The Stephen Duckett-led review should save community health rather than save the Cohealth board and management.
On 16 October Cohealth community health service in Melbourne issued a sudden announcement. Pleading financial exigency, it declared the 19 December closure of medical practices, nursing and counselling at three foundation community health centres, Kensington, Fitzroy and Collingwood; the latter centre closing entirely.
Questions arise daily in the lead-up to the 2026 government review of the operation. As reported by Health Services Daily, the gap between its cash assets of $27 million and its claim of financial difficulties has been exposed.
Its planned 19 December pre-Christmas closure of general counselling services remains scheduled rather than waiting for the report of the review, a reprieve which one might expect from a responsible organisation.
This matters, given questions about corporate management everywhere and Victoria’s community health tradition since the Whitlam government.
Overflowing community meetings included a unanimous “no confidence” motion in a board and management with few community connections.
Questions arose about the improved Medicare rebates, which Cohealth did not apply for, and the economics of long consultations.
Cohealth’s claimed “unique” status and special public request for a “golden Band-aid”, a contrast to Victoria‘s other community health services, was queried.
The Save Community Health movement has been supported by professional associations, protesting the closures and calling for more funding.
Two aspects dominate this debate: the often-forgotten community health history and the media campaigns through which the battle is being waged.
That continues even after the federal government’s $1.5 million intervention, following two local federal Labor MPs’ input, leading to a review of the Cohealth operation and $1.5 million to maintain general practice services until 31 July 2026.
History matters to the communities. It empowers the grassroots opposition to what the advocates, including me, view as the execution of the medical practices and then, later, the likely death of the depleted health centres.
The Kensington Community Health Centre, created in 1975 through cooperation between community volunteers and the Whitlam government, has a proud community history – and a 50th anniversary.
Yet signage rebrands it as a “Cohealth Centre”.
Collingwood’s even deeper historical inheritance is the legacy of pioneer public health advocate Dr Singleton’s original health centre for the poor.
Cohealth was founded in 2014 through a merger between Doutta Galla CHS (including Kensington), North Yarra (including Fitzroy) and Western Region (including Footscray).
Related
The directors of these antecedent organisations entrusted the new board with a core mission – to maintain and enhance community health through their local centres.
The principals of the Save Community Health movement are those former directors whose trust has been betrayed. Deep disillusionment with the Cohealth board and management is shared by staff, patients and the community.
While the 19 December services closure announcement was a total shock, the erosion of the key elements of community health was already happening.
“Community partnership” and “consultation” about services was disappearing, despite the words’ frequency on the Cohealth website.
Voluntary community board members were supplanted by paid directors. The membership roll, encouraging community citizen participation, was simply abolished. A community advisory committee exists, but its members’ identities remain a board secret.
Today’s battle is between an out-of-touch board/management corporate culture and a mass community movement.
In our neoliberal and corporate times, when top-down management is more important than memory, tradition or grassroots input, it is predictable.
Cohealth is not a modest organisation. It has a slick website and is running an active social media campaign. It believes that it controls the narrative with its self-described “ace comms practitioner”, skilled at “pre-empting issues”.
Cohealth’s strategy involves a media game to direct the narrative in three different phases.
The first combines sudden action, threats, demands for money, blame, and then a 19 December closure.
Cohealth declared it would close the practices unless it received $4 million from the federal government. That aroused medical progressives who agreed long consultations should receive larger rebates and Greens and socialists who sought to keep the practices running and blamed Labor governments.
Phase two, a four-week hibernation, media silence, followed.
Simultaneously, in a war of attrition, support services were run down, assuming decaying morale would drive doctors away before closure day.
Except, in November, the ground shifted when federal health minister Mark Butler pledged temporary funding and a review of Cohealth’s operations.
Unmoved, Cohealth still intended to sell the Collingwood building, which is likely to be protected by a human chain. From 19 December – in the season of stress and goodwill – it is still terminating counselling and cost-neutral pharmacy services, although clients are told that they can go to their Footscray centre, which is somehow immune from the guillotine.
A third phase ensued, talking the talk, rather than walking the walk. Soft-sell video statements, accompanied by sweet music, came from the CEO, finally declaring to medical clients only, “we hear you, we see you, we feel for you”.
The review, not the Cohealth board, will write the final chapter of the narrative, separating fact from fiction, even after counselling patients are sadly dumped before Christmas.
The review will evaluate the Cohealth administration and its costings. Indirectly, it may illuminate how Victoria’s other community health services function effectively.
Above all, in my view, it should save community health rather than save the Cohealth board and management. Ideally, it will ensure community health’s future in Kensington and Fitzroy, and in Collingwood.
Adjunct Associate Professor Stephen Alomes, RMIT University, is a former director of Doutta Galla and Kensington community health services.