Small rural towns face the greatest nursing shortfalls, research finds

Australia’s small rural towns are facing the greatest shortfalls in the medical workforce with the lowest number of nurses and allied health workers per capita impacting healthcare and aged care delivery.

Data analysed in a recently released study by the University of Wollongong also found that the number of healthcare workers did increase by 22% between 2016 and 2021 but rural and remote locations failed to see much of that growth. 

Lead author Dr Colin Cortie from the University of Wollongong’s Graduate School of Medicine said it’s important to understand the distribution of healthcare workers.

“Ultimately health care is delivered by people and having the right people in the right areas is really difficult,” Dr Cortie said.

“Many would expect the greatest staffing shortfalls to be in remote and very remote Australia, but we found it’s actually small rural towns suffering the most.”

Under the Modified Monash Model, small rural towns are classified as MM 5. Examples include Renmark (SA), Benolong (NSW), Condamine (QLD) and Marnoo (VIC). 

Locations like these typically struggle to attract healthcare workers due to smaller populations: they account for just 7.3% of Australia’s population. 

“Small rural towns are seeing far fewer healthcare professionals per capita compared to metropolitan areas and even remote communities,” Dr Cortie said.

“There are three times as many doctors per capita in metropolitan areas than in small rural towns, and twice as many nurses and allied health workers. This means that people in rural areas have a much harder time accessing healthcare.”

“At the end of the day, this shortage poses significant risks to the health outcomes of Australians living in these regions.”

The researchers attribute the disproportionate workforce shortfalls in small rural towns to a range of factors including fewer private healthcare workers in rural areas and insufficient public sector employment to fill the gaps.

Dr Cortie said private healthcare services often struggle to operate in small rural areas due to economic and logistical challenges.

“In remote areas the decline in the private sector workforce has been compensated for by increasing the number of health care workers in the public sector,” Dr Cortie said.

“However, in small rural areas, no compensatory mechanisms have been introduced which has led to the current workforce shortages. Based on these shortfalls it’s clear that improvements in the recruitment and retention of a rural health workforce in small rural towns is desperately needed, but this will take time before it makes a difference in the community.

“In the short term, more immediate solutions could encompass alternative funding models and increased flexibility of employment conditions. It would also be great to see new trials of publicly-funded health care workers, specifically targeted towards addressing challenges in small rural towns.”

In aged care, some providers have turned to supplying their own accommodation as one way to overcome logistical challenges like limited housing supplies. Others tap into international workforces through programs like the PALM Scheme. 

With a limited number of nursing and other healthcare professionals in rural, regional and remote areas, Dr Cortie believes that medical schools need to continue encouraging students to take on regional jobs. 

He said schools that do this, including the University of Wollongong, have seen one-third of medical graduates still working regionally ten years after graduation. 

“The medical program at UOW was designed to encourage graduates to work in regions suffering a shortfall of medical workers. It’s clearly working,” he said.

“In addition to changing how we train doctors, we also need to consider how we fund them. The funding models that work in cities aren’t working in rural areas.”