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Thursday, 12 August 2004
Page: 26355

Senator HUTCHINS (3:49 PM) —I present the report of the Foreign Affairs, Defence and Trade References Committee entitled Taking stock: current health preparation arrangements for the deployment of Australian Defence Forces overseas, together with the Hansard record of proceedings and documents presented to the committee.

Ordered that the report be printed.

Senator HUTCHINS —I seek leave to move a motion in relation to the report.

Leave granted.

Senator HUTCHINS —I move:

That the Senate take note of the report.

I seek leave to have a tabling statement incorporated in Hansard.

Leave granted.

The statement read as follows—

I am pleased to table the report, Taking Stock, by the Foreign Affairs Defence and Trade References Committee.

The report examines the quality of health services provided to deployed personnel, including the information provided on a range of hazards and potential exposures, and the quality of the data collected about these exposures and other health.

It also examines the extent to which necessary information was collected in respect of past deployments, and the accuracy and completeness of other data on personal medical records of veterans. As we all appreciate, this type of information is often essential in order for a veteran to make a successful claim for a disability pension relating to war service.

The terms of reference further required the Committee to look at a number of other matters, including the relevance of research programs on health and how much these have affected the ability of veterans to make claims, as well as identify health problems that may affect quality of life.

The report considers the work of both the ADF and the Department of Veterans' Affairs in the context of substantial changes to defence forces overseas and to the nature of combat itself. Increasingly, Australia is sending relatively small forces as part of larger missions to areas of conflict. It is also heavily involved in a range of peacemaking and peacekeeping missions, which have their own impact on personnel.

All modern defence forces have as a major priority the deployment of trained and healthy personnel. However, they also know that deployments will often be to areas subject to disease, that there is a high risk of exposure from various substances, and that many events experienced will be difficult to deal with. They are therefore required to plan effectively in order to minimise the impact of all these factors as much as this can be done. Effective post deployment health services are therefore just as important, so that issues can be identified and addressed.

The Committee found that the ADF has undergone considerable change in respect of its health services. In particular, there is clearly an effort to provide sound information on processes, to help personnel become involved in their own health care, and to overcome resistance to mental health services. These measures are very much in accordance with community standards and changes in community perceptions. The Committee commends the ADF for its considerable progress in these areas.

Nonetheless, there is some concern about the extent to which these intentions can be fully implemented because of problems with personal medical records and a lack of integrated data.

We recognise that there is a commitment to a new IT system which will eventually be able to provide more complete records, measure patterns of disease and injury, and provide overall reports on various types of deployment.

Such records will be substantially enhanced if we have access to other data collected on deployments which has accurately measured chemical and other exposures. All this will help the ADF and DVA work in a much more pro-active way in identifying potential health problems and required services.

Yet, however promising this is, we remain concerned that current information on personnel cannot be incorporated into the new system. This means that there will be no integrated electronic record of those who are now serving.

We do not believe this is adequate, and have recommended that all deployed personnel have access to their medical records prior to discharge so that they can identify missing material and incomplete data and have such problems rectified. This will at least avoid the problems experienced by older veterans who have often been unaware of incomplete records for decades until they have come to make a claim.

We also believe that some form of electronic record should be made of current files to facilitate service provision by the Repatriation Commission in the future.

We have further found that health files retained by the UN or other forces who have provided higher level medical services must be copied. This is useful for veterans from older deployments. It may be crucial for veterans of recent deployments who require follow-up treatment.

We also commend the recognition given to the short and long term psychological effects of warfare and related services. It is apparent that there was a limited recognition in the past both of the effects of hazardous substances and of combat stress itself.

Many veterans, including those from the First Gulf War, have felt insufficient attention was paid to their concerns, and that they were expected to deal with matters on an individual basis. The approach of the ADF and DVA in the past has been reactive. Research programs and other services have lagged behind needs. There has not been a ready provision of detailed information.

Over the past decade in particular there has been a change towards the proactive approach. The Australian Centre for Posttraumatic Mental Health was established and has gained a deserved high reputation. The new Centre for Military and Veterans' Health is expected to provide an equally high level of service to personnel and veterans.

Both the ADF and DVA have become more aware of the wide range of health issues experienced by veterans and serving personnel. DVA in particular consults widely and seeks to provide innovative programs.

Mental health is now an issue much more commonly discussed, and the ADF has many more services and information projects in this area than previously.

There is always room for improvement. There still remains some resistance to the idea that everyone, however well trained, may be vulnerable to pressures, and much work remains.

We are unclear about the use of doctors as opposed to other `medical' personnel, and would like to see this clarified. We would also like to see more obvious use of psychiatrists in mental health services, although we acknowledge the difficulties in obtaining such staff.

There have also been beneficial changes in administration. The Links Program has facilitated co-ordination and planning between the ADF and DVA. It is hoped this program will continue so that there can be greater rationalisation and an easier transition for personnel from the ADF to DVA services if required.

In particular the Committee considers the research program of both agencies has improved. We recognise that lack of appropriate methodologies and absence of data often prevented effective research in the past. Shortage of funds and lack of political will may also have been contributing factors which limited the development of basic data collection and even completion of nominal rolls.

We are all now much more aware that there can be short term as well as long term effects from deployments. Even when looking at long term outcomes it is better to establish systematic data collection processes early to avoid the problems experienced by much recent research which has had to recreate records and identify those who participated in deployments.

In assessing all these issues we also bore in mind that Australia has committed itself to a medical-scientific determination of injury and disease as far as the payment of a disability pension is concerned.

We have compared this approach with that operating in other countries, but only in order to show that the way our law operates makes the collection of accurate and detailed health information from deployments essential. Because there is less reliance on presumptive cause, it is vital that current and future personnel do not experience the same difficulties that earlier veterans have.

This inquiry was not established to find fault. It arose from a wide range of concerns that different groups had, especially a feeling that many problems were not heard or addressed. Some of these, such as delays in research, have been referred to above. We have found also that there have been some problems with the communication of information, and have made some suggestions on improving access to relevant information that will help veterans and serving personnel keep up to date with those issues of most concern to them.

I would also like to thank those organisations who made submissions and who made many useful suggestions. Their experience provides them with valuable insights into problems and we are grateful that they have raised these on behalf of their members.

Overall, we have been impressed with many changes and we look forward to further improvements.

I seek leave to continue my remarks later.

Leave granted.