Community outcry as clinic closures loom

Rachel Croucher is about to lose access to her GP and she’s ‘genuinely terrified’.
 
A quadriplegic with complex care needs, Ms Croucher of North Melbourne has relied on her GP to provide affordable, integrated, home-based care for almost five years via community health organisation, cohealth.
 
Before cohealth ‘my health was a complete mess’, says the 45-year-old law student and genealogist.
 
‘I am lucky to have found a GP that’s able to do home visits. He can come in, check me into the clinic, check out that I’m okay, make sure I’ve got everything sorted, and carry on with regular telehealth,’ Ms Croucher tells newsGP.
 
‘It just means that everything keeps going. It’s a well-oiled machine.
 
‘I know all the staff by name, and they just do so much – they go above and beyond.’
 
However, that vital, trusted relationship Ms Croucher has with her GP and clinic is about to change.
 
Last week, cohealth announced it will cease GP services at three inner-Melbourne clinics (Collingwood, Fitzroy, and Kensington) from December resulting from MBS failures to support the model of care its GPs deliver.
 
The clinics serve patients with multiple, intersecting challenges – including chronic illness, trauma, mental illness, homelessness, addiction and refugee experiences – and their closure will leave thousands of vulnerable patients without GP access.
 
Ms Croucher is now tackling a ‘near-impossible task’ of finding a similar service to take on her care.
 
‘I now face the urgent problem of finding a new GP clinic able to provide home visits. I’ve called 17 clinics, none of them can do home visits,’ she said.
 
‘I do not begrudge GPs for this. The GP model just simply does not pay for it – the model is not designed that way.
 
‘I’ve got surgery in two weeks’ time, and I’m supposed to get a new hip next year. What on earth will I do?
 
‘I am genuinely terrified for my future health and access to care.’
 
Around 12,500 patients have relied on cohealth for decades as the ‘last safety net for people who fall through every other crack in the system’.
 
Its loss will mean patients have to seek alternative GP services, some of which are delivered at mixed billing practices.
 
Ms Croucher said that with her ongoing health needs, from prescriptions and medical certificates to pathology and regular GP care, she questions whether she can afford the type of comprehensive and individually tailored care she receives at cohealth if delivered via a mixed-billing clinic.
 
‘I’m just going to have to reduce how much healthcare I consume,’ she said.
 
The ‘GPs of cohealth’ have called on the Victorian and Federal Governments to ‘work urgently with cohealth to find a funding solution’.
 
‘The human cost of this closure will be profound,’ the GPs said in a statement.
 
‘Many of us have seen our patients for 10, 15, 20 years. For some, that trusting relationship is their only stable support. Without it, where will they go? Who will manage their health, their medications, their crises?’
 
‘Because if these clinics close, the people who have nowhere else to go will truly have nowhere else to go.’
 
The call for support comes as locals and cohealth supporters are set to hold an emergency community meeting on Friday, with the City of Yarra council urging ‘every resident who believes in fairness, compassion and community needs’ to attend.
 
The council described cohealth’s decision to axe its bulk-billing GP clinics in Collingwood and Fitzroy as ‘a gut punch to the communities that need them most’.
 
‘Over the next few months, these vital primary health services will close their doors – a devastating blow to thousands of Victorians who rely on them,’ a City of Yarra statement said.
 
‘The patients who attend cohealth are individuals with nowhere else to turn. They are the single parents on low incomes, the newly arrived refugees learning to rebuild their lives, people facing homelessness or family violence, and residents managing chronic illness or mental health challenges.
 
‘Without accessible, local GPs, people will delay care until their conditions become emergencies. That’s not just inhumane, it’s fiscally reckless.’

The cohealth GPs added the loss of these clinics will also extend beyond patients.
 
Not only will around 20 GPs lose their jobs, but it will also impact the access they have to community care.
 
‘It deprives future doctors of the chance to train in “deep-end medicine” – the challenging, messy, deeply human work that reminds us why we became doctors,’ cohealth’s GPs said.
 
‘Once these services close, that pathway disappears.’
 
cohealth’s clinics see more than 46,000 patients each year across the three sites, with almost 70% of patients being concession cardholders.
 
‘Many of our patients can’t fit into short, simple consultations that keep most bulk-billing clinics financially afloat. They need time, patience, and continuity – and that’s exactly what cohealth’s salaried GPs have provided,’ the GPs said.
 
‘But under the current MBS funding model, clinics like ours lose money every time we give patients the time they need.
  
‘This is more than a financial decision. It is a decision about what kind of society we want to be. Do we turn away from those who are hardest to help, or do we invest in them because that’s what fairness looks like?’
 
A Federal Government spokesperson last week described the closure of cohealth’s GP clinics as ‘deeply disappointing’.

‘We have requested the board reconsider its position,’ the spokesperson told newsGP.
 
‘The Department of Health and North Western Melbourne Primary Health Network has met with cohealth to identify possible solutions to improve financial sustainability, including through maximising MBS billing.’
 
Log in below to join the conversation.

bulk billing complex care Medicare practice closure vulnerable patients