• Scott Sypek, Gregory Clugston, and Christine Phillips.
• Medical School, Australian National University, Canberra, Australian Capital Territory, Australia.
• Aust J Rural Health. 2008 Dec 1; 16 (6): 349-54.

ObjectiveTo explore the reported impact of regional resettlement of refugees on rural health services, and identify critical health infrastructure for refugee resettlement.DesignComparative case study, using interviews and situational analysis.SettingFour rural communities in New South Wales, which had been the focus of regional resettlement of refugees since 1999.ParticipantsRefugees, general practitioners, practice managers and volunteer support workers in each town (n = 24).ResultsThe capacity of health care workers to provide comprehensive care is threatened by low numbers of practitioners, and high levels of turnover of health care staff, which results in attrition of specialised knowledge among health care workers treating refugees. Critical health infrastructure includes general practices with interest and surge capacity, subsidised dental services, mental health support services; clinical support services for rural practitioners; care coordination in the early settlement period; and a supported volunteer network. The need for intensive medical support is greatest in the early resettlement period for 'catch-up' primary health care.ConclusionThe difficulties experienced by rural Australia in securing equitable access to health services are amplified for refugees. While there are economic arguments about resettlement of refugees in regional Australia, the fragility of health services in regional Australia should also be factored into considerations about which towns are best suited to regional resettlement.

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