The drought, fires and fears of running out of water are pushing regional NSW close to breaking point, Deputy Premier John Barilaro said.
The Nationals leader, whose electorate of Monaro takes in Queanbeyan and Cooma, was speaking at a Regions Rising event organised by think tank Regional Institute Australia.
Mr Barilaro said the triple whammy of drought, fire and water supply was taking its toll on those in regional NSW.
"People talk about how regional people are resilient," he said.
"The truth is that resilience is running out. It is one of the toughest times in the regions."
He said, since the election, more than $200 million had been spent on water infrastructure.
"We're seeing something like 175 projects to ensure that regional communities do not run out of water," Mr Barilaro said.
However, he added that NSW shouldn't allow the drought to "talk ourselves out of market", stating there was still international demand for NSW agricultural produce.
"Yes, the drought is impacting but some of our farmers are smart farmers; they're innovative, they know how to deal with drought and they're still producing."
Also speaking at the conference was NSW Rural Doctors Network CEO Richard Colbran, on the issues around recruiting and retaining doctors and nurses in regional NSW.
Mr Colbran said the urban-centric component of health professionals' training - which drew them to Sydney, the Illawarra or Newcastle - worked against getting them into regional NSW.
They may have every intention of heading back there at the end of their training period, but life just got in the way.
"A lot of the training for health professionals must take place at some point in the city," Mr Colbran said.
"If you're in your 30s and you're setting up families, those two or three years [in the city] are critical. If you've put down your roots in the city during the training period, it's very unlikely you'll come back."
Mr Colbran said every day there were more than 300 practices outside Sydney trying to recruit a GP.
The solution to this regional draining is looking at ways doctors and nurses can get that training in regional NSW rather than in Sydney, Wollongong or Newcastle, which have been drawing the bulk of the state's health professionals.
"So much effort now goes into what we call 'end to end career planning and management'," Mr Colbran said.
"We try to make sure they don't have to go back to the city at any point through their training pipeline."
Mr Colbran said the result of a shortfall in medical professionals in regional NSW led to a drop in life expectancy.
Living in Sydney, he said a man could expect to live around 80 years, for those out beyond the "sandstone curtain", that dropped by a decade.
And for Aboriginal people in regional NSW Mr Cobran said life expectancy fell further.