Press Conference regarding the Mental Health Commission's Review of Mental Health Programs and Services

Transcript of Minister for Health Sussan Ley's press conference regarding the Mental Health Commission's Review of Mental Health Programs and Services.

Page last updated: 17 April 2015

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16 April 2015

Subjects: Review of Mental Health Programs and Services, Public Hospitals funding

Sussan Ley: The Abbott Government is working towards the revival of a national approach to improving mental health outcomes and access to support services long term. The National Mental Health Commission's review of mental health programs and services paints a complex, fragmented and in parts disturbing picture of Australia's mental health system.

I acknowledge that there are clear failures, within both the mental health sector and Government. And we must all share the burden of responsibility and work together to rectify the situation. We cannot continue to place Band-Aids on the mental health system and expect it to heal itself.

This is why the Government has been working closely through the review's 700-plus pages in recent months, to develop a considered and most importantly, unified strategy to ensure the next steps we take actually deliver a genuine national approach. A consultative and collaborate approach is essential to achieving this, and I intend to seek bipartisan agreement to revive a national approach to mental health at tomorrow's COAG meeting of Health Ministers.

I am conscious of the damage Labor did in Government. By walking away from the fourth National Mental Health [indistinct] with the states and territories as well as the discontent with their alternative national roadmap for mental health reform, that has clearly led nowhere. However the review shows that fragmentation in the system is seeing far too many people still slipping through the cracks. I see the COAG process as essential to developing a co-ordinated, binding national approach long term.

And therefore the Abbott Government will seek to establish a dedicated COAG working group on mental health reform to co-ordinate the process. The mental health sector must also play a direct part in the development of any policies and work hand in hand with governments to develop this national approach.

I can confirm it is currently finalising the establishment of an expert reference group to inform the entire process. Including the development of short, medium and long-term strategies in four key areas based on the findings and recommendations presented in the National Mental Health Commission's review. Suicide prevention. Promotion, prevention and early intervention of mental health and illness. The role of primary care in treatment of mental health including better targeting of services. National leadership, including regional service integration.

The expert reference group will also be supported by broad stakeholder workshops to ensure mental health services and organisations at the front line can have a direct input into this process. An NDIS mental health working group, an Aboriginal and Torres Strait Islander mental health and suicide prevention advisory group. Setting better access to mental health services as a priority for the Government's new primary health networks. And an intergovernmental approach to ensure Commonwealth agencies respond to the report's concerns about fragmentation of payments and services, and better coordinate future system and policies. This further work is necessary because ultimately there is no easy fix to this problem.

It's also important to acknowledge this is a report to Government, not of Government, and while many recommendations offer positive ideas, others are not conducive to a unified national approach or require further investigation by experts. Which these COAG and expert reference group processes will be best to coordinate.

For example, the Government does not intend to pursue the proposed $1 billion shift of funding from State acute care to community organisations, as we want to work collaboratively in partnership with other levels of Government. Exact timings for the delivery of work will be finalised in consultation with the states and territories.

The Abbott Government also recently announced a $300 million extension of funding for front-line mental health services while this work is undertaken. I have been consulting continually with mental health stakeholders in recent months and they all acknowledge this is a once in a generation opportunity for serious reform in mental health in Australia for the long-term.

And I am determined to secure national support. The mental health review will be able to be down loaded from the website shortly. Thank you all for your patience and I'm happy to take your questions.

Question: So are there any specific recommendations in the report that you are going to adopt as they are?

Sussan Ley: Well, Sophie, rather than pull out individual reports to discuss today, can I say that the broad theme is well understood and appreciated by Government, particularly as Health Minister I recognise that the more we can do to keep people out of acute, particularly residential, mental health services, the better off we are.

Not just for the patients but for the finances and state and federal Governments. So the theme of stepped down approach and self-care is one that I have certainly taken on board and I know that the agencies and organisations that I'm in touch with every week around the country are informing me as we go through this consultation period, in fact at RUOK Rail Day this morning on platform one of Central Station, we had some of the key leaders in mental health in this country there. And they all recognised in conversations with me that major reform is needed. And that the fragmentation of the current system - and this report really does talk about inefficiency, it really does highlight to Government that while there is significant funding, I think some $14 billion a year, it's not being effectively spent. And of course people are slipping through the cracks as a result.

Question: Why do we need - given we have this massive report over all this time, why do we now need to set up more working groups and more experts on these issues?

Sussan Ley: Because we'll be implementing these recommendations and Government policy together. So this is an important part of the process. Having received the report, having worked through the recommendations, having taken careful note, I will now be in close consultation with the mental health sector to reform this fragmented approach and this multisector organisational delivery that we all acknowledge doesn't get the best spend for our mental health dollar - and let's not forget, this is not just about dollars, it's about people. It's about patients, it's about lives and it's about a commitment that I know all Health Ministers want to make to do better. So we're not extending a consultation process, we're implementing an important phase of that consultation process.

Question: So with that working group - you said that [rest of question inaudible]?

Sussan Ley: It will be our expert reference group and I will be working closely with State Health Ministers. I'm not going to pre-empt what we might do together, because I'm going to actually have a private conversation with those Ministers tomorrow morning, and remember we've got, I think, five new Health Ministers in the states and territories. And I know they're all coming to the table as determined as I am to solve the inefficiencies and the problems in funding really high-quality mental health services. So I'm not going to tell those State Governments what they might like to have - what they might like to have - what they might like to present to me in discussion. But I am looking forward to the conversation.

Question: [Inaudible question]

Sussan Ley: I think the broad recognition from everyone - from State Governments, from organisations, from - as I mentioned before, the key mental health groups in this country, whether it be professionals' networks, suicide prevention, mental health nurses, those who work at the front line every day. I was opening a Headspace in my own electorate just a few days ago. So I'm - I talk to the national, I talk to the local. Everyone agrees that it's time for reform. It's time for change. And that was the purpose of this report.

Everyone agrees that it's time for reform, it's time for change and that was the purpose of this report. It was to point the way forward through a major reform process but I'm not going to stand here releasing a report and then stating this is what government is going to do, I'm going to say, you know, I am committed to working with my state colleagues and consulting closely with organisations that we've worked with closely in the past, we've extended funding for another 12 months and we're going to use that 12 months to work through how we implement these recommendations and government policy and practice.

Question: And how would you sum up your response to this report if you had to use adjectives to describe it, what would the - be adjectives that you have to describe the content of this report?

Sussan Ley: It's a strong report, it's a good report and it's also positive because while describing a system that we should collectively be disturbed and even at times alarmed about, it does indicate a way forward. So, I am pleased that this important report is going to inform our future direction.

Question: Minister, given their report identifies how difficult it has been in some cases to work with the states on this issue, they're not providing information to the Commission [indistinct] that the Commission wants and also a long history of the states removing funding when the Federal Government does come in and give funding so that we end up with the same overall amount, how can you assure the public that working through the COAG process and through this working group is actually going to achieve change?

Sussan Ley: I don't think this is going to be a battle over funding. I'm not talking about reducing funding and neither is the report, it's talking about using the existing funding which, while we always say is never enough, is nevertheless substantial. So, all levels of government know that if we do work closely together, it's of advantage to both of us. It's of advantage to the state system because less people go into expensive residential facilities and get cared for in the community and it's more advantage to the Federal Government because primary care, which is the place where a person with a mental health condition usually first presents, needs to do and will do good work to prevent that patient ending up in the hospital and too often on a merry-go-round of outpatients, hospital, community care and so on.

I visit hospitals and that includes mental health facilities across the country and I recently visited one where the emergency department had good data on an electronic system about a patient who had been admitted several times to that ED and when I asked about tracking that patient through to the community health facility, which was literally a stone's throw away, the connections weren't there. The unfortunate reality is people slip through the cracks because of that lack of coordination. Now, we are very committed to e-health, to an electronic health record that actually assists in a case like this when someone moves through many different organisations and specialist areas. So, that's one example of where there's a lot of cooperative work happening now between state and federal governments that will assist this and I mentioned the primary health networks. I have already tasked them, even though they don't officially come into being until 1 July, to have mental health, particularly child and adolescent mental health, as one of their key areas of work and where they need to come back and report to government about how health outcomes have improved in that population.

Question: Minister, just on that point of funding, you say that the report isn't about cutting funding which, I'm not disputing, but the Government does intend to cut $57 billion in funding the state and territory hospitals over the next decade, so how will they actually be able to implement these kinds of performance improvements to care when they are facing a funding shortfall?

Sussan Ley: Well, I don't accept that it's a funding shortfall, I don't accept that it's a cut. What we have said is that in changing the way we fund state governments, and that includes their hospital systems, while our funding will continue to grow by a significant percentage every year, we will not use Labor's activity-based funding measure, attached to which was an expensive and meaningless funding guarantee that simply said to state governments we will pay you this in order to get you to sign up to this agreement and it doesn't matter how inefficient your hospital system is, you will still get the money from us. So, no responsible federal health minister should agree to that and we haven't. So, we recognise that funding for state hospitals is an important component and an important role that we have, something that I'll continue to talk to state ministers about. But I will reassure them in case they believe this nonsense that's being peddled by the Labor Party that we are cutting funding, is in fact our funding increasing each and every year…


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