Executive summary

This document has been written as Advice to the National Rural Health Commissioner by the National Rural Generalist Taskforce. It is anticipated that this Advice will provide a guide to discussions with Governments, professional bodies and health services when considering the implementation of a National Rural Generalist Pathway. Introduction Rural doctors have a long and proud history of serving communities in diverse settings across Australia. They follow a tradition of caring for the wellbeing of communities practised by Traditional Healers over millennia. Healthcare for Australia’s rural and remote populations is complex and given the challenge of distance and geography, depends on doctors who can integrate skills that are traditionally delegated to separate specialties in urban practice. As well as providing comprehensive General Practice and emergency care, rural communities often depend on their doctors having Additional Skills for an extended scope of practice to meet their needs. These Additional Skills include the fields of Anesthesia, Obstetrics, Surgery and more advanced Emergency Medicine as well as fields such as Aboriginal and Torres Strait Islander Health, Mental Health, Aged Care, Palliative Care, Addiction Medicine, Adult Internal Medicine, Pediatrics, Remote Medicine, Medical Education, Public Health and Health Administration. The development and use of these General Practice, Emergency and Additional Skills represent the broad scope of practice of a Rural Generalist. There are many doctors in rural and remote settings already practising across an extended scope of medical care, who were and continue to be supported by jurisdictional training pathways and existing College curricula. However, there is currently no nationally recognised pathway for training this workforce for the future, or any national process for recognising and supporting existing practitioners. There is an increasing number of medical graduates from Australian medical schools, but this alone has not resulted in sufficient access to the medical services required for rural and remote communities. In fact there is a persistent and pernicious workforce maldistribution. There is a well-established correlation between poorer access to health services and poorer health outcomes. Poorer health outcomes in turn lead to poorer social and cultural opportunities, and poorer economic participation, economic development and productivity.

These challenges must be addressed for the future of all who live in regional, rural and remote Australia. All Australians have the right to access high quality healthcare no matter where they live.