JOHN MENADUE. The failure of the National Party on rural poverty and rural health.

Country electorates have the most disadvantaged people, the poorest health and inferior health services.  But the National Party does very little about it. Barnaby Joyce  continually tells us that  country constituents are the poorest and that the National Party is 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 knows the problems but refuses to do much about them. He spends more time smoodging Gina Rinehart and looking for a headline from our gullible press.

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 kowtowing to the mining industry and the Liberal Party . 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 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 its July 2019 Fact Sheet, The  National and Rural Health Alliance reported  the disadvantage that country people suffer  in their health and in health provision.

In aggregate, people who live in rural areas have shorter lives and higher levels of illness and disease risk factors than those in major cities. This can be explained in part because they have poorer access to goods and services and educational and employment opportunities, as well as lower levels of income. Australia-wide evidence shows that:

  • the health of rural people is poorer than that of their city counterparts;
  • accessing primary care, dental care, allied health and specialist services is more difficult and in many regions requires greater time and expense on travel and accommodation;
  • shortages of health professionals, including doctors, allied health professionals, pharmacists and dentists, become more pronounced with remoteness;
  • the health of Indigenous people living in rural and remote areas is significantly worse than that of their non-Indigenous counterparts;
  • 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;
  • it is difficult to attract and retain health professionals in rural and remote areas, particularly those who study and train in metropolitan areas; and
  • infrastructure in rural and remote areas for health services and health-related activity is limited and being further eroded by a lack of ongoing investment.

The National Rural Health Alliance has also advised us that

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-bulk billing practices where choice of alternative provider is limited), specialists consulting in the community, and of course in private hospital settings.

The government provides an $12 b annual taxpayer subsidy for private health insurance (PHI) which benefits the wealthy  in the cities 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.

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 .

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John Menadue is the publisher of Pearls & Irritations. He has had a distinguished career both in the private sector and in the Public Service.

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