Community members and workers across the health and community sectors have been reeling over the last fortnight following the sudden news that some of the longest running community health centres in the country are closing their doors. 
The decision by Cohealth to close its general practice services in the Melbourne suburbs of Collingwood, Fitzroy and Kensington by the end of 2025, and to shut the Collingwood site entirely by mid-2026, will leave around 12,500 people without a GP. The closure will also cut off pharmacy services, including opioid replacement programs, as well as nursing, counselling and allied health care. 
Thousands of people depend on these clinics for their everyday health and survival, including some of the most vulnerable in the community: refugees, newly arrived migrants, people experiencing homelessness, those living with disabilities, and patients managing complex chronic illnesses.
Staff at Cohealth received notification of the closures via email on the same day the public announcement was made. There was no warning, no consultation and no plan to ensure continuity of care. For the communities affected, this is not just a policy change: it is a devastating loss of a vital lifeline.
Having spent eight years working as a doctor in public hospitals before moving to general practice and community health, I thought I understood what strain looked like in our system. I have sat through ward meetings where doctors debated who was “least sick” and could be discharged to make room for new patients who had been waiting in the emergency department for days. I have seen people essentially bedbound for months waiting for “non-urgent” elective surgeries. 
But the crisis in general practice is different—quieter, more personal, and in many ways more insidious. I’ve had patients tell me not to bother taking their blood pressure because they know it will be high, but that the ensuing discussion will mean their appointment will run over the standard consultation time and they can’t afford the extra fee. I’ve had women ask whether a follow-up appointment after a medical termination of pregnancy is really necessary, because the cost of the medication already means they’ll be short on food for the week.
These are the realities of general practice. Medicare’s promise of universal care has become increasingly hollow. A recent report from the Royal Australian College of General Practitioners found that only 12 percent of GPs now bulk bill all their patients, while 40 percent bulk bill few or none. Even in Victoria, one of the better performing states, the bulk-billing rate for non-concession card holders is an abysmal 19 percent. 
It is no surprise, then, that 9 percent of Australians delayed or skipped seeing a GP because of cost in 2023–24, up from 7 percent the year before. But those figures don’t fully capture the damage. Preventive care—the invisible work of managing risk factors and detecting illness early—is what keeps people well, and reduces overall disease burden. The positive effects of this sort of care are hard to measure—the absence of disease where it might have otherwise occurred—and long term, which is also hard to quantify and politically less rewarding for governments. When people delay seeing a GP because of cost, prevention disappears from the picture. 
The Australian government’s own Department of Health and Aged Care admits that every dollar invested in preventive health saves an estimated $14.30 in future healthcare and social costs. Yet Medicare rebates have stagnated for years, pushing more and more clinics to pass costs onto patients, while those who can’t pay fall through the cracks. 
For a time, community health centres held the line. We were able to offer bulk-billed services, integrated care and enough time to address the complex needs of patients in crisis. But now even that last line of defence is being dismantled. 
In addition to the Cohealth closures, the Age reports that two more community health centres are on the brink of closure. Many more of the surrounding clinics have closed their books to new patients because they are already at capacity, with wait times of two to three weeks for an appointment. 
Part of the problem lies in the fragmented way our healthcare system is funded. The federal government funds general practice through Medicare, while public hospitals are jointly funded by federal and state governments. This creates absurd incentives. When the federal government keeps Medicare rebates low to save money, the result is more people ending up in hospital—which costs the states (and taxpayers) far more. A non-urgent emergency department visit costs over $500, compared to $42 for a GP consultation. Yet Canberra continues to starve general practice funding, leaving states to mop up the fallout.
The rollout of Urgent Care Centres is the latest example of patchwork policy masquerading as reform. These centres provide episodic, walk-in treatment for minor emergencies. They relieve some of the pressure on hospitals—but at five times the cost of a GP visit. They don’t support preventative health, continuity of care, or long-term management of chronic disease. And they further fragment and complicate the health system. 
Meanwhile, the federal government has trumpeted its new Bulk-Billing Practice Incentive Program, which began on 1 November. It offers a 12.5 percent incentive payment to clinics that bulk bill all eligible patients for certain services. On paper, it looks like progress. In practice, it’s a drop in the ocean. 
The flat 12.5 percent incentive does not scale with consultation complexity or length, incentivising short, frequent consults and penalising clinics that care for complex patients. Many community health services also rely on a mix of bulk-billing and small private fees from those who can afford to pay. These organisations may opt out of the program to preserve this income, as the incentive payment may not offset the loss from private billings.
The government claims these changes will increase the number of fully bulk-billing practices to around 4,800 by 2029, with 90 percent of visits bulk billed by 2030. However, an analysis conducted by the healthcare accessibility organisation Cleanbill suggests that the real number of new fully bulk-billing clinics is likely to be closer to 740. So far, according to the government’s own figures, only 622 of the 4720 metropolitan practices have expressed interest in changing from mixed billing to the new bulk-billing system, despite months of government campaigning. 
The deep sense of anger and betrayal from the communities of Fitzroy, Collingwood and Kensington has been palpable. Hundreds have flooded mass meetings to voice their outrage, directed at the Labor government and the Cohealth board in equal measure. The people here have a strong memory of what community-controlled healthcare once meant.
North Yarra Community Health, one of the precursors to Cohealth, was run by a board elected by the community: bi-monthly community meetings were attended by hundreds and interpreted into ten languages. Annual general meetings were held in tents, not boardrooms.
When North Yarra merged with Western Region Health and Doutta Galla to become Cohealth, that democratic model was dismantled. The board became incorporated, community membership was abolished, and decision-making drifted away from those it affected most. The current crisis is a direct outcome of that shift. Today, unelected board members can decide to close clinics, terminate staff and sell off community assets without answering to the people affected.
This fight is about more than one organisation. Australia’s public health system is at breaking point. Hospitals are overflowing, ambulance ramping has become routine, and exhausted healthcare workers are being pushed to their limit. Every year brings new promises of reform, yet the underlying issues—underfunding, privatisation, and the widening gap between rich and poor—remain untouched.
If governments are serious about fixing the system, they must start with the basics: guaranteeing access to healthcare for all, fully funding preventive and community health services and returning control of those services to the people they serve. We must end the profiteering that treats health care as a commodity and rebuild a universal public health system—one in which healthcare is free, accessible and guaranteed as a human right for every person. 
On Saturday 8 November, community members and healthcare workers will rally outside the office of federal Labor MP Sarah Witty to demand just that—immediate intervention by the Victorian and federal governments to stop the Cohealth closures with no interruption to services, as well as a commitment to a public, fully-funded community health system—free, universal and democratically controlled by the communities it serves.

Shaday Wheatley

Community health centre closures must be stopped

When Victoria Police Commander Wayne Cheeseman huffed into his media conference on 19 October, armed with a box of rocks allegedly thrown by anti-fascist protesters, he engaged in a piece of theatre intended to malign anti-racists and praise far-right protesters. Cheeseman was also doing his bit for the wider campaign, supported by the Melbourne City Council, the Liberal Party and the mainstream media, to crack down on protests in Melbourne. 
That day, there had been two opposing rallies in the city centre. One was a far-right protest, attended by angry, racist nationalists waving flags and demanding an end to immigration. This protest was led and addressed by Matt Trihey, a member of the National Workers Alliance, a fascistic organisation with links to the Nazi National Socialist Network. A similar protest a few weeks before had ended in violent attacks on Camp Sovereignty, an Indigenous protest camp in a city park.
The other demonstration was an anti-racist counter-march. It involved at least 1,500 people marching against nationalism and white supremacy, the vast, vast majority of whom did so entirely peacefully. The police chose to target their fire on just one of these protests. 
Cheeseman ranted and raved at his press conference, about “issue-motivated groups” (left-wing people who are opposed to racism), and praised the far right who “protested by example”. This celebration of the well-behaved racists gave a predictable boost to the far right, some of whom called on social media for Cheeseman to become mayor. 
The mainstream media amplified the police commander’s calls, building on many months of campaigning about the need to restore “order” in the city. Chip Le Grand, political writer for the Age, quoted beleaguered business owners as part of his argument for scrapping democratic rights: “Prominent restaurant owner Chris Lucas wants the CBD to be declared protest-free for the rest of the year. While this would temporarily impinge on the right to assembly guaranteed by Victoria’s Charter of Human Rights and Responsibilities, it would protect the countervailing rights of business owners, residents and ordinary visitors to the city”. 
The reality is that this anti-protest campaign was under way well before the anti-racist protest over the weekend. Cheeseman was saying what most of the establishment were already thinking, and some doing. Rock throwing and other counterproductive tactics simply gave the police and their allies more authority to pursue it. 
Their real gripe is the Palestine movement, remarkable in its scope, depth and longevity, and which has organised weekly rallies in Melbourne throughout Israel’s stepped-up genocide. This show of internationalism and solidarity against Western-backed violence is part of what had motivated the far right to organise. And it has been the catalyst for the authorities, in particular the Melbourne City Council, to call for restrictions on the right to protest, such as exist in New South Wales. The permit system there gives police the ability to veto the right to demonstrate, and while activists can sometimes overturn this in court, it requires access to lawyers and costs time and money, which left-wing activists often don’t have. 
Already, the Melbourne City Council has approved a plan to request state and federal governments to restrict protest rights in the city. This would <a href="https://www.abc.net.au/news/2025-08-20/city-of-melbourne-councillors-vote-amendment-protest-disruption/105674980">include</a>
altering the routes of protests, moving them to parks or “stronger police intervention to minimise disruption”. 
Brad Battin, the Liberal leader, has likewise called for limits on the right to protest. Battin has pledged to introduce a permit system if the Liberals are elected at the coming state election. A Liberal press statement has Battin saying, “Under a government I lead, law abiding citizens will be prioritised ahead of those who seek to disrupt the activities of Victorians or endanger public safety”. The Liberals sleight of hand includes discussing protests and demonstrations in the same breath as machete crime and gang violence. 
Premier Jacinta Allen has so far resisted calls for a permit system, but her government has introduced other laws restricting protests. These include harsher penalties for people who lock on or glue themselves to surfaces—things that mainly environmental and anti-war activists engage in. 
Whatever happens, we have to defend the right to protest. We can’t let the very forces we are often protesting against take away our ability to challenge them. And we can’t let profit making for city businesses trump democratic rights. The best way to uphold and defend the right to protest is to keep getting out and protesting, and to make it impossible for the authorities to stop us.

Community health centre closures must be stopped

Cops huff and media puff—we need to defend the right to protest in Melbourne

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