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Create healthy and resilient communities

Create healthy and resilient communities banner imageGood health is essential for a good life, but it is not experienced equally across the Victorian community. Poverty, discrimination and a lack of education and employment can cause or exacerbate poor health and increase vulnerability to trauma and crises. To maximise health outcomes, Victoria needs locally accessible, integrated pathways between primary and acute care and an approach that acknowledges the social determinants of health. The healthcare system must also provide for people’s cultural safety.

Disadvantaged communities experience higher rates of preventable hospitalisation and chronic disease, and lower average life expectancy. Victoria needs a system that provides equitable access to timely, affordable healthcare and tackles the causes of poor health.

Health inequity is often more pronounced in rural and regional areas. Workforce shortages and a lack of local services mean people must travel greater distances for treatment and shoulder the associated challenges of time off work, transport costs and childcare. People with disability, LGBTIQ people, people from refugee and migrant backgrounds, Aboriginal people and people leaving institutions also have poorer health outcomes than other Victorians.

The community sector plays a role in reducing the social inequity that leads to poor health, and improving resilience and wellbeing. For marginalised Victorians, community health and social services are an entry point to the health system. Community health and social services can help identify problems early, before they reach crisis point, and connect people with other sources of assistance in their community.

Properly-resourced, community-based health services can help people and communities recover from illness and crisis quicker, and stay well longer.

Save community mental health rehabilitation services

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Allocate additional funding to preserve community mental health rehabilitation services.


VCOSS believes the Victorian Government has a responsibility to continue to fund community mental health services outside of the National Disability Insurance Scheme (NDIS). New funding must be allocated in the 2018-19 Victorian Budget to save Victoria’s rehabilitation services. The Victorian community mental health sector is calling for about $50 million each year to fund rehabilitation services.

In Victoria, publicly-funded community mental health services have long provided psycho-social rehabilitation and support to people with mental illness. These services help people stay healthy, commit to a job or education, care for their children and families, and fully participate in community life.

Community-based rehabilitation forms one pillar of a balanced mental health system, alongside clinical treatment and disability support. The NDIS will soon provide disability support to people with mental illness through tailored support packages, while the Victorian Government will continue to provide clinical treatment through hospital and community teams.

However, as this changeover occurs, Victoria faces a looming gap in mental health rehabilitation funding. Neither the NDIS nor the Victorian Government has committed to funding these services into the future, as rehabilitation is outside the scope of the NDIS.

Victoria redirected all its community-based mental health services funding to the NDIS. It is the only state to have done so. In contrast, New South Wales has recently increased its investment in community-based mental health.

Funding will enable Victorian community mental health services to continue to support people living with mental illness who are ineligible or choose not to access the NDIS.

For example, the NDIS may be unsuitable for younger people without a formal mental health diagnosis or people who feel alienated by the NDIS’ requirement for a ‘permanent’ condition. These people need continued support from community mental health services to recover from or manage their mental health conditions, and lead healthy and happy lives.

Invest in preventative health

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Increase funding for place-based preventative health programs through existing partnership platforms.


Victoria’s health system was originally designed to treat the ill and injured. In recent years, as the general population has aged and rates of chronic and ‘lifestyle’ diseases have increased, attention has shifted to how we keep Victorians healthy and happy.

Despite this, only about 1.34 per cent of health spending in Australia is on prevention.

The Victorian Government can improve the wellbeing and quality of life for current and future generations of Victorians by making long-term investments in preventative health.

This approach will also save money in the long term. Chronic disease contributes to nine out of 10 deaths in Australia, reduces productivity and puts a massive strain on the health system. However, every dollar spent on healthy eating and active living returns about $3.

Investing in preventative health will also help address health inequities, as it will benefit disadvantaged Victorians most. Preventative health investment is supported by the community; Australians identified it as a top-tier priority in a 2016 opinion poll.

The Victorian Government recognised the need to build a health system geared to prevention as much as treatment in its plan Health 2040: Advancing health, access and care. The plan commits to building healthy neighbourhoods by partnering with communities to identify and act on local health concerns and issues, and address health disparities across groups and communities.

These goals can be achieved by the Victorian Government investing in local preventative health programs.

Existing partnership platforms such as the Victorian Primary Care Partnerships and Regional Partnerships should be engaged to help design and deliver these programs, in conjunction with community health services, local governments and other service providers.

SEA Change Portland

SEA Change Portland is working towards creating a community where healthy eating and being active is easy, by reorientating existing resources to a collective, long-term, community-driven systems approach.

More than 60 Portland community members have worked together to tackle the town’s high rates of obesity by undertaking more than 200 actions to strengthen healthy living. These have taken place within schools, early years services, sporting clubs, service clubs, community groups, workplaces and community events. Some examples are:

  • Auditing and building accessible public water fountains.
  • Adjusting sporting club canteen menus to include healthier and more affordable options, and providing healthy food at social events.
  • The introduction of a health food policy at a local school, which has made changes to its canteen, held special food days and developed students’ cooking skills.

Reduce public dental waiting times

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Increase funding to Victoria’s public dental programs.


The Victorian Government can help people with oral diseases and pain by investing in public dental services. Australian Government funding cuts have extended general dental care waiting times to more than 16 months after blowing out in the past two years.

Poor oral health can cause pain and discomfort, impact on mental health and self-esteem and impinge on many aspects of people’s lives, including eating, sleeping, working and socialising.

The majority of oral disease is preventable. But people need access to timely or preventative dental care. While people on low incomes are eligible for public dental treatment, they often don’t get help until it is too late.

The Victorian Auditor General, in the 2016 report Access to Public Dental Services in Victoria, said we must break the cycle of poor oral health and build more preventative approaches to managing public dental health. Getting the balance right between treatment and prevention may involve changing the way public dental services are funded, delivered and administered.

Extend community-based palliative care

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Increase investment in community-based palliative care to help people in their homes.


The right to a good life extends to a good death. Most people wish to die at home, but some have no choice and live their final days in hospital.

The ongoing discussion about end-of-life choices and voluntary assisted dying in Victoria has clearly highlighted the need for high-quality palliative care. Palliative care provides emotional and practical support to people facing death, including pain management and help making decisions about their care and quality of life.

Population growth, an ageing population and high rates of chronic disease mean there is growing demand for palliative care in hospitals, aged care facilities and, increasingly, community-based services delivered in people’s homes.

Community palliative care providers help people in their homes, including after business hours. They support carers by providing counselling, bereavement support and respite. Yet just 40 per cent of community-based palliative care providers are able to meet current demand and only 14 per cent expect to meet anticipated demand over the next three years.

Rural and regional Victorians, people from culturally and linguistically diverse (CALD) backgrounds, people with disability and people in residential aged care facilities have particular difficulty accessing palliative care services.

The Victorian Government can help people live and die well by supporting community palliative care services to provide ‘24-7’ care, as well as carer support and respite as required.

Embed Aboriginal self-determination

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Ensure community and self-determination are at the heart of the treaty process.


“Aa Aa Yuwang-ngal-in marram nganjin budambun-djerring, which means in Taungurung language that Aboriginal Victorians and the Government need an agreement together that is reciprocal.”

Self-determination is vital to improving Aboriginal health and wellbeing. The full potential of Aboriginal peoples can best be realised through empowered communities making decisions about their own futures, helping determine all policy that affects them and delivering a range of programs and services.

Self-determination has been progressed through recent actions including establishing the Victorian Aboriginal Economic Board, transferring nearly 1500 public housing properties to Aboriginal Housing Victoria and empowering Aboriginal community controlled organisations (ACCOs) to take guardianship and responsibility for the care of Aboriginal children in out-of-home care.

As part of the Victorian Government’s commitment to self-determination, it has commenced a treaty-making process with the Aboriginal community.

A treaty should deliver recognition of our unique position as this country’s first people, repatriation for past wrongs and injustices, improve our lives today and allow us to establish the foundations for a strong and bright future for our future generations. It will enable us to build and celebrate our cultural strength.

More than 7500 Aboriginal Victorians have already been consulted on the pathway to treaty discussions. ACCOs need adequate funding to support their communities’ ongoing engagement in self-determination and treaty discussions and to make sure the community voice is at the heart of the treaty-making process.

Invest in a resilient recovery strategy

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Develop and fund a resilient recovery strategy promoting collaboration with community organisations.


The Victorian Government can help communities cope and adapt to change, and better recover from emergencies and disasters, by developing a resilient recovery strategy. Central to this strategy would be the role of community organisations in working collaboratively with the emergency management sector to build resilience at a local level. Investing in people-centred and place-based resilience will help strengthen communities and empower them to lead their recovery.

Stressors like poverty, unemployment or chronic diseases can weaken communities and affect their ability to manage change. Natural disasters and other crises and emergencies can uproot communities, separate families and destroy homes, livelihoods and threaten lives. Genuine recovery may take many years as people rebuild and find new directions and patterns of normality.

The lifetime social cost of the 2009 Black Saturday bushfires is estimated at $2.5 billion, which includes the cost of mental health issues, risky or high risk alcohol consumption, chronic disease and non-communicable diseases, and family violence. The Victorian Government can mitigate these sorts of costs through investment to strengthen communities and individuals before disasters or emergencies occur.

The five-year Beyond Bushfires study of the impacts of Black Saturday and related bushfires found that involvement in local community groups and organisations was associated with more positive health and wellbeing.

If a community functions well, has strong social connections and plentiful resources, it will be better able to withstand the challenges imposed by a crisis or emergency. Conversely, people and communities with pre-existing vulnerabilities, or who are disadvantaged, will be hit hardest by the immediate, medium and long-term effects of disasters.

Members of resilient communities are better able to manage traumatic life events; for example, family breakdown, mental illness or alcohol and other drug misuse. Members of resilient communities are also better equipped to manage broader events like social unrest or economic downturn.

Building individual and community resilience has been the core focus of the community sector for decades. By leveraging the resources, knowledge and skills of community organisations, a resilient recovery strategy can significantly enhance Victorian communities’ resilience before stress or disasters strike.

Strengthen Neighbourhood Houses

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  • Immediately fund the 30 under-resourced Neighbourhood Houses in Victoria’s growth corridors and other areas.
  • Increase support for country Neighbourhood House Networks to better support rural and regional Neighbourhood Houses and advocate on regional issues.


Neighbourhood Houses help Victorians make friends, get involved in their community and become economically engaged. They create inclusive and welcoming environments where people of any ability, background or age can connect, learn and share.

They are also a cost-effective way of combatting loneliness and social isolation, improving a person’s wellbeing and reducing their reliance on acute health and other government services.

The Victorian Government can help people facing disadvantage engage and connect with their communities by increasing funding for Neighbourhood Houses, especially in growth corridors.

The Victorian Government’s Neighbourhood House Coordination Program presently funds about 375 Neighbourhood Houses across Victoria. This leaves more than 30 – in areas such as Carrum, Geelong West and Wyndham – without any funding.

Regional Neighbourhood House Networks provide management and governance support to Neighbourhood Houses and advocate on behalf of Neighbourhood Houses and communities to local councils and the Victorian Government.

The way funding is calculated and awarded to Neighbourhood House Networks does not recognise the additional costs of networking in rural and regional Victoria. The current formula disadvantages rural and remote areas, leaving them under-resourced to help local Neighbourhood Houses respond to the needs of a dispersed community, meet complex governance requirements and remain sustainable.

More funding will allow these networks to better support individual Neighbourhood Houses, facilitate regional consultation and advocate on regional issues.

Victoria’s Neighbourhood Houses

Each week in Victoria:

  • 190,000 Victorians use a Neighbourhood House
  • 6,700 Victorians volunteer at a Neighbourhood House
  • Neighbourhood House facilities are used for approximately 56 hours of community activities (roughly eight hours per day, every day of the week).



Further strategies


Make community health facilities safe and fit-for-purpose

The Victorian Government can help community health services protect their workers from physical violence and aggression by investing in workplace redesign and infrastructure.

The Government has already acknowledged the risk of violence against mainstream health workers, providing funding to help prevent violence against hospital staff and first responders. With more than 90 per cent of health workers in Victoria having been victims of violence or aggression in the workplace, community health workers also need support.

Building design is an effective way to help protect community health workers. Many community health and Aboriginal Community Controlled Health Services buildings and facilities are ageing, too small, unsafe or not fit-for-purpose, partly due to limited capital investment in recent years.


Help alcohol and other drug treatment services respond to increasing demand

The Victorian Government has committed to rolling out a real-time prescription monitoring system to help identify people who misuse prescription drugs. This system is expected to commence in 2018 and the alcohol and other drug sector will need capacity to accept additional referrals to treatment, including pharmacotherapy. If there is no additional capacity, there is a risk of further harm to people the new system identifies, who could transition to other harmful, possibly illicit substances.

Despite recent welcome investment in alcohol and drug treatment services, long waiting lists for residential rehabilitation services remain. Funding additional rehabilitation places would help meet demand.


Continue to support the Sexual and Reproductive Health Strategy

Early in 2017 the Victorian Government released the first-ever Victorian Sexual and Reproductive Health Strategy. This document provided an overarching plan for improving Victorians’ sexual and reproductive health and reducing barriers to accessing affordable healthcare, contraception and termination services across the state.

However, while the $6.6m funding that accompanied the strategy was welcome, several important gaps remain. In particular, additional funding is required to establish a new pregnancy support phone hotline, to ensure all Victorian women and families can receive informed pregnancy advice when they need it.


Keep people safe through robust emergency planning

The Victorian Government can improve the safety of vulnerable people in emergencies by ensuring there is adequate emergency services planning and clear lines of responsibility for their care or evacuation during an emergency event.

The 2009 Bushfire Royal Commission found 44 per cent of Victorians who died as a result of the fire were more vulnerable to bushfire because of age, ill health or a combination of both. Following the Royal Commission, all service providers funded by the Victorian Department of Health and Human Services are required to plan for and respond to a diverse range of emergencies affecting people. This includes events caused by weather or natural emergencies, human health, animal health, failure of infrastructure and security emergencies.

With the transition to individualised funding models, including both the NDIS and My Aged Care, it is unclear who will have responsibility for emergency planning. NDIS providers report they have not been provided with templates or documents prompting thought about emergency planning or preparedness for people.


Review the adequacy of the Medical Cooling Concession

VCOSS’s 2017 Power Struggles report highlighted the interconnection between health and energy consumption. Nearly all interviewed households either had health issues that increased their use of heating and/or cooling, or would have benefited from using more heating or cooling.

Several people had health issues that caused heat intolerance and created a need for home cooling, but they were ineligible for the Medical Cooling Concession. In other cases, poor health contributed to people being home and sedentary through the day (for example, recovery from surgery, injury or depression), which increased their use of heating or cooling, or increased demand from lighting and other appliances.

The Victorian Government should examine whether the Medical Cooling Concession is too narrowly targeted.

VCOSS believes the concession could be expanded to include general medical need for increased cooling or heating, regardless of whether thermoregulation is required (this is the current criterion for concession access). People who are coping with illness or recovering from surgery over a long period would then be eligible for this concession.

Alongside this, the Victorian Government could examine whether concession eligibility should be needs-based, rather than providing a list of eligible conditions, which could make the concession clearer and easier to access.




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