A fresh wave of uncertainty has hit patients at three Melbourne clinics, with access tightening as a long-awaited review sits unreleased.
Vital GP services for patients at three Melbourne clinics run by Cohealth appear to be under threat again, throwing patients into a fresh swamp of uncertainty.
The services have been part of a review led by health economist Professor Stephen Duckett, who TMRunderstands handed the final report to the government in mid-March.
No date has been announced for the review’s public release, although Cohealth patients have reportedly been told it will be released on 1 May.
It can’t come soon enough for one patient, known only as Alice, who was rocked by the news earlier this week when she was told she could not make an appointment beyond May, and would have to go on the waiting list for an appointment in June.
She has since been offered an appointment in June but been told by Cohealth administration staff that there are no guarantees she will be able to access services beyond that.
Her online access to book GP appointments is also no longer available. She said she used to be able to make appointments “months in advance” but can no longer do this either.
“They told me they are only taking bookings on a month-to-month basis in case they have to close,” she told TMR.
“They got money from the government to stay open until 31 July but they told me they might have to close sooner.
“I am totally gutted – it’s beyond devastation. It was bad enough last year when they announced they were closing in nine weeks. This is much worse.
“Clearly Cohealth cannot be trusted. They are putting the lives of vulnerable people at risk. They should be investigated for that.
“I feel like I am being blindsided all over again. Where is the transparency and communication. If I am only just finding out about this now, what about all the other vulnerable patients?
“It’s cruel and inhumane – how could they do this to us again, only worse. What did they learn from last time? Just to come in more ruthlessly.”
In October last year Cohealth announced it would be ceasing GP services at its Collingwood, Fitzroy and Kensington sites. Its Footscray clinic would continue delivering GP services.
Cohealth CEO Nicole Bartholomeusz – who has since resigned and leaves her post, coincidentally, also on 1 May – said at the time that the 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”.
The move sparked an outcry from patients, doctors and both the Victorian and Australian governments, with the latter expressing “deep disappointment” and calling for a reconsideration.
A month later the federal government threw Cohealth a $1.5 million lifeline to stave off the closure and keep services open until 31 July – now a fast-approaching date.
Alice (not her real name) reached out to TMR in the days after the news first broke about the closure of GP services last year.
She has been a patient at one of the GP services slated to close for some 15 years – even before it was rebranded to Cohealth.
“I have complex needs to say the least. A history of decades of homelessness, C-PTSD, heart disease, type 1 diabetes, stage three cancer without the status of remission and physical disability. And that’s just the major things,” she told HSD then.
Alice is in her early 50s, articulate and self-educated and caring for herself in her home about an hour from her clinic. She literally has no one in her personal life – no friends, no family – in fact her GP is listed as her only emergency contact.
“My GP knows if I don’t turn up it means I’m dead. I know I’m not an ‘easy’ patient to have. I’m a traumatised person who doesn’t trust most people.
“I trust my GP more than anyone I’ve known in my life. That trust took years to build.”
She told TMRthen that the loss of her GP – her anchor to the world – would cost her her life.
“The closure of Cohealth means I can die two ways,” she says.
“I can suffer for a short while then die or just take my own life and not drag out the suffering.”
Speaking through distress and tears today, Alice said her resolve remained the same.
“There is no other option for me,” she said.
“I’m not going to find another GP who will give me the time my doctor does, who understands my complex care needs and who I trust completely.”
The fresh wave of uncertainty comes just a month after Cohealth released its submissions to the independent review into its GP services, in which it admitted it “could have done better” in handling aspects of communication and decisions about its GP closure.
“Cohealth recognises that the process leading to the decision to close GP services at these sites was difficult for many people, and that aspects of how the decision was planned and communicated could have been handled better by Cohealth,” it wrote.
The organisation said in its submission that it agreed that in future it would engage with communities earlier, before decisions were completed.
It would also make sure there was enough time to consider different pathways before decisions became urgent and make sure those decisions were understood by the people they affected most.
The submissions included a Health Policy submission and a Client Voice submission.
Alice said she had been told this week by a Cohealth administration staff member that the six-month reprieve had not been a permanent solution, but rather extra time for patients to find alternative GP services.
She told TMRthis was the first time she had been told this, and when she asked where the information had come from, she was told it was from Ms Bartholomeusz.
“We still haven’t seen the review and yet it seems the decisions have already been made,” Alice said.
“And then I find out I should have been using this time to find another GP. There was nowhere to go in December, what has changed now?
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“It was never made clear to me that during this grace period I should have been looking, and four months have passed.
“To tell me now is appalling, and if it is even possible, it’s much worse than last time. I know the CEO is leaving but the whole board has to go, in my view.
“They talk in their submission about remorse and how they could have handled things better. They have done the absolute opposite of that.”
In a statement to The Medical Republic today, a Cohealth spokesperson said the organisation had been “managing general practice appointment availability on a monthly basis at our Collingwood, Fitzroy, and Kensington clinics since March this year, with a follow-up list maintained for appointments in subsequent months”.
“Appointments are currently available to book through to the end of June, and we expect to advise patients of July appointment availability during May,” he said.
“This approach supports the management of appointment availability and helps ensure our general practice doctors are able to prioritise and support people experiencing vulnerable circumstances who may require additional care and longer consultations.
“There have been no changes to Cohealth’s commitment to continue delivering general practice services until 31 July, supported by the joint funding commitment from the federal government.”
The spokesperson said Cohealth understood the Independent Review report had been provided to the state and federal governments for consideration.
“The final report has not been provided to Cohealth,” he said.
“Cohealth has remained in active contact with both state and federal governments regarding the anticipated timeframe for the review’s release.
“We acknowledge that this uncertainty creates understandable concern for both our clients and staff, and we are committed to sharing any updates as soon as further information becomes available.”
He said that “Cohealth continues to advocate for solutions that ensure people with complex needs can access the care they require”.
“We are also working closely with clients and community partners to support continuity of care while the Independent Review process remains ongoing,” he said.
The Cohealth board was also continuing the process for the chief executive position recruitment, he added.
Two questions remained unaddressed however, including:
- Has Cohealth made any decisions on the future of GP services at any/all of its sites?
- Have any GPs left and if so, how many? How many are left?
Watch this space.
