A parliamentary committee finds NSW Health has been too slow to safeguard rural and regional healthcare services. And key stakeholders dispute the Ministry’s claimed successes.

Access to health care in remote, rural and regional NSW is in decline, with maternity services and mental health care now reaching a crisis point.

So said the Legislative Assembly Select Committee on Remote, Rural and Regional Health in a report published in March.

The Committee was established to monitor the implementation of recommendations handed down in a landmark 2022 Legislative Council report Health outcomes and access to health and hospital services in rural, regional and remote NSW.

The NSWNMA made a number of recommendations in a submission to the Committee last year. The Committee’s March progress report singled out maternity and mental health services for special mention.

“The Committee was particularly concerned about the closure of birthing and obstetric units in rural and regional hospitals, and escalating workforce shortages that are impacting on mental health care,” said Committee Chair Dr Joe McGirr, Independent member for Wagga Wagga.

In a foreword to the report, Dr McGirr said the Committee was “deeply troubled to hear that access to many specialist services has declined over the past two years, with many rural and regional health services in crisis”.

He said the Committee was concerned that “the intent” of many recommendations of the 2022 Legislative Council report “remains unfulfilled, despite NSW Health reporting that these recommendations have been implemented”.

“There continues to be a significant divide between the progress that NSW Health is reporting and the picture being painted by key stakeholders in the regional health system.”

Dr McGirr said NSW Health was “still not approaching some areas of regional health reform with an appropriate sense of urgency”.

“Workforce shortages continue to hinder the delivery of specialist services, and crisis levels have been reached in specialties such as obstetrics and psychiatry.”

Mental health services “are being impacted by significant and escalating workforce shortages” and

NSW Health should prioritise the development of “a comprehensive, long-term workforce strategy for mental health services across remote, rural and regional NSW”.

Dr McGirr said there was “a genuine desire and willingness” among health workers to improve the condition of rural and regional health care in NSW.

“However, the challenges that we have highlighted in this report cannot be addressed by LHDs alone, and urgent action is needed at the statewide level to address these challenges.”

The report made 32 recommendations to the NSW government, including:

• urgent development of a statewide plan to maintain and re-establish maternity services
• measures to address shortfalls within the obstetric and midwifery workforces, as well as gaps in rural and regional paediatric services
• development of a long-term strategy for developing the mental health workforce.

Maternity services closing down

A snapshot of maternity services in decline:

• Gosford Private Hospital – birthing services closed March
• Inverell Hospital – on bypass for birthing since 2024 (no anaesthetic cover).
• Muswellbrook – closed for birthing since 2022.
• Parkes Hospital – on bypass for birthing since 2019. The town’s sole obstetrician resigned in January 2025 leaving Parkes without obstetric services.
• Sydney Southwest Private Hospital – maternity services closed December 2024.
• Wyong Hospital Birth Centre – closed

MATERNITY SERVICES AT GOSFORD HOSPITAL HAVE BEEN IMPACTED BY THE CLOSURE OF MATERNITY SERVICES AT WYONG AND GOSFORD PRIVATE.

Decline in private births burdening public system

Public maternity services are coming under additional strain from the escalating closure of private maternity services.

The shutdown of private birthing units is “set to blow the national health budget unless there is an urgent fix”, The Australian reported in April.

Even on relatively conservative estimates, the decline of private births could cost taxpayers an extra $1billion a year, The Australian said.

The paper cited an economic analysis of birthing trends by Monash University professor Emily Callander.

Her analysis showed that “if a 50 per cent decline in births in the private system were to eventuate – a not unrealistic estimate – then taxpayers would subsidise public system antenatal care and labour ward delivery to the tune of $1billion annually”.

“Many thousands of women would be left with little option but to rely on public hospital antenatal clinics and to give birth in public labour wards.”

The Australian quoted Professor Callander as saying that a 10 per cent total decline in private birthing units would cost the public health system an extra $189 million per year.

“If there were a 30 per cent decline, taxpayers would foot a $380 million bill. If there were a 50 per cent decline, public hospital costs would soar to just shy of a $1 billion increase per year, increasing to $1.5 billion if private birthing became extinct in Australia.”