Victoria’s community health organisations are dealing with increasing demand and will be hit hard by a State Government decision to index funding at 2.5 percent while minimum wages increase by 4.75 percent, according to Anna Robinson, Chair of Community Health First.
This comes on top of a longstanding funding squeeze on the sector, which Robinson describes as “a slow and corrosive erosion of our services that will have lasting impacts on clients and staff with longer waiting times, reduced capacity, more people missing out on critical early intervention services”.
Anna Robinson writes:
Every week, a client will walk through our doors who has nowhere else to go. A young family who are looking for child development supports, a retiree who can no longer afford to see the GP they have been going to for the last 20 years, a local farmer who is looking for mental health support from a trusted local team.
Community health is where Victorians turn when they are looking for trusted local care or when cost has put mainstream healthcare out of reach.
From Mildura to Lakes Entrance, and everywhere in between, we have been supporting our communities since 1973. Today, Victoria’s 21 registered, independent community health organisations support roughly one in ten Victorians and employ close to 11,000 people who deliver care close to home.
Last year alone, we saw an 11 percent rise in people coming through our doors as cost-of-living pressures drove more people to seek out affordable healthcare. Our staff found a way to meet that need, as they have done year on year.
But there is a limit, and we are reaching it.
Each year the cost of delivering services rises, and base funding and indexation have not kept pace.
Without proper, equitable investment in community health, the foundations of the sector and the support we can provide in our communities become increasingly shaky.
Indexation gap
The Community Health Program is core to delivering flexible, wrap around care that is at the heart of our model. This financial year the Community Health Program will get 2.5 percent indexation applied, despite minimum wages increasing by 4.75 percent.
Indexation is the government process for adjusting funding to align with the rising costs of delivering care and services. Ideally, this would move in line with the real cost of delivery: wages, rent, insurance, fuel and supply costs. Unfortunately, this is not what has been happening.
Our staff are providing care and support to some of the most vulnerable clients in our communities, and the lack of recognition from government to meet the most basic of pay increases is concerning.
Where there is a gap between our funding and the real cost of delivering a service, there is an expectation from government that this amount will just be absorbed by community health organisations already running on increasingly tight budgets.
In comparison, Community Service Organisations (other nonprofits delivering community-based health and social services) will receive a 4.5 percent increase in funding this financial year.
Community Health First welcomes this announcement, as it clearly recognises the rising costs of delivering care in our communities – we are simply asking government to fund community health on the same basis.
This also isn’t a one-off shortfall.
Community Health Program indexation has trailed both CPI and Community Service Organisation indexation for four consecutive years, a cumulative gap that has been absorbed through efficiencies, reserves and workforce redesign for as long as that’s been possible. This is not a feasible long-term solution.
If we want to continue to have a highly skilled sector, providing quality care in our communities, we need funding equity and not a system that creates disparity between healthcare and social support workers in our organisations.
Cut now, pay more later
Preventative health is often the forgotten part of the healthcare puzzle. Conversations about healthcare should start here, but as a nation we have a long history of missing this critical piece.
Each year, Australia spends about around two percent of our healthcare budget on preventative measures (well short of the OECD average) and about half of what the UK does and a third of Canada’s annual spend.
This is even though we know that every dollar spent on preventative health can save the health system up to $14 in future avoided costs.
When governments are looking to cut funding, prevention is often the first to go because the impact is not immediately obvious.
The long-term impact of cutting health checks, screening programs, smoking cessation services, or oral health classes for kids won’t be felt by the system for years to come – by which time the government of the day or the Minister who made that decision is long gone.
Workforce and social costs
The pinch this year has not arrived out of nowhere. It is many years in the making. A low starting base rate and indexation that has failed to keep pace with the true cost of delivering care has compounded year on year, until the gap has become a structural hole.
Back in 2018, the Victorian Auditor-General recommended a review of community health funding. Eight years on, that review still hasn’t happened, and demand and costs have only climbed.
Community health organisations already do an enormous amount with modest funding, and are now asked to do even more.
This is a slow and corrosive erosion of our services that will have lasting impacts on clients and staff with longer waiting times, reduced capacity, more people missing out on critical early intervention services.
It means asking staff to do more with less, so it is no surprise that burnout is on the rise and 12 percent of health professionals are considering a new profession.
The unwillingness to recognise the true cost of delivering the Community Health Program will lead to 11,000 workers feeling ignored, undervalued and overlooked by government.
If governments are serious about wanting Victorians to live healthier, better lives, and wanting to relieve the hospital system, then we need community health now more than ever.
A sustainable health system is not one that keeps investing only in treating illnesses while neglecting the services that keep people well.
Our staff have found a way, again and again, to support our communities. Now we need government to find a way to support the organisations that make this possible.
See Croakey’s archive of articles on primary healthcare
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