The NZ Rural General Practice Network webinar set the scene by releasing a manifesto of policies it says are needed to rescue a sector that services 700,000 people.
While the politicians agreed with the manifesto’s tenor, they differed in how to achieve its aims.
The network seeks sustainable funding for rural health professionals who, it says, are struggling to make a viable living under the financial model.
“They are generally paid less than their urban counterparts, provide care for a dispersed population that requires significant travel time and cost and need to be available 24/7 for service emergency needs,” the network said.
The rural health workforce is in crisis facing a shortage of doctors, nurses and allied health professionals.
“This situation is going to get worse with an aged demographic signalling over 50% heading into retirement within five to 10 years,” it said.
Relying on health professionals from overseas is not sustainable and the network says a new approach is needed to training, recruiting, upskilling and retaining health professionals.
The covid-19 outbreak has shown the opportunity to access healthcare from a distance, but the network says this is not available to all rural people due to the mixed quality of connectivity.
It wants politicians to commit to extending the current planned rural broadband rollout to provide a service equal to that available in urban centres.
The webinar debate was between current Health Minister Chris Hipkins (Labour), Dr Shane Reti (National), Jenny Marcroft (NZ First) and Julie Anne Genter (Greens).
Hipkins says the problems facing rural health mirrored many of those facing education, of which he also minister, especially connectivity.
“It is reasonable for health practitioners to ask for better access, and if you can get it to school, then you should be able to get it to a health practitioner,” he said
He says work is under way to address the network’s concerns but admits logistically, rural connectivity is a challenge.
Labour is promising more funding for mental health and Pharmac, reducing surgical waiting lists and more mobile dental clinics.
Marcroft says NZ First has a policy of money for health following the patient, but she also saw a role for the greater use of mobile services and rural health professionals being compensated with isolation payments and other bonuses.
Genter says the inequities of rural health are linked to climate change, agricultural policy, food production and social inequality.
These can be addressed by changing the taxation system to generate more tax for the Government to spend in areas such as health.
Reti says the National Party will build a third medical school for graduate students with a focus on supplying and retaining rural GPs.
Business cases have already been filed and Reti says experience from Canada and Australia is that those who train in rural areas, stay in rural areas.
It will also invest to extend rural broadband and data collection, and has invested $16 million in rural suicide prevention.
Reti believes some of the greatest advances will come from the party’s policy to appoint what he calls primary care navigators, staff employed to help patients with their primary care requirements.
Similar roles at the United Kingdom’s National Health Service improved the management of the health of patients and their outcomes because navigators took a much broader approach to an individual’s healthcare.
“This will change the dial for primary healthcare, this will change the dial for rural healthcare,” he said.
Hipkins doubts a new medical school is the answer to bolster the rural health workforce.
“I do acknowledge we need more rural GPs, but I am not convinced that creating a whole new medical school and the enormous investment in capital is the best way to achieve the desired outcome,” he said.
Reti responded that is why he is seeking expressions of interest and business cases to ensure it stacks up.
Responding to the webinar, the network welcomed consensus that rural health is important.
There was also agreement that changes are needed to fund rural health services and it requires greater investment, a commitment to a rural health plan and the need for a larger interdisciplinary health workforce.
But there was a lack of consensus on how such a programme for training the future rural health workforce would be implemented.
“The network members are adamant that rural community input is critical in developing an effective training scheme and are committed to working with any incoming government to drive a rural community driven solution,” it said.