New book analyses health care reform in a rural community

December 06, 2006

A book that documents and analyses conflicting interests surrounding health care reform in a rural community has important implications for such communities throughout Australia.

One of the book’s authors, Associate Professor Jeanne Madison from The University of New England, said that the kind of “power struggle” analysed in the book could happen “anywhere where there are people”. “Health care is an issue that affects everyone in every community,” she said.

Healthcare Reform and Interest Groups: The Case of Rural Australia documents the conflict between doctors, government officials, and health care administrators when the small Victorian town of Corryong (population 3,200) had to make decisions about the future of its ageing hospital. The principal author of the book, Dr Frank Evans, was Chief Executive Officer of the hospital at the time of change, and wrote from his experience at the centre of the struggle. On one side were the doctors (supported by some members of the community), who wanted to maintain the hospital as an acute-care facility, and on the other were the government and health officials who wanted to replace it with a new, integrated health service (known as a “multi-purpose service”, or “MPS”).

The Right Honourable Ian Sinclair, former Federal Government Minister and Member for New England, officially launched the book during a function at UNE last week. Mr Sinclair said that MPS centres “suited to present demands” were an important development in rural communities, where populations were ageing more rapidly than in the cities. It was becoming more apparent that smaller communities were not able to staff and maintain an acute-care hospital, and the MPS was a more viable, alternative approach to the provision of health care.

In moving towards this more flexible type of health service, doctors (who often link their social status with the local hospital) “can be part of the problem”, Mr Sinclair said, “but are essentially an important part of the solution”.

Healthcare Reform and Interest Groups: The Case of Rural Australia (University Press of America, 2006) is written by Frank Evans, Gil-Soo Han, and Jeanne Madison. Dr Madison explained that she and Dr Han had supervised Dr Evans’s UNE doctoral thesis on which the book is based. “Our job was to help him to step back from the emotion of personal involvement, and keep him scholarly and analytical,” she said. Dr Madison is Head of the School of Health at UNE, while Dr Han is now an Associate Professor and Deputy Head of the School of Arts and Sciences at Monash University, Malaysia. Dr Evans is Chief Executive and Director of Nursing at Upper Murray Health and Community Services.

“The book addresses the issue of how much – and what kind of – health care is appropriate for small rural communities,” Dr Madison said, “and the struggle among interested parties to acquire and control services that each interest group thinks necessary. People in smaller rural communities across Australia are having to address these questions: How much health care is appropriate, and how accessible should that health care be?”

The MPS in Corryong became operational in 2002.

THE PHOTOGRAPH displayed here, taken at last week's book launch, shows (from left) Professor Victor Minichiello (Executive Dean of the Faculty of Education, Health and Professional Studies at UNE), Associate Professor Jeanne Madison, the Right Honourable Ian Sinclair, and Armidale Dumaresq Mayor Councillor Peter Ducat.

Posted by Jim Scanlan at December 6, 2006 05:05 PM