GPs are urging the Victorian Government to step in and save Cohealth GP clinics set to shut their doors for good leaving many disadvantaged patients in the cold.
Cohealth operates GP clinics across Melbourne helping disadvantaged communities by providing a range of integrated health and social support services, often at no cost, to people who may struggle to access mainstream healthcare services. This includes patients experiencing homelessness or chronic health conditions, including mental health issues. The not-for-profit organisation features doctors with special expertise in areas such as drug and alcohol medicine and mental health, as well as alcohol and other drug counsellors and myriad allied health professionals.
The Collingwood service will close its doors entirely, while the Fitzroy and Kensington services will close their general practice services and maintain some of their allied health offerings. The Footscray service intends to maintain several of its GPs.
It comes in the wake of Melbourne-based Reconnexion, an organisation that provides counselling and support for people dependent on benzodiazepines (e.g., diazepam), recently losing funding. This comes at a time when Victoria recorded its highest number of fatal diazepam overdoses, which is a commonly prescribed benzodiazepine. Last year, a medical clinic in Frankston, which provided 10% of the state's opioid pharmacotherapy treatment including methadone, closed its doors, leaving about 3,500 patients with addiction issues in the lurch, including patients with severe opioid dependence and 400 patients with schizophrenia.
Royal Australia College of GPs (RACGP) Victoria Chair Dr Anita Muñoz called for urgent action.
"Cohealth patients will now no longer have access to a GP they know and trust, and many will have few places to turn to. These clinics play such a vital role, we can't afford to lose them," she said.
"The Victorian Government needs to step up and save these clinics – this is lifesaving healthcare, including for people from disadvantaged backgrounds, those facing overwhelming barriers of living such as rising costs of rent and essential goods through to those living in a state of crisis."
Dr Muñoz said that the closure of the GP clinics was symptomatic of larger challenges facing Victorian practices.
"The closure of these clinics highlights what we've been warning about for many years – more must be done to secure the financial viability of general practice care statewide," she said.
"Payroll tax changes came into effect on 1 July this year, and we're continuing to advocate strongly for Victoria to follow Queensland's lead to abolish this tax on GPs and help keep general practice costs down for Victorians.
"The community health centre model has remained an important part of healthcare offerings in Victoria despite other states moving away from this model over several decades. It's a model that recognises that people in vulnerable situations, or who live with mental health, substance dependence or serious social disadvantage, have needs beyond which the traditional Medicare Benefits Schedule, or MBS, fee-for-service model can accommodate.
"This was once considered a point of pride in our Victorian system that recognised the need to provide specialised services for people living with significant complex health issues and comorbidities."
RACGP Victorian addiction medicine spokesperson Dr Eric Hadinata said the timing of the recent closures couldn't come at a worse time.
"First the medical clinic in Frankston, then Reconnexion, and now this. Victoria is moving in the wrong direction, and it will cost lives," he said.
"Caring for people with serious alcohol and other drug use and mental health issues is essential healthcare; however, it can be challenging work, particularly when you consider the caseload of patients accessing the services every day.
"There is a shortage of doctors who specialise in pharmacotherapy, and that must change. That's why the RACGP offers vital training for GPs and nurse practitioners on medication assisted treatment for opioid dependence, which includes prescribing buprenorphine and methadone. This makes a real difference; however, we must go further.
"It's also important to keep in mind that there is currently no compensation or subsidy available for doctors or clinics to take on 'higher risk' patients in the alcohol and other drug and psychiatric space. That is something that should be seriously reconsidered, and we look forward to working with the Government on these reforms.
"I fear that without these lifesaving services like Cohealth and Reconnexion, it will be extremely challenging to help people with complex needs. When these services close their doors, there is a high risk of patients relapsing and placing increased pressure on already over-stretched hospitals as well as potentially coming into contact with law enforcement, particularly patients undergoing psychiatric care unable to access medication and treatment.
"We need action, because every life matters and is worth saving."
