EXPLANATORY STATEMENT
Veterans’ Entitlements (Annual General Practitioner Health Assessment for First Five Years Post-Discharge) Determination 2019
(Instrument 2018 No. R93)
EMPOWERING PROVISIONS
Paragraphs 88A(1)(a) and (d) of the Veterans’ Entitlements Act 1986 (VEA).
PURPOSE
The attached instrument (Instrument 2018 No. R93) implements the Australian Government’s Annual GP Health Assessment measure which will enable Australian Defence Force (ADF) members separating from the ADF to access an annual comprehensive health assessment by a general practitioner (GP) for the first five years post‑discharge. All ADF members who separate from the ADF, including Reservists, on or after 1 July 2019 with at least one day continuous full-time service are eligible for the assessment.
The Annual GP Health Assessment measure was announced as part of a package of five new initiatives totalling $31 million in response to the Senate Inquiry into suicide in the veteran community The Constant Battle: Suicide by Veterans. The Mid Year Adjustment to the 2017–2018 Budget provided $3.5 million over four years for the Annual GP Health Assessment measure.
This measure builds on the existing one-off ADF Post‑Discharge GP Health Assessment, a 2013‑14 Budget measure. From 1 July 2019, a transitioning ADF member is entitled to GP assessments under the one-off ADF Post‑Discharge GP Health Assessment and the Annual GP Health Assessment measure. Importantly, the one-off ADF Post‑Discharge GP Health Assessment may be accessed at any time post discharge and is not limited to the post 5 year period of transition.
In mid-2018, the Australian Government commenced issuing Department of Veterans’ Affairs (DVA) Treatment Cards to transitioning ADF members with at least one day of continuous full-time service. All those discharging from the ADF (including Reservists) from 1 July 2019 with at least one day of continuous full-time service will be able to use their issued DVA Treatment Card to access the annual health assessment from their GP. Each ex-ADF member will be entitled to one session in each of the five years following their transition date. From January 2019, DVA Treatment Cards have been redesigned to the Veteran Card. A current DVA Treatment Card will retain the existing entitlement to medical treatment until it is replaced with the Veteran Card. Existing DVA Treatment Card holders will be issued a Veteran Card on expiry of their current DVA Treatment Card. For those clients without a DVA Treatment Card, they may apply for a Veteran Card (with medical treatment entitlements) via MyService.
Eligibility for the annual health assessment will cease at the end of five years post transition, or if the ex-ADF member rejoins the ADF during that five year period. Each time a person separates from the ADF they will be eligible for an annual GP health assessment for five years. This will enable the early identification and treatment of physical or mental health issues that may arise from each period of service.
The intent of the Annual GP Health Assessment measure is to improve the early identification and intervention of mental and physical health concerns during transition by ex-ADF members to civilian life, which research has found to be a high risk period for the emergence of mental health conditions and increased risk of suicide. It will significantly increase the opportunity for GPs to identify and treat the mental and physical health concerns of ex-ADF members during the five year transition period.
The attached instrument, made under section 88A of the VEA, specifies as the class of person who is eligible to be provided with the annual comprehensive GP health assessment, a person who:
- has rendered at least one day of continuous full-time service; and
- on or after 1 July 2019, ceases to be a member of the Permanent Forces or the Reserves.
The ADF comprises the Permanent Forces and the Reserves. The Permanent Forces consist of the Permanent Navy, Regular Army and Permanent Air Force. The Reserves consist of the Naval Reserve, Army Reserve and Air Force Reserve.
The instrument specifies the treatment under Part V of the VEA that the person is eligible to receive at the expense of DVA, namely an annual comprehensive GP health assessment for five years post‑discharge.
The instrument also provides that a veteran ceases to be eligible for the treatment if the veteran re-joins the ADF within five years after their discharge. However, a veteran becomes eligible again upon their subsequent discharge from the ADF.
Approximately 5,500 members transition from the ADF each year. It is expected that 5,500 members will be eligible in the first year of the program, with additional cohorts of 5,500 members added each year up to the five-year mark. This will stabilise to approximately 27,500 eligible ex‑ADF members on an ongoing basis.
CONSULTATION
Section 17 of the Legislation Act 2003 requires the rule-maker to be satisfied that any consultation that is considered appropriate and reasonably practicable to undertake, has been undertaken.
External consultation has been undertaken with the Department of Defence and the Department of Human Services. Consultation within DVA has been undertaken with Mental and Social Health Policy, New Initiatives, Health Entitlements Unit, Behavioural Insights, Health Advisors, Public Affairs, Defence Engagement, Client Access and Rehabilitation, Provider Engagement, Departmental Management Information System and Legislation and Instruments.
Further consultation was not considered necessary as the proposal is beneficial in nature in terms of its impact on clients and does not have regulatory impacts on businesses, community organisations or individuals. In these circumstances it is considered that the requirements of section 17 of the Legislation Act 2003 have been met.
RETROSPECTIVITY
None.
DOCUMENTS INCORPORATED BY REFERENCE
None.
REGULATORY IMPACT
None.
HUMAN RIGHTS STATEMENT
Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.
Human rights implications
The attached legislative instrument engages and promotes the Right to Health. The Right to Health is contained in article 12(1) of the International Covenant on Economic Social and Cultural Rights. The Right to Health is the right to the enjoyment of the highest attainable standard of physical and mental health. The UN Committee on Economic Social and Cultural Rights has stated that health is a fundamental human right indispensable for the exercise of other human rights. Every human being is entitled to the enjoyment of the highest attainable standard of health conducive to living a life in dignity.
Overview
The instrument specifies the class of person who is eligible for specified treatment, namely treatment consisting of one comprehensive health assessment by a general practitioner during each 12 month period of a person’s health assessment period. A person’s health assessment period is the period of five years starting on the day on which he or she ceases, on or after 1 July 2019, to be a member of the Permanent Forces or Reserves with one day of continuous full-time service.
Conclusion
The attached instrument promotes the Right to Health by enabling eligible ex-ADF members to access treatment by a general practitioner the first five years post‑discharge. This will facilitate earlier diagnosis, recovery and minimise the impacts of physical and mental health concerns on individual functioning, quality of life and workforce participation. This measure will significantly increase the opportunity for GPs to identify and treat the mental and physical health concerns of ex-ADF members early.
Accordingly, the attached instrument is considered to be “human rights compatible”
Repatriation Commission
Rule-Maker
FURTHER EXPLANATION OF PROVISIONS
See: Attachment A
Attachment A
FURTHER EXPLANATION OF PROVISIONS
Section 1
This section provides that the name of the instrument is the Veterans’ Entitlements (Annual General Practitioner Health Assessment for First Five Years Post-Discharge) Determination 2019.
Section 2
This section provides that the instrument is to commence on 1 July 2019.
Section 3
This section sets out the primary legislation that authorises the making of the instrument, namely paragraphs 88A(1)(a) and (d) of the VEA.
Section 4
This section is a purpose provision. The purpose of this instrument is to enable persons within a class specified in section 6 to receive treatment consisting of one comprehensive health assessment by a general practitioner during each 12 month period of the person’s five year health assessment period.
Note 1 to this section informs the reader that a person’s comprehensive health assessment by a general practitioner during each 12 month period of the person’s five year health assessment period is in addition to any other health assessment available to the person as a client of the Department of Veterans’ Affairs.
Note 2 to this section informs the reader that the term ‘health assessment period’ is defined in section 5.
Section 5
This is the interpretation section. It defines key terms used in the instrument.
The terms ‘Permanent Forces’ and ‘Reserves’ have the same meaning as in the Defence Act 1903. The Defence Act 1903 defines the Permanent Forces as the Permanent Navy, the Regular Army and the Permanent Air Force. The Defence Act 1903 defines the Reserves as the Naval Reserve, the Army Reserve and the Air Force Reserve.
The term ‘health assessment period’ is defined as the period of five years starting on the day on which a person ceases to be a member of the Permanent Forces or the Reserves. The note to that definition informs the reader that a person may have more than one health assessment period.
The term ‘continuous full-time service’ is defined in section 5C(1) of the VEA.
Section 6
Paragraph 88A(1)(a) of the VEA empowers the Repatriation Commission to make a written determination stating “that a veteran included in a specified class is eligible to be provided with treatment of a specified kind”.
Paragraph 88A(1)(d) of the VEA empowers the Repatriation Commission to make a written determination stating “that a person who is not covered by paragraph (a), (b) or (c) and who is in a specified class is eligible to be provided with treatment of a specified kind”.
Using these powers, section 6 specifies the class of person who will be eligible for the treatment specified in section 7 of the instrument.
The class of person specified in section 6 is a person who:
- has rendered at least one day of continuous full-time service; and
- on or after 1 July 2019, ceases to be a member of the Permanent Forces or the Reserves.
Section 7
Section 7 sets out the kind of treatment under Part V of the VEA that a person who is in the specified class in section 6 is eligible to be provided with. The treatment is one comprehensive health assessment by a general practitioner during each 12 month period of the person’s health assessment period.
A note to section 7 confirms that the Treatment Principles under section 90 of the VEA, the Repatriation Private Patient Principles under section 90A of the VEA and the Repatriation Pharmaceutical Benefits Scheme under section 91 of the VEA apply to any treatment provided, if they are relevant to the treatment.
The example in section 7 illustrates how a person may have more than one health assessment period where they have multiple service periods.
Section 8
Subsection 8(1) provides that if a person who has been a member of the Permanent Forces re-joins the Permanent Forces or joins the Reserves during their health assessment period, then the person, upon their re-joining the Permanent Forces or joining the Reserves, ceases to be eligible for the specified treatment under section 7 for the remainder of their health assessment period.
Subsection 8(2) provides that if a person who has been a member of the Reserves re-joins the Reserves or joins the Permanent Forces during their health assessment period, then the person, upon their re-joining the Reserves or joining the Permanent Forces, ceases to be eligible for the specified treatment under section 7 for the remainder of their health assessment period.
Subsection 8(3) clarifies that a person who is automatically transferred to the Reserves upon ceasing to be a member of the Permanent Forces does not lose their eligibility for the treatment specified under section 7.
The example in section 8 illustrates how the entitlement operates where a person ceases to be a member of the permanent ADF, becomes a member of the active Reserves and then rejoins the permanent ADF, and the operation of section 7.