Editorial


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Editorial 
 

REPORT FROM AUSTRALIA 
 

Desley Hegney 
 Editorial Board Member 

 
 

In Queensland Australia we have been the focus of two major inquiries into our 
public health system – Queensland Health. The basis for one of the inquiries (a Royal 
Commission) was the alleged activities of an overseas trained doctor in a rural town. 
Allegedly he was responsible for several adverse patient outcomes, some of which 
resulted in the death of patients. As a result of a nurse who decided to ‘blow the whistle’, 
an initial inquiry into the work of that doctor was established. That Royal Commission 
has yet to report its findings. However, a systems review was also established – called the 
Forster Inquiry – and I was a member of the rural and remote advisory panel to this 
inquiry.  

The Forster Inquiry report is available from the following web address: 
http://www.thepremier.qld.gov.au/news/media_matters/2005/30_09_05.shtm. The major 
recommendations from a rural and remote nursing perspective are: 
 

• That rural and remote communities have a right to expect safe and timely 
access to health services;  

• That approaches that look at preventing avoidable illnesses, promoting good 
health, managing chronic disease and coordinating care across the lifespan are 
critical to the longer term well being and health of rural communities;  

• Geographic isolation means that different models are needed than the models 
used for larger populations in metropolitan areas;  

• Rural workforces need to be made up predominately of ‘generalists;’  
• Peer support is very important to prevent ‘burn out’ and the loss of valuable 

skills for communities.  
 
Some of the recommendations made included: 
 

• Safe, sustainable service models should be developed in partnership with rural 
and remote communities, the Commonwealth government and other service 
providers;  

• Education and training providers will be engaged to assist with increasing 
workforce supply in rural and remote areas and better develop ‘generalist’ 
roles including rural generalists doctors, advanced rural and remote nurses, 
nurse practitioners and paramedic primary care providers;  

• The Queensland Government to engage with the Australian College of Rural 
and Remote Medicine to advocate for recognition of rural general medicine as 
a new speciality;  

Online Journal of Rural Nursing and Health Care, vol. 5, no. 2, Fall 2005 

http://www.thepremier.qld.gov.au/news/media_matters/2005/30_09_05.shtm


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• Remuneration and incentive packages, including better access to professional 
development should be improved, to attract clinicians to rural and remote 
areas;  

• Peer support networks should be established at Area Health Service level, for 
isolated workers, based around professional groups or streams of care;  

• All rural and remote services will need to be networked with larger centres, 
including a tertiary metropolitan hospital. The purpose will be to provide 
outreach services and some staffing relief;  

• Area Health Services will establish a register of clinicians willing to perform 
short or long term country service.  

             
The Report and its recommendations are currently being rolled out in Queensland. We 
have experienced a spill of all senior positions within Queensland Health, and new 
appointments are soon to be made. It will be a major challenge to change a culture which 
has developed as has been described as one based on bullying and intimidation. People in 
the past were strongly discouraged from any criticism of the system, and this culture 
needs to be changed.  

Hopefully we will see all the rural and remote recommendations implemented 
over time – we can only wait and see. 

   

 

Online Journal of Rural Nursing and Health Care, vol. 5, no. 2, Fall 2005