Department for Health and Ageing, $3,711,780,000

Minister:

Hon. L.A. Vlahos, Minister for Disabilities, Minister for Mental Health and Substance Abuse.

Departmental Advisers:

Dr A. Groves, Chief Psychiatrist, SA Health.

Mr J. Woolcock, Chief Financial Officer, SA Health.

Ms J. Richter, Deputy Chief Executive, SA Health.

Mr L. Richards, Deputy Chief Executive, System Performance, SA Health.

Dr T. Bastiampillai, Executive Director, Mental Health Strategy, SA Health.

Ms S. Cormack, State Director, Drug and Alcohol Services South Australia, SA Health.

Mr D. Slape, Manager, Liaison Services, SA Health.

Mr S. Runnel, Chief of Staff.

The CHAIR: I declare the proposed payments open for examination and refer members to the portfolio statements, Budget Paper 4, Volume 3. What budget paper are you going to start on, member for Davenport?

Mr DULUK: We will be starting on Budget Paper 3, page 24, and Budget Paper 4, Volume 3, page 25.

The Hon. L.A. VLAHOS: Madam Chair, could I just correct one thing. I stated before that on the day I visited Strathmont in May that the lifts upgrade had been completed. Apparently, the completion is not quite there and it is still being done today.

The CHAIR: It looked nearly finished though, did it not?

The Hon. L.A. VLAHOS: Yes, it did look nearly finished. It was working, I just think there was another scheduled service afterwards probably.

The CHAIR: If your qualifications were in lift maintenance, we would be upset. Member for Davenport.

Mr DULUK: Thank you, Chair. Minister, of the total health department and ageing budget of $5.6 billion, could you indicate what amount of this sum will be used to provide specific mental health services?

Mr TRELOAR: The member for Davenport refers to Budget Paper 4, Volume 3, page 25.

The CHAIR: He misled me.

The Hon. L.A. VLAHOS: It is fair to say that it is very difficult to separate the two streams of funding. The budget paper that I have been advised of, which is indicative not definitive, is around $383,675,000.

Mr DULUK: Moving to Budget Paper 4, Volume 3, page 25, how many of the department's 30,838 FTEs work primarily or exclusively on the development and delivery of mental health services?

The Hon. L.A. VLAHOS: I will just consult with my colleagues. According to the advice I am provided, in the 2016-17 budget period that would be around 2,527 full-time equivalent employees as of 30 June.

Mr DULUK: What is the total budget for mental health services in each local health network? I am happy for you to take that on notice.

The Hon. L.A. VLAHOS: We are happy to take that on notice.

Mr DULUK: What is the number of mental health FTEs for each local health network?

The Hon. L.A. VLAHOS: We will need to take that on notice.

Mr DULUK: How many acute mental health beds were there in each hospital as at 30 June 2015 and 30 June 2016?

Members interjecting:

The CHAIR: Order! Speaker Bishop has given rules on audible—

The Hon. L.A. VLAHOS: Total acute adult inpatient beds across a variety of settings include short stay, 41; 213 in open; peak queue, 37—so a total of 291.

Mr DULUK: Which hospital?

The Hon. L.A. VLAHOS: No, that is in total.

Mr DULUK: Will you come back and break it down by hospital as well?

The Hon. L.A. VLAHOS: No, I have that here. The total for SAHLN is 68, the total for NAHLN is 58, the total for CAHLN is 86 and the statewide acute is 38, but the total I gave you was across the system of 291 for acute inpatient beds for adults. Would you like adolescents and older persons as well?

Mr DULUK: Yes, please.

The Hon. L.A. VLAHOS: The total children/adolescent acute inpatients beds is 12 and the total older persons acute inpatients beds is 70, which brings a total of all acute inpatient beds to 373.

Mr TRELOAR: I refer to Budget Paper 4, Volume 3, page 37. How many subacute mental health beds were there in each hospital as at 30 June 2015 and 30 June 2016?

The Hon. L.A. VLAHOS: Currently, we have a total subacute residential for 130 across all of the system, and I can read it out line by line: Queenstown Intermediate Care (CALHN) is 15; Noarlunga Intermediate Care (SALHN) is 15; Mile End Community Rehabilitation Centre (CALHN) is 20; Noarlunga Community Rehabilitation Centre (SALHN) is 20; Playford Community Rehabilitation Centre (NALHN) is 20; Whyalla Community Rehabilitation Service is 10; Glenside Supported Accommodation (statewide CALHN) is 20; and Forensic Step Down Oakden (statewide NALHN) is 10.

Mr TRELOAR: Further to that, are any of the beds identified as mental health beds in hospitals being used for another purpose other than mental health?

The Hon. L.A. VLAHOS: Not at this point in time, I am advised.

Mr TRELOAR: Would the minister consider there is a need to increase the number of mental health beds in the hospital network?

The Hon. L.A. VLAHOS: The level of beds, and how they are spread through the system, is something we constantly monitor, based on the needs of the community. At this time, we think the balance of beds we have is correct, but it is something I continue to look at on a week by week basis with the team that is next to me.

Dr McFETRIDGE: I refer to Budget Paper 4, Volume 3, page 42. Minister, what criteria did you use to decide which former National Partnership projects the state government would fund and which the state government would not? Perhaps just for clarity: the opposition understands that a proposal by the Northern Adelaide Local Health Network to co-fund the Salisbury walk-in centre with a commonwealth agency after National Partnership funding ceased did not proceed after the Northern Adelaide Local Health Network proposal was rejected by SA Health.

The Hon. L.A. VLAHOS: The state government stepped in to ensure that some very important mental health services Whyalla and Adelaide are protected and continue, despite the two National Partnership agreements lapsing on 30 June 2016. The state government has allocated over $8.5 million over four years in the current state budget to restore mental health services in Whyalla which were scheduled to close on 30 June. I know that when I visited the town recently they were very appreciative of that, and I am sure the member for Giles, who attended with me that day, would attest to that.

We know that there are self-presentations of people with anxiety and depression and suicidal thoughts happening at the hospital, we know that the community is under pressure there and we know that the resources we have put in for the next four years will make a big difference to that town, with the pressures of the Arrium restructure going on. In addition, SA Health will continue to provide funding to continue the 10 forensic step-down beds in Oakden. These are very important because they would have impacted around $20 million of annual funding.

The CHAIR: Order! Hang on for a moment.

Dr McFETRIDGE: I was really asking about the Salisbury walk-in centre. The others are very important but the particular issue we had was with the Salisbury walk-in centre.

Mr DULUK: And the question was about what criteria you use.

The CHAIR: Just a second, let the minister finish the answer she is giving and then you can get onto the specific parts that you want to know about.

Dr McFETRIDGE: I want the answer to the question.

The CHAIR: I do not even know what page you are on. I have to ask you: what page are you on?

Dr McFETRIDGE: Page 42.

Mr DULUK: Volume 3.

Dr McFETRIDGE: I am not saying the others are not important, but this was a particular issue we were concerned about.

The Hon. L.A. VLAHOS: We know that at the Salisbury walk-in service people can still receive care there between the office hours of Monday to Friday, about 8.45 to 5 o'clock. We know that the Primary Health Networks is where Sussan Ley says she is sending the money that she cut from the National Partnerships—the money will be moving into those spaces.

The CHAIR: Just before you go on, you are looking at Budget Paper 4, Volume 3, and you are saying page 42?

Dr McFETRIDGE: Northern Adelaide Local Health Network. That covers it: net cost of sub-program, which is this. Minister, did you have any role in stopping the proposal to continue co-funding the Salisbury walk-in network or was that minister Snelling?

The Hon. L.A. VLAHOS: The decisions for these were made at a cabinet level when we decided this. I made the decision based on the needs that we have in our state at this time, and Whyalla needs resources.

Dr McFETRIDGE: So it was your proposal, was it, to fund the others but not Salisbury?

The Hon. L.A. VLAHOS: If this had been a political decision, I would have funded my local area, as a neighbouring MP—

Dr McFETRIDGE: I am not suggesting that.

The Hon. L.A. VLAHOS: —before that, but it is not; it was based on evidence that the communities in Whyalla and the top of the gulf, considering the economic challenges they are facing, needed the resources.

Dr McFETRIDGE: On the same budget reference, the intensive home-based support service, which closed on 30 June 2015, led to reduced use of hospital beds by 10 days per person and also helped to avoid future admissions. The evaluators estimated it would pay for itself in cost offsets and reduced hospitalisation. What was the rationale of the government in not funding the service, given the report suggested it would cost the state more to not fund it?

The Hon. L.A. VLAHOS: What report are you referring to?

Dr McFETRIDGE: The intensive home-based support service.

The Hon. L.A. VLAHOS: And the author of that paper is?

Dr McFETRIDGE: It was probably a cabinet decision again, was it, to not fund this particular service?

The Hon. L.A. VLAHOS: No, I am asking who the author is of the paper that you are quoting from?

Mr DULUK: I think we ask the questions.

The CHAIR: She is allowed to ask it.

The Hon. L.A. VLAHOS: I am allowed to ask for clarity around the definition of the source documents.

Dr McFETRIDGE: I think you would know who the evaluators were. Evaluators estimated it would pay for itself in cost offsets and reduced hospitalisation. That would be your department and your people.

The Hon. L.A. VLAHOS: I will let Ms Richter answer that question.

Ms RICHTER: The home-based support service was a commonwealth-funded service and the funding ceased, so there were—

Dr McFETRIDGE: Sorry, I cannot hear you.

The Hon. P. Caica interjecting:

The CHAIR: Order, member for Colton!

Ms RICHTER: So the decision was made not to continue funding that because there were not the funds to do it. We had to make difficult decisions about where we would place the funds and, as the minister has alluded to, the funds were prioritised for other places. The only way we can actually save money by keeping a service going is to in fact close something behind it. Therefore, we were not in a position to actually close any beds behind it.

Dr McFETRIDGE: Did the evaluator's report not say—and this is information I am given here—that it would cost the state more not to fund it?

Ms RICHTER: It may have said that, but I would need to have another look at the report.

Dr McFETRIDGE: Moving on, another NGO service, the crisis respite service, was independently evaluated as providing significant reductions in psychological distress, hospital admissions, time in hospital and emergency department visits. Again, what is the rationale for not funding this service?

The Hon. L.A. VLAHOS: Again, it was the COAG funding that was cut. The state government has always maintained that we could not bear $20.1 million of cuts to our state healthcare system. We had to make hard choices about what was in the best interest. If I had a magic fairy wand, I would have funded everything, but I do not. That is the reality of a hard decision and that is why I am a minister; I have to make hard decisions. One day, when you are in government, you will have to make hard decisions.

Ms Chapman interjecting:

The CHAIR: Member for Bragg, you are not on the committee and if I hear your voice you will be asked to leave the room.

Mr DULUK: Going back to the Salisbury walk-in centre, did cabinet decide not to accept the co-funding or was that a decision that you made yourself not to accept the commonwealth's co-funding for the Salisbury walk-in centre?

The Hon. L.A. VLAHOS: That was a departmental decision.

Mr DULUK: So the decision did not go to cabinet and you did not sign off on the decision?

The Hon. L.A. VLAHOS: It was a departmental decision.

Mr DULUK: So you as the minister signed off on the decision?

Dr McFETRIDGE: The buck stops with the minister.

The CHAIR: Order, member for Morphett!

Ms RICHTER: The department would have made a recommendation on what we were going to be able to afford to fund, given that we could not fund everything.

Mr DULUK: And, minister, you accepted that recommendation of the department?

The Hon. L.A. VLAHOS: I listen to a variety of sources. It is wise to listen to my department.

Dr McFetridge interjecting:

The CHAIR: Member for Morphett!

Mr DULUK: I refer to Budget Paper 4, Volume 3, page 27. Given that the RSL Repat at Daw Park will have a range of medical health and rehabilitation facilities, will the minister initiate a reassessment of the decision to relocate Ward 17?

The Hon. L.A. VLAHOS: The site of the former General Repatriation Hospital at Daw Park falls within the Minister for Health's portfolio. My responsibilities lie in the design and delivery of the veterans' mental health precinct at Glenside.

Mr DULUK: Why has the time frame for completion of the transfer slipped out or blown out by more than a year?

The Hon. L.A. VLAHOS: Which section are you referring to?

Mr DULUK: The transfer of Ward 17, or the funding allocated to it at least.

The Hon. L.A. VLAHOS: What is the budget line item? I believe you have to address the questions through budget line items.

Mr DULUK: So you accept the premise that it has slipped?

The Hon. L.A. VLAHOS: No, I reject your premise, and do not badger me.

Mr DULUK: Still on page 27, in 2015-16 there was $2 million allocated to the post-traumatic stress disorder clinic, which was not spent. The government estimated to spend $3 million but only spent $1 million, so the full budget has not been spent.

Ms RICHTER: This allocation would have been for preliminary works. We are still on track for the project to be finished as planned.

The Hon. L.A. VLAHOS: And delivered on time.

Ms RICHTER: We are about to go out to the market for contractors.

The Hon. L.A. VLAHOS: It is on track, it will be delivered and it will be an excellent service. It has been co-designed with a lot of people with lived experience in the veterans' space. It will be an amazing thing. People interstate are talking to me about this space and what a fantastic facility it will be.

Mr DULUK: I refer to page 29. The organisational chart of the SA Health website has not been updated since November last year and, accordingly, it does not mention you, minister. I am trying to work out who within the framework of government is in control of mental health policy, including within SA Health and the local health network.

The Hon. L.A. VLAHOS: What budget line item does that refer to?

Mr DULUK: Page 29, the net cost of providing services, and the budget that we are looking at here, which is your portfolio.

Ms RICHTER: The minister is clearly responsible for mental health policy. The minister is advised through the chief executive officer on advice from both Dr Tarun Bastiampillai, from a strategic perspective, and Dr Aaron Groves, from the Chief Psychiatrist's perspective.

Mr DULUK: Is all mental health and substance abuse legislation committed to the Minister for Mental Health and Substance Abuse?

Ms RICHTER: Yes, all authorities have been transferred appropriately.

Mr DULUK: Are all delegations under all relevant acts and authorities held solely by the minister or are they by delegation from the Minister for Health or concurrently held by the Minister for Health?

Ms RICHTER: No, they are all delegated directly to the Minister for Mental Health.

Mr DULUK: What controls does the minister have over funding decisions in the mental health and substance abuse areas?

Ms RICHTER: The minister was presented with a budget this year and is informed about the recommendations for any change.

Mr DULUK: Minister, do you have regular meetings with the Chief Psychiatrist?

The Hon. L.A. VLAHOS: I catch up with SA Health people on a very regular basis.

Mr DULUK: Once a month?

The Hon. L.A. VLAHOS: We would see each other more than once a month, wouldn't we, Dr Groves?

Dr GROVES: Yes.

The Hon. L.A. VLAHOS: I spent time with you at the suicide prevention conference, didn't I?

Dr GROVES: Yes.

The CHAIR: Does the member for Morphett have a question?

Dr McFETRIDGE: I have lots of questions, thank you, Chair.

The CHAIR: I was not sure if you were mumbling.

Dr McFETRIDGE: If the Chief Psychiatrist wanted to advocate for change in the way mental health services are funded or operated, would that advice be provided to you alone or to the Minister for Health?

The Hon. L.A. VLAHOS: What is the budget reference?

Dr McFETRIDGE: Look, page 25, net cost of services. Okay? It is the omnibus line, anything you want, we can do that.

The Hon. P. Caica interjecting:

Dr McFETRIDGE: Look, mate, when you know more about this than I do—

The CHAIR: Hold on a second.

The Hon. P. Caica interjecting:

The CHAIR: Just a second. Order, member for Colton! We have all done really well.

Dr McFETRIDGE: The human shields come out again.

The CHAIR: Member for Morphett.

Dr McFETRIDGE: The human shields come out again.

The CHAIR: The member for Morphett will stop.

Ms CHAPMAN: Top of page 29.

The CHAIR: Yes, you are on the wrong page. Thank you.

Dr McFETRIDGE: No.

The CHAIR: He was telling us the wrong page. Perhaps if we all just—

Dr McFETRIDGE: It is alright, it's okay.

The CHAIR: No, member for Morphett. Take a deep breath and re-ask the question perhaps in a less combative style and we might get there.

Dr McFETRIDGE: If the Chief Psychiatrist wanted to advocate for a change in the way mental health services are funded or operate, would that advice be provided to the Minister for Mental Health or the Minister for Health?

The CHAIR: Terrific! Now we will just wait for the answer which is coming.

The Hon. L.A. VLAHOS: Jenny is going to answer that.

Ms RICHTER: We are given a single budget from Treasury each year, and it is important to remember that mental health services are fully integrated into our general health services, so there is a single budget line. If we get a recommendation from the chief psychiatrist that we should be funding mental health in a different way, we would consider that, but it would have to be a joint consideration between both minister Snelling and minister Vlahos because it may mean we have to move money from one part of the system to another.

Dr McFETRIDGE: I refer to Volume 3, page 47, relating to commonwealth government payments for specific purposes. How much commonwealth funding for mental health services was provided to the South Australian government under the national partnership agreements?

The Hon. L.A. VLAHOS: For which year?

Dr McFETRIDGE: For 2015-16 and 2016-17.

The Hon. L.A. VLAHOS: As I cited in my answer before, we know that the lapsing of the COAG agreements was around $20.104 million.

Dr McFETRIDGE: How much did the state co-contribute to mental health services under the National Partnership Agreement?

The Hon. L.A. VLAHOS: We are happy to take that on notice.

Dr McFETRIDGE: Did the minister, her advisers or her department receive any correspondence from the commonwealth government regarding the future of NPA funding following the minister's letter to the federal health minister in March 2016?

The Hon. L.A. VLAHOS: During caretaker mode I had a letter from a federal health bureaucrat saying that one of the national partnership agreements would not be funded and there was no answer on the second.

Mr DULUK: Moving to page 37 in Volume 3, minister, what mental health support is provided to young people detained in our juvenile justice facilities?

Ms RICHTER: The service is provided by the Child Adolescent and Mental Health Service as an inreach into the juvenile detention centre.

Mr DULUK: Is this support delivered by CAMHS or another party?

Ms RICHTER: It is delivered by CAMHS.

Mr DULUK: How much funding has been allocated for work in 2016-17?

Ms RICHTER: I need to take that question on notice.

Mr DULUK: Minister, given mental health prevalence in our young people and society, what are you doing to reduce the use of restraints and seclusions in the juvenile justice facilities in South Australia?

The Hon. L.A. VLAHOS: This is one of Dr Groves's specialties, and I will let him answer.

Dr GROVES: I thank the member for his question. The juvenile justice facilities, or youth justice facilities, are under the jurisdiction of a different department. The staff from the Women and Children's Health Network—and we have quite a large multidisciplinary team that goes to the service—primarily undertakes assessment, writes up treatment and care plans, and is involved in ensuring that those treatment care plans are delivered.

We are not involved in the aspects of custodial care. Any use of restrictive practices is under the jurisdiction of that department. We would, of course, offer whatever assistance we would be able to provide if they asked us questions in relation to certain behaviours arising as part of mental illness. That would be an important part of a treatment care plan. In addition to that, during the period in early May we were able to fund a group of people from the United States who came to South Australia to provide specific training in trauma-informed care.

We made that available to Correctional Services and other correctional settings for staff to come and get some early training in trauma-informed practice and care to try to reduce the likelihood of them using any restrictive practices in any correctional facilities or youth detention facilities in South Australia. It will be a priority of the close working relationship between SA Health and any jurisdictions that provide treatment where somebody may need to be restricted to try to prevent that usage into the future.

Mr DULUK: Minister, there is no-one in the South Australian juvenile justice system who has a mental health illness who has been subject to any restrictive practices?

The Hon. L.A. VLAHOS: I cannot comment on that because I am not the responsible minister.

Mr DULUK: A moment ago, you said that you were responsible for everything to do with mental health in this state. Surely, as the minister, if someone in the juvenile justice system had a mental health issue, you would be concerned and your department would be concerned for their individual—

The Hon. L.A. VLAHOS: I think Dr Groves highlighted to you before that we liaise for care plans for all people who have been diagnosed with a mental health condition, no matter what setting they are in.

Mr DULUK: Are you aware of anyone in the juvenile justice system with a mental health condition who has been subject to restrictive practices?

The Hon. L.A. VLAHOS: Dr Groves will answer that.

Dr GROVES: Our clinicians are not made aware of whether restrictive practices are used on people in juvenile justice settings who have a mental health condition.

Mr DULUK: Has the question ever been asked?

Dr GROVES: I do not know. I would have to take that on notice.

The CHAIR: Member for Flinders.

Mr TRELOAR: Thank you, Chair. I refer to Budget Paper 4, Volume 3, page 33 and also page 38 over these next few questions. What is the average length of time mental health patients spend in emergency departments waiting for a bed after they have seen ED staff and a decision has been made to admit them?

The Hon. L.A. VLAHOS: We know that for ED waiting times we have targets with which we are reforming the system. We know that the total mental health attendance in 2015-16 was over 16,000 people and that in 2014-15 it was over 14,000 people. In late 2014, waits in ED on average were 15 hours compared with five hours for non-mental health patients. In October 2014, it was as high as 18.5 hours, and some patients waited for several days. In June 2016, this has been reduced to 10.2 hours, and in the last 28 days the average waiting time has been 9.5 hours. The number of patients waiting more than 24 hours has improved, from 8.4 per day to 2.9 per day. From October 2014, that is from 20 per cent to 6 per cent over the past 28 days.

Mr TRELOAR: How many of those patients were waiting in the emergency department of either the RAH or TQEH, particularly?

The Hon. L.A. VLAHOS: Combined, there were roughly three patients per day.

Mr TRELOAR: Since 1 January this year, what is the longest time that a mental health patient has had to spend in any of our emergency departments waiting for a bed?

The Hon. L.A. VLAHOS: I would like to take that on notice, thank you.

Mr TRELOAR: When do you expect the government will reach its target of zero mental health patients waiting more than 24 hours in a South Australian emergency department?

The Hon. L.A. VLAHOS: We have several sets of targets moving forwards, and the complexity of the system and the needs move from day to day. We have an approach that we have targets. We are encouraging all health networks to move for them as fast as possible. We do know that TQEH and RAH are the current areas where we are encouraging people to work towards those targets. The other local health networks are achieving their targets more easily.

Mr TRELOAR: Minister, you have identified that you have targets. What strategies do you have in place to achieve those targets and what funding is provided for those strategies?

The Hon. L.A. VLAHOS: It is up to each LHN to decide how they achieve those targets and how they are managed.

Mr Duluk interjecting:

The Hon. L.A. VLAHOS: No, that is not correct. If you look at the data—

The CHAIR: Order! Member for Davenport, you do not have the call unless you look at me and unless your microphone is on.

The Hon. L.A. VLAHOS: NALHN and SALHN are meeting their targets.

Mr TRELOAR: In relation to substance abuse, Budget Paper 4, Volume 3, page 33, what is the minister doing to ensure that the security of mental health and other patients is protected from hospital violence and, in particular, increased violence associated with the use of ice?

The Hon. L.A. VLAHOS: Survey data has shown the use of methamphetamines in South Australia is relatively low and similar to a national figure, at around 2 per cent of the population. This has remained relatively stable since 2001. We do regular wastewater analysis to check on illegal substance and prescribed substance use in this state. Data relating to the harms associated with methamphetamines and its use, its health presentations, its drug driving detections, police apprehensions and diversions into the criminal justice systems are things we look at as a whole of government.

The challenges of crystal meth (or ice) is something that requires a whole-of-government approach. Recently, when I was in regional South Australia, nursing staff told me that they have challenging behaviours. The media talks about ice a lot at the moment. Different towns have different patterns of illicit drug use. By far, the most common drug that I am told causes problems as I travel around the state is alcohol. Alcohol causes as much violence as methamphetamines, but we have run an education campaign to protect our ambulance and healthcare workers from violence, whether caused by alcohol, marijuana or any illicit drug.

We have seen those health education campaigns decrease violence towards our workers, but we also know that if members of the general population see one of their friends or family members behaving violently towards a first responder, nurse or clinician, they are now trying to divert them in those healthcare settings and deescalate the situation.

Mr TRELOAR: So that is the strategy?

The Hon. L.A. VLAHOS: That is one of many strategies. As I said, use of any illicit drug in this state requires a community joined-up solution. It is not something that the government can do alone.

Mr DULUK: Sticking to page 38, minister, the Eastern Lived Experience Liaison Group wrote to you on 23 June outlining that localised bed arrangements have resulted in a crisis situation for the RAH ED. What is your response to their concerns, and have you responded to them directly?

The Hon. L.A. VLAHOS: I am just about to reply to that group. Again, this comes back to the local health networks deciding how they deal with their ED challenges and meeting the targets. They know that I take these targets very seriously and I expect them to comply with that. We continue to encourage them to deal with the challenges of the EDs and their waiting times. I take their concerns seriously. I have met with a number of consumer networks and I always listen to what they have to say, and if there is an opportunity for feedback to the local health networks, we give that to the health networks, but I am sure the health network is aware of that concern already in that network.

Mr DULUK: Do you accept their claim that the localised bed management policy has led to a crisis situation in the RAH ED?

The Hon. L.A. VLAHOS: There has been a downward waiting time in CALHN, so they are improving their stats and targets at this time. They are making inroads. They may not be meeting them as quickly as NALHN and SALHN, but they are making inroads.

Mr DULUK: I refer to page 37, and this is going to move into the NDIS, the NDIS is in full implementation with future steps to include psychosocial disabilities. Minister, can you please advise what level of funding will be transferred out of the state mental health budget, as part of the resource allocation agreements under the NDIS, in response to the inclusion of psychosocial disabilities?

The Hon. L.A. VLAHOS: As recently as this week, I have written to the recently appointed minister in this space, Christian Porter, seeking clarity about psychosocial and mental health issues in the NDIS space. I look forward to discussing that with him after a six-month hiatus at the Disability Reform Council. It is something that the department and I continue to look at very closely. I know consumers and people supporting people in this sector. We are watching this space carefully and I am intent on making sure that we meet their needs within our budgetary frameworks and also ensure the commonwealth meets its commitment to people who are moving into the life-changing space of the NDIS.

Mr DULUK: Do you have a framework or an idea of which scope of services will no longer be funded by the state?

The Hon. L.A. VLAHOS: The DRC is yet to discuss this for a final time.

Mr DULUK: So you do have a short list at the moment?

The Hon. L.A. VLAHOS: No, I did not say that.

Mr DULUK: I assume that if you are going to discuss things for the final time, once that final discussion—

The Hon. L.A. VLAHOS: DRCs and COAGs, as you may not be aware, are often longwinded conversations that go on for many months over many COAG meetings. I cannot say a date on which that decision will be finalised, but I will advocate very strongly for people who are living with comorbidities and psychosocial challenges in this state. They need those supports and I will fight for them because that is my role.

Mr DULUK: When would you expect to make a decision around the proportion in the reduction of services between non-government and government services?

The Hon. L.A. VLAHOS: Most of the non-government sectors will transition across to the NDIS.

Mr DULUK: When do you expect the funding for those non-government services to cease?

The Hon. L.A. VLAHOS: That sort of framework is wellknown and you would probably be aware that this system, or NDIS full rollout, will not be completed until 1 July 2018.

Mr DULUK: Minister, moving to page 29, is the Mental Health Commissioner funded through the forward estimates?

The Hon. L.A. VLAHOS: Yes.

Mr DULUK: Will government funding for the commission be ongoing once the mental health plan is completed?

The Hon. L.A. VLAHOS: It is funded for the existing forward estimates.

Mr DULUK: But beyond the forward estimates, do you envisage a situation where, once the mental health plan is completed, it will no longer be funded appropriately?

The Hon. L.A. VLAHOS: It has a specific task to do and that is to write a state mental health plan.

Mr DULUK: Given that 18 months, in terms of putting together the plan, will put us near the end of the four-year funding commitment, is the plan the main deliverable of the commission and is the government leaving open the option of returning to old arrangements in terms of funding?

The Hon. L.A. VLAHOS: I leave options open to evaluate the commission's work at the end of the funding stream.

Mr DULUK: Sticking to page 29 and the Mental Health Commissioner, I understand the commissioner is not a statutory officer. On what legal basis is the person appointed then?

The Hon. L.A. VLAHOS: You are referring to the commissioner?

Mr DULUK: Correct.

The Hon. L.A. VLAHOS: He is appointed under the SA Public Sector Act 2009.

Mr DULUK: Does the Mental Health Commissioner report directly to you as the minister?

The Hon. L.A. VLAHOS: Yes.

Mr DULUK: In your opinion, is the commissioner free to speak on any issue without consulting with or seeking the permission of the minister or anyone else?

The Hon. L.A. VLAHOS: Yes. He is a free and independent agent and that is the reason why he has been appointed to deliver the state mental health plan. He is very good at stakeholder engagement and he will do an excellent job, as will the people he recruits to the commission. The commission is designed, by its very nature, to take into account consumers and lived experience in this space.

Mr DULUK: I have no doubt he will be a very good commissioner, and on this side of the house we are very keen to see the commissioner be as independent as he possibly can be. What security of tenure and protection from dismissal does the commissioner have?

The Hon. L.A. VLAHOS: Ms Richter will answer that.

Ms RICHTER: The commissioner is employed under the Public Sector Act as an executive under the SAES scheme. He has all the same rights and responsibilities as any other CEO of a government department.

Mr DULUK: So, he is not quite as independent if he is the same as a CEO of any other department.

Ms RICHTER: The question of independence, I guess, is something that could be explored further. The commissioner has been employed to undertake a specific task, and we can provide you with the things that he has been required to do. The commissioner is there to do a task. He is not a commissioner like the Public Advocate or the Commissioner for Health and Safety. He is there to assist the minister to develop the healthcare plan.

The Hon. L.A. VLAHOS: He is task related and at this point in time his job is to do the state mental health plan. There is a specific piece of work we are doing around borderline personality disorder and providing the right supportive care to those people who face that challenge.

Mr DULUK: If his role is task related, it will be at the minister's discretion in terms of what task the commissioner necessarily does or does not do.

The Hon. L.A. VLAHOS: He is independent. If you are trying to question his independence and capacity to deliver work, I think you need to be very careful of what you are saying.

Mr DULUK: Not at all.

The Hon. L.A. VLAHOS: The commission is a very important piece in the South Australian mental health landscape moving forward, and people who have lived experience need to have faith that he is an independent person. I have no doubts that he will acquit himself thoroughly as an upright person in this community to do the very best things for South Australia. I expect him to give me full and forthright advice. I may not always like that advice, but that is his role.

Mr DULUK: Minister, will you publicly release all reports, statements and advice from the Mental Health Commissioner and table them in parliament within 14 days of receiving that advice or reports or statements?

The Hon. L.A. VLAHOS: I am not required to do that. I do not believe I am required to do that.

Mr DULUK: Will the mental health plan be released directly to the public or will the approval of the minister be required before it is released?

The Hon. L.A. VLAHOS: He will undertake an extensive consultation process. He and I are yet to discuss his strategic plan and how he will deliver the piece of work that he has been commissioned to do. I am sure there will be a draft of the plan that he will consult with the community about along the way.

Mr DULUK: But do you envisage it to be released direct to the public first? Let's say there is a draft and then there is a final, do you envisage it to be released direct to the public, or do you expect to see it first and then that report be released?

The Hon. L.A. VLAHOS: I have not had a discussion with him to that effect on the strategic nature of how he will deliver it or a time line at this point in time. He has only been the commissioner since 1 July.

Mr DULUK: Given that, I imagine you have not directed the commissioner to consider the findings of the Coroner's report into the deaths of Robert Campbell and Jeremy Todd Williams?

The Hon. L.A. VLAHOS: I think you are confusing the role of the commission with the role of the department.

Mr DULUK: I may be, but in relation to my question—

The Hon. L.A. VLAHOS: Which budget line item did that relate to?

Mr DULUK: Page 29.

The Hon. L.A. VLAHOS: Coronial inquiries come within the jurisdiction of the department to make recommendations and respond to, not the commissioner.

Mr DULUK: You talked a bit about borderline personality disorder. When does the minister expect to have an action plan that will be publicly released in terms of that?

The Hon. L.A. VLAHOS: What budget line item does that relate to? Which page and which specific line?

Mr DULUK: Volume 3, page 29.

The CHAIR: Which bit? Even I am having trouble following. Are you just talking about the cost of sub-programs lumped all in together?

Mr DULUK: The net cost of sub-programs, the minister's role as—

The CHAIR: So you have lumped it all into just that one line?

Mr DULUK: Correct.

The Hon. L.A. VLAHOS: The commissioner is looking into it, via a project officer, as part of the planning framework. We know that borderline personality is a serious mental health issue and has significant mortality and morbidity.

I know that many people in this house have been to the seminars where people who are carers of people with borderline personality have brought their stories to this place. As a representative in this place and as the minister, I take this very seriously. I have lived experience of a family member who was potentially tagged in this space at one point in time. I know that the commissioner will explore the issue further and talk to those with a lived experience in this space, and their carers and their guardians, and deliver a plan that will be important to us as we move forward as a state.

I have had the opportunity since I have been the minister to visit Spectrum in Victoria and Project Air in New South Wales. I have talked to clinicians, nurses and consumers of those services and seen the number of lives that have been changed through a variety of different models of care. There is a variety of different ways that people living with this condition can be supported, and many people go on to recover and lead very rewarding lives. This state is looking at how we can better address the needs of people living with borderline personality disorder. I know that we will continue to address this as we move forward not just from a department of health perspective but from the commissioner's perspective as well.

Mr DULUK: When can we expect the action plan to be publicly released?

The Hon. L.A. VLAHOS: When I meet with the commissioner, I will be asking him that.

Mr DULUK: What funding has been provided in this budget for the implementation of the borderline personality disorder report?

The Hon. L.A. VLAHOS: The plan will determine the budget, but at this point of time it is a project officer.

Mr DULUK: I understand, and I think the commissioner has previously said, that the report will be issued in October. Will that report be issued directly to the public, or will it come through you first?

The Hon. L.A. VLAHOS: You asked me that question before and I gave you an answer.

Mr DULUK: This is in regard to borderline personality disorder.

The Hon. L.A. VLAHOS: You did not specify that in your question. You just said that.

Mr DULUK: Well, I am specifying now, minister.

The Hon. L.A. VLAHOS: When I meet with the commissioner, I will ask those questions.

Mr DULUK: Minister, do you have any concerns that the ongoing delays in implementing the recommendations of SA Health's 2014 Personality Disorder report is costing lives, given that there have been nine suicides since 2014 of young women with borderline personality disorder?

The Hon. L.A. VLAHOS: I would like to know where you draw that data source from. I have had regular contact with people who are carers and consumers in that space. There are a number of factors that influence people in this space. Until I had the source from which you are quoting that data, I would not want to comment. We can talk about suicide prevention. We are doing a lot of very good work in that space, and the Chief Psychiatrist is happy to fill you in on how we work in that space.

Mr DULUK: If the Chief Psychiatrist would like to provide a comment now.

Dr GROVES: Perhaps if I just give one answer that is specific to borderline disorder. As you will be aware, borderline personality disorder has a high rate of people presenting with a serious likelihood of harming themselves. Whilst we may answer questions in relation to community suicide prevention, one important aspect is to improve the way in which people conduct good assessments when somebody with borderline disorder presents acutely—whether that is to an emergency department or to one of our community mental health services.

During this year, we have commenced a process whereby we have trained 10 staff across SA Health, University of South Australia and also one of the PHNs in an approach called Connecting With People. It is an evidence-based approach out of the United Kingdom where about half of the NHSs now run the Connecting With People approach as a way of trying to reduce the likelihood that somebody who presents to health care subsequently goes on and either harms themselves or suicides.

There is a very large focus within the training around that of people who are presenting with borderline disorder to know the correct approach to how they are actually assessed and properly engaged in treatment, so it is going to become a very large feature. At the moment, we have commenced a rollout of training around that across the state. I think it is fair to say that it is going to be a huge undertaking in the next few years.

We currently have training in the first two modules that are most appropriate to mental health staff, which is four hours of training. This year, we have set the task of trying to train about 250 front-line staff across the state. This week, in fact tomorrow, we commence training in the outer south. We also have some training in one of the emergency departments down in SALHN. We have negotiated with NALHN around where we will do training, but probably at the Lyell McEwin ED in the first instance.

I have met with the Rural and Remote Mental Health Service to start to discuss where we will do training with them, but it looks like the Eyre and Yorke peninsulas might be where we first do our training because we know of some of the issues around there. With the Women's and Children's Health Service, I have met with them around the training that we might do that assists people when somebody presents to the Women's and Children's Health Service. That is what we plan to do this year. We will obviously review the effectiveness of that and then consider where the training would go after this financial year's investment.

Dr McFETRIDGE: On the same topic, perhaps Dr Groves can remind me of the name of the clinic in Victoria. Is it the Butterfly House?

The Hon. L.A. VLAHOS: The clinic that deals with borderline personality disorder in Victoria is called Spectrum. That is a specialised service.

Dr McFETRIDGE: Why have we not done something like that? I understand the budget is about $1.4 million and the economic analysis—I think it was Deloitte that did some work on this—was in the hundreds of millions of dollars. It has not been rocket science. We seem to be dragging the chain both on this and supporting eating disorder groups.

The Hon. L.A. VLAHOS: There are three models of care that are used in Australia in this space. They are Project Air, Spectrum in Victoria and Orygen is another one that does work in this area. I have had the privilege of visiting all of them and discussing borderline personality disorder. One of the tasks of the project officer is to look at the size of our population and, using a population-based planning method, what is the process that we could best deliver a service that is based in regional and remote areas, whether that might include telepsychology.

There could be a number of things that could be explored in this project space. It is not a case of just picking up a model from another space, dumping it in South Australia and expecting it to thrive. We also need to consult with the consumers and their carers. It depends on who you speak to; it is like Coke and Pepsi. Consumers have a variety of different opinions about the model of care that they would like and we need to look at all those pieces of information before we make a final model of care decision.

Dr McFETRIDGE: I can tell the committee that I have actually spoken to a number of those people and they think that the Victorian model is exceptionally good, but let's move on to forensic mental health in Budget Paper 4, Volume 3, pages 29 and 38.

The Hon. L.A. VLAHOS: Are you aware that in the Victorian model they actively encourage most of their people to take private insurance out?

Mr DULUK: Before we move on to forensic mental health, I want to come back to the Mental Health Commissioner. I know you touched on the fact that you are going to meet with him in, I assume, coming days or weeks to discuss the plan going forward. Since his appointment, how many times have you met with the commissioner?

The Hon. L.A. VLAHOS: Since he started on 1 July, I have had one briefing session at a regular briefing meeting with a whole of health team.

Mr DULUK: With the commissioner and the health team or just with the commissioner?

The Hon. L.A. VLAHOS: With the commissioner, I have not had the opportunity of meeting him one on one yet.

Mr DULUK: Thank you.

The Hon. L.A. VLAHOS: But I have been travelling in regional South Australia and attending suicide prevention conferences. I have been quite busy this month.

Mr DULUK: I did not pass judgement on whether you should or should not have.

Dr McFETRIDGE: I refer to Budget Paper 4, Volume 3, pages 29 and 38, forensic mental health. How many forensic mental health beds do we have in South Australia, and where are they located?

The Hon. L.A. VLAHOS: I will just refer to my notes. Previously, you asked me a question about the revitalised beds for intellectual disability and acquired brain injury at James Nash House. I can give you the answer to that now. There are seven beds in that unit.

We have been increasing our forensic bed capacity from 40 to 60. The state government has responded to the increase in forensic pressure with a number of initiatives over recent years. There is almost a 50 per cent increase in forensic beds, and this resulted from the completion of the Ashton House 10-bed step-down unit in September 2013, for which we recently continued funding. The additional 10 beds were located at the newly built Kenneth O'Brien rehabilitation unit, which was progressively opened between July 2015 and March 2016 following the completion of minor works in the Birdwood ward to accommodate the specialist unit for intellectual disability and brain injury.

I had the opportunity recently to go back to James Nash House to see the revitalisation and to talk to patients who are in the Birdwood unit about what a difference it has made to their lives. They were very excited to show me where they are living and how their lives have changed. There is certainly substantial improvement in their day-to-day surroundings, where they live, with the revitalisation of that unit and making it a specific unit for them.

The Kenneth O'Brien unit had quite a profoundly different approach from the rest of James Nash House. I had the opportunity to meet a consumer there, who I had met previously at James Nash House, and he told me about what a difference moving into the new unit had made to his life. The new unit is modern, contemporary, with best practice from other forensic mental health services that I saw around the country when I attended them with Dr Groves. It is something that South Australia should be proud of.

Mr TRELOAR: Minister, earlier you indicated that use of the drug ice in South Australia is comparable to other states. That was how I took your—

The Hon. L.A. VLAHOS: The information I had in my briefing notes is that it is a fairly static 2 per cent usage.

Mr TRELOAR: It gets a lot of media attention.

The Hon. L.A. VLAHOS: It does, and you and I heard about it when we were together the other day.

Mr TRELOAR: I refer to Budget Paper 4, Volume 3, page 17. What is the government doing to address ice addiction in South Australia?

The Hon. L.A. VLAHOS: We have a number of responses that we are working on in this space. Treatment services are obviously available statewide through DASSA and SA Health-funded non-government organisations. We have best practice guidelines for the management of drug dependence and amphetamine-induced psychosis. We are improving access to validated screening and assessment tools that can be used to identify drug problems early and implemented across a range of health and welfare service settings. We are also monitoring drug use and harm in the population through population health surveys, wastewater monitoring and service data, as I mentioned before.

There is also the Clean Needle Program, which provides sterile injecting equipment and disposal practices. The program also provides referrals to drug treatment, health, legal and social services for injecting drug users. We have police drug diversion initiatives, where people charged with simple possession offences are diverted from the justice system to the health system for assessment and intervention with their illness, as this is an addiction and addiction is an illness.

We are also working with SAPOL's corporate Operation Atlas. This action plan is aligned to SAPOL's Illicit Drug Strategy 2012-16 and is designed to focus collective efforts and improve coordination across SAPOL in the areas of enforcement, partnerships and community engagement, intelligence and analysis, and research.

The CHAIR: Before you go on, member for Flinders, which page 17 are you referring to? The one in Volume 3 of Budget Paper 4?

Mr TRELOAR: Page 33.

The CHAIR: You said 17. Sorry, we are trying to keep up with you. We are on page 33.

Mr TRELOAR: I am doing my best. My next question, I think, relates to Budget Paper 4, Volume 3, page 29. Let's have a go. My question from that page—

The Hon. L.A. VLAHOS: It is a bit like roulette, isn't it?

Mr TRELOAR: It is. Minister, what is the budget allocation in 16-17 specifically for drug and alcohol services?

The Hon. L.A. VLAHOS: For 2016-17, DASSA financial year's budget should be $40 million.

Mr TRELOAR: What is the number of full-time equivalents committed to drug and alcohol services?

The Hon. L.A. VLAHOS: Full-time equivalent employees as of 30 June is 170 for the 2016-17 year.

Mr TRELOAR: You made mention of the DASSA services, minister, and we heard a lot about them, particularly in Ceduna on a recent visit. How many people have used the DASSA services annually since 2011?

The Hon. L.A. VLAHOS: Let me get those numbers. I am advised that the number of people who interacted with the service would have to be taken on notice. However, I can give you some key performance indicators about activity to the end of June 2016, if that would be helpful, member for Flinders.

Mr TRELOAR: Absolutely.

The Hon. L.A. VLAHOS: We know that we had outpatients attendance of around 32,546 and inpatient separations of around 1,650. The proportion of inpatient treatment episodes where the reason for cessation was that treatment was complete was around 70 per cent, and the proportion of outpatient treatment episodes where the reason for cessation was that treatment was complete was above the target at 45 per cent. The one that I mentioned before was above the target as well at 70 per cent. For the proportion of registered client outpatient appointments with DASSA clinicians where the client did not attend, the target was met and that was 15 per cent.

Mr TRELOAR: On the same budget line, same page number, was an annual progress report on South Australia's alcohol and drug strategy for 2011-16 completed? Has a report been completed or tabled

The Hon. L.A. VLAHOS: A report has been concluded. I have not released it at this stage.

Mr TRELOAR: When will that be available, minister?

The Hon. L.A. VLAHOS: When I decide to.

Mr TRELOAR: Right.

The Hon. L.A. VLAHOS: I am still reviewing the information in the document.

Mr TRELOAR: Any idea?

The Hon. L.A. VLAHOS: We have to get through estimates, and then I will tell you. I am sure you will ask me a question time tomorrow.

Mr DULUK: Sticking with the report which I look forward to reading, and I hope there are fewer spelling errors in it than the last one, does the minister consider the existing strategy to have been successful? If yes, on what basis?

The Hon. L.A. VLAHOS: The strategy, which involves a number of agencies and is based on an evidence response to alcohol and other problems, has shown clear successes during its term. Since 2010-11, there has been a decline in the level of alcohol-related crime in licensed premises, and the percentage of South Australian school students between the ages of 12 and 17 who had consumed any alcohol in the past week decreased significantly from 15 per cent in 2011 to 10.4 per cent in 2014. The percentage of South Australians aged 15 to 29 who reported use of cannabis in the last 12 months decreased from 22.5 per cent in 2010 to 19.7 per cent in 2013. The percentage of South Australians aged between 14 and 29 who reported the use of any illicit drug, including cannabis, in the last 12 months decreased from 26 per cent in 2010 to 24.7 per cent in 2013.

The estimated number of alcohol-related hospitalisations in South Australia for the South Australian Aboriginal population decreased from 1,029 in 2009-10 to 786 in 2014-15. Of the 60 priority actions in the strategy, 56 are on track or completed and four require additional efforts. No actions are behind schedule or will not be met. Of the four actions that I am advised require additional effort, the Australian government has announced it will expand its funding to national online counselling services for people affected by substance problems. This priority action, 1.6, is now being progressed through this process.

A real-time electronic monitoring of community pharmacies, 1.13—which I know you have a passionate interest in, from your correspondence to my office—has been put on hold by the commonwealth due to competing priorities. However, since the reporting period, the states and territories have begun negotiating with the commonwealth to develop an implementation proposal for a national real-time prescribing monitoring system. The commonwealth has stated that it will provide advice to the states and territories.

The implementation of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) training at Families SA was deferred, that is 3.1, but development of the training program is currently being negotiated with SA Health and Families SA for implementation in 2016. A consultation process with the liquor industry and other key stakeholders is scheduled for 2016 to determine the most efficient way for wholesale alcohol sales data to be collected without imposing significant red tape on the industry. That is recommendation 5.2.

Currently, DASSA's South Australian Alcohol and Other Drug Strategy is due to expire at the end of this year, as you are well aware, and the development of the next iteration is currently underway as a joint project with SA Health and the South Australia Police. A steering group, which represents key government departments and agencies, commenced this work. We will continue to consult with key stakeholders, partners, agencies and experts in producing a draft strategy in consultation for this next quarter. A planning day with the steering group and other stakeholders was held on 29 June this year, facilitated by Curtin University.

Membership:

Ms Chapman substituted for Mr Treloar.

The CHAIR: Before we go on, I need to advise the committee that the member for Flinders has requested to be discharged, and I have acceded to that request. We are now joined by the member for Bragg, the deputy leader. The member for Davenport has another question.

Ms CHAPMAN: As a matter of interest, Madam Chair, do you actually have the right to refuse a request to withdraw?

The CHAIR: I wish at this stage I could check that to see whether I have made any mistakes during the week, but I think at this point we will just carry on as though it is a convention we adopt.

Mr DULUK: Thank you, Chair. Minister, I am keen to pick up on some of those stats you talked about regarding drug use in the community falling. On Monday in estimates, the police commissioner said, and I quote, in relation to drug use:

I think it is also fair to say that there is an increased incidence of the presence of illicit substances within the community…

If we look at page 137 of Budget Paper 4, Volume 3, estimated drug driver detections for 2015-16 was 5,503. In 2014-15, the actual was 4,945. Is the police commissioner wrong in his comments that he made to estimates on Monday?

The Hon. L.A. VLAHOS: I was not privileged to listen to his statement before the house.

Mr DULUK: I just read out his statement straight from the Hansard.

The Hon. L.A. VLAHOS: I would want to read the complete Hansard to get a correct understanding of it. I am not prepared to take your word alone on that, I am sorry, member for Davenport, even though you are a very honourable person.

Mr DULUK: No, I am not offended at all, minister. Page 137—

An honourable member interjecting:

The CHAIR: Order!

The Hon. L.A. VLAHOS: I called him an honourable person.

Mr DULUK: On Budget Paper 4, Volume 3, page 137, actual drug driver detections in 2014-15 were 4,945. In 2015-16, the estimate is 5,503. Why would SAPOL feel the need to do additional drug driver detections if the use of drugs across the community were falling, as you just outlined in your previous answer? It seems to be an inconsistency across government agencies.

The Hon. L.A. VLAHOS: I am happy for Ms Cormack, who is the head of DASSA in South Australia, to comment on this.

Mr DULUK: If you look at drug diversions as well, on page 132 of Volume 3, if you look at the drug diversion programs, if you look at the task force, if you look at the strategy, if you look at the percentages, it is all increasing. This is what SAPOL is saying, which seems to be at odds with your previous statement, minister.

The Hon. L.A. VLAHOS: As I said, DASSA is chaired by a very capable woman, who is now going to give you an answer. Her name is Simone Cormack.

Ms CORMACK: Thank you, minister. Essentially, the issue is that the prevalence of use or the evidence we have around the prevalence of use is that it has not changed substantially. However, the amount of the drug being used has increased substantially, and I am talking in relation to methamphetamine here. Clearly, law enforcement data is partly reflective of the investment in effort, and indeed service data is often responsive to the investment in effort, so the better we do in detecting users the more increase we see in services provided, whether they be health or law enforcement.

We do wastewater data analysis which looks at the amount of the drug that is being used in the system. It does not say anything about how many people are using, but it shows a significant increase in methamphetamine.

Mr DULUK: That goes against what the minister just said in her previous statement, when she said drug use was down.

The CHAIR: Order!

Ms CORMACK: No, the issue is that the prevalence of use has not changed. For example, with methamphetamine, there is a prevalence of about 2 per cent, which is about the same nationally, but the amount of the drug being used by the small number who are using has increased substantially. That tends to result in much more harm, essentially, whether it is violence, whether it is drug driving, whatever. You are much more likely to be detected with more drug on board.

Mr DULUK: If we could move to suicide prevention, minister, what is the budget allocation for suicide prevention strategies in 2016-17?

The Hon. L.A. VLAHOS: Last week, I spent quite a few days with one of your colleagues, the Hon. John Dawkins, who has a great interest and is a great advocate in this space, with Dr Groves and SA Health people who are delivering some of the work in this space.

The state government has a strong commitment to funding, developing and supporting locally-led suicide prevention networks—providing a suicide prevention community grants scheme; funding beyondblue and Lifeline for anxiety, depression and suicide prevention work—and employed an additional suicide prevention officer to implement the 'South Australian Suicide Prevention Strategy 2012-2016: every life is worth living'.

Suicide prevention, and the tragic results of the impacts of that, is something I heard from people when I was on Yorke Peninsula, how it has impacted on their communities in Ceduna. Most of us have been touched by someone who has been lost to suicide. It is an area of high priority across all levels of government and the non-government sector, private enterprise and the general public. The 2012-16 strategy, Every Life is Worth Living, was released in September 2012 and work begun on the South Australian Suicide Prevention Strategy 2017-2021 is due for release in 2017 to continue the work of the current strategy.

The state government is committed to this sector, with $925,000 in the 2015-16 year to suicide prevention, and $150,000 of this is for the development of suicide prevention networks. SA Health has been working with local government regions to develop and facilitate the training of mental health first aid and support for those bereaved by suicide. This work has seen the development of 15 suicide prevention networks across the state. I have had the opportunity of meeting several of them in the time that I have been the minister, the first one being in Mount Gambier, and also the first Aboriginal suicide prevention network. I have continued to talk to them, as recently as last week when I was in Canberra, about the work that they are continuing to investigate.

We know that these networks and a further eight local government regions are becoming involved in network development. I am speaking at the annual general meeting of the local Salisbury network with, I believe, councillor Vermeer and the Hon. John Dawkins and many other people as that network kicks off in the next couple of weeks. We have also provided $150,000 for the Suicide Prevention Community Grants Scheme for 2015, where 19 suicide prevention community grants of up to $10,000 each were provided to community groups to provide suicide prevention activities locally.

The Whyalla group told me about the comedy initiative they had provided, and I knew that there was a brochure being developed by a group based in Whyalla specifically targeted at men's health. A further 20 grants have been approved for 2016-17, as well as $125,000 for the appointment of a suicide prevention officer to assist in further developing this suicide prevention program. The sum of $200,000 has been given to Lifeline based in Adelaide and the South-East to assist with the increased provision of phone services for 24/7 crisis support and suicide prevention.

I know from talking to farmers in the South-East when I was in Mount Gambier that this is a service that they need, given the change of circumstances they have been facing, especially in the Murray-Mallee area. $278,000 has gone to beyondblue to assist with the ongoing work on suicide prevention. The remainder of the 2015-16 suicide prevention funding was used to engage additional consultants, Connecting With People, to deliver a package of training and education to 10 South Australian health workers to build their skills, expertise and clinical confidence in working directly with mental health clients. The training and education was provided in a train-the-trainer format, which has enabled the health workers to disseminate the model across metropolitan and regional South Australia.

In April 2015, the South Australian government's suicide prevention implementation committee commenced. An inventory of activity across department is being collated against the strategy. The committee has oversight of the South Australia Suicide Prevention Strategy 2017-2021 and its development. SA Health has continued to work in partnership with a number of non-government organisations. I have the good fortune of meeting with them and seeing their passion for this sector. MATES in Construction is one of those organisations.

MATES in Construction provides training, tools and support structures for workers employed in the construction industry to reduce the level of suicide. MATES in Construction also provides advice on suicide prevention to the mining industry. They were at the national conference we were at in Canberra last week and they are indeed looking at some innovative ways that they can reach out. I know that Mr Pederick is incredibly passionate about MATES in Construction, and the work and advocacy they put forward in this space.

Wesley Lifeforce is another group that works with local communities to develop suicide prevention networks. I know that they are at Ceduna. They build enablement to deliver suicide prevention projects within local communities. Currently, they support suicide prevention networks in Port Augusta, Port Adelaide and Strathalbyn. Living Beyond Suicide (Anglicare) and Standby Response North and South (United Synergies) provide statewide suicide postvention response services to the bereaved.

We know those people who come into contact with suicide have an increased chance of experiencing suicide themselves and making a poor choice further in their life. It has a ripple effect. National Suicide Prevention Day is on 10 September. I would encourage all members in the house to become involved in the activities in their local community. There will be dawn walks as there were in Andrews Farm and Henley Beach. I know that the member for Colton participated in that walk last year, and what a profound difference it made to his understanding of some of the suicide issues.

In June this year, as the minister I announced a once-off payment of $150,000 to MATES in Construction to provide additional resources to the industry, comprising peer-based support programs to have conversations at a workplace level encouraging workers to engage with their workmates who are doing it tough. Field officers will provide training and on-site visits, linking workers to the networks of support that they need to make sure that they do not go down this dark path at a loss to our community.

Dr McFETRIDGE: Just following up on the number of forensic mental health beds and the answer about the disability beds in James Nash House. Does the health department charge the people in James Nash House a portion of their disability support pension as a cost-recovery process—a rent for the beds?

The Hon. L.A. VLAHOS: I am not aware of that, but we will investigate and come back to you. We will take it on notice.

Dr McFETRIDGE: I understand it is 85 per cent of the DSP.

Ms RICHTER: If I may just add, certainly, in the general hospitals, if a patient is there for longer than 25 days, they do get charged a proportion of their pension.

Dr McFETRIDGE: What is that proportion?

Ms RICHTER: I am not sure.

The Hon. L.A. VLAHOS: We will take that on notice and come back to you, member for Morphett.

Ms CHAPMAN: In regard to forensic mental health patients, minister Malinauskas has told us that, as at 30 June, there were 15 mental health patients in his prisons. These are patients who unfortunately cannot be accommodated in James Nash House or some other mental health facility and, under section 269 of the Criminal Law Consolidation Act, of course, you are able to authorise that they can then go to a correctional facility.

You may not have it here, but I would like to know the average numbers during 2015-16 of mental health patients in our correctional facilities and also how many were in there as at 30 June 2015. As I say, I appreciate that you will need to take that on notice, but I would like to know the average through the last financial year and how many were there as at 30 June 2015. I assume you do not have it immediately there?

The Hon. L.A. VLAHOS: I thought you were pausing and you were going to add something else to the end of the question. Sorry, I was being polite.

Ms CHAPMAN: Do you have that off the top of your head, or are you happy to take it on notice?

The Hon. L.A. VLAHOS: We have some data in that space because we were expecting a question from you. Ms Richter will give you some of the data as of today.

Ms CHAPMAN: I am not actually asking for today. I am asking for the average numbers in the facilities during the last financial year—that is, to 30 June—and as at 30 June 2015.

The Hon. L.A. VLAHOS: What budget line does this relate to?

Ms CHAPMAN: Mental health, forensic, page 37.

The CHAIR: The minister can either take it on notice or provide some information.

The Hon. L.A. VLAHOS: We are happy to take that on notice.

Ms CHAPMAN: Thank you. In relation to that, when the patients are in the prison, does your department have to pay a fee to Corrections?

The Hon. L.A. VLAHOS: I am advised, no.

Ms CHAPMAN: Do you know the average daily cost to have a patient at James Nash House?

The Hon. L.A. VLAHOS: We would have to take that on notice.

Ms CHAPMAN: Do you know the average daily cost to have one of your patients stay in a correctional facility?

The Hon. L.A. VLAHOS: We would have to take that on notice, but when patients are acutely unwell in the forensic space I am more concerned about the quality of care they receive so they can resume their wellness journey, not how much they cost the state government.

Ms CHAPMAN: Indeed. In fact, I expect it costs a lot more at James Nash House than it does at the prison, which does raise the reverse of that. In any event, we will wait to hear what you find in relation to the costs of those. Has there ever been a request for the cost of accommodating patients in the prison system?

The Hon. L.A. VLAHOS: I am advised, not that we are aware of.

Ms CHAPMAN: At Glenside campus, there are areas that were to be built on for the purposes of supermarkets and other things, including outpatient drug and alcohol services. That plan has now been discontinued, but there are empty buildings where forensic patients have previously been accommodated. Has any consideration been given to allowing these patients to be accommodated on that site?

The Hon. L.A. VLAHOS: No.

Ms CHAPMAN: Why not?

The Hon. L.A. VLAHOS: Ms Richter will answer that question.

Ms RICHTER: The facilities on Glenside that are currently vacant are destined to be demolished because they form part of the land that is for sale. Those facilities are not available for use. They are basically below standard and would not be appropriate to use.

The Hon. L.A. VLAHOS: They are not fit for purpose.

Ms CHAPMAN: In fairness, minister, I visited the Women's Prison last Saturday and the 35 year old we spoke about in the parliament a few weeks ago has now been transferred to James Nash House, I am pleased to report. It is not a place I like to visit, but I do from time to time visit the Women's Prison and I also live very close to the Glenside campus.

Those facilities have now been vacant for years. They have been used for mental health forensic services. They have a protected area and are available, and the fact that the government has onsold them to the Cedar Woods development is no excuse for why they have not been used in that time. But, in any event, you have considered it—

The CHAIR: Sadly, there is no further time for questions, so I declare the examination of the proposed payments complete. I thank the minister and the advisers and the members for their cooperation today. I lay before the committee a draft report.

Mr HUGHES: I move:

That the draft report be the report of the committee.

Motion carried.

At 17:30 the committee concluded.