October 16, 2024

Small rural towns are suffering critical shortages of health care workers

Study highlights significant challenges in delivering health care workforce across rural Australia

A study by University of Wollongong (UOW) researchers has found that the greatest shortfalls in the medical workforce are in small rural towns. The study also revealed small rural towns have the lowest number of nurses and allied health care workers per capita, which is likely to lead to poor health outcomes for those regions.

Small rural towns make up 7.3 per cent of Australia’s population.

Lead author, Dr Colin Cortie from UOW’s Graduate School of Medicine, said understanding the distribution of health care workers across the country is important.

“Ultimately health care is delivered by people and having the right people in the right areas is really difficult,” Dr Cortie said.

“Many would expect the greatest staffing shortfalls to be in remote and very remote Australia, but we found it’s actually small rural towns suffering the most.”

The study, published in the Australian Journal of Rural Health, examined data from the Australian Health Practitioner Regulatory Agency (AHPRA). Previous research found that between 2016 and 2021 the number of healthcare workers, including doctors, nurses, and allied health professionals, increased by 22 per cent.

Despite this growth Dr Cortie said rural and remote regions continue to face major disparities.

“Small rural towns are seeing far fewer healthcare professionals per capita compared to metropolitan areas and even remote communities,” Dr Cortie said.

"There are three times as many doctors per capita in metropolitan areas than in small rural towns, and twice as many nurses and allied health workers. This means that people in rural areas have a much harder time accessing healthcare."

“At the end of the day this shortage poses significant risks to the health outcomes of Australians living in these regions.”

The researchers attribute the disproportionate workforce shortfalls in small rural towns to a range of factors including fewer private health care workers in rural areas and insufficient public sector employment to fill the gaps.

 Dr Cortie said private healthcare services often struggle to operate in small rural areas due to economic and logistical challenges.

“For example, under the current funding model most GPs work in the private sector. This model might be fine for metropolitan regions, but we think that in small rural towns a GP struggle to run a sustainable business due to high costs and other economic factors.

In remote areas the decline in the private sector workforce has been compensated for by increasing the number of health care workers in the public sector,” Dr Cortie said.

“However, in small rural areas no compensatory mechanisms have been introduced which has led to the current workforce shortages.

“Based on these shortfalls it’s clear that improvements in the recruitment and retention of a rural health workforce in small rural towns is desperately needed, but this will take time before it makes a difference in the community.

“In the short term more immediate solutions could encompass alternative funding models and increased flexibility of employment conditions.

“It would also be great to see new trials of publicly-funded health care workers, specifically targeted towards addressing challenges in small rural towns.”

Dr Cortie believes there are medical schools that are doing better than others when it comes to addressing health workforce shortages in rural and regional Australia, including UOW.

“Research I undertook late last year compared rural and regional locations of work and choices of specialty between UOW medical school graduates and graduates from all Australian medical schools,” Dr Cortie said.

“We found that UOW graduates are 50% more likely to work in regional or rural areas than those from other medical schools. And nearly a third of all UOW medical graduates were working in rural areas in the 10 years after graduating.

“The medical program at UOW was designed to encourage graduates to work in regions suffering a shortfall of medical workers. It’s clearly working.

“In addition to changing how we train doctors, we also need to consider how we fund them. The funding models that work in cities aren’t working in rural areas.”

More information

The Australian health workforce: Disproportionate shortfalls in small rural towns was published in The Australian Journal of Rural Health.

This research was partly funded by the Department of Health and Ageing's Rural Health Multidisciplinary Training (RHMT) program.