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Monday, 11 November 1991
Page: 2870

Senator LEES (Deputy Leader of the Australian Democrats) (9.41 p.m.) —The Hearing Services Bill 1991 follows last year's decision by the Government that the National Acoustic Laboratories become a statutory authority. It sets up the framework for the establishment of the Hearing Services Authority which will come into effect on 1 July next year. These changes largely arise from a report last year by the Industry Commission, which Senator Patterson has dealt with in depth.

  Among other things the Industry Commission recommended that the National Acoustic Laboratories should be privatised and that all suppliers should be able to compete to provide hearing aids through the hearing services program. The Industry Commission report caused considerable disquiet and, following its release, a number of organisations queried the ability of the private sector to provide a comprehensive audiological service. The groups responding to the Industry Commission's report were principally concerned about the possible effects of wholesale privatisation on hearing services, particularly for children and people on low incomes.

  Ultimately—as the Minister for Health, Housing and Community Services (Mr Howe) acknowledged in his second reading speech—the Government accepted the view that total privatisation would disadvantage those people who would not be able to afford hearing services if they were supplied privately. Consequently, instead of opening up the hearing services market, the Government decided to reform NAL by way of creating a statutory authority which aims to provide hearing services to eligible—or, as the Minister calls them, public interest—clients, as well as undertake a range of other activities.

  The Bill does not alter the availability of services to the traditional NAL clients and I suppose that is something to be grateful for considering this Government's record in such matters. However, there are two areas of concern. Firstly, although the Bill ensures provision of aids and services to the existing clients of NAL, there is a continuing failure to address a significant gap in the delivery of such services. The Australian Association of Speech and Hearing wrote to me recently, pointing out:

The establishment of a statutory authority without change of eligibility—

while being welcome—

still does not address a significant population in Australia who do not and would not meet the eligibility criteria. Many are on low or fixed incomes which cannot stretch to meet the costs of receiving services at the same professional level and accountability as the national service, plus the costs of suitable hearing aid devices. They are a significant disadvantaged group which should be addressed.

More specifically, every group I have spoken to about this Bill expressed the same view to me—that NAL services need to be extended to people who are unemployed, particularly those who are receiving Jobsearch and Newstart allowances. For example, the Australian Deafness Council expressed the following view:

With rising unemployment, there will be a growing number of people unable to afford the $1000 necessary for a hearing aid.

Other groups pointed out that people who have a hearing impairment are quite clearly impeded in their search for employment if they do not have access to hearing aids and hearing services.

  Many long term unemployed people with hearing impairment have received no assistance at all in this regard, and this Bill still offers them no assistance. The Hearing Services Authority will only assist the following people: pensioners; veterans; people under 21; members of the Australian Defence Force; a person whom the Commission for the Safety, Rehabilitation and Compensation of Commonwealth Employees has referred to the Authority for medical treatment under the Commonwealth Employees' Rehabilitation and Compensation Act 1988; a person referred to the Authority in connection with a service provided under a rehabilitation program under the Disability Services Act 1986; and Commonwealth public servants who are referred to the Authority by the Commonwealth for purposes relating to a medical examination in connection with their employment.

  The Minister also has the power to determine that a particular class of persons are to be eligible persons under the Act. This clause in the Bill was one that the Committee for the Scrutiny of Bills considered to be an inappropriate delegation of legislative power because the matter is left entirely to the Minister's discretion. There is no mention anywhere of people who are unemployed, and this omission is most disturbing at a time when the Government is supposedly taking stronger measures to get the long term unemployed back to work.

  It is also quite anomalous when one realises, for example, that under this list as it stands, it is possible for a senior, well paid member of the armed forces or the Commonwealth Public Service to receive assistance through the Authority, while an unemployed person who needs a hearing aid in order to obtain work cannot receive the same assistance. I find that extraordinary and quite ridiculous. Similarly, persons who are referred to the Authority for medical treatment or rehabilitation under the Commonwealth Employees' Rehabilitation and Compensation Act or the Disability Services Act are able to receive assistance, but what about those unemployed people who are compelled to seek rehabilitation under their Newstart agreements?

  It is not difficult to imagine a situation where, in the course of a CES or DSS interview, it appears that a person has a significant hearing loss, or that a hearing device being used is inadequate. It could be considered, quite reasonably, that the person's employment prospects would increase if the hearing problem were rectified. It would then also be conceivable that remedying this problem could form part of the person's activity plan under Newstart. In other words, people could be compelled to seek assistance in order to improve their employment prospects but, under this Bill, they would have no access to the services provided by the Hearing Services Authority. Again, this seems to me to be rather arbitrary and bizarre. Where is the point in setting up a scheme to get people back to work—leaving aside the merits or otherwise of the Newstart scheme—if they are then denied access to the sorts of services that will undoubtedly enhance their employment prospects?

  I am constantly amazed by the way the Government chooses to treat the unemployed. Time and time again the unemployed are denied benefits that are given to others, despite the fact that unemployed people and their dependants are amongst the poorest members of our society. The only conclusion that can be reached is that, yet again, the unemployed are being punished simply for being out of work.

  I cannot understand why, if it is important for pensioners to have access to these services—and I would certainly not be suggesting otherwise—it is not equally important for the unemployed to have the same access. People in the field to whom I spoke about this Bill were all concerned about the inability of low-income earners to obtain hearing services. For example, ACROD pointed out:

There are many people on fixed incomes (that is, low income earners, recipients of Family Allowance Supplements and people who are unemployed) who although they are holders of Health Care Cards, do not have access to NAL services and have to go begging to service clubs for assistance to purchase a hearing aid.

Pamela Rosenberg from Disabled Persons International told me that there needed to be more sensitivity to what she called the hidden people with a hearing impairment, particularly women not in the work force and the long term unemployed. Others told me stories of coming across unemployed people with quite severe hearing impairments who had never had a hearing aid because of the costs involved, or who continued to use out of date devices because they could not afford to purchase more modern products.

  I discussed this matter with the Minister's office and requested that, even if he could not see his way clear to include all people on unemployment benefits as eligible clients, the Government should at least ensure equity and fairness by making sure that those who were required to obtain hearing aids or services as part of their Newstart agreement were included. I thank the Minister for arranging costings of my suggestions. I was advised today that the Department estimates the recurring cost per year to be $6.5m to provide access to NAL services for JSA and Newstart recipients and $16.8m to provide access for all health care cardholders. I find these figures somewhat excessive, but I cannot comment further as I was not able to look at the figures to see how the estimates were arrived at. I will not go into any further detail. However, I appreciate that such an extension of services would require additional resources and that there is already a problem with a shortage of qualified audiologists.

  The Government appears concerned that there would be some anomaly in splitting health care cardholders by enabling Newstart clients to have access to NAL services while denying other cardholders the same right. I understand that concern, but repeat that it would be preferable to give access to all health care cardholders. However, if this is not possible, it seems to me that it is quite appropriate that we should give preference to those people who are unemployed and whose employment prospects will be enhanced by giving access to the same free hearing services as the Authority's eligible clients.

  I have been advised by the Minister's office that people on Newstart who have a hearing impairment at a level that is likely to affect their entry into the work force will be referred through the disability reform package for a rehabilitation program. At this stage of referral, they will pass through the Commonwealth Rehabilitation Service to the Authority if they are assessed as needing a hearing aid. I understand that the Minister is willing to ensure that this situation is reviewed in order to ascertain whether unemployed people on Newstart who require hearing services are able to access such services.

  I do not consider this to be the best possible outcome, but I am prepared to accept it at this point in time. I will be suggesting to relevant organisations that they make sure that their unemployed clients are aware of the Minister's concerns and offer and that they keep monitoring any problems unemployed people experience in obtaining access to hearing services. I urge the Minister to at least consider a subsidy for health care cardholders when he looks at introducing regulations under clause 62.

  The second item that concerns me is the announcement that a $25 annual fee will be introduced to cover the annual supply of batteries and other maintenance services. This charge will not apply to families receiving FAS and the children of eligible clients. The charge will be made by regulation under clause 62 of the Bill which also empowers the Authority to waive any such charge. We do not intend to oppose clause 62 of this Bill; however, we will closely examine the subsequent regulations which introduce the fee.

  Without going into great detail at this time, I want to make a couple of points about the proposed charge. Firstly, this additional charge, while relatively small—about 50c per week—comes on top of a number of other charges introduced by the Government over the past two years. The cumulative effect of these charges is particularly hard on people with multidisabilities or chronic illnesses.

  For example, a pensioner who has a chronic illness and who also has a hearing impairment and is now paying an up-front fee for pharmaceuticals will soon be paying an up-front fee for visiting the doctor, and will also be paying out for hearing services. In addition, he or she is more than likely to be up for some of the range of small charges and fees being introduced across a wide range of services: for example, the home and community care program. Because these charges are introduced under various schemes and programs, there is little recognition of how they can add up for the individuals involved. It is well within the bounds of possibility that my hypothetical pensioner will be up for at least an extra $10 per week simply to maintain his or her health at a very basic level.

  Secondly, the introduction of a charge very clearly creates the potential for more significant cost shifting and one can only speculate about whether this Government—or, indeed, any subsequent government—will feel inclined to bump up the charge even further. There is then the issue of whether the Authority will waive the charge in situations of genuine hardship. If this does not occur, it is clear that there will be some people who will simply go without services. I know that this is of great concern to several of the groups that I have been in contact with.

  Finally, we come again to the issue of failure to recognise the additional costs of disability. Instead of acknowledging that people with disabilities already incur considerable additional costs, and making some moves towards the introduction of a disability allowance, here is yet another Bill which penalises people with a disability by making them pay for it. I appreciate the resource issues involved, but the proposed charge really raises some basic questions about how we expect disabled people to become full and equal participants in our society when we continue to disadvantage them at every available opportunity by the imposition of extra costs and charges.