John Menadue. The Coalition, Barnaby Joyce rural poverty and rural health. (Repost from 16 January 2016)

Jan 18, 2018

It is not surprising that independents are making headway in country electorates. But what is the ALP doing?  

When listening to Coalition members of parliament it is hard to understand that coalition members represent the poorest electorates in the country. Furthermore, these electorates have the worst health services in the country – by a country mile.

I seldom hear Coalition MPs from the bush express their concern about rural poverty and poor health. I cannot recall any real effort by coalition MP’s to address the health problems in their constituencies.

The National Party primarily sees its role as a junior to the Liberal Party and easily bought off with a few ministerial posts. That tugging the forelock by the Nationals is often at the expense of the people they should be serving. When National Party members speak about rural issues it is invariably on behalf of their wealthier constituents. They speak volubly about roads and marketing but rarely about health

The eleven poorest federal electorates measured by median household income per head are all Coalition seats – Barker (Liberal), Grey (Liberal), Bass (Liberal), Braddon (Liberal), Mallee (National), Wide Bay (National), Lyons (Liberal), Page (National), Lyne (National), Hinkler (National) and Cowper (National).

On the mainland the poorest seven electorates are rural and all represented by the National Party. What was that about the ALP representing the poor in Australia?

The health of rural people is the worst in the country and mainly because they are poor. The social determinants of health tell us very clearly that poverty and poor health are linked.

In January this year the National Rural Health Alliance which covers 37 affiliated bodies concerned with rural health, reported:

  • The health of rural people lags well behind that of their city counterparts.
  • The state of indigenous health is a national disgrace and around 70% of the nation’s aboriginal and Torres Strait islander people live outside the major cities.
  • Other areas of rural and remote health in which urgent attention is needed includes mental health, oral and dental health, and maternity services.
  •  The prevalence rate of risky alcohol consumption in causing lifetime harm is much higher for rural people. In the major cities, the risk of lifetime harm from alcohol is 19% of the population, 22% in inner regional areas, 25% in outer regional areas, and 31% in remote and very remote areas.
  • Anti-smoking campaigns have been less successful outside the major cities.
  • The rate of obesity is higher in country areas, and ranging from 62% in major cities to 73% in remote areas.

Despite the poor health in country areas, the health services available are much inferior. The National Rural Health Alliance also reported in January this year:

  • Access to primary care, dental care, allied health and specialist services is becoming more difficult and in many regions requires greater time and expense on travel and accommodation.
  • Shortage of doctors, nurses, allied health professionals, paramedics and dentists persist, with the seriousness of these shortages only partly masked by success in recruiting overseas trained workers.
  • The shortage of health service professionals is acute in remove areas.
  • The viability of many rural hospitals is uncertain and there has been a serious loss of capacity for maternity services and other procedural care in rural areas.
  • Many young health professionals are not prepared to ‘go bush’ under existing conditions.
  • Infrastructure in rural and remote areas for health services and health related activity is limited and being further eroded by lack of ongoing investment.

The Grattan Institute estimates that if we continue with current policies it will take 65 years before people in many parts of rural and remote Australia have the same access to GP services as city people.

The government provides a $7 billion annual subsidy for private health insurance (PHI) which benefits the wealthy and enables policy holders to jump to the head of the queue for private hospital admission. But there are very few private hospitals in the country. As a result the benefits of this large subsidy for PHI go largely to wealthy people in the cities. Over a half of the payments from PHI goes to patients in private hospitals. I have not heard a squeak from any member of the National Party about this and how it disadvantages their constituents.

The needs of country people particularly in mental health are alarming. Medicare expenditure on mental health services per head of population in 2011-12 was as follows: major cities $42, inner remote $31, outer remote $18, rural and very remote $9. These services were provided by psychiatrists, GPs, clinical psychologists, other psychologists and other allied health professionals.

It is very hard to find a psychiatrist in most of our country areas.

Surely it is time that Liberal and National members of parliament who represent some of the poorest people in Australia did something to look after the health of their constituents. They seem focused on the wealthier people in their constituencies and doffing their caps to the Liberal Party which really does represent the big end of town.


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