The developed world is experiencing a significant health workforce shortage which is exacerbated in rural and remote areas. In keeping with its overarching objectives of providing quality health services to all Australians, the Australian Government has a particular focus on supporting the medical workforce in rural and remote areas.
The supply of the medical workforce, when considered as the number of doctors compared with the population of the area in which those doctors practise, is low to very poor in many rural and regional areas of Australia1. Rural and remote communities experience higher levels of morbidity and mortality as well as different patterns of disease. There are also complex social, cultural and economic issues underpinning the health problems found in rural and remote areas (Holub, 1995).
The Australian Government funds a number of programs aimed at increasing the number and skills of, support for, and access to, quality medical practitioners in rural and remote areas.
The Rural Health Workforce Strategy as a result of the Rural Health Reform – Supporting Communities with Workforce Shortages 2009-10 Budget measure has seen a number of strategies introduced to strengthen rural workforce support which has included increasing the level of funding and reach of locum programs under the NRLP. Two significant platforms of the Strategy are:
- the scaling or gearing of incentives and return of service obligations to provide greatest benefits to the most remote communities where there is the greatest need
- transition of program eligibility to the new Australian Standard Geographical Classification – Remoteness Areas (ASGC-RA) system.
Rural and remote classification system - ASGC-RA and RRMA
From 1 July 2009, the Australian Standard Geographical Classification – Remoteness Areas (ASGC-RA) system replaced the Rural, Remote and Metropolitan Areas (RRMA) system as the basis for determining eligibility for a number of rural workforce programs.
Remoteness Areas (RAs) are the spatial units that make up the ASGC-RA classification system. The RA categories are listed below, with workforce incentives available for categories ranging between RA2 to RA5.
RA1 - Major Cities of Australia
RA2 - Inner Regional Australia
RA3 - Outer Regional Australia
RA4 - Remote Australia
RA5 - Very Remote Australia
RRMA allocates areas into seven categories from ‘Capital city’ through to ‘Other remote area’ based on a combination of straight-line distance from urban centres of various sizes, and population density. The RRMA classification is based on population figures and Statistical Local Area boundaries as at the 1991 census.
As the transition from RRMA to ASGC-RA has been a recent change, the majority of recent demographic data for the rural and remote GP workforce is still categorised in the RRMA system. Therefore the two classification systems will be referred to throughout this document.