a job when they think Griffith or Deniliquin is the end of the earth," Ms Dalton told AAP.

She says rural people have no control over their health care, something many advocates are pushing for.

Mark Burdack, the head of Rural and Remote Medical Services charity, says listening to the needs of communities is key.

"Rural people are out of sight, out of mind," Mr Burdack said.

"The health system was designed to run hospitals in major cities and it isn't well equipped to manage services in rural and remote communities."

State and federal inquiries have heard the distribution of health workers is based on population data that doesn't reflect the realities of country life.

Mr Burdack says that model has catastrophically failed. His organisation has recommended to the inquiry a rural and remote health commission with an independent board overseen by community members.

At the inquiry, senior health official, Dr Nigel Lyons, apologised to rural patients, saying the department is committed to ensuring equitable healthcare.

The NSW government appears to have anticipated some of the inquiry's outcomes, appointing Bronnie Taylor as the minister for regional health, and setting up a regional division in the health department.

Rural Doctors' Association NSW president Charles Evill says doctors are optimistic their concerns will be heard by the new division.

But, Dr Evill says the rural health system needs a complete rethink after decades of centralisation, a declining workforce, and poor planning for local services.

"It's not going to be turned around quickly. But there's not that much of a choice."

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