3. Mental Health Services—Adequacy of ProvisionANDREW LITTLE (Leader of the Opposition) to the Prime MinisterMental Health Services—Adequacy of Provision3. ANDREW LITTLE (Leader of the Opposition) to the Prime Minister: Does he stand by his response when asked did he think he was failing New Zealanders in mental health No no I don't think we are failing New Zealanders"; if so is he saying that mental health services in New Zealand are in an acceptable state?Rt Hon BILL ENGLISH (Prime Minister): Yes. Ensuring New Zealanders get access to the mental health services they need continues to be a priority for this Government in full recognition of the growing demand and complexity of meeting all mental health needs but there is always more to do.Andrew Little: Is he aware that the number of people needing mental health services has risen 60 percent under his Government while mental health funding has risen less than half as much?Rt Hon BILL ENGLISH: There is plenty of measurement now that shows there is much greater awareness and more measured prevalence of mental illness. But of course services have expanded. For instance the number of people treated for alcohol and other drug addictions including methamphetamine has almost doubled—almost doubled—to 48000 since 2008-09.Andrew Little: What is his reply to Nancy Dally a mental health nurse with 40 years' experience who says: "it's worse than I've ever seen it before. Nurses can work up to 15 hours a day double shifts on a regular basis because we're so short staffed and we're short of doctors."?Rt Hon BILL ENGLISH: Overall there are a great deal more doctors and nurses in the health system and I would suggest that if staff are under that kind of pressure they need to be consulting with their employers about the suitability of working those hours. We fully understand that there is pressure on facilities and staff and that is why the spending on mental health continues to grow but bear in mind it is not just about acute mental health services. There is a great deal that is being done—and more to be done—in prevention and in dealing with the large pool of people who are designated as having some mental illness and who are in the welfare system.Andrew Little: What is his reply to the person quoted in the People's Mental Health Report as saying they cannot get the help they need unless they are on the verge of suicide and "I guess the budget doesn't stretch to hope."?Rt Hon BILL ENGLISH: If they are feeling that kind of distress of course we would want them to get the help they need. The member probably does realise though that in some cases there are differences of view over what help is appropriate and when that help is best available. We have skilled professionals in the mental health area who are always called on to make difficult judgments and sometimes families and patients do not agree with those judgments. [Interruption]Mr SPEAKER: Order! There is a significant level of interjection coming from both front benches. It will cease.Andrew Little: Does he agree with his Minister of Health that the 500 people who shared their stories with the People's Mental Health Review including many who have lost family members to suicide are "left-wing anti-Government protesters"?Rt Hon BILL ENGLISH: I do not believe the Minister was referring to those people in that way.Andrew Little: Does he acknowledge that in addition to a lack of funding in mental health there is also a lack of coordination and access meaning that people do not know which door to knock on when they need help and too often the police and the justice system end up picking up the pieces?Rt Hon BILL ENGLISH: The issues around the overlap with the police and the justice system are well understood and are being acted on because in some cases people have been dealt with inappropriately. But we are being much more creative about them than saying that—in the case of the member's policy—the best thing you can do for Māori who are caught up in the justice system is to give them their own prison.Andrew Little: After 9 years does he really think a 5-year quality improvement initiative starting in a couple of months is an acceptable response when we have got doctors like Dr Anne-Marie Cullen saying: "It can't take five years. Things will go wildly wrong."? Can we not have some fresh thinking now instead of in 5 years' time?Rt Hon BILL ENGLISH: Of course that is not the only measure but it is an important step to take—to ensure that you have high-quality services. There is no point in having services that are not effective and do not achieve results for the patient. Alongside that initiative of course there is more funding for acute services and for prevention to try to prevent people getting into the situation where they need acute services."