KEY STRATEGIC DIRECTIONS FOR 2004-05
Better Access to Health and Aged Care Services for Rural Communities
There is a range of initiatives targeted to increasing health care and aged care services in rural and remote communities that have improved access to services for rural Australians in 2004-05.
More Allied Health Services Sub Program
As part of the Rural Health Strategy, the More Allied Health Services Program (MAHS) continued to improve access to additional allied health professionals for residents of rural and remote communities. The allied health professionals funded under MAHS include Aboriginal health workers, audiologists, dieticians, physiotherapists, occupational therapists, podiatrists, psychologists, and nurses in specialist roles such as asthma and diabetes educators. Over the last two years, there has been an increase in the number of allied health professionals funded under the MAHS program. In 2002-03, there were 172 allied health professionals funded and in 2003-04 this increased to 210.5. (Please also refer to Outcome 4: Quality Health Care - Primary Health and Community Care).
Medical Specialist Outreach Assistance Program
The Medical Specialist Outreach Assistance Program (MSOAP) complements specialist outreach services provided by State and the Northern Territory governments. It improves access for people living in rural and remote communities to medical specialists and the program facilitates visiting specialists working with local health professionals. It increases and maintains the skills of regional, rural and remote health professionals. In 2004-05, MSOAP completed its first four year phase and provided an increase in access with more than 1,000 visits annually from medical specialists. Under the Rural Specialist Support Scheme, new agreements have been negotiated to ensure the continued provision of specialist outreach services for a further four years.
The Department allocates aged care places to approved providers able to serve special needs groups, including people living in regional, rural and remote areas. This allocation is based on community need and takes into account advice from Aged Care Planning Advisory Committees in each State and Territory. The Department managed funding for 600 places in Aboriginal and Torres Strait Islander Flexible Services in 2004-05. The Department administered the 2004 Aged Care Approvals Round which included allocation of $37.4 million of capital assistance to providers of residential aged care in regional, rural and remote areas. The Department is responsible for the implementation of a package of measures announced in the 2004-05 Budget in response to the report of the Review of Pricing Arrangements in Residential Aged Care. This implementation included changes to the viability supplement paid to eligible small rural and remote aged care providers in recognition of their lower incomes and higher costs. The supplement was increased and extended to Aboriginal and Torres Strait Islander Flexible Services. The new viability supplement scheme commenced from 1 January 2005, but start up was delayed with the first payments occurring from the end of June 2005.
Building Healthy Communities: A Guide For Community Projects
Better Treatment for Cancer Care
In 2004-05, the Department administered funding of $14.5 million to improve regional patients’ access to radiation therapy services through a range of workforce and outreach programs. Agreement has also been reached with four States for new and expanded radiation therapy facilities, and further outreach projects, in Western Australia, Victoria, Queensland and New South Wales at a total cost of $34 million.
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Focus on Preventive Primary Care and Management of Chronic Disease
Primary Health Projects Program
The Department manages the Primary Health Projects program which targets the main risks for many preventable chronic diseases (obesity, lack of physical activity, alcohol and smoking) and injuries in rural and remote areas of Australia. The Department supports several national projects in the rural context alongside community led projects at the local level through the Building Healthy Communities (BHC) in remote Australia initiative. The BHC projects support communities to adopt and maintain healthy lifestyles by finding their own solutions to the local health problems they have identified. Funding is provided for two year projects with a health promotion and prevention approach. The approach is to be through the development and dissemination of high quality information; the development of skills for community members and health professionals; and through the development and implementation of strategies targeting healthy lifestyle and/or injury prevention. The program also provides funding for national Primary Health Projects that address the risks that contribute to poorer health status in rural and remote areas compared with metropolitan areas. Funding for this program commenced in July 2004, with effort in 2004-05 focussed on the development and initial funding of projects.
Education and Training for the Rural Health Workforce
Rural and Remote Nurse Scholarships
The Department continued a partnership with the Royal College of Nursing, Australia for the management of the rural and remote nurse scholarship program. This program aims to remove some of the barriers to people from rural areas studying nursing or re-entering the nursing workforce. The program comprises four schemes:
- undergraduate scholarships target rural and remote students who, due to the additional financial burden of moving from home to study, would not have been able to undertake undergraduate nursing education studies. Scholarships are valued at $10,000 per academic year and the Department awarded 149 scholarships in 2004-05;
- the Enrolled Nurse to Registered Nurse scheme provides a means for career progression for rural enrolled nurses while helping to address the overall shortage of registered nurses in rural and remote Australia. Scholarships are valued at $5,000 per year. In 2004-05, the Department awarded 57 scholarships;
- the postgraduate scheme provides funding for rural and remote registered nurses and enrolled nurses to undertake further study, 2 build upon their qualifications and to attend relevant conferences. In 2004-05 three scholarship selection rounds were conducted with over 260 scholarships offered; and
- the Re-entry/Up-skilling scheme is designed to remove some of the barriers to re-entering the nursing workforce through short courses and accredited programs that enable former nurses to re-register and re-enter the nursing workforce. Scholarships are valued at up to $6,000 and 317 of these were allocated in 2004-05. This is a significant increase on previous years due to better advertising and improved selection guidelines.
Australian Government Aged Care Nursing Scholarship Scheme and Support Systems
The Department continued a partnership with the Royal College of Nursing, Australia to provide undergraduate, postgraduate and continuing professional development scholarships to people from rural and regional areas that are committed to caring for older Australians. During 2004-05, 300 undergraduate scholarships, 94 continuing professional development scholarships and 10 honours scholarships were offered. The Department also managed funding to the College and the University of Tasmania for programs to support the scholarship recipients. The scholarships are increasing the availability of professionally qualified aged care staff.
Support for Aged Care Workers Training Program
The Department manages the Support for Aged Care Workers Training Program which trains care staff in smaller, less viable residential aged care homes (including those in rural and remote areas) to upgrade their skills, thereby freeing registered nurses to concentrate on clinical care. In the three years since the establishment of the program, it has benefited more than 5,700 staff through 70 training programs in over 470 residential aged care homes throughout Australia.
Rural and Remote Health Professionals Scholarships
In 2003, the Department established a scholarship scheme to support rural and remote health professionals, other than doctors and nurses, to undertake continuing professional education opportunities, including postgraduate study, short courses, clinical placements and conference attendance. The Department managed scholarship funding of $600,000 per annum to Services for Australian Rural and Remote Allied Health to administer the scholarships. In 2004-05, 92 scholarships were awarded to a variety of health professionals, including physiotherapists, podiatrists, occupational therapists, speech pathologists, chiropractors, radiographers and optometrists.
Rural and Remote Pharmacy Workforce Development
The Rural and Remote Pharmacy Workforce Development Program was established to support the recruitment and retention of pharmacists in rural and remote areas of Australia. Through the Pharmacy Guild of Australia, the Department administered funding to a number of initiatives to increase student exposure to rural practice. Twelve undergraduate pharmacy scholarships were awarded in 2004-05 to students from rural and remote backgrounds, to bring the total awarded under the program to 65. The program continues to provide financial support to undergraduate pharmacy students to help address the costs of undertaking student placements in rural and remote areas.
The program also contains a range of initiatives to address factors that impact on the attractiveness of rural pharmacy practice. These include access to a locum in an emergency, with 19 emergency locums funded in 2004-05. Additionally, the program contributes to the cost borne by rural pharmacists in undertaking professional education that can be a deterrent to them completing training and development opportunities. In 2004-05, funding assistance was provided to over 370 individuals.
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Rural Workforce Training Infrastructure
University Departments of Rural Health
The Department administers funding to universities for the University Department of Rural Health (UDRH) Program which forms the foundation of a national rural health education and training network. The ten UDRHs that have been established provide a supportive environment to health professional students, and existing rural and remote health professionals, while they undertake their studies in rural and remote areas and allow students to experience life in a rural or remote setting. During 2004-05, the Department, in consultation with universities, revised the objectives for the program to more closely align the objectives with the key performance indicators for the program.
Rural Clinical Schools
The national rural health education and training network also includes 10 Rural Clinical Schools. The Department has administered funding to University Medical Schools through this program to establish infrastructure and training capacity to enable medical students to undertake clinical placements in rural and remote areas. In 2004-05, 25 per cent of medical students in participating Medical Schools undertook at least one year of clinical training in a rural or regional location through a Rural Clinical School.
Assistance with Vocational Training
Australian General Practice Training Program
Since 2004, an additional 150 general practice vocational training places have been made available on the Australian General Practice Training Program, bringing the total number of training places to 600 per year. During 2004-05, the Department continued to administer funding for these places. The increased number of training places assists in the provision of an adequate general practice workforce and has contributed to an increase in GP services available to rural and remote locations. (Further information on the uptake of these places is detailed in Outcome 4).
Advanced Specialist Training Posts in Rural Areas
The Department administered funding on a cost-shared basis with the states and the Northern Territory to support the establishment of accredited advanced specialist training posts in rural and regional locations. In 2004-05, there were 41 specialist training posts funded under this program. Funding was also provided through the Rural Advanced Specialist Trainee Support program to six medical colleges to provide support and training for advanced specialist trainees to prepare them for rural practice. An evaluation, which was conducted in late 2004 by Morey Australia Pty Ltd, found that the program was operating effectively.
Prevocational General Practice Placements Program
This program provides up to 280 voluntary, well supervised general practice placements each year in outer metropolitan, regional, rural and remote areas. The program is intended to be an educational experience for junior doctors to attract them to general practice and thus maintain workforce numbers in the longer term. For further information on this Program refer to Outcome 4.
Training and Support for the Established Rural Health Workforce
Training for Rural and Remote Procedural General Practitioners Program
During 2004-05, 617 procedural GPs were assessed as eligible to receive payments under the Training for Rural and Remote Procedural GP Program, and payments were made to 390 doctors on successful completion of training as at 31 March 2005. During 2004-05, the sixth year of the Rural Retention Program, payments totalling $21.3 million were made to 1,989 doctors - up from $19.1 million to 1,900 doctors in 2003-04.
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Support Scheme for Rural Specialists
The evaluation of the Support Scheme for Rural Specialists (SSRS) conducted by the Hunter Institute of Mental Health during 2004-05 showed that the program had been effective in improving access to continuing professional development activities to specialists working in rural and remote areas. Twenty three projects have been funded with nine specialist medical colleges under round five of the SSRS during 2005.
Rural Health Support, Education and Training
The Rural Health Support, Education and Training (RHSET) program contributes towards the recruitment and retention of rural health workers by funding initiatives that provide them with appropriate support, education or training. The RHSET program has, through its multifaceted, multidisciplinary approach, encouraged a wide range of health professionals and community groups to attempt a range of innovative methods of addressing local health service problems. The Department commenced the 2005-07 RHSET grant selection round in the first half of 2005, with advertisements seeking expressions of interest being placed in national, metropolitan, regional and rural newspapers.
Workforce Support for Rural General Practitioners Program
Funding for the Workforce Support for Rural General Practitioners program was continued as part of the Rural Health Strategy. Support is provided to GPs working in rural and remote areas with funding targeted at a range of activities, such as recruitment and retention, training and professional development, family support, locum coverage and assistance to overseas trained doctors. (Please also refer to Outcome 4: Quality Health Care - Primary Health and Community Care).