That long anticipated day when NSW re-opens from its COVID hibernation is drawing closer. But is our health system ready for it? It will begin with some eased restrictions on the Monday after the state hits 70 per cent double vaccinations. Even greater freedoms can be expected when that double vaccination rate hits 80 per cent. The state-wide road map to re-opening is based on modelling by the Doherty Institute, and that first target is shaping up to be mid-October. That's less than a month away. While at first glance the promise of more freedoms seems like a positive, the big question is 'are our rural, regional and remote communities ready?' More specifically 'is our health system ready?' How will our health professionals cope with an anticipated increase in patients, in particular COVID-affected patients requiring isolation, and possibly intensive care and ventilation? The Doherty report notes that "even high levels of vaccination will not be sufficient to stop COVID-19 in its tracks". The health landscape has changed forever because of this pandemic. And that impacts every one of us. Many would argue that our health system has been in poor health for quite some time - well before the threat of COVID added significantly to the expectations and burden on our frontline workers such as doctors, nurses and paramedics. Submissions and witness testimony to a State parliamentary inquiry that began in September last year paint a picture of an already chronically ill system. Health Services Union NSW Secretary, Gerard Hayes, has been quite clear about his concern that our regional and rural health care services are not prepared for what lies ahead. "I'm not saying this to be obtuse, but what we have seen over the past decade has been a system tightening its belt constantly and working to be as lean as possible," Mr Hayes said. Sure there have been millions of dollars allocated to hospital upgrades across the state in recent years, including Shoalhaven Hospital, but this is all window dressing. More skilled health specialists on the ground are what is really needed. What good are extra beds in an upgraded hospital if there are not enough staff to adequately support the patients that may occupy those beds? READ MORE: It is apparent that the powers-that-be have belatedly realised this fact with a recent call out to retired health staff to return to the fold. Quite frankly this may well be too little to late. Our health service should never have been allowed to get to this depleted state. Dr Debra King, North Coast representative on the Royal Australian College of General Practitioners NSW board fears an increase in general practitioners getting burnt out with the increased workload. "Our workforce doesn't go up, we just work longer hours," she said. Meanwhile, our paramedics are being pushed beyond the limit to transport seriously ill COVID patients to a hospital equipped for suitable treatment and isolation. This is on top of a the normal workload typical of a pre-COVID environment. Burn out among health professionals, pushed beyond the limit to provide care for patients, could well be our next health disaster. We don't have a vaccine for that. We do have them for COVID-19, though. Ready or not, we must move out of the lockdown phase of the pandemic. High vaccination rates are key to minimising harm as we do so. So too is an adequately resourced and funded health system. It is well past time regional, rural and remote NSW had one. Want to have your say? Send us a letter to the editor