Bradford Sue: Questions for Oral Answer — Questions to Ministers 
Bradford Sue: Questions for Oral Answer — Questions to Ministers 
[Volume:611;Page:8834] 
10.  
SUE BRADFORD (Green) 
 to the  
Minister of Health 
: What is her response to comments by an experienced Auckland psychiatric nurse that the practice of “risky discharges” from Auckland acute units to make room for new patients is “insane”? 
Hon ANNETTE KING (Minister of Health) 
: 
 Clinical decisions about what care is required for an individual patient and whether that care needs to be delivered in hospital can be made only by the clinicians responsible for the care of that patient. However I am advised that all discharges follow strict criteria based on clinical assessment by a discharge team. 
Sue Bradford 
: How can community care of seriously unwell people possibly be expected to work adequately when there is nowhere to put such a person on discharge from an acute unit except into a boarding house in west Auckland that sleeps 18 people in two houses four caravans and a sleepout? 
Hon ANNETTE KING 
: In assessing the needs of a patient there are three options to clinicians in terms of care. The first is that a patient can have high-level care if that is needed and go to another unit that provides long-term rehabilitation. Second a patient could go to a second level that is run by a non-profit organisation with varying levels of support and clinical follow-up. If the clinicians believe that patients should have another level of care which is a lower level of care there are at least three different interventions. The clinicians decide what the level of care will be within the criteria set and the assessment made. 
Dianne Yates 
: What is the basis of clinical decisions on what care is required for an individual patient discharged from an acute unit? 
Hon ANNETTE KING 
: Decisions will be informed by best practice including developments in care delivery in the community and by the needs of the patient relative to those of other patients. 
Hon Roger Sowry 
: When mental health services in Auckland have historically been under pressure why has the Taharoto Mental Health Unit had its beds reduced by the Minister from the planned 41 beds to now just 35? 
Hon ANNETTE KING 
: The member asked why have they been under pressure. The reason they have been under pressure for a long time— 
Hon Roger Sowry 
: I raise a point of order Mr Speaker. I did not ask why they had been under pressure. I will ask my question again. I asked why when mental health services in Auckland have been under pressure has Taharoto Mental Health Unit had its beds reduced by her from the planned 41 to 35. 
Mr SPEAKER 
: I heard the question. I have heard the question a second time. I am sure the Minister will go on to answer it. 
Hon ANNETTE KING 
: The reason that mental health services in Auckland have been under pressure is that funding for Auckland was less than provided for example in the South Island and this goes back to the days of regional health authorities. Fortunately this Government decided to increase funding to the Auckland and Midland areas by $12.8 million for this financial year. That will go some way towards bringing those areas up to the level of funding for the South Island. None of it is optimal but in terms of the beds talked about by the member the configuration of beds in Auckland is part of an overall strategy to provide what is required for Auckland and that is a mixture of acute in-patient beds community step-down beds and community care. What they have not had is the correct mix of those services. 
Sue Bradford 
: To what extent does the Minister believe that the action plan resulting from last year’s special review which had as one key goal additional accommodation with intensive support and crisis respite services has been achieved given the ongoing and dangerous situation in the Waitemata District Health Board and Manukau District Health Board areas as revealed in the  
New Zealand Herald 
 this week? 
Hon ANNETTE KING 
: As the member is aware part of the work that would be done to address those serious problems in Auckland was to get regional coordination. The first part of that was to appoint a regional director Derek White whom I understand the member will meet in the very near future. He informs me that more intensive care unit beds have been opened in Auckland there have been more packages of care and more resources have been put in place. The situation is improving. The Mental Health Commission stated in its report in April this year: “We have made significant gains in a relatively short time. However further gains need to be made.” 
Sue Bradford 
: Is the Minster aware of the recent briefing held for Auckland Labour MPs by social service agencies concerning the crisis in mental health housing and support services in Auckland and if she has not already will she immediately adopt the recommendation of setting up a working-group from the health housing and welfare sectors to help speed up real solutions to the current crisis? 
Hon ANNETTE KING 
: There are a number of issues there that relate not only to health but are intersectoral issues and I am very supportive of different agencies working together. Intersectoral issues relate to housing employment and health services. I am supportive of them working together not only in Auckland but in other parts of New Zealand. However I think Auckland will have the best opportunity to make improvements because it already has in place coordinations across a number of sectors and particularly the health sector.