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Wednesday, August 12, 2009
Grievance Debate
I rise to grieve for people with a mental illness who are unable to access care unless they are in crisis. I grieve for people with a disability and their carers who wonder if they will ever get accommodation or even some respite care. I grieve for abused and neglected children who are repeatedly bounced around in the government's out-of-home care. I grieve for the state of mental health and community services under the Brumby government and particularly under the responsible minister, the Minister for Mental Health and Minister for Community Services.
I want to look at the state of inaction of the government and the minister in each of these areas, and in many cases at the state of denial. I want to cover the facts, I want to cover what the media and community say and then I want to cover the perspective of the minister and the government.
To start I will read an interesting quote from the Minister for Mental Health reported in Hansard in February 2008 when she said:
- Within my own portfolio areas of responsibility much has been achieved ...
That sets the tone for her beliefs and for her lack of recognition of the failures within her area of responsibility. We see again and again that there is something very wrong with child protection, mental health, disability and drug and alcohol services, and the government not taking the action needed to change the outcomes for these individuals and families.
I will start with child protection. The facts are that every year nearly 6500 cases of child abuse are substantiated in Victoria, and on any one day around 5000 young people need to be accommodated in some form of out-of-home care -- and the numbers are increasing.
The number of children in out-of-home care in Victoria has increased by 25 per cent over the last three years and by nearly 50 per cent over the decade of this government. During Labor's time in office Victoria has gone from spending the most to spending the least of any state or territory government on our children in child protection and out-of-home care.
What do we read in the headlines? They say: 'Premier admits system failed critically ill toddler'; 'Inquiry on child security rejected'; 'Children overload'. The last headline is in today's Age. What do we hear from the minister? She says, 'Victoria has one of the best child protection systems in the world'. The minister said that only days before admitting it is unacceptable that caseworkers have not been allocated to 2000 at-risk and abused children. The reality is that we have seen the Premier having to come to the minister's rescue. He has had to express his confidence in her and deny the allegations that she is not doing her job.
He has also had to say that he is going to work closely with the minister to personally examine the recommendations of the inquiries. I would have thought that a Premier who had confidence in his minister would let her take responsibility for the job she has been given.
What do we see in the child protection workforce? Almost one in every four front-line professional staff members leave child protection each year. The union that represents child protection workers says the caseload is far too high, and in some instances workers are managing up to 25 cases at a time. Despite the load and because of the lack of workers, 2000 children have not been allocated a case manager, as I mentioned.
The minister flew business class to the United Kingdom, racking up a $52 000 bill in an attempt to recruit more workers. That is a clear admission this government has failed repeatedly over years to address the recruitment and retention of child protection workers in Victoria. We have seen a headline stating 'State child protection workers overburdened'. The minister has plenty of empathy. She says it is a difficult and stressful job, but there have been no comments about how the government is going to fix the system that she has known about for years and the government has known about for its entire time in office.
Foster care is another area. Over the last four years Victoria has lost half of its foster carers. By contrast, there has been a 25 per cent increase in the number of children needing that sort of care. The headlines we see in the media include 'Foster carousel harming children' and 'Children in need, but care is scarce -- shortfall in foster places, but demand keeps rising'.
The fact is that 43 per cent of 17-year-olds in out-of-home care are not attending school. That contrasts with 22 per cent of 17-year-olds overall. In 2007-08 more than 100 children left state care having had at least six carers in either foster care, residential care or with a relative. Of those 100 children, 27 moved between 11 or more care placements over several years. Of the more than 900 children who left state care in that year, about one-third had three or more placements, and some had been in the child protection system for less than six months.
Bernie Geary, who is the child safety commissioner, said that constantly moving was a form of 'retraumatisation' for these poor abused and neglected children, and he pointed out that the system was too reactive. Headlines in the media include: 'State children being --retraumatised--'; '100 children a night in temporary digs really is an emergency'; and 'Children in care miss out'.
In response the minister selectively picked some data which states that the number of children with multiple placements who had been in child protection for less than five years was down on the previous year. That was her entire response to the fact that children are being retraumatised by moving through the system so much. Wonderfully, on the topic of multiple placement concerns, the minister's comment was, 'We have funded a foster care recruitment campaign'. She has an inability to deal with the issues and an inability to address what is happening in her own area.
I will turn to the area of disability and supported accommodation. Currently there are 2551 people with a disability waiting to access supported accommodation, community support and daytime activities immediately. Last year the Auditor-General found that the Brumby government had not invested in one new supported accommodation bed since 2003.
Year in and year out the Office of the Public Advocate has found a shortage in accommodation options resulting in increasing numbers of young people with an intellectual disability or mental illness languishing in inappropriate accommodation.
Research by Deakin University found that almost one-third of carers are classed as severely or extremely severely depressed. Carers have the lowest level of health and wellbeing of any other group and a higher rate of disability or chronic illness. The headlines in the media include: 'Budget ignores carers plight'; 'Family carers --stretched to breaking point--'; and 'Drowning prompts care query -- state accused of underfunding'.
The minister's response to carers who are worn out and desperate is that the number of people on the supported accommodation waiting list is 'trending down'.
For the 1247 people who are still waiting for supported accommodation and who are identified as needing it now, trending down is not an answer. We need more action and we need more accommodation, and we are not getting it from this government.
What are we seeing in community service organisations across the board? The most recent budget provided a funding indexation of 3.14 per cent, 25 per cent less than the funding identified by the community sector as needed. In addition the government's disability pricing review, undertaken by PricewaterhouseCoopers but not yet released, apparently states that the sector is currently underfunded by more than $50 million. The peak group, National Disability Services (NDS), has confirmed that the disability sector is unable to continue to survive on this price indexation. The peak body in disability services says that this budget undermines the survival and future sustainability of disability organisations.
The Victorian Council of Social Service says that 7 out of 10 organisations are turning away clients due to a lack of funding. While NDS is launching a major campaign highlighting that disability organisations may have to lay off staff or close, the minister says, 'The figure of 3.14 going forward is a good outcome'. The minister is disconnected from the reality of what is happening in the community sector.
Let us have a look at mental health. What we have seen is a minister who relies on expenditure as a measure of success rather than the outcomes or the impact associated with that expenditure. The minister keeps saying that the government has increased spending on mental health by 108 per cent. The fact is that during Labor's time in office Victoria has plummeted from first to sixth in terms of state government per capita investment in mental health in any one year. Over 50 per cent of Victorians with a mental illness get no access to the care they need. They are not able to get access via emergency departments. People are unable to get community-based care so they try to access care via hospital emergency departments and many of them wait for hours.
Forty-six per cent of mental health inpatient beds are blocked because of chronic shortages in discharge options. A third of people are not receiving community care after they leave hospital so they are admitted again. The Victorian government performance indicators show that Victoria's mental health system is failing all but one of the government's performance targets for adult acute services.
What are the headlines?
They are: 'Government blamed for mental health services shortfall', 'Mental health system buckles', 'Government falls short on mental health care', 'Mental care failing more patients', 'Neglect hits mentally ill', 'Reports say state accused of failing to act' and 'A cry for help goes unanswered'. What we hear from the minister is that the government has increased spending, but unfortunately the reality is that investment in mental health services by this government has resulted in Victoria dropping from first to sixth among all state and territories.
The minister also said:
- Victoria is now acknowledged as having one of the best mental health systems in Australia.
Not too long after that the Minister for Mental Health admitted that too many people are 'falling through the gaps' and that mental health services are 'crisis driven'.
What we have heard more recently and very concerningly from the coroner is the admission that there is a crisis in mental health accommodation. The coroner said:
- ... the availability of accommodation for persons suffering from compromised mental health was and still is unsatisfactory at all levels.
Forty-two per cent of people with a mental illness live in insecure and unsafe housing such as rooming houses. In supported residential services set up for people who are frail aged, we find that 62 per cent of them have a mental illness and many of them are well under the age of 65.
Of the 4000 Victorians who are homeless each night, one in three has a mental illness.
These are the headlines we see: 'Victoria's mental health system --in crisis--: coroner', 'Killing highlights a system --in crisis--', 'Beds run out for mentally ill: patients sleeping in motel rooms'. What we have heard from the minister is:
- ... we know that meeting the accommodation needs of people with a mental illness is absolutely crucial in assisting their recovery.
I am sorry, but the minister's stating of the obvious is not good enough. We need action and outcomes.
Drug and alcohol is another area where this minister has failed to act.
We know that harms have increased under this government. We know that nearly two-thirds of 18 to 20-year-olds binge drink, and a further third of 14 to 17-year-olds binge drink as well. The number of 16 to 25-year-olds with alcohol-related brain injury has increased fivefold in Melbourne over the last decade. Treatment services are stretched to breaking point. The Salvation Army, one of Victoria's largest service providers, says the system is 50 per cent under capacity, and waiting times have blown out to years. We have a number of recorded cases of people who have died while awaiting access to a bed. This is particularly so in country Victoria.
What are the headlines? They are: 'Alcohol victims die on waiting list for help', 'Alcohol treatment swamped', 'Brumby ignores advice on big booze stores', 'Alarming increase in alcohol abuse' and 'Rehab funding slashed'. But what do we have from the minister? We have drug, alcohol and amphetamine strategies released but completely unfunded. She has also said:
- For supported treatment, waiting times are now less than one day. We have a strong record in this area ...
The reality is that the evidence is overwhelming; it seems to be incredibly obvious to everyone but the minister herself. Even the Premier is stepping in to oversee child protection so that he knows it can be dealt with competently -- and, as I have said, he has had to confirm his confidence in the minister.
Platitudes and generic statements are not enough. Comments about increasing spending are not enough. We need to know if things are changing fundamentally for individuals and families and whether the outcomes for those people who are relying on community and mental health services will actually be any different for their future.
Vulnerable people deserve better than a minister who believes her own rhetoric and platitudes and fails to see beyond the departmental briefing. She needs to look through to the individuals, families and carers who are crying out for better support. As Victorians grieve for their lack of support under this government on a day-to-day, week-to-week, month-to-month, year-to-year basis, I grieve for the lack of leadership, I grieve for the lack of decisive action and I grieve for the failure to improve outcomes for individuals, families and communities from the Minister for Mental Health and Minister for Community Services.
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