The mental health sector raised concerns about the legislation restructuring the health system but the select committee dismissed them, Marc Daalder reports

Health Minister Andrew Little says the new health system will be well-equipped to handle mental health, even though the legislation establishing the new system doesn’t mention the issue at all.

Critical submissions on the bill from groups in the mental health space have been highlighted by National MP Matt Doocey, who says the Government “talks out both sides of its mouth on mental health”.

Doocey, who holds the mental health portfolio for National, told Newsroom he was surprised to see no mention of mental health in the legislation. A report back from the Labour-dominated special select committee established to consider the restructure of the health system uses the term “mental health” only twice, in arguing why no specific mental health provisions are required.

“The Government says one thing publicly – that it wants to transform the mental health system – yet, behind closed doors, does the exact opposite. The Government really needs to answer the question on why mental health is so invisible in the health restructure bill,” Doocey said.

“We’re going through a once-in-a-generation restructure of our health system. It beggars belief that there’s no mention of mental health and addiction.”

Little defended the lack of a special focus on mental health in comments to Newsroom on Thursday.

“I know a lot of submitters had comments to make about things they didn’t see in the bill. This is a bill for the health system as a whole,” he said.

“We know that, for our health system, there’s a number of things it has to do including good-quality mental health services. The fact that the organisations themselves – certainly Health NZ – will have a mental health directorate, will have responsibility for delivering mental health services, the fact that we will continue to have ring-fenced mental health funding, I think ought to give some confidence that we will continue to take mental health seriously.”

The Mental Health Foundation (MHF), Emerge Aotearoa, the Mental Health Advocacy and Peer Support Trust, Changing Minds and the Government’s own Mental Health and Wellbeing Commission all pointed out gaps in the bill relating to mental health.

“Mental health and wellbeing should be an explicit focus of the new health system,” the MHF wrote in its submission. “The bill, as currently drafted, does not demonstrate the Government’s commitment to improving mental health and wellbeing outcomes. Our primary concern is the lack of any reference to ‘mental health’, ‘addiction’ or ‘drug-related harm’ in the legislation.”

Most of the submitters from the mental health space asked the select committee to change the legislation to require the new health entities to create a mental health and wellbeing strategy. This would be in addition to requirements in the bill for the entities to create strategies specific to Māori, Pasifika and disabled people. The select committee also suggested a requirement to create a women’s health strategy.

“The Commission strongly advocates for the addition of a mental health and wellbeing strategy in the bill,” the Mental Health and Wellbeing Commission wrote.

“The issue of mental health is almost invisible within the bill. To help strengthen the bill we recommend a more explicit referencing of mental health will provide assurance to the public that the health system is adopting a more holistic and transformative approach to health in the broadest sense.”

However, the select committee in its report back said this wasn’t necessary.

“We were advised that specifying further strategies based on particular population groups or conditions could result in certain populations having too much or too little focus on them. It could also result in a lack of flexibility in the system and an overemphasis on producing strategic plans rather than on innovative service design and provision,” the select committee wrote.

National and ACT formally disagreed with the report and Doocey said this wasn’t good enough.

“What we’ve got here is a Government that talks out both sides of its mouth on mental health,” he said.

“When we have our leading stakeholders and spokespeople from the sector itself speaking out, why haven’t they been listened to?”

Marc Daalder is a senior political reporter based in Wellington who covers climate change, health, energy and violent extremism. Twitter/Bluesky: @marcdaalder

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