One cancer patient is advised to increase fluids, another sent an electronic script, and a third consoled. All have been saved from an emergency presentation by the timely intervention of a nurse – in just the first hour of the day.

So, imagine my dismay when she warns me that her clinic will close for several weeks when she takes overdue leave. Thinking selfishly of my neediest patients, I ask why there’s no cover.

“Because there is no money.”

Considering the eye-watering price tag of many cancer therapies of limited, if not futile value, it seems incredible that there is no money to fund a cancer nurse who saves the healthcare system multiples of what she costs.

I sympathise that manoeuvring healthcare budgets must be like managing a refractory migraine but still, who looks at this business case and says “it’s not worth it”? In the absence of said nurse, when patients are routed straight to emergency, who says, “that sounds like a good idea”?

The catchphrase for every gap in healthcare delivery is that “there is no money” and clinicians are conditioned to believe it.

But as a scathing report into the failings of one healthcare organisation shows, mismanagement may loom larger than money.

Melbourne’s Cohealth is one of Australia’s largest community health organisations. Funded to the tune of nearly $120m annually, it serves highly disadvantaged patients including those facing mental illness, homelessness, substance abuse, domestic violence and incarceration.

Last year, the board announced that it had lost the good fight and was closing three GP clinics, citing – you guessed it – a lack of funding. This decision........

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