Health failings laid bare

NSW Independent MP for Murray Helen Dalton.

The “perilous state” of rural health care in NSW has been laid bare, and some argue the solutions proposed don’t go far enough.

NSW Independent MP for Murray Helen Dalton said the health outcomes and access to health and hospital services in rural and remote NSW puts forward 44 recommendations for change following an extensive NSW Upper House inquiry.

But she said there are some key requirements in the health industry that have been missed.

“We need the New South Wales Government to mandate safe patient-to-staff ratios in all our hospitals, as Victoria has done, but this isn’t a recommendation in this report,” Mrs Dalton said.

“If we don’t have better conditions for our nurses and midwives, we will keep losing them to other states.

“In my border electorate, nurses are waiting three months for their recruitment process to be finalised. In that time, they are taking up better positions one hour away in a Victorian town.

“At present, New South Wales health professionals and workers can get superior pay and conditions working on Sydney’s North Shore than they get in a rural town like Deniliquin or Finley. So why would anyone move out west?”

One of the inquiry recommendations is that NSW Health work with the Australian Government “collaboratively to immediately invest in the development and implementation of a 10-Year Rural and Remote Medical and Health Workforce Recruitment and Retention Strategy”.

The panel’s recommendation is that a range of stakeholders be consulted in setting out a clear strategy for how NSW Health will “work to strengthen and fund the sustainability and growth of rural, regional and remote health services in each town including quantifiable targets for tangible improvement in community-level health outcomes, medical and health workforce growth, community satisfaction, and provider coordination and sustainability.”

The strategy must also address hospital and general practice workforce shortages including GPs, nurses and midwives, nurse practitioners, mental health nurses, psychologists, psychiatrists, counsellors, social workers, paramedics, allied health practitioners and rural generalists.

Mrs Dalton acknowledges the report recommends reviewing pay structures, but said what’s needed is “immediate increases in base rates of pay and more financial incentives for those working in rural areas”.

“We don’t have time for more reviews, pilots and investigations and requests for New South Wales to talk more with the Commonwealth.

“We need direct financial rescue packages to keep GP practices and small hospital wards open while we implement the longer-term strategies.

“The New South Wales Government has six months to prepare a response. That’s far too long.”

The health outcomes inquiry was launched in August 2020, with 15 hearings held between March 2021 and February this year.

One of the early hearings was held in Deniliquin.

The 322-page final report, tabled in Parliament on Thursday, offered up 22 key findings and 44 recommendations to be enacted.

Among those findings, the inquiry panel’s first five points found that:

  • rural, regional and remote patients have significantly poorer health outcomes, greater incidents of chronic disease and greater premature deaths when compared to their counterparts in metropolitan areas.
  • residents in rural, regional and remote New South Wales have inferior access to health and hospital services, especially for those living in remote towns and locations and Indigenous communities, which has led to instances of patients receiving substandard levels of care.
  • residents living in rural, regional and remote communities face significant financial challenges in order to access diagnosis, treatment and other health services compared to those living in metropolitan cities.
  • rural, regional and remote medical staff are significantly under resourced when compared with their metropolitan counterparts, exacerbating health inequities.
  • the Commonwealth/state divide in terms of the provision of health funding has led to both duplication and gaps in service delivery.

Mrs Dalton said a further recommendation to establish an independent Health Administration Ombudsman to investigate health care complaints has to be implemented, but it needed to be “properly staffed” and have “real powers”.

“The fact that hundreds of submissions to the rural health inquiry were anonymous tells you the extent to which government has silenced our health workforce,” Mrs Dalton said.

“Nurses feel they have nowhere to go when they are bullied or harassed. At present, management make secretive internal investigations, sweep complaints under the carpet and punish the victims.”

Mrs Dalton has organised a rural health forum in Griffith to be held this Friday, where a panel of MPs and health experts will present their views on tackling the rural health care issues and take questions from the general public.

At the time of going to print yesterday, NSW Shadow Health Minister Ryan Park and NSW Greens health spokesperson Cate Faehrmann had confirmed their attendance.

Mrs Dalton said NSW Health Minister Brad Hazzard is making arrangements to see if he can log in remotely.

The full inquiry report can be found at