"Out of Sight, Out of Mind" - the $9 Billion Health Funding Gap Leaving Regional, Rural and Remote Australians in the Dust
By Jessica Dempster
The latest report from the National Rural Health Alliance shows the health expenditure gap between rural and urban Australians has widened by a further $880 million, leaving more than 7.4 million people without reliable access to the doctors, services and treatments they need.
According to the report, Forgotten Health Spend: A Report on the Expenditure Deficit in Rural Australia 2026, each rural Australian is receiving, on average, $1,218 less in healthcare funding each year than city residents.
This is up $138 from last year with those living in smaller rural towns with populations of 5000 or less bearing the brunt, receiving on average $6,368 less healthcare funding per person, per year.
NRHA Chief Executive Susi Tegen said the numbers outlined in the report are disappointing to say the least.
"Look it's really disappointing," she told FlowFM's Jess Dempster during an interview on The Country Viewpoint.
"Firstly, it's now a case of $9.23 billion of underfunding for rural, remote and regional Australia - this time last year it was $8.35 billion."
"It tells us that we're simply not receiving the funding, policies and change that we actually need for rural Australia."
Ms Tegen said the gap continues to grow due to a multitude of factors, predominantly because it's easier for the government to fund existing health services in urban areas, rather than try to build things from the ground-up in the country.
"You've got 30% of the population - roughly 7.4 million people - living in rural, regional and remote Australia, and they're out of sight out of mind," she said.
"It's not necessarily about governments deliberately choosing cities over the bush, it's about how the funding system works better in places where there's already hospitals, health professionals and established services to fund."
Alongside the funding gap, the report highlights other stark differences between rural and urban healthcare, none of which will come as a surprise to country locals.
It found that the medical workforce imbalance between regional and metro areas was particualry severe, with urban areas areas having 194 specialist doctors for every 100,000 residents, compared with just nine in small rural towns.
The shortage extends to other more specialist services, including physiotherapists, psychologists, obstetricians, pharmacists and other allied health workers, who are facing their own challenges as a result of their scarcity.
"Many rural people have lived in communities where allied health professionals, psychologists, GPs, and specialists are thin," Ms Tegen said.
"There aren't as many as those clinicians on the ground, and resultingly they end up feeling overworked, overwhelmed, and extremely under supported."
Ms Tegen said that the conventional Medicare model is failing rural, regional and remote communities as well, as the lack of patients increases operating costs, making medical practices difficult to sustain.
"Medicare, in theory, is a fantastic service for patients as it helps subsidise their payments," she said, "but it doesn't support the cost required to deliver care in those communities."
In turn, it's falling on rural and regional communities to bear the brunt of the fallout, a lot of time leaving them in worse health or financial states as a result.
"It's a family driving hundreds of kilometres to see a paediatrician, or an older person waiting months and years to be put onto an aged care package," Ms Tegen said.
"It's a person a person with a disability in a rural area waiting six months for an allied health appointment or a mother trying to get a doctor's appointment that they can't afford because they're having to drive two hours to go and see a GP because their local GP is booked out for months - or their office closed down two years ago."
Ms Tegen said these barriers to accessing local, reliable and affordable healthcare is leading people from regional areas to delay seeking and receiving treatment, a trend that's being exacerbated by the current cost of living crisis.
"What's actually happening is people are delaying their appointments," she said. "They're saying 'oh look I'll just have to deal with it, I'm tough'."
"We're expecting people who are already underfunded and under supported to go and subsidise the fact that they don't have a healthcare service, paying for travel, accommodation, the treatment itself, not to mention blowing all their sick and personal work leave in the process."
Research shows that people living in rural and remote Australia are continuing to experience poorer health outcomes and shorter life expectancies than those living in major cities.
Accounting for age, chronic diseases including arthritis, as well as mental and behavioural conditions, have been found more prevalent outside of major cities, and the rate of potentially avoidable deaths in very remote communities is almost three times that of metropolitan Australia.
"It's been getting worse and worse," Ms Tegen said. "We need to start asking how long? How long does this need to go on for before somebody actually stands up and listens? We just want action."
She said the health expenditure gap has gone beyond a health issue to an economic and social one too.
"It's an economic and social inequity," she said.
"It demonstrates that we actually need to do things differently because it's impacting the individuals on the ground that we rely on to keep our country going."
"70% of Australia’s export income comes from rural communities, and 90% of the food we eat, and 50% of the tourism income, even though rural Australia only makes up 30% of the population."
"We shouldn't have to beg for funding when we already know there is a $9 billion plus underspend - where is that money going to? It needs to fund solutions."
Ms Tegen says funding needs to be based on community need, with more flexible Medicare arrangements and long-term investment in primary care, aged care, disability services, workforce and local infrastructure.
She said state and federal governments must work together on a national rural health strategy, support existing clinicians while building a locally trained workforce, and implement solutions designed around the needs of rural communities.
And last but not least, she said, there needs to be public accountability.
"This funding is from taxpayers. They've paid their Medicare levies, they've worked in the industries that are bringing in Australia's income, and they are also paying their taxes."
"Governments, politcians, it doesn't matter which side you're on, any entity that's delivering care, they should be reporting on what they're actually doing for rural populations, what services are actually being delivered and available, how much money is going to those regions per capita and in addition to that what is happening when it's underfunded?"
She says any rural, regional or remote Australian wanting to learn more about the gap and how to advocate for themselves and their communties can visit the NRHA's website for more infomation, and to speak with a write to their local ministers, MPs and senators asking for action and updates.
"We need governments and communities in urban centres to stop treating rural health inequity as an inevitable process and start looking at the human rights of these individuals."
A full copy of The Forgotten Health Spend report can be found at https://www.ruralhealth.org.au/the-forgotten-health-spend-report/.
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