Glenside Hospital, Special Services Unit

30 May 2006 questionsarchive

I seek leave to make an explanation before asking the Minister for Mental Health and Substance Abuse a question about the special services unit at Glenside.

The Hon. J.M.A. LENSINK: The Palmer report into the circumstances of the immigration detention of Cornelia Rau made a number of comments and recommendations relating to the lack of leadership within departments, poor communication protocols, lack of clinical pathways between the Baxter detention facility and Glenside, Glenside’s reluctance to take detainees, the operation of the Mental Health Act and the number of beds provided through the Rural and Remote Mental Health Service. I will cite some of the extracts which are germane to this question. At page 133 of the report Palmer said:

The Inquiry is not persuaded by claims by DIMIA, GSL and the South Australian Health Department that, although a formal memorandum of understanding had not been signed, the clinical pathways and arrangements were clearly outlined, understood and working effectively. Obviously, they were not. This situation should not have been allowed to arise but, having arisen, should have been quickly and effectively resolved at an escalated management level.

Further, at page 138 Palmer said:

It is obvious to the Inquiry that in South Australia two systems operate to the detriment of the potential patient. . . In using the word ‘systems’, the Inquiry refers to the integrity of clinical pathways, the alignment between systems, protocols, procedures and MOUs, and the availability of services to meet the assessed needs of a patient.

At pages 150-151 Palmer said:

Glenside has 23 in-patient beds available for country patients . . . Baxter falls into the ‘country’ category. . . Given these small numbers, there is an obvious need to husband valuable resources.

Glenside has found that, when immigration detainees are referred to it, they are already in an advanced state of illness. As a result, they need to occupy beds for longer than other mentally ill patients and require lengthier rehabilitation. . . To cope with the problem of scarce resources, Glenside had a preferred operational principle of having only one bed available for immigration detainees at any one time.

Members will be aware of the 7.30 Report piece last week.

My questions are:

1. Has the government sought a review of practices at Glenside, including clinical arrangements and the consultative machinery, as recommended by the Palmer review?

2. Will the minister assure the parliament that the decision to discharge the detainees from Glenside over the period of March and April was a clinical decision, rather than an ‘operational principle’?

3. Does the commonwealth government have confidence in Glenside’s capacity to provide appropriate services to detainees?

4. Will the minister assure the chamber that none of the terms of the MOU have been breached?

5. Is the special services unit still operating and, if so, how many detainees are receiving treatment?

6. What has happened to the staff who were working in the special services unit?

The Hon. G.E. GAGO(Minister for Mental Health and Substance Abuse): I believe that in April this year we had six in-patients remaining within the special stay unit located at Glenside. Each were determined by senior clinicians as no longer requiring acute in-patient care. What is really important to note is that it is not the level or the quality of care that the detainees have received at the special stay unit that is in question. The quality of their care in the unit has never been questioned. However, there has been some concern about the location of discharge to detention facilities, rather than into the general community.

It is important to note that, because of their legal status, the placement of immigration detainees is the responsibility of the commonwealth government. The special stay unit currently contains no immigration detainees, but should any detainees require the services of this unit it will be reopened.

It is important to note that the unit remains available. I am advised that some immigration detainees are being treated at a Queensland hospital on a voluntary basis.

Since 2001, the Glenside campus has provided a range of services to commonwealth immigration detainees, including distance consultation and mental health in-patient care where appropriate. As a result of increased demand for immigration detainee mental health services, an unused six-bed unit on the Glenside campus was reopened. This unit is now known as the special stay unit, and it has been clinically led in line with principles contained in the National Mental Health Strategy.

The role of the special stay unit is to provide acute care for patients and, clearly, to try to get them well again.

The memorandum of understanding (MOU) referred to by the honourable member, which was entered into between the Commonwealth of Australia (represented by DIMA) and the State Government of South Australia (represented by the Department of Health) for the provision of identified areas of service to some immigration detainees, was signed by DIMA on 18 October 2005 and by the Department of Health on 17 November 2005. South Australia is the first jurisdiction to develop agreed protocols with the Department of Immigration and Multicultural and Indigenous Affairs for immigration detainees. It should be noted that this is an important leadership initiative of the government. The protocols prescribe that services to immigration detainees should be of the same quality and standard as those provided to the general community and that prevention and early intervention should be the focus of care.

Ultimately, the duty of care for immigration detainees rests with DIMA (as stated in the MOU) and the discharge of clients from that unit is made on a clinical basis. Staff who are placed in the special stay unit continue to be employed at Glenside and are simply relocated to other wards and units where needed. As members would know, agency staff are occasionally used to help with peak-time rostering arrangements, moving from workplace to workplace and ward to ward on an as needs basis. To my knowledge, there has been no known breach of the MOU.

The Hon. J.M.A. LENSINK: I ask a supplementary question. Is the minister aware of any particular reason why two detainees from Baxter are now being treated at Toowong in Queensland rather than at Glenside; is she aware of the recommendations that Palmer made to Mental Health Services in South Australia; and is she confident that they were all implemented?

The PRESIDENT: Order! I do not recall any reference in the minister’s answer to the two people mentioned by the honourable member in her supplementary question. The minister can answer the question if she wishes.

The Hon. G.E. GAGO: I have already answered that question. I said that, to the best of my knowledge, those clients who were discharged are being treated in Queensland on a voluntary basis. I am not exactly sure to which client she is referring, but the information that I have on clients who have relocated to Queensland is that they did so on a voluntary basis.