When I finished university in Melbourne and moved to Coonabarabran NSW in 2000 as a new grad speech pathologist, I was only intending to stay for a year. I certainly didn’t imagine that 22 years later I would still be here, married with 3 daughters on a cattle farm at the locality of Rocky Glen, 50km out of Coonabarabran. I worked in the disability sector, public health sector and then moved into practice which I have been running since 2011.   My daughters are now in Year 12, Year 11, and Year 5, with the 2 eldest at boarding school in Sydney. I know many families must make tough decisions when it comes to seeking education and health care for their children, whether it be travelling long distances, sending kids away to school, families living apart during the week or moving away to larger towns or cities.

Twenty-five percent of parents are concerned about their child’s speech and language development. Families are waiting up to 20 months for assessment and a further 20 months for therapy services. We know that parents in rural areas are travelling up to 300km for an hour of therapy and not only does this place stress on the family, but children are also missing the help they need during critical periods of development. This has a huge impact on their educational, social and employment opportunities in the future.

There have been many changes in health and education over the last two decades, and I am often asked why now there seems to be so many more children needing services, and the needs of these children are so complex.  There is no one answer to these questions, but the result is a higher demand on services than ever before. I find it incredibly difficult to have to turn away families when I know there are few other places they can seek help. The problems faced by families in remote Australia are even more desperate.

While waiting lists for health services in urban areas are long, my general experience has been that my two eldest daughters in Sydney have accessed the services they needed in a timely way and had multiple options of providers. This is a complete contrast to my experience where I live, both as a health consumer and a speech pathologist. Many parents must search far and wide for medical and allied health providers and, when found, the waiting lists, service fees, travel time and costs can be prohibitive.

Telehealth services have become more common practice, and since COVID-19 we have good evidence that it works. As a consumer of telehealth services myself, I have found it as beneficial as in per treatment – and more than that, I have experienced the benefits of consistency with the one professional. Building and sustaining trusting professional relationships is part of the therapeutic process that is often undervalued in achieving positive health outcomes. 

Telehealth isn’t the answer for every family or situation, and stable and consistent internet connectivity needs to be available. Some children love telehealth, and prefer it to in person services, while others find it unappealing and distracting. I have had a child take great delight in running off with their iPad and hide it to end a session!

We deserve health professionals on the ground and available to all families, but I also recognise the fact that we have been ‘saying we need more people’ for a long time with little change. Solutions to this problem need to be creative and respectful and come from the rural communities that are crying out for services. Real innovation will not be a stop-gap but a sustainable and understanding practice that takes in the realities of the technological, geographical and social needs of rural Australia. These solutions need to come from us. 

In 2020 I was walking down the hallway at a school between therapy sessions and noticed a child sitting in the classroom looking lost and worried, struggling to understand the classroom instructions and the schoolwork. I decided at that moment that I didn’t want any child to feel that way just because they couldn’t access the services they needed when they were younger. I concluded the best way I can help those children was to equip the adults around them with skills and knowledge to help and advocate for them.