Small towns report gives 'F' grade to access to psychologists, dentists and preschool teachers

Successive governments have poured billions of dollars into efforts to improve access to basic services for regional Australians but a new report questions whether that money has reached the towns that need it most.

The Pillars of Communities report compiles 30 years of data to reveal the level of access to professionals working in 10 basic services, such as health and education, in towns with populations between 200 and 5000.

While there were signs of progress in some areas, a report card produced alongside Pillars of Communities gave an ‘F’ grade for access to psychologists, dentists and preschool teachers.

The report was produced by the Regional Australia Institute and chief executive Jack Archer said accessibility problems corresponded with high mental health issues, poor dental health outcomes and early development problems in small and remote towns.

Regional Australia Institute CEO Jack Archer. Picture: Supplied

Regional Australia Institute CEO Jack Archer. Picture: Supplied

“A big part of the reason why we’re not solving these problems is that we just don't have the people in these communities to make it happen,” he said.

Between 1981 and 2011, the percentage of small towns with a preschool teacher dropped from 25 to 16 per cent, while dentists dropped from 9 to 5 per cent.

The percentage of remote towns with psychiatrists dropped from 24 to 11 per cent in the same period, however, small towns overall saw an increase from 1 to 6 per cent.

Coober Pedy in South Australia.

Coober Pedy in South Australia.

Pillars of Communities also revealed a greater proportion of Australians (8.5 per cent) lived in small towns in 2011 compared to 1981 and Mr Archer said a key takeaway was the gap wasn’t being closed.

“We’re still got big gaps in the availability of those basic service providers. What we’re also seeing is that inner regional areas are growing much faster than the rural and remote areas where we have really poor health and education outcomes,” he said.

CHALLENGES ON THE GROUND

Pillars of Communities hit home for North Burnett Regional Council deputy mayor Faye Whelan, who said the remote towns in her Queensland municipality faced some of the issues identified in the report.

“I’m saddened to think there’s other areas of Australia in the same boat as us,” she said.

Mrs Whelan has spent her whole life in rural areas and while she’s witnessed a decline in basic services, she said better government incentives could attract more professionals.

“I’ve seen instances where professionals have come for 12 months and they’ve realised it’s a much better lifestyle to bring up children and have stayed,” she said.

The latest Commonwealth budget allocated $2 billion over four years for workforce and incentive programs to increase the numbers of health delivery professionals in rural and remote areas.

But government initiatives don’t always recognise the unique challenges faced by individual communities as is the case for Moore Park Beach east of the North Burnett council district.

Local pharmacist Adam Harradine said the town had difficulty attracting general practitioners but a District Workforce Shortage classification would make it easier for doctors who’ve trained overseas to set up a practice.

But Moore Park Beach can’t get that classification because it's too close to the regional city of Bundaberg.

Mr Harradine said Bundaberg was only 20 minutes away but the only road there is prone to flooding and recently cut off Moore Park Beach for two days.

“There’s no GP and one road in and out that floods. That isn’t a great thing for a 70-year-old to drive,” he said.

REGIONAL SNAPSHOT

  • Most remote and very remote small towns are in Queensland and South Australia.
  • Queenstown, a small town on Tasmania’s West Coast, has seen a population decline of 47 per cent between 1981 to 2011, with residents noting a lack of access to welfare and social workers, dentists and health professionals.
  • Between 1981 and 2001, Coonamble, 161 kilometres north of Dubbo in NSW, had a reduction of primary and secondary school teachers of 45 per cent and 63 per cent respectively, but nurses had increased by one to 10, a 6 per cent increase.
  • For one resident suffering an asthmatic episode, it was easier to make the 300 kilometre round trip to Deniliquin for help than seek treatment in Hay, a small town in the south-western, Murray-Riverina region of NSW.
  • Victoria has no very remote small towns but the second most inner regional towns (206) behind NSW (266). 
  • In Western Australia, the police service enhanced relocation packages and facilities and improved the number of local and regional recruits, who are more likely to remain in small communities.

NOT ALL DOOM AND GLOOM

Pillars of Communities did show signs of improvement in some basic services, with general practitioners, primary school teachers and high school teachers all scoring a ‘B’ on the report card.

Only 14 per cent of small towns had a general practitioner in 1981 but that figure rose to 18 per cent by 2011.

And while there’s been a slight drop in the percentage of towns with primary and secondary school teachers overall, there’s been a significant increase for towns with populations between 1000 and 5000.

Pillars of Communities also has its limitations; it only tracks the number of basic service professionals and doesn’t take into account the quality of service, visiting practitioners or services delivered digitally.

Mr Archer acknowledged these limitations and said the report was a foundational work that could help governments evaluate whether they're deploying resources to the right areas.

“This is the first time we’ve really had a long-term perspective on these issues and it should help governments to stop and rethink whether the things they’re investing in are really having the impact that we really need,” he said.

FIGHTING FOR CHANGE

Twelve months ago, Buloke Shire Council in central Victoria launched its Rural Living campaign to seek government recognition that communities would become more unlivable without access to basic services.

While the campaign started with traditional council services, such as rubbish collection, director of community development Jessie Holmes said it’d since inspired advocacy in other areas including childcare.

Ms Holmes said the eligibility criteria for childcare rebates was too restrictive for rural communities and other regulation made it difficult to attract qualified staff.

She said lack of access to childcare impacted all levels of the community.

“It has an impact on the lower socioeconomic demographic. It has an economic impact because we can’t get parents back into the participatory workforce and it has an effect on volunteers … and rural areas rely heavily on volunteers,” she said.

Mr Archer said there could be costly consequences for those who live in small towns and governments without improvement in areas identified in Pillars of Communities ​

He added there was greater scope for more community-driven approaches rather than top-down solutions.

“Sometimes what looks like the solution in Canberra isn’t actually the solution when you get out to these communities,” he said.

“If communities can take ownership of these issues and identify solutions, governments really should back those. I think it's going to be cheaper and more effective in the long term.”