By Broede Carmody and Henrietta Cook
Thousands of vulnerable Melburnians will be cut off from free medical checks after funding shortfalls forced one of Australia’s largest community health organisations to axe many of its services and close its oldest clinic.
Cohealth said its decision to stop providing GP and counselling services at its Kensington, Fitzroy and Collingwood clinics by December was due to “significant funding challenges”.
The entrance of cohealth’s community health centre at Collingwood, which has previously been identified as badly needing an upgrade.
The organisation will also sell its 75-year-old Collingwood clinic, housed in a dilapidated building with leaking ceilings and cracked walls. This clinic – which also provides pharmacy services, including opioid replacement therapy – will close in the middle of next year.
Cohealth is blaming the situation on inadequate Medicare rebates for complex patients – a federal responsibility – and a lack of state government funding to upgrade the Collingwood facility. The changes are expected to affect more than 12,000 patients.
Australian Medical Association Victoria president Dr Simon Judkins said the decision to axe services in Collingwood, Fitzroy and Kensington would leave some of the state’s most vulnerable residents with no option but to present to emergency departments for treatment.
“We will see more patients with complex needs presenting to St Vincent’s, the Royal Melbourne Hospital and Western Health,” he said.
Cohealth delivers health services to some of Victoria’s most vulnerable patient cohorts – such as refugees living in the area’s public housing towers.Credit: Joe Armao
Judkins said the federal government’s Medicare rebates were inadequate for the type of care provided by cohealth.
“They are not widgets in a product line – this is a community with complex needs. It is incredibly disappointing that it has got to this point,” he said.
Royal Australian College of General Practitioners chair Anita Muñoz said she was shocked and dismayed by the decision.
“When people live with homelessness, severe mental health issues, are refugees or live in other complex social situations, they need wraparound services delivered by people highly trained in those populations,” she said.
Greens MP Gabrielle de Vietri, right, with cohealth CEO Nicola Bartholomeusz, outside the Collingwood clinic in 2022.Credit: Luis Enrique Ascui
“I’m deeply concerned. I don’t think it’ll be easy for those people to find the same high-quality care in the community that they have been receiving.”
Cohealth delivers health services to some of Victoria’s most vulnerable patient cohorts – such as refugees living in the area’s public housing towers.
The changes will not affect its specialised alcohol and other drug services in inner Melbourne. Cohealth operates the Victorian government’s public drunkenness response service as well as needle exchange programs.
Bulk-billed GP services will still be offered at other sites, which include Footscray and the CBD.
A cohealth public drunkenness bus.
Cohealth chief executive Nicole Bartholomeusz said she was devastated by her organisation’s decision to close three of its general practice clinics.
“We service part of the community who will not be able to access care elsewhere,” she said.
Bartholomeusz said staff were trying to find other GP clinics in the area to treat their patients, but many were already at capacity.
The Collingwood, Fitzroy and Kensington clinics employ 29 GPs and cohealth is hopeful it will be able to redeploy these doctors into other roles.
Bartholomeusz said the Medicare rebate just covered doctors’ salaries, and there was no money left to pay for nurses, receptionists and other operating costs.
“The gap between the cost of delivering the clinic and the Medicare rebate is getting bigger each year as wages and goods and services increase,” she said.
Bartholomeusz said this five per cent funding shortfall made it extremely difficult to maintain all its services.
Infrastructure Victoria has previously said cohealth’s facilities needed urgent investment, which has traditionally come from a mix of state and federal money.
State Greens MP Gabrielle de Vietri said the first letter she ever sent as a parliamentarian was about upgrading cohealth’s Collingwood site.
“It’s indefensible that Labor is letting community health services collapse instead of investing in them at the time when we know people are struggling more than ever to afford basic healthcare.
“Funding for our health services should never be chucked in the too-hard basket. Yet, that’s exactly what Labor’s done, and it’s local communities like ours that suffer.“
Yarra mayor Stephen Jolly – a former Victorian Socialist turned independent – said he had been receiving distressed calls and messages from patients and staff.
“Six days before Christmas, thousands of the poorest people in Yarra will lose access to their bulk-billing GPs,” Jolly said. “The state and federal governments need to step in and find a solution.”
Opposition health spokeswoman Georgie Crozier agreed that the state government needed to step up if it was serious about protecting vulnerable Victorians.
“Meanwhile, Labor shrugs off $50 billion in cost blowouts on major projects,” Crozier said.
A spokesperson for federal Health Minister Mark Butler said cohealth’s decision was deeply disappointing, and insisted clinics were better off under the Albanese government’s investment in bulk billing.
“While general practices are private businesses that make their own operational decisions, the government encourages cohealth to explore the financial and community benefits of participating in the new bulk-billing practice incentive program,” the spokesperson said.
Bartholomeusz said the government’s new incentive program would provide cohealth with around $400,000 additional funding, but that figure was far below what the clinics needed to stay open.
“While this helps, it unfortunately does not come close to the $4 million that cohealth tips in to keep the clinics open each year,” she said.
“The value of this incentive was considered prior to cohealth making the difficult decision to close.”
A spokesperson for the Allan government said the state invested $188 million in community health last year.
“We’ll continue to advocate to the Commonwealth to address medicare rebates for patients with complex care needs.”
With Rachael Dexter and Rachel Eddie
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