cohealth’s submission to the Federal Government’s pre-budget process proposes an innovative model of co-location of health care, social support services and housing services to create a community hub centred on the whole person. We emphasise the critical importance of also improving the circumstances in which people live, work and age.
cohealth has a clear vision of healthy communities, healthy people. The Australian health system is world class, providing excellent, cutting edge care. However, we also know that too many people are not able to access the care they need, particularly those who experience disadvantage. As a result, these groups have poorer health than other Australians.
Everyone deserves access to the physical and mental health care they require, that best meets their needs, 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 acute, complex care is required.
Australia’s health system also faces a range of challenges due to a growing and aging population, rising rates of chronic disease and increasing inequality. Responding to these challenges requires reorienting the health system towards prevention and early intervention and providing more care in the community.
Community health services are in a unique position to deliver health and social care in this way. The sector has extensive experience working with people who face disadvantage and marginalisation and developing service responses to reduce their barriers to accessing care. For some groups this might involve ensuring interpreters are available for all appointments and written materials are translated into community languages; for others this might involve longer appointment times or outreach approaches.
With co-located medical, allied health and social supports, community health services can assist people to navigate an otherwise fragmented system to deliver holistic, integrated care. The provision of holistic healthcare for our communities is enhanced by the sector’s ability to draw together both State and Federal Government investment to provide a wide range of health and social support services.
Community health services can deliver on the vision of Australia’s Long-Term National Health Plan for a modern health system that better supports people to stay well and contributes to the Fifth Mental Health and Suicide Prevention Plan – to improve the lives of people living with a mental illness.
cohealth proposes to take this approach a step further by investing in an innovative model that co-locates health care and social housing on the one site, creating a community hub centred on the whole person.
In order to realise this ground-breaking proposal, cohealth seeks a commitment in the 2020-21 Federal Budget to invest $10 million over the Forward Estimates in the redevelopment of cohealth’s clinic at 365 Hoddle Street in Collingwood, Victoria.
The current facilities on the site are beyond their useful life and without significant investment, cohealth may not be able to continue operating at the location beyond the next three years.
At the same time, widespread improvements in the health and wellbeing of all Australians will not be achieved unless the circumstances in which people live, work and age – that affect their chances of a healthy life – are improved. cohealth therefore also urges comprehensive action on addressing the social determinants of health, including reducing socio-economic inequalities and poverty, increasing social and affordable housing, and tackling stigma and discrimination.
|Population growth||Victoria is the fastest growing state in Australia in terms of population and this will continue.|
|Ageing population||Victoria’s aging population is growing and is driving significant growth in demand across the health and social services sector.[i]|
|Rising chronic disease||More of us have chronic diseases, and the proportion of people who experience multiple chronic diseases and complex needs is increasing.[ii]
Higher prevalence of multiple chronic diseases is experienced by people living in communities with lower socioeconomic status.[iii]
|Rising inequality[iv]||Health is directly correlated with income, with health status rising as income and wealth rise[v]. As inequality increases, so too will the differences in health outcomes[vi], unless radically different approaches are implemented.|
|Rising homelessness and housing insecurity||Nearly 25,000 Victorians are homeless each night[vii], and very few rental properties are affordable to low-income earners. 3,000 new public and community-owned homes per year for 10 years are needed to relieve the pressure.[viii]|
|Growing social isolation||Social isolation and loneliness significantly increase risk for premature mortality and a range of health conditions. It impacts more on those people who are the most vulnerable.[ix]|
|Increasing rates of avoidable hospitalisations||A large proportion of hospital admissions could be avoided with appropriate care in primary and community settings|
|People are delaying care due to cost||People on low incomes are significantly more likely to miss or delay care due to cost.[x]|
cohealth and Unison have partnered to propose a redevelopment of the high-profile community health centre at 365 Hoddle St, Collingwood.
It will generate a cutting-edge supportive housing model that will sustain tenancies and increase participation by connecting people to existing services and activities.
The new, purpose-built facility will:
The location of this site near to public housing and areas of concentrated disadvantage within the City of Yarra (as measured by SEIFA ranking) makes it critical to the health and social outcomes of the local population. People who access cohealth services are presenting with more complex and more chronic health conditions, overlayed with social vulnerabilities.
Demand is also set to increase – by 2031, it is predicted that 18,000 additional visits will be required across the City of Yarra each year with the resident population estimated to increase by 32%. The increase in population, coupled with the loss of affordable housing options, will only heighten the need for local, affordable health care and housing.
The site at 365 Hoddle Street, Collingwood is aging, inefficient and is at the end of its lifespan, limiting cohealth’s ability to keep up with community demand. This redevelopment will ensure that cohealth remains at the site beyond the next three years.
The redevelopment would contribute to several Commonwealth health policy objectives. It would deliver on the modern health system envisaged by Australia’s Long-Term National Health Plan, providing more equitable and integrated care that better supports people to stay well.
Primary healthcare will be patient-focused, more accessible, and better able to provide preventative health and management of chronic conditions. It would also provide mental health services to particularly vulnerable groups.
We believe it is a good candidate for critical infrastructure investment through the Community Health and Hospitals Program, as it addresses three of the four key areas: preventative, primary and chronic disease management; mental health; and drug and alcohol treatment.
It would also assist government to deliver on the Aged Care Roadmap, as people with multiple health and social support needs, particularly older people, are the key demographic for housing at the site. Housing, health care and social support will be integrated on the one site so residents will receive the care and support they need to remain healthy at home, avoid illness and reduce pressure on the residential aged care sector and hospital system.
The overall cost of the redevelopment is projected to be $40 million. We propose to split the costs between cohealth, Unison Housing, the Victorian Government and the Commonwealth.
We anticipate a contribution from the Victorian Government towards the housing component of the project through a Social Housing Growth Fund. We seek a Commonwealth investment of $10m in the health clinic redevelopment.
|Unison Housing||$3.5 m|
|Victorian Government||$19 m|
|Commonwealth Government||$10 m|
|Total Cost||$40 m|
A detailed project prospectus is available.
[i] The number of people aged over 70 is forecast to increase 95% in the 15 years to 2031. Growth will be concentrated in Melbourne, Brimbank, Hume, Melton and Wyndham. https://nwmphn.org.au/our-community/community-and-population-health-profiles/
[ii] More than 90 per cent of people aged over 70 years have two or more chronic conditions https://nwmphn.org.au/our-community/community-and-population-health-profiles/