Lees-Galloway Iain: Debate on Crown Entities Public Organisations and State Enterprises — In Committee 
Lees-Galloway Iain: Debate on Crown Entities Public Organisations and State Enterprises — In Committee 
[Volume:654;Page:3775] 
IAIN LEES-GALLOWAY (Labour—Palmerston North) 
: 
 During the Health Committee’s financial review of the Mental Health Commission the commission expressed its concern that district health boards sometimes used the ring-fenced funding that is provided for mental health for other purposes. However its greatest concern was the possible removal or reduction of the funding itself. It acknowledged that the transfer of existing services into the ring-fenced area without additional funds would cause problems. Against that backdrop we have the removal of mental health targets from the Government’s priorities. Although the Minister of Finance has assured us that a target’s removal from the list of priorities does not necessarily mean that funding will not be available we are already— 
Hon Ruth Dyson 
: Yeah right! 
IAIN LEES-GALLOWAY 
: Yeah right! I can see the Tui billboard now. We are already seeing the effects of this policy in real terms on the ground and at the coalface of mental health in our district health boards. 
At a recent meeting of the Nelson Marlborough District Health Board with its community mental health providers a note was made to say that recent correspondence indicated that the district health board was spending $1.8 million over and above the expected ring-fenced levels and that total savings of $1.8 million therefore needed to be made in mental health and addiction services for the 2009-10 and 2010-11 years to assist the funding of new Government priorities most of which Nelson Marlborough District Health Board had not been given additional funding for. 
That means unfunded priorities and it means that the additional money over and above the ring-fenced funding for mental health has got to go and that will include no more workforce development. That comes from a Government that has stated that it is absolutely focused on front-line services. How will the Government develop front-line services and how will it recruit and retain people who work in the mental health services if it will not offer workforce and career development to make the sector attractive and to get people in there for the long term so that they can get to know the sector well and build relationships with their clients? How will the Government do that when the money is being stripped away and the sector is no longer a priority? 
As a result of these funding cuts and as a result of mental health no longer being a priority for the National - ACT Government some community providers are already indicating that they may need to move away from district health board contracts. In order to provide the level of service that they feel comfortable with they need to move away from district health board contracts and instead provide services only to fee-paying clients. That is user-pays in the health system. 
Where have we seen that before? We have seen it before in privatised health-care. Despite the token concessions and lip-service paid to its commitment to public health the previous National Government slashed spending in the public sector and introduced part payment within its health reforms. The move was deliberately calculated to reduce demand for health care. People could not access the services that they needed and hospitals were forced to become debt collectors. They had tills at the front door. 
Who can forget Tony Ryall and John Key saying that the market would decide general practitioners’ fees? They said the market would provide. They said that only when the media flushed them out to ask what was not in National’s health policy document and later they did a quick U-turn on that. Already we are seeing the sowing of the seeds towards privatised health-care and user-pays because those mental health services will not be able to provide the services that are necessary given the funding allocations that they will no longer receive because their sector is off the priority list and unimportant. It is not an area that the Government thinks the health system should be focusing on. 
The Health Committee also expressed some concern about the paucity of services that were available to treat addictions in New Zealand particularly for young people. The select committee asked the Mental Health Commission for its thoughts on this point and it noted that addiction services were actually quite new to the blueprint and new to the mental health sector.