Warren Snowdon (Lingiari, Australian Labor Party, Minister for Defence Science and Personnel) Share this | Link to this | Hansard source

On 15 June 2012 I requested that the Joint Standing Committee on Foreign Affairs, Defence and Trade inquire into and report on the care of ADF personnel wounded and injured on operations. On Monday, 24 June 2013 the committee tabled its report. I would like to take this opportunity to thank the committee for the report, which makes 25 recommendations for the Department of Defence and the Department of Veterans' Affairs. I have asked both departments, as I am sure you would understand, to examine closely the report in order for the government to provide a full and considered response.

I should point out that both departments are committed to improving our understanding of the needs of veterans and their families and providing them with the highest quality service and support. I know this report will be a valuable contribution for us in continuing to develop our understanding of their experience and for both Defence and DVA in identifying any barriers to their receiving appropriate support, particularly after their military service as clients of the Department of Veterans' Affairs. The recommendations for DVA broadly address issues such as veterans' mental health, transition from Defence, and accessing DVA care and support.

As part of the committee's inquiry both DVA and Defence lodged submissions and presented before the committee. The submission lodged by DVA focused on five key issues: understanding the characteristics of those wounded or injured in operations; a more flexible, simple and comprehensive process for recognising service related injury; working closely with the ADF on services and the transition of personnel to civilian life; effective ongoing care and support after discharge; and readiness for the future. I should say that DVA has a strong and I believe proud history of supporting those men and women who have suffered and have offered service to our nation and the families that have made sacrifices to support them.

DVA's submission to the committee provided information on a number of initiatives aimed specifically at providing care and support to those wounded or injured on operations since 1999. Over the course of the department's 94 years of operation it has developed considerable knowledge and skills in understanding the risks and effects arising from the unique and demanding nature of military service. As such, DVA is transforming its service delivery models to meet the emerging and ever-changing needs of the contemporary cohort of veterans and their families.

I think it is important that we emphasise that immediate help is available for eligible veterans, including those currently serving with operational service such as in Afghanistan or Iraq, to access mental health treatment without the need to lodge a compensation claim. For eligible veterans with diagnosed post-traumatic stress disorder, other anxiety or depression, DVA will pay for immediate treatment. This access to immediate treatment for mental health concerns is separate to applying for compensation.

I welcome the committee's acknowledgement that, for the most part, the care provided to Australia's wounded and injured is world-class, particularly in the immediate aftermath of a battlefield incident. The committee states:

The Departments of Defence and Veterans’ Affairs have honoured their responsibilities to support the recovery and rehabilitation of these individuals and their families and, through various programs, continue to improve veteran support processes and coordination.

Unfortunately—

as referred to in chapter 6 of the report—

some veterans still ‘fall through the cracks’. This has to end.

I acknowledge that there is still more work for both the Department of Defence and the Department of Veterans' Affairs in this space to enhance the support they provide to our wounded and injured personnel. However, I think it is important to recognise that there is significant effort already underway in both departments to respond to the needs of these personnel. For instance, one recent initiative between DVA and Defence is the establishment of the ADF servicewomen's steering committee comprising current serving and former female ADF members, including reservists.

DVA also appreciates there are concerns for some veterans transitioning from Defence and the nature of the claims process. Both DVA and Defence have in recent years focused on improving transition of veterans from the ADF to DVA care. I must say that this is an issue which I have been driving very hard since I was first put into the DVA portfolio. Having been the Minister for Defence Science and Personnel, it occurred to me then as it does now that there is greater capacity for these two agencies to work more closely together to look after the needs of serving veterans. DVA will continue to work closely with Defence towards a seamless transition and to streamline the claims process—a process which, I know, is being taken on board by both agencies as a key component of what they are about.

Most of the report was focused on research. DVA is committed to a strong research program. Much of the report also focused on research, and I have commented on that. A new strategic research program will strengthen research relationships through collaboration with other research bodies and organisations, including Defence, and ensure that research is focused on the department's priorities. This will involve, importantly, developing relationships with the Defence Science and Technology Organisation, the key scientific adviser to the Department of Defence, for which I am also responsible.

Defence stands by its commitment to ensure ADF personnel always receive higher quality care, and the contact with Medibank Health Solutions underpins this commitment. Defence is holding MHS accountable for effective service delivery by closely monitoring performance against the contracted obligations and agreed performance indicators. This is a matter which is close to the front of my mind because I regularly visit the Defence facilities and have cause for discussions both with Defence health personnel and with service personnel, and we talk candidly about the access they have or do not have, depending on where they are, to appropriate health care services.

DVA and Defence are cooperating extensively and DVA is working with the ADF to make the process of discharge from the military into civilian life as smooth as possible, including for those personnel who have sustained wounds or injuries from their service. Both departments have recently renewed their commitment to supporting the ADF community with a signing of a memorandum of understanding. This MOU is for the cooperative delivery of care and support to eligible persons. The Support to Wounded, Injured or Ill Program, SWIIP, was established as a joint Defence and Veterans' Affairs undertaking that aims to provide coordinated, transparent and seamless support to individuals during their service and after transition from the ADF, including by enhancing support for personnel with complex or serious medical conditions who are transitioning to civilian life; improving information sharing between DVA and Defence relating to injury or illness; and streamlining and simplifying compensation claims handling. There are other initiatives which we have in play to assist those wounded and injured in operations, the first of which is soldier recovery centres. Soldiers wounded or injured are also already seeking care and services at soldier recovery centres on bases in Townsville and Darwin, with a third on its way in Brisbane. These centres provide a dedicated health precinct to those members to rehabilitate, recover and return to their duties.

A division having been called in the House of Representatives—

Sitting suspended from 12:34 to 13:03

Before the suspension I was talking about the further initiatives to assist those wounded and injured on operations. I recognise the time for the debate has expired. I was going to talk about the veterans mental health budget package of $26.4 million in the 2013-14 budget and I was also going to talk to you about the mental health strategy and the review of military compensation arrangements, so this is in response to the review of military compensation arrangements. The Veterans' Affairs Legislation Amendment (Military Compensation Review and Other Measures) Bill 2013 was introduced into the parliament on 20 March 2013. We are hopeful it will pass through the Senate this week.

Gai Brodtmann (Canberra, Australian Labor Party) Share this | Link to this | Hansard source

It gives me great satisfaction to have taken part in this inquiry on the care of ADF personnel wounded and injured on operations. It is a very comprehensive report. It is the result of hours and hours of discussion and hearings with people from all over Australia—with families, with vets, with public servants and with serving soldiers. It is a very comprehensive body of work and it has been a great pleasure to take part in this very comprehensive review. It is impossible to exaggerate what we owe to our service personnel. In thanking them for their efforts and showing our gratitude for the work they do in securing our nation and preserving the democracy here, we have to ensure that we provide the highest standard of care for both those who are currently in service and veterans.

The report covers a broad range of areas. As I said, it is a comprehensive body of work and it covers a broad range of areas. They range from the immediate action following an injury; aeromedical evacuation, which focuses on some of the activities that we are getting involved in in Afghanistan; rehabilitation and support following physical injury; mental health concerns; return from operations; and post-service issues, including Veterans' Affairs and veterans' support structures.

The report also highlights a number of gaps. Previous speakers have mentioned those gaps, or those areas where things are falling through the cracks—as one of the chapters is called—and areas where there can be improvement, and also areas of excellence. With the areas of excellence, the report underlines the fact that we are working very well in the aeromedical evacuation space. However, there are areas of concern and they include garrison health support, female veterans' mental health, improving communications between Defence and DVA in the management of post-service transition, continuing problems—despite improvements—in the nature of services provided by DVA, and the continued need to improve cultural understanding and empathy. That is particularly important.

In terms of progress in relation to areas of concern, there has been a strong recognition—as we have heard from Minister Snowdon—of the need to support those with mental health issues. Baby steps have been taken to make improvements in terms of streamlining the Veterans' Affairs-Defence processes and streamlining the information on injured soldiers. All the matters that are covered in this report are incredibly important. We have seen evidence of terrible hardship and unhappiness among our service people, as a result of their treatment. They have fallen through the gaps in this process, despite the best efforts of the ADF and DVA.

I want to focus on four areas where we can improve. The first concerns female veterans. As the report notes, the committee was very concerned about the issues raised in the June 2012 report Thehealth and wellbeing of female Vietnam and contemporary veterans. One of our recommendations is that the government implement, as a priority, the recommendations of that report, which was prepared by Dr Samantha Crompvoets. The recommendations in that report are to, as an overview:

We found these recommendations to be consistent with our recommendations, but I would like to stress that the care of female veterans does require a special effort. Hence the Crompvoets recommendation that there be targeted support, and resourcing is particularly important.

The other area that the report touches on is the cultural issues in mental health. I have personally been made aware of problems faced by service personnel in coming to terms with their incapacity, particularly in cases of post-traumatic stress disorder and other mental illness. Despite efforts, this is in part caused by the continuing culture of stigmatisation and shame in the ADF. As stated in the report, we were impressed by the work that General Cantwell and organisations such as Soldier On and Young Diggers are doing in terms of changing this culture. It is an area where ADF and the department do need to continue to focus their efforts. Despite the fact that there are a number of programs in place, there is still the issue of stigmatisation and shame and, as a result of that, individuals and returning soldiers are ignoring the signs of mental health issues and other injuries.

The report also focuses on the need for early recognition of mental health problems, because they do take time to be identified and diagnosed. Usually it is the families—the wives, the girlfriends, the children, the partners—who are on the frontline of those issues and who bear the brunt of them even before diagnosis. My father-in-law did two tours of Vietnam and my mother-in-law always said that the man who returned was very different to the man she married. Since Vietnam the issue of PTSD has become an increasing area of focus and attention, but now that we are aware of its symptoms and how it can emerge through alcoholism, domestic violence, depression and other mechanisms there can no longer be any excuses for us not knowing or treating it appropriately.

The report also highlights the post-service life adjustment and how hard it is for a wounded or injured soldier to adjust from being a highly skilled member of a professional force—a warrior, so to speak—to a seemingly constrained civilian. The inquiry has grappled with this issue. We have highlighted the need for greater continuity in the transition from Defence to Veterans' Affairs and we have recommended expediting or streamlining information technology connectivity and a unique service veteran health ID number. That is extremely important and it is a theme that ran through a number of the presentations in the hearings. DVA still faces dissatisfaction from the veteran community, although we found the department is doing much to improve client service, particularly in having a single point of contact for case management, moving to a single electronic claim process, and free treatment for PTSD, depression and anxiety. We have recommended that the department try to be less prescriptive, as well as monitoring its performance through periodic publication of claim processing times and claim success rates. This will need constant attention, but I hope the work of the committee will help to bring about improvements and make for better lives for our service people and their families after suffering physical or mental injury.

I am very proud to be associated with this report. I know everyone on the committee has had discussions with returning soldiers who have been injured or are suffering mental health issues. It is good to have all this consolidated in one report and to take a comprehensive and forensic approach to reviewing the existing treatment to highlight the gaps and then to work out how to make improvements. It is a report that brings together a very great number of issues and makes a serious attempt to find solutions. I would like to commend the Chair of the Defence Sub-Committee, Senator Mark Furner, for his great contribution, and the secretariat for their invaluable work.

Debate adjourned.

Sitting suspended from 13:14 to 16:00