Nurses are working overtime, expectant mothers are travelling long distances to have their babies and local councils are being forced to lure doctors to their towns - that's the health diagnosis for the bush.
As political parties promise thousands of additional health jobs in the lead up to the election, there are already hundreds sitting vacant across the state - some unfilled for 14 months.
An audit of health jobs on the website iworkfor.nsw.gov.au, show there are 404 unfilled health jobs outside of Sydney, Newcastle and Illawarra.
Labor want to introduce nurse-to-patient ratios to bring regional hospital staffing levels to the level of city hospitals, in a policy which will add 5500 more nurses.
The Coalition government has promised, in what they describe as "the largest workforce boost in the history of Australian healthcare", that patients will gain an extra 5000 nurses and midwives under its government over four years.
Of the jobs available in the audit, more than half are for nurses and midwifery positions. There are 50 allied health jobs, 29 medical doctor/specialist positions and 31 patient support.
The most heath vacancies are in the Murrumbidgee Local Health District (LHD) with 115, and there are 49 in the Southern NSW LHD.
The job board shows there are two nursing and midwifery positions in the Orange (Central West Local Health District), which have been left unfilled for 14 months - longer than any health jobs in Sydney.
Shadow Minister for Health Walt Secord has slammed the Coalition government’s failure to fill vacancies in rural and regional health positions saying the vacancies affected patient care and put an extra burden on existing hard working staff.
“This is unfair on so many levels – it is unfair to patients and it is unfair to hardworking hospital staff, who have to carry the extra patient workload," Mr Secord said.
“This has created a two-tiered health system where patients in the regions miss out on quality treatment and patient care.”
A spokeswoman for NSW Health Minister Brad Hazzard said NSW had one of the biggest workforces in the country, with 117000 employees and a relatively low vacancy rate.
"Like other states, it can at times be challenging to quickly fill positions in rural and regional areas," the spokeswoman said.
"However, the NSW Liberals and Nationals has found when you invest in hospitals - we have completed upgrades at Dubbo, Bega, Orange, Tamworth, Port Macquarie, Kempsey, Bryon, Bathurst, to name a few - it boosts local communities and makes it easier to attract trained staff."
The spokeswoman said the state government was committing $2.8billion to recruit an extra 8300 frontline staff in the next term, with 45 per cent for the regions.
Australian Medical Association NSW president Dr Kean-Seng Lim said building hospitals alone would not be effective in safeguarding the health system.
“Candidates of all stripes like announcing infrastructure, pilot programs, and funding for projects – but not always in the most helpful of ways," Dr Lim said.
“This can sometimes be ad hoc or done without a great deal of thought on how it may benefit the health system as a whole."
- The Land