Jason Staines writes:
The impending closure of the Australian Healthcare and Hospitals Association (AHHA), the national peak body for public and not-for-profit hospitals and healthcare providers, has been described as a devastating loss for the health sector and for independent policy advocacy.
Observers told Croakey the collapse represents the loss of nearly 80 years of health system knowledge, leadership and advocacy.
“It is the loss of a strong, independent voice for Australia’s public health system and ultimately, for the people who rely on it,” said one former staff member, who added that staff had been “deeply devastated” but fought hard to keep operations running until they no longer could.
On LinkedIn, Inala Primary Care CEO Tracey Johnson called the news very sad: “70 years of advocacy. Drivers of value-based care. Trusted change agents. All those Deeble Institute Reports. Amazing people with an amazing legacy.”
Independent consultant and Swansea University professor Sally Lewis wrote: “A big loss for the Australian healthcare system. Really sad indeed.”
McGrathNicol Restructuring confirmed that partners Barry Kogan and Shane O’Keeffe were appointed administrators on 29 September. In a statement, they said the financial position of AHHA meant they were “unable to trade the business and have no alternative other than to undertake an orderly wind-down of operations”.
A first statutory meeting of creditors was due to be held virtually on 10 October. Meeting notices were being distributed to creditors this week, with further information to be published on the McGrathNicol website.
Established in 1946 as the Australian Hospital Association, the current name was adopted in 2006. Its membership spans state and territory health departments, Local Hospital Networks, public and community health services, Primary Health Networks, aged care providers, universities and health professionals. However, the organisation does not publish a list of its members on its website.
Critical roles
The AHHA has been a prominent national advocate for universal, high-quality healthcare. It has produced policy submissions, hosted roundtables and briefings with governments, and published the Australian Health Review journal. It also operated the Deeble Institute for Health Policy Research and established the Australian Centre for Value-Based Health Care.
One reason AHHA’s role has been seen as so critical is that public sector employees, while central to policy design and delivery, are usually constrained in what they can say publicly. The association was able to speak independently and across the system.
Financial statements for the year ending 30 June 2024 show AHHA’s revenue falling from $2.5 million to $1.9 million, while expenses remained broadly steady.
Receipts from customers and others fell by more than $600,000 – suggesting a possible decline in membership or project funding – while the organisation carried a cost base of more than $2 million. This included rising event and travel costs ($87,000 and $25,000 respectively), alongside a $66,000 outlay on a website under development.
The result was a deficit of $239,000, compared to a $245,000 surplus the year before. Cash reserves almost halved over the same period, from $879,000 to $439,000.
According to information lodged with the Australian Charities and Not-for-profits Commission, AHHA employed nine full-time staff, with no part-time or casual workers, supported by an estimated 24 volunteers. Those positions will be lost as the administrators wind down operations.
Alison Verhoeven, who was AHHA’s chief executive from 2013 to 2021 and is now a director of Croakey Health Media, said the organisation played a role in major national reforms, from its advocacy in the 1970s and 1980s around the establishment of Medibank and Medicare, to its long-standing focus on hospital funding through successive National Health Reform Agreements. Its support for Medicare Locals and their transition to Primary Health Networks was also key.
Over the years, AHHA’s policy and advocacy work extended across a wide spectrum — value-based health care, oral health, community health services, aged care, mental health, disability, climate change and the COVID-19 pandemic, Verhoeven noted.
“A passionate voice for a strong public health system and universal healthcare, as recently as last month the organisation spoke out on racism and cultural safety, hospital funding and value-based healthcare,” she said.
Focus on evidence
Underlying this advocacy was a strong commitment to health services research. Through its peer-reviewed journal, the Australian Health Review, and the Deeble Institute, AHHA backed emerging scholars and contributed to evidence-based improvements in the health system.
Former staff and associates told Croakey that this work was often taken for granted, with limited funding support from governments and universities despite its impact.
“While there are other advocacy bodies who speak out on many of the issues the AHHA focused on, few bring a system-wide lens to these issues and many come from a position of self-interest,” said Verhoeven.
“For these reasons, it is a sad day to see the doors close on 80 years of hard work by individuals and organisations deeply committed to a better health system for all Australians.”
Although health inequities remain, Australia’s health system performance is consistently ranked in the top three compared with other high income countries, Verhoeven added.
“Those who have worked for and with the AHHA over the past 80 years should be proud of the significant contribution they have made to the health system we have available to us today,” she said.
The AHHA website currently lists its board members as the Hon Jillian Skinner AM, Nicole Bartholomeusz, Michael Brydon, Mike Bosel, Annette Crothers, Tina Janamian, Yasmin King, Susan McKee and Anthony Schembri. However, Bartholomeusz told Croakey she had resigned from the board in August this year and “prior to the current development”.
The move into administration raises uncertainty over the continuation of AHHA’s policy and research work, and over its role as an independent national voice in health reform. It also raises questions about who might fill this important space.
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