The Department of Veterans' Affairs (DVA) engages a number of doctors as contract medical advisers. They work in DVA offices and interact with DVA staff and processes on a daily basis, but they are engaged as contractors, not employees. DVA has reviewed its arrangements for health advisers (includes medical, dental and allied health professionals) and has gone to tender for new contracts. The AMA has pressed DVA for consultations on the matter and provides the following material for the information of members who currently work for DVA on a contract basis or are contemplating doing so.

At the beginning of 2004 the AMA took up with DVA the dissatisfaction expressed by members with remuneration and that contracts had not been brought up to date. The AMA wrote to DVA suggesting an appropriate fee adjustment and subsequently met with them on a number of occasions about contract medical advisers. DVA advised that they had been waiting on the outcome of an Australian Taxation Office (ATO) ruling on payment of superannuation in relation to contract health advisers.

The AMA met again with DVA in November 2004 and DVA undertook in writing to consult with the AMA as soon as the ATO decision was known. Despite this undertaking, DVA wrote to contract medical advisers on 24 December 2004 advising that contract issues had been resolved and that the Department was moving forward with new contracting arrangements.

After further representations, DVA officers met with the AMA on 15 March 2005 to explain new contracting arrangements. DVA advised that they were going to tender for an entirely new set of contracts to meet their assessed needs. The background was a projected decline in veteran numbers and a need for DVA to manage a correspondingly reduced workforce.

DVA will no longer engage individuals as contract medical advisers, only incorporated bodies. They will only deal with corporate "entities" rather than individuals.

DVA expect that contract medical advisers will have more of a distinctly clinical role with less "administration", although what this means in reality is not clear. On one possible view, a knowledge of DVA legislation, systems, policies, guidelines etc would be useful, if not essential, for a medical adviser to be effective in the job. Perhaps this will be a factor in selection of contractors.

Remuneration will be fixed at the rates determined by DVA - $88.38 per hour for medical advisers and $96.66 for senior medical advisers. There will be no negotiation over these rates and there will be no annual review of rates - they will be adjusted only by a wage cost index produced by government.

DVA has prepared a standard Services Agreement. Tenderers are afforded the opportunity to indicate those parts of the agreement they do not accept and provide alternative wordings or proposals.

At the AMA's request, DVA provided a copy of the proposed standard Services Agreement. The AMA made a number of comments to DVA that set out our concerns regarding the draft agreement - with the unresolved concerns being set out below.

Aside from a few relatively minor changes, DVA decided to leave the agreement largely unchanged. It will be interesting to see if this approach is reflected in tender negotiations and whether the process becomes a take or leave it scenario.

The comments provided by AMA to DVA are detailed below (the clause numbers referred to are those in the standard contract template) and provided in order to provide members with a detailed outline of the AMA's concerns.