Christopher Pyne (Sturt, Liberal Party, Parliamentary Secretary to the Minister for Health and Ageing) Share this | Hansard source

I wish to talk to the chamber tonight, in this debate on the Appropriation Bill (No. 1) 2006-2007 and related bills, about some of the areas of responsibility that I have as the Parliamentary Secretary for Health and Ageing, in particular to Tony Abbott and, less so, to Senator Santo Santoro, who is the Minister for Ageing.

One of the areas for which I have particular responsibility is mental health. I am delighted that in this budget a $1.9 billion package was announced for spending in the area of mental health. I would like to range across that topic tonight in this debate, and also to talk about some of the areas of change in the budget to do with drugs, suicide, asthma and the trans-Tasman therapeutic goods agency agreement that we are coming to with New Zealand.

The issue of mental health has been a major issue for some time in Australia, since the deinstitutionalisation of the mentally ill starting in the 1960s and 1970s. Over the last 10 years in particular, mental health has become an ever-present issue for us as members of parliament—I have found this as a lower house member, and I am sure the House would agree—and, more importantly, it is a major issue in the electorate and the community, particularly for the families of those with mental illness. There seems to be a dramatic dearth of facilities and services available to the mentally ill in the community. Part of the agreement the states had when they decided to deinstitutionalise was that they would put money into community support. That did not eventuate and, tragically, I think many of the states saw the denuding of mental health facilities and services as a way of saving money, which they did. To put that in perspective, in the early 1960s, when the population of the country was 10 million, there were 30,000 acute beds available for the mentally ill; today, in 2006, less than 4,000 beds are available and yet we have 20 million people. That puts in some perspective the incredible strain on the services that are available for the mentally ill when we have double the population. So it is no surprise that in the areas of homelessness and crime, one of the trends is that people with a mental illness commit many of the crimes and are homeless. They need help and support from a health perspective rather than simply being left on the streets, as they have been in the last 10 to 20 years.

It is not a traditional area of responsibility of the Commonwealth; it is a responsibility of the states. After a great deal of debate and discussion in this country over the last few years, it has become quite obvious that the states have not stepped up to the plate, no matter how much political pressure has been applied to them. As a consequence, the Prime Minister decided that he would step forward and put $1.9 billion of Commonwealth spending on the table and ask the states to match that spending. The area of spending that the Commonwealth will be responsible for is more primary health and clinical services and some of things that we traditionally fund through Medicare. The states are responsible for acute hospital beds, prisons, crisis services and emergency services—the areas that they have been traditionally responsible for. This package does not delve into their areas, but it tries to do the Commonwealth’s part of mental health well and then calls on the states to do their part of mental health well. We are not going to take over their areas of responsibility but nor are we going to let them off the hook by simply funding, through shared agreements, areas that we know they should be doing. We are going to do our areas well and expect the states to do their areas well, which would be a nice change.

We are going to put a substantial amount of funding into mental health in four broad areas. There will be more health services in the community through supporting new Medicare benefit schedule items that will help psychiatrists and GPs have closer working relationships with psychologists. They will be able to refer to those psychologists patients who are better serviced by a psychologist than a psychiatrist. This will give psychiatrists more time to free up their books to see those patients who need to be seen by a psychiatrist. It will mean that GPs will have another option than simply referring to a psychiatrist a patient who is better seen by a psychologist. And it will better use the services of psychologists who, in the opinion of the government, have been underutilised in recent years.

There will be new non-clinical and respite services for people with mental illness, particularly provided by the non-government organisations. This will help families, carers and those with a mental illness living in the community in particular. There is a substantial investment in the mental health workforce and there will be new programs of community awareness, particularly in relation to drugs like cannabis. We are now discovering more and more that it has an incredibly deleterious effect on people’s brains, yet it has been treated in many respects as a substitute for alcohol in some communities over the years.

I will flesh out some of these measures. From November this year, the MBS items will be restructured to allow psychiatrists and GPs to refer patients to particular types of psychologists—those who have done necessary training—to be taken care of. This will cost $538 million, so it is the largest and most substantial item in the package. There will be an extra $51.7 million for rural and remote areas to ensure that there is employment of mental health nurses and that these new arrangements for GPs and psychiatrists do not bypass rural and remote areas but get to everybody in the community. There will be the creation of specialist mental health nurses in psychiatry and GP practices, costing $191.6 million, and this will dramatically reduce the burden on GP and psychiatry practices, as they will be able to employ mental health nurses to help with the day-to-day management of their clients’ needs. It is a substantial change and I think is extremely well received by the industry. It does mean the government needs to make a commitment to increasing the workforce in mental health, and for that reason we are spending money on creating 420 new specialist mental health nurses and 200 more places for clinical psychologists from next year.

In new non-clinical and respite services, there will be new funding for drug and alcohol treatment services—$73.9 million from 1 July this year. That will largely go to non-government organisations, many of which are already operating rehabilitation services, crisis care and emergency services for the mentally ill in the community. This is a substantial injection of funds for many of the organisations, which put together what resources they have and use what trained staff and volunteers they have to run services which could be better and more comprehensively run with a substantial injection of Commonwealth funds. So that is what we are doing in this package.

There will be more funding for telephone counselling and web based activities for those people who try and self-help. This will be particularly useful for teenagers who will not necessarily speak to their parents, their GPs or even their friends about concerns they might have about their mental health but are likely to access web based services and self-help. There are some very good ones that are now operating in Australia, and the funding of $56.9 million under this package from 1 July this year will support Lifeline and the Kids Help Line specifically and also web based services.

We are also expanding the National Suicide Prevention Strategy by $62 million over the next five years. To put that into perspective, over the last 10 years, the Commonwealth has spent $10 million on national suicide prevention, so this is a dramatic increase in support for the reduction of suicide in this country. Even that $10 million has made a difference to the number of suicides in Australia, which I will get to later on in this speech on the appropriation bills.

Nine hundred new personal helpers and mentors will be rolled out as part of this package to care for people in their own homes and to give people support in day-to-day living and in accessing services, such as accommodation, Centrelink services and, ambitiously—maybe some would say too ambitiously—Job Network services down the track. We are also increasing the number of places in the Personal Support Program to help people return to or stay in employment, and we are going to put $46 million into non-government services in particular to help people stay in their own homes, conduct normal lives, cook, do domestic chores—things that everybody else takes for granted—and enjoy more social interaction with the community around them. In many respects, we are doing the things that the states promised to do but never delivered on as part of deinstitutionalisation.

For young people, we are expanding the Youth Pathways project by 8,500 places, which will help young people with mental illness to stay in school and to address issues at school rather than be lost to the system. We are also putting $28 million into new programs to help parents, local communities, teachers and principals identify and respond to children at risk of mental illness.

One of the Prime Minister’s pet aspects of this package is $200 million for new respite places for carers. Too often parent and grandparent carers are stoically struggling to look after their children or grandchildren with mental illness. We are not talking necessarily about teenagers; we are talking often about adult children in their 50s and 60s being looked after by parents in their 70s and 80s and beyond. It is a tragic situation. We have all seen the stories in the newspapers of such families. One I particularly remember in Sydney was of a Chinese-Australian who took his own life and that of his child because he did not believe that his child would be looked after when he was gone. A lack of respite services provided by the states means that there is very little support for carers of people with a mental illness. This $200 million will go some way to creating 650 new respite services for perhaps a day, a few days and maybe a week to provide opportunities to recharge the batteries of carers.

There is $20 million being put into the training of front-line workers in Indigenous communities for the early assessment of mental illness and the opportunity to get Indigenous people into mental health services very early in the piece. This will train 850 Aboriginal health workers and 350 transport and administrative workers in Aboriginal communities. It will fund 25 new scholarships and 10 direct mental health workers.

I have talked about the increase in the mental health workforce. We are providing $21 million for researching the link between cannabis and mental illness and to run education programs to expose the risks that people put themselves in by using cannabis. There is the potential of exacerbating a mental illness that might be genetic but not obvious or in fact causing schizophrenia, which has been linked with cannabis very clearly through the research. Finally, we are increasing funding to Mental Health Council of Australia by $1 million over the next five years so that they can continue to monitor the work that is being done and advocate on behalf of the mentally ill.

One of my other areas of responsibility is illicit drugs. I am pleased to say that we announced $38.9 million in the budget for combating emerging trends in drug use. I am sure the shadow minister for health will be pleased about this, because while we are having great success with respect to the use of cannabis and heroin in this country, the use of illicit drugs like ice and ecstasy—psychostimulants—is growing. It is an area that we obviously need to take a particular interest in. So about $40 million will go some way to helping front-line workers research the use of these drugs to try to combat the scourge that they are, particularly to young people. It will also help fund the continuing national drugs education campaign.

A new aspect of the budget is $19.8 million for university counsellors on university campuses to address drug issues and alcohol misuse at the university campus level. This gives counsellors access to many hundreds of thousands of undergraduate and postgraduate students for the early prevention of the abuse of drugs and alcohol and where possible to identify mental illness at an early stage so it can be treated. We are also establishing a National Cannabis Control and Prevention Centre for $14½ million to do a whole raft of tasks—to coordinate research, to coordinate campaigns and to provide a focus particularly for highlighting the links between cannabis and mental illness and to shine a light on cannabis in a way that has not been done in the past.

I have already talked about the substantial increase in funding for suicide prevention in the budget. Although every suicide is a great tragedy, over the last 10 years there has been a quite dramatic drop in the number of suicides in this country. The rate has dropped by 23 per cent since 1997, when the number of registered suicides was 2,720. In 2004, there were 2,098 suicides registered. That is a dramatic drop in the number of suicides in Australia. Particularly amongst young people the statistics are very encouraging. We have obviously particularly targeted young people as part of the National Suicide Prevention Strategy. In 1997, youth suicide peaked at 509 deaths. In 2004, that dropped to 265 deaths. It almost halved in that period of time. I am sure the issue of suicide prevention is a bipartisan one in politics in Australia. All sides would welcome the obvious impact that the government’s strategy is having on reducing suicide.

There are three other areas of my portfolio responsibilities that I would like to touch on briefly. The national priority of dealing with asthma is having some impact after some years of putting resources into trying to reduce the prevalence of asthma. The death rate attributable to asthma has significantly declined since its peak in 1989. In 1989 there were 736 deaths from asthma and in 2004 there were 311 deaths attributable to asthma. When government turns its attention dramatically to an area, puts resources into it, puts together a plan and work with GPs, schools and others to roll out programs, it can have an impact. To have more than halved the number of deaths attributable to asthma is a great achievement, and that has occurred under both Labor and Liberal governments.

As part of the budget, we also pledged $5 million to a new industry project called DrinkWise. As part of the alcohol industry’s attempt to reduce the abuse of alcohol, they have established with the community an organisation called DrinkWise, and we have pledged $5 million to DrinkWise. People involved in alcohol are part of the board of DrinkWise—Distilled Spirits Industry Council of Australia, or DSICA; the Winemakers Federation; the Australian Associated Brewers; and companies like Lion Nathan. The board is made up of representatives of both the alcohol industry and the community. People such as John Saunders, Peter McCarthy, John Dwyer, Father Chris Riley, and Trish Worth, the former member for Adelaide, are members of the board of DrinkWise. It is a genuine attempt by the alcohol industry to address concerns and to make a difference with respect to the abuse of alcohol in the community. I welcome that, and I am delighted to have been able to deliver a substantial injection of funds into that organisation to give it an opportunity to start making a real difference in the community.

Finally, one other area of responsibility I have as the parliamentary secretary is the trans-Tasman therapeutic goods agency agreement with New Zealand. I am happy to say that we are making great progress in bringing the TGA in Australia and Medsafe in New Zealand together to form the first trans-Tasman regulatory agency. I am very confident that it will be up and running by September 2007, or the second half of 2007. We have very recently publicised the rules that would go with such a joint regulatory agency for industry consultation. Industry consultation is very important as part of this process, because it will be up to the industry to implement the quite complicated arrangements for a trans-Tasman regulatory agency. It will be a template for arrangements for other regulatory agencies of its kind between New Zealand and Australia. I am delighted that Annette King, the New Zealand Minister of State Services, and I have been able to continue what has at times been a tricky negotiation process but one that does seem to be reaching an important period of fruition. I am sure the industry and consumers will be the better for it. I thank the chamber.

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