Regional Health Minister, Mark Coulton, chaired the ninth special rural health COVID-19 roundtable on 27 August 2020, with members of the Rural Health Stakeholder group.
Minister Coulton recognised the work of rural and remote health workers and communities, particularly those in Victoria, in managing the COVID-19 pandemic. Minister Coulton raised the service of 146 General Practice Respiratory Clinics (GPRCs) across Australia, which have conducted over 500,000 COVID-19 assessments since they began earlier in the year and especially the 82 that serve regional communities. Minister Coulton spoke of the aged care sector’s challenges with COVID-19 and urged recognition that 97% of aged care homes are COVID-19 free thanks to the efforts of aged care providers.
State border restrictions continue to be a challenge for health services operating across borders and the communities who seek their care. Minister Coulton has raised these challenges with various jurisdictions and efforts continue on many fronts to limit the impact on border communities.
Minister Coulton reported 27 million telehealth services have been delivered to 10 million people (40% of the population) since implementation. MBS Telehealth items are more likely to be refined rather than removed in the longer term. Minister Coulton spoke of the importance of demonstrated, established, and continuing relationships between GPs and patients to ensure telehealth remains a viable tool to improve health outcomes in the long term.
Minister Coulton invited the National Rural Health Commissioner, Prof Ruth Stewart, to update the group on the work of her office. The Commissioner reported she continues to Chair the Rural GP-led Respiratory Clinic National Leaders Network, which meets fortnightly, providing a direct line of communication between clinics and the Government.
Senior Department staff provided updates on the Commonwealth COVID-19 response. Participants provided valuable feedback to the Minister on the current focus and efforts of their own organisations in response to the outbreak.
An introduction from the Chief Allied Health Officer
Since beginning in the role as Chief Allied Health Officer, Dr Boxall has been focussed on COVID-19 with particular focus on the allied health and disability sectors. Dr Boxall has also started to meet regularly with the National Rural Health Commissioner. In the short term,
Dr Boxall will focus her work on improving the profile of the allied health sector and professions. Dr Boxall has been in discussions with other Departmental staff as well as with the state based Chief Allied Health Officers around the increasing need of rehabilitation services for COVID-19 patients and the importance of allied health professionals in this work.
Update on the COVID-19 pandemic response in the primary care setting
Department officials reported GP-led Respiratory Clinics had provided over 500,000 consultations since implementation and have rapidly responded to keep communities safe. GPRCs in Victoria doubled their capacity in a week. Primary Health Networks have recently increased distribution of PPE to allied health providers in Victoria and New South Wales. The Department continues to monitor the availability of PPE and provide supplies through Primary Health Networks where required.
Indigenous Health Update
Department officials reported COVID-19 positive cases in Aboriginal and Torres Strait Islander populations remains very low, with no deaths reported. There have been no COVID-19 cases in remote communities. Sixty-three point of care testing sites are in place in remote communities, with the final 22 sites to be rolled out over the next month. Royal Flying Doctor Service continues to provide early and primary evacuations, testing and swab transfer, and fly-in respiratory clinics to rural and remote sites.
The CDNA National Guidance for remote Aboriginal and Torres Strait Islander communities for COVID-19 was updated on 10 August, including findings from recent modelling work on COVID-19 in remote communities, undertaken to better guide response strategies.
For more information, the Department of Health directed members to the following webpage: https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/support-for-remote-indigenous-communities-at-high-risk-from-covid-19
Mental Health update
The Department continues to recognise the burden experienced by those where COVID-19 restrictions are in place. In response to this, the Government announced provision of 10 additional Medicare-subsidised psychological therapy sessions for people in areas impacted by the second wave of the COVID-19 pandemic. The measure was announced on Sunday 2 August with a focus on Victorian communities. More information can be found at: https://www.health.gov.au/news/additional-covid-19-mental-health-support-for-people-subjected-to-further-restrictions
Stakeholders were advised the Prime Minister had recently requested the Deputy Chief Medical Officer for Mental Health, Dr Ruth Vine, and Mental Health Commissioner, Christine Morgan, provide advice regarding further measures that could be taken to support the mental health and wellbeing of COVID affected communities. As a result, the Australian Government will provide an additional $31.9 million to create 15 mental health clinics across Victoria and further enhance essential support during the COVID-19 pandemic.
https://www.pm.gov.au/media/new-mental-health-clinics-support-victorians-during-covid-19-pandemic
Further Government funding has been provided to Headspace, Beyond Blue, Lifeline, and the Kids Helpline to manage an increase in demand for their online and phone services. Stakeholders raised the need for a mental health phone service for Aboriginal and Torres Strait Islander people.
Reports of rural and remote health workers experiencing fatigue and exhaustion continue. The Roundtable agreed that any support Governments can provide to facilitate the movement of health workers across borders is important for the mental and physical wellbeing of the rural and remote workforce. Department officials agreed to further discuss actions to address this issue.
Primary care reform update
The Government is considering extending the COVID telehealth measures and options to link them with voluntary patient enrolment in GP practices in the future. Discussions with the sector and representative groups have resumed to inform the 10 Year Primary Health Care plan. The primary care steering group will next meet at the end of September 2020. The 10 Year Plan will include discussions on reforms for improved health service integration, digital infrastructure and funding for rural areas. The Department is currently working with New South Wales PHNs and Local Health Networks on joint planning of primary care services, including opportunities in virtual health.
Stakeholders discussed post-COVID considerations including the potential for rural and remote Australians to suffer poorer health outcomes as a result of many important services being unavailable. It was agreed that monitoring impacts on services and programs is important for future planning with different situations likely across the country.
Update on training and workforce matters
Stakeholders were informed the Rural Multidisciplinary Health Training (RHMT) Program Evaluation has been published on the Department’s website at: https://www1.health.gov.au/internet/main/publishing.nsf/Content/rural-health-rhmt-evaluation. Government is undertaking consultation with stakeholders to guide future policy change and implementation. The National Rural Health Commissioner will assist with consultations and advise Government.
Access to locums to allow rural health workers to take leave was raised by stakeholders as a challenge due to border and travel restrictions. Demand for locums is likely to increase as we get closer to Christmas
Medical placements continue to be impacted primarily in Victoria. There is, however, a sense of optimism as new ways of training and delivery of services are opening up. Teaching students on how to deliver telehealth consultations is an example of this. Graduation numbers and the availability of rural and remote placements for allied health students has been impacted by COVID-19 travel and border restrictions.
The continued establishment of the National Rural Generalist Pathway and the additional 100 rural generalist placements were noted as important to address rural workforce issues.
Meeting summary
Minister Coulton noted the important reversal of the decision to increase fees for university courses including Social Work and Psychology. Minister Coulton also noted crucial role rural GPs play as the first point of contact for mental health services and the importance for local communities to see their GPs.
Minister Coulton advised that any immediate concerns can be raised directly ahead of the next meeting and thanked stakeholders for their engagement and advocacy supporting rural communities as the COVID-19 situation develops.
The most up-to-date information on the Australian Government response to COVID-19 can be found at www.australia.gov.au.
Twenty-one rural stakeholder organisations are members of the group, along with the National Rural Health Commissioner and the Commonwealth Department of Health.
Participant list
Members participating in the teleconference for the 24 July 2020 were:
- Australian College of Rural and Remote Medicine
- National Rural Health Commissioner
- Indigenous Allied Health Australia
- Australian Dental Association
- Royal Flying Doctor Service
- National Rural Health Alliance
- National Aboriginal and Torres Strait Islander Health Worker Association
- Rural Health Workforce Australia
- Pharmacy Guild of Australia
- Services for Australian Rural and Remote Allied Health
- Allied Health Professions Australia
- Australian Rural Health Education Network
- CRANAplus
- Pharmaceutical Society of Australia
- Rural Doctors Association of Australia
- Rural Workforce Agencies Network
- Federation of Rural Australian Medical Educators
- Australian Medical Association
- Australian Indigenous Doctors’ Association
Apologies:
- Royal Australian College of General Practitioners- Rural Faculty
- National Rural Health Student Network
- Congress of Aboriginal and Torres Strait Islander Nurses and Midwives