Amanda Rishworth (Kingston, Australian Labor Party, Shadow Minister for Veterans' Affairs) Share this | Link to this | Hansard source

I rise today to speak on the Treatment Benefits (Special Access) Bill 2019 and the Treatment Benefits (Special Access) (Consequential Amendments and Transitional Provisions) Bill 2019. These bills end a hard-fought campaign for recognition of the service rendered by the Australian civilian surgical and medical teams as part of Australia's contribution to the Southeast Asia Treaty Organization aid program in South Vietnam between 1964 and 1972.

This campaign has been run by a variety of ex-service organisations, but I predominantly give recognition to the Vietnam Veterans Association of Australia, along with the Australian civilian medical and surgical teams and the Australian Nursing and Midwifery Federation. These groups have been advocating for recognition for 20 years, seeking greater assistance for the individuals in the teams affected. I would like to congratulate all those tireless advocates who have fought long and hard. It is because of your hard work that the government has finally listened to these calls and is extending health coverage for those who served.

Approximately 240 doctors, 210 nurses and a small number of technical and administrative staff went to Vietnam to provide general surgical and medical services for the South Vietnamese population, to teach—mainly by example—new surgical techniques and procedures, and to establish goodwill and trust as part of the Australian civilian surgical and medical team group. Twenty-two teams were sent over from more than 13 Australian metropolitan hospitals to work in South Vietnam's provincial hospitals. The first team, with staff from the Royal Melbourne Hospital, arrived in October 1964 and was stationed at Long Xuyen in the Mekong Delta. The Australian teams developed a close working relationship with the local hospitals which lasted for some years.

Dot Angell, a nurse and a staunch advocate for recognition of civilian nurses, served at Bien Hoa Provincial Hospital from December 1966 to March 1967. She described herself as a 'free-spirited 20-something, headed for an adventure', when detailing her experience to the Australian Nursing and Midwifery Federation. The nurses and doctors worked day and night to treat patients, with some of the teams working in dangerous proximity to the fighting.

The SEATO teams were required to attend not only attend to Vietnamese citizens but also South Vietnamese local forces and wounded Vietcong and NVA troops. Dot recalled working around the clock to treat many patients caught in the crossfire of war, noting:

We treated anybody who came through the gates at the hospital, whether they were friend or foe. We were dealing with war injuries. We were dealing with traffic accidents because Bien Hoa was a refugee town and packed to capacity. We also dealt with illnesses, some of which we had never seen before, such as plague, typhoid, and cholera.

Another nurse, Janet Glasson, recalled in an interview with The Sydney Morning Herald her time in a ramshackle hospital in the province. She was 24 and could remember vividly the night the Vietcong Tet Offensive started. She was due to clock off from her shift when a surge of wounded people came flooding through the door. She said:

It was horrendous. They arrived however they could, in bus-loads or in rickshaws. You just worked as long as you were able, trying to help. Some of the wounds were terrible, but it was surprising how few we lost. It was all so heartbreaking. Especially with the orphans who came in.

In her time at the hospital, she and her fellow nurses would work in shifts as long as 32 hours straight, not just looking after patients but also preparing to defend the hospital and its patients if they came under attack. Their hospital had no base close by and, as such, the civilian surgical and medical teams had been issued with weapons and trained how to use them.

Speaking of her time at the hospital, Glasson commented on the sheer numbers of patients they had, with often two or three sharing a bed and others lying on the floors, with temporary emergency rooms set up for the overflow. In addition, they would experience blackouts, which would leave them holding torches for surgeons as they operated. Said Glasson:

But, at the time, you just got on with it. You didn't have time to think or process what was happening. You are there to do your job, to help people, and that's what you do.

These nurses and doctors performed invaluable service to our country and to those they helped in Vietnam. For many, they returned home, returned to their lives and continued working as they had before. However, the experiences and the trauma they had witnessed stayed with many. It was decades later that Dot Angel, while undertaking a PhD, interviewed a handful of civilian nurses who had also served in Vietnam and realised that many of them were experiencing similar issues to veterans who had served in Vietnam. These included post-traumatic stress and other anxiety disorders, autoimmune disease, non-Hodgkin's lymphoma, cancers and other immune system disorders.

However, because they were employed by the Department of External Affairs it was argued that these individuals should receive compensation and treatment for their medical related injuries due to their employment through the Safety, Rehabilitation and Compensation Act, administered by Comcare. While they've been able to access treatment through this model, advocates have argued that this scheme is not as comprehensive as the scheme available to veterans, particularly in relation to mental health conditions. Consequently, advocates have been fighting for 50 years for the circumstances of these nurses, doctors and civilians to be recognised.

Over this time, there have been a number of reviews. In 1999 the review of service entitlement abnormalities by Justice Robert Mohr made a recommendation that the Australian civilian surgical team service should be deemed as performing qualifying service for repatriation benefits. This was the only recommendation that the government of the time did not implement from the report. In 2003, the Clarke review concluded that the civilian surgical medical teams were part of the civilian aid efforts in South Vietnam, not the military effort, and, as such, recommended against the extension of VEA coverage to members of their teams.

The crux of the issue around extending full health coverage to these teams has come down to the manner of their employment in Vietnam, and not their duties. As they were civilians employed through the Department of External Affairs they were covered by Comcare for any health concerns; civilians were not generally covered under the veterans' legislation. However, advocates have argued convincingly that there have been occasions where the government has extended coverage to civilians. For example, the Australian Red Cross and Salvation Army did get coverage when they were deemed to be attached to the ADF. As such, advocates have continued to persecute the case that these teams were integrated with the ADF and performed like functions, as suggested by Justice Mohr in the 1999 review.

The Vietnam Veterans Association has been making representations to the government over the past two decades, arguing that the civilian surgical medical teams dealt with the harsh realities of life in a war zone without any adequate training and, at times, without adequate protection. They tended to the Vietnamese civilian and military sick and wounded in overcrowded and underresourced hospitals, often in life-threatening situations and sometimes at the end of a rifle barrel. They learned to handle US military weapons in order to protect themselves and they were subject to enemy mortar attacks.

I think we can understand from these firsthand accounts that it's clear the civilian nursing and surgical teams performed duties that were well beyond what civilians would be required to do. Indeed, there was no real differentiation between those who were nurses and doctors in uniform versus those who were part of the civilian surgical teams. Therefore, there is a very strong argument for these individuals to be given special recognition. So I'm pleased that we're here today to help bring into effect this legislation, which finally acknowledges the role that these individuals performed and the impact it had on their lives and their health.

This change was originally proposed by the government on 16 December, with a start date some 18 months later, on 1 July 2020. This arbitrary date drew justifiable criticism from the Australian Nursing and Midwifery Federation, Dot Angell and other advocates in the ex-service community, who do not want to see this individual wait any longer to receive the health care they're entitled to. Dot said that the delay was 'unacceptable' and that civilian nurses would continue to fight 'until justice is done'. Speaking to the Australian Nursing & Midwifery Journal, Dot worried that, if the bill is delayed 18 months, it is likely that a third to 50 per cent of the remaining nurses would no longer be alive. These doctors and nurses have waited long enough. There is absolutely no reason to delay the implementation any longer. I am pleased that the government have realised their mistake and have brought this date forward.

Of course, Labor is acutely aware of how few sitting days we have before the middle of the year, due to the incredibly light sitting schedule proposed by the government. Seeing that the Senate is sitting only two days before May, it is important that we expedite this bill. Given the importance of the bill, Labor will do what we can to try to assist the government to pass this legislation in the time we have available.

This bill is modelled on the provision of treatment available to persons eligible under the Australian Participants in British Nuclear Tests and British Commonwealth Occupation Force (Treatment) Act 2006. As such, many of the provisions are based on and similar to provisions in that act, including the review process and the enforcement of obtaining and giving information. The companion bill, the Treatment Benefits (Special Access) (Consequential Amendments and Transitional Provisions) Bill 2019, will give effect to the government's decision to provide medical treatment for members of the civilian medical teams. These consequential amendments are necessary to enable effective operation of the Treatment Benefits (Special Access) Bill 2019.

Labor welcomes the expansion of the gold card to this group of brave men and women who provided invaluable service in Vietnam. While we offer our bipartisan support to this legislation, it does raise questions in light of the fact that the recent Productivity Commission review of DVA did state that the gold card should not be expanded to any new categories of veterans or dependents. It is rightful that the government is clearly rejecting this recommendation. But, while rejecting this recommendation, they should also reject the recommendation that dismantles the Department of Veterans' Affairs. The commission's review has recommended that the department be dismantled, with a statutory authority established to handle claims and their policy responsibilities going into a division within Defence.

To date, the government have not given any indication of whether or not they'll adopt that recommendation. However, by rejecting the gold card recommendation as part of this legislation, the government have shown that they will not wait for the final report to rule out recommendations. I urge them not to hide behind the draft Productivity Commission report any longer when it comes to dismantling the Department of Veterans' Affairs, and I urge them to join with Labor and reject the dismantling of the Department of Veterans' Affairs. If they're listening to the same wide group of veterans that I'm listening to, the message is very clear: veterans do not support the abolition of a standalone department; they want a department that will look after them. And veterans want the comfort of knowing where the government stands; they don't want to wait until after an election to find out what the government's position is.

In closing, I'd like to reiterate Labor's support for the expansion of the gold card to members of the Australian civilian surgical and medical teams. These individuals volunteered their time and their skill to look after the South Vietnamese population. They were subject to many of the dangers and the traumas experienced by others who served in Vietnam. They continue to suffer as a result of volunteering their service. While the teams were awarded with the Australian Active Service Medal, this bill will finally recognise the injury and risk to their health and lives that travelling to Vietnam had caused.

To the advocates who have fought for this recognition: congratulations. It is your work that is why the parliament is listening today and acting. And, to all those civilian nurses and surgical teams who went to Vietnam: thank you for the sacrifices you made. I commend the bill to the House.

Debate adjourned.