Parliament of Victoria | Legislative Council | Motion #1336 by Dr Mansfield
17 March 2026
David ETTERSHANK (Western Metropolitan Region):
I rise to speak in support of this motion from Dr Mansfield on the urgent need to secure the long-term future of the Cohealth Fitzroy, Collingwood and Kensington facilities. These services form a critical part of Victoria’s community health system, providing essential, affordable and trauma-informed primary care to thousands of people who rely on stability and continuity for their health care.
For many years Cohealth has been sounding the alarm that the current funding model for community-based general practice is no longer fit for purpose. Medicare in its present design funds short standard consultations, yet the reality in community health is vastly different. Many patients present with complex physical, psychological and social needs that require extended appointments, multidisciplinary input and coordinated care planning. The mismatch between funding and service needs has grown steadily, leaving Cohealth with an unsustainable gap between the cost of providing care and the revenue available to support it.
Recently, temporary Commonwealth support has allowed these GP services to continue operating while a broader review takes place. That interim review is welcome, avoiding any immediate and damaging disruption to care. That independent review is now examining Cohealth’s clinical model, governance arrangements and financial structures. The findings will hopefully help guide a long-term solution, but temporary measures cannot be mistaken for lasting reform. Without decisive action now, we risk facing the same crisis again once the short-term funding expires.
The impact of GP service withdrawal would be devastating for the people who attend these centres, who often live with multiple chronic diseases and ongoing impacts of trauma or face challenges such as homelessness, unstable housing, addiction or mental ill health. For many their GP is the cornerstone of their health journey – the clinician who understands their history, their circumstances and their barriers to care. Losing that continuity is not a simple administrative inconvenience; it can mean the difference between stability and crisis, between life and death. The closure of Cohealth would place additional strain on hospitals already under significant pressure and increase the risk of late presentations, preventable complications and poorer health outcomes.
Just as concerning is the cascading effect that the loss of GP services would have on the broader integrated care model that defines community health. These centres do not operate as standalone general practices; they offer wraparound services, bringing together GPs, nurses, counsellors, pharmacists, allied health practitioners, mental health workers, alcohol and drug specialists and more.
However, it is the GPs who initiate referrals, manage medications, lead multidisciplinary case discussions and provide the medical oversight necessary for integrated care to function. GPs are the clinical anchor in this model.
When GP services are compromised, the entire ecosystem becomes unstable. We have already seen examples of counselling and pharmacy services and pathology services being cut or relocated because the loss of GP capacity weakens the model that sustains them. Without strong GP services, the other parts of community health cannot flourish.
I wish to highlight ongoing community concerns regarding governance arrangements across the sector. Community health was built on a foundation of local participation and accountability. Over time, however, decision-making at Cohealth seems to have shifted further away from the communities they serve. At recent forums, staff, patients and local residents have expressed their distress at feeling disconnected from processes that directly impact their health care. Restoring community involvement, transparency and partnership must be prioritised to rebuild trust in that system.
Then there is unmet demand. Many community health centres, including Kensington, where I have been a resident for some 30 years, have struggled for years with limited GP availability and lengthy waitlists.
It is clear that demand in many inner-urban areas exceeds supply, so there is a need to plan, not merely to preserve existing services but to expand capacity where possible. In Kensington, even as population grows rapidly due to densification, the number of GPs available to the community has actually dropped.
This is insane, particularly given that the redevelopment of Kensington housing estate included a large dedicated older persons’ building, as well as major age-friendly retrofits to the two towers, specifically undertaken because of its proximity to the community health centre only a couple of hundred metres away.
Closing or reducing services in high-need communities will only push more people into crisis and leave even fewer options for those with the greatest barriers to care. This is why the forthcoming recommendations of the independent review are so important. We have an opportunity to design a GP service that genuinely supports complex care while also expanding capacity to provide general bulk-billing services.
A new funding framework must include a stable base for the fixed costs of multidisciplinary work, flexible support for longer consultations, recognition of the extra time required for trauma-informed and culturally safe care and incentives that reward positive outcomes rather than high-volume, low-complexity throughput. This is the type of model needed to sustain and strengthen community health now and into the future.
The government needs to act decisively. First, we must ensure that GP services at Cohealth continue beyond the expiry of the temporary funding. Continuity must be guaranteed so that patients and staff are not forced back into uncertainty and the closure of services effectively becomes a self-fulfilling prophecy.
Second, we must embrace a modernised funding model that reflects the realities of community-based care and incorporates the findings of the independent review.
Third, we must invest in the infrastructure required for safe and effective service delivery, recognising that ageing buildings and outdated facilities can no longer support the demands placed upon them.
Fourth, the integrity of the integrated care model must be protected. General practice, counselling, pharmacy, allied health and mental health services cannot be separated without undermining outcomes.
Fifth, we must restore strong community governance structures to ensure that local voices and expertise guide the evolution of community health. Finally, we must expand GP services where demand is greatest to ensure that no Victorian is left without timely and appropriate care.
Community health is one of Victoria’s greatest social assets. It supports people who would otherwise fall through the cracks. We know that if these GP services disappear the cost will be borne not only by those most in need but by the entire health system.
We have the opportunity now to prevent that, to strengthen the foundations of community health and to ensure that every Victorian has access to the care they deserve. No Victorian should be left without the health care they need – not today, not next year, not ever.
[Motion agreed to]
