Health Care Services of Rural Australia - Case Study Example

Rural Australia Order No. 238509 No. of pages: 9 Premium 6530 Introduction Health Services, especially services in the rural areas form a crucial and vital section that involves the survival of the community. In fact, as rightly stated by Egan, ‘The importance of health workers and services in the survival of communities is such that closure of health facilities, is seen as a threat to the whole community’ (Egan 1989). There is no doubt that Primary Health Services plays a major role by representing the bulk of health services in rural Australia. Besides the general public, the other members that contribute as a significant part of this community are the General Practioners, nurses and many others who are within the primary health care sector. Rural area refers to that part of society where the ratio of land is much greater than the inhabitants. The cultivation and production of raw materials, foodstuff and fibers are the most important occupation of the rural people. In Australia, less than 15% of the population lives in rural areas. The Commonwealth of Australia was created in 1901and since there has been rapid development in agriculture and manufacturing. Large areas in the Outback are made up of stations where cattle graze. Australia has the largest number of sheep in the world. Life in the rural areas in the farms is healthy but it is also stressful and dangerous. Chemicals, animals, stress and machinery are instrumental in causing accidents or spreading diseases. The Australian country town has a stereotypical image of an organic community of morally conservative, like- minded, faithful church- goers who know each other by their first names. Therefore, it is a community that is proud and patriotic, but moralistic and overwhelmingly conservative. A myth surrounding rural Australia is that it is homogenous. Social and economic processes, population size, geographical location and many such features interrelate in giving rural Australia its distinctive structure, political outlook and style to these settlements. Approximately 36% of the rural Australian population is sixty five years and older. As compared to the metropolitan cities, many rural and remote communities have older people. The patterns of migration, rate of growth, social and economic disadvantage and higher levels of health risks have an impact on rural healthy aging. There has been a marginalization of the rural old people due to long standing urban-centric policies which goes unchallenged. The need of the hour is to identify the issues and challenges that face rural healthy aging. One of the most increasingly complex and burning issues of rural Australia is Health care in every sense of the word. The increasing distance away from specialized health systems has been a major concern for those that are involved. According to the traditional model of health care, patients who needed treatment, see a doctor, regain their health, pay for the doctor’s services and carry on with life. But now- a- days, health systems, especially in the rural areas have undergone a dramatic change when compared to Health care in a metropolitan setting. The reason for this is due to the geographical and demographical distance in particular areas and also the availability and allocation of various resources. In this scenario, there are many significant questions that crop up- such as - Why is Health Care not readily available to people in rural areas? What progress and development has been made in the Health Care sector. Should more stringent action be taken towards making some drastic changes concerning rural health? Other relevant questions could be as to where and how should health care be administered? What sort of skills and training is necessary for those who deliver health care? The existence of health services is seen as a major factor in the ability to retain and attract families (Wolstenholms 1995) and the existence of small hospitals are important in determining ability to attract and retain GPs and pharmacy services (Humphreys 1996). Primary health care is not only vital to the health or the whole community but it also has a great impact on the intellectual, economic and social aspects of the individuals involved. Pressures on the workforce forefront According to the Australian Institute of Health and Welfare (AIHW) there is an acute shortage of the numbers in General Practitioners (GP) – that range from between 900 to 1800 patients per GP. Usually Gp’s in rural areas spend a lot of their time in rendering health care to patients and other activities but yet are under- represented where their workload is concerned. When compared to health care in the Metropolitan areas, there is an acute shortage of staff – about 53% lesser per head of the total population. This misdistribution does not refer to only the Metropolitan and rural areas, but within rural Australia alone, the situation in health care is somewhat patchy. Rural general practitioners have been surveyed to investigate the discordance between what they feel they need for rural practice and what they feel they currently receive (Humphreys. Soc Sci Med 1998;46:939-945) Facilities necessary Rural areas fall short where facilities are concerned. They do not have adequate numbers of trained personnel nor enough locum relief. Even access to the continuation of an individual’s medical education is very limited. One of the primary requirements is job satisfaction and adequate recognition of ones practice skills in addition to a smooth and unimpeded career pathway. In dire contrast to the facilities required GP’s are prone to stress because of excessive workload. Their career pathway is strewn with obstacles such as poor facilities to pursue their medical education. In addition to this they do not experience good job satisfaction due to inadequate recognition for the tireless service rendered. Hence, due to all the above factors it becomes difficult to maintain a reasonable number of GP’s and other health professionals in rural areas. In order to remedy this situation a closer collaboration is of paramount importance. Health Care Services from consumer’s point of view: Shortage of services and proper skills is a perennial problem that exists both in the rural and regional areas. According to the data collected by the AIHW, we are aware that as the ratio of sick people per GP is on the rise, the quality of Primary Health Care decreases due to the utilization of Medicare. Rural patients are fully aware of what they need and what they are getting (Humphreys. Soc Sci Med 1998;46:939-945). The main thing a consumer looks towards Health Care Services is a doctor who is accessible and available locally at all times, and a well coordinated and integrated system of care which should be rendered on a continued basis. Distance seems to be one of the main reasons for the shortage of health professionals in rural areas and hence the consumer faces the problem of under- staffed hospitals and scarce health care services. Therefore, from the consumer’s point of view, health care services are not on a regular basis as it is in the Metropolitan areas and needs to be adequately addressed from all angles in order to form an integrated health care team which could render continued care services. Since agriculture is the main occupation in the rural areas, drought seems to be another problem because it causes mental stress sometimes leading to suicide due to financial pressures, family strain and social isolation among the rural communities. Challenges in Health Care Services: One of the major challenges that rural Australia faces is by introducing pro – competitive mechanisms in order to control the escalation of costs in health care. The main problem is that when costs are reduced, the quality of health care is also brought down. In fact, in some cases there have been adverse health outcomes. “Managerialism” is another challenge that poses itself as a problem. It is an approach that had been introduced but with adverse results. An example of this would be that in the United Kingdom, this approach was introduced and the number of General Managers was increased from 4,600 to 23,000 which escalated managerial costs from 25m to 251m. It is however out of the question to employ such managers in rural areas because the economies cannot be worked out. Current Approach – Highly competitive The health work force has seen a lot of dynamic changes taking place recently. “Paramedical” professions have seen a sudden spurt in growth and there is healthy competition within the medical profession between specialists and practitioners. A multi- disciplinary approach is being adapted while major changes are taking place in career development. On the work front there is an increasing amount of “feminization” taking shape. There are a lot of gender differences taking place in clinical circles. According to the Australian Medical Workforce Committee it is estimated that there are over a lifetime and estimated 63% of female doctors when compared to male doctors. In 2005, it is estimated that female undergraduates would increase from 53% to 60%. This current trend on the health care front which is not likely to be sustainable would definitely be first felt in the rural areas. However, there are many good things which the primary health care sector can learn from the rural sector. One example of this is that there are many different positive policies that render help and support to the rural primary health care centers such as the policies of Regional Health Services and the University Departments of Rural Health. Now with the advancement of modern medicine there is scope for optimizing health and raising the quality of life and thereby the happiness factor. They are also striving hard to reduce the social impact of diseases and minimize to a great extent morbidity and premature mortality rate. They are also working towards cutting costs and reducing the pricing in order to give the consumer better value for his money. Consumers of Health care of rural and remote Australia find that transport services are very poor in addition to the lack of consumer information about the services that are available. Even communication services at times become a hassle due to the distance of the location. Health Consumers of Rural And Remote Australia (HCRRA) continue making all effort in trying to air all the concerns of its community members to the Government with an idea to improve the transport and communication systems and thereby better services in Health care. Steps taken to meet their goals Health Consumers of Rural and Remote Australia (HCRRA) understand the importance of good health care in order to have a healthy and happy rural community and also to bring down the sickness and mortality rate. In lieu of this, they have set some goals which they hope to achieve. Canvassing for good committee members to stand for election. Encourage non- members to take an active part in the association and lend full support to their cause. Through an association newsletter, reports from consumers would be distributed to all its members. The information that is collected is ensured that it s authentic, accurate and up to date. In order to draw the government’s attention and put an end to inequalities in Health Services in the rural areas, the HCRRA is working between the consumers on one side and the Government on the other side and trying to create a bridge in order to create sound networks to facilitate better health services in the rural areas. Besides this, they also coordinate between individual consumers and other community organizations in order to make the best use of the resources that are available, thereby making good progress where the health of the whole community is concerned. References: The University Departments of Rural Health are already having an impact upon the rural health sector. If you would like to hear more about the UDRH in Shepparton (or require full references for this article - ed.) (Humphreys. Soc Sci Med 1998;46:939-945). Rural Primary Health Care In Australia. Article from Issue 74 of New Doctor: Journal of the Doctors Reform Society of Australia, www.drs.org.au/new_doctor/74/simmons.html Health Consumers of Rural and Remote Australia (HCRRA) - Policies www.ruralhealth.org.au/hcrra/policies.htm The Impact of Change on Rural Society www.regional.org.au/au/roc/1989/roc198963.htm Read More