Rural health’s $1.7b shot in the arm

With plenty of cash splashed on hospitals in areas such as Wagga Wagga, Tamworth, Dubbo, Parkes, and Forbes, the NSW Rural Doctors Network was happy with the government's performance.

"There are some really positive things happening... they've done well," said the network's chief executive officer Dr Ian Cameron.

"There's always a concern when a new government comes in that it will close things down, and blame it all on the previous government and the need to balance the budget," Dr Cameron said.

"There hasn't been wholesale closures in rural general practices... (and) changing from the Department of Health to the Ministry of Health and the local health districts has gone well."

General secretary of the NSW Nurses and Midwives' Association Brett Holmes was less impressed, and rated the government's support for rural health as a "fail", mainly based on nurse-to-patient ratios.

"To date, the O'Farrell government has not agreed to implement ratios State-wide, to ensure patient safety can be maintained at the same level in the country as it is in the city," Mr Holmes said.

"The government has a duty of care and must improve ratios throughout country areas.

"By refusing to do so, the government is discriminating against patients in rural and regional areas."

Mr Holmes said there was a 2011 election pledge from the government to recruit 2475 new nurses across the State, with 34 per cent of those in rural and regional hospitals.

The government has claimed success in achieving this goal in its first term, but Mr Holmes said a significant proportion only worked part time.

This could affect the minimum number of nursing hours per patient per day, Mr Holmes said.

Health Minister Jillian Skinner said the number of new nurses and midwives since March 2011 outstripped the number in the election commitment.

"There has been an increase of more than 4100 nurses and midwives (2800 full time equivalent) across the State - about 50pc of these in rural and regional NSW," she said.

Ms Skinner said in the past year, almost 300 extra doctors started working in regional and rural NSW as well.

"Pleasingly, some of the new appointments are at hospitals such as Dubbo and Griffith, where vacant specialist positions had remained unfilled for years," she said.

"Additionally, the 2014 State-wide intake of 959 medical interns included hundreds in rural and regional NSW."

Ms Skinner agreed with Dr Cameron the empowerment of local health districts had improved services in rural areas.

"People in rural NSW now receive 85pc of their health care within their local health district," she said.

Ms Skinner said the government had invested a record $1.7b in rural and regional health infrastructure since the election, which was significantly more than the $985 million pledged for rural hospitals before the election.

"Improving the health of people living in rural and regional NSW has been a major commitment of the government," Ms Skinner said.

"I travelled extensively across country NSW in the many years I have been involved in developing health policy and I was determined when I became Minister in March 2011 to provide a fair share of health investment outside of Sydney.

"We have increased access to a range of specialised services which were limited for country patients and we are continuing to spread them further - services such as palliative care in the community, pain management, expanded renal dialysis and trauma services and new cancer treatments."

Another election commitment was to reduce waiting times in emergency departments.

The Bureau of Health Information Quarterly Report (October to December 2013) indicated this pledge was also on track, with 70pc of patients treated and leaving the emergency department within four hours across the State.

Ms Skinner said this was the highest percentage for this criteria than at any other time.

Mr Holmes said while emergency department waiting times were slowly improving in rural and regional hospitals, many were still lagging behind the State average - meaning the additional pressure on nurses remained high.

Ms Skinner said the next step for rural health would be the Rural Health Plan, which was being formulated by the Rural Health Ministerial Advisory Committee.

She said some country hospital staff had already joined the committee, and were helping provide insights for the plan.

"I am incredibly proud of the huge commitment and inspiring work of our country staff - from cleaners and clinicians to senior managers," she said.