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Wednesday, 26 June 2013
Page: 7224

Ms BRODTMANN (Canberra) (13:04): 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:

Develop targeted support and resources for female veterans

Increase the visibility of experiences of and services for female veterans

Facilitate continuity of learned coping strategies post-discharge

Implement and evaluate family friendly practices

Provide training to civilian health care providers on issues for female veterans

Develop best practice guidelines for the treatment and care of female veterans

Set a strategic research agenda on female veterans' health

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