Aim: An analysis of general practice data for rural communities in close proximity to coal mining and coal-fired power generation in the Hunter Valley region of NSW was conducted to identify unusual patterns of illness. Methods: Bettering the Evaluation and Care of Health general practice consultation data from the Hunter Valley region for 1998–2010 were compared with data from all other rural NSW residents. Results: There were no significantly higher rates of problems managed or medications prescribed for Hunter Valley region residents compared with the rest of rural NSW. Rates of respiratory problem management in the Hunter Valley region did not change significantly over time, while for all other rural NSW areas these rates significantly decreased. Conclusion: There was no evidence of significantly elevated health issues for residents in the Hunter Valley region of NSW. The diverging trend for respiratory problem management over time is worthy of further exploration.