The National Rural Health Alliance: Advocating for rural and remote health

An article written by Susanne Tegen, Chief Executive, National Rural Health Alliance and Carmen Ellis, Policy and Research Officer, National Rural Health Alliance

For the over 7 million Australians who live outside metropolitan centres, accessing appropriate health care can be a struggle. Accessing palliative care services in rural and remote areas adds layers of complexity, if they can be accessed at all.  The fact is that 5 in 6 (84%) palliative medicine physicians and 5 in 7 (72%) palliative care nurses are employed in major cities [1], which results in rural and remote Australians missing out on services that are taken for granted in cities.

For the predominantly generalist palliative workforce available in rural Australia, delivering care comes with its own set of obstacles, including fragmented service availability, unclear referral pathways and the added pressures of the tyranny of distance. Demand often exceeds practitioner availability, and capacity for clinicians to participate in education and training is limited. Additionally, the isolation felt by rural practitioners can add emotional strain, making their already challenging roles even tougher. [2]

On the positive side, people living in rural communities tend to have a greater sense of belonging, usually experience less loneliness and are more likely to volunteer in their community, [3] factors that all contribute to supporting people who are nearing the end of life.

Rural health is both unique and complex, highlighting the need for tailored policies that recognise the distinct aspects of rural culture. At the National Rural Health Alliance, we are committed to advocating for better health across the lifespan of rural Australians. The Alliance represents 52 organisations dedicated to enhancing the health and wellbeing rural and remote Australians. [4] We have a network of Friends and Allies of the organisation who also provide us with grassroots feedback about their experiences of rural health. [5]

Our core mission is to listen to the people in rural, regional, and remote Australia and work as a conduit to raise concerns and bring solutions to governments, advocating for meaningful policy and funding changes. Australia needs a National Rural Health Strategy to ensure the Commonwealth and state and territory governments work together to implement policies and funding needed, in the way it is needed to build health equity across our nation. 

Through independent commissioned research, we know that the federal government spends $850 less on health annually for a rural person compared to a person in the city.  That equates to a $6.55 billion underspend for rural health care in Australia each year. So, we know more can be done to invest in rural health services across the lifespan.

When it comes to providing a rural perspective on end-of-life care, the Alliance is a partner on the Rural CarerHelp palliative care project which is developing resources and information for those caring for individuals with serious illnesses. The resources are designed to reach people in rural communities, including health professionals, care workers, and their families.   We also support the development of a Rural and Remote Institute of Palliative Medicine (RRIPM), a program being developed by the Australia New Zealand Society of Palliative Medicine (ANZSPM) to support palliative medicine training in rural and remote locations. [6]

Providing quality end-of-life care in rural and remote Australia is essential for equity and improving the quality of life for individuals and their families. The National Rural Health Alliance is committed to amplifying the voices of rural communities and ensuring that everyone has access to the care and support they need during life’s most critical moments, no matter which postcode they have.

Authors

Susanne Tegen

Chief Executive

National Rural Health Alliance

Carmen Ellis

Policy and Research Officer

National Rural Health Alliance

Reference

1. Australian Institute of Health and Welfare. Palliative Care Services in Australia [Internet]. Canberra, ACT: AIHW; 2024 [updated 2024 Oct 30; cited 2025 Mar 11].

2. Wenham S, Cumming M, Saurman E. Improving palliative and end-of-life care for rural and remote Australians. Public Health Res Pract. 2020 Mar 10;30(1):3012001.

3.  National Rural Health Alliance. Rural health in Australia: Snapshot 2023 (1.23 MB pdf) Canberra, ACT: NRHA; 2024.

4. National Rural Health Alliance. About us [Internet]. Canberra, ACT: NRHA; 2025 [cited 2025 Mar 11].

5. National Rural Health Alliance. Friends and allies of the Alliance [Internet]. Canberra, ACT: NRHA; 2025 [cited 2025 Mar 11].

6. Australian and New Zealand Society of Palliative Medicine. Welcome to the Rural and Remote Institute of Palliative Medicine [Internet]. 2025 [cited 2025 Mar 11].