At our recent annual policy conference, Health and Wellbeing: making equality a reality, we discussed the impact of centralised services on the rural population.
A volunteer involved in a voluntary car scheme in North Yorkshire said that volunteer drivers are now required to take people for appointments in hospitals further afield than before as a result of the move towards centralised services. This takes up a whole day of their time rather than the half day they used to give on a regular basis. As a consequence, volunteers are not able to give up their time as frequently, which is having an impact on the ability of the voluntary organisation to meet the need of those requiring help with transport.
The distances from home to health services are one of the major obstacles rural patients face:
- People in rural areas are more likely to live further away from health services than people in urban areas.
- The cost of fuel is more expensive in rural areas – Road fuel is around 2 pence per litre more expensive in sparse rural areas than the national average.
- Buses/public transport is less accessible and/or less frequent – Only 50% of households in villages and hamlets have an hourly or better bus service within 13 minutes’ walk (compared with 96% of households in urban areas)
- Residents in villages and hamlets spend 20 – 30% more on transport than those in urban areas
A result of this can be what is called Distance decay, i.e. where there is a decreasing rate of service use with increasing distance from the source of health care.
Studies have shown that the closer the service the more likely it will be used.
Rural and remote populations are therefore affected by distance decay, which is a cause for concern since it leads to delayed intervention and treatment and hence poorer health outcomes become more likely.
More information on the Involve Yorkshire & Humber annual policy conference.
More information on the Yorkshire and Humber Rural Network.
Are you involved with rural transport or rural health and social care services? Have centralised health services affected your rural community, or anyone you know?
Do you have any good practice case studies or examples of how the voluntary sector has adapted to meet changing demands?
Please share your experiences in the comments box below.
Guest blog by Jan Thornton, Involve Yorkshire & Humber trustee.