Coleman Jonathan: Mental Health Commission Amendment Bill — First Reading 
Coleman Jonathan: Mental Health Commission Amendment Bill — First Reading 
[Volume:636;Page:7208] 
Dr JONATHAN COLEMAN (National—Northcote) 
: 
 It is my pleasure to rise to speak in support of the Mental Health Commission Amendment Bill. National sees a role for the Mental Health Commission in monitoring and improving the New Zealand mental health system and as such we wish to see the bill proceed to its first reading. The Mental Health Commission has done much over the past few years to destigmatise mental illness and raise public awareness. It performs some very good work and as a result the general public now has a greater appreciation of just how common the symptoms of mental illness can be. 
The National Party believes that there is indeed some real work to be done in mental health. The fact is that mental illness has a significant impact on the lives of New Zealanders and that burden is growing not decreasing. According to the New Zealand mental health survey released in September nearly half of all New Zealanders will meet the criteria for having a mental illness at some time during their lives. One in five New Zealanders experienced a mental illness in the previous year and that does not take into account the 0.3 percent of the population who suffer from mental illnesses with psychotic features. The survey also found that 16 percent of New Zealanders had thought seriously about suicide. About 5 percent had made a suicide plan and 4 percent had attempted suicide. These are serious statistics indeed and are worthy of some consideration by members opposite rather than continued ad hominem attacks. 
The reality is that under this shameful Labour Government spending on mental health has increased by 75 percent since 1999 to nearly $1 billion per annum yet there is no measurable improvement in the mental health of the nation. In fact mental health statistics seem to be deteriorating. It is important to keep the focus on spending— 
Hon Trevor Mallard 
: Ha! ha! 
Dr JONATHAN COLEMAN 
: The member may laugh during this but this is a very serious matter for many New Zealanders. Mr Mallard can smile and laugh but this is something that the House should be considering. Members opposite might want to listen to some of this; it does not reflect well on their failure to actually take this seriously. 
But I digress. It is important to keep the focus on the spending of taxpayer money in the mental health sector in the most effective manner possible. There has been a lot of money spent by this Government on strategic plans studies and bureaucracy but the reality is that the money is not being targeted effectively. The Minister of Health needs to concede that the management of mental health services and the targeting of funds in this sector are not delivering the results New Zealanders deserve. 
The recent Commonwealth Fund report into primary care in seven OECD nations surveyed the views of primary-care doctors. When it came to ability to care for patients with mental health problems less than half the New Zealand practices surveyed felt that they were well prepared. The National Party believes that we need to be looking to primary care—[ 
Interruption 
] Mr Assistant Speaker if these members want to continue their conversation would they like to do it outside because this is a serious matter. 
The ASSISTANT SPEAKER (H V Ross Robertson) 
: Can I just say to the members on my right that I would like them to look at Speaker’s ruling 57/3(1) by Speaker Statham. Interjections are to be rare and reasonable and as a former colleague used to say witty. There are too many. 
Hon Trevor Mallard 
: I raise a point of order Mr Speaker. I think given the member’s recent history it is a bit on the nose for him to invite members on this side to step outside. 
The ASSISTANT SPEAKER (H V Ross Robertson) 
: If the member did such a thing then he should withdraw and apologise but if he did not I will take the member’s word. He is an honourable member. 
Dr JONATHAN COLEMAN 
: I have nothing to withdraw and apologise for but I make the point that with Mr Mallard’s history he might want to listen— 
The ASSISTANT SPEAKER (H V Ross Robertson) 
: Just get on with the debate. 
Dr JONATHAN COLEMAN 
: OK. [ 
Interruption 
] Mr Assistant Speaker do you think I should request to be heard in silence? This is a serious matter. There are people out there who want to listen to this speech. 
The ASSISTANT SPEAKER (H V Ross Robertson) 
: The member can seek leave for that. He is perfectly entitled. 
Dr JONATHAN COLEMAN 
: I seek leave for this speech to be heard in silence. [ 
Interruption 
] 
The ASSISTANT SPEAKER (H V Ross Robertson) 
: The member can require it if he wants to. 
Dr JONATHAN COLEMAN 
: OK I require it. 
The ASSISTANT SPEAKER (H V Ross Robertson) 
: The member has asked for silence and I ask other members to oblige. 
Dr JONATHAN COLEMAN 
: Thank you Mr Assistant Speaker. The recent Commonwealth Fund report into primary care in seven OECD nations surveyed the views of primary-care doctors. When it came to the ability to care for patients with mental health problems less than half the New Zealand practices surveyed felt that they were well prepared. The National Party believes that we need to be looking to primary care to take on more of the workload in mental health but to do so general practices need the resources and training to operate effectively. We would like to see the Mental Health Commission pushing the Government on this playing a major role in monitoring the subsequent outputs and providing an objective assessment of the success of such projects. 
Hospitalisations for attempted suicides are a good indicator of the mental health of a nation and the reality is that they have gone up by almost 20 percent since Labour came into power. If one looks at the hospitalisation rate for suicide attempts made by young women since 1999 one sees that they have risen by 45 percent. Suicide attempt statistics represent measurable outcomes in mental health and by those criteria this Government is failing the public in the management of the sector. 
This Government could be doing much more to target the needs of those affected by mental illness. The Government has talked up its 10-year action plan for mental health Te Kokiri and put an emphasis on prevention but it is all spin and waffle. The specifically listed action for promotion and prevention in the Government’s new 10-year mental health plan is to spend 3 years reviewing the strategic framework to develop a new framework to develop a plan to set out a strategy. 
Workforce development is a major issue in mental health. Earlier this year the Otago District Health Board had to pay out $60000 to two experienced enrolled nurses in order to remove them from their jobs following a Ministry of Health reminder that enrolled nurses cannot work in acute care. Mental health nursing is an area where experience is what really counts. All this meant was that the Otago District Health Board ended up two nurses short in acute mental health and it cost the board $60000 to arrive at that lamentable situation. A major problem in this sector is that the level of qualification for staff is being raised thereby excluding many experienced mental health workers. Not only are the staff not available but even if they were many mental health providers could not afford to employ them. 
Then there is the disgraceful mess over the Lake Alice Hospital compensation payout. Michael Cullen has admitted that Cabinet decided to withhold some of the compensation awarded to claimants as a result of the inquiry into Lake Alice Hospital. Continued delays in paying out compensation to Paul Zentveld a claimant in the case are completely unsatisfactory. After experiencing outrageous treatment at Lake Alice Hospital the claimants agreed to settle with the Ministry of Health in two separate compensation rounds. Mr Zentveld had $35000 secretly lopped off his compensation payment by the Ministry of Health and found out about it quite by chance. He took the ministry to court and he won. Rather than paying up with good grace this Government is appealing against the decision in the High Court. This is obviously because the Minister knows that the implication of this decision is that up to $3 million will need to be paid to the other second-round claimants who had part of their compensation secretly withheld. This Government keeps droning on about social justice but when it gets the chance to actually apply some it ducks for cover. Minister Hodgson needs to stop dodging the issue write the cheque to Mr Zentveld and pay back any money that his ministry rightfully owes the 87 other second-round claimants. 
Furthermore there are issues around the mental health blueprint and the funding being applied by various district health boards in fulfilling the blueprint. It is clear that adult and forensic services are being funded to the levels the blueprint dictates but other areas such as child and adolescent services are falling woefully behind. Yet at the same time district health boards are underspending their ring-fenced mental health money to the tune of $18 million a year much of it in Auckland. Something is grossly wrong here. Mismanagement in the mental health sector is rife. 
So all is not as well as it might be in the mental health sector. There is much work for the Mental Health Commission to do because this Government is spending more and more on mental health but the results are not getting any better. We think the Mental Health Commission has a real future. There are some people of real ability and knowledge at the commission who have extensive knowledge of the mental health system. We think the commission could have a wider role to play however. We would like to see the commission doing more to hold this Government to account by speaking out on its performance in mental health. The commission needs to be more demanding of this Government in terms of mental health outcomes. National would want to see the commission monitoring district health board spending in the mental health arena measuring outputs objectively and ensuring that the public money spent in mental health really is making a difference to the health of all New Zealanders. 
We feel however that an extension of the life of the commission to 2015 is excessive. Public spending should produce results and we would support the extension of the life of the commission until the end of 2009 at which time its output should once again be reviewed. The commission should in no way feel threatened by this because National supports the work that it does. However what gets measured gets done and we feel that a further review of the work of the commission in 3 years’ time is entirely reasonable. The National Party looks forward to working with the commissioners while in Government.