1 0 th NA TIO NA L RURA L HEA LTH C O NFERENC E 1 Human rights: the way forward for health equity in rural and remote Australia? Julaine Allan 1 , Patrick A Ball 1,2 , Margaret Alston 3 1 The Centre for Inland Health, Charles Sturt University, 2 School of Biomedical Sciences, Charles Sturt University, 3 Department of Social Work, Monash University Abstract Australia has a poor human rights record. This is demonstrated by the 17 year gap in life expectancy between Indigenous and non-Indigenous Australians. The health of rural Australians continues to be poorer than urban Australians. While rurality is identified as a factor affecting both health status and human rights there is limited attention given to it in the Australian research literature. The Australian government is a signatory to the UN Declaration of human rights. Health is identified as a critical component of that declaration. However, the declaration does not currently influence the planning or delivery of health care. This paper argues that a rights-based approach to health has significant benefits in planning and delivering health services to rural and remote Australia. Firstly, the social, cultural and economic factors affecting health can be addressed. Secondly, those most affected by poor health are not responsible for lobbying for more or different services. Thirdly, a minimum standard of health care access and availability directs the allocation of resources. Finally, an holistic view of an individual’s care and support needs prompts innovative strategies for transport and accommodation for example. International examples of rights based health care from the World Health Organization and The International Federation of Social Workers are described. The process of enacting human rights principles for Australian health is discussed using case examples from different stages in the lifespan. Introduction Delivering public services to people in rural areas at a basic minimum standard is a problem facing not just Australia but countries right across the world. The OECD argues that these problems need to be addressed using place-based solutions, service delivery innovation and resource pooling to find acceptable solutions. 1 However, in Australia we have a top down approach to service policy and planning that is unable to accommodate local variations. With only 18% of the population, rural Australia’s needs are subsumed into the larger population. 2 Concerns with cost effectiveness, consistency of reportable outcome measures and competition policy have driven policy and planning across the public sector. 3 A whole-of-government approach is suggested to foster the necessary inter-sectorial action required to implement public policy. 4 However, there are no comprehensive, structured and conceptually grounded processes to inform place-based inter-sectorial solutions. In Australia, this is further compounded by the Federal/State split in responsibilities for primary and secondary health services. There are two key related factors to consider. The first is ways of identifying local needs across sectors and the second is prioritising needs identified. 5 Need is usually established at a population level via consultation processes or locally by a needs assessment or identifying a community’s assets. Australia does not currently have an established, accepted standard against which the needs should be assessed.