50 YEARS OF HEALTH CARE IN COMMUNITY

North Richmond Community Heath turns 50 this year. It has, and continues to be, an organisation focused on health and wellbeing of the local residents, and one that responds to community needs. The local community as well as current and former staff gathered recently to celebrate and mark the occasion. The very special place that the centre holds in many people’s personal and professional lives was evident at the celebration.

The health centre was originally called North Richmond Family Care Centre and first opened its doors in 1974. It was housed in a temporary building on the grounds of the North Richmond high-rise public housing estate which sits on unceded Wurundjeri land. The five towers on the estate were progressively built from 1970, and residents moved in between 1971 and 1974. This was the last high-rise estate to be constructed in Victoria and the largest. The towers were an addition to several smaller apartment blocks of public housing that were built across the road from the estate in 1956. 

The future of the estate has been unclear since the then, Premier of Victoria announced in September 2023 that all 44 public housing towers across inner-city Melbourne would be demolished and redeveloped. Daniel Andrews, the then premier, was quoted as saying, “They’re old; they’re out of date. They’re crumbling; they need to go.” Just over a year later, a public notice was given that the last of the towers built on the North Richmond Estate, would be the first tower in Richmond to be demolished, along with eight of the smaller apartment blocks. This was despite the renovation programs that were undertaken on the estate between 2022 and 2024.

In stark contrast to this description of public housing buildings, and the abrupt ways the government makes decisions about people’s homes, the health centre on the estate in North Richmond has been an ongoing presence, and strongly connected to the local community from the start.

The initial submission to federal and state governments to fund the establishment of the health centre in 1973 described the organisation as one for ‘Health and Welfare’. The project was led by Professor David Penington, who was working at St Vincent’s Hospital and the University of Melbourne but was undertaking this work, in a private capacity.

The increase in population density due to the development of the estate and lack of medical care in the local area were the key reasons for developing a community health centre. This need was compounded by the large proportion of people living locally who had come to Australia from Europe as part of post-war immigration schemes. These ‘new settlers’ were described in the proposal for the centre as having ‘Language and cultural difficulties’ which impacted on their abilities to acquire ‘adequate legal, medical, social welfare and education services’. In addition, the low socioeconomic status of the population meant that there was a need for support services.

The goal of the centre was to have the local community as active participants in the centre. This is an essential element of the community health approach to public health that was formally established in Australia in the early 1970s. A social worker was employed as the first staff member to support the generation of community participation at the Family Care Centre in North Richmond. The goal was for the centre to be a focal place for social and community activities; as well as services for health and welfare. In this way health was understood in a broad sense and community involvement, participation and cultural relevance was seen as essential. Right from the start, this involved having multilingual staff, developing trusted relationships and creating services that met people’s needs. 

This foundation of an organisation embedded within the community it serves, has seen a range of programs developed and delivered over the last 50 years. The programs included art programs, festivals, health and dental programs, harm reduction work, cultural groups and advocacy work. The success of NRCH in supporting the public housing community at the beginning of the COVID-19 pandemic was remarkable. This included almost all residents of the estate being fully vaccinated against COVID-19. The culturally informed approaches taken and employment of staff from the local community meant, that services delivered were effective and appropriate. The reputation and authority of the centre, alongside experienced leadership and staff meant that they were able to effectively negotiate and advocate with the government on how public health issues should be managed best.

While there is a political push for smaller health services to be amalgamated, largely on the grounds of efficiencies and reduced costs. The loss for local communities is immense when this occurs. It is likely that there will be significant change with the proposed redevelopment of the housing estate, and the health centre will play a key role for the community during this time. A place-based organisation is best positioned to effectively care for the community it serves because it takes the time and effort to know, respond to, and work with the community directly. At the 50th celebration event, the centre was described as the heartbeat of the estate. This encapsulates the vital role the organisation continues to play in supporting people as well as bringing people together as a community.