The Road Not Taken by Robert Frost
Two roads diverged in a yellow wood,
And sorry I could not travel both
And be one traveller, long I stood
And looked down one as far as I could
To where it bent in the undergrowth;
Then took the other, as just as fair,
And having perhaps the better claim
Because it was grassy and wanted wear,
Though as for that the passing there
Had worn them really about the same,
And both that morning equally lay
In leaves no step had trodden black.
Oh, I kept the first for another day!
Yet knowing how way leads on to way
I doubted if I should ever come back.
I shall be telling this with a sigh
Somewhere ages and ages hence:
Two roads diverged in a wood, and I,
I took the one less travelled by,
And that has made all the difference.
DHBs and PHOs have by now all formed Alliance Leadership Teams, and in the near future ALTs will form “Service Level Alliance Teams” to provide advice and recommendations about “whole of system” approaches to improvement in services across a range of issues important in their communities – youth health, emergency care, and where appropriate rural providers across the country are being approached to engage in rural service level alliance teams.
This is a huge opportunity for rural providers. For the first time every DHB in the country – yes, even you South Canterbury – is being encouraged to develop an infrastructure that allows rural based providers a significant voice in the planning of sustainable health services for their communities.
At the recent workshop jointly organised by the MOH and NZRGPN (see what we are doing there – this is about working together) we heard the MOH say:
“This funding is to support rural general practice, there is no intention to reduce the financial sustainability of rural practice.”
“If ALTs think this is about making shifts in the way rural bonus is paid they have missed the point, this is about sustainable services for rural communities.”
Somewhere in ages and ages hence, we will tell our trainees with a heavy sigh, “two roads diverged in a wood, and I, I took the one less travelled by, and that has made all the difference.”
But if we are honest, just as for Robert Frost, the choice between the road taken and the alternative was not based on whether or not one was more trodden than another. For us the decision was based on the fact that one branch of the road looked pretty much like the road behind – increasingly fractured and uneven whilst the other had at the very least a few road signs.
At the end of the road whether we reach our destination will depend on how much effort we all put into the journey.
To be successful providers need to engage with the process.
The NZRGPN has on its website an “Alliance 101” link that hopefully will give rural providers a bit of a map to help them on their way. The website provides a link to tools to ensure that communication between the “centre” and rural communities works as best as it can in “rural proofing” – it provides a sample “terms of reference” to guide rural service level alliance teams as to how they should work together and direction for teams to consider principles and values by which they might work.
The website provides links to video summaries of the September Alliance Workshop and information about how these teams will be supported in the future.
The NZRGPN, MOH, DHBs and PHOs will regularly get together to share information and concerns about the sustainability of services to rural communities at the Rural Advisory Group – so even when the road travelled becomes leaf thick and slippery help is on hand to clear the path ahead.
No one relishes change, but the NZRGPN hopes and expects this change will be a positive one for our members and the communities they serve.
Don't Shoot.. 