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Advocacy

Our consultations, submissions, committees and position papers form the foundation of our advocacy for the remote health workforce.

As the voice for remote health in Aus­tralia, CRANAplus advo­cates for mean­ing­ful change to health pol­i­cy and issues affect­ing iso­lat­ed, rur­al and remote nurs­es and health professionals.

We voice the remote per­spec­tive through our exten­sive links with Com­mon­wealth and State Gov­ern­ments, polit­i­cal groups, and oth­er pro­fes­sion­al and work­force organ­i­sa­tions.

We rep­re­sent the views of our mem­ber­ship on steer­ing groups, advi­so­ry groups, work­ing groups, com­mit­tees, and gov­er­nance bodies.

We pub­lish pro­fes­sion­al stan­dards and guides, for­mu­late sub­mis­sions dur­ing enquiries and con­sul­ta­tions, and devel­op posi­tion papers on a range of con­tem­po­rary health issues. Through­out all of our advo­ca­cy, we engage with our mem­ber­ship to cap­ture their exper­tise and expe­ri­ence in the remote con­text of practice.

Two people leaning against a FWD on a dirt road

Key Issues

The Givens

Peo­ple liv­ing in remote and rur­al Aus­tralia suf­fer a much greater bur­den of dis­ease and poor­er health than their met­ro­pol­i­tan counterparts.

The Context

Health pro­fes­sion­als work­ing in remote Aus­tralia work in some of the most geo­graph­i­cal­ly, pro­fes­sion­al­ly and social­ly iso­lat­ing envi­ron­ments in the world. This requires them to be resource­ful, have a broad scope of prac­tice, use a com­pre­hen­sive pri­ma­ry health care approach, have pub­lic health knowl­edge and the skills to work cross culturally. 

Who are they?

Nurs­es, mid­wives, doc­tors, allied & oral health pro­fes­sion­als and Abo­rig­i­nal and Tor­res Strait Islander health practitioners/​workers.

Where are they?

They work in Abo­rig­i­nal and Tor­res Strait Islander com­mu­ni­ties, farm­ing dis­tricts, on & off­shore min­ing, tourism, defence, Antarc­ti­ca, on islands, in deten­tion cen­tres, jus­tice health, aeromed­ical and small remote towns often with high­ly mobile populations

Priorities

Improv­ing health status

The fol­low­ing is a list of pri­or­i­ties that will improve the health of peo­ple liv­ing in remote Australia.

  1. The Social Determinants of health are a significant causative factor of poor health outcomes for those living in remote Australia, particularly for Aboriginal and Torres Strait Islander people. Therefore:
    • All health debates should occur in this context.
    • A whole of government and whole of society approach is required to remedy this problem.
  2. The inequalities experienced by Aboriginal and Torres Strait Island people must be addressed to close the health and life expectancy gap, remove health disadvantage and eliminate racism.
  3. All remote women have access to contemporary evidence-based models of maternity care regardless of where they live. This includes:
    • Continuity of care by a known midwife.
    • Equitable distribution of maternity services.
  4. All remote consumers have a right to access safe, quality emergency care, provided by clinicians who are educated to a national standard.
  5. Remotely located older people have appropriate access to quality aged care services. These include:
    • Significant resourcing to develop innovative models of care and to support active ageing and quality of life.
    • Provision be made to address the growing burden of dementia.
  6. Remote communities are funded to have a sustainable fluoridated water supply as a matter of priority, along with increased access to affordable oral health services.
  7. Affordable and reliable high-speed Internet connectivity is a high priority for remote areas.
  8. The resourcing of, and access to health services must be based on local community needs, disease prevalence and population health planning in collaboration with relevant local stakeholders.
  9. Climate change imposes significant public health risks to remote communities, requiring the development of proactive and responsive policy changes across Australia.
  10. Acknowledgement of the impact of marginalisation on the health of people with disabilities, the LGBTI community and other minority groups.
  11. Palliative care services – those living in remote communities should have access to contemporary, supportive palliative care services.
Priorities

Improv­ing the workforce

  1. The model of health care in remote Australia is different.
    • Remote health professionals use a comprehensive primary health care approach. Greater investment is needed to educate the remote workforce in this model.
    • Need flexible models of service delivery in the remote context.
    • The remote nursing workforce is often the consistent primary provider of health care, including coordination and case management, due to a maldistribution of medical workforce.
  2. Investment and initiatives are required to increase and strengthen the remote Aboriginal and Torres Strait Islander health workforce. This includes:
    • Significant investment and support to improve the numbers successfully completing nursing, midwifery, Aboriginal & Torres Strait Islander health practitioner/​worker, allied health and medicine training.
  3. Cultural safety and cultural respect education is embedded in all aspects of remote health care from novice to advanced practitioner.
  4. Zero tolerance for racism. It is identified and eliminated from all work locations.
  5. Sole clinical posts in remote and isolated locations are not supported for any discipline.
  6. Safety and security of the workforce is paramount. Each location must have robust infrastructure, policies and systems to ensure a safe and secure workplace and accommodation. Particular attention must be given to ensuring the safety of the on call, after hours workforce.
  7. Remote area nursing should be recognised as a generalist profession and assessed against a nationally consistent standard for remote nursing practice.
  8. Initiatives to grow and retain the future remote health workforce should include:
    • Nursing students being able to access funded remote clinical placements, including assistance with travel and accommodation.
    • Novice practitioners are able to access remote employment opportunities with adequate support and resources.
    • Widely available and well-resourced mentoring programs.
    • Certification process to validate safe, quality remote area nurse practice.
  9. Investment is provided to educate and prepare remote health managers and leaders through structured programs, in an effort to improve retention of the workforce.
  10. Investment to support remote nurses, midwives and allied health professionals to lead and deliver action-based research to improve patient outcomes.
  11. Continued roll-out of Telehealth and Tele-medicine in remote areas to enhance collaborative practice amongst the remote health team and reduce travel cost for remote consumers. Continued support must be provided on the ground for training and education of the user.
  12. Acknowledgement of the contribution rural nurses make towards sustainable health services in our country towns.
Priorities

Reg­u­la­to­ry changes required

  1. Commonwealth state and territory legislation and health service policies are reviewed to remove barriers that prevent remote nurses, midwives and allied health professionals to practice to their full scope.
  2. Access to the MBS and PBS is reviewed and amended to better reflect the actual workforce breakdown and delivery of primary healthcare in remote and rural Australia.

Read our guide on how to put remote health on the agen­da in your electorate.

Advocacy Guide