Veterans allege government has failed to honour commitments made after the Royal Commission into Defence and Veteran Suicide, two years after its final report.
Veterans have laid their service medals outside Parliament House in Canberra this morning to protest the government’s proposed changes to veterans’ healthcare. But experts say the proposed changes are “entirely reasonable”.
A petition to reject the $5000 DVA allied health threshold argued that the current fee schedules would exhaust the limit after about 20 psychology or 50 physiotherapy sessions, which it said was “well short of the clinical need of veterans with multiple accepted long service”.
Appointments with Open Arms, a veterans’ psychology and family counselling service, would not count towards the $5000 annual threshold.
At a minimum, the petition called for Gold Card holders to be exempt from the cap and for a statutory clinical-need override – with published criteria – to be legislated, with assessments carried out by the Veterans’ Review Board.
It received over 5700 signatures before its closure on 22 July.
In an interview with Sally Sara on ABC Radio National this morning, health minister Mark Butler said there would be a “substantial increase” in fees for 13 allied health services providing veteran care.
To be precise, that was a $169.7 million investment – the largest in allied health provider fees in two decades.
He said this was due to the increasing difficulty for veterans in accessing allied health professionals, driven by lower remuneration compared with other programs.
Instead of requiring veterans to return to their GP for a new referral after every 12 visits to an allied health professional, the change would introduce a $5,000 cap before another referral was required, Mr Butler said.
“That’s a lot more than 12 visits. That might be several dozen visits,” he said.
“If there is a clinical need beyond that $5,000, we’ve been quite clear. Another referral would be made by their treating doctor.”
According to the Department of Veterans Affairs (DVA), only approximately one in 10 veteran cardholders spent more than $5000 per year on allied health services.
While Mr Butler said he understood the growing concern and anxiety about the proposed changes, he added that a consultation process, currently underway, would remain open until 30 October.
“These changes aren’t scheduled to take place until mid-next year [1 July], and we want to make sure that the changes operate in the best interests of veterans,” he said.
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Veteran and RACGP rural chair Associate Professor Michael Clements told The Medical Republic that GPs should rest assured the proposed changes signalled no limit on the care veterans would receive, and that the RACGP would work closely with the DVA to ensure continuity of care.
“What [the DVA is] communicating to us is not a cap, but actually a review at $5000,” he said.
The review would continue to allow GPs to support their veteran patients in accessing allied health services, while reducing administrative burden.
Professor Clements said the negativity towards the proposal potentially stemmed from concerns that a limit would be introduced or that it would mark the beginning of further downstream restrictions.
“The policy, as stated and promoted by DVA, has [indicated] a clear intent to work with the RACGP and GPs to determine how to have that review at $5000, which is entirely reasonable,” he said.
However, he acknowledged that it was time to examine how to better support veterans in receiving the care they needed, including measures to prevent providers from preying on veterans for financial gain.
“I’m well aware of many patients, including my own, who have been targeted by some commercial interests to have consultations with allied health providers that weren’t clinically required,” he told TMR.
Professor Clements recalled a patient who received an unsolicited consultation arranged by a commercial provider, involving four allied health providers – none of whom were relevant to the veteran’s needs.
“DVA has been very active in engaging with the RACGP over the years in terms of better understanding the GP experience on the ground,” he said.
This included developing GP education around entitlements and claims processing, with the DVA reportedly investing significantly in programs to help GPs better understand the system.
For more information, read the discussion paper here.
