How a small investment in community health would pay off big for Victoria

Half a million Victorians would be spared a trip to emergency departments, and the state could save more than half a billion dollars a year for just a modest funding boost to crumbling community dental, disability, allied and mental health centres.

Tired buildings, treatment rooms not fit for purpose and decentralised services far from public transport are restricting the number of patients whom registered community health organisations can treat, the state’s independent infrastructure advisory body has found.

Infrastructure Victoria says that spending $150 million to $300 million over five years would reduce the burden on the state’s finances because high-quality community health infrastructure would ease pressure on hospitals and save the Department of Health as much as $554 million annually. The body estimates 546,000 fewer Victorians would present to emergency departments as a result.

“That would not meet every need of the community health organisations, but it would be a pretty good start, and it would deal with a spectrum of the highest-priority maintenance and minor works to keep them going,” Infrastructure Victoria chief executive Dr Jonathan Spear said.

In Victoria, about one in 10 preventable emergency department presentations is due to dental issues. Registered community health organisations – independent, not-for-profit entities that receive a portion of their funding from the state health department – provide services such as free dental checkups.

Victoria allocates just 0.3 per cent of its annual $2 billion health infrastructure spend on community health infrastructure. Infrastructure Victoria’s recommendation would raise that to as much as 3 per cent.

The infrastructure adviser warns that the cash injection is necessary to improve health in Melbourne’s fastest-growing suburbs and Victoria’s regional cities. It wants the state government to audit community health centres to ensure as many services as possible are offered under one roof and that those sites are located close to public transport.

Tony Iacono knows first hand the importance of being able to access community health programs. Last year, the 62-year-old – who lives with cerebral palsy – had a fall and broke his hip.

He now gets around with the help of a scooter and attends physiotherapy once a week. But if he didn’t live so close to his community health centre, Each Ringwood East – which is about 100 metres from the local train station – he isn’t sure what he’d do.

“If I lived four or five kilometres away, I’d be using a lot of cabs and a lot of my NDIS stuff on that kind of support. I’d feel frustrated if there was nothing close by,” Iacono said.

The longtime Ringwood East resident said while Each offered a fantastic service – including physiotherapy, podiatry and speech therapy under one roof – it needed more infrastructure funding.

“I’ve been in someone’s office with a bed in it. Or they might use half a room and just close the curtain or something like that. Doesn’t worry me, I’m getting the treatments. But they need more treatment rooms.”

In its report on community health infrastructure, released on Wednesday, Infrastructure Victoria found that 40 per cent of buildings used by community health organisations had problems that affected service delivery. When it came to government-owned buildings, half were in poor condition or approaching their end of life.

Counsellor Brad Carter, from Gippsland Lakes Complete Health, said newer, purpose-built facilities were more comfortable and calm for clients, while older buildings can have harsh overhead lighting and were not always sound-proof.

“In a way, we’re very lucky to have a space to provide a community service,” Carter said. “But my hope is to have more therapeutically safe and inviting spaces to conduct counselling.”

Anna Robinson, chief executive of Access Health and chair of peak body Community Health First, described community health centres as a “one-stop shop where people can go to get all of their health needs met”.

But she said the sector was suffering from the lack of a dedicated funding source or funding plan. Until recently, the centre she heads was operating out of a 1960s building with failing heating and cooling, and a leaking roof.

Infrastructure Victoria says boosting funding to the centres could save governments money, by treating people’s needs before they require a more costly trip to hospital.

“We certainly think that there is an unrealised opportunity to make more out of the community health model, because of the good evidence that it works for the most vulnerable members in our community, and the good evidence that it can take demand off our hospital system, where it’s more expensive to treat people when they get to that point,” Spear said.

An Allan government spokesperson said $188 million was invested in community health last year alone.

“We will carefully review the recommendations in this report and continue to work with community health services to understand how best to support them and their vital work.”

Opposition health spokeswoman Georgie Crozier said Victoria’s debt was spiralling out of control.

“Labor’s priorities are all wrong when urgently needed health infrastructure is being neglected and not maintained.”

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