Gavin Marshall (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

The President has received a letter from Senator Fifield proposing that a definite matter of public importance be submitted to the Senate for discussion, namely:

The Gillard Government’s failure to properly fund mental health services, increasing pressure on public hospitals and emergency departments and leaving hundreds of thousands of Australian with mental health illnesses untreated.

I call upon those senators who approve of the proposed discussion to rise in their places.

More than the number of senators required by the standing orders having risen in their places—

The Acting Deputy President:

I understand that informal arrangements have been made to allocate specific times to each of the speakers in today’s debate. With the concurrence of the Senate, I shall ask the clerks to set the clock accordingly.

Concetta Fierravanti-Wells (NSW, Liberal Party, Shadow Minister for Ageing) Share this | Link to this | Hansard source

On the third anniversary of Labor coming to power, it is timely that we talk about mental health, because it has been one of the biggest failures of this government. There were two areas—mental health and ageing—in the Labor government’s grand hospital plans that were grossly neglected and omitted. I will comment on ageing at another time, but today’s matter of public importance is mental health.

I am pleased that the Senate is considering this today, because we are on the eve of a vote in the House tomorrow on an important motion on mental health. Here in the Senate we saw my motion on the subject of mental health passed on 26 October, and I am very pleased that that motion was supported by Senator Xenophon and Senator Fielding, both of whom I thank. Sadly, both Labor and the Greens opposed that motion despite their bleating about the need to take action on mental health.

Last week in Canberra the Australian of the Year, Professor Pat McGorry, told members and senators that the coalition’s motion on mental health should be supported. As I said, a vote on a motion on mental health is coming up tomorrow in the House and, despite Labor’s having voted against putting it to a vote last week and the Speaker’s having exercised his casting vote in favour of Labor, it is vitally important that that motion be passed tomorrow. This government must be counting the days until the game is changed so that there is an Australian of the Year who causes them less pain and puts them under less scrutiny.

I wish to pay tribute to Professor McGorry. He has been an outstanding Australian of the Year. He has brought attention to an issue that affects so many Australians and he has used his time to push this very important barrow, a barrow that can save our economy many millions of dollars in treating mental health before it grips a person into a lifelong spiral.

It is a false economy not to fund mental health properly as we will all pay through the cost of suicide and other mental health issues. Six Australians die from suicide every day. Costs related to mental health issues include the costs of policing, emergency hospital admissions, road accidents, unemployment, family dysfunction and other sad outcomes of mental health. As Professor Mendoza, the former chair of the government’s own National Advisory Council on Mental Health—who resigned so spectacularly in disgust at this government’s lack of action on mental health—said last week:

It is a moral imperative that we actually make the investment in mental health services and that there is parity in terms of access to care, to quality of care that people can expect if they have a mental health condition as we would all expect when we have a common physical health disorder.

At the moment those who have mental health problems really are getting a second- or third-rate health system. He continues that as a society—and I quote:

We would not tolerate young men having treatment rates of 13 per cent for testicular cancer ... yet that’s the rate of care for young men 16 to 24 in Australia for mental health problems.

This government has been well-informed—more informed than any other—about the state of mental health services in Australia. Since its election in 2007, major mental health reforms have been identified through inquiries and commissions. On 25 February 2008, we had the National Health and Hospital Reform Commission; in its final report it contained 12 recommendations for reforming mental health. In September 2008, we had the Senate Standing Committee on Community Affairs; its report, Towards recovery: mental health services in Australia, contained 26 recommendations. On 24 June this year, we had the report of the Senate Community Affairs References Committee, titled Hidden toll: suicide in Australia. In November 2009, the National Advisory Council on Mental Health released a discussion paper titled A mentally healthy future for all Australians, containing seven priority areas with 22 program investments. So this government has been well informed.

What are we now seeing? Despite all this, this government is being true to form. After all the work that was done by the National Health and Hospital Reform Commission, the government had to go out and do its own further investigations. That is when we saw Dr Rudd and Nurse Roxon out in the hospitals with the white coats and the picture opportunities that could be then put on MyHealth and MyHospital websites.

Carol Brown (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

Mr Acting Deputy President, on a point of order: can you remind the senator that she should use the correct titles of members in the other house.

Gavin Marshall (Victoria, Australian Labor Party) Share this | Link to this | Hansard source

Thank you, Senator Brown. That is quite correct, and I ask you, Senator Fierravanti-Wells to refer to members with proper respect.

Concetta Fierravanti-Wells (NSW, Liberal Party, Shadow Minister for Ageing) Share this | Link to this | Hansard source

Despite all this information, despite all these reviews, despite all these recommendations that have been put forward, despite the work that has been done by Professor McGorry, despite the work that has been done by Professor Mendoza, and despite the raft of information that is out there in the public arena calling on this government to act on this vitally important issue for Australians, Minister Butler is going out on his own tour. He is off to capital and regional centres to talk again. For goodness sake, Minister, stop and listen to what has already been said to you. This is just another way that this government fobs things off, just like it fobbed off aged care to the Productivity Commission and has not done anything for three or four years. Now we are seeing another instance of just fobbing things off. The minister is going off to consult again—just for the photo opportunities—and I am sure that we will be seeing the photos on some government website. It is not the lack of information that has paralysed the Rudd-Gillard government; it is the lack of guts to face a major health problem, and this government should be mightily ashamed of this.

What is the extent of this problem? Mental illness affects more Australians than almost all other health disorders; only cancer and heart disease impact more people. Almost half the population will experience a mental health disorder at some point in time. One in five Australians are waiting for this government to get off their backside and do something about mental health. Thirteen per cent of the total burden of disease in Australia is in mental health and only six per cent of the health budget is spent. A staggering 65 per cent of sufferers battle their disorder alone or only with the help of family. There is a prevalence of mental health in our young people. The coalition, with its $1.5 billion policy—which was the subject of a motion passed by this Senate, which hopefully will be passed by the lower house tomorrow—ought to shame this government into doing something about mental health. We all know that delay in accessing appropriate treatment is damaging not only for young people but for people of all ages.

The coalition’s $1.5 billion plan for mental health is a follow-on to the $1.9 billion that was invested in mental health—the biggest ever and the first of its size—when Tony Abbott was minister for health. What did Labor do when they came to power? They have been cutting the budget of some of these programs that were so successful under the coalition. When I speak to mental health experts, whether it is the not-for-profits or the various organisations that operate in this sphere, they are all telling me the same thing. They are constantly complaining that this government is cutting funding to them in this vitally important area.

As I stated, mental health was omitted from the COAG grand plan. One only has to look at the evidence produced at the Senate inquiry that was so scathing about the government’s lack of action on mental health—whether it was the Royal College of Psychiatrists, Professor McGorry, the Mental Health Council of Australia or the Australian College of Mental Health Nurses. As Professor McGorry said, we have a hidden waiting list of Australians needing mental health services, including three-quarters of a million young Australians. They need help and they need it now.

Claire Moore (Queensland, Australian Labor Party) Share this | Link to 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.

Rachel Siewert (WA, Australian Greens) Share this | Link to this | Hansard source

I tend to agree with the essence of this debate, and that is that the Gillard government has failed to properly fund mental health services. While I agree with the fact that we have not been funding our mental health services adequately, I cannot support this particular motion, because of the antics of the opposition. The opposition put a motion to this chamber about one specific aspect of mental health. It does not take a comprehensive approach in addressing mental health. As health spokesperson for the Greens, I have a particular passion for issues around mental health. I chaired the inquiry into suicide in Australia and that heightened my awareness around issues of mental health. I have consulted widely. I understand that our mental health services are significantly underfunded in this country.

The Senate has had two previous inquiries into mental health. One of the findings of those inquiries was that we need to have around 10 per cent of our health budget expenditure going to mental health. That puts Australia’s investment behind by about $5 billion a year for mental health. I am a realist and know that we are not going to catch up to that investment of $5 billion overnight. In fact, the Senate committee report on this said that you would need to phase in the investment over a five-year period. That has not happened. We are having this debate in the context of significantly underfunding our mental health investment.

I learnt many things in the consultation process. One of those things is the need for a comprehensive approach in dealing with mental health. I also learnt that early intervention is absolutely essential. Headspace and EPPIC—early intervention centres—are absolutely critical. The Greens fully support those centres, but they are not the solution to everything. They are not the silver bullet that we have been looking for. For example, there are younger people with mental health illness. Headspace says it deals with people between the ages of, say, 12 and 25. In reality, at the moment they are dealing with people between the ages of 18 and 25. So, for a start, those in their very early teenage years need some support. We need to invest in the primary school and early high school years. Of course, a lot of people in Australia over the age of 25 have mental health illness. We need to take a comprehensive approach. What we are saying is that those people will not get any additional services. We know they are missing out. I think it is the case that one in four people in Australia with a mental illness get some sort of support. What we are saying is that those people do not deserve any additional funding.

We know we need better primary healthcare services. We need better access to GPs for mental health issues. We absolutely know that when people go into an emergency department, having attempted suicide or threatening to attempt suicide, they need to see someone with mental health expertise. We also know that in this country very few emergency departments have somebody with mental health experience on call 24 hours a day. Quite often people go to an emergency department and then go home either not treated or inadequately treated, and we know people attempt suicide after that. So we know that we need to invest in that area. We know that people coming out of psychiatric care, having been admitted to hospital, absolutely need to be followed up, and we know that people are not being followed up. We know that we need to invest in that area. We absolutely know that we need more step-up, step-down accommodation. We know that we need more mobile support services. We know that we need to invest more in dealing with mental health issues in Aboriginal communities, and that requires a significant level of investment.

The Liberals brought in a motion, which they admitted in this chamber was just their policy. Essentially, their policy was purely about early intervention. The Greens asked the Liberals to give us a costing so that we could look at whether they intended to spend virtually all future investment in headspace, but we did not receive that. When we wanted to amend the motion, there was no agreement. In this chamber I was told to look at Liberal Party policy. So, in other words, the opposition just tried to bulldoze through their policy instead of taking a much more a cooperative approach and looking at how we can seriously address mental health in this country. We could take a more cooperative approach in this place, which is what the Senate has done in the past. We have taken a cross-party approach to mental health, which has been demonstrated by the good work that has been done through the Senate committee process. That has been thrown out to take a purely political approach so that they can—as Senator Moore said—get a few photos on websites, get a few media grabs around mental health and bash up the government and the Greens because we are taking a much more comprehensive approach.

Also, we have altered our approach. We suggested increasing the level of investment in early intervention as well as putting investment into primary health care, which we know is absolutely essential, and into emergency services, which we know is absolutely essential. We suggested a special commission for mental health because we believe this issue is so significant that it needs it. We took to the election the suggestion of putting in place a minister responsible for mental health, and we are glad the government picked that up. We think that is a very good step in the right direction. What we need to do now is see the government’s commitment to mental health. We need to see their investment. We agree with the opposition that we need to significantly increase investment in mental health. There is absolutely no disagreement there.

We do need to be very careful about where we increase that level of investment. We are not going to get the absolute level of investment that we need over the next 12 months or even the next two or three years, so we need to be constructing and focusing our investment on where it is going to meet need. We have absolutely no doubt that early intervention is critical, but we need to take a much broader approach. Yes, there has been a high-profile campaign about early intervention, and that is fantastic because it has focused the public’s attention on the need to address mental health issues. But we cannot invest just in early intervention. And do you know what? I have had so many emails, so many phone calls and so many personal visits where people have said: ‘Please don’t invest just in early intervention. Yes, that’s essential, but we need all these community services. We need community care services and we need better investment in rural and regional areas. If you focus just on early intervention, all those other people will not have their needs met.’ And we know what happens then; people get sicker. We know that homelessness can result from that. We know there are all sorts of consequences if we do not provide the services and support needed to support people through mental illness.

So my plea here to the government is: please invest in the level of resources we need. The Greens went to the election saying we needed an investment of at least $350 million a year. We actually agree with the opposition that it needs to be more, so we have said it should be $450 million a year—but not just on early intervention. We think you can have your cake and eat it too, which is why I beg the opposition to consider our amendments. The costings that have been put forward for the building of the number of headspace and EPIC centres it is estimated we need has to be phased in anyway, so we can phase in investment in headspace and EPIC—and there are other methods of early intervention besides headspace and EPIC. They are very good, but there are others. But we also need to invest in younger children and we need to invest in the over-25s. We can do that and invest in these other programs.

What I am really worried about is that if we just say ‘early intervention’, the government have a ticket to just go: ‘Yes, we’ve invested in mental health; we funded a few extra headspace and EPIC centres. That’s it, we’ve done mental health.’ And they will not have fixed mental health. So, please, let us take a coordinated, comprehensive approach to funding mental health and invest in the services that are desperately needed, not just early intervention. I do not want anyone thinking that we do not support early intervention, because we do. But it has to be part of a comprehensive approach to mental health funding, not a knee-jerk reaction because it is popular at the moment. We need a much more comprehensive approach, and the government need to fund that. We do agree with that part of the motion.

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

I think it is quite fitting that we are having this matter of public importance debate on mental health today. It is the same day on which we earlier moved a motion supporting and celebrating the work of the volunteers of Australia—recognising that International Volunteer Day will be on 5 December this year—because volunteers are often the people who have kept our mental health system functioning, for years and years. I would like to recognise the work of not just the higher profile people, such as Professor McGorry and Professor John Mendoza, and the many other people who are paid, such as those within the Mental Health Council of Australia and those in the member organisations of the Queensland Alliance, but also the thousands and thousands of volunteers. Many of them have been parents and carers, and have toiled for years and years, sometimes actually being opposed by their state governments over the sort of care and assistance that they wanted to have delivered to their spouses, their children and their siblings. It has been very hard work for many of them.

I think the first glimmer of hope that that group experienced was through the policies of the Howard government, when we funded the Personal Helpers and Mentors Scheme, PHaMs, and when we funded GPs to develop mental health management plans for patients who require them. That was the first glimmer of hope. I think the appointment of Professor Pat McGorry as Australian of the Year provided yet another glimmer of hope. Hopes were certainly raised that, finally, mental health was on the agenda and that, given Professor McGorry had been appointed to that position under a Labor government, Labor were serious about doing something about the mental health situation.

Unfortunately, earlier this year we had the resignation of Professor John Mendoza from the National Advisory Council on Mental Health—Minister Roxon’s advisory council. In another context, Professor Mendoza has talked of governments ‘low in courage’. I do not think I would be verballing Professor Mendoza in any way by saying that the reason he quit that job was that he found the Labor government ‘low in courage’ in terms of developing and genuinely supporting mental health funding. What we saw instead was artifice. They talk the talk, but that is the end of it from this Labor government. I guess we should not have been surprised, but the hopes of thousands and thousands of professionals, volunteers and carers in this sector were cruelly dashed, in my view.

Senator Siewert earlier talked about the Greens being in favour of early intervention but not just early intervention in this area. Could I turn that around and say that the coalition agree completely. We are in favour of not just early intervention. However, it is our funding of programs that has given the government their ability to boast about the spending that they have put into the area. For instance, it is very interesting that they boast about how much they have spent, compared to the Howard government—of course, they pick the figures that suit them—but the fact is that every one of the mental health programs that are currently funded by this government is an initiative or funding commitment from the Howard government. There is only $43½ million that they have put into ideas and thoughts for themselves over their life as a Labor government.

So it is appalling that the government would attempt to use the figures to suggest that somehow we have not supported a broad funding of this complex area and the many other areas that need to be funded. They have been funded. The two programs that I mentioned earlier—the PHaMS program and the program through GPs—are not aimed at any particular age group; they are aimed to help all people.

I must admit I was somewhat bemused by Senator Moore’s suggestion that people on this side might have been feigning outrage or making cheap political shots on this subject. I would like to suggest that when she talked about this motion and tried to distil it down to some sort of political act her views were wrong. This motion is not informed just by the views of the coalition; it is informed by the views of many others in the mental health area, who make the point over and over again—it is in the motion—that younger Australians between 16 and 24 bear the brunt of mental illness, with the prevalence of problems declining with age. Early and targeted treatment will allow many people to overcome mental illness or lower the incidence of progression or relapse.

Despite what they say, the government have cut services to mental health. There has been $5.5 billion extra in mental health spending from all governments since the national action plan was brought in—the biggest ever boost to mental health. But if you look for the new money and new areas of spending from this government you will find that they do not exist. This is where we need money to be spent.

The view has been put that somehow this is about hogging all the money for early intervention in mental health, as though somehow it is sucking money out of the system. Yes, that view has been put by a number of people. That view gets put because there is so little funding and so much unmet need in this area that people are jealous and scrabbling around over a few crumbs that the government might want to scatter about to keep them quiet.

We are talking here about putting new funding into early intervention—we are not talking about taking money out of existing programs to do it—to support the area that will best allow us to deal as quickly as possible with the problems of mental health. No-one denies that for decades mental health was under funded, but it is not a situation that we want to return to. It is up to this government to do something to prove that they are going to spend some money rather than keep it for an action plan that is not action at all.

Carol Brown (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

I want to begin my contribution today by supporting Senator Moore’s comments in the debate and by reaffirming that the Gillard government is committed to facing the challenges of mental health in Australia. Our Prime Minister has stated that mental health is an important second-term agenda and that this government is committed to addressing the mental health needs of the Australian community.

We are in the process of implementing the single biggest reform to the health and hospital system in Australia that the country has seen since Medicare. As part of our investments in the National Health and Hospitals Network, the Labor government is investing $1.6 billion to provide 1,300 sub-acute beds around the country, which will help to provide more mental health beds.

Through our health reforms, the Gillard government is building the foundations of the health system, on which we can build better health services for Australians, including better mental health services. We are committed to providing better access to GP and primary care services, and better coordination of service delivery to ensure that people with mental illness do not fall through the gaps. These investments are effectively a down payment to address the immediate service gaps in mental health as we move towards providing greater funding and policy leadership for community mental health services over time.

Our process of enduring reform is long overdue, particularly after those opposite had carriage of Australia’s health and hospital system for the better part of a decade. This government’s reform agenda acknowledges that the challenges we face in mental health are complex and require a coordinated and careful balance of services. This government’s response to mental illness will span across the age and illness spectrum. Contrary to what those opposite assert, we are working towards an integrated and connected mental health service that will meet the present and future needs of our community.

If we define and set the scope of the challenge before us it will make this debate a little clearer. We know that mental health has a profound impact on the community, with one in six Australians experiencing mental ill health in any given year, and one in three Australians experiencing mental illness at some point in their lifetime. That is 3.8 million Australians who will experience mental ill health in any given year. Of those 3.8 million Australians, we know that around 14 per cent, or 3.1 million, are affected by mild to moderate disorders. We know that one in forty Australians will experience severe mental illness and a third of those experience it as a chronic condition throughout their life.

We are taking steps to ensure that people are able to access services and treatment according to their needs. For people who may be experiencing symptoms, we are implementing early intervention strategies to prevent those initial symptoms manifesting into more serious and longer-lasting problems. For Australians suffering common and/or mild to moderate disorders the challenge before us is to improve levels of access and treatment to ensure that those disorders do not become severe. For those affected by severe and persistent illness, sometimes for the duration of their lives, the challenge before us is to improve the quality and coordination of different programs that people rely upon. For our children and our young people, we are focusing on teaching resilience and promoting problem-solving skills. For special needs groups in our community, like our young people and Indigenous people, we are working to improve our service design. This government is committed to ensuring that our mental health services are accessible and appropriate for our needs.

This government appointed the first minister for mental health, the Minister for Mental Health and Ageing, the Hon. Mark Butler, thereby giving mental health a special focus within the ministry and affirming our commitment to addressing the mental health needs of the Australian community. Minister Butler has spent considerable time meeting with experts and service providers, including Professor McGorry, to seek their views about gaps in priorities for addressing Australia’s present and ongoing mental health needs. In December the minister will start travelling around the country to talk directly to consumers and carers and to hear their stories and experiences firsthand. These consultations will inform future strategies to better integrate the support services for those with mental illness with other services, including housing, education and employment. This government is fostering a more inclusive Australia. We are committed to listening to those suffering from mental illness, and to those who are caring for our friends, families and colleagues with mental illness, to deliver the most appropriate support.

Whilst the minister is undertaking his national consultation, we are simultaneously investing in mental-health-specific programs. Funding for these programs, including Indigenous programs, over the next four years will almost triple—from $516 million in the four years to 2007-08 to $1.4 billion. We have included funding that we announced during this year’s election campaign as a part of the national tackling suicide package, which contains $274 million in funding over four years. This funding will redouble our efforts in suicide prevention, focus on the most at-risk groups and take practical action in suicide hot spots. The tackling suicide policy builds on the $176 million of funding announced in the 2010 budget to improve our mental health system and address immediate gaps.

Whilst the government is still drafting a formal response to the recommendations of the recent Senate inquiry, I am pleased that Minister Butler has welcomed the recommendations in the report The hidden toll: suicide in Australia. He said:

For example, the structural reforms being introduced under the new National Health and Hospitals Network will lay a foundation for further reform of the mental health sector.

I note, from the red, that we will be receiving that official response from the government today. I look forward to reading it. Minister Butler also affirmed that the government has already taken action on a number of fronts to tackle the problem of suicide. One such measure includes the government’s commitment to roll out an additional 30 headspace centres across Australia and flexible care packages to support people with severe mental illness. I am particularly pleased that in Hobart, in my home state of Tasmania, we are on track to receive a fully operational headspace facility by 2011. The expansion of these services affirms our commitment to early intervention and to providing additional support for our children and young people.

This government is delivering on its commitment to improve the health and wellbeing of all Australians. We have already seen this government make a $450 million new investment in mental health in the last 12 months. This is all happening, as I have mentioned, in addition to the structural reforms to the national health and hospitals network. These reforms lay the foundation for further reform of the mental health sector. They include better planning, management and coordination of local services based on local needs; more hospital and subacute beds, more doctors and nurses and a stronger primary care network; and a 21st century e-health system. Medicare Locals will work to improve local integration and referral pathways and care coordination of Commonwealth and other mental health services. The federal government is taking full funding responsibility for primary care outpatient services, supporting mental health services in community settings. All of these steps are reducing cost-shifting to our hospitals.

Those opposite still want to criticise and condemn us as we try to clean up their mistakes whilst planning and investing in our nation’s future health needs. I find it disappointing that those opposite would seek to condemn our response to mental health when the Howard government did not move on mental health for 10 years and, as Senator Moore has stated in her contribution in this debate, it was only in 2006 that the Howard government moved on the issue in any real way. Their now leader, Mr Abbott, as the Minister for Health and Ageing under the former Howard government, oversaw a $1 billion cut from public hospitals around the country—enough to provide 1,000 hospital beds—capped GP training places at 600 per— (Time expired)

Helen Coonan (NSW, Liberal Party) Share this | Link to this | Hansard source

I am very pleased to make a short contribution on this matter of public importance—the Gillard government’s abject failure to properly fund mental health services. It is a shameful situation that the government has let funding for mental health services deteriorate to such an extent that we have to resort to motions of this kind in an attempt to get the government to face up to its responsibilities.

With mental illness affecting more Australians than almost all other health disorders, ranking only behind cancer and heart disease in prevalence; with 45 per cent of the nation’s populace experiencing a mental health disorder at some point in life; and with younger Australians aged between 16 and 24 being the most vulnerable, the need for a properly funded national mental health strategy is an urgent problem that must be addressed. The Gillard government’s paralysis when it comes to dealing with this urgent matter is, unfortunately, all too familiar. Their inability to focus on priorities and implement much-needed reforms is the hallmark of a government that has lost its way. This is a problem crying out for immediate help today, not at some time in the distant future with the now Minister for Mental Health and Ageing still walking around the country trying to consult with people when we know what the problem is and we know what the problem is now.

The fact that the government is clinging so desperately, for example, to its determination to spend $37 billion or $49 billion or whatever the right figure is on a broadband network at the expense of delivering better health and education says it all. It is blindingly obvious that universal fast broadband can be delivered to every Australian far more economically and efficiently than the NBN, yet the government ploughs on, terrified it has nothing to show for three wasted years—and it certainly has nothing to show on mental health.

The tragedy of this policy drift by the Gillard government is plain for all to see. We all know that, between 1995-96 and 2002-03, expenditure on mental health by the Howard government—and I was very proud to be part of that executive—increased by 53 per cent from $792 million to $1.2 billion. They are real dollars. The coalition really gets the importance of funding for mental health. In 2006 the Howard government made the biggest single investment in mental health, with $1.9 billion over five years. Of course, during the recent election campaign, the coalition, after wide consultation, announced mental health policy proposals amounting to $1.5 billion.

In stark contrast, the Labor government’s actions and record are best described as cost-cutting and dismal. They include cuts to the Mental Health Nurse Incentive Program—from $191 million to just $63 million—and cuts to Better Access, removing occupational therapists and social workers from the program. Inexplicably, this government reduced funding to rural and remote services when all the evidence shows that, all too often, suicide, depression and despair lurk in rural communities, where mental illness is often undiagnosed and untreated.

In the Rudd-Gillard government’s national health and hospital reform plan, much touted in this afternoon’s contributions from the other side, mental health was completely overlooked, amounting to less than two per cent of the total reforms. We know that one of the consequences of all these cuts was the resignation of the chair of the National Advisory Council on Mental Health, Professor John Mendoza, who wrote in frustration:

... it is now abundantly clear that there is no vision or commitment from the Rudd Government to mental health.

Damning words indeed. There is some provision in the COAG health reform agreement. However, it is not enacted. So we must ask the question: why not? Yet again this Green-Gillard government is all talk and no action. The government has lost control of any sense of responsible direction on mental health. It is clear from the minutes of Kevin Rudd’s sign-off speech to the party room that the government acknowledges the waste and mismanagement under the $16.2 billion Building the Education Revolution program—administered, of course, by Ms Gillard. Just imagine if just some of the funds wasted and thrown away on useless make-work schemes had been invested in the mental health of this nation. That really would be a revolution to be proud of.

The coalition, on the other hand, promised in the lead-up to the recent election to commit $1.5 billion to mental health. That spend was comprehensive and endorsed by many prominent Australians involved in the field of mental health. Earlier speakers have outlined what that provides—a minimum of 90 headspace centres nationally, early psychosis and prevention intervention centres and early psychosis prevention that would add another 800 acute and subacute beds. The coalition’s plans, not surprisingly, received widespread acclaim and recognition, with Professor Pat McGorry—the Australian of the Year and an expert in mental health—saying:

… this policy would save lives—

I hope you are listening over there!—

ensure young lives are not stunted or derailed, and stem the tide of Australians with untreated mental illnesses flowing to our emergency departments, onto our streets and into our prisons.

The government is simply drifting into an abyss in failing to address mental health. This failure to act on mental health is a national disgrace. It is a comprehensive failure of leadership and political will. The government should stand condemned for miserably failing in its obligation to recognise and deliver on this urgent national priority to underpin the mental health of all Australians.

Mary Fisher (SA, Liberal Party) Share this | Link to this | Hansard source

Order! The time for consideration of the matter of public importance has expired.