Founder of the Werry Centre for Child and Adolescent Mental Health, Prof John Werry, of Auckland, said he would like to see a shift in focus from secondary to primary health care, while focusing largely on children.
Prof Werry told the Royal Australian and New Zealand College of Psychiatrists conference in Queenstown yesterday that child care was placed on the sidelines and treated as an "underclass".
"We need to operate more efficiently and develop a proper primary service focused on early intervention."
Admitting a "conflict of interest" as an advocate for infants and adolescents, he said the current health care structure was focused on the wrong patients.
Of the total health care budget, only 6% goes towards the primary budget and 9% to mental health and of that mental health care budget, only 2% goes towards primary care.
Prof Werry, who graduated in medicine from Otago University Medical School in 1957 and studied psychiatry, specialising in child and adolescent psychiatry, at McGill Montreal, said this was not equitable nor was it getting value for money.
"It's a dog's breakfast, basically."
He said he would like to see mental health care adopt structures that would include a GP practice and a public health nurse.
This could only come from moving money from secondary health care, such as the excessive amount of inpatient units, which cost $1100 a night, totalling 13% of the budget.
"They reinforce laziness and incompetence."
The 80-year-old also said dealing with district health boards could be hugely difficult as they were too "bureaucratic".
"The answer is always no. They tell you what you can't do, never what you can do when it comes to innovations."
He told the more than 100 psychiatrists at the conference that when dealing with DHBs to remember "rules are made for fools".
