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Health boundaries "don't make sense"

Tuesday, 14th December, 2010

By Andrew Robertson

Two competing proposals to create the region's new primary health care organisation have been dealt a blow with the release of the draft boundaries.

The federal government has released the boundaries for the State's 16 so-called 'Medicare Locals', which will expand the functions and activities of the Divisions of General Practice.

Medicare Locals, together with the establishment of Local Hospital Networks, are a key element of the government's national health reform program.

Despite calling for submissions on potential boundaries, the government's draft boundaries virtually mirror those of the State's Local Hospital Networks which come into effect from January 1.

The proposed Far West Medicare Local takes in Broken Hill, Tibooburra, White Cliffs, Wilcannia, Ivanhoe and Menindee.

The chief executive of the Outback Division of General Practice, Stuart Gordon, has described the boundaries as "a bit of a disaster".

The division, which is based in Bourke, had proposed an expansion of its boundary to take in all of the centres in the far west including Broken Hill.

Mr Gordon said that would have created a Medicare Local that focussed services on "communities of common concern", rather than larger regional centres.

He said the boundaries released by the government would have the opposite effect. Remote centres like Bourke and Brewarrina, which have been included in the Western Medicare Local, would be disadvantaged because most of the funding would go to growth centres like Dubbo and Orange.

Communities in the Far West Medicare Local would also struggle if that boundary was implemented, said Mr Stuart, as it would not have the critical mass of population required to attract sufficient funding.

"If this was to be implemented it would be a sad day for western NSW," Mr Gordon said. Another boundary submission received by the government proposes creating a Medicare Local that covers the far west and the area around Mildura, which would be a hub along with Broken Hill.

The joint proposal was put forward by the Northern Mallee Primary Care Partnership and Broken Hill Centre for Remote Health.

Professor David Lyle, from the University Department of Rural Health, said the proposal recognised the strong cross-border flow that already existed from NSW border towns such as Wentworth, and to a lessor extent Broken Hill, to Mildura.

He said there were also similarities between Mildura and Broken Hill in that both were major population centres with large hospitals that serviced outlying centres.

"We both service areas considered remote ... we have many things in common." But the government has instead placed Wentworth and Balranald in the Lower Murray Medicare Local, which straddles the Victorian and NSW border and includes Mildura.

Prof Lyle said he still expected a partnership between the far west area and Mildura to develop and strengthen in the future.

"We're still committed to that and if we have to operate as two separate operations we'll do that." Comment on the government's proposed boundaries closed yesterday and the first group of Medicare Locals are scheduled to commence operation by mid next year with the remainder to start in mid 2012.

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