Is it time to revisit “Rural Proofing” of all Australian governments’ policy development and implementation?

In the February 2019 editorial “Heating up rural policy climate,”1 the Editor discussed the fish kills in the Murray Darling Basin in January 2019 and highlighted the fact that Commonwealth and State governments had failed to implement, monitor and regulate policy. The outcomes splashed across the media and continue to have direct social, cultural, economic and environmental impacts on rural communities. The editorial also highlighted that so many policy decisions are made for rural communities by decision makers in capital cities, many of whom have little understanding of the rural context in which they are proposing to implement their policy. Could “rural proofing” government policy development and implementation mitigate against this? The National Rural Health Alliance describes rural proofing as a way to “…ensure that the needs and interests of rural people, communities and business are properly considered in the development and implementation of all policies and programs – and that those policies and programs are amended if damage is likely to be done.”2 Essentially, rural proofing is a process to assist policy-makers to identify specific rural community needs and rural factors that influence policy design. It embodies investigation to determine if the policy is appropriate and will work in a rural setting, and seeks to identify and overcome barriers to policy implementation. This process provides the opportunity to avoid unintended consequences and to tailor policy solutions to ensure rural communities are given a fair deal, socially, culturally, economically and environmentally. The concept of rural proofing is not new. In the late 1990s, Canada's Rural Secretariat introduced the “rural lens” as a tool for government departments to apply to government policy development. The UK introduced “rural proofing” to all government policies in the early 2000s. Norway, Sweden, Finland and New Zealand followed. South Africa introduced rural proofing specifically for health policy alone. In Australia, the notion of rural proofing has been proposed by several organisations: the National Rural Women's Coalition3, the National Rural Health Alliance (2015) and the Rural Doctors Association of Australia4 but the concept has not gained political buy-in. The concept of rural proofing is complex and variable. The different rural conditions of each country inevitably have produced different rural proofing policies and considerable variation in how each is implemented. Despite this, two common characteristics can be observed: there is a shared commitment that rural proofing can ensure that rural communities receive comparable policy treatment and receive equitable access to policies and programs5; and, each country has a government agency that has responsibility and governance for implementing, monitoring and reporting on the rural proofing policy. Studies examining the effectiveness of rural proofing policies have shown variation in the levels of success and yet the respective governments have continued to refresh and reinvigorate their respective rural proofing policies. In doing so, they send a message to the public and to government departments that rural has value. However, there have been many challenges in implementing rural proofing approaches. Evaluation of Canada's experience in implementing the rural lens offers valuable lessons.6 Implementing rural proofing policy requires a process to assess, monitor and report. Australia has experiences in implementing a range of impact assessment tools eg, for Health, Environment or Regional Impact assessment that have been effectively used to provide a process for evaluating the potential impacts of proposals for a policy, program or service. Rural proofing has synergies with these approaches, particularly as it needs much more than a tick box exercise. In gaining government department buy-in, the Health in all Policies approach championed by the South Australian Government provides a good example of how rural proofing in all policies can enable policy development across government. Translating policy from other countries by making some adaptations and expecting the same results is a flawed approach to policy design, given that economic, political, systems of government, social, ideological and spatial contexts are so vastly different.5 For rural proofing to work in Australia, there needs to be a rural and remote health champion at the federal level. The rural health champion would be well assisted by a national rural and remote health strategy which the Alliance et al7 have long advocated for. Achievement of this major innovation might not be too difficult, as there are some potential policy levers in place that could support a rural proofing approach. For example, through the federal government Minister for Regional Services, Sport, Local Government and Decentralisation or the National Rural Health Commissioner. Rural communities in Australia are facing ongoing and emerging eco-social pressures that are outside of their control eg, from climate change, population shifts and social and health inequities. To meet the needs of rural communities, policy formation must take into account the diverse rural factors and founded on the premise that no matter where they live, so that all Australians should have a reasonable ability to live, work and run businesses and fully contribute to society.8 Implementing a rural lens through a rural proofing policy could be one way to redress inequity and ensure that rural communities do get a fair deal.

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