Sue Boyce (Queensland, Liberal Party) Share this | Link to this | Hansard source

I have the opportunity to follow on from Senator Polley’s contribution in this matters of public interest debate because I was intending to speak on the topic of mental health. I find it interesting that Senator Polley can talk about health and hospital reform but neglect to mention that none of that health and hospital reform inquiry or review included the topic of mental health. Apparently, mental health has nothing to do with health, according to the Labor government. It gives me no pleasure whatsoever to speak on the topic of mental health. The reason I am, and the reason that many distinguished people in this area have raised this topic in the last few weeks, is the Rudd Labor government’s complete absence of any action on, any interest in or any funding for the area.

My personal interest in mental health follows from my interest in disability. Many years ago I realised the issues that affect people with disabilities and the families and others who care for them were very similar to those that affect people with mental health problems—the sense of powerlessness; the sense that you should be grateful for the very few crumbs that drop from the table; and the sense that, if you do not make yourself fit the system, too bad, the system will punish you for not fitting in with what it suggests or offers. There is no sense of what people want and no sense of asking consumers or those who care for them what they need—just a few crumbs off the paternalistic table that people are supposed to be grateful for. The issues are very much the same in mental health as they are in disability, and it is very sad that the issues for people in the mental health area are getting worse.

One would have thought that perhaps we had finished this debate. In 2006, the Howard-Costello government moved to introduce the Personal Helpers and Mentors scheme and they introduced the Better Access to Mental Health Care scheme. For perhaps the first time, people in the mental health area had the sense that at last a government got it—a government that was prepared to meet their needs and to listen to what they wanted, not simply offer a few bureaucratic crumbs from the table. There was a sense of hope in the sector that things had started to change, that at long last the needs of people with mental health problems would be put ahead of government budgets when policy was being developed.

This year’s appointment as the Australian of the Year of Professor Patrick McGorry, an outstanding expert and advocate in the field of mental health, gave further hope that mental health would be at the forefront of the thinking not just of the Labor government but also of politicians in general. How disappointed can everybody be—and bitterly disappointed. I would like to be apolitical on this topic, but it is not possible. I think we need only go back to the comments of Professor John Mendoza last weekend when he resigned as Chair of the National Advisory Council on Mental Health. Professor Mendoza was appointed to that position by Prime Minister Rudd and the Minister for Health and Ageing, Ms Roxon. He was their handpicked person to advise them on mental health issues. So it is somewhat shocking that a very short time into his role as the Chair of the National Advisory Council on Mental Health Professor Mendoza has seen fit to resign. I quote some of the reasons that he gave for resigning:

It is now abundantly clear that there is no vision or commitment from the Rudd Government to mental health. The Rudd Government is publicly claiming credit for the increased investment in mental health when almost all of this is a consequence of the work of the Howard Government.

Professor Mendoza went on to say:

This coming financial year total spending on mental health will fall to below less than 6% of all health funding … This fall in investment simply beggars belief … The Prime Minister has clearly decided there are no votes in mental health …

The bitter disappointment those words echo is supported throughout the mental health sector. There are no votes in mental health, according to the Labor government, and there is no money for mental health. Professor Mendoza made the point that mental health funding has fallen below six per cent of all health funding this year and yet the government’s own statistics show that mental health is responsible for 13 per cent of health problems. At least 13 per cent of the healthcare burden is attributable to mental health issues and yet only six per cent of healthcare funding is going into this area.

Annually, mental illness costs the Australian economy just on $30 billion. It is the highest area of disability covered by the health budget, yet the government’s response to Professor Mendoza’s resignation has been extraordinarily disappointing for the mental health sector. ‘We wish Professor Mendoza well’ was pretty much what they said: ‘There is new funding there.’ Well, sorry, there isn’t new funding there. The increase in funding has led to an overall decrease. They put some more funds in, but only enough to half keep up with what needs to be done.

We have the situation, as Professor Mendoza outlined very clearly, that about 330 Australians who present to emergency departments with serious mental illness are turned away, and fewer than one in 15 are referred. So, if you go to an emergency department with a mental illness, you have a one in 15 chance of getting some further support for your problem. Otherwise, you are just sent home—if you have a home to be sent to. More than 1,200 Australians a year are refused admission to a public or private psychiatric unit. At least seven people die of suicide in Australia every day, and another 180 Australians attempt suicide. That is one every eight minutes. The lack of interest that this government has in this area goes on and on.

I would be the first to admit that the coalition government did not get mental health all right, but we made a good start, and the expectation was that that start would be supported and followed up. It was not; it has not been. Let us add to Professor Mendoza’s criticisms of this government and its actions the criticisms of Australian of the Year Professor Patrick McGorry. He has said:

The system is absolutely on its knees. We have a famine-like situation and the mental health system is getting the scraps from the table.

Professor McGorry said that in his view this was because mental health did not have the cachet it had five years ago.

Yes, mental health is not a ‘sexy’ area. It is not an area that is found attractive for funding. There are very few cute kiddies and dogs to have your photo taken with in the mental health area. Nevertheless, it is an extraordinarily important area, a view that was apparently shared by Minister Roxon and the Prime Minister before the last election. At the national mental health conference just before the 2007 federal election, Minister Roxon told the conference delegates that Kevin Rudd had put mental health:

… high on his personal agenda of issues.

Well, we have seen what happens to the great moral challenge of our times when it is left in the hands of Prime Minister Rudd. It is even more disappointing to see what has happened to mental health and mental health funding left in the hands of Prime Minister Kevin Rudd.

I would like to briefly talk about two of the programs that were started by the Howard government and have good support within the mental health sector but are in the process of being emasculated by this government. The first of those is the Personal Helpers and Mentors Program, which was a five-year program designed, in the end, to provide the equivalent of 900 full-time workers to assist people with mental illness with the day-to-day tasks that can become insurmountable when you have a mental illness. The program has been very successful but it is getting to the end of its five-year life. Where is the funding for the next five years? Where is the funding to extend this? Currently, only 900 workers are employed in this area. It is a capped program. There is nothing proposed to continue this. There are some small trials in other areas and a little fooling around at the edges, but a program that has been considered one of the most successful ever in the mental health area is in limbo, waiting for the government to work out what to do about the cash situation.

The other program, the Better Access initiative of the Howard government, allowed for mental health treatment plans and programs to be developed and funded through the MBS. It is quite true that there was $500 million in the Better Access program under the last government and it has now gone up to $1.1 billion. This is because the government have not worked out how to cap it. It is an entitlement program under the MBS, and it is interesting to note that since the program started in 2006 there have been more than 1.9 million GP mental health consultations through to the end of March 2010. The number of plans that were in place as at the end of March is 4,583,979. This suggests that there is a very strong need for this program. But, rather than work out how to assist this program, how to support it and how to develop it, the government are working out how to move funds and move entitlements out of this uncapped funding area into areas where they can be as stingy and parsimonious as they like with their funds. I said in Senate estimates that the fact that the funding has doubled into the Better Access program has simply been because of the popularity of the program. All this government have done is met costs. They have not put new money in or expanded the services. The response I got from a department of health public servant was: ‘The services available under the program are the same as when the program commenced.’ Great! The services are still available, but all this government can do is try to work out ways to stop them being available.

I would also like to point out that the national Mental Health Council of Australia made their assessment of the budget and the spending on mental health very early. They said:

The Rudd Government today claimed that this is a “good budget for mental health”. The Government is wrong. There is no significant increase in funding for mental health.

How many experts, people who have dedicated their lives to working in this area, do this government need to tell them that they have got it wrong before they can do a little bit better than wish Professor Mendoza ‘all the best’? The first-ever national mental health summit will be held at the University of the Sunshine Coast tomorrow and on Friday. The guest speakers will include Professor McGorry, Professor Peter Bycroft and of course Professor Mendoza. The government will not be there, I am sure, but the government must listen.