Bradford Sue: Estimates Debate — In Committee 
Bradford Sue: Estimates Debate — In Committee 
[Volume:648;Page:17643] 
SUE BRADFORD (Green) 
: 
 After looking at the mental health portion of Vote Health I believe that the Government has to take a whole lot more seriously the signs of crisis evident in regard to psychiatric services—in some parts of the country at least. I was not at all comforted by answers I received in the House on Tuesday from Minister Jim Anderton to questions I posed around recent events involving Auckland’s and Wellington’s acute psychiatric units. 
For a start I find it astonishing that the Capital and Coast District Health Board announced last week that it has postponed indefinitely plans to replace Ward 27. That is 4 years after the district health board promised in 2004 that plans for a new ward would go ahead urgently. In recent years the ward has been renowned for its overcrowding and staff retention problems and for a number of serious incidents involving patient injuries and deaths. For example Chad Buckle died after walking out of the ward with no one apparently noticing his departure. 
Most recently there has been the tragic case of Nicole Maconaghie who died in June not long after being discharged from Ward 27. Her mother said and I quote from the  
Herald on Sunday 
: “I was told $80000 had been spent on her and ‘we can’t account for any more money; she just has to get on and live the best life she can.’ ” Her mother is further reported as saying that she tried to tell those caring for her daughter that she would not be able to look after herself but that she “felt like she was disposable from [the doctor’s] point of view.” 
I am sure that the hospital and the district health board will contend that the family’s statements are not accurate and that their apprehension of the situation is all wrong but whatever the exact details are in this case I believe there is an underpinning truth to the mother’s statements that this district health board’s acute unit like some others is often under stress; that staff do at times—and probably quite frequently—push people out into the community when they are perceived to have stayed in the unit too long; that there is an inadequacy of care once they are out there in the community; and that there is also a reluctance to listen to or to really hear the voices of family members who are desperately trying to tell staff about the real situation for their loved one. 
The reason that both the Minister and the Capital and Coast District Health Board give for not building a new unit when one is so manifestly needed appears to be that a new 10-bed house for people with mental illnesses will open in Wellington this year. Using this as an excuse for not building a replacement unit is ridiculous; both are needed. 
I turn now to the Auckland District Health Board and I believe that the crisis there is even worse. The Te Whetu Tarewa mental health unit at Auckland is chronically overcrowded and/or has patient numbers at its maximum. A number of deaths have been associated with the unit in the past year. There is pressure on staff to discharge people who are still very unwell. There is an inability to discharge people to adequate step-down or rehabilitation accommodation and health services. Waiting lists for the one in-patient rehabilitation unit in Auckland at the Buchanan Clinic are long and of course sadly many people will never access the benefits of its care. There are allegations by staff that there is an inability within Te Whetu Tarewa to keep male and female patients sexually safe and that there are cases of sexual abuse within the unit. There is an apparent lack of recognition of the true levels of need in the Auckland District Health Board district and there must be more resourcing appropriately spent even to begin to make the systemic changes needed. 
The Minister is correct that work has been done on a proposal for structural change within the Auckland District Health Board mental health services. I do not know whether the document resulting from this review is the one he referred to in the House on Tuesday as being under injunction but from what I know of the review—if it is indeed the one to which he referred—it is very unlikely that its recommendations will in any way shape or form go to meet the concerns surrounding both the operational and resourcing issues with Te Whetu Tarewa. 
I call on the Government to take some responsibility for what is continuing to happen in our mental health services. There is not enough resourcing. Mental health continues to be the poor cousin of physical health. The problems are systemic and they are acute. People are dying. District health boards should not be left unaccountable in any genuine way for the deficits in their approaches. People with or recovering from mental illness their families and the staff who care for them deserve a whole lot better than what is going on right now.