Committee Report: Public Accounts and Audit Committee

20 June 2017

Ms SWANSON (Paterson) (17:56): I would like to commence by commending my colleague and friend, the member for Bruce, and also the Deputy Chair of the Joint Committee of Public Accounts and Audit, who conducted the inquiry into the Auditor-General's report, for the work that he did on that committee.

The disability support pension is a vital part of our welfare safety net, to provide support for permanently disabled Australians who are unable to work or unable to work very many hours. Unfortunately, it has become a mountain too high to climb for many Australians. This report has highlighted many issues raised through the inquiry. I wholeheartedly support the committee's recommendation for a complete review of the administration of the disability support pension from go to whoa. It really is needed.

This inquiry focused on the reviews of the DSP, the government's 'scattergun'—as we have heard—approach to try and get some people off the DSP and back to work. These reviews appear to have been very poorly targeted, very costly and not very successful. Only 1.6 per cent of people who were reviewed were actually moved off the DSP. What was the point? The problems go way beyond just the review process itself. There are problems with the way the DSP is assessed and administered that cause Australians no end of heartache. And it is not just the incredible amount of time it takes; it is the insurmountable hurdles that people have to jump to prove they are eligible. It is the apparent disregard for their welfare and for the medical expertise of their treating doctors. And it is heartbreaking, completely demoralising.

My office has been helping several people trying to navigate the DSP process. Sometimes it is like hitting your head against a brick wall: it might be nice when you stop, but unfortunately these people cannot stop. They are desperate for help. We all understand there have to be evaluations and assessments and there have to be limits for eligibility, but these evaluations and assessments seem to be completely out of step with the reality of the lives many ordinary Australians seeking this important safety net are trying to lead.

I will give you one example. My office has been helping a fellow called Alex. Alex can barely walk—and I mean that. He does not just have a limp. He needs to be helped to take even the smallest, slowest steps and he struggles to sit down and stand up again. He is 62, and until five years ago he was a bus driver. In his words, his knees are completely stuffed. In the past five years, he has had both knees replaced and required revision surgery because of complications. In his left knee, he has pain and stiffness because of, in the words of his doctor, the failure of the knee implant itself. In his right knee he has pain, stiffness and instability because of the failure of the knee implant, because of the massive and complicated infection that followed and because he has also endured upper limb deep vein thrombosis because of the intravenous catheter that was used to treat the infections.

In his report his doctor writes that the symptoms in both knees are 'ongoing and permanent' and require Alex to take analgesics indefinitely. It advises that Alex is in need of help for domestic tasks, gardening, cleaning and cooking, and that these requirements will be lifelong. The doctor writes that there are no further surgeries planned for either knee despite the fact that there is a 25 per cent chance that one or both knees will fail again. If he does require additional surgeries they will be 'more complex, expensive and risky' as a result of previous failures. Alex is facing amputations. Currently, his doctor writes, he is not fit to work as a bus driver and not fit to perform any type of work at all. He writes, 'This will be ongoing and permanent.' It does not get much clearer than that.

Alex's disabilities, caused by botched knee surgeries, failed implants and the subsequent complications have now been going on for five years, and they are not going away. The doctor does not plan to do any more surgery. Alex's injuries are ongoing and permanent. Yet does he qualify for the disability support pension? No, he does not qualify.

Doctors do differ in opinion, and Alex accepts that. But the second doctor who assessed Alex for the DSP did so in a half-hour interview over the phone. That is right—on the phone. So this pain, this weakness, this stiffness and this instability that Alex now lives with, has lived with for five years and will live with forever was assessed in half an hour over the phone. For Alex, that was the most galling part—that the DSP assessors did not even conduct a face-to-face interview with him, let alone a thorough medical examination.

Alex appealed the decision and was rejected again. My office has made a representation on his behalf to the Minister for Human Services and a departmental liaison officer reiterated the rejection. Here is the rationale for the rejection: although Alex's medical condition was 'considered to be permanently and fully diagnosed', it was not considered to be 'fully treated and stabilised'. Not fully treated and stabilised. This fellow, who has had both knees effectively replaced twice and has endured infections and complications that have left him barely able to walk and with very little likelihood of being able to endure any further surgeries has been deemed not fully treated and stabilised. It beggars belief.

He is not the only one; it is a common story. It is the unholy trifecta or the catch-22—or potentially catch-33, if you like, seeing as there are three elements. To qualify for the DSP you have to have a permanent disability fully diagnosed and fully treated. Apparently, Alex has not been fully treated. This is after half an hour on the phone and contrary to what his treating doctor of several years has said.

This report has highlighted some of the problems with the DSP, but it has barely scratched the surface. A complete review is sorely needed. We need to challenge the assumption that a half-hour phone interview is enough to diagnose a complex medical impairment. We need to challenge the assumption that 21 days is enough time to get a specialist's report when we patently know that it is not. It is just ridiculous. We need to challenge the assumption that a punitive scattergun approach to flushing out people who could be working when they are not is offensive, insulting and damaging to many ordinary Australians. It is not good enough that a treating doctor's report is replaced with a phone assessment by a bureaucrat—it really is not. It is not good enough that people already under stress are given review deadlines they have no hope of meeting because they simply cannot get to see a specialist. Data must be shared between federal and state departments so that manifestly eligible recipients are not targeted for reviews. This would save time, energy and the most precious budget.

This government must not pick on vulnerable Australians and run up unnecessary medical bills and Medicare bills to prove the bleeding obvious. This government must better resource Centrelink so that fewer mistakes are made and fewer appeals are needed, and so that people have somewhere and someone they can actually go to for help and talk to. The delivery of the DSP must be done in a committed and transparent way and evaluations must not be ad hoc or over the top and on the hop.

The committee heard evidence of DSP eligibility reviews being conducted on Australians with severe and permanent intellectual, physical and psychological disabilities with no capacity whatsoever to work. Imagine what that does to them and their loved ones. Labor supports efforts to help people with a disability find work and no-one wants to see the system rorted, but this government is going about it completely the wrong way. These reviews have been cruel and unfair. The whole process, actually, seems to be cruel and unfair and not particularly efficient, thoughtful or smart at all. Surely this can be run better. This is a terrible indictment of the minister. I endorse the committee's recommendation that the Department of Social Services and the Department of Human Services conduct a complete end-to-end review of the administration of the DSP. It is well overdue.