The Regional Australia Institute (RAI) has released a ‘Pillars of Communities’ report on the availability of services in Australia’s small towns. The findings are not good.

The report is accompanied by a Report Card’, which rates how well Australia provides access to ten essential professionals for residents living in small towns across Australia. Access to psychologists, preschool teachers and dentists are given an F for Fail. No group rates an A, though teachers and GPs are rated B.

RAI CEO Jack Archer says while some professions have made progress over the last 30 years, the data in the Pillars of Communities report calls into question the effectiveness of government spending to improve education and health outcomes in regional areas.

“Governments have spent decades pouring billions of dollars into programs to give regional Australians better access to professionals and services. “ he  said.

“Many small towns are overwhelmed by significant dental, mental health and educational achievement issues. For many of the 1.8 million Australians who live in small towns, accessing a GP, dentist, pre-school teacher or psychologist is nearly impossible.”

The report tracks the number of police, teachers, doctors, nurses, paramedics, dentists, psychologists, and social workers in small towns across Australia over a 30 year period – from 1981 to 2011.

Inner regional towns, which are closer to cities, have seen an 85 per cent growth in professionals – while the numbers in remote areas have only grown by 7 per cent.

“While the story of declining services in small towns isn’t new, this is the first time the shift in professional services has been analysed to this extent by researchers in Australia,” Mr Archer said.

“From a place of advantage in 1981, the per-capita rate of preschool teachers in small towns has now fallen well below the national average. This lack of service professionals coincides with higher rates of early childhood development issues in rural and remote areas.

:We see the same pattern in dentistry and mental health, which are also areas where regional outcomes have been poor for a long time” Mr Archer said.

According to government figures, one third of students in regional and rural areas fail to finish Year 12, and only 18 percent will go on to complete a university degree. “Rural students are up to one and a half years behind their metropolitan counterparts on NAPLAN and PISA tests.

“People in regional Australia need to know that the services in their town will improve and that the spending will not be soaked up by places that don’t need it or in funding for initiatives that are based a long way from their community,” Mr Archer said.

The RAI report suggests four ways to address service delivery in small towns:

Support community led initiatives

Some towns are bypassing governmnet processes in order to attract service delivery professionals to their communities. Some places have worked around administration-heavy procedures to entice education and health professionals by offering attractive housing or low-rent business premises. These efforts should be encouraged and supported as part of professional support programs.

Flexibility in the roles of professionals in small towns

Where there are service professionals located in small towns, their scope of work needs to be flexible enough to better meet community needs.

For example, perhaps pharmacists and nurses should be able to provide vaccinations, dress wounds and take x-rays.

Virtual service delivery methods

For example, online services can complement the presence of service delivery professionals in small towns rather than replace them outright. Virtual services have the potential to significantly widen the scope of services that can be delivered to small town populations without the need for extensive travel.

But there is still considerable debate about the effectiveness of virtual only services that are delivered in isolation from local professionals, and how to embed virtual services most effectively. Services that complement and extend the scope of practice for local generalists rather than seeking to replace them should be the priority.

Incentives need to target hard to staff areas

The growth in inner regional service professionals combined with their proximity to more populous places with a great range of services lessens their need for support. Incentives to professionals should be closely targeted to promote growth in the professionals available in the remote areas that need them most.

Pillars of Communities and the Small Town Report Card are available here.