Psychiatrist accuses NSW government of ‘declaring war’ on mental health system

A psychiatrist who is resigning in protest over a lack of resources for the NSW public sector says the premier and mental health minister should have to explain themselves to a coroner if somebody gets hurt.
Of the 205 psychiatrists who tendered resignations, 43 have already left, with dozens more expected to depart the public health system in the coming days.
They are demanding the state government address chronic staff shortages by boosting psychiatrists’ pay by 25 per cent in a single year, which the government says it can’t afford to do.
Dr Korbel described the government’s response to the resignations as a declaration of war on the mental health care sector. (ABC News: Nick Dole)
Forensic psychiatrist Ian Korbel said the government’s response to the mass resignation of public psychiatrists amounted to a “declaration of war” on the mental health system.
“When the disasters happen — and it’s when.. not if — they should be the ones that have to be called in front of the coroner,” he said.
“[They] won’t of course. It will be the poor clinician who is dragged there and the coroner will have a finding saying the system isn’t working.
“I’m telling you, the system already isn’t working, and this plan will make it worse.”
Dr Korbel was responding to comments from Mental Health Minister Rose Jackson, who said social workers, peer workers, clinical psychologists, nurses and GPs could be asked to take on additional responsibilities following the mass resignation of psychiatrists.
“The system is resilient. [The] system is agile,” Ms Jackson said.
“We have other health professionals stepping up, putting their hands up to play a role.”
NSW Minister for Mental Health Rose Jackson said the state’s mental health sector was “resilient”. (ABC News: Nick Dole)
Dr Korbel said the plan appeared to be “written on the back of a beer coaster”.
“We’ll see people who are admitted to hospitals, but they’re not kept in the right level of security.
“We’ll see patients who are not prescribed the medications that they need to get well.
“I’ve worked as a doctor for 30 years. I’ve never seen a plan like this before.
’12 years of training can’t be replaced’
Pramudie Gunaratne, NSW Chair of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) said patients with severe psychiatric disorders needed specialist care.
“They might be paranoid, disoriented, fearful, and when they come to our emergency departments, it is a psychiatrist that is able to be able to assess and make decisions around [their] treatment,” she said.
“There is a reason why psychiatrists have a minimum of 12 years of training … and that is because of the serious risk and serious medical issues that are dealt with.”
Dr Korbel said the plan appeared to be “written on the back of a beer coaster”. (ABC News: Nick Dole)
However, NSW Health’s chief psychiatrist, Murray Wright, said it made sense to use the skills of other health professionals, including nurses, to ease the burden on psychiatrists.
“We are not asking anyone to operate outside their scope of practice,” he said.
“We’ve got a range of highly skilled nurses working in our system, and there are opportunities for nurses with ambition to improve on those skills,” he said.
The Nurses and Midives’ Association’s General Secretary Shaye Candish called the plan “ludicrous”.
“The government can’t expect nurses to mop up this mess, by taking on even larger workloads than they already are,” she said.
Government denies ‘significant disruption’
The government said 99 psychiatrists had agreed to delay their resignations, while 25 had rescinded them.
Ms Jackson said 23 locums had already been recruited to fill those roles, with more on the way.
Ms Jackson says no mental health wards have closed, but that some have been “amalgamated”. (ABC News: Keana Naughton)
“We’re not seeing the significant disruption of mental health services at the local level, and the message to the community remains [that] care is available,” she said.
“We haven’t closed any wards, we have amalgamated some wards.”
However, Dr Gunaratne said the government was trying to be clever with its language.
“We’re aware that in Cumberland and Westmead Hospital, in St George [and] Prince of Wales… there are huge changes in terms of service provision.”
NSW Health said eight mental health beds had been lost at Prince of Wales Hospital in Randwick.
However, it conceded that figure could change as more resignations were processed.
Ms Jackson called on psychiatrists to delay their departures until at least March, when the Industrial Relations Commission (IRC) will hear the dispute.
“If the IRC comes to the determination that a 25 per cent wage increase is fair and reasonable, we’ll pay it,” she said.