No ‘gold standard’: Two Victorian public health sites to close as job cuts bite

Dozens of job losses at Victoria’s local public health units will force the closure of sites at the Northern Hospital and Eastern Health on Friday and leave Victoria under-resourced in comparison to NSW’s lauded “gold standard” system, according to public health leaders.

There are concerns the lessons of Victoria’s second COVID-19 wave – when the state’s small and underfunded public health unit was overwhelmed – are being forgotten, amid claims the cuts threaten the ability of Victoria’s nine new public health units, still in their infancy, to manage their existing workload.

Public health sites will close at two hospitals in greater Melbourne.Credit: Getty

The North Eastern Public Health Unit, which serves more than a third of Melbourne’s population and some areas of Australia worst-hit by the coronavirus pandemic, is set to lose more than 40 per cent of its workforce over the next year, including 31 of 93 positions from Friday.

As a result of the job losses, two of the health unit’s three sites will shut down this week. The director of the unit, Professor Paul Johnson, said the sites at the Northern Hospital in Epping and Eastern Health at Ringwood were created following guidance from the Victorian Department of Health in 2020 because of the area’s large population, of about 1.8 million people.

Instead, after Friday, the unit will operate solely out of Austin Hospital in Heidelberg.

Despite the funding cut, Johnson said there had been no reduction in the unit’s scope of work. In fact, it’s preparing to take on responsibility for managing dozens of new notifiable health conditions over 12 local government areas by the end of the year – from its current 33 to 82.

Terry Slevin, the chief executive of the Public Health Association of Australia, said that “no one questions the simple observation that the system in Victoria is still absolutely under-resourced and is not near the standard that has been in place in NSW [for] some decades”.

“It’s time the Victorian government stopped pretending that they’re the best. It’s time for the Victorian government to accept and understand that … for more than a decade, and probably for longer than that, public health has been under-invested in Victoria,” Slevin said.

Johnson said the focus will now turn to ensuring they make the best use of technology and design an efficient system to ensure the unit has capacity to respond to future major outbreaks of diseases.

Johnson said the majority of the unit’s staff will have to reapply for their positions, at the same time the unit is being charged with helping to develop a population health catchment plan. “This has been a stressful time as we are losing many valued staff,” he said.

The office of Victorian Health Minister Mary-Anne Thomas was approached for comment, but it referred questions to the Department of Health.

“The funding for local public health units to manage communicable disease outbreaks, and to undertake disease prevention and health promotion programs, has not changed,” a departmental statement said.

“Any changes are associated with health units having fewer responsibilities in relation to COVID-19 ... It’s also consistent with the reduction in COVID spending alongside the National Partnership on COVID-19 with the Commonwealth Government, which has now wound up.”

The job of the public health units includes managing outbreaks of infectious diseases such as influenza, measles, HIV and Japanese encephalitis, contact tracing and providing information and programs that prevent people developing chronic conditions that clog up hospitals.

The head of Victoria’s health department, Professor Euan Wallace, told the public accounts and estimates committee earlier this month that the local public health units were “increasingly doing more and more work”.

“Our public health units in northern Victoria – so in Shepparton, for example – were fundamental to managing the floods and the mosquito-borne diseases. They also led mpox responses.”

However, he told the committee on June 9 he was not expecting any reduction in the services offered by the local public health units as a result of job cuts.

Last week this masthead revealed that Victoria’s local public health units would lose 40 per cent of their funding over the next two years. Senior health sources, speaking anonymously to discuss the situation, said public health workers in the health department’s CBD office were also being targeted in this month’s job cuts.

Experts say Victoria is neglecting to invest in preventative health.Credit: Chris Hopkins

One of these senior public health officials said there was no question Victoria’s public health system was now “underdone” and the cuts threatened the public health teams’ ability to respond in a timely manner to major events such as floods, thunderstorm asthma and bushfires.

“I think we will start to see more occasions where there’s public health failure,” they said.

“It is true we are still significantly under-invested in public health relative to other jurisdictions and New South Wales is a good comparison.”

Rob Moodie, a professor of public health at the University of Melbourne, said if there had been a better-resourced public health workforce in Victoria in 2020 when the COVID-19 pandemic began, Victoria would have been able to control the second wave much better.

The former chief executive of VicHealth pointed to the reliance on private security staff in the failed hotel quarantine program.

Moodie said it had always been more difficult to get people to see the value in preventative health measures that public health teams were tasked with focussing on.

“People aren’t saying ‘Oh, my goodness, help me stop smoking’ or ‘help me get a better diet’ because it’s not causing any immediate pain or discomfort … but the more you weaken the system the more you make it [vulnerable] to the next pandemic and open to the gradual expansion and poor management of communicable diseases.”

“You need the fence at the top of the hill, not only the ambulance at the bottom. You take the fence away, and gradually people start falling down.”

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