Bills Digest no. 31 2006–07
Australian Participants in British Nuclear Tests
(Treatment) Bill 2006
WARNING:
This Digest was prepared for debate. It reflects the legislation as
introduced and does not canvass subsequent amendments. This Digest
does not have any official legal status. Other sources should be
consulted to determine the subsequent official status of the
Bill.
CONTENTS
Passage History
Purpose
Background
Main Provisions
Concluding Comments
Endnotes
Contact Officer & Copyright Details
Passage History
Australian Participants in British
Nuclear Tests (Treatment) Bill 2006
Date introduced: 14 September 2006
House: House of
Representatives
Portfolio: Veterans' Affairs
Commencement: Royal Assent
To provide for an Act to provide for the testing and treatment
of Australian participants in the British nuclear tests conducted
in Australia in the 1950s and 60s.
From October 1952 to October 1957, British atomic weapons
detonation tests were conducted at Monte Bello Islands off the west
coast of Western Australia and at Emu Field and Maralinga in South
Australia. The table below sets out the tests that were conducted
in Australia.(1)
|
List of British
Atomic Detonation Tests in Australia
|
|
Location
|
Operation
|
Date/s
|
Kilotonnes
|
|
Monte Bello Islands
|
Hurricane
|
2 October 1952
|
25
|
|
Emu Field
|
Totem
|
15 October 1953
27 October 1953
|
10
8
|
|
Monte Bello Islands
|
Mosaic
|
16 May 1956
19 June 1956
|
15
60
|
|
Maralinga
|
Buffalo
|
27 September 1956
4 October 1956
11 October 1956
22 October 1956
|
15
1.5
3
10
|
|
Maralinga
|
Antler
|
14 September 1957
25 September 1957
9 October 1957
|
0.9
5.67
26.6
|
There were also British tests (involving hydrogen bombs) at
Christmas Island in the Indian Ocean and Malden Islands in the
Pacific Ocean, but Australians were not involved. There is also
more detail about the tests in Australia such as exact dates and
how the detonations were placed in Table 1.1 in the recent
Repatriation Commission Dosimetry Study(2) of 28 June
2006.(3)
The purpose of the Australian nuclear tests was to enable the
United Kingdom (UK) to develop nuclear fission bombs and, later,
nuclear fusion or hydrogen bombs and the tests occurred with the
full cooperation of the Australian Government.
The Explanatory Memorandum sets out who is to be regarded as a
nuclear test participant for the purposes of the testing and
treatment provided for by the Bill.(4) It is important
to note that a participant refers to more than a person who
witnessed or was present when the detonations occurred but includes
persons involved at the test sites up to 1965, in the case of
Maralinga.
There were also six hundred minor trials conducted between 1953
and 1963, including the testing of bomb components. For example,
one series was designed to determine what would happen to a nuclear
weapon in the event of a transport or storage accident such as a
fire. Some of these trials are claimed to have caused some of the
most extensive site contamination.(5) There is also more
detail of these minor trials in the Dosimetry Study report from the
recently released Repatriation Commission studies of Australian
participants in the British nuclear tests in
Australia.(6) The Dosimetry Study report also details
that these minor trials did involve relatively large quantities of
radioactive contamination.(7)
A summary of the levels of exposure to radiation that could have
occurred during the nuclear testing is provided in Appendix 1
attached to the recently released Repatriation Commission Cancer
and Mortality Incidence Study of 28 June 2006.(8)
Anecdotal claims by personnel involved are that service
personnel were required to line up with their backs to the
detonation with their hands over their eyes for the first minute or
so and then told to turn around to witness the mushroom cloud of
the blast. It is also claimed few wore anything more than shorts
and service uniform to witness the blast and it is only those who
were considered at risk of radiation who were issued with any
protective clothing and radiation dose badges.(9)
Both Australian and British personnel were involved in the tests
and included military and civilian participants. Details of the
numbers of Australian persons (civilian and military) recorded as
present at the British nuclear tests were provided in a press
release issued by the Hon. Mr Bruce Scott, MP on 29 June 2001. The
Nominal Roll of test participants lists:
- Navy 3 235
- Army 1 658
- RAAF 3 223
- 8 907 civilians - including 10 indigenous
people.(10)
The total of 17 023 persons comprises 8 116 service personnel
and 8 907 civilians.
UK personnel at the British nuclear tests in Australia
More than 20 000 British servicemen took part in the nuclear
tests conducted in Australia and on Christmas and Malden islands in
the 1950s. Of the 20 000 servicemen, most were on national service
and in their early 20s. The group also contained 238 New Zealanders
and 62 Fijians. All were involved in a wide range of duties from
highly technical detonation preparations to catering and small
other jobs.
Several inquiries and studies have been conducted by both the UK
and Australian governments and by others over the years arising
from concerns that participation in the nuclear tests in Australia
has lead to illnesses and medical conditions. Summaries of some of
the studies are to be found Appendix 1 to the recent mortality and
cancer incidence study.(11) The Appendix 1 comments
mainly refer to surveys of test participants that have been
undertaken. However, not all studies, inquiries and reports into
the health impacts on nuclear test participants are referred to in
this Appendix. Some of those referred to and also some not referred
to are discussed in more detail below.
The Australian Ionising Radiation Advisory Council (AIRAC) was
asked in September 1980 by the then Minister for Science and
Environment Senator the Hon. James J Webster to investigate certain
matters related to the British nuclear tests including their
effects of radiation fallout, the occurrence of black mists and
their possible health affects. The report by AIRAC was provided in
January 1983(12) and essentially concluded that the
tests were conducted within the limits existent at the time and no
persons were exposed to any excessive radiation that might lead to
adverse health affects in the future.(13)
Donovan Report
Arising from concerns about the health of nuclear test
participants, a survey was conducted by the Commonwealth Department
Health into the health of atomic personnel that was released in
1983.(14) The survey consisted of a health questionnaire
survey of all then surviving nuclear test participants and an
analysis of the causes of death for non-surviving participants. The
aim of the survey was to identify associations between test
participation and subsequent illness. The survey did find a
correlation between illnesses and test participation and also a
higher incidence of some illnesses with increased exposure to
radiation through the tests. These instances were mostly ascribed
to chance.
In May 1984, the then Minister for Resources and Energy, Senator
the Hon. Peter Walsh appointed a committee, under the chairmanship
of Professor C B Kerr, to review the data on atmospheric fallout
arising from British nuclear tests in Australia. The review only
dealt in part with health-related issues, but recommended that
there was enough evidence to warrant further investigation into
health affects and that a repository of nuclear test data and files
be established and maintained.(15) The Kerr Report was
quite critical of the AIRAC No. 9 report of 1983.(16)
The Kerr Report was fairly thin on substantive conclusions about
the impacts of radiation as it didn t have much independent
scientific evidence to refer to. Rather it noted there was much
anecdotal evidence of disease and illness amongst participants who
had made submissions to the report. In its own words it drew
conclusions from evidence submitted .(17)
The Kerr Report was heavily criticised by the AIRAC as being too
thin on professional analysis of the evidence and the AIRAC took
the Kerr Report as an attack on their professional conduct and
integrity in advising the government on the
issues.(18)
Arising from concerns about the impact of the tests in the Kerr
Report and the conflict between the opinions by the AIRAC with the
Kerr Report conclusions, the government in July 1984 appointed Mr
Justice J R McClelland to conduct a Royal Commission. The report of
the Royal Commission was presented in November 1985.(19)
The McClelland commission report was quite critical of the AIRAC
No. 9 Report and also of the Department of Health survey report.
The McClelland commission report concluded that there was no point
in conducting an epidemiological study of those involved in the
tests, due to the deficiencies in the available
data.(20) This appears to be, in part, based on
examinations by the McClelland commission report of survey reports
conducted by the South Australian government in the early 1980s
into the cancer incidence in Aborigines exposed to test radiation
and comments these reports made on the feasibility of post-test
epidemiological studies.
The South Australian government reports questioned the
reliability of post epidemiological studies, be they prospective
studies, or cross-sectional studies or retrospective case-control
studies, due to the very small population of Aboriginal people
involved and the lack of any comparable population elsewhere in the
community. The McClelland commission report seems to have concluded
that these comments/analysis made in the South Australian reports
would also apply to nuclear test participants as well,
notwithstanding they are a much larger group with a comparable
population in the broader community. The McClelland commission
report was also critical of the management of the conduct of the
tests by the Atomic Weapons Tests Safety Committee (AWTSC)
claiming:
The AWTSC failed to carry out many of its tasks in
a proper manner. At times it was deceitful and allowed unsafe
firing to occur. It deviated from its charter by assuming
responsibilities which properly belonged to the Australian
government.(21)
A report was commissioned by the Australian Radiation Laboratory
(ARL) into the public health impact from fallout from British
nuclear tests in Australia.(22) This report was
originally provided to the McClelland Royal Commission of 1985, but
was not included in the report as it covered matter outside the
Commissions terms of reference. The ARL report only examined and
reported on the population not directly involved
in the test activities, that is the civilian population (including
Aboriginal people) away from the test sites. So the ARL report did
not comment on nuclear test participants or the Aboriginal people
exposed to radiation in the tests.
In the UK, two studies were conducted by the UK National
Radiological Protection Board on personnel who participated in the
British nuclear tests in Australia. The first report was issued in
1988, with a follow-up report in 1993. The 1988 report identified a
possible increased risk in test participants developing multiple
myeloma and leukaemia (other than chronic lymphatic leukaemia). As
a consequence of this report, the British Government extended their
war pensions scheme to cover British participants in the nuclear
weapons tests who had these conditions. Following the publication
of the follow-up study in 1993, the British Government tightened
its regulations, deciding to accept new claims only if leukaemia
(other than chronic lymphatic leukaemia) had developed in
participants within the first 25 years after the nuclear weapons
tests.
Studies by Sue Rabbit Roff in the
UK
More recently, an Australian-born academic working at the
University of Dundee, Sue Rabbitt Roff, conducted two studies (1997
and 1998) which focussed attention on the health of personnel who
participated in the nuclear weapons tests in
Australia.(23) The first Rabbit Roff report on mortality
of 1997 showed a significantly higher mortality rate amongst
nuclear test participants from neoplasms than for a like group in
the general population. The second Rabbitt Roff study report of
1998 found an increased incidence of some cancers in the
participant population than in the general community that warranted
further comparison and examination.
The British Government has announced that a further inquiry is
to be conducted by the National Radiological Protection Board. Also
instigated by the Sue Rabbitt-Roff study reports in 2003, the UK
government also commissioned a follow-up study on the mortality and
incidence of cancer over the period 1952-98 in men from the UK who
participated in the UK s atmospheric nuclear weapons tests and
experimental programs.(24) Generally this study found no
greater incidence of death or cancer in the nuclear test
participant population than in a like population not involved in
the tests. This is similar to the very recent Australian government
mortality and cancer incidence study results.(25)
The process by which the Government monitors the results of
studies into the impacts of the nuclear tests was outlined by Mr
Kevin Andrews, MP in an answer to a question on notice in the House
of Representatives on 15 May 2002.(26)
John Kaldor, Professor of Epidemiology at the University of New
South Wales was asked in January 1999 by the Australian Government
to review research by Sue Rabbitt Roff into the health of nuclear
veterans from the UK.(27) Her work was of interest
because many of the tests had occurred in Australia and involved
the Australian military and civilians. The terms of reference for
his review were to basically examine the findings made by Sue
Rabbitt Roff, in particular her conclusion that there was a higher
incidence of cancer and deaths amongst nuclear test participants,
and report to government. Kaldor reported back to the Government in
July 1999.(28) The major findings of his report
were:
The Rabbitt Roff studies looked at the causes of death and
self-reported health status of members of the British Nuclear Test
Veterans Association. She did not use any standard epidemiological
method for comparing the occurrence of death or illness in the
study population with a relevant unexposed population. Due to
methodological limitations the studies provide no new information
about health risks experienced by Australian participants in the UK
Tests.
Rabbitt Roff s finding concerning high levels of multiple
myeloma should be tested further by cross-matching the cases she
identified with those identified in a 1991 study by the UK National
Radiological Protection Board (NRPB).
The value of further mortality or cancer incidence studies of
Australian test participants and the combination of those studies
with the NRPB studies should be investigated.
It was largely due to the recommendations in the Kaldor report
that the Government announced a study into the mortality and cancer
incidence of nuclear test participants in 1999.(29) The
cancer incidence and mortality studies studies were released on 28
June 2006.(30) The study estimated that there are some 5
500 nuclear test participants alive today.(31)
Compensation for illness/injuries
arising out of participation in the nuclear tests
UK and Australian agreement for compensation
The UK and Australian governments signed an agreement on 11
December 1993 under which Britain agreed to pay Australia 20
million in an ex-gratia settlement of Australia s claims concerning
the British nuclear test program in Australia. Under this
agreement, the payment was to cover future claims for compensation
for participants.(32)
There have been a number of means by which those who
participated in the British atomic weapons testing program have
been able to claim compensation for any adverse health effects,
which they claim to have suffered as a result of the tests. The
Explanatory Memorandum attached to the Bill sets out in brief these
compensation arrangements.(33)
The Safety, Rehabilitation and Compensation Act 1988
(SRCA), which is administered by Comcare Australia in relation to
civilian employees of the Commonwealth and more recently by the
Department of Veterans Affairs (DVA) in relation to Australian
Defence Force personnel, has applied at all times during and since
the tests were carried out in the 1950s and 1960s. This means that
claims for compensation for illness or injuries claimed to have
been instigated by participation in the tests are covered by the
compensation arrangements in the SRCA.
The SCRA has since been replaced by the Military
Rehabilitation and Compensation Act 2004
(MRCA).(34) However, the MRCA only covers military
service personnel still in the armed services on the date the Act
received royal assent, being 27 April 2004. Military personnel no
longer in the armed services prior to that date are provided for by
the SRCA.
The Department of Education, Science and Training (DEST) and the
Australian Government Solicitor s office have also been involved in
compensation matters relating to the British atomic weapons testing
program. Claims under these arrangements involve common law
actions.
DVA and the Department of Defence have accepted 25 claims from
claimants under the SRCA for services related to nuclear tests, the
majority of which have not been related to ionising radiation but
were for other (unspecified) conditions. Nine were for the effects
of ionising radiation and they have been paid in total $1 047
781.12.(35) There was also some detail provided in an
answer to a question on notice in the Senate on 22 August
2001.(36)
The Commonwealth had a Special Administrative Scheme , which is
now closed and it provided compensation for participants in the
tests who developed multiple myeloma or leukaemia (other than
chronic lymphatic leukaemia) within 25 years of participation in
the tests.
Act of Grace Scheme
There was also an Act of Grace scheme jointly administered by
the former Department of Primary Industry and Energy and the
Attorney-General s Department. This enabled plaintiffs with common
law actions issued and served on the Commonwealth from 1988 until
September 1989 to have their cases settled outside of the court
system. This provided some redress to plaintiffs who did not have
the financial resources to pursue a common law action through the
courts.
One of the long-standing hurdles for nuclear test participants
(civilian and Defence Force) seeking compensation is that the
compensation arrangements detailed above (claims against the SRCA
and common law claims) place the burden of proof on the participant
through the legal and court system. This makes the process very
time-consuming and expensive for any individual claimant. In
contrast the Government has deep pockets to fund the defence of any
claim. The ordinary individual does not have this access, rendering
the contest and process very one-sided.
The other concerns expressed by nuclear test participants in
pursuing compensation and common law claims arising from
participation in the nuclear tests were outlined in the Clarke
Review report:
Section 7(1)(37) of the SRCA (and the
predecessor s.30 of the 1971 Act) has been applied to claims for
disease or death related to exposure to ionising radiation from the
tests only where:
it has been established that the member was at a
test site at the time of, or after, a test was carried out
there;
it has been confirmed that the member was actually
exposed to a dose of ionising radiation at the test site; and
the member has suffered from a disease that is
characteristic of exposure to ionising radiation.
The major difficulty that atomic test participants
have had in satisfying these requirements has been in providing
evidence that they were exposed to a dose of ionising radiation.
Less frequently, claims have failed because claimants were not at
the test sites at the required times (or, if documentary evidence
did not record their presence, they were not able to prove that
they were there), or because they claimed for conditions not
recognised as characteristic of exposure to ionising
radiation.(38)
The records of who participated in the tests, and those exposed
to ionising radiation (and dosage levels) have their origins in UK
Ministry of Defence records and Australian Radiation Laboratory
records. Criticisms of these records include: they are incomplete,
and do not present exposure to all radiation types.(39)
Without a record of exposure to ionising radiation, section 7(1) of
the SRCA was considered not to apply. Therefore, claimants were
forced to use the civil standards of proof under section
14(40) of the SRCA, with the onus of proof on the
claimant applying; that is it is more probable than not that the
illness/injury is related to the service. Under this test few
claimants have been able to prove exposure to ionising radiation
and, therefore, a link between that exposure and their
disease.(41)
Frustration in the lack of access to proper compensation has
been recently manifest in the considerations by the Clarke Review
into veterans entitlements which reported in January
2003.(42) The Review received some 160 submissions about
the tests, mostly from former Defence Force personnel and a small
number from civilian personnel involved in the tests. The Clarke
Review s terms of reference was to generally review outstanding
claims for veterans entitlements . However, participants in the
nuclear tests are not considered to be veterans under the
Veterans Entitlements Act 1986 (VEA). Notwithstanding
this, the Clarke Review was specifically commissioned to examine
the nuclear test participation issue.(43)
The majority of the submissions to the Clarke Review urged the
classification of nuclear test service as hazardous service , and,
therefore, covered by Part IV of the VEA. A small number of
submissions also sought classification of participation in the
tests as qualifying service for the service pension.(44)
If this latter claim was accepted it would basically allow access
to the service pension and also to the Gold Card for those aged 70
or more. This was not supported by the Clarke Review and it did not
recommend that the nuclear test participation be classified the
same as qualifying service , or war service.
Part IV of the VEA provides for the classification of
peacekeeping service for members of the Defence Force.
Classification of Hazardous Service under Part IV provides for
access to the disability pension provided under Part II of the VEA
for illnesses/injuries arising out of the service. It also allows
for access to the war widows /ers pension provided under Part II of
the VEA, to surviving partners of a person whose death is accepted
as being caused/attributed to their hazardous service. Such
classification also allows access to a health treatment card (White
Card) for the medical condition/s accepted as being
caused/attributed to the hazardous service. For those with a
significant impairment arising from the hazardous service (that is
with an impairment of 70 per cent or more), there is also access to
the Gold Card providing coverage for all medical conditions.
Hitherto, governments have considered participation in the
nuclear tests in Australia by both Defence Force personnel and
civilians as peacetime service and, therefore, to be covered by
workers and other personal liability compensation arrangements.
Governments have not been persuaded that participants are to be
provided for under the VEA.(45)
In this context, it is interesting to note that the name of the
Bill refers to nuclear test participants and not nuclear test
veterans , being the terminology that is commonly used in the
media, in studies and by commentators on this issue. The Government
is careful to refer to them as participants and not veterans , as
it may be confused with the use of the term veteran in the VEA. In
the VEA veteran refers to a service person with qualifying war
service , so not all old ex-service personal are veterans .
Notwithstanding this, in the community any old sailer, soldier or
airman is commonly called a veteran . This Bill provides for
treatment and testing separate to the VEA and re-states the
Government s view that nuclear test participants should not be
provided for under the VEA.
Recommendations by the Clarke
Review examination of compensation for nuclear test
participants
As stated above, the Clarke Review did examine the nuclear test
service and what would be appropriate assistance by government. In
short, the Clarke Review recommended the accreditation of
participation in the nuclear tests for Defence Force staff as
non-warlike hazardous service .(46) Governments have for
a long period been very reluctant to accredit peacetime military
service the same as warlike service or hazardous non-warlike
service (peacekeeping service) as defined and recognised in the
VEA. Classification of the nuclear tests participation as hazardous
peacekeeping service would allow Defence Force staff access to the
same benefits under the VEA as for Hazardous Service as covered in
Part IV of the VEA, which is described in Complaints about lack
of recognition of service by nuclear test participants
above.
Government response to the Clarke
Review recommendation about nuclear test participation
Essentially the Government rejected the Clarke Review
recommendation to accord Defence Force personnel involved in the
nuclear testing with accreditation as being involved in non-warlike
hazardous service. It didn t do this overtly, rather in a general
way stating:
The Government also had decided to respond
positively to the needs of those affected by the British Atomic
Test programme when the outcomes are available of the Australian
Participants in the British Nuclear Test Programme Cancer Incidence
and Mortality Study.
The Government will continue to provide special
recognition and comprehensive assistance to those who have served
Australia in times of war, at personal risk of injury or death from
an armed enemy.
In keeping with this approach, we have accepted
the Clarke Report s recommendation that there be no change in the
incurred danger test for Qualifying Service. However, we reject the
view that this test has been interpreted too
narrowly.(47)
There was a period from 1973 to 1986 when provisions of the then
Repatriation Act were applied to peacetime service of
members of the permanent military forces, allowing access to the
disability pension for illness and injury and the war widows
pension for loss of life under the VEA. This originally arose out
of pre-1972 election commitments made by the Whitlam Government but
this was discontinued with the passage of the VEA in 1986.
There were several submissions made to the Clarke Review to have
various forms of peacetime military service accredited as either
warlike or non-warlike hazardous service under the
VEA.(48) Some of these claims included special submarine
operations to the north and west of Australia, personnel involved
in covert intelligence gathering or covert signals operations and
also major peacetime accidents, like the Black Hawk helicopter
accident of 1996. Generally, the Clarke Review did not recommend
that peacetime service should be accredited as service under the
VEA. The exception to this was service including mine clearing,
bomb disposal and improvised explosive device clearance. The Clarke
Review did make several recommendations about recognition (at
varying levels) in the VEA.(49) Some of these
recommendations were accepted by the Government, namely some mine
clearing and bomb disposal work post World War Two (WWII) in the
South Pacific. This was provided for with the Veterans'
Entitlements (Clarke Review) Act
2004.(50)
However, this extension of access to accreditation as warlike
service for mine and bomb clearance post WWII in the South Pacific
does show that some peacetime service, which is not during a war
period, has been recognised as service for the VEA. But it should
be acknowledged that this is exceptional. Generally, governments
have not wanted to have peacetime service recognised in the VEA, as
it would then diminish the special recognition given to the special
service provided for in the VEA. This was again emphasised in the
Prime Minister s press release when announcing the Government s
responses to the Clarke Review recommendations(51)
Governments have considered that illness/injuries/death incurred
by Defence Force staff during peace time activities should be
covered by workers compensation arrangements, as applies to public
servants generally. The most recent affirmation of this was the
Military Rehabilitation and Compensation Act
2003.(52)
In releasing the nuclear test participant cancer incidence and
mortality studies, the Government announced the extension of
coverage for all testing and treatment for all cancers for the
participants. The Government announced:
"Although the study found that the rate of some
cancers among the nuclear test participants was higher than in the
general Australian population, it did not find any link between the
increase in cancer rates and exposure to radiation," Mr Billson
said.
"Despite the lack of association between cancer
rates and radiation exposure, the Government has decided that it
would be appropriate to provide health cover for nuclear test
participants who have any form of cancer."(53)
The Government has decided to provide (for participants in the
nuclear testing), coverage for testing and treatment of all
cancers. So again the Government has decided not to extend
accreditation of the nuclear test participation as hazardous
service, as recommended by the Clarke Review. This is consistent
with past actions by government to not to provide coverage under
the VEA for peace time service.
Coverage for treatment and screening is to apply from 19 June
2006, being three months prior to the date of the Government s
decision, or from up to three months prior to the date of lodgement
of a claim, whichever is the later.(54)
In announcing that the government would provide for free testing
and cancer treatment for nuclear test participants, the government
emphasised this measure was not an admission that they accepted
there was a link between increased cancer rates and exposure to
radiation.(55)
The 2006 mortality and cancer incidence study of the Australian
participants of the British nuclear tests found that the death rate
from cancer was 18 per cent higher in this group than in the
general population, and that the incidence of cancer was 23 per
cent higher than expected.(56) No link with radiation
exposure and cancer incidence or mortality was established.
However, the findings of the mortality and cancer incidence study
were challenged by veterans and others, notably because of the
exclusion from the study of test participants who died before 1982,
alleged errors in data in the original hard copy (that were
subsequently corrected in the online version) and alleged
underestimates of the levels of radiation exposure.(57)
Although radiation exposure was not implicated in these higher than
expected mortality and morbidity findings, the government;
is of the view that support is appropriate for a
group that has a clearly defined healthcare need
.(58)
Funded through DVA, this Bill provides for eligible persons to
access free cancer treatment and ongoing cancer tests, provided the
test does not replicate an existing community wide government
screening program. Testing or screening for cancer is seen to be of
benefit because it is assumed that the person tested will benefit
from early diagnosis through early access to treatment. However,
there are risks and potential harms to cancer testing. Some cancer
tests, such as the prostate specific antigen (PSA) test for
prostate cancer are not considered reliable, and can result in
further invasive and potentially damaging procedures being
undertaken. The Cancer Council has expressed particular concern
over the negative effects of unnecessary testing for prostate
cancer in asymptomatic men:
testing well men for prostate cancer exposes them
to tests that can cause harm and treatment that may not offer
long-term benefits but may leave them with side effects such as
impotence and incontinence.(59)
Therefore, the Cancer Council advises that where screening is
initiated by the health system, individuals invited to participate
should be informed, prior to any testing, of potential adverse
effects as well as the potential benefits.(60)
In Australia cancer testing for individuals is already
subsidised under pathology arrangements through Medicare, provided
the patient is referred by a registered medical practitioner and
provided the test is considered clinically relevant
(61). Most services are bulk-billed.(62) The
Health Insurance Act 1973 specifically excludes payment of
Medicare benefits for community-wide screening programs, except
where Ministerial direction allows (as in the case of the Pap test
for cervical cancer).(63)
Testing for cancers already covered by community-wide screening
programs is specifically excluded under this Bill. Community-wide
free cancer screening is provided for under the Public Health
Outcome Funding Agreements (PHOFAs) between the Commonwealth and
the States.(64) Community-wide free screening is defined
by the Cancer Council as:
the application of a test to a population which
has no overt signs or symptoms of the disease in question, to
detect unsuspected disease while a cure is still
possible.(65)
The community-wide screening programs that are currently
available are:
the Breastscreen Australia Program, which funds biennial
mammographic screening for women aged 50-69
years,(66)
the National Cervical Screening program which funds biennial pap
tests for cervical cancer for women aged 18-70,
and.(67)
the National Bowel Cancer Screening Program (NBCSP) has recently
commenced in Queensland, with other States to follow in a staged
roll-out between 2006 and June 2008.(68)
The staged rollout of the NBCSP is to allow for the States to
prepare for an expected increase in demand on publicly funded
services (such as follow-up colonoscopies in public hospitals for
un-insured patients). Initially only people turning 55 or 65 years
of age between 1 May 2006 and 30 June 2008 are being invited to
screen.(69) This means that some British nuclear test
participants will be eligible for the NBCSP and therefore
ineligible for the benefits proposed under this Bill. For example,
a nuclear test participant who was 22 in 1963, and is turning 65
this year, may be eligible for the first round of bowel caner
screening under the NBCSP, and therefore ineligible for the bowel
cancer testing provisions under this Bill. In comparison, a
colleague who was just 18 in 1963 and turns 61 this year would be
deemed ineligible for the first stage of the NBCSP (which targets
only those turning 55 or 65) but would be eligible to access bowel
cancer testing under the provisions of this Bill.
Concerns have been raised that the NBCSP may increase the burden
on public hospital services (such as increasing demand for
follow-up colonoscopies in public hospitals for un-insured
patients), and lead to delays in timely treatment.(70)
If these concerns are founded, then nuclear test participants who
are referred to undergo bowel cancer screening through the NBSCP
(especially those who are uninsured) may face delays in accessing
treatment. Such delays are unlikely to be experienced by those
nuclear test participants who are ineligible for NBSCP but eligible
for bowel cancer tests under the provisions of this Bill, because
the tests and subsequent treatment (including in private
facilities) will be funded by DVA. To address this potential
discrepancy in equitable access to treatment services, the
definition of testing in s 4(1) could be amended so that the
requirement that testing which replicates an existing community
wide government screening program is not included, is removed.
The Explanatory Memorandum estimates the financial
impact of the Bill to the Commonwealth at $15.8 million over
four years.(71) However, estimating the cost of cancer
testing and treatment is complex, because treatment regimes often
involve a mix of surgery, chemotherapy, radiotherapy, and in
future, possibly gene therapy.(72) The direct cost of
cancer is lower to the health system than for many other diseases,
including circulatory, respiratory, digestive, mental and
musculoskeletal diseases. The total cost of cancer to the
government in 1993-94 was around $2 billion, or just 6 per cent of
total recurrent health expenditure.(73) Most estimates
of the cost of cancer treatment relate mainly to inpatient costs,
that is, treatment in hospital, which in a public setting are
largely borne by State/territory governments. However, it has been
noted that there has been a trend away from inpatient treatment
toward community-based care for cancer, an area where the
Commonwealth meets most of the cost.(74)
Item 4 in Part 1 sets out the definitions that
are used in the Bill.
Item 5 sets out who is to be regarded as a
nuclear test participant for the Bill and also the areas to be
regarded as nuclear test areas.
Item 7 sets out who is eligible for treatment
under the Bill. Essentially the person needs to be a nuclear test
participant as set out in Item 5 in Part 1 and an Australian
resident. A person is not entitled to treatment if eligible for
treatment coverage under the VEA or the SRCA, or the Administrative
Scheme set up by the Commonwealth government to provide for nuclear
test veterans. Item 10 provides that it is to be
the Commission who can determine claims refers to the Repatriation
Commission as set out in section 179 of the VEA see Item 4
in Part 1 of the Bill.
Item 12 empowers the Commission to approve
treatment. Item 13 allows the retrospective
approval of treatment for up to 3 months prior to a claim for
treatment approval. Item 14 removes from the
Commission the obligation to provide treatment or the right to
access to treatment for an individual other than that approved by
the Commission under the Bill.
Item 16 empowers the Commission to set out in
writing the treatment principles that are to apply under this Bill
and that they are binding on the Commission. Item
16 also empowers the Commission itself to modify the
treatment principles without amendment to the Bill in the
Parliament. Any modifications to the treatment principles have to
be approved by the Minister in writing. Such an approval is a
legislative instrument.(75)
Like Item 16, Item 17 empowers the Commission
to set out in writing the principles for private patient treatment
and also for the Commission to change these principles without
having to amend the Bill in the Parliament. Any modifications to
the treatment principles have to be approved by the Minister in
writing. Such an approval is a legislative
instrument.(76)
Item 18 empowers the Commission to set out an
approved pharmaceutical scheme and to modify such a scheme after
approval in writing by the Minister. Such an approval is a
legislative instrument.(77)
Item 19 sets out the power for the Commission
to provide for travelling expenses to access treatment provided
under the Bill and Item 20 allows for the advances
of treatment expenses. Item 21 requires a claim to
be made for the provision of treatment expenses and Item
23 empowers the Commission to determine travel expenses
claims.
Division 1 in Part 4 empowers the Commission to
review its own decisions made under the Bill.
Division 2 in Part 4 empowers the AAT to review
decisions made by the Commission under the Bill. This means if a
person is not satisfied with a decision by the Commission or a
review of a decision by the Commission they can appeal to the
AAT.
Item 30 prescribes that the Commission has
responsibility for the application of the Bill subject to the
control of the Minister.
Division 2 in Part 5 of the Bill contains the
normal and usual information access and information obtaining
powers for a department, or agency required to process claims.
These powers only extend to that which is necessary for the
determination of the claim.
Item 37 contains standard offence provisions
attached to legislation governing the lodgement of claims for
assistance and knowingly providing false or misleading information.
Items 38 to 44 provide provisions to ensure that
there is no misuse of powers and practices associated with
servicing under the Bill by medical practitioners or medical
service providers.
Division 4 provides items in the Bill to allow
the recovery of amounts obtained by way of false or misleading
statements. Item 44 provides for the recovery of
amounts overpaid under this Bill from ongoing payments provided
under the Bill.
Concluding comments
The history of claims about adverse health reactions and deaths
suffered by nuclear test participants goes back many years, far
longer than the first studies and reports undertaken in Australia
that commenced in the early 1980s. There are several reasons for
this. First, many of the participants themselves consider, in
retrospect, that they were exposed to hazardous radiation during
the tests, especially given what is now known about the dangers of
radiation. Secondly, the participants have continuously reported
incidences of illness and death that they consider are abnormal and
therefore are associated with the tests. Acceptance of their claims
for compensation by governments and relevant authorities of their
claims for compensation has largely not been realised as been
exacerbated by several studies and reports claiming there is no
higher incidence of illness in the participant population than in a
like population in the broader community.
Governments have consistently said that the redress for nuclear
test participants is available through claims for workers
compensation under normal workers compensation arrangements.
However, for many, this is a prohibitively costly, time consuming
and exhausting process, where the government choses to contest a
claim. The low number of successful claims made against the
government via the workers compensation route has been a source of
frustration to affected nuclear test participants.
In effect, this Bill does little to address the long-standing
issues of recognition and compensation for the ill effects claimed
to have been suffered by the nuclear test participants but does
provide assistance in identifying cancers and for treating
cancers.
- The Hon. John Clarke QC, Report of the Review of Veterans
Entitlements, January 2003, Canberra, Chapter 16, Table 16.1,
p. 373. http://www.veteransreview.gov.au/index.htm
- Dosimetry is an estimate of the dosage level of radiation
received, Australian participants in British nuclear tests in
Australia, Dosimetry Study report,
Repatriation Commission, Department of Veterans Affairs, Canberra,
May 2006, Chapter 7, pp. 101-103.
http://www.dva.gov.au/media/publicat/2006/nuclear_test/dosimetry/
- ibid., Table 1.1, p. 3.
- Explanatory Memorandum, pp. 1 3.
- J R McClelland, Report of the Royal Commission into British
Nuclear Tests in Australia, Canberra, November 1985,
Chapter 10 The Minor Trials, pp. 395 415.
- Australian participants in British nuclear tests in Australia,
Dosimetry Study report, op. cit., pp. 6 7.
- ibid., pp 6 7, 28.
- Australian participants in British nuclear tests in Australia,
Mortality and cancer incidence study, Repatriation
Commission, Department of Veterans Affairs, Canberra, May 2006, pp.
118 124.
http://www.dva.gov.au/media/publicat/2006/nuclear_test/mortality_and_cancer_incidence/
- Aiden Windle, Every cloud had a plutionium lining ,
Melbourne Age 9 October 2002.
- The Hon. Mr Bruce Scott, MP, Minister for Veterans Affairs and
Minister Assisting the Minister for Defence, Nominal Roll
Completed for Atomic Test Studies, Media Release, Canberra, 29
June 2001.
- Australian participants in British nuclear tests in Australia,
Mortality and cancer incidence study, op. cit., pp 124
127.
- Australian Ionising Radiation Advisory Council, Report to the
Minister for Science and the Environment, AIRAC Report No.
9, Canberra, January 1983.
- ibid. p. 19.
- The Department of Health, Survey of Atomic Personnel,
The Donovan Report, Canberra, 1983.
- Professor C. B. Kerr (Chairman), Report of the expert
committee on the review of data on atmospheric fallout arising from
British nuclear tests in Australia,
Atmospheric Fallout Committee, Canberra, 31 May 1984.
- ibid. pp. 34 35.
- ibid. p. 33.
- Professor, A M Clark, Australian Ionising Radiation Advisory
Council, Response to the Kerr Report, Letter to the Hon.
Barry Cohen, MP, Minister for Home Affairs and Environment,
Canberra, 13 August 1984.
- J R McClelland, Report of the Royal Commission into British
Nuclear Tests in Australia, op. cit.
- ibid., p. 609.
- ibid., 12.10.102.
- K N Wise, J R Moroney, Australian Radiation Laboratory,
Public health impact from fallout from British nuclear weapons
in Australia, Department of Health, Housing
and Community Services, Canberra May 1992.
- S Rabbitt Roff, Mortality profile from a pre-defined sample
of death certificates of veterans of UK nuclear weapons tests,
Dundee University Medical School, October 1997 and S Rabbitt Roff,
Report on morbidity study of the British nuclear tests veterans
association and the New Zealand nuclear tests veterans association
and their families, Dundee University Medical School, April,
1998.
- Berridge, M A English, N Hunter and G M Kendall C R Muirhead, D
Bingham, R G E Haylock, J A O'Hagan, A A Goodill, G L C, Follow up
study of the mortality and incidence of cancer 1952 98 in men from
the UK who participated in the UK s atmospheric nuclear weapons
tests and experimental programs , UK National Radiological
Protection Board, March 2003.
http://www.hpa.org.uk/hpa/news/nrpb_archive/press_releases/2003/press_release_03_03.htm
- Australian participants in British nuclear tests in Australia,
Mortality and cancer incidence study, Repatriation
Commission, Department of Veterans Affairs, Canberra, op. cit.
- Mr Kevin Andrews, MP, answer to a question on notice,
No. 68, House of Representatives Hansard, 15 May 2002, pg. 2294.
http://www.aph.gov.au/hansard/reps/dailys/dr150502.pdf
Veterans: British Nuclear Tests (Question No. 68)
Mr Murphy asked the Minister representing the Minister for
Health and Ageing, upon notice, on 13 February 2002:
Further to part (2) of the answer by the former Minister for
Veterans Affairs to question No. 2548 (Hansard, 6 August
2001, page 29189), has the Australian Radiation Protection and
Nuclear Safety Agency obtained international research regarding the
possible effects of exposure to ionising radiation and made this
information available to those affected by the British nuclear
tests; if not, why not.
Mr Andrews The Minister for Health and Ageing has provided the
following answer to the honourable member s question:
The Australian Radiation Protection and Nuclear Safety Agency
(ARPANSA) continually monitors international research and
publications on the effects to humans of exposure to ionizing
radiation. There have been no significant changes to the
understanding of these effects since 1986 when a detailed review of
the survivors of the atomic weapons tests in Japan was undertaken.
The most recent review of the available research on the effects of
ionizing radiation on humans is presented in detail in the United
Nations Scientific Committee on the Effects of Atomic Radiation,
UNSCEAR 2000 Report to the General Assembly, with Scientific
Annexes. ARPANSA generally does not have direct contact with those
who participated in British nuclear tests in Australia, as this is
the responsibility of the Department of Veterans Affairs. ARPANSA
provides information regarding ionizing radiation effects to the
Department of Veterans Affairs through participation on
inter-departmental committees and through direct contact with
officers of the Department.
- The Hon. Mr Bruce Scott, MP, Minister for Veterans Affairs and
Minister assisting the Minister for Defence, Government acts on
nuclear review, Media Release, Canberra, 16 July 1999.
- Professor John Kaldor, Report to the Minister assisting the
Minister for Defence on recent studies of nuclear test veterans
, University of New South Wales, July 1999.
- The Hon. Mr Bruce Scott, MP, Minister for Minister for
Veterans' Affairs and Minister Assisting the Minister for Defence,
Government acts on nuclear review , Media Release,
Canberra, 16 July 1999:
GOVERNMENT ACTS ON NUCLEAR REVIEW
Work will begin immediately on assessing the impact of the UK
nuclear tests on the health of Australian participants. The
Minister for Veterans Affairs and Minister Assisting the Minister
for Defence, Bruce Scott, today announced the Government would
compile a nominal roll, and conduct mortality and cancer incidence
studies, of Australians involved in the UK nuclear tests, following
receipt yesterday of a review by Professor John Kaldor of the
University of NSW.
In January 1999, the Minister asked Professor Kaldor to review
the work of Dundee University researcher, Ms Sue Rabbitt-Roff, on
the health of UK nuclear participants, and to assess implications
for Australians involved in the tests in the 1950 s and 1960 s.
Governments have acted too slowly on this issue in the past and I
am committed to getting on with addressing the issues raised in
Professor Kaldor s review, Mr Scott said. The review indicates that
the Rabbitt-Roff research from the University of Dundee in 1997 and
1998 has substantial limitations.
Mr Scott said the nominal roll would include all service
personnel involved in the testing, and any civilians involved
including aborigines and pastoralists, for whom information is
available. The mortality and cancer incidence studies, both based
on the names on the nominal roll, will enable the Government to
determine if current compensation and assessment arrangements are
sufficient.
Mr Scott said he would also establish a scientific contact point
to gather international research on exposure to ionising radiation,
which would be made available to participants in the testing. The
Minister assured all participants in the testing program that their
health was of primary concern to the Government. The Government
extended the initial deadline for the review, at Professor Kaldor s
request, to enable him to comprehensively address the review s
terms of reference, Mr Scott said. Professor Kaldor is a world
recognised epidemiologist whose careful attention to detail is
reflected in the high quality of this report. This public report
should reassure all participants in the testing program that the
Government is acting on their long standing concerns about the
effect of the tests. Mr Scott said.
- The Hon. Mr Bruce Billson, MP, Minister for Minister for
Veterans' Affairs and Minister Assisting the Minister for Defence,
Australian Participants in British nuclear tests in
Australia the full study , op. cit.
- The Hon. Mr Bruce Billson, MP, Minister for Minister for
Veterans' Affairs and Minister Assisting the Minister for Defence,
Nuclear Test Participants To Receive Additional Health
Care, Medial Release,
Parliament House, Canberra, 28 June 2006. http://minister.dva.gov.au/media_releases/2006/06_june/va058.htm
- Senator the Hon. Nick Minchin, Minister for Industry, Science
and Resources, Answer to a Question on Notice, Question
No. 3865, Senate Hansard, 27 September 2001, pp. 28303 28305.
http://www.aph.gov.au/hansard/senate/dailys/ds270901.pdf
(2) Was there a contribution from the British Government for
this compensation; if so, how much; if not, was the British
Government asked to make a contribution; if not, why not.
Yes, the Australian and British Governments signed an agreement
on 11 December 1993 under which Britain agreed to pay Australia 20
million in an ex gratia settlement of Australia s claims concerning
the British nuclear test program in Australia.
- Explanatory Memorandum, p. iii.
- Jennifer Nicholson, Military Rehabilitation and Compensation
Bill 2003, Bills Digest No. 112 2003 04, Parliamentary
Library, Canberra, 25 March 2005. http://www.aph.gov.au/library/pubs/bd/2003
04/04bd112.pdf
- Senator the Hon. Ian Campbell, Answer to Question on
Notice, Question No. 1130, Senate Hansard, 27 March 2006, pp.
186 187. http://www.aph.gov.au/hansard/senate/dailys/ds270306.pdf
The Department of Veterans Affairs and the Department of Defence
have accepted 25 claims from claimants for services related to
nuclear tests, the majority of which have not been related to
ionising radiation but were for other conditions. Nine (9) were for
the effects of ionising radiation and they have been paid in total
$1 047 781.12.
- Senator the Hon. Nick Minchin, Minister for Industry, Science
and Resources, Answer to a Question on Notice, Question
No. 3625, Senate Hansard, 22 August 2001, pp. 26428 26431. http://www.aph.gov.au/hansard/senate/dailys/ds220801.pdf
(1) Compensation has been paid to claimants under:
the Special Administrative
Scheme and the Act of Grace Scheme administered by the Department
of Industry, Science and Resources;
as result of a successful
common law action;
under the Safety,
Rehabilitation and Compensation Act 1988 administered by COMCARE;
and
the Military Compensation
and Rehabilitation Service (MCRS) which assumed responsibility for
claims by ex-service personnel in July 1991 from COMCARE.
The breakdown for each category is as follows:
(a) 9 payments have been made to Australian servicemen (a
further 7 cases are still under consideration);
(b) 5 payments have been made to indigenous people;
(c) 3 payments have been made to civilians;
(d) no payments have been made to pastoralists;
(e) 10 payments have been made to families of the deceased
(excludes 3 payments to families in category (b));
(f) the health disorders for which payments have been made
include malignant neoplasms and skin conditions such as
psoriasis.
(g) 1981 (1), 1989 (6), 1990 (6), 1991 (1), 1992 (2), 1993 (1),
1994 (2), 1996 (2), 1998 (1), 2000 (2) and 2001 (3).
(h) The average compensation payout has been $126,561.
(2) Australian servicemen 342 (This figure includes some cases
where the Commonwealth has accepted liability for conditions
arising from a member s service but where no compensation has been
paid.)
Indigenous people 14
Civilians 11
(3) Common Law Actions
Since the conclusion of the British Nuclear Testing Program, at
least 79 common law actions against the Commonwealth have been
instituted by ex-servicemen, other former Commonwealth employees
and employees of Commonwealth contractors. Many of the cases before
the courts have either been discontinued or withdrawn. Four cases
have been heard by the court.
- SAFETY, REHABILITATION AND COMPENSATION ACT 1988
SECT 7 Provisions relating to diseases
(1) Where:
(a) an
employee has suffered, or is suffering, from a
disease or the death of an
employee results from a
disease;
(b) the
disease is of a kind specified by the Minister by notice in
writing as a
disease related to employment of a kind specified in the
notice; and
(c) the
employee was, at any time before symptoms of the
disease first became apparent, engaged by the
Commonwealth or a
licensed corporation in employment of that kind;
the employment in which the
employee was so engaged shall, for the purposes of this
Act, be taken to have contributed in a material degree to the
contraction of the
disease, unless the contrary is established.
- The Hon. John Clarke QC, Report of the Review of Veterans
Entitlements, January 2003, op. cit. p377.
- The Hon. John Clarke QC, Report of the Review of Veterans
Entitlements, January 2003, op. cit. p378.
- SAFETY, REHABILITATION AND COMPENSATION ACT 1988
SECT 14 Compensation for injuries
(1) Subject to this Part,
Comcare is liable to pay compensation in accordance with
this
Act in respect of an
injury suffered by an
employee if the
injury results in death, incapacity for work, or
impairment.
(2) Compensation is not payable in respect of an
injury that is intentionally self-inflicted.
(3) Compensation is not payable in respect of an
injury that is caused by the serious and wilful misconduct of
the
employee but is not intentionally self-inflicted, unless the
injury results in death, or serious and
permanent
impairment.
- The Hon. John Clarke QC, Report of the Review of Veterans
Entitlements, January 2003, op. cit., p. 378.
- The Hon. John Clarke QC, Report of the Review of Veterans
Entitlements, January 2003, op. cit.
- The Hon. John Clarke QC, Report of the Review of Veterans
Entitlements, January 2003, op. cit., p. 371.
- ibid., p. 371.
- Senator the Hon. Nick Minchin, Minister for Industry, Science
and Resources, Answer to a Question on Notice, Question
No. 3625, op.cit.
(13) (b) No disability pension paid by DVA would be paid for
illnesses relating to atomic testing. Atomic testing is not service
covered by the Veterans Entitlements Act 1986. Therefore, all
pensions paid by DVA are for conditions arising from service other
than atomic testing.
- The Hon. John Clarke QC, Report of the Review of Veterans
Entitlements, January 2003, op. cit., p. 399.
- The Hon. John Howard, MP, (Prime Minister), Additional
benefits for veterans, government response to the Clarke
Report, Media Release, Parliament House, Canberra, 2 March
2004, http://www.pm.gov.au/news/media_releases/media_Release724.html
- The Hon. John Clarke QC, Report of the Review of Veterans
Entitlements, January 2003, op. cit., Chapter 14, Part II, pp.
342 354.
- The Hon. John Clarke QC, Report of the Review of Veterans
Entitlements, January 2003, op. cit., Chapter 14, Part II, pp.
346 351.
- Peter Yeend, Veterans Entitlements (Clarke Review) Bill 2004,
Bills Digest No. 134 2003 04, Parliamentary Library,
Canberra, 28 May 2004. http://www.aph.gov.au/library/pubs/bd/2003
04/04bd134.pdf
- The Hon. John Howard, MP, (Prime Minister), Additional
benefits for veterans, government response to the
Clarke Report, op. cit.
- Jennifer Nicholson, Military Rehabilitation and Compensation
Bill 2003, Bills Digest No. 112 2003 04, op. cit.
- The Hon. Mr Bruce Billson, MP, Minister for Minister for
Veterans' Affairs and Minister Assisting the Minister for Defence,
Nuclear Test Participants To Receive Additional Health
Care, op. cit.
- Explanatory Memorandum, p. iii.
- The Hon. Mr Bruce Billson, MP, Minister for Minister for
Veterans' Affairs and Minister Assisting the Minister for Defence,
Nuclear Test Participants To Receive Additional Health
Care, op. cit.
- Australian participants in British nuclear tests in Australia,
Mortality and cancer incidence study, op. cit., p. v.
- Maralinga report excludes pre-1982 mortalities Australasian
Science, August 2006, p. 10. Dr Sue Wareham; Paul Malone
N-test report errors corrected secretly Canberra
Times, 14 September 2006, p. 10. Paul Malone
Maralinga veterans still await justice Canberra Times 16
September, 2006.
- The Hon. Mr B Billson, MP, Minister for Veterans Affairs and
Minister Assisting the Minister for Defence, Australian
Participants in British Nuclear Tests (Treatment) Bill 2006, Second
Reading Speech, House of Representatives Hansard,
14 September, 2006, p. 7. http://www.aph.gov.au/hansard/reps/dailys/dr140906.pdf
- Cancer Council of NSW, Prostate cancer screening ,
Information sheet, http://www.cancercouncil.com.au/editorial.asp?pageid=358.
- The Cancer Council Australia, National cancer prevention
policy 2004, p. 88. National
cancer prevention policy 2004 06
- Department of Health and Ageing, Medicare Benefits Schedule
Book, November 2005, p. 3.
A clinically relevant service is a service rendered by a medical
or dental practitioner or an optometrist that is generally accepted
in the medical, dental or optometric profession (as the case may
be) as being necessary for the appropriate treatment of the patient
to whom it is rendered.
- The bulk billing rate for pathology tests for the financial
year 2005 06 was 85.7%, according to the Medicare statistics.
- Department of Health and Ageing, Medicare Benefits Schedule
Book, November 2005, op. cit., p 565.
- These are 5 year bilateral agreements which provide broad
banded and specific purpose funding from the Australian Government
to the States and Territories for a range of public health
programs, including for cancer screening. The current agreements
cover the period 2004 05 to 2008 09. For more details see the
Department s website,
http://www.health.gov.au/internet/wcms/publishing.nsf/Content/health-pubhlth-about-phofa-phofa.htm
- The Cancer Council Australia, op. cit, p. 86.
- BreastScreen Australia offers free breast screening every two
years to women aged from 50 to 69. Women from 40 to 49 and women 70
and over can also have a free breast screen. It's not available to
women under 40. See website
cancerscreening.gov.au
- Cervical cancer screening is provided largely through
mainstream health services with GPs performing the majority of Pap
smears (although States and Territories provide significant funding
as well). See website
cancerscreening.gov.au
- The National Bowel Cancer Screening program is being phased in
over a number of years, commencing in 2006, but is not specifically
covered by the PHOFAs.
- The Hon. Mr Tony Abbott, MP, Minister for Health and Ageing,
Bowel cancer screening starts this week , Media Release,
Canberra, 7 August 2006.
http://www.health.gov.au/internet/ministers/publishing.nsf/Content/health-mediarel-yr2006
ta-abb113.htm?OpenDocument&yr=2006&mth=8
- Lynette Hoffman, Screen test , Weekend Australian, 10
June 2006, p. 28.
- Explanatory Memorandum, p. ii.
- Optimising cancer care in Australia: a
consultative report, Clinical Oncological Society of
Australia, The Cancer Council of Australia and the National Cancer
Control Initiative, Carlton, Vic., 2003, p. 6.
- ibid, p 8. These estimates are the most recent available.
- ibid.
- Moira Coombs, Acts Interpretation Amendment (Legislative
Instruments) Bill 2005, Bills Digest No. 11 2005 06,
Parliamentary Library, Canberra, 8 August 2005. http://www.aph.gov.au/library/pubs/bd/2005
06/06bd011.pdf
- ibid.
- ibid.
Peter Yeend and Amanda Biggs
Social Policy Section
9 October 2006
Bills Digest Service
Parliamentary Library
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