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Outcome 6 - Rural Health

Access to health services for people living in rural, regional and remote Australia, including through health infrastructure and outreach services

Major Achievements

Established Rural and Regional Health Australia in July 2011 to provide information on regional health and aged care programs.
Publicly released the National Strategic Framework for Rural and Remote Health in April 2012.
Improved rural and remote health infrastructure through projects under the National Rural and Remote Health Infrastructure Program.
Continued to support the Royal Flying Doctor Service through a four-year agreement to provide essential health services to rural, remote and very remote Australian communities.
Completed the review of the Medical Specialist Outreach Assistance Program and the Visiting Optometrists Scheme.

Challenges

Ensuring health professionals continue to provide services to rural and remote communities under the Medical Specialist Outreach Assistance Program during the transition to the Rural Health Outreach Fund.

Trends

Nationally, the Royal Flying Doctor Service (RFDS) provided more than 41,600 patient contacts during 2011-12. This is a slight increase on the 40,900 RFDS patient contacts in 2010-11. The RFDS continues to provide essential GP/Community nurse services to isolated communities in Australia’s outback.

Figure 6.1: Royal Flying Doctor Service Combined GP and Community Nurse Clinics Patient Consultations

Text version of Figure 6.1

Outcome Strategy

Outcome 6 aims to improve access to health services for people living in regional, rural and remote Australia by supporting a range of targeted rural health programs and activities through its ongoing health reform agenda. The Department worked to achieve this Outcome by managing initiatives under the program outlined below.

Program 6.1: Rural Health Services

Program 6.1 aims to: improve access to health services for people living in rural and remote areas; and support activities through the Rural Health Outreach Fund to improve access to medical specialist, GPs and allied and other health providers in rural and remote areas of Australia.

Rural and Regional Health Australia

In 2011-12, the Department established Rural and Regional Health Australia to provide a single entry point to information on rural and remote health and aged care programs, policies and services in local areas through a 1800 information line, email facility and website. Rural and remote communities now have increased access to information about Government programs and services available outside metropolitan areas.

Rural and Regional Health Australia commenced operations on 1 July 2011 and was officially launched on 4 November 2011 by Ministers Roxon and Crean and Mr Oakeshott and Mr Windsor. The Department developed posters and brochures promoting Rural and Regional Health Australia’s information services, which were sent to 9,920 rural and remote stakeholders in November 2011.

In 2011-12, Rural and Regional Health Australia received 653 enquiries through the information line and 112 emails from the public and health professionals. Since November 2011, the Rural and Regional Health Australia website has been accessed by the public 12,842 times.

Rural and Regional Health Australia advocated for rural and remote health issues in 2011-12 by participating in interdepartmental committees, meeting with Government agencies (including the Department of Regional Australia, Local Government, Arts and Sport), liaising with national rural health organisations and providing input and advice on the impacts on rural health of national policies and programs.

In 2012-13, Rural and Regional Health Australia will continue to advocate rural and remote health issues across the Government and work with rural health stakeholders to identify emerging health issues or trends.

Rural and Regional Health Australia Information Service

Finding local health and aged care information is now a whole lot easier.

The Rural and Regional Health Australia information service can be accessed:

through the Rural and Regional Health Australia website at www.ruralhealthaustralia.gov.au;
by calling 1800 899 538; and
by emailing infoRRHA@health.gov.au

Deliverable: Establish an agency to provide advice to the public about needs, policies and service delivery in health and aged care in regional Australia.

2011-12 Reference Point: An agency to provide advice to the public about needs, policies and service delivery in health and aged care in regional Australia will be progressively implemented from 1 July 2011.

Result: Met.

Rural and Regional Health Australia commenced operations on 1 July 2011 and was officially launched on 4 November 2011. It provides a public information service about Government health and aged care programs that have a rural and remote focus including a 1800 freecall enquiries line and email address for queries.

Deliverable: Establish a new website to provide place-based regional health and aged care programs and initiatives.

2011-12 Reference Point: The new website will be progressively implemented from September 2011.

Result: Met.

The Department launched the Rural and Regional Health Australia website on 4 November 2011 which acts as a portal for rural and remote health and aged care information. A new version of the map locator on the Doctor Connect⁸⁵ and Rural and Regional Health Australia websites was made available in May 2012. The new map allows consumers to view health workforce programs for any location in Australia.

Rural Health Outreach Fund

The Rural Health Outreach Fund (the Fund)⁸⁶ was established on 1 July 2011, consolidating five existing rural and remote health outreach service programs⁸⁷ to provide a larger, flexible funding pool for initiatives aimed at improving access to medical specialists, GPs and allied and other health providers in rural and remote areas of Australia.

The objectives of the Fund are to improve health outcomes for people living in regional, rural and remote locations by supporting the delivery of outreach health activities.

In 2011-12, the Department progressed the Fund by consulting with existing fundholders and other interested stakeholders through a public discussion paper, developing program guidelines and preparing for an open funding round to select fundholders. The Department will ensure completion of the funding round by December 2012. The Department will also provide transition arrangements for health professionals. New arrangements are anticipated to commence under the Fund from 1 July 2013.

Deliverable: Consultation with stakeholders on implementation arrangements for the Fund.

2011-12 Reference Point: Timely initial contact and follow-up consultation where this is required.

Result: Met.

The Department sought comments on a publically available discussion paper and through the review of the Medical Specialist Outreach Assistance Program and the Visiting Optometrists Scheme.

Deliverable: Establishment of administrative arrangements for the Fund.

2011-12 Reference Point: Administrative arrangements in place.

Result: Met.

The Department consulted with existing fundholders and rural and remote health stakeholders to develop program guidelines. Administrative arrangements are in place for 2012-13. New fundholders are expected to commence provision of services from 1 July 2013.

KPI: Ongoing medical specialist, GP, and allied and other health services provided through the Rural Health Outreach Fund meet the needs of rural and remote communities.

2011-12 Reference Point: Organisations funded to support rural outreach will consult with stakeholder groups, and will be guided by Advisory Forums and Indigenous Health Partnership Forums, to identify community needs.

Result: Met.

Medical Specialist Outreach Assistance Program fundholders undertook detailed planning with input from state and Northern Territory advisory forums, which include representation from state and territory health authorities, health services and health professionals. These consultations ensured the needs of rural and remote communities were identified and incorporated throughout the planning process.

KPI: Number of patient contacts supported through the Rural Health Outreach Fund.

2011-12 Target: 80,000 2011-12 Actual: 164,304 Result: Met.

164,304 patient contacts were supported through the Rural Health Outreach Fund, therefore significantly exceeding the 2011-12 target.

Rural Women’s GP Service

The Department continued to fund the Royal Flying Doctor Service to deliver the Rural Women’s GP Service, which facilitates the travel of female GPs to rural and remote communities. The program improves access to primary health care services for women in rural and remote Australia, who currently have little or no access to a female GP. However, the service is open to all members of the community, including men and children. In 2012-13, the Department will continue to support the delivery of the Rural Women’s GP Service in rural and remote communities.

Deliverable: Number of rural locations visited by female GPs.

2011-12 Target: 170 2011-12 Actual: 149 Result: Substantially met.

A reduction in the actual number of locations receiving Rural Women’s GP Services is due to a range of factors including the increased availability of female GPs in rural and remote areas

Improve Access to Health Services in Regional, Rural and Remote Areas

National Strategic Framework for Rural and Remote Health

In 2011-12, the Department collaborated with the Rural Health Standing Committee to finalise development of the National Strategic Framework for Rural and Remote Health (the Framework).⁸⁸ The Framework was released by Health Ministers in April 2012 and promotes a national approach to policy, planning, design and delivery of health services in rural and remote communities.

In 2012-13, the Department will continue to work with the Rural Health Standing Committee to develop performance indicators and support strategies outlined in the Framework to assist governments to work together with rural and remote communities to improve access to health care services, address health workforce distribution issues and support innovative models for service delivery.

Deliverable: New National Strategic Framework for Rural and Remote Health finalised by the Australian Government and state and Northern Territory governments.

2011-12 Reference Point: The new National Strategic Framework for Rural and Remote Health is endorsed by Australian Health Ministers Advisory Committee and Standing Council on Health by 31 December 2011, and promoted to key rural health stakeholders in early 2012.

Result: Met.

The National Strategic Framework for Rural and Remote Health was endorsed by Australian Health Ministers Advisory Committee on 29 September 2011 and Standing Committee on Health on 11 November 2011. It was released by Health Ministers at the Standing Council on Health meeting on 27 April 2012. The Department distributed over 1,700 copies to stakeholders nationally and the document was made available on the Rural and Regional Health Australia website.

Rural and Remote Health Infrastructure

In 2011-12, the Department delivered 42 new projects nationally in rural and remote communities under round five of the National Rural and Remote Health Infrastructure Program. These projects established and refurbished health facilities, which provided a range of primary care services, including privately insurable health services such as podiatry, physiotherapy, speech pathology and dental health services. The Program also established facilities to support the training of medical students and registrars in rural and remote communities.

In May 2012, a further 50 projects were approved for funding under round six of the National Rural and Remote Health Infrastructure Program.

Deliverable: Number of new projects funded annually through the National Rural and Remote Health Infrastructure Program.

2011-12 Target: 40 2011-12 Actual: 50⁸⁹ Result: Met.

The National Rural and Remote Health Infrastructure Program is a highly popular program. In 2011-12, the Department received more applications than the grant funding available.

Royal Flying Doctor Service

The Department signed a new four-year agreement with the Royal Flying Doctor Service (RFDS) which commenced on 1 July 2011. Funding is being provided to enable the RFDS to continue to provide health care clinics, primary aero-medical evacuations, medical chests and remote consultations. People living on remote Bass Strait Islands will benefit from additional primary health care services. Provision has also been made to contribute to RFDS capital requirements including funding to assist with the replacement of older aero-medical aircraft.

KPI: Number of patients attending Royal Flying Doctor Service clinics.

2011-12 Target: 39,000 2011-12 Actual: 41,657 Result: Met.

The RFDS continued to provide essential community health and general practice clinics in locations beyond the normal medical infrastructure.

Rural and Remote Health Outreach Services

In 2011-12, the Department continued to support the Medical Specialist Outreach Assistance Program (MSOAP). MSOAP improves access for rural and remote patients to medical specialist services by providing financial assistance to medical specialists to cover the costs associated with delivering outreach services. MSOAP also supports local health care professionals by providing training and professional support. Services covering over 100 specialty and sub-specialty disciplines were provided locally in targeted areas of need.

Since 2009-10, the Department has expanded MSOAP services to include multidisciplinary care to Aboriginal and Torres Strait Islander people, multidisciplinary maternity care for women and their families and outreach ophthalmology services.

A comparison of MSOAP services provided to rural and remote communities across Australia in 2010-11 and 2011-12 is provided below:

Table 6.1 Medical Specialist Outreach Assistance Program

Program	Number of Services per Year
Program	2010-11	2011-12
MSOAP	1,328	1,234*
MSOAP-Indigenous Chronic Disease	541	1,330
MSOAP Maternity	N/A	285
MSOAP Ophthalmology	1	14

* MSOAP data is to 30 April 2012. All other data is for the full year.

Whole of Program Performance Information

Deliverable: Produce relevant and timely evidence-based policy research.

2011-12 Reference Point: Relevant evidence-based policy research produced in a timely manner.

Result: Met.

In 2011-12, the Department continued to provide timely evidence-based policy research and advice on a range of issues affecting regional, rural and remote Australia, ranging from regional economic development to the delivery of health outreach services.

Deliverable: Stakeholders participate in program development through a range of avenues.

2011-12 Reference Point: Stakeholders participated in program development through avenues such as regular consultative committees, conferences, stakeholder engagement forums, surveys, submissions on departmental discussion papers and meetings.

Result: Met.

Representatives of Rural and Regional Health Australia met at least on a quarterly basis with key rural health stakeholders including the National Rural Health Alliance, the Rural Doctors Association of Australia, Services for Australian Rural and Remote Allied Health and the Department of Regional Australia, Local Government, Arts and Sport, to discuss policy and program matters.

Deliverable: Percentage of variance between actual and budgeted expenses.

2011-12 Target: ≤0.5% 2011-12 Actual: -0.9% Result: Substantially met.

The underspend was primarily due to the non-availability of medical specialists to deliver services in regional, rural and remote locations for the Medical Specialist Outreach Assistance Program.

Outcome 6 – Financial Resources Summary

	(A) Budget Estimate 2011-12 $’000	(B) Actual 2011-12 $’000	Variation (Column B minus Column A) $’000
Program 6.1: Rural Health Services
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	101,623	100,350	( 1,273)
Departmental Expenses
Departmental Appropriation¹	12,996	13,194	198
Expenses not requiring appropriation in the current year²	642	676	34
Total for Program 6.1	115,261	114,220	( 1,041)
Outcome 6 Totals by appropriation type
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	101,623	100,350	( 1,273)
Departmental Expenses
Departmental Appropriation¹	12,996	13,194	198
Expenses not requiring appropriation in the current year²	642	676	34
Total expenses for Outcome 6	115,261	114,220	( 1,041)
Average Staffing Level (Number)	98	97	( 1)

Departmental appropriation combines ‘Ordinary annual services (Appropriation Bill 1)’ and ‘Revenue from independent sources (s31)’.

’Expenses not requiring appropriation in the current year’ is made up of depreciation expense, amortisation, make good expense and audit fees. This estimate also includes approved operating losses – please refer to the departmental financial statements for further information.

Available at www.doctorconnect.gov.au/
In the 2011-12 Budget the Australian Government announced the consolidation of 159 whole or part Health and Ageing programs within 18 flexible Funds. The Rural Health Outreach Fund is one of the 18 Funds that came into operation from 1 July 2011. The establishment of flexible Funds will, over time, reduce red-tape for funding recipients in line with the National Compact, provide increased flexibility to government to respond to emerging health and ageing issues, and deliver better value for money and evidence-based funding.
A full list of activities consolidated into each Fund is provided at Part 3.6: Activities Consolidated to Establish Flexible Funds.
The Framework can be accessed at www.ruralhealthaustralia.gov.au
Includes ten grants from round six.

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