Summary of findings and recommendations
The Committee finds:
Australia's veterans remain concerned at the
unknown long term effects of exposure to hazardous material during deployments
Some veterans are therefore concerned at their
continuing ineligibility to obtain either health care for disabilities in
question, or compensation.
With respect to exposure to radiation in Japan
and during the atomic tests in Australia in the 1950's, successive Australian
governments have been reluctant to accept any but a few downstream health
problems due to lack of sufficient medical scientific evidence on cause and
effect, and the unavailability of exposure data.
Despite the broad and generous application of
the benefit of the doubt in Australia, policy with respect to scientific
evidence on cause and effect is stricter than in the USA and New Zealand where
a presumptive policy has been more readily applied.
Australian veterans would like more use to be
made of the presumptive policy as contained in Section 180 of the Veterans
Australias restricted use of presumptive policy
and the concentration on medical scientific research remains appropriate.
recommends that the current restricted use of presumptive policy and the
concentration on medical scientific research continue.
Research by successive Australian governments
into the long term effects of
exposures to various substances decade
may have been inadequate until the last decade, but reflected the state of
research internationally, and the long gestation time of many disabilities,
Australian governments in the last decade have
been much more active in collecting baseline health data through surveys of
various veteran populations, with the result that veterans can feel more
assured that their concerns are not being ignored.
recommends that this type of data collection become an integral part of ADF and
DVA assessment of deployed personnel, so that basic information is available
for researchers on health status at return from deployment.
Recent mortality studies of Korean and Vietnam
veterans have reinforced the views of veterans that their service has seriously
affected their health, and reduced
The long term separation of medical research
management between the Departments of Veterans' Affairs and the Department of
Defence has hindered a more holistic consideration of veterans' concerns.
Current institutional changes, as evidenced by
the creation of the Centre for Veterans
and Military Health, link the research capacity of DVA and Defence. This is
a positive move which will lead to better prioritisation and bring greater
focus to the need for better medical scientific knowledge.
The international effort now being made in
establishing the aetiology of illness and disease is such that veterans can
have greater assurance that the shortcomings of medical science in the past
will be more readily eliminated.
recommends that DVA and Defence ensure veterans are kept up to date about
research on key issues and how these may have led to amendments in previous
Current claims assessment
The Committee finds that:
Despite veterans' concerns, the current process
of claiming disability pension is working well, and that the current policy
with respect to application of the benefit of the doubt, and the reliance on
medical science as determined by the RMA, remain appropriate.
While access to service and medical records by
veteran claimants is generally satisfactory, the state of those records in
recent years has declined so [to] such a state that claimants can have little
confidence as to their accuracy or completeness.
In respect of recent
deployments, the ADF ensure that a report on all likely exposures, records of
potentially traumatising events, and statements as to injury and illness be
available for all personnel. Updates should also be provided; and
In respect of earlier
deployments, DVA continue with its practice of reconstruction of evidence,
ensuring that all appropriate methodologies are utilised including those from
Access to some records where held by foreign
governments in cases of attachment to allied forces, is highly unsatisfactory.
With respect to future
deployments, a protocol be established to ensure complete and accurate copies
of medical records are provided; and
With respect to
relevant past deployments, DVA establish the location of medical data and
records and identify the most effective way of obtaining copies of these.
Veterans' views, that access to information is
difficult, are reasonable. The RMA website in particular is not readily
recommends that the ADF and DVA work together to ensure that all relevant
information, including that on illness, research and the impact of legislative
change, is provided in a straightforward style and a userfriendly format. In
particular, information provided on RMA Statements of Principle (SOPs) should
use everyday terminology and provide links to specific SOPs.
Defence Health Administration
The Committee finds that:
Administration of health in the ADF has long
been plagued by shortage of skilled and qualified staff in a labour market
suffering continual shortages.
Administration of health in Defence, once
divided between the services, has undergone considerable rationalisation and
that efforts are continuing to achieve more effective and streamlined services.
Considerable scope remains to further
rationalise the coordination of medical research and service provision to all
serving and ex service personnel receiving services from both the Department of
Veterans' Affairs and the Department of Defence.
The Committee recommends that the Links Program continue in order to
ensure effective rationalisation of service provision and co-ordination of
medical research by the ADF and DVA.
Planning for deployments both with respect to
environmental hazards and exposure to all other risk to the health and safety
of ADF personnel has dramatically improved, though records of that preparation
and actual experience during deployment needs to be better communicated made
more available post deployment.
recommends that detailed briefings on health issues be provided as much as
possible in advance of deployment and that this information also be available
in written format, for use on deployment and also for files. Updates must be
communicated as soon as possible and centrally stored on computer based
information systems as accessed by the ex service community.
Information on personal health protection and
treatment services, including vaccination regimes, needs to be better
communicated to all personnel deployed.
recommends that a more effective electronic system of current health status be
developed, allowing health service personnel to determine needs quickly
pre-deployment and also providing opportunity for individuals to check their
records and ensure these are accurate and complete.
Pre deployment health checks for personnel
have improved, but more attention could be given to psychological briefing,
preparation and assessment prior to embarkation.
recommends that all briefings and assessments on potential deployment psychological
issues must be developed or cleared by a psychiatrist with relevant experience.
post deployment health checks, debriefing and assessment need to be given
continued emphasis, with record keeping of those assessments being given
recommends that priority be given to ensuring that accurate records are
maintained of all post deployment briefings, checks and assessments, and that
individuals be able to access these records.
Defence is committed to improving the health
status and recording of data on personnel to be deployed.
The Committee notes and
commends the improvements made in health status and data collection of
deployable forces, and recommends that this continue to be a priority.
There is confusion within Defence ranks and
among personnel with respect to the appropriate status and classification of
medical personnel, and at the continuity of care available throughout any
recommends that terminology be clarified to ensure personnel are aware of the
status of medical officers and medical personnel. Information on the level
of medical officers on deployment should be part of predeployment briefings.
Records of medical services provided by other forces must include information
on the treating doctors so that any required follow up can be facilitated.
The Committee finds that while some aspects of
the anthrax vaccination issue were exaggerated, the lack of pre-deployment
information coordination demonstrated flaws in the deployment preparation
process and in information co-ordination more generally.
recommends that all information in manuals be checked against other data
provided to ensure consistency.
The Committee finds that the importance of
OH&S policy and administration is receiving more priority within Defence,
but that a significant level of concern remains at the promulgation of those
policies, the lack of accountability, and the need for incentives to do
The Committee finds that Defence is aware of the
particular health needs of women, but it should demonstrate this by identifying
the effect of policy and program changes on womens health status on an annual
Maintenance of health records for serving
personnel in recent years has become chaotic due to incomplete information and
Committee recommends that personnel be made fully aware of potential problems
with their health records and provided with the opportunity to obtain a copy of
these well before discharge with a view to identifying and rectifying
recommends that some form of electronic copy be made of health records of
current personnel, both to facilitate their access to services if required and
also to supplement HealthKEYS when this becomes operative. A copy of such
information should also be held by Defence with ready access by DVA if
The Committee finds that:
DVA has become much more proactive in its
research and more aware of the importance of obtaining as much data as possible
rather than waiting for veterans to identify needs later.
There has been improved rationalisation of
research projects because of effective liaison between relevant agencies.
Recent efforts have been excellent, though more
needs to be done in communicating processes and outcomes to the veteran and ex
service community. The Committee has made a recommendation above in respect of improved
information access on research and other issues.
Priorities for research need to be considered
consultatively with the ex service community leadership.
Mental health projects should continue to
receive priority, including, where appropriate, specific projects on problems
arising from peacekeeping and peacemaking.
Senator Steve Hutchins