Rachel Crozier lives 400 kilometres from the nearest city. As a childcare educator raising a family in Tibooburra, far north-western NSW, she has come to depend on something many Australians take entirely for granted: access to a doctor.
When her son woke with a painful toothache, the alternative to waiting for the Royal Flying Doctor Service's weekly visit would have meant an 800-kilometre round trip to see a dentist. For a young mother with animals at home and weather that regularly closes the roads, such journeys have become impossible.
Tibooburra is home to just 95 people, yet it represents a broader crisis in rural Australian healthcare. About half a million Australians live in 'GP deserts' and receive 40 per cent fewer services per person than the national average, according to the Grattan Institute. With poorer access to check-ups, screening and medication, the burden of chronic disease is higher in rural and remote areas and life expectancy is shorter.
The RFDS has quietly transformed from an emergency retrieval service into something far more fundamental: for many communities, the flying doctor is the healthcare system. The Royal Flying Doctor Service runs more than five dozen clinics each day in rural towns from 19 bases, delivering more than 23,000 nurse, GP and dental clinics across Australia each year along with 20,000 face-to-face mental health consultations.
In Victoria's Robinvale, where the only GP to 2500 people was under immense pressure, it's been a godsend. At Condobolin in central NSW, almost 1300 patients a year have come to rely on the service despite clinics only being made available to them in 2024.
The organisation has expanded its footprint aggressively. The RFDS has expanded its primary healthcare services elsewhere in NSW too, with 19 female GPs and rural generalists providing women's care through the Clive Bishop Medical Centre in Broken Hill and outreach clinics, including Tibooburra. This expansion recognises a gap that mainstream healthcare has abandoned.
Nici Williams, the RFDS clinical director of primary care, articulates what has become clear across rural Australia: "In many communities, the flying doctor isn't just supporting the healthcare system, we are the healthcare system. We provide the cervical screens, the contraception support, the antenatal checks, the mental health appointments and the chronic disease care that women simply cannot access elsewhere. This is what equitable care looks like in action."
Yet this should be deeply concerning. A nation should not rely on a volunteer-supported aeromedical service to deliver basic preventive care. The RFDS is a patch on a broken system, and patches only mask the underlying fracture.
Around 7 million people or 27% of the Australian population live in rural and remote areas. The maldistribution of healthcare resources has left them not with less choice, but with no choice at all. When the flying doctor cannot visit, there is nothing.
Crozier's experience during her pregnancy illustrates both the value and the inadequacy of this model. Nearly 45,000 people in remote and very remote Australia have no access to any type of primary healthcare service within a one-hour drive of their primary residence. She experienced severe complications but was transported to Adelaide within two hours by the service.
The real question is not whether the Royal Flying Doctor Service is important. It demonstrably is, and it is more so every year as permanent healthcare infrastructure in rural communities continues to erode. The question is why a wealthy nation accepts that its citizens must depend on aircraft and volunteer fundraising to stay healthy.
The RFDS is a national, charitable, health organisation delivering primary healthcare and 24-hour emergency services for those that live in rural and remote Australia. That description contains an uncomfortable truth: we have made our rural healthcare system run on charity. Until governments address the fundamental shortage of rural doctors and the inadequacy of funding for regional care, the flying doctors will remain a band-aid on a wound that keeps getting deeper.
For Tibooburra, Robinvale and thousands of other towns, the RFDS is not an optional service to be grateful for. It is the only service there is. In a functioning healthcare system, that should never have been allowed to happen.