REVEALED: The health funding crisis harming our kids

Wagga dad Dan Berryman says he is unable to get an appointment with a paediatrician in the public health system.

His son Charlie, now six, struggles with developmental delays and behavioural problems.

It was "critical" he was assessed before he started school otherwise the problems would be compounded, Mr Berryman said.

"There is just a lack of services in our area," he said.

In the end Mr Berryman's mother-in-law provided the funds to find a specialist in the private health system.

It comes as some children with significant development challenges are forced to wait up to six years to see a paediatrician in regional NSW.

The average wait time is 18 months in rural areas and in some parts of NSW families are being told there is no local service at all.

Children's health charity Royal Far West Dubbo has no appointments for developmental or behavioural referrals.

Tamworth has a wait time of up to six years, Wagga at three years, Orange two-and-a-half years and Coffs Harbour and Bega around two years.

Families that ACM spoke with on condition of anonymity expressed widespread frustration with the lack of services.

One parent who didn't want to be identified said they were at their "wit's end".

"We have three kids, two with autism and a third with behavioural issues," the mother said.

"We can't use telehealth because our children don't interact with a screen. We need face to face," one mother said.

Part of the problem, they say, is that medical specialists don't stay in the town for longer than a year.

However, the families said Royal Far West service in Manly was akin to "finding a piece of gold", but they had to travel there.

Wagga public hospital paediatrician Dr Theresa Pitts described the situation as a "national crisis".

"I don't think we realise the scale," she said.

"We haven't seen the full impact of it and we won't realise the scale until we see future generations because of the impact it will have on society."

In her area of expertise, a simple medical issue takes three months but an appointment for a behavioural issue could take almost three years.

"These are sliding door moments with these kids," she said.

Dr Pitts said if the issue was not tackled before school it could lead to significant problems at school and potentially lead to the child leaving school early and other societal issues.

Royal Far West chief executive Jacqueline Emery warned the delays meant that children were often already in school by the time they were seen by a paediatrician.

"The mental window where you can have an impact and change the trajectory of that child's development is starting to close very fast," she said.

The gap between kids in the city and the bush is stark when it comes to development.

Children living in very remote areas of Australia are up to twice as likely to start school developmentally vulnerable than city kids, according to the Australian Early Development Census in 2021 which is conducted every three years.

And fewer kids living in regional and remote NSW are on track for key developmental milestones when starting school, compared to their city counterparts.

That includes physical health and well-being, social competence, emotional maturity, language and cognitive skills and communication skills and general knowledge.

Anecdotal evidence suggests a "confluence of factors" including the COVID-19 pandemic and natural disasters had exacerbated the developmental challenges for country kids.

Royal Far West chief medical officer Dr Marcel Zimmet said in some cases a child might struggle with a range of behavioural issues but a GP would put a medical condition such as asthma on the referral to ensure a child gets access sooner.

"There is a critical window of time where we can intervene where we can support families, unfortunately for many children that window is being missed," he said.

The organisation is seeking funding for a three-year pilot to expand their developmental assessment and treatment service based in Manly with two new rural based paediatric assessment clinics in Wagga and Dubbo.

More than 60 per cent of the families they support come from the Murrumbidgee and western NSW regions.

Narranga Public School principal Michael Trist, who is also secretary of Primary Principals Association, said delays could have a serious impact on students and their families.

"In cases where behavioural issues need medical intervention, the impact can extend to other students and to teachers trying to manage these behaviours - sometimes to a significant degree.

He supported any initiative that would bridge the gap for non metropolitan communities and and improve access to paediatric services, the Coffs Harbour-based principal said.

Regional NSW politicians ACM spoke with were supportive of Royal Far West's proposal for more funding.

Independent MP for the Murray Helen Dalton said the lack of paediatric services in her NSW electorate was a "huge problem" and children and families should not be travelling long distances for any form of medical treatment.

"Expanded services in Wagga and Dubbo are necessary but Murray must also see an immediate increase in paediatric services," she said.

She had made "countless representations" to the Minns NSW government about the issue.

Wagga Wagga MP Independent Dr Joe McGirr also described it as a "critical problem" and had also made continuous representations on behalf of Royal Far West.

Dubbo MP and leader of the NSW Nationals Dugald Saunders "absolutely supported" Royal Far West's proposal.

Meanwhile, NSW health minister Ryan Park told ACM he recognised the challenges many regional families faced on getting an appointment with a paediatrician, but did not commit to Royal Far West's proposal.

Mr Park said work was "ongoing" in delivering "long-term solutions to this challenging issue" but added the Minns government had funded Royal Far West an extra $369,000 earlier this year.

"We know that recruitment is one of the biggest challenges to our regional, rural and remote health services," he said. The government had boosted recruitment by doubling rural health incentives and rolling out key worker accommodation.