I questioned the Aged Care Quality and Safety Commission on the severe problems within the aged Home Care Package system, highlighting the specific case of the Smith family (with their permission).
The Smiths had $3,000 taken from their package and paid to a contractor for incomplete tree trimming. The Commission dismissed their complaint without explanation, leaving them out of pocket, which severely impacted their health and forced them to cancel necessary medical appointments.
Despite assurances from the minister’s staff that the issue would be resolved and funds reimbursed within five months, no contact was made with the family. Minister Chisholm and departmental officials agreed to follow up and contact my office regarding this breakdown.
I raised concerns that upcoming co-payment policies, with service costs potentially exceeding $100 an hour, would make essential care unaffordable for aged pensioners.
Departmental representatives responded that co-contributions will be a small percentage for pensioners (5% to 17.5% depending on the service category), and that the government is cracking down on unreasonable pricing while funding major care shifts.
The problem appears to be finally resolving but only after repeated interventions from my officers. This is not how it should work for the thousands of recipients being ripped off.
Transcript
Senator ROBERTS: Thank you for appearing again. It’s good to see you, Mr Comley. My questions are for the Aged Care Quality and Safety Commission on problems with the aged Home Care Package, please. Late last year in Senate estimates, before this committee, I raised the case of the Smith family. Under their package, they’re entitled to some assistance in minor property maintenance. They needed some minor trimming of half a tree and a few branches of another on their property, which was not completed, yet they found that $3,000 had been taken out of their package and given to the contractor without discussion between the Smiths and the service administrator of the package. The Aged Care Quality and Safety Commission closed off their complaint and refused to even discuss it with the Smiths, with no explanation given. Isn’t this elder abuse by a government agency that is supposed to help older Australians, not abuse them? What’s the cover up, and why was $3,000 paid for next to nothing?
ACTING CHAIR: I’m not sure about the appropriateness of responding to individual complaints or issues. I think characterising them is one thing, but referring to individual cases is quite different.
Senator ROBERTS: We have permission from the Smiths.
ACTING CHAIR: We don’t have that, and the department don’t have that.
Senator ROBERTS: How typical is this?
Ms Hefren-Webb: Let me try and respond to you. Sometimes these cases are very complex. There is often miscommunication. There are different versions of events from providers versus older people. I appreciate—
Senator ROBERTS: I’m sure you’re right.
Ms Hefren-Webb: Sorry? What did you say?
ACTING CHAIR: Let the official speak.
Senator ROBERTS: I’m just backing her up. I’m sure you’re right; it would be complex.
Ms Hefren-Webb: And so we do our best to understand the circumstances—what’s happened, what’s gone wrong—and look at what we can do to restore people to make up for what’s happened to them and find an equitable solution. We do our best efforts. Obviously, I won’t speak about the individual case, because I don’t have permission from those people to speak. But cases like this, where people are quoted different amounts for different pieces of work and then may misapprehend what was going to be done, what’s happened with their package et cetera, are not unusual cases. And we do try and reach a sensible resolution. All our complaints are subject to review and appeal, so if people aren’t happy with where we’ve resolved a matter, they do have an opportunity to first ask for an internal review and to then seek external review if they’re still not comfortable.
Senator ROBERTS: Thank you. And I’m not pretending some of these cases are simple, but it’s badly affected the health of the two innocent senior citizens, who deserve an answer and for money to be put back into their package. A staff member of the minister contacted my office and assured us that the issue would be resolved and that money would be reimbursed quickly. The result, though, was that nothing happened, not even contact with the family. Five months have passed since the promise was made. Because of the depleted funds, the Smiths had to cancel some medical appointments that they could no longer afford.
ACTING CHAIR: Again, Senator Roberts, the department is not going to be able to respond to this individual case in this setting.
Senator ROBERTS: Well, if I’m told by the minister’s staff that they’ve contacted the Smiths and they haven’t—
Ms Hefren-Webb: I’m not aware of what the minister’s staff may have said, but I’m happy to go away and provide you with what advice I can about what engagement there has been in this particular case.
Senator Chisholm: Just to add to that, we don’t want to be dismissive of the issue, and I’m happy to follow up with the minister’s office to see what’s gone on there. But I think we’re just uncomfortable responding to a couple’s circumstance in this forum. But I assure you that we’ll do what we can to follow up appropriately and ensure that we can do what we can, where possible, to resolve it. But that’s knowing that some of these cases can be difficult.
Senator ROBERTS: That’d be great, Minister. Thank you. Could you contact my office?
Senator Chisholm: Yes.
Senator ROBERTS: The concept of co-payments is to be instituted into the aged-care packages. That will mean the cancellation of many services needed by package holders, because they’ll become unaffordable. The proposal is that many services will need to be paid for at more than $100 an hour—often more than twice the market labour rate. An aged pensioner cannot afford that. What are you doing about this situation?
Ms Hefren-Webb: The department might wish to speak about the policy on contributions. But we are undertaking extensive work around unreasonable pricing. We’ve been in contact with a number of providers where we have concerns that their pricing is unreasonable and we’ve asked them to provide us with an explanation for how they’ve reached their prices. In some cases, they’ve agreed to adjust their price and have even provided refunds. So, certainly, we’re dealing with those cases on an individual basis, but the question of contributions is a policy question, so I don’t know—
Ms Stewart: I’m happy to start. Thank you, Ms Hefren-Webb. In terms of the policy on co-contribution, that was a recommendation that was made by a taskforce to set co-contribution rates at a level where people who could afford to contribute would contribute to their aged care. We work very closely with Ms Hefren-Webb, and under the new legislation providers are required to be transparent in their prices, as well as reasonable. Older people can go and compare prices, and when they feel that they are not reasonable they can come to us. The last thing I’ll say before handing to my other colleagues is that the government has recently made an announcement for about $1 billion of funding to enable a change in the policy settings so that government will now pay for a category of service, which includes showering and assistance with dressing and continence. That’s been a significant announcement. I’ll hand over to Ms Trainor to talk in more detail.
Ms Trainor: The other observation there is that there is a difference between the service price—so when you talked about the $100 per hour—and the co-contribution, which is the proportion of that service price that the participant rather than the government pays. So, when you talk about a pensioner, for a full-rate pensioner, those rates are five per cent of services that are in the independence service list category, and then 17.5 per cent of everyday living, which are our cleaning- and gardening-type services. So whilst you may have a service price of $100 an hour what a person pays out of pocket is a very small share of that actual amount.
Senator ROBERTS: I get that. Thank you for your patience. I look forward to you calling our office.
When someone is facing a life-threatening illness and all standard treatments have been exhausted, waiting shouldn’t be a barrier to hope.
That’s why One Nation will be introducing legislation for the “Right to Try.”
If a patient’s condition is terminal and existing measures have failed, they can request, or a doctor can suggest, an alternative therapy or unlisted drug.
Patients enter voluntarily, creating a safe pathway that expands the market for pharmaceuticals, drives down drug prices and ultimately saves lives.
With nothing to lose and everything to gain, it’s time to give patients and doctors the freedom to choose.
Transcript
One Nation will introduce legislation in the next parliament for the right to try. This means that, if a person is being treated for an illness the outcome of which could be death and all existing measures have failed, the patient has a right to request from their doctor, or a doctor has a right to suggest, a drug not listed for that condition. It may be an alternative therapy or an unlisted drug. To put this simply, the patient has nothing to lose and everything to gain. This may expand the market for existing pharmaceutical products—who knows? That’s the point. It’s a free clinical trial that a patient has voluntarily entered into, reducing drug prices and saving lives.
One Nation’s motion to seek justice for the victims of the Infected Blood Scandal has been passed
Good news! The Senate has passed One Nation’s motion to hold a Senate Inquiry into Australia’s Infected Blood Scandal.
During the 70s, 80s and 90s, up to 20,000 people were caught up in a scandal that resulted in serious injury and death.
Hundreds of people died.
Others have endured life-long severe illness.
This terrible chapter in Australia’s medical history is attributed to the Australian Red Cross blood banks and the CSL.
Blood contaminated with Hepatitis B, Hepatitis C, and HIV was collected and then knowingly and recklessly given to healthy individuals via blood transfusions and blood products.
Those who received tainted blood, and contracted these diseases as a result, have been seeking compensation for decades.
And been ignored.
Similar situations in Canada and the United Kingdom have led to official investigations and appropriate compensation.
Commonwealth bodies have been avoiding responsibility for too long.
One Nation has been pursuing justice for the victims of Australia’s infected blood scandal for many years, and last week, we have finally unlocked the opportunity to put right this horrific chapter.
Our motion was passed on the voices, with support from the Liberals and Greens.
What will happen next?
This issue has gone to the Community Affairs Committee. They will start the process of opening up submissions. When this closes, public hearings will be organised and individuals will be called to give their testimony.
The New England Times published a hit piece falsely claiming One Nation plans to remove medications from the Pharmaceutical Benefits Scheme (PBS). This is an outright lie. One Nation will defend the PBS, just as we defend Medicare.
Here is the truth.
Our 2025 policy promises a sensible review of medications fast-tracked during COVID to ensure safety and efficacy. We are looking specifically at just three drugs — Paxlovid, Remdesivir and Molnupiravir — to examine safer, cost-effective alternatives.
No Australian will be left without medication. We are not changing PBS charges, altering existing government payments, or tearing up legally binding contracts.
Society benefits when the sick are healed quickly and cared for with dignity.
Financial barriers shouldn’t stand in the way of care and One Nation will protect the 40-year legacy of the PBS against Labor and Big Pharma’s attempt to spin sensible scrutiny into fearmongering.
Transcript
Senator Roberts: Tonight I discuss the heart of Australia’s future: whether our higher education system is identifying and supporting excellence or whether elites have captured education to reward size, history and established reputation. How many Australians know that some of the highest rated higher education institutions in our country, in terms of student satisfaction, are not the sandstone Group of Eight universities or any public universities? They’re smaller, independent universities, one of which, Alphacrucis University College, records student satisfaction rates of 90 per cent for overall educational experience when the national average sits in the mid-70s. The national regulator recognises Alphacrucis as delivering superior quality education and granted it unlimited self-accrediting authority, in part because students studying a postgraduate teaching degree at Alphacrucis graduated with a job 100 per cent of the time. Until recently, I didn’t know that tertiary education institutions with this level of success existed. Australians need to know there are exemplary institutions leading our country, yet we’ve never heard of them.
We need to reassess how our tertiary institutions are supported, because, if we don’t, we’re reinforcing the status quo, and that’s not working. Our universities have governance issues, financial issues, confidence issues and efficiency issues, yet there are higher education providers achieving excellent outcomes for students without the hundreds of millions or even billions of dollars in funding that our public universities receive, including grants and commercial activity. If institutions like Alphacrucis do not become well known, students who might have thrived in such a place will miss the opportunity. Students will be less satisfied with their education than they might otherwise have been. Students might be less likely to graduate into employment and less likely to leave their mark and their legacy on our society. Philanthropic foundations need to know that outside of the G8 there’s great teaching and research, and it’s worthy of support. Foundations need to be looking for opportunities to fund teaching and research institutions like Alphacrucis, because that’s where our future may well be.
Government has set lofty aspirational targets for tertiary attainment through the Australian Universities Accord and has already acknowledged that public universities alone cannot achieve these targets. The system needs provider diversity and rewards for excellence. Our tertiary funding must move to a level playing field. We must allocate funds on actual performance, not past reputation. The government makes much noise of diversity, yet where’s the funding for real diversity in higher education? The G8 sandstone universities would benefit from increased competition. We must do all that we can to remove barriers from lesser known institutions to enable them to compete. Part of that is to raise their profile, and part of that is to shift funds from the sandstone G8s to institutions already delivering.
One Nation is committed to greater scrutiny of tertiary institution funding and wants to know why funding favours established universities over new entries. I’m focusing on Alphacrucis, yet the issue is larger than one university college. It’s about whether Australia rewards performance or prestige. These are not the same thing. Reward is about working for today’s students. Prestige is about what’s been done for students in days past. It’s about whether new institutions with fresh ideas are given the opportunity to compete or whether the system remains tilted towards those who have always held advantage.
Alphacrucis University College is a test case, an institution achieving outstanding student satisfaction, national recognition for quality and a growing reputation for excellence, yet most Australians have never heard of it. If we’re serious about innovation, competition and value for taxpayers, then institutions should be judged on what they actually deliver, not on how old they are, how large they are or how well connected they are. Australia’s future depends upon identifying excellence wherever it’s found and giving it the opportunity to flourish. The Australian people deserve a higher education system that rewards achievement, encourages competition and invests in results. That’s beneficial for students, for taxpayers and for Australia’s future.
Tonight I address media misrepresentation of One Nation’s policy to review some drugs on the Pharmaceutical Benefits Scheme, the PBS. The New England Times newspaper flagrantly lied to readers in a story just published last Saturday, giving the false impression that One Nation will be removing medications from the PBS. Author RK Crosby’s hit piece was titled ‘Concern brewing as buried Hanson policy threatens affordable medicines’. Only last week, I included the PBS in a list of social welfare institutions that One Nation would defend in government—not tolerate or be afraid to touch but defend. This pathetic piece of journalism shows the lack of research the New England Times conducted for its story. I understand that, like many regional newspapers, the New England Times is short of staff. This leads them to accept a hit piece that Better Access Australia most likely prepared. It’s quoted extensively, and its mission statement is to transfer as much taxpayer money as it can into big pharma’s pockets.
One phone call would have cleared this up. The story stems from a two-line election policy promise in 2025 which said One Nation will review all medications fast-tracked during COVID to ensure safety and efficacy have been proven. It’s perfectly sensible and responsible. In fact, most of the drugs that were given emergency use authorisation, officially known as the provisional use pathway, have already been withdrawn or had their use reduced to insignificance. Only three remain of interest to One Nation, and these are the drugs we will review: Paxlovid; remdesivir, or ‘Run—death is near’; and molnupiravir. With each of these, there are alternatives which anecdotally carry a lower cost and better safety and efficacy outcomes. No Australian will be left without medication—not one Australian. This is actually a small promise that the pharmaceutical lobby has deliberately taken out of context. During COVID, big pharma benefited to the tune of billions of dollars and is terrified of any scrutiny.
To open their story, RK Crosby offered a vignette suggesting One Nation will remove asthma medication from the PBS—an outright lie; a fabrication, pure and simple. One Nation threatening affordable medicines is an outright lie. One Nation will not change PBS charges nor change the amounts government pays under the existing arrangements. Contracts signed will be honoured. If we start tearing up legally-binding contracts, confidence in government will never recover. We’re not going to tear up contracts. Negotiate? Yes. Tear up? No. For clarity, no PBS contracts are in our sights.
The COVID vaccines will be looked at in our terms of reference for a royal commission, although these were not supplied through the PBS. Perhaps the pharmaceutical industry didn’t want to mention their COVID products and instead chose to lie about our PBS policy. For the record, here’s the philosophy behind our policy. As I said last week in the Senate, One Nation supports the PBS for the same reason we support Medicare. Society benefits when our sick are healed quickly and returned to looking after themselves. For those with permanent conditions, the basic laws of humanity require society to care for those people with love and respect. The financial cost of medication and related devices should not detract from this care.
Last week, Minister Butler made similar comments. On this, we’re in alignment. Over the last 40 years, the PBS has balanced prices paid to pharmaceutical companies against product benefits. Sometimes negotiation has delayed drugs, and the Pharmaceutical Benefits Advisory Committee displayed a sensible balance, making our PBS the envy of the world. We will defend the process of negotiating drug prices to ensure no compromise on the principles that have informed the PBS for 40 years.
I’ll discuss two more policies. One Nation will introduce legislation in the next parliament for the right to try. This means that, if a person is being treated for an illness the outcome of which could be death and all existing measures have failed, the patient has a right to request from their doctor, or a doctor has a right to suggest, a drug not listed for that condition. It may be an alternative therapy or an unlisted drug. To put this simply, the patient has nothing to lose and everything to gain. This may expand the market for existing pharmaceutical products—who knows? That’s the point. It’s a free clinical trial that a patient has voluntarily entered into, reducing drug prices and saving lives.
The other policy is to introduce an eight-year wait for new arrivals to access the PBS, unless you’re a citizen or a permanent resident. Under One Nation, there’ll be an eight-year wait for citizenship and for permanent residence. This will not be backdated. You can’t be unmade as citizen. This will not deny medical care for new arrivals, who will pay for that care themselves. Anyone on prescription medication can vote One Nation without fear of losing access to or paying more for their medication. I trust that’s clear.
https://img.youtube.com/vi/Ut0sA6T0Fds/maxresdefault.jpg7201280Senator Malcolm Robertshttps://www.malcolmrobertsqld.com.au/wp-content/uploads/2020/04/One-Nation-Logo1-300x150.pngSenator Malcolm Roberts2026-08-26 16:40:412026-08-26 16:40:45Responsible Oversight, Not Cuts to the PBS
One Nation supports the sensible reforms to let trained registered nurses prescribe common PBS medications — a practical step that will ease pressure on doctors, strengthen rural healthcare and improve access for everyday Australians.
This isn’t a thought bubble; it’s the result of decades of professional evolution in nursing.
I also put an end to the latest round of “Mediscare” nonsense. One Nation will defend Medicare and the PBS — full stop. We’ll crack down on the $3 billion in fraud the government refuses to confront, protect patients from bureaucratic roadblocks, and ensure no Australian pays more for a prescription under a One Nation government.
Our healthcare system must serve patients, not criminals, not fraudsters and not political spin.
One Nation will keep Medicare strong, keep the PBS fair and keep pressure on a government too timid to clean up its own mess.
Transcript
One Nation will support the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025. It amends the National Health Act and the Health Insurance Act 1973 to enable approved registered nurses to prescribe certain pharmaceutical benefits under the Pharmaceutical Benefits Scheme, the PBS. Australia’s health system is experiencing increasing demand due to an ageing population and rising prevalence of chronic disease, something we do need to better understand. Improving access to safe and effective medications is essential to meeting the health needs of everyday Australians.
Registered nurses comprise around half the Australian health workforce and are the most geographically distributed health profession. They’re the best placed to prescribe certain common medications, taking the pressure off doctors while reducing travel and inconvenience to patients. This will support rural pharmacies. Registered nurses must complete a three-year bachelor’s degree in nursing. Nurse practitioners must hold a master’s degree in nursing and complete 5,000 hours of advanced clinical practice.
The history of the idea of allowing nurses, suitably trained, to write prescriptions is quite long. It began with a trial in New South Wales between 1991 and 2000—a generation ago. This went national in 2001 with the advent of the national Nursing and Midwifery Board, designed to bring regulation of nurses closer to the system used for doctors. It was at this time that the pathway to nurse practitioner was introduced. In 2010, nurse practitioners were approved to write prescriptions under the PBS, although only while working in collaboration with a registered medical prescriber. Then, in 2024, the government removed the need for collaboration with a registered prescriber, allowing nurse practitioners to prescribe most medications under their own Medicare Benefits Schedule prescriber number. Finally, in 2025, the government introduced the ability of registered nurses to prescribe. There are suitable checks and balances. Nurses must meet specified qualifications, complete the course and maintain endorsement. The first cohort were enrolled and have now completed their training.
This legislation will enable these health professionals to prescribe certain medications. Perhaps this could have been done the other way around, with the heads of power to allow registered nurses to prescribe written into law before we started training them, disrupting their careers and offering them a career path which didn’t yet exist. Maybe that’s just a sensible One Nation thing.
This legislation is being supported across the chamber and could have been supported a year ago. The point of this history lesson is clear. The move to allow registered nurses to prescribe is not a thought bubble. It’s the result of a generation of evolution in the education and professional certification of and skill base within the nursing profession.
The system they’ve put in place appears fit for purpose. Not all drugs can be prescribed by registered nurses, just certain ones: birth control; repeat prescriptions across a wide range of conditions. There are lots of opportunities to take the pressure off our doctors. This is particularly beneficial to regional and remote areas.
For those who may be concerned about this measure—and One Nation is not concerned with it—I reference the PBS auditing framework. The PBS has excellent audit routines which scan all the prescriptions written across the system and zero in on any patterns out of the ordinary. These are then followed up with a phone call or, if necessary, a visit. Misuse will be detected. One Nation does contend medical professionals are given insufficient discretion to use their wealth of medical knowledge. In this case, it will provide an additional check. The initiative in part stems from the Strengthening Medicare Taskforce. One Nation is pleased to strengthen Medicare with this initiative.
Next, I must address ‘Mediscare’ 3.0, which disreputable media have been promoting in the last few weeks. I say ‘Mediscare’ version 3 because the last two elections saw the Labor Party, or their supporters, smear the Liberals with a false ‘Mediscare’ campaign. Now it’s One Nation’s turn to be smeared, and Labor is smearing One Nation. They must fear us. While it has been only one week since the last time I defended Medicare and the PBS in a Senate speech, it seems I need to do it again. Very well. One Nation will defend the Pharmaceutical Benefits Scheme and Medicare. Both are part of a social-welfare safety net which maintains a healthy population and contributes to Australia enjoying a high standard of living. Medicare and the PBS are why people pay taxes—and don’t forget it, government.
Taxes are, of course, not the government’s money. Taxes are the people’s money and should only be spent accordingly. Hardworking Australians do not deserve to have their money wasted or handed over to fraudsters. One Nation will work with and better resource the Benefits Integrity Division and the Fraud Fusion Taskforce to ensure every cent of money spent through Medicare and the PBS goes to people who need it and who qualify for the benefit.
It’s intolerable to me that new drugs, drugs that could save lives, are held back, despite agreement between the Pharmaceutical Benefits Advisory Committee and the drug maker, because of the cost, because billions are being taken out of the system in fraud. And, yes, some prescribers are complicit, although a tiny amount. No patient with a legally obtained Medicare card should ever be afraid of using that card under a One Nation government. No Australian will have to pay more for a prescription under a One Nation government. We will support and maintain the system of the Medicare urgent care clinics, and we will work constructively with all stakeholders to extend operating hours for service delivery to take further pressure off public hospital emergency departments—which we will be able to afford because we will remove the criminals and fraudsters from the system and ensure everyone who uses a Medicare card is entitled to use that card. The government knows who these people are—yes, you do. The government knows where the $3 billion a year in fraud is coming from. Their own integrity division said as much in Senate estimates recently. The fraud figure is the government’s, not One Nation’s—we didn’t cook it up; the government’s own agency told us. The Albanese-Burke government doesn’t have the guts to do anything about it.
I’m concerned that the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025 could create a two-tier health system. Rural, regional and poorer suburbs would get registered nurses and nurse practitioners. Richer suburbs would get doctors galore. In fact, I’m sure that’s going to happen because it’s happening now. The Australian Institute of Health and Welfare and the federal department of health track their workforce using a framework called the Modified Monash Model. Their data shows a stark imbalance. Roughly 84 per cent of private hospital medical practitioners and the vast majority of medical specialists operate exclusively within major capital cities and metropolitan centres. Small, regional, rural and remote towns classified as MM4 to MM7 contain the lowest number of healthcare workers per capita. In these areas, access to medical care drops drastically. In these areas, GPs provide primary care and act as emergency doctors and hospital doctors, making up 60 per cent of the entire available hospital workforce because there are so few dedicated specialists. The bill before the Senate will help take the weight off those GPs, yet will not solve the issue of doctors gravitating to wealthy suburbs and cities. What may solve that problem is to do more to assist children from the bush to take up medicine as a career. One Nation’s health policy, to be released later this year, will add more detail to that statement.
Finally, I’ll be moving amendments to this bill on behalf of Senator Lambie, who’s recovering after recently herself quality-testing our healthcare system. As it currently stands, properly qualified podiatrists and podiatric surgeons can prescribe specific medicines to their patients, although these prescriptions are not recognised under the Pharmaceutical Benefits Scheme. Patients either have to pay the full price or meet with the GP to get the same medicine prescribed under the PBS—or, worse, go without and suffer the consequences. That’s ridiculous. Podiatrists require a university degree, must maintain membership of their professional association and are affiliated with Ahpra, like other medical associations. Their medical expertise in their area of care is well capable of supporting improved prescribing rights. The focus of our healthcare system must be what’s best for the patient, and what’s best for the patient cannot include bureaucratic roadblocks and financial pain. The amendments I foreshadow do not reduce safeguards. They do not give podiatrists greater prescribing powers. They will ease GPs’ workload and make things easier for patients. They are commonsense amendments, and they should be supported.
I recently asked questions about the government’s decision to cut the private health insurance rebate for seniors. Senator Green and government officials said that the rebate will now be based solely on income rather than age, aligning support across all cohorts. The government expects to save $3 billion from this measure, which it says will be reinvested into aged care and public hospitals.
It’s estimated that 3.1 million people will be affected, experiencing an average rebate reduction (and effectively a premium increase) of $250. Additionally, it’s predicted that approximately 44,000 people may drop out of private health insurance entirely.
I expressed my concern that forcing seniors into the public system would worsen existing hospital shortages. Amazingly, I was told that the impact on the public system would be minimal (less than 1%) and spread out. It was also highlighted that $24.4 billion was being invested into the public health system, adding that workforce and bed management are ultimately the responsibilities of state and territory governments.
I accused the government of punishing seniors to fund wasteful spending and a “socialist agenda.”
Senator Green rejected this statement, framing the move as a necessary offset to fund record investments in aged care.
Transcript
Senator ROBERTS: I want to talk about the private health insurance rebate being cut. It was announced in the recent budget that the rebate for premiums paid by seniors towards private health insurance would cease; why? Is this a socialist agenda, Minister?
Senator Green: No, it’s not. We did go through this quite lengthily this morning. I don’t plan to add too much to what the minister had to say in response to questions from Senator Ruston, other than to reiterate that, under the proposed changes, all Australians will now receive the same private healthcare support based on their income and not on their age. What we’ve set out is that, through this budget and as a consequence of this decision, we will be investing over $3 billion in delivering more aged care beds, more packages and better care for older Australians.
Senator ROBERTS: I’d like to get on to some specifics after this next question. Why does the government wish to punish seniors, most of whom have chosen to opt out of the public health system and pay premiums to receive private health treatment, by now wanting to make them pay even more than they currently pay?
Senator Green: I reject that assertion in your question. We are investing a record amount of funding into improving the healthcare system, particularly for aged care and older Australians, and that’s why we’ve made this decision. Of course, as you will stand up in the Senate many times over the next couple of months and decry the spending from our government, we know that it’s important to offset decisions that we have to make. That is why we have said that this decision will benefit older Australians through the aged care system.
Senator ROBERTS: How can you deny that older Australians on private health cover will not be paying more?
Senator Green: We’ve gone through this at length this morning. If you have a question about the impact or the policy decision, I will direct that to the officials. But I can say to you that, through this budget, we are making record investments in healthcare and aged care
Senator ROBERTS: And older Australians will be paying more, which is a point that I’ll get to in a minute, and this is during a cost-of-living crisis. Currently, how many seniors, effectively, will be forced to pay more for private health cover or enter the public system? Do you have any modelling?
Mr Hawkins: As we discussed this morning, 3.1 million people will be affected by the change in the rebate. We also put on record—we talked about this at length this morning—that our modelling would suggest that potentially about 44,000 might drop out of having cover and, therefore, would then no longer engage with the PHI system.
Senator ROBERTS: That’s what I was after. What would be the effect of the extra load being placed on the public health system? Hospitals are already short of beds now.
Mr Hawkins: As I’ve said, our modelling would indicate that it’s a less than one per cent impact on the public health system and, again, as we went through in quite a lot of detail this morning, that would be spread across the system, with not everyone needing to use the system at any one time. Also, we might find that people decide to opt out of PHI but then self-fund any care that they need.
Senator ROBERTS: We’re already critically short of beds in many hospitals due to mass immigration. Post COVID injections, cancer detection has increased dramatically. Cancer deaths have decreased, because of treatment. But the available beds have decreased. This is going to add more strain to the public health system.
Ms Street: An additional $24.4 billion has also been invested into the public health system, bringing it up to $220 billion over the five years. So, yes, there might be some ‘additional’ but, as we’ve said, it would be less than one per cent. We think that estimation is at the higher end, because we do think, potentially, people will self select into private, or they may be people who are less likely to use the services anyway, so a number of factors contribute to that number. So we think this investment and this measure will have a minimal impact on that element.
Senator ROBERTS: What would be the total value of the extra premiums raised by those who choose to stay in the private health system?
Mr Hawkins: We’ve calculated that there will be an average impact of $250 on those who will have their rebate reduced. Everyone was to have access to the rebate, but it’s the size of the rebate that is reducing, and our average calculation is about $250.
Senator ROBERTS: How much does the government plan to save by refusing to rebate premiums for older Australians, or by cutting them back?
Mr Hawkins: By cutting the rebate, we are looking at $3 billion.
Senator ROBERTS: Has the government modelled the extra cost to the public system by absorbing older Australians, who are more likely to require major healthcare in their elder years?
Mr Hawkins: No, we do not have that specific level of modelling. But as I’ve said, we have looked at and modelled what we think the impact would be, and that’s under one per cent.
Senator ROBERTS: What about the chronic shortage of beds, doctors, nurses, specialists and allied health professionals in public hospitals?
Senator Green: That’s veering a little bit into outcome 1, Public hospitals. But I’ve got Caitlin O’Brien from our public hospital team here, if you want to talk about the investment that the government is putting in through the NHRA agreement that we’ve put in place. Do you want to cover that?
Ms O’Brien: As Ms Street has said, an additional $219.6 billion over five years has been invested into the state- and territory-run public hospital system. Your questions in relation to workforce capacity and beds are best directed to state and territory governments who, under the National Health Reform Agreement agreed on 30 January, are very clearly listed as the stewards of their system.
Senator ROBERTS: Would you not have assessed that, though, before making the changes?
Ms Street: As we’ve indicated, we think the ‘additional’ is less than one per cent, and we think that estimation is at the higher end. So, in terms of the fiscal impact, it will depend on the services that people need and the conditions that they’re seeking treatment for.
Senator Green: The officials have made this point but, again, we’re investing almost $25 billion into the hospital system over the next five years.
Senator ROBERTS: Minister Clare O’Neill said, reportedly, that the budget is deliberately hitting older people. It’s a tax grab because you’re paying for so much waste in government.
Senator Green: I don’t think that’s what Minister O’Neill would have said. I think you might be verballing her.
Senator ROBERTS: I’m just going on reports. It is a fact that the budget is also hitting young people. What I’m getting at is that this is a cover for the massive waste within your government spending, and now you’re going to ask older people to share in that.
Senator Green: No. We are making record investments in once-in-a-generation reforms in aged care and healthcare. That includes investing almost $25 billion into public hospitals, funding the states and territories to do the very important work that they do in making sure that the public hospital system is free.
Senator ROBERTS: It’s a fact, Minister, that older people will be paying more.
Senator Green: We’ve changed the rebate so that now it’s means tested, so it’s based on income now. We can take you through how that might impact certain cohorts, but we have changed the rebate so that now it is means tested on income.
Senator RUSTON: On a point of clarification, Minister, you just said that you’ve changed the rebate so that it’s means tested on income. Are you suggesting that it’s currently not means tested on income?
Senator Green: No, that’s not what I said.
Senator RUSTON: You just did say that.
Senator Green: I’m not going to go back over the evidence that Senator Gallagher gave to you this morning. What I’m saying to Senator Roberts is that there is a means test for the rebate that is based on income.
Senator RUSTON: Now?
Senator Green: How semantic do you want to get?
Senator RUSTON: You just said that it is now going to be means tested. It has always been means tested.
ACTING CHAIR: I think, as the secretary has said, it is ‘solely’.
Mr Comley: ‘Solely means tested’. In fact, it hasn’t always been means tested.
Senator RUSTON: It was means tested prior to this change.
Mr Comley: I think it was, but it was not means tested on introduction in 2000.
Senator RUSTON: It has been means tested up until now.
A $68.5 million budget measure (allocated over three years) intends to provide HIV treatment to people who are not eligible for Medicare.
Why are Australian taxpayers funding treatment for non-citizens when we are in the middle of a cost-of-living crisis?
Officials declined to comment on this, stating the policy and funding mechanism were developed strictly by the Department of Health.
I then shifted the discussion to the Significant Cost Threshold (SCT) for visa health requirements, which was raised from $51,000 to $86,000 in July 2024.
How this works is that if a medical officer of the Commonwealth estimates that an applicant’s health condition (such as HIV, a physical disability, or other chronic illnesses) will cost the Australian healthcare system more than $86,000, they fail the health requirement, and the visa is refused (unless a specific waiver is applied).
I asked whether this framework allows Australian citizens a “perfect way” to bring in family members with known health conditions to receive immediate taxpayer-funded care, provided the projected costs fall just under the $86,000 limit.
The Department repeatedly stated they could not answer the “family member” line of questioning.
They reiterated that immigration rules and the $86,000 threshold are applied uniformly to all applicants, independent of separate Department of Health funding measures.
Data on exactly how many people reside in Australia under the updated threshold was taken on notice.
Transcript
Senator ROBERTS: I’ll get back to the topic I started on this morning. It’s an immigration issue, not a health issue.
Ms Foster: We’ll just get our chief medical officer up to the table.
Mr Willard: I can speak broadly about the criteria. There’s a health criteria that applies to all visas. It looks at questions of health protection for Australians. It looks at costs to the health service, and it looks at the access to health treatment for Australians. It’s applied across all our visa types. It’s applied on a risk management basis. It looks at where somebody is coming from, and the sorts of health risks that might be presented. It looks at what the person might be doing in Australia, whether they’re going to go to a medical facility, whether they’re staying for a short time or whether they’re looking for a permanent visa. All of these factors are taken into consideration when the health criteria are assessed. Dr Grant Pegg, our chief medical officer, oversees the system that undertakes medicals. I think there are very large numbers of medicals undertaken each year.
Senator ROBERTS: Can you tell me what the three basic criteria are again?
Mr Willard: It’s health protection for Australians. It’s cost to the health system, and it’s access to Australian health services.
Senator ROBERTS: This is primarily with No. 2—cost. The 2026-27 federal budget included $68.5 million, or $69 million, over three years to provide HIV treatment and pre-exposure prophylaxis, which is medication that stops transmission to people in Australia who are not eligible for Medicare. They’re not eligible for Medicare, but we are paying for their treatment anyway so they don’t infect Australians with their HIV. Is that the logic behind this allocation? I know it wasn’t allocated by you.
Mr Willard: Because it is a measure from the department of health, I really can’t talk to the logic behind the measure.
Senator ROBERTS: Why should Australians allow entry of people with HIV and then pay for their treatment, especially when Australia is under pressure economically and individual Australians are under pressure cost-of-living-wise?
Ms Foster: Mr Willard is unable to comment, because the measure was developed by the department of health.
CHAIR: Senator Roberts, I think that the right place for this is at the community affairs estimates committee next week.
Senator ROBERTS: But I want to know. Many Australians are calling for noncitizens who have HIV or AIDS to be deported instead of paying for their medical care. We’re letting people in here with a known liability of cost to Australians. What is your response to that criticism of this budget allocation—the criticism, not the budget allocation itself? People are concerned that we’re letting in people who have a disease, and now we’re paying for their treatment.
CHAIR: Senator Roberts, I think that is asking the officials at the table for their opinion on a matter that is not within the purview of the questions allowed to be asked at Senate estimates, particularly as it relates to the budget.
Senator ROBERTS: Okay. I’ll move on to the next one. Australia raised the significant cost threshold for visa health requirements in July 2024, from $51,000 to $86,000. For those following this thread, I’ll give a quick explanation. The significant cost threshold determines whether a health condition, such as HIV/AIDS or physical disability, is likely to impose significant costs on Australia’s health and community services. Exceeding it typically means failing the health requirements for a visa, although health waivers are available for some visa subclasses, including partner and humanitarian. A person who comes in under your new, higher cap can access medical care and medications for free or for a small co-payment depending upon the state in which they live. How many people are here under this arrangement across all health conditions?
Mr Pegg: I don’t have the data in that detail, so I’d have to take that on notice.
Senator ROBERTS: If you could. Thank you. This is my last question on this topic, Chair. Isn’t this a perfect way of getting a family member into Australia and having their care paid for straightaway? The other part of the question is that the numbers are increasing, which means the Australian taxpayer is paying more.
Mr Pegg: Perhaps, if I can just offer, that’s the purpose of the operation of the significant cost threshold—to try and avoid significant cost to the Australian healthcare system. That’s why it exists.
Senator ROBERTS: Could you explain that more?
Mr Pegg: When someone is identified as having a health condition through the immigration medical examination as part of their visa process, they’re then costed by a medical officer of the Commonwealth who looks at that, on a hypothetical basis for someone with the same condition—the nature of condition and severity— to determine what their costs might be to the Australian healthcare system. That could be lab tests, X-rays, visits to the doctor—those sorts of things. There’s a comprehensive process that is undertaken to do that. When that’s undertaken, a figure is determined, and then, if that figure exceeds the number that you talked about, $86,000, that is considered to be ‘not meeting the health requirement’.
Senator ROBERTS: The first part of my question was: isn’t this a perfect way of getting a family member into Australia and having their care paid for straightaway?
Ms Sharp: Are you talking about a situation where the health requirement is waived? I guess what we’re saying is that the general rule is that if you fail the health requirement—as in your healthcare costs are coming in above $86,000—you will not be granted the visa; you won’t come to Australia.
Senator ROBERTS: That’s initial assessment. Forget about the—well, the payment matters, but I’m not interested in the total amount. What I want to know is: isn’t this a perfect way of getting a family member into the country and having their health care paid for straightaway? That’s basically what it is. The government’s allocated $69 million over three years to provide treatment and pre-exposure prophylactics just for people with HIV. They’re coming in here with a known condition, and we pay for the treatment.
CHAIR: Was there a question, Senator Roberts?
Senator ROBERTS: Isn’t this a perfect way of getting a family member into Australia and having their health care paid for?
CHAIR: This is a question that the officials at the table have responded to. It sounds like—
Senator ROBERTS: Yes or no?
CHAIR: you’re not using the same words to describe the same thing. I think the officials at the table have spoken about what their role is. I think you’re talking about it in a different way, but it’s not necessarily what the officials are—
Senator ROBERTS: It’s about immigration, though.
CHAIR: I think they’ve responded to your question, which is that there’s a program that exists to essentially weed out, for want of a better term, people who have costs higher than the amount the official said.
Senator ROBERTS: No. If they’re projected to have a significant cost threshold higher than $86,000, then I understand, but, if it’s less than $86,000, isn’t this a perfect way of getting a family member into Australia and having their care paid for straightaway?
Ms Foster: Senator, I don’t understand the link between the answers we’ve been giving and the family member issue.
Senator ROBERTS: Yes or no?
Ms Foster: That’s why we’re struggling to answer you.
Senator ROBERTS: Yes or no?
Ms Foster: We don’t understand the relation of the question to the information we’ve given, and, in a sense, it’s asking us for an opinion: ‘Is this a perfect way to do something?’ That’s not our role. Our role is to provide you with information about how the program operates.
Senator ROBERTS: Okay, I’ll make it easier. Is it a way of getting a family member into Australia and having their care paid for straightaway?
Ms Sharp: We might finish it where we began which is I think you need to direct this question to the department of health to ask them for the policy reasoning behind the measure—which group of people they were aiming to support.
Ms Foster: We apply our immigration rules irrespective of whether or not the government has funded a measure such as this through the department.
Senator ROBERTS: One of your immigration rules covers a significant cost threshold maximising at $86,000. If you assess an application to migrate here and it’s less than $86,000 then they are welcomed in. Is it a way of getting a family member in here?
Ms Foster: We don’t understand the relationship between what we’ve told you and the question about a family. I can’t say that any more clearly. I’m not trying to be unhelpful. We just don’t understand the question.
Senator ROBERTS: Could a citizen of Australia use this to bring in someone who is going to cost Australia money and health care immediately?
Ms Foster: The rule would apply irrespective. We would apply that rule as part of our visa consideration to any visa applicant.
Senator ROBERTS: I understand that, but this is a way for a citizen of Australia to bring in a family member and have their health care paid for by the taxpayer?
Ms Foster: I’m sorry, but we have nothing further to add.
These Estimates questions relate to the Department of Veterans’ Affairs’ proposed $5,000 aggregate cap on allied health services.
Our veterans and doctors are worried – and they have every right to be.
The government claims this cap won’t hurt complex-case veterans, yet they admit the system to apply for funding above the cap hasn’t even been designed yet.
Fix the system, don’t punish everyone! If there’s fraud, target the fraudsters. Do not penalise the vast majority of honest, caring doctors and vulnerable veterans.
Those who sacrificed for our country should never face cost-cutting measures disguised as ‘reforms.’ Our veterans deserve certainty, respect, and our support.
Transcript
Senator ROBERTS: Thank you for attending. I want to go over some changes to the annual monetary limit— some details that may not have been covered. I’ll do my best to try and avoid questions that were going to be asked but have since been covered. If I miss out, let me know. I’m also passing on a lot of complaints and questions from veterans as well as doctors. Doctors are appalled and resigned, yet, fundamentally, they all care. You have already confirmed that the cap is an aggregate cap across all allied health services, not per discipline. Is that correct?
Mr Kefford: No, that’s not correct. It does not include optical, dental or hearing services.
Senator ROBERTS: Apart from them. Physio, physical treatment, mental health—they’re all aggregate?
Mr Brown: Open Arms counselling services are also not included.
Senator ROBERTS: Does the minister accept that an aggregate cap would force complex-case veterans to ration treatment between conditions formally accepted by the Commonwealth?
Mr Kefford: Again, no. We gave evidence earlier today about the ability, particularly in complex cases, for there to be additional thresholds. The point of having the $5,000 threshold is to ensure that treatment is effective, and there’s an undertaking in the announcement for there to be consultation on the basis on which that additional funding will be provided.
Senator ROBERTS: Will the TPI gold card holders with multiple accepted conditions be exempt from any aggregate cap, consistent with existing exemptions for physiotherapy and exercise physiology?
Mr Brown: No. Exceptions to the cap will be considered on a basis of clinical need. Many of the cohort that you’re referring to would potentially meet that requirement, but that will be subject to a consultation process around the design with the veteran community and provider groups.
Senator ROBERTS: So that’s not designed yet?
Mr Brown: The process for veteran card holders to go above the $5,000 annual monetary limit where there is a clinical need has not been designed yet. This measure commences on 1 July 2027, and we’ve got that lead-in time to do that consultation work.
Senator ROBERTS: What objective criteria will DVA use to determine when funding above $5,000 will be approved, and how will veterans be informed of their eligibility?
Mr Kefford: The focus, as we’ve said, will be on clinical need and effectiveness of the treatment, and the announced consultation process, once it has been concluded and the arrangements have been confirmed, will be communicated to veterans so they can understand the operation of the new arrangements.
Senator ROBERTS: How will they be communicated?
Mr Kefford: In our usual mechanisms.
Senator ROBERTS: Well, that’s what bothers a lot of veterans.
Mr Kefford: We use our Vetaffairs newspaper, our social media and other presences, as well as the formal publication of the outcomes of the consultation process, as we’ve done for other similar ones.
Senator ROBERTS: Do you have a collection of microservice organisations, as well as the RSL, that you can send it to?
Mr Kefford: Indeed. We would normally engage with the ex-service community as well—ex-service organisations.
Senator ROBERTS: Have you heard of W Edwards Deming?
Mr Kefford: No, sorry.
Senator ROBERTS: He was famous, globally, as a management consultant; he died at the age of 95. He said that 95 per cent of problems are not with individuals but with the system. How have you approached the design of the new policy? My point is that you’ve got a problem. There’s some fraud going on—I accept that; wherever there’s money, there are tendencies for some fraud. But the majority of doctors and the majority of veterans are honest and caring people. Has there been any thought to, rather than punishing everyone or limiting everyone, putting a severe punishment on the few miscreants?
Ms Frame: As we explained earlier this morning, the measure will benefit most veterans in terms of providing them with clearer, up-to-date insights on who they are seeing and where they are up to with their cap. They will have that on MyService, which is a facility they don’t have now. They will have the benefit of more providers. We anticipate there will be more providers availing themselves of the increased rates that are also part of the measure, and we have designed the consideration around $5,000. The policy objective of that threshold of $5,000 is to ensure the maximal effectiveness of the treatment that veterans are receiving. It provides a way by which we can assure the veteran that the providers who are delivering them services are accountable for genuine improvements in their condition and not just delivering services in perpetuity that aren’t subject to any checks and assurances that they are affecting real improvements in veteran wellbeing.
Mr Brown: I reiterate the evidence I gave earlier today that, of those veteran cardholders who access allied health services with those veteran cards, the average amount of services they provide, based on historical data, is around $3½ thousand per annum, so the $5,000 cap is adequate to facilitate allied health services for the majority of veterans accessing those services through card arrangements.
Senator ROBERTS: Averages can be really misleading and deceptive. They can hide things. I’m not accusing you of hiding things, but averages—that’s a fact. What percentage of—
Senator McAllister: He has the median as well. There are a number of statistical indicators. You may enjoy this.
Senator ROBERTS: They’re partial indicators.
Mr Brown: We have a number of high-end users that skew that average. The median is $1,900 without those high-end users skewing that average.
Senator ROBERTS: What percentage of veterans go over $5,000 in a year?
Mr Brown: It fluctuates, but it’s between eight and 12 per cent, so roughly one in 10 of the eligible population.
Senator ROBERTS: That’s a sizeable number nonetheless. That skews. It distorts. Have you built systems— or are you still building systems—to take care of that 10 per cent’s needs?
Mr Brown: That would be the process that we’ll build off the back of the consultation that will occur over the next 12 months to ensure that we’re meeting the clinical needs of those veteran cardholders who require an amount over the $5,000 threshold.
Senator ROBERTS: What I’ve found in my career is that humans are not afraid of change. People misleadingly say that humans are afraid of change. What they’re afraid of is uncertainty. Is there anything you can do to make things less uncertain for veterans who are worried?
Ms Frame: I announced in my opening statement this morning that we will be doing this consultation. We have conveyed that. We will be consulting on the mechanism, but we have also put a section on our website in the last week that responds to miscommunications, what is coming to us about the veteran community and where they have fears about how the measure will be affected. As we said, it hasn’t started yet, but we are doing our best to proactively engage with that and put up-to-the-minute information that responds directly to where we see misinformation and misapprehension circulating in the veteran community to address that exact uncertainty and provide as much information as we are able to at this point in time.
Senator ROBERTS: Are you consulting with any veterans to design the communications before you release the communications? This is not meant disrespectfully. It’s meant with complete respect. Your environment is different from the veterans’ environment. Your language is different. Are you using veterans to guide you in the messaging? That seems to be a big problem.
Ms Frame: No, not directly with that communication as I understand it at the moment. It is based on direct feedback from veterans, so we’re looking at exactly what they are saying and using their own language and terminology in our responses as much as possible.
Senator ROBERTS: So veterans will be required to apply for additional funding. What evidence will be required, and how long will approvals take? Is that still being designed?
Mr Kefford: That’s the nub of the consultation, which will involve a process of both presentations from us and submissions from individuals as well as professional organisations. So that will be worked through, and it will be communicated once it’s been settled.
Senator ROBERTS: Will there be regular updates and communications?
Mr Kefford: Indeed.
Senator ROBERTS: What appeal mechanisms will exist if DVA declines to fund clinically necessary care above the cap? That’s still part of the process being designed, I take it.
Mr Brown: That will be considered during the design process, but it’s not going to be an administrative decision made under any primary legislation. We’ll consider that issue during consultation, but it’s unlikely—I don’t want to speculate too much—that it will be appealable through our normal administrative decision-making processes.
Senator ROBERTS: Do you have any ideas on how it will be appealable?
Mr Brown: No. I don’t want to speculate further about what the process might look like ahead of a consultation period.
Mr Kefford: Mr Brown’s absolutely correct. I would say two things. First of all, the intention here, as the secretary has outlined, is to ensure that allied health is clinically appropriate and effective. And the purpose of having the process that we’re describing is to ensure that, particularly, those veterans who have more complex needs are properly cared for and receive the support and rehabilitation that they need.
Senator ROBERTS: What assessment has the government made of the risk that a capped funding model will further reduce provider willingness to treat veterans, given existing concerns about low DVA fee schedules? I’ve had a number of doctors say this is insane.
Mr Kefford: Part of the measure is, directly to that point, to actually increase allied health fees. One hundred and sixty-seven, is it, Luke?
Mr Brown: It’s 169—$170 million in round numbers.
Mr Kefford: And that’s intended to encourage more providers to provide services to veterans. That’s been welcomed by a number of bodies, and we tabled a letter from the physiotherapists association—that’s not the proper title—this morning.
Mr Brown: For example, as part of that measure, for a face-to-face standard room consultation with a physiotherapist, our fee will increase from $75.10 to $110. Those fee increases apply across the board to allied health providers.
Senator ROBERTS: How does the government reconcile the introduction of a monetary ceiling with the royal commission’s finding that barriers to healthcare access contribute to veteran suicide risk?
Mr Kefford: A part of the measure is to, below that threshold, actually remove the requirement for the treatment cycles that currently exist and to provide that flexibility, recognising that the threshold’s been set with regard to what is normal usage, but then to have a process to ensure that necessary treatment is available and that treatment that’s provided is clinically appropriate.
Senator ROBERTS: Does the government accept that veterans with numerous accepted conditions will exhaust the cap more quickly than those with a single injury, despite both having conditions recognised as service caused?
Mr Kefford: That would be the logical conclusion, and that’s why we’re having a process of—the $5,000 limit is a threshold at which point there can be further decisions about clinically necessary care that needs to be provided.
Senator McAllister: I think it’s worth—just in response to your last three or four questions, Senator—putting the whole measure in context. The royal commission did say that the government should take steps to improve access to health care, including by raising the charging or the provisioning for procuring allied health services. This measure does that; it raises the fees. It also seeks to remove some of the administrative hurdles for veterans by removing the treatment cycle, which will remove some of the impediments to people procuring the services that they want for their own needs. And, as Ms Frame said, it also will allow us to invest in some digital systems that will let veterans see what services they’ve already used and what resources might be available to them. So the context for this is actually a broad measure to improve access to allied health across the sector.
Senator ROBERTS: What safeguards exist to prevent the cap from disproportionately harming veterans with complex, chronic or degenerative conditions?
Mr Brown: Part of the measure that’s been announced by the government is that, where there’s a clinical need to access allied health services above the $5,000 cap, that will be provided.
Senator ROBERTS: What transitional provisions will be put in place to ensure veterans do not experience sudden loss of access to essential treatment when the cap begins in July 2027? This is a source of pretty severe mental health pressure. Is there a transitional arrangement?
Mr Kefford: The detail of, particularly, the mechanism by which veterans will seek additional funding above that first threshold is the nub of the consultation process. I’m sure the concerns that you’re raising will be aired in that context.
Senator ROBERTS: When will clear, written guidance be issued to veterans and providers explaining how the cap will operate in practice? Do you have a scheduled time or an approximate time?
Mr Kefford: The undertaking is that the consultations will commence in August. We haven’t set a conclusion or detailed timeline for that yet, but certainly the intention would be to have arrangements clear and able to be communicated well in advance of 1 July.
Senator ROBERTS: Minister, we understand what you’re trying to do, but I don’t think the message has got out from the department, the DVA, as clearly as possible, because $5,000 is seen by many veterans as pitifully and ridiculously small. It’s an insult. How much of this is a cost-cutting exercise to get your government through the hoops with regard to the waste and hypocrisy that it’s shown—
Senator McAllister: I indicated to you earlier—
Senator ROBERTS: across all budget areas.
Senator McAllister: that our goal is to ensure that veterans have access to the allied health treatment they need in a timely way, and to make sure that the services they’re being provided are clinically effective. One of the consequences of creating a system where very large quantities of services are procured from the private sector by individuals is that we see the emergence of some behaviours in that market that are not in the best interests of veterans. At the worst end of it, it looks like fraud: claiming for services that were never delivered. Stepping a few clicks back from that, sometimes it looks like overservicing: making a set of recommendations for which there is no clinical evidence and from which the individual doesn’t see a material benefit in their own health and wellbeing. We judge that, given what we know about the use of these services by veterans, most veterans are using well under that $5,000 limit. When we see veterans experiencing higher rates, we think it’s appropriate for there to be a threshold to evaluate whether what’s on offer to that person is genuinely going to assist them. We have every intention of ensuring people do get the healthcare services they need, and this reform is about a multipronged approach to make sure that’s true, both for the people whose needs are at lower levels of intensity and for the people whose needs are at the higher level.
Senator ROBERTS: This government has developed a reputation for wasteful spending and loose spending, and people are concerned about that. It seems to me that there’s a lot of work going on, but the root causes are resignation among the veterans that nothing concrete has been done, and there’s so much fear. I think it’s a matter of not only what you just stipulated as your desire and what your targets are but how it’s being done—the process. Would you agree?
Senator McAllister: I don’t agree with many of the things you said. Our government in each and every budget have found savings so that we can prioritise the things that we care about and that we know the community cares about. One of those areas of investment has in fact been in DVA, because we came to government knowing that it was significantly underprovisioned and that the lack of staff, in particular, in this organisation had led to unconscionable delays in people being able to access the services that they deserve as veterans. We’ve set about addressing that, and there’s a lot to be proud of in the work that’s been done by the many people who work in this department and the collaborative way that the veterans community has engaged in that work to make sure that we do improve the service level that’s available.
https://img.youtube.com/vi/WOLD4gV430g/maxresdefault.jpg7201280Senator Malcolm Robertshttps://www.malcolmrobertsqld.com.au/wp-content/uploads/2020/04/One-Nation-Logo1-300x150.pngSenator Malcolm Roberts2026-06-24 18:42:572026-06-24 18:43:01Veterans Face New $5,000 Care Restriction
How government greed turned citizens into criminals …
As a government, if you wish to stop a destructive public behaviour – you punish it. This can be through fines, incarceration, or economic coercion (taxes).
If you want to turn a public behaviour into a permanent cash-cow that props up the Budget – you tax it carefully.
Somehow, uniparty greed has found a way to implement a ‘worst of both worlds’ policy surrounding tobacco and nicotine products which has turned smoking into a criminal underworld gold mine.
Between 2010 and 2026, tobacco excise has increased in the order of 490% and returned half the revenue in real terms. People didn’t quit. If anything, there is evidence of Australia’s 30-year trend of decreasing smoking being reversed.
After reaching its lowest level with Millennials, smoking has become ‘cool’ again for Gen Z and Gen Alpha. Excessive taxation has destroyed all the good public health work done in this field.
Economically, this is not only a concern for the estimated $11 billion lost excise tax for tobacco.
It also involves the loss of general revenue associated with the full cost of tobacco which previously paid wages, kept stores open, and was re-invested in local communities.
Tens of billions is now being given to the black market where it funds violent crime. This tears apart Australian suburbs and has a follow-on health and economic impact that lowers the quality of life for everyone, not only those directly involved in illegal tobacco. Everything from personal safety to house prices are being affected.
Police have warned that this money, often funneled into crypto, has also been used to expand drug trafficking, firearms offences, worker exploitations, and property damage through activities such as coordinated firebombing.
Worse, if that is possible, the quality and safety of illegal tobacco and vapes is a matter of acute concern. Australians are now exposed to a considerably more dangerous product that was once strictly regulated for safety. And it’s dirt cheap. We are hearing reports of those who gave up smoking previously falling back into the habit because it’s only $10… As for kids, how likely is it that illegal traders are checking them for ID?
Every single feature of the system has been undermined.
It’s clear to me that public health, citizen choice, and the Treasury are in conflict.
And yet they should share the goal of a profitable, legal, regulated industry.
Our current incoherent approach to nicotine products is often referred to as ‘thoroughly broken’ by those trying to petition the government to act.
As Professor Ron Borland said, ‘We are worse off in every conceivable way.’
Tobacco isn’t quite Australia’s re-run of American Prohibition. However, it does share similarities. As with Prohibition, the first question we have to answer is: Should smoking tobacco (and other nicotine products) be legal?
Like alcohol, if the answer is ‘yes’, then any civil penalty or pseudo ban (vaping doctor certificates), should be discontinued.
The second question is: Do we consider smoking tobacco a health risk that costs the state money and which the state actively seeks to discontinue in the long-term?
If ‘yes’ – and this is what we were told for decades through school programs and public advertising campaigns – then the government cannot expect to use taxation on tobacco as a permanent feature in their Budget spreadsheet.
As Clive Bates said, ‘If you push it too hard – the taxes are too regressive, too brutal – then people will defect from the system and they will move to illicit trade and illicit suppliers will come in because there are enormous economic gains to be made.’
The Treasurer must have a replacement plan for tobacco revenue that does not entail continuously raising excise to the point criminals take over distribution.
Experts have suggested alternatives, such as using public information campaigns and alternate products, to wean society off tobacco long-term rather than smacking Australians with tax hikes on an addiction exasperated by economic stress.
To that point, there may never come a time when tobacco and nicotine products exit public use.
As with alcohol, they require a legally and economically stable environment that protects as many people as possible, dissuades new users, and yet does not create opportunities for crime. The most effective measure so far involved banning smoking from bars, clubs, restaurants, and residential balconies which turned it into a social inconvenience rather than a cost burden.
And here sits the heart of the problem.
Tobacco was a huge part of society until earlier suspicions of health risks were confirmed in the 1960s. Community anger and government complicity in a public health catastrophe created a lot of guilt and revenge.
Those days are almost gone. People who choose to smoke today do so knowing the risks and great lengths have been taken to contain those risks to the individual smoker. And so the conversation becomes one about public health costs similar to obesity. How is it fair, it’s said, that the public pay for the self-inflicted health problems of smokers? The numbers strongly suggest that this was never the case. Revenue on tobacco is widely held to cover the health bill. Until now.
The situation today reveals a growing smoking population with a more dangerous product and decreased revenue that doesn’t cover the cost of health, let alone the huge cost of policing the illicit trade. Economic arguments for the current excise level do not hold up to reality.
Scroll through the crime releases…
Permanent surveillance and enforcement on hundreds of tobacco shops. Thousands of online ad takedown orders. Monitoring nation-wide criminal distribution networks. Raiding shipping deliveries. Prosecuting and incarcerating those responsible. Storing and destroying the product. It’s an open-ended revenue drain. And then you have to include illegal vapes, of which the market is in the billions.
If you’re wondering how much policing this costs, the answer is, ‘we don’t know’. No full-cost figure is published. It’s estimated in the hundreds of millions just for policing itself at a state and federal level, while the government admits to investing approximately $350 million specifically for the ‘fight against illicit tobacco and vapes’.
Whatever the number is, it came out of your pocket.
The Australian Federal Police reported that 2.66 billion illegal cigarettes, 510 tonnes of loose-leaf tobacco, and 7.5 million vapes have been seized since 2016. Operation PRINTWALL saw the Australian Border Force intercept 998.5 tonnes of tobacco.
Just this year 20 million illegal vapes worth $1 billion were seized by the Australian Border Force since 2024. The Therapeutic Goods Administration removed another 2.2 million valued at $110.5 million in the same period. They also reported a 300-fold increase in requests to remove online ads for illegal vaping products.
These are not victories so much as temperature readings offering a glimpse at a thriving market.
We must sit down and soberly confront the truth.
Government informs the public that tobacco costs the taxpayer money through the healthcare system, and yet it desperately wants Australians to keep buying tobacco and funding the Treasury. When vapes entered the market, and people began to organically switch products due to health, convenience, and cost – government all-but banned the product. A cynic may say this had little to do with health and a lot to do with an absence of lucrative excise tax. The Treasury saw tobacco revenue evaporating and instead of taking the public health victory – they panicked. This raises serious questions about the government’s motives and ability to solve the current problem.
Listening at length to experts in the industry, it seems clear that we require a carefully timed approach.
The legal market must be restored before law enforcement can come down on the black market.
To do this in the wrong order risks wasting money and encouraging citizens to protect a criminal underworld to facilitate their smoking habit. This would entrench the behaviour we’re trying to resolve. As one expert said, in some communities, illegal tobacco sellers have reached a ‘Robin Hood’ status actively supported by locals. A path back to legal markets must be seamless as it would in any competitive business environment.
The suggestions that I have heard from a variety of people from within the industry include:
Setting the tobacco excise at a level that keeps cigarettes competitive against black market alternatives.
Removing the ban on vapes and adding the same location restrictions as smoking.
Considering an excise on vapes to recoup some lost revenue.
Ensuring that the tobacco and vape products on offer include a wide variety to ensure maximum customer return from the black market to legal channel.
And then…
Severe and serious penalties for black market traders and the criminal gangs involved.
Mandatory sentencing to simplify the process of cleaning up crime.
Reporting channels to allow people to alert police to continued criminal activity.
And as I have said publicly in front of the Panel of Harm Reduction Experts at the Legal and Constitutional Affairs References Committee, the solution will not be simple.
The cost of living is very high and will naturally lead otherwise law-abiding citizens toward illicit markets – in general. They don’t want to break the law. Any solution must deal with lifestyle measures right across our economy.
People are suffering and nicotine products are part of their lives.
All measures must be enacted with a least-harm approach to Australians who were pushed toward the black market due to government-enforced economic pressures.
And we absolutely must support the legal businesses who wish to help rebuild the market – this will include protecting these shops and owners from crime gangs. For example, insurers say it has become almost impossible to find cover for tobacconists after arson attacks…
Once the legal and government approach is fixed – the criminal infrastructure will have to be dismantled – rapidly – or it will adopt a new product such as alcohol – which is experiencing an almost identical problem.
Make no mistake, excessive alcohol excise has already started to push people toward extremely dangerous black market product. This is even more concerning than illegal tobacco.
No one can solve a public health problem for a product owned and distributed by the criminal underworld.
I spoke with Ms. Liz Hefren-Webb and raised the issue of overcharging by service providers, which is depleting the limited funds available through Aged Care packages.
I highlighted the case of David and Sandra Smith, whose package was debited $3,000 for a small, incomplete gardening job. As a result, they were unable to access certain medical services because they could not afford them. Their complaints to the Commission fell on deaf ears; the Commission provided no explanation for its decision and refused to discuss the matter with the Smiths.
I also raised the case of Mr. Garry Bayliss, who had $14,000 taken from his My Aged Care account simply to replace some timber railings on a fence. Again, the Commission failed to take any action to remedy the situation.
Ms. Hefren-Webb suggested sending the details to the Agency for re-examination. I also raised concerns about the proposed introduction of co-payments into Aged Care packages, which will reduce the actual services provided. Many recipients cannot afford these additional costs, with some services charged at rates of $100 per hour or more. I stated that these shortcomings do not constitute quality care and amount to institutional elder abuse.
– Senate Estimates | December 2025
Transcript
Senator ROBERTS: Thank you for appearing today. Since the introduction of personalised aged-care packages, there has been an abject failure, it seems, of monitoring how funds allocated are actually spent. This is one of the major failings of the administration of the NDIS that may well bankrupt Australia and be responsible for the death of vulnerable Australians. My question is specifically about the case of David and Sandra Smith. Under their package, they are entitled to some assistance in minor property maintenance. They needed some minor trimming of half a tree and a few branches of another on the property. That was not even completed. They found that $3,000 had been taken out of their package and given to the contractor without discussion between the Smiths and the service administrator of the package. Having raised the issue as a complaint, the Smiths have been ignored. Because of the depleted funds, the Smiths had to cancel some medical appointments they could no longer afford. This issue is gravely affecting their health at an age when they can ill afford such events. The Aged Care Quality and Safety Commission closed off their complaint and refused to even discuss it with the Smiths. They refused to even discuss it, and no explanation was given. To me, this seems like elder abuse by a government agency that is supposed to help older Australians, not abuse them. What is the cover-up, and why was $3,000 paid for next to no work?
Mr Comley: I think the commissioner will provide a response, noting, of course, that it’s difficult for us to talk about individuals in this forum. I will ask Ms Hefren-Webb to comment.
Ms Hefren-Webb: Obviously, I can’t comment on any individual case, and I don’t have any knowledge of the case you’re talking about. We receive around 10,000 complaints a year. Each of them is triaged and assessed, and we do provide a comprehensive response to people. I am not aware that we would ever refuse to provide a response, so I would be very happy to follow up the case you’re talking about.
Senator ROBERTS: So we can put you in touch with them?
Ms Hefren-Webb: That would be great. I’d be very happy to get in touch.
Senator ROBERTS: It does raise issues of accountability, the level of care and the attitude in the department.
Ms Hefren-Webb: It sounds like it’s an issue of pricing that they’re concerned about.
Senator ROBERTS: It might actually be fraud as well.
Ms Hefren-Webb: Potentially. I think the third-most-common complaint we receive around home care is about pricing of services. We do investigate those complaints and we do follow up to see what has driven the particular pricing. You weren’t here earlier when I said we will compare providers and, if another provider is offering the same service for a lot less, we will ask the provider to explain how they arrived at that price.
Senator ROBERTS: Do you normally get quotes?
Ms Hefren-Webb: We don’t get quotes; we ask the provider how they have come up with their quote.
Senator ROBERTS: So you do not insist on a second quote, but you ask them the source of their quote?
Ms Hefren-Webb: It’s the provider who is managing the package. If there’s a price that the consumer feels is excessive, we will investigate how that’s come about. That’s our role. If we suspect that there is a fraudulent aspect, we will obviously refer that through to the department, because they’re responsible for fraud and assurance and we’re responsible for compliance with the standards.
Senator ROBERTS: Okay. We will send the contact details.
Ms Hefren-Webb: That would be great.
Senator ROBERTS: Could you check on notice if you have dealt with this or if Aged Care have dealt with this? We would like to know what happened.
Ms Hefren-Webb: Will do.
Senator ROBERTS: This disgrace has badly affected the health of two innocent senior citizens who deserve an answer and money put back into their package. Is that what happens when something is found to be incorrect, wrong or unfair?
Ms Hefren-Webb: I think the department has responsibility for dealing with fraud and how that is dealt with in terms of the individual’s package.
Senator ROBERTS: If there’s something wrong specifically, is the money given back to the aged person?
Ms Snow: I think there would be a range of options. If it’s okay, it might be best to work with the commission really closely to have a look at the case, have a look at what’s been undertaken to date and come back to you.
Senator ROBERTS: Okay. Thank you. I see the caveat, but, if appropriate, can money be put back into their account?
Ms Snow: Yes.
Senator ROBERTS: Thank you. Then there is the case of Mr Gary Bayliss, who had $14,449 taken from his My Aged Care account to replace some worn-out timber rails from a fence. Again the commission failed to take action to remedy the fraud. Now the minister has announced that the concept of co-payments is to be instituted into the aged-care packages. That will mean the cancellation of many services needed by package holders, because they will become unaffordable. Minister, the proposal is that many services will need to be paid for at a rate of least $100 per hour, often at more than twice the market labour rate. An age pensioner cannot afford this. From the absurd to the impossible, this is not care, as I said earlier. It’s abuse. Minister, what can you do to fix this?
Senator McCarthy: Thank you for your questions and the concerns that you’re raising on behalf of your constituents. Clearly, there are many stories there that you’re hearing that really hit at the heart of how people are feeling in terms of their own care. I will take your questions on notice if that’s okay and get back to you with regard to that particular question.
Senator ROBERTS: Please also take on notice the bigger picture of what can be done.
Senator McCarthy: Sure.
Senator ROBERTS: Commissioner, could you take on the case of Mr Gary Bayliss?
