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Tuesday, 11 September 2018
Page: 3


Ms RISHWORTH (Kingston) (12:14): I rise to speak on the Veterans' Entitlements Amendment Bill 2018. This bill amends the Veterans' Entitlements Act in relation to how the Department of Veterans' Affairs administers bereavement payments, correcting an inadvertent error from amendments made in 1996. This bill reinstates an element which deals with the provision of bereavement payments and recovery of overpayment of a surviving partner.

Essentially, when a veteran passes away the surviving partner is entitled to a bereavement payment, which is made up of 14 weeks of the partner's income support payment. This payment is to assist individuals with the costs following the death of a partner and provide a period of time for the surviving partner to adjust their finances. During this difficult time, it's not uncommon for there to be a delay in advising the department of the death of the veteran, resulting in an overpayment to the partner. In these circumstances, rather than send an overpayment notice, DVA instead deducts the overpayment from the bereavement payment amount. For example, if it takes four weeks to notify DVA of a veteran passing, the bereavement payment will be reduced by four weeks and the surviving partner will receive only 10 weeks of income support in the form of a bereavement payment. This only happens in circumstances where the surviving partner has access to funds through a joint account or some other mechanism.

Where the partner has not had the benefit of the additional weeks, DVA seeks the overpayment from the estate directly. This is consistent with the similar process of the Department of Social Services to minimise unnecessary interactions with DVA. Labor understands that, while DVA has the legal authority to provide the bereavement payment and the legal authority to recover the income support pension paid to the veteran after death, the amendments in this schedule will confirm this authority and streamline the administrative process.

The bereavement payment and the way in which overpayments are recovered is a compassionate process that is supported by the Alliance of Defence Service Organisations and their member organisations, the War Widows Guild and the Partners of Veterans Association in particular. We have sought assurances, as the opposition, that this continues to be supported by these organisations. These organisations have commented that it's better to deduct an overpayment from a partner's entitlement than to send an account weeks or even months after the veteran has passed away, and it is for this reason that Labor supports the bill.

That being said, while Labor support this bill and are happy for it to progress, we are deeply, deeply concerned about the government's undermining of veterans' access to health services. It's for this reason that Labor will be moving an amendment to draw the House's attention to an issue that the government has refused to acknowledge and which is rapidly reaching crisis point. Labor has long been pursuing the issue of the impact that the government's Medicare rebate freeze has on veterans. As members may be aware, the Repatriation Medical Fee Schedule that DVA pays is directly linked to the Medicare Benefits Schedule, which has been frozen by the Abbott-Turnbull-Morrison government since 2014. This freeze has led to a situation where DVA rebates have been gradually eroded and they are no longer covering the costs of treatment. Because veterans can't be charged a gap payment, some medical and allied health professionals have had no choice but to turn DVA clients away. Let me say that again: clinicians, doctors and specialists are having to turn veterans away because the DVA payment does not cover costs.

This rebate gap is starkly illustrated when we consider the gap between what a clinical psychologist can charge versus what DVA covers. This is demonstrated by GO2 Health in the Productivity Commission's review into DVA. A clinical psychologist can charge private patients $251 per 60-minute session. In comparison, DVA pays only $148.95 for a 60-minute session. This is a gap of $102.05 per session. And non-clinical psychologists can charge up to $251 per session for private patients while DVA pays only $101.45. This is a gap of $149.55 per session, which means the gap for psychologists is almost 1.5 times the amount that the DVA pays them. There are dedicated and passionate professionals working in this space to assist veterans, but gaps of more than $100 per session are simply too much to overcome.

Australian doctors are telling us that there is a significant problem. The Australian Medical Association completed a survey of their members last year about the impact of the fee schedule freeze. The survey found that almost 30 per cent of specialists were no longer committed to treating veterans. In addition, only 44 per cent of specialists said that they would continue to see veterans if the freeze continues, with the remainder considering other ways to charge veterans.

Anecdotally, veterans have been telling me for some time that they've been unable to access providers due to the ongoing freeze. These are veterans like Andrew, who was seeing a psychiatrist in Sydney but then moved to Darwin and was unable to access a new psychiatrist. During his search, Andrew was told by the psychiatric provider that they were unwilling to treat him as a direct result of the gap in fees.

This issue was also raised by submitters to the Senate inquiry last year into suicide by veterans and ex-service personnel, and by submitters to the current review into compensation and rehabilitation for veterans being conducted by the Productivity Commission. Critically, submissions to the Productivity Commission review from the Prime Minister's own advisory council on veterans' mental health and from the Veterans and Veterans Families Counselling Service National Advisory Committee raised concerns about this emerging gap. The Prime Ministerial Advisory Council on Veterans' Mental Health said in their submission:

It would appear there is a limited, but perhaps increasing, number of medical specialists turning our veterans away once they become aware they are DVA clients. The Council understands the concern regarding accepting DVA clients stems from the fact that the MBS fees have been frozen for many years.

The Veterans and Veterans Families Counselling Service National Advisory Committee elaborated on this, stating:

The remuneration gap between seeing veterans versus private patients from the general community or Defence members is now so significant that clinical providers are prioritising other clients over DVA referrals. In some cases, providers are refusing to accept clients with DVA white or gold cards because of the poor remuneration offered.

Over the course of these two inquiries, issues have also been raised by Occupational Therapy Australia, GO2 Health, the Australian Institute for Suicide Research and Prevention, the Australian Psychological Society and the Royal Australian and New Zealand College of Psychiatrists. All of these submitters have raised their concerns about the gap and its impact on service for our veterans.

Despite the evidence provided and the statements coming from the government's own advisory board, the government continue to bury their head in the sand when it comes to the impact of the medical freeze on the DVA fee schedule. DVA have stated that they believe that because they pay more than the MBS there is no problem and veterans should simply shop around. But, while DVA does, indeed, pay more than the MBS, it is clear that the DVA fee schedule is out of step with what providers are charging. The crux of the issue is that, unlike private patients, veterans cannot be charged a gap. So, unless the DVA fee schedule is reflective of broader costs of delivering services, veterans will continue to be turned away from services in favour of private patients.

This is particularly the case, and of particular concern, where there is lack of supply of these services. If there's lack of supply, the medical professionals will go for the highest bidder; they will take private patients over our veterans. In some parts of Australia, it is being made very clear to me, veterans do not have the luxury of shopping around. Frankly, this is unacceptable. Veterans who have access to DVA cards do so with the understanding that they will be able to access the health care they need as a result of the service and sacrifice they have made to our country. Instead, due to the unfair freeze, it is the veteran's own DVA card which is closing off options to them. Labor has been a strong supporter of the government's non-liability healthcare arrangements, and continues to advocate it to members of the ex-service community. But there is little point in having a program for veterans if providers are turning veterans away.

The government has a responsibility to address this issue, which is increasingly impacting veterans. It has been undermining Medicare since 2014. We know that it cannot be trusted with Australia's healthcare system. It is now time for the government to admit that it is impacting not only the wider community but veterans as well, who should not have to worry every day about whether they'll be able to access the health care that they need. But the reality is that they are doing so under this government.

Our veterans do deserve better, and it's for this reason that Labor, whilst not declining to give this bill a second reading, will be moving an amendment today to draw the House's attention to this important issue which is undermining veterans' access to health services. Given the significant concerns raised by providers, by peak organisations and by veterans themselves, we believe it's important to draw attention to these concerns. I call on the government to act urgently to protect veterans' access to health services. I urge the government to listen to their own advisory boards, the organisations, the specialists, the ex-service community and the veterans themselves who are raising these concerns. I ask that the government take serious action to address this issue to ensure that veterans can access the services they need as a result of their sacrifice to our country. Therefore, I move:

That all words after "That" be omitted with a view to substituting the following words:

"whilst not declining to give the bill a second reading, the House notes with concern that the Government has undermined veterans' access to health services".

The SPEAKER: Is the amendment seconded?

Ms Chesters: I second the amendment and reserve my right to speak.

The SPEAKER: The original question was that the bill be now read a second time. To this, the honourable member for Kingston has moved as an amendment that all words after 'That' be omitted with a view to substituting other words. If it suits the House, I will state the question in the form that the amendment be agreed to. The question now is that the amendment be agreed to.