Mental Health Commission Amendment Bill

Hon PETE HODGSON (Minister of Health) Link to this

I move, That the Mental Health Commission Amendment Bill be now read a third time. It gives me great pleasure to be able to speak to the third reading of the Mental Health Commission Amendment Bill. This bill, which proposes to retain the commission until 2015, and revises its functions to support the future direction of the mental health sector, is a good indication of the Government’s wish to promote and protect the health and well-being of New Zealanders.

Hon TONY RYALL (National—Bay of Plenty) Link to this

The National Party is of the view that the membership of the Mental Health Commission should not be rolled over for as long as is being proposed in this legislation, and we think its performance needs to remain under the close scrutiny of the Government and of Parliament.

As we travel around the country, it is becoming clear to us that all is not well in the provision of mental health services for families and those in need of mental health care. Even though the Government is spending $1 billion a year on mental health, many of those people are hard-pressed to tell us that the services for them, their family, and their family member with a mental health issue are any better, at all. It strikes us that in many parts of the mental health sector, there is not the drive to improve the services for families and individuals that we would like to see.

We think that so much more could be done for mental health in primary care. International survey after international survey has found that New Zealand general practitioners consider themselves among the least prepared to deal with mental health issues at a community, primary-care level. We think that so much could be done with the huge resources we have in the health sector to get those services improved, so that people know they can go to their family health centre and get mental health issues and addiction issues dealt with well by general practitioners and their staff who feel confident to provide that service for them. The reliance on services provided by hospitals is failing many of the communities and many of the families and individuals who face mental health issues every day.

It is not just the person with a mental health issue who is vitally interested in mental health services. As we travel around the country, we see that it is, in fact, the family members—the mums and dads, the brothers and sisters, and the people who try to care for those suffering from mental health issues—who feel incredible frustration with the services being provided in mental health. It would be fair to say that there are those who believe that the Mental Health Commission has done a good job in presenting and advocating for those with mental illness. There are those who would say that the Government has made some effort in its recent media campaigns to raise the awareness of mental illness and what can be done. But raising awareness is only one part of the equation.

The future of quality mental health services in New Zealand rests in primary care. It rests with an integrated service that brings together not only the health care but also the social care that can be provided in our community to the sufferers of mental illness. The drive to bring those services into primary care, which Dr Jonathan Coleman and Jo Goodhew will expand on in their contributions to this debate, will deliver a quality-improved service for New Zealand families. People should not have to rely on the remoteness of so many hospital-based services to get the care and support that they need. Our general practitioners and our nurses should feel that they are being properly supported and trusted to provide mental health services much closer to home and much closer to the needs of the community.

That really is where this bill and this Government are so lacking: there is no sense of vision, purpose, or future direction for mental health services in New Zealand. It is great to have endless vision, hui, and plans, as this Government has for everything. But equipping, trusting, and valuing our health professionals to provide an improved, quality service for mental health at a primary-care level much closer to home, integrated with social care, is where the future lies. In the next few months, New Zealanders will see a much better plan for mental health services, which will integrate and bring together health and social care for New Zealanders at a community level. That will provide a much more exciting vision for mental health services in New Zealand. Members will be seeing that in the next few months.

So the National Party is very clear. We think the Mental Health Commission Amendment Bill should not extend the life of the commission as far as is proposed. We have some issues about how that collaboration might work, and many people have expressed that to the select committee. We will be continuing to monitor the performance of the Mental Health Commission. But, more important, rather than talk about how much money has gone into the system or how much money is being spent on an advertising campaign, we will continue in our efforts to put the focus on what is being done to future-proof mental health services to get them down into the community at the primary-care level, thereby integrating them with social care, so that we can leverage off the resources that we are spending on our health services in order to provide a much better future for those with mental illness, and, very importantly, a much better future for the families of those with mental illness, who are the people who carry most of the care responsibility for these people.

MARYAN STREET (Labour) Link to this

It gives me great pleasure to speak to the third reading of the Mental Health Commission Amendment Bill. I wish to develop further, perhaps, some of the points made by the previous speaker, Tony Ryall.

This bill represents a further step forward in the development of the mental health sector. It recognises that the environment has changed since the national mental health strategy was first published in June 1994. When Looking Forward: Strategic Directions for the Mental Health Services was published, the sector was in some turmoil, as evidenced by the establishment of the Mason inquiry in late 1995. The mental health sector has matured since then, and the roles of the commission in the mid-1990s can safely be refocused. For example, there has been substantial progress made in the development of the mental health and addictions workforce, and I will make some comments about that workforce in the first instance, before moving on to a specific thing that I wish to cover.

Collectively, the ministry, district health boards, and non-governmental organisations are working towards developing a mental health and addictions workforce that has the knowledge, the skills, and the attitude required to deliver the services that New Zealanders need. The ministry is leading the implementation of Tauawhitia te Wero—. The ministry’s funding of workforce development initiatives is aligned with the District Health Boards New Zealand’s sector-wide workforce action plan. A nationwide structure has been established, through which workforce initiatives are delivered, and this structure is primarily based on four non-governmental organisations.

There is Te Pou, the National Centre of Mental Health Research and Workforce Development, which has a work programme that addresses areas such as worker competencies, national training needs, recruitment, and service development. There is Te Rau Matatini, which has a focus on increasing the responsiveness of services to the needs of Māori, while also promoting careers in health and mental health as rewarding careers for Māori. There is the Werry Centre for Child and Adolescent Mental Health, which is located within the University of Auckland’s Department of Psychological Medicine, and which works to apply best practice to the skills development of providers of mental health services for New Zealand’s children and young people. There is Matua Raki, delivered by the National Addiction Centre at the Christchurch school of medicine and health sciences, which has a focus on the infrastructure for the development of a workforce for alcohol and other addictions. It has a commitment to research and evaluation, as well. The Ministry of Health also distributes funding for workforce training via the clinical training agency for post-entry clinical training and psychiatry training. Through its extension in this bill, the Mental Health Commission will be able to contribute to the workforce initiatives I have just referred to, and a statutory requirement for this is necessary.

I want to speak also about an issue that was raised in the course of the second reading of this bill. There was a degree of misinformation put forward by the Opposition about suicide and suicide statistics, and about efforts that have been made through the mental health workforce, and the mental health initiatives of this Government, to bring down the disturbing trend of suicides that we have seen in past years in this country. I would like to inform the debate with some facts, as opposed to the inaccurate assertions promulgated by the Opposition in this area, and a few facts will not go amiss.

The suicide rate in New Zealand for the years between 2002 and 2004, for example, for which we have the statistics, has decreased by nearly 20 percent from that of 1996 to 1998—by 19.6 percent, in fact, in case people think I am exaggerating by rounding the figure up to 20 percent. It is true that males continue to have a higher suicide rate than females, with approximately three male suicides to every female suicide. It is also true that Māori suicide rates for both males and females are significantly higher than for non-Māori. But it is important to note that Māori suicide rates have decreased by 17.9 percent—or by about 18 percent—in the early 2000s from those recorded in the late 1990s. Similarly, the very significant male suicide rate has decreased by nearly 23 percent since the late 1990s. The female rate of suicide also remains less than before, although there has been some levelling off of that rate of improvement.

The previous speaker referred to the need for mental health services to consider the needs of families. That is absolutely right, and that is a commitment and a direction for the Labour-led Government in the delivery of mental health services. So the kind of unsubstantiated nonsense that we have heard in this area from the other side of the House needs to be refuted not only by facts but by the spelling out of the initiatives taken in recent times—

JO GOODHEW (National—Aoraki) Link to this

I rise to join other National Party MPs in supporting the Mental Health Commission Amendment Bill. We have taken this opportunity, as has been brought up by the member opposite, to add our own particular views on the way mental illness is dealt with in this country. Although this bill gives the Mental Health Commission the opportunity to review the way it operates, given that we had submissions both for and against the continuation of the bill, now is a good time to reflect on just how well mental illness is addressed in this country.

We know that the commission’s role is now slightly altered. When we outline that role, we see that it is around advising and reporting to the Minister on the implementation of the national mental health strategy, promoting and facilitating collaboration and dialogue about mental health issues, and advocating for the interests of people with mental illness and for those of their families generally. That too is the role of a local constituency member within an electorate. I find that I speak with organisations that look to address not only the needs of those who are mentally ill and their families but also the needs of the organisations—the organisations and the families. I have had occasion to meet with groups in the last 20-odd months. I have also had occasion to talk to the families of those who believe they have not been well served by the health sector.

We know that about $1 billion is spent on mental health in this county. I was at a meeting recently where a large group of people asked: “Why is the district health board not funding some counselling services? Why is the district health board not funding some of the low-level services that may well stop people deteriorating into a higher level of mental illness?”. The district health board said, quite plainly: “Because we cannot. We are prohibited from using the blueprint funding for counselling services, because that is simply not what that money is for.” But that does not get around the heartache of the people who see their family members or loved ones descending into a state of desperation or suffering from depression.

I mentioned the rates of depression in the second reading debate, and I will mention again that up to one in four women and one in 10 men can expect to become clinically depressed at some point in their lives. I think that is an understanding that New Zealanders are coming to very gradually, and in understanding that particular fact we also increase, I believe, our understanding of those people. Hopefully, we will reduce the discrimination in the community against those with mental illnesses and those who suffer from depression. I am happy to say that there are fewer people out there now who say to someone suffering from depression: “Pull yourself together. Come on. Get a decent night’s sleep. Pull yourself together.”, because it is not like that.

There are a number of different forms of depression. I know that some district health boards are putting money into trying to monitor the occasions of post-natal depression in women who suffer from it. I know that that has been very much a hidden illness in society for many years. This is not just about third-day blues. It is not just about feeling a bit low because one is short of sleep. Post-natal depression is very, very real for those who suffer from it.

The World Health Organization has predicted that by 2020 depression will be the second-highest cause of ill health and disability in the world. That is a phenomenal statistic to hear. So what are we doing in this country? We are spending $1 billion or more on mental health, but we are actually doing that for roughly the top 3 percent of New Zealanders who suffer from significant mental illnesses. There are a lot of people who still feel that their needs are not being met—like the lady who came to my office and said that her husband had committed suicide after being in a unit at the local district health board. He was sent home, despite the fact that she pleaded with the staff and said he was not well enough to go home. Of course, the ultimate tragedy was that he went home and committed suicide.

All is not completely well within the mental health sector, but we know that it is a lot better than it used to be. The Health Committee made some comments about wanting to ensure that addictions were covered within the Mental Health Commission. We recommended that an addiction advisory group be established to provide expert advice to the commission. Certainly, as New Zealand’s number of addictions, or the types of addictions and the number of people suffering from them, continues to grow, this is an area that we must give the due interest and the due concern that it deserves.

In speaking in the second reading debate, I noted my concern about the number of masters that the Mental Health Commission has. Those masters include the Ministry of Health, the district health boards, the mental health service funders, the providers, those with mental illnesses, their families and caregivers, and also groups representing the interests of people with mental illness, their families and caregivers. There are not a lot of people who do not fit into one of those groups. They are quite a diverse bunch of masters, so I am sure the Mental Health Commission’s job is not a simple one. But I also hope the Mental Health Commission reflects on the submissions that we received that said they would rather the commission did not continue and that we did not renew or amend the bill to have a continuation of the Mental Health Commission. I hope it reflects on that and looks at why it was not meeting the needs of those people.

I will make just one other comment, and that is to talk about a group in my electorate that is working very, very hard and very, very well to meet the needs of those who have a severe mental illness. This is a group called the Victoria House Trust. It is a caring landlord service for those with mental illness. This caring landlord service helps people who experience mental illness to go into rental accommodation. The trust pays the rent on behalf of the person, and also the power and phone bills. Those are the sorts of things that can worry someone who has a mental illness—turning on the power, then having to pay the power bill. The trust supports those people very, very well within that particular arrangement—so well, in fact, that eventually some of these people are able to go into accommodation without having the caring landlord service. In speaking on this particular bill, I just wanted to put forward my thoughts about that organisation. It does a fabulous job in South Canterbury, in Aoraki, and I think that other areas of the country would be well served if it were happening there, too.

In conclusion, I just reiterate that this is a turning point for the Mental Health Commission. We have changed slightly the way it operates. We are now giving it an opportunity to continue to grow and to meet the needs more ably than it has done in the past, with those many masters, and now that opportunity has arrived as the commission looks forward to the future.

BARBARA STEWART (NZ First) Link to this

On behalf of New Zealand First I rise to support the third reading of the Mental Health Commission Amendment Bill. As others have outlined, the purpose of this bill is basically to extend the term of the commission to 2015 and to make some amendments to the commission’s role. New Zealand First believes that these are very positive steps forward for the mental health sector. There is a role in New Zealand for the Mental Health Commission, and it is a very valuable one.

We in New Zealand First are aware that the demand for mental health services increased dramatically after the very successful television campaign that starred John Kirwan. This campaign would not have occurred without the assistance or the support of the Mental Health Commission. More people now are aware of depression. They now know what they can do, and most important, who they can go to for assistance. That was outlined in an article in the New Zealand Herald. It reported that since the advertisements were run, a ministry helpline was fielding between 50 and 300 calls a day from people who were concerned about their mental health. That was a very significant step forward. It was an excellent initiative that has helped to destigmatise a condition that many New Zealanders suffer from.

In New Zealand First we were pleased to see that the life of the commission is to be extended to 2015. We believe that the commission will now be able to plan the most effective ways to get the greatest benefits for service users and the mental health sector. We believe that in 2015 there should be a thorough review of the commission so that we can be sure it has achieved the objectives it set. We know it is very difficult to implement anything of any great weight with a 3-year deadline looming over the head of any commission, and we know too that uncertainty does not produce a results-orientated culture or organisation.

The longer term the commission now has gives it an opportunity to liaise with parent groups and to solve the apparent conflict that has arisen between these two groups. We heard about that during the select committee process. The commission does need to work with parents if it is to be successful in its function, as stated in the bill, of advocating for the interests of people with mental illness and their families. It is not good enough for any commission to be at variance with parents, who are one of the most important interest groups.

It was a real concern that during the submission process, and afterwards, parents said they could get absolutely nowhere with the commission. They said the commission was ideologically captured to the extent that it believed everyone was able to recover from a mental illness, and that all mental health patients could live quite successfully in the community or at home with their families. We were given examples that were very sad. Some people were actually living in fear for their own safety. Their lives had been totally altered by a family member who had a mental illness. The commission’s statement to parents that recovery from severe mental illness is possible was not assisting them in any way. There are a lot of tragic examples, which we read about in the newspapers—fortunately, not regularly—of mental health patients who have created havoc in the community and at home, and are not aware of what they have done or even why they have done it. So it is sad.

We believe it is absolutely essential that the Mental Health Commission reassesses its role with this very important stakeholder group and realises that, really, parents are working at the forefront and coping every single day in a very stressful and quite lonely environment. We do not believe that parents’ views can be dismissed as lightly as they have been in the past, nor can their concerns. New Zealand First looks forward to the commission rectifying the situation that has developed, and we believe it should be a very high priority. It has time to put it right and it does need to do so.

Perhaps the commission could be proactive on this front and involve a parent representative. Other organisations have parent representatives, and there is no real reason why the Mental Health Commission should not. There does need to be somebody who can advocate for parent’s interests and who understand the stresses and strains parents have as they cope on a daily basis. We will be very interested to see what occurs, as the bottom line is that a Government commission cannot work in isolation and on a totally different tangent from one of its important stakeholder groups. So we will be looking forward to some improved feedback on this aspect of the commission’s work.

The growth of various addictions in the community is a challenge, and those issues are increasing. Along with the latest addiction of telephoning psychics to hear what the day may hold, there are gambling and alcohol issues, so the range of addictions is expanding quite rapidly. An addiction advisory group, and even, perhaps, an addiction commissioner, now may be able to be considered in light of the longer term that the commission actually has.

Like many others in this House I must say that I have appreciated the work the Mental Health Commission has assisted with: the confidential forum for former inpatients of psychiatric hospitals; its comments earlier in the year on acknowledging the high level of risk of electroconvulsive therapy as a treatment; its call to protect the rights of mental health service users; and the call for advanced directives where people can specify what treatments they do want and what they do not want to receive in the event that they become incompetent. So some good work has been completed.

We believe there is a very important role for the Mental Health Commission, and it is essential that it meets the many functions that are directly attributed to it, and, most important, that it does not isolate any of the stakeholder groups. It is only by working together that it will achieve the most for all its stakeholders. So New Zealand First is supporting this bill, and we look forward to further developments in this very important mental health area.

SUE KEDGLEY (Green) Link to this

The Green Party, like other parties in the House, is extremely pleased to support this Mental Health Commission Amendment Bill. I think it really is, in a sense, a testimony to the Mental Health Commission, and to our confidence in and support for it, that we are extending its term. The commission was originally set up in 1998 for 5 years, and we are now extending that term until 2015.

This is a brief bill, and we did not hear many submissions on it, but most of the submissions we heard were extremely positive about the Mental Health Commission. I think that in reviewing the performance of the commission—which the submissions involved—not many organisations could have come under the scrutiny that the Mental Health Commission had with such overwhelming support. The commission has performed an incredibly valuable role, and that role is widely acknowledged. Not only does the commission monitor the implementation of the national mental health strategy but it has played a very key role as an advocacy voice that speaks out on behalf of people with mental illness.

I think that the previous speaker was expressing concern, and the concern of some submitters, about the approach taken by the Mental Health Commission—namely, the assumption it makes that people can recover from mental illness. I am incredibly glad that the Mental Health Commission takes that approach. I do not wish to be Pollyanna-ish about this but to thank God the commission does that, because it would be very depressing if it took the other approach and assumed that people could not recover from mental illness. I think we need to reflect upon the not-so-recent treatment of people with mental illness, and the assumption not so long ago that people could not recover from it. The consequence of that approach was that we locked people away—we kept them under lock and key. We had them tied up, we administered electric shocks to them without anaesthetic, and we generally treated them almost as though they were animals. We locked them away, and we did not want to know about them. Any of us can read in Janet Frame’s compelling novels about the hideous treatment that was meted out to persons suffering from mental illness.

So I thank God that we have changed radically our attitudes to people with mental illness. I echo the sentiment of others about the incredibly valuable work the Mental Health Commission has done in its campaigns to reduce the stigma of mental illness, and I thank God, when we look back now at how persons with mental illness were treated, probably only a decade ago, that we can really recognise how much society has improved and how much our attitudes have changed in that respect.

We also need to recognise that the Government has poured a lot of money into mental health. The Opposition has said that we are not getting results from that, because one in five New Zealanders still suffer from mental illness. That is a very daunting figure—one in five New Zealanders suffer from mental illness.

TE URUROA FLAVELL (Māori Party—Waiariki) Link to this

Tēnā koe, Mr Assistant Speaker; tēnā tātou katoa. Today is an extremely significant day to be passing the Mental Health Commission Amendment Bill into law. Today, 9 August 2007, is the thirteenth commemoration of the International Day of the World’s Indigenous People. It is an important day on which to acknowledge the clear link between mental health and well-being and the strength and resilience of indigenous families and communities—a link that our indigenous brothers and sisters acknowledged long before this bill came into the House.

As I thought about the significance of this bill on this day, I came across a passage from around 1,000 AD in a founding document of the Six Nations of the Iroquois Confederacy. Its statement is based upon the principles of peace, equity and justice, power, and the health of the good minds, so the founding authority has this to say: “When you sit and counsel for the welfare of the people, think not of yourself, your family, nor even your generation. Think of the future generation, so that they will enjoy what you enjoy today. This will ensure peace and health for your generation.” Those words are as relevant today as they were 1,000 years ago, and we cannot disconnect responsibilities to the present generation or future generations of our people. So the Mental Health Commission Amendment Bill is an important measure towards supporting the mental health and well-being of peoples and their families generally.

The bill extends the expiry date of the commission from the end of this month to 31 August 2015. Like the Greens, we are delighted that the life of this commission has been given another reprieve. The commission has the unique capacity to be able to provide us with the objective report-card we need on mental health and well-being in Aotearoa. If one thinks of the demands that are made on the mental health status of this country, even just in this last month, one sees that there is no doubting the need for this watchdog body.

The roll call is rather staggering, actually. We have received the report of the confidential forum into the experience of former patients at psychiatric hospitals—a report that concluded there needs to be continued scrutiny of the mental health system. Just last week research was released indicating that work-related stress is a cause of clinical depression and anxiety amongst young adults. The latest findings from the Dunedin multidisciplinary health and developmental study, which has followed about 1,000 Dunedin-born people since their births in 1972, found that almost half of the cases of depression and generalised anxiety disorders newly diagnosed at age 32 were directly related to workplace stress and high job demands. Then there is the finding that 14 percent of the people whom the police have used Tasers on since the trial began in September last year had mental health issues or were suicidal.

These three entirely separate and distinct issues—psychiatric institutions, workplace stress, and Taser use—are but a taste of the full range of complex issues impacting on the mental health of New Zealand individuals and their families. I want to place a particular emphasis on whānau well-being and commend the fact that this amendment bill places a new priority on advocacy for service users and families. The voices of whānau in sharing their experiences of mental health services have often been lost from the record. The House may recall the John Kirwan scenario, in which a well-meaning friend told him to “just get over it”. I am told that at the Health Committee there were submitters who talked about the alienation they experienced and the sense of loneliness and desperation they felt, as it seemed that the health sector, or society in general, was telling them to “just get over it”. The Mental Health Commission has come right smack dead into this void. It has been able to look at and unpack what is happening in the mental health system—a quality that we desperately need.

I want to mention particularly the importance of quality services for tangata whaiora and their whānau. I believe it is critical that we do what we can to support the Mental Health Commission in providing leadership in the sector, and that the leadership will involve asking some very important questions for Māori. Why are Māori failing to access services? Why are there proportionately more Māori in acute services? What will this country do to address the high prevalence of mental illness and addictions amongst Māori? I understand that the commission has been prepared to tackle the hard issues before, and it must be supported to continue its vital monitoring role in guarding the mental health and well-being of Māori for this and future generations.

During the passage of this bill we have received a number of emails that underline the critical need for leadership in the recovery-based and whānau approach to mental health and addiction services. One consumer of mental health services highlighted the desperate association between poverty and well health. The email read: “I’m a chronic asthmatic sufferer, and when I look at the cost of my medication for both asthma and mental well-being it places me in a position of choosing whether I get my meds at $90 a fortnight each time or food for the fortnight.” How did we get to a position in this country where mental well-being and physical well-being are juggled and compromised by such basic needs as food for the table? Another person wrote in, reflecting on one of her kaumātua who had trained and worked as a nurse in a psychiatric hospital. She recalled: “You never ever believed Māori had mental illness. He said it became a stigma placed on people because no answers could be found at the time. My mind always goes to his whakairo when the word ‘mental’ is used for Māori.”

The comments are not just from people who can “just get over it”; they have come from users, from workers, from consumers, from whānau, and from tangata whaiora. The Mental Health Commission is ideally suited for being able to provide an independent voice that allows these concerns to be aired and for aspirations to be shared, as well. We are pleased, too, to recognise that the additional roles articulated in this legislation include the opportunity to nurture dialogue across the mental health sector.

I want to return to the examples I posed earlier in my speech in order to remind the House that a healthy environment for mental well-being is not just about psychiatric institutions and community care, vital as it is to ensure that these mental health services are supported to work together. A healthy environment is also about a mentally healthy workplace. The research from Dunedin reminds us that we all have a responsibility towards collective care. For example, employers should put in place support structures to ensure a positive, proactive workplace. We all have a role to play in supporting those who experience mental illness. The challenge of reducing stigma and discrimination is a key component in the journey to recovery and well-being—a challenge that the Mental Health Commission has played a vital role in promoting.

The Māori Party is proud to put its name to supporting legislation that will enable the voices of tangata whaiora and their whānau to be heard. We recognise the continuing need for an independent voice, and we support the Mental Health Commission in ensuring that people with experiences of mental illness can lead full and satisfying lives.

JUDY TURNER (Deputy Leader—United Future) Link to this

I stand on behalf of United Future to speak in support of the third reading of the Mental Health Commission Amendment Bill. I would like to support the comments of the speaker from New Zealand First, Barbara Stewart, and pick up on some of the issues she raised.

We need to make sure that all the stakeholders are catered for and all opinions are considered in this hugely important area. I recently heard this very interesting statement: “A just society should not just be measured by how it cares for the most vulnerable members but also how it attends to the concerns of those who support and care for vulnerable people.” I believe this is a challenge for the ongoing life of the Mental Health Commission. I am not on the Health Committee that heard the submissions, but I have certainly gathered that a number of submitters were family members of mental health patients, who were not happy with the performance of the Mental Health Commission. Parents spoke of their grave fears, during the process of deinstitutionalisation, concerning their children who were given to self-harm, or spoke of great fears about their children’s serious episodes where other people’s well-being was at risk.

I want to mention something historical, and it may be a challenge for the National Party, because in the last Parliament—

SUE MORONEY (Labour) Link to this

I am pleased to be able to speak to the Government’s commitment to the mental health sector at the third reading of the Mental Health Commission Amendment Bill. I am very pleased that the bill has been dealt with in such a timely fashion by the House. The life of the Mental Health Commission was about to expire, so it was important that the Health Committee could progress the bill through all of its processes in a timely fashion. With the third reading of the bill today, the conclusion of that process is about to come about, and it is not before time.

The bill gives some certainty to the ongoing life of the commission, and it provides an opportunity for the commission to look at its functions as an important watchdog body and enhance those functions in this very important area of mental health. As many speakers have outlined already, mental health is an area in which the users are particularly vulnerable, so having a commission in both a watchdog role and an advocacy role is extremely important.

It is from that perspective that I raise concerns about the National’s Party’s view that the life of the commission should not be extended through to 2015. This Government thinks the role of the commission is very important, and we have no fear about having an independent watchdog body advocating for families and advocating for users of this service. We have no fear of that, but during the select committee process we detected that National was very nervous, perhaps, about the prospect of becoming the Government. That is a view that it holds—that it may well form the next Government. But there is good news for the rest of the country, though: National would not need to think about the issue until 2015, because this Government is extending the life of the commission until then. That change has been supported by the House, so it is just as well.

The National Party will probably not want to take over mental health services until 2015, at this rate. A party that stands on a platform of tax cuts, which must mean cuts to public spending, knows very well that that means the health sector will suffer the most from funding cuts. National members know that very well. They desperately would not want to be in the situation of cutting funding to health, which would therefore mean a cut to mental health funding, and having a watchdog body overseeing that so that it could report every single cut and its impact on users of those services and their families.

For people listening to this debate, that is a warning about the type of attitude that exists within the National Party in respect of the role it wants the commission to have. In fact, I think the first position National Party members came up with at the Health Committee was that of not wanting to see the commission exist beyond 2009; they wanted the life of the commission to expire at that point. They are supporting this bill, and I thank National members for doing so, but they did want to record their view in the report back from the select committee that the commission should not be in place for any longer than 3 years after the passing of this bill. But we are up to the third reading debate, and that means that, with the support of all the other parties in the House, this bill will become an Act. The commission will have its life extended and it will also have new functions.

I particularly want to speak on the new function of advocacy. The bill puts in place a position where the commission is going to have a function to discuss service user and family advocacy—that is one of the commission’s new functions. So giving a voice—

Dr JONATHAN COLEMAN (National—Northcote) Link to this

Is that not disappointing? That was Labour’s last speaker on the third reading of the Mental Health Commission Amendment Bill, and all that speaker could do was talk about the National Party. She talked about the National Party for 7 minutes of a 10-minute speech. That was a great opportunity for Labour members to lay out what they are going to do in mental health, and I can say that that speech was enough to make a member want to read the Bills Digest for the second time in this session. It was very, very disappointing material. The first 7 minutes of that speech were about us, and the last 3 minutes were a recitation of what is in the bill, which we have heard again and again in this Chamber through the three readings and the Committee stage. There was no vision. There was a lot of talk about us, but what that member does not actually realise is that her own Minister of Finance will be cutting taxes well before the next election, and if she has not caught up with that yet, she really is well back on the backbenches.

We are supporting this bill. We have made that quite clear. There is some unanimity on this issue, and I think the select committee worked pretty well. But some real differences were exposed on the philosophy and the approach to mental health services. What we heard from Maryan Street before was an excuse for Labour’s poor performance in mental health over the past 8 years. It was a recitation of strategic plan, after hui, after workshop, after plan, and she said it was the answer in mental health. Well, we all know that this Government has spent a billion dollars a year on mental health. That is a 75 percent increase on what was being spent when it came into power. Has mental health got any better in that time? The answer, as Labour members actually admit, is no; it has not.

We now know that one New Zealander in five will experience symptoms of mental illness over the course of their lifetime. We know, according to the Ministry of Health, that people cannot get access to the services they need. We know that Māori cannot get access to the services they need. Young people, children, and older people are not getting access to those basic services. Were Labour members saying anything about this? No. All they had to say was that more and more money is going in, and they are very happy with the Mental Health Commission.

As I said yesterday, we know why that member did not agree with the idea of a 3-year review—because her own 3-year review within the Labour Party is coming up, and, basically, Labour members would be very happy to have their terms extended, with no review period. But that is not the reality of what we can do when we are spending public money. The Government is spending $1 billion a year, and the public needs to have some accountability.

We believe that the Mental Health Commission has a very real role to play—we have been quite upfront about that—but when we are spending massive amounts of public money we have to be able to review at regular periods how that money is being spent and whether the taxpayer is getting value for money. We are quite sure that if the Mental Health Commission continues to perform well it will have nothing to fear under a National Government, and that term will be extended. But it just seems natural and right that the Act should be reviewed at a date 3 years from the date on which this bill receives the Royal assent. So that is what we were in favour of. Unfortunately, we were not supported in that—be that as it may—and the term of the commission will be extended to 2015.

We want to see the commission hold this profligate spending Government to account. As in all other areas of the health sector, spending has gone up and up and the results have not improved at all. In fact, the whole health sector is in crisis. We have a Minister of Health who is on the ropes. He has no answers, and we are not hearing any answers at all from the Labour team. I hope the Associate Minister will take a call at the end of my speech and tell us what his team will do should, heaven forbid, they ever get another crack at power.