Wednesday, 18 March 2026

 Sarah MANSFIELD (Western Victoria) (16:16): I move:

That this house notes that:

(1) a federal government review into Cohealth’s funding has just closed, with the report due mid-March;

(2) regardless of the outcome of the review, Victoria cannot afford to lose Cohealth services in Collingwood, Fitzroy and Kensington;

(3) Cohealth will have to begin wrapping up services at the end of April, if no funding is offered before then;

(4) staff and patients deserve certainty that they will be able to continue to deliver and access free, integrated health care at their local community health centre;

(5) community pressure resulted in an emergency $1.5 million from the federal government in 2025 to keep Cohealth operating until 31 July 2026;

(6) no funding or support has so far been offered by the Victorian state government, including infrastructure support to keep their services operational in Collingwood;

(7) Infrastructure Victoria has recommended that the Victorian government increase community health funding from 0.3 to 3 per cent of their health infrastructure budget;

(8) community health centres play a critical role in Victoria’s healthcare system, and Cohealth’s closure and reduction in services would be disastrous and result in increased poverty, disadvantage, poor health and hospital overloading;

(9) operational funding for primary and community health funding is a shared responsibility between federal and state governments;

and calls on the federal and Victorian Labor governments to commit to long-term, sustainable funding for community health and infrastructure funding for Cohealth in Collingwood.

I rise to speak in support of the motion standing in my name on Cohealth, because this is a test of whether we are prepared to fund the parts of the health system that actually prevent harm, keep people well and reduce pressure on hospitals, or whether we will once again wait for vulnerable people to be in crisis and then act too late. The independent review of Cohealth’s general practice and related services has now closed to submissions and is in its final stages, but regardless of what the review says, the underlying problem is already clear: Victoria cannot afford to lose Cohealth services in Collingwood, Fitzroy and Kensington. That is because Cohealth is not just another GP provider. It is a large-scale community health service delivering accessible, wraparound, team-based integrated care to tens of thousands of people with complex and intersecting needs. It cannot just be replaced by a couple of new private GP practices.

In my 2023 adjournment matter on community health, I said that community health services target the root causes of health inequality, intervene early and keep people out of hospital by providing care as a collaborative team. That remains exactly the issue before us now. Cohealth’s own submission to the review says it provides services for fair, local, coordinated primary care to people with complex needs and that the current funding system does not support longer team-based care for complex clients.

The numbers alone make the case for long-term investment. Cohealth’s closure and service reduction would affect more than 12,500 community members who rely on affordable and accessible integrated care. The clinics were only recently kept open because of intense community pressure, which forced the Commonwealth to provide an emergency $1.5 million package in late 2025 to keep GP services operating until 31 July this year while the review took place. Hundreds of locals attended community meetings in Richmond and Kensington, and the Parliament itself passed a Greens motion calling for a rescue package. That should have been a signal to Labor that people understand exactly what is at stake here.

But short-term extensions are not a solution. If funding is not confirmed by the end of April, Cohealth will have to begin wrapping up services again, and we will be back to square one. That means staff and patients are now living with profound uncertainty. People do not know whether they will be able to keep seeing the clinicians that they trust, whether they will have to retell often deeply traumatic stories to new providers, or whether they will instead end up in an emergency department because there is nowhere else to go. That is not just a rhetorical concern. I mean that seriously. Cohealth’s own client survey found that local services are critical, especially for older people and those with complex needs; that 77 per cent preferred services in one location; and that 46 per cent said they would go to an emergency department first if they could no longer access Cohealth for medical care. Cohealth’s policy submission says approximately half of its clients would seek care at a hospital or emergency department if they could not get an appointment at Cohealth. This is exactly what integrated care is designed to prevent – fragmentation, avoidable deterioration and unnecessary hospital use. If you think hospitals in the city and inner north are busy now, just wait to see them inundated with people in need of complex emergency care if Cohealth closes.

The broader system evidence points in the same direction. Infrastructure Victoria reported last year that for the financial year 2023–24 around 546,000 emergency department visits in Victoria could have been avoided if people’s health needs had been managed in primary care or the community health sector. It is estimated that this would have saved public hospitals about $554 million per year in emergency department expenditure alone. It also found that primary health care, social support and health promotion programs keep people well, manage chronic conditions and prevent acute deterioration that requires hospital care. This is not a marginal part of the system, this is how a functional health system works – and yet community health continues to be treated as an afterthought. Infrastructure Victoria has recommended increasing community health infrastructure funding from 0.3 per cent to between 1.5 and 3 per cent of the state’s health infrastructure budget. It is still a minuscule amount compared to the whopping amounts that are spent on shiny new hospitals. And I am not saying we do not need some of these new hospitals, but I think our priorities are a little bit out of whack if we cannot afford to spend a little bit more on community health infrastructure. As I have said in this place previously, community health centres play a critical role in our healthcare system, despite receiving just 0.3 per cent of our health infrastructure spend. Cohealth has been requesting support from the Victorian government since 2019 to rebuild the Collingwood centre. As my motion says, no funding or support has so far been offered by the Victorian government, including infrastructure support to keep services operational at Collingwood. That is an accurate description of years of neglect.

We also know that the funding problem is structural. We know the Medicare bulk-billing model is not appropriate for the complex, time-consuming care community health centres so often provide to vulnerable patients. The current funding model fails to reflect the true cost of caring for people with complex needs – that these clients require longer consultations and substantial work that cannot be billed for. In fact the Strengthening Medicare Taskforce itself identified that Medicare does not effectively support team-based integrated primary care. This is not a failure of Cohealth, it is a failure of governments. We currently have Labor governments at state and federal level to reform Medicare to be able to do the kind of care they know people need. We could be getting on with this. This motion is asking for something very basic and very reasonable. It asks state and federal Labor governments to stop treating community health like a dispensable add-on and instead recognise it as core health infrastructure. Operational funding for primary and community health care is a shared federal and state responsibility. Health infrastructure funding is plainly a state responsibility. If Cohealth is allowed to shrink or close, the consequences will not disappear; they will be shifted onto other people who are already doing it tough and onto hospitals that are already under enormous strain. That is bad policy, it is bad economics and it is bad public health.

I urge the house to support this motion to send a clear message: Cohealth services in Collingwood, Fitzroy and Kensington must not be lost. We need long-term, sustainable operational funding for community health, and we need infrastructure funding for Cohealth in Collingwood, because if we are serious about prevention, about health equity, about keeping pressure off hospitals and about saving money, this is exactly the kind of service we should be investing in, not allowing to disintegrate.

 Jacinta ERMACORA (Western Victoria) (16:24): Thank you, Dr Mansfield, for the opportunity to comment on this important topic of community health. Regardless of whether Victorians live in Collingwood or Koroit, community health services are a critical part of our health landscape. I want to start by pointing out that under the agreement with the Commonwealth government, Cohealth will continue to deliver GP services through to 31 July this year. The Commonwealth and Victorian governments’ independent review is ongoing, and it is important to let that process and these independent, expert-led processes take place. It is wrong to pre-empt the findings and recommendations of this report. That review of Cohealth’s general practice service model, organisational governance and finances is intended to find long-term solutions and ensure patients continue to get the care they need.

Community health centres are quite unique to Victoria. Our government has a proud record of supporting independent community health organisations. Independent community health organisations are unique to our state, as I said, and they receive funding from multiple levels of government. Government departments have funding streams. This reflects the multidisciplinary work that they do and the mix of responsibilities for health funding under the Australian federal system. The Allan Labor government continues to provide them with significant funding. Cohealth received $68.3 million from the Victorian government in 2025–26 across Department of Health and Department of Families, Fairness and Housing programs. This includes funding of $14.9 million for community health programs and $6.02 million for child protection and family services, plus homelessness support. More broadly, we invested $188 million last year alone to support the delivery of care across the state.

In contrast, part of the cause of the demise of general practice, not just at Cohealth but also across the state and across the nation, if we have a look at the federal coalition’s record between 2013 and 2022 when they were in government, support for Medicare was contracted for families wanting to visit the doctor back to concession card holders and children. What was a universal service under Hawke and Keating et cetera became a two-tiered system. To my friends across the chamber here: your friends in Canberra implemented a rebate freeze in real terms, reducing over time the value of the rebate and causing an increase in the amount that patients have to pay. This had the desired effect, as intended by the coalition government, of reducing bulk-billing. This freeze of the rebate in 2014 stripped $8 billion out of the Medicare system. GPs could no longer afford to bulk-bill. This is essentially the journey of Cohealth, whose patient cohort consists of a significant proportion of low-income people. The impact on Cohealth patients was devastating. I am very, very thankful to see that we now have a federal Labor government reinstating its commitment to universal health care, and in doing so it has introduced a number of initiatives, not least of which is the introduction of incentives for bulk-billing. Medicare and GP visits were run down under the federal coalition government, and this had significant impacts in Victoria. Victoria had to invest to cover off on the impacts, because when you cannot afford to go to the doctor, you leave your health issues behind or delay responding and you end up in emergency departments, which then become overcrowded with a whole range of issues that could easily be dealt with in a general practice.

Despite the fact that primary health care is the responsibility of the Commonwealth government, no other government has invested in accessible health like the Allan Labor government. This government has invested to mop up the primary health care mess created by the Abbott–Turnbull–Morrison Liberal governments. We have invested in improving statewide access to affordable health care close to home. We have delivered 29 urgent care centres in partnership with the Commonwealth, including in Warrnambool, where bulk-billing had pretty much contracted back almost entirely to state government funded agencies like WRAD, Western Regional Drug and Alcohol Centre, and Brophy Family and Youth Services. Also, $27 million was included in the last budget for 12 urgent care clinics across our state. These clinics are giving more Victorians access to the free health care they need when they need it in their neighbourhoods. I notice one has opened up in the Northcote community recently as well. It is very, very welcome. Open seven days a week, they accept both walk-ins and bookings. They are staffed by GPs and nurses who can treat a range of urgent but non-life-threatening conditions, such as sprains, broken bones, cuts and mild infections.

In my home town the benefits of an urgent care clinic have been fantastic, and it has taken significant pressure off the local emergency department. It is a hugely important part of improving access to health in the regions, taking pressure off the emergency departments. Across the state more than 800,000 visits have been made to urgent care clinics since they opened – more than 7500 people every week. It just goes to show you that money is a barrier to seeking health services and that the sooner you get to the doctor, the healthier you remain. I think 7500 people every week using urgent care clinics is very indicative of the inaccessibility of primary health care.

We also now have more than 870 pharmacies participating in our community pharmacy program. Over a quarter are in rural and regional Victoria, and women are benefiting from that. Over 25,000 consultations have been delivered to women for treatment of an uncomplicated urinary tract infection and over 14,000 for a resupply of the oral contraceptive pill. The Allan Labor government will be investing an additional $18 million in this year’s budget to make the program permanent. These investments are reducing the cost of living for Victorians and making it easier to access local services, reducing the burden on bulk-billing GPs. Victorians know that when it comes to their health, the Victorian Labor government are on their side and the federal Labor government are on their side.

As reported by the ABC on 16 October 2025, the closure of Cohealth general practice services is driven by the Commonwealth’s primary care funding model. The model is inadequate to meet the needs of Victoria’s most vulnerable patients. We welcome the Commonwealth’s decision to invest $1.5 million to continue GP services while this review is underway. The Commonwealth has an obligation to support organisations like Cohealth to work through business or operational challenges to maintain access to bulk-billing GPs. The Victorian government, along with other state and territory governments, lobbied the federal government to make changes to Medicare in order to encourage more bulk billing. Our proposals include a tripling of the rebate and additional quarterly 12.5 per cent incentive payments for eligible services.

In conclusion and in contrast, that is the kind of approach that we take; instead the Liberals cut, and the Greens lob things from the sidelines. When they were last in power, the Liberals and the Nationals cut health and education, and it was Victorian families that paid the price. We can see that 7500 people per week are actually benefiting with the return of those services that we have put back in place. Now the Liberals have their $11.1 billion budget black hole, so it is hardly likely that there will be further investments in Cohealth should they gain power. They sold off the Mildura and Latrobe hospitals and prepared the Austin for sale, but luckily that was stopped. There were hospitals closed in Koroit, Mortlake, Murtoa and Macarthur. I could go on, but I will not.

 Georgie CROZIER (Southern Metropolitan) (16:34): I have just been listening to Ms Ermacora and her contribution to the motion put forward by Dr Mansfield, number 1336 in her name, regarding Cohealth. Just last October we were debating a similar motion around Cohealth and the shutting down of the services because of the lack of investment by the Allan Labor government. There has been concern for many years around the infrastructure and the ability for services to be sustained within that service alone in Collingwood. I listened to question time in the other place today, where the minister was asked a question about this. She was talking about the review that was being done and that was meant to be completed in mid-March, or about now. I am not sure if that actually has been completed, but it must be very imminent. I think everybody is looking forward to that report coming out. As I said back in October when I was supporting Dr Mansfield’s motion, this government has failed to recognise the needs this clinic meets, because they are not simple. Ms Ermacora just indicated that urgent care centres are the panacea and that they are there for sprains, cuts and bruises. These are far more complex patients. Some of them have got drug and alcohol addiction or very complex mental health needs, and they need sufficient time and they need a holistic approach to their care and a continuity of care that cannot be provided in an urgent care centre. That often is the case. I want to come back to the urgent care centres in a minute.

Ms Ermacora also spoke of the expansion of the community pharmacy program, and I am in support of extending the scope of practice where it is safe to do so and being able to provide the care that people require. Again, this community health centre is providing a lot of advice around pharmacological support and medicines and the like. I do take on board some of the concerns that have arisen with the college of GPs around some of the government’s community programs where there have been some significant concerns and failures. I will just read out a couple. They said:

One patient I saw was on estrogen + progesterone MHT (and clinically needed to have endometrial protection). The pharmacy did not have the progesterone product in stock so they told the patient they could just continue with estrogen alone.

A second patient, a primary school age boy had pretty obvious impetigo. The parents had taken him to two pharmacies. The first said it was eczema and sold them steroid cream. A few days later without any improvement they went back and were then told to use tea tree oil. A week in when they saw me the kid had uncomfortable impetigo lesions on his genitalia, and had been going to school all week.

There are many examples showing up where this program is not the panacea that the government is stating it is.

I want to just go back to the urgent care centre issue. I am aware of one of my colleagues that took their son to an urgent care centre next to the Alfred. He had come off a bike and had grazes all down his arms, and they wanted to just have it dressed – pretty simple, actually. They rang me, and I said I would do the dressing for them, because they rang me to tell me that the child was referred out of that urgent care centre and back into the emergency department in the Alfred. How utterly ridiculous when it was just a few grazes. Urgent care centres have a place, but they are not doing what the government is telling the Victorian public that they are doing. Often patients turn up and they are closed because they are not open for the hours when they need to be seen.

I will just get back to Cohealth, though, and the importance of continuity of care and the importance of community-based care. I was just listening to Ms Ermacora around what the government is doing. I note that she continually failed to state that the Labor government has been in power in this state for the best part of over a decade – far too long, in my view; we need a change, and I am hoping Victorians will make that change in November to get this state back on track – as well as at a federal level, for many years, and still we get this blame game. Look, could we just stop and fix the problems? You talk about funding shortfalls, and you go back to the Kennett era. I mean, it is quite pathetic. We are living in 2026, where we have got a debt that is just eye-watering, where interest repayments are $20 million every single day – over $1.7 million every hour and increasing. This is a failure of this government’s administration. It is why we are in the pickle we are in in Victoria, and it is why Cohealth has not got any funding certainty from the Victorian state Labor government. It is quite a disgrace.

I want to go to a letter I received from a doctor, who spoke about the work they do and the importance of the work they do. It says:

… as a practising GP of more than twenty years at the cohealth Kensington site … many of us working in the clinics find ourselves in a period of waiting and uncertainty.

… the past few months have inevitably brought a deterioration in workforce morale and patient confidence.

That is a result of the government’s inaction and decisions. The letter continues:

For many, community health general practice often provides the anchor that coordinates care across a fragmented system. If these services were reduced or disrupted, the risk is more than inconvenience. It is fragmentation: patients repeating their histories, medication errors occurring, preventive care being missed, and acute services absorbing preventable demand.

And that really was highlighted in Dr Mansfield’s contribution around the acute system and what would happen to those 12,500 patients at Collingwood Cohealth. Where are they going to go? They are going to end up in the emergency departments of St Vincent’s, at Royal Melbourne, Royal Children’s, Eye and Ear or wherever because of ailments that could have been treated and advice that could have been given in this community health setting.

I say again that the government have themselves to blame for this – no-one else. They have gone rushing to the federal government to get some funding to bail them out because the state has no money. The health budget is being cut. You go and speak to any CEO of a health service now and they will tell you about the funding restrictions they are under and the huge demands that have been placed upon them. And what is going to happen? It will be elective surgery that cannot go ahead because it is activity-based funding. That is what they are asking to be cut. So make no mistake, we have got 64,000-odd people waiting for surgery, and that is as a direct result of the failures and mismanagement of this government’s administration. It is very concerning. In fact it is more than concerning; it is alarming to see the deterioration of the state, whether it is health, whether it is community safety or whether it is potholes. I have gone off here, but it is the deterioration of the state I am talking about.

In health, when you want the health and wellbeing of your citizens to be able to be supported, I am a little bit fed up of the blame game from this government, given the enormous $200 billion debt and rising that we are facing and the enormous interest repayments. With the interest rates going up yesterday, that is going to put more pressure on the Victorian government to pay back that interest that Victorian taxpayers have to pay before they pay for any services. Those interest repayments have to be paid before anything else gets done, because they have racked up this debt because they are so hopeless in managing a budget. Vulnerable patients that need these services and quite rightly expect these services are going to be the ones that suffer. This government might talk about how they care, but they actually do not care about or understand their actions and what they are doing. So they have run to the federal government to bail them out. The federal government has said, ‘Well, you’ve got till 31 July to sort it out. Let’s have a look at this review.’

In the last few seconds, I do agree with Dr Mansfield and want to support her motion and the very valid points that she has raised and say again:

no funding or support has so far been offered by the Victorian state government, including infrastructure support to keep their services operational in Collingwood …

That says it all. That is my point. There are many other very good points in this. On the basis of that, the Liberal and Nationals will be supporting Dr Mansfield’s motion.

 David ETTERSHANK (Western Metropolitan) (16:44): I rise to speak in support of this motion from Dr Mansfield on the urgent need to secure the long-term future of the Cohealth Fitzroy, Collingwood and Kensington facilities. These services form a critical part of Victoria’s community health system, providing essential, affordable and trauma-informed primary care to thousands of people who rely on stability and continuity for their health care. For many years Cohealth has been sounding the alarm that the current funding model for community-based general practice is no longer fit for purpose. Medicare in its present design funds short standard consultations, yet the reality in community health is vastly different. Many patients present with complex physical, psychological and social needs that require extended appointments, multidisciplinary input and coordinated care planning. The mismatch between funding and service needs has grown steadily, leaving Cohealth with an unsustainable gap between the cost of providing care and the revenue available to support it.

Recently, temporary Commonwealth support has allowed these GP services to continue operating while a broader review takes place. That interim review is welcome, avoiding any immediate and damaging disruption to care. That independent review is now examining Cohealth’s clinical model, governance arrangements and financial structures. The findings will hopefully help guide a long-term solution, but temporary measures cannot be mistaken for lasting reform. Without decisive action now, we risk facing the same crisis again once the short-term funding expires.

The impact of GP service withdrawal would be devastating for the people who attend these centres, who often live with multiple chronic diseases and ongoing impacts of trauma or face challenges such as homelessness, unstable housing, addiction or mental ill health. For many their GP is the cornerstone of their health journey – the clinician who understands their history, their circumstances and their barriers to care. Losing that continuity is not a simple administrative inconvenience; it can mean the difference between stability and crisis, between life and death. The closure of Cohealth would place additional strain on hospitals already under significant pressure and increase the risk of late presentations, preventable complications and poorer health outcomes.

Just as concerning is the cascading effect that the loss of GP services would have on the broader integrated care model that defines community health. These centres do not operate as standalone general practices; they offer wraparound services, bringing together GPs, nurses, counsellors, pharmacists, allied health practitioners, mental health workers, alcohol and drug specialists and more. However, it is the GPs who initiate referrals, manage medications, lead multidisciplinary case discussions and provide the medical oversight necessary for integrated care to function. GPs are the clinical anchor in this model. When GP services are compromised, the entire ecosystem becomes unstable. We have already seen examples of counselling and pharmacy services and pathology services being cut or relocated because the loss of GP capacity weakens the model that sustains them. Without strong GP services, the other parts of community health cannot flourish.

I wish to highlight ongoing community concerns regarding governance arrangements across the sector. Community health was built on a foundation of local participation and accountability. Over time, however, decision-making at Cohealth seems to have shifted further away from the communities they serve. At recent forums, staff, patients and local residents have expressed their distress at feeling disconnected from processes that directly impact their health care. Restoring community involvement, transparency and partnership must be prioritised to rebuild trust in that system.

Then there is unmet demand. Many community health centres, including Kensington, where I have been a resident for some 30 years, have struggled for years with limited GP availability and lengthy waitlists. It is clear that demand in many inner-urban areas exceeds supply, so there is a need to plan, not merely to preserve existing services but to expand capacity where possible. In Kensington, even as population grows rapidly due to densification, the number of GPs available to the community has actually dropped. This is insane, particularly given that the redevelopment of Kensington housing estate included a large dedicated older persons’ building, as well as major age-friendly retrofits to the two towers, specifically undertaken because of its proximity to the community health centre only a couple of hundred metres away.

Closing or reducing services in high-need communities will only push more people into crisis and leave even fewer options for those with the greatest barriers to care. This is why the forthcoming recommendations of the independent review are so important. We have an opportunity to design a GP service that genuinely supports complex care while also expanding capacity to provide general bulk-billing services. A new funding framework must include a stable base for the fixed costs of multidisciplinary work, flexible support for longer consultations, recognition of the extra time required for trauma-informed and culturally safe care and incentives that reward positive outcomes rather than high-volume, low-complexity throughput. This is the type of model needed to sustain and strengthen community health now and into the future.

The government needs to act decisively. First, we must ensure that GP services at Cohealth continue beyond the expiry of the temporary funding. Continuity must be guaranteed so that patients and staff are not forced back into uncertainty and the closure of services effectively becomes a self-fulfilling prophecy. Second, we must embrace a modernised funding model that reflects the realities of community-based care and incorporates the findings of the independent review. Third, we must invest in the infrastructure required for safe and effective service delivery, recognising that ageing buildings and outdated facilities can no longer support the demands placed upon them. Fourth, the integrity of the integrated care model must be protected. General practice, counselling, pharmacy, allied health and mental health services cannot be separated without undermining outcomes. Fifth, we must restore strong community governance structures to ensure that local voices and expertise guide the evolution of community health. Finally, we must expand GP services where demand is greatest to ensure that no Victorian is left without timely and appropriate care.

Community health is one of Victoria’s greatest social assets. It supports people who would otherwise fall through the cracks. We know that if these GP services disappear the cost will be borne not only by those most in need but by the entire health system. We have the opportunity now to prevent that, to strengthen the foundations of community health and to ensure that every Victorian has access to the care they deserve. No Victorian should be left without the health care they need – not today, not next year, not ever.

 Sheena WATT (Northern Metropolitan) (16:53): Thank you very much for the opportunity to rise and speak on Dr Mansfield’s motion regarding Cohealth, and I do thank her for bringing this motion before us. I want to begin by acknowledging the significant and deep concern this issue has raised amongst my constituents in the Northern Metropolitan Region. Since the news broke regarding Cohealth’s general practice services, my office has been heavily engaged by residents in Collingwood, Fitzroy, Kensington, Footscray and the other surrounding areas who rely on Cohealth each and every day. I have met with community leaders and advocates, frontline workers, the union and other people who have been impacted by this.

We must remember that community health is more than just a medical appointment; it is about the social, emotional and cultural determinants of health being addressed all in one place. I have seen the outreach work that Cohealth does firsthand, joining their workers to meet with homeless folks in Melbourne, and I know that their presence on the ground is vital. I have seen it and know very much the impact that it has. For many in my electorate – the parents, the elderly, people from all walks of life – Cohealth has been a vital hub for integrated, culturally safe and compassionate care for decades. I deeply understand how important this issue is, and to have that looming question of ‘Where do I go and who do I see?’ is something these people should not have to go through, because they deserve better. I have heard so many stories about how these health organisations are part of people’s lives, their sense of community and how they connect.

Independent community health organisations do an incredible job treating the most vulnerable in our community. They offer a depth of services across mental health, dental, physiotherapy and child and family health care. These services are designed specifically for easy access, addressing common and low-risk health concerns to reduce the overall burden on our hospital system, and that is why for many Cohealth is the only place they feel safe and supported enough to seek care. It is not just about a doctor’s appointment but about providing a place where the most vulnerable feel comfortable coming back time and time again to get the help that they need. We know that these types of local community health centres are a distinctive and important part of Victoria’s healthcare system.

However, to address this issue effectively, we need to be clear about how these services are structured. Independent community health organisations are exactly that – they are independent. They receive funding from multiple levels of government and remain autonomous in their management structures and day-to-day decisions. Their boards and management teams are responsible for the decisions they make, and they are ultimately accountable to the communities that they serve. It is important to note that Cohealth’s decision to close certain GP services was based on federal funding arrangements. In a previous contribution that I made on a motion that Dr Mansfield brought to this place last year on Cohealth, I made mention of how many times the federal model is like putting a square peg in a round hole – a reality I saw firsthand at Merri Health as the former deputy chair. Before entering Parliament I sat on deliberations around funding models, the Medicare benefits schedule and the payment system and how, for community health, it just does not work. It was clear that the system can be inadequate to meet the needs of vulnerable patients. I recall asking the very question ‘What is the average appointment time for Cohealth?’ and let me assure you, it is much longer than in other areas. That is why I know from those conversations about MBS modelling that the current federal system is just not enough. These calls for reform have been going on for a very long time. I know because I have been in those conversations.

Cohealth’s own leadership have confirmed that they cannot afford to continue running all their bulk-billing GP services because these exact challenges with the current Medicare model are as yet unaddressed. We must note that GPs, primary care and the Medicare system are all the direct responsibility of the Commonwealth. If the Commonwealth’s current funding model does not actually recognise how complex these services are and if it has not seen the reality of the care that has to be provided in these settings, then it is incumbent on that level of government that is responsible to step up and do something about it. They need to listen and think about different ways of supporting the very unique circumstances of service users in community health. The Commonwealth has an obligation to support organisations like Cohealth to maintain access to bulk-billing GPs, just as it has done with its recent changes to GP bulk-billing right across the country.

In terms of our track record, the Victorian government supports having more GPs, and more GPs that bulk-bill and are accessible. It is our government, along with other state and territory governments, that has lobbied the federal government for a long time to address challenges within the Medicare system to encourage more bulk-billing, including tripling of the rebate and the additional quarterly 12.5 per cent incentive payments for eligible services from the start of November. We welcome the Commonwealth decision to invest $1.5 billion to ensure Cohealth’s GP services continue until 31 July this year, and I want to emphasise very clearly that through this agreement with the Commonwealth Cohealth is required to deliver GP services until that date.

In 2025–26 the Vic government is providing Cohealth with $68.3 million across various health and social care programs. This includes $14.9 million for the community health program that helps fund services such as the general counselling service and over $6 million for child protection, family services and homelessness support. We are ensuring that vital services remain stable and all clients of Cohealth’s alcohol and other drug services will continue to receive care from alternative Cohealth sites. The specialised Bourke Street clinic has not been impacted, and I think that is important to note. We are also making health care more accessible through our urgent care clinics and the community pharmacy program – I spoke about that earlier today – which reduces the burden on bulk-billing GPs. Now 22 mental health and wellbeing locals are already supporting more than 35,000 Victorians to access free care without a referral, and we are continuing to support community health. The Victorian government is supporting community health by investing $188 million last year alone to support care right across the state.

I do want to mention an update since Dr Mansfield’s motion last year in that our government and the Commonwealth have commissioned an expert review of Cohealth’s general practice service model, its governance and its finances. We are trying to find long-term solutions to ensure patients continue to get the care that they need. The independent review is being led by Professor Stephen Duckett AM, a pre-eminent expert on health governance, innovation and reform. Professor Duckett is being supported by Professor John Furler, a GP and researcher, and Ms Jane Seeber, who has extensive experience in working for community health organisations, their finances and their operations. The review is focused on the overall service model at Cohealth’s general practice, including the clinical service model, the operations, governance and financial viability in the context of the overall operations of the organisation. I will repeat: this is an organisation that the state government funded to the tune of $68 million. The intended outcome of the review is the development of options that support the continuation of these services to the community. It is an important piece of work – absolutely no doubt about it – that must be left to run its course. Instead what we see with this motion before us is an attempt to pre-empt Professor Duckett’s report and undermine his expertise and that of his fellow review panellists and the significant amount of work that has been done to understand the root causes behind Cohealth’s challenges in delivering GP services, some of which I mentioned earlier in my contribution and some which I am sure will come out as we undertake more consideration of the findings. The review is ongoing and it is important that we let these independent expert-led processes take place. It is really wrong to pre-empt the findings and recommendations of this report. I am certainly not going to be running roughshod over community submissions, Cohealth’s own submission, bulk-billing data, insights and expertise. On one hand what we hear is that independent expertise is critical when it comes to health, but on the other what I am seeing is attempts to undermine the very independent expertise of Professor Duckett, amongst others.

I am interested in ensuring that Cohealth has the right structures, the right governance, the right processes and the right finances in place so that it thrives as an independent community health organisation and not in using this as a political opportunity like so many others. This matter is not going to be resolved by spreading misinformation and disinformation about organisations like Cohealth. Many vulnerable Victorians rely on these services, and misinformation only seeks to further that harm. Even today I saw in question time, as was mentioned by Ms Crozier, a question asked by Ms de Vietri trying to again pre-empt the review that has yet to be seen certainly by the community as a whole. I am not going to stand by and see fearmongering take place when really it is people’s lives that are very much on the line. I want to assure constituents that I hear their concerns – it does hit home for me. I believe in community health, this government believes in community health, and our government knows that our community absolutely needs it. I am going to stand by my community because the people that deserve patient-centred care deserve to be at the very forefront of our decision-making, and that is what they are today and every day. I look forward to continuing my work with the health minister and our federal colleagues to get a true outcome for Cohealth.

 Renee HEATH (Eastern Victoria) (17:03): I rise to support Dr Mansfield’s motion on Cohealth. This is an extremely important motion, and I want to start by acknowledging the incredible work she has done, and we are supporting this. It was interesting – I want to pick up on some comments made by members of the government. One member of the government said this – I am not joking – when Georgie was speaking about why this is important. Ms Ermacora actually yelled out and said, ‘Well, the Liberal government would cut that anyway.’ So I wanted to respond to that, and the first thing I will say is: it is pretty hard to cut something that is not funded. Dr Mansfield points this out in point 6 of the motion:

no funding or support has so far been offered by the Victorian state government, including infrastructure support to keep the services operational in Collingwood …

I want to talk about something else. Just yesterday Labor took the scissors out and they began to cut, cut, cut. I will speak first about the cuts to VicHealth, and the reason I want to talk about the cuts to VicHealth is that VicHealth very much talk about the social and economic determinants of health. Their whole mantra really is that you should build some guardrails so people do not fall into the river, rather than going downstream, rescuing people and trying to pull them out when they are in trouble. This is a very smart idea, and it is based on the Ottawa charter that says one of the key indicators as to whether you will have good health or ill health is whether or not you are economically secure. That is why Cohealth in areas like Collingwood, Fitzroy and Kensington matters, because our healthcare system is so under pressure that it cannot keep up with the demand in Victoria because the Allan Labor government has completely mismanaged it. Not only that, the cost of living is so out of control in this state. There are more taxes and charges in Victoria. Over 60 new or increased taxes have come into play since you lot have been in government. It is very hard for people to even put food on the table, let alone pay for private health insurance. It is just about impossible for these people.

What I did want to pick up on – and I just jotted down a few notes while I was listening to Ms Ermacora as she spoke about the Liberals and cuts – is: isn’t it interesting that just yesterday the Labor government cut Recycling Victoria. They are merging with the EPA. They are getting abolished, and they are moving their functions to the EPA. They cut it. Another thing that Labor cut just yesterday was the Victorian Marine and Coastal Council. They cut it regardless of the fact that one of the biggest issues facing coastal areas in Victoria is coastal erosion. This affects not just people living on the coast, it affects tourism. I just want to call this out because it just goes to show that what they say is not even close to what they do. They can gaslight. They can bag people out. They can blame us for cuts, but I am just going to take you through a few that they led the way on and did themselves.

That is Recycling Victoria out and the Victorian Marine and Coastal Council out. We have got another one here: the Mine Land Rehabilitation Authority. It has been merged with the Department of Energy, Environment and Climate Action. They have been abolished, and they have been subsumed by that body – another cut. There are a few more. The Victorian Public Sector Commission Advisory Board – cut. Let us just keep going. The Victorian Government Purchasing Board has been abolished, and they have transferred their functions to another body – cut. There is another one. This one is very important, by the way. I think this is important. Here is another one for you: Road Safety Camera Commissioner Reference Group – cut. Then let us go to one that is very close to my heart – I would say close to everyone’s heart in here; everyone stands and supports it, every single one. On one hand, you are saying, ‘We support mental health.’ This is one of the biggest issues that is facing the next generation. Well, guess what they have done: mental health and wellbeing commissioner – cut. Let us not stop there. Here are a few other things that this government has cut just recently. Police recruitment – do you reckon it is up or down, team? It is down. It has been cut. What about the Children’s Court?

Harriet Shing interjected.

Renee HEATH: Hey, at least we’re honest, Minister. What about the Children’s Court? Cut. What about health? Cut. What about mental health in this?

Harriet Shing interjected.

Renee HEATH: What would you like? Call a point of order, actually. All right, you are not calling a point of order.

Mental health – cut. What about community housing projects and programs? They have been cut. Let us talk about the 44 housing towers that you have bulldozed. I tell you what: getting rid of 44 housing towers over the next decade or so is not just a cut; that is a demolition. Let us just keep going through.

Members interjecting.

Renee HEATH: It is so nice to have a bit more energy in the chamber. It is nice to see you actually have some passion in here. What about community housing programs that are not being continued? Plenty of those have been cut. VicHealth – I have gone through that; VicHealth has been cut. Maternity services across the state have been cut. What about fisheries officers? Cut. Here is another one: road maintenance and roadside maintenance in Victoria under the Allan Labor government have been cut. And here is another one –

A member interjected.

Renee HEATH: No, this a good one that you have overseen. What about the big cut from the Victorian budget of $15 billion that under your watch has been cut from the public purse because corruption has been able to go wild in this state. That is just my little response to Ms Ermacora’s throwaway comment about how we are going to cut a program that has not been budgeted – I wanted to point that out.

I commend this motion to the house, because I tell you what, Cohealth helps people in communities. It absolutely does that. Staff and patients that have been there for many, many years need these services. The other thing is it also makes families feel secure, knowing that they have a Cohealth service. You guys might not know that, because right now in Victoria people are not financially secure. There is crime and there is a crime committed every 6 minutes, so they are certainly not secure in terms of their safety. I wanted to raise that. In the interest of time, that is just a few of the Allan Labor government cuts that I have been able to go to, to respond to some of what I believe is disingenuous and dishonest rhetoric coming from the government.

Joe McCracken interjected.

Renee HEATH: It is misinformation, thank you, Mr McCracken. So thank you to Dr Mansfield for bringing this important motion to the house. I commend it.

 Tom McINTOSH (Eastern Victoria) (17:12): I think I am exhausted before I even start, having listened to all of that. But if we want to talk about cuts, if Dr Heath wants to talk about –

Harriet Shing interjected.

Tom McINTOSH: We will cut to the chase, Minister Shing. Twelve hospitals in country Victoria are what the Liberals closed. We know the Liberal Party’s health record: they close and privatise and shut down hospitals. It is this side that builds them. It is this side that invests in health care, and Victorians know that. They have seen it time and time again, and Cuts McCracken is over there trying to hide away from the history that they have of health cuts in this state. Victorians can clearly see there is an $11 billion budget black hole that the Liberals have, and we know how they will fill that: they will fill that by cutting services.

I am proud to be part of a party that has invested in health. In fact just this morning the mobile women’s health bus was out the front, an incredible fit-out that is getting out to regional and rural Victoria, meeting women in place with free health care to assist them. We have got our virtual emergency department, what we are doing in schools from a health perspective – with Smile Squad, Glasses for Kids, our Get Active Kids vouchers and the breakfast club programs – our community pharmacies, the community sports programs, our active transport and our bike paths. Dr Heath would be well versed with the rail trails all throughout eastern Victoria, with one of the longest rail trails in the Southern Hemisphere – even from a tourism perspective, we are getting people active and out in their community. At our community health centres in eastern Victoria, we are even supporting them to open kinders from that early stage, that early education, that early connection into our community, into our community health groups, from start all the way to finish.

I was out with Minister Stitt in recent months at the public aged care facilities that are being built in eastern Victoria. They are incredible in keeping people ageing in their local communities and giving workers first-class facilities to work in. I have been out with the bush nurse and others at Goongerah. Our community groups, our community gardens – the fresh produce that they are growing and getting out to the community, whether that is cooking, whether that is food or the paddock to plate to ensure that locals have fresh, healthy food. Of course there are our major projects like Frankston hospital and others where we are investing in big health infrastructure. You can see from just some of the examples I have touched on, whether it is preventative, whether it is the touchpoint of community health or whether it is primary health care, that it is all there. This government knows how important it is that it is accessible and affordable for all Victorians. We know independent community health organisations are unique to Victoria and do an incredible job treating some of the most vulnerable in our community. It is important to note that community health organisations receive funding from multiple levels of government and multiple government departments and remain independent from government in their management structures and day-to-day business and decision-making.

We want more GPs in Victoria. We want more GPs in Victoria who bulk-bill. Despite GPs, primary care and Medicare being the responsibility of the Commonwealth government, no other government has invested in accessible care like the Allan Labor government. The Commonwealth have an obligation to support organisations like Cohealth, and the Commonwealth and Victorian governments have commissioned an independent review of Cohealth’s general practice service model, organisational governance and finances to find long-term solutions and ensure patients continue to get the care they need. The review is ongoing, and it is important we let these independent, expert-led processes take place and not pre-empt findings.

Community health organisations play an important role, and the Allan Labor government invested $188 million last year alone to support the delivery of care across the state. I think it is important to reinforce the fact that it is Labor governments that invest in health care, it is Labor governments that invest in healthcare workforces and it is Labor governments that ensure that healthcare workers are paid. Where we have workforces that are female dominated, we ensure that there is pay equality for those workforces. It is Labor governments and only Labor governments that will do that work to ensure the workforce and the community’s healthcare needs are met. I will leave my contribution there.

John BERGER (Southern Metropolitan) incorporated the following:

I rise to speak on the motion in regard to the CoHealth site in Collingwood, Fitzroy and Kensington.

It is important to acknowledge the significant impact of community health organisation within Victoria’s health care system.

They are unique to our state, and they do an incredible job at treating some of the most vulnerable in our community.

The Allan Labor Government knows the importance of affordable primary care for all Victorians.

CoHealth organisations provide a wide range of essential services that support people in their local communities.

They deliver a mix of State, local government and federally funded services.

By providing services locally, they help ensure that people can access healthcare earlier and more conveniently, often preventing the escalation of health issues that might otherwise require more extensive treatment.

But to be clear, independent community health organisations are just that – independent.

Their business decisions are made independently of government, and each organisations board and management is responsible for the decisions they make.

The Commonwealth has an obligation to support organisations like Cohealth to work through business or operational challenges to maintain access to bulk billing GPs.

Which is why we welcomed their decision to invest $1.5 million to ensure GP services continue to 31 July 2026.

However, there is a lot of fearmongering going on at the moment.

Through its agreement with the Commonwealth Government, Cohealth must continue to deliver GP services through to 31 July 2026.

An independent review of Cohealth’s general practice service model, organisational governance and finances has been commissioned by the Commonwealth and Victorian Governments.

In order to find long term solutions and ensure patients continue to get the care they need. 

This review is ongoing and it is important we let these independent, expert led processes take place.

It is wrong to pre-empt the findings and recommendations of this report.

The Allan Labor Government continues to provide funding to support the delivery of community health services across the state.

In the last year alone, $188 million was invested to support the delivery of care through community health organisations.

This funding supports services that are often delivered in partnership with both state and federal programs.

Community health centres are often the first point of contact for patients seeking healthcare and helps ensure that people receive timely diagnosis, treatment and ongoing management of health conditions.

And nothing demonstrates this government’s commitment to supporting our health care sector more than the 2025/26 State Budget.

Which has been putting investment in frontline care as a top priority.

The Victorian Government will provide cohealth with $68.3 million in 2025–26.

This includes funding for a number of programs, including $14.9 million for programs delivered via the Community Health Program and $6.02 million for child protection and family services, plus homelessness support.

The Allan Labor Government have implemented a range of initiatives to support the delivery of primary care services and to strengthen the broader health system.

These include investments aimed at improving access to urgent care and reducing pressure on hospital emergency departments.

These urgent care clinics provide treatment for situations that are urgent but not emergencies.

Patients presenting with conditions such as mild infections, burns, suspected fractures or sprains can receive care in these clinics rather than attending an emergency department.

The aim of these clinics is to relieve pressure on hospitals while ensuring patients still receive appropriate and timely care.

Funding has also been provided to support these GP-led urgent care clinics so they can continue delivering these.

This Budget invests $27 million to continue 12 Urgent Care Clinics across our state, giving more Victorians access to the free healthcare they need, when they need it.

29 Urgent Care Centres, in total are now delivered in partnership with the Commonwealth.

More than eight hundred thousand visits have been made to UCCs since they opened.

Allowing emergency departments and hospital services some reprieve to focus on more serious cases.

While patients with less urgent conditions still have affordable access to appropriate care.

Another component of the primary care system that has increasingly played a role in supporting patients is the work undertaken by pharmacists through pharmacy-based care.

Community pharmacies are often one of the most accessible points of contact within the healthcare system.

For many people, a local pharmacy is available with or without an appointment and provides an opportunity to seek advice and treatment for a range of common health concerns.

The Community Pharmacy Program, introduced just this year by the Allan Labor Government, allows pharmacists to consult on certain aliments.

They can provide treatment or advice for specific conditions assisting in relieving pressure on GP clinics by ensuring that patients with straightforward or minor conditions can receive timely care.

A consult from a pharmacist is a free service in which you can get professional advice.

In doing so, pharmacy-based care helps ensure that general practitioners are able to focus their time on patients who require more complex medical care.

With more than 870 pharmacies participating in our Community Pharmacy Program across the state.

Providing over 59,000 services.

Over a quarter of those which are in regional or rural Victoria.

This type of care does not replace the important role of general practitioners, but it can complement the work of GP practices and community health services.

By providing additional access points within the health system, pharmacy-based care contributes to a more integrated approach to primary healthcare.

Giving the community quicker access to expert opinions on minor concerns.

Women are benefitting the most with over 25,000 consultations delivered to women for treatment of an uncomplicated urinary tract infection, and over 14,000 for a resupply of an oral contraceptive pill.

The Allan Labor Government will be investing an additional $18 million in this year’s budget to make the program permanent.

The Allan Labor Government wants a more accessible health care system.

A system that extends to regional communities and make it easier for Victorian’s to get the treatment they need no matter where they are.

Supporting the primary care workforce more broadly is also an important element of strengthening healthcare access.

We have delivered 22 Mental Health and Wellbeing Locals across 24 locations.

Which have supported more than 35,000 Victorians to access free mental health care and support close to home – without making them jump through hoops like a GP referral or meeting eligibility criteria.

These services are supporting Victorians with cost-of-living expenses and convenience and making it easier to access local services for common, low risk health concerns reducing the burden on bulk billing GPs.

A grants program was established to encourage doctors to specialise in general practice.

Through this program, financial incentives were offered to support doctors undertaking GP training.

Around 800 grants of $40,000 were made available through this initiative, with approximately 400 grants allocated in 2024 and a further 400 in 2025.

These measures were designed to encourage more doctors to enter general practice and help strengthen the primary care workforce across Victoria.

By supporting the training of new GPs, these initiatives aim to improve long-term access to primary healthcare services.

This was all about supporting doctors to specialise in General Practice in order to help strengthen the primary care sector, and in doing so help improve health outcomes for all Victorians.

Another core example is how this government gave exemptions from the payroll tax to bulk billing GPs starting this financial year.

Now if a GP clinic is bulk billing for its patients, those instances are exempt from the payroll tax, lightening the tax burden from these businesses.

We are focused on strengthening care across Victoria’s healthcare system, whether it is through our public hospitals or through our community health partners so that every Victorian can get the essential care they need close to home.

The Victorian Government has outlined a plan to create more connected health systems through the Health Services Plan.

This plan seeks to strengthen the primary care sector and improve coordination between different parts of the health system.

The Health Services Plan focuses on building stronger connections between specialised health professionals, hospitals and community health services.

By improving coordination and communication between these services, the aim is to ensure that patients can access the care they need more easily and more efficiently.

The plan also recognises the importance of ensuring that health services are available closer to home, particularly for people living in regional and rural communities.

By investing in local health service networks, the goal is to create a more resilient and well-resourced healthcare system that can respond effectively to the needs of the population.

The Allan Labor Government will continue to provide funding for our frontline health services.

We saw during the COVID-19 pandemic, how quickly an overwhelmed frontline care workforce being overrun with the virus led to system-wide issues with pressure and under-resourcing.

When we invest in the various aspects of our health system, it not only takes pressure off other areas, just as how Urgent Care Clinics are taking pressure off GP Clinics, but it also delivers more effective primary care for Victorians.

President, the Allan Labor Government is proud of its record when it comes to investing in our health system, and in particular when it comes to supporting community health programs and organisations.

We have always put our health system first, and we will always advocate for Victorians to get the very best.

We will always back in our front line and primary care services.

 Sarah MANSFIELD (Western Victoria) (17:17): I thank members for their contributions to this debate, which at times became quite wideranging and, I think, drifted a fair way from the actual motion. But I think what I grasped from most contributions is that there is broad support for the work of Cohealth and recognition of the need to ensure that we continue to fund Cohealth and that it continues to be able to deliver for the communities that it currently serves. I hope that this motion will serve as a prompt to the government to look at what more they can do to provide financial security, stability and certainty for Cohealth, in particular with respect to infrastructure funding, which is a state responsibility, and remove some of that uncertainty that is currently hanging over those key community facilities. Spending money on community health is one of the best investments you can make in our health system. The return on investment is huge because of the quality of the care and the avoidable harms and hospitalisations that result from the sort of care that is provided by these facilities. I really urge the government to take heed of this motion today and ensure that they act and listen to the people who are living in these communities, who desperately want their services to continue.

Motion agreed to.