"There is a shortage of paediatricians in regional areas and children are being left un-diagnosed with behavioural issues until they are adults."
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Those words were published by ACM's Daily Liberal in July 2023, when Royal Far West (RFW) CEO Jacqueline Emery and Regional Education Commissioner Fiona Nash visited a school in Narromine to highlight their concerns with an alarming shortage of paediatric appointments state-wide.
Now Ms Emery and her organisation are again trying to shine a light on what can be done.
Ahead of the NSW state budget, RFW hopes to expand their service to Dubbo and Wagga Wagga and $6 million is what it would cost the state government to help fund the two new assessment centres for children in regional NSW.
RFW operates one assessment centre, at Manly on Sydney's northern beaches. But more than 60 per cent of families it helps with are coming from the Western and Murrumbidgee health districts.
The charity is calling on the government for funds to set up a three-year pilot program to expand its developmental assessment and treatment service.
In 2023 it received 346 referrals, but the proposal to the state government says many more children are precluded from gaining any access to developmental services due to critical paediatric and allied health workforce shortages.
In Dubbo alone, there has been difficulty in filling paediatric positions making it harder for families to seek help.
"Paediatricians have reported to us that the most complex families are not reaching our service as the barriers to travel to Manly are too high," the RFW proposal said.
In the July 2023 interview with the Daily Liberal, Ms Emery, spoke passionately about the challenges faced by children and families in the region.
"We've always worked with children with complex developmental challenges, but the additional stresses families have faced in recent years have exacerbated a lack of capacity for families to best support kids with developmental challenges," Ms Emery said.
The increased complexities faced by families have led to a surge in the demand for paediatric services, which has put additional strain on an already "dire" situation.
As Ms Emery pointed out, almost every paediatrician across the state in rural and remote areas has either closed their books completely or has an 18-month to four-year waitlist.
The Manly clinic has been co-funded by NSW Health for more than two decades and the charity said the extension of this service would require an uplift from the government of up to $6 million per annum by the 2027 financial year.
The proposed Dubbo service would delivered by a full RFW Child and Family Multi-Disciplinary Team.
RFW said the new model would allow it to see more families where they live and grow its service capacity.
The RFW team will be a combination of local staff, telehealth and outreach and in some cases, assessment in Manly may be required.
RFW said the Dubbo-based team would work with local services and clinicians throughout the assessment process, including case conferencing.
The local team should include a clinic nurse co-ordinator and care navigator role, as well as an indigenous health officer.
Children would be discharged to local services for treatment where possible. Where there are gaps and no local services are available, children may be offered treatment and care from RFW (including NDIS).
NSW health minister Ryan Park told ACM he recognised the challenges many regional families faced in getting an appointment with a paediatrician but did not commit to Royal Far West's proposal.