Health services for rural communities
Last Friday the East Sussex Health Overview and Scrutiny Committee started its investigation into NHS delivery to rural communities with a conference at the Uckfield Civic Centre. It was well organised and sparked some very interesting discussion.
AirS had been asked to contribute an initial presentation to prompt discussion and ‘get the juices flowing’. My powerpoint presentation can be found here.
We take the view that resources and initiatives tend increasingly to be focused on the small number of, mainly urban, places where there are a high proportion of disadvantaged people; despite there being many similarly disadvantaged people spread across our more dispersed rural areas. The perception within the Health Service is clearly different: they see the better off and vocal middle classes who live in rural areas tending to demand more from a service that must try to be universal.
Resolving this tension would seem to be about focusing on the needs of individuals and families wherever they live and responding accordingly irrespective of their location. So what might intrude on this excellent solution? There are probably three key barriers to be overcome: 1. Government set targets are easier to achieve in urban areas because the target population comes in big clumps 2. There may not be a ‘travelling premium’ attached to the budget for outreach services for rural areas and 3. Away from urban centres people often look across administrative boundaries for services and this often results in a poor focus on the individual or family.
Overcoming these barriers means taking account of the particular situation of rural people and treating them with the same respect, engagement and lack of discrimination as any other minority group. The NHS in East Sussex is clearly listening, so roll on HOSC’s investigation, it was a good start.
Jeremy Leggett, 30th November 2009