Cohealth is owning its mistakes with an apology to staff and clients for how they managed the closure of their GP services. But still the board remains.
Community health hub Cohealth has started its journey of rebuilding trust, sending an apology letter to each client and staff member.
The letters admitted that Cohealth failed in how it communicated and managed the proposed closure of its Collingwood, Fitzroy and Kensington GP clinics.
“We heard you. We are deeply sorry. We recognise that this process has been traumatic for many of our clients, communities and staff,” the letter to clients began.
Cohealth admitted it didn’t give people enough time, information or support to understand what the changes meant for clients. It also didn’t inform people or support them well enough.
Cohealth admitted it needed to work hard to rebuild trust and that people deserved to have more certainty about their care.
This article originally ran on TMR’s sister site, Health Services Daily. TMR readers can sign up for a discounted subscription.
The organisation said it will work with governments to support these services and will keep clients informed about this work.
“We want to make these changes with you, not for you,” the letter said.
In the letter to staff, Cohealth admitted it should have drawn on the collective knowledge, expertise and insights of coworkers and the community.
“Engaging earlier and more meaningfully may have helped us better understand the impacts of our proposals and identify possible alternative pathways forward.”
It admitted it didn’t give enough time to consult, understand the impact and put appropriate pathways and alternative supports in place for clients.
“We should have better anticipated and understood the widespread impact such a decision to close the services would have on you, our clients and our communities and better prepared for this.”
The letters are the beginning of a period of transparency, a spokesperson told The Medical Republic on Friday.
“The board feels it’s very important to draw a line in the sand with the community, recognise the impact, apologise for it, and be able to move forward in a different way,” she said.
Cohealth management hopes that it is enough to show the community that the board is ready to show up differently.
However, what it also shows is that while the communication may be different, the actual board remains the same.
There was a recommendation from the authors within the body of the report that the board be sacked. Head of the review, Professor Stephen Duckett, went further the day after the review was released, saying on Melbourne radio: “They’ve had their chance. They’ve got to go.”
Despite these explicit words, it didn’t translate into one of the key 13 recommendations of the Duckett review.
Instead, the review recommended the Victorian government “invite Cohealth to show cause why the Minister should not form the view that Cohealth:
- “is ineffectively managed; and/or
- “has failed to meet one or more performance standards.”
When asked why the board has not been sacked, the Cohealth spokesperson referred to the fact that it wasn’t a formal recommendation.
“That actually is a matter for government in relation to what they are choosing to do for that recommendation,” she said.
There will be some renewal at the top, however.
It was was announced in the year that CEO Nicole Bartholomeusz had resigned with an original departure date of 1 May. However, after board chair Kate MacRae stepped down, Ms Bartholomeusz’s departure was delayed until 31 July.
There have recently been calls within some areas of Cohealth to keep Ms Bartholomeusz on. Some staff are allegedly concerned about being asked to support such a campaign.
The Cohealth spokesperson confirmed that such a campaign would not be successful and that recruitment of the role was ongoing. Ms Bartholomeusz will leave at the end of next month.
The spokesperson also confirmed that deputy CEO Christopher Turner is not currently working, although she didn’t confirm the reasons why not.
The last few weeks have seen other activity, including active recruitment to bring on several new board directors and a chief medical officer, as recommended in the review.
Cohealth has been working on an implementation plan in partnership with both state and federal governments. This may include reinstating the Collingwood Pharmacy and counselling services in a service redesign, as community feedback has shown how important those services are.
Cohealth has resubmitted the Collingwood redevelopment proposal to government, as recommended in the review.
With the federal government, Cohealth said it was taking the recommendations into account and working on what actions need to be taken.
“That is what’s being worked through at the moment, in relation to that timing around those recommendations, what activities come first,” said the Cohealth spokesperson.
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With the state government, Cohealth has been having conversations throughout the whole process.
“The state’s been really constructive in that engagement and those conversations continue.
“It’s about how the governance arrangements, involvement of them in some of the recruitment activities that are underway.
“Then obviously with the governance issues, and some of the issues that were called out in the report, [we are] talking to government about what the enhancement to improve those arrangements looks like,” she said.
However, what Cohealth really wants is federal government support.
“We are still seeking [the federal] government’s public endorsement and acceptance of the recommendations that are for them,” she said.
While Cohealth has publicly come out and accepted the recommendations 10 to 13, it is still working with government to accept and fund and support the recommendations that were directed to the government.
“Without government accepting those recommendations, we are not able to realise the full potential of the reform,” the spokesperson said.
One of the recommendations was that the federal government consider using Cohealth as a pilot for a new approach to funding multidisciplinary teams in primary care services.
As reported in Health Services Daily, some of the GPs at Cohealth have already been working on what that looks like.
“Cohealth has a belief that a two-year pilot is the way to go to give enough time to actually properly develop a model of care that has the input that the review calls for, and give it enough time to run,” the Cohealth spokesperson said.
“You’ll see in the recommendations a call for funding of an evaluation of that pilot. We think it’s really important that it’s funded and evaluated, so the community and government can see what is required to run a different model now.
“But what it requires is acceptance and support and funding of all of those recommendations.
“Stephen Duckett said that this has to be done in its totality. This is a reform package … We can’t do it alone. The stuff that we’re being asked to change will only go so far,” she said.
TMR asked both the Victorian and federal governments for a response to the recommendations and to provide a statement for this article. Neither responded before our deadline.
Read Cohealth’s apology to clients here, and its apology to staff here.
