Spotlight on Queensland veterans’ access to healthcare

While accessibility of affordable healthcare is a prevalent issue among the whole community, veterans are currently facing additional challenges. 

In the ACT, veterans have recently voiced their challenges with finding general practitioners (GPs) who accept veteran healthcare cards.  

Despite the Department of Veteran Affairs’ (DVA) saying there had not been a decline in the number of health professionals willing to see veteran patients, veterans have experienced difficultly finding GPs and specialists with open books. 

Additionally, many GPs in Canberra believe the DVA renumeration to healthcare providers has not kept pace with the actual cost of providing services.  

For context, GPs who accept white, or gold cards are usually paid a rebate of $50.50 by the DVA, plus the Veterans’ Access Payment of $25.70. Depending on the doctor’s individual fee structure, this puts the doctor out-of-pocket between $50-$60 as doctors cannot ask veterans to pay a gap fee. (Source: ABC)

Challenges for doctors

As an Army veteran of 29 years who then became involved in medical and health advocacy after his discharge, RSL South Eastern District President Kerry Gallagher AM empathises with both sides. 

“The primary reason for this shortage of healthcare providers accepting veteran healthcare cards is that the MBS rebate, and the subsequently linked DVA rebates, have not been increased in line with real practice costs in a long time,” he says. 

“The costs involved with running a practice or performing a service is extraordinary. You’ve got to account for the cost of wages, medical indemnity, equipment, software and technology, administration and general bills to name a few. 

“Then you’ve got the indirect costs of referring to pathology, radiology and ophthalmology. There are big costs involved with providing health services, GPs and specialists can no longer afford to give unlimited access to people who cannot pay the full bill.”

Kerry has a deep connection to the veteran community and has served in a variety of roles within the ex-service organisation sector. Most recently, he has been selected as the Queensland nominee for the RSL National President. 

Alongside his roles in the veteran space, Kerry has previously served as CEO for the Australian Medical Association Queensland as well as Secretary General for the Federal Australian Medical Association. He has seen that these problems are not just specific to ACT.

“The issues we’re hearing from veterans and doctors in Canberra are happening Australia-wide,” he says.

“In regional areas of Queensland particularly, the impact of this shortage is amplified as there simply isn’t an array of health practitioners available out there.”

Another layer to the problem is the reducing number of new GPs.

“We’re also seeing more medical students choosing to go into other specialty fields rather than general practice. So, this, coupled with the fact that a lot of current GPs are getting older and heading into retirement, means the proportion of available GPs to the general population is decreasing. Which in turn means it’s becoming increasingly difficult to get in from of one.” Kerry explains. 

RSL South Eastern District Company Secretary Judy Alterator and RSL South Eastern District President Kerry Gallagher AM

Barriers for veterans

In conversations with veterans across the League, Kerry has uncovered common factors that are impacting veterans using their healthcare cards.  "I’ve spoken to many veterans who don’t even use their white or gold card anymore,” he says. “The main reasons for this are financial factors and the limited availability of GPs accepting white or gold cards.

“It can also be difficult for both doctor and veteran to navigate the strict guidelines and regulations of the system during consults.

“This navigation adds extra time and complexity to standard appointments and because of this, we see many veterans offer to just pay the extra money and see a doctor privately.”

Queensland veteran needs

Queensland is home to Australia’s largest population of veterans, one in 20 Queensland households includes a member who serves or has served in the ADF. Veterans bring a wealth of skills and expertise to a large share of Queensland. 

Kerry explains that while some health challenges facing veterans can be complex, there are a few common issues that can arise.

“With respect to physical health challenges, they can vary simply due to the fact that some roles within Defence may be more demanding on the body,” he explains.

“Some veterans may need more orthopaedic support if they were involved in more physically demanding roles. But generally speaking, you tend to see common issues arise from prolonged sun exposure that require dermatology or ophthalmic services. 

“The Royal Commission into Veteran and Defence Suicide also shined a light on the mental health challenges that some veterans face during and after service. A large contributing factor to these figures we’ve seen is the inaccessibility of GPs. They’re the frontline of healthcare and are able to guide a veteran to other support they may need, be that allied health or specialists. 

“With the dwindling number of available GPs, I’ve seen the impact it can have on veterans mentally due to them not being able to make that first step and get their foot in the door.”

Given the large proportion of veterans in Queensland, Kerry says the health of veterans is critical to the wellbeing of our state.

“Our primary focus should be on providing health services that are world-standard for veterans so that we are setting them up with a solid foundation to support them through their transition journey and beyond.”

Remaining solution-focused

This year, the state government announced a new Queensland Veterans’ and Veterans’ Families Strategy to address and improve the issues Queensland veterans are facing. RSL Queensland Deputy CEO – Veteran Services Troy Watson is hopeful that the Strategy could succeed if there is a strong focus on improving access to healthcare for veterans.   “It’s promising to see that, through this new strategy, the state government is committed to supporting and identifying the needs of veterans in Queensland,” Troy says.  “While it is difficult to quantify just how many veterans are experiencing challenges accessing healthcare, we acknowledge that there is a major problem. 

“It is imperative that we continue to better understand this issue and its impact on Queensland veterans, as well as identify what needs to change for clinicians to accept veteran healthcare cards.

“Although there is only a certain amount the state government can do with respect to healthcare, this strategy is a major step forward for our state. If we can help shine a spotlight on the meaningful changes the federal government needs to make to support veterans and healthcare practitioners, we’ll be on the right track.”