Exclusive: Deal will change hands amid growing concern about high rates of mental illness and suicide among defence veterans

This article is more than 1 year old

This article is more than 1 year old

Psychologists say it may be harder for defence force personnel to seek counselling when Bupa takes over the armed forces healthcare contract from July and reduces the fees paid to them for consultations.

The news comes amid growing concern about the alarming rates of mental illness and suicide among defence veterans.

The former defence minister Christopher Pyne announced in January that Bupa would replace Medibank as the Australian defence force’s healthcare contractor from 1 July.

Bupa has subcontracted Victorian Counselling and Psychological Services to provide mental healthcare to serving defence personnel nationally.

An Australian Capital Territory-based private psychologist, who has 50 defence personnel on his books, said the transition from Medibank to Bupa “was a complete mess” and there had been little proactive communication from Bupa or VCPS.

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The psychologist, who asked not to be named, said that while he had received a new contract after much wrangling, many of his colleagues were still in the dark about the revised arrangements.

There is a huge disparity in payment levels for psychologists depending on whether a patient is a federal public servant covered under the commonwealth workplace safety regulator Comcare scheme, a serving member of the defence force or a veteran.

“If I see a public servant with a paper cut I get paid 210 bucks, and if I see a [soldier] who has been to Afghanistan and has post-traumatic stress disorder I get paid $164 and if they have left the army [and have veteran status] I get paid $120,” the psychologist said.

“It has always been more challenging for defence members to find psychs that would accept the low rate.”

Psychologists fear further cuts slated under the new fee structure will undermine an already difficult situation.

“I’m torn, I really want to keep seeing … defence clients but I feel like saying, ‘No, go away, Bupa,’ because I don’t want to do it for less money,” the ACT psychologist said.

Scores of defence personnel are grappling with war-related trauma, depression and anxiety. The waiting lists in Canberra can vary from one to three months. There are 9,364 Australian defence force personnel, including reservists based in the capital.

It is understood the previous fee structure will be retained for existing clients to ensure that psychologists do not abandon those patients.

The ACT psychologist said VCPS was insisting that psychologists use their system for administration and bookings, which meant running two separate lots of books and an increased risk of errors.

Psychologists are also upset by demands from VCPS that they seek blanket consent from all defence personnel clients for access to clinical notes.

Under the Australian Psychological Society’s code of ethics, there is a confidentiality obligation that can be broken only through a court subpoena or if a client consents.

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The Australia Defence Association’s executive director, Neil James, said this was the third time the defence health contract had changed hands since 2012, and each time there had been enormous problems.

“They keep taking the lowest tender without adequate thought to the quality of care,” James said. “Bupa is obviously trying to maximise its profit margins by screwing the psychologists.”

A VCPS spokeswoman referred Guardian Australia to Bupa for comment.

A Bupa spokeswoman said overall preparation for the defence health contract takeover was “progressing well”.

“We are confident of a smooth transition,” she said. “VCPS has secured a comprehensive network of psychologists and will be able to deliver a seamless service to Defence.”

Asked about the fee cut for psychologists, she said: “The new arrangement with Defence has adopted different service items and consultation times and the fees have changed accordingly.”

The Bupa spokeswoman said psychologists had been requested to obtain consent to access clinical reports for the “purposes of clinical governance, quality and professional supervision, however, this is not a requirement and Defence clients are at complete liberty to withhold consent”.

Bupa, a health, insurance and nursing home business that is headquartered in London, has been in the line of fire of the royal commission into aged care.

There are nine Bupa nursing homes nationally that have been sanctioned – they cannot take new residents or receive federal government funding. A resident at Bupa’s nursing home in Eden, New South Wales, was admitted to hospital this year with maggots in a head wound.

The company has also been in trouble with the Australian Taxation Office.

A spokeswoman for the defence personnel minister, Darren Chester, said the department had undertaken a value-for-money assessment that had considered the price, technical solution and risk of each proposal during the tender process.

“Defence is committed to providing a high-quality health service in a timely manner and in a way that supports continuity of care for the patient,” she said.

Defence was not privy to the commercial arrangements between Bupa and its subcontractors, she said.

“Defence is confident in Bupa’s ability to provide a sufficient network of skilled psychologists to deliver high-quality, timely and clinically appropriate services to Defence members.”

• Crisis support services can be reached 24 hours a day: Lifeline 13 11 14; Suicide Call Back Service 1300 659 467; MensLine Australia 1300 78 99 78; Beyond Blue 1300 22 4636