Community health means no-one falls through the cracks Analysis

Community health means no-one falls through the cracks

Community health services are the quiet achievers of Victoria’s health system. Under increasing pressure and desperate for more resources, they continue to give healthcare to those who need it most. They step in when someone puts their hand up for help, and respond with comprehensive care.

Martin Proudfoot, a client of Star Health in inner Melbourne, knows how valuable community health services are for him and other community members. “Our health care system is very hard to navigate by yourself, and for people with complex needs, or those who can’t because they have depression, brain injury or intellectual disability. Often a clinician in one discipline may identify a service that could help individuals presenting for something totally different. There are so many skilled professionals available and willing to help – this can be life-changing.”

This life-changing help could come from health professionals like dietitians, counsellors, drug and alcohol workers and podiatrists. There are suicide prevention programs, youth services, chronic disease programs and Aboriginal health services. Outreach workers find people sleeping on the streets and help them get much needed care from their local community health service. Care is given at low or no cost in places that are easy to get to. Amongst other things, community health services provide state-funded primary healthcare, focusing on people at risk of poor health.

Strong primary and community health services help to keep people out of hospital. They provide effective prevention and early intervention services. A recent VAGO report found that, in 2017–2018, the 85 community health services across Victoria delivered around 100 million hours of allied health and nursing services, while receiving about $105 million in funding. This makes up less than 1 per cent of Victoria’s health expenditure. Now, in the lead-up to the Victorian election, community health services are banding together to advocate for more funding.

In 2015–2016, more than a quarter of hospital visits were considered avoidable. The health dollar can go further by focusing on health outcomes, prevention of chronic disease and early intervention. This is the bread and butter work of community health.

Make no mistake – without community health, people in need will fall through an ever-widening gap.

This is the real fear for Margaret McDonald, CEO of Cobaw Community Health Service in the Macedon Ranges. Since Cobaw’s paediatric service closed its books to further referrals in June, parents in the region have been searching for ways to get their kids in to see a local specialist. Cobaw’s strength is that it provides intensive paediatric support in the community: locals don’t have to go to Melbourne to see a paediatrician.

The service has one paediatrician working eight days a month, and another full-time paediatric registrar. They have ongoing management of 650 children. Cobaw covers five local government areas, and its 100 staff can’t keep up with demand. “Last year we promoted our services, and within 10 days we had 19 referrals. We’re cautious to market a service where we know there is demand”.

There is no doubt that the community paediatric service is much needed, but it has not been able to secure more funding. This has brought Margaret McDonald’s voice to the campaign for more community health funding.

“For 20 years we have known that you get quadruple return on your investment. We need government to be courageous and invest in community health just to meet the demand. We know community health can deliver these services at a cost effective level.”

Community health services are unique in that they’re well connected to the community and, importantly, they’re the go-to service for hospitals, general practitioners and any organisation working with people at risk of falling through the cracks.

In the lead-up to the Victorian state election, community health services have agreed on key priorities that will help them meet the needs of their clients and communities. We understand how important community health services are in improving the lives of Victorians, and we #standwithcommunityhealth.