A shortage of GPs has left the Gunnedah hospital emergency department "operating as a makeshift GP clinic", an alliance of community groups has told a parliamentary inquiry.
The Gunnedah community roundtable told the upper house inquiry into rural health the town lacks adequate primary and allied healthcare.
The hospital is forced to fill the gap, they wrote in a submission.
"This is not a sustainable situation. Locum GPs located at the hospital are transitory, and do not have the community knowledge or connections to refer people to community-based services which can provide ongoing support," the submission read.
They also said the situation is having a negative effect on the health of the broader community.
"Risk factors and early stage illnesses are not addressed or appropriately managed until a person's health has experienced significant decline," they said.
"This is a direct result of the barriers our community faces to accessing GPs."
The community roundtable submission follows complaints by the Gunnedah Shire Council.
In its own submission, the council told NSW Parliament the town has just one GP for every 3000 people, the worst ratio in the Hunter New England Health area.
"Local GP's are effectively running a crisis medical service and preventative practice is nonexistent," the submission said.
The Gunnedah Community Roundtable said a dependence on the hospital's emergency department makes it more difficult to do needed health followup, because patients find it hard to book check-ups with a GP.
Their submission said government ought to allow psychologists and social workers to develop and implement mental health care plans, not just doctors.
They said the health system should establish formal GP clinics within rural hospitals, and allow nurses to perform a broader range of duties and require early-career doctors to work in rural areas.
Nearly 500 submissions to the health outcomes and access to health and hospital services in rural, regional and remote New South Wales have been made public so far.
Many of them are anonymous.
But Liverpool Plains farmer and rural advocate Fiona Simson said rural health services have "declined drastically" over the last decade or so, to such a degree that she was compelled to speak up.
The inquiry is due to hold its first public hearing in March.