Melina Morrison, CEO of the Business Council of Co-operatives and Mutuals (BCCM) provided this comment to Australian Rural & Regional News in response to the Westfund Regional Health Gap Report and commentary from Westfund CEO, Mark Genovese. Melina has also responded to some questions from ARR.News, below.

The Business Council of Co-operatives and Mutuals (BCCM) welcomes today’s [2 November 2023] report by not for profit health insurer Westfund, which highlights the disparity in health care services available to those living in regional and remote areas of Australia.

The report provides yet more evidence of the need for innovative solutions to tackle the shortage in services in these areas in order to ensure all Australians have access to the highest possible standards of care and to address the glaring shortage of workers available to provide that care. It is clear that we need solutions that are community based and structured to suit the needs of those receiving the care as well as those providing the care. The co-operative business model, with its emphasis on grass roots democratic management, and sustainability, is ideally suited to providing care services in small and under-supplied markets.

This is why the $7 million Care Together program has been tasked by the Federal Government to identify opportunities for co-operative and mutual businesses to help address shortages in the delivery of care where other models have failed.

Today’s report reveals just how important it is for those communities living with insufficient health services to find alternatives that will provide long term solutions as soon as possible. Care Together operates on the basis that social care services should be available to people when they need them and no matter where they live.

Care Together aims to assist existing businesses in aged care, disability support, veterans care and indigenous care, to convert to a co-operative structure, help existing co-operatives to achieve scale, and advise on the launch of new care co-operatives. Four of the 12 projects have been approved and will commence in coming months.

Attraction and retention of care workers is a key focus of Care Together and we hope that through the program we can identify local issues and find local solutions that might have wider application across regions and the nation.

Background

The Westfund Regional Health Gap Report 2023 shows that access to healthcare remains an ongoing issue for Australians in regional areas, with half (49 per cent) considering the wait time to see their GP unreasonable, some having to wait up to six weeks to get an appointment, and many having to travel more than two hours for an in-person consultation with non-GP specialists.

The report, developed in partnership with Insight Actuaries, used claims data over a seven-year period from 66,000 patients across eight regional locations (Mudgee, Orange, Dubbo, Bathurst, Lithgow, Wollongong, Mackay, and Townsville). Its findings show that geographical factors significantly impact access to care, availability of services, and consequentially Australians’ healthcare outcomes.

Questions from Australian Rural & Regional News

ARR.News: Are you able to point to current examples of co-operative business models operating successfully to provide healthcare services in rural and regional Australia?

Melina Morrison: The longest standing and best known examples are community owned hospitals, member owned health funds like Westfund based in Lithgow, and friendly society pharmacies which are community owned by their customer members. Aboriginal community controlled health organisations all started as co-ops and some are still under co-ops law. But there are some new and really innovative co-ops like This Co-operative Life in non-residential aged care services in the New England region.

ARR.News: Can you identify the key strengths and weaknesses of the co-operative model for providing health care in rural and regional Australia?

Melina Morrison: Co-ops are ideally suited as a structure for community owned health care in the bush. They are a robust legal model with stringent governance requirements. They can do anything a company can do but they behave like a not for profit. The ‘one member, one vote’ structure means the voice of every member matters. The only weakness is that people haven’t heard of the model enough so they sometimes take another, less suitable structure.

ARR.News: How might a co-operative model adjust to suit the particular needs of specific areas, noting that Westfund report has helped identify gaps in different areas?

Melina Morrison: Co-ops start at the grassroots. They are literally built around the specific needs of the communities where they are based when people or organisations come together because they can’t go it alone. Where current models are failing and you have gaps, perhaps a co-op can fill that void because it is autonomous and jointly owned by local people. Gaps that co-ops help fill include areas where existing smaller businesses do not have the scale to operate sustainably. A shared services co-op provides back office and other solutions for organisations that can be spread over a large area.

ARR.News: How might it be possible for co-operative businesses to grow without the different businesses already existing in an area? Don’t they depend upon there already being health care services operating, whereas a key problem for rural and regional Australians is the lack of accessible services, co-operative or otherwise?

Melina Morrison: Sometime co-ops are set up specially to run a health care service that might be missing. They are the legal structure for the healthcare business to operate. It runs like any other business so it needs to attract income and workforce to be a going concern. But it has the advantage of a lean operating model. Co-ops are set up to run different businesses including aged and disability care, Indigenous health care, veterans care, GP services and allied care. Obviously issues like lack of housing for care workers impacts co-ops like any other structure.

ARR.News: The Care Together program appears to target specific rural and regional Australians (aged, disabled, veterans and Indigenous)? How might the program benefit not only these groups but all rural and regional Australians?

Melina Morrison: The health of the local population is the bedrock of a thriving community. If people can get their healthcare needs met locally then the local economy will benefit as well. This program is set up to make sure that all Australians whatever your background or where you live can access affordable, high quality health care.

Related story: Shortage of healthcare providers putting regional Australians’ health at risk: Westfund