Local developer Harridan is seeking to turn its Woolloongabba apartment project into the first stage of a broader transformation of Burke Street, using a new 16-storey mixed-use building to establish a greener pedestrian connection toward the rapidly evolving Boggo Road transport and knowledge precinct.

The South East Queensland developer has filed plans for 154 apartments on the <a href="https://www.apartments.com.au/new-apartments/4-burke-street-woolloongabba-qld-4102">southern side of Burke Street</a>, where its proposal has been designed alongside a wider vision by LatStudios for the street.

That vision positions the southern side of Burke Street for buildings of 15 storeys and above, while envisaging lower-rise development of up to five storeys on the northern side to transition into Woolloongabba's existing character housing. It also proposes wider pedestrian verges, deep planting, new street trees and upgrades to the pedestrian approach to Boggo Road Station.

The Harridan development itself has been designed by Brisbane-based Arqus Design and will comprise 154 apartments across 16 storeys. The mix is weighted heavily toward two-bedroom apartments, with 121 proposed alongside 10 one-bedroom and 23 three-bedroom residences. There will typically be around 14 units per floor.

A lower-ground car park and three podium levels will accommodate 156 resident parking spaces, along with visitor and commercial parking. There will also be 154 resident bicycle spaces and 40 visitor bicycle parks.

&nbsp;

Harridan is a family-owned developer and part of the Holmwood Highgate Group, with more than three decades of development activity across South East Queensland. Its portfolio spans residential, commercial and industrial property, with current residential projects including Riverbank on Byron in Bulimba, Esperance Residences in Carina and The Precinct at Kinross Road in Thornlands.

Wooloongabba has been popular for apartment developers, particularly since the announcement of the 2032 Summer Olympics games in Brisbane.

While there have been a lot of development applications, it has failed to materialize into real supply.&nbsp;

Sarazin has been the major player in the area. They are under construction at Murcia Residences, on the fringe of East Brisbane and Woolloongabba. They have just launched <a href="https://www.apartments.com.au/new-apartments/the-stanley-residences-woolloongabba-8-trafalgar-street-woolloongabba-qld-4102">The Stanley Residences</a>, in Woolloongabba on Trafalagar Street. They also have Nuage coming soon on the nearby <a href="https://www.apartments.com.au/new-apartments/nuage-woolloongabba-14-wellington-road-woolloongabba-qld-4102">Wellington Road</a>.

Joel Robinson

First look: Harridan plans Burke Street transformation beside Boggo Road transport hub

IN BRIEF

<ul>
	<li>
	Just three double-storey Sky Homes sit at the top of The Waterline, each with its own private marina berth and rooftop terrace.
	</li>
	<li>
	Construction on The Waterline is complete, with the first residents expected to move in from mid-October.
	</li>
	<li>
	Sky Homes range from 282 sqm to 367 sqm and are priced from $3.65 million.
	</li>
</ul>

<hr />
Lewis Land has opened the first completed sky home for inspection at Harbour Shores, giving buyers their first opportunity to step inside one of just three double-storey residences crowning The Waterline.

Each sky home comes with its own private marina berth, rooftop terrace and Broadwater views, combining the scale of a larger home with direct access to the boating lifestyle that underpins the wider <a href="https://www.apartments.com.au/new-apartments/harbour-shores-biggera-waters-564-oxley-drive-biggera-waters-qld-4216">Harbour Shores</a> masterplan.

[smartcode_project:default project_id=113271 project_image_fid=366708]

Lewis Land Head of Development Michael Long said the inclusion of a berth with every Sky Home had become increasingly valuable as marina access across the Gold Coast tightened.

“Marina berths are becoming increasingly difficult to secure across the Gold Coast, so including one with every Sky Home makes this a genuinely rare offering,” Long said.

“The private 70-berth marina will accommodate boats up to 12 metres in length and is positioned just 2.5 kilometres from the Broadwater, placing the open ocean only 15 minutes away.

“Being able to step out of your home onto your boat is a rare luxury, and it’s something residents here can look forward to when it opens later this year.”

[smartcode_project:default project_id=113271 project_image_fid=366709]

The display opening comes as construction completes on The Waterline, with the first residents expected to move in from mid-October.

The three Sky Homes range from 282 sqm to 367 sqm and each feature three bedrooms, three bathrooms, multiple living zones, expansive kitchens with butler's pantries and large balconies taking in the Broadwater outlook.

Each residence also has three secure basement car spaces and additional storage.

“This is the first opportunity the Gold Coast has had to step into Harbour Shores and see, touch and feel what we’re bringing to life here,” Long said.

“There are only three Sky Homes within The Waterline, ranging in size from 282sqm to 367sqm, with each residence featuring three large bedrooms, three bathrooms, multiple living zones, expansive custom-built kitchens with butler’s pantry, and large balconies capturing Broadwater views.”

<img alt="Harbour Shores" data-entity-type="file" data-entity-uuid="bab65e10-4fab-45e1-92d8-fc56e2ab98ff" src="https://s3.ap-southeast-2.amazonaws.com/www.urban.com.au/s3fs-public/inline-images/Screenshot%202026-08-25%20at%202.00.16%E2%80%AFPM.png?VersionId=XT8q76LsPkw3cYTsvN3JfFDaPLud90PN" />

Residents of The Waterline will have access to a private pool, along with Harbour Shores' wider collection of amenity including a lagoon pool, social clubhouse, tennis court, gym, yoga facilities and sauna.

Lewis Land partnered with Studio Collective to furnish the completed display, with the interiors designed to demonstrate how the residences could function as permanent homes rather than simply as show apartments.

Studio Collective Director Melissa Park said the surrounding waterways informed the interiors, but in a more restrained way than a traditional coastal scheme.

“We drew inspiration from the canals and coastal surrounds, but our approach was to interpret that subtly through layered materials and a grounded palette of earthy tones, rather than literal coastal references,” Park said.

“We introduced hero moments of green and teal to reference the surrounding waterways, while mirrored elements help reflect natural light.

“The result is a residence that feels elevated yet comfortable, somewhere buyers can genuinely imagine themselves living, entertaining and unwinding.”

Sky Homes are priced from $3.65 million.

Lewis Land is also offering private marina berths with The Residences, its limited collection of three and four-bedroom villas positioned directly along the Harbour Shores waterfront boardwalk.

Three-bedroom villas are priced from $2.99 million, while four-bedroom residences start from $3.19 million.

Harbour Shores is being marketed by Colliers International.

[smartcode_project_cta:default project_id=113271]

Lewis Land opens sky home display as The Waterline completes at Harbour Shores

St Vincent de Paul Society Housing Australia has filed plans for a major mixed-use housing precinct on the southern edge of the North Sydney CBD, adding another significant proposal to a pocket around North Sydn​ey Station that is quickly becoming one of the LGA's busiest development zones.

The State Significant Development Application covers a 5,990 sqm site at <a href="https://www.apartments.com.au/new-apartments/1-19-mackenzie-street-lavender-bay-nsw-2060">1-19 MacKenzie Street and 211 Blues Point Road in Lavender Bay</a>, immediately south of Nor​th Sydney Station and between the commercial core and the lower-rise Lavender Bay Heritage Conservation Area.

Designed by Wardle, the proposal would deliver a new residential tower comprising 88 build-to-sell apartments and 19 affordable apartments, alongside a separate co-living building with 57 rooms and a building manager's studio.

It would also see the significant restoration and upgrade of St Francis Xavier Catholic Church, the adaptive reuse of the former school building, new parish facilities, retail, a new public square and around 1,000 sqm of publicly accessible open space.

<img alt="Vinnies North Sydney" data-entity-type="file" data-entity-uuid="d5dd7f87-a617-463e-b577-17541e01f0e9" src="https://s3.ap-southeast-2.amazonaws.com/www.urban.com.au/s3fs-public/inline-images/Screenshot%202026-08-26%20at%209.10.13%E2%80%AFAM.png?VersionId=4R8TsFN3P_LrrXO2HswTOIrx2blil8lh" />

The project is seeking a concurrent rezoning of the site to R4 High Density Residential and an increase in the maximum building height to allow a tower reaching RL120, or up to 20 storeys. The proposal was progressed through the NSW Government's Housing Delivery Authority pathway.

The build-to-sell component will be weighted toward larger apartments, with just six one-bedroom apartments compared with 31 two-beds, 43 three-beds and eight four-bedroom residences.

The 19 affordable apartments will comprise two studios, 15 one-bedroom apartments and two two-bedroom apartments, taking the total apartment component to 107 residences before the 58 co-living rooms are included.

<img alt="Vnnies" data-entity-type="file" data-entity-uuid="7d568ca5-cb90-4e18-96c6-d9795dba0c56" src="https://s3.ap-southeast-2.amazonaws.com/www.urban.com.au/s3fs-public/inline-images/Screenshot%202026-08-26%20at%209.10.05%E2%80%AFAM.png?VersionId=GY2R5M9VtQh0EKy1vajaea19PSLOPuRD" />

Wardle's design for the Vinnies site has sought to negotiate that emerging high-rise context while retaining the lower-scale character of MacKenzie Street and the adjoining heritage conservation area.

The main building adopts a three-storey podium and tower arrangement, with the podium aligned to the ridgeline and front setback of St Francis Xavier Church.&nbsp;Wardle has designed the podium with colonnades, seating, recessed entries and active ground-floor frontages, with sandstone-toned precast concrete and face brick referencing the materiality of the existing church.

The tower then steps back eight metres to the south and six metres to the north before rising in a sculpted form comprising four interlocking quadrants. Wardle has also introduced rounded forms and chamfered corners to reduce the tower's perceived bulk and improve view sharing with neighbouring development sites.

Resident facilities and outdoor areas are planned at the separation between the podium and tower at Level 3, oriented toward Sydney Harbour and the CBD skyline.

The tower itself will feature a glass reinforced concrete facade, with recessed balconies and deep reveals used both to provide shading and privacy and frame views toward the harbour and city. The lower levels take a different architectural approach, using brick and sandstone-toned finishes intended to establish a stronger relationship with St Francis Xavier Church. The Church itself will be conserved and upgraded for its continued use, while the former school building will be adaptively reused as part of the co-living component.

<img alt="Lavendar Bay" data-entity-type="file" data-entity-uuid="2d4418ad-90aa-4d49-af93-c80b140aea80" src="https://s3.ap-southeast-2.amazonaws.com/www.urban.com.au/s3fs-public/inline-images/Screenshot%202026-08-26%20at%209.09.47%E2%80%AFAM.png?VersionId=Kv4gzbsACaGvZSRuaqcfGC54jEJRXIDJ" />

&nbsp;

The proposal adds to an increasingly concentrated pipeline of residential development around Blue Street, MacKenzie Street and Lavender Bay.

Just west of the site, Central Element lodged plans earlier this year for one of the most significant residential developments proposed in Lavender Bay in recent years.

Central Element's SJB-designed scheme at 64-66 Lavender Street and 3-7 Middlemiss Street would deliver 163 apartments across two towers rising 23 and 32 storeys, replacing five existing apartment buildings containing 32 homes. The project also forms part of the Housing Delivery Authority pathway.

<a href="https://www.apartments.com.au/news/nsw/first-look-central-element-reveals-lavender-bay-apartment-plans?utm_source=chatgpt.com" rel="noopener" target="_blank">First look: Central Element reveals Lavender Bay apartment plans</a>

Immediately around North Sy​dney Station, another two significant proposals have emerged at 5 and 15 Blue Street.

Zurich Australian Insurance Properties is seeking to adaptively reuse its longstanding commercial building at 5 Blue Street, directly above North Sydney Station, rather than demolishing the structure.

Its SSDA proposes converting the building into a 14-storey mixed-use development with 62 apartments and 86 co-living rooms, together with ground-floor retail and a major refurbishment of Blue Street Plaza. The application is currently at the Response to Submissions stage.

<a href="https://www.apartments.com.au/news/nsw/first-look-zurich-targets-north-sydney-office-conversion-with-148-unit-proposal-above-metro-station">First look: Zurich targets North Sydney office conversion with 148-unit proposal above Metro station</a>

&nbsp;

First look: Vinnies files for 20-storey Lavender Bay apartment tower as North Sydney housing pocket heats up

When the opportunity arose for South Australian developer Palumbo to return to Kent Town, where it had previously delivered East Park Apartments and the East 
Rundle Apartments, it wasn't one the longstanding developer-builder was going to pass up.

The decision was quickly vindicated, with more than 30 apartments sold within the first month of launching <a href="https://www.apartments.com.au/new-apartments/royal-apartments-kent-town-2-8-north-terrace-kent-town-sa-5067">Royal Apartments</a> to the market.

The 206-apartment development, which will bring significant new supply to Adelaide's tightly held eastern city fringe, also gives <a href="https://www.apartments.com.au/developers/palumbo">Palumbo</a> the opportunity to bring new life to one of Kent Town's most recognisable watering holes.

[smartcode_project:default project_id=6109 project_image_fid=376073]

Royal Apartments incorporates the historic Royal Hotel, a venue Palumbo Managing Director Daniel Palumbo said has a longstanding connection with the local community.

"Everyone in the area has history with the Royal Hotel," Palumbo told Apartments.com.au.

"It was quite an active pub and social gathering place for locals. We want to bring it back to its former glory."

[smartcode_project:default project_id=6109 project_image_fid=376072]

The wider development will comprise two residential towers alongside the restored hotel, sitting on North Terrace opposite the Adelaide Park Lands.

For Palumbo, the project also marks a return to familiar territory.

The developer completed East Park Apartments next door more than a decade ago and jumped at the opportunity to develop in Kent Town again when the Royal Hotel site became available.

"The opportunity emerged, and we moved to secure the site," Palumbo said.

"We were approached by the previous landowner, who said they had extensive commitments in Sydney and weren't in a position to deliver the project.

"We took over the site and within six months recut the design scheme to be more in keeping with the type of development we want to bring to Adelaide.

"Now we're on the market and those changes have really resonated with local buyers."

That has translated into a strong start to sales, with 33 apartments transacting in the project's first 35 days.

Palumbo said the early purchaser profile had been consistent with the group's traditional focus on owner-occupiers rather than investor-led apartment stock.

"Local owner-occupiers have always been our market," he said.

"There are always some investors, but we've never developed what would be called traditional development stock. Owner-occupiers are very much our market."

[smartcode_project:default project_id=6109 project_image_fid=376068]

The buyer mix has been diverse so far, with downsizers and younger professionals both accounting for a significant portion of early sales.

South Australia's current stamp duty settings, which allow&nbsp;eligible homeowners in South Australia aged 60 savings of up to $103,830 on stamp duty when they downsize to a new property valued at up to $2 million,&nbsp;have helped encourage downsizer activity, while younger buyers in their late 20s and early 30s have been attracted to the opportunity to live immediately outside the CBD while still being able to walk into the city.



Location has been a major part of the proposition for both buyer cohorts.

[smartcode_project:default project_id=6109 project_image_fid=376075]

Royal Apartments sits on North Terrace directly opposite the Adelaide Park Lands, with residents able to walk through the parklands toward the East End, Rundle Street and Rundle Mall.

Apartments have been positioned to capture views across the parklands, Adelaide skyline, Botanic Gardens and Adelaide Hills.

Palumbo believes the scarcity of developable land along this section of the Park Lands makes the site particularly difficult to replicate.

"There's very few allotments on that side that can be developed," he said.

"If this location was in New York and you were sitting on Central Park, you'd be talking about a $60 million apartments."

Royal Apartments will offer a broad mix of residences, ranging from one-bedroom apartments through to four-bedroom sub-penthouses and penthouses.

Current listings include one-bedroom apartments from $680,000, while larger three and four-bedroom residences are priced around $2.5 million.

Residents will have access to a swimming pool, gym, barbecue and recreation areas, residents' lounge and dining space, and a communal deck.

[smartcode_project:default project_id=6109 project_image_fid=376067]

The apartments will feature generous balconies, while secure parking, bicycle storage and storage cages will also be provided.

A porte-cochère-style arrival and drop-off area has also resonated with buyers, particularly those attracted to being able to walk into the CBD during the day while retaining secure vehicle access at home.

Palumbo is acting as developer, architect and builder on Royal Apartments, continuing the vertically integrated model it has used across its South Australian portfolio.

The group was also behind the $150 million Sofitel Adelaide, the 251-room five-star hotel and residential tower which opened in 2021.

Palumbo said Royal's launch had come at an interesting time for the broader Adelaide apartment market.

Buyer confidence had initially been impacted by uncertainty surrounding the Federal Budget and broader economic conditions, but Palumbo believes sentiment is beginning to improve against a backdrop of significant investment flowing into South Australia.

He pointed to increased activity across defence and resources, including Olympic Dam, as potential long-term drivers of the state's economy and housing market.

"Money is starting to flow into Adeliade, significant amounts as Adelaide bucks the trend of the rest of the country.," Palumbo said.

"There's a lot of activity in the economy over the next decade. I think more investment will come into this market."

Early works on Royal Apartments are expected to commence this year, with major construction activity and cranes anticipated on site from early next year.

[smartcode_project_cta:default project_id=6109]

Palumbo's return to Kent Town strikes early chord with buyers

Go-to builder-developer <a href="https://www.apartments.com.au/developers/graya">GRAYA</a> is continuing to bulk out its already impressive and diverse apartment portfolio across South East Queensland. Their latest milestone is securing development approval for Silk, its boutique riverfront apartment development in St Lucia.

The approval clears&nbsp;the way for the team to begin construction planning for the 22-residence project.

<a href="https://www.apartments.com.au/new-apartments/silk-st-lucia-16-18-sandford-street-st-lucia-qld-4067">Silk</a> will rise 15 levels from an 810 sqm site at 16-18 Sandford Street, occupying a prominent bend of the Brisbane River with a prized northern aspect across Orleigh Park toward the Brisbane CBD.

The approved scheme will comprise 16 split-floor and six full-floor residences, continuing GRAYA's move into larger-format apartment developments targeting Brisbane's prestige owner-occupier market.

The project has been designed around the site's broad river frontage and dual-direction views, with GRAYA prioritising larger residences, privacy and outlook over apartment yield.

<img alt="Silk St Lucia" data-entity-type="file" data-entity-uuid="aa5c2349-f96c-4914-a812-1f2cd6827af8" src="https://s3.ap-southeast-2.amazonaws.com/www.urban.com.au/s3fs-public/inline-images/Screenshot%202026-08-26%20at%208.25.44%E2%80%AFAM.png?VersionId=WY0vEU_7vYjeRJKQHiCwFdMxu8PvFh52" />

GRAYA Co-founder and Chief Executive Officer Rob Gray said the project had been shaped around local homeowners wanting to remain in St Lucia without maintaining a traditional family home.

"St Lucia is one of those suburbs people do not want to leave," Gray said.

"They know the river, the trees, UQ, the golf course, Toowong and Indooroopilly, and that familiarity is hard to replace.

"True riverfront opportunities here are exceptionally scarce. What we have designed at Silk is a way to stay in the suburb people love, with the scale and privacy of a private home and far less to maintain.

"This is not typical apartment product. It is a proper home on the river, and that is exactly what this market has been missing."

The approval comes as new apartment development continues to increase across the St Lucia and neighbouring Toowong corridor, although direct riverfront sites remain considerably more tightly held.

GRAYA Co-founder and Managing Director Andrew Gray said securing the approval had removed a significant element of development risk from Silk.

"Genuine riverfront sites of this quality in St Lucia are not something that comes up regularly," Gray said.

"The approval removes a substantial layer of execution risk, and the location underwrites demand in a way very few inner-city sites can.

"The fundamentals here are as strong as anything we have assessed in Brisbane."

<img alt="Silk St Lucia" data-entity-type="file" data-entity-uuid="d0f3d734-65e1-48e8-8ed3-2e0715ffcdd9" src="https://s3.ap-southeast-2.amazonaws.com/www.urban.com.au/s3fs-public/inline-images/Screenshot%202026-08-26%20at%208.25.56%E2%80%AFAM.png?VersionId=sOLSs_jdHkXLWbBKzRyayf5BfTb2vPsD" />

Silk will see GRAYA return to a stretch of the Brisbane River where it already has recent construction experience. The vertically integrated group recently completed ARC in neighbouring Toowong as builder for developer Spyre, delivering the riverfront project on a constrained site.

GRAYA will take a different role at Silk, controlling the project from design and development through construction and aftercare under its vertically integrated model.

The development will include a gym and resident leisure areas at ground level, integrated with the river's edge.

Silk joins a growing pipeline for GRAYA across Brisbane and the Gold Coast, which includes Enclave, The Gallery, Coral and Ripple.

The developer-builder has also recently lodged plans for its largest project to date, <a href="https://www.apartments.com.au/new-apartments/the-silo-19-chester-street-newstead-qld-4006">The Silo</a>, a proposed <a href="https://www.apartments.com.au/news/qld/graya-buys-frasers-newstead-site-plans-the-silo-between-james-street-and-gasworks-precincts">$700 million mixed-use development</a> in Brisbane's James Street precinct.

Silk is expected to predominantly target local owner-occupiers and prestige buyers seeking a permanent riverfront home in Brisbane's inner west.

Registrations of interest are now open, with further details on the project and construction program to be released as it progresses.

<hr />
<h2>SILK PROJECT FACTS</h2>

Developer-builder: GRAYA

Project: Silk

Location: 16-18 Sandford Street, St Lucia

Apartments: 22

Built form: 15 levels

Site: 810 sqm riverfront holding

Mix: 16 split-floor and six full-floor residences

Status: Development approved

Next step: Construction planning underway

[smartcode_project_cta:default project_id=152168]

GRAYA greenlit for riverfront St Lucia apartment development, Silk

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>.
</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.
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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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