Funding cut makes no economic or health care sense

13 May 2015

 You may not have noticed the news about the funding cut and if you did, it may not have looked like a very important service or a very important funding decision. But it is. The Haymarket Health Care Clinic in inner Sydney has been providing comprehensive primary health care to homeless people for more than 20 years. I think it’s sad that we need to have a dedicated primary health service for homeless people in our community. But unfortunately, we do. Until we end homelessness (with housing and support) we need to ensure that the most vulnerable citizens amongst us get appropriate and co-ordinated primary health care services.

I’m not complaining about this bad federal government decision because I’m a bleeding heart and this type of service just ‘feels like a good thing’. I’m saying this because this type of service makes significant economic sense. Homeless people don’t just disappear when a service closes its doors. They have to go elsewhere. And in this instance that ‘St. Elsewhere’ will be the closest tertiary hospital with an emergency department – St Vincent’s.

Let’s be quite clear about this. The federal government is cost shifting to the state government and the people who will lose are those that have already lost the most – people without family, without advocates and without homes.

However, they are not the only losers. We will all lose. Instead of providing health care at a fraction of the cost, homeless people will be heading to an expensive (but State funded) emergency department for their health care needs. We all foot that bill. Do we care if the expenditure our taxes fund are Federal or State dollars? Every bit of it is our money and our governments have an obligation to spend it in the most cost effective way.

A few years ago the Mercy Foundation undertook a health needs survey of street homeless people in inner Sydney and it has provided some concerning statistics. Of the 262 people surveyed, 139 were found to be vulnerable; 63% had at least one serious medical condition; 29% had a brain injury; 56% had both a mental illness and an addiction. I could quote further troubling statistics, but I want to focus on one particular one. That was the question about where people go for their health care. In inner Sydney almost 50% reported going to a primary health care facility. The same survey in western Sydney (where there is no service like the Haymarket clinic) showed a different response, with the majority of people nominating a hospital as the place they went for health care. The difference in the cost of a primary health care clinic compared to a presentation at a hospital emergency department can be significant. As well as the financial cost, emergency departments are simply not set up to co-ordinate health and community care and monitor chronic conditions.

Of course, homeless people could just find their own GP and go there. Some might, but most will not and many cannot. A health care service open to all, that doesn’t care if you’ve lost your Medicare card and which provides the necessary follow-up and the holistic health care you need when you have multiple health conditions and have nowhere to live is not a luxury, it is a cost effective and compassionate way to provide health care to vulnerable people. And the bonus always was that they will work with people to find them housing and support them in that housing. I don’t know of any other GP clinics that can claim to do that.

Not only should the Federal government have not cut funding to the Haymarket Foundation, they should have actually used this highly successful model to roll out similar programs in inner city areas across Australia.

This is an appalling funding decision and we should all be appalled by it.

Please go to this link and sign the petition ask the Federal Minister for Health to reverse this decision.

Felicity Reynolds

CEO, Mercy Foundation