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Thursday, 12 August 2004
Page: 26357


Senator KIRK (3:49 PM) —I seek leave to have a speech by Senator Mark Bishop on the Foreign Affairs, Defence and Trade References Committee report Taking stock: current health preparation arrangements for the deployment of Australian Defence Forces overseas incorporated in Hansard.

Leave granted.

Senator Mark Bishop's speech read as follows—

The health and welfare of Australia's defence forces is an issue of some prominence.

As a country we have always promised those who are sent away to defend Australia's interests overseas that they and their dependants would be cared for should anything go wrong.

In general we as a nation have honoured that promise.

In sponsoring this inquiry by the Foreign Affairs, Defence and Trade Legislation Committee, we in the ALP were acutely aware of one thing.

That is, there's been a degree of dissatisfaction within the veteran community at their inability over the years to obtain compensation and treatment for what they believe were service caused injuries and illnesses.

There has also been concern at the health care provided to those about to be deployed and those recently returned.

For the record, and for the benefit of those listening, this is an excellent report.

It is titled a “stock take” which was its intention.

Let me iterate the terms of reference because they effectively summarise all the concerns.

The Committee was charged to examine:

The adequacy of current arrangements within the department of defence for the deployment of the ADF overseas

The adequacy of record keeping of individual health and treatment episodes of those deployed, and access to those records by the individual

The adequacy of information provided to individual ADF members,

pre- deployment, of the likely health risks and anticipated remedial activity required

The adequacy of current administration of preventive vaccinations, standards applied to drug selection, quality control, record keeping and the regard given to accepted international and national regulation and practice

The engagement in this process of the Department of veterans' Affairs and the Repatriation Medical Authority for the purpose of administering and assessing compensation claims, and

The adequacy of the current research effort focussing on outstanding issues of contention from the ex service community with respect to health outcomes from past deployments, and the means by which it might be improved.

May I also add that in addition to the long standing concerns of veterans who have been unable to obtain either health care or compensation, the events of the deployment of troops to Iraq were also part of the picture.

This especially concerned the effects and processes of anthrax vaccinations.

This issue alone serves as a useful case study in the examination of these terms of reference, and has been one attracting most media attention.

By way of perspective may I say it is a pity that some of that concern has not been focussed on the past where long term effects of exposures remain equally important..

Time prevents me from doing justice to all the detail of this very thorough and detailed report.

I did provide some context for this report in the Senate on 3 August last, and I will supplement that commentary in the near future if an opportunity arises.

Let me therefore simply summarise the findings.

The concern of veterans at the unknown long term health effects of their exposure to hazardous material were confirmed.

Governments of all persuasions over the last 50 years have been reluctant to accept veterans' views due to the lack of medical scientific evidence on the cause and effect of that exposure

Policy in Australia with respect to the need to properly establish public liability has been strengthened with respect to that medical scientific evidence- as opposed to policy in the US and NZ for example, where a more presumptive, discretionary approach is applied.

Australian veterans would like to see that presumptive policy applied more liberally in Australia through Section 180 of the Veterans' Entitlement Act

Nevertheless the Committee found that the current attitude to presumptive policy and the need for public liability to be based on sound medical scientific evidence, is appropriate—and so recommended.

Mr Acting Deputy President, with respect to veterans' concerns at the long history of denial of liability for disabilities of long gestation, but where medical science has been inadequate, the Committee found as follows:

Research by successive Australian governments into the long term effects of exposures to various substances may have been inadequate until the last decade, but this reflected the state of research internationally, and the long gestation time of many disabilities, particularly cancers.

Australian governments in the last decade have been much more active in collecting baseline health data through surveys of various veteran populations, with the result that veterans can feel more assured that their concerns are not being ignored.

Having so found however, the Committee recommended that thorough data collection become an integral part of DVA and ADF assessment of deployed personnel, to facilitate research.

Continuing through these very important findings, the Committee found that:

The long term separation of medical research between the Departments of Veterans' Affairs and Defence has hindered a more holistic consideration of veterans' concerns

But that the creation of the new Centre for Veterans' and Military Health is a positive move which will lead to better prioritisation, and bring greater focus to the need for better scientific knowledge.

Without going to all findings may I make special reference to the availability of health risk and treatment information to serving personnel and veterans.

The popular issue of note here was the anthrax vaccination program.

The Committee in particular found that:

While some aspects of the anthrax vaccination issue were exaggerated, the lack of pre-deployment information coordination demonstrated flaws in the deployment preparation process.

Pre- deployment health checks have improved, but more attention needs to be given to psychological briefing, preparation and assessment prior to embarkation.

Information on health protection and treatment services, including vaccination regimes, needs to be better communicated to all personnel.

Pre deployment health checks, debriefing and assessments need to be given continued emphasis, with record keeping of assessments being given priority.

Defence is committed to improving the health status and recording of data on personnel to be deployed—though I add personally there is a long way to go.

The next set of findings concern the administration of OH&S policy within Defence, and in particular the keeping of records.

Records in particular have been a serious defect in the compensation area for many decades.

Necessarily in times of war, records are incomplete and indeed are lost.

The legislation allows for that.

But in a modern electronic age, the continuation of that is intolerable. In short the Committee found that:

The importance of OH&S policy and administration is receiving more priority within Defence, but that a significant level of concern remains at the promulgation of those policies, the lack of accountability, and the need for incentives to do considerably better.

Maintenance of health records for serving personnel in recent years has become chaotic due to incomplete information and divided responsibility

Defence is aware of the particular health needs of women, but that it should demonstrate this by reporting on an annual basis.

The recommendations follow these findings and in my view should be accepted by defence as a useful way forward.

To this I would simply add that something needs to be done urgently about expediting the implementation of the proposed new Healthkeys electronic recording system.

Finally I would like to summarise the findings on research. The Committee found as follows:

DVA has become much more proactive in its research and more aware of the importance of obtaining as much data as possible, rather than waiting for veterans to identify needs later.

There has been improved rationalisation of research projects because of effective liaison between relevant agencies.

Recent efforts have been excellent, but more needs to be done to in communicating processes and outcomes to the veteran and ex service community.

Priorities for research need to be considered consultatively with the ex service community leadership

Mental health projects should continue to receive priority, including where appropriate, specific projects on problems arising from peacekeeping and peacemaking.

There are more findings of an administrative nature going to the management of health service delivery within Defence, and of course a number of recommendations for implementation of change which are well worth considering.

Management of health services in Defence both by way of operational support and routine health management has long been a very difficult issue.

That though is also the broader community experience as expectations increase and medical science rapidly develops.

No doubt better solutions will be found, but from the point of view of this report, the downstream consequences post retirement and discharge must be better incorporated.

In essence the summary of findings I have just made covers much of the terms of reference.

As a stock take this report serves a very useful purpose because it both vindicates the long held views of veterans, but also notes that government at last has responded.

All is not well though—there is much to be done, but there at least is no doubting the bona fides of hose in Defence and DVA seeking to pull it together.

In conclusion may I compliment the secretariat again for a job well done, and in particular the key researcher Ms Pauline Moore.

The research had to be taken beyond the transcript and submissions, but nevertheless does address the terms of reference very fully.

I commend the report to the Senate.

Debate adjourned.