This report presents the results of a review into the availability of health, education and social service professionals in towns with populations under 5,000 between 1981 and 2011. While the number of professionals in inner regional small towns grew by 85%, in remote and very remote areas the growth was only 7%. In these towns occupants were most likely to have a nurse or primary school teacher than any other type of service delivery professional. Overall, the report contends that the gap in service delivery between major cities and small towns continues to be significant, and in some cases is widening. The report includes a range of recommendations to address this discrepancy including increasing incentives to target areas where it is difficult to attract staff, supporting community-led initiatives, virtual service delivery and having flexibility in the roles professionals can fill.