Legislative Council: Tuesday, June 04, 2019

Contents

Mental Health Services

The Hon. C. BONAROS (14:42): I seek leave to make a brief explanation before asking the Treasurer a question about funding for mental health services in South Australia.

Leave granted.

The Hon. C. BONAROS: As the Treasurer and, indeed, the Minister for Health and Wellbeing would know, a lack of comprehensive primary mental health services provided by community-based service providers correlates directly to increased presentations and admissions at hospitals and involuntary treatment mental health facilities. Again, I'm sure the Treasurer and the Minister for Health and Wellbeing are also acutely aware of the cost of this, not only to the healthcare budget but also the negative impact the presentations at emergency departments and hospital admissions have on those affected, including their families and the loved ones of those with a temporary or long-term illness.

There is a growing evidence base that tells us that primary mental health services provided by community-based service providers make a huge contribution towards improving not only the mental health outcomes of people so affected but are cheaper than tertiary services and, therefore, they are also good for the government's health budget bottom line. We also know that mental health clients are scheduled to transition to NDIS funding over the next year or so, but it remains to be seen how mental health clients will fall between the SA NDIS funding gaps in the longer term; however, we already know that there is a huge gulf appearing with mental health services in SA as the NDIS rollout has been slower than expected.

SA Health contract managers have been contacting mental health services providing critical psychosocial supports to advise them that their block funding cuts will commence from 1 July 2019, well before the one-year transition period they understood to have been recently promised, and there is currently unmet demand for these services. My questions to the Treasurer are:

1. What cuts to mental health services has the government decided to implement?

2. Precisely what services will be cut, by how much and when?

3. How many people are expected to be impacted by those cuts?

4. When were the service providers advised that the cuts would occur?

The Hon. S.G. WADE (Minister for Health and Wellbeing) (14:44): I thank the honourable member for her question. I think it is important to be clear: the NDIS is a long-term plan, an agreement between the commonwealth and the states to transfer significant elements of disability service provision from the states to the federal government, and that includes people whose disability relates to their mental health issues. In that agreement, both the commonwealth government and the state governments agreed to basically ensure continuity of support.

The changes in the 2019-20 financial year to which the honourable member refers particularly relate to the psychosocial mental health services budget. The changes in the budget are not a state budget decision, it is a part of the ongoing process of transitioning people from state-based mental health services to the NDIS. What the government has said consistently is that we will ensure that funding doesn't transfer until the eligibility of the client is established and, if you like, we can ensure continuity of services.

In that context, I don't know whether the implication was intended but if the suggestion is that we are transferring money to the commonwealth ahead of clients transferring to the NDIS, that is not my understanding. My understanding is that, in the IPRSS program, 23 per cent of clients have already been determined to be eligible and in the next financial year we are proposing to transfer 25 per cent. So, if you like, the money is following the clients.

The whole concept of the NDIS is that the clients make the choices. If service providers think that, as their clients leave and have access to NDIS services, they should have double funding for that client who has now been transferred to the NDIS, I just say to them that that is not the concept behind the NDIS, and I think service providers should appreciate that. The government has made a commitment that no mental health consumer will be disadvantaged as a result of the NDIS transition, and SA Health-funded psychosocial clients who are not eligible for the NDIS will continue to receive ongoing psychosocial services via state-funded NGO programs.

In May 2019 (last month), the Chief Psychiatrist wrote to mental health non-government organisations impacted by this transfer of funding to the commonwealth and confirmed the government's commitment as a result of the NDIS transition and requested that the Chief Psychiatrist be advised of any client-related continuity of support issues that arise from the funding reduction.

Since I have been appointed minister, I have been pleased that the Chief Psychiatrist established a transition task force to actively engage both the commonwealth, NGOs and consumer reps to ensure that any issues in relation to the NDIS transfer are ironed out. There will be issues, there have been issues, this is an issue, but we are working within the NDIS bilateral agreement. It was always intended that, as clients transferred, so did the resources.