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Transcript of joint press conference with the Hon Christopher Pyne, MP : Parliament House, Canberra: 5 April 2006: Mental health; Workchoices; Indonesia.



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PRIME MINISTER

5 April 2006

TRANSCRIPT OF THE PRIME MINISTER THE HON JOHN HOWARD MP

JOINT PRESS CONFERENCE WITH THE HON CHRISTOPHER PYNE MP, PARLIAMENTARY SECRETARY TO THE MINISTER FOR HEALTH AND AGEING, PARLIAMENT HOUSE, CANBERRA

Subjects: Mental health; Workchoices; Indonesia.

E&OE…………………………………………………………………………………

Ladies and gentlemen, I’ve called this news conference this morning with Christopher Pyne, who’s the Parliamentary Secretary to the Minister for Health and Ageing, and with responsibility for mental health matters, to make a very important announcement on behalf of the Commonwealth. You’ll be aware that at the last COAG meeting it was agreed between the Commonwealth and the States that we would work on building a joint response to the mental health problems of this country, and that process of consultation has proceeded quite well, and the discussions between the officials are proceeding very effectively. And I’ve decided after discussion with my Cabinet colleagues that I would announce what the Commonwealth is willing to put on the table, and to do in any event, irrespective of the state response, and today I’m announcing that the Commonwealth will contribute a total figure over a five-year period of $1.8 billion towards addressing very significant areas of shortage and need in relation to mental health.

This funding includes approximately $500 million in the fifth year, which of course will be ongoing. I stress that the Commonwealth will do these things irrespective of the response of the States, but naturally we would look to the States in the spirit of cooperation that has been evident thus far, to match in their areas of responsibility with an equivalent amount. I think most people agree there are a number of gaps in the area of mental health. The two major gaps are that we need more primary health and clinical services, and these are areas for which the Commonwealth, through its Medicare responsibility, has traditionally carried the burden. And there must be a significant increase in supported accommodation and improvements in emergency and crisis services, and hospital and prison care, and these are also if you look at the

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sharing of responsibility in the past, these are areas where we believe that there is a greater contribution needed from the States.

We’re going to make our contribution in four main areas. We’re going to provide more health services in the community, including support for new team work arrangements for psychiatrists, GPs, psychologists and mental health nurses. We’re going to provide new non-clinical and respite services for people with mental illness, their families and carers, including an additional injection in to an area of, I think, tragic need in the community, and that is the plight of elderly parents caring for often adult children in their middle years with profound mental disabilities, and they represent some of the most tragic cases of the burden carried by carers in our community that I’ve come across in the time I’ve been in politics. Also an increase in the mental health workforce and also new programmes of community awareness.

Now I’ll come to some of the detail in a moment, but these are the areas that we’re going to cover with this funding. From the 1st of November this year, Medicare will be restructured to support new team work arrangements in mental health. Psychiatrists and GPs will be able to refer patients with a mental illness to psychologists and these services will be eligible for a Medicare rebate, and that will operate from the 1st of November of this year, funding to enable psychiatrists and GPs to employee mental health nurses, including ensuring that people in rural and remote areas can access these services.

In the area of non-clinical and respite services, we’re going to have new funding for drug and alcohol treatment services, so they can care for people who have both got a mental illness and a drug or alcohol problem. More funding for telephone counselling, self help and support services, including through Lifeline, Kids Helpline and more funding under the National Suicide Prevention Strategy.

We’ll have 900 new personal helpers and mentors to help people with severe mental illness, better manage their day-to-day living and access services such as accommodation and income support. We’ll increase the places in the personal support programme to help people with mental illness remain in or get back in to employment. And we’re also going to provide funding to the non-government sector to help people with severe mental illnesses to live more normal lives, with help to cook and shop and enjoy social outings.

We’re going to provide for young people 8500 more places in the Youth Pathways Programme, which helps young people with a mental illness to stay in school and then get a job. We’re going to provide new funding to help parents and school communities identify and respond to children at risk of mental illness. In relation to families and referring back to what I said a moment ago, we’re going to provide 650 new respite care places, particularly for elderly parents who live with and care for

children, including adult children with severe mental illness or intellectual capacity. These places I should mention will be in addition to the new respite programme for older cares announced in the Commonwealth Budget of 2004. This programme was to have been matched by the States and Territories. I can say two years later that all

States and Territories, except New South Wales, have signed a funding agreement with the Commonwealth, however so far after nearly two years, the States have only drawn down $10 million of the $72.5 million that the Commonwealth made available

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in the 2004 Budget to this programme, and I very strongly urge my colleagues in the States and Territories to implement this programme as quickly as possible. There’s a terribly chronic need and it is a tragic gap in our community, a wealthy community such as ours should be doing more for these poor unfortunate people whose adversity and relation to the disability of their children has been compounded by a lifetime of having to care for them in very stressful circumstances without adequate respite.

In relation to the indigenous, there’ll be more funding for health workers in indigenous communities. From January 2007, there’ll be 420 new mental health nursing places and 200 clinical psychology places each year. And finally there’ll be new funding to promote community understanding of the links between drug abuse and the development of mental illness.

Now I’m releasing today, and I think you already have it, a statement that goes in to the detail of this announcement. I want to recapitulate that this is a shared responsibility. I don’t regard it as something that the Commonwealth can simply say to the States it’s your job, your burden, you do it. We accept our areas of responsibility. I do hope and I do expect, and I think the community will expect that, there’ll be a joint effort from both the Commonwealth and the States and we’re putting $1.8 billion on the table. We’re not putting it on the table conditionally, we’re not saying that if the States don’t match it than we’re going to take it away. We’re going to do these things irrespective of what the States do, but we do believe that they have a very strong responsibility. And I believe they will match that responsibility. I’ve been satisfied in the discussions I’ve had with a number of the Premiers that they want to seriously address this issue. It is a problem.

The two areas we need more services of the type that I’ve outlined, and they are things that the Commonwealth has traditionally funded, and we need a lot more money for supported accommodation. There needs to be more money injected in to the prison system and there has to be more done to fix the capacity of the state hospital system, to deal with mental illness.

So those are the areas that I hope the States will respond with the one….in hopefully in kind of $1.8 billion, and if they can get money of that magnitude in to supported accommodation, and we put these resources in, and I believe over the years ahead we can begin to make a very big impression on this huge community problem. And it’s something we can afford to do, it’s something we need to do and it’s something that we have a responsibility to do. Can I finally thank Christopher Pyne, who’s done an outstanding job as the Parliamentary Secretary in this area. He’s been given exclusive responsibility by the Minister for Health and he’s done a great job, and he’s contributed systematically at every point to the development of this policy and I’m very pleased that we’ve been able to get it together. I think it’s appropriate that the public know where the Commonwealth stands on this issue. We are unconditionally committed to doing these things and we hope and we expect and we believe that the States, in the spirit of cooperation, which is so important across the levels of Government in areas like health, will come to the party.

JOURNALIST:

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Prime Minister, (inaudible) psychologists. That’s going to get pretty expensive. How are you actually going to say what is a mental illness and how much access will they get to psychological services?

PRIME MINISTER:

Well I certainly won’t be making that judgement. There will be, I imagine, and Christopher will add to or correct anything I say on this subject, but I imagine in the normal course there will be protocols established to between Medicare Australia, I think we now call it don’t we, and the general practitioners about conditions under which referrals are made. Look it will cost quite a lot of money, but it is one of the huge gaps and this is a huge breakthrough to establish this new Medicare item, a massive breakthrough. And it’s one of the things that’s needed to dramatise our determination to deal with the problem.

JOURNALIST:

Mr Howard, you’ve said your funding is unconditional and the Commonwealth is to carry out these roles. How essential is the cooperation of States? I mean can this package survive and work without them?

PRIME MINISTER:

Well these things can happen without the States but you won’t fix the problem without the States. You need both. I’m not saying it’s their responsibility alone, I’m demonstrating that today, any more than it’s ours, but this is an area where the

Commonwealth and the States share the responsibility and these are areas where the public is sick and tired of any buck-passing. And what I’m saying today is we will do these things whether or not the States respond. But I believe they will respond and the area where they should direct their response in my respectful submission is in the area of supported accommodation. Because anybody who’s studied this area knows that there are two big gaps. There’s the services gap and I’ve dealt with that in some detail, and there’s the accommodation gap. Now there are other gaps as well, but

they’re the two big gaps. And traditionally accommodation has been something that the States have administered. We don’t administer programmes in that area, they’re administered by the States. And if you go back, you know in the mists of time in relation to mental health when deinstitutionalisation occurred, the thought was that you’d have some kind of intermediate accommodation, that you’d have cluster community groups, you’d have step-down, whatever the technical jargon is, that the idea was that you’d have something between the old mental institutions, which for a combination of reasons we felt were no longer the right way to go, and the situation we tragically have now where there’s really nowhere to go and people are ending up in night refuges. The responsibility is being carried by organisations like the Wesley Mission and St Vincent de Paul in a very ad hoc, overnight fashion. People don’t take their medication. Many of them are gathered up in the criminal justice system. The percentage of people with a mental illness in prisons in Australia is unacceptably high. This involves a lot of misery for other people as well through assaults and through robberies and through other crimes of violence against people and property. Now you need some intermediate accommodation. Somebody can have a mental illness. They can go to a GP, get referred to a psychiatrist, get on to some medication,

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but if they don’t have somewhere to go, they’ll pretty quickly lapse back into perhaps committing a crime, being on the streets and we just don’t have enough support mechanisms to look after them. Now we’re making this contribution and the other [inaudible] is supported accommodation. We need a lot more money into that and because that’s an area where the States have traditionally done the job, or not,

according to your assessment, they need to make a big contribution. And I think if the States essentially match what we’ve done with equivalent dollars in supported accommodation and some of the things they need to do with the prison service and the public hospitals, then we’ll really have a first-class package that will begin to respond to these difficulties.

JOURNALIST:

Mr Howard, do you think that there is a need for the States to consider some extra level of re-institutionalisation on the basis that some people, it is argued, shouldn’t be out - that they need full-time residential care?

PRIME MINISTER:

Well I think if we greatly expand the supported accommodation services, then we can make a big difference. See it was, as I recall it, and this is going back a long time and I think it started in New South Wales in the wake of the Richmond Report wasn’t it?

MR PYNE:

Yes. In the 1960s.

PRIME MINISTER:

In the 1960s so it was a long time ago when institutions like Gladesville and Callan Park were closed down. The idea was that people would go into supported accommodation which was smaller residential units and there could be more customised care. Now that was the idea of it. It never really happened. The institutions closed down and as a result, people were either thrown back more on to their own families, and in some cases that was better, much better, but in many cases

it imposed an incredible burden on them. And people stopped taking medication or never took it in the first place. They went onto the streets and many of them have ended up in and out of overnight refuges and into prisons, they go into hospital, they leave hospital. They ideally should go to an intermediate place, a step-down facility. Some of them are available and where they are available they work quite well and when they’re not, it’s back to being on the streets. Now I would think that if we can do something about supported accommodation, we can help remove any pressure for re-institutionalisation. I mean whether we should have done that or not 40 years ago there’s no point in debating it. The fact is that we went down that path as a

community but we never put in place the accommodation services that were meant to replace institutions like Gladesville and Callan Park.

JOURNALIST:

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(inaudible) supported accommodation. Isn’t this go-it-alone approach a recipe for more blame-shifting?

PRIME MINISTER:

This is not going alone. We’re just announcing what we’re willing to do.

JOURNALIST:

(inaudible)?

PRIME MINISTER:

Well we can coordinate. Everything that we’re announcing today we’re going to do. And we’ll continue to talk to the States but clearly the States are not going to share the Medicare funding responsibility are they? I mean that’s our responsibility and a coordinated approach in my bookmark is that we do the things for which we are responsible. We fund the things for which we are responsible and the States fund the things for which they are responsible. We don’t construct an elaborate bureaucratic system whereby we jointly fund every single service. That’s ridiculous. I’m quite sure the States are not going to pick up any of the Medicare funding.

JOURNALIST:

(inaudible)

PRIME MINISTER:

If he agrees with it.

JOURNALIST:

What consideration was taken or was there any consideration given to the basic fundamental philosophy governing mental health at the moment, harking back to the Richmond Report and so forth. Or was it just decided to go ahead with the system we have?

MR PYNE:

I think the key factor was to do the things the Commonwealth does well. There’s no enthusiasm in the sector for re-institutionalisation. That horse has well and truly bolted. In 1960 when we had 10 million people there were 30,000 acute beds. Today in 2006 with 20 million people there are less than 4000 acute beds. So re-institutionalisation is a very difficult thing to even attempt to consider. The philosophy behind this is to try and do a holistic approach of the Commonwealth’s measures to deal with children, parents, respite, psychologists and psychiatrists and GPs and mental health nurses and the consumers themselves and do the Commonwealth things very well. And to make sure, to pick up Mark Metherell’s question, that the States have areas of their responsibility that they can now do well. So we are coordinated. We know that this will work better with supported

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accommodation being massively expanded, but that is the States’ area of responsibility and we want them to do their part well while we do our part well. That’s the general philosophy.

JOURNALIST:

Prime Minister, it’s been reported that a new boatload of West Papuans has arrived in Cape York, just a small group. If they do seek asylum, will they be processed in the same way as the last group and do you expect this to further exacerbate tensions with Jakarta?

PRIME MINISTER:

Well as recently as an hour ago there has been no confirmation of that report so therefore I don’t intend to deal with the other parts of the question.

JOURNALIST:

Mr Howard, Kim Beazley is unveiling policy today that he describes as a mutual obligation, businesses that hire skilled migrants from overseas to look at boosting the number of local apprentices they hire and even looking at possibly making companies pay more for some people are currently hiring on TPVs that they can currently pay below award rates. What do you think of that policy?

PRIME MINISTER:

Well I’ll have a look at it.

JOURNALIST:

Prime Minister, do you believe the decision to grant those 42 West Papuans asylum will encourage more to come here and have you spoken with President Yudhoyono and if not, why not?

PRIME MINISTER:

I’ve been announcing a mental health policy. In relation to whether it will encourage people or not, I’m not going to speculate about that. Clearly the decision which was taken by the relevant decision-maker in the Department of Immigration was based on the normal approach that’s taken in these matters and that’s something that I indicated to the President when I spoke to him some weeks ago. As to my own speculation about whether there will be more and what will happen and what will be the impact of that, there’s nothing to be gained by that. I mean I’m going to engage in running speculation. Clearly this has caused or created a strain in the relationship but I don’t regard it as, in any way, a fatal strain. I think the relationship is strong enough and deep enough and warm enough to survive this but it is an issue about which the Indonesians feel a great deal of sensitivity and it’s an issue that we are closely following. As to my talking to the President, well it’s my normal custom to have discussions with people and then speak about them afterwards.

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JOURNALIST:

Prime Minister do you believe the Cowra abattoir sackings were in line with the Workchoices legislation and have you been given any advice about whether that…

PRIME MINISTER:

Well I don’t know all of the details and can I tell you right now I am not going to get into the situation of making pronouncements on the ins and outs of every dispute in every workplace in Australia. I’m just not going to do that. I think what this incident demonstrates is that the allegations made by the Labor Party and the unions that we had taken away all protection for Australian workers are absolute nonsense. Now it’s always been the case that people can be made redundant if a firm finds a more efficient way of carrying on its business or if a firm doesn’t have enough business to maintain its current level of staff. And that was the case 50 years ago, it was the case 25 years ago and it was the case five years ago and it’s the case now. Now as far as the Cowra dispute is concerned, the thing that comes through to me was that people got notices of termination, the Office of Workplace Services had a talk to the

company and those notices of termination have been withdrawn. Now as to all the ins and outs of it, I don’t know, and I think that’s a matter that really should be worked out by the company and the employees, but the Office of Workplace Services was there as the defender of fair play and that’s exactly what we said it was there for. And you may remember in this very courtyard only a week ago we introduced the new head of the Office of Workplace Services and he said he was going to be very proactive. I think he has been very proactive. But I don’t know the economic state of the company. I don’t know whether, what the technological reasons are or so forth and look, I can’t become the arbiter of every single dispute any more than the Minister can. That’s what you have an Office of Workplace Services for?

JOURNALIST:

Do you think there are enough inspectors in the Office of Workplace Services to cover the introduction of the….

PRIME MINISTER:

Well yes I do, but Dennis, it has only been going for a week. I mean for heaven’s sake, can we get a sense of proportion. This is a very significant but fair change and inevitably there’s a lot of interest in so-called test cases and so forth. But let’s just take a deep breath and understand it’s always been the case that if a firm doesn’t have enough work for people it lets them go. We all know that and it’s always been the case that a firm that finds a more efficient way to do something with fewer people,

well some people will lose their jobs. But they find jobs in other firms. I mean, this goes on all the time and I think it’s very important that we give the new Act a while to operate before we start rushing to judgement. But the thing that came through to me apart from the strength of the Office of Workplace Services was that Mr Beazley and

Mr Combet were interested in the politics and not the workers. Everything they said was about the new Act, not about the welfare of the workers.

JOURNALIST:

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Overnight Premier Peter Beattie appears to be wavering in his opposition to uranium mining, having ordered his Mining Department to examine the potential impact of (inaudible) on the coal industry. What level of confidence do you have that the Commonwealth won’t have to invoke or seek to invoke constitutional powers to get through…

PRIME MINISTER:

He’s wavering in what?

JOURNALIST:

He’s wavering in that he says previously he opposed uranium mines completely. Now…

PRIME MINISTER:

Well that’s not wavering from what he told me on Monday. I mean I got the impression that Mr Beattie was taking the realistic Martin Ferguson view, rather than the Neanderthal Anthony Albanese-view in relation to this and I thought Peter Beattie was exercising great commonsense in relation to this issue and… I hope the States are sensible about this and it’s in the national interest that we drop this absurd three-mine policy, or no new-mine policy, when given that we have three, is the same thing, I think it’s absurd and I think we should drop it. No Michelle.

JOURNALIST:

Mr Howard, Cabinet’s been looking at the smartcard in the past week or so, have you finished your deliberations on that and are we going to see a smartcard start up very soon?

PRIME MINISTER:

If the Government has an announcement to make in relation to any policy decision, it will do so. No, can we have Louise

JOURNALIST:

Thank you. Prime Minister, do you have a message for West Papuans who might be thinking of coming to Australia?

PRIME MINISTER:

Well my message to the people of West Papua, is simply this, I regard them as citizens of the Republic of Indonesia, that’s my message to them and I have a very strong view that the best resolution of these issues is within the sovereignty of the Republic of Indonesia over West Papua.

JOURNALIST:

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Prime Minister just back on mental health, just back on mental health….

PRIME MINISTER:

I must go in a minute I’ve got to go to Western Australia. Last question.

JOURNALIST:

Given the stigma that’s been associated with mental health, early diagnosis and everything has been a problem, streamlining the GP referrals to psychiatrists, do you think that could take the lid off something really big, we could see an explosion of

diagnosis of mental problems?

PRIME MINISTER:

Well I think it will be a dramatic breakthrough. I think what it’s going to do is to really lance the boil in this whole area because this has been one of the problems, this has been one of the log jams and this is something that we can as a Commonwealth clear and clear very effectively. You talk about stigma, I think the stigma has begun to disappear and that process has been going for a while. People talk more freely about mental illness now, a lot more freely than they did. I think it’s a phenomenon of the last 10 or 15 years and in a way the responses of services have lagged behind the community realisation of what a problem this is and I don’t think it’s the stigma it was. I think we do talk far more freely in the community. People verbalise, particularly men, a lot more than they did many of these things, even as recently as 10 years ago. So I would see the announcements that I’ve made today as a very important recognition of something that’s been going on for quite a while.

Thank you.

[ends]