Australia’s country communities are facing a paediatric health crisis

Country communities are facing a paediatric health crisis, with NSW families waiting up to six years to access paediatricians, or being told that there is no local service at all.

Experiences in the early years of life form the foundation of our brain’s architecture, and we know that learning, behaviour and health across a person’s lifetime are all built on that foundation. Unfortunately, too many children are being left behind because they can’t access vital support services, simply because of where they live.

Evidence suggests a “confluence of factors” including the Covid pandemic and natural disasters have exacerbated developmental and mental health challenges for country kids. Teachers and early educators on the ground in rural areas are consistently reporting that following COVID lockdowns there are greater numbers of children they worry about, and these children are increasingly younger and more complex in their needs.

In response to this healthcare crisis, we are calling on the NSW Government to fund an expansion of our highly respected assessment service, to provide urgent paediatric behavioural, developmental and mental health support for regional and rural communities in NSW.

We are seeking funding for a three-year pilot to expand its multidisciplinary developmental assessment and treatment service, through the establishment of two new rurally based clinics in Wagga Wagga and Dubbo, that would support the Western NSW and Murrumbidgee regions – two of our greatest referral areas.

The innovative model is expected to improve early detection rates for children’s developmental and mental health needs and provide timely access to intervention – which is critically needed in these communities. With this, we aim to support 1,000 country children each year with vital assessment and treatment services, and capacity building for parents and caregivers as well as local health professionals.

Jacqueline Emery, CEO of Royal Far West, says this proposal is critical in ensuring country children are not left behind at arguably the time of greatest need given the events of recent years.

“We are regularly receiving calls from GPs, in despair about the lack of paediatric access and assessment support for children who are developmentally vulnerable. Paediatric waitlists have been an ongoing and worsening situation in many major rural centres. Our families, referrers, local government and state MPs have indicated their support for the proposal.”

Jacqueline Emery CEO of Royal Far West

Royal Far West has received confirmation from public and private paediatricians in Wagga Wagga, Dubbo, Orange, Tamworth and Bega that their books are either closed to children who require developmental support, or these children are waiting years for an appointment.

Over 60% of the families we currently support come from the Murrumbidgee and Western NSW regions. RFW’s proposed new model would allow us to see more families where they live and help country children access the services they need to thrive.”

Similar to the shortage of paediatricians in rural and remote areas, there is a shortage of allied health services – speech, occupational therapy and clinical psychology. These services also have long wait times, are long distances away or cannot see clients regularly enough to have an impact.

In the most recent survey of parent participation for our Manly assessment service, covering the past 18 months, over 80% of parents/caregivers surveyed said they experienced difficulties in accessing local speech therapy, occupational therapy or psychology services. The main difficulties faced were:

  • Over 70% said waiting times for local services were too long.
  • Nearly 60% said local services were inconsistent.
  • A third of parents surveyed said local services were too expensive and 30% said travel time and no local services were the main difficulties.

While our proposal is focused on health outcomes, it also has positive long term economic impacts. A substantial evidence base shows that if you start school developmentally vulnerable this will not change without adequate support. Not addressing these disadvantages has long term economic and social impacts.

Only 44.1 % of children living in very remote areas of Australia are developmentally on track compared to 56% in major cities, and that gap is widening.


  • of children in the lowest Year 4 NAPLAN Band, only 47% are expected to complete their HSC.
  • poor developmental outcomes increase the risk of adverse long-term impacts such as chronic illness, unemployment, mental ill health, substance abuse, homelessness, and incarceration – representing significant downstream costs to government.

International cost benefit analysis shows that for every dollar spent on effective early childhood intervention, there is a $13 to $25 return to society.

For more information on Royal Far West’s Child & Family Services Click Here