Ryall Tony: Mental Health Commission Amendment Bill — Second Reading 
Text is incorporated into the Bound Volume 
Ryall Tony: Mental Health Commission Amendment Bill — Second Reading 
[Sitting date: 24 July 2007. Volume:640;Page:10664. Text is incorporated into the Bound Volume.] 
Hon TONY RYALL (National—Bay of Plenty) 
: 
 I am pleased to report that the National Party moved an amendment to the Mental Health Commission Amendment Bill at the Health Committee which I will talk about a bit later on. As our mental health spokesperson Dr Jonathan Coleman has made clear it is the National Party view that the principal Act should expire 3 years after the bill receives the Royal assent. It is our view that Parliament should reassess the role and performance of the Mental Health Commission before granting a further extension in another 3 years and we moved an amendment to make that change.  
National sees that the Mental Health Commission has a role in monitoring and improving New Zealanders’ mental health system and we think that mental illness has a significant impact on the lives of many New Zealanders. The burden is in fact growing not decreasing. According to the New Zealand Mental Health Survey released in September nearly half of 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 small portion of the population that suffers 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 a further 4 percent had attempted suicide. These are serious statistics indeed and they are worthy of the consideration of the House as they make us realise how important it is that the nearly $1 billion a year now being spent on mental health should in fact be delivering measurable improvements in the mental health of the nation. In fact unfortunately many mental health statistics seem to be deteriorating despite the substantial increase in additional funding.  
One area in particular to look at is the hospitalisations for attempted suicides. They have actually gone up by almost 20 percent in the last 8 years. If one looks at the hospitalisation rate for suicide attempts by young women since 1999 one sees that they have risen by 45 percent. These suicide-attempt statistics represent the measurable outcome of spending on mental health and by those criteria I think many people would say that spending—that investment by the Government—is failing to make the impact it should have.  
During the select committee process we heard from many submitters who were dissatisfied with the way the public investment in mental health is being spent. A number who came forward criticised the rather large amounts of unspent blueprint money in many parts of the mental health service—money that should be providing much-needed services. I know that in my own constituency on Sunday I received a rather desperate call from a man who had obviously come to the realisation that he was alcoholic. He was in desperate need of getting in touch with addiction support services and had real trouble doing that on the weekend. I was somewhat despairing of him over the remaining 18 hours before I could get my office to get on the phone to arrange some support from for example the Hanmer Clinic. That identifies a need for services to be able to respond quickly when people with addiction issues identify themselves as being in need of care. Unfortunately in that case I am not sure that the Bay of Plenty services were as swift as one would like them to be.  
It also became clear in our discussions with submitters to the select committee that primary care could be doing much more to provide mental health services for New Zealanders. In fact earlier this week I met with people from a Mount Maunganui general practice to talk about the mental health care services they provide. It is one of the few general practices in the country to be quite upfront about being keen to be involved in mental health services. I make that point because a recent Commonwealth Fund report on primary care in seven OECD countries surveyed the views of primary care doctors. It asked them a number of questions and very interesting results came out. For example New Zealand general practitioners report that their patients wait longer for surgery and emergency care than the patients of any other group of doctors in the survey. There was a very good question on mental health that showed that when it came to the ability to care for patients with mental health problems less than half of New Zealand practices said that they felt they were prepared. That was one of the lowest ratings. What that indicates is that even though there is extra spending of a billion dollars on the mental health service we are not getting the gains in the quality of the service provided by primary care that we should be getting.  
General practices need support to operate effectively in providing mental health services. We hope the Mental Health Commission will be pushing the Government and general practice to play a major role in the monitoring and support of patients with mental illness. People in general practice are able to provide faster more convenient health care for New Zealanders and we think there could be significant gains if primary care were to realise the vision of the Primary Health Care Strategy and play a much greater role in providing mental health support services.  
That leads on to one of the most significant pressure points in the entire health sector and that is workforce development. That is a major issue in mental health. Many of those problems I think were witnessed in a number of high-profile cases we have seen recently. For example enrolled nurses can no longer have a role in this form of care. That is an issue that the health service needs to grapple with. Why have 3000 or 4000 people who could be trained to have an active role in providing support in these areas not— 
Steve Chadwick 
: That was never the training of enrolled nurses. 
Hon TONY RYALL 
: We have some chirping across the road from the outgoing member for Rotorua but what I do not think she— 
Hon Lianne Dalziel 
: You cancelled the enrolled nurse training. 
Hon TONY RYALL 
: Oh National cancelled enrolled nurses! It was Labour that wanted to take that name off them. Under this Government enrolled nurses have had their scope of practice so limited that there is not even a future for those people. The National Party respects the work of enrolled nurses and a National Government will bring back enrolled nursing and we will give those nurses a role in the health service. When New Zealand is so desperate for people to help in our hospital system for Labour and its cronies to disenfranchise enrolled nurses and give them some sort of Labour Party bureaucratic name such as nurse assistant is we think demeaning to the work they are doing. [ 
Interruption 
] We think that all is not well in the area of mental health and the members opposite show us that. [ 
Interruption 
] Oh it was a bad caucus this morning—it is showing.  
We do not believe that the community is getting the returns it should be getting for the extra spending that has gone into mental health. The hospitalisations the suicide statistics and the feedback from patients and their families show that most of that money is being wasted. I bet the next member of the Labour Party will stand up and say: “We have put double the amount of money into mental heath.” I bet that is what the member says. Labour measures its success only by how much it spends and not by the quality of the service or the amount of people getting care. What those members would know if they listened to the submissioners is that families and those most affected do not think they are getting the quality of service they should be getting from our district health boards’ mental health services.  
Steve Chadwick 
: No we’re building it up. 
Hon TONY RYALL 
: Oh the member says the Government is building it up. It has been throwing money at it for 8 years and suicide statistics have got worse. And those members say they are doing a good job! Actually it is not the case. They can chirp as much as they like because in 8 9 or 10 months’ time those folks opposite will have no input whatsoever and the people who are padding their way to our corridors will be working with National members as we improve the quality of mental health services for New Zealand families and patients.