Budget health spend analysis - ASMS/CTU
A significant tightening in District Health Board mental health funding has been revealed as the Government appears to be shuffling money around mental health.
In a joint working paper analysis of Budget 2019, Council of Trade Unions Economist Bill Rosenberg and Association of Salaried Medical Specialists Director of Policy and Research Lyndon Keene estimate, in real terms, a $55 million shortfall in DHBs’ mental health funding that is ring-fenced for those with severe needs.
“The high threshold to be eligible for these specialist mental health services is already denying access to too many people who need urgent care,” says Mr Keene.
“As the Mental Health Inquiry report says: ‘A consistent theme in submissions was having to fight for access to mental health care due to high thresholds of acuity, limited and non-existent services, or complex care requirements beyond current service provision. We heard that some people presenting with a high risk of suicide were deemed ineligible for help and were unable to find timely, responsive service…’.
“The funding cut will most likely make access even more difficult,” says Mr Keene. “The Government appears to be relying on significantly improved prevention from the additional $73 million it is putting into ‘National Mental Health Services’, mostly for primary care, managed by the Ministry of Health. But we estimate this is nearly $8 million short of what is needed and is unlikely to have an impact on reducing the need for specialist services in the short term.”
Problems accessing mental health treatment are exacerbated by shortages in the psychiatrist workforce and high levels of burnout, says Mr Keene.
Hamilton psychiatrist Dr Annette van Zeist-Jongman speaks about her hopes for change in a short video produced by ASMS, one of several being released in coming months to highlight issues of concern to New Zealand’s senior medical workforce. The video can be viewed at https://www.youtube.com/watch?v=1mtY-6rikk0&feature=youtu.be.
Dr van Zeist-Jongman hopes the Government’s priority will be to build a strong workforce, in hospitals as well as the community, to improve patient safety and outcomes.
“If the promised 1600 new mental health workers will really one day be trained and working in primary care, we could prevent some people’s mental illness becoming so serious that they need hospital admission,” she says.
“This, however, will take time to develop and be effective. In the meantime, our mental health wards are bursting at the seams with far more beds filled than we are paid for. We all know that our buildings are not suited any more for the current time or level of occupancy, but even more important is our lack of staff.”
Dr van Zeist-Jongman says good leadership in mental health will be key to ensuring the funding is used effectively.
ASMS Executive Director Ian Powell says it is heartening to see hospital specialists speak about the challenges facing the public health service.
“Our public hospitals are still grappling with the consequences of years of under-investment in facilities, services and the health workforce. Mental health is an example of a vital health service in need of a lot more attention and resourcing. There’s a real chance for the Government to improve the lives of some of the most vulnerable people in New Zealand, and we need the people holding the purse strings to step up.”