Amanda Rishworth (Kingston, Australian Labor Party, Shadow Parliamentary Secretary for Health) Share this | Link to 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.

Andrew Wallace (Fisher, Liberal Party) Share this | Link to this | Hansard source

I acknowledge the service that the member for Kingston provides to the veterans' affairs community and her work in that area. This government could not be more committed to understanding and promoting the health and, in particular, the mental health of our veterans' community. In 2016, the government released the most statistically robust study of the mental health—in particular, in relation to suicide rates—of the Defence service personnel. That was the most robust study that had ever been done before.

In 2013, of the 148,000 veterans with service-related disabilities being supported by the Department of Veterans' Affairs, 46,400—almost a third—were living with an accepted mental health disorder, including post-traumatic stress disorder, anxiety, depression and substance dependency. In 13 years to 2014, there were 292 deaths by suicide among people who had served in the ADF for at least one day since 2001. Among male veterans, the suicide rate was 13 per cent higher than for the equivalent general population. Given that the statistical data was so limited in relation to women serving, I am unable to provide the data in relation to women—but I am not trying to take away from anything in relation to the service of servicewomen. Among male veterans aged 18 to 24, the suicide rate is twice that of their peers. There have been 23 deaths since 2001.

So what has the government done? In this year's budget, we have increased the financial support by $350 million to support our veterans. Last year's budget made treatment for depression, post-dramatic stress disorder, anxiety and drug and alcohol misuse free for anyone who had served full time in the ADF. In this is budget, we have extended that to all mental health conditions. We have increased the budget by $33.5 million. Importantly, there is now no need to prove that a condition is related to their service. Funding has not been capped.

All veterans with a mental health condition have access to the Veterans and Veterans Families Counselling Service. The government has provided $8.5 million in this budget to extend this service to all current partners and children of veterans. Also, former partners of ADF personnel, up to five years, are also eligible after the couple separates or while they are co-parenting a child under the age of 18 years. There has been $9.8 million provided to pilot a new approach to suicide prevention and improve care and support available to veterans. I am hopeful that some of this pilot money will go to the Thompson Institute to research PTSD for veterans.

One of the best ways to ensure good mental health is to ensure employment. The government is providing $2.7 million for the Prime Minister's Veterans Employment Program, launched in November last year. This money will be used to help businesses understand the unique skills that former ADF members can bring to a job through supporting the industry advisory committee, creating an ex-service organisation industry partnership register and developing the Prime Minister's Veterans' Employment Annual Awards. Another $9.1 million is being provided for accelerated access to rehabilitation services, streamlined access to incapacity payments and improved access to the totally and permanently incapacitated disability pension for veterans working past the age of 65. DVA has further committed to implement a suite of initiatives to support members to successfully transition out of the ADF, such as conducting a two-year trial that will allow veterans to access medical treatment while their Military Rehabilitation and Compensation Act claims are processed.

This government stands by its veterans. As the Prime Minister has repeatedly said: the best way we can honour the memory of our Anzacs is to properly care for our ex-service men and women. (Time expired)

Joanne Ryan (Lalor, Australian Labor Party) Share this | Link to this | Hansard source

I rise to support the motion put by the Hon. Amanda Rishworth, our shadow minister for defence personnel and veterans' affairs, and thank her for the careful attention she is paying in her portfolio to the things that really do impact on our veterans.

Like all members here, I have met with veterans who live in the electorate: I have heard their stories, I have marched with them on Anzac Day, I have attended remembrance ceremonies with them. I would agree with most in this place that spending time with our veterans is an eye-opening experience into some of the challenges that they face on returning to civilian life, and particularly the challenges they face around their health after serving our country. It is with that in mind that I thank the shadow minister for raising what is a considerable issue.

It is an issue where we need to see from this government their rhetoric meet some action, because on the ground now our worst fears about the 2014 budget cuts are being lived out by our veterans. They are being lived out because the indexation freeze for the DVA rebate paid to the health professionals helping our veterans has been frozen since 2014. It has created a gap between what the DVA will provide for services to our highly skilled medical practitioners who are trying to support our veterans, particularly in the area of mental health. This is a $52 gap that is not being picked up by the government. As a result, we are finding that veterans are unable to access the support, the clinicians, that they need to access to ensure their continued mental health. This is particularly concerning if you think about our veterans who may be in some kind of personal crisis. Their ability to get on the phone and access the best clinicians in this country is being blocked because of a simple indexation change that needs to be made by this government to ensure that the best people are available to our ex-service men and women.

The good news is this can be easily fixed, and this motion calls on the government to take the action required: to lift the freeze and ensure that our veterans have access to the professional health support that they need. It is a simple fix, one that this motion calls to the attention of the government. I am sure—I am absolutely sure—that the minister in this area would be supportive of this motion if he were in this chamber today, because no-one who takes a commonsense view would see this as a difficult thing to do. Everyone I have spoken to supports the notion that this gap should be taken away so that our veterans can access the service they need. And we do not have to go far. I listened to the member for Fisher. He raised some very important points around ex-servicemen and veteran suicide rates, particularly in young men. They are extraordinary numbers, and numbers that need to be addressed. Having this small thing, or what seems a small thing in parliamentary terms, standing in the way of them accessing the clinicians they need seems an absolute shame and something that could be fixed quite quickly.

The member for Fisher made reference to the inquiry into veterans suicide and the impact there. Griffith University's Australian Institute for Suicide Research and Prevention gave evidence to that inquiry into the suicide of veterans and ex-service personnel. Dr Katelyn Kerr stated:

… there has been a fee freeze for psychologists since 2014, creating a disincentive for experienced and skilled clinicians to see veterans.

This freeze has meant that supply is not meeting the demand of our veterans and ex-service personnel who require mental health support. That pretty much sums this up. It is an easy fix. I call on those on the government benches to have a look at this motion, to have some clear understanding, to speak directly to the Minister for Health and try and influence him to have this index freeze unfrozen to allow this gap to be filled and ensure that the next time we are standing with ex-servicemen around our country, laying a wreath or at a memorial, we can look them in the eye and say, 'We are doing everything possible to ensure your health and wellbeing into the future'.

Sharon Bird (Cunningham, Australian Labor Party, Shadow Minister for Vocational Education) Share this | Link to this | Hansard source

There being no further speakers, the debate is adjourned and the resumption of the debate will be made an order of the day for the next sitting.

Sitting suspended from 12:26 to 16 : 00