There are six key questions being asked by parents, clinicians, academics and advocates in relation to the paediatrics health crisis faced by families across regional NSW.
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As children with significant developmental challenges continue to wait up to six years to see a pediatrician in regional NSW, doctors plead for help and experts point to a clear link between the lack of access to child health services and growing youth crime rates, ACM posed these six critical questions to Premier Chris Minns.
The questions and background behind them are listed below, along with Mr Minns' response.
1. Will you commit to funding Royal Far West's submission for regional paediatric support clinics in Wagga and Dubbo?
The average wait time to see a paediatrician is 18 months in rural areas and in some parts of NSW families are being told there is no local service at all.
Royal Far West is seeking funding for a three-year pilot to expand their treatment service based in Manly with two new rural-based clinics in Wagga and Dubbo.
2. What do you say to the dozens of regional families, many of whom we have written about over the past few weeks, who are struggling to access and afford basic paediatric services for their children?
Families that ACM spoke with expressed widespread frustration with the lack of services.
One parent who didn't want to be identified said they were at their "wit's end".
"We have three kids, two with autism and a third with behavioural issues," the mother said.
"We can't use telehealth because our children don't interact with a screen. We need face to face," one mother said.
Part of the problem, they say, is that medical specialists don't stay in the town for longer than a year.
However, the families said Royal Far West service in Manly was akin to "finding a piece of gold", but they had to travel there.
3. Is it acceptable that, based on expert data, child health and development outcomes in regional and remote NSW trail those of kids in the city and the gap is widening?
Children living in very remote areas of Australia are up to twice as likely to start school developmentally vulnerable than city kids, according to the Australian Early Development Census in 2021 which is conducted every three years.
And fewer kids living in regional and remote NSW are on track for key developmental milestones when starting school, compared to their city counterparts.
That includes physical health and well-being, social competence, emotional maturity, language and cognitive skills and communication skills and general knowledge.
Anecdotal evidence suggests a "confluence of factors" including the COVID-19 pandemic and natural disasters had exacerbated the developmental challenges for country kids.
4. Carers, clinicians, educators and academic experts all point to a significant link between lack of access to child health services and growing youth crime rates. Do you agree that a lack of paediatric services may be affecting youth crime rates in regional NSW?
The lack of services in regional NSW is contributing to the youth crime epidemic in the bush.
From 2019 to 2023, the rate of young people coming into contact with police in regional NSW increased by 9.2 per cent, compared to Sydney, which dropped by 3.8 per cent.
Wagga paediatrician Dr Theresa Pitts said if developmental issues are not tackled before school it could lead to significant problems at school and potentially lead to the child leaving school early and other societal issues.
Head of the Discipline of Psychiatry and Mental Health at the University of New South Wales, Professor Kimberlie Dean told ACM that children who display "vulnerabilities as far back as their first year of school are more likely to find themselves in very early contact with police".
"If we are going to prevent ongoing contact with the justice system, we need to go intervene with children and families in early life," said Prof Dean, who was the lead author of a study of 79,000 children looking at the link.
"We know that people with mental health problems are more likely to have contact with the criminal justice system in adulthood and adolescence, but this study indicates that the association can begin much earlier in life," she said.
John Southon, of Trundle Central School, said the resulting paediatric crisis "absolutely" led to more youth crime.
"If you've got a child that has a disability and that stops them from reading, and they become an angry young man, where do you think that's going to go as a society?" Mr Southon told ACM.
5. You have pledged to toughen bail laws as a measure to tackle the regional youth crime epidemic. What do you say to those saying you need to focus on prevention, too, and improving access to kids health services is key to this?
Youth crime rates have risen statewide according to the NSW Bureau of Crime Statistics and Research.
From 2019 to 2023, the rate of young people coming into contact with police in regional NSW increased by 9.2 per cent, compared to Sydney, which dropped by 3.8 per cent.
The Orana Far West (encompassing Dubbo, Cobar and Broken Hill) is by far the worst area.
NSW Police Assistant Commissioner Gavin Wood told ACM that children as young as 10 are stealing cars and using them in "different and varying" types of crimes.
While police aim to disrupt crime, "diversionary" practices also need to be considered, he said.
"We need to look at where we can get in front of these kids and divert them from the criminal justice system. In the longer term that is a better result for everyone."
6. Health Minister Ryan Park has pointed to general funding increases to increase access to GPs, hospital staffing and other measures to improve outcomes in the regions. While these are all welcome and required, you have yet to identify specific strategies to improve access to paediatric services. What new measures will the government take to alleviate this crisis?
NSW health minister Ryan Park told ACM last month he recognised the challenges many regional families faced on getting an appointment with a paediatrician, but did not commit to Royal Far West's proposal.
Mr Minns declined to provide specific answers to any of these questions.
In response he told ACM there was "always more to do" and the government was committed to ensuring people had access to services wherever they live.
"Since forming government we have started to rebuild the health system, including recruiting 500 regional paramedics, providing financial and non-financial incentives for health workers to move to our regions and expanding virtual care statewide so kids and families in the bush can receive care closer to home," he said.