Although the Australian banks have not soiled their nests and everyone else’s, like many international banks, pragmatic reform is needed.

Rural doctors tell of the impacts on rural communities of drought, climate change, withdrawal of services and government policies. There is stress, anxiety, depression, family and community breakdown and adverse impacts on child social and emotional development.

Yet whether or not you believe in the coming ravages of climate change, these are the communities that will sustain Australia in a world of increasing population and food shortages. These are the communities needing the expertise and finance to increase efficiency, revive marginal land and create programs for carbon offsets that will surely come. These are communities who could be made more sustainable by diversification of incomes by the creation of more local renewable power sources and pilot biochar programs. In the context of regional Australia these are health issues as well as developmental ones.

The commercial bank is the fulcrum of economic society that cannot be allowed to fail whatever the subsequent debt to society. It is a position of power and indeed, as we have seen from the present crisis, it has wielded power without responsibility. George Soros points out that we have to live with the recurring self induced crises of every 10 or 15 years.

The economic structure of society determines that most important decisions are taken by the people who run the banks and their partners in big corporations. The banks exist only for themselves and their shareholders. Some may feel these to be harsh words, but to those who know that the present debacle has added to poverty, ill health and mortality in many developing countries, it is a fair judgement.

This is not a secure means to run a life support system, the production of food nor is it reasonable to have security and sustainability of production under the ethos of short term financial gain rather than long term investment. Is it reasonable to subject this production to market interest rates at the behest of speculative systems? Is it credible to have ventures such as managed investment schemes take out their needs on productive land and people?

We need new models. It is not suggested that Prof. Muhammad Yunus and the Grameen Bank be invited to help the Australian rural poor. But remember that the Commonwealth Bank helped to establish 400,000 small businesses in its 30-year history prior to privatisation and was more attuned to community needs than its successor.

A Peoples Development Bank is appropriate to the needs and security of production in rural and regional Australia. Its charter would avoid the plethora of financial creations. Will Bailey, formerly of the ANZ Bank, made such a proposal in 2001 after talking to rural communities:

They do raise their concerns, particularly those people who come from non-urban areas. One group of 350 I talked to — at the end of the discussion they stood as one person and suggested it was time that someone had a damn good look at providing financial services to that 15 or 20 per cent of people who had been left behind following deregulation.

Little has been done by the two major parties since 2001 to address this question.

To such a proposal the private sector would cry “unfair competition”. Who cares when we are coping with an increasingly complex and unstable world? Governments would wash their hands at the thought of a nationalised bank for fear of the responsibility of failure.

But there are other choices. Many with understanding of the threats to the world often seek in vain to invest for the common good; a public-private partnership bank with a strong charter might satisfy all needs and would likely gain support from wealthy business identities.

What is all this to a practicing doctor? The issue is one of health equity. In several measurable factors the health of rural communities in Australia is inferior to that of comparable citizens in cities. It is tempting to relate some of these differences to availability of medical services, but this is not the entire story. Rural lifestyles, which on the face of circumstances would seem healthier, are not — and some of the reasons should be apparent from this article. And the bottom line — the land in question is our nutritional support system.

David Shearman is a practising doctor and Hon Secretary of Doctors for the Environment Australia, which concerns itself with the with links between the environment and human health.