Access to timely, affordable and high quality specialist care is critical to improving the health outcomes of remote, rural and regional (RRR) communities. This report examines the progress that has been made and the challenges that have persisted in the delivery of various specific health services and specialist care in RRR New South Wales. It presents 24 findings and 32 recommendations. 

Specialist services covered

• Maternity and paediatric services
• Cancer care
• Aged care
• Palliative care
• Mental health and drug and alcohol services
• Aboriginal health services
• Patient transport and paramedicine

Key findings

• Declining numbers of obstetrics units and closures of hospital birthing services continue to be reported with no evident plan to re-establish these services.
• A shortage of specialist GPs and allied health clinicians has meant that many paediatric specialists working in public hospitals are no longer seeing non-emergency patients, particularly those with developmental conditions.
• Paediatric services in regional public hospitals have long wait times.
• There are still significant out-of-pocket costs for cancer patients in some regional areas, and not-for-profit organisations are increasingly relied upon to help cover these costs.
• The population of older people living in remote, rural and regional areas is increasing, but aged care services are constrained and not keeping up with this demand.
• Access to data to inform regional palliative care services remains limited.
• Mental health services are being impacted by significant and escalating workforce shortages.
• Mental health, drug and alcohol treatment services remain poorly integrated.
• Although Aboriginal Community Controlled Health Organisations are essential primary health care providers, they are not included in state-level approaches to recruitment and retention, and are unable to access key state-level incentives for regional health workers.
• Funding for community transport is not sufficient to meet community needs.
• Restricting Intensive Care Paramedics to large stations and limiting training for Extended Care Paramedics outside of metropolitan areas is disincentivising senior paramedics from working in remote, rural and regional NSW and effectively de-skilling the paramedic workforce.