Croakey: It’s (well past) time to rewrite election narratives about healthcare

Introduction by Croakey: As the Victorian state election approaches, the political and media focus on acute care and hospital “announceables” obscures the value of community-based health services, according to Lanie Harris, communications and media adviser for cohealth.

cohealth is one of Victoria’s largest community health services, with more than 1,200 staff delivering health services from 30 locations across the inner, west and north of Melbourne, delivering services to Melbourne’s most disadvantaged people. 

Lanie Harris writes: 

Recently a journalist from a major media outlet contacted cohealth to ask if we could help them get some stock photos to accompany health-related coverage in the lead-up to the election.

“It’s a ‘health election’ after all, so we’ll be needing lots of shots of health settings and health workers,” the reporter told us.

The media is an important ally, and a vehicle for bringing attention to the issues that matter to cohealth – and to our communities – and we’re always keen to facilitate their needs.

However, it soon became clear that the journalist had a very narrow brief for capturing images that represented Victoria’s health system. Specifically, he was seeking photos of nurses and doctors in scrubs, surgical equipment laid out on trays, people on examination beds shielded by curtains.

Although I explained we could mock up such ‘hospital-type’ scenarios at any one of our 30 community health sites across Melbourne’s north and west to satisfy the photographer, I encouraged him to broaden the images he was considering.

What about some photos of our refugee health team who provide culturally-safe, trauma-informed health care to people who would otherwise miss out due to barriers of language, finances or discrimination?

Perhaps shots of our exercise physiologists who run exercise programs for older people to help reduce their chance of falls, and prevent hospitalisation?

How about our alcohol and drug programs which distribute overdose-reversal drug Naloxone to clients to reduce drug-related ambulance callouts?

Or our Community Connectors working in the public housing high-rises to make sure people have the health information they need in the language and format they understand?

Or our Homelessness Health outreach team, who take multidisciplinary care to people on the streets, in rooming houses and caravan parks?

I’m sympathetic to this busy journalist’s dilemma. He’s simply trying to find a way to communicate with a readership with a short attention span, and a limited understanding of the health system.

But the exchange reflects a much larger systemic issue; an entrenched public narrative that healthcare equals hospital-care.

Can you blame the public for holding such a narrow view of health when this view is perpetuated by both the media they consume and the politicians they look to?

So far this election campaign we’ve seen some big ticket health commitments, but they have all been oriented towards acute care settings, including most recently a $6 billion pledge to upgrade the Royal Women’s and Royal Melbourne Hospital and build ‘Australia’s largest hospital’.

As Dr Stephen Duckett, a former federal Department of Health secretary, recently told The Age “At election time, health policy is always at risk of succumbing to the ‘edifice complex’: Health policy gets defined as building more hospitals because governments think that’s what the electorate understands.”

The political lure of a hospital announcement can be difficult to resist; however, we need the major parties to balance pledges to new hospitals with more funding for services that keep people out of hospital.

Of course it’s not an ‘either/or’ scenario. We need well-funded hospitals for very unwell patients, but if we don’t adequately resource community-based health services, then we will be missing opportunities to prevent many of those people ending up in hospital. 

Prevention is, of course, not only about most efficient use of our health dollars but just as importantly is also about preventing illness and suffering – the human costs.

As cohealth and countless other health advocates have long pointed out, our health system is fragmented and oriented towards responding when people get very sick, which is inefficient and costly for patients and the state.

We need a shift in political thinking and public understanding of what makes a good health system, and to strengthen the services that do the heavy lifting to keep people out of acute care settings.

Everyone deserves access to the physical and mental healthcare they require, delivered in the places that suit them.

Care should be provided as soon as it is needed and integrated with social support to best treat conditions before they require acute, complex care.

Just four kilometres away from the promised ‘largest hospital in Australia’ is cohealth’s rundown Hoddle St community health centre in the inner-city suburb of Collingwood.

The building has been providing health services for 45 years to 12,000 people very year. The services are open to anyone. From cohealth Collingwood, people can access GPs, allied health, a low-cost pharmacy, mental health programs, alcohol and drug support and community cohesion activities.

But the clinic is rundown and in much need of funding. The ceiling leaks, the floor is uneven, many of the clinical spaces have no windows and the carpet is water-stained.

In many ways, our tired old community health centre in Hoddle Street is emblematic of the neglect of community health. We’ve been calling for State Government investment for nearly five years to enable for the redevelopment of our much-loved health centre, but so far, the pleas have fallen on deaf ears.

The community health sector knows how to create healthy communities, healthy people, and adequate funding is vital to allow us to achieve that vision.

With just 40 days until Victorians go to the polls, it’s time for the major parties, and the media, to resist the pull of an easy photo opportunity, and give attention to the community-based care that helps people stay well and prevents avoidable hospital admissions.