Health services in remote and rural communities, particularly for the most vulnerable elderly and First Nations groups, will be stretched to the limit by COVID-19 outbreaks, says Flinders University Professor Paul Worley.

National Rural Health Commissioner Professor Worley has raised the alarm for Australia’s rural health workforce, including for elderly clinicians remaining in rural practice and the need to isolate and care for any confirmed cases in rural and remote areas.

In an editorial in Rural and Remote Health, Professor Worley suggests sweeping changes to cope with the crisis, and prepare for improved services in the future.

He says urgent changes to be more prepared and resilient in future include making better use of resources across primary care, secondary care and other social services; greater integration of services between towns and smaller centres; rural practice based on teams of generalists; using technology and remote learning options to continually improve the rural workforce; and affordable and accessible telehealth for patients and their clinicians. 

“We will not be immune as systems and people are strained to breaking point,” he warns.

“If the elderly are more at risk, what will be the impact on the large number of older doctors and clinicians still working if rural practices haven’t been able to find younger replacements?

“What happens when local clinicians have become deskilled due to health service role changes and there is suddenly a need for high-level care for more people than can be retrieved to a larger centre?

“While drive-through testing points are operating in metro areas, how do small rural communities manage testing without putting at risk the same clinicians and facilities that are needed for treatment?”

Professor Worley says questions also surround rural patients feeling isolated from the national coronavirus response. 

“How do we avoid stigmatising and discriminating against rural patients, particularly those who are immune compromised or have co-morbidities or chronic conditions?

“How do we scale up home care, clinic care and hospital care scaling up for more cases when funding and training have separately focused on either the clinic or the hospital.

“There are urgent needs stimulated by this crisis that can improve all systems.”