Amanda Rishworth (Kingston, Australian Labor Party, Shadow Parliamentary Secretary for Health) Share this | Hansard source

I move:

That this House:

(1) notes that the Australian Medical Association's survey highlights that the freeze of the Repatriation Medical Fee Schedule (RMFS) is leading to some healthcare professionals no longer accepting Department of Veterans' Affairs (DVA) clients;

(2) recognises the negative impact that the DVA RMFS freeze has had on veterans accessing specialist medical care;

(3) notes that the Australian Institute for Suicide Research Prevention, the Australian Psychological Society and the Royal Australian and New Zealand College of Psychiatrists have raised the negative impact that the freeze is having on veterans accessing skilled clinicians;

(4) expresses concern that some mental health and allied health services are not accepting veterans into their service as a result of the indexation freeze; and

(5) calls on the Government to immediately drop the RMFS indexation freeze, which is significantly impacting on veterans' access to mental health and specialist medical services.

This motion highlights the impact that the Repatriation Medical Fee Schedule indexation freeze is having on our veterans and our ex-serving community. Our ex-service men and women have served our country with pride and devotion and, if wounded, deserve world-class care and support. However, access to the very best specialists and health providers is being eroded by the government's Medicare indexation freeze. As it stands, veterans who have access to the gold or white cards and who are covered by the extension of non-liability health care can access allied health care for conditions that are covered under their respective card.

As part of accessing these services, psychologists and other clinical practitioners are paid by the Department of Veterans' Affairs at a set fee, with no gap payable to the veteran. This fee is known as the Repatriation Medical Fee Schedule and is tied to the Medicare rebate and indexed in line with the Medicare rebate indexation. As such, this fee has remained stagnant since 2014, directly impacting those professionals who are helping our veterans. This ongoing freeze has led to a situation where the rebate is no longer covering the costs of medical treatment and, because our veterans cannot be charged a gap payment, there are some medical and allied health professionals who have had no choice but to turn DVA clients away. These are hardworking, dedicated health professionals who would help veterans but are hamstrung with this gap in funding—a gap which is starkly illustrated by the difference between fees for psychologists paid by Defence, at a rate of $200.95 per session, and those paid by DVA, which pays only $148.95. This is a difference of $52, which only stands to grow under the current indexation freeze. Fifty-two dollars is a considerable gap per session and, as we know, this difference is determined only by whether you are currently serving in Defence or have served our country and transitioned into civilian life. The service may be the same, but there is now a gap in what is paid to those health professionals. We must recognise that a veteran's treatment plan could be quite complex, requiring a number of sessions. For some mental health specialists, this gap is simply too wide to overcome.

The impact on our veterans was highlighted by Griffith University's Australian Institute for Suicide Research and Prevention in recent evidence given to the Senate inquiry into suicide. They stated that there has been a fee freeze for psychologists since 2014, which is creating a disincentive for experienced and skilled clinicians to see veterans. This freeze has meant that the supply is not meeting the demand of our veterans and ex-service personnel who require this specialised mental health support. This sentiment was echoed by the Australian Psychological Society and the Royal Australian and New Zealand College of Psychiatrists, who said in their evidence to the same Senate inquiry: 'We know it is important for our veterans and ex-service personnel to seek support when they need it. However, when the support is not available to them due to the government's freeze on indexation, then we realise a greater issue in the system.' The Australian Medical Association recently released the outcomes of a survey of their members in relation to these issues. The survey demonstrated that the indexation freeze is also impacting other specialist services, including surgery, medicine, psychiatry and ophthalmology, amongst others. Of those who participated, they cited the government's current indexation freeze as the primary reason to refuse service to those with DVA cards. The AMA survey highlighted that 71 per cent of specialists are currently continuing to treat veterans under the DVA RMFS system, with the remainder adopting a range of approaches, including closing their books the new DVA funded patients or treating some is fully private or public patients. This means that there are many who have responded who are saying they are reluctant to actually use the white card and bill DVA patients.

This is a serious issue. It is time that the government lifted this unfair freeze, as it is affecting veterans access to specialist healthcare services. Our veterans deserve better, and I commend the motion to the House.

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