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Tuesday, 10 September 1985
Page: 374

(Question No. 379)

Senator Collard asked the Minister for Veterans' Affairs, upon notice, on 31 May 1985:

(a) given that some 35 to 40 nurses are now employed on a fee for service basis has the Department costed the proposed change which will transfer the work presently done by these nurses to the Repatriation General Hospital;

(b) does the Department plan to provide a fleet of cars for the work use of these new positions;

(c) has the Department considered increased costs associated with superannuation and holiday benefits, etc., to be offered under the new arrangements; and;

(d) has the Department considered the costs associated with the increased bureaucracy associated with these changes, bearing in mind that it will now be required that all administrative and medical decisions, prescriptions and medicines etc. be obtained through the Repatriation General Hospital rather than directly from individual doctors, pharmacies etc. who have traditionally provided good service.

Senator Gietzelt —The answer to the honourable senator's question is as follows:

The Government's decision to review the arrangements for providing domiciliary nursing care to Department of Veterans' Affairs clients in Tasmania was made in the interest of reducing expenditure on these services. There was particular concern that, in 1982/83 for example, Tasmanian Branch expenditure on domiciliary nursing represented 11.6 per cent of national expenditure, despite Tasmania having only about 4 per cent of Department of Veterans' Affairs clients.

An investigation of cost control options was undertaken by the Department of Veterans' Affairs. Following this investigation, the Government decided to end using fee-for-service providers and to provide services using Departmental employees.

This decision is presently under review following a request by the Tasmanian Minister for Health Services that the State be given the opportunity to consider the possibility of providing all the domiciliary nursing needs of my Department's entitled beneficiaries. Discussions are taking place between Commonwealth and State officials on this matter. Another option is also being investigated.

Against this background, the answers to the specific questions asked by the honourable senator are as follows:

(a) Yes. (There are in fact some 90 nurses now employed on a fee for service basis);

(b) No. Under the proposed arrangements, nurses would receive a mileage allowance for the use of their own vehicles, as is the case under existing arrangements;

(c) Yes.

(d) Under the proposed new arrangements, it would not be the case that `all administrative and medical decisions, prescriptions and medicines etc.' would be obtained through the Repatriation General Hospital.Most decisions on these matters would continue to be made by the existing network of local medical officers.