Builder-developer ALAND has drawn back the curtain on its first city-focused new apartment development.

The North Sydney development, <a href="https://www.apartments.com.au/new-apartments/the-walden-north-sydney-173-179-walker-street-north-sydney-nsw-2060">The Walden</a>, is the first time the company has ventured this close to the city, having previously completed thousands of apartments predominantly in Sydney's west, and more recently in Gosford.

<a href="https://www.apartments.com.au/developers/aland">ALAND</a> acquired the prime North Sydney site, spanning Walker and Hampden Streets just down the road from the Victoria Cross Metro station, for $240 million in June.

Now they've unveiled the new project, a mix of one-, two-, three- and four-bedroom apartments across a 30-level building designed by Rothelowman.

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The Walden will capitalise on the site’s front-row position on the eastern fringe of the <a href="https://www.apartments.com.au/developments/north-sydney-nsw-2060">North Sydney</a> CBD, which offers uninterrupted Sydney Harbour views stretching from the Sydney Harbour Bridge all the way to Sydney Heads.

The main tower will be flanked by a small four-level amenity building known as The Pavilion, offering exclusive resident-only amenities including a dedicated concierge service, a sauna and private wellness studio, a gymnasium and fitness studio, a resort-style rooftop pool and sundeck.

There will also be a&nbsp;residents’ lounge, private dining and a wine cellar, and co-working facilities with an on-site meeting room and boardroom.

&nbsp;

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ALAND Founder Andrew Hrsto said the company knew they could create something "iconic" with The Walden when they saw the site.

&nbsp;

“As a company, we had been searching for a site in one of Sydney’s blue-chip locations, spanning the Eastern Suburbs, the Sydney CBD and the North Shore, and when we had the opportunity to purchase this site, we immediately recognised that it could be something iconic – being the last development with a view offering this exceptional.

“We identified the attributes and quality of the site as being perfectly aligned for ALAND – and we feel that this off-market acquisition is a perfect opportunity to showcase our craftmanship and expertise through a truly unique offering."

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Hrsto pointed to ALAND’s longstanding development expertise as a significant benefit in delivering a positive outcome for The Walden.

“Being a fully integrated development and construction business with a highly experienced team, we have the benefit of in-house experts across the development spectrum, from acquisitions, design, planning, and construction, to sales, marketing, property management, through to building management.

“As one of Australia’s largest private development and construction groups, we’ve been in operation for 23 years, with a Gold Star iCIRT rating and a 100 per cent delivery success rate across numerous masterplanned and mixed-use projects – and we’re very much looking forward to bringing this expertise to The Walden and contributing to the ongoing revitalisation of North Sydney."

The Walden is the latest development in Sydney to have the 10-year Latent Defects Insurance policy by Resilience Insurance, protecting buyers from any structural or waterproofing-related issues for 10 years post-completion.&nbsp;

Demolition of existing structures on The Walden site has already commenced through specialist civil contractor Moits, with the aim of completing preparatory ground works by the end of 2025, ahead of construction commencement in early 2026.

[smartcode_project_cta:default project_id=134323]

Joel Robinson

ALAND unveils The Walden, North Sydney's latest luxury apartment development

<a href="https://www.apartments.com.au/developers/toga-group">TOGA</a> has opened sales for the final building in Macquarie Rise, its latest mixed-use development in Macquarie Park.

Since launching its <a href="https://www.apartments.com.au/new-apartments/macquarie-rise-122-herring-road-macquarie-park-nsw-2113">Macquarie Rise</a> in late 2023, TOGA has secured over 125 sales in the Herring Road development, to a range of purchasers, from first home buyers to investors and downsizers. Around 65 per cent of purchasers have been owner-occupiers.

TOGA has now launched a new release of one-, two-, and three-bedroom apartments in the final building, Saunders Rise. Many of the apartments feature multi-purpose rooms and offer views of the surrounding greenery. Also part of the release is a series of&nbsp;sub penthouses housed on the upper floors.

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&nbsp;

“We’re delighted with the ongoing strong interest in our Macquarie Rise development, which is testament to the need for premium housing in this much-loved Sydney suburb,"&nbsp;Allan Vidor AM, Managing Director at TOGA, said.

"We’re proud to be able to offer buyers a unique product that includes luxury amenities, spacious living areas and flexible layouts, designed to suit all kinds of buyers, from young professionals to families and investors.

“We have long been advocates of Macquarie Park, and once Macquarie Rise is complete, TOGA will have built 1,000 apartments in the area, delivering much needed homes within a thriving precinct. It’s great to see the area become renowned for high-quality apartments, proximity to amenities and green spaces."

TOGA, one of Australia’s few Gold Star iCIRT rated developers, is also handling construction of Macquarie Rise. They are on track to complete the building in 2027.

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Macquarie Rise boasts a prime location, placing residents within immediate reach of Macquarie Centre, Macquarie University, and the newly completed Macquarie University Metro, connecting to the Sydney CBD is just over 20 minutes.

&nbsp;

Macquarie Rise residents also have access to Club Rise, an exclusive, residents only lounge designed by luxury hotel designers Stack Studio, offering an abundance of work and break-out areas, a Pilates studio, a gym, and a karaoke room. As well as these premium amenities Macquarie Rise will also feature an impressive podium top 20m lap pool.

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“Offering luxury, spacious apartments in a vibrant and well-connected neighbourhood, it’s no surprise that Macquarie Rise remains popular with a range of buyers," said TOGA's General Manager of Sales, Anthony Falas.&nbsp;

"With interest rates tracking downwards, we expect the final apartments to continue to receive high levels of interest.”

Located at 122 Herring Road, Macquarie Park, the development will be delivered in partnership with Baptist Union NSW and Morling College with a value of over $400 million.

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[smartcode_project_cta:default project_id=89243]

TOGA launches final stage apartments in Macquarie Rise

Southern Cross Station anchors the western end of <a href="https://www.apartments.com.au/developments/melbourne-vic-3000">Melbourne</a>’s CBD, connecting metropolitan and regional rail with tram and bus interchanges in one of the city’s busiest transport corridors.&nbsp;

Just metres away, <a href="https://www.apartments.com.au/new-apartments/640-bourke-street-melbourne-640-bourke-street-melbourne-vic-3000">640 Bourke Street</a>&nbsp;will place residents in the heart of the city, with immediate access to Spencer Street trams, a growing mix of retail, hospitality and cultural venues, and a neighbourhood evolving into a lively residential precinct.

Developed by <a href="https://www.apartments.com.au/developers/far-east-consortium">Far East Consortium</a>, the 68-level project integrates a sculptural glass tower with the heritage-listed Eliza Tinsley Building on a 2,765 sqm Bourke St site.&nbsp;

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Designed by <a href="https://www.apartments.com.au/architects/rothelowman">Rothelowman</a>, the development replaces a previously approved scheme for 813 apartments with a refined offering of just over 600 larger-format residences, responding to a growing owner-occupier demand for spacious city living.

The location sits within a dynamic pocket undergoing significant transformation. Marvel Stadium and the Docklands waterfront are less than 10 minutes away on foot, offering both sports and leisure attractions.&nbsp;

Bourke Street Mall, Queen Victoria Market, and the State Library are all within walking distance, while Flagstaff Gardens, Melbourne’s oldest park, provides a green escape just to the north.

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Proximity to some of the city’s largest employers and education hubs, including the courts precinct, legal chambers, RMIT, and major hospitals, makes 640 Bourke Street an appealing residential address for professionals, families and students alike.

Education opportunities span all levels. Nearby, Haileybury City Campus offers private schooling just a short walk from 640 Bourke Street. Just beyond the CBD fringe, Carlton Gardens Primary School, one of Melbourne’s oldest state primary schools, and Docklands Primary School provide convenient government schooling options.

Higher education is equally accessible. RMIT University’s city campus spans multiple buildings just a few blocks away, while the University of Melbourne’s Parkville campus is easily reached via tram along Swanston or Elizabeth Streets.

Victoria University’s City Queen campus, focused on law and business, is also close by, positioning 640 Bourke Street within walking distance of three of Melbourne’s major tertiary institutions.

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The neighbourhood’s retail tapestry continues to evolve into something distinctly local and walkable. Just steps away, Woolworths Metro on Bourke Street ensures that everyday essentials are easily within reach.&nbsp;

For larger shopping trips, Spencer Outlet Centre on Spencer Street and QV Melbourne on the opposite side of the CBD broaden the offering with supermarkets, fashion, dining and specialty stores.

The lane-to-lane vibe unfolds beautifully in nearby arcades and alleys. Hardware Lane, with its European-style red-brick paving and alfresco dining, pulses with jazzy evenings and casual lunches.

A few minutes north, Howey Place and Centre Place offer leafy, boutique-lined lanes where hidden cafés and niche retailers congregate under historic glass-covered cloisters.

Completing this tapestry is the newly opened Mecca “beauty playground” on Bourke Street. Spanning 4,000 sqm over three levels, the flagship blends immersive retail within an art-deco heritage setting.

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This finely grained network of shops, eateries, arcades and service outlets defines the everyday lifestyle at 640 Bourke Street - further enriched by over 3,000 sqm of resident amenity including a Turkish-inspired pool, gym, co-working rooms and private cinemas.&nbsp;

Apartments are priced between&nbsp;$640,000 and $3.95 million. Off the plan stamp duty concessions available until October 2026. Prospective buyers can visit the on site display gallery which has&nbsp;fully built one, two, and three-bedroom apartments.

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640 Bourke Street: A heritage address at the heart of Melbourne

Lower North Shore development specialists&nbsp;<a href="https://www.apartments.com.au/developers/abadeen-group">Abadeen</a>&nbsp;has topped out its new local apartment development,&nbsp;<a href="https://www.apartments.com.au/new-apartments/northcote-collective-naremburn-2-6-northcote-street-naremburn-nsw-2065">Northcote Collective</a>.&nbsp;

Located in the tightly held suburb of <a href="https://www.apartments.com.au/developments/naremburn-nsw-2065">Naremburn</a>, Northcote Collective is a collection of just 58 one-, two-, and three-bedroom apartments designed by award-winning architects Rothelowman.&nbsp;

The building is just a five to 10 minute walk from the heart of Crows Nest and the new&nbsp;St Leonards and Crows Nest Metro stations. Abadeen has also brought doorstep convenience, with a ground-floor retail offering on Northcote Street.

Northcote Collective is being delivered by&nbsp;<a href="https://www.apartments.com.au/builders/decode">Decode</a> — an iCIRT-rated construction company well regarded in the new development industry.

[smartcode_project:default project_id=114189 project_image_fid=272840]

“This is an important and exciting moment for Northcote Collective, and we’re proud to celebrate this milestone with our partners, consultants, and future residents,” said Justin Brown, Executive Chairman and Founder of Abadeen.&nbsp;

“From the outset, our vision was to create something truly special for Naremburn — homes that respect the character of the neighbourhood while elevating the standard of Lower North Shore living. With connectivity to transport, retail on the doorstep and a true village lifestyle, this milestone also comes at a perfect time when buyer confidence is returning to the market. I am incredibly proud of our team and of Decode for their dedication in helping us bring this vision to life.”

[smartcode_project:default project_id=114189 project_image_fid=272865]

The development is two-tiered, with two rooftops for residents. The taller building has an impressive rooftop pool, a rare inclusion in the new Sydney apartment market. The level, with panoramic views, also includes an entertaining terrace with barbecue facilities.

Local downsizers and young professionals are showing the strongest interest in the development, with recent improvements in the property market — supported by three rate cuts in 2025 — boosting borrowing power and buyer confidence.

Auction activity across Sydney surged by almost 30 per cent in recent weeks, with clearance rates above 70 per cent — signalling a renewed wave of buyer demand.

Northcote Collective will welcome buyers in 2026.

[smartcode_project_cta:default project_id=114189]

Abadeen tops out Northcote Collective in Naremburn

Sunshine Coast-based <a href="https://www.apartments.com.au/developers/devcon-property-group">Devcon Property Group</a> has acquired one of Maroochydore’s most prominent development sites for $12 million unlocking the potentialfor a mixed-use project in the Cotton Tree precinct.

&nbsp;

The 4,178 sqm site at 41–43 Aerodrome Road—well known locally as the former home to one of Australia’s last Sizzler restaurants—was sold via an off-market expressions of interest campaign by Colliers agents Nick Dowling and Baydn Dodds. More than 70 targeted buyer groups were approached, resulting in multiple competitive offers for the property.

Devcon Property Group Managing Director Michael Kain said the acquisition was a strategic move in line with the company’s focus on delivering high-quality projects in prime coastal locations.&nbsp;

“We’re excited about the possibilities this site, in one of the Sunshine Coast’s most iconic beachside &nbsp;communities, offers for a broad range of development outcomes,” Kain said.

“Its location, ocean view potential, and proximity to the Maroochydore CBD and beach make it an &nbsp;outstanding development prospect. Our plans are to refurbish the existing building and then review &nbsp;development options for the remainder of the site.”&nbsp;

<img alt="Aerodrome Rd site overlooking Beach (Large)" data-entity-type="file" data-entity-uuid="a29dc4ed-68c1-4bec-a4fc-283063dcde1e" src="https://s3.ap-southeast-2.amazonaws.com/www.urban.com.au/s3fs-public/inline-images/Aerodrome%20Rd%20site%20overlooking%20Beach%20%28Large%29.jpg?VersionId=b0WxJWevmLoAfCP4YvGImZpR3rSCJJ9L" />

Colliers Special Projects Manager Baydn Dodds said the sale reflected the ongoing strength of the &nbsp;Sunshine Coast’s development site market, particularly for projects capable of achieving water views. &nbsp;

“Sites of this scale, in walkable beachside locations with ocean views, are tightly held and continue to attract significant interest from both local and national developers,” Baydn Dodds said. &nbsp;

“Holding a prominent position as the former home to one of Australia’s last Sizzler restaurants and more recently occupied by Rashays, the prime site is located just 150 metres from Maroochydore Beach.&nbsp;

“With stunning ocean view potential, located in one of the Sunshine Coast’s best known iconic &nbsp;beachside communities, within steps of shops, cafes and the beach it is no surprise that there was strong interest in the site. The transaction highlights the ongoing depth of demand for well-located &nbsp;mixed-use sites across the Sunshine Coast.”&nbsp;

Colliers Sunshine Coast Managing Director Nick Dowling said the transaction reinforced the &nbsp;Sunshine Coast’s status as one of Australia’s most active development markets.&nbsp;

“The combination of strong population growth, lifestyle appeal, and infrastructure investment is &nbsp;driving demand for quality development opportunities,” Nick Dowling said. &nbsp;

“The Sunshine Coast is one of only three markets nationally to record an increase in crane numbers, &nbsp;reflecting the strength of the region’s construction pipeline.&nbsp;

“Opportunities like this are rare and continue to generate strong buyer interest in the region.”&nbsp;

The Sunshine Coast development market is booming, with several high-profile developers like Cube Developments, Gardner Vaughan Group, and RCQ, planning developments in the region.

Devcon buys Sunshine Coast’s former Sizzler site for new apartment development

Healthcare

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In the past, when you needed chemotherapy or intravenous (in-the-vein) treatments such as antibiotics or hydration, you needed to be admitted to hospital.
These days, it’s possible to have such treatments in the comfort of your home, with nursing or other clinical supports.
Public hospital-in-the-home and other hospital-substitute programs are burgeoning in the public sector, including in <a href="https://www.mja.com.au/system/files/issues/193_10_151110/mon10237_fm.pdf" target="_blank">Victoria</a>, <a href="https://www.silverchain.org.au/wa/" target="_blank">Western Australia</a> and <a href="https://www.health.nsw.gov.au/Performance/Pages/HITH.aspx" target="_blank">New South Wales</a>. These programs now provide the equivalent of hundreds of hospital beds.
Having treatment at home is more convenient for patients, reduces the demand on hospitals, and <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007491.pub2/abstract" target="_blank">cuts costs for the health system</a>.
But if you have private health insurance and want to access these services via a private hospital, it’s often not possible. This needs to change.
<h2>What’s the problem?</h2>
Private health insurers are tightly regulated. If you have a top “gold” package, for example, the insurer must pay for all hospital services that attract a government Medicare Benefits Schedule (MBS) payment, other than cosmetic surgery.
But insurers are currently <a href="https://www.health.gov.au/health-topics/private-health-insurance/about-private-health-insurance/how-does-private-health-insurance-work" target="_blank">not allowed to cover</a> care provided outside of hospitals, except in very limited circumstances.
Insurers are allowed to cover eligible home-based programs developed by private hospitals. But they get to decide on a case-by-case basis whether to cover these programs. And each insurer makes a separate decision for each program.
This means private hospitals must negotiate with each private health insurer for each separate program, for each contract period. This makes it almost impossible for private hospitals to develop sustainable business cases for their programs.
The upshot is patients often miss out on the convenience of having hospital-type services in their home, and instead may face prolonged hospital stays.
The red tape needs to be untangled to make it easier for private hospitals and doctors to run these programs and for insurers to pay for them.
<h2>What kind of care can you get at home?</h2>
Few hospital-type services are delivered at home under the current system for privately insured patients: they account for about <a href="https://www.apra.gov.au/quarterly-private-health-insurance-statistics" target="_blank">4% of hospital treatments paid in 2018-19</a>.
<a href="https://www.cabrini.com.au/patients-and-families/services/directory/hospital-in-the-home" target="_blank">Common hospital-type treatments</a> in the home include IV therapy and wound care.
A number of insurers are conducting pilot programs for out-of-hospital rehabilitation after strokes, <a href="https://www.medibank.com.au/livebetter/my-medibank/using-your-cover/rehab-in-the-home/" target="_blank">joint replacements</a> or an accident; chemotherapy; kidney dialysis; and <a href="https://media.bupa.com.au/palliative-care-pilot-recognised/" target="_blank">palliative care</a>, so people can die more comfortably in their own homes.
Untangling red tape would also allow private hospitals to offer more “<a href="https://www.bmj.com/content/358/bmj.j3702" target="_blank">prehabilitation</a>” programs to prepare people for elective surgery, and to offer <a href="https://www.mja.com.au/journal/2018/209/5/predictors-inpatient-rehabilitation-after-total-knee-replacement-analysis" target="_blank">rehabilitation programs in people’s homes</a> after surgery.
Theoretically, hospital-substitute programs at home could expand to other treatment areas such as obstetrics to have your baby at home. Or for <a href="https://www1.health.gov.au/internet/main/publishing.nsf/Content/05EB674588C31EB7CA257E28001F1BBD/%24File/Guidelines%20for%20Determining%20Benefits%202015%20Edition-Checked.pdf" target="_blank">mental health</a> treatment, which may be more efficiently provided outside hospital.
But legislative restrictions (designed to stop insurers covering general practice) have limited the expansion of these programs.
<h2>How should the system work?</h2>
Regulation should support people’s access to the most efficient form of care. And private hospitals should have more certainty about how they’ll be reimbursed when they invest in alternatives to hospital inpatient care.
Rather than each insurer deciding whether they should fund good programs, the independent body which assesses and approves the public-sector equivalent of home-based care – the <a href="https://www.ihpa.gov.au/" target="_blank">Independent Hospital Pricing Authority</a> – should do the same for the private sector.
If a program has been approved by the authority, then private health insurers should be required to pay for it.
Specialist doctors, such as oncologists, should also be able to establish hospital substitute programs and have them approved for funding by private health insurers.
All of this is about improving quality and access to care, while at the same time reducing costs. It should be easier for private health insurers to pay for better alternatives to hospital care, where they can deliver the same treatment with the same or better outcomes, <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007491.pub2/abstract" target="_blank">but at a lower cost</a>.
It is also about providing good alternatives to private hospital care, increasing competition in the health system, and reducing the number of unnecessary hospital admissions.
There are big opportunities for system-wide efficiencies in the private sector by shifting care from inpatient to outpatient settings – particularly for rehabilitation, psychiatric care, <a href="https://www.asrs.org/patients/retinal-diseases/33/intravitreal-injections" target="_blank">eye injections</a> for retinal conditions, and outpatient <a href="https://www.veinhealth.com.au/ambulatory-phlebectomy/" target="_blank">vein surgery</a>.
The public sector has already expanded its alternatives to hospital inpatient care. It’s time for the private system to do the same.
<a href="https://theconversation.com/profiles/stephen-duckett-10730" target="_blank">Stephen Duckett</a>, Director, Health Program, <a href="http://theconversation.com/institutions/grattan-institute-1168" target="_blank">Grattan Institute</a>
This article is republished from <a href="http://theconversation.com" target="_blank">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/private-health-insurers-should-start-paying-for-hospital-type-care-at-home-126345" target="_blank">original article</a>.
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j.ballantyne1990-6AQqhLzZaK

Private health insurers should start paying for hospital-type care at home

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Chemistworks, Myhealth medical centre, and Anytime Fitness have been announced as the three new tenants at Western Sydney's Ed.Square town centre.
The tenancies are apparently part of the planned community’s sustained initiative to attract health services.
It has also confirmed that a massage and acupuncture specialist, sporting goods retailer, pathologist, and childcare operator will be among the first batch of tenants, while a radiologist is currently being sought out for the project.
The Frasers Property group collaborating with HDR, GroupGSA and HASSELL are behind the development, which when completed, is expected to incorporate 1,884 homes in a mix of apartments, terraces and ‘mews’-style townhouses.
<a href="https://www.propertyobserver.com.au/subscribe" target="_blank"><img src="https://res.cloudinary.com/dz9xllyip/image/fetch/c_scale,w_580,q_auto:good/https://s3-ap-southeast-2.amazonaws.com/po.images/2019/Subscriber%20strip%20ad.jpg" alt=""></a>
Stage 1 of Ed.Square Town Centre will comprise approximately 25,000 sqm of retail space, with a Coles supermarket, Liquorland store, and Event Cinemas complex set to be rolled out.
On completion of Stage 2, which will roughly add an additional 15,000 sqm, the development will comprise up to 40,000 sqm of retail space with over 120 shops.
It is expected to open in the second half of 2020.
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wdavis-8cCN98p7xp

New tenants announced for Western Sydney's Ed.Square 

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GUEST OBSERVATION
The poorer people are, the <a href="https://apps.who.int/iris/bitstream/handle/10665/44289/9789241563970_eng.pdf?sequence=1" target="_blank">higher their chances</a> of contending with domestic violence, crime, social conflict, homelessness and unemployment.
All these factors contribute to increased levels of psychological distress, which is associated with common mental disorders such as depression and anxiety.
In <a href="https://www.propertyobserver.com.au/https://journals.sagepub.com/doi/abs/10.1177/0004867415615948" target="_blank">our research</a>, of adults who recorded “very high” levels of psychological distress on what’s called the Kessler Psychological Distress Scale, more than three times as many (30%) came from the most socioeconomically disadvantaged fifth of Australian areas than from the most affluent fifth (9%).
Along with where you live, personal income is an important influence: among the poorest fifth of Australians, one in four people reported “high” or “very high” psychological distress when compared to about <a href="https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00536/full" target="_blank">one in 20 people in the richest fifth</a>.
To begin to tackle this problem, we need to see more equitable distribution of mental health care; that is, delivery of care proportionate to need. As it currently stands, socioeconomically disadvantaged groups very often <a href="https://theconversation.com/three-charts-on-why-rates-of-mental-illness-arent-going-down-despite-higher-spending-97534" target="_blank">do not get optimal mental health care</a>.
<hr>
<img src="https://images.theconversation.com/files/282184/original/file-20190702-28321-1bgx6ot.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="">
<a class="source" href="https://theconversation.com/three-charts-on-why-rates-of-mental-illness-arent-going-down-despite-higher-spending-97534" target="_blank">This chart first appeared in an article published on The Conversation in 2018.</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/" target="_blank">CC BY-ND</a>
<hr>
The <a href="https://rcvmhs.vic.gov.au" target="_blank">Royal Commission into Victoria’s Mental Health System</a> has begun its public hearings this week in Melbourne. Hopefully, it will provoke improved collaboration between state and Commonwealth services, enabling better access to mental health services for those who need it most.
Socioeconomic disadvantage affects mental health from birth
Unintended pregnancy, being younger, experiencing intimate partner violence and having insufficient emotional and practical support <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3302553/pdf/BLT.11.091850.pdf" target="_blank">can lead to mental disorders</a>, including depression, among pregnant women and new mothers.
Babies of depressed mothers are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150769/pdf/BLT.11.088187.pdf" target="_blank">often underweight</a>, a <a href="https://www.propertyobserver.com.au/https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2722846" target="_blank">risk factor for later depression</a>.
One study showed the mental health of four-year-old children is affected by factors including <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0187974" target="_blank">family income, maternal education and neighbourhood disadvantage</a>. The researchers followed children in this study until the age of 14 to 15 and found the effects persisted.
Children from low socioeconomic backgrounds are also more likely to do poorly in school, and <a href="https://www.cambridge.org/core/journals/psychological-medicine/article/relationship-between-exclusion-from-school-and-mental-health-a-secondary-analysis-of-the-british-child-and-adolescent-mental-health-surveys-2004-and-2007/C01898F768A7C47FB9A1F2F894B22A85">are more likely to be suspended or expelled</a>.
Financial difficulties have been highlighted as <a href="https://core.ac.uk/download/pdf/74395807.pdf" target="_blank">an important determinant of mental health for university students</a>, too.
Adults with interpersonal, employment or financial stresses experience <a href="https://www.annualreviews.org/doi/full/10.1146/annurev-publhealth-031210-101146" target="_blank">higher levels of psychological distress</a>.
Job loss is associated with mental health problems, and this association becomes more pronounced <a href="https://www.annualreviews.org/doi/full/10.1146/annurev-publhealth-031210-101146" target="_blank">with long-term unemployment</a>.
Those on welfare support have a <a href="https://jech.bmj.com/content/71/12/1198.long" target="_blank">higher risk of mental disorders</a>.
Poor people can’t access the best treatment
People in countries with <a href="https://www.equalitytrust.org.uk/resources/the-spirit-level" target="_blank">greater socioeconomic inequality</a> are more likely to have poor mental health than people in more equal societies. Australia is a high-income country, but there remains <a href="https://www.acoss.org.au/inequality/" target="_blank">a significant gap</a> between the richest in our society and the poorest.
Many health, educational, transport, housing, welfare and fiscal policy shifts could improve mental health in communities by addressing socioeconomic disadvantage and its impacts across the lifespan.
But while this issue persists, we need to look at what people from disadvantaged groups with mental illness are getting by way of treatment.
Most commonly, people with depression and other mental disorders will be prescribed medications, and/or receive “talking therapies” which might include sessions with a psychologist or other mental health professionals.
Importantly, evidence suggests antidepressants alone are <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/wps.20089" target="_blank">less likely to be effective</a> than a combination of antidepressants and cognitive behavioural therapy. So where antidepressant medication is recommended, <a href="https://www.thelancet.com/commissions/global-mental-health" target="_blank">psychological therapies should be available too</a>.
But as we know, many Australians with common mental disorders such as depression live in areas of socioeconomic disadvantage. Here, despite the greater need, <a href="https://theconversation.com/three-charts-on-why-rates-of-mental-illness-arent-going-down-despite-higher-spending-97534" target="_blank">fewer psychological treatment services are delivered</a>. Location of therapists and out-of-pocket costs can both act as barriers to accessing these services.
Ultimately, while poor people generally need mental health services more, rich people tend to access them at a much higher rate. So poorer people often receive only antidepressants, and alone, these may have only a modest effect, <a href="https://www.propertyobserver.com.au/https://journals.sagepub.com/doi/full/10.1177/0004867419857821?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%3dpubmed" target="_blank">placing them on the back foot in terms of their recovery</a>.
Much of this care provision rests with Commonwealth Medicare-funded services. State services, meanwhile, struggle to respond to needs left unmet.
The Commonwealth and the states must work together
Although spending on mental health has increased in recent years, so too has the system’s complexity and fragmentation. Delivering equitable mental health care for Australians is complicated by the federal structure and divisions of responsibilities.
For private provider services, there is a need for incentive structures that secure the delivery of free or lower-cost services for the people and in the places where there is greatest need.
The Victorian royal commission into mental health is asking about <a href="https://rcvmhs.vic.gov.au/submissions" target="_blank">drivers of poor community mental health</a>, and flagging the importance of community and economic participation in improving mental health.
Within state mental health policy, funding models should ensure that while all communities get a decent level of mental health care, there is more service availability in areas and communities we know have higher rates of mental health problems.
We’d also be well-served by adopting newer strategies to facilitate access. For example, some people in difficult circumstances may nevertheless have broadband internet sufficient for video links. Getting psychological therapies into people’s homes through this route may be one way around other access problems.
The Victorian royal commission should propose making state funding distribution fairer, but cannot fix these problems alone.
In a recent positive step, the Commonwealth and state governments have <a href="https://www.health.gov.au/internet/main/publishing.nsf/Content/mental-fifth-national-mental-health-plan" target="_blank">signed up</a> to a <a href="https://www.health.gov.au/internet/main/publishing.nsf/Content/mental-health-intergrated-reg-planning" target="_blank">set of tasks aiming to move towards</a> better integrated mental health care planning.
The challenge for governments now is to cooperate with and support mental health service providers to ensure these services are better connected with each other, and importantly, more fairly and consistently delivered in relation to need.

Graham Meadows, Professor of Adult Psychiatry, Monash University
Anthony Cichello, Clinical Psychologist, Melbourne, and Adjunct Research Fellow, Monash University 
Anton Neville Isaacs, Senior Lecturer, Monash School of Rural Health, Monash University
Frances Shawyer, Research Fellow, Monash University
This article is republished from <a href="http://theconversation.com" target="_blank">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/when-its-easier-to-get-meds-than-therapy-how-poverty-makes-it-hard-to-escape-mental-illness-114505" target="_blank">original article</a>.
Submissions for the Royal Commission into Victoria’s Mental Health System <a href="https://rcvmhs.vic.gov.au/submissions" target="_blank">are open</a> until July 5.
If this article has raised issues for you or you’re concerned about someone you know, call Lifeline on 13 11 14.<img src="https://counter.theconversation.com/content/114505/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1">
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How poverty makes it hard to escape mental illnes

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A private investment group has listed one of the first premium grade healthcare offerings in Mornington in two years.  
Recently refurbished, the property sits within the centre of the Mornington healthcare hub. 
CBRE agents Josh Twelftree, Sandro Peluso, Jimmy Tat and Marcello Caspani-Muto have been exclusively appointed to negotiate the sale, following a generous track record of success along Melbourne’s coast. 
Mr Twelftree noted, “The property’s Beleura Hill medical precinct location is a relatively tightly held pocket in the area.” 
“Less than 1km from Beleura Private Hospital, Bays Hospital and Mornington Centre – Peninsula Health, it’s a real medical hotspot – benefiting from strong cross flow demand in the region.”  
<img src="https://res.cloudinary.com/dz9xllyip/image/fetch/c_scale,w_580,q_auto:good/https://s3-ap-southeast-2.amazonaws.com/po.images/2019/6/20/1050_Nepean_LifeStyle036.jpg" alt="">
The 635 sqm landholding features a medium-term lease to beauty clinician Jo Hannah of Hannah Aesthetics, former CEO of ASX listed Total Face Group, offering a passing income of $90,000 per annum. 
1050 Nepean Highway will be sold via public auction on July 13.
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Rare refurbished medical property offered in Mornington

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GUEST OBSERVATION
The federal government has just promised to increase spending on public hospitals from A$21.7 billion in 2018 to A$26.2 billion by 2023. Expect more hospital promises in coming weeks. There is a long history of parties at both state and federal level pledging new hospitals during election campaigns.
Building new hospitals may at first seem sensible, especially as the population grows. But it will not cure the health system’s most pressing ailment. Instead, <a href="https://bcec.edu.au/assets/2018/12/BCEC-To-Health-and-Happiness-Report.pdf" target="_blank">our research</a> shows it’s more effective to focus health policy on people and prevention.
A problem of demand
It is true that hospitals in Australia aren’t keeping up with demand. Though supply of beds has increased, the population is growing while also ageing. This is increasing demand for all health-care services, including hospital beds.
The following graph shows the change in the number of beds per 1,000 people in all states and territories since 2006. Only in the Australian Capital Territory has the ratio improved.
<a href="https://images.theconversation.com/files/264557/original/file-20190319-28496-ii13jb.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/264557/original/file-20190319-28496-ii13jb.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt=""></a>
Available hospital beds per 1000 population, by region, public hospitals (including psychiatric). <a class="source" href="https://bcec.edu.au/assets/2018/12/BCEC-To-Health-and-Happiness-Report.pdf" target="_blank">Bankwest Curtin Economic Centre | AIHA (various years), Australian hospital statistics, Health Services Series; AIHW (various years), hospital resources' Australian hospital statistics, Health services series.</a>
State and federal governments thus feel a lot of pressure to spend more on hospitals. In 2016-2017 it was <a href="https://www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure-australia-2016-17/contents/summary" target="_blank">$69 billion</a> Australia-wide – $2 billion more than the previous year. The following graph shows expenditure on public hospitals by state over the past two decades.
<a href="https://images.theconversation.com/files/264579/original/file-20190319-60956-6i0qhw.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/264579/original/file-20190319-60956-6i0qhw.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt=""></a>
Public hospital spending in each state since 1996. <a class="source" href="https://www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure-australia-2016-17/contents/data-visualisation" target="_blank">Australian Institute of Health and Welfare</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/" target="_blank">CC BY</a>
Queensland shows the greatest growth over the past two decades. In Western Australia, where we did our research, the proportion of government health budgets spent on public hospitals rose from 26% to 31%.
Preventive measures
We looked at why the hospital care is growing faster than the overall health sector, and what can be done about this.
Our conclusion: there needs to be more focus on the “unsexy” parts of the health-care system that treat people before they get sick enough to need a hospital. Prevention is cheaper and more effective than cure.
For example, it is estimated that A$9 million invested in <a href="https://www.propertyobserver.com.au/https://www.ncbi.nlm.nih.gov/pubmed/18719075" target="_blank">anti-smoking campaigns</a> between 1997 and 2007 saved A$740 million on smoking-related illnesses like lung cancer.
Yet our breakdown of health spending in Western Australia shows just 1.7% is spent on preventive measures – called “public health spending”. Australia-wide the average percentage is even less, according to <a href="http://fare.org.au/wp-content/uploads/Preventive-health-How-much-does-Australia-spend-and-is-it-enough_FINAL.pdf" target="_blank">research</a> from La Trobe University and the Australian Preventative Partnership Centre.
<a href="https://images.theconversation.com/files/264563/original/file-20190319-28468-c37pcs.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/264563/original/file-20190319-28468-c37pcs.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt=""></a>
Breakdown of health care spending in WA. <a class="source" href="https://bcec.edu.au/assets/2018/12/BCEC-To-Health-and-Happiness-Report.pdf" target="_blank">Bankwest Curtin Economics Centre | Authors’ calculations from AIHW health expenditure database.</a>
Early medical attention is another way to reduce the need for hospitals. In analysing data from around Western Australia between 2009 and 2016, we generally found that increasing visits to general practitioners reduced the incidence of avoidable deaths (deaths that could have been avoided with better treatment or prevention).
People-centred approach
Limited prevention and early detection comes back to the way we fund health care. Australia’s health system is funded using a “<a href="https://beta.health.gov.au/resources/publications/australias-health-landscape-infographic" target="_blank">hospital-centred</a>” rather than “people-centred” approach.
This means hospitals are funded by the number of patients cared for and the type of procedures done. Hospital and GPs are funded separately. There is no incentive to cooperate and keep people out of hospitals.
A people-centred approach, on the other hand, would give funds based on patients’ health outcomes, rather than their particular treatments. GPs would be paid to manage patients, with the goal of keeping them out of hospital.
This system would particularly help people living in remote and rural regions, including Indigenous Australians, who are disadvantaged by the relative lack of resources being spent on local and preventive health.
The Canterbury model
<img src="https://images.theconversation.com/files/268298/original/file-20190409-2905-15ie8ak.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=237&amp;fit=clip" alt="">
The Canterbury region in New Zealand. <a class="source" href="https://upload.wikimedia.org/wikipedia/commons/c/c9/Position_of_Canterbury_Region.png" target="_blank">English Wiki</a>
The best example of such a people-centred system is New Zealand’s <a href="https://www.cdhb.health.nz/about-us/key-projects-and-initiatives/international-report-encourages-health-systems-to-learn-from-canterbury-dhb/" target="_blank">Canterbury model</a> – named after the Canterbury region on New Zealand’s South Island (which includes Christchurch).
Instead of separate budgets for GPs and hospitals, Canterbury created a “one system, one budget” approach. This led to new programs that weren’t possible under the old system. An example is <a href="https://www.kingsfund.org.uk/publications/quest-integrated-health-and-social-care" target="_blank">Healthpathways</a>, which brought together GPs and specialists to decide on treatement programs for individual patients.
In working to make hospitals the last resort, more time and resources have gone to GPs. There are now more 24-hour clinics, for example, making it easier to get treated by a local doctor when needed.
A <a href="https://bmjopen.bmj.com/content/6/5/e010709" target="_blank">study of the Canterbury system</a> showed that between 2007 and 2014 the number of people being hospitalised declined from 6.59 to 5.83 per 1,000. While an 11% decline may not seem huge, it represents a significant financial saving, given the high cost of hospitalisation.
Canterbury shows what can be achieved by rethinking how health care funding works. Australia has the opportunity to reimagine its health care system in a similar way.
New hospitals get a lot of attention. Politicians can point to them as concrete evidence they’re doing something to help. But emphasising hospitals as the most important part of the health system comes at a cost, and will only get more so as the population ages.
It’s time to discuss alternatives. Putting more resources into prevention and people is the right medicine for our future health needs.<img src="https://counter.theconversation.com/content/111084/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;">
Steven Bond-Smith, Research Fellow, Bankwest-Curtin Economics Centre, Curtin University
Alan Duncan, Director, Bankwest Curtin Economics Centre and Bankwest Research Chair in Economic Policy, Curtin University
Astghik Mavisakalyan, Associate professor, Curtin University
Yashar Tarverdi, Research fellow, Bankwest Curtin Economics Centre, Curtin University
This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/more-hospitals-will-not-cure-australias-ailing-health-care-system-theres-a-more-efficient-way-111084">original article</a>.
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