Labor has a plan to meet the challenges facing remote, rural and regional health.

We know what the problems are:

• Lower incomes, fewer doctors and health professionals and a very limited "private market" for healthcare mean that people in rural, regional and remote Australia rely on over-stretched public hospitals and other government-funded services for healthcare.

• There are higher rates of chronic disease, higher rates of suicide, more preventable deaths, lower cancer survival rates and lower life expectancy. Instead of supporting improved services to these communities the Turnbull Government has cut spending to hospitals, Medicare, dental services and proposes increasing the cost of medicines.

• The biggest single threat to the viability of health services in regional Australia is the Medicare rebate freeze. The GP Tax by stealth will require doctors to pass on $20 per consultation by 2020; however, doctors in regional Australia know that most of their patients can't afford to pay. They are openly talking about the ability to maintain services in some towns.

• We still dont know the impact of this GP Tax by stealth on mental health services in regional and rural Australia. It is in these areas where the GP is often the principal provider of mental health services and where the Medicare rebate freeze is likely to lead to a withdrawal of services. This is no answer to the growing suicide and mental health problem in regional Australia.

• An increase in the cost of Pharmaceutical Benefit Scheme co-payments ignores the fact that there is already a higher rate of people who don't fill their prescriptions in poor regional areas.

A Shorten Labor Government will:

1. End the Medicare rebate freeze, which is the single biggest threat to the viability of rural medicine.

The most immediate and direct way that a Shorten Labor Government can make significant and lasting change is to ensure adequate access to primary health care. There are already reports of patients in rural Australia with chronic diseases waiting up to eight weeks for appointments with a GP. Some patients need to travel up to four hours to see their doctor.[1]

Upfront costs to see a GP - when there is no bulk-billing alternative - create a barrier for people to seek treatment. It leads to a two-tiered health system where only those who can pay get the treatment they need when they need it.

Michael Gannon, the new President of the Australian Medical Association, has already told us that GPs are at breaking point. Meanwhile, Malcolm Turnbull has said that the Medicare rebate freeze will remain until the economy improves.

Rural general practice viability is completely undermined by the rebate freeze. Modelling completed on the impact of the freeze shows that by 2017-18 doctors would be losing 7.1 of their gross annual earnings. This loss increases year on year under Mr. Turnbulls plan to extend the freeze all the way to 2020.

General practice is good preventative health and it helps keep down unnecessary and more expensive hospitalisations. Investing in Medicare and general practice just makes sense.

1. Reverse the Governments plan to increase the cost of medicines by $5 per script (.80 cents for pensioners).

1. Establish 12 regional trials of suicide prevention services and use the Primary Health Networks to extend the scope of regional health services to include regionally tailored mental health services. There were will be six in rural areas and two in remote areas.

1. Establish the Healthcare Reform Commission which will have an explicit role in workforce planning, the maldistribution of doctors and the need for greater alignment between university training places and postgraduate vocational training opportunities.

Access to a GP and allied health professionals is not only determined by the viability of country practices. Its determined by the health professionals who are working there. We know we have a maldistribution problem in Australia.

There is a tendency for doctors, nurses, dentists, speech pathologists, and so-on to practice in the urban centres. As a general rule the concentration of health and medical professionals tend to skew towards living in the main cities.

A Shorten Labor Government will apply a methodical, strategic and evidence-led approach to managing the health workforce pipeline.

This includes establishing the Australian Healthcare Reform Commission. The Commission will be focussed on preserving universality, reducing inequality, eliminating waste and duplication, integrating services and improving the collection and use of data. It will have a key advisory role to Federal, State and Territory governments.

Labor will task the Commission to advise on:

• Addressing the maldistribution of the medical and allied health workforce.

• Improving the retention rate of Indigenous medical students and Indigenous doctors in training.

• Ensuring effective utilisation of the allied health workforce.

• Improving graduate nurse employment.

Its about getting the right health workforce worker in the right place.

1. A Shorten Labor Government Labor will work with stakeholders, including regional Doctors, on a plan for regional rural and remote health. However, our most immediate priority must be the prevention of the wholesale destruction of Medicare through privatisation and Budget cuts.

Because social and economic circumstances are such a strong determinant of health outcomes, Labor understands that some of the most powerful levers which impact upon health lie outside the health portfolio. This is why we are determined to invest $37.8 billion in our schools and $40 billion in early childhood education and care and why we are determined to complete the task we started of getting fast, reliable and affordable broadband to all Australians through the National Broadband Network. It's why we are determined to ensure universities and TAFEs remain accessible and affordable to all Australians.

[1] http://www.abc.net.au/news/2016-03-13/rural-patients-waiting-months-to-see-gp/7242488