Given the demands of military service, both physical and mental, a sizeable proportion of Australian veterans require the services of occupational therapists—clinicians who help our veterans participate in meaningful and productive activities. While occupational therapists derive enormous professional satisfaction from working with veterans and war widows, their work has become increasingly difficult to sustain.
This is because remuneration for such work has, in effect, been frozen for nearly twenty years by successive Australian governments. Rather than addressing these concerns, last year’s federal budget included funding cuts of more than $40 million from allied health services over the next four years.
Those experienced occupational therapists still doing veterans work, do so at a loss; they only keep doing it out of loyalty to longstanding clients and by cross subsidies from other work.
If the exodus of experienced occupational therapists from The Department of Veterans’ Affairs (DVA) work is to be staunched, the federal government must act now to ensure the provision of occupational therapy services is, at the very least, sustainable.
It should be a source of national shame that clinicians with longstanding relationships with wounded, disabled and ageing veterans are having to cut these ties because the Australian Government is unwilling to provide fair compensation for their services.
This graph compares the pay increases afforded to our nation’s leaders between 2007 and the current day with those afforded to occupational therapists working with veterans and war widows.
Which means that, in real terms, occupational therapists are actually being paid less now than they were in 2007.
INCREASES FROM 2007 TO THE CURRENT DAY
Annie Davis is a Darwin based occupational therapist (OT). To meet consumers in Mandorah (located across the harbour from Darwin), Annie must either make a six-hour round trip by road, or take the short 15-minute ferry ride. Yet Annie is not reimbursed for the cost of ferry travel (as the town is on the mainland). The task of requesting approval and extra funding for ferry travel is so time consuming that it costs Annie more than any eventual remuneration paid by the Department of Veterans’ Affairs (DVA).
Consequently, veterans in Mandorah no longer have an occupational therapist visiting them.
Annie often receives referrals to assess veterans living in Adelaide River, a 90-minute drive from Darwin. Annie can’t afford three hours of inadequately subsidised travel to remote areas when she could be seeing three metro clients during that time. Without funding, it is not commercially viable for Annie to treat clients in Adelaide River. And while one visit (at a loss) might be possible, Annie simply can’t afford the follow up visit to confirm that equipment supplied to the client has been installed appropriately and is being used safely.
It is the sad reality that the more isolated clients—the people who might benefit most from direct contact with an OT—are the most disadvantaged under current arrangements.
For nearly twenty years there has been no meaningful increase in the rebates paid to OTs working with veterans and war widows. Over that time rents, utility bills, wages, and the cost of running a car (of particular concern to OTs working in remote communities) have all risen steadily. And all work done before and after the actual face-to-face consultation is done without any pay whatsoever.
Is it any wonder that the majority of veterans in the Top End needing occupational therapy support now only have access to the public hospital system, with its lengthy waiting lists? The waiting time for some non-urgent OT services is now up to three months. And as more OTs are forced to give up working with veterans, waiting times in the Territory will only get longer.
Nola is an 87 year old war widow whose husband served in Korea. Living in a high level care facility in Darwin, Nola has had a number of falls and now relies on a walker to get around. She also suffers from a build-up of fluid in the legs (oedema) which causes swelling.
After finding that compression bandages were not improving the condition of her legs, Nola’s doctor referred her to an occupational therapist. Nola’s OT has been able to reduce her discomfort by prescribing a pump for Nola’s legs that improves blood flow.
Currently, Nola’s therapist is able to visit her at the care facility whenever she requires support, however the lack of reimbursement for travel costs incurred by OTs means it is unclear if the OT will be able to continue with regular visits. Residents of the Northern Territory face a number of unique challenges, including higher living expenses and fuel costs.
Both Nola and her daughter Martine believe it is incredibly important that OTs are not forced to stop seeing clients in the Territory because they are unable to cover practice costs.
The supports her therapist provides enable Nola to maintain her mobility and participation in events at the care facility including carpet bowls and weekly bus outings. Both mother and daughter are incredibly grateful for the individualised support that Nola receives from her therapist.
As Martine put it, “We need these people and they need to be funded”.
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Occupational Therapy Australia has prepared a message of action that concerned citizens can send to both:
You can view the contents of this message here.
OTA encourages all those who are personally affected by this issue (including occupational therapists, veterans, war widows, family members and advocates) to write to OTA and share their experience.
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