It is now one year since I started my role as chief executive of the Rural General Practice Network. The country was in lockdown and the health system appeared under threat from a global pandemic surging across the borders.
Thankfully, we have not had to deal with the issues assailing countries such as India, Brazil and Mexico. The fact the Government listened and acted pragmatically on key scientific information and advice has been this country’s blessing.
So I find myself able to write this having just attended a face-to-face, kanohi ki te kanohi, rural health conference.
The big financial and reputational risk for our board in hosting this event was mitigated to some extent by holding it in a regional town, some distance from any managed isolation or quarantine facility or border.
Imagine if it had become a super-spreader event. Four hundred rural health specialists from around the country, taken out of action in one hit. The impact on rural communities is not worth contemplating.
No such nightmare ensued and, in contrast, this conference acted as a welcome stress relief for many.
It was the first time in 18 months that rural health professionals had been able to get away from their practices and communities, share stories and experiences, network, learn from one another, and let down their hair and relax.
The timing was perfect. Ten days after health minister Andrew Little’s announcements on the health reforms (no mention of rural), we were able to hear directly from Mr Little and associate minister Peeni Henare about the reforms and what focus there was for increased equity on rural health outcomes. So, what did we learn? Unfortunately, not a lot that was new.
There was the reiteration that primary and community care was the focus of the reforms. Diagnosing and treating people in their communities, thereby preventing unnecessary and expensive hospital admissions, is described as the key to a better health system.
We heard an acknowledgement that rural health outcomes are unacceptable, as are the rural workforce shortages, funding of rural general practice and the slow rollout of rural broadband, which would help unlock the potential of telehealth solutions.
We heard again about the promise to remove the “postcode lottery” of health outcomes in New Zealand.
Many in the audience wanted to be assured that this didn’t just relate to the different outcomes across the 20 DHBs, but the difference between RD addresses and urban street addresses.
Mr Little finished with the point that the opportunities for rural communities lie in the upcoming consultation over how the detail of the reforms will be shaped and implemented by the Transition Unit. Our challenge is getting our rural voices into those key discussions.
I listened with the hope that he might reward the group with a pre-Budget announcement to do with funding a rural health education initiative.
After all, predecessor David Clark had promised at our last conference two years ago, that rural education hubs would be set up. We had also been working for some time with the Health Workforce unit, through sector involvement with working groups and a steering group, to formalise a recommendation to the minister on a programme of interprofessional rural training: for rural, by rural, in rural.
It is common practice nowadays to have pre-Budget announcements of specific initiatives, but no announcement was made, which probably indicates no intervention is budgeted. I would welcome being proven wrong.