Australia: Labor’s mental illness plan and the healthcare crisis

By Joe Lopez and Socialist Equality Party candidate for Swan
28 July 2010

Yesterday’s pledge by Labor Prime Minister Julia Gillard to spend just $69 million more a year on suicide prevention measures underscores the government’s utter contempt for people suffering from mental illness and for professionals working in the mental health sector. The additional revenue is a pittance compared to what the chronically underfunded mental health sector requires.

Mental health professionals have sharply condemned the Labor government. Since its election in 2007, it has done nothing to resolve the mental health crisis. At the last COAG (Council of Australian Governments) meeting in April, the mental health sector was allocated just 2 percent—or $116 million over four years—of the total new health funding on offer. This was followed by the resignation last June of the chairman of the government’s Mental Health Advisory Council, John Mendoza, who declared that Labor had “no vision or commitment” for the mental health sector. Instead, Mendoza said, the government was claiming credit for mental health spending allocated by the previous Howard government.

Mendoza explained that the mental health system required at least another billion dollars annually in public funding. By this benchmark, Gillard’s commitment yesterday of $69 million amounts to less than 7 percent of what is needed. Labor’s pledge is a small fraction even of the Liberals’ inadequate commitment of $375 million annually.

Of the $69 million, or $277 million over four years, nearly half is to go toward frontline mental health services, including psychological counselling and specialist psychiatry. The rest is for suicide intervention services, including telephone hotlines and “suicide hotspots” safety measures, and mental health programs aimed at men and children. There was not a cent more announced for a range of other issues, including psychiatric public hospital beds.

Mental health experts slammed the government’s commitment. Mendoza and Patrick McGorry, a psychiatrist and the official 2010 Australian of the Year, were especially outraged, as they had been called to a meeting with Gillard two days before the election campaign was announced.

McGorry declared that he was “devastated” by Gillard’s failure to implement any of the proposals they had presented. He said: “John Mendoza and I handed the prime minister a clear blueprint that was endorsed by all in the mental health sector. But she just seems to have contacted the same old advisers and rolled out policy that really is just a drop in the ocean... Over the next five to ten years we have to double the size of our mental health system—and we’re not going to do that with $60 million a year.”

Mendoza described Labor’s proposed measures as a “grab bag” that “simply patches on a broken system”. Insisting that, “Labor really needs to go back to the drawing broad,” he rightly accused the Gillard government of “state-sponsored discrimination” against the mentally ill.

Mendoza also condemned the prime minister’s promise to allocate $9 million for suicide “hotspots”. “The Woollahra council in Sydney has alone estimated the cost of putting up suicide hotspot protection and prevention at The Gap [a coastal cliff where at least 50 people commit suicide every year] at $3 million,” he explained. “That’s one site. This [the government’s funding] is $9 million over four years. Frankly it’s a joke... This is really quite tokenistic.”

Despite Gillard specifically referring to The Gap in her speech yesterday, the Woollahra council has been told that no specific funding has been set aside for the site and that an application ought to be submitted for a portion of the national fund. The council has had two previous applications for funding to construct fencing, railings, and emergency phones declined. Mayor Andrew Petrie said of Gillard’s policy: “It just doesn’t make sense. Now we have to go through another application process, when time is of the essence when we are talking about people’s lives.”

Questions have been raised about other aspects of yesterday’s policy announcement. Brain and Mind Research Institute executive director Ian Hickie told the Australian: “Much of this money looks to be repackaging of programs that have already been announced. We need immediate clarification of if this money is new or if it’s just a re-announcement of the pre-existing Rudd-government programs.”

Labor’s stance on mental health reflects its function as a party of big business and finance capital. Gillard’s installation through the unprecedented coup against Kevin Rudd was orchestrated to enact a policy shift to the right, advancing an austerity agenda for the population. The new prime minister has handed over billions in dollars of anticipated public revenues to the transnational mining giants, and in the campaign is stressing her commitment to lowering the corporate tax rate.

While the Labor Party bends over backwards to win favour with corporate CEOs and the ultra-wealthy, it has nothing but contempt for the mentally ill. Mental illnesses, including depression, afflict every sector of society, but the chronically mentally ill form one of the most vulnerable and impoverished layers. A large proportion of the 100,000 homeless suffer from mental illness. A recent survey found that 38 percent of those afflicted have an income of less than $20,000, while more than half said that they had been unable to afford the treatments recommended by their doctors. Many said there were times when they could not afford essentials such as food.

These layers suffer both from the Labor government’s poverty-level welfare payments and from the rundown public health system, within which mental health is especially neglected. Every day, on average, about 330 people with serious mental illnesses are turned away from hospital emergency departments, more than 1,200 people are refused admission to a public or private psychiatric unit, and at least seven people commit suicide, with more than one-third involving those discharged too early and/or without care following hospitalisation.

Gillard’s refusal to commit any significant new funding to mental health in the midst of an election campaign is designed to send a very clear signal to the corporate elite—that the Labor government’s long-term health plan will cut public spending and restrict patients’ access to expensive treatment and technologies.

At the last COAG meeting the government announced a new centralised hospital and primary care system featuring an “activity based” (casemix) funding system. Under this scheme, hospitals are funded according to pre-determined “efficient” prices for procedures and services that they provide. Once in place, these mechanisms will be used to ram through an unprecedented assault on the public health system as part of the Labor government’s austerity drive.

The deliberate underfunding of the mental health sector is a sign of what is to come more widely. In her speech yesterday, Gillard insisted that “money can buy services, but to make lasting change, we need to undertake real reform” and that progress on mental health “will not just take investment, but it will also take reform”. This was one the central themes of the address. Gillard declared: “These changes can only be achieved through dialogue and negotiation and, yes, sometimes hard bargaining.”

As in the US and virtually every advanced capitalist country, healthcare “reform” and “hard bargaining” means restricting treatment and making people pay the full cost for whatever medical services they do receive.

This historic regression underscores the bankruptcy of the capitalist system. The Socialist Equality Party insists that freely accessible, high quality health care, including for mental health, is a basic right. Hundreds of billions of dollars in emergency public investment must be poured into the health sector to resolve the medical infrastructure crisis, chronic understaffing, lack of technologies, shortage of beds and other basic necessities, and to provide treatment and medication free of charge for all who need it. This can only be achieved through an independent movement of the working class fighting for a socialist society in which social need and not corporate profit determines economic and social life.

Authorised by N. Beams, 307 Macquarie St, Liverpool, NSW 2170

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