If you had to name the top three health issues in Port Macquarie, what would you say?

In July 2018 the North Coast Primary Health Network surveyed Port Macquarie residents about what they thought were the most serious health concerns in their community. 

67% of respondents identified issues around ageing. 

That doesn't surprise Dr Vahid Saberi, the former CEO of the North Coast Primary Health Network.

"Port Macquarie has an ageing population and the evidence clearly shows that as we get older we get more chronic and long-term conditions," he said. 

"Those conditions are not amenable to cure and they requires ongoing management, and often they requires specialist care.

Unsurprisingly 44% of Port Macquarie respondents in the survey found it difficult to access a specialist.

While specialists are traditionally seen as the domain of the Federal Government, Dr Saberi said the State Government plays a role too.

"The health system is complex and for a specialist to successfully practice anywhere requires an arrangement that requires the State and the Commonwealth.

"In most places where specialists have successfully settled the state has had a major role to play."

Dr Saberi said there are some wonderful examples of specialists working in Port Macquarie but because of the ageing population attracting specialists to the area remains an issue.

"The population is growing and ageing, and the prevalence of chronic and long-term disease requires more specialist arrangements, such as cardiac, cancer , diabetes."

Sticking with hospitals, nurse to patient ratios continue to be an issue in the region.

President of the Nurses and Midwives Association Port Macquarie Base Hospital branch Mark Brennan said nurses were at breaking point.

"We are regularly looking after too many patients," Mr Brennan said. 

"For eight years we've asked the government to introduce a transparent nurse to patient ratios system but they refuse.

"We are exhausted and burning out, trying to maintain a high standard of care with limited resources. "

Results from the National Health Performance Authority indicate young people in Port Macquarie are more likely to be on antidepressant and anti-psychotic medication.

They also have more overnight hospitalisations for mental health conditions.

NSW operations manager of Headspace Jenny Sinclair said there needs to be greater investment in early intervention services for young people.

"We would like to see a commitment to improving access to safe and early intervention services to some of our most vulnerable and youngest community members, which we know is key to responding to both personal and community challenges when regarding all matters of health. "

What do your state political candidates think?

Drusi Megett, The Greens

Healthcare in NSW is being undermined by privatisation by the Liberal-National government. The health system has been put in the hands of companies that care more about profits than about good health outcomes.

The current government has underfunded Local Health Districts, particularly in Regional NSW, and then shifted the blame onto underfunded districts for not providing sufficient health services. The Greens are calling for greater funding of regional Local Health Districts, to ensure they deliver the healthcare people need.

Everyone in NSW should have access to excellent health services, irrespective of where they live.

The Greens are committed to increasing funding for public mental-health services, including increased resources for early-intervention programs. Mental health must be treated like any other part of our health system, with a range of different preventative programs and treatment options available to the public.

Leslie Williams, The Nationals

NSW Labor's announcement to mandate nurse ratios puts industrial demands beforepatients, and risks the closure of hospital wards across the State.

Labor would abolish the flexibility at the heart of the NSW health system, which allows our hardworking nurses to ensure all patients receive world-class care.

In fact, in 2011, former Labor Health Minister Carmel Tebbutt said "the government does have concerns about a blunt nurse-to-patient ratio tool because it lacks the flexibility that is often needed to staff a modern hospital."

NSW Labor have walked away from Carmel Tebbutt's advice on ratios, but they can't walk away from their record of failure and neglect while in government, including the closure of more than 2000 hospital beds; their failure to deliver at least four major hospitals they promised and the closure of 37 maternity units.

By contrast, since 2012 right here in the Mid North Coast Health District, the Liberals and Nationals have increased nursing staff by 21.4% and increased medical staff by 46% and we will deliver a further 5,000 new nurses and midwives over the next four years.

Peter Alley, Country Labor

It is Labor Governments that have made the right investments into the Health of our community. It was a NSW Labor Government that purchased the Port Macquarie Base Hospital back into public hands. It was a Federal Labor Government that funded the expansion of the hospital 6-8 years ago.

While we may have a nice shiny hospital, the services provided are lacking. Inadequate staff, both nursing and allied, means that the hospital is not operating properly. An incoming Labor Government will provide more nurses, more paramedics, more cleaners and more security staff. Staffing levels need to ensure that every patient receives proper and safe care.

Labor is investing in more mental health beds in our hospitals, but also more psychologists in our schools and in our rural communities where many people are doing it tough

Labor can do this because we priorities Hospitals and health ahead of stadiums in Sydney.

Jan Burgess, Sustainable Australia

We are twice fortunate to live in Australia (with a world leading health system) and in Port Macquarie (with good access to the base hospital, facilities and specialists). Hospital access is an issue and we would support exploring options such as remote parking and shuttle buses.

Sustainable Australia's policies place a high emphasis on preventative health care, including a ban on junk and high-sugar food advertising to children and a sugar tax (used to subsidise fruit and vegetables and public health). A focus on healthy eating and exercise, particularly in schools, is essential. Teaching children where their food comes from with school gardens and cooking classes will help ensure our children are given the tools to make the right choices.

We also advocate affordable access to primary health care, universal access to free contraception and reproductive health advice, better resources for mental health and community health centres, prioritised rollout of NDIS and treatment of drug abuse as primarily a health issue.