2016-02-16
Senator RICE: You mentioned in your answers to questions from Senator Gallagher that there were two programs that were going to have their funding continued for three years. Partners in Recovery was one. What was the other one?
Ms Cole: Day to Day Living.
Senator RICE: The streamlining savings for Partners in Recovery, the $141 million, was largely coming from Partners in Recovery, was it not?
Mr Cormack: That was a big part of the savings.
Senator RICE: I think you said that there was $33 million for the perinatal initiative, so it was about $108 million if those two programs—
Mr Cormack: As I said, that was a very big component of the savings. That is right.
Senator RICE: How is that consistent then with the continuation of Partners in Recovery for the three years?
Mr Cormack: There has been no budget measure that has reduced the funding available to that program as it now stands. This was future growth money that was not deployed to services.
Senator RICE: So it was there in the budget? Were you basically going to go to continue Partners in Recovery at its existing levels, but without that growth money for three years?
Mr Cormack: That is where the savings were identified through future growth that had not been committed.
Senator RICE: But it was budgeted for?
Mr Cormack: That is exactly right.
Senator RICE: So essentially are you saying Partners in Recovery will have ongoing funding at its current levels rather than growth?
Mr Cormack: That is correct.
Senator RICE: I understand the evidence suggests Partners in Recovery is highly effective for individuals and families dealing with severe and persistent mental illness, yet approximately 20 per cent of Australians do not have access to it. Are there plans to extend its availability to all Australians, whether it is within this three years or beyond?
Mr Cormack: This is on the pathway to transition into the NDIS. The policy responsibility for that rests with DSS, not with Health.
Senator RICE: But a majority of the people currently accessing Partners in Recovery will not be eligible and will not fit into the NDIS basket because they do not have permanent and severe disability.
Ms Cole: I am not actually sure about that. At the moment, some of the trials suggest that there is actually quite a high rate of eligibility for Partners in Recovery. It is a lower rate for Day to Day Living. Until we have a clearer assessment process of the clients as each region rolls in, we are not really able to say one way or another what kind of flow-in to the NDIS there will be from Partners in Recovery.
Senator RICE: I understand that many of the people who access the Partners in Recovery program are episodic rather than being permanent. Hence, we do not really want them to be included in the NDIS because they do not want to be assessed as having a permanent disability. The nub of the question is: is there going to be a big cohort of people who do not have a permanent disability? It may be severe and episodic but they will not be eligible for NDIS, but the Partners in Recovery program is currently meeting their needs, and certainly there is a desirability to see it continued.
Ms Cole: As I mentioned to Senator Gallagher earlier, the three-year period basically allows us to capture how many of those clients are likely to move in and what the scale is of people left, essentially. A policy decision then has to be made about how they are dealt with. There is an overall commitment around ensuring that people do not lose services through the transition period to the NDIS. Whether they are eligible or not eligible is really a question for DSS. There is that overall commitment.
Senator RICE: Will you be sharing that analysis and your criteria of who would be eligible, who would not be and what will happen to them over that three-year period?
Ms Cole: I think the criteria about who is in and who is out are a question for DSS in terms of what they make available. I certainly do not imagine that we as a department would have much of a problem of indicating what level of clients are moving in or out.
Senator RICE: The government's response to the commission's review stated that there would be a new approach to suicide prevention. I am interested to know what exactly that means.
Mr Cormack: The approach to suicide prevention recognises that currently it is a recently fragmented array of programs and approaches at a national level, at a state level and at a regional level. The approach that we are taking here is a much more assistance based, regional approach to suicide prevention that will be very much led by the PHNs. This really looks at implementing multiple strategies that target suicide risks, both through medical and social intervention, because the fact is that influenced risk of suicide in one geographical area may be completely different to another. The essence of this is to recognise it is not one size fits all and also to recognise that what is important in dealing with this very challenging problem is that it is collaborative work across the primary health care sector, the education system, emergency services, community organisations, non-government providers and other stakeholders. The mix will vary from one region to another. It is a systems based approach. It does not say that there is only one way to deal with it. We think that this sort of approach can be better sorted through much more structured partnership arrangements at the PHN level with all of the providers that I have outlined.
Senator RICE: Are there particular programs that you see will be changed within those broad parameters that you have just outlined?
Mr Cormack: I think there is certainly an opportunity to have a look at the range of different programs in the system. In many ways that is the purpose for creating greater flexibility at a regional level. It is to recognise that there are some really great programs for which if a PHN has some flexibility they might be able to strengthen and invest more in. If there are others that maybe historically based, they may have been good at a point in time but are not part of a broader systems based approach, then there is an opportunity to revisit those. We are trying to build that facility.
Senator RICE: Are there any programs that you have identified that you do not think would be changed? Are they all up for assessment?
Mr Cormack: We have basically got a range of programs in place, such as the community prevention for high-risk groups element of the TATS program, the Taking Action to Tackle Suicide program. There is a whole range of programs in there that we think form the basis for a much more regionally determined approach. We would certainly encourage the partnerships that will be led and forged by PHNs to focus on that regional approach, but also complemented by a range of other national programs which are already established and have a broader national appeal and are not regional specific. It is a combination of the two.
Senator RICE: In terms of those national suicide prevention projects, how are they going to interact with this change at a regional level? In particular, how will continuity of service be ensured for the national projects that are due to end on 30 June this year?
Ms Cole: There will be an ATM for those national projects.
Senator RICE: Sorry, what will there be?
Ms Cole: There will be an approach to market for those national projects.
Senator RICE: When will that be out?
Ms Cole: We think that will be around late March, most likely. The goal is to revisit the most effective way to do the kinds of work that those organisations are already doing and give them an opportunity to refocus. Many of them have had the same sort of funding agreement for a long period, and this gives them some scope to change where they need to.
Senator RICE: Do you see that happening to ensure continuity of service from 1 July?
Ms Cole: Yes. For example, the kinds of programs that will still continue to be funded at a national level will be things like Lifeline or a Lifeline-like service—things like R U OK? and those sorts of things. There may be some amalgamation or there may be some partnerships developing where it makes it a bit more effective. For example, we have a Mates In Construction program at the moment that is funded and they have indicated an interest in expanding their work into other professions that have a high correlation with suicide. It is providing that opportunity.
Senator RICE: It seems like a pretty tight time line if you are not getting your approach to market out until the end of March and you have got projects that are going to be finishing, that are only funded until 30 June, to then have the replacement projects beginning from 1 July.
Ms Cole: It does put pressure on us to assess those applications quickly, but the affected organisations have known since December and they are already working on what they wish to put forward in that arrangement.
Senator RICE: Another project that I understand has not got funding beyond June is the Mental Health in Multicultural Australia. Am I correct that it is going to be discontinued from June?
Ms Cole: That one is currently under review and is being managed by the Mental Health Alliance. I think it is more an issue around changing some of the structures of that agreement more than anything else. There is a review underway at the moment and then it will be a decision for government.
Senator RICE: Its funding is due to end on 30 June, so is there no certainty of funding until after the review?
Ms Cole: Yes.
Senator RICE: Is this the KPMG review?
Ms Cole: Mental Health Australia is running that review rather than KPMG. Are we talking about the same organisation?
Senator RICE: I am told there is a KPMG review that has not been released.
Ms Cole: Can I take that on notice to confirm? That is not our understanding.
Senator RICE: Okay. So there is a Mental Health Australia review. When is that due?
Ms Cole: It is due to the department in March.
Senator RICE: So again the review is due in March and they have to sit there not knowing whether they have a future yet. They might be winding up with very short notice.
Mr Cormack: I think we are getting the theme here. I think the point is that we fund a very large number of services and programs across the country in mental health and in other areas as well. They all go through cycles of renewal. Some of them have organisational problems that need to be addressed and focused on and when we come at varying times in the cycle, whether it is coming up to an approach to market or if there are specific issues with a program that need to be addressed, we do need to take advice, review and make sure that we do not just lock in programs that are not meeting the needs for the future and that are not in line with—
Senator RICE: They are very short time lines for people who are employed in these services, which is rather unfair on them. The loss of staff that occurs if the program does continue because people with that uncertainty decide that they just cannot afford to take that risk that they are not going to have a job.
Mr Cormack: We certainly recognise that risk. We do understand the impact of uncertainty. That is why we try to progress these necessary processes of accountability for public funds as quickly as we possibly can.
Senator RICE: Finally, I have a question broader than mental health. It is about the minimum datasets reportable to the Commonwealth by the states. My understanding is that country of birth, language spoken at home or ethnicity are not part of these minimum standards, which of course makes it extremely difficult to get any data nationally about populations and subpopulations. I just wanted to clarify if that was the case.
Mr Cormack: We might be in a different area there.
Mr Bowles: Yes, we are in a different space now.
Senator RICE: I was told that it was going to be fine to ask this question here. Could you maybe take it on notice?
Mr Bowles: Yes, we can take it on notice.
Senator RICE: Also, whether the department has looked into adding to these standards, because we need to have that data to be able to make appropriate policy decisions for different communities.
Mr Bowles: We can take that issue on notice.
Senator RICE: Thank you.