Dr Alan Nelson Pharmacists DVA
Unit 550 AFME
Bull Creek Drive
BULL CREEK WA 6149
Phn: +61 8 9312-0550
Mob: +61 0419-802-490
Have attached a letter from a doctor that impacts care services of all Veterans, Distribute to all.
Dr Alan Nelson
28th January 2021
The Honourable Mr Phillip Thompson OAM, MP
Member for Herbert
Nathan Business Centre,
Cnr Ross River Rd and Nathan St
Cranbrook Qld 4814
Dear Mr Thompson,
I wish to draw to your attention a grave error in the administration of the Department of Veteran Affairs (DVA) that will worsen the Medical care of Veterans with potential for increasing their extraordinary high suicide rate. This decision also will make it harder for community-based Doctors like myself who work in the area of Veteran’s Health harder to meet their needs.
Background: For over twenty (20) Years DVA has run a telephone Prescription Authorises hotline. This enables authorisation of prescriptions for Veteran for larger amounts of medication and for indications other that the PBS indications for governments subsidy. This service came into being as it was recognised that Veterans have very different and more complex Health Care needs than the general population. It was recognised that Veterans’ needs were not being met by the Pharmaceutical Benefits Scheme (PBS) Hotline due to a lack of expertise. The DVA hotline services is staffed by professional staff, specifically, Pharmacists. This is 24 hour/ Seven day a week service. The staff are highly skilled, knowledge, helpfully and enthusiastic. Importantly, they aid in the upskilling and education of Community Doctors’ about the system due to their willing to address any question the doctors may have. Their presence makes the working life of Doctors’ much easier when addressing the health needs of the Veteran Community.
Given my nearly 15 years works with Veterans, I feel safe in saying this in the one part of DVA that actually works well, is not obstructive and provides the intended service.
The Problem: Last week, the Pharmacists on the Hotline service (telephone 1800 520 580) learned that their services were no longer required and that they are to be replaced by contractors supplied through the Private Health Insurer, BUPA. The staff will not be Pharmacists but essentially Clerks paid at the Australian Public Sector, Administrative Service Officer level 3 (ASO 3) rate. This change takes effect on 1st April this year and will results in a very difference and inferior service. No amount of training can compensate for the loss of years of Corporate knowledge and professional expertise of this body professional Pharmacists.
It is highly likely that the new service will be scattered around call centres that may not even be located in the country and will contrast to a centralised service based in Brisbane. This current service is provided by a central and cohesive group who have provided an extraordinary service over the years. A services that understands and reflects Veteran needs and have a clear culture of assisting not obstruction.
The Veteran Community has to contend with general DVA culture that is obstructive, secretive and unhelpful due to the complexity of the laws they are charged with administering. I am gravely concerned that this decision will dismantle the only part of DVA that actually is of assistance will succeed in bring the standard down that of the rest of the Department.
My fear is that veteran will be denied correct access to medications and in turn will lead to increased rates of suicide. For example: Antipsychotic medications (those used for Schizophrenia, a Psychotic condition, and the like) are only subsidised s for Psychotic conditions, under the PBS (the general public). Under the PBS these cannot be prescribed for Depression that is refractory or resistant to ordinary antidepressant medications. The Current DVA service is able to authorise subsidise subsidised prescriptions for Antipsychotic Medication for Resistant Depression. This reduces the economic cost of the medication to the Veteran so they can afford them and allow Veteran access to these important medications where they would otherwise be denied.
Your Government is to be applauded for initiatives like the establishment of National Commissioner for Defence and Veteran Suicide Prevention. Yet decision of this nature run counter to the stated aims of that Commission.
By any measure a decision of this nature should be put in abeyance until such as the Interim Commissioner Dr Bernadette Boss has been given ample opportunity to reports her initial findings of the cultural and organisation problems the beset the DVA and Defences and contribute to the challenges of Veteran Health generally and Mental Health specifically. Better still shelve permanently this poor and ill-considered decision
I urge you as a Veteran and Members for Herbert to champion the cause of the services for the good of our Community.
I and my many Veteran patients look forward to a change of position by the Department of Veterans affairs.
Dr Alan Nelson,
BCom. MB,BS, FRACGP.