Katy Gallagher (ACT, Australian Labor Party) Share this | Hansard source

I welcome the opportunity to speak on the Social Services Legislation Amendment Bill 2015 this morning. This bill should be opposed in line with the additional comments that have been provided to the Senate Community Affairs Legislation Committee's report on the Social Services Legislation Amendment Bill 2015.

One can only imagine how the origins of this bill arose. We know there is a process that all governments go through in terms of identifying savings, going through an ERC process, ultimately getting it ticked off and then finding their way into drafting legislation that comes before this chamber. This bill reeks of a government without any understanding of mental illness. But perhaps that is too generous. Maybe the government do understand and the decision that was taken around this bill and the savings it incorporates is just another example where the government identify a vulnerable group, then go out and seek to demonise that group and attach savings to it at the same time.

In his address Senator Canavan argued that this is simply an adjustment and he kept using the term 'adjustment': 'It's just a straightforward adjustment.' But each of the 350 people whom this bill will affect—and the 50 people it will affect every year for year after year after that, and their families and carers—would see the impact of this bill as much more than simply an adjustment. If 'adjustment' means the entire removal of income support, then I agree it is an adjustment. But let's not try to dress this up by using language that seeks to misrepresent what this bill actually does for a very, very vulnerable group in our community.

Last year ACOSS released a report around members of the community experiencing poverty. When you look at that report you will see that it found that under half of people on disability support pensions were living in poverty, one quarter of Australians receiving carers payment were living in poverty and 15 per cent of those receiving the age pension were living in poverty. Again, the vulnerability of the group is well understood when they are living in the community but, when they are living in a forensic mental health unit, that vulnerability remains with them.

I have read the Senate committee report on this legislation and it identifies some of the concerns that have been raised by other members today, particularly this notion of defining serious and non-serious offences as part of mental health policy. As anyone who has worked in mental health policy and planning and delivery of services knows, as it relates to forensic services, it is unusual to provide a distinction between a serious and a non-serious offence. I think the general understanding of people living with mental illness and committing those sorts of offences is that they are not deemed to be morally culpable, or indeed responsible, for their crimes. They often have no intention to commit those crimes and definitely—as found by a court—have limited, if any, understanding of the impact of those crimes. Again, to determine someone's income or lack of income—that is, to provide some income or none at all—based on the activity that led them to their sentence or the term they are to serve in a forensic mental health unit really flies in the face of modern understanding of mental health service delivery and the policy that is put in place around that.

When we look at the issues of cost shifting, which again probably rank No. 2 in terms of (1) saving money and (2) the ability to cost shift through this bill, the arguments are identified in the Senate report and in the additional comments provided by Labor members. It is important to understand that, while members from the government talking on this bill today are arguing that it is a relatively minor amount of money, essentially the debate in this chamber today is: who is going to pay that money? The federal government seeks to save $29½ million over the forward estimates, but there is an acknowledgement that those costs do not disappear. They do not vanish. The costs of providing accommodation, other services and reasonable living expenses for these individuals are still incurred; they are just not incurred by the federal government anymore. This bill, in a sense, really does sum up some of the major problems there have been over the last 10 to 15 years with how governments work together to deliver a seamless mental health services system for the people who need it in this country. They are the people who have a mental illness, who live with a mental illness and the families and carers who support them.

Too often we have seen completely disjointed decision making happening between state and territory and federal governments where, in most cases, the federal government will take a decision. They might announce it to the newspapers or they could just slip it in the MYEFO, as they did in this instance, and not tell anyone. The decision is taken, it is out there and then state and territory governments invariably are on the back foot, looking at what the impact is, what it means to them and where they will find the money. It has happened time and time again.

I recall opening a newspaper one morning, when we used to open the newspapers and before we swiped them, to see a decision by the Prime Minister of the time, John Howard, about putting $2.9 billion into the mental health system. It was a big announcement which was welcomed by many. They were additional resources to fund a range of services by going around state and territory governments which were delivering a lot of those services. So it was quite different from the times we live in now. I think everyone worked around that example because it meant there was more money going in and the impacts are much more severe when it is money going out.

The National Partnership Agreement on Preventive Health had money going into quite a number of early intervention mental health programs. That was gone in the first budget—I think $368 million. Then there was the $50 billion cut to hospitals. That funding does go to support acute mental health units across the country. So state and territory governments were already reeling with those kinds of cuts and then on top of that here comes another one. I image the policy makers, the advisers, the people sitting in the minister's office all thought, 'This is one we can get through. These are only 350 people who do not have a voice.' They do not have a voice because they have a chronic and serious mental health illness and they are residing in a forensic mental health unit. So they are hardly the most vocal group. You are not going to get them campaigning in the streets to retain their income support. So, 'Here we have this particularly vulnerable group. Are they being rehabilitated? Probably not, so let's take away their income.' It could slip through pretty easily. That is why it is announced in the MYEFO and not through the budget process. At the end of the day, someone is going to have to pick up the tab and it will not be the federal government. That, I think, says in a nutshell how the mental health system, at a government level, is working at the moment—that is, an announcement is made, money is removed and the other funding partner, the one which has to deal with people when they have nowhere to live or need to be integrated back into the community, they can deal with all of this because we are not the government which has responsibility.

I disagree with that. I think the federal government, the national government, does have a responsibility not only through the social security system but also as the national government of this country to care for people in this most vulnerable of groups. We know they are going to be young men who perhaps are going through their first psychotic episode with terrible consequences, we know it is going to be disproportionately Aboriginal and Torres Strait Islander people and we know it is going to be people with drug and alcohol addictions. That is the group for whom, if this bill is passed today, we will be turning off the tap. There will be no income support for them while they undertake rehabilitation. As to the government where they reside, 'Good luck with that.' And the governments where these individuals reside will have to pay, not only while people live in the forensic units or the secure mental health units but also while people are transitioning, once they are rehabilitated, into the community.

I wonder whether a social impact analysis or any other cost-benefit analysis was done for this bill because the cost of accommodating a forensic mental health patient—they are patients; they are not criminals—can exceed $1 million a year per person. So when you crunch through the numbers and have a look at them, I wonder how much money the bill will save and who it saves the money from.

This bill flies in the face of current thinking on mental health policy and planning. I note the references in the department's advice to the committee that, 'This was one of the original intentions but it was never intended for the 1986 amendment to work this way and we are making it very clear for those who have committed less serious offences,' as defined by this bill, 'to have their income protected.' So it is a good thing we are doing today by specifically including this group who are deemed to have committed not serious offences. When you look at mental health policy and planning, what actually works—read any policy document from any government, probably including the federal government's own mental health policy guidelines—is early intervention, mental health expertise in determining the policy, diversion, support programs, restorative justice, supporting people and investing in frontline workers to provide key services to people. Those are the strategies which help people with their rehabilitation, with their recovery and with their reintegration into the community.

This is also about observing people's rights. I know it is very easy to demonise this group. Many of them, in their psychotic state, have engaged in terrible crimes that hurt people. The court has a way of dealing with that but it is easy to demonise them. It is harder to paint a picture that creates understanding, care and compassion for this most vulnerable group, but that is what works in mental health planning and policy. These are the key ingredients in building up a mental health system that is going to work.

Concerning consultations with governments—and I concede again that this has been raised by submitters and I touched on it before—it is very difficult for state and territory governments to always be on the back foot when these announcements are made and where the consultation starts from the point that the decision has been made. So, 'Here is our decision and now we are going to open up discussions around it.'

I have been a part of many COAGs and many ministerial councils where that is the beginning of the discussion: 'This is what the federal government has decided. Now all of you tell us how best we implement this, because it is a bit tricky and we have not actually thought it through.' And that goes to the department's willingness to engage with what 'reintegration' means. Clearly, they have no idea on how to run that side of the implementation of this bill. They would need the state and territory governments to work with them to identify the individuals and also to make sure that, presumably, those individuals can start or recommence income support when they are released from their mental health units.

I note that the ACT government provided a submission to the bill, along with other governments and the quite eminent tribunal from New South Wales—people with experience in delivering services and understanding people with a mental illness. I do not believe there was one of them that supported the bill in all of the submissions provided. The ACT government itself sent a letter that I would probably have signed off on as well if I were in the role that I had been in, overseeing the mental health system. The ACT government raised concerns and believed that it would unfairly discriminate against and disadvantage people with a disability and people who have not been found guilty of an offence. The ACT government's concern centres on individuals suffering an immediate disadvantage associated with being deprived both of their liberty and a source of income during their confinement period.

It goes on to talk about the imposition of financial hardship upon individuals and how that will transfer those residual support costs to the states and territories. I think the submission from Queensland talk about having to find an additional $2 million , and South Australia talks about having to find an additional $1 million.

This bill fails in being able to argue around any of the public policy arguments for the rationale for this bill. I do not think that any government members have attempted to argue the public policy imperative. It is a bill designed to save $29 million, it is a bill designed to cost shift and it is a bill designed to take money away from a group that have no voice. They do not have a voice because they are the most vulnerable members of our community.

The bill is trying to diminish the impact it will have. Sure, if this bill is passed it will not stop people at the watercooler like other discussions have over the winter recess; it will not stop them. But that is exactly why the debate on this bill should be extensive, so that everyone voting on this bill today understands that for those people who have no voice in the mental health service system, and who are about to lose any income support—and I think the original intention was to have that commence on 1 July 2015—there are people who believe that this bill is unfair; that it is mean and that it is a sign of a government that is prepared to attack the most vulnerable in order to elicit modest savings. While it will make Senator Cormann's budget look a little better over the out years, the costs will still be incurred. And they will be incurred by cash-strapped state and territory governments, which are already dealing with the larger cuts that are coming from the Commonwealth in relation to health services.

This bill should not be supported today. There needs to be a lot more work done. I think there needs to be a lot more discussion around the definitions of 'serious' and 'nonserious' offences and their role in mental health policy and decisions. If this is going to be the first step into governments and parliaments forming judgements which have already been well understood around people who have little or no understanding of their behaviour—that we are now putting them into two different groups—there needs to be a clear plan in place as to how these costs will be met. And for people leaving under their reintegration into the community and how that is managed, there should be agreement reached through the Commonwealth, states and territories—before it is announced, ideally. But, now that it has been announced, how will that actually be worked through?

If you do not agree with any of those arguments: if you have the slightest interest in mental health policy and how we treat people with a mental illness in this country, then question what role this is going to have in encouraging rehabilitation for people experiencing severe and chronic mental illness across the community. I do not think that it is going to advance in one way the rehabilitation needs of this most vulnerable group. It is going to have the opposite effect, and the bill should not be supported today.