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Wednesday, 28 August 2002
Page: 3923


Senator BUCKLAND (4:32 PM) —I rise to speak in support of the urgency motion moved by Senator Bishop today. I do so because of the concerns I have for the difficulties faced by many of the veterans who have received gold cards under the Veterans' Entitlements Act. The government has promised veterans that they will receive free medical treatment with their choice of doctor. Currently, the veterans gold card system is facing one of the gravest disasters in the history of Australia's repatriation program, despite what has been said on the other side—and I listened carefully to what was said. But there are fundamental problems with the program.

At present, there is an increasing number of doctors and specialists who are refusing to accept the gold card because it reimburses at the scheduled rate only and no copayment can be charged. When you consider some of the difficulties that veterans have—the medical problems that confront them—you can understand that they quite often require a greater level of care than many people in the general population. So doctors are rightly concerned about the level of funding they have and payments they receive for treating these patients.

I do not think it is just a few specialists and GPs complaining about this; I think it is a general groundswell towards a condemnation of what is happening with the program. There are even some private hospitals which are refusing to accept the gold card, especially on weekends. Again, what do they get for the service they deliver? Looking at it strictly from a business point of view, you can understand that they are not getting a great deal for the services they are required to provide. I do not agree with that, because I think that free medical services for these people should mean free medical services fully funded by the government. This is not the fault of the private hospitals, doctors or specialists; it is the fault of the government. It is becoming apparent that in the face of rising costs the scheduled fee is up to 50 per cent below cost, thus creating a real strain on their commitment to serving the veterans of this great nation.

The real issue that needs to be addressed is for the Howard government to make an offer adequate to keep the specialists engaged—an offer that is realistic and that does properly recompense them for the services they provide to this elite group of Australians. Doctors are pushing for increased fees for treating veterans under the Repatriation Private Patients Scheme. They are arguing that they can no longer meet the expenses of offering the discount rates to such a significant proportion of their patients. We need to remind ourselves that these patients are those who have taken up the call to serve their country and to serve their country well. They have not shirked their duty. They are suffering not by acts of their own but by acts of war and by acts of confrontation, defending the great democracy which we all enjoy. We should not trade off these people's welfare and their health at the expense of doctors.

The doctors of this nation are straining to keep up with the great demands upon their time and expertise and with the costs that are confronting them in their everyday practice, so it is not something that either group can claim responsibility for. Veterans are not forcing doctors to do more for less; the veterans have no control, nor do the doctors have control, over the fees that they charge. But doctors should be able to seek recompense in a true sense for the cost of servicing our veterans. When the rates were initially set, doctors were receiving a high level of support from repatriation hospitals. Now they are providing this themselves. To add to these financial pressures, we have spiralling medical indemnity insurance premiums which are adding to the strain of the cost of providing health services. This is another issue where the Howard government has failed to react sensibly to resolve a problem confronting the nation.

If you go outside the main city areas, you see that veterans in rural areas are confronted by greater pressures, as are the doctors practising in these areas. You have the tyranny of distance for many: whilst we think an hour's drive in the car is not too much, it is often more than these veterans can handle so they cut back on the medical services they are seeking. Any doctors who travel to them are not being properly recompensed for what they are doing.

There are also increased levels of private health insurance so there is a greater demand for doctors' services by patients who are treated at a much higher fee. It does not take a financial or business genius to work out that if you get more for your money that is where you go, and those who can afford to pay are getting higher levels of service than those who have served our country by putting their lives on the line in our defence. It is absolutely imperative that the government settles the issue of gold card payments to medical specialists and that it issues rates that are acceptable to the AMA as a matter of first priority.

The gold card is supposed to provide security by entitling the holder to access comprehensive free health care and related services for all health care needs and conditions whether or not they are related to war service. What this government is doing—what it provides as payments to doctors for treatment of these patients—does not do that at all. Veterans deserve free access to health care. People who put their lives on the line when they go out to defend the democracy that we enjoy deserve free access to health care, especially in their old age or if they are suffering from war-caused injuries. This government is not providing an adequate level of service and care for our aged veterans.