Update: Just 2 hours after publishing this post it was picked up and republished on the United for Change Network blog (minus the links). They are hosting a global Twitter chat on privatisation of public services using the #U4Change hashtag commencing at 6am Australian Eastern Daylight Savings Time on Wednesday, October 26. This would be a timely opportunity for Australians interested in or concerned about the introduction of  “managed competition” through Medicare Select to become more aware of the global push to privatise public services.

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The Hon. Frank Walker, QC, President of the Schizophrenia Fellowship NSW made some prescient comments about the changes that are taking place in how state and federal mental health programs are being funded in the report he gave at the annual Symposium held by SFNSW in May 2011 and printed in the June 2011 edition of FOCUS. The final paragraphs are what drew most of my attention:

The Schizophrenia Fellowship, committed to its belief in the development of the community health sector, has taken up Government offers to tender for contracts for services for rehabilitation of consumers, education programs, carers support programs, respite care and housing and employment services. Such contracts not only help us fulfill our mission statement but give us valuable insights into the strengths and weaknesses of the mental health system which facilitate our advocacy and policy development functions.

One of the insights we have been given is that cash flows of multi millions of dollars and large workforces present a real risk of your organization getting enmeshed in the unremitting growth culture pervading neo-capitalism and losing sight of the raison d’être of our charitable objective which is to improve the lives of consumers and carers.

I am proud to be blessed with a Board who is prepared to grow its services but not at the expense of its role as a fearless advocate. I say that because over dependence on government contracts puts organizations at risk of being gagged by grantors whose policies or performance have been criticized by the simple expedient of threatening to withdraw funding.

Another danger is that over commercialization of its business in search of profits could put at risk an organizations tax exempt status. My point is that we should ensure we continue to operate more like Mother Teresa than Gordon Gecko. Some charities are now involved in highly profitable commercial operations that have absolutely nothing to do with the succor, education or medical treatment of the poor. Australian Courts and Treasuries are increasingly making noises to the effect that NGOs may be stepping outside the boundaries of the legal meaning of a charity.

To my mind the not- for-profit community health sectors greatest asset is its close links to local communities and consumer friendly reputation. Governments are heavily pressing us to merge and grow into huge corporations. Our large mental health institutions failed because their size led to them becoming impersonal dangerous places for patients beset by the bureaucratic bungling and ruthless cost cutting. The same disease currently bedevils our Hospital system. Very big is beautiful to bureaucrats but it is often devoid of the care and compassion that is a vital component for the recovery of people with a serious mental illness.

My message is that we should not be seduced by multi million dollar profits into losing sight of our charitable objectives and thereby forgetting about the real needs of our constituency.

Frank Walker


Reading this again in the light of the generally unexpected budget night announcement to divert funds from the Better Access scheme primarily to the programs of Orygen Youth Health; the ad-hominem attacks against opponents of these funding changes by the Orygen-associated Professors, Dr. Ian Hickie and Dr. Patrick McGorry; the pushing ahead of these ‘reforms’ by the Minister, Mark Butler MP, despite the many hundreds of submissions to the Senate Inquiry against them; and the rollout of e-health (and e-mentalhealth initiatives) tied in with the introduction of managed competition into the Australian health system under Medicare Select (yes folks, don’t miss the often non-disclosed links between eHeadspace/Headspace/, McGorry, Hickie, the NHHRC, Christine Bennett, Bupa Australia (formerly MBF, HCF, Manchester Unity, HBA, Community Mutual, etc.) & Colonial Foundation (fmr. Colonial Mutual insurance society Trust), I’d like to give the Hon. Frank Walker an Order of Australia for his service to Australian mental health.

Frank, you’re right. There’s a lot of bullshit going on under the guise of reform.

Let’s get the private insurance corporations, the pharmaceutical companies and their compromised lobbyists out of OUR health policy decisions and instead work by all means to place the power back in the hands of consumers/patients/clients.

Let’s investigate and support those not-for-profit community-guided mental health organisations whose charitable objectives encourage the care, compassion, and ‘consumer’ & carer participation in service provision that could truly make a positive difference. And finally, let’s keep our GPs and psychologists from becoming solely employees of public-private partnerships if the current UK NHS ‘reforms’ are anything for us to go by.


Further reading:

Mental Health Expert Working Group (MHEWG) documents obtained under Freedom of Information request to DoHA.
List of Submissions received by the Senate Community Affairs Committee Inquiry into Commonwealth Funding and Administration of Mental Health Services.
Transcripts of the hearings undertaken by the Senate Community Affairs Committee Inquiry into Commonwealth Funding and Administration of Mental Health Services.
Cutting Therapy Short – The Alliance for Better Access.
Op-ed: Dear Mr. Hickie – Linda Wemyss, The Drum Opinion, September 23, 2011.
Psychosis project divides experts – Jill Stark, The Age, October 23, 2011.
Cuts to hurt mentally ill, say doctors – Jill Stark, The Age, October 23, 2011.
Op-ed: The problem with health advocates is when they don’t – Clem Bastow, National Times, August 25, 2011.
Mental health GP quits panel over Medicare rebate cuts – Sue Dunlevy, The Australian, July 14, 2011.
Medicare Select won’t work, claims economist – Adam Cresswell, The Australian, November 07, 2009.
Now is the time for all good people to come to the aid of Medicare – John Menadue, Australian Policy Online, November 09, 2009.
Medicare Select – Entrenching Inequality in Health Care? (Article and Paper) – Centre for Policy Development

Blog posts:

Argument by anecdote on mental health – Seize The Data
What’s the fuss? I / What’s the fuss? II  / Back on that path /Corner on the Market– Some of a series of blogposts raising concerns from retired psychoanalyst & psychiatrist Dr. Mickey Nardo about Professor McGorry’s form of early intervention in prodromal youth at risk of a first psychotic episode.
Australian of the Year Patrick McGorry’s call for early intervention to prevent Psychosis: A Stitch in Time or a Step too Far? / Extra EPPIC and Headspace funding in the Federal Budget: A quick fix to a political problem but where is the evidence? – Martin Whitely MP, Speed Up & Sit Still.
Ian Hickie rejects Better Access in mental health reform debate – JohnAlchin.info
The McGorry-Hickie reform controversy: Why has mental health become so political? – Dr. Tad Tietze, The Left Flank.
Cuts to Medicare Psychology Sessions, please Mr Butler are you serious? – Precocious Lotus.
Once upon a time… – Talking Fairleigh.
Sebastian Rosenberg – Linda Mad Hatter.

Related reading:

Bupa to rebrand insurers under widening umbrella – Eric Johnston, Sydney Morning Herald, October 22, 2011.
How ethical are the companies that will run our public services? -Ethical Consumer (UK).
Op-ed: Serco: immigration’s outsourced elephant in the room – Peter Chambers, The Drum Opinion, May 10, 2011.
Serco announced Preferred Bidder for Fiona Stanley Hospital – Media Release, October 19, 2011.
Opinion: Privatising the Public Good and the Profitability of Public Interest – Dominic Harrison, posted on United 4 Change Network blog.

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