Adjourned debate on motion of Hon. J.S.L. Dawkins:
That the report of the select committee be noted.
(Continued from 4 February 2009. Page 1184.)
The Hon. J.M.A. LENSINK (20:24): I support the motion for the report to be noted. This is the second report that has been published, there having been an interim report. The committee took evidence from some expert witnesses who said that they thought it would be a great opportunity to provide an education hub specialising in mental health, where the critical mass of different disciplines and services would be located on one site. We did receive a reply from the minister—a polite no—which was disappointing.I do not propose to speak about all the detail in the content of the report, which was done by the committee chairperson (Hon. Mr Dawkins) some weeks ago. He covered all those areas very well, particularly the recommendations which were made by the majority of the committee—the Hons John Dawkins and Sandra Kanck and me.
I note, not surprisingly, there was a dissenting statement. We all found it to be a productive committee and, despite the fact there were difficult and perhaps contested matters with which we dealt, I commend the government members who were members of this committee—in spite of the fact they put in a dissenting report with which I strongly disagree.
They conducted themselves in a manner which is appropriate and which people expect as a standard for this parliament. I was a member of another committee inquiring into a similar matter and it was quite different in that it was highly politicised, and I think some of the witnesses were badgered with questions which must have been designed by the then minister's staff. I thank the secretary of the committee, Guy Dickson, and the research officer, Geraldine Sladden, who conducted themselves in a professional manner. The committee put together a report of the right size. Sometimes it is easy to get stuck into all the detail and people do not end up reading the report, but I think this document has been well prepared. I also commend Sandra Kanck for her participation.
This is an area in which she has an ongoing and deep interest. She played a very constructive role, particularly in relation to some of the recommendations and findings. While it is available, people would need to go hunting for some of the evidence, and I think some of the evidence we received is worth putting on the parliamentary record in order to make it more accessible in Hansard. I divide the witnesses who provided evidence into three categories. First, in terms of planning issues, I cite the local council—the City of Burnside—and the National Trust; secondly, the government—officials from the Department of Health and the chair of the Social Inclusion Board, Monsignor Cappo; and, finally, people for whom these issues are close to their heart, that is, the Public Advocate, mental health professionals, consumers and their family members. The committee received quite a number of letters. Committees receive the usual form letters, but it is worth noting that not just 200 or 500, or even 1,000, form letters were signed but, rather, 1,500 form letters were received from local residents, health professionals who had worked there previously and people who had family members there; and I would like to read the letter into Hansard. It states:
Proposed sale and development of the Glenside Hospital site. We strongly object to this proposal because:-
1. The effect of the proposed sale of 42 per cent of the site and its impact on the amenity and enjoyment of open space for patients and the public, biodiversity, conservation and significant trees.
2. Loss of open space will prevent any expansion of the hospital dictated by future needs as the population increases.
3. The effect of the proposed sale of precincts 3, 4 and 5 as identified in the state government's concept master plan and the resulting traffic problems at entry and exit points this plan will create.
4. The proposed sale of publicly owned land in precinct 4 under a special arrangement to a commercial organisation as a preferred purchaser.
5. The state government is prepared to spend $42 million on film studio infrastructure but will only fund the hospital by selling 42 per cent of the land.
As I said, a number of other letters were received also in which people detailed their own experiences and why they believe the site should be retained purely for mental health purposes, and so forth. To return to those three different areas, the first being planning, Burnside council provided evidence and a couple of written submissions and, from what they said, it appeared they were pretty angry. In response to term of reference (a) they said:
Models of care have yet to be announced. The community and council are unable to provide informed comment. The community has expressed concern at proposed drug and alcohol services, and associated security issues. The security concerns of neighbours appear to have been trivialised and overlooked. New services are proposed in a predominantly residential area. It is legitimate and appropriate to consider the impacts on the existing community.
In part, I think that refers to the fact that their own zoning for that area does not include provision for any commercial development on the site. In relation to term of reference (b), they state that the sale of a large proportion of the site will adversely impact existing open space, biodiversity, conservation and significant trees. This is quite a lengthy submission which obviously I will not read: it is 11 pages.
They were highly critical of the consultation process—and I think just about all stakeholders have been highly critical of the way in which the government has gone about this. They also were concerned about heritage aspects of the site—and we heard about the issue of the shed which the minister at the time dismissed in parliament this year and which they state should have been included on the state heritage register—and they expressed concerns for some of the other buildings that similarly may be bulldozed in favour of this plan. The National Trust representatives did not really mince their words. They provided evidence as well, and I will quote from their written submission in which they stated:
The best practice approach to a site of Glenside's significance is to prepare a well researched master plan for the whole site. This must, firstly, document the key qualities of the place which need to be sustained and then identify appropriate new uses for redundant buildings and suitable sites and forms for new buildings which will not compromise the heritage significance of the place as a whole. Unfortunately, the current Glenside campus concept master plan is a poorly conceived, ad hoc planning document which does not represent best practice principles in managing and developing an historic place.
Overleaf it says:
The methodology is deeply flawed. A proper master plan is needed which treats the site as a whole and respects and recaptures some of the spirit of the original landscape plan. I turn to the government witnesses from the health department and Monsignor Cappo. The health officials, I have to say, did not really provide us with a whole lot of information that we did not know. They came in a few times, and they gave us a site visit as well. Apart from swapping around a few of the precincts, they would not provide us with any information about negotiations with the potential commercial developers, and it really was a case of Sir Humphrey coming to hide the government's plans from the committee. I think in some instances they treated us somewhat contemptuously and did not accept the fact that the community had general concerns.
Monsignor Cappo, who has been cited as part of the reason the Glenside plan has turned out the way it has, unfortunately has been prepared to accept some of the blame for this proposal, and I think he diminishes his office by just falling into line when there is clearly so much opposition to so many aspects, not of the way that this has been promulgated but the way in which the end result will unfold. A number of professional groups came to speak. John Brayley, who was the director of mental health services and is now the Public Advocate, brought with him to give evidence a couple of consumers, and we were incredibly grateful for the genuine and heartfelt evidence that they provided. They gave us great insight into their experiences as consumers.
The Hon. J.S.L. Dawkins: Not everybody would be prepared to do that.
The Hon. J.M.A. LENSINK: Yes, I agree. Their names are Meryl McDougall and Anna Ruediger. Ms McDougall stated:
I have seen the diagram and looked at it and in some ways I feel that it is almost backwards.
It should be a question of: what facilities do we need? Therefore, what sorts of buildings do we need to put the facilities and services in? How much space will that use up? Now let us decide what will happen to the rest of the land, rather than saying we will chop up the land into this bit and that bit, and that bit is being allocated to the hospital. The Royal Australian and New Zealand College of Psychiatrists provided a very comprehensive piece of written evidence and also gave verbal evidence, and I state on the record that I was disappointed that the CEO of the health department deliberately tried to misrepresent their position in evidence by saying that the college supported it. I would like to read into the record some of their comments. Their covering letter states: The Glenside Hospital site is an important and extremely valuable resource for all South Australians. It is a resource that should not be squandered for short-term gain without real consideration of the state's current and future mental health needs. The college stands in a unique position to comment on the proposal. We believe it imperative that our views—together with those of other health care providers and health care consumers—inform any future development. They have expressed considerable disappointment with the way in which consultation has taken place as well.
They provided evidence that there are some services at the moment which, if anything, need to be expanded, which is what drove some of the recommendations in the report. They are specifically that the Mother and Baby Unit at Helen Mayo House should have at least eight in-patient beds as a minimum and also that the current forensic mental health services are inadequate, let alone what will happen during that period when Glenside is no longer providing forensic services and before the new facilities are built. They state that before any land sale proceeds the exact model of hospital buildings must be designed to general satisfaction. They also refer to the Stepping Up report. They said that it is 'oft cited as the evidence and support for such a sale, together with the need for the government to "reduce the stigma"'. They have pulled out specific aspects of the report (which I will not read in the interests of saving time) that are used as justification. They said: The government argues throughout the Master Plan that the development reduces the stigma attached to mental illness, that the reduction of stigma is the proposed sale and the redevelopment's primary purpose, and the sale and redevelopment is consequently in accordance with the primary purpose outlined by the Social Inclusion Board in the Stepping Up report. We submit with respect that these statements draw a rather long bow. They do not believe that the number of beds is enough and that the new hospital will not meet benchmarks, particularly if one considers the State Strategic Plan's population target of 2 million people.
They are particularly concerned about the chronic treatment resistant population of people. They say they have concerns that that group is not in the master plan, 'pushing them into mainstream hospital environments which are already inadequately resourced to deal with the general health needs of the population, let alone able to cope with those with severe and unrelenting mental illness'. The letter further stated: There are serious questions about the effectiveness of alternative community services for those existing consumers forced into the community, and those new, young chronic patients who are in fact in need of extended care. The extended care function previously provided at the Glenside Hospital which involved slow stream rehabilitation has no parallel in the proposed model of care. Many clinicians are concerned about the lack of this function in the new stepped model of care.
These are very important things to observe because the government is, I suppose, still in the process of designing models of care, but it is ignoring particular client groups that have specific needs. The easiest thing would be for the government to ask the experts what is needed but, sadly, that has not been happening. On page 12, where they were wrapping up a few issues, they stated: The College does not wish to be cynical. That said, the sale of such a large portion of land to retail, residential and commercial land remains of serious concern and is poorly disguised by the Government as a way in which mental health service provision can be improved. It is a loss of resource plain and simple. In their final comments, under 'Future Consultation', they stated: The College has significant concerns about the lack of formal and specific consultation which has taken place with it, other mental health stakeholders, and the community at large. We accept that communications [and this is where they have been misrepresented by the health department CEO] with individual fellows may have been interpreted as formal consultation inadvertently.
Representatives of the College were involved in early consultation with the Social Inclusion Board along with large groups of other stakeholders. Other Fellows did not take part in meetings undertaken in the build up to the Stepping Up report. That said, the Glenside redevelopment was presented in September 2007 as a finished product despite there being no clear history of consultation on the specific development. To suggest the redevelopment is completely supported by the Stepping Up report and therefore no further consultation is required is somewhat dismissive to all parties who hold an interest in this development—not least of whom the South Australian community to whom this land rightly belongs. It is widely viewed that the sale of land will continue irrespective of valid community concern, and future input should be directed only to the design of the hospital. If this is the case, and the government has no regard for input on that issue, it is both an extraordinarily careless and insulting attitude to all South Australians who rightly deserve a say in how the assets are managed.
That is fairly damning language from a very important professional group which ought to be front and centre of the debate on this issue. The Australian Psychological Society also expressed a lot of concern about this proposal. It said in its submission: It is the Australian Psychological Society's (South Australian Branch) position that there appear to be too many factors producing difficulties in the Glenside Redevelopment for a reasonable outcome. It may be that the consultation and resultant change processes are flawed. It also stated:
...many of the initial ideas and principles of the Stepping Up report are worthy, but that consequent attempts at implementation and adaptation to significant feedback have been and are inadequate.
They are not my words: I am just quoting the words of the professional association. I think that, unfortunately, a couple of the stakeholder groups that gave evidence are probably hamstrung by the fact that their funding is completely dependent on government, so we did not get a very independent voice on that. I would like to finish with a letter from a group of people who said, as follows:
We are a concerned group of relatives of patients with chronic mental illness who currently live in Karingai Ward at Glenside.
There are some 10 signatures. They are very concerned about the care of their loved ones. The letter continues:
Many of our relatives are under Guardianship Board Treatment Orders which attests to the need for a very high level of care, supervision and treatment in a professionally monitored environment. It is clear that any lesser level of care and monitoring would place our relatives at risk, both medically and psychiatrically, of potentially fatal consequences. In the months since the announcement of the proposed redevelopment of the Glenside site we have constantly sought information in regards to the future care of our relatives. We have heard nothing about the proposed future accommodation and have not received any assurance that new facilities (at this or any other site) will provide the same level of professional care that our relatives currently receive.
Karingai Ward is currently designed as a rehabilitation ward, a place from which patients can be in theory moved back into the community. Karingai has in fact been operating for many years as a closed ward, reflecting the intractable nature of the illness of the people involved, and the significant difficulty in providing effective rehabilitation. Our relatives have been in Glenside for many years and, as previously stated, suffer from chronic psychiatric and physical disabilities. The needs of these patients and the long-term nature of their illness have not changed and they remain unsuitable for rehabilitation as the word is generally known. We believe that the term 'rehabilitation ward' is a misnomer in this case, and as a result our relatives may be placed in similarly named and therefore similarly unsuitable facilities as a result of the development. We seek assurance that any development of the Glenside site will not disadvantage our relatives or detract from the level of professional psychiatric care they receive and quality of life they experience.
We are appalled at the lack of communication from the Minister for Mental Health and Substance Abuse, Gail Gago, who has effectively ignored our request for information about the future of our family members. No satisfactory response to inquiries made by us to the Glenside Campus have been received and the staff and Director of Nursing repeatedly say that they have no specific information about the long-term future of our relatives. I would like to finish on that note; I think it probably says it all. There are a lot of people who have a stake in this and who have been treated with absolute contempt. This plan is potentially a disaster for mental health services in the state. We agree that we need a new and improved service, but not at the expense of what has been taking place. We certainly do not believe that we need a film hub for the indulgence of the Premier to be placed in here at the expense of mental health services. I commend the motion to the council.
Debate adjourned on motion of Hon. I. Hunter.