Community health services across the region reluctant to promote their services because of capacity worries: Auditor General

NEW MODEL: Bendigo Health said the effectiveness of some of its community health programs can be difficult to measure. Picture NONI HYETT
NEW MODEL: Bendigo Health said the effectiveness of some of its community health programs can be difficult to measure. Picture NONI HYETT

Community health services across the region are reluctant to promote their programs for fear of overwhelming demand.

The revelation was made by Victorian Auditor-General Andrew Greaves in his report into community health programs and was confirmed by health providers.

Bendigo Community Health Services chief executive officer Kim Sykes said the notion was true for community health services across the state. 

“We don't want to raise expectation by creating new demand and find we can't respond to people,” she said. 

Cobaw Community Health Service received four months of referrals in a matter of weeks after recent media coverage of a particular service. Its chief executive officer Margaret McDonald said finding the balance between informing but not disappointing the community had become increasingly difficult over the past three years.

Cobaw had “incredible” demand for its housing, mental health and early childhood services, but was not appropriately funded by the government, she said.

The report highlighted the Department of Health and Human Services’ inability to measure the extent of demand for services across the state, suggesting the department “did not regularly monitor whether the CHP’s limited service hours are being provided primarily to Victoria’s priority populations or what outcomes these services are delivering”.

The report stated DHHS’ “limited insights” meant it was missing an opportunity for a more strategic approach to funding community health services.

The document, which audited 10 community health providers including Bendigo Health and Bendigo Community Health Services, said at present, the Department of Health and Human Services performance measures focused solely on quantity of hours delivered, and not their effectiveness. 

Funding model queried

The Auditor-General made a number of recommendations to DHHS, one of which was to develop a more sophisticated funding model to identify and understand different service needs, demand and priorities for community health service locations across Victoria, to inform its funding distribution. 

Bendigo Health executive director of healthy communities and continuing care Liz Hamilton said in some cases, like with its diabetes service, referrals were more appropriate to come through a GP, rather than advertising the service. 

Bendigo Community Health Services chief executive officer Kim Sykes said the Auditor General's report was "very balanced and thoughtful". Picture: DARREN HOWE

Bendigo Community Health Services chief executive officer Kim Sykes said the Auditor General's report was "very balanced and thoughtful". Picture: DARREN HOWE

Ms Hamilton suggested an early-intervention program like speech pathology with youngsters was harder to measure in the long-term, making it difficult to gauge the effectiveness of certain services, but that didn’t make them less invaluable.

All three providers welcomed the report, with Ms Sykes suggesting “good evidence was the best form of advocacy”. 

“Everyone knows there's not an unlimited bucket of funding so any government has to make decisions about where it is best to invest. With that in mind if there is a program that has really strong evidence of achieving greater results for the community and improving population health and potentially reducing the demand on intensive measures like hospitalisation, then that potentially looks like a good investment,” she said.

The state government last week announced it will establish an expert, industry-based taskforce to identify ways to strengthen the role of Victoria’s community health sector.

Minister for health Jill Hennessy said: “Community health services help Victorians live happy and healthy lives, boost independence and stave off chronic disease.” The state budget included $292 million for community health care.