JOHN MENADUE. The failure of the National Party on rural poverty and rural health. Repost from 23 February 2018

Aug 20, 2018

Country electorates have the most disadvantaged people, the poorest health and inferior health services.  But the National Party does very little about it. Does it care?

 The National Party record on climate change,NBN and irrigation is appalling.I have written previously on these subjects

Today I refer to its failure to address rural poverty and poor rural health

On Q & A, a few years ago Barnaby Joyce said

“Our constituents are the poorest, that’s one thing we do know and so we are always looking out for them”.

But there is scant evidence that they are ‘ always looking out for them’ in any serious way to address their problems. Apparently, Barnaby Joyce knew the problem but refused to do much about it. He spends more time smoodging Gina Rinehart.

I have yet to hear of a National Party member who gives serious attention to rural poverty and poor rural health. So much of National Party political energy is directed to following the Liberal Party and gaining ministerial positions. If it has any serious focus on rural matters, it is usually on behalf of well-to-do corporate farmers and business people in country towns.

The evidence is clear about the National Party’s failure. ABC Fact Check said:

“Three separate data sets all indicate that the National’s electorates are on average poorer or more disadvantaged than those represented by Labor and the Liberal Party … Associate Professor Oliver at UNSW School of Mathematics and Statistics told the ABC ‘From a proportional perspective, there are more in poverty in National electorates than there are in the other two parties’. He added that ‘Electorates represented by the National Party have a lower score showing greater disadvantage on average than Labour and the Liberal’s [electorates].”

The recent major political reverses by the National Party are not at all surprising. It is neglecting many struggling country people. One Nation sees country voters as a very promising target. Good independents are also making headway in country electorates

The National Party is easily bought off with 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

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

The health of rural people is by far 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 2016 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

  • 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 remote 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 National Rural Health Alliance is now conducting an Out-of-pocket Costs Survey.  In announcing the survey, the Alliance said:

Country people in particular are adversely impacted by the additional non-claimable surcharges where there is no re-course either through Medicare or through private health insurance funds for re-imbursement. These additional fees apply in general practice (rural and remote areas are over-represented by non-bulkbilling practices where choice of alternative provider is limited), specialists consulting in the community, and of course in private hospital settings.

The National Party has been silent on the out-of-pocket health costs that country people have to bear.

The government provides an $12 b annual taxpayer 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.  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  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 miners and the wealthy in their constituencies and doffing their caps to the Liberal Party which really does represent the big end of town.

(This repost has been slightly amended -John Menadue)

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