Blue Mountains Health Services

Today I raise the issue of health services in the Blue Mountains. I particularly draw upon some of the critical points I raised in my submission to the Public Accounts Committee inquiry into the management of health care delivery in New South Wales last year. On a daily basis, my office is contacted by Blue Mountains residents who hold concerns about the capacity of our health system to respond to their health needs.

Whether it be surgery waiting times, capacity of our hospital emergency departments or the mental health system, my constituents highlight a health system which is struggling to find the capacity to respond with timely and appropriate care and treatment. It is likely that these problems will only worsen at both of my local hospitals with the increasing population in this region. With the ageing of the population and the effects of socioeconomic disadvantage, presentations and health issues are becoming increasingly complex, frequently accompanied by increased acuity.


The health system is reliant on the goodwill of its workforce. I acknowledge the professional and dedicated healthcare workforce who staff our hospitals and community health facilities. Staff must be acknowledged and supported and their perspective valued to ensure a system that is sustainable and willing to reflect on what it does well but also where it can do better. There is no doubt that we have a world-class public health system. Nevertheless, without adequate funding and resourcing, the health system will be ill‑prepared to meet the challenges of coming decades, especially with regards to the ageing of the population and, with this, growing chronic and complex disease.


Today I focus on the continuing growth in mental disorders and distress facing many within our community and the serious challenges facing the health system in providing a timely, comprehensive and compassionate response—especially being able to provide such a response given current funding cuts and constraints. The delivery of mental health services and related issues in my area is troubling, but I am sure this is not a Blue Mountains problem alone. After a recent conversation with some of the dedicated and skilled workers in the mental health sector and hospital system and police from our local area command, we really need to acknowledge such problems in this place—that there is a crisis and we need to find practical solutions to address it. I acknowledge my constituents who have come forward and raised their concerns and complaints with me. This is no easy task but the system cannot learn unless it is made aware of its gaps and shortcomings. I also honour the doctors, nurses, allied health and support staff who provide ongoing care under very challenging circumstances.


One of the major issues I hear about is capacity issues within the system, known as bed-block. With regard to inpatient mental healthcare, there remains an ongoing pressure on bed availability. Whether it be beds in the Psychiatric Emergency Care Centre [PECC], the Nepean or Blue Mountains Mental Health Unit or access to Community Mental Health Teams, the system is struggling to meet demand. In response to bed-block, staff on a regular basis are forced to make decisions to discharge or admit patients on the basis of bed availability. We need a whole‑of‑government approach to deal with this crisis—and it is a crisis.


This was highlighted very recently in a traumatic and public way when a man in my electorate on the verge of homelessness, faced with eviction, became absolutely desperate and his subsequent distress escalated, resulting in troubled behaviour. Streets went into lockdown, a siege was discussed on social media and, finally, days later there was a failed attempt to admit the unwell man to hospital. There has been a worrying and unnecessary increase in suicides in the Blue Mountains recently, residents and non-residents alike, after people have been prematurely discharged from mental health units in hospitals to free up beds. This has caused considerable concern for my community.


Our local police force is the frontline in the emergency response to people suffering mental illness or severe distress. Experienced police have shared with me their frustration when they take a person to our local mental health facility, often under traumatic circumstances, and where the person potentially poses a risk of harm to themselves or others, only to discover that the person is released back into the community without a plan to deal with their illness or keep them safe. I am not describing a one-off situation. We have a memorandum of understanding between health services, the police and the ambulance service which clearly states that health is the lead agency in mental health. However, unless our hospital emergency departments and mental health services have sufficient resources and beds, people who are suffering will continue to be discharged with inadequate care plans and support to keep them safe and well.

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