Covid, covid, covid. It's hard to look beyond the rampaging delta-variant that's been popping up across Australia.. What started with a case in Sydney's eastern suburbs has seen Armidale and Cairns shutting down, and poor, poor Melbourne plunged into its sixth lockdown since March last year.
But let's try and move beyond COVID for just a moment. Healthcare in regional Australia has always suffered in comparison to the metro areas. Sometimes it's simply not feasible to offer specialist treatments without a certain population density. Sometimes the equipment is too expensive, too difficult to maintain, or simply too difficult to operate without specialist training.
This is nothing that regional and rural Australians haven't heard before. Long before COVID struck there have been numerous attempts and studies on how to rectify this but figures from a 2017-18 study by the Australian Institute of Health and Welfare shows that despite regional Australians having a similar level of access to healthcare based on numbers of visits, those in remote areas continue to have limited access to services.
It's probably one of the few positives of the COVID-19 pandemic that has seen a quiet change in healthcare. The telehealth appointment. Until March 2020 telehealth appointments received no Medicare rebate and therefore couldn't be bulk billed. The temporary measure has been extended to the end of 2021 and there are hopes amongst the medical profession that it becomes permanent.
It's not a total solution, but for specialists who maintain practices in cities but want to continue to work with communities beyond the inner city it's a boon.
Dr Joseph Lawler is a Gastroenterology and Hepatology specialist based in Sydney's Inner West who has continued to practice in western NSW despite COVID travel restrictions. Having grown up in Dubbo he remains passionate about providing care to Australians living in rural areas and working with local health districts and Aboriginal health services.
Prior to March 2020, he was travelling monthly to Dubbo to hold clinics and treat patients who would frequently travel for hours from towns such as Lightning Ridge, Cobar or Brewarrina for their appointment. Whilst he acknowledges that telehealth won't replace face to face consultations and that it can be an imperfect service, for him and many of his patients it has been game changing.
Despite being unable to travel to see his patients, he continues to regularly consult with healthcare workers in Dubbo and beyond and because he's spending less time travelling he's able to see more patients. He notes that it's not a perfect solution with technology and digital access being necessary to treat patients remotely, but it's a great start.
Dr Lawler and his patients may be benefiting from the opportunity to engage with each other despite being in separate parts of the state, but other initiatives are all about keeping healthcare workers in situ and offering them the opportunity to advance their career without having to move to large metropolitan areas.
Another regional university, this time UNE, continues to support healthcare workers who want to remain working in a regional setting whilst also participating in research in their field. The Spinifex Network provides support to remote researchers, giving them the resources to carry out much-needed research in areas of rural and remote health.
Other more futuristic options to support regional health outcomes have included the use of drones to deliver medical supplies in the NT. It might seem a little far-fetched but it seems a more exciting use than the use of drones to deliver takeaway coffees and burgers.
Unfortunately, despite many initiatives launched by government, universities and local health districts with support from their communities the struggle to retain medical staff remains real.
Chronic underfunding remains a key complaint as the NSW parliamentary "Inquiry into Health outcomes and access to health and hospital services in rural, regional and remote New South Wales" continues to work its way across the state.
Even as the inquiry highlights the issues faced by doctors and nurses in regional areas. Of overworked staff and a lack of resources seeing significant wait times for treatment it's not all doom and gloom. For many local GPs the decision to remain in a regional town is as much a lifestyle choice as a career decision.
The question is: will the ongoing focus on the benefits of a regional or rural lifestyle entice more medical workers to make the move?