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Legislative Assembly for the ACT: 1997 Week 4 Hansard (8 May) . . Page.. 1170 ..

MS TUCKER (continuing):

We already know that consultancies have increased. It is particularly concerning that there appears to be no extra money for the community sector, which is already overstretched. The whole point of consultancies is that they are supposed to result in less invasive methods of supporting families - less invasive than a notification - but less invasive methods need support. It means moving within the community sector to help the families who are at risk or troubled, so that their children do not have to be put into care. So, we have to see an appropriate increase of resources in the community to match an increase in consultancies. It is not clear from the budget papers how great the increase is. We are told only that there are 600 consultancies, and there is an increase in that number, but I am not clear on how much it is.

Unfortunately, the small gains from the ACT may not cover the losses from the Commonwealth. In some major programs, such as the home and community care program, the ACT has promised to match funding, and the community sector is obviously very pleased to have an additional nearly $1m in this area. But what happens if the Commonwealth funding is not as high as predicted? It is very unclear from the budget papers. Mrs Carnell indicated yesterday that she would take no responsibility for a net loss brought about by Commonwealth cuts. She is happy to include in the budget papers projected increases from the Commonwealth, but she takes no account of projected cuts. If our economic and employment strategies need to be reassessed in light of Commonwealth decisions, our social policies do too. Just as an example, if national mental health strategy money does fall, as projected, by $338,000, that means that our overall mental health budget is falling.

I turn to other general issues of health. There are questions in relation to some of the figures. For example, $9m of savings is attributed to "implemented efficiency measures". The details of these claimed savings are important matters in determining how achievable the budget for the portfolio is going to be; but they are not apparent in the budget documentation. Similarly, where the funds are being reallocated from is not at all clear. Who, then, are the losers? Given the moves claimed from institutional- to community-based care, a significant reallocation from one to the other may have seemed likely; but, again, this is not immediately apparent from the budget documentation. There are many areas of increased expenditure in relation to the institutional elements of the health system, including additional funds for cardiac surgery in the new cardio-thoracic unit, $3.5m; additional funds for hospital waiting lists, $1.5m; and provision for increased throughput of patients in the hospital system. The budget also sets out the establishment of a convalescent care unit "within existing Canberra Hospital resources". What activities are stopping to achieve this?

The Greens strongly support the greater availability of options in both health and community care. However, this budget takes only tiny steps towards changing the focus of the system. For example, the Government claims to be targeting "people with a mental dysfunction" in its budget. With this and its overall focus on care in the community, it might be expected that there would be a significant shift in the balance of funding towards community-based assistance. This does not seem to be the case. For example, with a 1997-98 budget target of $18.2m for mental health services, it provides only $0.25m for additional accommodation, respite care and day care services in the community for people suffering from mental illness. The budget provides no transparent analysis of what money is going where in this important sector.

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