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"Conflict of interest" concerns over merger of top mental health roles

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A State Government shake-up is set to merge key responsibilities of the Chief Psychiatrist and the Executive Director of Mental Health, InDaily can reveal – but the Opposition warns the move could compromise the independence of the state’s mental health watchdog.

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The independent statutory officer charged with oversight of the state’s mental health system will soon also be responsible for designing its strategy, as SA Health plans to take mental health policy and strategy out of the hands of the Executive Director of Mental Health – bringing the functions into the Office of the Chief Psychiatrist.

Opposition Health spokesperson Stephen Wade told InDaily this raised “significant issues of conflict of interest” because the Chief Psychiatrist is responsible for independently assessing the functioning of the mental health system.

Under the Mental Health Act, the Chief Psychiatrist is responsible for monitoring the standard of mental health care in South Australia.

An SA Health spokesperson confirmed the planned change this morning.

In a statement to InDaily, new Mental Health Minister Peter Malinauskas said the Chief Psychiatrist “has an important statutory role to monitor and promote improvement in the safety and quality of South Australian mental health services”.

“As the clinical lead for mental health services, the role will focus on setting appropriate clinical policies and procedures,” he said.

“I do not expect the Chief Psychiatrist to make operational decisions.  Operational matters will still fall under the Chief Executive of SA Health.”

But Wade argues that former Chief Psychiatrist Dr Aaron Groves was only able to inquire into the abuse of patients at the Oakden Older Persons Mental Health Service independently because he was not involved in the design of policy and strategy in the mental health system.

One of Dr Groves’ criticisms of Oakden staff in the report was a failure to be aware of SA Health’s Departmental Strategy for Safeguarding Older People.

Wade told InDaily that in cases where the system fails catastrophically, such as occurred in Oakden, the Chief Psychiatrist had to be able to independently assess “which part of it is poor policy, which part of it is poor strategy and which part of it is poor implementation”.

Bringing strategy into the Chief Psychiatrist’s remit “just undermines the people’s confidence that they’re being completely independent,” he said, adding that SA Health should have waited for the findings of the Independent Commissioner Against Corruption’s inquiry into the Oakden scandal before making any modification to the Chief Psychiatrist’s role.

Wade did not suggest any wrongdoing on Groves’ part.

However, strategy has previously been one of the function’s of the Office of the Chief Psychiatrist, but it was stripped during the tenure of Dr Margaret Honeyman.

InDaily understands the primary rationale for that decision was the slow pace with which the office was producing policy and strategy – rather than because of concerns about independence.

However, doctors’ union senior industrial officer Bernadette Mullholland told InDaily she shares Wade’s concerns and would write to the Minister for Mental Health, Peter Malinauskas, to seek an explanation for the decision.

Mulholland said she was yet to see the detail of the professional merger, but warned against any weakening of the Chief Psychiatrist’s independence from the administration of the mental health system.

“This person, for their own protection, needs to be able to (perform his or her role) away from the administrative side of decision-making,” she said.

Mulholland argued that merging the roles may “cloud the ability (of the Chief Psychiatrist) to provide the government and the minister with appropriate advice” about the mental health system.

Dr Brian McKenny is currently Acting Chief Psychiatrist. Groves quit the post in June.

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