Linda Reynolds (WA, Liberal Party) Share this | Hansard source

I would ask that I be extended the same courtesy that I and other colleagues extended to Senator Lambie and be heard in silence.

Further, this bill proposes to issue a gold card solely on the basis of a current or ex member having necessary service. As I said, this is a well-intentioned policy, but it is completely uncosted. We have no idea how much it would cost, which is particularly ironic because at this exact moment the Minister for Defence is releasing the Defence white paper and is committing almost $30 billion of new spending towards defence. That will include going towards veterans and current serving personnel.

My greatest concern with this bill is that by making this very important resource for our most vulnerable veterans and ADF personnel as widely available as Senator Lambie wants it would not be targeted and would be spread too thin. It is completely uncosted. The result would be that those who need this assistance most would end up losing out. There is no question about that.

As part of this government's defence policy, we are fiercely committed to ensuring the health and wellbeing of Australia's current and former service men and women and to providing support for their families and dependents. The government's 2015-16 budget is delivering $12 billion for veterans' affairs—$6.5 billion for pensions and compensation and $5.5 billion for health care. In 2014-15 the Department of Veterans' Affairs supported more than 316,000 clients through treatment cards—gold cards and white cards in particular—and some compensation for incapacity or permanent impairment and whole-of-person rehabilitation.

Senator Lambie has stated that:

Australia has a moral as well as a legal duty to give our veterans access to the best medical care our country can offer.

Senator Lambie, let me emphasise this: the government absolutely supports this and is delivering it. This is why it has programs in place that work with healthcare service providers to ensure they understand the unique and particular needs of current and former ADF members.

The government's mental and social health action plan for 2015 and 2016 outlines a comprehensive e-learning program to improve the capabilities of healthcare providers to support veterans' mental health. DVA has also worked with peak provider organisations to make veteran-specific compulsory development point training available, further enhancing providers' understanding of veterans' requirements.

DVA invests considerable effort to make it easier for health providers to do business with government. This includes providing free, fast and simple e-billing arrangements and reducing the red tape associated with providing treatment. DVA also has a streamlined process to consider approving new and emerging treatment options where these can provide a benefit to patients, ensuring access to contemporary care in a timely manner.

I would note that this bill is of such great interest to Senator Lambie that she has left the chamber. She clearly does not want to hear all of the things the government is actually doing. I am sure if she were here she would be interested to know that DVA has recently also established a comprehensive and streamlined consultative forum with providers to ensure their voices are heard and responded to. This forum is in addition to consultation being undertaken in respect of dental and allied health services.

DVA's major focus is on early intervention as the critical first step in identifying and meeting the mental health needs of veterans. Veterans and their families can access mental health support. Again, it is a shame that Senator Lambie is not here to hear about the mental health support aspects of what DVA is providing. Nonetheless, I will recount them for colleagues in this place. First of all, veterans can talk to their GP, who may provide treatment or refer them to a psychologist, psychiatrist or social worker. They can access DVA's mental health web portal, At Ease, which gives access to videos, self-help tools and mobile apps on mental health and wellbeing. As well, they have the option to call on the Veterans and Veterans Families Counselling Service at any time to access free and confidential Australia-wide counselling and support.

If Senator Lambie were here for this debate she may have also been interested to hear that there are three main ways clients may access medical care through current DVA arrangements. Clients with qualifying service who are aged 70 years and older automatically receive a gold card that covers treatment costs for any condition. I will say that again because I think that is something that Senator Lambie and those who support this bill clearly do not understand. Clients with qualifying service who are aged 70 and older automatically receive a gold card which covers treatments for any condition. Eligible clients seeking treatment for cancer, TB and certain mental health conditions—whatever the cause—may access treatment by taking the non-liability pathway. Clients seeking treatment and compensation for medical conditions, including mental health conditions, related to service in the ADF may take the liability pathway and lodge a claim.

I understand and acknowledge that validation of service and sacrifice is essential to the mental health and wellbeing of all veterans—of course it is—and that includes contemporary veterans of more recent operations. Nobody in this place—and certainly not me—is saying that DVA is perfect and that they get it right for all 316,000 clients all of the time. Of course they are not and of course they do not. But DVA does know that it needs to learn from the past, use new knowledge about mental health and continue to adapt its systems to new generations of veterans and their families.

Like Senator Lambie and many other Australians, I believe that we owe veterans and their families a debt of gratitude for their service and their sacrifice. This means we must provide them with easy access to the treatment they need and to all the compensation and benefits to which they are entitled, along with vocational rehabilitation options and opportunities to enhance their wellbeing. To this end, my focus is on providing the support veterans need through improvements like ensuring they have access to transition processes for personnel leaving military service and that they access those provisions, vocational rehabilitation options to assist those who are able to return to the workforce, the ongoing availability of mental health resources and treatments, and also the streamlining of DVA's claims processes.

In the debate today on this very ill-conceived, unfunded and highly emotive bill, let us have a look at what the gold card already provides. A gold card provides lifetime healthcare treatment at DVA's expense for health conditions experienced by the cardholder, regardless of any link between the condition and service. It is a shame Senator Lambie is not in the chamber for debate on her own bill, because I think she would probably be surprised to know that a gold card provides lifetime healthcare treatment at DVA's expense for all health conditions experienced by the cardholder, regardless of any link between the condition and the service. You would not know that from listening to Senator Lambie's speech and reading her ill-conceived bill.

What else does a gold card already provide? The gold card provides access to a broad range of treatment and services, including to private and public hospitals, theatre fees, intensive care, GP services, referred specialist services, allied health services, dental services, and optical and ambulance cover. Cardholders are also covered for a wide range of rehabilitation devices and appliances, pharmaceutical needs and travel for treatment. It is very comprehensive support, as it should be, and it went unacknowledged by Senator Lambie in her speech.

Who is eligible for the gold card? All veterans with qualifying service, including those who have served in operations in Afghanistan and in certain other operations in the Middle East, will automatically get a gold card when they turn 70 years of age. Under the VEA, a gold card is also provided to any veteran who is in receipt of a disability pension paid at or above 100 per cent of the general rate or in receipt of a disability pension at 50 per cent or above the general rate and any amount of service pension. But that is not all. A gold card is also provided under the MRCA to former ADF personnel, cadets and reservists with service since 1 July 2004.

And guess what? It is actually extended more widely than that. The gold card is also extended to those who have permanent service related injuries or diseases assessed at or above 60 impairment points. And, yes, there is even wider coverage. It is also extended to those who have permanent service related injuries or diseases assessed at or above 30 impairment points and who are also receiving any amount of service pension, to the category of veterans who are assessed as eligible for the special rate disability pension safety net payment, even if they have chosen not to receive that pension, and, again, to those who are at least 70 years old and who have qualifying service.

What do the veterans community and other people who know a lot about this say on the expansion of the gold card eligibility? The Clarke review observed that the notion that only some people may receive a gold card has been:

... widely accepted by successive governments and the community, that those veterans who suffered the rigours of service that exposed them to harm from the enemy in war or warlike operations have been affected by that service in ways not tangible, and thus should be provided with assistance where they cannot work due to age or disability ...

These views continue to be widely supported by the veteran community. Again, I am really sad to see that Senator Lambie is not here for the debate on her own bill, because I think she would be very interested to know what the veteran community are saying about her bill.

As I said, these views are widely supported by the veteran community. As recently as September and October last year, ex-service organisations and other members of the veteran community expressed their concern to Senator Lambie about her suggestion that a gold card be provided to all discharging veterans. On 25 March last year, the Senate agreed to establish an inquiry into the mental health of ADF personnel who have returned from combat, peacekeeping or other deployments. I understand that that inquiry is due to release its report this month. The inquiry has received 79 submissions, and a number of public hearings have been held in Brisbane, Sydney and Canberra. The public hearings were attended by a diverse range of representatives from the veterans community, including the RSL, the Alliance of Defence Service Organisations, Australian Families of the Military Research and Support Foundation, Walking Wounded, Soldier On and Stand Tall for PTS.

What did they have to say? Senator Lambie, as you are not in the chamber, I hope you are at least watching this, because I know you should be very interested in what the veterans organisations themselves have to say about your bill. Mr Bradley Allan Skinner, the executive officer of Walking Wounded, said:

I would like to say yes—I really would ... I am a returned soldier. I saw active service in East Timor. I am never going to pretend that the service I saw in East Timor compares with the service that these diggers that I knew in 2CR underwent in Afghanistan ... But honestly, when you put your fair dinkum hat on, it does not compare. If that were the case and I could put my hand out for a gold card, my hand would be shaking, as they used to say, because I would know, deep down, that I would not deserve it.

Mr Anthony Ross Dell, founder of Stand Tall for PTS, suggests that a temporary gold card should be issued for a short time after discharge and that a permanent gold card should only ever be provided to veterans with a diagnosed condition—as is already the case.

Mrs Emma Louise MacDonald is Director of the Australian Families of the Military Research and Support Foundation. What did she say? She was very concerned that, if every discharging member were to be automatically issued with a gold card, the people who already have gold cards and who have been injured, wounded or have other disabilities would see that it devalued their service, and it would reduce the funding available to give them the support they so badly need.

What is the cost of expanding eligibility for the gold card? I note at this point that Senator Lambie is not in the chamber for the debate on her own bill. We have seen that there are no costings for this bill. As noted previously, the proposed amendments are understood to apply to service rendered during war, conflicts or peacekeeping operations. Indicative costings have been prepared for the automatic provision of a gold card to all veterans, current and ex-members of the ADF, and AFP members who have rendered operational service, including in peacekeeping operations. Senator Lambie has asserted that the increased costs could be absorbed by government and would somehow—through the fairies in the back of the garden—be 'cost neutral'. She says that there would be no cost to this. Her assertion is clearly and patently incorrect and seems to rely on some fanciful assumption that veterans will not claim compensation once they have a gold card. So, if people are not going to claim for services when they get a gold card, why on earth would it be issued in the first place?

Compensation benefits are entirely separate from the treatment available through a gold card—and DVA makes approximately $3.8 billion in such payments each year. These costs will continue. This proposal is not cost neutral. The overall net cost of providing a gold card to all veterans with operational service is estimated to be at least $1.5 billion over the first four years and $11 billion across 20 years. Where are the costings? Where is the money coming from? Senator Lambie has been completely silent on that. Senator Lambie suggests that the proposed bill will ensure that 'everyone who serves in war or war-like operations will receive vital, necessary and timely medical and psychological treatment'.

I say in conclusion that expanding eligibility for the Gold Card is not the way to achieve this goal. Non-liability health-care treatment for mental health conditions is already available free of charge, without the need to lodge a compensation claim. The government does not support Senator Lambie's proposal to expand Gold Card criteria— (Time expired)