Health service models

This chapter presents a selection of the range of different health service models that have been developed in rural Australia in response to local community needs, historical conditions and workforce composition. In 1975, the current Medical Benefits Schedule (MBS) was developed to support universal health care for all Australians. The MBS set the relative values of medical procedures and consultations, which were then used as the basis of the funding available to support the different types of medical practices. At that time, the usual type of medical health service was based on solo or small-group private medical practice. This medical care funding has not changed substantially in Australia over the last 30 years. State and territory governments are responsible for hospital care and the Australian Government is predominantly responsible for outpatient or community care. In many cases, the traditional model of clinical practice may not be viable in many rural communities. As doctors leave or retire from clinical practice in small communities, the burden of service delivery on doctors who remain increases. As a result, in the last decade, a health professional workforce shortage has developed in rural areas. However, the workforce crisis has led to the development of innovative health service models, based on population characteristics and remoteness of local communities.