Penny Wong (SA, Australian Labor Party, Minister for Finance and Deregulation) Share this | Link to this | Hansard source

I present the government’s response to the report of the Senate Standing Committee on Community Affairs on mental health services in Australia. I seek leave to incorporate the document in Hansard.

Leave granted.

The document read as follows—

GOVERNMENT RESPONSE

Senate Standing Committee on Community Affairs

Towards recovery: Mental health services in Australia

Senator Claire Moore

Committee Chair

PO Box 6100

Parliament House

CANBERRA ACT 2600

Dear Senator

I am writing in regard to the 2008 Senate Community Affairs Committee's Inquiry into Mental Health Services, and its Final Report Towards Recovery: Mental Health Services in Australia.

In particular I wish to provide you with information on key activities which have been announced and progressed since the tabling of the Report on 25 September 2008 and which address in whole or in part its recommendations, to finalise the Australian Government's consideration of the Committee's work. The delay in the Government's response to the Committee's Report is a result of the significant amount of mental health reform and health reform that has been underway and implemented since 2008.

I wish to acknowledge the significant and welcome interest of the Committee in improving the health and wellbeing of all Australians affected by mental illness, their families and carers. The Report provided an important resource that has contributed to the Government's thinking and decisions in respect of reforms to the mental health system.

Importantly, the Report's recommendations acknowledge the need for a long-term plan and vision for mental health, including:

Since the Report's release, there have been a number of Government investments and new initiatives relating to mental health and which form part of the wider national health, social and economic reform agendas. I am pleased to enclose a summary of these initiatives for the Committee's information.

Most significantly, the Government has delivered on its second term commitment to mental health with a number of initiatives consistent with the 2008 Report's recommendations through the 2011-12 Budget's Delivering National Mental Health Reform package.

Through this package the Government has provided the largest mental health investment in the nation's history with $2.2 billion being invested over the next five years to drive fundamental reform in Australia's mental health system.

These measures have been informed by extensive engagement with experts, service providers and consumers and carers that I undertook at the end of last year. Through this process, I received valuable insight and feedback and much of this feedback affirmed the Committee's findings.

The investments made as part of this $2.2 billion investment include initiatives across a number of portfolios including:

The Government is also investing a total of $32 million to establish a National Mental Health Commission to increase accountability and transparency. The Commission will provide leadership and drive a more transparent and accountable mental health system in both the health and non-health spheres, and provide an Annual Report, through the Prime Minister, to Parliament.

Included in this record investment over the next five years is $1.5 billion in new expenditure and $624 million from the 2010 Budget and election commitments in mental health.

If the Government's mental health investments in sub acute care beds, the Health and Hospitals fund and in specialist training places are included the total investment in mental health over the next five years is in fact $2.5 billion.

These investments act on the advice of the millions of Australians who have experienced mental illness, their families, their carers and the experts. However, these investments also act on the advice of the Towards Recovery report.

The Delivering National Mental Health Reform package is a cross-sector reform package that recognises the diverse impact of mental illness throughout a person's lifetime and will build resilient kids, support teenagers and families dealing with the challenge of mental illness, improve access to primary care and target more community based services to people living with severe mental illness and their families.

The establishment of a new National Mental Health Commission to independently monitor, assess, oversee and report on how the system is performing will also provide cross-sectoral leadership in mental health, including for consumer and carer activities.

The Commission's functions, including through the production of an Annual National Report Card on Mental Health and Suicide Prevention, will strengthen public accountability and transparency by monitoring whether services deliver lasting outcomes for people experiencing a mental illness.

Importantly, the Government will work further with states and territories, mental health consumers, carers, experts, and leading advocates in the mental health sector on the detailed implementation of the 2011-12 Budget measures and in the preparation of a 10 Year Roadmap for Mental Health Reform.

The Roadmap will set out an agenda for long-term reform of the mental health system. It will signpost our efforts to reform the mental health system, ground investments in the advice of experts and stakeholders and commit the Government to ongoing action.

In addition to the investment in the Budget, the Government has also undertaken a range of other initiatives consistent with the 2008 Report recommendations. For example, the first ever national Expert Group has been established to provide advice to Government on better management of Borderline Personality Disorder (BPD) and funding has been provided to the National Health and Medical Research Council to develop a BPD clinical guideline for the Australian context.

Through the $274 million Taking Action to Tackle Suicide election commitment package, the Government has doubled funding for suicide prevention. This comprehensive package was designed to target those most at risk of suicide, including:

The report also recommended investment in step up-step down accommodation facilities and as part of the Governments $1.6 billion investment to expand sub acute care facilities in partnership with state and territory governments, step up-step down facilities are already being rolled out.

Thank you again for the important work the Committee has undertaken.

Yours sincerely

MARK BUTLER

SUMMARY OF AUSTRALIAN GOVERNMENT AND OTHER IMPORTANT MENTAL HEALTH RELATED INITIATIVES, INVESTMENTS, CONSULTATIONS, INQUIRIES AND REPORTS SINCE 2008

2011

10 May—Government announced in the 2011-12 Budget its Delivering National MentalHealth Reform package and commitment to develop a 10 Year Roadmap for Reform.

10 May—Government announced in the 2011-12 Budget the Building Australia's Future Workforce package to build an educated and skilled workforce and ensure there are opportunities for all Australians to experience the benefits of work.

May—release of 'Working with Australians to promote mental health, prevent mental illness and support recovery'. Evaluation of the FaHCSIA Targeted Community Care Mental Health Initiatives.

March—release of a consultation paper for the development of a National Foundational Skills Strategy to improve foundation skills, such as numeracy, literacy and employability skills, of adult Australians . Submissions closed on 6 May 2011. The draft National Strategy is expected to be released at the end of 2011.

28 February—the Minister for Tertiary Education, Skills, Jobs and Workplace Relations, Senator the Hon Christopher Evans, asked the Standing Committee on Education and Employment to inquire into and report on mental health and workforce participation.

28 February—release of the Productivity Commission Draft Report on Disability Care and Support. Public hearings were held in April 2011. Written submissions closed on 30 April 2011. The final report will be forwarded to the Government in 31 July 2011.

13 February—COAG endorsed the National Disability Strategy.

21 January—the release of the draft inquiry report by Productivity Commission on Caring For Older Australians. Public consultation on the draft inquiry report was sought to inform further development. Submissions closed on 21 March 2011. The final report is due to be forwarded to Government in mid June 2011.

2010

December—the Prime Minister asked Minister Butler to establish the Mental Health Expert Working Group.

November-December—Minister Butler attended national forums with mental health consumers and carers.

November—Commonwealth tabled its response to the Senate Inquiry into Suicide Prevention, The Hidden Toll: Suicide in Australia report.

November—release of Mental Health Carers Report by Mental Health Council of Australia. A follow-up report from Adversity to Advocacy: The Lives and Hopes of Mental Health Carers (October 2009).

November—release of the National Mental Health Report 2010.

October-December—discussion paper Towards a National Carers Strategy was released for public consultation, and consultations were conducted by FaHCSIA and DoHA across Australia in November and December 2010. The Strategy is due for release in July 2011.

October—the Government established the Office for the Not-for-Profit Sector to drive and coordinate the policy reform agenda (supported by the Non-Profit Sector Reform Council). Establishment of the Office was one of several 2010 election commitments relating to support for the Not-for-Profit Sector.

September—release of the revised National Standards for Mental Health Services, and three implementation guidelines for non-government community services, private office based mental health practices and public mental health services, and private hospitals.

July—announcement of the Government's $274 million Mental Health: Taking action to tackle suicide package to boost frontline services and provide more services to those at greatest risk of suicide; for direct suicide prevention and crisis intervention; to provide more services and support to men who are at greatest risk of suicide; and to promote good mental health and resilience in young people to prevent suicide later in life.

May—2010-11 Budget package provided additional funding as an initial step to address gaps in mental health services including: $78.8 million for up to 30 new headspace youth friendly services and enhanced online counselling services; $25.5 million for an expansion of the Early Psychosis Prevention and Intervention Centre (EPPIC) model in partnership with interested States and Territories; $13 million for the employment of 136 extra mental health nurses under the Mental Health Nurse Incentive Program; and $58.5 million for delivery of flexible care packages to better support people with severe mental illness.

May 2010—the Department entered into a Memorandum of Understanding (MOU) with the NHMRC to develop a clinical practice guideline for Borderline Personality Disorder (BPD).

April 2010—the Minister for Health & Ageing, Nicola Roxon MP, gave approval for the development of an Australian clinical guideline on BPD using the United Kingdom's clinical guideline on BPD adapted to the Australian context and the establishment of an Expert Reference Group (ERG).

March—New Disability Employment Services were introduced on 1 March 2010. For the first time, services are demand driven, meaning all job seekers with disability will have immediate access to assistance from an employment service that will help them gain and maintain employment. The new services also provide more support to employers employing people with disability and mental illness.

February—paper released for public consultation to inform development of the National Volunteering Strategy. Submissions closed on 30 June 2010 and an online survey closed on 25 July 2010.

February—publication of Outcomes and proposed next steps: review of the Access to Allied Psychological Services component of the Better Outcomes in Mental Health Care program.

In 2010 other Australian Government reforms include:

December—Australia's Draft Initial Report under the Convention on the Rights of Persons with Disabilities.

December—establishment of the Australian Government's Not-for-Profit Sector Reform Council.

October and November—consultation and discussion paper for the development of a National Carers Strategy.

September—establishment of the Joint Select Committee on Cyber-Safety.

September—release of the Commonwealth Ombudsman report, Falling through the cracks: Centrelink, DEEWR and FaHCSIA—engaging with customers with a mental illness in the social security system.

July—release of the discussion paper, Inclusion for people with disability through sustainable supported employment.

June—release of the Progress and Action Plan: The Australian Government White Paper on Homelessness.

May—release of Australia's First National Primary Health Care Strategy.

May—release of A National Health and Hospitals Network for Australia's Future: Delivering better health and better hospitals.

March-April—Treasury consultation on Unfair Terms in Insurance Contracts.

February—release of Productivity Commission final research report on the Contribution of the Not-for-Profit Sector.

January—release of the Social Inclusion in Australia: How Australia is faring.

2009

November—release of the Fourth National Mental Health Plan: an agenda for collaborative government action in mental health 2009-2014.

November—Australian Health Ministers agree to the Framework for the National Perinatal Depression Initiative 2008-09 to 2012-13.

October—release of Adversity to Advocacy: the Lives and Hopes of Mental Health Carers by Mental Health Council of Australia.

September—release of the National Mental Health and Disability Employment Strategy.

June—release of A Healthier Future for All Australians (National Health and Hospitals Commission Report).

May—publication of the Post Implementation Review of the Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule (MBS) initiative.

May—release of The Mental Health of Australians 2—a report on the 2007 National Survey of Mental Health and Wellbeing.

April—release of the National Mental Health Policy.

2008

December—release of The Road Home—the Australian Government White Paper on Homelessness.

October—release of the 2007 National Survey of Mental Health and Wellbeing, Australian Bureau of Statistics.

October—release of a discussion paper for the development of a National Disability Strategy for Australia.

Release of the revised The Living Is For Everyone (LIFE) Framework.

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

by leave—I move:

That the Senate take note document.

I welcome the government's response, but let us not forget that the original Senate Stand­ing Committee on Community Affairs report is dated September 2008. It has taken this government three years to deliver a response, but this is business as usual for this gover­nment. It consistently orders reports and then has more conversations with the Australian people while it considers those reports. Mental health is very much like ageing. There were 17 or 18 requests for inquiries into ageing but then the government shunted everything off to the Productivity Commiss­ion. Now that the Productivity Commission has delivered its report we are going to have another national conversation.

Ageing and mental health have been the two areas that this government has well and truly neglected. Throughout that whole health 'reform' process, mental health and ageing well and truly fell by the wayside. Let us not forget Professor Mendoza resigning on 21 June 2010 in utter disgust at this government's position. This February the Prime Minister and the Minister for Health and Ageing forgot to include mental health in the heads of agreement on health reform. Finally, this government was shamed into doing something on mental health.

Let us not forget that in October last year there was a motion in the Senate—supported by senators on the crossbenches but not by the Labor Party or the Greens—that called on the government to implement the coa­lition's mental health policy. As if that was not enough to spur the government on, in the House of Representatives in November last year a similarly termed motion was passed. Again, the government and the Greens voted against that motion. After sustained pressure, the government was finally shamed into doing something in the budget, but it was not because it decided to something, as the government would have you believe.

Let us look at that budget. What an illusion it really is. There is this big spend on mental health, yet the net spend over the forward estimates is only $583 million. That is after you rip out almost $600 million from the better access program without consult­ation with practitioners. When you look at the fine print there is only $47 million in new funding in 2011-12 and $62 million in program cuts over that same period of time.

The minister is very careful because he talks about new initiatives. He does not talk about new money; he just talks about new initiatives. Why? If you go back and look at the evidence given by the Department of Health and Ageing at the last estimates, it was confirmed to me that they are simply refinancing Howard government programs. Let us not forget that the biggest investment in mental health in this country was made by the Howard government in 2006—$1.9 billion over five years.

Penny Wong (SA, Australian Labor Party, Minister for Finance and Deregulation) Share this | Link to this | Hansard source

Not true! Our package is $2.2 billion.

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

Through you, Deputy President, I would invite Senator Wong to go back and have a look at the evidence that was given at estimates. I just heard Minister Butler in the other place and he was going on with his usual waffle. But look at the fine print of what this government has done, because it is all tainted with the never-never, as are all its other programs. This is going to happen 10 years down the track. We are talking about 10-year road maps. One in five Australians have a problem with mental health now. They want action now. They want the government to deliver now. They do not want to wait another 10 years. Sadly for those who do need help with mental health issues, we have seen a another hallmark ALP smoke-and-mirrors budget.

Let us look at the report of the Senate Standing Committee on Community Affairs. The first recommendation of the Towards recovery: mental health services in Australia report was for the government, in consult­ation with the states, to develop a national mental health plan for future years. Let us look at the progress. Minister Butler is talking about COAG. Mental health has finally made it to the COAG agenda again after 2006, when the Howard government made sure that they well and truly invested decent money in mental health. What are COAG now talking about? They have also talked about the first recommendation in the community affairs report. They are talking about it three years later.

Let us look at COAG's progress in mental health and the progress reports that are supposed to be released. The progress report for 2007-08 was not released until September 2009. Today I looked for the latest progress report, hoping beyond hope that they had got their act together. The 2008-09 third report still is not available for inspection. That is the great progress that COAG has made on mental health. This was supposed to be a second-term priority for Prime Minister Gillard. On 27 July 2010 she told us:

I want to be absolutely clear—mental health will be a second-term priority for this government.

You have forgotten to put it on the COAG agenda. Finally it got on the COAG agenda last week. Bear in mind that mental health is not part of the so-called health reform. When you look at the first draft of what Kevin Rudd originally promised—in the full white coat as he travelled around the hospitals and told us that he was going to fix all sorts of things—and you look at what has finally happened at the end, there is not very much for mental health.

It is little wonder that the sheer frustration, the hurt and the disappointment of those suffering in mental health was so clear at the recent Senate hearing. I was very pleased that the Senate agreed to have a wide-ranging inquiry into the funding and administration of mental health services in this country. We have had over 1,000 submissions. There are not many Senate inquiries that get over 1,000 submissions. Why were there so many? Because people are very concerned. They are frustrated because services are just not working under this government. Minister Butler talks about consultation, but I wonder if he has bothered to even look at any of those submissions. If he looked at even a very small portion of those submissions, he would not be telling the Australian public that we are going to have a 10-year road map for mental health somewhere in the never-never and fudging his budget figures. It is very clear that it is not new money. It is simply a rolling over and repackaging of previous initiatives. Yet you have tried to pass this off as some great big spend on mental health.

Go and ask those one in five Australians who need help now and those thousands of people who have in many cases shared their most painful experiences in the confidential submissions. They need help now. It is very clear that, because this government have wasted so much money on school halls and pink batts and all sorts of other things, they are now forced to go and cut programs like better access. You ought to come along, Minister Butler, and listen to what those people are telling us at the hearings and what the impact of that is going to be on the daily lives of those one in five Australians who are suffering from mental health issues. The year of decision and delivery has absolutely come to nothing. (Time expired)

Question agreed to.