Submission No 136
INQUIRY INTO FOUNDATIONAL AND DISABILITY SUPPORTS AVAILABLE FOR CHILDREN AND YOUNG PEOPLE IN NEW SOUTH WALES
Organisation: Australian College of Rural and Remote Medicine (ACRRM) Date Received: 25 September 2026
25 September 2026
Ms Natasha Maclaren-Jones Chair, Select Committee on Foundational and Disability Supports Available for Children and Young People in New South Wales, Legislative Council NSW Parliament House
Via Email:
Dear Ms Maclaren-Jones
ACRRM Submission to the Select Committee on Foundational and Disability Supports Available for Children and Young People in New South Wales
The Australian College of Rural and Remote Medicine (ACRRM) welcomes the opportunity to respond to this inquiry. In this submission ACRRM provides comment on issues of the inquiry that fall within its scope of operations in both the New South Wales (NSW) and national context, noting the complex intersections between state and Commonwealth funding arrangements, as well as disability services and the broader health system. This includes comments that relate to the following Terms of Reference:
(a) the role of such services and supports on a child’s overall development, health and wellbeing
(b) the types of services and supports available and measures to improve effectiveness, availability and access of such services and supports in metropolitan, regional, rural and remote New South Wales, including medical, community-nursing, allied health services, NDIS services and other service delivery models
(c) the role of diagnostic services, existing gaps and barriers, and measures to improve effectiveness, availability and access of such services
(g) workforce issues in the child development and early childhood intervention sectors, including workforce demand and the availability, quality and capacity of existing workers
About the Australian College or Rural & Remote Medicine (ACRRM)
ACRRM’s vision is for ‘Healthy rural, remote and First Nations communities through excellence, social accountability, and innovation’. ACRRM plays an important role setting professional medical standards for training, assessment, certification and continuing professional development; and, providing quality education programs, innovative support, and strong representation and advocacy services for the dedicated doctors and the rural and remote communities they serve.
ACRRM is accredited by the Australian Medical Council to set standards for General Practice and the specialty of Rural Generalism. Programs are specifically designed to provide Fellows with the extended skills required to deliver the highest quality Rural Generalist model of care in rural and remote communities which, as will be further explored in this submission, often experience a shortage of face-to- face specialist and allied health services. Rural Generalists are also trained to provide advanced specialised care in at least one additional discipline, which may include paediatrics.
Australian College of Rural and Remote Medicine Limited ABN 12 078 081 848 acrrm.org.au
Children and young people in rural and remote areas
It is well established that people in rural and remote parts of Australia experience disability at notably higher rates than those in major cities¹. This also includes children who, in regions outside of major cities experience not only higher rates of disability, but poorer health and developmental outcomes, with the potential for lifelong challenges².
Children living in rural and remote areas are more likely to be developmentally vulnerable when they start school, with this vulnerability increasing with increasing remoteness - in 2015, children living in very remote areas were twice as likely as those living in major cities to be developmentally vulnerable on one or more domain(s) (47% compared with 21%) in their first year of school. They were also three times more likely to be developmentally vulnerable on two or more domains (31.8% compared with 10.2%)³.
Service access for children with disability and developmental delay in rural and remote areas
It is similarly well documented that accessing health and disability services and supports can be particularly challenging in rural and remote areas. Finding 3 of Report No. 1 of this Committee⁴ highlights that: “Families in rural and remote New South Wales face longer waits, higher travel burdens, higher out of pocket costs, and, in some cases, a complete absence of needed qualified expertise, services and supports compared to their counterparts in metropolitan areas of New South Wales”, alongside Finding 4 which notes that Aboriginal families who face complex and additional disadvantage are also more likely to live in rural and remote areas with limited access to services. ACRRM strongly supports these findings, and in particular Finding 7 that notes that in relation to accessing health and disability services and supports, workforce shortages have a particular impact on regional, rural and remote areas.
GPs and RGs are commonly the first interaction an individual has with the health system and hold a unique role in their community as one of only a few people available to provide medical care, often without the extensive range of support services available to practitioners in urban settings. This heightens and broadens their responsibilities.
Key to the aforementioned health workforce shortages is that of GPs and RGs in rural and remote locations. In 2023-24, 36.3% of regional, remote and very remote communities reported waiting longer for a GP than they felt was acceptable, compared to only 26% in major cities.¹ Longer wait times indicate a higher strain on services and, of particular relevance to this inquiry, a lack of access which has a direct
1 Australian Institute of Health and Welfare (2025) Rural and remote health Available: https://www.aihw.gov.au/reports/rural-and-remote-health?utm [Accessed 27 August 2026] 2 Arefadib, N. and Moore, T.G. The Centre for Community Child Health at the Royal Children’s Hospital and the Murdoch Children’s Research Institute (2017) Reporting the Health and Development of Children in Rural and Remote Australia Available: https://www.rch.org.au/uploadedFiles/Main/Content/ccchdev/CCCH-Reporting-the-Health-and- Development-of-Children–in-Rural-and-Remote-Aus-September-2017.pdf [Accessed 27 August 2026] 3 (2) 4 Select Committee on Foundational and Disability Supports Available for Children and Young People in New South Wales (February 2026) Foundational and Disability Supports Available for Children and Young People in New South Wales, First report Available: https://www.parliament.nsw.gov.au/parliamentary- business/committees/inquiry-details?committeeInquiryId=3080 [Accessed 11 August 2026]
impact on families seeking medical advice early in a child’s development, including diagnoses and referral to additional and support services.
ACRRM acknowledges that Early Childhood Education and Care (ECEC) services (such as preschool), and Early Childhood Intervention (ECI) services (such as allied health services and paediatricians) are recognised as a significant contributing factors to positive health and development outcomes. However, as for GP services, these can be hard to access in areas outside of major cities.
In a report for Royal Far West, the Murdoch Children’s Research Institute found that: “Children with a disability and/or developmental delay in rural and remote Australia, and their families, face multiple and concurrent barriers to accessing ECI services as a direct consequence of their geographical location”. These include (and are not limited to): travelling long distances, extensive waiting times and workforce shortages (including paediatric, allied health and mental health services for children) resulting in complications accessing therapy. This results in high levels of unmet need.5 These factors are shown to be contribute to lower ECEC participation rates. Indeed, the lack of access to comprehensive health care and early childhood education services for children in rural and remote areas has resulted in increased vulnerabilities in this population compared to their metropolitan counterparts 6 and much greater risk of poorer developmental outcomes with impacts on lifelong health and well-being.
Workforce and service solutions
ACRRM is strongly committed to training and building a national rural and remote network of RGs to provide their communities with sustainable, high-quality health services.
While in rural communities the critical role of strong GPs must be supported, the cornerstone of the RG approach is the creation of strong, comprehensive healthcare services, locally based and coordinated as much as possible. As such, ACRRM supports initiatives that strengthen the health system holistically, recognising that direct programs must be carefully designed to avoid placing additional pressure on existing organisational and workforce capacities.
ACRRM strongly supports building the RG workforce as a key strategy to increase access to health care services, including to improve access for children and young people with disability or developmental delays, and there is concurrently a pressing need to invest in strategies that build strong and sustainable rural health teams throughout the State. Workforce planning and policy should be designed with the goal of providing each community with a high-quality, locally based system of services in strong, team-based models. To better support areas of need for children and young people, particular focus needs to be brought to the workforce outside of more urban areas.
As such, ACRRM supports the following recommendations from the first report of the Committee:
Recommendation 5
That the New South Wales Government implement and fund a rural and remote access guarantee strategy for foundational supports, including outreach service models, telehealth
5 (2) 6 (2)
ACRRM
expansion, mobile allied health teams, travel subsidy enhancements, workforce incentives and regionally tailored commissioning to address geographic inequities in access and wait times.
Recommendation 14
That the New South Wales Government develop a cross-sector workforce strategy for foundational supports that includes a transitional fund for providers, pay parity initiatives, indexed funding rates, rural workforce incentives, student placement pipelines, supervision supports and joint workforce planning with health, education and disability sectors.
ACRRM particularly notes that there are a range of factors that encourage people to work and settle in a rural or remote location. The range of social issues which impact on the recruitment and retention of health professionals and trainees in rural and remote areas must also be acknowledged in distinctive approaches.
Stakeholder engagement and care coordination
In seeking to build the rural and remote workforce to better provide the necessary health, disability and foundational supports in NSW, ACRRM strongly encourages close engagement with communities and care providers. Engagement should include GPs/ RGs as they often reside and have a deep relationship with a community ,and understanding of the local health and support needs. ACRRM also strongly advocates for strong engagement with local First Nations groups, recognising the unique cultural, geographic, and socio-economic barriers there can be to accessing care. This requires tailored policy interventions and funding mechanisms.
Lastly, critical to the improvement of service access for children and young people requiring disability and foundational supports in NSW is the assurance of coordination, for individual patients and across care providers. Coordination across all levels of the health system is imperative, and especially important for rural and remote communities who regularly rely on cross-sector collaboration to maximise local capacity. From the general practice and primary care perspective, coordination between the public and private sectors is also important. This extends to robust communication systems to ensure comprehensive patient handovers that are key enablers of continuity of care.
Thank you for the opportunity to contribute to this consultation process. Should you have any further queries relating to this correspondence, please contact ACRRM at
Yours sincerely
A/Prof Rod Martin President
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