Julia Gillard (Lalor, Australian Labor Party, Deputy Leader of the Opposition) Share this | Link to this | Hansard source

I move:

        Schedule 1, items 37-46, page 8 (line 30) to page 9 (line 21), omit the items.

I rise to move the in detail amendment which I foreshadowed during my speech on the second reading. It deals with an issue that the Minister for Workforce Participation, who is at the table, clearly does not understand. We have just seen another very clear example of hubris under the Howard government. Apparently the sun only shines because of the Howard government. People only smile because of the Howard government. Children only enjoy their childhood because of the Howard government. But, when you strip away all of the arrogance that this government now drips as it cheerfully misuses taxpayers’ money for its party political propaganda, what you find is a contribution from the minister that was all about the past and all about Labor’s policies with not one word about the future. The minister managed to tie all of that to a misunderstanding of the meaning and intent of the bill that she has brought to the House. One wonders, when one has arrogance tied with incompetence, where we really are.

For the purpose of explaining this to the minister, because she clearly does not understand it: this bill removes the phrase ‘medical officer’ from the relevant sections of the Social Security Act relating to the assessment of work capacity for disability support pension applicants, replacing it with the word ‘assessor’.

Sharman Stone (Murray, Liberal Party, Minister for Workforce Participation) Share this | Link to this | Hansard source

Medical assessor.

Julia Gillard (Lalor, Australian Labor Party, Deputy Leader of the Opposition) Share this | Link to this | Hansard source

Replacing it with the word ‘assessor’. The minister at the table just said ‘medical assessor’. It replaces it with the word ‘assessor’. The assessments that are being referred to are known as ‘job capacity assessments’. One element of those is the assessment against the impairment tables. We know that an applicant must get a minimum of 20 points to be assessed as eligible for the disability support pension; however, an applicant can get more than 20 points and still not be granted the pension because the job capacity assessment finds they are still theoretically capable of at least 15 hours of work.

The effect of what the bill before the House does is to roll together the impairment table process into the general job capacity assessment process, to have them all conducted by the job capacity assessor. The problem with this—and clearly the minister does not understand this—is that making a decision about disability against impairment tables is a task that requires the exercise of medical knowledge and medical judgement. We do note that there can still be input or advice from a medical officer, such as treating doctors, but of course the bill, by deleting the phrase ‘medical officer’, moves that determination to a determination made by an assessor—that is, it has taken the impairment table determination, rolled it in with the rest of the job capacity assessment and made that the province of the job capacity assessor. If there is any further confusion about this by the minister, she might like to reflect on the words of the National Welfare Rights Network, which points out:

The impairment tables are replete with complex and detailed references to multifarious medical conditions. Points under the impairment tables are given according to the actual impairment caused by an identified medical condition. They are not given according to their likely impact in the workplace. It therefore makes sense that a person’s rating be assessed by a medical officer.

Those are not my words but the words of the National Welfare Rights Network. It is a simple point, and it ought to be conceded, that making a judgement against the impairment tables requires the exercise of a degree of medical knowledge and skill. It consequently should be done by a medical officer. Of course, that is only going to form one element of the assessment. The rest of the assessment needs to be done by an assessor. That is understood. But the minister, in proceeding with the bill in its current form, is deleting the role of the medical officer by deleting the use of the words ‘medical officer’ and replacing them with the word ‘assessor’. So it would do everybody a favour, particularly the Australian people, if the minister conceded the point and accepted the amendment. (Time expired)

Sharman Stone (Murray, Liberal Party, Minister for Workforce Participation) Share this | Link to this | Hansard source

As I said in my earlier remarks, there seems to be a clear misunderstanding of what this is all about. The Social Security Amendment (2007 Measures No. 2) Bill 2007that is, the original bill and not the amendment that is now being discussed—removes outdated references to ‘medical officers’ in schedule 1B of the Social Security Act 1991 and replaces them with ‘assessors’. These changes reflect the broad range of health professionals who now determine impairment ratings against the impairment tables. The changes do not prohibit the involvement of medical officers and do not reduce the importance of medical information when assigning impairment ratings—quite the contrary. The job capacity assessors have to take on board all information including treating doctors’ reports and any other available medical evidence or any other information that is relevant to the person’s situation. They must do that when determining impairment ratings. In addition, job capacity assessment providers can refer people for specialist medical assessments if they do not think there is enough information there. The government will pay for these specialist assessments.

We are absolutely determined that we will have the full information in order to make the right decision. When someone has a very serious incapacity, why would we set them up to fail? When someone presents with a very serious condition—whether it is a mental health condition or a physical or intellectual incapacity—why on earth would we refuse medical evidence or eliminate the possibility of medical information coming forward? That is just absolutely absurd and it is not the case.

These guidelines are the legislative basis for the JCA process for reviews under the social security law. They deal with the situation—and this is what it is all about—where additional medical evidence that was not originally presented to the JCA is then presented to tribunals or authorised review officers. This is not unheard of and, although it is not frequent, it happens enough for us to be concerned. Sometimes an individual who has been to the JCA does not agree with the outcome so they go to the tribunal or to an authorised review officer, as is their right—and we are pleased that they do. If at that next stage they produce new information—perhaps from a medical officer—we will now require that the new information be sent back to the JCA so that they also can consider it. The tribunal or authorised review officer will then reconsider the revised report from the JCA—we presume that with the new information there has been a revision of the original assessment. This is all about protecting the individual’s rights and making sure that they are accurately and properly assessed so that they get the very best support from the Australian government.

In addition, if the tribunals or authorised review officers disagree with a report of a JCA, the guidelines then require them to seek a second review of the claim by a different JCA. The second review will go back to the tribunal or authorised review officer for consideration before they make their decision. We are bending over backwards to give some of our most disadvantaged Australians every right and opportunity possible to have their cases properly heard. The decision of the tribunal remains independent. The original bill therefore strengthens the process and gives maximum support to persons with disabilities who are seeking support. I commend the original bill to the House.

Julia Gillard (Lalor, Australian Labor Party, Deputy Leader of the Opposition) Share this | Link to this | Hansard source

Clearly we still do not have an understanding of this essential point and I am not sure why it is proving so difficult for the Minister for Workforce Participation. I refer the minister to the evidence that the Mental Health Council of Australia submitted to the inquiry into the Social Security Amendment (2007 Measures No. 2) Bill 2007 by the Senate Employment, Workplace Relations and Education Committee. They said that taking the term ‘medical officer’ out of this legislation—and consequently the role of the medical officer out of the assessment—could have ‘damaging unintended consequences for the person with mental illness’. Then there were the words of the Australian Federation of Disability Organisations, who were also concerned with the implications of this bill. They said that even under existing arrangements:

... people whose impairments are not visible have been inappropriately assessed by people with poor knowledge or appreciation of the impact of their condition on their capacity to work, the supports they need to work and the range of work that they can realistically undertake.

Given this predicament, disability advocates are concerned about the impact of removing the limited remaining role of medical officers from the process.

As usual we get from the Howard government this degree of arrogance that suggests that they are the only people who are right and it is impossible for anybody else on the planet to be right. When the minister rises to the dispatch box and refutes these suggestions, she might think that it is cheap politics to throw insults at the opposition. But she should understand that she is not insulting us; she is insulting the professionals who run the Mental Health Council of Australia. She is inviting this House to believe that the people who dedicate their lives to trying to improve the condition in our society of people with mental illnesses—psychiatrists, psychologists, academics, family members of people with mental illness and people who have insights that ought to be listened to and thought about such as the dedicated people I enjoyed meeting from the Mental Health Council of Australia—are idiotic and simply do not understand that their views are not worth listening to and that maybe they are trouble makers. She is saying that these are people of no account or no wisdom. We say to the minister that these people are of account and wisdom and she should think about that before she gets up with a glib and insulting response to the Australians who involve themselves in the Mental Health Council of Australia and the Australian Federation of Disability Organisations.

Can I say to the minister that I no longer know what it is that she is arguing, and I suspect that she does not know either. If she is arguing that, despite this legislative change, there has been absolutely no change to the involvement of medical officers in the assessment process, then why make the change? If it makes no difference in substance, if in the big, wide world where reality exists these words in the bill mean nothing, if they mean that nothing will change and that a medical officer will still be able to do everything that a medical officer has done in the past, then why amend the bill?

The minister is shaking her head; she does not get that concept. Why amend the bill if there is not going to be any change? If there is to be no change, you might as well leave the legislation the way it is now—that is, you might as well accept Labor’s amendment. If the purpose of changing these words in the bill is of no account, is of no consequence, then this is a completely redundant piece of legislation-making and you might as well leave it out by accepting Labor’s amendment. Or is the minister arguing—because she does not know; she has argued both positions even though they are completely inconsistent—that there is a change but that it is possible for any errors made as a result of this change to be fixed in the appeals process? If the minister is arguing that, wouldn’t it be better for government policy to try to aim to get these things right the first time, rather than saying, ‘If something goes wrong, when it goes wrong, after it’s gone wrong, we can have an appeal process, and we can do that and this in the course of the appeal process’? Wouldn’t you aim to get it right the first time?

I do not know what the minister at the table is arguing; she does not know. But we do know that people who have dedicated their lives to assisting others, assisting people with mental illnesses and disability, think that this is a foolish change. We are inviting the minister to think that they are Australians who should be respected and to think about their views. Their views are reflected in Labor’s amendment, and, consequently, she should think about accepting it. (Time expired)

Sharman Stone (Murray, Liberal Party, Minister for Workforce Participation) Share this | Link to this | Hansard source

Talk about getting desperate. I repeat: the member for Lalor clearly needs better advice. She suggests that the Mental Health Council and other welfare advocates are opposing this bill. No, you read the transcripts and you talk to these parties—

Julia Gillard (Lalor, Australian Labor Party, Deputy Leader of the Opposition) Share this | Link to this | Hansard source

That is not what I said.

Sharman Stone (Murray, Liberal Party, Minister for Workforce Participation) Share this | Link to this | Hansard source

I am sorry; you claimed that mental health advocates are opposed to this bill.

Julia Gillard (Lalor, Australian Labor Party, Deputy Leader of the Opposition) Share this | Link to this | Hansard source

Ms Gillard interjecting

Sharman Stone (Murray, Liberal Party, Minister for Workforce Participation) Share this | Link to this | Hansard source

No, they do not. If you read the transcripts and in fact speak to these advocates you will find that what they said, which we totally agree with, is that medical evidence should be key to a person’s job capacity assessment, depending on their condition. That is why this bill strengthens the medical information access issues. I understand that the member for Lalor is busy because she has an election that she is rushing around trying to campaign for! But this bill ensures that all layers of the assessment process have the same information. Do you get it? It is not about withholding medical information; it is about whether the job capacity assessor also has medical information that might have been submitted at a later stage—for example, when the individual decides to appeal a decision.

I understand that the member for Lalor has been involved in a lot of law cases before. Surely it is absolutely natural justice that the person who is seeking to have the very best outcome for their condition is comforted by the knowledge that all stages of the process have the same information to consider. That is what this is about. I know for a fact that the Mental Health Council, which I have worked very closely with, is one of the very close allies of the Howard government in producing some of our best mental health outcomes—for example, the Mental Health First Aid Kit—

Julia Gillard (Lalor, Australian Labor Party, Deputy Leader of the Opposition) Share this | Link to this | Hansard source

Ms Gillard interjecting

Sharman Stone (Murray, Liberal Party, Minister for Workforce Participation) Share this | Link to this | Hansard source

Yes, the member for Lalor sniggers. She would not know about any of that work, I know. This is about making sure that when people with a disability present additional information, often medical information, it is made available at other stages of the process where that information may not originally have been presented. It is that simple. I strongly suggest that you do not support the amendment of the opposition, and that we move quickly to support the Social Security Amendment (2007 Measures No. 2) Bill 2007, as presented.

Question negatived.

Bill agreed to.