Special issue: Trans-Tasman Issue.

Abstract

This special issue represents a collaboration involving the New Zealand (NZ) Rural General Practice Network, Rural Health Alliance Aotearoa NZ (RHAANZ) and the National Rural Health Alliance (NRHA) in Australia. It is envisaged that this will be the beginning of an ongoing Australasian focus for the Journal. In this issue, some of Australia's and NZ’s most prominent rural health researchers and leaders have provided complimentary trans-Tasman commentary on a range of important rural health topics. The topics cover rural health delivery, advocacy, policy and education for a range of health professional groups, as well as original research. Few countries have as much in common as Australia and NZ, including the way their health and education systems are organised. Given the commonalities, the differences in rural health highlighted in this special edition are surprising. David Lyle and Jennene Greenhill outline the history and the achievements of the university Departments of Rural Health and the Rural Clinical School Programs, a collective ‘critical mass’ of academic health activity now embedded in rural communities across Australia. John Burton and Martin London have been advocating over a similar period for similar initiatives in NZ,1, 2 where progress has been much slower. The proposals from NZ universities currently being taken to government is a positive step, but there is no immediate prospect that they will receive the funding they need. This underscores the important role of rural health advocacy and the successes of the NRHA that Lesley Barclay and Gordon Gregory outline in their article. This includes the publication of the AJRH. The initiative taken by the RNZGPN and RHAANZ in sponsoring this edition of the Journal is encouraging. At the same time, it is disappointing to hear from Martin London that the NZ equivalent of the NRHA, RHAANZ, has gone into ‘hibernation’ because of a lack of funding. John Wakerman and John Humphreys discuss the development of the Modified Monash Model, an evidence-based rural typology that has been adopted by the Australian Government. In an accompanying commentary, Dave Fearnley discusses the implications of not having a fit-for-purpose rural urban classification in NZ3 and Jesse Whitehead presents early work to help rectify this. Other articles co-authored by Australian and NZ authors suggest that in paramedicine (O'Meara & Duthie) and in efforts to improve the physical health of people living with mental illness (Roberts et al.), the similarities outweigh the differences between the countries. Given the documented disparities, improving health outcomes for rural Māori and Aboriginal communities must be the top priority for all of us working in rural health research or clinical practice. Although Māori students are now entering NZ medical schools in much greater numbers,4 the short report by Yassar Almari raises the concerning possibility that Māori students may be less likely to take up careers in academic medicine. Marara Koroheke-Rogers and Katharina Blattner also remind us that partnering rural Māori communities in research involves much more than following university and ethics protocols and necessitates engaging in the processes that belong to that community. This article is presented alongside the results of the original research into rural point-of-care ultrasound (Nixon et al.) and a commentary by Kate Senior. Two guest editors were appointed, Dr Garry Nixon (University of Otago) and Associate Professor Oliver Burmeister (Charles Sturt University). Associate Professor Burmeister is a technologist who specialises in health care technologies. He has previously published in AJRH5 and has collaborated with various health care professionals for publications in clinical journals,6-9 as well as in technology journals.10-14 Dr Nixon remains in active clinical practice as a rural generalist at Dunstan Hospital in Central Otago, NZ. He was recently appointed as Head of the new Section of Rural Health at the University of Otago. His interests include the vocational training of rural generalists and rural versus urban disparities in NZ, with particular focus on improving access to diagnostic services for rural populations.