The joint statement warned that people in rural and remote parts of the Wimmera are being denied the services they need, and that long term reform strategies are needed to address system inequities.

A series of reforms to the health sector, including the national roll out of Primary Health Networks in 2015, have led to increased staff turnover, decreased stability, and a need to compete against other health services for funding.

Grampians Pyrenees Primary Care Partnership Executive Officer Emily Anderson said the outcome of this is compromised patient care in rural and regional areas.

“Our rural health workforce is suffering. Gaps in specialist expertise, inadequate resources and training opportunities, and considerable staff turnover are the result of massive system changes over a consolidated period of time,” she said.

“This has lead to worrying levels of uncertainty and instability across the sector and compromised patient outcomes, particularly in rural areas. In a time of escalating chronic disease and immense health reform the health and social service sector needs to be supported by long term strategic policy, training and sector development.”

Ongoing shortages of qualified specialists and general medicine practitioners have been a key election topic, with both major parties pledging to make changes to the current system. 

Read more: Pledge for patient transport subsidies.

Grampians Community Health Chief Executive Greg Little said policymakers and political leaders need to realise that rural and remote is not the same as regional, and that funding needed to be targeted appropriately.

“People in small rural communities have the same right to access services as those in metropolitan or regional communities," he said.

"The tyranny of distance, poor digital connectivity and a lack of public transport require government to ensure local services can extend into these areas.

"This can be achieved by adequate funding that measures the outcomes for rural people, not just how many people come through the door.” 

Under the current reforms, designed to enhance sector efficiency, some of the most vulnerable clients falling are through the cracks, including those with disabilities, said Grampians Disability Advocacy's Deb Verdon.

“At every turn a person with a disability is asked to provide medical evidence about their situation, be it by Centrelink or the NDIS," she said.

"Reports from GPs are no longer good enough. Support agencies demand a report from a specialist, but where are the specialists to be found?”

Read more: More paramedics for Ararat under Labor.

Ms Anderson agreed that the reforms meant those with disabilities and other complex issues struggled more to find support. 

“There’s been quite a shift since the formation of Primary Health Networks about three years ago,” she said.

“It’s a reflection of government improving their processes and making organisations more accountable, which is a good thing, and it’s also giving health care consumers greater choice, but the way they’ve rolled that out has been super problematic for everyone.

“For example, with the NDIS it puts a lot more of the coordination and understanding (of the system) on the client, family or carer rather than the health organisations themselves. For some people that’s a really good thing because they’re really across it but for others it’s a really big ask to manage all of that themselves and have the understanding of what they can choose from. 

“It means some families who are more vulnerable … have to be really informed of the changes and the process, in a system where health workers still aren’t really across it and are confused. So when the sector’s confused how can we expect people to be across it?”

Ms Anderson also said changes to the way funding is acquired has increased pressure on the sector.

“Australia wide, services are now required to do more tendering to provide more services rather than historical or traditional processes of assigned funding,” she said.

“We have to put in a business case and go against each other, which has really impacted the health sector.  

“Many organisations are restructuring because of health reforms, and financially the pressures are so many, which then creates more instability.

“Local (practitioners) are doing everything they can – we just need to raise awareness that there are serious challenges across the sector.” 

Read more: Coalition’s $1m doctor shortage plan. 

Victorian Council of Social Service Chief Executive Emma King said policymakers and political candidates must listen closely to the voices of regional communities.

“People in local communities are best placed to identify local challenges and develop local solutions,” she said.

The organisations which issued the statement were Grampians Pyrenees Primary Care Partnership, Women’s Health Grampians, Grampians Disability Advocacy, Grampians Community Health and the Warracknabeal-based disability organisation Woodbine, and the joint call was part of the organisations’ membership of the Victorian Council of Social Service, the peak body for the state’s social and community sector.