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House of Assembly - Fifty-First Parliament, Third Session (51-3)
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MENTAL HEALTH BILL

Second Reading

Adjourned debate on second reading.

(Continued from 5 February 2009. Page 1461.)

Ms CHAPMAN (Bragg—Deputy Leader of the Opposition) (12:00): I continue my remarks, when I was advising the house about the importance of a submission by Mrs Helen Beck of Streaky Bay in respect of her son's plight and history with the Glenside Hospital. It continues:

In our experiences of assisting our son, we have come to appreciate the provision of medical care which we recognise as an essential component in the goal of seeking good mental health. Furthermore, now, drawing on our family's personal experience and knowledge, we unequivocably proclaim that the presence of wide open spaces of natural environment is equally important.

This view that we personally arrived at, is supported in a wide range of relevant literature; for example:

1. Campbell, Chandler, Gordon (2002) refer to the 'value' of rural areas and open space to those suffering mental ill-health;

2. Morris, N. (2003) lists a wide range of health benefits to be gained from interacting with the natural environment—social, economic, physical and general enhancement of the quality of life;

3. A study centred on Callum Park Hospital (2008) points to the 'healing role' and 'therapeutic calm' of open areas.

Many other reports in a similar vein, based on studies and practical action can inform administrators and policy-makers with regard to client wellbeing.

My personal observation, as a frequent visitor to Glenside Campus during the recent week that I have spent in Adelaide, indicates that the use of wide open spaces does not necessarily involve organised games—although it can be so. Self-fulfilling 'use' can be taking a long walk, a short walk, running, sitting alone or with others, watching the creatures of nature that abound in this area: a bird hanging upside down seeking nectar in a tree flower; a galah 'beaking out' a monkey nut from a fallen pine cone, strident powerful magpies flying down to the oval to peck in the grass. Staff and local residents speak enthusiastically of koalas seen in the over-arching trees and black cockatoos pausing in their flight across the suburbs to rest in the tall pine trees.

The Glenside Campus oval is the place where the local community enjoys sport—cricket, football, bike riding and running. Last Saturday, a family brought a large kite and ran about in the middle of the oval guiding and chasing it with glee. It was a joy to all watching—clients and visitors alike; 'hands on' interaction with the environment, direct and indirect.

This evening before tea my son was part of a group of clients who played a game of cricket in the wide shadows of the gum trees near the R and R—a happy scene in a beautiful and unique setting. Minutes later, we watched bees darting around a bee hive hollow high in a tall white-trunked gum.

Rehabilitation programmes. Essential to rehabilitation (preparation for moving into the wider community) is interaction with the outside natural environment. Rehabilitation is the heart of any self-respecting mental health promotion plan. It should be available for all who need it. Glenside Hospital grounds are the best place for promoting rehabilitation programmes. The peace of the setting would be shattered if the proposed development occurs.

The current arrangement of the buildings, spread out over the grounds in various locations, adds to the open-ness of the setting. Clients are able to find their 'own space'. It is preferable that they have an opportunity of moving away from overlooking windows.

It is obvious that there is need to upgrade the site with the several old unused buildings, dilapidated extensions and add-ons to buildings. Once such improvements are made, the site could be elegantly enhanced by the means of sympathetic and sensitive landscaping to be in keeping with the heritage buildings.

There is no need to destroy the site and irreparably alter its modus operandi. Its many attributes can form the basis for timely programmes of intervention, therapeutic care and rehabilitation—

its central location

the presence of trained, skilled, experienced staff, who are knowledgeable of particular clients

the local neighbourhood has longtime acceptance of mental health patients; (eg) in shops and streets

wide open spaces of natural environment.

Need for services

It makes sense to build on this firm basis of unique attributes in such ways as:

Developing on Glenside campus a centre of excellence

Establishment of research programs and

Training centre

as recommended by the Legislative Select Committee's Interim Report (September 2008).

There is increasing need of mental health services in SA as evidenced by:

The continuing of the drought that engenders stress;

The economic downturn also provoking stress;

Depression is widespread (recognised by World Health Organisation (WHO) as the number one sickness);

The unacceptable rate of suicide;

The increasing rate of drug and alcohol abuse that influences the lives of those afflicted by mental health issues;

Stress in everyday life being compounded by any of the above, and by constant media presentation of stressful situations—war, disease, suffering, climate change, the plight of the River Murray.

It follows that special programs directly responding to such needs could be set up on the already-available Glenside campus with its central location.

A specialised unit to deal with depression

Programmes dealing with the first presentations of psychosis

Accelerated research in schizophrenia (SA could be the scene of the breakthrough discovery!)

Rehabilitation programmes designed in accordance with individuals' needs, allowing TIME for recovery. The illness can be all pervasive, requiring sometimes years of rehabilitative support, as with the USA programme, PACE.

Provision of long term care and permanent care for those particular people in the community who require ongoing refuge and protection—in the true meaning of the term 'asylum'.

Setting up of organisations to assist people with mental illness, similar to those established to assist people with special needs (eg Alzheimer's, autism).

Special programmes of training developed in response to community needs

(eg) addressing the situation of homelessness (frequently linked to mental ill-health)

(eg) training of Police in de-escalating threats of violence in order to avoid killings

The setting up and/or improvement of such on-campus programs in this centralised location is the preferable way to meet the community's needs.

Needs of clients

Of major concern is the situation of clients who are currently

in hospital

in care

in the community

That the length of time in hospital is now usually only 3 weeks. Experienced mental health professionals recommend that it should be at least a minimum of 6 weeks.

In a psychotic episode, trauma to the brain is experienced. Compare the time allowed for recovery following the trauma of brain injury in a car accident; (viz) as long as it takes.

Time and structural clinical support are essential to promote the wellbeing of mental health clients. Reducing hospital time can lead to the closing down of programmes and present the illusion that hospitalisation is not required. The true situation is thus distorted.

Considering the central importance of rehabilitation programmes, it is of great concern to note that the current number of clients receiving this service on the Glenside campus has been reduced from 129—to mid 60s—

under the proposal that has been outlined by the minister. She continues:

The current clients are receiving treatment and care from trained and experienced professionals. But such a model is not due to be continued under the redevelopment plans, when rehabilitation will be administered by well-meaning ngo's, unqualified and inexperienced. Thus the opportunity for achieving maximum benefit for clients will be compromised.

While such programmes, administered by ngo's are being established in the community (eg Elpida, and at Lyell McEwin Hospital) there is alarm being expressed by experienced professionals and by families of clients (who are the ones who generally have to 'pick up the pieces') that in reality, there is a serious lack of effective community supports.

For example:

In the community rehabilitation centres

residency is available for only 6 months;

prospective clients are required to have a fixed address to return to;

if not, what is the alternative?

then what?

In private accommodation and supported accommodation

clients can attend regular appointments at community offices of mental health services, if able to;

less able clients can be visited by the MAC team for medication and maybe some occupational therapy support on a weekly or fortnightly basis;

generally they are left on their own to cope, for long periods of time

Their life in the general community is further complicated by:

clients' lack of insight (ie acceptance that they have a mental illness)

non-compliance with the taking of medication

inability to care for self or possessions

poor judgement in dealing with the demands of everyday life

leading to social ineptitude and isolation

difficulty in keeping to schedules, including keeping of appointments

It follows that it makes good sense to retain the specialist service provision of the Glenside Rehabilitation, to enable mental health clients

to spend periods of time there for respite and rejuvenation

with qualified staff monitoring their functioning

with schedules and activities being set in place

with variations in length of stay time

linked to individual needs of the kind of degree of intervention required

The current situation with regard to gaining access to Glenside rehabilitation programs (open or closed) is daunting:

there are very long waiting lists;

it is subject to approval being granted by a special committee;

unless the client has a strong advocate it is almost impossible.

Mainstreaming or maindumping? The idea of 'mainstreaming', admirable in intent, is aimed at allowing all people, whatever their individual attributes or needs, to be incorporated into the wider community. However, when applied to situations of the less able, it cannot 'just happen' without a network of adequate community supports, including the security of accommodation, being available.

To reduce the structure of support to such people, under the guise of promoting greater freedom (to quote the current jargon) in the 'least restrictive environment' is virtually to abrogate responsibilities of promoting human rights.

My own experiences as a parent and teacher indicate that the presence of structure is essential in providing a framework for development and learning of life skills. The process of deinstitutionalisation of mental health clients, also well-meaning in intent, has led to much suffering, because of the reduction and loss of structural supports. Countries such as Britain and the USA, who adopted a process of deinstitutionalisation, have acknowledged pitfalls in the process and are now moving to restore supportive frameworks.

Mainstreaming without effective community supports means gaol for many people. They move from one institution to another, where there are no mental health services. Most alarming of all, a spectre of great trepidation for the future is apparent: for the chronically and seriously ill, who have given indication of their inability to cope successfully with life in the general community (through frequent hospital admissions) there is no provision for permanent (or even long-term) care within any psychiatric service. This presents no comfort for consumers and their families. Rather, it draws attention to the fear of the escape route of suicide, so often chosen.

The situation of mental health clients in aged care and some special units: a group of families who are most concerned about the provision of programs at Glenside campus are those who have family members currently in aged care and some special care units. It is planned that during the demolition and building phases of the redevelopment, these clients and others in adjacent buildings receiving specialised care are to remain in their current wards. This could predictably be a time of great stress to such clients, with wrecking machinery destroying buildings and trees being felled all around them; that is, they would be living amidst the destruction of their familiar home landscape.

This would entail constant dust, the continual very loud noise of heavy machinery and demolition of buildings, followed by the upheaval of new building activity. Peace and serenity, which has been the constant attribute of the campus and so necessary in the lives of these clients, would thus be dramatically shattered.

For one group of these clients there is an additional burden; it is planned that they will be moved into temporary accommodation of one of the (now closed) wards. The period of demolition and rebuilding activity is predicted to take up to four years.

The question of what the future of all of these clients will be is of extreme concern to their families. Some of these people have spent much of their lives (20, 30, 40 years) on the Glenside campus and as yet there are no firm plans for their future accommodation.

Regarding the situation of secure beds: the provision of adequate numbers of secure beds is paramount in times of severe mental illness when danger to self and others is an issue. Secure care is needed for some clients in order to enable stabilisation to occur and to allow for administration of medication.

There is concern amongst families about what will happen to the services of the Brentwood and closed Banfield departments housed in the comparatively new purpose-built building, which is apparently due for demolition.

From our experience of suffering the nightmare situation of our mentally ill family member absconding from an open department into the streets, we learnt the hard way that there are not necessarily enough secure beds available on the campus, if and when the missing person is returned. Our family member did return briefly but was soon 'off again' and this time for a considerable period, without money or plastic or spare clothes.

Such a situation is of particular import to country-based clients, who in Adelaide are generally in unfamiliar territory and far away from their homes and families. It follows that availability of secure beds for remote and rural clients is a basic necessity. For the smooth running and well-being of the whole campus there needs to be provision made for rooms with the propensity to be adapted as required.

It is not a joking matter and as any parent would know, an abscondment is indeed the stuff of horror nightmares—but I did find the temerity to suggest to the Consultant Psychologist that perhaps we should provide our family member with a camp bed and a leg rope on admission!

If the patient does not stay around the campus long enough to be treated, what is the point in admitting him/her in the first place? Thus it is with great misgiving that we hear that what secure beds there are will be part of the mix put into the 'squashed-up' situation of the new hospital building. What a hotbed of activity with all types of clients being treated together—acute patients, recovering patients, and also those receiving treatment for conditions relating to issues of drug and alcohol abuse.

What about the proven need of open outdoor space being required for and beneficial to all mental health clients? My family and I emphasise again that there is peace and a tranquil atmosphere under and around the many great trees, beside the much-loved oval and in the open spaces. If a redevelopment is to occur, it needs to incorporate these already present attributes.

Perceptions about the Glenside site. Glenside Hospital is viewed in different ways. For some it represents

a relic of the past

a symbol of stigma

representative of a deep dread

reminiscent of difficult episodes in life

a part of the old methods of mental health services

However, the reality is generally otherwise for consumers and families who have benefitted from care, treatment and guidance, and for local neighbours of the area who are supportive and appreciative of having within their ambit, the open spaces, oval and trees. The accepting attitudes of the neighbours for mental health clients who visit the local shops and streets can be witnessed daily.

Many changes in mental health delivery have occurred over the years, with advances being made in mental care, new understanding of health needs and changes in psychological procedures. We of the consumer carer families continually live in hope that we are on the verge of great advancement.

Most South Australians, and particularly those with direct involvement in mental health services, realize that there is need of improvement, and that with regard to the Glenside campus, there is need for an upgrade of facilities. An apt admonition springs to mind: 'Don't throw the baby out with the bath water.'

From the basis of our family's knowledge and experience and hope for the future, we with other consumer-carer-families maintain that the welfare and observed needs of South Australia's mental health clients should be at the centre of all plans. This group in our community is the most marginalised and vulnerable. Thus, with the aim of promoting good mental health in South Australia, we maintain that:

the Glenside campus should not be rezoned

that it should be retained in its entirety for the direct purpose of mental health

including the heritage buildings

including the oval and trees

that the site should be upgraded

that the idea of filling the site with unneeded and unwanted development—shops, offices, parking, housing, etc., is detrimental to the idea of promoting rehabilitation programs on the site

that the retention of open spaces is of vital importance in this urban area

that the planned comparatively small hospital building relegated to a corner of the site, is an unsuitable mesh of activity with a 'squashed-up everyone' kind of situation. It can be seen as a token gesture in a move to take over land

that the redevelopment master plan, as it is, goes directly against the will of the majority of people, as seen in

results of surveys (...in a survey conducted by Burnside Council, overwhelming majority against plans; 93% against loss of open space, especially the oval)

consultations—witness the anger of participants at Burnside Ballroom meetings, Oct. 2007

the expressions of concern amongst current consumers about their future

recommendations of the Upper House, Sept. 2008 [report]

views expressed by Royal Australian and New Zealand College of Psychiatrists

that the pool of amassed skills available on the campus must be kept and enhanced

that it be promoted and developed as a hub of excellent mental health service for the whole State of South Australia.

As programmes are closing down and the number of patients treated on campus is being lessened, it is important to point out that this is not an indication of the site not being needed. Treatment is occurring on other sites, such as Tobin, Flinders, Morrier and Elpida as outlined above, but the Glenside campus with its resources, particularly that of open natural environment space cannot be viewed as just another suburban regional service.

As a rural resident, where there are virtually no mental health services, my family and I are particularly concerned about the need to not encroach on the availability of land for mental health services promotion.

The Glenside site is important for all of South Australia.

Yours sincerely,

Helen Beck

I have received hundreds of letters from consumers expressing many of Mrs Beck's sentiments. Mrs Beck has comprehensively outlined a number of concerns. She herself is the parent of a long-term resident patient, a client of the Glenside Hospital. She is an experienced schoolteacher who has eloquently and comprehensively covered the concerns of consumers and ordinary members of the public, and I thank her for that. I thank her for being brave enough to speak out on behalf of South Australians, as a rural South Australian and as the mother of a consumer of a much-needed service at the Glenside site.

When the government—via the minister or the former minister—comes into this parliament and tells us that it is going to provide a whole new regime which will involve a comprehensive program of support for those in the community who need our mental health services, and then goes on to brag about its proposals in this world-class redevelopment at Glenside Hospital, I say that is a complete nonsense. Not only does the public tell the minister that, but there is a very clear message to the government from hundreds of people who have turned up at public meetings, from thousands of people who have signed petitions (not just for this parliament but for local government), and from the many people who gave submissions to the select committee on the inquiry into the government's Glenside Hospital redevelopment and its program purporting to be world class. You do not have to take my word for it: those submissions are very clear.

The professionals who have come to the select committee, and others who have sent in submissions to minister Holloway's rezoning public meetings and to the former minister Gago's public meetings on local issues, have given the government a resounding message that it has got it wrong. Whatever donkey in the department who might be advising the government on what should be happening in relation to providing the services which will be much needed when we pass this bill—

The Hon. J.D. LOMAX-SMITH: I have a point of order. I do not think it is appropriate for the deputy leader to call members of staff donkeys. They are public servants who work to the best of their ability on our behalf and, should she ever become minister, on her behalf, and—

The DEPUTY SPEAKER: Order!

The Hon. J.D. LOMAX-SMITH: I think it is extremely disrespectful.

The DEPUTY SPEAKER: That is sufficient. Standing orders relate to the language for members of parliament, and that is a word that would be unparliamentary in terms of members of parliament. I believe I cannot make a ruling on that, but I invite the deputy leader to reconsider her wording.

Ms CHAPMAN: Thank you, Madam Deputy Speaker. If I have caused any personal offence to those who work in the Public Service, I apologise, but I want to make it absolutely clear that what I am about to present to this parliament is in direct contradiction of myriad professional people who will rebut overwhelmingly the government's action.

The government has repeatedly said, 'We have listened to the advice of the Cappo report'—which, incidentally, does not mention building a new supermarket in Glenside—'and we have listened to the expert advice that we have had from the department.' I say to this parliament that it is wrong, and it is about time the government and, in particular, the minister—who is an intelligent member of this chamber—went to their cabinet and said, 'We've got it wrong. We've made a mistake. This is not a world-class redevelopment.'

We have read the report and we have read this information. The government says that someone in the department is advising that it will be able to afford to do this—it needs to flog off half the property to be able to pay for this service. Of course people in departments come to ministers and say, 'This is how we can save money; this is how we can fund this new project.' This government should not assume that they are the first—and they certainly will not be the last—people from departments coming to it and saying that they have found the answer, the way to move forward. That is part of their job, to find inefficiencies and define for the minister opportunities for improvement. However, sometimes they get it wrong.

The importance of a minister's leadership when they go into cabinets is that they have to make decisions about the future of their portfolio—in this case, for the health and wellbeing of people who suffer mental health issues in this state. Ministers can receive that advice, but they must act in a leadership manner. They have a responsibility to the people of South Australia, in particular, to those who are vulnerable and who may need those services now and in the future.

This minister is not the first who has had to debate this decision. I go back to the last administration, when I remember public statements being made about the department telling former minister Brown, when he was minister for health, that he should sell Glenside Hospital. Even in the 1990s, at a time when this state was haemorrhaging with debt and when government was desperate to find money to get us out of the quagmire, he said no; he said, 'This property will not be sold.' I can go back to other ministers. I remember former minister Cornwall, who decided to look into the question of selling Glenside. He said no; he decided he would sell Hillcrest instead. However, the point is that they have to make the decision; they have to go to cabinet and say, 'This is what we have to have.'

Well, we are down to the bare bones. This is the last free-standing institution for mental health in this state, and it is the only place available for a third of the population of this state, namely, country South Australians. So the current minister has even more of a responsibility, and if her predecessor, the Hon. Gail Gago in another place, who announced this redevelopment and who put it through the cabinet in the first place, has made the wrong decision it is up to this minister to expose it, to say, 'We've got it wrong', and fix it. That is her responsibility, not just to accept some cheap option being presented by the department and dressed up as a model of care that is world class. It is utterly ridiculous, and the minister should reject it.

Let me give you just a taste of what other experts have said. I will start with Mr Jonathon Phillips, a former director of mental health in this state and an experienced psychiatrist who practised in South Australia but who now resides interstate. In correspondence to one of the members of this house he said:

Glenside is an extraordinary tract of land. Glenside currently houses an old-fashioned hospital principally located within heritage buildings. The original concept of Glenside was based on the belief in 'moral therapy', a 19th century but benevolent view of mental health. Essentially, persons with mental illness were to be treated with dignity. Glenside was constructed on the 'Kirkbride' hospital model and was state of the art at the time.

Glenside in its original form met all principles of 'moral therapy'. Essentially, the patient had decent housing, healthy food, a quiet environment and, most of all, the patient was offered security and safety. Notwithstanding the huge developments in mental health care, few would accept that our current public patients are guaranteed security and safety.

Glenside is an irreplaceable asset. South Australia is desperately short of inner city land appropriate for health purposes, notwithstanding the site over the railway yards set aside for the Marjorie Jackson facility.

South Australia will lose its most outstanding health asset if Glenside becomes a multi-purpose campus, or worse still should it be sold.

The best use for Glenside would be as a health campus. Obviously psychiatric services should continue to be provided on the site.

However the size of the site might allow for more general health services additionally.

In stating the above, psychiatric services must always be seen as a critical part of the larger health sector, and not an entity separated from the rest.

In my mind, health services at Glenside should be as broad-based and include safe and satisfactory long-term accommodation.

Whilst I understand that the South Australian Film Corporation would be a high profile tenant, the heritage buildings could provide excellent accommodation for mental health clients in keeping with the common ground model as advocated by Ms R. Haggerty, a former thinker in residence.

To use the Glenside site for other purposes (eg, a retail precinct) would truly be 'selling off the farm'.

That is what an experienced administrator, a former head of mental health in South Australia and an experienced psychiatrist had to say.

Let us go to another former director of mental health in this state, who has now been appointed as the Public Advocate, Dr John Brayley. He is an experienced clinician and public administrator in this state, which was clearly recognised by this government as it has now appointed him as the Public Advocate. This position is appointed by a minister, is accountable to the parliament and has funding from the parliament to be an advocate inclusive of the mental health population.

As Public Advocate, he submitted to the select committee of the Legislative Council inquiry into the Glenside proposal a very lengthy submission in which he outlined the importance of retaining the hospital. It is a very long submission, and I am not going to quote all of it. However, the select committee accepted much of what he had to say regarding the importance of retaining and redeveloping the site for mental health services. These are fundamental issues, not just for the community but also for the mental health population, who has needed this service in the past, needs it now and will need it in the future. He comprehensively rejected the 42 per cent of land sell-off of this property for any other purpose.

On the question of the model of care, he also has a view—hardly surprising, as he is an experienced administrator and clinician. He sets out the very important argument of ensuring that we develop the site for future expansion of more mental health services, particularly given the decision to collocate drug and alcohol services on the same property, and I wholeheartedly endorse that. He is comprehensive in his position.

He also confirms the importance of research, which has also been endorsed by the select committee in their interim report of September last year. At this point, I mention that he also wholly commends the community visitors scheme. This scheme operates in other states, and the opposition has foreshadowed an amendment to incorporate it into the legislation and not just have it tacked on as a possible rehabilitation. In his submission on community visitors schemes which, he points out, operate in both the disability and mental health sectors in other states (he has visited the institutions in which they operate), he states:

Services are visited, sometimes without notice, so that visitors can identify abuse or neglect, advocate for the best possible assessment and treatment, assess the standard of facilities and their care for people, and ensure that there are maximum opportunities for recreation, occupation, education, training and rehabilitation. A Community Visitors Program was recommended in Paving the Way, the review of South Australian mental health legislation and there are provisions for these visions in the new mental health bill—

which, of course, we are already considering. He goes on to state:

The new facility should be open to trained Community Visitors.

Here is another expert who is very well trained and highly experienced in both clinical and administration. He says, 'You have got it wrong.' He says to the select committee, 'The government's program is wrong. There are bits of it that are good but in relation to the model of care and the sell-off of land it is wrong.' Remember that he is the public advocate for the disabled and mentally unwell in the community. He ought to know.

He also knows, like Dr Phillips whom I mentioned earlier, about the pressures of working in and running a department. He does not look at it from just a clinical perspective, he comes with the experience of knowing what is like to work in a department with the never ending demands of trying to deal with shrinking budgets, even when receiving increased amounts every year to cope with workforce increases. He knows what it is like.

Others who have put in submissions and who have made public statements include the Australian Psychological Society (SA Branch). Associate Professor Jacques Metzer is the chair of that society. He put in a submission again confirming the importance of ensuring that the plan gets it right. He gave a very comprehensive statement on the therapeutic value of environmental factors which is not only supportive of not selling off land but ensures it is redeveloped in a manner so that it is maintained. He talks about patient welfare, the community interests and the professional psychology issues. It is a very commendable submission.

Again it has been accepted by the select committee. He outlines its importance. It is also very important to note his conclusions. Having looked at a number of processes which are flawed in the redevelopment proposal, he goes on to say:

The Society also believes that sound principles of mental health care and the central role of Psychology and Psychiatry in that care are considered by the Government to be of lesser priority than are relatively more peripheral issues. This may be an instance of attempting to implement a diminution of sound (and not so sound) principles, in favour of more commercial and other considerations under the label of community involvement and removing stigma in mental health.

He could not have made it clearer. The government is flogging off land for commercial benefit to the detriment of psychological wellbeing of mental health patients in this state. It is absolutely clear. Take heed, minister, please, and understand the importance of your going back into cabinet and getting rid of this ridiculous idea. Incidentally, on the question of consultation, in his submission he says:

Unfortunately, the Society sees little evidence of the Government paying heed to the legitimate concerns of significant stakeholders and significant professions.

In other words, you have not even come to us and asked us about this. We are here to help. We are in the same boat as you in that we are looking after the people in this state, so why cut us out of the equation altogether?

It is very interesting that, when I re-read the Cappo report (which is a document on which the government placed great weight in support of its redevelopment), I also noted that there was no consultation with the private sector. I find that unbelievable. Monsignor Cappo recommends in his report that there needs to be cooperation with the private sector for the future development of mental health in the state, but in preparing his report as a comprehensive synopsis for the government to make decisions on, he does not even consult with them.

I find it unbelievable that the very people who provide 60 per cent of mental health services in this state in their consulting rooms or private hospitals are completely ignored. Good on him for at least saying that it is important that we consult them, but it is unbelievable that the government would not give him the remit, resources or instruction to consult with them. Anyway, they have made it clear here that, even though they have been cut out of the loop, the government has it wrong, it can be done in a better way and they ought to heed it.

I want to move to the submission presented by the Royal Australian & New Zealand College of Psychiatrists. This is a very comprehensive submission and members will be pleased to know that I will not read it all. Oral evidence was given to the select committee by this group. These people are the most highly trained experts in relation to mental health. That does not mean that they are the only ones, because a number of other highly trained experts provide for other aspects of mental health wellbeing in this state.

Clearly, they have undertaken 12 to 15 years of study and training in order to understand the most acute and most serious cases and they are given the highest responsibility for the most acute. They have a vested interest in this matter, especially in relation to a bill where we are talking about those who, potentially, will cause harm to themselves or others and are unwilling to have treatment. That is exactly what we are talking about here today: how we will manage those people.

Psychiatrists have an important role, and the government's answer is to present Glenside Hospital in all its detail in the minister's explanation about how it will help. Well, the Royal Australian & New Zealand College of Psychiatrists has a different view. Far from being world class and state of the art—I suggest that it is total window-dressing and a facade of what has been presented on websites and in announcements about the provision of acute mental health services and programs by the government—they say that the government has got it wrong. They say that the information that has been provided to date about the model of care and the programs that the government intends to provide is completely wrong. They say that it produces a model of care which is the direct reverse of what Monsignor Cappo quite rightly advocates as an important outcome for mental health patients.

How could it be the complete reverse? I will refer to some of their comments. A letter signed by Mr Marco Giardini, chair of the royal college in South Australia, states:

The Glenside Hospital site is an important and extremely valuable resource for all South Australians. It is a resource that should not be squandered for short-term gain without real consideration of the state's current and future mental health needs. The college stands in a unique position to comment on the proposal. We believe it is imperative that our views—together with those of other health care providers and health care consumers—inform any future development.

They plead for consultation and they say that the government has got it wrong. They say that the government should go back to the drawing board and start again and not flog off this valuable asset.

I have paraphrased, of course, a very lengthy submission, but obviously it provides some very important historical context. I want to refer to one aspect of this submission which resulted in the select committee's recommending just what they say, that is, to go back to the drawing board and start again. 'If you want to come up with a world-class model, you will need to do that process completely, otherwise you will not achieve the outcome as stated and which we all seek to achieve.' In respect of the sale of a number of precincts, page 17 of the report states:

…it is our view that before any sale of land proceeds, the exact model of hospital building(s) is designed to general satisfaction. Indeed, the college needs to know that each collocated service will be properly resourced, have sufficient infrastructure including rooms and car parking, separate access as required and the integration has been properly researched before development proceeds.

That forms part of the basis of the finding of the select committee not to proceed. I need to go back to the submission, so I ask the indulgence of the house while I find its reference to the model. I will not refer to the whole submission but, obviously, it has made significant inquiry which it has provided for the government to review. It has looked at other redevelopment proposals overseas, including the Queen Street project in Ontario, Canada, and the Southfields Village in south-west London in the United Kingdom. The submission goes on to name other best practice models that this government is claiming are to be implemented with its proposal, and it talks about the options for collocation of services on a single site. It talks about a move-off site, a campus model or an integrated model. The submission further states:

Both of the overseas examples opted for the integrated model, noting that the campus model 'fails to provide the best possible treatment environment and meet Trust and community objectives'.

So, it is utterly rejected in other instances overseas. In relation to the Springfield Village proposal under its campus model, the submission states:

Mental health care uses will be integrated into the site within two distinct clusters: at the centre of the plan on either side of the Central Square; and a more peripheral site to the south...The central cluster will be integrated with the residential, commercial and community uses, contributing to a vibrant urban village centre.

Sounds familiar! In terms of security being raised as a major problem, it further states:

The government continues to claim that it has followed international best practice in the overall plan of the site, putting forward arguments raised by overseas sites in an integrated model. The clear evidence is that the hospital site is not an integrated model but rather the campus model—which does not have the support of overseas best practice. The committee has raised issues of security. There are few resources which provide data on security issues raised by collocation of certain services. The college hopes that security is a prime consideration in the future development and that research would inform how services can be collocated safely. This may mean multiple buildings, multiple entrances and different access roads.

It goes on to make further submissions about the security for patients and the workforce under the government's model. They say, 'We have looked at this and we can agree on the importance of a certain model. We have looked at the overseas aspects as well, but what the government has come up with is actually the wrong one.' One would think that, when the Royal College of Psychiatrists came up with this and later presented it in May last year to the select committee (taking into account the government had the full report), at the very least the government would go back and say, 'Well, did we get this wrong?

The select committee is suggesting that we start again; that, in fact, whatever advice we have been given from the department and all the reports and things that have been done—these pictures on the website, this program where we will sell off 42 per cent for private housing (a little bit for public housing), a new supermarket and retail and the new building that we will be putting in the south-east corner of the site after we have taken up the rest of it for the film corporation—we have actually come up with the wrong model.'

It is actually not world's best practice. I despaired when the government announced its other $1.7 billion cost, or whatever it is now going to be, to move our premier tertiary hospital from one end of North Terrace to the other—and they tell us that this is going to be world's best practice, the great model, the cutting edge! I hate to think, when we start to dig into that, what money is going to be squandered if it is the wrong model and not world's best practice. I am not being filled with confidence, because the Royal Adelaide Hospital itself at the moment (not just at the Glenside campus but also at the North Terrace campus) provides mental health services. It is of direct relevance to the resources that we are going to have for this bill.

What if they got that wrong? What if, in fact, when we dig into that when the government is required to disclose the documents, which it has consistently refused to do to date, they got that model wrong? We are going to start all over again! The Hillingdon proposal, a hospital in England which is touted as a basis for new rooms in that hospital, which is going to have psychiatric patients as well, is a model that is nearly 20 years old. I start to despair for what we are getting from that.

Having had the direct evidence from the experts, you would think that they would go back and say, 'We may have got it wrong.' Instead, they are going to bulldoze this through, and evidence of that of course is they are still cleaning up at Glenside and still preparing to bring in the film corporation as a head tenant in the heritage buildings. This is the property the Premier's department has bought for $2.5 million, smack bang in the middle of the site. He is going ahead with that. We do not have enough money to actually build the hospital for another two years.

The Treasurer is running around saying, 'I will save $26 million if I delay the new hospital for two years', but there is plenty of money to throw around and build the film corporation a new home in the middle of the site and for the Premier to spend another $2.5 million for his department to own part of the site. There is plenty of money for that, yet they have the gall to proceed with this development. This is the basis for one of the major resources the minister will have to deal with the extra burden of public need we will have as a result of introducing these amendments, and she says, 'We are going to proceed nonetheless. Nothing is going to stop us.' Let me tell the house a reminder of that.

Recently, I was at minister Holloway's planning meeting at which a panel was appointed, which is required as a matter of law for any changed rezoning of the site, in this case, to give permission to the government to be able to sell on part of its site for retail and commercial purposes and private housing instead of hospital services. It has to do a rezoning and it has to have a new plan, and it has to consult publicly to do that. So we had many people over three hours come before a panel three weeks ago to put their submissions. One after another they came forward to say, 'This is where we think this is wrong'—except, of course, those representing the family that is about to get a preferential deal to buy a piece of the land to build a new supermarket. That was the exception. However, the rest of them came forward.

I say that because, irrespective of all of these experts before the select committee, the government is pressing ahead. There is not even a shadow of decency to say, 'We are not going to build the hospital for another two years so we will go back and look at that and we will rethink what we have done. We will not sell off anything until we have had a good look at that.' No; they are saying they have to press ahead with the rezoning so they can flog off this land for supermarkets, retail accommodation and private housing.

I want to come to the third area of experts at that meeting. These are the silent workforce, and I call them that because they are employed by the government. These are the mental health nurses who work at this site. Many of them have worked for 19 and 20 years. As you would expect, they stay for a long time because they are dedicated, and people who go into such a profession do not do so if they are not dedicated. Obviously, they do not do it for the pay: they do it because this is very hard, cutting edge work. They are dealing with the sickest people in our state with mental health problems, often coupled with behaviours that makes it even harder for them to manage and assist not only in the care of these people but also in their rehabilitation.

One of these mental health nurses bravely stood up at the public meeting and described the government's redevelopment as genocide by stealth. They are harsh words. I have heard just about everything in courtrooms, but this is a mental health nurse standing up and saying that at a public meeting; a person who is a long-term employee on that hospital site who deals with mental health patients. He said, 'We have seen the plans of what is to be done, and we are concerned about the collocation of drug and alcohol patients with mental health patients unless there is a very, very, very high level of security and the planning is done in a manner that will ensure their protection.' He said that this is like putting the most dangerous with the most vulnerable.

He despairs, and he pleaded with the panel to re-look at this matter and not zone for this situation where two very high-need groups in the community will be squashed together in one facility in one corner of what is left of the Glenside Hospital. Members should remember that what is left today of the Glenside Hospital is 20 per cent of the total area that it used to have. If another 42 per cent is to be sold off, then I say that that mental health nurse needs to be heeded in the advice he gave to that public meeting.

James Hundertmark is an experienced psychiatrist and a clinical head and administrator (I think he is currently the head of the Margaret Tobin Centre at the Flinders Medical Centre, a new facility). The concept of having divisions within our general hospital structure was initiated by former minister Dean Brown and was kept up by minister Stevens (which I applaud) and she, before they split off mental health services, I think proudly maintained a commitment to build that centre.

Mr Hundertmark (who has been a chair of the Royal College of Psychiatrists) is now the head of that centre. This is a man we should be very pleased to have in South Australia. He has had a lifetime commitment to public mental health. At that meeting, he pleaded for there to be a rethink about what is to be done with respect to mental health services. He urged the government to re-look at the model and ensure that the services will be provided in a secure manner for the patients and the workforce, both permanent and visiting, and the relatives of the members of that workforce who come and go from the property. I seek leave to continue my remarks later.

Leave granted; debate adjourned.


[Sitting suspended from 13:00 to 14:00]


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