Don’t expect a quick fix to rural New Zealand’s stretched health services, warns the Rural Health Network.
This is despite a new study revealing significantly higher mortality rates from preventable causes in rural areas, higher rates of suicide especially for rural males, and twice as many people living in social and economic deprivation as those in urban centres.
Rural Health Network (RHN) chair Fiona Bolden has been told by the coalition government to expect something in the 2025 Budget, meaning another year of stretched services and experienced health professionals retiring or resigning.
Data for its latest report, Rural Health NZ Snapshot 2024, was collated from a variety of studies and determined 900,000 people live in rural areas, including 25% of Māori.
Among its findings is that Māori aged under 30 living in remote areas are twice as likely to die from preventable diseases as Māori living in a large city, and non-Māori, aged 30 to 44 living in rural areas, are 1.8 times more likely.
The rural suicide rate for those aged 15 to 44 is 64% higher than urban and overwhelmingly involves firearms.
Half of rural general practices have an “unacceptably high” ratio of registered patients to GPs and as at last June, nearly 60% had a GP vacancy.
Despite having poorer health outcomes, rural people are 37% less likely to be admitted to hospital, suggesting they have poorer access to hospital services.
“If rural New Zealanders were admitted to hospital as often as those in the cities, we would need to fund more than 5000 additional hospital admissions each year,” the report states.
Fewer rural families have access to mobile phones and internet and vaccination rates are low.
“These findings are not unexpected, but are pretty out there,” said Bolden
She listed the steps needed to address the issues:
More health professionals must be trained for rural practices and steps taken to retain those already working there.
Pay parity is needed for health professionals working for trusts and private practice with those employed by Health NZ (HNZ), while rural practices should be funded to reflect the workload and pressures of the stretched services.
A solution is needed for the provision of urgent and emergency services in rural areas and the placement in rural practices for trainee healthcare workers, GPs and nurses needs to be better co-ordinated to utilise the training.
An evidence-based system is required to measure the performance of the government’s rural health strategy.
Bolden said she is heartened by the influx of rural people into government and at HNZ, but says change is slow.
“We are pushing levers but the machinery doesn’t move very quickly.”
Rural Affairs Minister Mark Patterson described the state of rural health as stretched to breaking point, and said it is an issue that keeps him awake at night.
“It’s front of mind. It’s sobering and confronting when you get under the bonnet.”
Patterson said he has been in discussion with the RHN and been briefed on the issues facing rural health services.
He said local delivery of health services will ease the pressure on base hospitals, provide access to minor procedures and bolster local capacity.
“That is the accepted direction of travel.”
He identified pay parity as an issue to be addressed, noting that if the trusts were to close, the services and staff would become HNZ’s responsibility.
He said the coalition government is increasing the number of medical school placements and is proposing a specialist rural medical school at Waikato University.
“It’s a signal we are really serious about improving training with an emphasis on rural health.”
The other policy Patterson said should help rural health service is adjusting immigration settings top attract foreign medical professionals.
The minister acknowledged these initiatives are pending and the issue is becoming pressing as the population ages.
