Chapter Four considers the rehabilitation process of Australian Defence
Force (ADF) members who receive wounds and injuries while on operations. It
also addresses broader Department of Defence (Defence) health care
responsibilities, and the various rehabilitation and support programs available
to assist members in their recuperation.
Rehabilitation and recovery
Professor Peter Leahy AC highlighted to the Committee that:
For most Australians, Afghanistan is a long, long way away. We
acknowledge the sacrifice of those who die, but I am not sure that we know just
what is happening to those who come home wounded or, indeed, those who just
come home and it has been pretty tough for them.
Defence advised the Committee that within five to ten days of returning
to Australia, a wounded or injured member is placed in the ADF rehabilitation
program to manage all their health and rehabilitation requirements. The ADF
rehabilitation program aims to:
n reduce the impact of
injury or illness through early clinical intervention;
n reduce any
psychological effects of the injury;
n return the member to
suitable work at the earliest possible time; and
n provide a
professionally managed rehabilitation plan tailored to individual needs.
Defence health care responsibilities
Defence submitted that whilst the health and welfare of members is a
command responsibility, which ultimately rests with the Chief of each Service
regardless of where the ADF member may be posted, the Surgeon General
Australian Defence Force/Commander Joint Health is responsible for the
technical control of ADF health services. This includes all personnel involved
in the provision of health care (which includes psychology services) within the
ADF, the provision of specialist health advice, development of policy on health
issues and delivery of all garrison health care.
Joint Health Command is responsible for the Defence health care system
which is designed to prevent and minimise the impact of operational,
environmental and occupational health threats and to treat ill, wounded and
injured members. As previously noted, the provision of health care to ADF
personnel does not start when an individual is wounded or injured and the
Defence health care system provides a continuum of care from enlistment through
to transition from the ADF and during all phases of an operation.
Components of this health care system include all routine and emergency
health care within Australia, health promotion activities, pre-deployment
fitness assessments, first aid and advanced first aid training for non-health
personnel, operational health support in theatre, a tiered medical evacuation
system and post deployment assessment and care, physical and occupational
rehabilitation and mental health support.
Defence submitted that Joint Health Command provides the standard of
health care required in order to ensure the operational readiness of the ADF,
and enable all personnel to perform their military duties. Defence has a
commitment to managing the health consequences of operational service as well
as providing health treatment to wounded and injured personnel.
Defence advised that Joint Health Command is required to provide to
members of the Permanent Forces such health care as is deemed necessary to
detect, cure, remove, prevent or reduce the likelihood of disease or infirmity
which affects, or is likely to affect:
n The efficiency of the
member in the performance of their duties; or
n Endangers the health
of any other member; or
n Assists to
rehabilitate the member for civilian life; and
n Restores the member,
so far as is practicable, to optimal health in the ADF context.
Garrison health care
Defence’s submission states that Joint Health Command is responsible for
the ongoing health care of all ADF personnel when they are not operationally
deployed. This includes specific health care needs such as routine health
care, regular health checks, comprehensive vaccination programs, pre- and
post-deployment screening, and health care to manage the physical, mental and
social wellbeing of the fighting force to ensure they remain ‘fit to fight’.
Joint Health Command staff also maintains strong communication pathways with
units and Commanders to ensure that the welfare and health needs of individuals
are coordinated, comprehensive and well managed.
This suite of preventative and primary health care is delivered through
five Regional Health Services across Australia. Each Regional Health Service
has a number of Health Centres and Clinics which deliver healthcare and support
to ADF personnel and Commanders to ensure continued operational capacity and
capability of ADF personnel. Current health services delivered include primary
health care, preventive health care, diagnostic testing, pharmaceutical supply,
physiotherapy services, dental services, mental health and psychology services,
access to specialist medical care, access to tertiary level inpatient services
within the civilian local hospital/healthcare network, and rehabilitation
services including specialised case management. Joint Health Command services
are delivered by a wide range of practitioners including:
n Uniformed doctors,
nurses, dentists, medics and allied health professionals from all three
n Australian Public
Service health practitioners within health centres and clinics;
n Contracted health
providers who assist in the provision of many clinical roles;
n Reserve health
practitioners who provide clinical services and specialist care; and
n Civilian specialist
health providers who provide advice and support to Joint Health Command practitioners
while also providing specialist health care for ADF personnel.
Rear Admiral (RADM) Robyn Walker AM, Commander Joint Health Command
advised the Committee that on-base garrison health care services transitioned to
the new service provider beginning in November 2012. She advised that the five
service arrangements have transitioned successfully and that she was unaware of
any ADF member who has not received health care for an urgent medical
Defence went on to advise the Committee that they are confident that:
n All garrisons have
access to the required level of health services both on-base and off-base; and
n Sufficient levels of
outsourced arrangements are in place to ensure that ADF personnel continue to
receive timely and clinically appropriate care within their locale.
Defence acknowledged that throughout the contract term there will be workforce
pressures for the on-base services due to critical workforce levels in the health
industry, especially in remote localities and areas of need. The current percentage
of positions filled is approximately 93 per cent nationally. Defence submitted
that they and Medibank Health Solutions (MHS) continue to work together to
ensure sufficient fill rates for on-base personnel are achieved across the
garrison environment; and that ADF personnel continue to receive timely access
to high quality health care.
Defence submitted that it is confident that ADF personnel have continued
to receive timely, clinically appropriate care within their locale during the
transition to the new off-base services arrangements. Whilst there were
initial concerns regarding the sufficiency of the off-base service provider
numbers, Defence and MHS claim to have worked through these concerns to ensure
appropriate access for the ADF.
Defence said that MHS continue to monitor, review and grow the off-base
service provider list and will do so through the life of the contract to ensure
appropriate, timely access is available to the ADF; and also ensure that it is
aligned with Defence’s changing healthcare needs. Defence advised the
Committee that they will continue to work with MHS throughout the contract term
to ensure ADF personnel have access to appropriate care through the off-base
service provider arrangements.
Defence went on to advise that they undertook a customer satisfaction
survey from 1 August to 31 October 2012 which was intended to provide a
baseline of customer satisfaction prior to entering into the ADF Health Service
Contract. The next iteration of the survey is scheduled to commence in
September 2013. The final report of the survey is still pending however the
following data was provided. Of the 5,341 customers of ADF health services who
provided a valid survey response about their visit:
n 82.8 per cent were
seen within 30 minutes of their scheduled appointment;
n 34.6 per cent were
able to get an appointment in less than one week;
n 23.4 per cent took
more than three weeks to get a non-urgent medical appointment;
n 74.2 per cent agreed
that access to the health service they required was available in a reasonable
n 73.3 per cent
indicated that they were satisfied or very satisfied with the health service
n 64.0 per cent agreed
or strongly agreed that the overall quality of the health service they received
Mr Brian Freeman, the Director of Centori Pty Ltd, advised the
Committee, however, that that ‘nearly all’ the hundreds of wounded and injured
soldiers who have visited the Mates4Mates Family Recovery Centre say that the
time it takes to get an appointment with the Defence system for treatment – ‘mental,
and even sometimes physical’ – is too prolonged.
At least one submitter felt that doctors and physiotherapists are
dangerously underqualified, do not care about the injuries of soldiers, and
have a total lack of professionalism. There were also reports
of substantial wait times:
With the processes that we have and the waiting times for
medical stuff, it was probably four to five months before I could get an MRI.
Then it was another month before I could see the specialist again, and then I
had to see another doctor. … The MRI would have been at least a year after the
initial injury, if not longer.
It was not until late 2010 that I could not handle anything
anymore. I went into the RAP in Townsville and saw the doctor to see if he
could point me in the right direction to start getting fixed up. He told me I
had poor abdominal strength and I needed to work on my core strength. He
booked me in for an X-ray, but nothing was followed up.
At the moment we are having a bit of trouble because it takes
so long to see a doctor and some of us have quite bad injuries.
Defence Families of Australia (DFA) highlighted the importance of
provision being made for members to obtain independent medical assessments from
specialists of their own choosing.
RADM Walker was aware that there were still some transition issues in
that the on-base workforce, particularly in Townsville and Darwin, were still
not meeting the Key Performance Indicators (KPI) that Defence had stipulated in
the contract. She advised that Defence is working with the contractors to
address those issues. RADM Walker stressed that health care is being delivered
in a timely fashion for people who need urgent health care.
Defence submitted that for on-base non-urgent medical appointments, of a
total 51 facilities, 80 per cent had improved or not changed waiting times
following the new contract. For non-urgent on-base mental health appointments,
85 per cent of 40 facilities were improved or unchanged; for non-urgent
psychology appointments, 79 per cent of 43 were improved or unchanged;
non-urgent physiotherapy appointments, 80 per cent of 40; and likewise for
non-urgent on-base dental appointments.
In terms of off-base waiting times, Defence advised that when referring
an ADF member to an external specialist, the referring health practitioner is
required to identify the referral priority (Routine, Clinically Urgent or
Operationally Urgent) and the Service Delivery Priority (Priority 1: Less than
7 days, Priority 2: 7 to 28 days and Priority 3: Greater than 28 days). The
Central Appointments Team then books specialist appointments in accordance with
the referral and service delivery priority identified by the referring health
practitioner. Defence advised that the average national wait time for an
appointment with the following medical specialists booked through the Central
Appointments Team is:
n Orthopaedic Surgeon -
16 days (business days);
n Dermatologist - 22
n General Surgeon - 17
- 18 days; and
Neck surgeon - 22 days.
Defence went on to advise that Joint Health Command does not provide
health support in the operational setting. This is the domain of the single
Services, however, Joint Health Command supports the generation of ADF
operational capability. Joint Health Command provides ADF health personnel
with access to training which ensures that they can deliver health care while
in the field, air and at sea during operational and training activities or when
in the garrison health facilities. This training covers a number of areas
including combat first aid, care of battle casualties, emergency/trauma care
and mental health care and support.
Commander Joint Health, in her role as Surgeon General of the ADF, also
has technical responsibility for health care in the deployed environment, and
exercises this responsibility through the development of policy and doctrine,
and management of operational health capability requirements. This work is
undertaken with input from the single Services.
In response to a question on the implications of Defence budgetary reductions,
RADM Walker said:
There are no treatment services that are not provided on the
basis of any budgetary restrictions. We have never refused anyone treatment.
Likewise, Major General (MAJGEN) Angus Campbell DSC AM, Deputy Chief of
Army, said to the Committee:
The Chief of Army’s very clear. We will support operations
and we will support our wounded.
Finally, Defence advised that they are responsible for the health care
of serving members and the provision of all ancillary support services
resulting from a health issue. The Department of Veterans’ Affairs (DVA) will
provide compensation and other support for a work related wound, injury or
illness but not health care or rehabilitation until the agreed point of
transition from the ADF.
Reservists serving on Continuous Full Time Service (CTFS) are provided
with the same level of health services as Permanent Force members. When
wounded, injured or suffering an illness resulting from Defence service, health
care for that injury or illness will be continued after the Reservist ceases to
be on continuous full time service and resumes part-time service.
Reservists serving on other than CFTS contracts receive health care for
injury or illness resulting from their Defence service until the transfer of
the member into the military compensation system, administered by the DVA, is
DVA advised that a significant sub-group of those with operational
service include reservists, with active reservists numbering 21,554 as at May
2011. Twelve per cent of this group had undertaken continuous full time
service in the 12 months to May 2011, with a median period of service of 140
days. Sixty per cent had undertaken continuous defence service of five or more
consecutive days in the same period, with a median period of service of 28
The Returned and Services League of Australia (RSL) South Australia Branch
submitted concerns about the issues confronted by Reservists who, after
decompression (the term for a programed period where members who have returned
from operations de-stress in a controlled environment) immediately return to
civilian work and tend to be forgotten by the ADF.
Likewise Associate Professor Susan Neuhaus CSC expressed concern about the
psychological effects of service on Reservists because the visibility of that
group diminishes as they leave service and moved back into the civilian
One Reservist submitted that they are treated as second class citizens
when health issues arise months or years after returning from operations. They
argued that in the case of psychological trauma or other injuries, which often
take some time to manifest, the ADF wants ‘no part’ of the rehabilitation
process except to possibly downgrade the member’s medical classification and ‘show
them the door’.
It was submitted that greater support must be given to Reservists following
their return to Australia, particularly those who have deployed individually,
without the support of a unit. RADM Walker responded:
We have some concerns about reservists…. If you are a
reservist and you have gone back into your civilian occupation … it is … about
identifying those people and how they access all the support mechanisms that
are there. So, we are continuing to look at the reservist population.
The Committee also notes that many Defence civilians deploy as reservists
and return to work within Defence as veterans, resulting in special management
issues. The Committee heard of one instance where ‘poor and totally
inappropriate people management practises’ were displayed while dealing with a
reservist’s operationally caused post-traumatic stress disorder (PTSD).
Defence submitted that there are three complementary programs for the
recovery and rehabilitation of ADF personnel and each has a different purpose
and scope depending on the clinical, vocational and psycho-social needs of each
individual. These are described below.
ADF Rehabilitation Program
The ADF Rehabilitation Program is delivered by the Garrison Health
Organisation and provides an occupational rehabilitation service. This
includes the coordination of care through Comcare approved rehabilitation
consultants, who are the conduit of information between other support Services,
Command, medical and the member.
In addition, the ADF Rehabilitation Program provides rehabilitation
assessments, rehabilitation programs and specialist assessments such as home,
workplace, daily living activities, functional capacity and vocational
assessments. This program also provides for non-clinical aids and appliances.
Paralympics Sports Program
The Paralympics Sports Program, through an established relationship with
the Australian Paralympic Committee, supports all serving ADF members with
acquired disabilities to adopt an active lifestyle, regain their physical
fitness and participate in adaptive sport right through to elite Paralympic
Simpson Assist Program
Joint Health Command identified a rehabilitation capability gap relating
to the overall clinical services for severely injured members and support to
their families which resulted in the development of the Simpson Assistance
Program. The program will deliver new recovery and rehabilitation services by
developing a tailored, integrated and multidisciplinary approach to accelerated
rehabilitation for seriously wounded, injured and ill members. Simpson
Assistance Program initiatives will contribute to rehabilitation excellence
through a focus on:
n a new Intensive
Recovery Program to be trialled in Townsville and Holsworthy in 2013;
n new holistic
psychosocial member and family support services;
n improved clinical
n provision of
meaningful engagement options to Defence members on rehabilitation;
n improved coordination
of services (case coordination as well as a member’s healthcare needs
research investment funding; and
n an ADF Rehabilitation
Strategy and improved governance and reporting.
Intensive Recovery Program
The Intensive Recovery Program is the major clinical effort within the
Simpson Assistance Program. The Intensive Recovery Program aims to fill the
void between the specialist rehabilitation services available through
public/private partners and the general restorative therapies available through
The Intensive Recovery Program commenced in February 2013 and is
intended to develop a specialist and highly experienced rehabilitation team,
and the required equipment and supporting facilities, to provide
individually-tailored recovery programs to members with complex circumstances.
The team will also provide a specialist advisory and assessment service within
the region and nationally. Following a scoping phase, the Intensive Recovery
Program will be piloted over 18 months, in Lavarack Barracks (Townsville) and
at Holsworthy Barracks (Sydney).
Support for Wounded, Injured or Ill Program
In late 2010, a review of practices to support personnel moving to
civilian life found that, while the system supporting these personnel was
generally good, it was inherently complex and improvements could be made. The
aim of the review was to support the development of a seamless and integrated
support process for injured or ill ADF personnel.
An analysis and identification of gaps in the support to ADF wounded,
injured or ill personnel resulted in DVA jointly implementing the Support for
Wounded, Injured or Ill Program (SWIIP) which is designed to take what is
generally acknowledged as a good system and make it better.
SWIIP aims to ensure the focus is on the member and their family, that
complexity involved in obtaining support is reduced, and that any gaps in
support are closed. The ADF aims to provide
coordinated, transparent and seamless support to individuals during their
service and after transition including by:
n Enhancing support for
personnel with complex or serious medical conditions who are transitioning to
n Improving information
sharing between DVA and Defence relating to injury or illness;
n Simplifying processes
involved in applying for an acceptance of liability for compensation; and
n Streamlining and
simplifying compensation claims handling.
RSL Victoria submitted that while SWIIP is a very good model, it appears
that the partnership between Defence and DVA has ‘some way to go’ to ensuring the
program is delivering best practice service. Similarly, RSL National
Headquarters believes that, whilst there have been significant improvements in
the management of ADF personnel wounded and injured on operations, they
submitted that there were still ‘many areas’ which were problematical and needed
to be addressed.
Army – Support to Wounded, Injured and Ill
Army – Support to Wounded, Injured and Ill Program (A-SWIIP) facilitates
the effective management of seriously wounded, injured and ill Army personnel.
Defence submitted that responding to the needs of a seriously wounded,
injured or ill member and their family necessitates the coordinated and
focussed efforts of the chain of command and supporting agencies to ensure that
every member returned to the workplace after an injury or illness contributes
to ongoing capability.
The framework of A-SWIIP is intended to ensure that Commanders are able
to mobilise and coordinate all the resources required to support their wounded,
injured or ill soldiers. Commanders appoint a Unit Welfare Officer as the
soldier’s primary contact to access local services and oversee the Welfare
Welfare Boards with multidisciplinary representation are conducted
regularly to track progress, coordinate support and identify any issues to be
Army Member Support Coordinators are regional subject matter experts on
casualty management. They provide the member and unit an established point of
contact to assist with provision of aids for independent living, access to
compensation forms and assistance in meeting travel and accommodation
The A-SWIIP framework functions to manage seriously wounded, injured or
ill soldiers requiring convalescence, hospitalisation and/or significant
assistance with activities of daily living.
The three broad levels of management are:
n normal medical
management – applies where no medical employment classification (MEC)
action is required and supported by usual command arrangements;
rehabilitation – applies to members who are classified as ‘MEC 3’ for periods
up to 12 months and managed via Unit Welfare Boards; and
rehabilitation – applies to members with severe wounds, injury or illness and
is managed via Individual Welfare Boards.
Extended rehabilitation is a two year program designed to provide time
in which to evaluate the member’s ability to be retained in their previous
trade, retrained or transitioned. Options exist for a further three year
extended transition period focused on vocational/civil employment skills and
education. This phase prepares the member for separation from Army.
Navy SWIIP initiatives
Navy has stood up similar processes to Army including Member Support
Coordination officers. During the initial phase of the wounded or injured
member’s treatment a medical employment classification determination is made
and this is the authority to administratively post the member to the nearest
Navy Personnel Support Unit. Defence advised that currently, the Member
Support Coordination officers will be the liaison between the medical facility
and Command. The Commanding Officer of the Navy establishment in which the Personnel
Support Unit is located has the ultimate responsibility for the health and
welfare of the member under their command.
The Member Support Coordination officers will continue in the liaison
role between the appointed Joint Health Command Rehabilitation Consultant and
the Personnel Support Unit once the member has been discharged from hospital
and commences rehabilitation. The Member Support Coordination officers
coordinate with the member, the member’s next of kin and the Rehabilitation
Consultant to ensure all non-health agency or other authorities’ actions are
coordinated to align with the healthcare of the member. The Member Support Coordination
officers will ensure that the member or their representative is visited by DVA On
Base Advisory Service (OBAS) personnel for the processing of DVA compensation
claims. The Member Support Coordination officers ensure that the member’s care
and rehabilitation is raised for discussion at the member’s parent unit Command
Focus Group. On behalf of Command, the Member Support Coordination officers
ensure that periodic case conferences are convened to track the progress of
their care and have the member, their representative and other key stakeholders
agree to treatment/rehabilitation course of action.
If the member’s medical condition indicates that a return to work in
their current or alternative employment is likely, a return to work strategy is
planned at one or a series of Case Conferences by the Rehabilitation
Consultant, the Member Support Coordination officers and the Personnel Support
Unit Case Officer. In addition to the active clinical rehabilitation of the Navy
member, the Rehabilitation Consultant, the Member Support Coordination officers
and the Personnel Support Unit Case Officer ensure that the member has ‘meaningful
engagement’ during periods when they are not undergoing actual rehabilitation
If the member will not be able to return to work in the Navy, a
transition timeframe is developed to ensure a strict succession of actions are
implemented to ensure the smooth transition of the member. These are
coordinated by the Member Support Coordination officers with oversight from the
Personnel Support Unit Case Officer. These actions include, but are not
limited to resettlement counselling and liaison.
Air Force SWIIP initiatives
Air Force intends to establish a Member Support Coordination Office
incorporating the existing Compensation Claims Liaison Officer-AF. It will encompass
both compensation claims support and the Member Support Coordinator function. The
Member Support Coordination Office will assist commanders with the effective
management of members with complex health circumstances and link into the Soldier
Recovery Centres where required. This will ensure that all relevant support
services are in place for the member. The dual role of the Member Support
Coordination Office will also ensure that these members will receive
appropriate and prompt compensation assistance.
Air Force is also in the process of establishing Individual Welfare
Boards for individual case management of Air Force people. These Boards will
be conducted at unit level and will allow a member’s commander to consider all
aspects of a member’s health and wellbeing so that appropriate action is taken
to ensure the best outcome for the individual.
Physical rehabilitation and medical treatment
The Committee heard that, generally speaking, the military view physical
wounds and certainly combat related injuries as ‘a badge of honour’.
Of more concern to the Committee is how members who are wounded or injured
convalesce and recover. The Committee heard evidence that the opinion of the
standard of medical support provided by the ADF can vary from individual to
individual. The RSL believes that the overall treatment and support of ADF
personnel wounded and injured on operations is managed well by the ADF.
Some individuals reported very positive experiences to the Committee.
Others, however, felt their career management and treatment has been appalling
Unless you are missing a limb — something which they can
physically see — you are in the back corner.
Additionally, evidence provided to the Committee suggested that some
members are bastardised, receive threats and are accused of malingering while
undergoing rehabilitation and discharge. The Committee heard that in some
instances the way that injured soldiers are treated is ‘truly disgusting’; and
that the system is ‘broken with rampant and unchecked corruption’.
Associate Professor Malcolm Hopwood, Clinical Director of Austin Health’s
Psychological Trauma Recovery Service (PTRS) told the Committee that he considers
it desirable that individuals who have both physical and mental health
difficulties receive integrated physical and mental health care. He gave
evidence that rehabilitation care for physical health can be integrated well
with mental health care. Go2 Human Performance
also highlighted the importance of an ‘integrative’ approach to rehabilitation.
Having interacted with a great number of wounded and injured soldiers
while providing adventure training, Mr Freeman ventured the opinion that a great many veterans with physical wounds also have mental wounds to some
Every Wednesday morning we have sessions with our adventure
conditioner. Most of the soldiers in there are suffering from post-traumatic
stress, diagnosed or undiagnosed.
The Vietnam Veterans’ Association of Australia submitted that, while
expanding the availability of dedicated repatriation-specific hospitals and
convalescent facilities is not justifiable, the high standard of care set by
these types of facilities should be mandated in caring for wounded and injured
Soldier On submitted that the bulk of the rehabilitation equipment used
by recuperating wounded and injured within private hospitals is generally
supplied and supported by the hospital or, in many instances, has been bought
through private fundraising. Organisations such as Soldier On work to
fundraise and provide additional specialised rehabilitation equipment to
private hospitals. Professor Leahy told
the Committee that Soldier on are investigating putting similar machines in
troop concentration areas around Australia.
Sergeant (Sgt) Craig Hansen from 7th Battalion the Royal Australian
Regiment told the Committee that the Defence Housing Authority had become very
responsive to the needs of wounded and injured members.
The Committee heard some evidence that individuals with real physical
injuries are sometimes suspected of malingering, or at least of deliberately
letting their mates down. One soldier reported that he was treated like an
outcast because he was incapable of doing his job and was rubbished and
ostracised by the hierarchy within the unit and treated poorly, he said, mainly out of ignorance. The Committee heard that the attitude within that
particular unit had, however, been dealt with.
There is a stigma in the Army if you are broken: you are a
malingerer. It just keeps going. It is more of an old-school thing.
Mr Rod Martin, the Director of Go2 Human Performance, told the Committee
that lower back pain and neck pain were the most common presentations to their clinic.
He attributed this to the weight of the helmets worn, and equipment carried, by
soldiers on operations. Indeed, the Committee
heard from several witnesses regarding the weight of equipment that was
required to carried:
I weighed my kit over there — body armour, weapon, and
carrying all the equipment stuff that went in for all that. It weighed 51
kilos, which is more than half my body weight, and we did 15- to 20-kilometre
patrols with that.
The Committee heard also, however, that equipment is being continually
improved and lightened, and that by 2012 body armour and operational specific
equipment ‘changes were quite significant, and they had come a long, long way’
and that while body armour was always going to be relatively heavy, the fit of
body armour had been greatly improved.
One soldier suggested using ‘quad bikes’, or at least smaller tactical
vehicles, to carry heavier equipment. The Committee decided
that this was beyond the scope of the terms of reference of the Inquiry (as
with the issue of Army’s decision to remove berets as standard headwear).
The Committee heard that ‘blast gauges’ had been issued to soldiers to record
blast and shock waves and Mr Simon Bloomer, Executive Officer of Carry On
(Victoria) said that it was a significant step forward.
The Committee believe that for the most part there is a general acceptance
of legitimate physical and the need for appropriate rehabilitation within the
ADF. One soldier commented that:
I have not really experienced any sort of stigmatising
because of my injuries. There is always the odd bloke having a joke, ‘Ya ‘lingerer!’
or whatever else. There is always going to be a bit of that, but generally,
throughout, I feel everyone has been supportive, from the rank onwards. They
acknowledge that I have an injury and that that injury needs time and effort to
be rehabilitated to whatever standard I can get it to.
The Committee is concerned, however, about the general state of garrison
health support, particularly given the reports of time taken to receive
non-urgent treatment, not just for members wounded or injured on operations,
but for all ADF members.
The Committee recommends that
the Department of Defence annually publish detailed written assessments of
garrison health care contractor key performance indicator statistics. The
Committee further recommends that the written assessments include the results
of an ongoing survey of Australian Defence Force personnel regarding their
experiences with the performance of garrison health care contractors.
The Committee notes that Defence is aware of the issue of access to
support mechanisms for Reservist post deployment and is nonetheless concerned
that Reservist support needs are not being met.
The Committee recommends that
the Department of Defence address the shortcomings in Reservist
post-deployment support mechanisms identified in this Inquiry as a priority.