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Foreign Affairs, Defence and Trade Legislation Committee
23/10/2019
Estimates
DEFENCE PORTFOLIO
Department of Veterans' Affairs

Department of Veterans' Affairs

[20:20]

CHAIR: The committee will now move to its examination of the Department of Veterans' Affairs. Welcome, Liz Cosson, secretary, and officers of the Department of Veterans' Affairs. Ms Cosson, do you wish to make an opening statement?

Ms Cosson : I do. Thank you, Chair.

CHAIR: Do you have copies of it for the committee?

Ms Cosson : Yes, we do.

CHAIR: Thank you. If they can be circulated, thanks. Can I ask: the statement won't be too long?

Ms Cosson : No. It shouldn't be too long.

CHAIR: Thank you.

Ms Cosson : I'll speak as quickly as I can. As the committee is aware, the department has now entered the third year of our transformation program known as the Veteran Centric Reform. I am pleased to update the committee that we have now over 100,000 veterans who have registered using our new online channel MyService. This new channel has seen over 66,000 claims lodged as it is allowing veterans and their families to lodge claims faster and more easily.

We are also seeing quicker decisions with over 80 per cent claim acceptance rates for our MRCA initial liability. As a result, we are seeing unprecedented growth in the volume of claims of around 83 per cent against the three acts. This is having an impact on how quickly we can process claims, and it is causing a backlog, a backlog we are committed to remedying.

We are making great strides in modernising our telephone system. It is making it quicker and more direct for veterans and their families to get the assistance they need. We have digitised over 327,000 veteran files and, for the first time in the organisation's history since 2016, we now know every veteran who is leaving the Australian Defence Force and our relationship with Defence has never been stronger with our ability to leverage data from Defence as all current serving members leave the Australian Defence Force.

I also recognise the passing of the Australian veterans' recognition bill, which includes the covenant, as this is important to encourage all Australians to recognise and acknowledge the unique nature of military service and to support veterans and their families.

It is important to recognise that the vast majority of Australian Defence Force personnel transition well from their service. They find employment or purpose and integrate into communities. They go on to lead healthy and productive lives, enriched and enabled by their military service. They further enrich and enable this nation and its economy as veterans in so many ways.

However, there are some veterans and families who need some additional support, and this is where we continue to place our priority of effort. Some find the transition into civilian life challenging. Others may need additional support throughout their post military life. We will continue to prioritise our efforts to deliver this support to them and their families.

I am pleased to see improvements in our client satisfaction results. Since our transformation program commenced, overall client satisfaction continues to rise. The MyService access satisfaction rate is four out of five stars, and the annual satisfaction rate of veterans under 45 years of age has notably increased.

As mentioned by the minister—oh, the minister hasn't said anything!—we are aware that the department has acknowledged the Productivity Commission report and its findings regarding the veteran support system. I acknowledge there is more to be done for veterans and their families.

I would like to acknowledge all the staff in DVA. I am proud of their commitment and know that they work exceptionally hard to build on achievements and to deliver supports and services to strengthen the trust and confidence of our veteran community. I thank you for the opportunity to address the committee and am happy to take questions.

CHAIR: Minister, I assume you don't have an opening statement?

Senator Reynolds: I don't, but I might just pick up on Ms Cosson's comments. I have just a couple of quick points. I would reinforce, again, this government's commitment to ensuring that veterans and their families are given the supports that they need and deserve. The Productivity Commission report was obviously a very important report, which the department and also the government are reviewing carefully. It does create some good opportunities for further reforms in the department.

What I did want to say in relation to Ms Cosson's comments about her staff is that the department has gone through significant reform now for a number of years. Large reform like that is never easy on staff. I just want to acknowledge the progress, on behalf of Minister Chester and myself, to the staff for the work that they have done to get to this point. While there is still a lot of work, I know that everybody in that department goes to work every day actually wanting to do the right thing by our veterans. And while we still have some work to do on processes and more reform, I just want to thank them and acknowledge the work that they do.

Senator FAWCETT: Secretary, thank you for your great advocacy and support for assistance dogs. That's brought the program forward faster than many of us had feared that it would occur, so thank you. You may be aware that the Royal Society for the Blind in South Australia were strong advocates for this and have a good track record in this area. They were one of the groups who were pushing for this to occur originally. To say that there is bitter disappointment that they were not included on the panel with that first limited tender would be an understatement. Could you just explain to the committee if, for groups such as them, there will be further opportunities, and how soon, so that veterans in South Australia can benefit from this initiative?

Ms Cosson : I would also acknowledge the committee, which did actually advocate for the assistance dogs for our veterans' community. As you'd appreciate, Senator, we do have a trial underway to gather that research and evidence to support the assistance dogs for our veterans—particularly those who are suffering from mental health conditions and PTSD. We do see that there is great support for those veterans with a program such as the assistance dogs.

We were very clear when we went out for the limited tender to have a look at what governance and arrangements we wanted to put in place. As you would appreciate, we announced two successful tenders—and Mr Cormack will just outline what the next steps are. I did have the opportunity to speak to the CEO of the Royal Society for the Blind as well about what we were doing. I'll hand over to Mr Cormack.

Mr Cormack : We are pretty much at the launch stage of an open tender. That will be to encourage all providers of assistance dog services to put in a bid to participate in a broader panel arrangement, of course subject to the requirements being met. If those requirements are met through the tender process then we envisage that there would be a significant increase in the number of providers.

Senator FAWCETT: You said you were almost there; are we talking weeks, months?

Mr Cormack : Yes, weeks.

Senator FAWCETT: Weeks. And how long do you anticipate that tender will be open for, and then how long until the announcements are made?

Mr Cormack : We've envisaged that the tender would be open for a minimum of four weeks and then there would be an evaluation period, probably in the order of about five or six weeks. At the conclusion of that, we would identify a number of bidders—tenderers—who've met those requirements, and then we would enter into a process of contract negotiation with them. So I think, realistically, that will take us into early 2020 to have a broader range of providers than the two that we've currently got.

Senator FAWCETT: Will you be contacting known providers, or will this be advertised?

Mr Cormack : It will be an open tender. It will go up on AusTender, and it will certainly be available to all organisations.

Senator FAWCETT: I understand that's a requirement for procurement. But, in terms of alerting and advising existing providers, will they be contacted?

Mr Cormack : It'll be announced through the standard government procurement process, which is a release on the AusTender site.

Senator FAWCETT: Ex-service organisations who have members who would like to have assistance dogs provided as part of this program then perhaps need to be contacting their local providers to make sure they are looking out for that. Not every provider will be scanning the government sites daily. You're not going to advertise in papers or do any other advertising?

Mr Cormack : As I said, the standard process we go through for all of our tenders is to go through the AusTender site. That's the way that we advertise those. We've got networks, of course, across the department. We've got a very active ex-service organisation network that provides advice to the secretary and to the minister, and we always make sure that they're well informed about activities such as this. But the formal process is governed by the government procurement arrangements and the AusTender arrangements.

Senator FAWCETT: Sure. I accept that.

CHAIR: Senator Lambie?

Senator LAMBIE: I'll quickly go on with the dogs, while we're on that. I believe these questions come out of outcome 2 for DVA.

CHAIR: We are covering all of DVA.

Senator LAMBIE: Yes. I just thought, since we're on dogs, I'll go straight to my dog questions. Does the committee have the appropriate departmental officials in attendance to deal with these matters?

CHAIR: I reckon they do, so ask your questions.

Ms Cosson : We should have. We have all our officials here.

Senator LAMBIE: The Department of Veterans' Affairs has announced several different funding figures over the past 18 months for an assistance dog research program with La Trobe University and the Centre for Service and Therapy Dogs. These published figures included indicative spends by the department of $2.4 million, $2.2 million and $2 million over the period of 2018-19 to 2021-22. Could you please advise what the actual figure for this research project with CSTDA and La Trobe is?

Mr Cormack : I'll get a colleague to give us the precise answer to that.

Ms Nowland : On the figures that we have, it's approximately $2 million for La Trobe to undertake the research and then approximately $350,000 for Evolution Research's evaluation of the program.

Senator LAMBIE: And how much has been spent on the scheme so far?

Mr Cormack : We'll see if we can get you an answer on that tonight, but the project's been underway for about 12 months, and the money's not all expended, but we'll give you an indication as to where we're up to with that before the hearing concludes.

Senator LAMBIE: How many veterans have received a dog under the scheme so far?

Ms Nowland : We have 12 veterans who've participated in the program so far, and we have space for up to 20.

Senator LAMBIE: How many veterans do you believe will receive dogs under this program?

Ms Nowland : Under the trial, there'll be a maximum of 20, and that's for the purpose of the research program that La Trobe University is undertaking.

Senator LAMBIE: So we're paying $100,000 per veteran assistance. That seems like an extraordinary amount of money when we've done studies in the past with dogs and what they affect. Why are we going back over old ground?

Mr Cormack : It's very important that—while there is certainly some good evidence about the effectiveness of this, we're keen to make sure that the effectiveness of assistance dogs for veterans with PTSD is based on the best possible research. The purpose of this trial is to establish not only the efficacy of assistance dogs for veterans with PSTD but the various circumstances—the way of training the dogs, the way of pairing the dogs with the veteran that works the best and gets the selection process right. So it's really about making sure that it's done to the highest possible standard, based on the latest available evidence.

Senator LAMBIE: Okay. I have some questions in reference to the TPI benefits now. When is the government planning to release the KPMG report on TPI benefits?

Ms Cosson : I can take that one. The KPMG report was actually commissioned by the department. We have the final report from KPMG, but I haven't actually released it at this stage. I was waiting for—as you may remember, the Prime Minister appointed David Tune to do an independent review into the TPI pension, so I held the release of the KPMG report; I just didn't want to interfere with that process. I'm happy to release the KPMG report once I know the outcome of David Tune's report.

CHAIR: Can I follow up? I understand Mr Tune's report has been delivered to government. Is that correct?

Ms Cosson : It has been delivered to government, yes.

CHAIR: I think that was in August some time; would that be right?

Ms Cosson : I think the report was due 31 August; I think that might be the date.

Senator Reynolds: I understand it was the end of August, and government are still considering the report.

CHAIR: And do we have a general time line? I don't expect a specific date.

Senator Reynolds: That is the information that I have to hand, and I'll take that on notice and see if I can get the answer back tonight. If not, I'll take it on notice.

CHAIR: Good, thanks a lot. Senator Lambie.

Senator LAMBIE: With or without the government's support, is there any reason why you're dragging your feet on this, and what have you got to hide? I think that's a fair question.

Ms Cosson : When we commissioned the KPMG report—I had been engaging with the TPI Federation before releasing it, but I have now received advice from the president of the federation to say that they actually don't want to offer any further comment, so if we want to release it we can. Unfortunately, the report didn't deliver what the federation wanted, so it's ready to go.

Senator LAMBIE: I doubt if it's what anybody would want. Anyway, is it any different to the review on the TPI benefits conducted by David Tune? Is it similar? Can you at least tell us that much? Are they matching up or—

Ms Cosson : I can tell you what was in the KPMG report and what it found, if that is helpful? Certainly the KPMG report—

Senator LAMBIE: That's okay; I have a copy.

CHAIR: I suppose the question is: is there any overlap, without giving the game away completely as to what's in the Tune report? Are there are certain similarities, at least in some areas?

Senator Reynolds: As the government's still considering the Tune report, I'll see if I can get further information about that. But I think it would be inappropriate to comment further until I can report back.

CHAIR: All right.

Senator LAMBIE: The TPI SRDP compensation payments are supposed to compensate veterans who cannot work as a result of a total and permanent disability as a result of their service, yet estimates from the TPI Federation of Australia suggest that the economic loss component of TPI benefits is worth nearly $10,000 less than the minimum wage. The compensation for veterans who are totally and permanently incapacitated is worth less than 50 per cent of male average weekly earnings. Does the DVA agree that there is a shortfall in the economic loss component of the TPI benefit?

Ms Cosson : The purpose of the KPMG report and also David Tune's report was to look into the case that had been put forward by the TPI Federation.

Senator LAMBIE: I suppose that you have seen that. Do you have anything that you'd like to say about that?

Ms Cosson : I can speak to the KPMG report. The KPMG report said that they did not have a case. Certainly the KPMG report, as you would know—you have a copy—said that there were some opportunities to look at some of the TPI veterans who were in greater need and that we could look at potential opportunities to give them some relief.

Senator LAMBIE: So you haven't actually seen a copy of the Tune report?

Ms Cosson : I have seen it, but it's not my place to comment on it. As the minister said, it is under consideration by government at the moment.

Senator LAMBIE: Have you as the secretary given advice in relation to the Productivity Commission report, the Tune review and the KPMG review to the minister on the TPI Federation's claim for the rightful restoration of the amount of compensation paid to TPI SRDP veterans?

Ms Cosson : If I can take the KPMG report, I have provided a copy of that to the minister. We're prepared to release that. David Tune's report went to the Prime Minister. That was commissioned by the Prime Minister.

CHAIR: No. The specific question was: in relation to each of those reports, have you proffered any advice? It's not for Senator Lambie or this committee to find out what the advice was, but has advice been proffered?

Ms Cosson : With the KPMG report, it was more a case of providing the report to the minister, and giving him the highlights of the report and what KPMG potentially recommended. In relation to the David Tune report, I can't recall, to be honest, if we provided a copy. I wouldn't have provided advice on David Tune's report, because it was an independent report commissioned by the Prime Minister through Prime Minister and Cabinet.

Senator Reynolds: Again I can confirm that the government is considering both reports at the moment.

Senator LAMBIE: I want to ask about the delays in processing compensation claims. How long does it take on average for a veteran to have their compensation claim assessed at this point in time? You said that there's a backlog. I have had letters sent to me with your signature on them, Secretary. Obviously you're saying to people that you have a backlog. What's your backlog here in dealing with these claims?

Ms Cosson : It depends on which part of the claim and which claim. If we're looking at initial liability under MRCA, that certainly is very quick. As you would appreciate, under Veteran Centric Reform we identified the top 40 conditions. We were able to streamline the decision-making in relation to those initial liability claims. So they're going through relatively quickly.

What we have seen, as I mentioned in my opening statement, is unprecedented growth in the demand and the claims that are being put forward—about 83 per cent. We are seeing a backlog in the permanent impairment claims. We are making a real effort. We are looking to see where we can redistribute our workforce. We are also prioritising claims. We are trying to understand where we have got veterans who are at risk and have greater need to make sure that we're getting to them early. We are bringing on additional workers to actually deal with those claims and get them through as quickly as possible. I'm happy if Ms Cole wants to talk about the claims generally and what she's doing. The annual report as well has where we have met the targets and where we haven't been able to meet targets.

Senator LAMBIE: That's okay. Has the department thought about getting rid of all the low-hanging fruit that is sitting there and giving the staff a little bit more room to concentrate on those who have worse injuries? Wouldn't that be a much quicker way of doing things? There would be quite a lot of low-hanging fruit. They could check it off.

Ms Cosson : We are looking at veterans who have mental health conditions, who are experiencing financial difficulties or who have been subject to abuse. We're looking at those who are high risk. That's certainly where the staff are focusing their efforts. That is the priority that they are applying to the claims that are waiting to be progressed.

Senator LAMBIE: I note the department has put out a tender for a private contractor to improve—well I think you guys could say 'improve'—these processes. What are you hoping the private contractor that you're going to send our medical documents out to for assessment, like a medico-legal, without seeing us will do? What are you hoping they will do to actually fix this mess?

Ms Cosson : That's part of the issue. The Senate's inquiry into veteran suicide, The constant battle, recommended that we look at our medico-legal arrangements, as did the Australian National Audit Office. They recommended we look at medico-legal. Similarly, the Collie report identified there was some evidence that claims processing could aggravate a mental health condition. All three of those reports said, 'Have a look at your medico-legal arrangements, strengthen them and try to have better performance metrics around them,' because there were delays in some cases.

I know Ms Cole has made an effort with her delegate training that anybody lodging a claim in accordance with our legislation needs to have evidence that they've got that condition, that injury, and that it is related to service. The first step is to look at defence records; the second is, if they don't have their defence records, to use their treating clinician to provide a report to us; if they don't have a treating clinician or their treating clinician isn't wanting to put forward a report, then that's when we go to medico-legal. To go to medico-legal, we actually have to have the veterans' consent to do that; we don't just send medical records to a third party. At this stage we haven't gone out to the market yet; we've gone out to seek interest before going to the market.

Senator LAMBIE: How is this going to improve the situation when a veteran has a report from their GP and from probably two or three specialists who are treating them and it says the same thing? What difference is this going to make when you send them to a medico-legal, who currently sees them for 15 or 20 minutes and downgrades them anyway and who, in the future, will not be seeing them at all? Tell me how you expect this is to work exactly?

Ms Cosson : We'd use their treating doctor's reports. That's the first thing we would do. We would have a look at the report to ensure that it covers what we need to progress that claim. It's only if that report and/or their treating doctor aren't able to give us the information we need, that's when we'd go to a medico-legal. The first step is to use the treating doctor.

Mr Cormack : Senator, by going out, as we are, initially for expressions of interest and then making an approach to the market, once we get those providers on board they will actually speed up the processing time. So if the concern that you have is that there are delays, then refreshing that panel, making sure that we've got the best available medical advice, will speed processing up.

Senator LAMBIE: My problem isn't the delay; that is secondary. My problem is the results that will come out of this. What sorts of KPIs are up for this contract? Will they receive kickbacks for the number of claims they reject? What sorts of wages are they getting paid here? I imagine this is very questionable.

Mr Cormack : Senator, this will be going through formal government procurement processes, and I can assure you there will be no kickbacks paid along the lines of what you've suggested. We'll be seeking the best quality and availability of medical advice and the best value for money, and they'll be acting in accordance with the legislation, which is beneficial. That's what we'll be seeking to do: the best quality advice, the shortest possible time, the least delays to the veteran and there will not be any adverse KPIs incorporated into any contract for these providers.

Senator LAMBIE: I guess we'll see. Regarding the AAT decision in the matter of Thurlow vs Repatriation Commission involving Mr Thurlow, a World War II veteran, can you please advise how much did DVA spend on legal costs with respect to the AAT application relating to Mr Timothy Thurlow? How much did DVA spend on the disbursements relating to the Thurlow AAT application in 2015?

Ms Cosson : Senator, I can take on notice how much.

Senator LAMBIE: That would be great. Do DVA have lawyers seconded from panel firms assisting with respect to reviews of claims (a) at a primary level and (b) before the VRB, subject to the response to the above?

Ms Cosson : Sorry, Senator; I'll have to check on that one for you and take that on notice. We do have lawyers that work in our legal and assurance branch to support providing advice to our delegates. But I'm not too sure of what your question is.

Mr Cormack : If you're talking about representing the—

Senator LAMBIE: I'm talking about the panel firms. I'm talking about how much is spent with the Australian Government Solicitor. You obviously get tapped for that.

Ms Cosson : Okay. We do have those figures for you.

Senator LAMBIE: For the panel firms, I'd like to see whether they're all paid the same. I'd like to know how much is spent with the Australian Government Solicitor and how that works—the hourly, monthly and yearly rates and what that is costing.

Ms Cosson : Are you happy for us to take that on notice to give you that breakdown?

Senator LAMBIE: Sure.

Ms Cosson : Absolutely.

Senator FIERRAVANTI-WELLS: On that point, I used to do this work at the Australian Government Solicitor's office. Are you getting a bulk rate, if I could put it that way, because of the number of cases that they—whether it's the Australian Government Solicitor or any other law firm—are doing for you? Are you being charged as if that were a standalone case, or are you getting a discounted rate for the number of cases?

Ms Cosson : I'll have to defer to the general counsel on this one.

Senator LAMBIE: I guess this would be the same question: is there a different amount paid to lawyers seconded subject to their level of seniority and experience? If so, what are the different rates paid? How much was paid to individual panel firms to provide lawyers on secondment to DVA in the last 12 months?

Brig. Worswick : Which question would you like me to answer first?

Senator FIERRAVANTI-WELLS: There are two sets of questions, so both of them.

Brig. Worswick : All right. The department has a panel of three providers which assist with the AAT litigation. That panel was put together under the previous Commonwealth legal services arrangements. Those arrangements changed as of 1 July this year, but the department has not reorganised and gone out and put together a new panel as yet. We are in the process of preparing to do so.

The three panel providers are the Australian Government Solicitor, Sparke Helmore Lawyers and Moray & Agnew Lawyers. I can tell you the amount that we expended on each of those three firms for the financial year 2018-19. Those figures are published in the annual report. They are also reported annually to the Office of Legal Services Coordination in the Attorney-General's Department. For the financial year 2018-19, we spent $2.49 million with the Australian Government Solicitor for veteran appeals, $1.74 million with Sparke Helmore and $1.22 million with Moray & Agnew.

Senator LAMBIE: How much do you believe you saved by using this method? What do you believe you've actually saved, and how many actual people—veterans and those who've served—did that involve?

Brig. Worswick : When a veteran decides to take their case to the Administrative Appeals Tribunal to seek an appeal of a decision, the department is obliged to engage legal services to represent the Commonwealth's interests in the Administrative Appeals Tribunal. We do that in accordance with the Legal Services Directions. The three firms that we use have specialist practitioners who understand the complexity and detail of the three different pieces of legislation that veterans are appealing about in the Administrative Appeals Tribunal. There are only a very small number of legal practitioners in Australia that have the expertise and are able to work at the quality standard that we require in representing our interests in the tribunal.

Senator LAMBIE: Yes, I'm aware of that. I can just imagine how our poor advocates are trying to get through all that stuff out there. But my point is: have you weighed up what it's costing you? I certainly know that, for some people who are paid out, the amount you people spend fighting us far outweighs what you're actually paying out, and then you lose anyway. So you must have a table or something that weighs it up to see how that's going and whether that's worth your while.

Brig. Worswick : The department doesn't take a 'win or lose' approach with respect to these cases in the Administrative Appeals Tribunal.

Senator LAMBIE: I'm asking: do you do a cost approach?

Brig. Worswick : The Legal Services Directions regulate the way a Commonwealth agency conducts its litigation. In respect of veteran appeals in the AAT, the department is required to only pursue litigation where there's a proper legal basis for doing so.

Since my time as general counsel, we have spent a considerable amount of energy focused on trying to find ways to resolve these matters as soon as the veteran takes the matter to appeal, and looking for opportunities at all times for early resolution. The interesting thing about trying to resolve early a lot of the veterans cases is that it actually costs us more in legal costs because we ask the law firms to engage in more investigation, and to engage further with the advocate and the veteran, to try and get the best possible evidence and the most favourable outcome possible for the veteran. But if the matter continues through to a hearing—and only 1.5 per cent of our cases, on average, go through to hearing because many are resolved beforehand—it is being litigated because it's in accordance with proper principle and proper legal procedure.

Senator LAMBIE: And what's your win-loss ratio once it gets to that?

Brig. Worswick : I can tell you the figures, if it would be helpful, for matters that ultimately end up being affirmed in the tribunal. But I can say to you that, on average, the department has between 350 and 500 veterans appeals per annum. It's never a finite figure because, from year to year, cases don't necessarily get resolved. An aggravating factor about the veterans appeal jurisdiction of the Administrative Appeals Tribunal—and it's a matter of public record—is that it is one of the slowest divisions in the Administrative Appeals Tribunal, so veterans appeals take a long time.

In 2017-18, as I said, 1.5 per cent of decisions ended up going to the AAT. That's a total of 144 decisions under DRCA, 57 decisions under MRCA and 205 decisions under VEA. Of those, 86 were affirmed or withdrawn by the veteran under DRCA, 39 were affirmed or withdrawn under MRCA and 125 were affirmed or withdrawn under VEA. Of those that were set aside, 58 were set aside or conceded by the department, and 18 MRCA decisions and 80 VEA decisions.

We publish those figures every year. The ones I just read out to you are actually published in the Productivity Commission report, but our figures are also published—and the figures are also published by the Administrative Appeals Tribunal.

Senator LAMBIE: And is DVA still carrying out the practice of using surveillance on those who have served, with regard to their injuries?

Brig. Worswick : Since I've been general counsel in the department, we have never—

Ms Cosson : No.

Brig. Worswick : engaged in any surveillance.

Ms Cosson : We don't engage in surveillance of our veterans.

Senator LAMBIE: No, but you used to.

Ms Cosson : I understand that that may have been the case, but we do not undertake surveillance.

Senator LAMBIE: When did that stop?

Ms Cosson : I haven't been aware of it since I've been in the department. I joined in 2016.

CHAIR: Why is that? If you think somebody's cheating the Australian taxpayer, why wouldn't you bother looking into it?

Ms Cosson : Our legislation is to be beneficial, and what we do in applying our decision-making is look at the evidence that's been put forward to lodge a claim. We don't undertake surveillance to then check if the veteran is genuinely experiencing that injury or that illness. That's just not part of our legislation—or our practice.

CHAIR: Legislation or practice?

Brig. Worswick : The way these matters unfold in the Administrative Appeals Tribunal is that, by the time the veteran makes a decision to go to the tribunal, the case has usually been subject to at least one if not two independent reviews. Once we are in the tribunal's jurisdiction, we're in the hands of the tribunal as to how the matter is run. The first port of call is a summons for all the material in relation to the veteran's claim, and often that evidence alone will be supplemented by additional reports and the like that we commission. There's no need to surveil, because the evidence base to be able to assist the case and assist the tribunal is quite extensive.

Senator FIERRAVANTI-WELLS: But you still do surveillance for a personal injuries claim?

Ms Cosson : That's separate.

Brig. Worswick : The department in 2019 hasn't had any personal injuries claims.

Senator FIERRAVANTI-WELLS: Right. Okay.

CHAIR: It's 9 pm. The committee will suspend for 15 minutes.

Proceedings suspended from 21 : 00 to 21:15

CHAIR: We will resume, and Senator Roberts has the call.

Senator ROBERTS: Thank you for coming today. How many Defence veterans are homeless in Australia, and, if this figure is not known, why is this so?

Ms Cosson : We actually didn't know the figure. We understood that we have heard many figures over recent years, so what we did was commission some research to try and actually understand the nature of homelessness in our veteran community. The first piece of work we commissioned is with—I always use the acronym and I'll find you the correct name—

CHAIR: The question was about the numbers. Do we have the numbers or not?

Ms Cosson : It depends on which report you're reading. The AHURI, Australian Housing and Urban Research Institute, determined a figure in their report. They identified 20 veterans and then they gained some insights on whether they had experienced or felt that they were at risk of homelessness.

CHAIR: Time is going to be of the essence.

Ms Cosson : I'm sorry.

Senator ROBERTS: Thank you, Chair. How many veterans do you see as homeless?

Ms Cosson : I beg your pardon?

Senator ROBERTS: In your eyes, how many veterans are homeless?

Ms Cosson : It depends on the report. The Australian Institute of Health and Welfare identified 1.1 per cent of veterans as potentially homeless.

CHAIR: Which is how many in number?

Senator ROBERTS: How many is that?

CHAIR: Take it on notice if you don't—

Ms Cosson : Thank you, Chair. I'll take that on notice.

Mr Cormack : It's 1,215.

Senator ROBERTS: You've established what measures are being taken to establish a national database, and you're starting to do the research—

Ms Cosson : That's correct.

Senator ROBERTS: but there's no database yet. How much does the department spend on addressing this problem?—just a quick broad figure.

Ms Cosson : There are a number of programs that we actually have. We're entering into partnerships with our ex-service community to address that, but we're also looking at risk factors. We're talking to veterans who may have experienced homelessness, so—

Senator ROBERTS: You don't know how much you're spending on it?

Ms Cosson : Not the exact figure, because it crosses many programs that we deliver for our veteran community.

Senator ROBERTS: We've seen research figures recently that indicate more than 5,000 veterans may be homeless in Australia.

Ms Cosson : That was the AHURI report that I was referring to earlier. They based that on 20 veterans, and then they extrapolated that to work out that it was probably about 108,000 using their modelling, which then came up with a figure of 5,800.

Senator ROBERTS: How has this growing problem been allowed to get out of hand, given an estimated figure of 3,000 homeless veterans was made by the department in 2009 in the DVA veterans at risk report? It's grown by 66 per cent in 10 years.

Ms Cosson : To be honest, it depends on which report that we're looking at. We haven't just let it—

Senator ROBERTS: It's still pretty alarming though.

Ms Cosson : Absolutely. Homelessness is alarming. We take it very seriously and are looking at what the risks are. Importantly, we have identified that one of the key risks is during that transition period—

Senator ROBERTS: I want to pursue this quickly, because the chair is under pressure for time. Isn't it a matter of understanding the root cause of this, and there are many root causes?

Ms Cosson : Absolutely.

Senator ROBERTS: It indicates a problem that's growing.

Ms Cosson : What we have done is invested a lot of time working with the Department of Defence and the Australian Defence Force in that transition space, because what we have recognised is that a key period, particularly of—

Senator ROBERTS: Doesn't that indicate something's going wrong, because it's increased by 66 per cent in 10 years?

Ms Cosson : In the last three years we have committed a lot of effort into that transition, looking at employment opportunities, understanding what are the—

Senator ROBERTS: How can we understand the problem if we don't even know the count?

Senator Reynolds: Chair, I know Senator Roberts is trying to go fast, but I think it would be helpful if he could at least allow Ms Cosson to answer a question.

Senator ROBERTS: With respect, I'm asking specific figures and all I need is a yes or no on whether you have the figures. I'm getting a lot of vague stuff about 'We're working with this and that.'

Senator Reynolds: With respect, I don't think you have allowed the secretary to answer a question.

CHAIR: Let's try to ask the questions again. Senator Roberts, ask the question and then see how we go with the answer.

Senator ROBERTS: How much does the department spend on addressing this problem? You don't know about that. How has this problem been allowed to get out of hand, given an estimated figure of 3,000 homeless veterans was made by the department 10 years ago and the DVA veterans at risk report—so it has increased by 66 per cent in a decade?

Ms Cosson : We don't have an exact figure and we have been committing a lot of time and resources to understand what is the nature of the issue with homelessness in our veteran community. Even though we didn't have an exact number we've been looking at what programs and what services we can provide to try to reduce the risk of homelessness. I wouldn't reflect that it's out of hand at all, because we have been doing a lot of work with defence and we do understand what those risk factors are. We have been talking to veterans who have experienced homelessness in order to inform those programs. I can't give you an exact figure of what we spend to address homelessness, because it does cover a number of programs across the department for all veterans, of which it can target those risk areas for our veteran community.

Senator ROBERTS: Do you agree that we as a country owe a significant debt to our service veterans?

Ms Cosson : Absolutely.

Senator ROBERTS: They deserve to be treated with dignity and respect and in a way that shows our gratitude?

Ms Cosson : Absolutely.

Senator ROBERTS: Wouldn't that start with having a roof over their heads, as a good example of our gratitude?

Ms Cosson : As you know, we have had the passing the veterans recognition bill, which went through the House yesterday. That is fundamental to all Australians recognising and respecting and helping veterans to integrate into community.

Senator ROBERTS: Just a final comment: I talk to veterans and listen to them about that and they say that this was done some time ago and it is just yet another signal. What they're after is some action.

Senator LAMBIE: Minister, when was it taken to COAG to speak to the states about veteran homelessness?

Ms Cosson : In 2016, Minister Tehan, our veterans minister at the time, convened what was then called a Veterans' Ministers' Round Table. We don't have a COAG in our veterans space. Minister Tehan took it to the Veterans' Ministers' Round Table. Then, Minister Chester took it to subsequent round tables and the Veterans Ministerial Council, because, as you would appreciate, it is an issue for the states as well. But we're working very closely with our state and territory colleagues and ex-service community. It has gone to all of the Veterans Ministerial Council round tables.

Senator LAMBIE: When they have their COAG meetings—

Ms Cosson : No, they're not called COAG.

Senator LAMBIE: No, if it's so important when we have COAG meetings, when the ministers go and meet their state counterparts, when was this raised at that level?

Ms Cosson : Certainly, from 2016, when Minister—

Senator LAMBIE: You told me they're round tables. When did a minister go to COAG and sit with his state counterparts and raise this, because it's so important?

Ms Cosson : He does raise it with his ministerial colleagues—

Senator LAMBIE: But he hasn't raised it in that environment? That's what I'm asking you?

Ms Cosson : Because we don't have a COAG for veteran issues, we do have a council. It doesn't have the formality around a COAG but it does discuss veteran issues with all state and territory ministers.

Senator Reynolds: The Veterans Ministerial Council met in August this year and the need for a more coordinated approach with state and territory governments and ex-service communities on veteran homelessness, particularly when it comes to the collection of data and the provision on-the-ground services, was discussed and agreed.

Senator LAMBIE: When did you take it to COAG—yourself—because it's so important? When did you take it to the states at the COAG meetings they have and bring this across the table and actually ask them what they're doing about it, straight from you?

Senator Reynolds: I haven't personally, because I'm not the minister directly responsible. That's Minister Chester. The last time he did was in August of this year.

Senator AYRES: Ms Cosson, I'm not sure that I followed the end of Senator Lambie's line of questioning. Was there a request to provide the KPMG report? Did we agree that was going to happen?

CHAIR: It's been provided to the minister—is that right?

Ms Cosson : That's correct. The KPMG report has been provided, but I did not release it—it was commissioned by the department—because I was conscious of the Prime Minister asking the Secretary of the Department of the Prime Minister and Cabinet to commission an independent report, which was done by David Tune, and that is the one that is currently under consideration by government. So the KPMG report that we commissioned has been finalised, but I didn't think it was appropriate to release it when Mr Tune was developing his own.

Senator AYRES: When will that be released?

CHAIR: We've gone through this.

Senator Reynolds: What we've already discussed in relation to this is that the government is considering both reports. Any further questions need to go to PM&C because it was PM&C and the Prime Minister who commissioned the report.

Senator AYRES: Okay. I want to ask some questions about budget cuts. I know there have been questions in previous estimates about the impact of budget cuts on staff numbers. What is the reduction in staff numbers this year?

Ms Cosson : In our annual report we do actually have the breakdown on page 208. Our current staffing headcount—if I can use headcount—totals 1,681. That is a reduction of 108 positions since last financial year.

Senator AYRES: Is that since 2017-18?

Ms Cosson : From 2017-18, our total headcount was 1,885. At the end of 2018-19, our total headcount was 1,681.

Senator AYRES: What's projected for—

Ms Cosson : For 2019-20, our cap will be 1,615. That's for APS. That doesn't count where we have contractors or labour hire. If we look at that, then we're sitting over—

Senator AYRES: I'll come to contractors and labour hire in a minute. Is that 1,615 cap—

Ms Cosson : APS

Senator AYRES: Is that what you have budgeted for?

Ms Cosson : That's the average staffing level that we have in our budget for 2019-20—that's correct.

Senator AYRES: Are they full-time equivalents?

Ms Cosson : APS is a little bit different. It's the average staffing level over the year rather than full-time equivalent.

Senator AYRES: Okay. Did you say how many less that was? I could do the maths myself I suppose—1,681 and 1,615.

Ms Cosson : That's correct.

Senator AYRES: So they're round figures. Were the individuals who lost their job in the last year, 2017-18 to 2018-19, made redundant or redeployed?

Ms Cosson : There was a mix. I did provide an answer on notice to this earlier—that is, we do have voluntary redundancies, where staff actually seek a voluntary redundancy, and I think that was around just over 40 in the last financial year. But there are also staff who want to be redeployed, and we will always try and do that, particularly when we've been going through significant transformation. Some staff have preferred to leave, but that is normal management. So it's been pretty steady over the last financial years.

Senator AYRES: So 40 voluntary redundancies—

Ms Cosson : It was 43. We answered that in question on notice No. 63. From 1 July 2018 to 17 April 2019, there were 43 staff who wanted a voluntary redundancy.

Senator AYRES: And how many redeployed?

Ms Cosson : I don't have that number. I'll take that on notice.

Senator AYRES: Thank you. And then, I assume, the balance are forced redundancies?

Ms Cosson : We don't have forced redundancies.

Senator AYRES: You don't have any forced redundancies at all?

Ms Cosson : No, it would be natural attrition—people that retired.

Senator AYRES: So it's either voluntary redundancy or redeployment?

Ms Cosson : Voluntary redundancy, redeployment or natural attrition, where someone has retired or taken a job elsewhere and we have elected not to fill that position.

Senator AYRES: I'm conscious that you have provided answers on notice before to some of these questions, but what was the total cost of the redundancies?

Ms Cosson : For those 43 staff, it was a cost of $4.8 million.

Senator AYRES: Have you got a budget for the number of redundancies from 2018-19 to 2019-20?

Ms Cosson : We would put funding aside in the departmental budget to cover redundancies. I don't want to guess, so I'll take on notice what the budget was for the last financial year.

Senator AYRES: It's an obvious question, isn't it? If the number of staff is being reduced, doesn't that mean less support for veterans?

Ms Cosson : I don't agree with that. Even though we have reduced our APS numbers, we do have the opportunity to bring in contractors, labour hire, to actually support the work we are doing in progressing, particularly in our claims area. Our headcount is still up there—over 2,000 staff to deliver support to our veterans. I can give you that number if you like; the total headcount as at 30 September this year is 1,646 APS staff and 1,332 non-APS staff. Adding those together, we get the total headcount of our blended workforce. What we are also doing is having a look at staff that aren't necessarily delivering frontline services to make sure we've got the right balance, to ensure that we are not reducing services to our veteran community.

Senator AYRES: Just so I understand: 1,646 is the number of APS staff, and 1,332—

Ms Cosson : Those are labour hire contractors, health advisers, medical advisers, information technology experts—people we need to actually support our business who aren't part of the APS workforce.

Senator AYRES: I accept that there are some specialist contractors that organisations engage from time to time. How many of those contractors, or labour hire, are doing work that is interchangeable with the work that APS staff do?

Ms Cosson : Usually you'd look at the labour hire number. Potentially—

Senator AYRES: How many are labour hire?

Ms Cosson : it would be 777.

Senator AYRES: What sort of work are the labour hire people doing?

Ms Cosson : It could be a range of tasks that they undertake with the department.

Senator AYRES: Call centre work?

Ms Cosson : They could do call centre work. They could also be supporting in our claims area. They could be doing administration. It could be a range of tasks. For example, if we are looking to put a workforce in the service delivery area, we may need to backfill behind the service delivery area, in the administrative area. So it could be a range of tasks.

Senator AYRES: DVA is an organisation that deals with people, and that requires an absolute focus on their needs—a lot of skill, a lot of capacity. How do you end up in a position where such a large proportion of the staff are labour hire? It's not really a defendable long-term proposition, is it?

Ms Cosson : We put a lot of effort into recruiting the right people, particularly those who we recruit to deliver services to veterans, who have that frontline role in working with our veterans. We also invest a lot in training and making sure that they understand what the veteran experience is. We have a number of programs—for example, It's Why We're Here. Our staff go through that training to understand what is the nature of military service and what is the experience of veterans, so that those staff who are actually working with veterans understand what the veteran experience is. We do put a lot of effort into making sure we've got the right people doing that.

Senator AYRES: I'm sure you put a lot of effort in; I don't doubt that. Maybe I can come at it another way: what is the rationale for 777 labour hire positions? I assume some are part time and some are casual?

Ms Cosson : Yes.

Senator AYRES: Why aren't they direct employees of the department?

Ms Cosson : Like all Commonwealth departments, we have efficiency dividends that are applied to the department. For many years the nature of our workforce has been a blended workforce, where we have APS staff, contractors and specialists. Our responsibility in the department is to make sure that we put the workforce where they can best serve the community that they're supporting, and we do look at making sure that they're the right people for working with our veterans. We're not always going to get that right, but that certainly is our priority—to make sure that they're the right people. So, even though you look at the number of labour hire, they can be working anywhere in the department, not necessarily on the frontline.

Senator AYRES: So, at least in part, the efficiency dividend is what drives the high level of labour hire and casual employment?

Ms Cosson : It drives our ASL cap; that's correct. What we do, and what we have been doing, is look at how we can be more efficient in delivering services and how we can best use that workforce. We look at the claims area, for example, at combined benefits processing—I failed to mention that when the senator asked the question—and at how to reduce the backlog. One of the great initiatives that Ms Cole has implemented is that we have a delegate working with a veteran from the time they lodge their claim, and take it through the needs assessment and then determination of their permanent impairment. What we're finding with that is it's a great experience for the staff but also a great experience for the veteran, and we're finding that it's quicker. So using the workforce differently, and just this mix of a workforce, encourages us to do that.

Senator AYRES: I accept that you are doing good things. I can't understand why—there appear to be two rationales coming through what you're saying. The first is that the efficiency dividend drives the cap, which drives a higher level of labour hire because there is a lot of work to be done with veterans; if you just applied the ASL cap—and that's all you have—you could not do it. The second is that, it appears to me, there are some management advantages to what you described as a blended workforce. But it's a pretty raw deal for veterans, isn't it—the efficiency dividend driving a casualised labour hire workforce? Wouldn't you be in a better position if you could deliver flexibility? It's all there for you; that's not a difficult proposition, if you had a larger number of permanent or directly employed staff. But it's the efficiency dividend and the staffing cap that drive—

Ms Cosson : They drive the number. Can I say: a lot of our contractors are great. I don't want to suggest that contractors aren't delivering services to veterans as well, because when we have contractors join us—one of the things we are concentrating on now is how we recognise that talent and bring them into the APS, because there are always opportunities.

Senator AYRES: I'm not critical of the contractors; I'm critical of the efficiency dividend and the impact it's having on services for veterans. What is the saving that's been generated by the last round of staff cuts?

Ms Cosson : I'll have to take that on notice; I don't have that in front of me. I think I might have answered that in a question on notice as well, where we looked at the reduction in the number and how much that equated to in dollars. Here we go; it was question on notice No. 7. The total ASL reduction in 2019-20 was 108, which equates to $7 million.

Senator AYRES: How much did you spend on labour hire?

Ms Cosson : It's somewhere. I might have to take that one on notice while we find it.

Senator AYRES: Could you tell me, if it's on notice, how many labour hire people there were and how many direct APS staff there were in the APS categories—I accept that these were people who were providing specialist services—in 2017-18 and 2018-19, and what the savings that arose out of staff cuts were and what the cost of the labour hire component of the workforce was for each of those years?

Ms Cosson : I'm happy to take all that on notice.

Senator AYRES: Thank you. Is it correct that one of the other drivers of staff reduction is the move to the 1800VETERAN number?

Ms Cosson : No. We looked at the 1800VETERAN number a few years ago, because there was some concern about what number you call the department on. With 1800VETERAN, we were able to look at all the phone lines we had coming into the department, and, essentially, we found over 200 phone lines that we spend money on. We have still got all those phone lines in existence so that, if people phone them, people can now be redirected to 1800VETERAN. But it wasn't about staff savings at all, because we recognised that the phone channel is still very popular with our veterans. What we have implemented as a result of that is open speech, where we are picking up words now. That can direct calls to the right person in the department. I think 71 per cent of the calls that were coming through that open speech were going straight to where they needed to go rather than having to wait while we took time to find the right person for them. So it wasn't about staff cuts in 1800VETERAN.

Senator AYRES: So, before, people would ring a number for a particular purpose?

Ms Cosson : That's right.

Mr Cormack : The experience for the veterans, and their families, was that they had to sit through a menu—press one for this, two for that, three for whatever. The new technology that's been introduced through 1800VETERAN enables the call to be steered directly by the veteran simply saying, 'I want this'—so they articulate their need, and the call is directed to the area. It saves time and it saves frustration. The other thing is that it enables, through modern technology, the individual and their file to be called up on machine recognition of their voice. Our transformation journey is about knowing our veterans, and part of that is technology based—that is, when veterans ring up, it will recognise many veterans simply by their voice. That enables their records to be brought up on the screen, and the operator is able to help and direct their call appropriately. So it's not about cost saving; it's actually about better service, and it's going down pretty well.

Senator Reynolds: Just on that: I think it's also important to reflect back on the secretary's opening statement, where she said that veterans themselves voting with their feet, in terms of satisfaction, is improving significantly; in fact, I think it was 4.5 out of 5 stars. So, in terms of those who are being supported by DVA, these new arrangements are working and they are becoming more satisfied.

Ms Cosson : Particularly for our under-45 age group, we were very focused on how they were interacting and how they felt about their experience with the department. In the recent survey we've seen an increase from 49 per cent satisfaction to now 65 per cent satisfaction, but importantly, also, the dissatisfaction that they were experiencing with the department has gone down. So we're doing something right, but we still always acknowledge that there's more that we need to be doing.

Senator AYRES: So, with the technology that's been adopted, are more staff or fewer staff taking phone calls?

Ms Cosson : We still have the same staff taking the phone calls. I visited our access network up in Sydney recently and watched how they are still taking all the calls—it's actually now giving them time to spend more time with the veterans because they haven't got calls waiting, and that is a really good outcome for the veterans as well. The staffing profile is the same, but it's a better experience for the staff and for veterans.

Senator AYRES: What labour hire companies do you use?

Ms Cosson : I don't have that, but Mr McHardie might have that.

Senator LAMBIE: While you're doing that, maybe you can explain to us how you do the surveys. How do you get your star ratings? Who do these so-called surveys go to?

Ms Cosson : There are a couple. When you register with MyService, it will ask you to rate how you found the experience in registering, and that's where you can do a star rating—at the time of that engagement with us. That's where you get the 4½ star rating out of five. We have been doing the other survey for several years, but now we're doing it annually. We randomly select around 3,000 veterans and invite them to participate in the survey, and we make sure that the selection picks up on the different age groups and different cohorts. We survey them on how they feel about their experience with the department. We ask them a range of questions.

Senator LAMBIE: You ask what sort of star rating they give on that initial contact. Is that correct?

Mr Cormack : The star rating is associated with MyService.

Senator LAMBIE: Which is their first contact—MyService; you go in there?

Ms Cosson : Sometimes not.

Senator LAMBIE: What are they surveying? They are saying, 'This is good' on that bit, but they're not saying that about the whole of DVA, are they?

Senator Reynolds: That's the second survey.

Ms Cosson : That's the second survey. One is that point of experience; it's really important to capture when you're engaging with us how you feel about that experience. The other is looking back on how your overall experience with the department was. So we're trying to get the best out of surveys in real-time and then looking back.

Senator AYRES: How did we go, Mr McHardie?

Mr McHardie : The core contracts and the core providers of HR services for us are Hallis, Randstad Pty Ltd, Hays specialist recruitment and DFP Recruitment.

Senator AYRES: Are those contracts let on a geographic basis or are they for particular functions?

Mr McHardie : I believe they're right across the country, so not set on a geographic basis.

Senator AYRES: On what basis then? If you've got four labour hire providers, how does that work?

Ms Cosson : It depends where the need is. There may be a need in Victoria and they will tap into one of those contracted providers to bring in a workforce. We have staff all across the country.

Senator AYRES: That's what I thought I asked. Is it a particular labour hire contractor in a particular geographic location?

Ms Cosson : No, I think Hays, for example, is a national provider, so—

Senator AYRES: So your Victorian centre could have a choice of many or four different labour hire companies?

Ms Cosson : Yes, that's correct. They would go to the labour hire company and outline what the particular skills are that they're looking for and what gaps they're trying to fill, and then the labour hire company would fill them based on the geography.

Senator AYRES: I've asked for a schedule of the costs for labour hire over the course of the last two years—

Ms Cosson : Yes, that's right.

Senator AYRES: What about consultants? On notice, could you provide the same material for the consultants that you use and the functions you use them for?

Ms Cosson : Absolutely.

Senator AYRES: And the costs associated with each of those?

Ms Cosson : Yes, we can do that.

Senator AYRES: Could you tell me if the DVA headcount has declined since the Veteran Centric Reform program began, and by how many?

Ms Cosson : It has declined. From 30 June 2016, our headcount was 1,986; a year later it was 1,938; and on 30 June 2018, it was 1,885.

Senator AYRES: That's your APS headcount, is it?

Ms Cosson : That's APS, that's correct. Then, on 30 June 2019, our APS headcount was 1,681.

Senator AYRES: Let's do it as a job lot, then. If you could provide me with the APS figures and the labour hire figures for each of those years, I think that'd make more sense.

Ms Cosson : My challenge will be in 2016-17, when we didn't have the system to capture the non-APS. It's quite a manual system, so it's not going to be as accurate as it has been since 2018 when we moved onto a new HR system. But we'll do the best we can to give you the breakdown of APS and non-APS.

Senator AYRES: Is PwC still working with DVA?

Ms Cosson : Yes, it is.

Senator AYRES: How many staff?

Mr McHardie : Primary work for PwC is around the Veteran Centric Reform program. We're currently in contract for them to provide up to—this is dynamic, based on need—47 resources this year.

Senator AYRES: What do they do?

Mr McHardie : There's a range of activities. They assist in the Veteran Centric Reform program with running portfolio management, they help us with cultural change activities, and they assist with some of our technology uplift with DHS—a wide range of activities.

Senator AYRES: Could you tell me how much has been spent on consultants since VCR began?

Mr McHardie : Yes, I can. There are two core contracts that sit behind VCR. One is with KPMG, and then the other one is with PwC, as you've mentioned already. I'll just bring those figures up.

Senator AYRES: While you'd doing that, in round figures, since 2016, it's a 15 per cent APS staff cut. Is that right? In round figures, it's 300 out of 1,980?

Mr McHardie : Do you mean across the last two years of the program?

Senator AYRES: From 2016 to now, you started at 1,986, and you've ended on 1,681—

Mr McHardie : VCR has been running for just over two years. We just kicked off our third year—

Senator AYRES: You wouldn't say the 2016 cuts are related to VCR?

Ms Cosson : No, you wouldn't link them to VCR. That's right, Senator. It'd be 2017 through to 2019, but noting that we also had a big chunk of the workforce move into the Department of Human Services, where we transitioned all of our ICT branch when we entered that partnership with DHS. There's quite a bit of the workforce that went across last year.

Senator AYRES: Apart from savings from fewer staff, are there other savings that are a consequence of the budget cuts or the application of the efficiency dividend, or whatever the language is that people use to describe this?

Ms Cosson : We're certainly looking at our travel. Looking at departmental costs is something that all departments are required to do as part of being efficient. But we certainly have had savings as a result of doing things differently.

Senator AYRES: So in terms of changes to rehabilitation, public and private hospital billing structure, Type C certificates, are there savings attached to those measures?

Ms Cosson : Yes. What we're doing is undertaking auditing of our hospital services. That was announced a couple of budgets ago. We've now entered into a contract to undertake that auditing. We're looking at how they code different services provided in hospital, but also looking at whether there is potential to have those services out of hospital, rather than in hospital. It's a range of different ways—

Senator AYRES: Have you been generating those savings over the period of the—

Ms Cosson : Not yet, no.

Senator AYRES: So it's a planned savings there?

Ms Cosson : That's correct. To reinvest—

Senator AYRES: And are those being sucked up into the efficiency dividend or are they going to be reinvested?

Ms Cosson : Reinvested into our veterans services.

Senator AYRES: Would you be able to provide the committee with an outline of the savings measures and the amount that's planned for 2019-20?

Ms Cosson : Yes.

Senator AYRES: Media reports have indicated that DVA is overloaded, that it is struggling to deal with a surge in claims through MyService. Is that accurate?

Ms Cosson : We can deal with the claims coming through MyService. What MyService was intended to do, particularly for MRCA, where we identified 40 of the top conditions to help them be decision-ready when you went onto MyService—so MyService is okay and we're actually seeing the initial liability determined quickly. What we are seeing is a growth in the demand in our claims.

Senator AYRES: What's driving that growth?

Ms Cosson : It's easier to come to the department, and veterans are feeling more confident to lodge a claim with us earlier. So rather than wait until they've been out of the Australian Defence Force for years they're now engaging before they leave the Australian Defence Force, which is really good. That's through a huge effort working with Defence. They now talk to serving men and women from the point of enlistment, essentially, to say, 'Be aware of DVA.' What we're seeing is a result of making it faster and easier to access through MyService. We've seen, as I mentioned in my opening statement, about 83 per cent growth in the claims. We are committed to reducing that backlog that is growing. That's because that hasn't been automated. That still requires our delegates to make decisions. Our whole transformation in the compensation area was pushed a little bit to the right because we were waiting for the Productivity Commission's report, because we knew that was going to be their focus of attention. So we're in a bit of catch up there with the claims, particularly in permanent impairment and particularly in DRCA.

Senator AYRES: I've seen some private briefings that were provided to one of the committees in relation to this work. I don't want to argue with the assertion that you're making, but, beyond the fact that Defence is providing more information to people as they're exiting the forces, what evidence do you have to sustain that that 83 per cent is driven by better access to DVA's services? Is there anything else that's going on out there?

Mr Cormack : There are a number of initiatives.

Senator AYRES: I accept that there are initiatives. I wonder whether there are other factors driving the backlog.

Mr Cormack : What we have available is very solid evidence that the initiatives associated with the transformation have delivered exactly what they were intended to do. The first thing is that we know our veterans sooner, better and a lot more. We've done that through a number of initiatives. We've heard about MyService. We've also heard about issuing every veteran with a white card as they discharge from the military. In the past, it wasn't automatic that transitioning ADF members took up their card entitlements. Now it's happening automatically. In fact, our plan is to have that happen even earlier. The impact of that is that both serving and ex-serving ADF members are more comfortable with and have a greater understanding, and it's easier for them to access those services 24 hours a day, anywhere in the world. That's what they're doing. This is manifest in the increase in the number of claims that are coming through. I think it's best described as evidence of the service being more accessible and evidence that the department is responding to that increase in demand.

Senator AYRES: The use of MyService has been increasing. What's the number of paper claims versus MyService claims?

Ms Cosson : We've had over 100,000 users register on MyService, which is incredible.

Mr McHardie : We've had 66,000 claims to date in MyService, so it's had significant uptake. We're basically gaining approximately 10,000 just about every month now.

Senator AYRES: During the election campaign the government committed to cutting waiting times. You're telling me, really, that there's an 83 per cent increase in the number of claims. What's happened to waiting times?

Ms Cosson : We're still committed to cutting the waiting times.

Mr Cormack : The waiting times for a number of our claim types have increased.

Senator AYRES: So some waiting times have increased?

Mr Cormack : Correct.

Senator AYRES: In some categories—what are they?

Mr Cormack : They've increased in VEA pensions. They've decreased for MRCA initial liability. They've decreased for MRCA permanent impairment. They have slightly increased for DRCA permanent impairment, and for MRCA incapacity—DRCA incapacity—there are slight increases. So across the board there are ups and downs, but overall there has been some increase in the time taken to process. The secretary has already outlined efforts that are under way to get those numbers down. But they are directly as a result of veterans accessing services where previously they didn't, and it will take time to catch up. And we will catch up and there are lots of measures in place to do that—combined benefits processing is one of them.

Senator AYRES: I accept that all that work's been done. It's really a question for the minister, isn't it? Minister, you made a commitment during the election period that waiting times would decrease. It sounds to me like DVA needs more staff, not less staff, in order to meet that commitment. You've driven an efficiency dividend that's meant less staff and more labour hire workers. And, despite the department's best efforts—the introduction of new technology and what sounds to me like big efforts in cultural change and managing change—the government has not met the commitment it made during the election. Waiting times have gone up, not down.

Ms Cosson : Senator, we're still committed—

Senator AYRES: It's a question for the minister. I understand where you're up to, Ms Cosson, and I understand the process that's been gone through. I understand the impact of the efficiency dividend on staffing levels. But the government said waiting times would go down and waiting times have gone up. And the application of the efficiency dividend to this department is the government's responsibility.

Ms Cosson : If I can, Senator, we have seen the times go down in some of the categories.

Senator AYRES: Yes, in some areas. I take that point.

Ms Cosson : But also, the minister made a commitment that we would reach out to as many veterans as we could and that we would make it easier for them to enter our system. It used to be quite difficult to actually get that initial liability established with the department, where we did require 40 questions to be answered to prove that it's related to service. And we've made it so much easier.

Senator AYRES: The chair has just indicated that I've only got half an hour left! The amendments to the act require DVA to process MRCA claims by veterans within 90 days. Is this still going to be possible?

Ms Cosson : Certainly our aim is always to do it as quickly as possible, but one of the things—

Senator AYRES: Ninety days can be a very long time for somebody who's made a claim.

Ms Cosson : Yes. Thank you for acknowledging the cultural change, because one of our key areas of focus is to say: 'If a veteran needs more time to talk, don't just be focused on the time. Look at what their needs are.' Sometimes veterans need a tailored response rather than just, 'make a decision'. So our aim is to do it as quickly as possible to reduce the stress of waiting. And, as we talked about before, staff will have more time to be able to talk to a veteran on the phone because of what we're doing with the 1800VETERAN number and our technology. So our focus is a mix of time—to do it quickly, particularly for those that have a greater need and need some certainty—but also, where some veterans would benefit from more time, talking through what the options are for them. It's just balancing all of those outcomes.

Senator AYRES: My argument's not with the process; it's with the efficiency dividend. Have you made representations to the minister for more APS staffing?

Ms Cosson : Yes. We have in previous budgets received supplementation because of what we are doing to meet the demand.

Senator AYRES: Over the last 12 months have you made representations about supplementation?

Ms Cosson : Yes, we have.

Senator AYRES: When did you make those?

Ms Cosson : Recently. The normal budget process. We put forward our business case for supplementation, which we have done for the past few years.

Senator AYRES: How did you go?

Ms Cosson : We were successful in previous budgets in receiving that supplementation.

Senator AYRES: In previous budgets. But that has gone to the labour hire line, not the staffing line?

Ms Cosson : No, not the APS line. We do get relief in the 2016-17 budget, where we were able to retain our staffing level. That was APS.

Senator Reynolds: Can I make a point? Pulling out some of the key bits of information from the secretary and her team tonight, there has been, in 12 months alone, an 83 per cent increase in claims, the majority of which are dealt with faster than previously. They're working on those other categories that still need to be sped up. The outcomes, clearly by the research, are improving markedly. I think, as the secretary has said, it is not perfect—but it never will be—but there has been significant change. The fact that they were able to deal with 83 per cent more claims in 12 months alone speaks volumes for the reforms that the secretary and her department are going through.

Senator AYRES: But the government made a commitment that waiting times would go down. While in some areas they have gone down, in aggregate they have gone up.

Senator Reynolds: Senator, with the greatest respect, you are looking at a single tree in a whole forest.

Senator AYRES: It's an average number, and the average is up. The commitment that you gave to veterans was that it would go down. The evidence here is that at least in part the increase in the number of applications has been driven by an expectation that service will improve and that waiting times will go down. That's the challenge, isn't it? They are doing their best. The government has let them down.

Senator Reynolds: Senator Ayres, with the greatest of respect I have to completely reject that. I really cannot fathom the logic in that. The fact is that significant reform has resulted in—what was it, over 100,000 new registered veterans?

Ms Cosson : Yes.

Senator Reynolds: And an 83 per cent increase in claims in one year. If anything, I think that it is a demonstration of the success—

Senator AYRES: Increased waiting times are a good news story, are they?

Senator Reynolds: Senator Ayres, don't put words in my mouth. What I'm saying is that these reforms have been incredibly successful. Veterans are speaking with their feet in terms of joining up. Over 100,00 in 12 months. An 83 per cent increase in claims and the department is dealing with them in a very efficient way and in a way that has received great satisfaction from the veterans themselves. If anything, they're a victim of success. In fact, greater success—would it be fair to say, Secretary—than we had anticipated?

Ms Cosson : Absolutely.

Senator Reynolds: I really fail to see, Senator Ayres, where you can draw any black cloud over this or any sort of broken promise. This is a good news story. The staff have done an amazing job.

Senator AYRES: That's where I thought you'd get to. Increased waiting times are somehow a good news story. You made a commitment to veterans—

Senator Reynolds: Senator Ayres, as I said, you are trying desperately to find and focus on a single tree in a forest of good news, and wilfully ignoring the reasons for that.

Senator AYRES: I've listened very carefully to the department's evidence.

CHAIR: Can we get back to questions?

Senator AYRES: Maybe we shouldn't argue about the outcome, but it seems to me that the conclusion that I've drawn is the correct conclusion.

Senator Reynolds: Senator Ayres, I said with the greatest respect that I don't agree with that.

Senator AYRES: Chair, Senator Ciccone has a series of questions.

Senator LAMBIE: Just quickly, doesn't it take longer to process claims? You say you're getting faster here, but your claims process is blowing out.

Ms Cosson : Some part of the claim process is quicker and some areas, as Mr Cormack was pointing out, are taking a bit longer, and that's where we are looking at our investment in prioritising those claims, making sure that we actually respond to the needs of the veterans that are waiting for those. There are some categories that are taking longer than we had anticipated. That's correct.

Senator CICCONE: I have a couple of questions on the allied health budget to do with the treatment cycle initiative. I understand that in previous estimates the secretary to the department advised there had been some undertakings to veteran organisations, particularly TPI associations, to monitor, I guess, the implementation of the changes to the allied health treatment model. Are you able to provide me with a bit of an update as to what has occurred since the last round of estimates?

Ms Cosson : Certainly, Senator. We deferred the implementation of the 12 treatment cycles for allied health. It was scheduled to commence 1 July this year, but we deferred that to 1 October. So it has only just kicked in. Also, we provided an exemption to the treatment cycle for our TPIs for exercise physiology and physiotherapy. What we have done since we last appeared is engage with a number of providers and we have written a number of letters outlining what the framework involves. What we will now do is continue to monitor the effectiveness of the 12 treatment cycle over the next 12 months, with effect from 1 October this year.

Senator CICCONE: What was the basis for the decision to delay?

Ms Cosson : It was felt that we needed to do some more consultation, particularly with the providers and the peak bodies in the allied health area. We just wanted to make sure that, when we implemented it, we had everyone aware of what that framework looked like. The team has done a great job in pulling together a very comprehensive package so that veterans know what the 12 treatment cycle entails, how they engage with their GP, how they then engage with their allied health providers, what they can expect in relation to reports back to their GP, and how the treatment cycle is for their best quality of care, particularly at the primary level.

Senator CICCONE: What was the feedback that you received from the health professionals about this? It obviously resulted in the delay.

Ms Cosson : Mr Cormack can outline that, if that's all right.

Mr Cormack : Thanks for that question. I think the feedback fitted into a couple of categories. Overwhelmingly, the allied health organisations were very positively engaged with the department and they wanted to understand more about the initiative. They also wanted some guidance material so that they would be able to explain the arrangements to their clients. I also point to a number of useful outcomes of the consultation. I'll ask Ms Campbell to talk about the risk framework. That was very much the result of engagement and consultation with both medical and allied health professionals.

Ms Campbell : In recognition of exceptional circumstances that may result in a small percentage of DVA clients being adversely affected by treatment cycle requirements, the department established an at risk client framework which will identify and support those clients and allow their usual GP to make a determination based on specific criteria and their clinical judgement—that the client would benefit from tailored referral arrangements specific to their needs and outside of treatment cycle requirements.

Senator CICCONE: What I'm interested to know is why there was the delay. Was it because you had backlash from health professionals? Was the department not ready on 1 July? It's a quite significant delay.

Mr Cormack : It's important to listen when issues are being raised.

Senator CICCONE: It is very important to listen. I agree with that. But why was there a delay?

Mr Cormack : There was a decision taken by government in recognition of the complexity of the change, plus some specific modifications that the government had decided to do in relation to TPI, physiotherapy and exercise physiology. Clearly, our advice was a little bit more time would make this transition from the previous arrangements to the current arrangements smoother, more effective and less disruptive for providers and for clients. That's in essence what we've done.

Senator CICCONE: Is there now more support because of that delay?

Mr Cormack : I think there's more information out there.

Senator CICCONE: Not information; support.

Mr Cormack : The feedback we're getting from the allied health providers is that they welcomed the additional time that was available for them to be able to adjust their practices and get used to the new arrangements. I think that was a very sensible arrangement. So I think the treatment cycle will proceed, whatever disruption there may have been will be significantly diminished, and it will be able to progress. And, as the secretary said, it will be evaluated. We'll continue to look at it and we'll continue to listen to the feedback we're getting.

Senator CICCONE: Which stakeholders did you consult prior to this announcement?

Mr Cormack : I'll ask one of my colleagues to run through the list of the groups we consulted with.

Senator LAMBIE: And the service organisations. I'd like to see which one of those approved this. Please enlighten me.

Ms Campbell : We undertook extensive communication and engagement activities. Peak general practice and allied health provider associations—would you like me to run through the list?

Mr Cormack : Yes.

Ms Campbell : We consulted with Audiology Australia, the Australian Association of Practice Managers, the Australian College of Nurse Practitioners, the Australian College of Nursing, the Australian College of Rural and Remote Medicine, the Australian Dental Prosthetists Association, the Australian Medical Association, the Australian Nursing and Midwifery Federation, the Australasian Podiatry Council, the Australian Primary Health Care Nurses Association, the Australian Psychological Society, the Dietitians Association of Australia, Exercise & Sports Science Australia, Occupational Therapy Australia, Optometry Australia, Osteopathy Australia—

CHAIR: How long is the list?

Ms Campbell : I have four more to go.

CHAIR: All right.

Ms Campbell : ACT Primary Health Network, the Royal Australian College of General Practitioners, the Royal Australian and New Zealand College of Psychiatrists and Speech Pathology Australia.

Senator LAMBIE: How many of those were for this implementation and how many were against?

Mr Cormack : We didn't take a vote.

Senator LAMBIE: There it is!

Mr Cormack : We consulted.

Senator LAMBIE: What about the service organisations? How many service organisations did you go out ask and how many were for and against?

Mr Cormack : That's not our job—

Senator LAMBIE: No. It is your job to consult.

Mr Cormack : Senator—

Senator LAMBIE: It is your job to get the facts. You're not listening.

Mr Cormack : The government makes policy decisions and the department implements them and it consults with those affected—

Senator LAMBIE: You don't consult. If had consulted, we wouldn't be sitting here talking about these 12 visits.

Mr Cormack : We just gave you a list. We gave you a long list of those we consulted with.

Senator LAMBIE: This is rubbish—absolute rubbish!

Mr Cormack : We don't go out taking votes against government decisions. The government has made its decision. The department is responsible for implementing it. It's not a—

Senator CICCONE: In that list, surely they've expressed views. The department would be recording information and no doubt that information would be passed on to the minister's office that we've had this many stakeholders that were in favour or against or were neutral. Is that not something you can provide the committee?

Mr Cormack : The flavour of the consultations was overwhelmingly that the organisations wished to work closely with the department to implement this policy change.

Senator CICCONE: What information was—

Senator LAMBIE: Show me the evidence.

Senator CICCONE: provided to the minister or the minister's office?

Mr Cormack : We provided regular updates to the minister on the implementation of this government policy initiative.

Senator CICCONE: If you can take on notice, can the department provide an itemised list of all advice, submissions and correspondence provided to or requested by the minister or her office?

Mr Cormack : Sure. We'll take it on notice.

Senator CICCONE: Thanks.

Senator LAMBIE: I take note that you didn't have any audiologists or optometrists at the table either.

Mr Cormack : I think we did consult with Audiology Australia.

Ms Cosson : I think optometry is exempt, isn't it?

CHAIR: The list is already in the Hansard record.

Senator CICCONE: How does the department explain the preliminary costing of excluding TPIs and special rate disability pension recipients from this treatment cycle, given it was anticipated to cost $22 million, when the measure itself is to save around $20 million a year?

Mr Cormack : The—

Senator LAMBIE: No. $40.7 million actually.

Mr Cormack : I haven't got that figure in front of me. But the revised government decision to incorporate that exclusion was recosted, and that would be taken into account in terms of the projected financial outcome of the measure.

Senator CICCONE: I understand at the last hearings—which I wasn't at—PwC provided some modelling on the changes. Are you able to provide that or is someone here able to talk about that analysis?

Ms Cosson : We do have the question on notice response. I'll try and grab that for you. We did provide the details in regard to the modelling.

Senator CICCONE: I'm curious to know what the results or findings were from that.

Ms Cosson : And we can show that. We can find that number again.

Senator CICCONE: Have you got that now?

Ms Cosson : This is one of them. This talks about the modelling we did with PwC—and established a range of service usage patterns, which informed our report in to the allied health arrangements. It was published on our website, and I can give you the link to that if that's helpful.

Senator CICCONE: Just take it on notice. I can get it afterwards if you've got it there.

Ms Cosson : It's question No. 12 that we responded to on notice.

Senator CICCONE: Some allied health professionals have said that better, smarter and more contemporary health practices could achieve DVA's aim for improved quality and efficiency of services they have been offered. Have you considered any other feedback from health professionals? We see from time to time that potentially this could be one way of trying to save on costs—from pressure from government.

Mr Cormack : We engage regularly with health professionals and indeed other service provider groups. We have regular provider forums, and those health provider forums are held, I think, three times a year. That provides us with an opportunity to hear directly from provider organisations and the different professional groups about latest developments in their field and recommendations and ideas that they have to modernise and improve health services. We really welcome that engagement. That's very much part of what we do. Whenever there are opportunities to change, to evaluate and to improve the quality of service delivery—and certainly the transformation program that the government has committed to gives us that opportunity—we will be very much seeking their input to design and improve the program offerings of DVA in relation to health and other services.

Senator CICCONE: I'll have to leave my questioning there, chair.

CHAIR: Can I ask a few questions. On what basis do we assert that the treatment cycle is best practice in relation to the 12 treatments for allied health?

Ms Cosson : We're putting the GP at the centre of your care, and it looks at: is that treatment that you're receiving actually the best treatment for your condition or—

CHAIR: Should the veteran be the centre of care, as opposed to the GP?

Ms Cosson : It's to ensure the veteran is at the centre, that the veteran is getting the best possible care, and not just receiving treatment that isn't contributing to their health and a healthy outcome. What we've heard from our veterans in a lot of the workshops we've had is that what is really important to them is quality healthcare and particularly at the primary level.

CHAIR: Would anybody disagree that they wanted quality health care?

Ms Cosson : Sometimes people think that our veterans are interested in compensation, but they're actually interested in their health care. When we're talking health care, and that's what we're doing now, whether they're interested in compensation or not is one issue. But, with these 12 treatments, does the department accept that there are a lot of conditions where the veteran will require ongoing treatment, year after year, for conditions that will not go away?

Ms Cosson : If there's a clinical requirement for the veteran to go beyond the 12-treatment cycle, and Ms Campbell was talking about that, within our framework there is an option to do that.

CHAIR: How do we do that?

Ms Cosson : Here's their chief health officer, Dr Firman. She'll be able to talk about that.

Dr Firman : The treatment cycle offers an opportunity for the GP who's at the centre of care to check with the veteran and make sure they're receiving the sort of care that's appropriate and gets the best results for them. At times, patients can repeatedly visit their allied health provider from whom they perceive they're getting really good care. But it may not be in their interests to do that, sometimes, for prolonged periods without checking back and making sure that that's the most appropriate level of care for them. It's a way of making sure the GP is at the centre. Many veterans have said to us that they really make sure that their GP knows what their specialist is doing, what their allied health professional is doing, that they know about all the reports and understand their care. This is a way of assisting that.

Ms Cosson : Ms Campbell could talk about the framework where, if there's a clinical need, you can go beyond the 12-treatment cycle.

Ms Campbell : Under the framework, the client's usual GP is required to make an assessment using criteria outlined in the framework and their best clinical judgement about whether that particular client would benefit more from tailored referral requirements for up to 12 months. The GP makes the assessment. They must select, from a list of options, what that tailored referral arrangement is. They then complete an at-risk client assessment form and they provide it to Veterans' Affairs for information. It is the GP that makes the decision about which clients receive tailored arrangements. The onus is on the GP to advise the allied health providers that those tailored requirements are in place.

CHAIR: The question is in relation to the limitations. If there is a requirement that they be treated by an allied health professional on an ongoing basis, how is that able to be achieved without the need to go back to the GP?

Mr Cormack : I think that's the purpose of the at-risk framework, to deal with that.

CHAIR: But how does that work?

Mr Cormack : I think Ms Campbell has just explained it.

Senator LAMBIE: What? I'm not getting this.

CHAIR: I'm a bit slow or it's late, but can you please repeat it?

Dr Firman : An example would be someone who perhaps has seen two or three allied health professionals. According to the framework, they would have to return, potentially, at every 12 visits. That gets quite complicated. This is someone with complex needs. The GP would assess those complex needs and could apply to have a review point at three months, six months or 12 months depending on the complexity of that case. They apply to say, 'Instead of following the usual treatment cycle, the veteran I'm looking after would be better off being seen less frequently.' They're usually monitored quite closely in such a situation and seeing their GP fairly regularly anyway, but this is a way of reducing any stress for that veteran.

CHAIR: If they're seeing their GP regularly, chances are it's not an issue—

Mr Cormack : That's right.

Ms Cosson : That's correct.

CHAIR: but it's been put to us that there are some who have the need of only an allied health professional, and the need to go to a GP, just to have it signed off again for another 12 months, is a waste of their time, a waste of taxpayers' money and serves no useful purpose. So what I'm trying to get at is—for example, is podiatry on the list for DVA?

Dr Firman : Yes.

Ms Cosson : Yes, podiatry is on the list. Importantly, they're not—

CHAIR: It stands to reason, for example, that if there is a podiatry need and that is, hopefully, the only need for this particular veteran, it ain't going away. In those circumstances, what is the benefit to the taxpayer or to the veteran to have to go back each time? Is there the capacity for the GP to say, 'This is going to be an ongoing requirement; therefore, there shouldn't be the need to come back to visit the GP'?

Dr Firman : Everybody needs a clinical review at some point, and to go potentially to a podiatrist for a prolonged period of time without review would not be appropriate. Most of these—

CHAIR: So, who knows the most about podiatry—the podiatrist, or the GP?

Dr Firman : The GP knows about the whole person. Podiatry is part of the care that's provided.

CHAIR: But there are specialists, aren't there, in the allied health areas, who might know a little bit more in that specific detailed area than a GP?

Senator Reynolds: One of the key issues, as we know in other areas of health provision, is overservicing. I think the point is that it is now uncapped with the GP, but it is appropriate at some point clinically to go back to be reassessed. But, again, they've now expanded—

CHAIR: At what point, then?

Dr Firman : For podiatry, that would often be at the 12-month point, because most people, even if seeing a podiatrist regularly, wouldn't be going more than once a month. That would be the normal—

CHAIR: I would agree.

Dr Firman : And they would see them at 12 visits at 12 months.

CHAIR: So, there is no capacity for a GP to say, 'Look, with this podiatry need it's pretty basic—once a month and there's no need to come back in 12 months'—but it should be for two years or three years before the veteran comes back?

Senator LAMBIE: Good one!

Mr Cormack : The arrangements are for—

CHAIR: Sorry: does the GP have that capacity under this framework? It's either yes or no.

Mr Cormack : If they meet the at-risk framework requirements, yes. But otherwise the policy requires a return for a referral either every 12 months or after 12 sessions, whichever comes first.

CHAIR: So, that's the policy.

Mr Cormack : That's the policy, and that's what we're required to implement.

CHAIR: But can the policy be, if you like, set aside for the sort of condition that I refer to?

Mr Cormack : The at-risk framework is the way to address those clients who have complex needs—

CHAIR: But does that allow for the GP to say, 'We don't need a review for 24 months or for 36 months'?

Mr Cormack : No. The government policy setting requires that. But the at-risk—

CHAIR: So it has to be every 12 months, no matter what?

Mr Cormack : The treatment cycle—

CHAIR: That's not what I was told the other day.

Mr Cormack : It's a government policy decision, which requires—

CHAIR: So, there's no flexibility in it.

Mr Cormack : There's a lot of flexibility for those who are high users—

CHAIR: There has to be a review after 12 months or 12 treatments no matter what.

Mr Cormack : Correct.

CHAIR: And the GP cannot sign away that need for the review.

Mr Cormack : The GP, under the at-risk framework, can forestall the requirement for a person to keep coming back after the 12th session for review of their arrangement if they meet the at-risk client framework.

CHAIR: When and how does the GP communicate that to the veteran?

Dr Firman : The GP can tell the veteran that this is how the DVA treatment cycle operates. In addition, the podiatrist is also informed, so the podiatrist also notes and tells the veteran. If the veteran, for example, had been seeing the podiatrist for 10 months and happened to have an appointment with their GP at that point, the GP could then re-refer at that point. We don't say 'must be at 12 visits'. There's some flexibility between eight and 10 visits, for instance, such that you can come into the GP, discuss the treatment and make it appropriate—

CHAIR: That's earlier. The whole basis of these questions has been for lengthier periods, not shorter periods, with respect. Has DVA referred the setting of health fees to an independent review?

Mr Cormack : We're undertaking an exercise at the moment to have a look at the rates that are being charged in the broader health market and having a look at how that compares with the DVA rates.

Senator LAMBIE: That's weird. I thought we joined that ages ago.

Mr Cormack : It's an independent market assessment of our rates. It's not setting those rates, which I think is what your question was. It's not independent rate setting; it's actually assessing the alignment of the DVA rates with, what the market—

CHAIR: Although it shouldn't take you too long to do that in comparative terms. But when do you hope to have that finalised?

Mr Cormack : We are in the middle of that at the moment.

Senator LAMBIE: When?

CHAIR: When do you hope to have it finalised? Telling me that you're in the middle of it doesn't answer the question.

Mr Cormack : I haven't finished the answer yet.

CHAIR: Telling me that you're in the middle of it does not help me.

Mr Cormack : You interrupted me when I went to give you the rest of the answer.

CHAIR: If you just answered the question, Mr Cormack.

Mr Cormack : I am answering it.

CHAIR: The question is when.

Mr Cormack : We anticipate this being completed by the end of the year.

CHAIR: Thank you. That's all we needed to know. Once you've done that, it will go to the minister for consideration?

Mr Cormack : The minister will certainly be advised of the outcome of that, and whatever decisions may or may not need to be taken in relation to that are a matter for government.

CHAIR: Then there's been a standard but ever-louder TPI claim about the eroding value of the economic loss disability compensation issue. Where are we at with that and have you received the letter from the TPI federation dated, I think, 23 October?

Ms Cosson : Yes. There are a couple of things there. The KPMG report was the first one. As I mentioned, it has been completed, but I have held that pending Mr Tune's report, which is currently under consideration by government. Sorry; I forgot the other part of the question.

CHAIR: The letter of 23 October.

Ms Cosson : Yes, today I did see the letter written by the federation.

CHAIR: Right. When do you think we might we get a response to that?

Ms Cosson : I hope that it won't take long, because it's actually asking for the Tune report.

CHAIR: So that will be considered in that total context, which is fair enough.

Ms Cosson : That's correct.

Senator Reynolds: I can provide a little bit more information in relation to your questions about fees. The Productivity Commission did make recommendations on fees, and issues around this are being considered as part of the government response to the PC.

CHAIR: Very good. Thank you for that, Minister; that's helpful. If this is the case, can somebody explain why veterans are being asked to pay up to $6,000 or more for their hearing aids when it's supposed to be part of their compensation entitlements?

Ms Cosson : This has been an issue that the TPI Federation has raised. The Hearing Services Program, which is a Commonwealth run program, actually does provide 210 fully subsidised devices that are available and accessible for our TPIs and for all Australians if they need hearing services. So those are 210 devices that are available which are fully subsidised. What we do have are occasions when a veteran will be recommended by their audiologist to have a different device that isn't on that fully subsidised list. Occasionally, veterans will approach us and ask us to meet the additional costs. We have an audiology adviser who then looks at the case to see if there is a clinical need for that other device and then gives either approval or otherwise. We are now working very closely with the head of the Hearing Services Program because he's going through a big transformation to have better education in relation to those 210 devices, the view being that those devices should meet the majority of clinical needs, particularly for our veterans as well. So we are going to sit down—

CHAIR: That doesn't mean they're a lot cheaper?

Ms Cosson : No, they can be any cost, to be honest. They have a range of lower-end and top-end devices, but the view by the hearing services team is that they should meet the majority of clinical needs to address hearing. We also provide assisted listening devices to our veteran community, but I am aware that the federation has raised some individual cases of concern. So our chief health officer, Dr Firman, and our audiologist will sit down and review all those cases with the federation.

CHAIR: Thank you for that.

Senator LAMBIE: How many prior requests for top-up hearing aids were rejected and approved in 2018?

Mr Cormack : There were 50 requests for prior approval for hearing aids outside of the range that the secretary mentioned, and 34 of those were approved.

Ms Cosson : Ten of them were TPI requests for prior approval.

Senator LAMBIE: You can tell me if I'm wrong here, but back in 2013, I believe, it changed. When we changed to the DRCA, you had 520 under the SRCA which would have been able to obtain full hearing aids but now can only obtain basic hearing aids. Could you please tell me why you didn't have that grandfathered?

Ms Cosson : The 210 hearing devices on the list through hearing services are not basic; they are fully subsidised. So there has been a communication issue. I acknowledge that we need to communicate better what is available. But they're not basic hearing aids.

CHAIR: In relation to veterans accessing Open Arms, which is, as I understand it, a service to assist those that are incarcerated, I've been told that Open Arms psychologists are unable to get permission to access jails. Has that been an issue that's been raised with you?

Ms Cosson : That hasn't been raised with me directly.

CHAIR: It hasn't?

Ms Cosson : No, but our national manager for Open Arms may be able to respond to that one.

Senator LAMBIE: Since we've been talking about this for six years, when did you actually start doing a log of who is in jail and whether or not advocates are out there visiting them? This has been a problem for six years. What have we done about trying to obtain who is in a jail so advocates can get in there and see them—or have we still not done anything about that and the suicides?

Ms Cosson : We have been working with our state and territory colleagues to understand, for a start, if—

Senator LAMBIE: For six years?

Ms Cosson : For the last three years that I'm aware of. Since I've been in the department, we've been talking to them.

Senator LAMBIE: Three years?

Ms Cosson : Well, I've only been back in for—

Senator LAMBIE: No; I'm saying three years to get something done even in your time?

Ms Cosson : The first challenge really is for a veteran to identify that they are—

Senator LAMBIE: Yes, I know. I've heard them all. I'm asking you what you're doing about them.

Ms Cosson : We are working with the states, so if they can provide us details of veterans that may be incarcerated—

Senator LAMBIE: And when are they doing that? When are the states going to provide you with that list?

Ms Cosson : South Australia has done a lot of work. They are actually leading in capturing that information. and Dr Hodson might be able to talk a bit about that.

CHAIR: In fairness, in this space, jails are run by the state and therefore access to the jails is largely determined by state regulation et cetera. That is why I was wanting to ascertain what the various state bureaucracies were up to and then how we might be able to break through.

Ms Cosson : The states are working very closely with us.

CHAIR: Is it true that Open Arms were unable to get permission to access the jail, Dr Hodson?

Dr Hodson : I have not heard of that actual case. Typically, jails do have their own psychologist, and we will typically work with them. The guidance we have for our psychologists is that we could be invited in at request, and there would be no barrier, but the actual jail psychologist would take the lead on any clinical care. At the moment, especially down in South Australia, we are working on a transition process. A young individual who is a veteran himself and who works in the jails—his name is on our younger veterans list: Chris Tilley—is working with us to look at a transition point. What we have probably not done well in the past is, as these individuals are leaving, just like when people transition out of defence. It's important that we look at the social determinants that might mean they won't actually do well and try to help by doing a psychosocial assessment. We've just kicked off that work down in South Australia, and it is actually driven by a young veteran who is driven. What we'd love to see, if it works in South Australia as a lighthouse case, would be that, as people are transitioning out, we do a full assessment and then look to see what ongoing care they need.

CHAIR: But that's only in South Australia?

Dr Hodson : That's where we've started. It's really important with this to get it right and then take it national. So, at the moment, the focus is on South Australia working—

Senator LAMBIE: What's the timeline?

CHAIR: Because the Open Arms psychologists, one assumes, have special expertise dealing with veterans—

Dr Hodson : Yes.

CHAIR: and therefore might be able to value-add a bit more than the clinical psychologist who's attached to the jail.

Dr Hodson : And, if invited in by the jail, we would be happy to go.

CHAIR: But the issue is that you're not being invited in—

Senator LAMBIE: Excuses. You're not being proactive.

CHAIR: and that access is being denied. That's the assertion. I don't know if it's true. Are you saying you have not experienced that?

Dr Hodson : It hasn't come to my attention. I'm happy to take it on notice.

CHAIR: That's fine. I don't have a specific case to put to you.

Mr Cormack : It's really important that—and you've raised this before—corrections are the responsibility of the state government. Responsibility for all aspects of health and welfare is solely the responsibility of the state governments. Incarcerated prisoners have no access to the Medicare system. They have no access to the Commonwealth health support arrangements. That's been a longstanding arrangement. The delivery of all health care to prisoners is the responsibility of the state government.

Senator LAMBIE: And it is your responsibility to help everybody that has served in the military every step of the way if they've got a physical or psychological injury, veteran or not. You've obviously failed in this area, and that bothers me greatly. You have a responsibility as well.

CHAIR: In relation to compensation payments, how quickly does a veteran have to come to a determination as to whether they will accept what is being offered?

Mr Cormack : I might ask one of my colleagues who's got very specific knowledge in this space to help me, because it varies to a certain extent.

CHAIR: There's been a suggestion made to me that it's a relatively short time frame.

Ms Cosson : We're trying to find the right person, Chair.

CHAIR: Whilst they're coming to the table, the assertion is that it's a relatively tight time frame and so, if somebody is especially on the verge of or actually dealing with mental health issues as well, they can be pressured into a settlement. Or if they don't take a settlement within the time because they're not in the mental space to make the decision then they miss out on a particular option.

Ms Kairouz : We provide to our MRCA and DRCA veterans, who are our more modern contemporary veterans, compensation in the form of incapacity payments and—

CHAIR: Sorry, what sort of payments?

Ms Kairouz : Compensation in the form of incapacity payments, which are for economic loss, and also compensation for non-economic loss, which are permanent impairment payments. For permanent impairment payments, MRCA provides for individuals to receive a periodic payment. It's a weekly payment. What that is, depending—

CHAIR: If it's a weekly payment, the veteran wouldn't—

Ms Kairouz : They have a choice. They have up to six months to determine whether or not to take that as a lump sum payment. So there is a period there. Under DRCA, it can only be a lump sum payment that's provided. They're the only time frames that are set out for our legislation.

CHAIR: To cut through: the only time frame is the six-month one?

Ms Kairouz : In relation to permanent impairment for MRCA, the payment's initially—

CHAIR: That's the only time frame?

Ms Kairouz : That is a time frame.

CHAIR: How's that working? Are you getting complaints that that rushes people into decision-making?

Ms Kairouz : Not that I am aware of. We'd have to—

Ms Cosson : We'll take that on notice, if that's all right.

CHAIR: Yes, if you could.

Ms Cosson : We did hear from some of our younger widows, for example, that the time in which we required them to make a decision was too short, so we did review that.

Ms Kairouz : And it was extended. So, for widows, they have up to two years now to make decisions—

CHAIR: Good.

Ms Kairouz : on whether or not they want to take that money as a lump sum. During the course of waiting to make that decision, they're provided with a periodic payment.

CHAIR: Thank you for that. That's helpful.

Senator LAMBIE: Are DVA collating, or have they moved any further in making sure that they've got, the number of veteran suicides each year?

Ms Cosson : Sorry, Senator. I missed that.

Senator LAMBIE: Veteran suicides. Obviously there are groups on the outside keeping the numbers. Is DVA doing anything about trying to collect numbers on veteran suicide each year?

Ms Cosson : Senator, as you know, we commissioned the Australian Institute of Health and Welfare to look at what the suicide numbers were, and we get an annual report. At this stage, that report relies on the death being certified by a coroner as suicide. We should be receiving the report from the institute later this year for the figures from 2001 to 2017. But, other than that, we don't keep our own register of suicide, because we rely on the coroner to certify that it is a suicide.

Senator LAMBIE: Since the Bird review, do you know how many are at least at risk?

Ms Cosson : We certainly have a much better understanding of what the risk factors are for our veterans, and we have introduced a lot of changes as a result of Jesse Bird's suicide. In particular, on all our IT systems now, if you have a mental health condition it comes up as a flag so our delegates are aware that they're dealing with a veteran who may need some extra care or some urgent support, such as a veterans payment. So we have introduced quite a few changes as a result of Jesse's passing.

Senator LAMBIE: Is there any reason why Jesse Bird wasn't with the Client Liaison Unit?

Ms Cosson : We've implemented a brand-new client framework, and it wasn't really as solid or mature as it is now. The reason Jesse wasn't with the Client Liaison Unit is that it was a different structure back then for the CLU.

Senator LAMBIE: Great. How many do you now have within that unit or whatever you're calling it?

Ms Cosson : It's called managed access arrangements. We've got 60 veterans who are in there at the moment, and we regularly review that. That's come down from, I think, about 130. But that managed access is in addition to our coordinated support arrangements and also our WASP, as we call it, which is case management. So we have now a stronger, more mature client framework so veterans can move in and out of any of those support arrangements in the department.

Senator LAMBIE: Are you using this same unit to deal with the difficult advocates out there and those who are representing the veterans? Are you using that unit to deal with them? They're starting to get a little irate.

Ms Cosson : We did use the unit for that reason, but we don't anymore. Interestingly, we did have some veterans in the old CLU—the managed access arrangements now; it's a different arrangement—who have asked to remain in that because they like to have that single point of contact. But it's a different arrangement now to what the old CLU was.

Senator LAMBIE: Why would you not just have a single contact for an advocate anyway? Why would they not be able to have direct access so they're not wasting time and the client's time, which is putting them under immense pressure, obviously?

Ms Cosson : They do now.

Senator LAMBIE: Since when?

Ms Cosson : Advocates can actually deal with particular delegates. They build relationships with delegates in the department, so they don't need that managed access arrangement. That is really for veterans who need some additional support around them.

Senator LAMBIE: How many of the 23 recommendations from the 2017 review on veteran suicide have been implemented fully?

Ms Cosson : Do you mean The constant battle, the Senate inquiry?

Senator LAMBIE: That would be the one.

Ms Cosson : I've got a breakdown against each of the recommendations, but—

Senator LAMBIE: Are they in full? Have the recommendations been finished in full? My count is that at least seven—and I'm being extremely kind here—have been completely ignored.

Ms Cosson : I'd suggest they haven't been completely ignored.

Senator LAMBIE: Okay.

Ms Cosson : But if I can take that on notice—

Senator LAMBIE: That would be great.

Ms Cosson : because we've got a complete breakdown of all of the recommendations and what we're doing, so that might be helpful.

Senator LAMBIE: That would be wonderful. The review recommended:

… the Minister for Veterans' Affairs and Defence Personnel should liaise with the Minister for Health to oversee the development of strategies … to engage and support former members of the ADF aged 18-29 years who have left the service in the last 5 years and who could be at risk of suicide or self-harm.

What's happened with that?

Ms Cosson : We regularly engage with the Department of Health. Importantly, the Prime Minister has appointed an adviser on suicide, Ms Christine Morgan, and we've had a meeting with her, and Mr Cormack has actually written to her. I met with her yesterday as well, just to talk about the veterans suicide initiatives that we have. She is facilitating a summit in November, which I think is 13 November, and I think we'll be participating in that.

Senator LAMBIE: Another summit? Seriously?

Ms Cosson : But it's a workshop.

Senator LAMBIE: I'm sick of summits.

Ms Cosson : It's a workshop, Senator—

Senator LAMBIE: Yes, well, I've seen them all.

Ms Cosson : and she is very keen to work with us very closely.

Senator LAMBIE: Okay, so nothing's been done at this point in time for those aged 18 to 29 who have left the service and are most at risk of suicide and self-harm. We still are waiting for anything to be done. Nothing has happened.

Ms Cosson : No, no, no.

Mr Cormack : No, that's not the case.

Ms Cosson : No, we've done a lot, actually.

Mr Cormack : There's a wellbeing and support program that focuses on them.

Senator LAMBIE: Okay. How's this being evaluated? Can you supply me with all the evaluations—what's come out of that, the accomplishments?

Mr Cormack : It's into its second year and it will be the subject of a formal evaluation, and we're happy to give you the details of that on notice.

Senator LAMBIE: When is that evaluation happening?

Mr Cormack : The evaluation design is underway. The program is still running. It is a three-year program, and it's targeting support for just the sorts of people that you mentioned. The evaluation will be fully undertaken at the end of that three-year period.

Senator LAMBIE: With your 12-session treatment cycle pathway, how did you contact every serving member and veteran to let them know that was going on and explain that to them?

Mr Cormack : We used a range of communication measures. There were articles in Vetaffairs. There was social media. I can give you the details of all the different communication activities.

Senator LAMBIE: So nothing in the mail, nothing in emails—you just threw out some ads. 'That's it, well done.' Seriously?

Mr Cormack : No, no. I'll provide you with the details.

Senator LAMBIE: But there was nothing in the mail and nothing in emails, was there?

Mr Cormack : Senator, I'll take it—

Senator LAMBIE: I specifically asked you a question, mate. Was there anything sent in the mail, was there anything sent out in an email?

Mr Cormack : Yes. Vetaffairs was sent out to a very large mailing list of our clients—

Senator LAMBIE: How many of them?

Mr Cormack : I'll need to get you the circulation figures for that publication, but that goes out on a regular basis and it contained full details of that initiative before it commenced.

Ms Cosson : We also have that electronically—

Mr Cormack : That's right.

Ms Cosson : so we can take that on notice to work out the distribution list for that.

Senator LAMBIE: Okay. You've got all the names there, though, right?

Ms Cosson : Yes.

Senator LAMBIE: You've got all the names; you've got all your database. Why didn't you send out an email to everybody?

Ms Cosson : I'll check if we did or didn't do that.

Senator LAMBIE: No, you didn't, trust me.

Ms Cosson : Okay.

Senator LAMBIE: If you're really trying to sell something and you're not trying to hide it, because there's nothing wrong with it, why wouldn't you just flood it out there?

Ms Cosson : We'll take that on notice, Senator—how we communicated that.

Senator LAMBIE: Okay, and can you please tell me how you reached every GP out there if they've still got no idea about your 12-session cycle pathway.

Mr Cormack : Sure.

Senator Reynolds: Senator Lambie, I understand there was an email that was sent to all veterans who'd accessed the service in the previous 12 months—as well as any other activity.

CHAIR: We will find that out on notice, in detail. This now concludes the committee's examination of the Department of Veterans' Affairs and the Defence portfolio. I thank the minister and officers for their attendance, and Hansard and Broadcasting staff. In these notes, the secretariat don't refer to themselves, but allow me to thank the secretariat staff as well. The hearing is adjourned. Thank you, all.

Committee adjourned at 22 : 59