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Doorstop interview about funding for mental health initiatives and novel coronavirus

Read the transcript of Minister Hunt's doorstop interview about funding for mental health initiatives and novel coronavirus.

The Hon Greg Hunt MP
Former Minister for Health and Aged Care

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Thanks everyone for joining us here today. My name’s Rachel. I'm the CEO of Independent Community Living Australia. Really pleased to welcome you all here.

Before we begin, I’d just like to acknowledge the traditional owners of the land on which we meet, the Bidjigal and Gadigal people of the Eora nation. We pay our respects to their elders past and present.

Just a very quick bit about where we are right now. This is one of about 40 homes managed by ICLA.

We’re an organisation with a 35-year history in providing supported accommodation for people living with mental health issues.

We're very excited to actually be opening this site today; we scrambled to open our doors to people in bushfire affected regions.

We know that for many people the best support would be resilience building and support in their local community.

But for some, the need to take a break and come and get some peer support from people who also have a lived experience trauma will be something they can benefit from.

And we're really proud to have with the support of the Minister and the Department of Health to be able to throw open our doors for that purpose.

I'm also excited to be able to name the site today.

We've chosen the name (inaudible) in recognition of the resilience of those (inaudible), they're interconnected connected root systems beneath the ground and the community support that goes into maintaining their resilience.

I'd like to formally welcome. Christine Morgan and the honourable Greg Hunt, Minister for Health. And thank you all for joining us here today.

And also a quick shout out - we're actually live streaming to our own peer support workforce which is one of the first paid workforces trained in suicide prevention with a lived experience.

So this is a really exciting development for the- They couldn't be here today because they’re in training but they are watching from head office.

Thank you everyone and I'm going to handover to the Minister.


And look, thanks very much to Rachel and Christine, and to Rachel, all of your wonderful peer support workers.

What is peer support?

Peer support is people who have experienced helping people through need. And that's what ICLA is doing and that’s what the Rule My House is about.

And it’s part of however a much broader package. We know that suicide can affect any family and this is something which is an agonising condition, particularly in indigenous Australia.

And I want to thank you for your acknowledgement of indigenous Australia, I (inaudible) myself.

Christine, through her consultations ourselves, myself through my work, we’ve come across too many families that have suffered the agony and the loss of suicide.

However, there is a real sense of hope and possibility in the support that people give to each other, the systems that are in place, the ability to find a safe space and if I were to find them in my house, I would say it's a safe space.

It's a place where people can come and to know that there are places such as this means that we are able to give them hope and support and comfort.

More generally, the Prime Minister commissioned Christine Morgan who is the Head of the National Mental Health Commission to also be the first National Suicide Prevention Adviser.

And Christine's work has informed the Government Suicide Prevention Strategy.

And so today I'm delighted to announce that we will be investing $64 million in the National Suicide Prevention Strategy to help save lives and protect lives.

We only have one goal and that goal is towards zero. To say that each life matters and that we can do everything we can to support the pathway and salvation for each one, to give them a sense of hope, to give them a sense that their lives are important.

Now our funding contributes to that, but much more importantly than that is the community message that we care, the family message that we care.

And all of these things come together.

So what we're doing is assisting those in the field and in the community, in addition to what we're doing on the medical front.

And so today is about community support components and Christine's helping to provide advice along with the medical community of the medical components.

The elements here include $12 million for peer support and crisis support. Support for groups such as Lifeline who are here today.

And John Brogden is here and so is Lucy Brogden. They have different hats; John is the head of Lifeline, Lucy is the Chair of the National Mental Health Commission.

But they’re a powerful force together on that front. That includes funds for the way in which peer support operates and includes three million doses for the (inaudible) Foundation and $1.4 million for ReachOut, $100,000 for Stand Tall and other funds as part of that.

We also have $13 million for extending the national suicide prevention trial sites program. Twelve sites around the country.

That includes a particular focus in sites such as Darwin and Karratha on Indigenous needs, a particular focus in Townsville on veterans needs and these sites are about pioneering new techniques which reach out to and work with the community on providing support.

There is $17 million which is going to vulnerable groups. In particular, that’s about aftercare.

And aftercare through the Way Back program – which will be supported with $7 million – is to identify that group of people who we know are most likely in all of Australia to take their own lives, and that is those who have been discharged from hospital after a suicide attempt.

And in those six months afterwards, if we can reach out, if we can work with them and through the Way Back program do precisely that, give them a way back, then we absolutely increase their chances of survival and avoiding suicide.

Similarly, there’s $10 million to work with families who have lost somebody to suicide.

Suicide can be a contagion. Shortly after coming into this role, I went with the wonderful Patton (inaudible) to Grafton, a community which had been affected by a series of youth suicides.

And we saw that impact. We were able to put in place a headspace and through that headspace, what we were able to see is that in itself has helped stem the contagion by providing hope.

And that then leads me to the third element- the fourth element, which is $22 million for Indigenous communities and that includes headspace in remote Indigenous areas and remote areas.

The additional support for those communities can focus them on an area where we’ve had too many tragedies for too long and we have to say there is a line in the sand.

And that line is now and so I’m really honoured to be able to implement your advice, Christine, thank you. I’ll invite Christine, she’ll say some words and then (inaudible) break for a moment and then Professor Paul Kelly, the Deputy Chief Medical Officer and I will give an update on coronavirus and open ourselves to question time.


Thank you Minister, and what a significant day this is.

I look at the package, I listen to the package which has been announced and where it’s coming from is- I guess stems back to the approach that the Prime Minister himself took when he asked me to take on this role and to adopt a cross-portfolio, whole-of-government approach to suicide prevention.

Why? Why because to date it’s been predominantly out of health and mental health, and we call that suicide prevention but it’s actually more about intervention.

Now, why does that matter? Why it matters is that because we lost 3046 people in 2018 in Australia to suicide.

What’s shocking is that approximately half of those people were not in touch with the health system or the mental health system.

So, what today marks for me when I look at the underpinning substance to this package which is being announced is we’ve pivoted. We’ve pivoted.

We have said we’re not just going to wait for people to come to us. We’re actually going to implement initiatives, programs and train peer workers and others who can actually assertively outreach. We want to connect with our Australians in need.

We also fundamentally recognise this is not just about when somebody is at that point that they attempt.

The cross-portfolio whole-of-government approach says that yes, at that time, they are very significantly mentally distressed.

But it’s not necessarily about mental illness. So what we want to do is identify those stressors and distress and intervene early. It’s a long journey and it will take quite a bit of work.

One of the things that we do want to do is we want to try and develop an Australian suicide model which will actually help us identify what those portfolio changes should be.

But in the interim, I so welcome this package which really has said let’s not just have good services within mental health, but let’s actually take up touch points with community and strengthen those touch points and provide people at those touch points to reach out.

So, we really welcome that.

As the Minister has said, suicide affects not only those we lose. But what about those who have attempted (inaudible) even included in that statistic of 3046?

They’re the ones we also need to talk to. We need to learn much, much more about what is this personal journey people go on and most importantly what helps them.

So I see these initiatives as being really fundamental to being able to start to make that change, so thank you on behalf of so many Australians.


What we’ll do is we’ll invite Professor Kelly, so to talk (inaudible) Deputy Chief Medical Officer and also one of Australia’s most renowned and leading epidemiologists so we’re very fortunate to have him.

Just in relation to the coronavirus, we’re expecting new figures from the WHO and Chinese officials overnight.

The latest figures that we have are 6000 people infected and 132 lives lost. We do expect those figures will increase when the latest report comes later today from the overseas authorities.

In terms of our own preparations I have spoken again with the Director of the National Critical Care and Trauma Centre, Len Notaras, this morning and they operate and deploy the Australian medical assistance teams, or AUSMAT, and his advice to me was one word – ready.

So his message is very clear, they are prepared. They were put on contingency earlier on. They have secured the personnel and are prepared to deploy to Christmas Island and are forward deploying today.

The Administrator of Christmas Island, Natasha Griggs, was visiting and briefing the centre in Darwin – she knows both Christmas Island and obviously the Centre well and I've spoken also with Natasha Griggs and they are prepared as well.

So I've got to say that this is an extraordinary national asset and so what we have done is brought into being what the World Health Organisation identified as one of the worlds most prepared systems for an epidemic.

We have the National Incident Room which has been established, the National Medical Stockpile which is available and from which masks are being deployed.

We have the National Trauma Centre which runs the AUSMAT medical teams and they are deployed, as well as the consular crisis process, as well as the state and territory hospital and pathology systems.

I want to acknowledge that the VIDRL, the Infectious Diseases Reference Laboratory in Victoria as part of the Doherty Institute has achieved something extraordinary – and Paul, I might ask you to add more on that – overnight with the replication of the coronavirus, that's of immense importance.

I spoke with both the Director and Deputy Director, Mike Catton who leads the team there, overnight and what this means is that Australia is helping the world with faster testing, with potentially better treatment and potentially early development of a vaccine.

And they are important, huge steps – not just for Australia and protecting Australian patients, but globally. Paul.


Thank you, Minister.

So, as the Minister mentioned, we are very well prepared. I'm in virtually constant communication with my state and territory colleagues, we're having meetings virtually daily and then a lot of other emails and phone calls.

And so, as the Minister said, there's been 6,000 cases, almost all of those in China, but there’s about 100 internationally now over a range of conditions including Australia.

We have seven cases here in three states and so we are taking the measures that are appropriate to protect the Australian public as well as, as the Minister has mentioned, this plan to assist those that are in Hubei at the moment, or in Wuhan city, in relation to getting back to Australia.

There's one thing we- that I do want to stress – after yesterday's announcement about- we are now sure that there is a possibility that people can transmit this virus before they become symptomatic.

So this is quite a change in what we understand about the virus and it's led to some different ways that we're dealing with the public health issues.

But I want to reassure the Australian public, this is a very precautionary measure and when we're talking about those that have been in contact with people with a diagnosis of the coronavirus infection, or who have been in the last 14 days, in Hubei province.

This is not just casual contact, this is someone who has been very close to someone who has the illness or develops the illness later.

So for example, we've had inquiries today about receiving parcels from China, that's totally safe. The virus does not last on a parcel coming from China.

In terms of walking past people in the street who may or may not be infected, that is also virtually totally safe.

When we're talking about contact we’re really close contact for over a period of time and so I think that's an important message that people should take on board today.


Great. Happy to take questions.


In terms of evacuees, can you confirm that they won’t have to pay for any medical or operational costs?


So the Foreign Minister and DFAT are taking care of that and the position that- was that there would be some contribution towards the assisted departure but the accommodation and quarantine is a matter for the government to absorb.


In terms of the health preparations on Christmas Island, how many personnel are being sent there? What kind of facilities are prepared (inaudible).


So, AUSMAT is the Australian Medical Assistance Team, so Len Notaras is putting that together. He will be providing a briefing later today on that.

He has secured a significant number of medical personnel so I'll leave that to him because it's operational.

For example, they have recently deployed teams to the measles outbreak in Samoa, so they are set up as one of the world's premiere organisations for rapid deployment to high-contagion areas.

And in fact, measles – and Paul will be better placed than me – is a far more contagious condition than, as we understand, this novel coronavirus to be.

So they have not only personnel but they also have negative pressure facilities that they can take with them and so they have intensive care facilities.

So they are a mobile unit that can be dropped into any part of the world. In this case, it will be taking Christmas Island.


The AMA has denounced the taking of evacuees to Christmas Island saying it's very harsh. What's your response to that?


Look, I respect the views, I understand there is full support for the quarantine processes. And then as to the logistics of it, I mean the government as a matter of national security has to make that call as to where.

And I'm not aware that any state has offered to clear out a hospital.

All states and territories, all states and territories – and I think, Paul, you were part of this call yesterday – unanimously supported the quarantine procedures, given the additional medical advice which came overnight before yesterday’s meeting from the WHO and in particular out of Germany.

So they were supportive of the quarantine. We're not aware that any state or territory has offered to clear out a hospital for 600 people. So that’s that.

Our job is to protect Australians citizens as well as to provide support for those citizens overseas and the best way to do that is to find a place which was designed to deal with people who were coming were overseas in circumstances and to do that in a way which is humane.

This is a humanitarian mission. But no state or territory – to the best of my knowledge – has offered to clear out any of their hospitals. And in that circumstance, this is the right thing to do, it's the most appropriate thing.

It protects Australians at home but it provides a pathway home for those Australians who are in Hubei.


So why have other people been advised that they should self-isolate and yet this group of evacuees has to be isolated on Christmas Island?


Well, it's the same period of isolation for the same group. They are coming from the heart of Hubei.

They are coming as a group which has been in close contact with each other and therefore, we have followed the medical advice.

This was a process of medical advice to the National Security Committee of Cabinet yesterday.


Mr Hunt, Peter Dutton said anyone evacuated to Christmas Island who becomes sick has the option to go to Australian hospitals if needed, and he said possibly Darwin.

Can I have a bit more detail on this approach, more details?


So I think that- I'll refer to the medical care. As to other elements, Home Affairs is running that operation so I wouldn't want to step inside that.

But in terms of medical care, that if somebody became sufficiently ill that a transfer were required, we would do that immediately.


Okay. There are reports there are two Australians in China who are ill. Is that correct in your understanding and will they be brought back to mainland Australia?


So my advice before coming to this event from the National Incident Centre in our morning briefing is that two Australians did contract the virus in Guangdong province.

They have been treated and the advice that I have – and I would want to be cautious on this – is that they have been released and are not seeking consular assistance at this stage.


On masks, logistically, how will the government be getting these masks to doctors (inaudible)?


Masks, as was announced yesterday, masks could be provided to Primary Health Networks and the Primary Health Networks would assist in the distribution to general practices that wish to receive them.

I've asked to make sure that I have an update on the distribution process, today, from each of the 31 Primary Health Networks.

Paul, did you want to add anything?


So, just to say this, these masks are coming from the National Medical Stockpile. They will be going to each and every of the 31 PHNs.

We are looking to prioritise Victoria and New South Wales because of the fact that they've been somewhat overrun by the bushfires in recent weeks and a lot of mask distribution there.

But every PHN will get them. That's logistically getting these masks out to the whole of Australia. And so, that will start today.


And how will that happen – postage, courier, drop-off? How is the distribution going to happen?


So, under the arrangements for the National Medical Stockpile, we do have a contract with Toll and they are responsible for the logistics of moving anything from the Medical Stockpile, in this case, masks.


So they've been commissioned. They're in distribution mode. In fact, I visited one of the National Medical Stockpile sites in Melbourne last Thursday to examine exactly for this preparedness.

One of the things that Australia has – I mentioned the National Incident Centre, the National Trauma Centre, which oversees AUSMAT, the National Medical Stockpile, as well as the consular crisis process within DFAT and then the emergency management processes with the states and the experts through the state hospitals and state pathology services – is a system which was developed for this moment in history.

And what the Prime Minister has been doing through the National Security Committee – met yesterday and he's announced that it will meet tomorrow, earlier on in the week on Monday – is making sure that all those elements that need to be implemented are being implemented and those which may need to be used in the future are ready to be used.

And I think that's the preparedness which is important for the Australian public to understand.


Minister, the World Health Organization has advised against evacuation from China. Why is it that Australia going against this?


Well, we're following the Australian medical advice which, by the way, is consistent with the practice of other countries such as the United States and Japan, and I note that some would be very critical if we were not to do what like-minded countries were to do and some may take a different view.

What we're doing is following the medical advice that not just Professor Murphy and Professor Kelly have provided, but the unanimous advice of all of the state and territory chief health officers in conjunction with the Australian ones, and, again, that itself followed the expert advisory panel which the Chief Medical Officer convened yesterday, which brought together communicable and infectious diseases experts.

So, of any country in the world, the World Health Organization, two years ago when they did the review of Australia's epidemic preparedness, identified us as being at the absolute global forefront.


Would you please give us an update on the timeline for this evacuation from China?   


I’ll respectfully leave that to the Minister for Foreign Affairs. I know that they’re working around the clock.


Do you trust that China is telling the truth about the epidemic?


Look, we have had constant briefings from China. We can only go on the information we have.

I do know that the WHO has, in the last 24 hours, been very praising of the information that they’ve received. They’re in a better position than myself to judge.


Minister, if someone has been in contact with someone on Christmas Island who becomes sick, does the period where- like the 14-day period start again?

Like, will they stay on Christmas Island longer if they’ve been in contact with someone who becomes sick?


Okay. So, if you talk about contact, and then I’ll talk policy.


Thank you. So, in terms of contact, the 14-day rule is based on what we know so far about the virus in terms of the incubation period and the infectiousness.

And so, that would be- that’s where we’ve come up with the 14 days. And just to say, (inaudible) we do know a lot about this virus very quickly.

So we’ve only known that there was a viral outbreak in China just over a month ago and already, as the Minister has said, we have the virus.

We have the full genetic sequence. We have a test. And so, we can make very rapid assessments about someone who becomes sick, whether they actually have this novel coronavirus.

The people that are coming from China, they won't be travelling if they are sick. They’ll be only travelling if they have no symptoms.

It is a possibility that those that end up at Christmas Island may well develop this disease, but there will be processes in place to make sure that they are protected from that and, if they were to develop the disease, they will be treated accordingly.


And will the people that had been in contact with them have to stay longer on the island?


So, I’m sure that there will be procedures put in place so that contact is minimised, and so, that is unlikely to be a problem.


In terms of transmission, do we know anything more about the major form of transmission of the virus at this stage or is that still a bit unclear?


No, it’s quite clear. We know quite a lot about coronavirus. This is a new coronavirus, but there are many of them that infect both animals and a few in humans.

This is quite a different one to the ones that we know quite well. SARS from 2002, 2003 and MERS more recently are very different viruses in terms of how infectious they are. They’re much less infectious.

And they are probably more dangerous than the one we have now. This is quite a virus that seems to be able to be transmitted from person to person more easily than the previous ones.

But as we start to see more and more cases with mild illness, I’m more confident that we will see that the serious end of the disease is actually the minimum.

In terms of its transmission, it’s transmitted by a droplet. That’s very similar to the way that influenza and cold viruses are transmitted.


Could you just explain the difference between droplet and airborne?


Yeah. So, it’s s somewhat scientific, epidemiological difference, but it’s an important one in terms of the way we deal with public health threats.

So, this is a droplet spread- it actually relates to my previous comment about parcels. People that sneeze or cough- the virus particles can go on to surfaces.

They rapidly die. They don't get transmitted over a long distance. It’s quite different from measles, for example. Measles is much more infectious.

On average, a person with measles with infect another 12 or 18 people if there’s no vaccine. So this can be rapidly infectious as we saw most recently in Samoa for people that are not protected.

Whereas for the droplet infection, it tends to be between one and two extra people, which is still a concern, that means it will continue to increase over a period.

But it’s definitely not as transmissible or dangerous as measles, for example.


Last one, please.


What are the chances that the number of confirmed cases in Australia will remain at this quite low level, maybe not even get into double figures?


So, that’s a crystal ball question, which I don't have a crystal ball with me.

I think the measures we’ve taken, in terms of identifying the virus, having rapid testing available; importantly, getting very detailed and rapid information out to the wide community and including, in particular, the Chinese community because of their links with where this virus has first started; I’m confident that we will minimise the cases in Australia.

How many will end up with, I’m not going to speculate on that.

It depends a lot on what happens in relation to China getting this under control, and they are doing a marvellous job at the moment and it’s a very different approach to what we experienced with SARS some years ago.


So I’ll just finish off. We plan for additional cases.

We prepare to avoid those cases and that’s precisely why we’ve taken strong steps with the quarantine declarations yesterday, both at home and for those coming from abroad.

And both of those are about saving lives and protecting lives, about preventing contagion, preventing spread and anything less wouldn't be the appropriate thing for the Government.

So I know that this will be difficult for some and I want to acknowledge that we know this will be difficult for some.

But these decisions are taken on medical advice to save lives and protect lives and to do everything that we can to achieve exactly the outcome you’ve raised, of minimising that spread.

Thank you very much.

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