This is an edited version of a letter sent to federal Health Minister Sussan Ley, Minister for Aboriginal Affairs Nigel Scullion, and Assistant Minister for Health Fiona Nash. Photo: Andrew Meares
Closing the Aboriginal Medical Service Western Sydney will deprive 11,000 patients of their special cultural, social and medical needs.
With 11,000 active patients on its books, the Aboriginal Medical Service Western Sydney, a health service developed over the last 28 years, is to be closed by the end of September.
For 15 years I have been the one day a week psychiatrist who works in the mental health team of that service.The mental health team has been providing mental health services for hundreds of Aboriginal patients, many of whom have very serious mental illnesses.
There is a core of about 140 patients who need close case management and regular assessment. Apart from relieving the distress of mental illnesses and disorders, the team has stabilised many seriously mentally ill Aboriginal people and helped them escape the cycle of poorly treated mental illness that leads to personal and family horrors, self-harm, addiction, violence, incarceration, suicide and homicide.
These are the very things you, as the relevant ministers, claim to be deeply concerned about yet you are about to close a very active mental health team working effectively to prevent them.
There is an appalling contradiction between your words and your actions.
You state that you have ordered the closure of the service because it has become insolvent. The insolvency has a number of causes, including poor management, inadequate funding for ambitious health programs and both the federal and state governments withholding funds and grants.
You, as the ministers involved, have ordered that all AMSWS patients be transferred to the two state local health districts or to other entities and that it be done by September 30.
Yet there is no safe, ethical and practical way of transitioning 11,000 active AMSW patients to other local health services before September 30th or earlier. It cannot be done.
The closure will precipitate a general medical and mental health catastrophe for the Aboriginal people of western Sydney. It seems to me that your decision lacks compassion, defies logic and can only be understood as a desire by the federal government to land a crushing blow to Aboriginal people living in western Sydney.
I can only conclude that you are driven by an ideology that runs right against competent and ethical management of Aboriginal health problems.
The Institute of Public Affairs clearly has a strong influence on the Abbott government and for many years it seems to have taken the position that urban Aboriginal people should not have government support for services designed to meet their special cultural, social and medical needs.
I very much hope the closure of AMSWS is not the first shot in a federal government campaign based on the Institute of Public Affairs’ fantasy that Aboriginal people in urban areas are not really a distinct community with needs that differ from those of mainstream Australians.
As a psychiatrist with long experience in working with Aboriginal people in NSW I think it is likely that many of our AMSWS’s most seriously mentally ill patients will not have the trust to be successfully treated by generic mental health services and that those services will not have the cultural understanding of or engagement with the community to work safely and ethically with them. Their mental health will deteriorate and the results of such deterioration will be tragic.
A wiser, alternative course, would be to allow the Aboriginal people of western Sydney time to set up or engage a different community-controlled entity to take over the existing service and facilities and, with the right kind of support, to continue to provide an excellent and efficient health service.
I have been in psychiatry for 44 years, much of it working with Aboriginal and rural and remote services. I have never before been so worried that an awful, avoidable tragedy will be inflicted on my patients, their families, their community and, indeed, the wider community.
As the responsible ministers you have precipitated this crisis and will be held morally and politically accountable for the likely tragic consequences. Please rethink this absurd and dangerous decision while there is still time to do so.
Neil Phillips works at the Aboriginal Medical Service Western Sydney. This is an edited version of a letter sent to Sussan Ley, the federal Health Minister, Nigel Scullion, the Minister for Aboriginal Affairs, and Fiona Nash, the Assistant Minister for Health.