Presentation to Charnwood Community Health Group

30th November 2004

Tim Budge, South Kingsville Health Services Co-op Ltd

Overview

How It Started

25 Years in 5 Minutes – A Potted History

A Profile of SKHS Now

A Profile of the Local Area

Our Challenges

What Would We Do Differently

How SKHS Started

Genesis in radical Christian Community

Focus on analysing & responding to local need

1980 – One Doctor prepared to “have a go”

Auspiced by Baptist Social Services Department –

but a difficult relationship

1986 – Became independent – South Kingsville

Health Services Co-op Ltd

A Potted History

Wages – originally very low – progressively became more competitive

Early Days Community Health/Outreach “Learning for Life” Casserole Bank Free Counselling/Support Volunteer Transport

Voluntary Management Committee (from the start)

More Potted History 1987 – Purchased property

1992 – Purchased premises next door, pharmacy as major tenant

1993 – Purchased medical clinic in Newport (next suburb)

1995 - Dental equipment donated (with a dentist prepared to provide low-cost service)

1990 – 2000: finances progressively tighten

Even More Potted History

1997 – Co-op membership made compulsory for bulk-billing (membership funds needed)

1999 – 2004: GP recruitment becomes much harder

Focus of last few years: Understand business Recover financial stability Membership growth Develop systems, structures and processes

SKHS in 200425 staff: 11 GPs (most p/t), 2 dentists, 3 practice nurses, p/t bookkeeper, p/t CEO & p/t Practice Manager7,600 membersApprox 25,000 consultations/year$1.9 million turnover

Our Patients/Members

Where they come from: Immediate suburbs – 50% 5 km radius – 30% 10 km radius – 10% 20 km (Werribee) – 5%

Demographics: 36% members concession

card holders 42% patients concession

card holders 20% patients > 65 years 40% attending co-op > 10

years

Local area is changing

A Profile of the Local Area

For the Westgate Division of General Practice (Cities of Hobsons Bay & Wyndham): 180,000 people across 610 square kms; 45 practices (13 solo); 155 General Practitioners (approx ½ part-time); Approx GP Ratio - 1:1,500 (national - 1:1,300); In Last Seven Years:

24% increase in population; 18% decrease in GP “providing attendances”; 52% increase in number of people per GP;

= Shortage of 40 doctors across both LGAs.

GPs & Bulk-Billing - Hobson’s Bay

Hobsons Bay:

Population approximately 80,000

24 GP practices, approximately 79

GPs;

Equates to approx 60 fulltime GPs;

Approximately 1,350 people/GP.

Clinics & Bulk-Billing in Hobson’s Bay

26%

22%

26%

17%

9%

EveryoneNo-oneAged PensionAny PensionPension/ U16

Advantages of SKHS Model/Philosophy

Let’s doctors “get on with their job”

Builds local capacity and local benefits

Improves health care: Patient focus

Community focus

Genuine “community health”

Capacity to develop Community Health

Advocates

Current Challenges

Consolidate – stick with 2 clinics

Develop excellent systems and processes

Computerise all records

Excellent medical care & an excellent model of care (comprehensive)

Adding value for co-op membership

Develop volunteering

Keeping “In the Black”

What Would We Do Differently?

More work on Governance and Management

Value and develop model of Community-Owned Health Service

Focus on Mission (not try to be just another medical clinic)

More focus on financial sustainability

Right people in the right job

Questions

and

Discussion