Abbott at his best on mental health
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Yesterday’s mental health funding announcement by the coalition was Tony Abbott was at his best, directing his big-spending tendency towards a deserving area, and adeptly targeting a government weakness. Thanks to Kevin Rudd’s distraction with the RSPT, health reform has dropped entirely from the media cycle. Until Julia Gillard rids herself of the mining tax issue, either by nutting out a deal or offering a compromise and telling an increasingly divided mining industry to take it or leave it, what was a strong issue for the government remains parked in the garage. Worse, Rudd and Nicola Roxon — but primarily the former — allowed mental health to turn against them as an issue. After criticism that mental health had been omitted from the health reform package, Rudd agreed to an additional $171 million in order to get COAG over the line on April 20. But then the head of the government’s mental health advisory council, Professor John Mendoza, was allowed to resign, focusing further attention on the issue. Mendoza gave plenty of notice about his intention to quit and not merely did Roxon and Rudd’s offices fail to stop him, they took their time even responding to him. It’s the sort of error that seems typical of this government in the last days of Rudd’s prime ministership. It’s always wise to be sceptical of the claims of health professionals about the lack of government funding. A certain self-interest informs their criticism — there isn’t a health professional who doesn’t think more money should be spent in their area, and as with everything in health there’s always a few extra zeros involved in the funding figures. Alas, in the absence of a magic pudding for a budget, politicians are stuck with the task of having pick which deserving cause gets funding. But Australia has historically underinvested in mental health. Morris Iemma was the first to put his hand up and say governments had to do much better in funding mental health services, back in 2005. The Howard government, with Tony Abbott as health minister, followed suit in 2006. Now Abbott has adeptly seized the opportunity provided by the government’s inattention. With a package as large and as complex as the government’s health reforms, it was always easier to draw attention to what was missing than what was there. While it’s rare that good politics makes good policy, Abbott’s proposed rollout of more Headspace centres and a lot more psychosis prevention and intervention centers drew strong praise from mental health professionals. Andrew Robb’s participation yesterday might have looked awkward except that Robb is always ready to explain what he has been through, in detail, without the least personal embarrassment, convinced that by doing so he is encouraging people who suffer from depression or other mental illnesses to seek treatment. In his remarks, he made a nice contrast between his capacity to pick up the phone to Jeff Kennett and seek help, and the plight of those enduring mental illness in the community. Now suddenly the government looks flat-footed and reactive on health, which should be its strength. Plenty of time to respond before the election, though, even if mental health isn’t a vote-changing issue. |
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48 Comments
Oh Bernard../.stick your fingers down your throat and throw up! 11 years, $20B in the bank, power in both houses for the last 3 years of their Government and NOW they come up with a mental health plan??? Now they are experts and have all the answers????? Why don’t you ask them why they didn’t do this when they had the power to do anything???? Not one Journo asks them that question….
By the way…are you and Michelle Grattan Abbott’s new campaign managers?????
Cood move by the Coalition and additionally Roxon, nasty and churlish is beginning to look like a liability for Labor.
In retrospect, I think Tony was overly nice to her during the last election campaign.
I heard the Libs health spokesperson, this morning indicate that Abbott when health minister injected 1.3 billion dollars into mental health during his tenure of the portfolio. Have searched and cannot find any evidence of it!!!!! I imagine Abbott has found this a very convenient policy plank to throw at the Government. I at the same time am critical of the Govts position on mental health. Neither party have covered themselves in glory and action.
Bullshit Bernard. Good lord you little folk have short attention spans don’t you. Abbott stripped billions out of the entire health budget which is why it is so run down.
Abbott started the reform of mental health with a 1.9 billion dollar program in 2006 ….. the same program Labor is trying to claim as theirs. If you dont believe it have a read of Prof Mendoza’s own resignation letter.
“The Rudd government is publicly claiming credit for the increased investment in mental health when almost all of this is a consequence of the work of the Howard government.”
Didn’t John Howard express a principle here?:
‘He can’t escape responsibility for the health policies of the Howard government because he was the Health Minister and … er … you know … my ministers weren’t subject to a ‘kitchen cabinet’.
Abbott did do something if you read this 2006 media release -
http://www.health.gov.au/internet/ministers/publishing.nsf/content/1E5EE2EC62859E87CA25711100287B3A/$File/abb011.pdf
shepherdmarilyn
While I enthusiatically agree with you on most things the better access to metal health services saw billions made available to primary mental health care - much above its projected use - this was an initiative arising out of the mental health policies of the Howard Government
ie : On 1 November 2006, Medicare rebates were introduced that allow patients with a mental disorder to receive up to 12 individual and up to 12 group allied mental health services per calendar year
LoL at Denis and not knowing any Howard History.
In 2006 the former Coalition Government made the single biggest investment in mental health by any government in Australian history. $1.9 billion was committed over a five year period for services for people with mental illness, their families and carers.
Despite continually talking about its importance, the Labor Government has largely ignored mental health. Labor’s failure to significantly boost mental health funding as part of the $7.3 billion so-called health ‘reforms’ was branded as “inexcusable” by the Mental Health Council of Australia.
In contrast, the Coalition has a strong track record of taking mental healthcare seriously and providing the necessary funding to provide necessary services to those suffering a mental disorder.
Yes copya pasta
Hang on a sec. I was working for the old Dems in Parliament House when the National Senate Report in to Mental Health was tabled - led by my boss Lyn Allison. Abbott didn’t want a bar of it. It was Howard who thought ‘Jeeez, I’d better respond to this with $2.6B in funding.’ Abbott was too busy licking his wounds over the RU486 debate which he tried to turn in to an abortion debate.
Short memory here.
why is anyone referring to previous government policies??
in government, as K Rudd found out, you are only as good as your policy stance today.
if Abbott stripped money out of a portfolio in a previous government, unless the new government had put that money back in, (which they havent) then you have no moral high ground. Roxon’s reactive vitriol proves her view of policy is much the same as her expunged former leader - wishy-washy at best.
Gosh, I guess the Libs really DO bekieve they have a chance of victory at the next election. Putting plans in place now to cope with the inevitable increase in depression, psychosis and suicide should they win shows unwonted foresight on their part.
Oscar - that is the funniest post I have read for a while
@Surfer, thankyou for the link. Reading the release from Abbott the 600 million (not 1.3 billion) the then Govt said they would contribute and the States the balance, was a ‘plan of action’. The question still to be answered, did it happen? I cannot find any evidence it did.
Great that we are doing more about mental health - hopefully this includes looking into “prevention” as well but everyone seems to be busy patting Abbbot on the back but not questioning where he is getting the money from and the impact that will have. Or why it even has to be a zero sum decision.
http://www.medicalsearch.com.au/News/Psychologist-visits-are-up-after-coming-under-Medicare-24995
http://blogs.news.com.au/dailytelegraph/suedunlevy/index.php/dailytelegraph/comments/a_big_black_hole_in_abbotts_credibility/
Now Bernard and others, do try and have an attention span longer than a gnats.
Dunlevy’s expose was only in May for pete’s sake.
Fancy seizing on this straw Bernard Keane to seek to build momentum for mental health.
I was at a consumer group meeting at a local hospital’s mental health unit last night attended by staff and clients alike and not one person … not one … when TA’s name was mentioned in a discussion of frustration about the status of mental health in the current climate of Federal politics paid any note of a song to the notion TA can manage the needs of mental health reform.
This essay, Bernard is a narrow minded appreciation of Abbott’s overall impact on the mental health of Australians were he elevated to a position of being the PM. Carping silly moralist TA is who believes in an imaginery friend and still struggling to adapt to the contemporaneously understood realities of biological differences you have to be kidding.
Rush Limbugh
Posted Thursday, 1 July 2010 at 2:28 pm…yes you are right…it has helped many people - but as Malcolm said - it was no thanks to rAbbott….and Oscar…great post….very funny…well done….
I am a practicing psychiatrist in public mental health in Victoria and I can tell you that the proposed expansion of Headspace and Early Intervention Services would be a disaster for existing public mental services because it would draw staff from services which are already chronically understaffed. Furthermore, what the high profile proponents of dedicated youth (18 - 25) mental health services won’t tell you is that this model has been enacted in large scale in the North West region of Melbourne for over ten years in the form of EPPIC initially then ORYGEN and there is no credible evidence that outcomes are any different from other parts of Melbourne. And guess what? Schizophrenia doesn’t disappear at 25. The public is being conned. This is as good an example as you would find of the truth being the first casualty of an election campaign. As for John Mendoza, he knows so little about public mental health that he claimed that beds had been decreasing by 4% per year, when the AIHW report he quoted makes it clear this applies only to beds in standalone psychiatric hospitals. Total public psychiatric beds have actually increased significantly.
Bernard - rhetoric and promises are one thing, but what did they actually DO?
A promise made in 2006 - probably in response to Rudd’s and Labor’s stratospheric approval ratings and the proximity to the next election - means nothing unless they actually DID anything prior to 2007.
Just because Labor has failed to take this ball and run with it does not mean it isn’t committed to mental health reforms. Remember the GFC? Lots of programs were put on the back burner because of it whilst the government concentrated on its stimulus spending (rightly or wrongly).
And just because the Libs promised something before - and have again - doesn’t mean they will actually do it. They have form for coming into government, saying “OMG! Look at TEH DEBT! Sorry, we can’t honour those election promises now” and their current rhetoric points to them almost certainly doing it again this time.
On past performance - 12 years of doing nothing in health in the face of huge asset sales and taxation windfalls - indicate they will again be all mouth and no trousers.
Abbott at his best? What at? Spin? Hypocrisy? Ruthless political exploitation of the weakest in our society?
Thanks, Oscar! You’re an inspiration.
Perhaps it isn’t so surprising
When Julia Gillard’s stocks are rising,
That Abbott, whom we always thought was mad,
Is making sure that if a loss should leave him sad
He will have done everything possible
To make good services available
For anyone and everyone who’s blue.
Why them? Not those of any other hue?
It’s obvious. Of course that group will need a bed.
The cheerful ones will all be red.
As a friend of mine who has worked for decades in the public health arena - not a jot of the extra money has been spent on actually mentally ill people but it has made a lot of shrinks pretty rich.
Hullo Surfer, earth to Surfer!!!!
Yes, nice to see Tony “When “facts(?)” change I change my mind - what do you do?” Abbott - leader of the “Non-core, Not to Mention “Cast Iron”, Promises Party”; “Health Minister” in a government that devolved mental health care over the “12” years it ran, to where it finds itself lost and disoriented even today (with other “international events”, requiring resources to counter); in response to the handy negative publicity that “lack of mental health provisions”, in the budget and Rudd’s “Health Overhaul”, has drawn; and propped by “Handy Andy” Robb - announcing “his policy” yesterday on how he’s “going(?)” to care for those suffering “mental illhealth” …… “after he wins” (with his history and these “india rubber policies”), he just has to do that first?
But, was he reading from “prepared script” in the light of that window of opportunity?
This is so bullshit. The rest of the time they couldn’t give a rats about mental health.
Politician = charlatan.
Robert Bruce is on the money. Throwing money at EPPIC might keep the Australian of the Year happy, but the evidence that this is a useful thing to do is at least open to question. And the loss of staff from elsewhere is an important consideration. There was a similar consequence with the Batter Access to Mental Health Program, the 2006 Howard initiative. This prompted numerous psychologists and allied health providers to head off to private practice, leaving the public sector depleted. And for what? The budget blew out, and others have suggested that much of these services are not just for the worried well, but the scarcely worried too. No evaluation of this program appears to have been done.
I worked in the field of mental health from 1994 to 2005 and I know the previous gov’t did stuff all to redress the chronic underfunding in this sector. If he were to win the election Abbott would drop this proposal in a nanosecond and yes, one more vote for Oscar.
I don’t believe Robert the Bruce for a minute.
Well you just can’t win, can you. What would you have him do, close down half the mental health facilities, thus ensuring the remaining facilities are packed to the rafters with staff?
No, but the rate of acute episodes leading to suicide, including suicide by cop, as well as other violent crimes committed as a cry for help, after being refused admission because there are insufficient voluntary mental health beds goes down dramatically after age 25, doesn’t it.
Anything which takes pressure off the number of involuntary and voluntary mental health beds has got to be a help.
Or do we now delete all occurrences of “take pressure off” and substitute “drain staff from”? Quick! Somebody close down half the fire stations and police units, before the rest run out of staff!
As for all those saying “He took to long to act 10 years ago,” move on people. Did you do 10 years ago all the things you now know you should do today?
DONTLOOKATMELIKETHAT do you have any idea how labour markets work? Do you have any idea how complex service systems operate? If new services are created without an equivalent expansion of the qualified mental health clinician workforce they can only be staffed from existing services, unless there is a significant pool of unemployed or underemployed mental health clinicians out there, which there is not, it has been a sellers market for so long. Far from taking pressure off existing services these proposals will put existing services under greater stress. Your argument by analogy about emergency services is completely wide of the mark. Politicians are always proposing to train/employ so may extra Police or Ambulance officers, not how may stations they are going to open. The starting point for any service development is to consider what you are trying to achieve and what you need to achieve it. In the case of Headspace and Early Intervention Services the main need is staff. Buildings are cheap compared with the recurrent expense of staff. And the staff have to come from somewhere. System of service delivery reform without workforce expansion is truly just shuffling deckchairs on the Titanic.
And another thing, thanks to SHEPHERDMARILYN for pointing out what a waste of public money the better access scheme (introduced under Tony Abbott) has been. Clinical Psychologtists used to charge around $100 an hour. Now they charge around $185 an hour. They have simply added the Medicare rebate to their fee schedule. Don’t get me wrong, good clinical psychologists are worth their weight in gold, but there is no evidence that the Better Access Scheme, which has been around for long enough now, has had any impact on population health.
Robert Bruce, just listen to yourself:
and …
and …
You’re telling me you don’t see any connection between adding public money to increase the rate of pay for clinical services, expanding private services, and redressing those staff shortages?
And you question my knowledge of how labour markets work?
DONTLOOKATMELIKETHAT I’m not sure what planet you’re living on. If you increase pay for private service providers without increasing training places for clinicians (or importing clinicians) all you achieve is increased pay for rebated clinicians, and create a lucrative market which draws certain clinicians away from salaried public work. The universal experience in public mental heatlh services since the better access scheme was introduced has been an exodus of clinical psychologists from public mental health services, most specifically from fulltime positions. There has been no equivalent expansion of tertiary places for clinical psychologists. We are still suffering from the efffect of Michael Wooldridge’s brake on doctor training in Australia.
Robert Bruce, I don’t think I’ve ever before heard psychiatrist say something like “I’m not sure what planet you’re living on” to a stranger. I bet the psychiatrists in private clinics don’t say that.
I’m not offended. I am living on a planet where the best is the enemy of the good and the good is almost never achieved without some negotiation and goodwill.
You sound like a person who is offered a new table and then says, “Damn you, then I would have to buy more chairs.”
Why don’t you rewind and start again, with something like this:
“Gee Tony, I’m really glad to see you’re serious about mental health and you’re planning to fund it more. You would really be the ace of mental health if you would top it off with more training positions.” Or whatever it is you think will do the most good.
Or am I missing the subtext and the real issue here one of political partisanship, rather than who gets the job done?
And I still need to make this point clearer about labour markets:
Increasing pay for an occupation, as you acknowledge Abbott did a few years ago, tends to make that occupation more attractive and draw in more recruits (typically after a time lag).
If it doesn’t have that effect, it’s either because you’re still seeing the time lag, or because of some bottleneck, most likely a bureaucratic one. The problem then is to identify that bottleneck, draw attention to it, and then lobby for its removal by someone who shows a bit of interest. An example of the latter would be a party which has just announced $1.5 billion in spending in that area.
DONTLOOKATMELIKETHAT you’re being a bit precious aren’t you? This is public debate. Are you a clinical psychologist by any chance? The better access scheme was never officially intended to increase the earnings of clinical psychologists, but to increase access, and all costings were based on the presumption that fees would not be increased. How naive that was. Oh and by the way, tertiary places are set by the federal government not determined by market forces. As for your risable table analogy, what would be the point of obtaining a new table without any chairs? You have actually proved my point!
And you’ve provided inductive support for my point about bureaucratic bottlenecks: “Oh and by the way, tertiary places are set by the federal government not determined by market forces.”
No, I’m not a clinical psychologist. I’m the sibling of a person who examines every passing car or word spoken on the TV for secret messages, who is physically crippled by inept but genuine suicide attempts, many of whose friends were more successful, one shot dead by police after failing to get admitted even though there were about half a dozen involuntary beds vacant. I don’t know about Victoria but it’s a recurrent pattern where I come from.
So I leave the analysis of particular labour incentives and bottlenecks to you. One thing I learned from another family member, who was a respected committee member in a mental health policy NGO, is that you take help wherever you can get it. You choose either the issue you’re committed to, or taking sides; if you try to mix them you end up fighting yourself.
DONTLOOKATMELIKETHAT I am sorry about your family situation. I too have a first degree relative with a chronic severe disabling mental illness. I am a passionate advocate for better resourcing of public mental health services. To propose extra funding for a particular model of service delivery without costing the staffing requirements and implications for the whole system of service delivery is dishonest. We are talking about Tony Abbott I know, so it sort of goes without saying. If you want to significantly expand a service delivery system you need to expand training and you have to wait the typical training time for the specialist clinicians needed to be trained to implement it.
“We are talking about Tony Abbott I know, so it sort of goes without saying.” So I’m right, this is about political partisanship, and any glass Abbott poured was always going to be half empty.
Your point about training places is vital information, good to know. You should be communicating this to the party in question. Unless the Labor party has got a better plan to match up supply and demand for training places, not just as a one-off but for the long term? Market forces are the only way I know to do that.
Who was the last Federal Health Minister? Tony Abbott. The most laissez-faire, uninterested, anti-health Minister you could ever hope not to have. Now the Libs have been kicked out Abbott and his crew are looking for any point of weakness to claw their way back into power, regain their fat salaries, and go back to being laissez-faire and indifferent once again for a couple more terms.
Abbott was the most notable in his time as minister for rejecting the idea that schools ought to get kids onto a healthier diet, acting as chief apologist for the junk food and processed fast food industry throughout the whole sorry debate. In the end, the parents and the state Labor govts revolted and instituted their own canteen revolution. So much for Federal leadership by a pro-big business, crony capitalist political party.
That he comes up with something approaching a good idea in Opposition is just a mark of the desperation of the man to get back into power. He is promising big, and I suspect would deliver very very little monetarily on getting into power. Not a core promise, sorry.
@SEAN - Agreed! I just don’t trust Abbott and his mates. Who’d trust them on anything? If he wrote it in gold with the pope as witness, I still wouldn’t believe him!Maybe if I was a bright eyed 5 yr old I might be conned with a bag of lollies such as this, but - you only get an overdose of licorice with this lot - with the predictable outcome!
SEAN:
Some people think there has to be a federal law for every problem in the world. That’s the Labor way and it appeals to the masses — shortest path between two points. The problem is this has led to a culture which justifies unconscionable behaviour by saying, “It’s not illegal. If the government gets of its ass and bans it, I’ll stop doing it.”
Abbott did not defend the junk food industry. Nor did he order parents and schools to go on supporting canteens which acted like junk pushers. What he actually said was:
It’s a tough one, but if you’re a parent, at some point when your kids grow up, they need to learn to solve their own problems instead of spending all their lives complying with rules made by you that cover every possibility. By this analogy, I am not talking about schoolkids solving their own dietary problems; I’m talking about adult Australians taking responsibility for the way they run their schools and canteens, which are supposed to be for their children’s benefit.
Where does the nanny state end and community responsibility begin?
“Where does the nanny state end and community responsibility begin?”
Good point. How about all the Libs really live by the principle and stop blaming the Government for PRIVATE BUSINNESS’S failure to provide a safe working environment and/or proper staff training in relation to the delivery of the Home Insulation Scheme or for their appalling rorting of the Building an Education Revolution programme?
No? Thought not.
@CHINDA63…Good point it is utterly absurd that pratt Pyne is still going on and on about how its Ms Gillards personal fault unscrupulous builders rorted the schools programmes. Where were the school committees, parents and principals who are now whinging to Pyne about overcharging in the tens of thousands of dollars. Of course she should have been standing over every construction site supervising the quotes and ensuring they were exact to the nearest dollar.
That is nanny state stuff. Of the 6 schools in my area that received stimulus money, not one sat back and accepted quotes as gospel, they were scrutinised and checked by responsible principals and parents.
Let’s not forget that to implement his mental health scheme that this article so highly praises, Abbott plans to more or less trash the rest of the public health system. It’s what he did over a long period of time when in government (blame shifting failures to the States) as he pushed health and public money towards the private sector and it’s what he will do again, then find a reason to privatise the mental health system as well, long before he’s spent the amount he’s promised.
@CHINDA63,
It’s a bit like asking why do GPs overprescribe antibiotics for common cold, breeding antibiotic-resistant and potentially deadly bacteria strains.
Medicare pays a flat rate for an Item 23 consultation no matter how short, and antibiotics are almost gratis from the taxpayer, so GPs who don’t take the opportunity to churn through lots of these easy mass-market consultations could find themselves financially unable to maintain a high quality clinic, threatening the care of more serious patients who really need it.
More cynical behaviour, like stretching the truth just a little bit on your tax return, or overloading your building schedule with government contracts which pay a lot more and demands a lot less than ordinary clients do, is something that goes up and down according to the risks and rewards available. The shonkiest operators prosper, while the honest ones start thinking about a career change.
Laws and subsidies are blunt instruments, which can sometimes take many years of further laws and further spending to clean up the harmful side effects. Those who’ve seen this all before were completely unsurprised when the BER and the insulation scheme went bad.
These were rookie mistakes by ministers who spend money first and ask questions later. Schools could have made far better use of cash, and homeowners could have made far better use of a more flexible subsidy program based on improvements in energy-efficiency rating.
I wonder by the time the election is called how many balls Mr Abbott can keep in the air,excluding his own of course.
I am soooooooo impressed to read the replies by Dontlook… (..”DLAM” ..hope shortening name is ok).
I am a health practitioner (non mental health area now) that worked early on in my career in psych services. I have a sibling and parent with a chronic depressive/psychosis issue. I have experienced multiple state and federal govt initiatives in health both in public and private in my time. I have worked in UK and asian hospitals and studied in the US. Australia’s mixed public/private system is much to be preferred to these alternatives.
I sometimes think that too much funding goes to the middle class in our current system. The very poor and mentally unwell receive insufficient funding by comparison.
My guess is that the selfish motive of those who could afford to pay for their health is translated into political health policy, somewhat similarly by both major political parties. This means that Australia chooses to take care of middle Australia well, and tries to forget those at the bottom end.
In my opinion those who point to Abbott or Gillard’s previous time in govts are making historical comments that have limited applicability to the future, at best.
This initiative by Abbott is so praiseworthy, if for no other reason, because it illustrates the current Govt’s awful lack of an appropriate principled response to this most difficult area of health.
Yes market economics are the reality of all areas of activity in society where dollars are spent. I laughed when I read DLAMs brilliantly incisive rebuttals of RB, all the time DLAM not particularly falling into an ‘ad hominem’ approach. Well done!
I like Tony’s approach, and I think the current leaders attitudes, (and probably more importantly their relative closeness in the polls) will lead to an excellent standard of debate and better policy decisions for us.