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Tuesday, 27 August 2002
Page: 5791


Ms JANN McFARLANE (6:01 PM) —I am pleased to speak today on the two bills that we are debating, the Veterans' Affairs Legislation Amendment (2002 Budget Measures) Bill 2002 and the Veterans' Affairs Legislation Amendment Bill (No. 1) 2002. The measures in these bills come at a cost to taxpayers of $84.7 million over four years. I am sure that taxpayers will see this as being money deservedly spent and will support the measures. These bills are primarily concerned with rectifying drafting. However, they provide me with the opportunity to highlight a growing crisis in veterans affairs with the mounting pressures on the gold card.

The federal electorate of Stirling has 1,559 veterans affairs pensioners living in it. This figure has dropped from 1,669 in 2000. We can assume from the drop in the number of veterans that the majority of them are World War II veterans and that their numbers are being eroded due to death. With such a large number of World War II veterans, many are now coming into the twilight of their years and are suffering deteriorating health and wellbeing. They are spending more time at their doctor and in hospitals. As well, some are receiving respite care services. In short, they need more health resources.

Up until now the majority of veterans had been receiving free treatment with their gold card. This number increased after the last election, when both major parties promised the gold card to veterans over the age of 70, and the necessary legislation was passed, with bipartisan agreement, through both houses of parliament. The gold card entitles the veterans to free health care for all conditions. This includes benefits such as treatment as a private patient in a public or private hospital, choice of doctor and a range of other ancillary benefits.

The increase in the number of veterans receiving the gold card has put enormous pressure on our health system. This pressure has resulted in some doctors, including doctors in my electorate of Stirling, refusing free treatment to gold card holders. What are the reasons for this? The government has promised gold card holders free treatment, yet it is not honouring this promise to our veterans. The crux of the matter is that some doctors are claiming that it is not financially viable to treat veterans at present Commonwealth medical benefits schedule—MBS—rates. The minister has made claims that the Department of Veterans' Affairs is negotiating with the Australian Medical Association, but the government had not approved a negotiating position for the department as late as last week. How can you negotiate when you do not have a negotiating position? The minister needs to make sure that this issue is dealt with as a matter of urgency. To highlight the government's inaction on this issue I will quote Dr Johnston from the department who, on 4 June 2002 in front of the Senate Foreign Affairs, Defence and Trade Legislation Committee, made the following statement in response to a question from Labor shadow minister, Senator Mark Bishop:

We are talking with the AMA, exploring some possible approaches. The government has not yet decided what approach we should take in concluding those discussions, but we are talking with the AMA in a productive way. We will shortly be going to the government for guidance on how those discussion might be concluded.

The government owes it to our veterans to finish these negotiations as quickly as possible. If more medical practitioners make good their threat to withdraw their services, then this scheme faces real prospects of failing. What will happen if this occurs? Firstly, we will see more veterans shunted to public hospitals to be treated as public patients. Secondly, we will see many veterans not being able to access the quality health care that they rightly deserve. But why are they faced with this dilemma? Many doctors claim that the schedule fee is up to 50 per cent below cost, therefore placing them at a severe financial disadvantage.

What is causing this blow-out in costs? A number of factors are directly responsible for this cost blow-out. The first of these is the fact that, when the original rates were set, doctors had high levels of support in repatriation hospitals: hospitals that have been or are being privatised and sold or that have been closing. The second factor is the crisis, which is affecting doctors throughout the country, in medical indemnity insurance premiums. This has been well documented in the media and has not yet been fully resolved. The government's policy in forcing more people to take up private health insurance has seen participation levels soar. This has meant that doctors have faced a greater demand for their services from patients who are treated at much higher fees. What this does is place the doctor in a position where they have to make an economic decision—an economic decision which is seeing greater numbers of veterans being left out in the cold. What can the government do in the short term to ensure that this economic decision made by doctors is not hurting our veterans' community? I will examine some of the options proposed by Labor's veterans' affairs spokesman, Senator Mark Bishop, in a recent media release.

The first thing the government can do is instruct the Department of Health and Ageing to reissue Medicare cards to veteran gold card holders. In my electorate, veterans have told me that, when they are unable to access health care with their gold card, they have applied for a Medicare card so they can access treatment. Why would veterans want to get hold of a Medicare card? Increasing numbers of doctors and specialists are refusing to accept the gold card as it reimburses at the schedule rate only and no copayment can be charged. The Medicare card at least allows copayments. If a veteran faced with this situation is able to afford private health insurance, they are immediately penalised by this government. Under the policies introduced by this government, people over the age of 30 who take up private health insurance are charged a premium. This scheme was effective in increasing participation rates as people were forced into private health insurance, but it penalises veterans who expected free medical treatment from the department.

Another response that was suggested by Labor shadow minister Senator Mark Bishop would see the government making an interim agreement with the AMA, effective immediately, to increase the scheduled fees, subject to final negotiations, as a sign of goodwill to the medical profession. Why the government cannot do this in the interim is beyond me. It amazes me that the opposition has to provide the government with ideas on how to minimise the damage done by its inaction.

The minister is a kind and caring person and she must be embarrassed by the policies her cabinet ministers have adopted. The minister, though, does have carriage of the portfolio and the policies. The minister has clearly failed the veterans' community. Maybe the minister should spend more time looking after the welfare of veterans than parading around the country giving the same speech, time after time, at veterans' functions. News travels fast in the veterans' community. You only have to look on the web to see how well this group is organised and how quickly it disseminates information to its members and the broader community.

There are over 285,000 veterans with gold cards. This is a huge number of people who could be affected by this government's inaction. Earlier in this speech, I outlined the benefits of the gold card. One of the fundamental benefits is being able to have your doctor of choice. Senator Bishop, in response to his letter to doctors, has received a large number of representations from doctors who advise that it is no longer viable for them to continue to treat veterans at CMBS rates. Senator Bishop, in his press release dated 27 June 2002, stated:

If the rates do not change—

doctors have advised him—

that they will not treat veterans unless they pay for the services.

Veterans who have a gold card should be able to go to their own GP without having to pay. They should not be deprived of treatment by the GP that they know and trust. The government's inaction is putting their free treatment and their choice of doctor in jeopardy.

In the bills we are debating tonight a measure has been included to index the pensions of war widows income support supplement, the ISS. I support this measure. The Labor Party supports this measure. The measure effectively removes the freezing of the ISS benefit, which over time has decreased in real terms. This proposal to index the ISS by increasing it by a proportion of the increase to the age pension—CPI or to a minimum of 25 per cent of MTAWE—essentially reverses the previous policy to limit war widows' access to income support benefits. It acknowledges, and rightly so, that war widows are entitled to more generous treatment than their age pension peers. The bill we are examining also backdates the ISS to coincide with the payment of war widows' pensions and introduces means testing of the ISS.

Labor shadow minister Senator Bishop has identified a serious policy consequence of the proposed change to a pre-existing policy to limit access to income support. There are a small number of war widows and widowers under 57, with no children, who are specifically excluded from access to ISS or any other benefit, including Newstart and the disability support pension. In this scenario, a war widow or widower may be left with nothing but the war widow's pension. Senator Bishop has identified that there are over 1,600 people in this category.

Senator Bishop asked a question on notice in the other place in which he sought the exact number of people who are affected. In response, the department's records show that there are 1,607 war widows and two war widowers under the age of 57, without children, included in their pension assessment. The inequality in this situation, which is exacerbated by this bill, means that these people, should they wish to re-enter the work force, will be discriminated against by not being able to access Newstart and any training program to assist them to find work. This is entirely unacceptable. It would only cost the government approximately half a million dollars per annum to address this issue. This figure is peanuts compared with the money spent on advertising by this government.

The electorate of Stirling has a large number of dependants of deceased veterans. These dependants include war widows and orphans. This year, 671 dependants in my electorate had a gold card. This figure shows us just how many people the provision of this bill will affect. I suspect that there will be a number of people affected by this anomaly in my electorate. In an effort to provide practical assistance to the veterans' community in Stirling, I have advertised in my electorate newsletter, Jann's Journal, that help is available through my office on Mondays between 1 p.m. and 4 p.m. I have been lucky to have been approached by Mr Greg Young, the pensions officer at the local Osborne Park RSL subbranch, who is willing to assist my office and me with inquiries from veterans and war widows and their families. Mr Young is donating his time to assist veterans in the local area. I hope that more veterans in the electorate of Stirling make use of this valuable service in my electorate office.

Speaking of the Osborne Park RSL subbranch, I was lucky enough to be invited there in July to present the first recipients of the national service medal with their medals. It was a moving ceremony where the subbranch honoured five of its members. I would like to thank Bill Sullivan and the committee of the subbranch for making this event possible. Ceremonies such as this provide the community with an opportunity to acknowledge the contribution of people who willingly responded to the call up for national service. Many of these people went on to serve their country, often in times of conflict, and are the veterans honoured by us all.

My office has processed hundreds of national service medal applications. I applaud the award, however I must criticise the long processing times associated with the medal. I am constantly being rung by people who sent their applications to the department months ago and have still not received their medals. In some cases, the wait has been over six months. I hope that the government takes notice of this and provides some assistance for the staff in the medals directorate of the defence department, who are doing a sterling job in trying to deal with the tens of thousands of applications. The government should at least alert veterans that they will be waiting quite a long period of time for their medals. I know many of the veterans in the RSL subbranches in my electorate had been hoping to march in the 2002 Anzac Day ceremonies with their national service medals. Unfortunately, none of them received their medal in time.

I will be holding a series of ceremonies at local RSL sub-branches in my electorate over the second half of this year. Hopefully the bottleneck in processing the medals will be overcome so that more veterans can receive the recognition that they richly deserve. I plan to hold ceremonies at the North Beach, Scarborough, Osborne Park and Nollamara/North Perth RSL sub-branches in the near future. These sub-branches provide not only a social gathering place for veterans but also support in accessing government benefits and support services. The efforts of all the sub-branch committees need to be recognised more often. To the committees, I salute your efforts and offer you my ongoing support.

What I have done tonight is highlight some of the challenges facing the veteran community. It is essential that the government move quickly to avert a disaster in the area of the gold card. Action needs to be taken immediately to overcome the impasse that is starting to form. The provisions of this bill that deal with income support for war widows also need attention. The points I made earlier in my speech about the inability of these 1,607 people to access the services and benefits that are available to the rest of the population should be addressed as a matter of urgency by this government. I support the passage of this bill.