To truly care, you must listen.
The forthcoming Gippslandia stories echo the community needs related to mental health. access to services, social inclusion and more.
Sep 22, 2022
Like so many of Gippsland’s stories, this one links to the region’s coal mining and power generation legacy too.
Similar to other tales tied to the mines, some elements are positive and others negative, and there’s a transition currently underway that will impact Gippsland’s future.
To begin with a positive: over 70 years ago, as power industry workers pooled their resources, they were able to establish Latrobe Health Services (LHS) to provide for the health care needs of residents in the Latrobe Valley.
Kate Jarvis, the Head of Marketing and Business Development for LHS, explains that in the 1950s the aim of the member-owned private health insurer was to provide local services such as hospitals and ambulances. While LHS maintains its roots in Gippsland, it has become one of Australia’s largest health insurers; over 100,000 people along eastern Australia are supported by the not-for-profit insurer.
In 1991, LHS established the Maryvale Private Hospital, Gippsland’s only private acute medical and surgical hospital.
The community spoke about keeping physically fit, appreciating what they have, enjoying the company of others, staying connected and living pain-free.
Conversely, on February 9 2014, a bushfire burned into the Hazelwood brown coal reserve, blanketing Morwell and the surrounding area in ash for six weeks. This catastrophic event has been recognised as ‟possibly the worst incident of environmental pollution in Victoria’s history”; one of the state’s ‟worst industrial disasters” and a ‟world first in terms of prolonged adverse air quality”.
As Tom Doig writes in The Coal Face, unfortunately, it may also prove to be one of the worst public health disasters Victoria has ever seen.
This horrific incident is one of two key influences that we see motivating change in Gippsland’s health care. The other is migration to the region and our shifting demographics.
The Hazelwood Mine Fire Inquiry Report 2014 found that the health profile of the Latrobe Valley is poorer compared to other local government areas in Victoria. For instance, the Gippsland Primary Health Network (PHN) Health Needs Assessment (2021) found that over 30% of adults in Gippsland report more than one chronic disease, compared to the state average of 25.5%. The cancer mortality rate here is above the national average too.
Recommendations to improve service coordination and health outcomes stipulated by the Mine Fire Inquiry included the appointment of the Latrobe Health Advocate, the establishment of the Latrobe Health Assembly, and the designation of the Latrobe Health Innovation Zone.
The Victorian Department of Health and Human Services commissioned the Hazelwood Health Study (HHS), which aims to identify potential health outcomes for people who were exposed to the smoke from the mine fire. These might include heart and lung disease, cancer or mental health problems. The study will also look at the effects on vulnerable groups such as infants and children, young people and older people.
Study leaders from Monash University’s School of Public Health and Preventive Medicine, and the School of Rural Health, have declared it the largest environmental health survey of its kind in the world. Two-and-a-half years after the mine fire, 4056 residents from Morwell (exposed to the smoke) and Sale (unexposed) participated in the HHS Adult Survey. The data collected from the survey and regular studies with the participants is to provide evidence – numbers – of what has occurred over time.
Jane Anderson, the Latrobe Health Advocate (LHA) since the role’s inception in 2018, has a different approach to learning the concerns and aspirations of the area’s health and wellbeing. She’s still interested in the numbers, no doubt, but her focus is on… listening to you.
As Australia’s first Health Advocate, Jane’s had over 280 dedicated conversations with Latrobe community members and/or groups over the past 12 months, reaching thousands of people in the past year alone.
In their 2020/21 Annual Report, the Advocate's office stated the top five priorities as formed from the community consultations. They are:
Mental health
Young people and people from LGBTIQ+ communities expressed their concerns about the lack of mental health services and support in the region. The Advocate consistently heard that it makes a difference when people feel a sense of belonging, and where there is a holistic approach to health that includes physical, mental and spiritual care.
Access to services
There is a continued aspiration for local services to understand their diverse needs. As the Advocate outlines, “They said their ability to get the help they need is impacted by their knowledge of the health system, how well services work together, and the experience people have with health professionals.”
Social inclusion
There is continued acknowledgement that social inclusion can improve quality of life. Community events help people connect with others and participate in society. The Advocate stated that this has gained greater significance since the pandemic.
Healthy lifestyles
The community spoke about keeping physically fit, appreciating what they have, enjoying the company of others, staying connected and living pain-free. Access to nutritious food was another topic raised.
Safe environment
Concerns were raised with the Advocate about the proposed used lead battery facility and the Delburn Wind Farm.
Notably, the stories presented in the forthcoming pages of Gippslandia have elements that echo the first four priorities presented in the Advocate's report. This provides a degree of justification for the topics to be representative of the entire region, but with subtle, local differences.
To link the concept of access to the changing demographics of the region, Maryvale Private Hospital CEO Lee Garwood noted that new residents to Gippsland from metropolitan areas expect access to the same level of care that they could receive previously in the city. The new, state-of-the-art robotic surgery resources at Maryvale are one example of this.
While this migration adds a vocal jolt on matters concerning the area’s health literacy, the health literacy of long-term residents is rapidly improving too. We’re all more aware of both the needs for our improved personal wellbeing and the health environment, which places pressure on achieving greater health equity compared to our city-dwelling brethren. Jane adds that there’s evidence that Gippslandians’ voices are far more influential in the development of local projects than in the past.
As our communities grow, the propensity of rare medical conditions occurring here increases, which requires medical specialists in niche fields. Our local practices and hospitals are creating unique offerings to attract those skills and knowledge to the region permanently or establishing partnerships with providers in Melbourne.
But it’s not only the acquisition of staff that requires consideration, ‘access’ – which includes accessible transportation and the language used to discuss health care – actually requires an examination of the entire health system over the entirety of a human life (and there are more conversations occurring currently about palliative and end of life care in Gippsland).
Through their engagement program, the Advocate found that signage, paperwork and communication used by health services could be discriminatory to LGBTIQ+ community members. By listening to the community's needs, new cancer screening language was adopted and participation increased.
A similar approach will be adopted to encourage older people in our region to use new health technologies. And, the Advocate highlights that as an inclusive society, we could do better in listening to our youth. We could address their anxiety for the future and anxiety from expectations by providing them with the opportunity to design recognition processes, academic and sport awards, for example.
Jane highlights this key challenge for health care, not only in Gippsland, but throughout Australia: how do you have a place-based approach – programs tailored to the needs of Gippslandians and the many different communities that live here – that can be implemented at a state or federal government level?
Promisingly, Gippsland appears to be on the right path, even ahead of the curve in many ways. A case in point is that when a key architecture publication challenged world-leading designers to reimagine the future of hospitals, a recurring concept was improved interactions with nature, an architectural feature that is central to Islamic medical architecture. Visit our hospitals throughout Gippsland and you’ll quickly notice how many are open in the bush landscape they’re embedded in or how many have sweeping green vistas, which deliver better health outcomes for their patients.
There is an inevitability of change in Gippsland’s health care system. The power industry is transitioning, the population is growing, our demographics are changing, and the distances from our remote, rural and regional communities to Melbourne’s health care facilities aren’t going to get shorter. We’re seeing that our health and wellbeing needs are increasing, especially given the fact that the area is already enduring the devastating effects of a changing climate; the increased severity of droughts, bushfires and flooding are challenging our resiliency and mental health – again, see that this is the most significant concern of our community according to the Advocate.
In listening to our community, our neighbours and friends, we can realise better future health and wellbeing outcomes for Gippsland. Take a flick through this paper; you can see that our community is not short for ideas.