Presenter: Wayne Bucklar
Guest: Gordon Gregory
Guest Bio: Gordon Gregory (OAM) is CEO of the National Rural Health Alliance (NRHA) – a position he has filled since August 1993. The NRHA is the peak non-government body working to improve the health of people throughout rural and remote Australia, organiser of the biennial National Rural Health Conference, and owner of the Australian Journal of Rural Health. Before 1993 he worked at the University of New England and as a Ministerial adviser in Canberra. He has had a longstanding interest in policies and services for rural and remote communities in Australia.
Segment overview: In this segment, Gordon Gregory talks about National Rural Health Alliance’s policy and lobbying procedure.They are Australia’s peak non-government organisation for rural and remote health. Its Vision is good health and wellbeing in rural and remote Australia and it has a commitment to equal health by the year 2020. The Alliance manages the biennial National Rural Health Conference and the Australian Journal of Rural Health, and produces position papers, submissions, media releases and newsletters. It is also the national management agency for the Australian Government of the Rural Australia Medical Undergraduate Scholarship (RAMUS) Scheme and Stream 2 of the Rural Health Continuing Education program (RHCE2).
Health Professional Radio
Wayne Bucklar: You’re listening to Wayne Bucklar on Health Professional Radio. Recently I spoke with CEO of the Rural Health Alliance, Gordon Gregory, who told us about the organization and its part in the Australian health system. And that interviewed is available on our archive for people who may have missed it. I’ve invited Gordon back to tell us about the policy and lobbying work of the Rural Health Alliance and he’s joined us today. Gordon welcome back to Health Professional Radio.
Gordon Gregory: Lovely to talk to you again Wayne. Thanks a lot.
W: Now tell me, apart from rounding up 37 organizations into one coherent perspective on policy issues, what are the issues that you’ve been working on that would resonate with the audience now?
G: Yeah, interesting question. There’s a mix Wayne, we’ve been around for about 20 years and there are a number of issues which is you would imagine, have always been with us. I mean there is one pretty obvious one … and that is the state aboriginal towards that of the health. I mean, I think people are aware that this is not only a national shame, the fact that we haven’t been able to do as well as fully indigenous populations in this country as they’ve done in New Zealand or Canada or America. So it’s not only a national shame, it is probably one of the social policy areas which actually brings us some international shame. So you can imagine and your listeners can imagine I’m sure that we have always be concerned with the state of aboriginal on towards their health. The life expectancy at birth as people know is between 10 and 13 years, depending on who you ask and how you measure it lower for people for the first Australians under this non-indigenous Australian. This is a horrible, a horrible thing I have to admit. However of course we are not exclusively, we are not even strongly an indigenous organization. Of the 37 member bodies you mentioned we have, only three are indigenous. They are National Aboriginal Community Controlled Health Organization, the Australian Indigenous Doctors’ Association, and Indigenous Allied Health Australia. Now they’re 3 wonderful, energetic, busy organizations, which obviously we look to for leadership but we are quintessentially wide if you like it, in a sense that you know we hold teleconferences. We expect people to be able to contributed teleconference whether 30, 40 people on, which is quite a large for people who might be shy or whatever. So what I’m saying is we are a wide organization. I don’t apologize for that at all, we are led and directed in our work on indigenous health by three wonderful indigenous organizations, and we do what we can. We are faithful, we are loyal to the cause, and we never miss an opportunity to say to governments and oppositions of the day, “You know, we really must do better.” And of course that’s a, there’s only a few words. But we’ve got some views about I won’t go to them now. But we’ve got some views about how we can do better and of course this goes to the very broad basis solve the problems, the challenges, the unmet needs in relation to aboriginal on towards down the health and wellbeing. So that’s one issue with which we are still constantly busy and the hope is that one day soon will it will not be a priority because it’s is all fixed. That’s our long term aim as with everybody else’s. Our other issues in that sort of category, that is those that have always been with us, I guess the first to mention is workforce. It’s long been the case and sadly still is the case, that the workforce distribution in Australia, I’m talking about health workforce is crooked. We do not have are fair share of doctors, nurses, especially allied health professionals, dentist, pharmacist, managers and so on. So we’ve got a lot of organization which are closely involved in this, immediately involved because they’re at actually professional organizations ao we’ve got amongst us 37 members as you remember from the previous bit we did to air. We’ve got professionals group like the doctors, like the … nurses, the rural nurses, the psychologist, the physiotherapists, the allied health professionals, the pharmacist, and so on. So all these have got a very special interest because it’s their profession. So we’ve been working away for years and years and years and have all sorts of policy proposals for what you have called “improving the distribution of the health workforce.” You can hear me saying Wayne “improving the distribution” because it is the case that for some profession, we’ve got enough in Australia. I mean some people would actually argue we’ve got enough doctors, but the problem is their distribution. We’ve got too many of them in the major cities. And also some people would point out that we’ve got enough pharmacists and even dentists. I mean dentists in remote areas – no pun intended – are as scare as hen’s teeth but we’ve got a lot of dentists who are living and working or living and not working as dentists in capital cities. So this is the second issue then workforce distribution is a second issue with which we have long been concerned and still are because we still haven’t got it right, we as a nation still haven’t got it right. Thirdly, there are a small number of policy issues related to population health group. So I’m gonna mention really only two I think. I’m gonna mention mental health and dental oral or dental health because in both cases, well let’s go of mental health first. Mental health is actually not more prevalent in rural areas in the cities but its impacts are worse for obvious reason because there are few specialist staff around you that the mental health nurses they are not there, nurse’s, poor access to psychologist, busy GP’s and so on. So mental health consequences or mental illness consequences in rural areas are greater than cities so this is a particular challenge to us which we’re working on along with our colleagues with mental health Australia and others, because we’re an organization that loves to collaborate with other organizations to do good works and we do that whenever we can – so that’s mental health. Now for oral and dental health as I’ve said, the distribution of dentist is even worse than the distribution of doctors, and yet we’re not quite well aware of this. The commonwealth government and the previous government in fact promised to put significant amount of additional money into public dental health services which could have reach to rural areas and help with the waiting list and so on. So this is one area where we are concerned, for instance in the coming budget in May – the federal budget. We would like to see the commonwealth government and reverse the postponement of this significant new funding for public dental health services which was promised by the previous government. In the country’s fiscal environment this is I guess is unlikely, but if it doesn’t happen, then we will still have this situation in which serious diseases by oral and dental health problems which are entirely preventable are affecting people’s comfort, affecting people’s ability to eat well, affecting people’s ability to get a job and affecting the intake the people who go to hospital for oral and dental health emergency. You would be surprised or perhaps not, at the proportion of people who enter emergency department hospitals because of an oral or dental emergency. So there’s two. And so what I’ve listed so far and I’m sorry I’m talking perhaps too quickly I’m sure, I hope like you can understand me. So there’s a range of issues which are ongoing and I’ve mentioned a couple of them. And then the second class and with this I’ll end, are the opportunistic one. So for instance there is a government inquiry, there’s a senate inquiry into speech pathology service as there was six months ago. The senate inquiry into out of pocket cost which of course is very much flavor of the month in terms of the debate about whether they should be co-payments. So this is a second set of issues which from time to time become a priority for us because they’re important for rural and remote people and because there is an opportunity to do something created by a government inquiry or something which is cropped up.
W: Yes and you try and take advantage of those at the time.
G: That’s right. We will write a submission, so the processing which I outlined briefly in our first chat. So there will be an inquiry into speech pathology and this is a real example from what happened six months ago or so. Our council say “yes” there are particular issue related to speech pathology in rural areas probably because we don’t have enough speech pathologists. And it’s very hard to access this small specialized type of service. Therefore council agree that we should make a submission. The job of the staff here is to draft such a submission, so obviously we then go out and we seek evidence. It’s got to be evidence based. So we seek the data and we seek evidence from people who knows. So obviously we’ll talk to speech pathologists, we’ll talk to patients who are in need speech pathology services, we’ve drafted a submission and then it goes to council and it will go it will knock back and forth until the council say “Yeah this is right” and I should write of course, there were with 37 member bodies. We never get 37 ticks so we have to work to the presumption if we don’t hear from a particular body then we assume agreement. Most organizations will get back, but many will say “Well that’s fine,” and they won’t have time or the opportunity to get back. So we have a strict protocol that if we don’t hear from the members of council who represent their body on council, then we have to assume agreement. So we proceed, we then make the submission to the senate inquiry or whatever it is, we then have of course for the opportunity to provide evidence to the public hearing that we often do. We often get, because of the number of bodies we pull together, we often get invited to actually deliver evidence to the public hearing of this inquiries. We say as it is, we represent the rural voice, we make sure that they’re at the table, and then of course the committee of inquiry, the secretary will do their thing and there will be reports. So then we’ll look into the reports and we’ll say “okay these are the recommendations they have made” and we will then promote to governments and anybody else in the position to act them – those of the recommendations from the report which serve rural people.
W: A fascinating and very essential procedure, I think to Gordon. Can I say thank you for articulating it so plainly and clearly for us today? Unfortunately we run out of time. You’ve been listening to Wayne Bucklar on Health Professional Radio and I’ve been in conversation with Gordon Gregory, the CEO of the Rural Health Alliance. This conversation is on our archive as both a transcript and an audio file, for those of you who are seeking more information, I do urge you to go to www.ruralhealth.org.au for an insight into the policy perspectives as they affect rural health in Australia. Gordon, it’s been a pleasure having you on the radio, I look forward to talking to you again.
G: That would be great Wayne. Anytime you’d like another chat, I’ve be very pleased to do so.
W: I’m sure our listeners would love to hear more from you.
G: Thank you so much.
W: This is Wayne Bucklar on Health Professional Radio.