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HEALTH
A healthier plan for rural Australia Providing real solutions to close the gap in health services between metropolitan and rural Australia has prompted three key researchers at Charles Sturt University (CSU) to devise a blueprint for rural health based on human rights.
The CSU academics, all with extensive experience working and living in regional and rural Australia, believe their blueprint will raise the debate on rural health to include social equity and provide a positive step to address the poorer health outcomes currently experienced by rural Australians.
The rural health blueprint will also provide a framework to guide the provision of services into rural areas across the country.
 Behind the blueprint are Professor of Social Work and Human Services, Margaret Alston (pictured left), Professor of Rural Pharmacy, Patrick Ball and Dr Julaine Allan from the University’s Centre for Inland Health. “To date, health services in rural and remote areas have been based on a negative or deficit model of health,” said Professor Ball.
“They have also mostly been provided on an historical basis on what a community has had or for which they have successfully lobbied, not against any uniform standard of what services are to be delivered or what they are intended to achieve.”
This system of allocating health resources in rural Australia has produced marked differences in the services between apparently similar communities.
The impact of inferior rural health services is well documented. According to the Australian Institute of Health and Welfare, these include higher death rates in rural Australia, whose residents die younger and are more likely to die prematurely from avoidable causes.
A clear human right
The researchers propose a set of principles, developed from a human rights position, to address the underlying issues associated with rural health and providing healthcare.
As a signatory to the United Nations’ Declaration of Human Rights, Australia supports the right to a
 :“… standard of living adequate for health and well-being of self and of family, including food, clothing, housing and medical care and necessary social services and the right to security in the event of unemployment, sickness, disability, widowhood, old area or other lack of livelihood in circumstances beyond his control”.
Australia has also signed the International Covenant on Economic, Social and Cultural Rights, sponsored by the United Nations. In Article 12 of the covenant, it states that “…States Parties to the present covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health”.
“If good health is enshrined as a human right, communities should be able to ask whether they have what they need to ensure good health. If these principles are acted on by governments, non government agencies and local communities, then rural health will necessarily improve,” said Professor Alston.
“By using the human rights principles we argue that rural Australians have a right to expect health chances and health experiences similar to those of their urban counterparts rather than be treated as second class citizens who must be thankful for the delivery of any kind service.”
Principles underlying blueprint
These principles supporting the blueprint frame government, non government agencies, community and individual responsibilities for addressing rural health. Acting on all of these, argue the CSU team, will immediately improve health chances and experience.
Focus on solutions
 “Our approach promotes solutions rather than the continuing commentary of rural health deficits,” said Dr Allan.
“We firmly believe that when the principles we are developing are applied to rural health then rural health will improve.”
The CSU researchers are calling on three levels of government, non government agencies, academics and local rural communities to work together in defining the practical elements of the blueprint principles.
“The federal Government has highlighted the need to ‘end the buck passing and blame’ in the health system,” said the CSU researchers. “Our blueprint puts forward real solutions to the problems without buck passing. Government must pick up the ball and run with it.”
“The debate over how to improve rural health services also needs to go further than how many general practitioners are in a particular town,” said Dr Allan.
“While this figure is obviously important to that town’s residents, the debate over rural health services should extend to early intervention of children with disabilities, employment opportunities, recreational and social facilities. These are areas that address prevention as well as cure.”
Future
The blueprint team is working on case studies that, they argue, will demonstrate the health chances and experiences that would be available to all rural and remote Australians if human rights principles are upheld.
“We aim to develop a checklist that will be a self-help resource for rural and remote communities. They can identify what resources and services they require and promote cross sector collaboration to lobby for them and access them,” said the CSU academics.
As part of the national university of inland Australia, the CSU academics are well placed to spark debate and find solutions to issues and problems close to the heart of rural and regional Australia. With campuses across regional NSW, the University is already working towards overcoming shortages of health care workers, teachers and veterinarians and, from 2009, dentists in inland Australia.
ends Author: Fiona Halloran
Editor's Note: The CSU Centre for Inland Health aims to raise awareness of rural health issues in Australia. Professor Margaret Alston will start a 12 month secondment at Monash University in July 2008. See more about Professor Alston here and here and here. See more about Professor Patrick Ball here and here. See related CSU News articles here.
Media Note: Professor Margaret Alston, Professor Patrick Ball and Dr Juliane Allan are available for interview. Print quality photos are also available. Contact CSU Media.
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