Parliament of Victoria | Legislative Council | Motion 1118 – Dr Mansfield
29 October 2025
David ETTERSHANK (Western Metropoltian Region):
I would like to talk a little bit about the Kensington experience in this matter, because I have been a resident there for 30 years and the Kensington community health centre has been a part of that community since 1975 continuously. I will come back to the history and the nature of the organisation in a minute, but the meeting we had on Saturday morning was on very short notice.
It was 10 o’clock in the morning, which is a terrible time to do a community meeting, and we still had a couple of hundred people there packed into the Holy Rosary School hall, and they were thoroughly, thoroughly outraged and frustrated.
I think in large part that was due to the fact that the communication from Cohealth was atrocious, to the point where both staff and patients found out about it from the Age, from the Herald Sun, from the ABC or from their neighbours but not from Cohealth. No rationale, no FAQs, and going hand in hand with that was the entirely opaque decision-making process.
As Cohealth have grown so too have their governance structures changed, and they have gone from roughly half professional and half community voices to a self-selecting board that perpetuates its own wisdom and invariably narrows its scope. I think the way in which this has been handled is just an indictment of the current organisation. They really need to take a good, hard look at themselves, because there are so many distressed people that having a simple discussion is extremely difficult.
As I said, the Kensington community health centre was set up in 1975. My first involvement with it was in about 1993, I think. I was working for the Health Services Union, and I got a phone call from the union rep saying, ‘They’re forcing us to merge with the Flemington community health centre. We’ve put a ban on the CEO; we’ve cut off her communications. We’ve set up a picket line out the front. Can the union send someone out, because we need to know what to do next,’ which I thought was pretty damned impressive.
But it is a spirit of fight that has been within these community health centres for more than 50 years. And when they were merged into Doutta Galla Community Health Centre there was argy-bargy and a bit of aggro, and then that in turn ultimately got aggregated into Cohealth.
Cohealth do some great work. They have some innovative programs. They have a lot of incredibly skilled, talented and committed staff, many of whom feel betrayed by this. More than that, in many of these suburbs the community health centre is part of the fabric of the community. It is something that people come to rely on.
Particularly in Kensington, where we have got a large public housing cohort, the Kensington community health centre also services a lot of residents from the Flemington flats and some from the North Melbourne flats. It has got a big catchment, and its books have been closed for years – literally one in as one dies or moves away. It is that tight, and it is also a testament to how good the service is and how restricted the resources are.
If we look at who is, for example, in the Kensington public housing estate, we see that there was put in by the government – a Labor government at the time – specifically an older persons block, so we inherently got older, complex patients. It is also a first port of call for refugees, many of whom have been through horrendous life experience prior to coming here, and they get dropped into Kensington.
Up until now they could look at a suite of wraparound services, from primary health through to allied health and suchlike. This is a really, really important part of the community, and to have the rug so suddenly ripped out from under them is horrendous.
My understanding is that of the roughly 55 community health services around Victoria only seven now offer GP services, so that is a dying trade. But in those neighbourhoods and in those catchments where we are talking about older and often more complex clients, the wraparound suite of services that are provided are critical not just to caring for those people in situ but also to preventing, as has been alluded to before, admissions to hospital and to other health services.
When we look at an organisation like this and we hear the state government saying, ‘We only do capital works,’ and the feds saying, ‘We do Medicare, but their model doesn’t work with us,’ it is not good enough. From a state point of view there are something like 80 programs that are run through and funded – many of them are state, and you cannot just tease out one service or another, particularly if you are offering a wraparound suite of services.
The other thing that Cohealth does is it has its doctors on salary, and those salaried doctors are fantastic. But of course if you look at, for example, the recent Medicare bulk-billing incentive from the feds, it was targeted particularly at places where you are not dealing with salaried medical officers – you are dealing with GPs who are doing a bulk-billing service, and bit under half goes to the service and bit over half goes to the GPs. At Cohealth that does not happen, because they are salaried, so that is a problem as well.
If we have this rug pulled on the GP services, it is like pulling one thread in a woollen jumper: it is all going to unravel, and the quality of care and support provided will inevitably be fundamentally reduced.
In that context we support the motion that has been moved by the Greens. We thank them for kicking this off. We indicate that this is a really, really important issue for the communities that are directly affected, and I think everyone is very committed to fighting it. Kenny and Flemington have always been fighting. This will just be another encouragement and the next campaign because this is worth fighting for.
The community is committed to getting this change, and I would call upon the Minister for Health at a state level and I would call on the health minister at a federal level to come together to reach some understanding about how funding shortfalls can be addressed and how the structure of Medicare incentives can be tweaked to allow for the models of care that are premised upon quality time with patients over a longer timeframe to be maintained and for that suite of wraparound services to continue to be provided to the communities concerned.
[Motion agreed to]
