Hospitals, Acute Beds

I seek leave to make a brief explanation before asking the Minister for Mental Health and Substance Abuse a question about acute bed numbers.

The Hon. J.M.A. LENSINK: Under questioning last year in relation to acute services bed numbers and waiting lists, the minister said:

. . . we’ve got adequate acute bed numbers and we’re committed to retaining those numbers. . . we’re committed to the current levels of acute mental health beds. . .

In a separate comment, the minister said:

I amvery proud to say. . . that South Australia has, on a national average, quite a high number of acute beds.

The press release issued today by the minister and the Premier indicates that hospital acute beds numbers will be cut. Indeed, the Cappo report indicates a shift out of the acute system of some $12 million. My questions are:

1. Was the minister telling the truth last year?

2. Which hospitals will experience ward closures?

3. How much will the government cut from our acute hospital mental health services?

The Hon. G.E. GAGO(Minister for Mental Health and Substance Abuse): I thank the honourable member for the opportunity to talk about our new and most important reform agenda, which was announced today. A great deal of work went into the Social Inclusion Board’s report, which was delivered today. It involved discussions and consultation with 1 400 people and has resulted in 41 recommendations—and this government is committed to the overall direction of all 41 of those recommendations.

As indicated very early in the piece, South Australia is committed to delivering a new reform agenda. We accepted that our mental health had been sadly neglected for many years, particularly by the opposition sitting across from us.

For eight years, they sat on their hands and allowed our mental health services to virtually deteriorate and collapse around their ears. It was an absolute disgrace. We were committed to doing that. As of today, not only have we released the reform agenda with its 41 recommendations and the government’s commitment to the direction of those recommendations but we have shown our commitment by announcing $43.6 million to deliver the first steps to that new reform agenda. This reform agenda outlines the new service deliveries, and members need to listen very closely to this— they obviously failed to listen to the ministerial statement—

Members interjecting:

The PRESIDENT: Order! The minister is answering the question.

The Hon. G.E. GAGO: The Social Inclusion Board identified that the current services are inadequate to meet our current needs. That was a clear finding from the report; that is, the current services are inadequate to meet our needs. The board identified a significant gap in services, a gap between the hospital-based services and the community-based services. The $43.6 million to which we have committed today will fill that gap. It will fill the gap with 90 new intermediate beds and 73 24-hour supported accommodation beds. We do not resile from the fact that approximately 48 acute beds will be replaced by the 90 intermediate level care beds. We have not resiled from that at all; that is in our media release, I understand.

When the stepped level of the reformed care is put in place, it will involve the steps of secure care, hospital care, intermediate care, community rehabilitation centres, 24-hour supported accommodation and, of course, packages in people’s homes. When all those services are in place, it will result in an increase of around 76 additional new mental health beds across the system. As I have said, we have not resiled from the fact that the Social Inclusion report clearly identifies that South Australia has well above the national average of acute beds. The report found that the current services are inadequate and inappropriate to meet the mental health service needs of patients in South Australia. We are about to fix it, unlike this lot opposite who do not have a plan and who sat on their hands for eight years and watched this system collapse around their ears. We have a five-year plan and, what is more, we have announced that plan today with an up-front commitment of $43.6 million to build over five years—

An honourable member: Over how many years?

The Hon. G.E. GAGO: Over five years. The plan is over five years and funding components will still be delivered under the normal budgetary rounds of government. It is a five year plan. There will be further budgetary considerations. The Social Inclusion Board has produced a fantastic piece of work and I am very proud to have it presented to both houses today. It is to be followed by the government’s commitment of $43.6 million to build a new mental health system, a stepped level of care system which will help provide a broader range of services to those people who need it most where they need it and which will stop this revolving door type cycle that keeps happening when people become seriously ill and end up clogging up the system.

Currently, we have no intermediate care beds in this state and only a handful of supported accommodation beds. This planned $43.6 million delivers a stepped model of reform to our mental health system and provides the building blocks for a new mental health service in South Australia.

The Hon. J.M.A. LENSINK: I ask a supplementary question. Given the minister’s comments last year, at what point and by whom within the government was she informed that this government would cut acute bed numbers?

The Hon. G.E. GAGO: The government was given the Social Inclusion Board’s report in late November. A great deal of work was done by government in putting together a response. The report is very detailed and comprehensive; a blueprint for the reform of our mental health system. It involves across-agency matters and a wide range of costing matters. A great deal of work has been done since early December on modelling and costing the recommendations.

The final submission was endorsed by cabinet yesterday and the final plan is presented today.

The Hon. J.M.A. LENSINK: Given the minister’s response, who makes the final decision about mental health issues: the minister or Monsignor Cappo?

The Hon. G.E. GAGO: Really, is the opposition member thick or something? After almost a year in opposition, does she fail to understand the structure of our mental health system? As Minister for Mental Health and Substance Abuse, I will take responsibility for the implementation of this fabulous new reform agenda.

Members interjecting:

The PRESIDENT: Order! The Hon. Mr Lucas has a supplementary question.