Calls for urgent, practical reform of rural healthcare have intensified this past week, with the Country Mayor’s Association formally backing the Better Care, Closer to Home Alliance push for a new Rural Health Action Plan, at the same time the Minns Labor Government handed down its long-awaited response to the Special Commission of Inquiry into Healthcare Funding.
The Alliance, convened by Member for Wagga Wagga Dr Joe McGirr MP, argues that rural and regional NSW is being failed by a system that is “under-resourced, unaccountable and dependent on short-term fixes”. The group says patients across the regions continue to struggle to see a GP, emergency departments remain stretched, and birthing units are closing. Locum doctors are flown in at enormous public cost, only to leave as quickly as they arrive.
The Alliance states that NSW Health acknowledges many of the problems but “continues to operate with a metropolitan-first mindset and a lack of urgency”, with community voices too often ignored. The group says further inquiries are not what rural communities need, and that “it’s a system in need of reform that is practical, affordable and long overdue.”
Its Rural Health Action Plan draws directly from the recommendations of the NSW Legislative Assembly Select Committee on Remote, Rural and Regional Health. The Plan is pitched as a roadmap for turning things around without large-scale restructuring or unachievable spending, instead favouring “simple, common-sense reforms that put people first and redirect funds to be more effective.”
At the centre of the proposal is a GP guarantee, where every town should have at least one doctor supported by flexible, team-based primary care. The Alliance is also calling to restore local maternity services so mothers can safely give birth closer to home, to replace high-cost locum reliance with permanent clinical teams, and to embed genuine community input into local health decisions. Other measures include establishing an independent Rural Health Commissioner to provide oversight, and building a more integrated system linking hospitals, GPs, councils and community care providers.
The Alliance argues the Plan can be funded largely by addressing the “locum merry-go-round”, which it says is costing taxpayers $270 million a year while delivering poor value and little continuity of care. The goals, they say, are clear: faster access for patients, safer birthing options for families, better support for healthcare workers, stronger local decision-making for communities, and improved value for taxpayers.
Country Mayors Association Chairman Mayor Rick Firman OAM said the Alliance’s plan “aligns with the key priorities and concerns of CMA Members and their communities”. The CMA, which represents councils across rural and regional NSW, has written to Minister for Regional Health Ryan Park MP expressing its strong support.
“We have written to Minister Park to commend the practicalities and affordability of the Plan’s reforms to him,” Mayor Firman said.
“I understand Dr McGirr has put the plan to Minister Park in writing and they have had an initial discussion about it. I’m confident that constructive discourse will continue.”
Mayor Firman said while rural clinicians “work hard and do the best they can”, the system remains “crook and band-aid solutions are increasingly costly and short-term, like the locum situation.” He said greater collaboration is needed across health sectors, including allied health, and that communication between health services and communities must improve.
He repeated the CMA’s longstanding principle that “what we want is nothing more than equity”, warning that while some parts of Sydney are facing a shortage of doctors, the challenges are far more acute in the regions.
“We believe this is not as serious an access or equity issue as a rural mother-to-be having to drive more than 100 kms to reach a hospital with obstetric services,” he said.
The CMA has also partnered with the Rural Doctors Network for a major Health Access Survey, gathering information from member councils about service provision in remote, rural and regional NSW. Mayor Firman said more than two-thirds of members responded, and the survey is believed to be the first of its kind in Australia. The results will guide future advocacy for the CMA and help shape RDN’s strategic planning.
As regional leaders renewed their calls for action, the NSW Government released its formal response to the Special Commission of Inquiry into Healthcare Funding, which examined 226 written submissions and heard evidence from 225 witnesses over 70 days of hearings across NSW.
The government has supported in full or in principle the majority of the Inquiry’s 41 recommendations, many of which focus on improving data, workforce planning, health worker wellbeing, and transparency within NSW Health. The cornerstone of the response is a commitment to back health workers, expand preventative care, modernise workplace structures, strengthen hospital infrastructure planning, and advocate for NSW’s fair share of federal funding.
“We asked this Inquiry to tell us, honestly, what’s working in our health system and what isn’t – and now we can get on with improving it,” NSW Premier Chris Minns said.
“We want better data, better planning and better support so they can focus on what they do best – looking after patients.”
Only one of the Inquiry’s recommendations deals specifically with regional health workforce needs. Recommendation 6 calls for NSW Health to facilitate more regional training opportunities for primary care clinicians and to provide the training and support required for them to work to their full scope of practice. The government has supported the recommendation.
In its response, the government said it “continues to support the delivery of education, training and support to current and future GPs and Rural Generalists,” including through regional training hubs and expanded regionally based training positions. NSW Health’s Rural Generalist Training Coordination Unit continues to support and educate current and future GPs and Rural Generalists.
Several recommendations in the Inquiry also focused on improving First Nations health planning and outcomes, with the government committing to further work across these areas.
Health Minister Ryan Park said the response “makes good on a core election commitment, first championed by the HSU, for a root and branch review of our health system.” He said the new measures are “the beginning of a new chapter of reform that supports and empowers health workers; embraces preventative care; ensures hospitals meet the health needs of the community; and secures NSW’s fair share of health funding.”
HSU Secretary Gerard Hayes AM said the government’s response “recognises the expertise of allied health and paramedics with the need to support these clinicians to work toward their full scope of practice,” and welcomed commitments to replace outdated awards, improve data and workforce planning, and strengthen prevention and integration.
“A health system that prioritises prevention, integration and the wellbeing of its own staff will not only be fairer, it is the only way to keep people well and stop pressure overwhelming the system,” he said.
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