Malaysian developer <a href="https://www.apartments.com.au/developers/s-p-setia">SP Setia</a> is the latest to jump into St Leonards booming Transport Oriented Development precinct.

The developer, which has previously delivered Sapphire by the Gardens apartment development in Melbourne, identified the Atchison Street site in 2023. It filed a Scoping Report around 12 months ago, and now has revealed the designs for the new&nbsp;40-storey mixed-use tower.

The State Significant Development Application covers <a href="https://next-portal.urban.com.au/projects/14650/summary">20-22 Atchison Street</a>, a 1,374 sqm site positioned between St Leonards Station and the new Crows Nest Metro station.

Designed by <a href="https://www.apartments.com.au/architects/cox-architecture">COX Architecture</a>, the project would deliver 181 apartments, above a four-storey commercial podium, five basement levels, and new public domain works along Mitchell Street. The apartment mix comprises 35 one-bedroom apartments, 39 one-bedroom-plus-study apartments, 85 two-bedroom apartments, and 22 three-bedroom residences.

The proposal has been lodged as a shop-top housing development under the NSW Government’s TOD planning pathway, which allows increased density around key transport infrastructure. The site sits within the recently rezoned Crows Nest Accelerated TOD Precinct.

<img alt="First look: SP Setia targets St Leonards skyline with 40-storey TOD tower" data-entity-type="file" data-entity-uuid="b799673d-48e2-46b0-801a-0e33a9330100" src="https://s3.ap-southeast-2.amazonaws.com/www.urban.com.au/s3fs-public/inline-images/atchinson%20site.png?VersionId=dPh0UfwfaHpbFL1R7H1cbZNbIW0CHbCC" />

SP Setia acquired the Atchison Street site as part of its continued expansion into the Australian apartment market. In comments made to City &amp; Country (The Edge Malaysia) in 2023, SP Setia President and CEO Datuk Choong Kai Wai described the acquisition as “a strategic move” aligned with the group’s post-pandemic market recovery strategy.

“Our target for this exceptional development is local and overseas buyers, including first-home buyers, downsizers and investors,” Choong said.

The tower has been designed as a slender vertical form rising from a mixed-use podium, with COX Architecture positioning the development as a response to the evolving St Leonards and Crows Nest skyline.

“The purpose of the project is to facilitate the delivery of high-quality housing at a strategically located site and deliver a built tower outcome that is consistent with the desired future character of St Leonards and aligns with the TOD controls,” the design report stated.

<img alt="First look: SP Setia targets St Leonards skyline with 40-storey TOD tower" data-entity-type="file" data-entity-uuid="b1a85eee-76f7-436c-a6da-73ba827b9b13" src="https://s3.ap-southeast-2.amazonaws.com/www.urban.com.au/s3fs-public/inline-images/atchinson%20entry.png?VersionId=dA9jHGPMcm.dDbwk4QfxqWiY5bfh3UVt" />

The podium would incorporate retail uses fronting Atchison Street, commercial tenancies, landscaped communal areas, and pedestrian improvements along Mitchell Street. Vehicle access and loading would be consolidated via Atchison Lane.

Residents would have access to more than 665 sqm of communal indoor and outdoor spaces, while the development proposes 96 parking spaces across five basement levels.

The proposal also includes a commitment for 10 per cent of residential floor space to be allocated toward affordable housing through a monetary contribution.

COX said the tower form responds directly to the emerging high-density character of the precinct while seeking to maximise solar access, cross ventilation, and outlook from apartments.

<img alt="First look: SP Setia targets St Leonards skyline with 40-storey TOD tower" data-entity-type="file" data-entity-uuid="2163f85c-f63b-4be3-aafa-f8763976cec5" src="https://s3.ap-southeast-2.amazonaws.com/www.urban.com.au/s3fs-public/inline-images/Article%20Feature%20Image%20%28Grid%29_5.png?VersionId=WiAmtIKJ6.ZQ41EtYEQ1fol7AeorKBlL" />

“The building is orientated towards north,” the Apartment Design Guide compliance report noted, adding that the tower’s slim form was driven by the constrained inner-urban site dimensions.

The design also incorporates landscaped setbacks and communal open space at podium level, intended to soften the interface with surrounding streets and improve pedestrian amenity.

The project adds to a growing wave of redevelopment proposals reshaping St Leonards and Crows Nest following the opening of the Sydney Metro City line and the NSW Government’s push for higher-density housing around major transport nodes.

Last week Stockland filed plans just down the road. They want to build a <a href="https://www.apartments.com.au/new-apartments/601-pacific-highway-st-leonards-nsw-2065">52-storey tower on Pacific Highway</a>.

Read more:&nbsp;<a href="https://www.apartments.com.au/news/nsw/first-look-stockland-plans-52-storey-538-apartment-st-leonards-tower">First look: Stockland plans 52-storey, 538-apartment St Leonards tower&nbsp;</a>

Joel Robinson

First look: SP Setia targets St Leonards skyline with 40-storey TOD tower

<a href="https://www.apartments.com.au/developers/urban-property-group">Urban Property Group</a> has revealed plans for a new mixed-use tower at 10 Dangar Street, Wickham, advancing a proposal that would reshape the southern gateway to Newcastle’s city centre with one of the city’s tallest residential buildings.

The State Significant Development proposal, now on exhibition, seeks approval for a <a href="https://www.apartments.com.au/new-apartments/bowline-10-dangar-street-wickham-nsw-2293">43-storey tower</a> immediately adjacent to the Newcastle Interchange. The project would deliver around 200 apartments, including 42 affordable housing dwellings, alongside 99 co-living units, a 171-room hotel, retail space, and new public domain integrated through the site.

The scheme marks a significant escalation of plans previously approved for the site. Urban Property Group took over the prominent 2,904 sqm parcel, where excavation and demolition had already commenced under an earlier consent for a 14-storey mixed-use development.

<img alt="First look: Urban Property Group unveils Newcastle’s next supertower at Wickham interchange" data-entity-type="file" data-entity-uuid="58a96dd9-407f-4d20-86b4-94e4bfeef74b" src="https://s3.ap-southeast-2.amazonaws.com/www.urban.com.au/s3fs-public/inline-images/wickham%20podium.png?VersionId=LGlf08pdFGAZDzvx_CXC4XakHNZRuEE0" />

Designed by <a href="https://www.apartments.com.au/architects/sjb-architects">SJB</a>, the tower has been conceived as a landmark transit-oriented development anchored to the Newcastle Interchange precinct. The proposal includes 245 build-to-sell apartments across a mix of one, two, and three-bedroom residences, as well as two penthouses. Fifteen apartments and one operational unit are earmarked for NDIS housing. The co-living component would add a further 99 units, while the podium would accommodate retail uses and hotel facilities.

SJB said the site presents “a valuable opportunity to anchor the precinct by setting the standard for design, active ground planes and character at the key southern gateway.”

The architecture responds directly to the site’s position beside major transport infrastructure and within one of Newcastle’s fastest-evolving urban renewal precincts. The tower form sits above a sculpted podium designed to frame new public spaces, including a through-site pedestrian link connecting Station Street to Hannell Street, landscaped plazas, and activated retail edges.

<img alt="First look: Urban Property Group unveils Newcastle’s next supertower at Wickham interchange" data-entity-type="file" data-entity-uuid="a7bd6ff0-f7db-4ce8-a6dc-ea56e72c6149" src="https://s3.ap-southeast-2.amazonaws.com/www.urban.com.au/s3fs-public/inline-images/wickham%20lanne.png?VersionId=xzf39VADyhj7zBQY2I9fx9vI62u2tuSb" />

The design report describes the project as part of the broader transition of Wickham into “a vibrant, high-quality mixed-use urban precinct” that leverages proximity to the station, open space, and regional connectivity.

A detailed public art strategy has also been prepared for the development. The strategy positions the project as “a transit-oriented development of state significance at the gateway to Newcastle’s city centre” and outlines a series of integrated artworks responding to Newcastle’s industrial and transport heritage.

Creative Road’s curatorial framework for the project, titled Unveil, draws on “stratified surfaces, carved volumes, and light-filled apertures” while referencing Newcastle’s transformation from an industrial city into a contemporary education and technology hub.

<img alt="First look: Urban Property Group unveils Newcastle’s next supertower at Wickham interchange" data-entity-type="file" data-entity-uuid="77a882bb-14b1-4d28-99ff-9438e39508c0" src="https://s3.ap-southeast-2.amazonaws.com/www.urban.com.au/s3fs-public/inline-images/wickham%20site.png?VersionId=cevgo_vN0eKPK78P8YcEu3mKPLkpFqE7" />

The proposal is being advanced through the NSW Housing Delivery Authority pathway after being declared State Significant Development in June 2025. The accompanying scoping report states the development aims to “maximise the site’s proximity to the Newcastle Interchange by delivering transit-oriented development” while increasing housing supply and affordable housing provision within the Newcastle LGA.

Urban Property Group’s plans align with the long-term strategic vision established under the Wickham Master Plan, which identified the interchange precinct as suitable for substantial uplift in height and density. The current proposal would significantly intensify that vision, positioning the tower among the tallest developments proposed for Newcastle.

The site sits immediately north of the Newcastle Interchange, bounded by Dangar Street, Hannell Street, and Charles Street. It is surrounded by a rapidly growing cluster of residential towers and mixed-use projects that have emerged following the completion of the light rail and transport interchange.

First look: Urban Property Group unveils Newcastle’s latest tower at Wickham interchange

Bottega House has completed settlement of a landmark riverfront site in Macquarie Street, St Lucia, representing its first major Brisbane development.&nbsp;

Positioned on the banks of the Brisbane River, the <a href="https://www.apartments.com.au/new-apartments/180-macquarie-street-st-lucia-qld-4067">premium site at 180 Macquarie Street</a> features uninterrupted river frontage in one of Brisbane’s most tightly held residential precincts.&nbsp;

The proposed development, currently under assessment with Brisbane City Council, has been designed by <a href="https://www.apartments.com.au/architects/plus-studio">Plus Studio</a> with interiors by <a href="https://www.apartments.com.au/interior-designers/mim-design">Mim Design</a> and will deliver a boutique collection of premium residences positioned specifically for owner occupiers and downsizers.&nbsp;

The residences are set to redefine luxury apartment living in the area, with a focus on architectural quality, refined finishes, landscape integration and elevated amenities including curated wellness facilities, resort-style pools and recreation spaces rarely seen in the local market.&nbsp;

Exclusive sales for the project will be led by Keenan &amp; Byrne, ahead of an anticipated launch later this year.&nbsp;

Bottega House Managing Director Nick Malloch said the project reflects the group’s ambition to deliver a highly curated residential offering within one of Brisbane’s most tightly held precincts.&nbsp;

“This is an incredibly rare riverfront opportunity and one we have approached with a long-term perspective,” Malloch said.&nbsp;

“Our vision from the outset was to create a boutique collection of residences that feel more like private homes than traditional apartments, with generous proportions, refined finishes and exceptional amenity throughout."

Malloch says there is a&nbsp;lack of premium owner-occupier stock of this quality in the market, particularly for downsizers wanting space, privacy and a true lifestyle offering without compromise.&nbsp;

"Demand is expected to be strong given the scarcity of premium riverfront opportunities of this nature within Brisbane’s inner-west."&nbsp;

Bottega House secures landmark riverfront site in St Lucia 

<section data-scroll-anchor="false" data-testid="conversation-turn-6" data-turn="assistant" data-turn-id="request-WEB:84a2af5e-d7cf-4ddf-922a-f4d44d6c6caa-2" data-turn-id-container="request-WEB:84a2af5e-d7cf-4ddf-922a-f4d44d6c6caa-2" dir="auto">
<section data-scroll-anchor="false" data-testid="conversation-turn-2" data-turn="assistant" data-turn-id="request-WEB:5a5ab36c-8dd3-454c-b456-c501f22f0eb4-0" data-turn-id-container="request-WEB:5a5ab36c-8dd3-454c-b456-c501f22f0eb4-0" dir="auto">
The arrival of the first piling rig officially marks the commencement of construction at SIERA’s new beachside apartment development, Exhale, in Northcliffe.

<a href="https://www.apartments.com.au/new-apartments/exhale-surfers-paradise-8-enderley-avenue-surfers-paradise-qld-4217">Exhale</a>, a glass-encased tower featuring 54 large-scale apartments at 8 Enderley Avenue, is SIERA’s third Gold Coast development. It follows the recently completed PIPIS Bilinga beachfront project, which achieved suburb-record prices, and the soon-to-be-completed Chevron Island development, Tapestry.

[smartcode_project:default project_id=112661 project_image_fid=359603]

<a href="https://www.apartments.com.au/developers/siera">SIERA</a> Founder and Managing Director Brent Thompson said the arrival of the piling rig represented a significant milestone for the development, which is scheduled for completion in late 2028.

Over the next month, around 260 piles are expected to be installed as work progresses on the basement structure. The building is anticipated to rise above ground level early next year, before unveiling its sculptural glass curtain wall, developed in collaboration with specialist façade engineers.

“The façade was designed to maximise panoramic coastal views while creating a distinctive architectural identity,” Thompson said.

[smartcode_project:default project_id=112661 project_image_fid=355935]

Designed by BDA Architecture, Exhale will comprise just 54 two- and three-bedroom residences across 26 levels, a level of low-density living rarely delivered in this beachside pocket between Surfers Paradise and Broadbeach.

The project has been conceived as a resident-only building, with no short-stay accommodation permitted. SIERA says the model is intended to appeal to long-term owner-occupiers rather than transient holiday demand.

[smartcode_project:default project_id=112661 project_image_fid=361052]

Residences have been designed with large-format layouts and expansive glazing, with most apartments featuring more than 30 metres of glass frontage to maximise natural light and ocean views.

The amenity offering spans two levels and centres on wellness and lifestyle, including a heated magnesium pool, sauna, yoga and Pilates studio, gymnasium, private dining facilities, cinema lounge, and dedicated surfcraft storage.

[smartcode_project:default project_id=112661 project_image_fid=359607]

More than half of the apartments have already sold. SIERA has also opened a sales gallery for Exhale at its Chevron Island commercial premises, near its Tapestry tower and the site of its second Chevron Island apartment development, which is slated to launch in early 2027.
</section>
</section>

[smartcode_project_cta:default project_id=112661]

SIERA kicks off construction at Northcliffe tower Exhale

Local Little Bay residents, along with buyers from premium postcodes across Sydney’s affluent Eastern Suburbs, have dominated purchases in developer-builder Urban Property Group’s first Eastern Suburbs apartment development, <a href="https://www.apartments.com.au/new-apartments/este-little-bay-jennifer-street-little-bay-nsw-2036">ESTE Little Bay</a>.

The $250 million coastal project, one of the first new developments in the area in several years, has proven particularly popular with downsizers, especially those from Coogee and Bondi. One Double Bay downsizer paid $4.7 million for a four-bedroom penthouse, setting a new local apartment price record in the process.

Buyers have been attracted to the combination of coastal tranquillity, premium design and amenity-rich neighbourhood living. The walkable village setting, along with proximity to three of Sydney’s leading golf courses, New South Wales Golf Club, St Michael’s Golf Club and The Coast Golf Club, has also been a key drawcard.

[smartcode_project:default project_id=112343 project_image_fid=352689]

Built across two low-rise buildings designed by <a href="https://www.apartments.com.au/architects/hill-thalis-architecture-urban-projects-pty-ltd">Hill Thalis</a> and set along a lush, landscaped green spine, designed by leading landscape architect <a href="https://www.apartments.com.au/landscape-architect/arcadia-landscape-architecture">Arcadia</a>, ESTE Little Bay offers a collection of one, two, three and four-bedroom residences with interiors by Richards Stanisich.

<a href="https://www.apartments.com.au/developers/urban-property-group">Urban Property Group</a> Sales Director, Tom McIvor said the response to ESTE has been "nothing short of extraordinary."

“Buyers have been quick to recognise ESTE as a rare opportunity to invest in a coastal sanctuary that offers both seclusion and connectivity to the heart of Sydney,” McIvor said.

[smartcode_project:default project_id=112343 project_image_fid=352687]

<a href="https://www.apartments.com.au/project-marketer/srm-residential">SRM Residential</a> Senior Director, <a href="https://www.apartments.com.au/project-marketer/srm-residential">Clayton Ross</a> said the local market has responded incredibly well, driven by ESTE’s exceptional location and the rarity it offers.

“We’ve seen strong interest from a variety of buyer groups, all of whom are drawn to the exclusivity and quality of the build and construction by the 4.5-star iCIRT-rated builder / developer, Urban Property Group. There’s truly nothing else like it along Sydney’s coastline.”

[smartcode_project:default project_id=112343 project_image_fid=352690]

The project also includes robust buyer protections, including Resilience Insurance’s Latent Defects Insurance, providing 10 years of structural cover, and an independent iCIRT-rating of the developer.

“The iCIRT-rating adds another layer of confidence,” Ross added. “Buyers see it as a safeguard for their investment and their lifestyle.” A highlight of ESTE’s offering is its exclusive wellness amenities, including a heated rooftop infinity pool and outdoor heated spa, a state-of-the-art Technogym fitness centre, and a sauna.

<a href="https://www.apartments.com.au/new-apartments/este-little-bay-jennifer-street-little-bay-nsw-2036">ESTE Little Bay</a> is topped out and is on track to complete towards the end of 2026, with residents moving in before Christmas.

[smartcode_project_cta:default project_id=112343]

Eastern Suburbs buyers snap up ESTE Little Bay apartments

Healthcare

<html><body>
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>.
</body></html>

j.ballantyne1990-6AQqhLzZaK

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

<html><body>
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.
</body></html>

wdavis-8cCN98p7xp

New tenants announced for Western Sydney's Ed.Square 

<html><body>
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">
</body></html>

How poverty makes it hard to escape mental illnes

<html><body>
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.
</body></html>

Rare refurbished medical property offered in Mornington

<html><body>
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>.
</body></html>

Healthcare

Editor's Picks

Have something to contribute?

Developments

New apartments

New townhouses

News

Healthcare

Editor's Picks

Receive the latest news stories to your inbox

Have something to contribute?

Developments

New apartments

New townhouses

News