National policy frameworks for rural health
The accepted goal of health policies for rural and remote areas of Australia is to bring about improvements in the health status of people living these areas. A number of rural health policies have emerged in Australia to move toward this goal, both at national and state levels.
National Rural Health Strategy 1994
This jointly Commonwealth, State and Territory endorsed strategy had a declared purpose to provide a coordinated framework for ensuring equitable access to effective health care for rural and remote communities through the:
- provision of appropriate health services,
- promotion of measures designed to maximise the health status of rural and remote residents, and
- adoption of strategies that minimise barriers and problems that impeded the delivery of effective health care.
The National Rural Health Strategy outlined several principles that should underpin programs with respect to rural heath. Central to these were that rural health services should be:
- accessible
- needs based
- accepted by the community
- comprehensive
- multidisciplinary
- integrated
- coordinated
- provide continuity of care
- sufficiently flexible to respond to changing needs.
In 1998 a review of the National Rural Health Strategy was undertaken by the Australian National Audit Office. The report concluded that many health programs failed to have a specific rural focus and were falling short of meeting the objective of addressing the health needs of rural Australians.
National Rural Health Strategy Update 1996
The goals detailed in the 1994 National Rural Health Strategy were reaffirmed in the 1996 update.
Healthy Horizons 1999-2003
The Commonwealth and State governments released their new framework for guiding rural and remote health activity for the period of 1999-2003. The Healthy Horizons framework outlined a number of guiding principles to underpin health care activity with respect to rural and remote communities. The vision for rural health stated in this framework document is that:
‘[p]eople in rural, regional and remote Australia will be as healthy as other Australians and have the skills and capacity to maintain healthy communities’ (Healthy Horizons 1999).
The seven interdependent goals as the focus of the national framework for rural health care activity were to:
- improve the highest health priorities first
- improve the health of Aboriginal and Torres Strait islander peoples living in rural, regional and remote Australia
- undertake research and provide better information to rural, regional and remote Australians
- develop flexible and coordinated services
- maintain a skilled and responsive health workforce
- develop needs-based flexible funding arrangements for rural, reional and remote Australia
- achieve recognition of rural, regional, and remote heath as an important component of the Australian health care system.
As a result of the Healthy Horizons policy framework there now exists general agreement across governments on the need for a specific policy response to rural health issues and the principles that should underpin planning for the provision of health care services.
Healthy Horizons Outlook 2004 - 2007
The Australian Government and State and Territory Governments reported on programs that contribute to the achievement of the goals in Healthy Horizons, titled Progress against the Healthy Horizons Framework for Improving the Health of Rural and Remote Australians.
The report concludes that:
“ … progress against the goals of Healthy Horizons that action at all levels to improve the health of rural and remote Australians is substantial and increasing. At national level governments and the non-government sector are working together to address priority areas, particularly the health of Aboriginal and Torres Strait Islander peoples, and to develop improved approaches to funding and service delivery. At regional level, this collaborative approach has been translated into myriad programs and projects that involve stakeholders and communities and strive for long-term changes that will improve the health of all rural and remote Australians”.
The report also acknowledges there is still considerable progress to be made. It asserts that refocussing within the Framework should be the impetus for increased action at all levels.
The above report can be accessed at the National Rural Health Alliance Website: http://nrha.ruralhealth.org.au/?IntCatId=14
State Policy Frameworks for Rural Health
Tasmania Together
http://www.tasmaniatogether.tas.gov.au/
Other rural policy and information documents can be found at the Department of Health and Ageing, Office of Rural Health:
http://www.health.gov.au/ruralhealth
State frameworks and information relevant to Tasmania can be found at the following websites:
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