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The above factors have been noted to present significant barriers to the equitable distribution of health workers. They are recognised as contributing to the difficulty in attracting and retaining health workers to rural and remote areas. The current health worker shortage and maldistribution is more than normal cyclical variation.3 Poor access to health services by people living in rural and remote communities is such an entrenched problem in Australia it seems unlikely it can be easily addressed. Due to factors related to the economic market, health services will likely continue to be concentrated in more densely populated areas, in order to provide access to the greatest number of people possible and maximise cost effectiveness. The increasing health care demand in Australia The increasing shortage of health professionals is critical amidst numerous forecasts of a substantial increase in demand for health services. A number of factors are thought to be responsible for this projected increase in demand for health care, including; • advances in health technology • a growing consumer expectation of being able to access those new technologies • an increase in chronic diseases. Advances in health technology are providing an ever-increasing range of higher quality health services and procedures that treat or prevent disease, and promote recovery. As these new technologies become available, and people globally become more aware and astute regarding health care issues, their expectation to be able to access these services will also increase. Additionally, as incomes rise people generally spend more on health care and demand higher quality services. Modern lifestyle factors are also predicted to impact upon the requirement for increased access and quality in health care. Nationally, the burden of chronic diseases such as diabetes (due to increasingly sedentary lifestyles and poor diet), strokes (as a result of smoking and poor dietary habits), and an increasing prevalence of dementia in the ageing population are forecast to increase. Older health consumers generally account for a disproportionately greater share of health resources. By 2045, the percentage of the population that will be aged over 65 is projected to be 25%, which is double the current level. The ageing population and increasing focus on lifestyle-related diseases, will generate an increasing demand for the management of chronic diseases. Amidst a scenery of increasing chronic disease, and subsequent demand for treatment and prevention of such ailments, the emphasis of rural health services is predominantly on treatment of acute conditions, rather than prevention of illness and injury. People living in rural and remote areas are known to experience higher rates of injury-related mortality, homicide and suicide, and higher rates of coronary heart disease and diabetes.
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