Chief Executive Blog

Community health is critical to reducing health inequity

15th June 2018

‘cohealth saved my life one piece at a time’.  The woman who said this had used a range of our services over the years – doctors, dentist, physiotherapist, podiatrist, dietician and counselling services.  She’d been linked in with other support services and now, having been able to get the support she needed when and where she required it, sees a positive future. To me, her experience of wrap-around, person centred and culturally relevant care epitomises the value of community health services.

I’d like many more people to be able to receive this sort of care, in their community, with stronger links between primary care, hospital and other health and social services facilitating this care.

Community health is too often overlooked in health conversations that focus on hospitals and doctors.  So I was delighted that the value of our sector, and the integrated care we provide, was recognised recently by the Victorian Auditor General’s Office (VAGO) in a report on the Community Health Program.  The report highlights the exceptional contribution community health services make to the health of individuals and the community.

Our Victorian community health services are unique in Australia.  Working from a social model of health we provide primary care to local communities, with a deliberate focus on key groups of people: those who are socially or economically disadvantaged, experience poorer health outcomes and have complex health needs or limited access to appropriate health care.  Our services support healthy bodies, minds, families and communities. So along with medical care, we also provide nursing, physiotherapy, speech therapy, occupational therapy, dietetics and podiatry. Community health service providers respond to the needs of their local community.  Across the state we provide a platform for the delivery of an array of services: early years, family violence, dental and oral health, mental health and alcohol and drug, homelessness support, refugee health Aboriginal and Torres Straits Islander health, and many others.

Critical to our success is our close connection to the communities we work with, and the way we work with them to ensure the design of services that best meet local needs.  For decades now we have been building successful models of care with those who use them.

We know, and it’s supported by research, that there’s a pressing need to provide health care in the communities where people live, and early, before conditions worsen and treatment and care become more costly. Increasing inequality means that ensuring there is affordable access to care is critical for people who experience disadvantage.  This is precisely what community health does.

In a world of increasing health inequality, it’s my firm view that community health services have a critical role to play in reducing health inequity – bringing much needed equity and efficiency to our health care system.  But to effect this change we need sufficient, sustainable, and flexible funding.

I’m pleased to see that the VAGO report recommends the Department of Health and Human Services develop a more sophisticated funding model. Also that better understanding of our key population groups needs to underpin planning for service delivery. It’s also clear that community health funding is not sufficient to meet the demand.  The VAGO report highlighted that as a consequence, many community health services are unable to promote their services as they don’t have the capacity to meet increased demand.

Over recent years, the combination of growing and changing community need, reduced funding, increased administrative requirements and significant and ongoing changes to policy and funding approaches has created considerable pressure and uncertainty for many community health organisations.

The Government has recognised these challenges, and is establishing an Expert Taskforce to identify ways to grow Victoria’s community health sector. I expect this will greatly enhance the knowledge and opportunity presented by community health to leverage engagement and good practise to improve access and efficiency.

I look forward to working with the Government to develop a more sophisticated and flexible approach to community health funding and policy that will ensure the sustainability and quality of community health services for years to come.  An approach that will see community health properly aligned with other parts of the health system and funding structured to incentivise models that demonstrate outcomes in areas we need them most.

I am confident that with the right investment community health services can play a significant role in improving health outcomes for priority populations, and reducing pressure on other parts of the health and social care system.




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