The National Rural Health Alliance (NRHA)’s Chief Executive of 23 years, Gordon Gregory OAM, has retired.
His career was celebrated at Old Parliament House on 9 June 2016 (#thanksgg) at an event attended by colleagues and well-wishers from around Australia, including his long-time boss and former Hawke Government Minister John Kerin AM. The following is an abridged extract of his comments.
On this embarrassing, but extremely gratifying occasion, those of you who know me might expect three things: some personal observations on rural and remote health and the NRHA, some professional observations, and some specially composed doggerel of dubious taste but acceptable rhythm.
Let me not disappoint.
Firstly, I would like to thank all of you for paying me the great honour of being here this evening. Against the possibility that I would be too overcome to say anything, I have prepared a special PowerPoint. It says a big ‘thank you’.
This afternoon we held a webinar on the past, present and future status of the rural and remote health sector. Its premise was that there is such a sector and that it is relatively coherent. What this means, among other things, is that the disparate groups living in and concerned with the health and wellbeing of rural and remote communities regularly demonstrate the capacity to come together, to speak with one voice and to overcome the differences determined by place, circumstance and profession.
I see the work I have done with the NRHA as a contribution to a segment in time of the history of a sector which has almost natural coherence. Natural in the sense that it is caused partly by nature, by distance, by shared deprivation and challenges, by equivalent delights and advantages, and by observances which transcend locality.
I believe that the rural and remote health sector owes its coherence to some of the characteristics of rural and remote Australia as a whole. As Bruce Chater said at the time, the first National Rural Health Conference in Toowoomba in 1991 saw not so much the birth as the renaissance of the rural and remote health sector. Rex Walpole’s Country Towns, Country Doctors had gone before in 1978 and no doubt other such meetings before then which are now beyond our recall.
Neither Rex Walpole nor the Steering Committee for the 1991 conference created a caring rural health sector. But both did an important service: they galvanised its members at a particular point in time, in the context of cultural, professional and communications norms of the period, in the hope of achieving – mainly through governments – changes which would underpin more localised action to improve the wellbeing of country people.
One of the significant changes in the context for these activities was the establishment of an organisation capable of maintaining a high level of activity between the bursts of energy displayed by particular leaders at particular times.
This has been the role of the National Rural Health Alliance.
The Alliance’s work has been based largely on collegiality, widespread support at all levels, common sense and much hard work. Unlike Foy Vance’s daughter, it is not sufficient for the NRHA just to be. It must engage, observe, listen, create, speak and act.
The role of people here this evening has been critical, but others have done just as much and will continue to do so in the future. For those who see yourself as a health consumer, or a clinician, manager, academic or researcher are representative of a thousand more who contribute in similar ways but may not know the Alliance or its staff.
To be sure that we are part of a larger coherent whole, we have to see, hear and feel evidence that the common purpose can indeed triumph over difference. In Australia, the greatest challenge of this type seems to be between people of different cultural background and origin. For too long this has been experienced as a gap in understanding between Indigenous and non-Indigenous people.
For the NRHA, it is a matter of significance and pride that its 12 founding members included the Aboriginal and Torres Strait Islander Commission (ATSIC), established in 1990, and the National Aboriginal Community Controlled Health Organisation (NACCHO), established in 1992. The NRHA has maintained respectful, persistent and faithful support for improvement in the living circumstances, health and wellbeing of Aboriginal and Torres Strait Islander people – but without the satisfaction of major success. There is more and different to be done.
Wherever you believe the rural and remote health agenda is, the NRHA has played a leading role in getting it there. I was frequently asked to what extent our issues were “on the political agenda” – with any reasonable answer requiring a level of prescience, faith and inside knowledge beyond the NRHA’s competence.
What, then, have been the achievements of the NRHA?
It has been and is an identifiable entity to which Ministers, Shadow Ministers, departments, research agencies, students and the media can go for information and views on all aspects of rural and remote health and wellbeing.
It can take the credit for some specific programmatic initiatives being established and/or maintained and/or grown. These include programs which have in effect extended the Commonwealth Government’s engagement to allied health and nursing in addition to general practice. Programs for general practice recruitment and retention have generally been retained and occasionally improved, as with the shift to the Modified Monash approach to the classification of rurality.
The NRHA has mandated, legitimised and supported the development and operationalisation by others of a multidisciplinary professional approach to health practice, particularly in rural and remote areas.
It has taken the biennial conference from which it sprang and shaped it into an event of outstanding effectiveness, interest and fun which many now see as the gold standard in such events. This could not have happened without the skills and industry of Lynne Eiszele and Leanne Coleman.
Working with tireless editors and John Wiley & Sons, the NRHA has nurtured and sustained the Australian Journal of Rural Health.
It has set and maintained high standards in the quality, feel and content of its other publications, including the website.
It has been an exemplary, effective and approachable manager of the Rural Australia Medical Undergraduate Scholarship scheme through which some 2,000 medical students have passed, as well as Stream 2 of the Rural Health Continuing Education program.
Through its behaviour, the NRHA has given the rural health sector a reputation for reasonableness, approachability, and a positive and creative approach to the challenges in rural health. This has from time to time disappointed those who would prefer to march in the street, shout loud and, if necessary, make enemies in the course of seeking amends. But even they have usually been won over through the persistent making of strong, warm relationships.
More broadly, the NRHA has given alliances a good reputation and has led the way in developing effective modus operandi for organisations that want to combine with others in common purposes. Bodies such as the Mental Health Council of Australia, the National Aged Care Alliance, the Australian Health Care Reform Alliance, and the National Rural Women’s Coalition have sought start-up advice from the NRHA and benefited from learning about issues that crop up in the early years of a new combined body.
The NRHA has been the reason for a number of professional bodies sharpening and expanding their focus on their own rural and remote members. Services for Australian Rural and Remote Allied Health (SARRAH) was established (largely through the work of Michael Bishop) in order to give individual allied health practitioners a voice within the NRHA.
The NRHA has provided an experiential training ground in some of the realities of political action for its organisations and members of its Council. There must be 600-800 people who have served some time on Council of the NRHA, all of whom have contributed something and very often have learned a great deal.
Summarising the good and bad
The good things about working for the NRHA include:
- the unequivocal support of the sector and a broad consensus around the justness of the NRHA’s purpose
- the smorgasbord of activity, ranging from policy work through communications, to networking and representation, writing and design, to desk research and meetings with Council, colleagues and others
- the very broad range of policy content, including all of the social determinants of health and wellbeing
- the capacity to sing shanties in the lunch hour
- a collection of brightly coloured conference t-shirts
- building relationships and making friends
- Andrew Phillips and Helen Hopkins
- the people one meets and the people one doesn’t who support the cause and, although sometimes complaining, never give up.
The bad things about working for the NRHA include:
- tracked changes from multiple sources
- not being able to have a personal opinion
- knowing that many of the same problems exist now as when Country Towns, Country Doctors was held
- professional boundaries and
- frustration over the use and misuse of the terms ‘primary care’ and ‘primary health care’.
And some doggerel
Fittingly, Gordon finished his address with some doggerel in iambic heptameters, ending as follows:
So thanks to all of you tonight – I really am impressed
With friends like you my future life will surely be quite blessed
Good luck to future leaders right across the Commonwealth
We know you’ll take the challenge up of universal health.
Please take away one message – once again it’s shown just here:
(You always need proportion if you mean to be quite clear)
I offer all a thank you – and a big one it is true
Many things I will not miss – but I will miss all of you.
Congratulations and best wishes go to Gordon and his family.