After 11 years of providing primary healthcare to vulnerable patients, Cohealth is set to close its Collingwood location entirely and significantly scale back services at two other clinics.
The majority of Melbourne’s Cohealth group of non-profit primary healthcare clinics will stop providing GP services by December this year, as advocacy groups call for the government to step in.
Cohealth was founded in 2014 with the merger of three existing community health clinics and operates as a non-profit. Its website states that it received funding, at least at one point, from local, federal and state governments.
Clinics did not universally bulk bill, but instead charged fees to higher income earners to offset the cost of bulk billing low-income patients.
On Thursday this week, news broke that Cohealth’s Collingwood clinic would be shutting its doors in December.
It will also stop delivering GP services at two other Melbourne sites, Fitzroy and Kensington. It’s understood that the Footscray clinic will maintain GP services.
A spokesperson for Cohealth told The Medical Republic that vulnerable patients often did not fit into a neat Medicare item number.
Even the bulk-billing incentives, they said, would not result in Medicare matching the cost of the care that Cohealth provides.
“This decision reflects multiple, complex pressures including decades of underinvestment, ageing infrastructure, and a funding model that doesn’t match the reality of the need or the type of care that is required,” Cohealth CEO Nicole Bartholomeusz said.
“These compounding issues have made it impossible to sustain services that our communities rely on.
“We are funded for standard care, but we’re servicing extraordinary need.”
Cohealth is now appealing to the federal government for support.
“Every day, our GPs are delivering complex, person-centred care and support for vulnerable Victorians who face some of the greatest barriers to health,” Ms Bartholomeusz said.
The prospect of the federal government stepping in is not unrealistic.
In September, the Department of Health, Disability and Ageing released grant documents that will see $3.8 million in funding going toward securing the future of Interchange Health Co-op in Canberra.
The Co-op entered voluntary administration in April of this year, and was one of the ACT’s few fully bulk-billing clinics.
Like Cohealth, it specifically served a vulnerable cohort of the community.
Both the AMA Victoria and the RACGP have spoken out in support of Cohealth’s bid receive additional government funding.
“AMA Victoria has spoken with the Victorian Government and will continue to engage to ensure the implications of these closures are fully understood and appropriately addressed,” an AMAV statement read.
“Our Workplace Relations team has already met with impacted cohealth staff and is supporting affected members. We are working to understand immediate needs and to advocate for fair treatment, proper transition arrangements, and continuity of patient care.
“Many of the doctors affected already earn far less than they could in private practice or the public system.
“They choose to work in community health out of commitment to vulnerable patients. But goodwill alone cannot keep these services going.”
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While governments at all levels debate where the fault lies, AMAV said, vulnerable Victorians risk being left without care.
“Community health is an essential part of our healthcare system and must be funded sustainably,” the association said.
“The immediate priority must be ensuring continuity of care and support for affected patients and clinicians, alongside a longer-term commitment to rebuild a viable, well-funded community health system.”
RACGP Victoria chair Dr Anita Munoz called on the state government directly.
“Cohealth patients will now no longer have access to a GP they know and trust, and many will have few places to turn to. These clinics play such a vital role, we can’t afford to lose them,” she said.
“The Victorian Government needs to step up and save these clinics – this is lifesaving healthcare, including for people from disadvantaged backgrounds, those facing overwhelming barriers of living such as rising costs of rent and essential goods through to those living in a state of crisis.”
Dr Munoz said that the community health centre model – while having largely fallen out of fashion in other states – had remained an integral part of Victoria’s healthcare system.
“It’s a model that recognises that people in vulnerable situations, or who live with mental health, substance dependence or serious social disadvantage, have needs beyond which the traditional Medicare Benefits Schedule, or MBS, fee-for-service model can accommodate,” she said.
“This was once considered a point of pride in our Victorian system that recognised the need to provide specialised services for people living with significant complex health issues and comorbidities.”
