Wunan’s enterprise approach to quality healthcare in the East Kimberley

Background

Established in 1997, Wunan aims to drive long-term socioeconomic change, break welfare dependency and reinstate self-responsibility amongst Indigenous peoples in the East Kimberley. Strategic priorities of health, education, housing, employment and leadership are supported by over 15 programs and services.

Crucially, Wunan drives change through a self-sustaining economic model. As CEO Ian Trust explains,

“We’ve always had a clear vision in terms of economics that we had to generate our own money. The best way to describe it is that we have created an ‘economic horse’.”

Wunan’s portfolio of enterprises, which provide employment and training opportunities for Indigenous peoples in the region, include: iBase, Social Compass, East Kimberley Job Pathways, Wunan House B&B and Kununurra Lakeside Resort.

In 2013, Wunan realised a long-held ambition to venture into community health care (and fulfil its holistic approach to community reform and wellbeing)acquired the small private practice Kununurra Medical. It was a one doctor private practice and the doctor was leaving town. Dr Stephanie Trust, younger sister to Ian, became Senior Medical Officer of what was rebranded Wunan Health, beginning the task of building the service offerings and patient base.

Approach

Since 2010, 160 secondees from Jawun’s partners have supported Wunan in a range of areas including social enterprise development. From 2015, 4 secondees (from Freehills, Macquarie Group and NAB) supported the development and growth of Wunan Health, from service and staffing plans to business planning as the practice expanded.

Annie Liu, a manager at Macquarie Group, gave 120 hours of virtual support to Wunan Health in late 2020. She worked alongside another secondee from NAB on a financial revenue and cost model for the practice’s sustainable (and financially viable) growth. As Dr Steph explains, getting help to get the business model right has been critical:

“We’ve had some really good Jawun secondees help us along the way. We’ve recently been looking at financial re-modelling, and begun putting all those things that we’ve learnt with the support Jawun into practice in terms of a business model.”

A robust business model was the basis for Wunan Health’s expansion. In September 2020, construction was completed on a new health and wellbeing centre, designed as part of Wunan’s holistic health strategy. It includes training facilities and capacity for allied health and mental health professionals, and its additional treatment rooms allow Wunan Health to see more patients with decreased wait times.

Annie, on secondment at the time, described how she saw the business model and growth strategy supporting the efficiency (and integrity) of Wunan Health’s enterprise approach:

“Dr Steph and her team are determined to make an impact but also to achieve greater profitability. As a social enterprise, any profits Kununurra Medical make are used to fund community projects. This drives them to run efficiently and not take funding for granted. It has made me rethink how not-for-profits operate.”

Outcomes

In its first 6 years, Wunan Health doubled its active patient base. In its first three years, the number of Indigenous patients more than tripled. Today, Wunan Health has 6281 active patients, 11% of whom are Indigenous. It is the only private GP practice in the East Kimberley and its expanded services include: GP services, remote outreach, mental-health care, pre- and post-delivery pregnancy care, vaccinations as well as pre-employment and visa medicals. There are now 5 doctors employed, and in all 12 employees, 3 Indigenous.

Wunan Health has shifted perceptions of health care: once on a bulk-billing service provider, it now represents high quality healthcare and has justified its fee-for-service model. Dr Steph explains how this is supported by much broader involvement in (and influence over) local health strategy, policy and research development:

“We’re involved in sitting on boards that influence local health strategies and local health policies – something your run-of-the-mill Melbourne GP practice often doesn’t do. We’ve been involved in research as well. From that point of view, the end game for Wunan Health is far from being just financial.”

Wunan Health continues to invest 100% of its profits back into Wunan, supporting the foundation’s broader Indigenous-led reform agenda. It has an increasingly significant place in Wunan’s enterprise portfolio which, together with property income, generates over $8million to be invested across its programs (around 55% of the organisation’s total funding).

Next steps

Jawun secondees will continue to support the ambitious reform efforts of the Wunan foundation and its enterprises.

Wunan aims to more than double its current asset base to $100 million over the next 15 years, enabling it to operate beyond the East Kimberley and support other Indigenous groups driving their social reform agendas.

Wunan Health intends to consolidate and grow its health care provision for all residents of the East Kimberley. Plans rest not only on a strong business model but also on the very personal motivations of the Trust family who sit behind Wunan – as illustrated by Dr Steph:

“I grew up in school hearing about apartheid and separate hospitals in South Africa, but there was no conversation about the fact we had that here in Australia. That gave me a real sense of injustice and I wanted to make a difference, which is why I took the path I did.

With this centre, it was about flipping that racialised model totally on its head. An Aboriginal organisation runs the private practice and owns the private practice, but the private practice is for everybody and you will get treated equally. It doesn’t matter who you are when you walk through the door.”