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Another Triumph of Ideology over Common Sense

Release Richmond Fellowship

The head of a major mental health provider says mental health services are extremely vulnerable from constant changes in health purchasing structure.

Speaking at the National Health Care Summit, Dr Gerry Walmisley of the Richmond Fellowship said health care providers had seen eight different funding structures since 1985 and the whole sector was now punch-drunk with change. The Government proposes to reverse the funder-provider split and form up to 22 District Health Boards, each with a hospital committee and a primary health committee. The Minister of Health, Annette King, has already acknowledged that some services, such as mental health, could become sidelined.

"The HFA had its faults and I used to be one of its harshest critics. But in recent years, as the HFA developed expertise in purchasing, it accumulated a detailed knowledge of mental health and encouraged many new and innovative services. Mental health strategies were being developed at a nationa l level, and that developed into a world-leading approach to community mental health care.

"As a result, the non-government sector in New Zealand now receives about 30% of the mental health budget, compared with only 2.2% in Australia. The work of the HFA has contributed to great progress being made in community-based mental health services, but now there’s a real danger that expertis e will be lost."

"The new model will tend to favour hospital services and unless there are proper guidelines to protect mental health funding there is a strong possibility that these services will once again become health care’s poor cousin. While there are many hospital managers who support the role of the non-g overnment sector, it is inevitable there will be some who will actively discourage NGOs from being able to provide high level services."

Dr Walmisley said the constant reforms from successive governments were a triumph of ideology over common sense. Health services, and particularly mental health services, needed to be planned and implemented in an apolitical way.

He said the Minister must encourage a clear definition of mental health funding and ensure that gains and expertise developed by non-government providers is maintained. "It is to be hoped," says Dr Walmisley, "that whatever system we see implemented will not diminish the real gains of the past in order to serve a political agenda. Changes in the health system must deliver real benefits to people and not be used as a mechanism to assert a different political poin t of view."


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