There are fewer doctors, specialists and medical services the further out you go from the mountainous middle.

It could be considered a normal distribution as there is pragmatism in setting up a practice near hospitals.

But it does mean there is a disadvantage in access to health care for some of our community's most poor and sick.

We've opined previously in this column about the health care challenges many patients face in the Highlands.

The July 1 change to the federally funded administration of local health care saw some services at risk; others, lost.

A 20-years-strong diabetes clinic closed with the loss of two specialist educators, and the after-hours medical clinic based at the private hospital had to wait until late June to hear its funding was confirmed - for two more years, and then?...

The GP Rural Incentives Program to attract and retain doctors in outlying areas also changed its classification system.

Robertson lost out, becoming ineligible for incentive funding when it was reclassified as part of greater Wollongong.

But the tiny towns of Hill Top and Colo Vale have also lost out, having the same classification as Bowral and surrounds.

That means there is no greater incentive for GPs to set up remote practices there than in the relatively affluent town centres.

For the infirm, the elderly and the dirt broke, it leaves no choice but to travel for medical appointments and care.

Those towns have no rail access, and bus services are sporadic, necessarily long-winded, and not often suitable for the sick.

This is not to start a class war between the haves and have-nots, but to ask: how do we flatten the disparity of health care services?