Ms O'BYRNE (12:37 PM) —I move:

The SPEAKER —Is the motion seconded?

Mr Sidebottom —I second the motion and reserve my right to speak.

Ms O'BYRNE —Those who have volunteered or have been required to serve our country in armed conflict are very special Australians. They have been prepared to risk their lives and the livelihoods of their own families to defend our land and to protect the rest of us. They have ensured that we have been able to enjoy the democratic and independent lives that Australia provides us with today, and we owe each and every veteran a very special debt. Whilst it is appropriate that we honour them and remember those who have gone before on occasions such as Anzac Day and Remembrance Day, we must recognise that they should also have other rights and other privileges—and these are not tokens. They are practical acknowledgments on a day-to-day basis that our war veterans and those they have left behind are entitled to some benefits in recognition of their sacrifice and, in the case of many of them, because they have special needs arising from that very sacrifice.

Over the last six months, veterans all over Australia have begun to receive notification from their general practitioners and medical practices that they are no longer able to recognise the gold card, that preciously regarded symbol that shows Australians do care about those who have served us in times of conflict. The gold card is more than just an entitlement to be bulk-billed for medical care. To veterans, it is their contract with the rest of the Australian people, the material recognition that we do acknowledge what they have done for us. In some cases, the doctor's advice has been that the change will be effected immediately, whilst, in the majority of cases, it has taken the form of advance notice of future implementation a few weeks or perhaps a few months later. The practical effect of this is that veterans now have to make a contribution to the cost of their basic medical care. They may also be faced with additional cash flow problems by having to pay the full account prior to receiving reimbursement and/or additional paperwork, postage costs et cetera. This is the result of laziness, indifference and a lack of understanding by a miserly government hell-bent on looking after the top end of town at the expense of our servicemen and our servicewomen.

The question that we are bound to ask now is: how has this come about? The answer is twofold. Firstly, it is clear that this government does not care about the veteran community. It has allowed the worth of the gold card to diminish. It has also taken hours of home care away from veterans and war widows, forcing them to reconsider their independent lifestyles and look at joining already bursting queues for aged care places. I know my colleague the member for Braddon has been approached by many people who have really suffered through this miserly cut. Secondly, this government has not acted fairly or responsibly in dealing with the medical profession on this issue. Three years ago, the government entered into a memorandum of understanding with the medical profession for the provision of medical services to our veterans. Under the arrangement, the doctors agreed to incorporate health care plans, health assessments and medication re-evaluations in return for an increase in the basic fee. They did so in anticipation of a further improvement in fees when the memorandum was renegotiated. The deal meant that doctors would get $29.45 for a standard consultation with a veteran patient. This is $8.60 less than what they get for seeing a pensioner or a health care card holder.

Apart from the fact that doctors receive less when seeing a veteran patient, they are also expected to do more. There is more often than not additional paperwork, completion of D904 forms to get access services, authorities et cetera. Under the old arrangement, the Department of Veterans' Affairs used to pay doctors within 12 days or pay interest. Now doctors say that their payment is via a Medicare type reimbursement, usually taking a minimum of six weeks. Doctors say that they remain prepared to subsidise the treatment of veterans to a reasonable degree. They say they have done so willingly for many years. This is done, in effect, by cross subsidy from income from fee paying patients.

Three years on from the signing of the memorandum, where do we find ourselves? What has happened is that, after the agreement's expiry date and with no new deal in sight, doctors were given an ultimatum to sign up for an extension of the old deal with no increase in fees. If they did not sign, they receive even less—a fee of just $25.65, almost exactly half the fee which they receive for a normal consultation. The medical profession says that it needs a substantially better deal not only because it has not had an indexed increase over the past three years but because it has also faced greater pressures and costs through medical indemnity, accreditation documentation and the requirements of the Privacy Act.

Most importantly, where does this leave our ex-service men and women? First and foremost, it leaves them angry. Rightly or wrongly, they believe that they were promised that they would be looked after. Whether they were or not, I—and I am sure that most other Australians would join with me—feel that they are entitled to have this expectation. Veteran patients tend to attend doctors more often for a variety of reasons, most of them obvious. If the average number of attendances at the doctor per annum is seven, then for a veteran it is 10. For many individuals, of course, it is even more than that.

The reality is that many veterans, in anticipation of continuing to receive a fair deal from the government, dropped out of private health cover. They have budgeted for their future lives and retirements accordingly. The majority of veterans are happy with their general practitioners. They feel comfortable that they are seeing a doctor or a practice who knows their personal medical history and their circumstances well. They do not want to change to another doctor. It may be hard for them to even travel to get to another practice. And this is where our next problem arises. The answer given to those veterans who contact the Department of Veterans' Affairs about the advice they have received from their doctor is that they should simply change to a practitioner who will recognise the gold card. A veterans advocate from my electorate has been told on several occasions by the department that it has a list of those practitioners who are continuing to recognise the gold card, yet it refuses to provide him with access to that list. What is the point of having a list if we cannot actually see it?

Apart from that, the reality is that most doctors—certainly those where I come from—simply cannot take on any more patients. Whether they be veterans, pensioners or fully privately covered fee payers, the lists are closed. It is a nonsense to say that the solution is simply to shop around until you can find a doctor who will accept a gold card. What happens six months later when that doctor faces the same pressures already faced by his or her colleagues? It should not be necessary for our servicemen and servicewomen to look further than their preferred doctor of choice. I have been made aware of cases where local practices are so overloaded that veterans have to travel to the next town for their treatment and then they are denied travelling allowance because they apparently could have seen a doctor in their own town.

Some practices and practitioners have substantial numbers and percentages of veterans as patients. The impact for them of a government indifferent to their situation and the entitlements of veterans can be extremely significant. I am advised that some 2,500 doctors out of 14,000 have not signed the government's unilateral contract extension. The real question is whether this 2,500 includes many of those who are currently shouldering the heaviest load. I suspect, particularly in regional communities, that that is the case. I am becoming convinced that this government has no concept of how great the discontent amongst veterans and their families is, and how big these problems are becoming for our community.

I want to acknowledge, in particular, those medical practitioners who are continuing to recognise the gold card in return for the measly reimbursement they get from this stingy government. They are doing the right and proper thing. It is costing them a bit of money, but they are decent community people who are trying to do the best for the people who they care for and for the people they represent. This government, however, is not. Unless it changes soon, this government's attitude to this issue will devalue the gold card to a level where it is meaningless or worthless. That is the message we are sending to our veteran community—that the services we provide you can be diminished at any time. This ought to be unacceptable to any Australian.

I have no doubt that the government's response is probably going to come out something along the lines of: `Oh, well, we cannot afford it.' But, I believe—and, once again, I am sure that this is a feeling held by the majority of Australians, except perhaps the minister responsible—that we cannot afford not to do it. We cannot afford to walk away from these people. For me, some things that are the responsibility of the Commonwealth government are simply non-negotiables. The provision of basic support services to our returned servicemen and servicewomen is one of those things. I ask that the House note these sad developments and implore the government to act to redress the situation without delay. Without action one of the fundamental pillars on which citizenship and the national spirit of this country have been built will be seriously undermined.