Australia’s first National Rural Health Commissioner, Professor Paul Worley, has finished his two-term tenure in this world-first position.
Professor Worley was guest speaker at the 2019 Annual General Meeting of Gippsland Primary Health Network and shared his vision for a health system with access and equity for all rural and remote Australians.
Read Professor Worley’s open farewell message:
Dear Rural and Remote Australians,
It has been my great privilege to serve for two terms as your inaugural National Rural Health Commissioner. I complete my tenure today. This Australian and world-first position, with its independent status enshrined in legislation, has placed a national and international focus on rural and remote communities, their health, wellbeing and development. These three interlocking elements are the barometers of how we function, as individuals, as communities and as a nation.
Improvements to Australia’s health system over the next decade will be framed by Australia’s Long Term National Health Plan and the target set by the Minister for Health, the Hon Greg Hunt MP, to make Australia’s health system the world’s best. As a nation, our health system performs extremely well. We are currently ranked number two in the world. However, in the areas of access and equity, our performance is less optimal. As we enter a new decade our challenge is clear – the benefits of our progress must be available to all. Access and equity must be increased for Australians who live outside urban centres and in particular for Aboriginal and Torres Strait Islander populations.
Since commencing my role, my activities have focused on improving access and equity through improvements to the supply of a sustainable, high quality, rural and remote health workforce. I have approached this work with a clear and lived understanding of the capacity of rural networks to develop the means of production that will create self-sustaining systems of workforce training and service delivery. However, in order to realise this, we need to move away from current models that rely on a workforce that is primarily developed for and by market-driven, metropolitan training systems and a dwindling cohort of solo practitioners working in isolation in small towns. We must move to a system of integrated, place-based, regional health networks that train and support a rural and remote workforce – working in collaborative teams across defined geographical areas. The foundations for this system have already been established through several decades of rural health education development, and, more recently, the National Rural Generalist Pathway for medicine and the allied health Service and Learning Consortia – two models I have developed with you over the last two years and presented to the government on behalf of you all.
Consultation has been a key component in ensuring that the reforms I have recommended were community designed and led. In-depth engagement across such a diverse and broad terrain as Australia is challenging but vital to the integrity and veracity of the resulting recommendations. My approach has been to be as strategic and efficient as possible, utilising the natural gathering places of rural stakeholders – meetings and conferences – where I was both a speaker and a participant in discussions. I was also supported through the establishment of expert reference groups who provided a high quality evidence base for policy recommendations at various stages of their development. I am profoundly grateful to the thousands of rural and remote Australians – consumers, local councils, students, trainees, clinicians, educators, supervisors, health and service delivery organisations and professional groups – who have contributed so generously to the work I have been engaged in during my term and who support the recommendations it produced.
I also recognise the leadership and commitment of the Ministers, Members and Senators I have worked with during my terms and the Departmental staff who have supported me as an Independent Statutory Officer. The independent nature of my role has allowed me to listen to, learn from, and be a voice for all representatives of the rural and remote health sector, and reflect these learnings in all aspects of the advice I have produced.
In the aftermath of a devastating cycle of fire and flood that swept through many already drought suffering rural and remote communities in the latter half of 2019, we now face a new crisis – COVID-19. While the pandemic is a threat to the health and livelihood of every Australian, its potential ramifications in rural and remote communities where the health system is reliant on fragile workforce supply chains from other countries and our major cities, are arguably far more severe. Rural and remote Australians have risen to meet these challenges, but the need to establish a self-sustaining, integrated system of local workforce supply and service delivery that ensures continuity of care for rural and remote patients has never been more urgent.
Thankfully there is a way forward. The work I have undertaken over the last two years, the strong evidence base that has supported it, and the wisdom and experience of Indigenous and non-Indigenous leaders in this field, have demonstrated that the solutions to many of the challenges that rural communities face lie within rural communities themselves. I thank all the clinicians who serve rural Australia so well, in particular those who have come from overseas or through locum agencies to help our rural communities in times of need. Now is the time for you to become the supervisors of the next generation of rural and remotely trained health professionals. Through targeted investment and an urgent realignment of funding priorities towards smaller rural and remote communities, we can create the local means of production for a world class rural and remote training and service delivery system, starting with those where our nation’s food and mineral resources are produced, far from our major cities. In doing so we will increase access and equity for the health and wellbeing of those populations and develop the productivity and prosperity of their communities and of our nation as a whole. If we can achieve that, then we will become the world’s best health system.
Thank you to my wonderful family who continue to inspire me and have sacrificed so much to allow me to spend so much time on country.
Thank you to my staff who, as a small team, have listened and leaned in to you all to find the best solutions.
Thank you all for the privilege of serving you as your National Rural Health Commissioner.
I wish you and my successor ongoing success and good health.
Professor Paul Worley
National Rural Health Commissioner