PORTFOLIO COMMITTEE NO. 2 - HEALTH Thursday 11 March 2021 Examination of proposed expenditure for the portfolio area MENTAL HEALTH, REGIONAL YOUTH AND WOMEN CORRECTED The Committee met at 9:30. MEMBERS The Hon. Greg Donnelly(Chair) The Hon. Lou Amato Ms Abigail Boyd Ms Cate Faehrmann The Hon. Wes Fang The Hon. Emma Hurst (Deputy Chair) The Hon. Natasha Maclaren-Jones The Hon. Tara Moriarty The Hon. Penny Sharpe PRESENT The Hon. Bronnie Taylor, Minister for Mental Health,Regional Youth and Women CORRECTIONS TO TRANSCRIPT OF COMMITTEE PROCEEDINGS Corrections should be marked on a photocopy of the proof and forwarded to: Budget Estimates secretariat Room 812 Parliament House Macquarie Street SYDNEY NSW 2000 Thursday, 11 March 2021 Legislative Council Page 1 CORRECTED The CHAIR: Welcome to the public hearing of Portfolio Committee No. 2 – Health and its inquiry into the 2020-2021 budget estimates. Before I commence I acknowledge the Gadigal people, who are the traditional custodians of this land. I also pay respect to Elders past, present and emerging and extend that respect to other Aboriginals present and any who may be joining us on the internet. I welcome Minister Taylor and accompanying officials to the hearing. Today the Committee will examine the proposed expenditure for the portfolios of Mental Health, Regional Youth and Women. Today's hearing is open to the public and is being broadcast live via the Parliament's website. In accordance with the broadcasting guidelines, while members of the media may film or record Committee members and witnesses, people in the public gallery should not be the primary focus of any filming or photography. I also remind media representatives that they must take responsibility for what they publish about the Committee's proceedings. The guidelines for the broadcast of proceedings are available from the Committee secretariat. All witnesses in budget estimates have a right to procedural fairness according to the procedural fairness resolution adopted by the House in 2018. There may be some questions that a witness could only answer if they had more time or with certain documents to hand. In those circumstances witnesses are advised that they can take a question on notice and provide an answer within 21 days. Minister, I remind you and the officers accompanying you that you are free to pass notes and refer directly to your advisers seated at the table behind you. Any messages from advisers or members' staff seated in the public gallery should be delivered through the Committee secretariat. We expect the transcripts of the hearing will be available on the web from tomorrow morning. I invite everyone to please turn their mobile phones to silent for the duration of the hearing. All witnesses will be sworn prior to giving evidence. Minister, I remind you that you do not need to be sworn as you have already sworn an oath to your office as a member of Parliament. I also remind the following witnesses that they do not need to be sworn as they have been sworn at an earlier budget estimates hearing before this Committee last week: Ms Koff, Dr Lyons and Mr Minns. PORTFOLIO COMMITTEE NO. 2 - HEALTH Thursday, 11 March 2021 Legislative Council Page 2 CORRECTED CHRISTOPHER HANGER, Deputy Secretary, Public Works Advisory and Regional Development, Department of Regional NSW, affirmed and examined NIGEL LYONS, Deputy Secretary, Health System Strategy and Planning, NSW Health, on former oath ELIZABETH KOFF, Secretary, NSW Health, on former oath MURRAY WRIGHT, Chief Psychiatrist, Ministry of Health, sworn and examined TANYA SMYTH, Director, Women NSW, Aging and Carers, Department of Communities and Justice, affirmed and examined SIMONE WALKER, Deputy Secretary, Strategy, Policy and Commissioning, Department of Communities and Justice, sworn and examined JULIA RYAN, Director, Office for Regional Youth, Department of Regional NSW, affirmed and examined CATHERINE LOUREY, New South Wales Mental Health Commissioner, Mental Health Commission of New South Wales, sworn and examined DAVID PEARCE, Executive Director, Mental Health Branch, NSW Health, sworn and examined PHILIP MINNS, Deputy Secretary, People, Culture and Governance, NSW Health, on former oath The CHAIR: We will now commence with questions. The Committee has resolved that we will rotate between the Opposition and the crossbench. We further resolved that we will do that in 20-minute blocks and will keep going through until we get to what is the last tranche for the three-hour session this morning, and indeed the same this afternoon. The last tranche no doubt will be less than 20 minutes each and we will simply divide the time between the Opposition and the crossbench equally. That is how we intend to proceed if everybody is agreeable to that. That is all I need to say in terms of introductory remarks. Do you have any questions, Minister, before we get underway? The Hon. BRONNIE TAYLOR: No, thank you, Mr Chair. The CHAIR: We will commence with questioning from the Opposition. The Hon. TARA MORIARTY: Minister, there is a critical shortage of staff across the mental health sector. It is affecting the community because people cannot get access to mental health services when they really need them. What are you doing to address the shortage of staff across the sector? The Hon. BRONNIE TAYLOR: Thank you very much for your question. We have a total workforce of 9,690. We have 5,160 mental health nurses. I think that we have a very robust base of staff. I think that there are always challenges in terms of particular areas in recruitment, and I acknowledge that. But there are wonderful programs going on across all local health districts [LHDs]—I have to be careful I do not say south-western or south-eastern Sydney. In south-western Sydney there were wonderful programs going on with new graduate nurses. We are actually looking at accessing those nurses directly out of university and mentoring them when they are on their practicals to then continue into mental health nursing. I know that in terms of when we did the additional 220 positions in mental health across the board with the COVID response that we were able to fill all of those positions. I think workforce is always an issue in terms of making sure that you have enough workforce, you have that interest and you have that expertise in mental health. I think we have very sound programs right across all of our local health districts. Obviously the local health districts operate their own districts very individually and have their own programs as well, and that has actually been a huge strength that we have seen during COVID. Also in terms of psychiatry—are you also referring to psychiatrists? The Hon. TARA MORIARTY: I will come to the specifics but just generally— The Hon. BRONNIE TAYLOR: Yes, just generally I will keep going. You have questioned me previously about psychiatrists, actually quite continuously. As I have said before there is a national shortage of psychiatrists across Australia, and that is something that we are looking at in New South Wales. I know that Dr Wright has been working very closely on our psychiatry workforce plan with the College of Psychiatrists doing that. We have that and we are implementing that and I am looking forward to that rolling out. We also have to look at our registrar placement. But I think again with mental health, we know that the best outcomes come from a multi-disciplinary approach. So I am really pleased that we have, I think, one of the best peer support workforces PORTFOLIO COMMITTEE NO. 2 - HEALTH Thursday, 11 March 2021 Legislative Council Page 3 CORRECTED in the country. I think that is work that has been done for decades in the fact that we have the whole process with our Living Well strategy and we are now half-way through our 10-year strategy. One of the really important things that has come out of that strategy is that we have to look at workforce and particularly at peer support and people with lived experience. The Hon. TARA MORIARTY: I will ask a couple of questions on that. The Mental Health Commission—the 10-year strategy or actually the most report that you tabled, I think late last year, from memory, does say that there is a critical shortage and it wants it to be dealt with. It is saying it is quite urgent and it wants an update by June of this year. I understand that programs are in place but the shortage is quite critical. Because a lot of these positions are highly skilled, it does take time to make sure that people are trained up and ready to go. My first question is: Your agency is saying that this is urgent and it wants an update by June. Are we on track to be getting better with staffing numbers generally? The Hon. BRONNIE TAYLOR: One really great thing—and Dr Wright might want to elaborate—is that it is the first time in a long time that all of our psychiatry registrar positions were filled. That is a huge step forward. Dr Wright, did you want to add anything further on that? Dr WRIGHT: Certainly, thank you. I think that in the time that I have been a psychiatrist, I think for the last 25 years, there have been real challenges in attracting and retaining junior doctors to a career in psychiatry. There is a variety of issues that contribute to that. We have done a lot of things over the last 15 years to try to address some of the concerns that were raised by that group as to why they either did not stay in the specialty training or why they were not attracted in the first place.