Blue Jackie: Mental Health Commission Amendment Bill — Second Reading 
Blue Jackie: Mental Health Commission Amendment Bill — Second Reading 
[Volume:641;Page:10833] 
Dr JACKIE BLUE (National) 
: 
 National supports the second reading of Part 2 of the Mental Health Commission Bill. However it is the National Party’s view that the principal Act should expire on a date that is 3 years after the date on which this bill receives the Royal assent. That is of course at variance with the bill which extends the term of the commission until 2015. National feels that 2015 is too far into the future and considers that its proposal for a date 3 years after the date on which the bill receives the Royal assent is more realistic. 
The Mental Health Commission was established and began work in September 1996. It has three key functions: firstly monitoring and reporting the implementation of the mental health strategy; secondly promoting better understanding by the public of mental illness and eliminating discrimination; and thirdly and importantly strengthening the mental health workforce. National supports the work of the Mental Health Commission but is concerned that we have not seen objective measurable outcomes. The Mental Health Commission has been in existence for 11 years and the proposal of the Government bill would see the commission continue for another 8 years. National considers that the public spending and the work of the Mental Health Commission should be accountable and produce results. 
Mental health is a serious health issue for New Zealanders and the burden is increasing. A recent survey showed that nearly half of all New Zealanders will meet the criteria of having a mental illness at some time in their lifetime. There are many other serious findings such as that 16 percent of New Zealanders had thought seriously about suicide at some point. A recent Commonwealth Fund report found that less than half of New Zealand practices felt well prepared for patients with mental health issues. Hospitalisations for attempted suicide have increased 20 percent since 1999. Is this due to increased awareness or increased reporting or a combination? That is the conundrum? Certainly the John Kirwan TV advertisements have destigmatised depression in the community and increased awareness. Those advertisements have cost between $7 million and $8 million over the last 4 years. I stand to be corrected but I understand that they were a Ministry of Health initiative. 
That brings me to another point—the split between the Ministry of Health and its mental heath directorate and the Mental Health Commission. I wonder why there was a split and why these two agencies are working separately. That raises the interesting question of whether the Mental Health Commission should be brought back under the Ministry of Health at some point. I think that as colleagues ponder that question they will come to the correct conclusion: if that question is on the table it is very appropriate that the term of the Mental Health Commission should not be a distant 8 years into the future but a time more tangible and closer. 
Another interesting question is how and why the Mental Health Commission became a Crown entity in 1998. Another example of a well-known Crown entity is of course Pharmac. I will just explain about Pharmac. It was established in the 1990s to curb the rocketing budget and it was given Crown entity status to give it a degree of independence so that it could be kept at arm’s length and kept up with making the deals. But of course Pharmac has morphed into a law of its own. But that is another story in itself and I will not digress. I also wonder about the sense in having the Mental Health Commission as a Crown entity. Was this really necessary and should it be under the umbrella of the Ministry of Health? 
An important function of the Mental Health Commission is to strengthen the mental health workforce and this is an area where I feel it has let the workforce down. It brings me to the issue of the enrolled nurse and the sorry tale that follows. In 2001 after Mark Burton a psychiatric patient killed his mother an enrolled nurse was incorrectly implicated. In 2004 following a health and disability report that raised concerns about the enrolled nurse in an acute mental health unit the Ministry of Health and the Nursing Council of New Zealand released a joint letter to all district health boards recommending that enrolled nurses should not be working in acute mental health units and enrolled nurses were subsequently demonised. Subsequently there was an ethnic cleansing of this workforce. In 2004 there were just on 4000 enrolled nurses with only 250 or so working in mental health. In 2005 the figures were much the same. I hate to think what will have happened to the figures in 2007 when they come to hand. 
 Where was the Mental Health Commission in all of this? Well I went to its website and I looked up its archived press releases. I could not find one single solitary release that referred to this issue or that supported its own workforce. It seems that the Mental Health Commission has left this invaluable workforce high and dry. 
In summary National supports the objective and role of the Mental Health Commission but is concerned that there seems to be a lack of accountability. National does not want the indefinite extension to 2015 that this bill would bring. A lot of money has been spent on reports and bureaucracy and we are concerned that it has not been effectively targeted. National considers that the Mental Health Commission should have a greater monitoring role and in all of this we are concerned that district health boards are underspending their ring-fenced mental health money. Supposedly the lack of a mental health workforce is implicated. 
National supports this bill but we wish to amend it so that the commission’s term is not extended to 2015 but rather to 3 years from the day on which it receives the Royal assent. Thank you. 
Bill read a second time.