Senator Mark Bishop asked the Minister representing the Minister for Veterans' Affairs, upon notice, on 13 January 2004:

(1) (a) What programmes have been offered in the past 2 years and are currently on offer by the Vietnam Veterans' Counselling Service (VVCS) in each state; (b) what is or was the budget for each programme; and (c) how many registrations were received for each programme.

(2) How many registrations failed to show or were withdrawn from each programme for which a registration was received.

(3) For veterans in both Western Australia and Queensland: (a) what rehabilitative programmes, by type and number, have been offered by Hollywood and Greenslopes hospitals respectively in the past 2 years; (b) how many registrations were received for each; (c) how many sessions or courses were cancelled; and (d) what was the total value in each year of the courses conducted.

(4) What are the terms in the agreement with Ramsay Health Care Limited for the provision of rehabilitation courses to veterans.

(5) (a) How many rehabilitation and/or counselling programmes have been offered by the Heidelberg Centre for veterans in each of the past 2 years; (b) how many veterans participated in each programme; and (c) what was the turnover rate in each programme.

(6) What was the value of the Heidelberg Centre courses run in each of the past 2 years.

(7) (a) How many rehabilitation and/or counselling courses were provided to the department and/or VVCS by other private providers in each of the past 2 years; (b) what was the cost of each course; and (c) what was the number of participants.

(8) What evaluation is conducted of all courses referred to above.

Senator Hill (Minister for Defence) —The Minister for Veterans' Affairs has provided the following answer to the honourable senator's question:

(1) (2) The Vietnam Veterans Counselling Service (VVCS) offers a comprehensive range of group programmes for veterans and partners and, in the case of Vietnam veteran families, the cohort of sons and daughters.

Programmes are identified according to four main categories - therapeutic, psycho-educational, lifestyle management and health and wellbeing.

Therapeutic programmes are aimed at treating the symptoms of mental health disorders such as anxiety, stress or depression and are generally offered as an adjunct to more intensive treatment provided on an inpatient or outpatient basis or by individual clinicians.

Psycho-educational programmes are designed to promote awareness of mental health problems, to offer practical coping strategies and provide opportunities for social support.

There is a major lifestyle management programme offered by VVCS which is a week-long residential course for veterans or veterans and their partners that combines aspects of both therapeutic and psycho-educational groups. The aim is to promote a model of “wellness” with a focus on strengthening relationships, managing stress, problem solving and living with disability.

Retirement programmes are a more specific form of lifestyle management course, with a greater emphasis on planning for the future.

The major health and wellbeing programme is Heart Health, which aims to reduce the risk of cardiovascular illness and related conditions and re-engage veterans in healthy social and recreational activities.

The following tables identify the VVCS programmes in each State and Territory for the previous two financial years. The tables also show expenditure against each programme type, the number of clients who registered and the number of subsequent withdrawals or cancellations.

Note that for 2003-04, the VVCS continues to offer the same core programmes, with registrations running at similar levels to 2002/03. Final figures are not available.

(3) (a) (b) and (c)

Admission to Day Programmes and PTSD rehabilitation programmes conducted by Greenslopes and Hollywood

Patients are referred to the day therapy programmes and residential/inpatient PTSD programmes by the treating psychiatrist. Under the Australian Centre for Posttraumatic Mental Health (ACPMH) guidelines for PTSD and Drug and Alcohol programmes patients are required to undergo a pre-admission assessment to ensure their suitability for admission to the programmes.

(d) Greenslopes Private Hospital (Queensland)

Total cost of the programmes conducted in the 2002/03 financial year was $1,002,000.

Total cost of the programmes conducted in the 2001/02 financial year was $949,000.

Hollywood Private Hospital (Western Australia)

Total cost of the programmes conducted in the 2002/03 financial year was $1,248,000.

Total cost of the programmes conducted in the 2001/02 financial year was $1,064,000.

(4) The response to this question interprets “rehabilitation” to include psychiatric rehabilitation, characterised as a range of range of psychiatric and psychogeriatric care programmes provided under the terms of agreement with Ramsay Health Care, Greenslopes Private Hospital and Hollywood Private Hospital.

The services have a special emphasis of those suffering from posttraumatic stress disorder and associated conditions (such as alcohol dependency) and cover:

- Acute inpatient psychiatric services;

- PTSD programmes;

- Psychiatric nurse home visits;

- Outpatient clinic services; and

- Day centre programmes/sessions (individual, family and group counselling) as reflected in Tables 1 and 2 in the response to Question 3.

(5) (a) and (b) Table 3 Lifestyle rehabilitation day programmes (psychiatric) and PTSD programmes.

(c) The question refers to “turnover” which has been interpreted to mean repeat attendance. There have been no veterans who repeated Younger Veteran PTSD programmes in 02-03.

The Department only receives summary data on non-PTSD programmes therefore it is difficult to ascertain if there have been repeat attendances in this circumstance.

(6) The total cost of the programmes conducted in the 2002/03 financial year was $2,668,900 and the cost of the programmes in the 2001/02 financial year was $2,920,700.

Please note that the above figures only include the amounts paid directly to Heidelberg Repatriation Campus. The Department also pays a grant to the Victorian Department of Human Services for Outpatient Psychiatric Services which covers all Victorian Public Hospitals (including Heidelberg Repatriation Hospital) that provide outpatient psychiatric services.

(7) (a) (b) and (c) (PTSD) Programmes

Table 4 excludes the Post Traumatic Stress Disorder Programmes conducted by Greenslopes Private Hospital (Qld) and HPH (WA) shown in the response to Question 3 and Heidelberg Repatriation Campus shown in the response to Question 5.

Non metro PTSD programmes in Qld are Townsville (Nth Qld) and Gold Coast

Non metro PTSD programmes in NSW are Tamworth, Taree, Wauchope and Nowra

Non metro PTSD programme in Victoria is Geelong

Total Cost PTSD Programmes conducted in 2002/03 was $4,163,790 (excl travel except SA)

Total Cost PTSD Programmes conducted in 2001/02 was $3,839,200 (excl travel except SA)

Non- PTSD Rehabilitation Programmes/counselling sessions (Private Hospital)

Queensland

Day therapy programmes/sessions are available at Private Hospitals in Brisbane, Pine Rivers, Gold Coast, Ipswich, Toowoomba, Sunshine Coast, Mackay, Townsville.

The total cost of psychiatric day programmes for the 2002/03 financial year (excluding PTSD) was $407,192 and for the 2001/02 financial year (excluding PTSD) was $385,926.

Day therapy programmes/sessions are available at Private Hospitals in Sydney, Taree, Wollongong, Tamworth, Port Macquarie and Wagga Wagga.

The total cost of psychiatric day programmes for the 2002/03 financial year (excluding PTSD) was $205,913 and the total cost of psychiatric day programmes for the 2001/02 financial year (excluding PTSD) was $174,436.

The total cost of psychiatric day programmes and the Drug and Alcohol Programmes for the 2002/03 financial year was $94,200 and the total cost of psychiatric day programmes and the Drug and Alcohol Programmes for the 2001/02 financial year was $185,155.

The total cost of psychiatric day programmes for the 2002/03 financial year (excluding PTSD) was $44,750 and the total cost of psychiatric day programmes for the 2001/02 financial year (excluding PTSD) was $32,500.

Tasmania

All day therapy programmes are conducted by the VVCS.

Western Australia

All day therapy programmes are conducted by either Hollywood Private Hospital or the VVCS.

(8) All VVCS programmes are subject to detailed evaluation of some kind, unless there are valid clinical reasons for not doing so. The core programmes have a nationally consistent approach to evaluation and may include: physiological measures, measures of general health functioning and quality of life, instruments measuring clinically significant change and more general assessments of functioning. Staff or providers are expected to conduct appropriate evaluations on other programmes, which have not yet achieved national consistency (eg pilot programmes). Satisfaction surveys are also sent to all clients at completion of a programme and are reported on quarterly.

Where participants give permission, VVCS data from lifestyle management courses is collated and analysed by the ACPMH and feedback on outcomes provided to centres.

PTSD programmes are accredited by the ACPMH. Follow up programmes occur at 6, 12 and 24 months, post completion of a programme. An ACPMH minimum data set is completed by clinicians and participants at commencement of the programme, completion of the main phase and as part of each follow up session. This is collected and assessed by the ACPMH and summary data by hospital is made available to the Department. This is one of the criteria used to assess the effectiveness of programmes.

Other courses provided in private hospitals collect outcome data using the Health of the Nation Outcome Scales (HoNOS) and the 14 items constituting the Mental Health, Role-Emotional, Social Functioning and vitality subscales of the Medical Outcomes Study short Form 36 (SF-14-M). Hospital-level summary information for veterans is made available to the Department through the Strategic Planning Group for Private Psychiatric Services Centralised Data Management Service.