5. Question No. 5—HealthMATT DOOCEY (National—Waimakariri) to the Minister of HealthQuestion No. 5—Health5. MATT DOOCEY (National—Waimakariri) to the Minister of Health: Does he agree with the Mental Health and Well-being Commission's monitoring report finding that improvements in services have not materialised as we had hoped for over this time" and what is his response to the article in New Zealand Doctor that says "the $1.9 billion Wellbeing Budget touted as a game-changer the Government has done little or nothing for mental wellbeing"?Hon ANDREW LITTLE (Minister of Health): I acknowledge the total context in which the Mental Health and Wellbeing Commission made its findings which also included the following finding: "we [the commission] acknowledge some examples of genuine progress. There is evidence of growing collaboration between public health services and other community-based organisations. We recognise the enormous effort that is going on to effect changes like this which we believe will ultimately pay huge dividends in service improvements." It should be noted that this report that the member refers to did not focus on the access and choice programme which is the integrated primary mental health care programme we're implementing and which was the subject of a separate published report last October. But I do agree with and acknowledge the sentiment of the latest report by the commission which is that there has been slow progress in improvements in the acute end of mental health care. So far as this Government rebuilds mental health services which were badly neglected by the previous Government we have given priority to primary mental health services. This has seen around 870 fulltime-equivalent new front-line positions created that were not in place two years ago. Regarding the comments by Barbara Docherty I have read the article that Ms Docherty wrote and I find her comments ill-informed and confused.Matt Doocey: Is he aware of the report finding "access to specialist mental health … and addiction services has not changed over the past five years."; and does he think this is a good outcome for the $1.9 billion announced for mental health by his Government?Hon ANDREW LITTLE: I am aware of that comment and that's why I also reminded the member that the centrepiece of the $1.9 billion programme is the money that this Government is putting into primary mental health care services. The 2018 report He Ara Oranga made it very clear that the biggest gap in mental health services was for those with mild to moderate mental health conditions and that report recommended that priority be given to those services. That's what we've given priority to; that explains the 870 fulltime-equivalent new roles in primary mental health care services. The reason why I find Ms Docherty's comments so confusing is that she seemed to be criticising this Government separately from the primary mental health care services for a recruitment campaign to get more mental health workers into the acute end of services. Matt Doocey: When he says his new front-line mental health service at 870 fulltime-equivalents at 20000 sessions a month has he done the figures that show that is one appointment per worker per working day?Hon ANDREW LITTLE: I've got around and met some of the people who are actually doing these front-line roles doing many sessions many appointments in their work and they are doing fantastic work—doing the very sort of work that Ms Docherty says in her article needs to be done. So for example last week I met Adam. Adam is a former butcher by trade but he's got into mental health supported services through a range of his own personal experiences and he is doing incredible work with a range of people in the Tauranga Moana area and helping them get on top of fitness issues activity issues and nutrition issues to the point where the day I met him he had that very morning accompanied one of the people who he was supporting in a trip to the supermarket to assist them in making good choices on food and nutrition. That's the stuff that actually makes a difference to people and gets their lives back under control and helps with their mental wellbeing.Matt Doocey: Point of order Mr Speaker. I asked the question: was he aware of the calculation.SPEAKER: And we had a very very long answer—[Interruption] Ms Willis will you ever learn?Nicola Willis: I was genuinely laughing at your joke.SPEAKER: I'm now trying to decide whether the member wants to stay here or not. You know getting up and putting another comment in while I'm on my feet is even sillier than her first attempt. Now Mr Doocey your question as to calculations and maths was right at the edge of being ruled out. We had an answer which was as I indicated far too long and addressed much more than it should have. Do you want a further supplementary? If so wait until after Brooke van Velden. Brooke van Velden: Does he believe that money spent is a better indicator of success than measured results? Hon ANDREW LITTLE: No. I look at what is actually happening on the ground and when you add 870 fulltime-equivalent roles to the front line of our mental health services—so people who have levels of anxiety low levels of depression people who just need that little bit of extra help to get on top of the issues that they are confronting in their lives and can get that free of charge and ongoing assistance—that's the stuff that makes a difference. It's happening now and it's helping New Zealanders up and down the country. Matt Doocey: Is he aware of reports that there has been a "catastrophic collapse" of Wellington's Child and Adolescent Mental Health Service with an exodus of staff resulting in ballooning waiting times and does he think this is a good outcome of the $1.9 billion announced for mental health by his Government?Hon ANDREW LITTLE: I'll try to help the member again because the principal investment made in the $1.9 billion was for services for those with mild to moderate mental health problems. We know that there continue to be challenges in the acute end of services and in Wellington I can assure the member that the DHB is taking appropriate action including relying on the assistance of senior mental health professionals from other DHBs and from out of the region and doing their best to keep abreast of the major challenges that the services here in Wellington are facing. When I look across acute mental health services generally across the country they are holding up but it is true to say—as the Mental Health and Wellbeing Commission acknowledged—more assistance is required. Matt Doocey: Can he explain why solitary confinement as shown by this graph was trending down prior to 2017 and is now at record levels under his Government? Hon ANDREW LITTLE: What we do know is from a range of reports from the Ombudsman and from other independent monitors that this has continued to be a problem. I think the most recent reports show that most DHBs who operate mental health facilities where this has become a regular practice it is starting to improve but more is required and that is why—and again in accordance with the recommendations of the He Ara Oranga report—we are reviewing the mental health Act so that the powers and responsibilities of those running acute mental health services are aware of their responsibilities."