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18 Oct 2016

Last year my partner floated the idea of moving to Darwin for a few years. In a fit of adventure I agreed, which led to one of the most beautiful drives one can do in Australia: Perth to Darwin via the coast.

It was then that I discovered that old Land Rover windscreens aren’t as waterproof as you might think, and that losing your alternator in Broome over a

public holiday weekend is a genius way to get stuck in Matso’s Brewery for four days.

I’ve driven from Perth to Hobart to Darwin and most places in between. All of this driving has served one extremely important purpose: you just can’t appreciate the size of Australia from the seat of a plane. You need to see it from the ground level, and feel it in the hours that pass as you make your way around what is arguably one of the most beautiful countries in the world. And to those mad ones who ride their bicycles alongside road trains, I simultaneously salute you and constantly worry about the safety of your skulls.

Size matters, because you can’t deliver healthcare in a country this large without factoring in the distances that you need to cover. Both patients and practitioners need to traverse large swathes of land to get what they need, only to have to make the same journey home again.

Some patients don’t even have the privilege of having a home anymore, tethered to foreign cities by the bittersweet umbilicus of haemodialysis three times a week.

Service provision is a perpetual problem for regional communities.

It’s not just a case of finding doctors to work in these communities. It’s also about providing these communities with the resources and infrastructure to sustain these health services. It’s about training a sizeable workforce that not only wants to work in the country, but wants to stay there.

And there’s the rub: training.

Almost every single vocational training program across Australia cannot be completed in rural and regional settings. Apart from a few isolated local hospital networks, there are no uniform pathways for trainees to move from metropolitan settings to regional settings and vice versa.

In a workforce full of people vying for job security, the ability to train in rural Australia is quickly becoming a luxury that some trainees simply can’t afford.

There are a number of key initiatives that the AMA has called for to increase rural training opportunities, such as the expansion of the Specialist Training Pathway program and increased targeted rural intakes for medical student enrolments.

One very important policy that we plan to focus on is our proposal for Regional Training Networks (RTNs). RTNs are vertically integrated networks of health services and regional training hubs of generalist and specialist prevocational and vocational training in regional areas. They allow for flexible entry, reciprocal links with metropolitan areas and targeted partnerships with regional communities and their healthcare needs.

Without programs like RTNs to organise regional training opportunities, we run the risk of isolating the most isolated parts of Australia even further.

The Council of Doctors in Training is continuing to develop RTNs, and will present these models to both Government and Opposition, in a concerted effort to turn policy into practice over these next two years.

To the metropolitan reader, this might just sound like a good idea to increase rural participation. I think it’s much more than that. Regional communities can’t exist without health systems to serve them, and without regional communities you lose the lifeblood of this amazing country of ours.

The red dirt and the blazing sun aren’t just tourism ads.

They’re the source of the food you buy so conveniently in your supermarket. They’re places of immense history and significance for Indigenous Australians. They’re places of serenity in a world obsessed with an endless stream of media.

If you’re reading this in the middle of a major city, do me a favour. I want you to take the time to listen to Paul Kelly, Missy Higgins and Augie March covering one of Kev Carmody’s most beautiful songs: Droving Woman.

If I can’t convince you of the importance of regional training networks and regional healthcare needs, I’m certain that they can.

Published: 18 Oct 2016