Mental Health Commission Amendment Bill

It is a pleasure to rise to speak to the Mental Health Commission Amendment Bill this evening. When we adjourned on Thursday, I was in the middle of talking about a recent experience of attending the opening of Waiatarau, which is the new acute mental health unit of the Waitemata District Health Board. It was a wonderful experience. I was very familiar with the conditions in which people worked and patients were treated in the former acute unit, in my previous occupation. It was interesting to see a brand new acute unit established by the Waitemata District Health Board to accommodate those people who, from time to time, require residential acute facilities.

During the course of the hearing of submissions, and also in the course of the health estimates this year, it became apparent that a great deal has happened over the last few years in respect of the provision of mental health services. On questioning, it became apparent that there are twice as many psychiatrists now than there were 10 years ago—a fact mentioned in the Health Committee’s report. There has been a huge improvement in the services provided.

One of the significant things that I learnt at the opening of the Waiatarau centre was in response to my question about staff retention. Sometimes there has been difficulty in applying all the mental health blueprint money to mental health services because of a lack of staff. I was delighted to be informed by the Waitemata District Health Board that—in large measure because of the Public Service Association’s multi-employer collective agreement that was reached in the last year or two—the board has the lowest turnover rate of mental health nursing staff in years. People are getting jobs, staying there, and enjoying them, because the pay rates are better and much more satisfactory. But, more than that, the direction of mental health services provision is becoming increasingly satisfying for those mental health professionals who are committed to their work.

I want to talk about a couple of things in particular. First of all, I want to talk about a couple of the Mental Health Commission’s new functions. The first new function of the commission, as outlined in the amendment bill, is service-user and family advocacy. The commission has articulated the voice of service users particularly well since its inception in 1996. The service-user advocacy role that the commission has taken on is not a function of the commission under the current Mental Health Commission Act. Submitters to the policy consultation process expressed very strong support for this role, and some felt that the commission represented service users of mental health services in a way that had not occurred before the commission was established. The bill before us tonight now makes this role transparent.

Some submitters to the policy consultation process expressed concerns that, in the commission’s advocacy for service users, the voice of the families and whānau of mental health service users had been lost. There was a sense of alienation in some of the submissions—not only those to the ministry, I believe, but also those to the Health Committee—of those representing the families and whānau of mental health service users in the policy consultation process and, as noted in our report, in submissions to the committee. I am pleased to say that I believe that the bill addresses that problem by extending the commission’s advocacy role to the families and whānau of mental health service users. The commission will be able to identify and articulate the needs and aspirations of mental health service users and their whānau. This will often be a difficult balancing act, as not all interests will align smoothly. However, it is vital to the future cohesion of the sector that the commission works to promote a balanced view of the issues facing the sector. In carrying out its advocacy roles, the commission will work at a systemic level; that is, it will identify and articulate the needs and aspirations of mental health service users as a whole, and of their whānau as a whole.

The second new role of the commission is to foster collaboration and dialogue in the mental health sector. Much of the commission’s work over the last decade has been well-received. For example, the commission’s work on the recovery model of care and the blueprint for mental health services come to mind as being highly significant in the development of the sector. However, submissions to the Health Committee indicated that not all stakeholders believe that the commission engaged with them appropriately. We believe that an inclusive approach to mental health is very important and will be particularly so in the future. Te Kōkiri emphasises this inclusive approach. The collaboration of district health boards, providers, whānau, caregivers, non-governmental organisations, and clinicians will be critical in achieving the Government’s broader objectives in mental health. The commission can play an important role in supporting collaboration by engaging with stakeholders and facilitating dialogue over issues facing mental health. Although an important focus of the commission will be to identify the needs and aspirations of users and their families, it is important that the commission engage collaboratively with all relevant interest groups, and endeavour to reflect a broad range of perspectives in their work. This includes those engaged in the planning and delivery of mental health services and those engaged in the research community.

There is a lot that can be said about this bill. One of the things that I want to touch on briefly as well is that in this bill the Mental Health Commission retains its role of addressing the stigma associated with mental illness. I think this House needs to commend the Mental Health Commission for its consistent work through public advertising in reversing people’s attitudes towards mental illness. I commend all of those famous New Zealanders who have allowed themselves to be used in the process of de-stigmatising mental illness, and I congratulate them and the Mental Health Commission on that work.

Finally, I say two things. Firstly, there was an announcement earlier this year of a funding boost of $21 million over the next 4 years for mental health primary care, and this is critically important. It is really essential that there are more developments that support people’s mental health in primary health care settings. Secondly, I pay tribute to another change to the Mental Health Commission, and that is the appointment of a new commissioner, Ray Watson, who is here in the public gallery tonight. Mr Watson is a former chief executive of the Ngāi Tahu Development Corporation and Lakeland Health. He has an extensive clinical and management background in mental health services, and I wish him all the very best on behalf of the members here for his new role with the Mental Health Commission. Kia ora koutou.

I am pleased to report that the National Party moved an amendment to the Mental Health Commission Amendment Bill at the Health Committee, which I will talk about a bit later on. As our mental health spokesperson, Dr Jonathan Coleman, has made clear, it is the National Party view that the principal Act should expire 3 years after the bill receives the Royal assent. It is our view that Parliament should reassess the role and performance of the Mental Health Commission before granting a further extension in another 3 years, and we moved an amendment to make that change.

National sees that the Mental Health Commission has a role in monitoring and improving New Zealanders’ mental health system, and we think that mental illness has a significant impact on the lives of many New Zealanders. The burden is in fact growing, not decreasing. According to the New Zealand Mental Health Survey released in September, nearly half of New Zealanders will meet the criteria for having a mental illness at some time during their lives. One in five New Zealanders experienced a mental illness in the previous year, and that does not take into account the small portion of the population that suffers from mental illnesses with psychotic features. The survey also found that 16 percent of New Zealanders had thought seriously about suicide, about 5 percent had made a suicide plan, and a further 4 percent had attempted suicide. These are serious statistics indeed, and they are worthy of the consideration of the House, as they make us realise how important it is that the nearly $1 billion a year now being spent on mental health should in fact be delivering measurable improvements in the mental health of the nation. In fact, unfortunately, many mental health statistics seem to be deteriorating despite the substantial increase in additional funding.

One area in particular to look at is the hospitalisations for attempted suicides. They have actually gone up by almost 20 percent in the last 8 years. If one looks at the hospitalisation rate for suicide attempts by young women since 1999, one sees that they have risen by 45 percent. These suicide-attempt statistics represent the measurable outcome of spending on mental health, and by those criteria I think many people would say that spending—that investment by the Government—is failing to make the impact it should have.

During the select committee process we heard from many submitters who were dissatisfied with the way the public investment in mental health is being spent. A number who came forward criticised the rather large amounts of unspent blueprint money in many parts of the mental health service—money that should be providing much-needed services. I know that in my own constituency, on Sunday, I received a rather desperate call from a man who had obviously come to the realisation that he was alcoholic. He was in desperate need of getting in touch with addiction support services, and had real trouble doing that on the weekend. I was somewhat despairing of him over the remaining 18 hours, before I could get my office to get on the phone to arrange some support from, for example, the Hanmer Clinic. That identifies a need for services to be able to respond quickly when people with addiction issues identify themselves as being in need of care. Unfortunately, in that case I am not sure that the Bay of Plenty services were as swift as one would like them to be.

It also became clear in our discussions with submitters to the select committee that primary care could be doing much more to provide mental health services for New Zealanders. In fact, earlier this week I met with people from a Mount Maunganui general practice to talk about the mental health care services they provide. It is one of the few general practices in the country to be quite upfront about being keen to be involved in mental health services. I make that point because a recent Commonwealth Fund report on primary care in seven OECD countries surveyed the views of primary care doctors. It asked them a number of questions, and very interesting results came out. For example, New Zealand general practitioners report that their patients wait longer for surgery and emergency care than the patients of any other group of doctors in the survey. There was a very good question on mental health that showed that when it came to the ability to care for patients with mental health problems, less than half of New Zealand practices said that they felt they were prepared. That was one of the lowest ratings. What that indicates is that, even though there is extra spending of a billion dollars on the mental health service, we are not getting the gains in the quality of the service provided by primary care that we should be getting.

General practices need support to operate effectively in providing mental health services. We hope the Mental Health Commission will be pushing the Government and general practice to play a major role in the monitoring and support of patients with mental illness. People in general practice are able to provide faster, more convenient health care for New Zealanders, and we think there could be significant gains if primary care were to realise the vision of the Primary Health Care Strategy and play a much greater role in providing mental health support services.

That leads on to one of the most significant pressure points in the entire health sector, and that is workforce development. That is a major issue in mental health. Many of those problems, I think, were witnessed in a number of high-profile cases we have seen recently. For example, enrolled nurses can no longer have a role in this form of care. That is an issue that the health service needs to grapple with. Why have 3,000 or 4,000 people who could be trained to have an active role in providing support in these areas not—

💬 Steve Chadwick: That was never the training of enrolled nurses.

We have some chirping across the road from the outgoing member for Rotorua, but what I do not think she—

💬 Hon Lianne Dalziel: You cancelled the enrolled nurse training.

Oh, National cancelled enrolled nurses! It was Labour that wanted to take that name off them. Under this Government, enrolled nurses have had their scope of practice so limited that there is not even a future for those people. The National Party respects the work of enrolled nurses, and a National Government will bring back enrolled nursing, and we will give those nurses a role in the health service. When New Zealand is so desperate for people to help in our hospital system, for Labour and its cronies to disenfranchise enrolled nurses and give them some sort of Labour Party bureaucratic name such as nurse assistant is, we think, demeaning to the work they are doing. [Interruption] We think that all is not well in the area of mental health, and the members opposite show us that. [Interruption] Oh, it was a bad caucus this morning—it is showing.

We do not believe that the community is getting the returns it should be getting for the extra spending that has gone into mental health. The hospitalisations, the suicide statistics, and the feedback from patients and their families show that most of that money is being wasted. I bet the next member of the Labour Party will stand up and say: “We have put double the amount of money into mental heath.” I bet that is what the member says. Labour measures its success only by how much it spends, and not by the quality of the service or the amount of people getting care. What those members would know if they listened to the submissioners is that families and those most affected do not think they are getting the quality of service they should be getting from our district health boards’ mental health services.

💬 Steve Chadwick: No, we’re building it up.

Oh, the member says the Government is building it up. It has been throwing money at it for 8 years, and suicide statistics have got worse. And those members say they are doing a good job! Actually, it is not the case. They can chirp as much as they like, because in 8, 9, or 10 months’ time, those folks opposite will have no input whatsoever, and the people who are padding their way to our corridors will be working with National members as we improve the quality of mental health services for New Zealand families and patients.

On behalf of New Zealand First I rise to support the second reading of the Mental Health Commission Amendment Bill. One of the purposes of this bill is to amend the Mental Health Commission Act to extend the term of the commission until 2015. It also makes a number of other amendments to the Act, and previous speakers have already outlined those amendments. I must say that in New Zealand First, we are very pleased with the increased amount of dollars invested in mental health. We believe that investment in mental health is critical. We are very aware that there is still a shortage of professionals in the mental health area, especially for children and teenagers, and we were assured when we considered the estimates that the Mental Health Commission and the Ministry of Health are working through this very issue.

In New Zealand First we believe that the concept of a Mental Health Commission is sound, as there does need to be a reporting function to the Minister. Of course, we do need a body to ensure that the national mental health strategy is being implemented, in order to improve mental health services overall and destigmatise mental illness. So we believe that the role is quite a vital one.

In New Zealand First, we believe that, in order to give certainty to the commission members, the role of this body does need to be for far longer than the 3 years that was initially granted to it. It is definitely difficult for the commission to develop a strategy, implement parts of that strategy, and monitor and report on progress with a 3-year deadline looming. In reality that means that for the third year its focus is elsewhere and results can be minimal, due to that little bit of uncertainty. The fact that the term of the commission has now been extended to 2015 means that improved strategy and improved operational results should become apparent fairly quickly. We believe that the commission should report to the Minister regularly, as well as when the Minister requests a report on a specific aspect of mental illness.

We in New Zealand First would have liked to see the issue of addiction emphasised in the commission’s role throughout the bill. We believe that the commission should be obliged to obtain expert advice on addiction issues, to the extent that, perhaps, one commissioner would be primarily responsible for addiction issues. But we were told throughout the select committee process that addiction issues are already implicit in the work of the Mental Health Commission, and that addiction is already recognised as an aspect of mental illness, so there is not really a need to have a separate commissioner for addiction issues.

However, we would have liked to ensure that an addiction advisory group was established to provide some expert advice to the commission. We all know that addiction issues are increasing, and the types of addiction issues that are increasing now are ones we would never have normally identified. We know that drugs is one issue. We know that gambling is one. We know that computer-game addiction is definitely on the increase. More recently, we heard that even telephoning psychics was fast becoming an addiction—women regularly telephone psychics at 99c a minute. So we have a lot of challenges in the addiction area that families have to cope with, and positive steps need to be taken to deal with these challenges.

But I must admit that, throughout the select committee process, we heard some very real concerns from submitters about the Mental Health Commission and its mode of operation, and these do need to be solved in the short term. These problems revolve principally around family members of people with mental illness, who generally express opposition to this bill. We were rather concerned in the select committee when we heard that less-than-positive report from some of the submitters.

Later I was quite astonished when someone rang me personally. This person had been unable to take part in the select committee submission process or even to be involved in the hearings, and she wanted to discuss her opposition to the continuation of the Mental Health Commission in its present form. She said that parents of mental health patients believe that the bill requires a number of very significant amendments if the commission is ever to be successful. She said that many parents believe that the commission is ideologically captured, to the extent that it actually believes that everyone with a mental illness can recover and live successfully in the community or at home with the rest of the family.

Some of the examples that we heard from people during the submission process—and one that I heard personally afterwards—were very sad. The one I heard was very sad, and it was a very real example of mental illness. Quite frankly, one’s heart went out to some of these people. Basically, they could get nowhere with the commission. Their lives were altered totally by one family member having a mental illness, to the extent that some of them were living in real fear for their lives.

The lady who rang me told me that her son, who lived at home, had set the house on fire three times. She said that he could not help himself, that he could not even remember having set the house on fire, and that, basically, her son would never recover from his illness. It could be managed by drugs as long as the drugs were regularly taken, but sometimes, despite her very best efforts, her son absolutely refused to take them. To her, the commission’s statement that recovery from mental illness is possible is totally wrong.

We also heard of the Mental Health Commission stating at public meetings that a person known to the commission had stopped taking their medication and was managing quite well without it. We were told that as a result of this, other people also decided to stop taking their medication without the advice of their doctor, and generally wreaked havoc in the community and—again—at home. Some of these people have been picked up and charged by the police, and some of them, consequently, go to prison because of the trouble they create. Unfortunately, prison is one of the few places in which they feel secure. Their medication is given to them very regularly and they cannot really refuse to take it. These people cannot live in the community and need the strict regime of an institution. In this case it is prison. It is sad that prison actually provides a secure environment for these mentally ill people. That is not really what prison is all about.

So there does appear to be a need to have a provision for long-term care that protects patients, families, and the police. We all know there have been very tragic examples of this need for protection; for instance, the Mark Burton case in Queenstown, where mental illness was involved.

We believe that there are some challenges ahead for the Mental Health Commission. Now, with this bill, it will have time to assess its mode of operation and practices and to put them right. New Zealand First definitely has some concerns after hearing the submissions, and we look forward to the commission rectifying those concerns. In 2015 we believe that Parliament needs to reassess the role and the performance of the commission before any further extensions can be granted.

Perhaps the commission needs to involve a parent representative—someone who has the responsibility of looking after a person with mental illness; someone who understands the stresses and strains of parents coping at home. The rights of the family need to be considered. If the Mental Health Commission is to assist parents and be on the same track as parents, which we would like to see, then that does need to be considered.

We believe that the credibility of the Mental Health Commission is absolutely paramount. Perhaps someone like John Kirwan, who has done an outstanding job in bringing to depression the understanding that it needs, does need to have an active role in the commission. But, whatever it does, the commission cannot afford to isolate parent groups, as it appears to have done. Some very constructive work is needed so that parents and the Mental Health Commission are at least working together for the future of mental health patients. The commission cannot afford to work in isolation and go off on a totally different tangent.

In New Zealand First, we look forward to this challenge being resolved. As I said, New Zealand First supports this bill, and we look forward to improved feedback in 2015 on this very important commission.

The Green Party strongly supports the Mental Health Commission Amendment Bill and the extension of the term of the Mental Health Commission until 2015. Overall, we have been very impressed by the Mental Health Commission and its functioning. We strongly support the idea of having an independent body that has a key role in monitoring the implementation of the national mental health strategy, the so-called blueprint; that has a role in working to reduce the stigma associated with mental health; and that has a strong monitoring role generally. We think that the model of an independent Mental Health Commission is an excellent one, and we strongly support its extension to other areas; we think it provides something of a role model.

Certainly, there were submitters who expressed concerns about certain aspects of the commission’s work, in particular the unspent blueprint money—basically, the underspending on mental health in some district health boards—and also, as the previous speaker has said, there were some family members concerned that the commission did not sufficiently represent family members but, rather, advocated principally for people with mental illness. But, overall, there was strong support for the commission. This support was echoed very widely, and, I think, will be found in this House, because the commission does have an extremely important advocacy role for people with mental illness. Our success in dealing with mental illness in New Zealand would be undermined if we did not have the Mental Health Commission.

As other speakers have said, mental health is a huge problem in our community. Mental illness is the cause of a huge amount of suffering. It is a very painful issue, it is draining our human resources, and it is very traumatic for families with members who experience illness. The fact that one in five New Zealanders has mental illness is a shocking statistic, and one would have to ask what is going wrong in New Zealand that causes so many of us to have mental health problems. It is all very well for National to say that the Government has thrown all this extra money at mental health but mental illness and suicide rates have not declined over the last year, or whatever; the truth is that many of the underlying issues in our society produce mental illness, including poverty, powerlessness, hopelessness, the widening gap between rich and poor, dysfunctional families, abuse, and poor nutrition. The factors that cause mental illness are very deep-seated and are exacerbated by, in particular, the growing gap between rich and poor in New Zealand and the feelings of helplessness and hopelessness that many in our community suffer from.

Those sorts of underlying causes will not be resolved simply by throwing a bit of money at the problem. We will not find that in 6 months’ time mental illness in New Zealand has suddenly declined by 10 percent, or whatever, because the causes are often very long-term, underlying issues. If someone is suffering from abuse, for example, it is not easy to suddenly resolve the mental health issues that result from that abuse. We need to focus on enabling people who have mental health issues to get the best possible assistance and support that they can. Clearly, there is a lack of adequate counselling in New Zealand. One issue that we have concern about is that there is a tendency to look very much for what we might call psychiatric solutions—giving pills to people to manage their illness, rather than being able to offer the underlying counselling that is needed and that can actually help individuals to deal with and, in some cases, recover from mental illness.

One of the concerns expressed by submitters was that the monitoring role of the Mental Health Commission could be undermined by a provision that the commission would monitor at intervals agreed to by the Minister of the Health and the commission. Select committee members were assured that this was not the intention of those drafting this bill, but we added in a new clause that said that the Mental Health Commission could report from time to time whenever it saw fit to do so. In our view, that certainly gets round those concerns that were expressed, and we look forward to the Mental Health Commission being able to report whenever it wishes on any matter relevant to mental illness.

Like others, the Green Party thinks the commission has done wonderful work in reducing the stigma associated with mental illness. The recent television advertising campaign has been an incredible success—it has won awards and so forth—and is having a significant effect on changing attitudes towards mental illness. This is yet another example of the success of the Mental Health Commission. The commission is being given certain additional functions—to act as an advocate not only for people with mental illness but for their families generally—and those additional functions should take care of some of the other concerns that were expressed by submitters. The commission is also being asked to facilitate collaboration and communication about mental health issues amongst stakeholders.

So we think that the very valuable work of the Mental Health Commission will be strengthened by this bill. We are delighted that its independence will be preserved, we are delighted that it will have its remit extended until 2015, and we are very pleased that it will have this independent monitoring role and can report to the Minister whenever it thinks there is a concern that needs to be addressed. We are pleased that the commission can undertake research on any matter relevant to mental illness, and that it will be able to continue to advocate, as it has done, for the interests of people with mental health issues.

The Green Party is very, very pleased to support this bill. We are quite confident that the extension until 2015 will be supported by the House, and that there will not be support for the National amendment to simply extend the commission’s term for a couple of years. That would be very unsatisfactory and would not be recognition of the incredibly valuable work that the Mental Health Commission carries out. Thank you.

Hoi anō hei tīmatangia i taku kōrero me mihi mātou o Te Pāti Māori ki te matua a Denis Simpson mō tōna māia, whakaaro nui, tohutohu hoki ki te Komihana Oranga Hinengaro. He kaumātua o te Komihana, he rangatira anō hoki o Ngāti Awa, o Ngāi Taiwhakaaea.

He pukumahi a Denis mai i te tīmatanga o te Komihana i te tau 1996. Ko tāna he huaki kuaha ki te ao Māori, ki te ao Pākehā nā tōna tautoko, whakapono hoki. Ka noho tonu tana wairua ki roto i te kaha o te Komihana Oranga Hinengaro me te kaupapa mahi nāna i waihanga.

Kotahi te kupu whakahirahira mō tēnei Pire, mā tēnei kupu kotahi e mōhiotia ai ka taka pēhea te pōti o Te Pāti Māori i ngā kauhau ka whai ake. He kupu e kore e kitea e tēnei Kāwanatanga, he kupu me ōna āhuatanga katoa hei hīrau i tēnei Kāwanatanga. He kupu ko tāna tohu ko te kāpō o te Kāwanatanga ki te kite i te whakaaro hōu me te tirohanga rere kē. Nā, i runga i ngā whakapāho atu i ōku nei kupu i ngā rā tata nei, i whakaaro au kia huri ki te pukapuka kupu a Oxford i mua noa atu o taku whakaputa kupu i tēnei wā.

Ko tētahi o ngā whakamārama i tēnei kupu e pēnei ana, “he ngārara paruru nō te ao tawhito, he roa te kakī, he tinana poto. E ai ki ngā kōrero, ko tāna he whakatūpato kei te haere mai te kumi ihuroa”. Tērā pea, he kupu ake hei kōrerotanga i a tātau e wānanga ana i tēnei pire. Kia titiro tonu i ngā wā katoa, kia whakatūpato, kia āta tirohia. Ko taua kupu motuhake, ko “tirotiro”.

Ko te tino kaupapa o tēnei Pire he aukati, he whakakapi i ngā mahi tirotiro a te Komihana. Ko te mahi a te Komihana Oranga Hinengaro i tēnei wā, he tirotiro i te pai, i te kuare rānei o ngā mahi kua tukua e Te Manatū Hauora mō ngā tūroro wairangi. Ko te āhua o te kaupapa whakapūmau, he kaupapa whakahirahira mō te mana tuku iho mō te tangata, he pou tokomanawa mō te mana motuhake o te Komihana, ā , he pou reo kōrero hoki mo ngā tūroro me wā rātau whānau. He aha hoki tā tēnei kāwanatanga e mataku ana ki te tirohanga a wētahi ki āna mahi, ā, nā tērā ka waimehatia e rātau te mana o Te Puni Kōkiri ki te tirotiro, nā, kua huri rātau ki te whakawaimeha i ngā mahi tirotiro a te Komihana Oranga Hinengaro. He aha rātau i tino mataku ai ki ngā kumi ihuroa e haere mai ana ki te uhi i te rāngai kāwanatanga.

Nā te wāhanga 5 o te Ture a Te Puni Kōkiri o te tau 1991 i tino whakamārama nā tēnei ture i whakatakoto mā Te Puni Kōkiri e toro ki wētahi atu Tari te āhua kia tuku wā rātau kaupapa ki te Māori, kia mōhiotia ngā painga ka riro i aua ratonga mahi. Nā, i te 16 o ngā rā o Maehe i tērā tau, kāre i taea e te tumuaki o Te Puni Kōkiri te whakamārama atu, he aha ai i kitea he moumou tāima noa iho ngā mahi tirotiro i wētahi atu tari, ā, he aha i kāhore wā rātau māhi i whakaritea i raro i te ture. Ā, anei tēnei pire hōu. He tohutohu nā te Minita o te Manatū Hauora kia kaupare atu tōna titiro ki nga mahi kua whakaritea kia mahia i raro i te Ture Oranga Hinengaro.

E ōrite ana Te Pāti Māori ki ngā rōpū, he hōhonu wō rātau whakaaro, arā, mātau kua titiro ki te Komihana Oranga Hinengaro, kia whakaatu mai mēnā kua tutuki e te kaupapa o Te Tāhuhu ngā mahi i whakaritea kia tutuki i a rātau. Nā te Komihana i whakaatu mai te pōharatanga o te wāhanga mō ngā tamariki me ngā rangatahi, hākoa e mōhiotia ana te taumaha o ngā hiahia. Ko tā te whakatakotoranga kaupapa, 26 ō-rau te putea kia tuku ki aua ratonga engari, 11 ō-rau anake i tukuna atu. Ko te 15 ō-rau te tārepa e kore e tae atu ki ngā tamariki me ngā rangatahi, auē!

E te Kaihautū, e mōhio ana tātau katoa, ehara tēnei Kāwanatanga i te whakatutuki i ngā hiahia a ngā tamariki. Koi nei te Kāwanatanga i panui i tērā wiki, te ripoata o tōna ake Tari, arā, Te Manatū Whakahiato Ora, kua whānui, kua rahi ake te rawakoretanga i waenganui tamariki, “he nui ake tēnei tū āhuatanga mō te tini”. Kei a tātau tētahi Kāwanatanga, kāhore i te aro ki ngā taumahatanga kei runga i wā tātau tamariki. Kei a tātau he Kāwanatanga e kore e aro ana ki te titiro ki te āhua o ngā ratonga ki te Māori, hākoa ko ia a rā te whakatau a te ture; ā, he Kāwanatanga e mea ana, ehara mā mātau hei tirotiro i nga mahi a ngā Poari Hauora ā-Rohe, Te Manatū Hauora hoki e pā ana ki te oranga hinengaro.

E te Kaihautū, ehara i te mea ko Te Pāti Māori anake te rōpū e āwangawanga ana, kei hea rā te kumi ihuroa. Ko te nuinga o ngā kaitāpae kaupapa ki te Komiti Hauora o te Pāremata e mea ana, kia tīnihia te Pire, kia mau e te Komihana tōna mana motuhake hei tirotiro i ngā mahi ā-kāwanatanga nei. Ā, ko tā te Kaunihera Mana Tangata, kia whānui ake te mana tirotiro, kia kaua e whakawhāiti. Ko tā te Komihana āwangawanga, kāhore i ōrite ngā rere kētanga ki ngā whakatau tika i puta mai i te tūtohutanga o ngā Patapatai a Mason o te tau, 1996. Tērā pea ka mau mahara tēnei Whare ki tā Tiati Mason i taunaki, mā ngā momo rōpū whakariterite pērā i te Komihana Oranga Hinengaro, hei parau i te ara kia pai ake ngā mahi, ā, kia rewa ake he tino take hoki ngā mahi e pā ana ki te oranga hinengaro i Aotearoa.

Tini ana ngā rōpū i karanga kia kaha te whakatinana i te tūranga o te Komihana Oranga Hinengaro mō ōna kaupapa tirotiro i ngā Rōpū Hauora ā-Rohe me Te Manatū Hauora.

He waimarie kua kitea he ara kia puta i tēnei poharu. Ko ngā wāhanga o te ture ka kati i te mana o te Komihana, kia kore e taea e ia ngā mahi i whakaritea māna. Ka tū te tau otinga mēnā ka takawiri ngā aho, te ngāwari hoki engari, ko te mate kē ko te wāhanga ka pā ki tēnei Pire.

Kei te whakaaro nui mātau o Te Pāti Māori ki te tirohanga motuhake o te Komihana Oranga Hinengaro, nā rātau i whakamōhio kei te raru ngā ratonga, ā, kāhore i pai te kite a ngā rangatahi i aua ratonga. Ko wā mātau rangatahi te rēanga kei a rātau te moemoeā mō ngā rā kei te tū mai. I te ao Māori, e mārama ana mātau, ka tae atu ki te tau 2050, 50 ō-rau ngā Māori kei raro tonu i te 27 tau. Nō reira, atawhaitia taua rēanga kia pai ai tō tātau iwi.

Ko tētahi atu take mō mātau, he iti tonu ngā kaimahi Māori, Pasifika rānei e mātau ana ki ngā mahi oranga hinengaro mō ngā rangatahi.

Nā ngā pēhanga o ngā kaupapa, kua puta ngā tūroro i ngā wāhi nohonga tangata, arā, ngā wāhi hauora ā-kāinga.

[An interpretation in English was given to the House.]

[Indeed, as a way of starting my address, we of the Māori Party acknowledge the death of the fatherly figure Denis Simpson, and his compassion, wisdom, and gentle advice to the Mental Health Commission as its elder, and respected leader of both Ngāti Awa and Ngāi Taiwhakaaea.

Denis worked tirelessly from the first days of the commission in 1996, opening doorways to both Māori and Pākehā worlds, through his staunch support as well as his belief. His presence will remain, through the energy of the Mental Health Commission and the work programme he created.

There is one word that is pivotal to this bill, one word that will determine the way in which the Maori Party votes in subsequent debates, a word that this Government fails to find—all guises of it trip up this Government. It is a word symbolising the Government’s blindness to fresh perspectives and other viewpoints. Given recent publicity around my use of particular words, I thought I had better just check the Oxford Dictionary before uttering it.

One of the definitions for this word was “a large tropical Old World lizard with a long neck and a short body, formerly believed to warn of the approach of crocodiles”. That is a word, perhaps, for us to mull over as we debate this bill; to look over at all times, to be cautious over, and to check over carefully. Indeed, that special word is “monitor”.

The significant feature of this bill is the change it proposes to constrain and curtail the monitoring roles of the commission. The Mental Health Commission currently monitors the adequacy of the Ministry of Health in its delivery of the national mental health strategy. This emphasis on accountability is central to the upholding of human rights; it is central to the independence of the commission; it is central to the advocacy of the mentally ill and their families. Why is this Government so afraid of the power of a monitoring role that it has weakened the capacity of Te Puni Kōkiri, the Ministry of Māori Development, to do exactly that, and it has now moved on to the Mental Health Commission to dilute and weaken its monitoring rol, as well? What is it that leaves those across the State sector in such fear of being warned of the approach of crocodiles?

Section 5 of the Ministry of Maori Development Act 1991 makes it absolutely explicit that Te Puni Kōkiri has a statutory function to monitor and liaise with each department that provides services to or for Māori for the purpose of ensuring the adequacy of those services. Yet on 16 March last year, the head of the Ministry of Māori Development, in response to the claim that auditing and monitoring of other agencies was a waste of time, was unable to explain why they were ignoring their legal responsibilities. And here is this new bill, with its direction from the health Minister for the key agency in the mental health sector to avert its gaze away from its statutory role in the Mental Health Act.

The Māori Party, like other collectives, has depended on the birds-eye view of the Mental Health Commission to advise us how Te Tāhuhu, the mental health strategy, has set out targets to achieve. We have learnt from the commission that Child and Youth Services remain significantly underfunded in relation to known needs. According to the blueprint, 26 percent of mental health funding should be allocated to those services for children and young people, yet only 11 percent is getting to them. A shortfall of 15 percent—how disconcerting!

We all know about the Government’s poor performance in responding to children’s needs. This is the same Government that just last week issued its own report from the Ministry of Social Development that records that both poverty rates and poverty depth are “substantially higher for children than for the population as a whole”. So we have a Government that is prepared to disregard the needs of children; we have a Government prepared to ignore the statutory function of monitoring the quality of services provided to or for Māori; and a Government that is prepared to absolve itself of any responsibility of monitoring the performance of key agencies, including district health boards and the Ministry of Health, regarding mental health.

The Māori Party is not the only group concerned about where the crocodile is. The majority of submitters to the Health Committee recommended amendments to the bill in order that the commission should retain its independent monitoring role. The New Zealand Council for Civil Liberties recommended that the monitoring powers should be broadened, not limited. The Human Rights Commission was concerned that the changes were incompatible with the accountability that emerged from the recommendation of the Mason inquiry of 1996. This House may recall that Judge Mason recommended that the creation of an organisation such as the Mental Health Commission would act as a catalyst to improve performance in regard to, and lift the priority given to, mental health in New Zealand.

So it went on, many groups reiterating the need for the commission’s role to be strengthened in monitoring and reporting on the performance of both the district health boards and the Ministry of Health.

Fortunately, there is a way through this quagmire. Clauses of the bill serve to constrain the capacity of the commission to maintain its watchdog role in areas set aside for it. So the solution lies in tweaking the clauses—which sounds so simple, but the problem is the sector that this bill applies to.

We of the Māori Party have given much thought to the unique perspective offered by the Mental Health Commission in alerting us to the crisis state of our acute services and the largely negative experiences of adolescents in such services. Our young people are the generation with aspirations for the future. In Māoridom, we are particularly aware that, by 2050, 50 percent of Māori will be 27 years old or under. So we should foster that generation as a salvation for our people.

Another matter for us is the particular shortage of Māori or Pasifika skilled mental health workers for adolescents.

Because policies are so restrictive, patients are leaving residential and home institutions designed especially to meet their needs.]

Debate interrupted.

The House adjourned at 10 p.m.