It’s a debate with no sign of abating – is the Government doing enough to tackle the rising demand for mental health services?
Appearing before Parliament’s health committee to discuss the Government’s spending plans, Health Minister Jonathan Coleman would have known the topic would not be far from the minds of his interrogators.
Before Coleman’s appearance, the Council of Trade Unions and Association of Salaried Medical Specialists released a joint analysis claiming the Budget would provide just $18 million in extra funding, which it said was a cut in real terms.
Opening the questioning, Labour’s health spokesman David Clark grilled Coleman on the lack of new mental health initiatives in the Budget, given a system “at breaking point”.
“There has been a 60 percent increase in demand for services in the last decade, and funding has only gone up 28 percent….I’m wondering in light of this growing crisis why you as minister did not have any new mental health money appropriated in response to what the public thinks is a health crisis.”
Coleman pushed back, pointing to a $100 million fund for new mental health initiatives as part of the Government’s social investment initiative coupled with another $100m “ring-fenced” for DHBs to spend on the area.
He said the Government was working on more initiatives as part of a new mental health strategy going before Cabinet – a response received disdainfully by Clark.
“Isn’t that ‘the dog ate my homework’, minister? With respect, if you get to the point where we’ve had the Budget and we still don’t have the initiatives, that is hardly a response to a growing crisis in New Zealand society.”
However, Coleman argued it was important to take time to develop a cross-government approach, rather than “throwing in a political sugar lolly”.
“You were saying yourself that we need to do something different and we are focusing on developing that new strategy and approach. It’s not a matter of throwing a whole lot of stuff into a bucket, just because the Budget is on May 25,” he said.
While Coleman’s past exchanges with former Labour health spokeswoman Annette King always had a tinge of respect and good humour, his exchanges with Clark were less amicable.
Clark slumped in his seat and rolled his eyes at some of Coleman’s responses, while the minister grew testy at the Labour MP’s constant interjections: “I tell you what, why don’t you speak, then I speak?”
Coleman said there was no need for an inquiry into the state of the mental health system, as some critics have called for, but insisted that did not mean he was afraid of what it might find.
“I don’t think we need more diagnosis of the problem…just sitting down for an inquiry on mental health is not going to tell us anything we don’t already know.”
He said the increased demand was not unique to New Zealand, with countries across the Western world trying to find a solution.
“While mental health issues have always been around, [they’ve] really taken on increasing prominence over the last five years, but even more so in the last two years, so everyone looking to adapt their models of care to deal with the increase in demand.”
That doesn’t cut the mustard for Labour, who point to reports like a damning Auditor-General inquiry into discharge policies as signs of the need for more money.
Hole in health funding?
The mental health discussion is part of a wider debate over the funding, or lack thereof, for the health system which could shape up as a significant election issue.
Labour has tried to highlight what it sees as a growing deficit in health spending when compared to rising demand for services.
Coleman made a preemptive strike early in the hearing, saying the health budget had increased by about $5 billion since National came into government.
“I want to make the point, because I’m sure it will come up today: people who say that the health budget has been cut are absolutely incorrect…
“What they’re arguing over effectively is the size of the increase, but that is a considerable amount of money over time and it is delivering increased performance and improved results.”
However, Clark came armed with figures of his own, in the form of a new Infometrics economic study commissioned by Labour, and claiming there was a $2.3b shortfall in real-terms health spending.
That sparked a peculiar if comical exchange, with Coleman asking Clark to define core crown health spending.
“What do you know?” asked Coleman, with Clark retorting, “I want to know what you know.”
Coleman insisted Labour was ‘not comparing like with like” by matching Budget initiatives against wider core Crown spending, further claiming the Government had “fully funded” health for population growth, demographics and inflation.
Yet that claim will not satisfy Labour as it attempts to keep pressure on Coleman and the Government heading into the campaign.