Without adequate consultation and driven by a desire to show government savings, it’s no surprise the threshold was abandoned, the AMA says.
The Australian Medical Association is claiming that it was not made aware of the government’s “poorly targeted” $5000 allied health threshold until it had already been introduced.
The threshold, which would have taken effect on 1 July 2027, would have scrapped the current 12-session or 12-month treatment cycle, under which veterans must obtain a new referral after 12 allied health sessions.
The DVA said the measure would save the budget $748 million over three years, with just over $340 million saved each year thereafter.
In turn, the government would have invested $169.7 million – the largest investment in two decades – to increase fees for allied health professionals.
“While we support appropriate review and accountability, a blanket financial cap is a poor substitute for clinical oversight,” AMA vice president Associate Professor Julian Rait told The Medical Republic.
In its submission, which was released this week, the AMA said the government should have worked to improve current treatment arrangements, rather than “potentially risk losing its core elements essential to delivering quality care”.
Inadequate indexation, including a prolonged freeze that lasted roughly six years, was only one of the issues affecting DVA-funded health treatment – a glaring omission from the proposal, the AMA said.
“Many doctors will not accept DVA cards for the treatment of veterans as fee schedules have fallen behind and in many cases are well below what is paid under other schemes, including workers’ compensation arrangements,” the submission read.
For veterans in regional and remote communities, this often meant care required long-distance travel, at the expense of their “significant dislocation”, according to veteran members of the AMA.
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The AMA’s scathing assessment said the DVA had “increasingly avoided meaningful consultation with the health sector” and questioned the purpose of the threshold, given that allied health services under the current arrangement had already been “quite streamlined”.
While the government’s proposal aimed to curb unnecessary overservicing, administrative burden and predatory providers – most recently exposed by ABC’s Four Corners – the AMA said any future reform must be co-designed from the outset with veterans, their GPs, allied health practitioners and relevant representative bodies.
“Any changes to health funding need to be tested against whether they make those existing access problems better or worse,” the AMA vice president said. This included practical clinical, digital and administrative workflows.
“If there is evidence of inappropriate treatment or over-servicing, it should absolutely be addressed, but a $5000 cap applied to every allied health service is a very blunt way to do that,” he said.
“The treatment cycle already provides for reporting back to the referring practitioner and regular clinical review.
“If those safeguards aren’t working well enough, they should be strengthened and inappropriate practice targeted directly rather than restricting clinically necessary care for veterans who may have complex needs.”
In August, veteran and independent senator for Tasmania Jacqui Lambie accused the government of “callous disregard for veterans’ health and wellbeing” and urged the threshold be scrapped.
Soon thereafter, veterans laid their service medals outside Parliament House in Canberra to protest the proposed changes, and a petition to reject the $5000 annual threshold received more than 57000 signatures by its closure on 22 July.
Despite an initial consultation process to remain open until 30 October, the federal government officially scrapped the proposal on 17 September.
By contrast, RACGP rural chair and veteran Associate Professor Michael Clements said the DVA had worked hard with GPs, within the constraints of the MBS, to support patients.
Read the AMA’s submission here.
