01 July 2010

Pull the other one, it tells a narrative

In an age where you can't tell whether or not a political promise will manifest itself as a reality, or what form that reality might take given the hype and folderol in the kind of announcement pitched at the journosphere, the best you can do is try to fit announcements into some sort of consistent narrative.

Michelle Grattan was right that Julia Gillard needs a narrative. For the time between now and the election, being the first woman PM and appearing to engage in some traditional activities (opposing gay marriage, tidying up the mess left behind by her male predecessor on resources tax) while eschewing others (not being married or having kids, not kowtowing to organised religion) will be enough. The Labor government has its own narrative: health is squarely a part of that and could do with being burnished a bit more than it is. Rudd was at the height of his powers with his steady demolition of Abbott at the Press Club, aided more than either of them knew by Abbott's decision to play parliamentary pantomime in a non-parliamentary setting.

Tony Abbott was Health Minister, but so what? John Howard had been Treasurer, and you didn't hear him crowing about maintaining a fixed exchange rate, unemployment and interest rates above 10%, or industry protection. Abbott has not built a healthcare narrative for the Liberals, and neither has his so-called shadow minister for health. That's why this is surprising, however welcome it might appear.

It may be that mental health practitioners have finally lost patience with politicians and aren't prepared to play nice any more, proving that sometimes rocking the boat can be the only way to move it forward. Professor McGorry is right, however, to realise that the government is the main game:

With yesterday's "very welcome" $1.5 billion announcement from the Coalition, he hopes he may be halfway there.

"I'm optimistic that the Gillard government will now turn their attention to (mental health)," Professor McGorry said.

The Abbott opposition are merely being provocative about this issue: it is the government who are playing the main game. Michelle Grattan is wrong in placing too much importance on this news cycle to an issue that is long-term, non-partisan and way too complex for press gallery gadflies (or most people really) to evaluate on any sort of sensible level.

The incumbent government has, like other governments before it, not invested enough in maintaining mental health services, let alone exploiting new developments in the field. All it needs to do is match the recent announcement and Abbott and Dutton are stuffed, because mental health fits the narrative of the current government. It is not enough for Nicola Roxon to declare that Abbott's policy lacks credibility, but it won't take much of a departure to make it so.

When the Coalition announced its parental leave policy, it felt like a stunt. After Abbott's strutting do-it-yourself, anti-government narrative (well beyond anti-Labor or anti-Rudd), opposing niggardly pay rises for the lowly paid, the idea of action on parental leave by a Coalition government was just wacky, at best. At worst, it looked cynical. The way it was to be funded ( a new tax on the 300 biggest companies) damaged the Coalition narrative on economic responsibility. This policy didn't fit the narrative so it was ignored.

A Coalition mental health policy doesn't fit the narrative either. It was unaccompanied by what Andrew Norton would call "familist" rhetoric, on the burden on carers and families of mental illness (neither Labor nor the Coalition are doing much for carers). It doesn't begin to place neglect of mental health care on wider social issues (e.g. the prevalence of prisons being misused as mental health facilities of last resort), which would complicate state campaigns in Victoria and NSW on "laura norder". It doesn't fit with the recent Coalition record of administrative trimming on Medicare and kyboshing big reforms (GP clinics, dental health). It doesn't fit with Liberal policy on the state level: Jeff Kennett's work on mental health with beyondblue has been magnificent, but his record as Premier of Victoria in this area can best be described as scant (the Black Dog Institute exists as a back-handed compliment to Kennett: it arose from both his activism in addressing depression as a social issue, while being targeted at people who would never give Jeff Bloody Kennett the time of day).

You can be as giddily optimistic as Professors Mendoza and Hickie if you will:

"This is a game-changer in that it creates a whole new service infrastructure, that offers ... evidence-based services to hundreds of thousands of young Australians and their families, who at the moment are locked out of any specialist support for what are the most common illnesses in early adulthood," Professor Mendoza said.

He added he was hopeful the $1.5bn would "break the cycle of crises in mental health that have dogged the sector for four to five decades".

Ian Hickie, executive director of the Brain and Mind Research Centre and a prominent critic of the Labor government's limited funding for mental health so far, said the planned early intervention services for psychosis were the "critical missing link" in the current system.

"This is very welcome news and certainly proves that someone in Canberra is listening to what's really needed in mental health," Professor Hickie said.

Smells non-core to me. Yeah, that's cynical but then cynicism can be well earned - all the more so after four or five decades in this area - and it's much more cynical to promise something to vulnerable people to get into office and then drop it once you're there.

However supportive, none of those authorities quoted show any sign of having been asked their opinion by Coalition policymakers. This isn't to say that experienced mental health practitioners should write their own ticket, or even that industry insiders with vested interest should be entitled to hold one area of public policy ahead of the others. If there was intensive consultation, if there was close work with carers and practitioners in developing policy and making announcements and criticism of the current government, a narrative would have built itself.

Thus the Coalition accepts the government's proposal for activity-based funding. But it says it would not have a new "bureaucracy" to administer it but use existing entities, saving nearly $92 million.

So, you're going to use "existing entities" largely responsible for mental healthcare dysfunction to manage something different and more substantial? Do you think this should be taken on face value or should it be examined? Where has this figure of $92m come from, and from what is it being saved? Only if you take this on face value can you really sustain press gallery drivel like this:
Health is naturally Labor's ground but the Abbott move gets him back into the debate in a substantial way.

Until this weekend (during which no election will take place), perhaps. It would be a triumph of hope over experience to treat Coalition mental health policy in any other way. It's facile for someone like Dennis Shanahan to gibber on about "Abbott [getting] a double bang for his buck". It doesn't fit with anything else they are doing or with a general approach of having the state step in to address social and market failures.

Abbott needs to get out in the public with positive policy and now that the drama of the Labor leadership is passing he needs to do so quickly.

Yes, he sure does. Pity that all the policy brains have gone from the Liberal Party, leaving only stunt-pullers and log-rollers hoping to get away with offering the Howard-Costello government without Howard or Costello. He's got a swine of a narrative, Dennis, and no amount of pearls is going to make much of a difference to that.

When it suits them, the journosphere can talk about the tyranny of "the narrative" as an excuse for not looking at policy through the eyes of those most affected by it, or those most vulnerable to sudden and far-reaching policy shifts. They can be quite content to fall back on press releases, statements and stunts that fit "the narrative", all the while oblivious to the breadth of sources working against a limited narrative, or the ability from time to time to turn an established narrative on its head. Yet, the Coalition narrative on mental health is established and this announcement need only be placed in context to be found wanting.

The whole idea of being a press gallery doyen(ne) is a refusal to be impressed with stunts, even detailed ones. Once again, by merely reporting what's in front of them, the journosphere has failed us once again.

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