TONY JONES, PRESENTER: We've known for some time that Australia's handling of mental health lags behind other areas of the health system.

There've been some more shocking stories this week about desperately ill people turned away from hospital emergency wards with a script or a handful of pills only to commit suicide a short time later.

Well that happened not so long ago to the nephew of one of country's leading mental health experts, John Mendoza, prompting him to say that a dog run over on the side of the road has a better chance of getting care than people with serious mental illness.

Well after sitting on it for five months, the Government today released the critical report of the National Mental Health Commission, which had already been leaked.

SUSSAN LEY, HEALTH MINISTER: It's a strong report, it's a good report and it's also positive because while describing a system that we should collectively be disturbed and even at times alarmed about, it does indicate a way forward.

TONY JONES: The report says the current system isn't cost-effective and very often does the wrong things. It says too much money is being sent on acute hospital care and it recommends moving more than a billion dollars of that funding into community-based services. But the Health Minister, Sussan Ley, has ruled out taking direct action on that issue.

SUSSAN LEY: The Government does not intend to pursue the proposed $1 billion shift of funding from state acute care to community organisations as we want to work collaboratively in partnership with other levels of government.

TONY JONES: So the minister says she'll set up an expert reference group to guide the state and federal governments through the process. One of the authors of the report is Professor Ian Hickie from the National Mental Health Commission. He's not fuzzed about who funds what, just so long as the money is directed where it's needed. Professor Hickie's here with us now in the Sydney studio.

Thanks for being here.

IAN HICKIE, National Mental Health Commissioner: Thanks, Tony.

TONY JONES: Now the Government wants an expert working group, more expert panels to back up what its expert report has already said. You must feel like you've been through this before?

IAN HICKIE: We've all been through this before. We've had dozens of major inquiries in the last decade in this country. We've had 20 years of national planning. We've had COAG plans since 2006. We've had a year now under the Abbott Government of experts in this country, experts, consultation, all coming together under Allan Fels' leadership to produce specific reports. I think the Abbott Government did a really good thing this time around. It said, "Tell us specifically what we the Commonwealth can do to make a difference tomorrow."

TONY JONES: Yes, but that's precisely the point, really; the Commonwealth minister is now saying, "Well, we're not going to act. We're going to get more experts, more panels, more groups together to keep talking about this." I mean, there isn't lot of money to go around. Are you surprised she's delaying things?

IAN HICKIE: Well I think it's an issue for the Prime Minister. Minister Dutton commissioned this report on behalf of the Prime Minister to tell us what we the Commonwealth can do specifically. Now very importantly, the Prime Minister was the Health minister when John Howard and Morris Iemma really made a political difference in this country to lead this in 2006. But John Howard, the big changes he achieved, the Commonwealth did. It started Medicare funding for psychologists, it started the Headspace services. The Commonwealth took direct action. And that's the key here, Tony: the Commonwealth can go into the big regions of Australia tomorrow. It controls the health spending outside of hospital, the GP services, the psychologist services, the suicide prevention programs. It can take the leadership role tomorrow.

TONY JONES: I don't think anyone's sort of missed the point here. You're laying this at Tony Abbott's feet. Your saying that he has the power and the responsibility, is that right?

IAN HICKIE: And he has a track record of actually taking action where necessary. He's made a commitment in this area and ...

TONY JONES: But he's also got a track - if I may say so, he's also got a track record of saying the states need to handle these kinds of issues - education, health etc.

IAN HICKIE: Well in mental health and in suicide prevention, these community issues, he's made it clear, in Indigenous communities where this really matters, and in fact that's the report they commission. This is where it was different to what went before. We've been trying to sort out the federation, the Commonwealth-state issues forever. There are about 60 big regions in Australia where we need effective health services, effective suicide prevention. The Commonwealth can take the leadership role throughout primary health care networks at the local level. The states will partner. Mike Baird has come out of NSW with a great plan with John Feneley, his commissioner. They've got a plan. Mike Baird launched it. He's ready to act tomorrow in concert with the Prime Minister to organise at a regional level what needs to be done. We don't need more reviews, we don't need more experts. Every expert in Australia has already made a very significant contribution to very specific recommendations on which the Abbott Government can now act.

TONY JONES: Does it need to go to COAG tomorrow? I mean, does it need COAG to sort of sign off on it? Should this be on their agenda?

IAN HICKIE: It's a been with COAG since 2006.

TONY JONES: Right.

IAN HICKIE: I mean, John Howard and Morris Iemma thought that getting COAG together would help. Everything's on the COAG agenda. This requires direct action by the responsible governments and they can work in partnership. I'm sure Mike Baird will work tomorrow with Tony Abbott. He's got his own plan already committed to, re-elected, funded, going ahead. And the same thing: he's a state premier saying, "Look, it's not about hospital beds. We're not closing any beds, any services, we simply need to expand the community end so that people can move from hospital to community in crisis and live effective lives."

TONY JONES: Alright, let's talk about that 'cause that's the critical thing because that recommendation in particular, the minister has categorically or appears to have categorically ruled out. She says she doesn't intend to shift the proposed $1 billion funding from state acute care - that's in hospitals to community organisations. Your response?

IAN HICKIE: It's the money the Commonwealth sends to the states each year to support hospitals in addition. It's $200 million a year over five years - that's where the billion comes from.

TONY JONES: So is this going to close down acute hospital wards?

IAN HICKIE: This is not gonna close ...

TONY JONES: That's what people are assuming.

IAN HICKIE: And that's what's the wrong assumption from the way this has been communicated. Not a hospital bed will close, not a hospital ward will close, not an emergency service will close; in fact, they'll be supported by the services so when you leave those services - the terrible stories like John Mendoza's nephew that you reported this week; the tragedy was not at the hospital end, it was at the hospital door. The moment the person left: no service, left alone, readmitted, representing with suicidal tendencies. Those critical risk periods - the out-of-hospital services must be great to accompany effective in-hospital services and we can't use hospital beds to house people for accommodation, for social services, for crisis.

TONY JONES: OK. But it begs the obvious question, doesn't it? Say the $200 million a year extra that would have gone to the hospitals actually goes to community care, will you be creating little hospital units with beds or will you be taking care of people in their homes? What kind of care would someone like Mendoza's nephew get?

IAN HICKIE: That whole range. You just hit the nail on the head. That whole range. You need acute hospitals, you need step-down care, you need community residences, you need effective support for families who can be treated at home. That's what it funds. Now let's be clear here: the Commonwealth spends $10 billion a year on mental health. The states spend $5 billion directly and at least that again in other family and social services - so about $20 billion a year. We're talk about $200 million a year slowly shifting, not to close any hospital wards, but what the Commonwealth spends money on to increase the community supports.

TONY JONES: So why - presumably these arguments have been made to the minister and we presume she's read the report since it's been sitting there for five months, so hasn't she got that message ...

IAN HICKIE: This is detailed.

TONY JONES: ... or have they already rejected that message?

IAN HICKIE: It's detailed in the reports. It's detailed. It's very conservative in fact in the shift, but it says, "Look, in Australia, we need to make those community services." If you're sitting in Far North Queensland, you're sitting in Western Victoria, you're sitting in the Pilbara, what you need is not another hospital bed; you need the range of community services and it's really the people in rural and regional Australia who've been most let down by this. That's where the suicide rates are the highest, in the Indigenous communities. And Tony Abbott's made it really clear, as has the minister herself, being from these kind of backgrounds, that these are the areas that really matters. That's under the Commonwealth's control to act now.

TONY JONES: Final question then: are you convinced that these changes you've proposed in the report would save lives?

IAN HICKIE: Absolutely. We can reduce suicide in this country through effective services. We've had major experts like Helen Christensen review the suicide prevention literature, deliver it regionally. That's what the report contains: big regional trials of suicide prevention. That saves lives.

TONY JONES: And if the reforms are not made, that will effectively lead to death - is that what you're saying? More death.

IAN HICKIE: Every rural and regional backbencher we've spoken to understands this completely: people will die in rural and regional Australia if the Government does not get on and implement the report.

TONY JONES: Ian Hickie, we'll have to leave you there. Thanks for coming and joining us.

IAN HICKIE: Thank you.