Question for the Minister for Health and Substance Abuse on the subject of mental health.
The Hon. J.M.A. LENSINK: I seek leave to make an explanation before directing a question to the Minister for Health and Substance Abuse on the subject of mental health.
The Hon. J.M.A. LENSINK: On 2 November, the Principal Community Visitor's 2016 annual report in relation to mental health services was tabled. In the report, the Principal Community Visitor advises the minister of his concern that the government's strategy to reduce the time mental health patients wait in emergency departments for an inpatient bed has created some serious 'downstream problems' and ultimately a 'revolving door' situation for people with acute mental health conditions. The Principal Community Visitor writes:
One of the most disturbing issues raised with the CVs was where at The QEH adult mental health unit, Cramond Ward, they had $1,000 fines imposed on them by the department as they did not free up a bed by discharging patients when there were patients in The QEH ED needing a bed and at risk of breaching the 24-hour target.
This matter was reported to both the Chief Psychiatrist and the deputy chief executive by the PCV, expressing concerns about the added pressure this places on clinicians, adding that it was 'difficult to see how this improved clinical practice, and the severe fines imposed simply takes more resources out of the unit'.
My questions to the minister are:
1. What action has he taken in response to this concern being raised with him?
2. Did the then Chief Psychiatrist, Dr Aaron Groves, raise this concern with the minister in his 2016-17 report?
The Hon. P. MALINAUSKAS (Minister for Health, Minister for Mental Health and Substance Abuse): Let me thank the honourable member for her question and let me also thank Mr Corcoran for the development of his report. I had the opportunity to meet with him earlier this week. I think it was earlier this week. He is doing an outstanding job in his role. It is an important role and we welcome the contribution that he makes.
Improving access to mental health services and reducing waiting times in emergency departments for people with a mental illness of course remains a priority for the state government. As minister, I am obviously committed to ensuring that no mental health patients wait more than 24 hours in an emergency department.
Since late 2014, the average waiting time in our mental health emergency departments has more than halved, I am advised. We have seen some drastic improvements, and I expect these good results to continue, because it is an important community service for those people who need access to emergency departments.
In 2015, mental health emergency department targets were developed in consultation with clinicians. These include, from 1 January last year, that mental health consumers should not routinely wait more than 24 hours in an emergency department, and that by July 2018 we aim for 90 per cent of mental health consumers not waiting more than eight hours in an emergency department and 75 per cent not waiting more than four hours.
Since the announcement of these targets, there has been an improvement across emergency departments, with the average waiting time reducing from 18.5 hours in October 2014 to 8.4 hours in September 2017, I am advised. I am also advised that the percentage of the patients waiting in emergency departments for more than 24 hours improved from 20 per cent in October 2014 to 2.3 per cent in September 2017.
These are important metrics. They make a real difference, if they are realised, for the benefit of mental health patients. We continue to strive to do better. We look forward to continuing to work with the statutory officer in terms of the Principal Community Visitor, Mr Corcoran, to achieve those targets. They remain an important organisation to keep us on our toes.
The Hon. J.M.A. LENSINK: This does not necessarily arise out of the minister's answer, but he has not actually responded to my concerns at all, which were expressed by the Principal Community Visitor in his annual report.
The Hon. P. MALINAUSKAS (Minister for Health, Minister for Mental Health and Substance Abuse): Again, I enjoyed the meeting that I had with the Principal Community Visitor. We discussed a number of things, including the context of his annual report. There was a recent story in the media about the length of the report. The Principal Community Visitor and I discussed other legislation that governs his capacity to give an annual report and also his capacity to deliver a special report. We discussed the possibility of him potentially doing that. We hope to have a productive working relationship. He has an important function to serve, and that includes monitoring waiting times in emergency departments.
The Hon. J.M.A. LENSINK: Further supplementary: is the minister concerned that the practice of the department in fining psychiatric units might be taking resources from those psychiatric units and also not addressing the fact that some units may have so much demand that they can't discharge patients in order to meet the 24-hour target?
The Hon. P. MALINAUSKAS (Minister for Health, Minister for Mental Health and Substance Abuse): The fine regime has the capacity or the potential to be able to serve as an important incentive in driving the behaviour that we are looking for. We are serious about realising these targets. They are good targets, and they have already resulted in substantial improvements. We think the fine mechanism, notwithstanding the legitimate concerns that the Hon. Ms Lensink raises, acts as an important incentive.
The Hon. J.M.A. LENSINK: Further supplementary: in situations that arise where a particular unit may be experiencing more demand, is there any flexibility in the policy to not fine those units and to investigate the root causes of the problem?
The Hon. P. MALINAUSKAS (Minister for Health, Minister for Mental Health and Substance Abuse): I am happy to take that on notice and get some advice about that.