VICDOC Summer 2023 - Magazine - Page 36
R EG I O N A L
U R BA N H EA LT H CA R E
About three years ago, I decided to make the move to rural – well, sub-regional –
Victoria. This was after 20 years in a major urban ED, nine months into Covid,
and after being in the Director role in that ED, with the amazing support and
assistance of a great ED team, I was tired, burnt out and unhappy. I loved and
respected that team – still do – but I needed a change for my own mental health.
I needed a new space and challenge to reinvigorate my career and personal growth.
In 2020, after four years on the frontline at the Australasian College of Emergency
Medicine (ACEM), two as President, where I quite a bit of my time advocating
for more support for regional and rural healthcare, I decided to make the move.
I drove 230km from Melbourne to a small sub-regional hospital in Echuca,
did a few shifts and have been the Director of that ED for the three years since.
assistance is not good enough. Regional
and rural facilities should attract higher
levels of support (money, accommodation,
I still have a foot in the urban camp and am educational allowances, and relocation costs)
acutely aware of the gaps that divide regional to get the right staff, including support for
accommodation packages for those willing
and urban healthcare and what needs to be
to move, significant remuneration boosts
done to see better care delivered to those
for those who work in areas of need, and
communities outside city boundaries. You
generous allowance for education and travel
don’t have to go too far to see the gaps in
to conferences and seminars – most of
care. Many of our larger regional centres,
which are in major centres.
where you might expect to have a plastic
surgical service, or ENT access fall short.
The irony is that the budget for these
And another 100km past those places,
facilities is tight and getting tighter, even as
it’s down to bare bones. Postcode matters
the needs of regional and rural communities
when it comes to the delivery of health.
grow. As hospitals get busier and ED
Even within major cities, wealthy suburbs,
presentations rise, those facilities who
with wealthy, connected residents, do better. cope and excel and exceed the budgeted
No-one can argue with that.
activity for the year are, through the
National Weighted Activity Unit (NWAU)
The most glaring gap the further you go
from a major urban centre is ‘the people’
system of funding, essentially penalised
– people with the expertise to get the jobs
for outperforming. So, if ED presentations
done. From doctors, nurses, mental health
jump (which they do, and are and can’t be
clinicians and allied health staff to the IT
capped), other services must be cut to close
that funding gap, which then contributes
experts needed to keep systems running,
to a widening healthcare gap, which then
hospitals outside of Melbourne have major
probably leads to more people accessing
challenges filling those roles with the right
level of expertise and the right number of
ED for care. It’s a cycle and it just doesn’t
employees. The current levels of government make sense.
THE GAPS THAT DIVIDE REGIONAL
AND URBAN HEALTHCARE
-
36
AMA VI C TO RIA
