Gary Fry and Libby Kartzoff.
As Local Government NSW launches a landmark action plan to fix the rural health crisis, one small NSW town has already built the proof of concept – from spare bedrooms and reverse mortgages to the question du jour: how much is enough?
Most mornings, Libby Kartzoff walks up to the lookout above Bellingen. It’s a ritual, and a reckoning. On any given day, she’ll pass a car with someone sleeping in it. Sometimes a tent. People moving, as she puts it, “like Tetris” – shifting between bush clearings and rest stops to avoid receiving a move-on order. Some are itinerant by choice. But others, she says, have jobs. They work in town. They simply cannot find anywhere to live.
“There are professionals here who are in the same boat,” Libby says. “And I think if we have the right to anything in this country – a wealthy country – it’s a roof over your head and food in your belly.”
Kartzoff, a conservationist and former zookeeper who spent over a decade managing wildlife programs across the country, has a particular way of framing the housing crisis eating at the edges of communities like Bellingen, on the NSW Mid North Coast. She thinks about it the way she thinks about ecosystems. At Taronga Zoo, she worked with one of the world’s largest chimpanzee groups in captivity – a complex, thriving social structure that only functioned because of its demographic diversity. Young and old. Male and female. Dominant and peripheral. Remove any one group, and the whole thing destabilises.
“The demographic about who can live here is getting narrower and narrower,” she says. “And it doesn’t work. That seems like a no-brainer.”
It does. And yet across regional NSW, the narrowing continues. The Airbnb lists grow. Essential workers commute impossible distances or leave entirely. Hospitals go understaffed. Wards close. The problem is named, analysed and lamented, and largely left to fester.
Until, sometimes, a community decides it won’t wait.
Earlier this month, Local Government NSW launched its Caring for our Regions Action Plan, a six-step blueprint calling on state and federal governments to invest urgently in regional health infrastructure, workforce incentives, and the structural conditions needed to attract and retain healthcare workers outside the major cities. LGNSW president Darcy Byrne was blunt at the launch: “It is completely unacceptable that someone’s postcode will determine their access to essential healthcare services.”
He’s right. But while government prepares to act, Bellingen already has. And what this town of roughly 3,000 people has quietly assembled – without a ministerial budget line or a policy framework – may be exactly the model that other communities need to see.
A spare room becomes a workforce solution
It’s called Homes for Health. And it starts, improbably, with a spare room.
Libby Kartzoff and her partner Gary Fry are empty nesters. When their son Tom moved out, there was a room at the end of the house – self-contained, with its own entrance, a bathroom, a fridge, a view of the valley that would fetch serious money on Airbnb. They chose a different use for it.
When the Bellingen Housing Matters Action Group (HMAG) put out a call for community members to offer accommodation to healthcare workers, after housing shortages had forced Bellinger River District Hospital to close wards and turn away staff, the Kartzoff-Frys said yes.
“It costs almost nothing to run the house,” says Libby, who, like Gary, acknowledges they could never afford to buy in Bellingen today. ” We’re fortunate that we have an energy-efficient home, and we don’t need a rental income.”
What they charged their first guest – a student nurse on rotation – was five dollars a night.
That guest was 20 years old, six weeks in Australia from India, placed with the Kartzoff-Frys while a friend from Nepal stayed across the road with a neighbour. Both were nursing students doing their placement at the local hospital. Both were anxious. Their families, separated by continents and circumstances that most Australians would struggle to imagine, were anxious too.
“Her mother was a nurse working in the Middle East,” Libby recalls. “They’re still a married, cohesive family. They spent a lot of time on the phone. Her parents were equally anxious.” What settled everyone, she says, was simply knowing the young woman was somewhere safe, somewhere kind, somewhere with a kettle and a dinner invitation in the first week and two older adults who understood what it meant to be far from home and new to everything.
By the second week, she was finding her feet. By the fourth, she was confident. “She was a young woman capable of living on the other side of the world,” Libby says. “She just needed to know she was secure.”
They’ve also housed a more senior nurse – a woman nearing the end of her career – during a stretch of night shifts that coincided with the closure of Waterfall Way. After working four consecutive nights and then facing an hours-long detour home along a narrow, poorly lit alternate route, she was simply too exhausted to drive safely. The Kartzoff-Frys opened the room at no cost. She brought her own linen.
“She just needed a bed,” Gary says. “It wasn’t a hard thing for us to do.”
Vicki Parkes. Courtesy Bellingen Housing Matters Action Group.
Turning unused space into essential housing
A few streets away, Vicki Parkes has done something more structural, literally. She owns one of Bellingen’s old timber houses, the kind built nearly a hundred years ago with generous verandahs and a logic of space that modern developers have forgotten. When she found herself alone in fourteen rooms following some serious family financial strain, she started to see what a corner of the house could become.
The renovation cost her around $30,000, funded through a reverse mortgage, and took most of 2023. What she created was a self-contained apartment: a bedroom, a guest room or office, a bathroom, a kitchenette, and a separate entrance through what used to be the laundry. Connecting her side of the house to the tenant’s side is a utility cupboard with a door on each end – lockable from both sides, breakable in an emergency. Practical. Thoughtful. Entirely compliant, confirmed by an architect and a building surveyor she proactively brought through.
The question of who to house solved itself. As a patient at the local Three Rivers Health, she’d watched a parade of new doctors come through on six-month rotations and realised what they needed: something close to the hospital, already furnished, with no gardening and no lease complications. She called the clinic. They had someone coming in August.
“They’re travelling light, they’re working weekdays,” she says. “They don’t want to buy furniture. They don’t want to take a family home out of local stock.”
That last factor is vital.
Vicki charges $450 a week (“The charge must not represent more than than 30% of their income. This is important.”), all utilities included. She arrived at that number by looking at what comparable accommodation costs on Airbnb. “A bedroom in someone else’s house, that’s about the going rate,” she says. But her guests get their own entrance, their own bathroom, walkable distance to work, and none of the churn of short-stay rental.
Her current tenant is a young doctor doing a placement at Three Rivers. His hospital requirements in ER and as Registrar are now complete, but he does weekly rounds at the town’s nursing home, Bellorana, and is enjoying getting to know the patients there.
“I want to support him in being the best version of himself,” Vicki says. “So he can really do his job well.”
The community model that helped reopen hospital wards
Homes for Health, co-ordinated by HMAG in partnership with the Bellinger Health Action Group and brokered with Bellingen Shire Council, has drawn more than 65 offers of accommodation from across the shire. Properties ranging from bush retreats to inner-town cottages. More than 20 were vetted and approved. The programme helped clear a critical barrier to staffing, and the two closed hospital wards, including the 14-bed Hartley House medical ward, have since reopened.
This is the part of the story that deserves to be said plainly: community members opening spare rooms helped reopen a hospital.
Why local solutions still need systemic backing
Madeleine Lawler, CEO of Regional Development Australia Mid North Coast, says the region’s workforce pressures need to be understood against the realities of place, industry and community.
“Regional communities struggle to get traction when it comes to having the scale of their challenges understood. By the numbers, we’re dwarfed by the metropolitan areas both in terms of perceived return on investment and what is required to make models fit the communities they are meant to serve. Seeing the houses that are already in the community opened by people with big hearts, who value their amenity and services in the name of solving our own problems is encouraging. Bellingen has an incredible community, where those with means have the minds and hearts to share, in the name of the greater good.”
LGNSW’s new action plan calls for a $440 million Regional Health Workforce Investment Package to address systemic workforce shortages. It is a necessary ask. But Bellingen’s experience suggests that while we wait for government to fund the structural fix, there is something communities can do right now, something that requires no new legislation, no tender process and no waiting. It requires, instead, a particular quality of character.
“When the opportunity came,” Libby says, “it was really easy for us to make that space available. Just to help out.”
She pauses. “It’s not a hard thing for us to do.”
The bigger question: how much is enough?
The word Libby keeps returning to, the one that ties the housing crisis, the healthcare crisis, and the particular cruelty of both together, is agency. The ability to live somewhere, to build something, to choose. She invokes it in the context of people who cross oceans in unsafe vessels, who traverse deserts and push through fences, who sacrifice and scrimp and wait.
“People risk their lives for agency,” Libby says. “For hope.”
The inverse of that hope, she suggests quietly, is what happens when a community becomes so expensive, so narrow in who it will accommodate, that the people who make it run – the nurses, the doctors, the café workers, the mechanics – can no longer afford to stay. The ecosystem collapses. Not all at once, and not dramatically. Quietly, incrementally, ward by ward, spare room by spare room left empty on holiday booking sites.
Her partner Gary has a simpler formulation for the same idea. He asks it as a question, and he asks it often: “How much is enough?”
It’s a question worth sitting with. Because right now, across regional Australia, the answer that too many of us are giving – through the investment properties we hold, the short-stay listings we maintain, the wards we can’t staff – is more. Always more.
Bellingen, for now, is answering differently.
The Homes for Health program is coordinated by the Bellingen Housing Matters Action Group in partnership with the Bellinger Health Action Group and Bellingen Shire Council. For more information, visit housingmatters.org.au. Local Government NSW’s Caring for our Regions action plan can be accessed at lgnsw.org.au.
Article: Liz Ginis, Communications and Marketing Manager, RDA Sydney.