Nicolette Boele (Bradfield, Independent) Share this | Hansard source

I thank the member for Fowler for raising what is clearly a matter of public importance—that healthcare in this country should not be a postcode lottery. It is a proposition with which it is impossible to disagree. In Australia we quite rightly pride ourselves on our world-class healthcare system. We rank first among the OECD countries for equity and healthcare outcomes and third for overall healthcare performance, behind only Norway and the Netherlands. But, like all systems, ensuring its ongoing success requires maintenance and vigilance, and healthcare equity—in other words, ensuring that we do not succumb to a postcode lottery—requires not just funding but funding where and when it is needed.

In addressing that issue today, I want to focus on one particular part of the healthcare system, and that is mental health and the inequity of service delivery around the country. According to government data, we spent almost $14.5 billion on mental health services in the year 2023-24. That's around seven per cent of total government expenditure. That's an extraordinary amount of money, so it very much matters where and how it is allocated. We also know that five million people, or 18 per cent of the population, were dispensed a mental health related prescription in the same period. So mental ill health is incredibly prevalent and widespread, but the delivery and accessibility of mental health services is inconsistent.

Let's first have a look at the variations between states and territories. The 2025 Report on government services identifies major differences in per capita spending on mental health, access to state and territory specialised mental health services, and rates of delayed or avoided care due to cost. For example, my home state of New South Wales recorded the lowest per capita expenditure on specialised mental health services among the states, and, despite the vast public spend on mental health services, 22.4 per cent of people across Australia delayed or avoided obtaining care due to cost, with cost pressures differing between jurisdictions. These variations affect service quality, wait times and the ability of people to receive appropriate care at all.

As we've been discussing already today, national reporting also consistently shows that communities in regional and remote areas have fewer mental health professionals per capita and that emergency departments in regional areas, like the member of Calare's, bear a disproportionate load, as community services are thinner. This leads to longer wait times for services, greater reliance on emergency departments and limited continuity of care after discharge.

In short, the delivery of services in Australia's mental health system is not uniform. There are clear measurable differences in service availability, funding, waiting times, outcomes and access to community versus hospital based care. These disparities exist between states, between urban and regional and remote areas and between individual primary health networks.

Pleasingly, the government is acting to address inequities in health outcomes, and I do commend the minister for his work in this regard. The Reducing Health Inequities Mission is investing $150 million over 10 years from 2027-28 to research and address inequities in health outcomes. This funding aims to improve access to quality health services by priority populations. But is it enough, and is work going to be done quickly enough? As is the case in all complex public policy areas, there is much, much more work to be done.

Similarly, we could not lay claim to having a world class without already exceptional services being operated by incredible healthcare professionals, and that's certainly true in the mental health services space in my electorate of Bradfield. KYDS Youth Counselling offers free, confidential counselling for children aged 10 to 18 without the need for a Medicare card, GP referral or a mental health plan. If you're a young person at risk, KYDS makes the barrier to accessing these services very low. That's ever so critical for people who are very often too shy to ask for help. Lifeline Harbour to Hawkesbury has also provided vital services to my community for over 56 years. EPIC, Empowering Parents in Crisis, collaborates with schools, police, hospitals, family support organisations and the community to demystify pathways to support and create awareness regarding youth mental health. I want to thank these wonderful organisations for their high quality and sustained service to our community. I also want to urge the government to continue to work to ensure that funding for mental health services like these ones continues to be successful and thrive in my electorate of Bradfield and in other communities because we do not want Australia's mental health services to be a postcode lottery.

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