Minority Report
Senator Rachel Siewert, the Australian Greens
The Australian Greens welcome the intent of the inquiry and
the Committee report. There is near universal agreement in the evidence
submitted to the inquiry that the new funding for health is significant and is
much needed in the health system. However, the degree to which this could be
described as reform is debatable. It is not within the scope of this inquiry to
determine how the proposed new structure will work but the relationships
between the authorities, local hospital networks and Medicare Locals remains
unclear. There is insufficient detail on how this will evolve. The inquiry
process has made clear that those outside of government service delivery,
especially consumers, must be involved in the design of the system.
The Committee’s conclusions reiterate a number of the issues
the Greens have identified since the reforms were announced. In particular,
the Greens have noted the inadequacy of funding for community based mental
health services and called for increased funding for this important health area
and a universal dental scheme. The inadequate response to mental and dental
health reform issues is noted in submissions by The Australian Health Care
Reform Alliance, Catholic Health Australia, the AMA, SARRAH and the Consumers
Health Forum of Australia.
The following comments by the Committee are strongly
endorsed by the Australian Greens:
- Leadership on
mental health was promised by the Commonwealth but what has emerged with the
announced reforms is a small, incremental change to the system which will do
very little to address inequity in access to services and decrease unmet need
for mental health services.
- The Committee
notes the comments by Professor Patrick McGorry who pointed to the excellent
evidence-based programs which are available in this country that, if provided
with adequate funding could have a tremendous, positive impact for those
Australians with mental illness. In particular, expanded funding for the
Headspace and EPPIC programs would see many more young people access services.
- The Committee also
notes that there is overwhelming evidence that the benefits of providing
increased access for young people far outweigh the additional cost to the
health budget. The reduction of disability, the improvement in survival rates,
the decrease in use of services and improved outcomes point to the high cost
effectiveness of early intervention programs. Professor McGorry stated that the
costs are three times as much over an eight-year period if a person goes
through the normal late intervention system.[1]
- The Committee
considers that the Commonwealth has not delivered on its promise of reform of
mental health services. Rather, the rhetoric continues and inadequate levels of
mental health services remain.
In addition the Committee’s conclusions on aged care
reiterate issues the Greens have long championed.
1.0 The provision of
care for Australia's ageing population poses significant challenges. The
Government's proposed reforms do not address those challenges. They have been
formulated before the Productivity Commission has completed its inquiry. The
Productivity Commission is not due to report until December 2010.
1.1 In the meantime, the
aged care sector is still underfunded and still lacking in certainty about
capital funding to ensure that new beds are actually constructed and
maintained. The complex funding arrangements remain.
1.2 It is doubtful that
the measures to address the issue of long stay older patients will in fact see
older people move out of public hospitals. To do so, there needs to be beds for
them to go to and more importantly, staff to look after them.
Given that the Government is to redirect $276.4 million
funding over three years from high-care residential aged care beds to the
states and territories to provide 'similar levels of care' for LSOP in public
hospitals, this seems unlikely any time soon.
Senator
Rachel Siewert
Senator for Western Australia
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