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Tuesday, 1 November 2011
Page: 7810


Senator FIERRAVANTI-WELLS (New South Wales) (18:08): I rise to speak on the tabling of the report of the Community Affairs References Committee inquiry into the funding and administration of mental health services and, in particular, the dissenting report by coalition senators. What we set out to do in our report was to talk about, as Senator Siewert said, the primary changes. One of the main reasons why the coalition was keen to establish this inquiry was the changes that were being effected to Better Access. As a consequence of that, it was quite a broad-ranging inquiry into the funding and administration of mental health services.

As part of the coalition's dissenting report, we go back to 2006 and to the Howard initiatives and why Better Access was established. Let us not forget that Better Access was part of a broader package of $1.9 billion that went to help people access mental health services. We did not discriminate against people with mild to moderate or severe mental illness. In our report, we traverse the background to this. But we also underline that the evaluation that was undertaken by the government, which took two years to do, was not a good evaluation. It was an evaluation that was based, unfortunately, on bad methodology and a dataset that was very critical. Our concern is that this evaluation did not actually test and evaluate the original objectives of the Better Access initiative. We set that out in our report. Many of the findings of that evaluation are actually qualified. At past estimates, we have been very critical of the government in relation to that evaluation. The reason why we have done this is that clearly the government has used this evaluation to cut Better Access. Our criticism of the government on this front is that, in effect, this was a cost-cutting measure and there is a real question whether this evaluation was set up to fail so that it could be simply used to justify these cuts.

We also in our report look at the history of the government's National Advisory Council on Mental Health and we traverse Professor John Mendoza's involvement in that and the fact that Professor Mendoza resigned, critici­sing the then Rudd government for its lack of action on mental health. The importance of this was that the Minister for Mental Health and Ageing, Minister Butler, instead of finding a new chair, set himself up as the chair of his own advisory council. How can you have an advisory council to the minister with the minister himself chairing that advisory council?

We look at these changes and we also look at the fact that, as part of this process, the government set up, on top of its council, an expert group. This expert group was criticised because it appeared to have access to information, and it appears that this expert group did give some advice in relation to these cuts. This not only led to confusion in the mental health sector but actually brought into question the point of the council and the transparency of the whole process.

One of the things that cause us concern is that nowhere in the evaluation that was done of Better Access is there justification for these cuts. We traverse in our report the fact that it is clear that about 87,000 people are going to be affected by these cuts. There is concern that these people, who will no longer have access under Better Access, will then be forced onto ATAPS, and there is then a question as to whether the ATAPS program, the Access to Allied Psychological Services program, is equipped to provide the service to those patients.

In our report, we look at what ATAPS is currently doing. We examine criticism of the ATAPS program by the ANAO, the Australian National Audit Office, which undertook an independent audit of the ATAPS program. Our concern throughout all of this is the impact that it is going to have on existing services. As with many other things in health, the minister and the govern­ment have acted before they have properly consulted the very people who needed to be consulted about these very major changes. There is no doubt that there are going to be a lot of services withdrawn from the system. A lot of money has been taken out of Better Access. The government has failed to assess the impact of these changes on existing programs—for example, headspace. We had evidence from headspace. We also had evidence in relation to EPPIC, the Early Psychosis Prevention and Intervention Centre. Yes, the government has indicated that it will expand EPPIC. But—and there is always a 'but' with this government—it will be if the states and territories come on board. That is unlike the coalition. Our commitment is to 20 early psychosis intervention centres, which will be funded by the Commonwealth, in addition to 800 mental health beds and 60 additional youth headspace sites. That was the basis of the coalition's $1.5 billion investment in mental health promised at the last federal election.

The coalition has been very strident in its criticism of the government's lack of action in mental health. It is very clear that this government has been forced kicking and screaming into taking action in mental health. Let us not forget that the Senate passed a motion in October last year calling on the government to implement these very measures. Then that same motion passed the House of Representatives in November last year. For the record, in April the Leader of the Opposition and I made further announce­ments of a $432 million spend in mental health to take the total spend to $1.2 billion.

In relation to headspace and EPPIC, it is important to see how these headspace and EPPIC centres roll out in conjunction with the other services before we take arbitrary decisions to cut services without carefully considering not only the impact but how this government is going to monitor the impact of these changes on patients.

Our report concluded with some comments in relation to the National Mental Health Commission and the two-tiered Medicare rebate system for psychologists, which certainly generated a lot of submiss­ions and excitement in the professions. It is unfortunate that, at a time when one in five Australians need assistance because of some sort of mental health issue, our psychologists demonstrated that there is a division within their profession. The coalition makes certain suggestions in relation to a way forward, such as potentially referring the issue of a two-tiered system to the Australian Health Practitioner Regulation Agency for further consideration.

I would like to end my comments on the subject of the National Mental Health Commission. Yes, the government has said that it is going to have a National Mental Health Commission. But it will certainly not be the independent body that so many in the sector have been advocating. Many submitt­ers indicated that the National Mental Health Commission must be independent and must be outside government in order to fulfil its proper function of scrutiny of the sector and advice to the government. I want to repeat the coalition's concerns about the appoint­ment of Monsignor Cappo to the National Mental Health Commission and the issues that that generated. Most importantly, I want to repeat the coalition's concerns about the lack of transparency and the lack of proper processes, which appear not to have been addressed in relation to not only Monsignor Cappo's appointment but also the appoint­ment of the commissioners and indeed his successor. The coalition remains committed to the reform of mental health, but that reform must be undertaken with consulta­tion, which is what this government has not done. (Time expired)