cohealth was born in 2014, but has a long and distinguished record of taking care of people in our local communities.
cohealth was born in 2014 with the merging of Doutta Galla Community Health, North Yarra Community Health and Western Region Health Centre. Each centre had a long and distinguished record of taking care of people in their local communities. The dynamic and diverse histories of each of the three original centres reflects the rise and evolution of community health in Australia. Their origins were in inner city localities which were home to working class, heavily industrialised communities with successive waves of immigrants and frequently high levels of disadvantage.
cohealth has continued to build on this people-focused history by expanding its services to all members of the community, reflecting the vision in the 2019-2023 strategy for ‘healthy communities, healthy people’. For cohealth, ‘care’ is about providing high quality healthcare to people who are unwell, as well as caring for the social conditions that people need for good and healthy lives. We continue to advocate and campaign in partnership with people who have lived experience of the issues. We work at individual, community and societal levels. Our efforts are proportionate to need.
The inner north-west was, in the 1970s, a heavily working class area, surrounded by industry and with a large immigrant and dependent population, yet under-resourced medically. Local church leaders, residents and academics campaigned for a health centre. The community health model appealed because its integrated and responsive approach could “address the wide range of need in disadvantaged communities whose health problems were often grounded in political, social and economic inequalities’ (Paul Aron, p.12). The federal election of the Whitlam government in 1972, with its support of community health and policy of working with states to develop regionalised services, accelerated the establishment of a community health centre in Kensington in 1974. The centre’s 1976 Annual Report declared that within the first few months of the centre’s opening, “half the families of Kensington already use the centre” (page 18).
The Flemington Community Health Centre was established in 1977 with centres eventually being established in North Melbourne and Ascot Vale. A ‘drop in’ atmosphere saw regular users accessing diverse social support and medical services. Community development strategies saw numerous health support groups being established, many crucially supported by interpreters, to support community engagement. Many of the groups focused on women, recognising gender equality as integral to the social model of health. Centres were run as a flat staff structure staffed by people adept at political campaigning. Community issues such as housing, high utility bills and inappropriate urban developments were addressed through political advocacy and activism.
The end of the 1980s saw a review of community health from the state Health Department and sweeping changes to Victoria’s health services and their administration. Subsequent pressure to amalgamate eventually led to the creation of Doutta Galla Community Health Centre. The Jeff Kennett Liberal state government in 1992 saw funding cuts totalling 11% and community centres were pressured to operate as businesses with fees consequently introduced on a means tested basis for some services. There was a shift towards ‘health promotion’ in the health sector which was at odds with the belief that community health starts with addressing the social determinants of health . The Flemington Health Centre controversially closed, and then Ascot Vale, while Doutta Galla was forced to extend its services to provide for a larger population catchment area to gain funding. The push to rationalise services and increase efficiencies was a fraught affair with the popular demand for some services not matching funding or fees.
Another Kennett era reform was a move toward competitive tendering for services. Organisational informational flow between competing organisations was compromised but partnering organisations were now able to win large scale tenders. The Labor government of 1999 introduced the ‘Primary Care Partnership’ model to replace the competitive approach and promote a fully integrated range of services. Doutta Galla expanded greatly in the 2000s while a Community Advisory Group was formed in 2008 to strengthen the board’s mandate as a voice for the community.
Established at 162 Wellington Street, Collingwood in 1889 as the Collingwood Free Medical Mission Dispensary ‘for the relief of the destitute sick of every creed and clime’, it was the first Dispensary in the Colony of Victoria. Responding to public crises resulting from industrialisation and urbanisation, dispensaries provided medications, clinical care, home visits, minor surgery, casual dentistry and vaccinations.
Since 1840, industrial Collingwood remained a ‘hard-bitten, hardworking, hard living and hard drinking neighbourhood’ (Missionaries, Radicals & Feminists: A History of North Yarra Community Health by Hamish Townsend, page 29). Known as ‘Singletons’ after its founder, reformer, philanthropist and evangelical Christian, Dr John Singleton the dispensary viewed ill-health as largely a result of ‘intemperance’. Patients were encouraged to read scripture and pray while waiting for medical attention. Female doctors were controversially engaged.
Demand for medical services by people living in poverty greatly increased during times of economic depression (1890s and 1930s) and during World War I and II when Singleton’s distributed welfare. The 1970s saw the rise of social justice movements and a new generation of educated, progressively minded health professionals. The brief tenure of a progressive federal government under Labor’s Gough Whitlam provided funding and support for community health. The ethos of the health service evolved from providing welfare to the ‘deserving’ disadvantaged to one aimed at providing healthcare to all and promoting empowerment, agency and advocacy.
In 1977 the organisation moved to 365 Hoddle Street as the new Collingwood Community Health Centre. Occupational health was a focus, as was an emphasis on prevention and conducting ‘hyper local’ research. Research outcomes into the health effects of lead petrol on the local community – after the much-opposed construction of the nearby Eastern Freeway – contributed to the 2002 phasing out of lead petrol in Australia.
The Carlton Community Health Centre was established in 1979 at 622 Lygon Street while the Fitzroy Community Health Centre resulted from the 1982 separation of St Vincent’s Hospital with its community health centre, Depaul. The rise of economic neo-liberalism saw a political climate of deregulation and privatisation, with governments increasingly seeking private provision of health and education services. A ‘Campaign against Entrepreneurial Medicine’ mobilised the Fitzroy Community Health Centre and the Collingwood Community Health Centre, amongst others, against private super-clinics establishing themselves in the area.
The late 80s saw the rise of youth homelessness, drug taking and the appearance of HIV/AIDS. Collingwood Community Health Centre provided a ‘drop in’ service which included a needle exchange program. Funded federally, the needle exchange program represented a highly successful national strategy to prevent the spread of HIV/AIDS and Hepatitis C.
The Jeff Kennett-led Liberal Party in the early 1990’s resulted in funding cuts to community health centres and a move toward amalgamation, despite the neighbouring community health centres having little contact with each other. More than 500 users took to Brunswick Street to demonstrate on 17 May 1993 and the Collingwood site was occupied for nine months. Carlton, Collingwood and Fitzroy Community Centres amalgamated as North Yarra Community Health (NYCH) in 1994, with an enforced emphasis from the government on clinical services over community participation, development and liaison programs. While core operational funding had contracted significantly there was however an increase in program delivery budget. Reconnecting with the community became a priority and public members and groups attended weekly meetings, addressing the broader view of community health.
Western Region Health Centre (WRHC), formerly the ‘Trade Union Clinic and Research Centre’, was established in Footscray, in Melbourne’s west, in 1964 by the Australian Meat Industry Employee’s Union (AMIEU) in response to the high incidence of injury in the meat industry.
This innovative Clinic broke new ground in providing treatment for people who had industrial accidents or work related illness, and in conducting research into causes and possible solutions. Instrumental in establishing the Clinic was Mr George Seelaf, then Secretary of the AMIEU, who lay the foundations for the Clinic’s first Medical Director, the visionary Dr Moss Cass to bring health services to the workers.
With the demise of the meat industry in the 1970s, the Clinic became Western Region Health Centre and engaged in providing health and support services for the largely low-socioeconomic local community, at a time when support for community-based healthcare was increasing. Greater ethnic diversity in the inner west, as new waves of immigrants including people from refugee backgrounds, added to the already complex demographics of the area, and called for greater health outreach services in order to connect with the community.
The 1990’s saw considerable growth for WRHC as it expanded its reach throughout the western region. This growth included the opening of a public dental clinic in Paisley Street; pioneering work in the development of the Refugee Health Service Model in partnership with the Victorian Foundation for Survivors of Torture; and the merge with the Braybrook/Maidstone Community Health Centre.
In the tradition of its founders, throughout its fifty years of service delivery, WRHC continued to be quick to recognise and respond to community needs. Post-millennium WRHC commenced delivery of mental health services; opened a primary health service for injecting drug users; took over management of the School Dental Service in Geelong Road, Footscray; extended its range and spread of mental health services; launched an arts program to engage community and improve health; embedded a community advisory committee in the organisational structure and processes to support input from consumers; added many specialist services; and expanded services across the west.
By 2014 WHRC operated from 20 locations across Melbourne’s western region and delivered an extensive and diverse range of health and support services. The focus of WRHC had shifted since its inception, away from the labour movement and industrial safety, towards community and in particular, people experiencing disadvantage who needed services most.
2013 Premier’s Award for Primary Health Service of the year
2010 & 2009 Victorian Government’s Fair and Flexible Employer Recognition Award
2005 Premier’s Award for most outstanding Ambulatory Healthcare Provider
cohealth is a not-for-profit community health organisation. We provide essential health and support services in Melbourne’s CBD, and northern and western suburbs.