GUEST BLOG: Dave Macpherson – Mental healthcare heading for privatisation

In a plaintive cry a few days ago from health minister Jonathan Coleman in response to another hammering from the community and – this time – from unions representing mental health workers, on the occasion of the closure of a chunk of Waitemata DHB’s mental health facilities, we were told that the Government has responded well to mental health needs in the country by increasing the budget allocation from $1.1B in 2008 to $1.4B this year.

Simple math tells us that this is about a 2.5% increase per year, but measured against record official* suicide levels, mental health facilities turning patients away, mental health wards closing due to staff shortages, high staff turnover in community mental health services and growing public unease about the state of this sector, current public expenditure on mental health is clearly not cutting the mustard.

During the same period, we’ve seen the growth of private mental health services and facilities, charging huge fees affordable to only a few; after Capri’s latest round of TV advertising, my partner contacted them to find out the cost of basic 4-6 week treatment course for a patient – there was no change from $30,000 – and the parent of another person told me recently they had forked out $40,000 for a 6-week treatment course for their son at another private provider. Soon, I’m sure, BUPA and Radius will be getting into this game!

In 2015, the Ministry of Health floated for the Government the concept of privatisation of mental health services, where assessed patients would be effectively granted cash to ‘purchase’ services – a budget would be attached to their mental unwellness, and used to fund the services they accessed. Quite how such a cockamamie idea would work in practice was never discussed, but various pseudo-community mental health services were audibly salivating at the prospect of competing in this particular marketplace.

Although this concept doesn’t yet seem to have been progressed, you can see where the Government and its ideological bedmates are heading. They are keen to abandon the public service model of healthcare, and promote the private corporate model in its place, with aged care and soon mental health being among the first testing grounds.

One of the dangers of this move is that there will be well-meaning groups in the community, as well as some iwi health providers, who will be easily convinced (see charter schools) that a privatised mental healthcare model will enable them to get out from under the heavily bureaucratic, professionally-dominated public funding model currently in place, and they will jump at the chance for a greater degree of independence. In return, the Government will jump at the chance to present some token community-based ‘successes’ to counter the criticism they will receive for a much larger chunk of Vote Health going to their corporate mates.

*many suicides are not recorded as that – as no official determination is made or, as in our son’s case, has yet to be made – so his is classed as death by suspected drowning, 18 months after it happened.

Dave Macpherson is The Daily Blog’s mental health blogger after losing his son to mental health incompetence. He is also a candidate for the Waikato DHB.