Specialist Services in Rural
Western Australia
Gap and Equity Analysis Update
February 2014
Rural Health West
This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part of
this report may be reproduced without prior written permission from Rural Health West.
Enquiries concerning rights and reproduction should be directed to Rural Health West, PO Box
433, Nedlands Western Australia 6909.
Suggested citation
Rural Health West (2014). Specialist Services in Rural Western Australia: Gap and Equity
Analysis Update. February 2014. Perth: Rural Health West
Limitations
Rural Health West acknowledges there are limitations with data collection for various reasons.
The information in this report is a snapshot in time and was current at February 2014.
Website
www.ruralhealthwest.com.au
Compiled by
Sally Congdon – Manager Special Projects, Rural Health West
Rosalie Wharton – Data Coordinator, Rural Health West
Anne Rowe – MS Access Support Officer, Rural Health West
Hannah Cauchi – Program Officer OITO, Rural Health West
Acknowledgements
Rural Health West thanks all rural and remote specialists, visiting specialists practice staff, WA
Country Health Service, Medicare Locals, GP Networks, Aboriginal Medical Services and others
for their support and contributions in providing and validating the data used in this report.
Rural Health West’s visiting outreach programs are funded by the Australian Government
Department of Health through the Rural Health Outreach Fund (RHOF), the Medical Outreach
Indigenous Chronic Disease Program (MOICDP) and the Healthy Ears, Better Hearing, Better
Listening Program.
February 2014
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1. Introduction
In March 2010 Rural Health West undertook its first assessment of equity of access to, and
gaps in, specialist services available to residents in each rural region of Western Australia, to
support priority setting for the then new MSOAP-ICD stream. This exercise was updated in
March 2011; then in June 2013 to support the new RHOF and MOICDP; and has been updated
with available information about specialist services as at 28 February 2014.
2. Purpose
To provide a tool to support funding and resource allocation decisions for the outreach specialist
programs funded by the Australian Government and managed by Rural Health West.
3. Methodology – determining equity
The number of sessions provided on a per annum basis by all resident, private and visiting
specialist services in each of the seven rural regions in Western Australia has been collated to
determine regional access rates to individual specialties, with equity being defined as the
comparative quantum of specialist sessions delivered to a region per annum per 1,000
population basis. The exercise is a snapshot in time at February 2014 and no weighting has
been given to burden of disease.
This information is summarised in charts on the following pages, separately where possible for
paediatric and adult services. However, specialist services for ENT cover the total population
as there was no capacity to reliably identify Paediatric ENT. Anaesthetics and Radiology have
not been included as they are not specialties funded through RHOF, MOICDP or the Healthy
Ears, Better Hearing, Better Listening Program.
4. Modelling resident specialist activity
The modelling assumptions that have been made in determining the level of resident specialist
activity are:

A full time private or salaried resident specialist (or locum filling the position) works 44
weeks per year at 10 sessions per week = full-time equivalent of 440 sessions per annum.

Where full time resident specialists are separately funded to provide outreach or visiting
services, the number of funded sessions is deducted from their full-time-equivalent
sessions.
5. Rural regions
This analysis continues its assessment of equity within the seven rural regions historically used
by the WA Country Health Service, (Government of Western Australia). These regions align
with the rural Medicare Locals boundaries in Western Australia as follows:
Medicare Local
Rural region
South West WA
Great Southern, South West, Wheatbelt
Kimberley-Pilbara
Kimberley, Pilbara
Goldfields-Midwest
Goldfields, Midwest
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6. Information sources
This Gap and Equity Analysis Update identifies key specialist services provided across the
seven rural regions. To achieve the best possible outcomes, the development of the dataset
has relied on both written and verbal information. Verbal information was obtained from
WACHS regional specialist coordinators, specialist’s private rooms, other relevant WACHS staff
and Outreach in the Outback (OITO) Program staff.
Written information has been collected from:

OITO approved service provider information;

Visiting and resident specialists schedules for 2014 as supplied by Medicare Locals,
government and private hospitals;

Medical & Surgical Specialist Referral Directory (Western Australia) 2014; and

Population data 2012 projections from Western Australia Tomorrow, Population Report No.
7, 2006 to 2026, January 2012
7. Definition of Terms
Resident specialists
Resident specialists live in the rural or remote location in which they work and usually reside in
the town where the Regional Resource Centre is located. Resident specialists provide outreach
services to other towns and communities within their region.
Visiting specialists
Visiting specialists travel from their base (usually Perth, but could be from another rural region
or interstate) to deliver occasional planned specialist services in a rural or remote location.
8. Specialties identified
The following specialties are reported here:
Children’s specialist services
Paediatrics (all)
Combined specialist services
Differentiation not possible for Endocrinology (adult and child) and ENT (adult and child)
Adult specialist services
Cardiology, Dermatology, Gastroenterology, General Medicine, General Surgery, Genetic
Medicine, Immunology, Renal Medicine, Neurology, Obstetrics & Gynaecology, Oncology,
Ophthalmology, Orthopaedics, Palliative Medicine, Plastic/Reconstructive Surgery, Psychiatry,
Respiratory Medicine, Rheumatology, Urology and Vascular Surgery.
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9. Equity of Access – Paediatrics
Specialist Paediatrics (all)
Sessions / 1,000 population
160.00
140.00
120.00
100.00
80.00
60.00
40.00
20.00
Wheatbelt
South West
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
10. Equity of access – child/adult services
Endocrinology (Adult & Child)
Sessions / 1,000 population
0.80
0.60
0.40
0.20
South West
Wheatbelt
South West
Wheatbelt
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
Specialist ENT (Adult & Child)
Sessions / 1,000 population
5.00
4.00
3.00
2.00
1.00
5
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
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11. Equity of Access – adult specialty services
Specialist Cardiology (Adult & Echo)
Sessions / 1,000 population
8.00
7.00
6.00
5.00
4.00
3.00
2.00
1.00
Wheatbelt
South West
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
Specialist Dermatology (Adult)
Sessions / 1,000 population
1.60
1.40
1.20
1.00
0.80
0.60
0.40
0.20
South West
Wheatbelt
South West
Wheatbelt
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
Specialist Gastroenterology (Adult)
Sessions / 1,000 population
1.40
1.20
1.00
0.80
0.60
0.40
0.20
6
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
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Specialist General Medicine/Physician (Adult)
Sessions / 1,000 population
60.00
50.00
40.00
30.00
20.00
10.00
Wheatbelt
South West
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
Specialist General Surgery (Adult)
Sessions / 1,000 population
35.00
30.00
25.00
20.00
15.00
10.00
5.00
South West
Wheatbelt
South West
Wheatbelt
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
Specialist Genetics (Adult)
Sessions / 1,000 population
0.35
0.30
0.25
0.20
0.15
0.10
0.05
7
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
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Specialist Immunology (Adult)
Sessions / 1,000 population includes Sexual Health
0.40
0.35
0.30
0.25
0.20
0.15
0.10
0.05
Wheatbelt
South West
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
Specialist Nephrology/Renal Medicine (Adult)
Sessions / 1,000 population
12.00
10.00
8.00
6.00
4.00
2.00
South West
Wheatbelt
South West
Wheatbelt
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
Specialist Neurology (Adult)
Sessions / 1,000 population
0.30
0.25
0.20
0.15
0.10
0.05
8
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
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Specialist Obstetrics & Gynaecology (Females 15-54)
Sessions / 1,000 population
60.00
50.00
40.00
30.00
20.00
10.00
South West
Wheatbelt
South West
Wheatbelt
South West
Wheatbelt
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
Specialist Oncology (Adult)
Sessions / 1,000 population
6.00
5.00
4.00
3.00
2.00
1.00
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
Specialist Ophthalmology (Adult)
Sessions / 1,000 population
16.00
14.00
12.00
10.00
8.00
6.00
4.00
2.00
9
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
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Specialist Orthopaedics (Adult)
Sessions / 1,000 population
16.00
14.00
12.00
10.00
8.00
6.00
4.00
2.00
Wheatbelt
South West
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
Specialist Palliative Medicine (Adult)
Sessions / 1,000 population includes Telehealth
8.00
7.00
6.00
5.00
4.00
3.00
2.00
1.00
Wheatbelt
South West
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
Specialist Plastic/Reconstructive Surgery (Adult)
Sessions / 1,000 population
0.80
0.70
0.60
0.50
0.40
0.30
0.20
0.10
10
Wheatbelt
South West
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
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Specialist Psychiatry (Adult)
Sessions / 1,000 population
50.00
40.00
30.00
20.00
10.00
Wheatbelt
South West
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
Renal Medicine (Adult & Child)
Sessions / 1,000 population
10.00
8.00
6.00
4.00
2.00
Wheatbelt
South West
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
Specialist Respiratory (Adult)
Sessions / 1,000 population including Sleep Medicine
0.80
0.60
0.40
0.20
11
Wheatbelt
South West
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
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Specialist Rheumatology (Adult)
Sessions / 1,000 population including Telehealth
1.40
1.20
1.00
0.80
0.60
0.40
0.20
Wheatbelt
South West
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
Specialist Urology (Adult)
Sessions / 1,000 population
8.00
7.00
6.00
5.00
4.00
3.00
2.00
1.00
South West
Wheatbelt
South West
Wheatbelt
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
Specialist Vascular Surgery (Adult)
Sessions / 1,000 population
1.00
0.80
0.60
0.40
0.20
Pilbara
Midwest
Kimberley
Great
Southern
Goldfields
0.00
REPORT END
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