NSW Regional Health Strategic Plan for 2022-2032

The NSW Government is primarily responsible for hospitals, but its decisions and policies have a major impact on the accessibility of primary health and social care in rural and remote communities. For example, rural and remote towns cannot sustain primary health care services (e.g. a local GP, pharmacy funded by the Commonwealth) without a local hospital facility funded by the State. That is because rural GPs rely on income from the hospital for acting as a Visiting Medical Officer (VMO) to make enough money to run a general practice in the town. The local pharmacy relies on the GP for prescription referrals, and so on and so forth. If the GP and pharmacist leave, the town will struggle to attract teachers, social workers and other professionals leading to the loss of business activity in the community. We know from research that having a GP in town is essential to sustaining a whole network of services on which rural and remote people rely. We also know that when a hospital withdraws funding for the local GP to work at the hospital as a VMO, the GP practice will become financial unsustainable causing a cascade failure of local services and contributing to population and economic decline, and an increase in poor health outcomes. While the health and hospital system are split between Commonwealth and State responsibilities, cooperation has and could ensure more stable, sustainable and reliable health and social care in rural and remote communities. Rural and remote people therefore need to understand what "plans' the State and Commonwealth have for rural and remote health and social care, exactly what these plans mean for expansion of services in their town, and whether the goals are backed up with funding, clear performance indicators, timelines and accountabilities. The NSW Regional Health Strategic Plan is more properly characterised as a narrative about a possible future health system. The document lacks any of the elements that makes a document a Plan such as clear community health outcome indicators (e.g. a 50% reduction in child mortality in rural and remote communities), performance timelines (by 30 June 2027), clear accountabilities (who will be held responsible if the outcome isn't delivered) and funding. Despite the fact that the document is not a Plan from the perspective of rural and remote communities, residents need to understand it and its potential implications for the sustainability of health care in their town.