One of the Productivity Commission’s principal concerns was the specific problems facing health care delivery in rural and remote areas.
Lorna Scott, a nurse practitioner in community health, said the extension of the Medicare rebate to work done by nurse practitioners and midwives would make a big difference to the availability of health services in rural and remote areas.
‘The services just aren’t there. There aren’t the doctors and nurses are holding it together,’ she said.
‘I’d like to see more nurse practitioners out there. We’re very under resourced. Our women’s health clinics are already booked out until May. Extending the Medicare rebate will make a big difference. When people can’t get a rebate it often stops them using a service – from a midwife for example – because they can’t afford to pay out of pocket.’
Lorna said there were other recommendations in the report that would make a difference in the bush.
‘Improving educational opportunities in rural areas and providing better support for rural health workers is very important.’
Lorna said that while opposition from groups like the AMA was disappointing, the attitude on the ground in rural areas was often different.
‘At a local level I don’t have too many problems with doctors. The resistance has lessened and there is more rapport. Our work is seen as being complementary. In fact some GPs have turned around their attitudes completely and are asking us to work with them because it makes their lives easier. It depends on whether they have had contact with us. A lot of doctors don’t have the opportunity to work with nurses and are still locked into a mindset of what it was like 20 years ago.’
Brett Holmes says the NSWNA has, over the years, devoted considerable time and energy to the issue of lack of health services in rural and remote areas.
‘The Commission rightly points out that nurses are the backbone of health care delivery in rural and remote areas. They are the only professional group with any real numbers in most of these areas. In fact, health services would completely collapse in rural and remote areas if it were not for nurses,’ he said.
“The NSWNA agrees with the Commission that a more sustainable and responsive health workforce is necessary for health service delivery in rural and remote areas. New models of care are also essential to this and the introduction of nurse practitioners is a good example of such innovation.
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