Research highlights struggle for good health outcomes in rural areas
According to Hauora Taiwhenua Rural Health Network’s Rural Health New Zealand Snapshot 2024, those in rural areas have poorer health outcomes than those in urban areas.
That's how Dr Fiona Bolden, the chair of Hauora Taiwhenua Rural Health Network which represents all rural health groups, describes the decision by the Minister of Health Andrew Little to have a separate and legally binding rural strategy in the new health reforms.
Initially a special strategy for the rural sector was in the bill, along with strategies for Maori, Pacifica, women and people with disabilities, but 'rural' was taken out by the Labour majority on the select committee.
Bolden strongly criticised the omission of 'rural' saying it was outrageous and left 750,000 people enrolled in rural practices out in the wilderness.
But when the bill was brought back to Parliament, Minister Little announced that rural would go back into the bill, citing pressure from Labour's rural caucus.
Bolden told Dairy News her organisation is so pleased that the health of rural communities will now be prioritised in the legislation. She says its inclusion will mean that rural health will have its own strategy developed, health outcome data tracked, and government agencies held accountable for those outcomes.
"Rural communities, manby with high percentages of Māori, can now have some surety that they will be visible and front of mind among government agencies when these health reforms are implemented come 1 July," she says.
Bolden says a lot of work was done behind the scenes to get the Government to change its mind about making 'rural' a priority.
"It was a multi-tiered thing involving a lot of people over the long period of time to get the change. It involved a lot of meetings with key people and MPs from other parties did good work in Parliament," she says.
According to Bolden, having a rural strategy will have more long-term rather than short-term benefits and she hopes it will encourage young doctors and health professionals to see a future working in rural health.
She says there are a number of issues to be tackled in terms of rural health: namely, having a workforce plan to create a well-trained, supported rural workforce across all specialties acknowledging the huge gap around the clinical workforce at the moment. Dr Bolden says more funding is needed to address the pay anomaly which sees primary health care workers paid less than those in hospitals.
"This is well known issue that needs addressing if we are going to attract people into rural. It seems that Minister Little does have an interest in addressing inequity wherever it is," she says.
Bolden says there has been some criticism about the need for reform in general practice, but rural general practice is very complex because there are a large number of different models operating. She says some practices are privately owned, some are owned by DHBs and other PHOs and many operate in very low income rural communities and don't make a profit.
Dr Bolden says, in some places, things aren't working well.
"But there are some places where it is working really well. People have been innovative and have found solutions, and we certainly don't operate from antiquated model. That doesn't happen in rural because people there tend to be more innovative. You have to, in order to survive," she says.
Bolden says, with the passing of the new bill and with rural having its own strategy, she is hopeful that some of these long-standing issues will be addressed.
