Mark Butler (Port Adelaide, Australian Labor Party, Minister for Mental Health and Ageing) Share this | Hansard source

I thank the shadow minister for his question, in many parts. I think I got them all down and I will try to deal with them all, but not necessarily in the same order he did. Can I deal, firstly, with the government's reforms in relation to EPPIC? The EPPIC model has existed for almost 20 years and, as members would know, it was initiated by former Australian of the Year Patrick McGorry and has operated in western Melbourne since about 1991 or 1992. It has never previously received Commonwealth government funding and support. In all of the 11 or 12 years of the Howard government, the EPPIC model did not receive Commonwealth government support.

It was this government, in the 2010 budget, which, for the first time, indicated that it would provide direct funding to an expansion of the EPPIC model beyond Victoria, which is where the only EPPIC model—certainly, with fidelity to Patrick McGorry's model—operates. That was a recommendation from the Health and Hospitals Reform Commission, chaired by Christine Bennett, and funding was provided in the 2010 budget for up to, I think, four additional EPPICs, based on cost sharing with the states: 60 per cent Commonwealth, 40 per cent states. As the shadow minister would know, that was then the cost-sharing arrangement for acute care included within the National Health and Hospitals Agreement, concluded in April. This current budget adopts a different proposal based on the varied arrangement agreed by the states and territories and the Commonwealth in February, which is that there be a fifty-fifty cost-sharing arrangement. The money included in the 2011 budget is for 16 centres to be rolled out across Australia based on a fifty-fifty cost-sharing arrangement with the states. Obviously that is something we have started to talk to states about but we have not yet got agreement. If we get no input from states, the Commonwealth will proceed to roll out eight centres fully funded by the Commonwealth, and the costing arrangements are based on advice that Patrick McGorry's organisation, Origin, has provided to the department since the 2010 budget measures. That work, as well as ongoing discussions with the states about the degree to which they have an in-principle interest, as opposed to a financial commitment, has meant that none of the four EPIC centres that were contemplated in the 2010 budget have yet been rolled out. Correspondence that I sent to the states in late 2010—after being appointed the Minister for Mental Health and Ageing—asking for their indications of interest in this model elicited a very positive response. Obviously, since the 2011 budget we have started to have more substantive discussions with them about that.

The Better Access program that was initiated by the former government in about 2006 was the subject of a comprehensive evaluation that was received by me over the few months leading into the budget. The evaluation showed that the Better Access scheme had improved the level of access to treatment, particularly for people with high prevalence, mild to moderate disorders, and that there had been a reasonably positive outcome for consumers. It also showed that there was a very differential distribution across the community. It cut a number of ways, but the most stark and obvious way was that different quintiles, by socioeconomic status in the community, received very different levels of service. In 2009, for example, the richest quintile of Australians received 2½ times the number of services, attracting three times the amount of Medicare dollars compared with the poorest quintile of Australians. The difference between service numbers and Medicare dollars reflects that those in the highest quintile disproportionately received services from psychiatrists and clinical psychologists. We decided that we needed to take a look at that program to see whether or not there were ways in which we could redirect funding from that program, which is still projected to grow significantly, into more targeted primary care. One of the ways we have done that by reducing GP rebates for mental health treatment plans back down to a standard time-based formula, still with a 27 per cent premium for those doctors who have done their six to eight hours of mental health skills training, which is about three-quarters of them at the last analysis.

I will take the other questions on notice about particular staffing numbers for the three authorities that the shadow minister identified.

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