Ms CHAPMAN (Bragg—Deputy Leader of the Opposition) (11:00): I rise to support the motion to accept the draft address of His Excellency Rear Admiral Kevin Scarce. In doing so, I wish to place on the record my appreciation for our Governor's service to South Australia, his duties to executive council and patronage of numerous charities, which he has undertaken over a number of years and which is expected to conclude later this year. I also extend and record my appreciation to Mrs Liz Scarce, who has attended countless civic events and undertaken her duties in support of the role of Governor for all South Australians both in the grounds of Government House and across the state.
The electorate of Bragg honours the work of father and son team, Sir William and Sir Lawrence Bragg, who were duly recognised with a Nobel Prize in the field of science. As the re-elected member for Bragg I wish to thank my constituency for the strong support that they gave me during the recent election. My re-election is something that I am very proud of and I undertake, to my electorate, to continue to represent them all to the best of my ability with pride, enthusiasm and resolve.
I congratulate all new members on their election to our parliament. You are from diverse backgrounds, and if you maintain the zeal of the aspirations reflected in your maiden speeches I expect you will serve our parliament with distinction. Regrettably, you will find that some of these aspirations will be crushed by the decisions of the government, but do not let that deter you.
Like many South Australians I was pleased to hear of the government's commitment, via the address from His Excellency, on the question of mental health. It was pleasing to me to read that there was a commitment. There was clearly an understanding that this was a large area of high need and that there was need for further mental health reform. There was a claim that there had been significant steps already taken to support those in our community with mental health and their families. I dispute that, but, nevertheless, they did claim to have spent $330 million to invest in a new modern mental health system.
Their promise, as outlined in His Excellency's address, was to establish a new independent health commission apparently to better coordinate integrated services critical to South Australians who suffer from mental health, and that they will be given a task to develop the next phase of mental health reform. Secondly, having acknowledged the growing problem in this area the government would:
Expand existing efforts to implement the positive psychology approach that Martin Seligman has introduced to South Australia.
There is no detail of this. I expect that it is a practice of high standard in dealing with psychiatric care which does not require the imprimatur of this parliament or, indeed, the government. I would have thought that if he had some good ideas that that would have been taken up by the people working in mental health and would already have been implemented. However, I will come back to the appointment of a commission in due course.
Unquestionably, the demand for services for those who are suffering poor mental health and support for their families is increasing. Depression alone has been described as the pandemic of the 21st century. Countless reports and spiralling statistics tell us this. One of the most damning, I suggest, is that the number of deaths by suicide in South Australia—representing, of course, a tragic waste of life— now doubles the number of deaths on our roads. Some 200 people a year are recorded as having taking their own lives, and we obviously hope to curb the deaths on our roads, which number about 100 a year.
There would not be a member in this house who has not had a family member, friend, neighbour or constituent who has suffered in this way. Untreated or under-treated, it so often results in harm to persons affected, and many spousal and family relationships are destroyed, children are neglected or abused and even strangers become victims of assault or offence.
Drug and alcohol addiction often features in the comorbidity of those presenting in need. We have heard about the consequences of a failure to provide adequate services in this area. Members, especially new members, will see—as we have, particularly in the time that we have been in the parliament—alarming newspaper reports and coronial reports and inquests and the resulting recommendations from inquests, court judgements, evidence, transcript and endless government reports and reviews, and they all tell the same story and they all plead for the same respite. So the government's commitment is welcome, but is it just another empty promise?
Let us consider what has happened over the last 12 years. Starting in 2002, the Rann government convened a drug summit, which I attended, as did other members of this house. I think it came up with some excellent recommendations. It clearly understood that it had a relationship with a number of people requiring mental health services. It appointed Monsignor David Cappo, a senior member of the Catholic Church, and commissioned him to prepare an audit of the demand for services that were current in mental health and to set out a plan, culminating in what has been described as the Stepping Up report. That confirmed the demand for multiple services and the need for an extension of care services, including in the community, and in particular that that be offered to help address the increasing demand.
The government announced that it would rebuild a new Glenside Hospital, that it would co-locate drug and alcohol treatment at the new facility, that it would introduce a cultural centre, that, consistent with social inclusion, there would be retail amenities for patients and the public generally. So what happened? I think everyone would agree that those announcements, those initiatives, were a good start, but let us look at what happened. Under the stewardship of successive ministers—minister Stevens, minister Gago, minister Lomax-Smith, minister Hill and minister Snelling—this is what has happened:
1. The government sold off the three drug and alcohol treatment centres in metropolitan Adelaide before adequate replacement services had been installed.
2. They stripped services in the psychiatric wards in The Queen Elizabeth Hospital, the Modbury Hospital and the RAH North Terrace campus, downgrading acute beds to day and short-stay beds.
3. They announced the sale of 40 per cent of the Glenside campus, ostensibly necessary, they claimed, to pay for the new hospital. They did not ask the football community to pay, to sell off their assets to pay for the new stadium, but for mental health patients in this state, they demanded that it was necessary to sell off half their asset to provide for their capital upgrade.
4. They bulldozed two heritage buildings whilst under protest by local government. One was a heritage building under local government and the other by the public generally and the heritage community.
5. They destroyed the oval used by local schools, clubs and patients. The oval provided them with an open area of sanctuary, which they covered with mountains of dirt.
6. They tipped out many of the mature-age patients, who had been long-term patients, into facilities at Oakden and, with the fear and frightened response of relatives, out into the community generally before any—not any—of the promised facilities in aged care were in place.
7. They ignored the public outcry at the loss of open space and public amenity and chopped down numerous trees, repeatedly refusing over two years to answer questions in this house about what was going to be happening.
8. They dismissed the local council's concern about the felling of trees, lack of open space, unsafe and unmanageable traffic numbers, and proposed building heights.
9. They sold the central administration building, including the iconic heritage assets, to the Department of the Premier and Cabinet—they picked it up for just over a million, if I recall—and made it into a film hub.
10. They excluded the patients, families and visitors from access to the chapel on the campus and gave them the barren contemplation room. Where was Monsignor Cappo when that happened?
11. They ceased operation of the gardens and many of the programs that provided occupational therapy for patients and clients.
12. They utterly rejected the recommendations of the select committee of this parliament, chaired by the Hon. John Dawkins, recommending inter alia that there be a complete rewriting of the design of the new hospital as it clearly failed, on the evidence that it received, to reach the high world standards that were claimed.
13. They refused the advice of health professionals that the proposed model of care was also flawed against international standards.
14. They ignored the repeated complaints of nurses and health professionals who were concerned about the adverse impact that the development was having on their clients.
15. They threatened to introduce car parking fees to hospital staff and visitors, while the Film Corporation patrons got it for free.
16. They prioritised $40 million to provide new accommodation for the Film Corporation before even starting to build the new hospital—priorities completely out of sync.
17. They hosted the then premier's goodbye party at a cost of tens of thousands of dollars, while mental health services were crying out desperately for funds.
18. They kept patients on the campus during construction. Why was it so bad to interfere with the sanctuary of those who were receiving services? Members might recall and new members might appreciate that the government rejected a rebuild of the Royal Adelaide Hospital partly on the grounds that it would cause distress to patients and disruption to staff. It was not good enough for those patients to put up with that, but mental health patients—who gives a toss about them? They can have a construction site going on for years next door to them.
19. They wasted the funds in progressing a preferential deal with a neighbouring landowner, which later fell over.
20. They placed patients and staff at risk when they built the new hospital without a sprinkler system. Many members will not realise that we have already had a fire in the brand new hospital, where a patient lit a fire which caught light to the mattress, and they discovered that there was no sprinkler system to protect them. It is concerning that those patients were then evacuated. They have been put into another area on the Glenside campus site while they retrofit the sprinkler system. I do not know how much that is going to cost, but I refer today to the cost and risk to human life as a result of the incompetence of this government.
Far from the beautiful world-class haven for the recovery of the mentally ill as displayed in the brochures, the plans and the publicity surrounding the announcement of this facility, what we have ended up with is a hospital crammed into the corner of the Glenside site, empty buildings left derelict on the property and an oval that is now covered in weeds. It is an absolute disgrace!
We have heard the reports, many of which have been published. After 12 years, we now have a situation where we have only 220 acute mental health beds in this state. That is a disgrace, and I refer to the Public Advocate's report to confirm that.
Mentally ill South Australians have been cruelly abandoned by this government. The condition which nurses and health professionals have to work in are an insult to the dedication of these professionals. Promises have been made with reform under the new Mental Health Act. We have had the appointment, under the Mental Health Act, of a new chief psychiatrist from New Zealand, whom I have met—she did not last long. I do not know where she is now.
We have had the government ultimately accepting, under protest, the Community Visitors program, which is to be a voice for patients and clients. We have had the Stepping Up report, a plan for mental health services, published by Monsignor Cappo. It was to cover mental health services from 2006 to 2012. Now we have had an announcement that the government is going to have a new commission to start looking at the next lot of the agenda. What has happened to the last two years?
We have had the Ernst & Young review, commissioned by the current Minister for Health, a review to stepped system care that was supposed to have been implemented by this government. Every year, we have had the Public Advocate highlighting the plight of vulnerable people, including those with mental health issues. It is one of the most disturbing reports to read in this parliament every year. I wonder whether these successive ministers even read it, because it seems they do not seem to care about what is important.
They certainly have announced more reviews, but clearly the public do not want more appointments or more bureaucrats; they want action. Unless we address the services of the inadequate 24-hour supported care services as part of the Step Up program, we will continue to have excessive demand on our acute beds. If the government is serious in this area, it will:
1. Announce that it will not further sell off the Glenside site and ensure that it is kept for the clearly growing demand, which the government acknowledges, for health services, including independent accommodation to assist those who move from acute care or, hopefully, do not get to acute care.
2. Extend the supported accommodation in the community and make available areas on the Glenside site.
3. Maintain acute services and accept that they are an important tool in the recovery of those in highest need.
4. Ensure any replacement is operating before the existing service is cut. That is critical, and it is only humane, in my view, to ensure that that occurs.
There are other areas that are in need of attention, which have been highlighted over a sustained period by the Public Advocate and others. One is that we provide mental health services to people in prison.
Some members have not been down to the Women's Prison, Yatala and to other areas of high security, and I urge those members to do so. There are people in there who have committed crimes, and they need to be rehabilitated because we need to appreciate that one day they will be released and that they are going to live in a street next to any one of us and that they need help. If they are in the Women's Prison because they have killed a child—often their own child—or their husband, they need help and assistance to be able to deal with the fact that they are separated from family and that they will be incarcerated, usually for a long time. We need to ensure that that help and assistance is there. There seems to be little charter or care for those who are in that category.
Let me highlight an even worse example of neglect by this government, and that is the practice of placing forensic mental health patients in prisons and not in hospitals. For members who are not familiar with the term, forensic mental health patients comprise those who have been found mentally incompetent to commit an offence or mentally unfit to stand trial. Pursuant to our law, a declaration is made to that effect and we treat them in another manner, as we should. Often, that requires that they are to be at James Nash House as part of their future treatment, custody or supervision, which is a dedicated forensic facility—but it is full, and it has been full for all the time that I have been in the parliament. There is a waiting list that varies from time to time between 20 and 30 persons who are waiting to get into this facility. These people are mentally unfit and they need help, and what happens to them in South Australia is shameful. What happens in South Australia is that they are placed in prison.
Why is it that other states are able to ensure that if they do not have adequate room in the dedicated forensic patient facilities like James Nash House, they are held in a hospital? That is what they do in other states. In this state, the minister has power to not only set the determinations for persons who are declared in this category, but also has the capacity to order that they be held in a prison. That is exactly what is happening in South Australia.
Why is this a problem? This is a problem because if you are in a prison and not in a hospital, you do not have nursing care. What does that mean? It means that you do not have trained people to look after you. So, we have reports, such as last year's Public Advocate report, which tells us—not that we need to be told, because we see it on the front page of the newspaper more often than not—that we find mentally ill forensic patients are held secure in their cells for up to 22 hours a day. We find stories of them being strapped to a barouche in a corridor, sometimes waiting for an admission in a hospital. That is what is being scandalously neglected by this government.
Unless the government are prepared to build a new facility—again, when they first got in, they said, 'Yes, good idea; we are going to build a new prison, we are going to build an extra facility for forensic mental health at Murray Bridge.' Well, that lasted five minutes; they cancelled it in the next budget, and we still do not have these services. But, in the meantime, at the very least provide humane services to ensure that they are treated with some dignity. They do it in other states and they should be able to do it here. It is no excuse; it is a deplorable neglect of those in need.
If the maturity of a civilised society is judged by the way we care for the most sick and vulnerable in our state, then this government needs to grow up very, very fast. I accept that there is competition for those in need and those that are vulnerable: the disabled, the disadvantaged, unemployed, homeless; it is a long list, and we do have a responsibility for them.
Let me remind members that in the 19th century, when we established this colony, the main treatment for the mentally ill was asylum, and if necessary, placement under restraint. The way we dealt with the unsociable behaviour of people with a mental illness, sometimes associated with drunkenness, was to hold them in the Adelaide Gaol. Temporary asylum was established first at Parkside and then on North Terrace in the Botanic Gardens—there are a few ruins there still today; I mention it because it is History Month—and by 1870 the hospital, now known as the Glenside Campus of the Royal Adelaide Hospital, was opened.
By the early 20th century, over 1,000 patients were accommodated in this service. Certainly, it included a broader spectrum of the destitute and disabled, and the campus was much larger. In fact, they had a dairy herd, they had a silkworm industry, and they had gardens; now, of course, they are squashed into a corner. It seems that advances in psychiatric treatment in South Australia are back where we started. Our mentally ill are in prisons. It is a shameful indictment on this government, and I only hope that I am wrong in being sceptical that the promise of the appointment of a bureaucrat is going to solve this problem in the Governor's address.