Jenny Macklin (Jagajaga, Australian Labor Party, Shadow Minister for Families and Payments) Share this | Hansard source

I am speaking today on the Social Services Legislation Amendment Bill 2015. This bill will take income support payments away from people in psychiatric confinement who are charged with a serious offence and who are undergoing a course of rehabilitation. Since 1986, legislation has provided that a person undergoing psychiatric confinement who is undertaking a course of rehabilitation can receive income support payments. They are people who have been found to be suffering very serious mental health issues like schizophrenia; bipolar disorder; intellectual disabilities; acquired brain injuries from a car, sporting accident or a stroke; and other conditions that impair mental functioning.

The people impacted by this measure will have been charged with serious offences, which is why any change to the arrangements for people in psychiatric confinement needs to be properly considered. Any change should be based on extensive consultation and debated sensitively. Unfortunately, the government has not consulted on the changes in this bill prior to its announcement. The government did not speak to the patients who may be impacted by these measures, to their families or to their carers. They did not speak to the mental health advocacy organisations or to state and territory governments. They did not speak to the psychiatric institutions that provide the care.

Little has changed since the announcement. No genuine effort has been made to communicate this decision to make sure that those impacted by the measure are aware of the change and can prepare accordingly. The government has left mental health services to communicate with patients, families and carers. This is just not good enough. A proper process of consultation is needed for such a complex, sensitive and serious matter.

Today's consideration of the bill pre-empts the findings of a Senate inquiry. A public hearing as part of that inquiry was held only last week. There have been 26 written submissions to the inquiry, and not one of these submissions is in support for this bill. Minister Morrison's own department's submission provides no justification for the bill, no evidence to suggest that these measures will assist in the rehabilitation of people in psychiatric confinement.

The Victorian government has written expressing their opposition and concern about the bill. The Queensland government provided a submission opposing this bill. The Queensland Office of the Public Advocate opposes the bill. The New South Wales Mental Health Review Tribunal opposes the bill.

Given the seriousness of the measure and given the government's lack of consultation on the bill, Labor wants to see the Senate inquiry properly consider this measure and its potential impacts before determining a way forward and any amendments that may be needed.

On the face of it, this bill is another attempt to pass costs on to the states and to the most vulnerable. In last year's budget, the government announced a cut of $80 billion to school and hospital funding for state and territory governments. We understand that patients in psychiatric confinement use their income support payments to pay for their clothing, toiletries and other personal items. The removal of all income support for these patients will leave this very vulnerable group with no means to meet basic living needs not provided by a psychiatric institution.

In some cases, patients may use their income support payment to contribute to other costs of their care and accommodation. In Queensland, for example, a fee of $40 per day is applied to patients in psychiatric confinement. The fee helps the Queensland government meet the costs of a patient's accommodation and care. This fee also helps the patient learn budgeting skills as part of their rehabilitation. The Queensland government estimates around $850 will be lost per patient per fortnight. Queensland estimates an increased cost of $150,000 a week in meeting this payment for patients who may lose income support payments as a result of this bill. This is yet another example of how the bill shifts the cost burden of care to patients' families and carers, and state and territory governments. It is yet another example of cost shifting by this government.

Submissions to the Senate inquiry suggest the bill will undermine the rehabilitation efforts of people in psychiatric confinement. The discharge process is often very gradual. Training, employment and other community links are put in place whilst a patient is in psychiatric confinement to help ensure a successful transition at the time of discharge. Access to income support is crucial to establishing these links. Patients self-fund their external rehabilitation activities, transport to attend these activities and any supplies required to carry them out. Patients fund these activities from their income support payments. The cost of accessing general health care and purchasing medications in the community is met by the patient, with concessions from their health care card. Access to income support is also essential for patients to secure and maintain the community accommodation they need in order to be granted leave and eventually be discharged.

The proposals in the bill suggest income support payments will not be made available to a patient charged with a serious offence until they have been granted three nights per week of overnight leave. In Victoria, that is the maximum amount of leave that is able to be granted by a psychiatric institution. The rehabilitation and leave system relies on gradual progress to make sure that recovery and risk are safely managed for the person and the community, increasing the amount of leave granted as it is safe and appropriate to do so. Without income, patients will not be able to access the accommodation necessary to commence overnight leave as part of their rehabilitation program. The Chair of the National Mental Health Commission, Professor Allan Fels, sums up these issues in the commission's submission to the Senate inquiry. He says:

Once again, this is why further and comprehensive consultation on this measure is so important.

This bill will see people in psychiatric confinement charged with a serious crime treated the same way as a person in jail who has been charged with or convicted of an offence. It is right that social security payments may not be paid to a person detained in prison. However, there is a significant difference between people in psychiatric confinement charged with an offence who, because of a mental impairment, are not found criminally responsible for their actions and people in prison who are responsible for their actions.

There needs to be further consideration of and consultation on this bill. Labor will look very closely at the recommendations of the Senate inquiry and the submissions that have been made. We call on the government to consult in detail with the people who will be affected by this bill, advocates representing people with mental illness, families and carers, and state and territory governments before this measure proceeds any further.

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