History

The inner north-west was, in the 1970s, a heavily working class area, surrounded by industry and with a large immigrant and dependent population, yet under-resourced medically. Local church leaders, residents and academics campaigned for a health centre. The community health model appealed because its integrated and responsive approach could “address the wide range of need in disadvantaged communities whose health problems were often grounded in political, social and economic inequalities’ (Paul Aron, p.12). The federal election of the Whitlam government in 1972, with its support of community health and policy of working with states to develop regionalised services, accelerated the establishment of a community health centre in Kensington in 1974. The centre’s 1976 Annual Report declared that within the first few months of the centre’s opening, “half the families of Kensington already use the centre” (page 18).

The Flemington Community Health Centre was established in 1977 with centres eventually being established in North Melbourne and Ascot Vale. A ‘drop in’ atmosphere saw regular users accessing diverse social support and medical services. Community development strategies saw numerous health support groups being established, many crucially supported by interpreters, to support community engagement. Many of the groups focused on women, recognising gender equality as integral to the social model of health. Centres were run as a flat staff structure staffed by people adept at political campaigning. Community issues such as housing, high utility bills and inappropriate urban developments were addressed through political advocacy and activism.

The end of the 1980s saw a review of community health from the state Health Department and sweeping changes to Victoria’s health services and their administration. Subsequent pressure to amalgamate eventually led to the creation of Doutta Galla Community Health Centre. The Jeff Kennett Liberal state government in 1992 saw funding cuts totalling 11% and community centres were pressured to operate as businesses with fees consequently introduced on a means tested basis for some services. There was a shift towards ‘health promotion’ in the health sector which was at odds with the belief that community health starts with addressing the social determinants of health . The Flemington Health Centre controversially closed, and then Ascot Vale, while Doutta Galla was forced to extend its services to provide for a larger population catchment area to gain funding. The push to rationalise services and increase efficiencies was a fraught affair with the popular demand for some services not matching funding or fees.

Another Kennett era reform was a move toward competitive tendering for services. Organisational informational flow between competing organisations was compromised but partnering organisations were now able to win large scale tenders. The Labor government of 1999 introduced the ‘Primary Care Partnership’ model to replace the competitive approach and promote a fully integrated range of services. Doutta Galla expanded greatly in the 2000s while a Community Advisory Group was formed in 2008 to strengthen the board’s mandate as a voice for the community.

Established at 162 Wellington Street, Collingwood in 1889 as the Collingwood Free Medical Mission Dispensary ‘for the relief of the destitute sick of every creed and clime’, it was the first Dispensary in the Colony of Victoria. Responding to public crises resulting from industrialisation and urbanisation, dispensaries provided medications, clinical care, home visits, minor surgery, casual dentistry and vaccinations.

Since 1840, industrial Collingwood remained a ‘hard-bitten, hardworking, hard living and hard drinking neighbourhood’ (Missionaries, Radicals & Feminists: A History of North Yarra Community Health by Hamish Townsend, page 29). Known as ‘Singletons’ after its founder, reformer, philanthropist and evangelical Christian, Dr John Singleton the dispensary viewed ill-health as largely a result of ‘intemperance’. Patients were encouraged to read scripture and pray while waiting for medical attention. Female doctors were controversially engaged.

Demand for medical services by people living in poverty greatly increased during times of economic depression (1890s and 1930s) and during World War I and II when Singleton’s distributed welfare. The 1970s saw the rise of social justice movements and a new generation of educated, progressively minded health professionals. The brief tenure of a progressive federal government under Labor’s Gough Whitlam provided funding and support for community health. The ethos of the health service evolved from providing welfare to the ‘deserving’ disadvantaged to one aimed at providing healthcare to all and promoting empowerment, agency and advocacy.

In 1977 the organisation moved to 365 Hoddle Street as the new Collingwood Community Health Centre. Occupational health was a focus, as was an emphasis on prevention and conducting ‘hyper local’ research. Research outcomes into the health effects of lead petrol on the local community – after the much-opposed construction of the nearby Eastern Freeway – contributed to the 2002 phasing out of lead petrol in Australia.

The Carlton Community Health Centre was established in 1979 at 622 Lygon Street while the Fitzroy Community Health Centre resulted from the 1982 separation of St Vincent’s Hospital with its community health centre, Depaul. The rise of economic neo-liberalism saw a political climate of deregulation and privatisation, with governments increasingly seeking private provision of health and education services. A ‘Campaign against Entrepreneurial Medicine’ mobilised the Fitzroy Community Health Centre and the Collingwood Community Health Centre, amongst others, against private super-clinics establishing themselves in the area.

The late 80s saw the rise of youth homelessness, drug taking and the appearance of HIV/AIDS. Collingwood Community Health Centre provided a ‘drop in’ service which included a needle exchange program. Funded federally, the needle exchange program represented a highly successful national strategy to prevent the spread of HIV/AIDS and Hepatitis C.

The Jeff Kennett-led Liberal Party in the early 1990’s resulted in f