Topic: State and Territory Elections
Kai Coff is accessing gender-affirming care via an interstate provider. ( ABC News: Grace Marshall )
Regional Victorians and healthcare providers are advocating for improved access and funding to reduce health inequality ahead of the November state election.
Victorian Alliance of Rural and Regional Community Health (ARRCH) chair Sean Duffy said population health data across the country shows people living in rural and regional areas have a lower life expectancy.
"People living in remote Victoria are living somewhere between five and seven years less than people in Melbourne," he said.
The alliance said this inequity in life expectancy was due to a delayed healthcare response in the regions.
"I think it's a difficult conversation to confront," Mr Duffy said.
"Whether it's access to emergency departments or ongoing treatment of a chronic condition, people in rural and regional Victoria are disadvantaged."
Factors such as higher rates of chronic diseases including diabetes, respiratory conditions, cardiac conditions and higher rates of obesity were leading to shorter life expectancies, the alliance said.
"We know that with the available supports in rural Victoria, it's near or impossible for people to access specialist support," Mr Duffy said.
He said he was advocating for a separate funding model which "could see a reduction in the inequity between life expectancies".
"It is so much more expensive to deliver services, and it is so much harder to recruit the professions," Mr Duffy said.
"Less than 1 per cent of the total health budget in Victoria is spent on community health.
"If we shifted that to say 3 per cent, we will stop people going to hospital.
"And we will improve the lives of people."
Sean Duffy says your life expectancy decreases the further from Melbourne you live. ( Supplied: ARRCH )
For people experiencing homelessness, a regional postcode only adds to the inequity in health outcomes.
"The smaller health problems can quickly escalate," Council to Homeless Persons chief executive Deborah Di Natale said.
"It's harder to keep appointments if you don't have a phone or reliable transport.
Deborah Di Natale says health care is often not a priority for those experiencing homelessness. ( ABC News: Jesse Thompson )
According to the 2021 Census, approximately 30,000 Victorians were without a home.
The Council to Homeless Persons said it was advocating for a Victorian homelessness strategy.
"That's because homelessness creates severe physical and mental health impacts.
"I would like all political parties to commit to a Victorian homelessness strategy that would enable us to approach homelessness as an all-of-government response.
"Every Victorian deserves the dignity of a home."
In Central Victoria, Bendigo Community Health Services (BCHS) said it was seeing success in a trial program that supports people sleeping rough with access to mental and physical health care.
BCHS chief executive Mandy Hutchinson said at least four lives had been saved as a result of the program in the initial months of the trial.
"People that are sleeping rough are getting to their appointments now," Ms Hutchinson said.
"It's been a real win for people getting better access.
"We're putting in our own resources to try and get a better system in place because the system's currently failing."
A complex health system is made more difficult when English is a second or third language.
Ethnic Council of Shepparton and District case manager Abdullah Naveed spends his spare time supporting migrants and refugees through the health system.
Mr Naveed immigrated to Australia in 2014 and speaks five languages, including Afghan languages Dari and Pashto as well as Persian and Urdu.
Interpreting is not his job, but Mr Naveed said he received "many many calls whilst people are with GPs requesting interpreting via the telephone".
"They don't have any other facilities."
Abdullah Naveed is translating important health care information to refugees and migrants in his spare time. ( ABC News: Rhiannon Tuffield )
Mr Naveed said low literacy and language barriers impacted migrants' ability to access healthcare.
"When the patient can't understand the doctor about the medication, about the next appointment or any other advice, then the patient suffers," Mr Naveed said.
"I try my best whenever I can, even when I receive calls at midnight."
In north-west Victoria, people accessing gender-affirming care have limited options.
When trans man Kai Coff first started looking for access to gender affirming care in Mildura, he could not find it.
After a recommendation from a trans friend, Mr Coff is now accessing gender affirming care via telehealth from a Queensland GP.
"This gender clinic was recommended to me by another trans person, and that was the only experience I had with outside help," he said.
But Mr Coff would prefer something local and close to home.
"If they say yes, good. If they say no, then find someone else.
"That's really all I've got at the moment."
Kai Coff's family has been extremely supportive in helping Kai navigate a complex and overwhelming health system. ( Supplied: Kellie Coff )
Findings from a 2023 Australian Institute of Health and Welfare study found easy access to gender affirming care was associated with lower psychological distress and suicidal thoughts.
Participants who were able to easily access gender-affirming care when needed were less likely to experience suicidal thoughts.
LGBTIQA+ Victoria commissioner Joe Ball said that all services were under pressure in regional Victoria but "to be LGBTIQA+ it's another pressure".
" There's a reduced number of services like GPs etc. in regional Victoria already," he said.
"LGBTIQA+ people might only have a small selection of people to choose from, so it's a compounded pressure that they're experiencing."
Mr Duffy acknowledged how difficult access to care was in regional and rural Victoria for trans people.
"It's impossible for transgender people to access specialist support right across regional Victoria," he said.
"More often than not, people have to travel, and they have to travel extensive distances.
"And there's extensive wait lists."
Joining a local Mildura theatre group was where Kai was first able to feel accepted. ( Supplied: Kellie Coff )
An uplift in funding for the community health sector in regional and rural towns would be transformational, Ms Hutchinson said.
"If we had an uplift we could be responding even better to what's happening in the community," she said.
"Our greatest hope is that we get some commitments from potential Governments to better support community health.
"The whole idea of our work is to try and keep people out of the health system if we can."
Mr Duffy said increasing the funding was a "no-brainer".
"Let's be proactive, let's intervene early," he said.
"We will stop people going to hospital."
In its campaign launch, Labor committed to slashing surgery waitlists by half, and a spokesperson said the party had delivered record health funding while in government and was aiming to also slash emergency wait times by 20 per cent.
Shadow health minister Georgie Crozier said the coalition would incentivise health professionals to work in regional Victoria through incentives of up to $10,000.
