A new report about rural primary care identifies inequities in service provision, major pressures on funding and workforce, unsustainably high levels of clinical risk, and barriers for patients to access care when and where they need it.

The Rural Services Review Report recommends that funders, planners, advisers, and community advocates (nationally and locally) continue to push for change in healthcare provision for rural communities.

Advocacy group Health Action Wānaka (HAW) told the Wānaka App the report reflects what the group has been hearing from people since it began researching the healthcare needs of the Upper Clutha community earlier this year. 

“This report builds on an ever-increasing body of research that tells a compelling and disturbing story of longstanding inequity in health services in the southern region,” HAW said. 

“The Hauora Taiwhenua Rural Health Network’s 2024 snapshot showed rural people are falling behind in almost every metric they’ve measured so far; and now we have this new report that documents inequities in service provision, funding, patient costs, and workforce in our region. Yet, we also know that districts such as ours are seeing some of the fastest growth in the country.” 

The Rural Service Review was led by independent chair and former Gore district mayor Tracy Hicks and facilitated by Leonie Williamson, Project Manager – Rural Services Review, WellSouth Primary Health Network on behalf of a Rural Services Review Group that was commissioned in July 2022 by WellSouth.

Leonie Williamson: “Inequities in rural health remain significant”.

Leonie said while many of the recommendations are not new to New Zealand’s health landscape, the report specifically represents “our Southern voice now, and the challenges for our healthcare representatives who are [at] the coal face daily”. 

“We are underserved and the inequities in rural health remain significant,” she said.

Health New Zealand’s Southern district has the largest geographic catchment of New Zealand and includes several isolated communities. 

The Review Group consists of 16 volunteer clinical and non-clinical members selected from local primary care providers, rural hospital specialists, community and iwi representatives across Southern - including Wānaka GP Dr Andrew McLeod.

The report recommends the following areas be addressed:

• Sustainable development of the rural workforce
• Addressing 24/7 urgent and unplanned care
• Delivery of equitable patient access for rural people with services located closer to home
• Efficient transport options for patients at an equitable cost
• Achievement of manageable clinical risk for providers and patients

The group also asks for a forward-looking Southern Rural Health strategy that considers all regional patient and provider needs across both primary and secondary services, along with pay parity, workforce wellbeing, diagnostics, mental health support, the role of telehealth, and access to pharmacy services. 

The group consulted widely with more than 60 regional providers with participants asked to identify the main challenges and priorities for improvement in rural health services in their area.

Next steps - planning and work programmes

“If our community is to have access to equitable and sustainable healthcare, it is imperative that the findings and recommendations in this report are acted upon with a sense of urgency,” HAW told the Wānaka App.

The recommendations are being incorporated into health planning at local, regional, and national levels and identified programmes of work will be communicated once these are finalised, WellSouth said.

WellSouth CEO Andrew Swanson-Dobbs said the report provides a single point of reference for the health sector to address the inequities that exist in the rural health network, adding that WellSouth has already adopted some of the actions, aligning work programmes, training, education and workforce with the recommendations.

Health NZ will have the opportunity to do the same when it receives the final recommendations in August. Te Waipounamu regional commissioner Chiquita Hansen said the report would be a key input for decision-making and planning across all levels of health provision in the region.

Read the full report here.

PHOTOS: Supplied