Claire Moore (Queensland, Australian Labor Party) Share this | Hansard source

It is important that we have a discussion about mental health in this place. I share the view that we need ongoing discussion and consideration of the very important issue of mental health. I do want to take issue with Senator Fierravanti-Wells, though. To begin her contribution by implying that our government has not given due respect or consideration to the wonderful work of the Australian of the Year, who was appointed this year by this government, was an unnecessary attack, Senator Fierravanti-Wells, through you, Mr Acting Deputy President. When it comes to disagreeing on politics, we absolutely do, but it is wrong to make that kind of implication about a man who has genuine respect. We acknowledge that his role is to keep the issue of mental health on the agenda and keep the debate strong and informed. No-one can question the important role that he has had for over 20 years. This engagement with Professor McGorry has not occurred just in the last year while he has had the title of Australian of the Year. It has been going on for over 20 years and probably longer. Those of us who have been involved in all of the Senate committee activities around mental health know that his work has been absolutely inspirational. The questions he raises and the points he makes are important and necessary in any discussion of public policy. I just thought I would make a quiet comment about that.

It disappoints me that, having had the opportunity to look at the very serious issues around mental health, the opposition has yet again come up with the standing order 75 approach of going for the cheap political shot rather than looking at the facts and building effective arguments. Oh, no, it is a chance for people to vent their spleen and talk about policy failures. In many ways—and I have said it before, Mr Acting Deputy President—it is a case of ‘my policy is bigger than your policy’. That cuts across the importance of these issues. There is no doubt that mental health is an important issue. The government has asserted that and committed to ensuring that, during its second term, it will be the major priority for the government. That is on record.

The largest single contribution in historical terms to the area of mental health was begun in 2006. However, in its response to the report of the Senate Select Committee on Mental Health and during the following reforms, the then Howard government—with Mr Abbott as the Minister for Health and Ageing—never at any time acknowledged that the Senate committee report into mental health had impacted on the decisions they made. When you see the initiatives that emerged, obviously there was some awareness of the work that had been done for well over 12 months by the committee, which was set up in good faith from all sides of this parliament. It was the first time that mental health was given the priority it should have had.

Towards the end of the then Liberal-National government, they brought forward a mental health package and COAG initiatives which are the basis of mental health policy in Australia to this day. The important element of the 2006 reform was to ensure that the COAG commitment was locked in, because mental health services in this country are shared between the Commonwealth government and state governments. As you well know, Mr Acting Deputy President Marshall, when you are talking about the provision of services, you need to lock in the COAG process so that the commitment is met. In this case that commitment was included in a range of areas of public policy and health policy in the 2006 period.

I want to remind people who are concerned about this issue that during the 11 years of the Howard Liberal-National government there was the same community pressure, the same outrage, around issues of mental health. Through you, Mr Acting Deputy President, regarding Senator Fierravanti-Wells’s arguments about what governments should do and the need to listen and be concerned, if you care to turn to any of the papers that were written during 2006-07 by the Mental Health Council of Australia and the Senate committee, you will see that the same issues were raised. The then government, a government that at that time had had 10 years to consider its policy, had not moved on mental health. We do acknowledge that the 2006 reforms began at that point—it was an important moment for our country. That government had about 12 months to work with it and then the new government came in. We are celebrating that today. This is the third anniversary of the new Labor government.

We hear this feigned outrage, for political purposes, by the opposition about the lack of movement on mental health. Look at the time frame. We need to move and develop effective policy, but to lay all the blame on a Labor government—to suggest it was all the fault of this government for not taking action quickly enough in that period—is just not accurate. It does not mean that there should not be action. We need to act and ensure that we take note of the information we have. Senator Fierravanti-Wells, through you, Mr Acting Deputy President: I agree with the fact that there is evidence about the need to act on mental health. No-one denies that. There is real evidence, though, that you must not respond to just one element of a very complex area. This has always been an issue for governments. This is an extraordinarily difficult area of health policy, because mental health affects so many people at every stage of their lives; it involves all kinds of age groups and needs. When you are considering a mental health response, it needs to be coordinated and it needs to address the needs of so many people in the community. At times, there tends to be a form of division or competition that sets up one form of need against others. That is exactly what this government is attempting to avoid.

I was pleased to hear the very strong arguments that were had during this year’s election campaign. Until this year, I had not heard debates around mental health in any election program. I think it is important that these issues are raised and policies are developed. But what we had leading up to the last election and have had subsequently both in this place and in the House of Representatives is an argument about a particular form of investment that should happen in mental health. I think it is good to have the argument, but the expenditure that has been so proudly put forward by the opposition in motions in this place and in the House of Representatives looks at one segment of mental health need and demands that that is funded immediately. That expenditure needs to be looked at within the whole complex need of health expenditure and policy.

What this government and I do not want is further debate and conflict about whose need is greatest. The way the political argument has been run has been that if we cut money from a number of areas, the money could be directed towards youth mental health, an extraordinarily important area and the basis of this motion. That certainly has not been widely debated by the opposition but, when you look at the election process, that was clearly in their funding program. The money that was going to be directed to youth mental health was going to be funded at the expense of a whole range of other health commitments made by the government. So immediately there is this issue of divide and change. That does not move us forward. That certainly does not let the government off the hook regarding the need to look at budgetary expenditure in the future and to look at the very real needs of the whole mental health area.

To actually say, ‘You must spend your money in this way and not spend it on other things,’ and create that division does not respond to the recommendations of the 2006 Senate select committee report on mental health or the subsequent reports we have done on the ongoing need in the area. We need a coordinated and well-resourced response to all the issues, and our government has started that. We need to do more. No-one has tried to hide from that point. When you hear the opposition rhetoric it is as though suddenly in 2007 all expenditure on mental health needs ceased. That is not true. I am not going to run through all the different elements of funding because that gets back to my statement about ‘mine is bigger than yours’. Basically what we need to do is ensure that we see what the needs are and listen across the board to the community—not just selectively pick the people with whom we wish to have discussions but talk across the board to the people who really know and who are always so willing to talk to government.

We have put the first dedicated minister into this area. It was long overdue. Governments should have done this before, but now we have a dedicated Minister for Mental Health and Ageing in our government. That minister, Minister Butler, quite rightly is informing himself on the key issues and listening to people. It is not some kind of ‘I’m going out there telling you what should happen’ tour; it is actually a genuine attempt to listen to people across the country—not just in capital cities; not just at set-up meetings—about their needs on mental health. That is an appropriate mechanism.

Senator Fierravanti-Wells concentrated on the photographic opportunities. I did take a quick glance at Fierravanti-Wells’s website and found that she is not averse to a photo opportunity herself. That is quite reasonable. I think everybody likes to be seen out doing their job. But it is a cheap shot to say that the only reason people listen to and work in the community is to get a flattering photograph. To begin with, they are not all that flattering. Also, you would not have any interaction if you were frightened that you could somehow be represented as taking an opportunistic approach rather than fulfilling a genuine need to consult.

As I have said, the need to have a response to mental health in our health policy and in our general policy is important. The way that this motion was phrased was once again saying that somehow the work in the hospital reform area was not effectively responding to people’s need in public health. That, again, is a real danger. By representing that mental health issues are not general health issues as well, you are dividing people and you are withdrawing need. The government’s position is that in order to reform the way the public hospital system operates and the way the management and the engagement of local communities will operate in the new health reform process, we must engage and involve mental health practitioners and consumers. We cannot have a silo approach that mental health is only to do with one segment of health and is not part of the whole health program.

Our reforms within the public hospital system and also within the regional process across the country are designed to have people’s health needs addressed. That includes—and must include—mental health. We want to develop a coordinated response which makes sure that mental health is part of the major health initiative—not somewhere off to the side, not somewhere where people are a little bit ashamed to identify that that is their area, but a core health issue.

The attempt to say that the hospital system is somehow a different issue to mental health needs is just not real. One element of our response to mental health is to ensure that the hospital system is appropriate and responsive to the needs—that when people need a bed in a hospital it will be available. One of the core aspects of the discussions we have had in the mental health area for many years is that the ‘medicalisation’ model—the hospital and medical response to these issues—is but one element of the needed response. People who know this area—consumers, carers and practitioners—must be involved in the discussions and involved in the response. Into the future, in the hospital reforms in the new Medicare Locals, the issues around mental health will be part of that—again, not a contest but a genuine response from all the community to the community’s needs.

We need to continue to have this discussion about mental health. All too rarely do we have the chance to gather and share knowledge and to listen to people like Patrick McGorry—who, when he is no longer the 2010 Australian of the Year, will continue to be important in any ongoing development of public policy around mental health. So we do not just have that small window of opportunity. I think the real value has been the way the community has listened and the way he has been available to get that message across.

The government is committed to ensuring that there is effective action on mental health. We maintained expenditure on core aspects through the first three years of the 2007 government and into the first year of the 2010 government. There is a commitment that we have to work across the board to look at a genuine response—and that will occur. But it will not be a divide, conquer and combat approach; it must be a coordinated response.