DECEMBER 2000

Newsletter of the National Rural Health Alliance Working for Good Health and Well-being in Rural and Remote A DIVISION TO END ALL DIVISIONS?

COURTESY OF SABINA KNIGHT

A team approach to effect improved health outcomes

A strong desire to improve health outcomes across the board has led professionals, not just doctors, to put aside self interest and work to the formation of Australia’s first Division of Primary Health Care. The for cohesion in primary health care rather than protecting their own patch.” Central Australian Division of General Practice in Alice Springs has Dr Wake said that the challenge is whether doctors could recently voted in a range of constitutional changes associated with a become social engineers and public health oriented medical Division of Primary Health Care. practitioners who could see themselves as equal partners with other primary care providers in service delivery. In the future, the At the same meeting, attended by nineteen General Division system cannot remain wrapped up in the world of doctors. Practitioners and a number of allied health professionals, the That future must be involved in actively working towards better Council of Remote Area Nurses of Australia (CRANA) was outcomes for our communities in education, housing, welfare and accepted as a member organisation with representation on the social justice. Only by this means can improvement in health Board Of Governance. CRANA joins the Central Australian and outcomes that has proved so elusive be achieved, particularly in Barkly Aboriginal Health Worker Association (CABAHWA) and rural and remote locations. consumers on the Governing Committee of the Division. There is significant interest in the PHC Division agenda from Expressions of interest have also been received from other allied many other Divisions and Divisions of General health organisations. Practice (ADGP), the Divisions’ peak body. The Central Australian “We need to recognise that without multidisciplinary teams Division of Primary Health Care sees itself as the trail-blazer for a in health care we cannot change health outcomes,” said Dr Chris new, national thrust in the Divisions’ movement, a coming of age Wake, Chair of the Division. He added, “It is for all health for that movement. continued on page 3

IN THIS issue Special Feature – CouncilFest 2000 – Not Just Another “Bored” Meeting ...... 6 Regional Health Services – The Answer? – A resident’s view ...... 4

A New Alliance for Rural Australia – Rural education in focus ...... 3

Advancing the Practice of Nursing – A national workshop report...... 16

Number 7, December 2000 PARTYLINEeditorial There’s a belief in some sectors of the sales profession that more can be achieved by a cohesive Contents team of good salespeople than by a group of individual sales superstars all acting in their own A Division To End All Divisions? ...... 1 self interest. This is a principle that is also practised in many a progressive workplace. It could well be the worthy, though unintentioned, theme of this edition of PARTYline. PARTYline Comes of Age ...... 2 Our Page one story, “Division To End All Divisions”- an account of the formation of A New Alliance For Rural Australia .. 3 Australia’s first Division of Primary Health Care, is an excellent example. The Central Regional Health Services – The Australian Division of Primary Health Care (formerly General Practice) has realised that the best way to positively achieve their desired health outcomes is through the combined Answer? ...... 4 and integrated efforts of all health professions in that area. Australian Journal of Rural Health ... 5 The formation of a new national Alliance, this time to facilitate the improvement of education in rural and remote Australia, is another case in point. This article provides a glimpse of the very beginning of what could be a significant collaboration with a very Special Feature: valuable goal – the improved quality of education for the future generations of rural and CouncilFest 2000 – Not Just Another remote Australia. “Bored” Meeting ...... 6 A cohesive, collaborative and cooperative approach is perhaps the remedy required by the nursing profession in its long running battle to advance the cause of Advanced friends News – The Friendly Face of Nursing Practice and Nurse Practitioners. These are models which, if successfully the Alliance ...... 10 implemented, are sure to herald some very real health benefits for our rural and, especially, our remote communities. However, as our Page 16 news feature explains, the absence of 6th National Rural Health a team approach may well mean that the reality of these practices is still a long way away. Conference ...... 12 PARTYline’s Special Feature this issue is about what is possibly the best and most relevant example of what can be achieved with the team approach, the Alliance itself. As In Short – reviews, reports and a peak body of 22 national associations, all with declared interest in rural and remote papers in summary ...... 13 health, and many of whom have traditionally practised an isolated or competitive approach to their business, the Alliance is living proof of what can be achieved collaboratively. Government News ...... 14 The Special Feature provides an overview of CouncilFest 2000. CouncilFest is the annual face-to-face meeting of the Alliance’s governing body and as the feature shows it Advancing the Practice of Nursing 16 is a lot more than just the vital strategic planning of the Alliance. I am sure you will find this edition of PARTYline very interesting reading if not challenging and possibly even provocative at times. Whatever your response, I believe we are seeing a definite trend emerging of what “getting the job done” in rural and remote health will look like in the future. David Petty

Editorial details

PARTYline is the Newsletter of the National Rural Health Alliance, the Peak PARTYLINE COMES OF AGE Body working to improve health and well-being in rural and remote Australia. The Editorial Group for PARTYline is With this edition, PARTYline reaches its Gordon Gregory, Executive Director of Michele Foley, Gordon Gregory, Irene maturity. PARTYline is now the official Alliance, has extended his appreciation to Mills, David Petty, Mandy Pusmucans, friends of the Alliance for the creation and newsletter of the National Rural Health Storry Walton and Gratton Wilson. nurturing of such a valuable asset for the PARTYline is distributed free. Articles, Alliance. It has been almost two years since Alliance. “This is one of many ways in letters to the editor, and any other it began its life as the newsletter of the then which friends has supported the Alliance contributions are very welcome. newly-formed friends of the Alliance. and as a result the Alliance and those with an interest in rural and remote health will Please send these to: Along with friends, PARTYline has benefit for a long time to come,” he said. David Petty, Editor, PARTYline grown in its importance as a vital PARTYline will continue in its current PO Box 280, Deakin West ACT 2600 communication organ for the work of the format and page extent, although there are Phone: (02) 6285 4660 Alliance. Such has been the response to the already plans to increase its frequency to Fax: (02) 6285 4670 articles and issues covered by PARTYline, bi-monthly if and when funds permit. E-mail: [email protected] that the Alliance has recognised the important strategic value in adopting it as The opinions expressed in Partyline are the official newsletter and thereby those of contributors and not substantially increasing PARTYline’s necessarily of the National Rural Health distribution. Alliance or its individual Member Bodies.

2 Newsletter of the Alliance, December 2000 PARTYLINEnews A NEW ALLIANCE FOR RURAL AUSTRALIA

A new national alliance for rural Australia has the Alliance in furthering the needs of rural “The ICPA is very keen to carry the been proposed, this time for rural education. and remote health. torch for rural education. But I emphasised to delegates at the Conference that this will The proposal has arisen from the October The proposal for a national alliance for rural and remote education received be a marathon effort,” Ms McNicholl said. Federal Conference of the Isolated Children’s additional emphasis from needs identified For more information contact: Parents’ Association (ICPA). by the Human Rights and Equal Opportunity Commission. Human Rights Mrs Megan McNicholl, Federal President ICPA’s Mission Statement is “to Commissioner, Mr Chris Sidoti, addressed ICPA – 07 4627 6364 or provide equality of access to education for the ICPA Conference and strongly 0428 655 725 all students who live in rural and remote supported the proposal for a new alliance. communities”. In seeking to fulfill this “Education is not a privilege for rural mission, delegates to the conference agreed children but a human right,” Mr Sidoti told that there is a need for a new national focus delegates. to promote and monitor education and As has been the National Rural Health educational access in rural and remote Alliance’s experience, the formation of a areas. ICPA is a member of the National national peak body is not an easy path to Rural Health Alliance, recognising the pursue, however. Megan McNicholl, inextricable link between good education President of the ICPA, warned that a major

NIGEL JEFFORD and good health in a community. ICPA has and ongoing effort would be required to been greatly encouraged by the success of Megan McNicholl – make it successful. Federal President Isolated Children’s Parents’ Association A DIVISION TO END ALL DIVISIONS?

(continued from page 1) whole primary health care agenda in Central One of the first priorities of the new Australia. The PHC Division will be Division will be to explore why it is that different because it will work well and will health professionals are unable to work not be bogged down in internecine together across organisations. Having arguments about control.” identified the blocks the Division then CARE Y HEALTH The Division sees many opportunities intends to actively seek, with whole of arising from this transition. These include Government help, to pull down those trials of budget holding in remote practice barriers. Dr Wake believes it is highly likely which will free doctors from the burden of that the PHC Division will become a fund the Medicare system so that they are able holder for consideration of training, to perform more public work and more recruitment and retention and possibly for public health work. Other expectations are service delivery in difficult environments. a renaissance in allied health for remote Application for Membership of the areas out of all that has been learnt from Central Australian Division of Primary maintaining doctor and nurse practitioners Health Care is open to any incorporated in the bush and a new professionalism for

COURTESY-CENTRAL AUSTRALIAN DIVISION OF PRIMAR primary care related organisation whose Aboriginal Health Workers who will Dr Chris Wake aims mirror those of the Division. An assume a rightful pre-eminent place in organisation seeking membership must health care in Central Australia. also agree to the Division’s agenda as General Meeting is required for the And a final word from Dr Wake, expressed from time to time. An application application to be successful. “A brave new world maybe, but then never to join the Division must then obtain a 75% Dr Wake believes that the Division in forget that fortune favours the brave.” vote of the Board of Governance. This is its Primary Health Care clothes has multiple designed to ensure that groups who are advantages in advancing the agenda for For more information contact: considered by the Board to be groups of health professionals. “We will Dr Chris Wake (Chair) (08) 8951 8976 or inappropriate members of the Division quickly develop two financing streams. One 0411 755 329 may not be admitted. Then a 66% majority to continue to roll out programs to medical Vicki Taylor (Executive Officer) of the general membership vote at a Special practitioners but a new one to advance the (08) 8950 4806 or 0407 977633

Newsletter of the Alliance, December 2000 3 PARTYLINEnews REGIONAL HEALTH SERVICES – THE ANSWER?

Budget 2000 announced unprecedented allocations and initiatives to address health issues in rural and remote Australia. One of these is the Regional Health Services Program of the Commonwealth Department of Health and Aged Care. This program aims to improve the access of smaller rural communities to health, aged care and other community services. It has both a primary care and an aged care component and incorporates the Multipurpose Services initiative.

But, like all programs and initiatives, its true value will be tested in its implementation. PARTYline has recently received a submission from a correspondent who is a resident of a rural community. This report suggests that perhaps there is still some fine tuning to be done to enable this important initiative to fulfill its aims. The correspondent’s comments are reported here in full. “There are several areas that need to be commented on relating to this document and other programs put out with the same intent from the Commonwealth. They all PETTY DAVID have far too many ‘strings’ attached and too Potential for increasing small town rivalry much bureaucratic language for the normal community submission writer to follow. Also, these guidelines are far too broad and “…local government is not in the business of delivering non-specific. health as its primary role…” The following points are some of the areas I believe are restrictive or received and it often seems to be ‘first in, This program should be able to help inappropriate in my own service provider best dressed’. The Regional Health Services enhance the MPS program and speed up area. Program has the potential to go down the development of new sites. It should also Equity same road as HACC and other assist with the integration of services, not If we wanted to make health services really Commonwealth initiatives generated from create fragmentation. equitable, the Commonwealth could hand unless we are careful and Division and competition all health service provision money to the consider some better ways of There are some very real fears that this States on a per capita basis and make implementing it. program will create a situation, in rural and adjustments for remoteness and One of the difficulties encountered regional areas, of division and competition community disadvantage. when a community is developing an MPS rather than putting the dollars to services Historically HACC services (initially agreement is the strong resistance from and community benefit on a needs basis. Commonwealth funded) are provided established HACC and other Towns and areas will again be bidding through a community group or Shire Commonwealth funded aged care facilities against each other for limited funds. An Council via a submission or application. (hostels) to become integrated within the alternative would be to allocate money This has caused huge problems and MPS and the fear of loss of control. At all directly to existing service providers and duplication of services to a community, not the rural health conferences I have disadvantaged groups addressing areas of to mention the inequitable distribution of attended, it has been a recommendation need in Aboriginal health and isolated those funds and services. For example, the that all health services be administered communities. better the application the more money through the one provider. continued on page 5

4 Newsletter of the Alliance, December 2000 PARTYLINEnews NEW FEATURES FOR THE NEW YEAR

valuable way of extending discourse and 2001 will see new additional features debate on current articles, research and included in the Australian Journal of Rural issues. Health giving the Journal appeal to an The themes for the two thematic issues even broader spectrum of readership. for 2001 have been chosen. They will be Aboriginal and Torres Straight Islander Submissions are currently being sought Health, and Occupational Health and for a new section entitled “Experiences in Safety in Rural Industries (agriculture, Rural and Remote Practice”. Associate forestry and fishing). Professor Lorraine Sheppard has been The Editorial Board of the Journal has For further details contact Professor Desley recently appointed Professor David Hegney, Editor on phone 07 4631 2971 or email appointed as the Assistant Editor for this Wilkinson, Head of the South Australian [email protected] or David Petty, Journal feature. This is an opportunity for Centre for Rural and Remote Health, as Manager, at the Alliance on phone (02) 6285 practitioners to reflect on experiences in Assistant Editor – Clinical. David will bring 4660 or email [email protected] their practice and relate those a strong balance of clinical papers to the Journal from across all health disciplines. experiences and lessons learnt – a true Letters to the Editor will also be a feature sharing of hands-on practical issues. of the Journal in 2001. This will be a

continued from page 4 REGIONAL HEALTH SERVICES – THE ANSWER?

Aged care dollars need to have more was quite critical of Western Australia’s could hardly place the same incentives for flexibility, enabling providers to provide a parochialism and inter-town rivalry. These towns of 10,000 or more residents as you wider range of services closer to the homes types of programs encourage rivalry and would for those with populations of less of the clients, allowing them to remain at competition. than 1000. home longer. Appropriate stakeholders and purse holders Conclusions This mechanism also allows Local The real danger in the program is that it “…real danger in… Government to be the host organisation. I won’t get out to where the real needs are, creating a bigger gap have a real problem with allocating health therefore creating a bigger gap between between those who have and service dollars to Local Government, those who have and those who haven’t. It especially primary (or acute) care dollars. will be the smarter ones, not necessarily those who haven’t…” The reason for this is that local government those with the greatest need, that will be is not in the business of delivering health successful. Some of the problems I see in this as its primary role. However there does In summary, the program may be okay program are the need for communities to need to be recognition and assistance to but the method of application is flawed, develop a submission around an idea/ those local government authorities who with the opportunities swinging in favour initiative and have an incorporated body contribute significantly to the recruitment of the larger towns and regional centres to be the applying organisation. The and retention of a medical practitioner. again. difficulty with this in the rural context, and As for Divisions of General Practice Programs such as these may look good more so in the eastern states than Western being the purse holders for health, doctors from Canberra but they may do little to Australia, is that health mostly no longer are busy and vital members of the health address the shortfall of services to the real has local hospital boards as incorporated team in a rural area and are quite keen to rural areas. Furthermore they by no means entities that can apply for the money or participate in primary health care. But offer equity. program. Consequently, the application when it comes to the crunch their practice, Primary health care needs to be would need to be done at a district or and the patient numbers and time included in the main stream of health further removed at a regional level. This available, dictate where they prioritise their service provision and funded accordingly, would be acceptable if communities trusted time. thus ensuring there are fewer gaps. each other and worked together for each Recruitment of health professionals Thank you for my say!” other’s benefit along the lines of ‘healthy should be addressed nationally and More information about the Regional communities’ that Jack Best spoke about in equitably with support scholarship Health Services Program can be found at: his report. But, we all know that this often schemes and incentives for practitioners in www.health.gov.au/ruralhealth/services/ does not happen. For instance, Jack Best relation to the situation they work in. You rhsp.htm

Newsletter of the Alliance, December 2000 5 specialPARTYLINE feature COUNCILFEST – NOT JUST ANOTHER “BORED” MEETING

Once a year the Council of the National Rural Health Alliance gathers for a face-to-face meeting. This is the Alliance’s CouncilFest and, as the name suggests, this is more than the usual corporate boardroom planning meeting. Held over a five day period, CouncilFest incorporates everything from strategic planning and review to the Annual General Meeting and elections, to a day in Parliament House meeting with the politicians.

CouncilFest 2000 has just finished and this intended to bring to the attention of each The Council members took a break PARTYline Special Feature provides a parliamentarian who was visited. This year from the individual discussions to attend glimpse into what happened and what was the three key areas of need were: Question Time. At the conclusion of the achieved. 1) family health (with an emphasis on day the entire Council met together again early intervention, parenting and to hold discussions with the Federal A Day on Capital Hill youth suicide), Health Minister, Dr Michael Wooldridge. In addition to providing members of Perhaps the hardest and certainly the most 2) rural and remote health workforce and Council with an update on current physically demanding part of CouncilFest 3) putting rural policy and rural government initiatives, Dr Wooldridge for the Councilors is the day spent in resourcing into rural hands. was keen to hear the concerns of the Parliament House, Canberra. The Council Alliance and to engage in productive members together with Alliance staff Parliamentarians visited during the discussion on appropriate courses of members are divided into groups of five or day included Senators Ron Boswell, action to address these concerns. six and are allocated a number of Rosemary Crowley, Alan Eggleston, John appointments each with individual Herron, Sue Knowles, Meg Lees, Ian A Focus on Some Key Issues parliamentarians in their offices. These Macdonald, Jocelyn Newman, Grant One important item of business for the parliamentarians are chosen on the basis of Tambling, , and MPs Larry Council of the Alliance was to determine their relevance to and/or interest in rural Anthony, Fran Bailey, , its position on certain key policy areas. health either by virtue of their Ministerial Martin Ferguson, , Steve Draft Alliance Position Papers had been or Shadow Ministerial responsibilities or Gibbons, Kay Hull, , Kirsten prepared for discussion, amendment and the geographic location of their electorates. Livermore, Ian MacFarlane, Jenny adoption. The four key policy areas chosen Prior to this day, the full Council of the Macklin, Phillip Ruddock, Warren for this Council meeting were Dental Alliance had determined three key issues Snowdon, Sharmon Stone, , Health, Suicide, Allied Health workforce affecting rural and remote health that they Wilson Tuckey, and Barry Wakelin. and a 30% Fair Share.

NIGEL JEFFORD Federal Health Minister, Dr Michael Wooldridge, in discussion with Alliance Council.

6 Newsletter of the Alliance, December 2000 specialPARTYLINE feature A NEW EXECUTIVE

Each year elections are held during the AGM to appoint an Executive of the Alliance Council. This year saw a number of new faces elected to the Executive as well as the retention of some of the more experienced Councillors. The Executive for the next twelve months is:

NIGEL JEFFORD

NIGEL JEFFORD

NIGEL JEFFORD Dr Nigel Stewart – Mrs Shelagh Lowe – Mr Mark Dunn – Chairperson Hon. Secretary Hon. Treasurer

NIGEL JEFFORD

NIGEL JEFFORD

NIGEL JEFFORD Mr John Lawrence – Dr Steve Clark – Ms Louise Lawler – Deputy Chairperson Immediate Past Chairperson Executive Member

NIGEL JEFFORD

NIGEL JEFFORD

NIGEL JEFFORD

NIGEL JEFFORD Ms Sabina Knight – Dr Jane Greacen – Dr Nola Maxfield – Mrs Megan McNicholl – Executive Member Executive Member Executive Member Executive Member

Newsletter of the Alliance, December 2000 7 specialPARTYLINE feature A Chance to Meet Other Stakeholders A highlight of each CouncilFest is the Associations’ day. This is a day extended to include representatives from many national associations, community organisations and government departments. Time and resource restrictions saw this component of CouncilFest limited to a morning session this year. Nonetheless, the morning proved particularly popular and valuable with two prominent guest speakers in Professor John Chudleigh, Chair of the Regional Australia Summit Implementation Committee and Rt. Hon. , Chair of the Foundation for Rural and Regional Renewal of Australia.

NIGEL JEFFORD Professor John Chudleigh – Chairperson, the Regional Australia Summit Implementation Professor John Chudleigh, Rt. Hon. Ian Sinclair and Alliance Executive Director, Gordon Committee Gregory, discuss regional matters at the Associations’ day As the Regional Australia Summit Implementation Committee puts the impact on regional Australia of the Renewal is currently seeking to address finishing touches to its final report, irreversible changes arising from according to its Chairperson, Ian Sinclair. “Regional Australia – Making a globalisation been considered thus far. Young people in many of Australia’s rural Difference”, Professor Chudleigh was well Professor Chudleigh’s final advice and remote localities are forced to leave placed to provide the gathering with a clear concerned life after the end of his their communities to obtain a quality overview of what has and has not been Committee. When the Committee is secondary and tertiary education. Their achieved since the Summit. Since the wound up after the delivery of its final failure to return after completing their Committee will then be wound up, there report, it will be over to the community to education is a major contributor to a was also some timely advice on how we pursue the continuation of reforms. His declining and aging rural population. Thus should proceed from here. advice was that the formation of the Foundation considers this to be a key The report being prepared will partnerships between the government and priority for project funding. specifically contain an assessment by the the community is the way to achieve The Foundation for Rural and Committee of what the Government has progress. It is necessary to keep reminding Regional Renewal is a product of the done from the recommendations of the the government of what was said at the Regional Australia Summit. It is a Committee’s first report and what is still Regional Australia Summit and what partnership of corporations, philanthropy to be achieved. Specifically, Professor commitments it gave. and government. The Foundation has Chudleigh expressed concern that issues of recently opened its office at Mt Barker and economic development and investment in “…the benefits of the has appointed a Chief Executive Officer, Mr regional Australia are still not being successful economic reforms Peter Cook. To date, $500,000 in project addressed. These included the general and efficiencies…had not finding has been approved. areas of infrastructure, innovation and Mr Sinclair had commenced his natural resource management. been distributed equitably presentation with some comments on the Equity of services and access to them with respect to regional work of the Alliance and how the in regional Australia, particularly achievement of its aims might be achieved. education, health and communication, is Australia…” He highlighted an issue that had been still a significant issue. There is a clear link spoken about in so many different venues between the standard of education and the Rt. Hon. Ian Sinclair – Chairperson, across the previous days of CouncilFest – Foundation for Rural and Regional Renewal health of the people in a community. This Commonwealth/State relations. The is particularly relevant in the context of How do you attract young people back to Commonwealth and the States do not trust Indigenous communities. This was again your community when they have been each other, he said. However, he felt that explored in the Northern Australia Forum forced to leave to gain a quality secondary the only way to achieve adequate service and Professor Chudleigh expected that and tertiary education? How do you delivery across the diversity of a country both health and education will benefit convince them that there is a viable future like Australia was to involve the three when Senator Macdonald receives the for them back in their own community levels of government, the community and report from the Forum. using their newly acquired qualifications? a wide breadth of health professionals. Professor Chudleigh noted that the How do you create or sustain the He implored all present to run benefits of the successful economic reforms infrastructure that will provide such seminars for politicians – they need to be and efficiencies of the present government opportunities? kept informed. had not been distributed equitably with These are some of the key issues that respect to regional Australia. Nor had the the Foundation for Rural and Regional

8 Newsletter of the Alliance, December 2000 specialPARTYLINE feature Meet the New Chairperson community and your family and you have This year saw the election of a new to be resourceful and resilient.” He adds Chairperson of the Alliance, Dr Nigel that the challenge and excitement is there Stewart. Nigel is a child health specialist for the whole family too. They have to who lives in Port Augusta, SA. He make new friends, get involved in a new represents the Regional and General community, be supportive and be Paediatric Society on the Alliance Council. supported. Nigel, a Kiwi by accent, trained as a child Nigel particularly values the support health specialist in New Zealand and he receives from his partner and four practised for five years in South Auckland PETTY DAVID children. He says they are the ones who pay Dr Nigel Stewart with Maori, Pacific Islander and Pakeha the real costs of what he does both in his children. practice and with his work with the Seven years ago he moved to Australia “…rural people should Alliance. They don’t receive the benefits of and took up practice in Port Augusta, South be in charge of their own what he strives for but pay the price of not Australia, as the sole paediatrician for that having him around. area. At that time, as he does now, Nigel lives…” Regarding his new role as Chair of the found the support of the town’s GPs, National Rural Health Alliance, Nigel nurses, Aboriginal Health Workers, Allied solutions. He is passionate about children admits to being a little overwhelmed by the Health professionals and health and that their needs and those of their role. He says he will be looking to Council, administrators invaluable. families are being met. He believes that the the Member Bodies of the Alliance and the Today, Nigel has two specialist Commonwealth and the States have a staff for lots of support in this position. His colleagues as well as paediatric registrars special responsibility to rural and remote priorities are keeping the Alliance safe and visiting from and medical communities where the services have been sustainable and working with the whole of students from the University of Adelaide. centralised in the metropolitan areas. government ie politicians, bureaucrats and His practice has an outreach area of some When asked why would you go to a other stakeholders. 800klms. rural community to practise, Nigel is Nigel believes in working What does Nigel hold important? He passionate about the challenges the change collaboratively. He enjoys what he does thinks that rural people should be in charge in environment and community bring. “It and when it stops being fun – he’ll find a of their own lives and believes that is a real test of your skills – to act on your new job. ultimately they have to find their own own. You have to depend on yourself, your

The Member Bodies of the National Rural Health Alliance The National Rural Health Alliance is a peak body comprised of 22 national associations known as the Member Bodies of the Alliance. Each Member Body nominates a representative to the Alliance and they collectively comprise the Council of the Alliance: Below are listed the names of the 22 Member Bodies and their respective Council member. Association for Australian Rural Nurses (AARN) ...... Ms Kris Malko-Nyhan Australian Community Health Association ...... Ms Sue Wade Australian College of Health Service Executives (rural members) (ACHSE) ...... Mr John Lawrence Australian College of Rural and Remote Medicine (ACRRM) ...... Dr Jane Greacen Rural Policy Group of the Australian Healthcare Association (AHA) ...... Mrs Judith Adams Australian Nursing Federation (rural members) (ANF) ...... Ms Margi Stewart Australian Rural and Remote Allied Health Taskforce of the Health Professions Council of Australia (ARRAHT) ..... Mrs Shelagh Lowe Aboriginal and Torres Strait Islander Commission (ATSIC) ...... Ms Christine Thorne Council of Remote Area Nurses of Australia Inc. (CRANA)...... Ms Sabina Knight Country Women’s Association of Australia (CWAA) ...... Mrs Marie Lally Frontier Services ...... Ms Barbara Foggin Health Consumers of Rural and Remote Australia (HCRRA) ...... Ms Marg Brown Isolated Children’s Parents’ Association of Australia (ICPA) ...... Mrs Megan McNicholl National Association of Community Controlled Health Organisations (NACCHO) ...... Ms Colleen Prideaux National Association of Rural Health Education and Research Organisations (NARHERO) ...... Ms Louise Lawler National Rural Health Network (NRHN) ...... Mr Richard Sager Rural Doctors’ Association of Australia (RDAA) ...... Dr Nola Maxfield Rural Faculty of Royal Australian College of GPs (RACGP) ...... Dr Bruce Harris The Australian Council of the Royal Flying Doctor Service of Australia (RFDS) ...... Ms Barbara Ryan-Thomas Regional and General Paediatric Society ...... Dr Nigel Stewart Rural Pharmacists Australia (RPA) ...... Mr Mark Dunn Services for Australian Rural and Remote Allied Health (SARRAH) ...... Ms Chris Ward

Newsletter of the Alliance, December 2000 9 PARTYLINEfriends news friends – THE FRIENDLY FACE OF THE ALLIANCE

By Michele Foley After a long day of meetings in Canberra, Michael, an occupational therapist from Toowoomba, and Sabina, a remote area nurse from Alice Springs, sit under a tree with a drink and a view of Parliament House. The two Alliance Council members, a long way from home, contemplate how best to bring the message from the bush to those in the Nation’s Capital who make decisions about matters related to rural and remote health.

How could the Alliance get more people talking about the fact that families in towns near them were waiting up to two years to get to a dentist, that young males were committing suicide at twice the rate

SANDE TALESKI

DAVID PETTY DAVID of their city counterparts and that Sabina Knight and Michael Bishop – inspiration for friends decisions about transport systems, hospitals, schools and banks needed to be considered with a “rural perspective” and not one that just reflects the needs of the phone to an organisation with a secretariat members was established to administer the city? which is in contact with over 80,000 people project, with eight members representing How could they get more of this “real through its 22 Member Bodies. the six States and two Territories to ensure life” experience expressed in government “We need a means for people to a truly national focus. Two representatives policy positions and a fair share of become involved, you know, like a friends were from the Alliance Council and an government funding? of the Art Gallery or friends of the Botanical additional person elected as Chairperson. They also wanted to keep in contact Gardens, a joining of a core group of people A part-time Project Manager was with all the special people they had worked who want to support the Alliance employed at the office of the Alliance. with and met over the years who had seen financially as well as through sharing of With 55 founding members, the the Alliance grow from a loose-knit group information and networks,” they organisation gave itself 12–18 months to of a dozen enthusiasts who met on the concluded. increase membership and become And so the concept of friends of the financially independent. Alliance, affectionately known as And join they did! Three levels of friends “friends”, was born. friends has a small “f” membership were offered: individuals, Foundation Corporate to connote a friendly, inclusive “club” that small and large organisations. Some had represents grass roots values and is seen stories to tell, others just wanted to lend Sponsors as a great way to incorporate all of these their support. There was K. from concepts; two-way flow of information, Lockwood whose son was dying of cancer grass roots input into the Alliance’s and expressed concern about the lack of position statements, a means for those adequate health services in rural areas, and interested in rural and remote health to the Coleraine District Hospital that wanted become more involved with the Alliance, to be kept abreast of what was happening a great way to earn funds to put the with other Multi Purpose Centres and keep Alliance on a more sustainable financial abreast of changes in policy. Other larger footing. organisations were happy to “donate” The friends “baby” was conceived in some funds as they saw the work of the 1997 and birthed with the official launch Alliance as invaluable. by the Minister for Regional Services, The friends movement has since grown Senator Ian Macdonald, at the 5th National to become a robust and healthy Rural Health Conference in March 1999. organisation, with some 500 members. Ian Macdonald has remained a good A pleasing number of them are community friend. An Advisory Committee of eleven organisations and health groups.

10 Newsletter of the Alliance, December 2000 PARTYLINEfriends news PARTYline, originally the quarterly The quality and detailed nature of the received by friends that we will be newsletter of friends, became the key means responses showed that friends had put a continuing this with additional topics in for effecting this two-way flow of considerable amount of time and thought the new year. information. The 16 page newsletter, used into the returned work. Some friends The 6th National Health Conference by many as a ‘coffee table mag’ (although provided statistical and referencing in March 2001 will see the changeover of we did have one friends member admit it information, some commented on changes the friends Chairperson, John Ward, a was something he read whilst on the toilet), to style and emphasis of the content, whilst radiographer from Bathurst, NSW. John was extremely well received by friends. others provided anecdotal information has been involved with the project from Feedback indicated a liking to the mix of which enhanced the text. Written the very beginning and his pragmatic policy information with anecdotal stories comments through the post and email were and easy-going approach to the project from friends members as well as the use of popular, with others preferring to pick up will be missed. John has been assisted by photographs and graphics. the phone and tell us their story. a wonderful committee, some of whom It’s not just the negative or the The result for the Alliance is position have moved on and others who have problematic issues either. The flow of papers on Dental Health, a 30% Fair Share, stayed through the organisation’s information between rural and remote Allied Health and Rural Suicide which various transitions. Whilst some communities to government must also truly reflect the experience and priorities members of the Advisory Committee are reflect the positive and innovative solutions of people living and working in rural and no longer actively involved with the and spirit such as the Be Positive Campaign remote Australia. With friends members project, their ideas and input are still in Kilmany, Victoria, and the community being from such a diverse background, and invaluable and through friends can still spirit in Exmouth, Western Australia, after with such a wealth of knowledge and be involved and kept informed of the the floods in early 1999. It is important to experience in the field, the final documents, work of the Alliance. retain a mix of ‘good news stories’ as well. when used as part of the Alliance’s Anita Phillips, the original Project friends members also received other advocacy work, will give an accurate Officer, who left for greener pastures this benefits. A CD-ROM containing 9 years of message to policy makers and government. time last year played a vital role in the rural and remote health information papers establishment phase and set up many of was provided free with membership. “… friends has a small ‘f’ the systems whilst never losing sight of Certificates of Membership and reduced to connote a friendly, individual members. And, of course, the subscription to the Australian Journal of Alliance Council has always been integral Rural Health were also included. With the inclusive ‘club’ that to the development and moulding of the Alliance having a comprehensive rural and represents grass roots project. It has been some time now since remote database, members were also able values…” to tap into a wide network of individuals Michael and Sabina sat and reflected on better representation for the bush. The and organisations with an interest in rural The current status is that the 30% Fair concept of friends has been redefined at and remote health. A reduced registration Share and Rural Suicide papers have been various times along the way, and this new fee to the National Rural Health Conference approved by Council of the Alliance and phase is developing the project with as has since been included as part of the the Dental Health and Allied Health papers much enthusiasm as when it was first friends membership. are still being considered. All documents conceived. But as with any evolving organisation, will be made available for circulation in the emphasis of friends has changed. The time for the 6th National Rural Health For further information about friends, number of members, whilst substantial, Conference in March 2001. contact Michele Foley, friends Manager was not at a level great enough to pay for This consultation process has proved on 02 6285 4660 or email itself without ongoing Alliance support. so beneficial for the Alliance and so well [email protected] PARTYline was such a success that it has now become the newsletter of the Alliance itself. friends members wanted more involvement at the policy level and wanted contact on a more regular basis. WHY NOT JOIN The shift has seen a greater emphasis on policy development and away from the selling and marketing of products of friends. Whilst all the original benefits have friends been maintained, friends members now have the opportunity to have direct input If you would like to be more involved with the work of the Alliance and into the Alliance’s draft position papers, and therefore have a tangible means of receive regular up-to-date information about rural and remote health issues, influencing change in rural and remote then join friends of the Alliance. Complete the enclosed application form health policy. and return to NRHA, PO Box 280, Deakin West, ACT, 2600. If you are intending The response from the circulation of three position papers has been extremely to attend the 6th National Rural Health Conference, then take advantage pleasing. friends expressed their pleasure of the discounted friends membership/conference registration package. and gratitude at being given the opportunity to have input into the process.

Newsletter of the Alliance, December 2000 11 PARTYLINEnews THE 6TH NATIONAL RURAL HEALTH CONFERENCE

The 6th National Rural The Conference theme is Good Health There are 7 concurrent sessions in the Health Conference will – Good Country: from conception to Conference program. Delegates will have completion. This connotes the connections the choice of attending one of 6 streams: 2 be held from 4–7 March 2001 at the between health status and so many aspects Infront-Outback streams, 3 general streams National Convention Centre in Canberra. of life in this country and also speaks of and 1 arts stream. These streams have been The Conference has become a key part of the importance of getting it right at each organised so that it will be logistically the agenda–forming process for rural and stage of the human life cycle. possible to change in mid-stream. The Conference will pick up a range All plenary and concurrent sessions remote health. It provides a valuable of current strategies and developments that will be held at the National Convention opportunity for those living in rural and are important, including those spelled out Centre located in Constitution Avenue in remote areas and those working in the in Healthy Horizons. It will help participants the civic centre of the national capital, health sector to exchange views with to see and feel the relationship between Canberra. their local work and national, state and each other and with policy makers. If you would like more information regional developments. Finally, the please contact the National Rural Health This biennial Conference is the biggest Conference will make an explicit attempt Alliance: public event for the rural and remote health to involve people from outside the health The 6th National Rural Health community in Australia. The last sector in work to improve health status. Conference (incorporating ‘Infront- conference in Adelaide in March 1999 was If you are interested in better health in Outback’) attended by 930 delegates. It has now rural and remote areas, this Conference is Email: [email protected] become even more important, given the a major opportunity. Consumers and Web: www.ruralhealth.org.au incorporation of the Infront-Outback, the service providers. The public and private Rural and Remote Health Scientific sectors. All health professions, researchers Phone: 02 6285 4660 Conference previously held in and policy makers. City and country – we Fax: 02 6285 4670 Toowoomba. need to work together! PO Box 280 DEAKIN WEST ACT 2600 ADVANCING THE PRACTICE OF NURSING continued from Page 16 The role and value of Aboriginal “…the debate is now ten concerns of the doctors he represented that Health Workers was further supported by years old in Australia. The the NSW legislation had been “hijacked” Professor Dirk Keyzer, University rest of the world has moved by metropolitan interests and did little to Department of Rural Health, Broken Hill, address the needs of rural and remote who said that non-indigenous people were on from here…” Australia. not appropriate AHWs. Professor Keyzer A series of small discussion groups in expressed disappointment that this issue the afternoon of the Workshop produced (Advanced Nursing Practice/Nurse a variety of responses regarding the need Practitioner) remains unresolved. In giving to advance the issue further. Most common his international perspective, he noted that though was the need for quality, higher the debate is now ten years old in Australia. education for health professionals working The rest of the world has moved on from at an advanced level in rural and remote here – this is no longer a leading edge issue. Australia. “Rural and remote” needs to be AMA National President, Dr Kerryn recognised as a specialty in its own right. Phelps, was unable to attend and the Perhaps the lack of a national organisation declined to nominate another approach and the rural and remote versus representative. However, Dr Les Woollard, metropolitan factions have been the main a rural GP from Moree, , impediments to advancement of these represented both the Royal Australian practices. This would suggest a less than College of General Practitioners and the united profession stemming from differences of a political and factional Rural Doctors Association of Australia. NIGEL JEFFORD Dr Woollard maintained that the nature. medical profession fully supported Professor Dirk Keyzer In the meantime those who stand to Advanced Nursing Practice and stood benefit in real terms, the rural and remote eager to cooperate and collaborate with the health workers of Australia and, most nurses. Nurse Practitioners, however, were Dr Woollard felt that the current importantly, the members of the rural and another matter. He argued that a medical proposed New South Wales legislation on remote communities, continue to miss out degree is the only appropriate basis for Nurse Practitioners had been or, worse still, have to operate outside of prescribing, interprofessional referral and counterproductive to a uniting of the two the protection of the law because there is a diagnosis. professions. He strongly expressed the need and an obligation.

12 Newsletter of the Alliance, December 2000 PARTYLINEin brief Regional Solutions Program La Trobe Uni telehealth seminar – Applications for funding under the fist Following the telehealth round of the 4 year Regional Solutions seminar held there on Program are invited from non-profit Tuesday 14 November, groups with strong community or regional La Trobe University support, or a local government body. To Telehealth Group has demonstrate community support for posted two items of proposals, applicants will be encouraged possible interest to you on to obtain cash or in-kind contributions from their web site. other sources, which may include This medium appropriate state and local government therefore is an excellent bodies. Grants are available of between opportunity to view all of $1,000 and $500,000. the slides and continue the Information on Regional discussion on line. Solutions is available at http:// Working With Indigenous Peoples The discussion forum is at http:// www.regionalsolutions.gov.au or by www.sph.health.latrobe.edu.au/Ryan/ freecall 1800 026 222. (Note: If you have With Disabilities All the slides can be viewed at ideas for your community but are not yet Working With Indigenous Peoples With http://www-sph.health.latrobe.edu.au/ ready to make an application, you have the Disabilities has recently established a Ryan/TeleHealth_Ryan_2000_files/ opportunity to complete an expression of website to provide access to resources for frame.htm interest form and forward to the Regional allied health professionals who work with Solutions Program – they may be able to Indigenous people with disabilities in the Chris Ryan, Director provide information or advice on how to most remote areas of Australia. If you TeleHealth Victoria develop your idea.) Applications for haven’t already done so, I would invite you Level 3, 150 Albert Rd funding can be submitted at any time in to visit the site (the address is PO Box 365 accordance with published Guidelines and www.wired.org.au ) and provide us with Application Forms. Proposals that miss the some feedback. South Melbourne, Vic 3205 advertised closing date for an assessment Tim Ziersch [email protected] round will be assessed in the following Chairperson – Website Reference Group Tel +61 3 9696 2799 round. Calls for applications will be advertised several times per year. Working With Indigenous Peoples With Fax +61 3 9690 0430 Disability Website Michelle S. Whyard MB 0414 587 608 Address: PO Box 2438 Regency Park 5942 Manager, Transport & Regional Web: www.telehealth.com.au Development Ph: 8243 8278 New Sexual Health Phone Help Line Australian Local Government Fax: (08) 8243 8208 Association Mobile: 0414 880 674 The Acting Prime Minister Mr John Anderson launched a 1300 number for the Ph: 02-6122-9443 Email: [email protected] FPA Healthline on 27 October 2000. The Website: www.wired.org.au Fax: 02-6282-2110 launch took place in Gunnedah. web site: http://www.alga.com.au The FPA Healthline is a telephone information service responding to questions about reproductive and sexual RAMUS SCHOLARSHIPS FOR 2001 health. It provides information and referral Senior secondary school leavers and medical students from rural and remote Australia for people in NSW including the general interested in a career as a country doctor can apply for financial support from the public, doctors and nurses and other Federal Government under a scholarship scheme which is part of a broad strategy to service providers. Young women are major encourage more doctors to practise in rural and remote Australia. users of the service. Experienced clinical The Rural Australia Medical Undergraduate Scholarship (RAMUS) Scheme provides nurses with specific expertise in sexual and medical students who have a rural background with $10,000 annually to help cover reproductive health staff the Healthline. the costs of accommodation, living and travel expenses during their medical course. FPA Health (formerly Family Planning The Scheme is open to Australian citizens or permanent residents who have lived in a NSW) has for some time had an rural or remote region in Australia. Applicants must be entering, or currently enrolled as information line with a metropolitan a full-time student in an accredited undergraduate or graduate medical course at an number. Last year some 10,000 calls Australian medical school. were received. The new service (Phone 1300 65 88 86) will enable a better service Eligible applicants for the scholarship scheme will be ranked according to their rural to be provided to people in rural and experience and financial need. Around 80 new scholarships in total will be awarded regional NSW. for 2001. Applications close late January 2001. David Wheen For more information on the RAMUS and to register for an application form telephone the National Rural Health Alliance on 1800 460 440 or visit their website at: [email protected] www.ruralhealth.org.au

Newsletter of the Alliance, December 2000 13 governmentPARTYLINE news

The information printed on this page is provided by the government department identified and is reprinted unedited by PARTYline. Commonwealth Department of Health and Aged Care EASY GATEWAY TO RELIABLE HEALTH INFORMATION

Many Australians now recognise the control, the latest therapies for asthma care, A copy of the asthma satellite broadcast can usefulness of the Internet, with on-line and asthma management strategies. The be ordered through: program recognised that people with shopping, email and workplace Internet The Rural Health Education Foundation asthma in rural and remote areas are a connections becoming commonplace. Unit 5, 53 Dundas Court, Phillip ACT 2606 priority population, and it is vital that PO Box 219 MAWSON ACT 2607 More and more, rural communities are health professionals in those areas are Telephone (02) 6232 5480 also taking advantage of the benefits of provided with access to the latest Facsimile (02) 6232 5484 information technology. information. www.rhef.com.au The broadcast occurred in the lead up [email protected] Nick and Kate live on a large property to National Asthma Week, held from 8–14 west of Mt Isa. Their teenage son Brett had October. Organised by Asthma Australia, experienced breathing difficulties and a the aim of the week was to encourage doctor had diagnosed him with having a people with asthma to be active. mild form of asthma. After seeing the People who go into HealthInsite for doctor, Kate worried that Brett would have information about asthma, will find that an asthma attack when away from the there are links to over 100 asthma resources house with no one around to help. Seeking ranging from the treatment of asthma to further advice, she logged onto the Internet asthma and pregnancy. All the information to find more information about asthma. She available through HealthInsite is credible, quickly found the Federal Government’s reliable and up-to-date. An expert editorial HealthInsite, an easy-to-read website with committee reviews all articles for accuracy accurate information on many different before they appear on the site. health topics. HealthInsite will be especially useful “I found heaps of information about to people living in rural communities, who 6th National Rural Health Conference asthma on HealthInsite, including what to sometimes do not have the same ready 4–7 March 2001 do when someone you’re with has an access to the latest health information as asthma attack,” Kate said. people in metropolitan areas. Through She also discovered that her son’s HealthInsite you can access information on Good Health – condition wasn’t as intimidating as she first a range of health topics including thought. cardiovascular disease, cancer, diabetes Good Country “I know now that asthma can be kept and children’s health. The current list of under control with a good asthma nearly 4,000 items grows every day. from conception to completion management plan,” she said. “It’s very common, with one in seven teenagers Visit HealthInsite on the web at: experiencing some form of asthma.” www.healthinsite.gov.au Program, Registration and Exhibition Presently around two million brochures now available th Australians have asthma, a figure of major The 6 National Rural Health Conference concern to health professionals. The (incorporating ‘Infront-Outback’) Federal Government has recognised asthma as one of its national health priority areas, along with other illnesses such as PO Box 280 DEAKIN WEST ACT 2600 cancer and cardiovascular disease. Asthma management was the subject Phone: 02 6285 4660 of a recent satellite broadcast to rural and Fax: 02 6285 4670 remote doctors. The broadcast covered the Email: [email protected] Web: www.ruralhealth.org.au most appropriate medications for asthma

14 Newsletter of the Alliance, December 2000 governmentPARTYLINE news

The information printed on this page is provided by the government department identified and is reprinted unedited by PARTYline. Commonwealth Department of Transport and Regional Services NORTHERN AUSTRALIA LOOKS TO THE FUTURE

Katherine in the Northern Territory played to the national economy. While not all host to an array of delegates from across delegates shared the same views, they the north between 17 and 20 October as shared a common desire to see the North the Northern Australia Forum brought prosper in a sustainable way. Priorities discussed during the Forum forward a collaborative vision of northern included examining mechanisms to Australia’s requirements for a sustainable effectively access private and public sector and prosperous future. infrastructure funding; continuing to expand tourism while respecting The Northern Australia Forum: For

VICES indigenous cultural needs and traditions; Growth into the New Century, hosted by taking a comprehensive and coordinated Federal Minister for Regional Services, approach to service delivery; balancing Territories and Local Government, Senator environment, social and economic the Hon Ian Macdonald, involved almost T & REGIONAL SER concerns in developing opportunities for 200 delegates contributing their ideas about growth; and forming a northern Australian “where to from here”. advisory body to progress trade and export A common desire to sustainably options. develop the enormous potential of Senator Macdonald said he would be Northern Australia for the future referring issues raised during the process prosperity of the nation was the hallmark

COURTESY OF DEPT. OF TRANSPOR COURTESY OF DEPT. to his ministerial colleagues so a ‘whole- of the Northern Australia Forum. of-government’ response to the Forum Senator Ian Macdonald Delegates at the Forum included could be developed, and praised the members of all three spheres of Forum delegates for the spirit of government, corporate influencers and cooperation that has existed throughout that delegates set their own agenda community leaders, all of whom came the three-day event. through a pre-Forum local consultation together under the one banner of looking Information on the Forum and the lead process; delegates were selected by forward for the future of northern up local consultations, including the members of their own communities; and Australia. Forum Business Paper and Communique politicians attended the Forum, not to lead Opening the Northern Australia Forum are available on the Commonwealth but to listen and hear what delegates had in Katherine, Senator Macdonald said the Department of Transport and Regional to say. Forum provided them with an Services website at: The common issues raised through the unprecedented opportunity to shape the www.dotrs.gov.au/regional/ st 21 pre-Forum local consultations included future of the North well into the 21 northern_forum/ century. infrastructure, education, health, “This Forum provides a perfect environment, employment and economic opportunity for these sectors to get into the development. ears of policy decision makers, as the “Really it’s the commonalities and the Federal Government and all spheres of initiatives that are coming out. The fact that government across , Western we’re talking Northern Australia and we’re Australia and the Northern Territory are talking about our common issues…” said here to listen and respond to what the one delegate representing the WA Tourism North has to say,” Senator Macdonald said. Commission, “…and we’re starting to find The Forum represented the first time common solutions, which are fantastic.” that all 10 regions across northern Australia Forum delegates called for increased had worked together to develop a shared recognition by the rest of Australia for the vision for the future. It was also unique in significant contribution the North makes

Newsletter of the Alliance, December 2000 15 PARTYLINEnews ADVANCING THE PRACTICE OF NURSING by David Petty The National Association of Rural Health You say “Advanced Nursing Practice”, I say Education and Research Organisations (NARHERO) is the peak sector body “Nurse Practitioner”, let’s sort the whole thing representing organisations involved in the out! This could well have been the theme of education of rural and remote area health professionals. It is a collaborative group the national Advanced Nursing Practice working for the integrated support and Workshop held in Canberra on 27 October development of the rural and remote health 2000 organised by the National Association workforce in Australia through research and education. of Rural Health Education and Research NARHERO is a Member Body of the National Organisations (NARHERO – refer to insert). But Rural Health Alliance. It is taking a leading by the end of the day it seemed that there role in facilitating discussion on priority rural and remote workforce issues, including those was more to “sort out” than just names and outlined in Healthy Horizons. NARHERO’s definitions. first project was a Workshop to progress a national approach to Advanced Nursing

Whilst the definitions of Advanced NIGEL JEFFORD Practice, co-ordinated by Lesley Fitzpatrick, Nursing Practice versus Nurse Practitioner Dr Alex Hope Convenor of NARHERO. The workshop are two different factors to consider, the focused on common ground shared by all rural and remote versus metropolitan Ms Jill Iliffe, Federal Secretary of the parties to Advanced Nursing Practice. debate also entered the free-flowing Australian Nursing Federation, brought A discussion paper on the issue is currently being prepared and will be released by discussions of the day as did a State versus some enlightenment to the debate by NARHERO in early 2001. National approach. And interprofessional providing definitions for the two roles (refer to insert below). Whilst these could suspicion is still a potent force to be whose service area crosses State borders. not be portrayed as universally accepted considered. He added that it is outrageous that definitions they certainly seemed to be The aim of the workshop was to Aboriginal Health Workers have not been accepted as contributing to a clearer bring together a national forum on this included in the strategies by nurses to understanding for the day. very important and current issue. promote this cause. Dr Hope said it was But the second part of Ms Iliffe’s Approximately 75 delegates from across unrealistic to expect the average address perhaps highlighted one of the true Australia representing every health “whitefella” to stay in a remote area for dilemmas for the development of discipline as well as consumers, more than two years. Advanced Nursing Practice. In providing bureaucracy and academia attended the This was supported by Ms Jean Ah a summary of the progress of Advanced one-day workshop. They were treated to Chee, an Indigenous Health Worker from Nursing Practice and/or Nurse a range of notable speakers on the Alice Springs, who relayed that in two Practitioner in each State/Territory, it subject. areas she was associated with, the turnover became obvious that -old problem Professor David Lyle, Director, of Doctors was 80% and nurses 110%. of every State doing their own thing (the University Department of Rural Health, Aboriginal Health Workers, on the other railway gauge syndrome) still thrives – Broken Hill, in providing the context for a hand, were there to stay – it is their home. much to our detriment. discussion on Advanced Nursing Practice, She added that often the only available The folly of a non-national approach noted that the majority of rural support for nurses was from Aboriginal was driven home by Dr Alex Hope, a communities in Australia are small Health Workers. remote area GP from Central Australia, continued on page 12 communities and therefore are ideal for Primary Health Care teams. A Primary Health Care team would comprise a GP, At present it would seem very difficult, if not impossible, to provide universally accepted nurse, Aboriginal Health Worker and other definitions for Nurse Practitioner and Advanced Nursing Practice. However, the following health professionals. characteristics provide some guidance as to the fundamental differences. He stated that the principle • Both are characterised by advanced educational qualifications and clinical underpinning Primary Health Care is one experience. of what needs to be done rather than what • Different State legislations will vary the scope of each practice. doctors do and what nurses do. He added that in some rural and remote areas nurses NURSE PRACTITIONERS become mainline health workers. • Have autonomous decision making authority It was quite apparent however, very • Are able to prescribe medications early in the day, that delegates’ perception • Can conduct or order diagnostic investigations of Advanced Nursing Practice varied • Can make referrals to other health professionals and services. APER considerably. Some definitions were needed to delineate between Advanced ADVANCED NURSING PRACTICE Nursing Practice and Nurse Practitioner. It • Unable to prescribe medications but can initiate, supply and adjust medications was obvious that some thought they were the same thing, some thought they were • Unable to prescribe diagnostic investigations if they are to be subject to Medicare there to discuss, debate, defend or debase claim by diagnostician Nurse Practitioners and others were there • Able to refer GPs and Allied Health practitioners (lower Medicare rebate applies if to discuss the pros and cons of forms of referring to specialist medical practitioners)

PARTYLINE IS PRINTED ON RECYCLED P advanced practice for nurses. Source: Australian Nursing Federation

16 Newsletter of the Alliance, December 2000