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Legislative Council - Fifty-First Parliament, Third Session (51-3)
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Parliamentary Committees

SELECT COMMITTEE ON PROPOSED SALE AND REDEVELOPMENT OF THE GLENSIDE HOSPITAL SITE

Adjourned debate on motion of Hon. J.S.L. Dawkins:

That the interim report of the select committee be noted.

(Continued from 29 October 2008. Page 472.)

The Hon. SANDRA KANCK (21:57): I know that the select committee responsible for this interim report cannot stop the development of the Glenside site taking place. It is a reflection on government that the previous minister for mental health felt that, because of the funding constraints placed on the portfolio by the Treasurer, she had to find money from somewhere to fund the action she wanted to take place in the mental health portfolio. I offered to be on this select committee in order to find out more about the processes involved and to do what I could to ensure that proper procedures and consultations had taken and would continue to take place. There was an opportunity to question the decision makers to find out whether the final detail of the plans was there, and to seek justification and even request and suggest changes.

This select committee process has allowed the spotlight to be shone on the fact that South Australia is the only mainland state that does not have a mental health research and training institute. Shining the spotlight for the committee on 13 August was the Professor of Psychiatry at the University of Adelaide, Robert Goldney (although he stressed he was not representing the university), and from the Royal Australian and New Zealand College of Psychiatrists, Dr Marco Giardini and Dr James Hundertmark. The college's written submission had already advised us of the existence of the South Australian psychiatry training program, housed in the administrative building at Glenside. But in the government's plans that building will be taken over by the Film Corporation.

The submission informed the committee that, while the college has been advised that the training facilities will be incorporated in the redevelopment, they had received no information or guarantees about the type and nature of facilities that would be offered anew. They made the following comment:

The land size presents an opportunity for development of world-class training facilities in a central location.

In comments to the committee Dr Giardini described it as a golden opportunity to establish a centre of excellence in mental health, not just for psychiatry or the psychiatric discipline but for mental health disciplines. Dr Goldney suggested that nursing would be encompassed. I quote Dr Goldney, as follows:

South Australia does not have a centre that is seen nationally as a centre of excellence in terms of teaching and research. There is no critical mass of people at any one site. We have so much diversification, with little units all over the place, but none of them have sufficient people in them really to make a difference.

Later in his evidence he elaborated:

If there was more aggregation of expertise we would have centres of excellence. People would wish to go to those centres and there would be that critical mass of people who could treat, rub shoulders with their colleagues in the corridor and ask second opinions, but we get people scattered around the community and that is the way to get idiosyncratic treatment without that ongoing peer review.

Dr Hundertmark told the committee:

...the Glenside site would be ideal for establishing that kind of facility...it is an excellent opportunity to have those kinds of functions occurring on a site that is close to the city, because a lot of the researchers who work on that site will have a clinical load somewhere like the Royal Adelaide Hospital or the Glenside Hospital, and if it is near...they can work between the two sites.

I observe that the Women's and Children's Hospital, which has a psychiatric unit, is 10 minutes drive north of the Glenside campus, Flinders Medical Centre is 20 minutes south, Fullarton Private Hospital is only 2 minutes drive away, Queen Elizabeth Hospital only 25 minutes and Lyell McEwin Hospital 30 minutes. Additionally, Flinders University, Adelaide University and the UniSA campuses are 10 to 20 minutes away. So, locationally, the Glenside site has a lot going for it. That 'rubbing shoulders', as described by Professor Goldney, would provide a sharing of information and the creation of strong links between research and practice.

The evidence that we in South Australia need such a facility where that critical mass of thinking can come together was clear. It was also clear that if the committee wanted to recommend the setting aside of land or facilities at Glenside for such an institute we needed to act quickly with a recommendation to this effect before decisions were finalised about the carving up of the land and the doling out of the buildings. So, immediately after witnesses had retired on that day, I moved that we publish an interim report, which was agreed to, and which we are now noting. Since then, a strong rumour has emerged that the Adelaide Central School of Art will also be moving to that site, so this interim report is very timely.

In the process of giving evidence on 13 August, Professor Goldney made a statement that was quite a revelation to me, and I will read it, as follows:

When I took up my position 18 months ago, I was astounded to hear that the Mental Health Training Centre is contracted out to the New South Wales Institute of Psychiatry. South Australian money is sent to New South Wales for people there to come here and teach mental health training. It is absolutely absurd. We have two university departments of psychiatry, we have the university departments of mental health nursing and we have university departments of psychology. It is a waste of money.

I found that to be extraordinary information, and it is an insult to the 200 psychiatrists in our state. From what Professor Goldney told us, however, that contract expires at the end of this year and he says he has been assured that it will not be renewed. I think that is a good thing. A research and training institute, as this report recommends, would have that training role, I expect, as its brief. We would not have to go out of this state.

Dr Goldney also made the point that having such an institute would be consistent with the Shine and Young report. I did a bit of a search on the government web site to find the Shine and Young report. It was given to the government in May this year. Its full title is the Review of Health and Medical Research in South Australia. As I see it, everything they say in this report, which is about medical research in general, fits what this committee is recommending in relation to mental health.

A couple of the problems that the Shine and Young report says exist at the moment in regard to medical research are: a lack of coordinated strategic research priorities, directions and outcomes for the alignment and implementation of health and medical research development activities; and the absence of a critical mass of researchers that would foster collaboration between universities, health services, hospitals, and other groups involved in health and medical research. So that fits very much with what the committee has recommended.

In the recommendations of the Shine and Young report about medical research in general, it says:

A 'centralisation' model (with limited specific nodes) is the only viable model for South Australian research, given the relatively small size of the population and the necessity for critical mass to be competitive in national and international research.

So it applies equally to the much more specific area of mental health.

As I will no longer be in the parliament when this select committee releases its final report next year, I want to take this opportunity to make a few other remarks about the decision making in the mental health portfolio, including the matter of the carving up of the Glenside site. The government reassured us in the lead-up to the 2006 election that Glenside would not be closed down. Obviously, this was not a core promise because, since then, it has been closing it down bit by bit by stealth. I am sure most of us can remember—and I can hear it in my brain, unfortunately—Mike Rann's 'no more privatisations' mantra in the 2002 election. What is happening at Glenside is privatisation. The government is handing over public land to private developers for their profit. In February 2007, minister Gago said:

We are currently developing a master plan to retain Glenside as a centre of specialist services to relieve pressure on our hospitals and we'll be announcing details of that in the coming months.

The consultation around this whole project has been lacking from the start. Quite clearly, you can hear in that statement from the minister that 'we will be announcing the details, just fall into line'. Unfortunately, this is standard operating procedure for this government. Last Friday morning I went to a breakfast of the Planning Institute where the planners in South Australia ranked South Australia, compared with all other states, as the worst in the country on consultation. Obviously, we have seen that lack of consultation with the Glenside site. We have seen it with the proposed Marjorie Jackson-Nelson hospital. We were told out of the blue that we will have a hospital. Then we had consultation, so to speak, in the Sunday Mail a couple of weeks ago, asking questions such as whether we want internet facilities. That is not real consultation: that is fake consultation. When the Glenside plans were announced, my media release stated:

All the decisions have been made and the only opportunity for input will be about where some of the services, houses and shops will be located on the site—and that is not consultation.

There have been major mistakes in the Glenside planning, which I hope might be redressed with a new minister; for example, reducing the number of beds in Helen Mayo House which has six beds for women with post-natal depression, some of whom are suicidal and some of whom are rejecting their babies. I cannot think that the government thinks that six beds at any one time will cater for the number of women in that situation.

With the sell-off of the land for housing and the transfer of it to arts organisations, I question whether adequate facilities will exist in a much more compacted site for the psychiatric telemedicine facility that is currently on the site. We still do not know what will be provided for in the plans. In the past two years the extended care facility at Glenside has been dismantled, which raises the question of the validity of the current policy of further progressing deinstitutionalisation. Some 12 months ago James Nash House—the state's forensic mental health institution—was going to be closed as a consequence of a new facility to be built at Murray Bridge—and I have been very critical of that decision. Only today or yesterday the Hon. Stephen Wade was raising questions about staff and their unwillingness to go there. It would also have created problems for family members wanting to visit inmates—I suppose that is what they are called—at James Nash House—a site which is remote from the metropolitan area and which has no public transport.

That plan has been put on hold because of the government's response to the current world economic situation—fortunately I think, because it provides an opportunity to reflect on the question of whether the siting of it at Murray Bridge was ever a good idea.

In relation to what happened with James Nash House, again I put out a media release when the idea/plan was first promoted. I then said:

In the now typical style of Rann's Government, Labor has announced they will 'fully consult with staff about the move'—starting today, after their announcement. It creates a new definition of consultation.

The Murray Bridge plan also included the closure of 10 forensic mental health beds at Glenside. So, it will be interesting to see whether the government will now be backtracking on this. One would hope so, but it is something that I think the select committee can pursue.

In May we saw the closing of the supported residential facility at Norwood, with 19 beds going, on top of the plans to reduce services at the Glenside site. The College of Psychiatrists put out a media release about that on 23 May this year. I will refer to one paragraph. It is a little confusing. They brought in the issue of Glenside Hospital at the same time as criticising the closure of that particular supported residential facility and, having done that, they then talked about Glenside. The media release states:

We question whether this is the right time in the evolution of this State's mental health services to sell off land which will forever be lost to mental health consumers and services, when the State is in dire need of a substantial increase in appropriately run, high quality supported accommodation options for those with serious, chronic mental illnesses.

I really stress the words they use: 'the state is in dire need of a substantial increase in appropriately run, high quality supported accommodation options. Yet this government is heading in other directions.

In looking at some of my notes on mental health, I found that, in the lead-up to the 2006 state election, I addressed the Mental Health Coalition, and the following is part of what I had to say, because it is so relevant now. I said:

There are two types of health systems—the ambulance at the bottom of the cliff to pick up those who have fallen off or jumped off, and the fence at the top of the cliff to prevent the falls and jumps in the first place. South Australia has the ambulance at the bottom of the cliff system, and because there are so many people falling or jumping off, we're having to put the money into the ambulances and haven't got the money to put into erecting the fence. It's a vicious circle. The South Australian Democrats want the fence put up, but we must not take the money away from the ambulances to do it.

But I observe that is what we are doing right now. Just as we need more community care as a way of dealing with that, we turn around and close mental health beds. It ought not to be one or the other.

In 1993, the Human Rights and Equal Opportunity Commission Inquiry into the Human Rights of People with Mental Illness (I think that is the Burdekin report) recommended the establishment of a community visitors program for monitoring of standards in mental health institutions. That was 15 years ago. In 2005, I introduced my human rights monitors bill, which was the gold-plated version of an official visitors bill. I understood, however, that around that time the then minister for human services (Hon. Lea Stevens) was consulting on an official visitors bill and therefore I expected that the incoming government in 2006 would introduce some form of legislation. But it looks like, in the splitting up of the portfolios—turning DHS back into health and families as two separate portfolios—no-one took responsibility for it. We still lack such an agency in South Australia to undertake independent and random inspections of mental health and other institutions, and it is still very much needed.

Coming back to the issue of the Glenside site, I refer to a few sentences from a media release put out by the South Australian College of Psychiatrists. In part, the media release states:

'Mr Rann told South Australians before the last election that Glenside would remain open. Surely that did not mean most of the area would be lost to mental health,' said Dr Hundertmark.

The media release further states:

Government did not seek advice from the College with regard to any specific aspect of the plan before it was released...'The existing Glenside site should be retained in its entirety for current and future mental health use,' Dr Hundertmark said. 'Open space has a proven role in rehabilitation for people with mental health issues.'

I think that is really important. We will replace open space with shopping centres, and that is not what is needed by people recovering from a mental illness. It causes me to ask whether the government is throwing out the baby with the bathwater. We are continuing to reduce bed numbers, and that does not make sense in the context of a State Strategic Plan which aims to increase our population. It seems sensible to retain as much of the Glenside site as possible in anticipation of the extra demands that an increasing population will create.

A new mental health training and research institute, as recommended by the select committee, is a perfect use of the Glenside site. I am hopeful that our new Minister for Mental Health and Substance Abuse, the Hon. Jane Lomax Smith, with her training in pathology, will understand the importance of critical mass in the health profession and therefore the value of the recommendation made by the committee, and act upon it. If, when the Glenside carve-up plans are finalised, we find that provision has been made for this institute then this select committee will have served a vital purpose.

The Hon. J.S.L. DAWKINS (22:16): In wrapping up the debate I would like to thank my colleagues the Hons Sandra Kanck and Michelle Lensink for their contributions to the motion. I would particularly like to thank the Hon. Sandra Kanck for coming up with the idea to move the motion; as she said, it was a day when we had particularly compelling evidence from Professor Goldney, Dr Giardini and Dr Hundertmark. The report has been brought down and has gained some publicity, but we are keen that the government take notice of the very strong views that those three eminent gentlemen put to the committee.

Before concluding, I would also like to thank the Hon. Sandra Kanck for her involvement in the committee during the time it has been underway; I know she will be leaving us very soon. With those few words I commend the motion to the council.

Motion carried.

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