Thank you to everyone who attended AMA Victoria's recent Regional and Rural Clinician Forum. The breadth and depth of insights shared were invaluable as we work to address the critical issues facing healthcare services in regional and rural Victoria.
The forum provided a comprehensive discussion on several key topics, including feedback on health service employment and workforce arrangements, the proposed Health Services Plans (HSP), experiences with recent health service amalgamations, and the anticipated challenges and opportunities surrounding the proposed local health service network arrangements. We also discussed the underutilisation of regional and rural health services in certain contexts, disparities in pricing for the same services across rural and regional health facilities, and the upcoming release of the Ministerial Review, among other issues.
Discussions highlighted past health service amalgamations, with attendees drawing on experiences where community voices were often overlooked despite perceived benefits. This has led to concerns that future amalgamations might repeat these mistakes. The fear of losing local hospitals and further erosion of healthcare services was palpable, particularly among smaller communities, resulting in a deepening mistrust in the system and a growing sense of disconnection from decisions affecting their health services.
The disparities in NWAU pricing for regional health services compared to metropolitan and rural health services were a significant point of contention. Attendees expressed a strong sense of injustice that regional health services receive less funding for delivering the same level of activity and patient care. This funding inequity places additional strain on workforce recruitment and retention, making it increasingly difficult to sustain high-quality services.
The forum also highlighted ongoing challenges in emergency departments, many which have been operating at capacity for months, dealing with increasingly complex and acutely ill patients. The shortage of general practitioners in rural areas was identified as a significant contributor to poorer health outcomes, with minimal capacity to deliver preventive care in the regions. Despite the presence of Commonwealth-funded GP clinics in certain areas, their impact on public health has been minimal, raising concerns that the situation will worsen.
Structural challenges within the Victorian health system were another key point of discussion. Participants agreed that this moment presents an opportunity to contribute positively to the design of a future system that addresses existing deficits. However, there was criticism of the Health Services Plan, which lacks a clear roadmap or blueprint. Attendees expressed disappointment that the plan does not firmly establish networks or provide detailed guidance on implementation.
The role of virtual care was also discussed. While its value was recognised, there was concern that once after hours care is transitioned to virtual delivery, it becomes difficult if not impossible to reinstate on-the-ground services and the workforce that delivers them. The group emphasised that Victorian virtual care should complement, not replace, in-person care.
A significant portion of the conversation addressed the underutilisation of specific regional and rural health services. Despite their capacity to manage elective (planned) surgeries, these services are often overlooked and underused. This discussion expanded to include issues related to forward and backward referrals and transfer of care, as well as step-down care.
Financial pressures facing regional health services were also a recurring theme. The current funding mechanisms, particularly those related to Medicare reimbursements and proceduralist remuneration, were described as broken, hindering the transparent and fair operation of hospitals. There was a call for a more equitable remuneration process that supports the sustainability of regional health services.
Throughout these discussions, the need for clinical experts to be consulted in decision-making processes, particularly regarding the Health Services Plan, was repeatedly emphasised. There was consensus that AMA Victoria must continue to advocate for the inclusion of clinical voices to ensure that the realities of healthcare delivery are fully understood and addressed in any future HSP implementation.
There was consensus that the status quo is untenable, with Victoria's health system lagging behind other states in the delivery of co-ordinated care and in digital health maturity. Participants emphasised the urgent need for more consistent and accessible healthcare networks and called for leveraging the collective expertise of clinicians to develop feasible alternatives that address the broader impacts on all healthcare workers.
The meeting highlighted the necessity of a coordinated and well-thought-out approach to healthcare reform in Victoria’s regional and rural areas. The challenges are multifaceted, ranging from funding inequities and workforce shortages to the complexities of amalgamations and the integration of virtual care. However, there is also a sense of optimism that, with the right approach and sufficient consultation, Victoria can develop a more sustainable and effective health system that meets the needs of all Victorians.
How to get involved
Your insights are crucial as we move forward in our efforts to create fair, effective, and equitable healthcare solutions for all.
Please send any additional feedback on this issue to AMA Victoria's Director of Communications and Advocacy, Taryn Sheehy at [email protected].
Our organisation thrives on the strength of its members, and to further the force behind our push for meaningful healthcare reform, we also ask that you consider joining as an AMA Victoria member.
AMA Victoria stands as the sole voice for doctors in Victoria's workplaces. Our unique position enables us to elevate your concerns to the highest governmental echelons, ensuring that the voices of healthcare professionals are not just heard, but acted upon.
Membership offers a partnership for change, an opportunity to amplify your voice, and a commitment to the betterment of healthcare in Victoria.
Proposed local health service network groupings
Click here to see all Health Services Plan local health service network groupings.