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Royal Australian Air Force F111 workers and their families

CHAIR —I again welcome you to the Defence Subcommittee. The subcommittee does not require you give evidence on oath, although I do advise you that these hearings are legal proceedings of the parliament and therefore , have the same standing as proceedings of the respective houses. Also, at the outset, I thank both departments for agreeing to participate in what is not the normal arrangement. I thought that a roundtable discussion might produce some useful exchange of information and enable us to examine some of the more difficult questions. Having both departments before us at the one time hopefully will enable a freer exchange of those thoughts. Would you like to make any opening remarks?

Air Vice Marshal Brown —As stated at the outset of the inquiry, the Department of Defence is committed to helping the committee find solutions that will assist those whose lives have been adversely affected by their involvement in F111 fuel tank maintenance. That remains our focus. This inquiry has provided a unique opportunity to help provide resolution to those affected. Defence is determined that people who have been harmed by military service should be looked after.

Defence also believes that the mechanisms for long-term care and compensation exist and intends to work with the Department of Veterans’ Affairs and other government agencies to see that this care and compensation is delivered. The solution to this problem will take time and money and expectations need to be realistic. However, defence owes it to those who have served and their families to ensure they receive the care that they need for their continued wellbeing.

The previous response to SHOAMP focused on the very poor working conditions of the personnel who were employed in the four formal deseal-reseal programs. The ex gratia payment was recognition of those working conditions. The focus on this group of workers was driven by the board of inquiry, which was concerned with the deseal-reseal programs and the SHOAMP, which studied the health outcomes of this group.

The ex gratia payment scheme led to disillusionment and disappointment for many. The scheme was designed to recognise adverse working conditions, not health outcomes. While the scheme acknowledged the working conditions of deseal-reseal workers, it led to payments being made to many people who were not sick and, hopefully, will remain unaffected by their work on F111 aircraft. At the same time, other personnel involved in F111 fuel tank repair who did not receive the ex gratia payment have become seriously ill, possibly as a result of exposure to the same or similar chemicals involved in the deseal-reseal process. The focus on potential solutions should be on providing health care to those who are sick and financial compensation to those whose lives have been adversely affected by their work on F111 fuel tank repair. The supplementary submission that we have provided concentrates on the possible responses and solutions to provide additional support for that group of people affected by their service with F111 fuel tank maintenance.

While the Department of Veterans’ Affairs is the lead agency in relation to providing health care and compensation for those injured through military service, defence is the other major stakeholder and has a significant role to play. Identifying the parameters of the group that have been involved and the unique working environment of the F111 fuel tank will require significant technical advice and support from defence. This task is complicated by the absence in some cases of documentary records that prove that personnel were involved in fuel tank repair. Defence will work to identify F111 fuel tank maintenance workers who performed work similar to that performed by those in the formal deseal-reseal programs. Defence and DVA have jointly looked at options for expanding the group of people who can get access to health care and simplified access to financial compensation. Defence and DVA will work closely to ensure that the enhanced response is targeted at those most in need.

While the focus now should be on health care and compensation, the committee should also consider the previous ex gratia scheme, which has been the source of contention for so many. The committee might consider whether there is any benefit in continuing to pursue this strategy. The committee should also give consideration to removing at least one of the constraints on the previous ex gratia scheme. I refer to the criteria of the scheme that prevented spouses of personnel who were involved in deseal-reseal who died prior to 8 September 2001 from making a claim. This condition should be subject to fresh consideration

I would like to emphasise that we have presented a number of options to the committee. This is a departmental position, but I understand that it is ultimately up to the committee to recommend and government to decide what should be done. Thank you.

Mr Killesteyn —The needs and expectations of F111 workers involved in fuel tank maintenance and their families are complex. Perhaps that is an understatement—the first of many, no doubt. Their experiences as we understand them are unique in the modern RAAF. The Department of Veterans’ Affairs remains committed to helping the committee find solutions

The department’s role has been to administer the health care schemes, the compensation provided under existing legislation and the ex extra payments system against the rules and policies provided by the former government, but in the face of imperfect information and records of events dating back up to 30 years ago.

Our administration of the ex gratia scheme has been a particular source of criticism. We acknowledge that we may not have got every decision right the first time or dealt with every deseal-reseal workers’ claim as quickly as we would have liked, and we have been seen as insensitive in the case of some. This is disappointing. Nevertheless, I commend the efforts of the team that has worked so hard under difficult circumstances.

The department has acknowledged the Ombudsman’s observations about our administration of the scheme. It is important to note that claimants were advised of their recourse to the Ombudsman. The Ombudsman reported 102 complaints from the 1,215 ex gratia decisions and concluded that in many cases, they—the Ombudsman’s office—had been able to assure the complainants that eventually DVA assessed their claim according to the tiers in a way that they could not criticise. In other words, outcomes were in accordance with government policy, albeit that the process was in some instances less than perfect.

There were some difficulties with the use of statutory declarations. We understand that individuals always expect to be taken at their word, even at a distance of 30 years. Unfortunately, in a small proportion of cases, the available records or supporting evidence did not support the declaration. As is normal administrative practice, statutory declarations provided a line of inquiry, which was followed assiduously and energetically. Our intention, as I stated before, was to find a basis for inclusion wherever possible. In this regard, I note that 662 individuals were identified in the board of inquiry as being possibly exposed. In the end, some 726 people have been accepted into one of the three tiers, with the largest number being at tier 1.

The department has been criticised for its insensitivity, such as when two of its staff visited a very ill man in hospital in the company of his wife to tell hill that his ex gratia claim had been unsuccessful. An alternative interpretation of this action is that, rather than being insensitive, it demonstrates a mark of the concern of the staff in circumstances where a letter might have been easier. Knowing the staff involved, this is my preferred view. I can assure the committee that we did not act capriciously but on the advice of the treating psychiatrist and counsellors from the veterans and veterans’ family counselling service.

As to the administration of compensation schemes, we are ready to provide the committee with an outline of the Veterans’ Entitlements Act and the Safety, Rehabilitation and Compensation Act schemes, including the benefits under each at an appropriate point, and can do so immediately after my opening remarks, if the committee wishes.

However, I want to provide the committee with a summary of compensation outcomes so far. There have been 626 individual complainants; 70 claims have been made under the Veterans’ Entitlements Act only; 114 have been made under the Safety, Rehabilitation and Compensation Act only; and 442 have been made under both acts. Of 626, 500, or around 80 per cent, are now in receipt of a disability pension or have received a lump sum permanent impairment payment or a widows’ benefit. Of the 500, 378 are receiving benefits under the Veterans’ Entitlements Act, the 373 disability pensioners consist of 67 totally and permanently incapacitated, three each of extreme disablement allowance and intermediate, 77 at the 100 per cent rate, 223 at rates varying from 10 per cent to 90 per cent and five receive a war widows’ pension. The remainder of the 122 have received benefits under the Safety, Rehabilitation and Compensation Act. Of that, 113 people have received lump sum permanent impairment payment of between $10,000 and $370,000, with the majority receiving between $30,000 and $40,000, and nine have received the widows’ benefit.

It is important to note that this includes all those who have claimed compensation for conditions caused by deseal-reseal service, whether or not their condition was accepted as due to that service. Our records show that a small number of people—around 30—had conditions accepted but received no additional compensation. This was because they were already receiving pensions at the maximum—for example, the TPI rate—or their accepted condition was not great enough to move them to the next higher level of compensation. The department is still working hard to provide the committee with whole-of-life estimates of the cost of these benefits. But we have provided five case studies in our answers to questions taken on notice on 21 July.

The Department of Veterans’ Affairs and the Department of Defence have worked together on a joint submission to the committee that outlines some of the options that the committee might wish to consider. These focus on enhanced health care, streamlining access to compensation under the Safety, Rehabilitation and Compensation Act and potential future health studies. We are, of course, happy to discuss them in detail to assist the committee in its consideration of the merits of options in and resolving the issues of concern that have been raised by the fuel tank maintenance workers and their families. Thank you.

CHAIR —Thank you.

Senator FERGUSON —What was the figure of 1,200 that you mentioned earlier?

Mr Killesteyn —It was 1,215 claims for the ex gratia payment.

Senator FERGUSON —Yet the Air Force’s estimate was that 600 were involved and 727 were being considered.

Mr Killesteyn —I think one of the difficulties we are find here is that the numbers of people exposed jump around quite a bit. There are quite a few figures. The board of inquiry, which was established back in 2001, had a figure of some 600. We have just heard, for instance, that the University of Newcastle had a figure of some 900 exposed. They move around a bit.

Senator FERGUSON —In fact, you really do not know, do you?

Mr Killesteyn —The records are such that we cannot provide an accurate figure. But I think ballpark figures are illustrative.

Senator FERGUSON —If you said that you err on the side of inclusion rather than exclusion, do you think there is a likelihood that more people will now be included even though their claims were initially not assessed as eligible?

Mr Killesteyn —We are not receiving anymore claims for ex gratia payment. Most of those claims that have come forward have done so on the basis of the policies that were set down. So it is unlikely that we will receive more claims unless the policy is altered. That said, we have done a 100 per cent quality assurance on all of the 1,215 claims to ensure that the decisions we made, either to accept or reject, were correct and substantiated on the basis of the evidence that was provided.

Senator FERGUSON —I understand that a number of the claimants have suggested that the department is prepared to expend a much greater amount defending a claim than the actual claim would be in payout anyway. Is that a fair comment?

Mr Killesteyn —I would reject the assertion and the allegation. Firstly, we are talking about different claims here. There is the ex gratia claim, but there are also claims for compensation.

Senator FERGUSON —I am referring to ex gratia claims.

Mr Killesteyn —There is no recourse at all for legal matters. The only recourse that a person has for taking that matter forward if it is rejected is a complaint to the Ombudsman, and there is no other legal recourse for us to take. So the whole issue of the department wanting to spend more on legal costs is entirely irrelevant.

Mr ROBERT —Mr Killesteyn, when you first came before the committee, 427 claims had been settled. That figure is now 500, which is fabulous. Before it was about sixty per cent, which you said was on par with your normal claims. It is now at 80 per cent. That is well and truly acknowledged. It is certainly acknowledged that the 80 per cent of claims fulfilled and paid is higher than the 50 per cent average. You said 30 had accepted conditions but were already necessarily receiving benefits and no more could be paid. Does that mean that you had accepted 500 plus 30, or was that 30 included in the 500? I just want to clarify that.

Mr Killesteyn —I will turn to my statisticians for advice.

Mr ROBERT —A wise decision.

Mr Killesteyn —I am told they are included.

Mr ROBERT —Can you comment on the 126 that have not been accepted? Is that because of lack of documentation or that statutory declarations were not accepted? I just want to get a feel for the 126 that were not accepted and if there were any general trends as to why they were not.

Mr Killesteyn —Essentially these are claims for compensation. Presumably the evidence that was provided was not sufficient to enable the person’s defence service to be associated with the particular conditions, or that the conditions were not establish in the first place through diagnosis. There could be a range of conditions.

Mr Douglas —Generally there are four elements that must be established before a claim can proceed. Firstly, you have to establish that the person is a veteran or a serving member; secondly, that they had some particular service that is eligible under the act; thirdly, that they have some particular injury or disease that they believe relates to that particular service; and, finally, that it is confirmed in a diagnosis as to the extent of limitation. Those who are not successful in establishing a claim would not have been successful in establishing all four of those elements.

Mr ROBERT —Do you have the information, Mr Douglas, on each of those four points? For example, with the 126, did we establish that they were all veterans and serving?

Mr Douglas —I am not aware that we have any analysis of that 126.

Mr ROBERT —It would certainly be useful if the committee could actually have it to understand what were the issues. For example, if you cannot prove they are veteran or a serving member or, indeed, that they served with RAAF, there is not a lot you can do about that. However, if the issue was a confirmation of diagnosis, that perhaps might be a different ballgame.

Mr Killesteyn —We can take that on notice.

Ms Spiers —Mr Roberts, I suspect, knowing the nature of the sort claims involved, that it is not the first three issues that Mr Douglas has referred to. It might be that we cannot establish a diagnosis because of the nature of that particular condition. I think we have mentioned before multiple chemical sensitivity. That is not in the International Statistical Classification of Diseases. On the other hand, because of the compensation scheme they were applying under, they might not have been able to satisfy the statements of principle. The purpose of those couple of pieces of paper is to explain how the two compensation schemes operate.

Mr ROBERT —We take that as read, and we know, of course, that the statements of principle do not include many of the effects that have been experienced. I want to follow on from Senator Ferguson’s point that there had been some reports. Submission No. 13 from William Knilands states that reports were passed from doctor to doctor and subsequently each found in favour of DVA to repudiate claims regarding health conditions. We have heard that a number of times in evidence. This is where the senator was coming to in respect of doctors coming back and saying, ‘Well, no, we repudiate that claim. We do not believe you.’ We now have a doctor representing a serviceman who says it is and the commonwealth saying that it is not. Out of that 126, it would be interesting to know how many of those cases exist. In how many cases is the medical profession at odds with itself over the confirmation of diagnosis?

CHAIR —While I am happy to for us to work on the assumption that your advice is roughly the ballpark for today’s purposes, if we can get a breakdown of that on notice that would assist us all.

Mr Douglas —Yes.

Senator MARK BISHOP —Mr Killesteyn, various sets of figures show that there has been something like 1,200 or 1,300 people involved in the program over the years. There were 1,200 claims for ex gratia payments and you have processed to finality some 626 claims under the VEA or the SRCA, 500 of which have been accepted to some extent. That 500 out of 626 strikes me as being enormously high from a further set of workers that is only 1,200 or 1,500 men. Is that figure of 500 claims relating to disability out 626 highly disproportionate or the norm in your experience over the years in the DVA when you have claims for disability compensation, or am I just going down the wrong path?

Mr Killesteyn —As I mentioned in earlier evidence, the average acceptance rate for claims across many, many years and across all claims that we get for compensation is generally around 60 per cent.

Senator MARK BISHOP —Right.

Mr Killesteyn —Perhaps what is happening here is that the Military Rehabilitation and Compensation Commission has made a determination under the Safety, Rehabilitation and Compensation Act for facilitated access into the compensation schemes. In other words, it is the section 7 (2) determination. I think that is potentially at work here in making the acceptance rate higher because of the presumption under section 7 (2) that the work that has been done by the people involved in the deseal-reseal and their injuries and conditions are associated with that work. I makes the process easier, if you like.

Senator MARK BISHOP —With that explanation, are you then talking about the beneficial aspect of legislation?

Mr Killesteyn —That is correct.

Senator MARK BISHOP —But the beneficial aspect of the two acts applies to all claimants.

Mr Killesteyn —It does, but I am also talking about the beneficial aspect of the section 7 (2) SRCA determination. That is the key. It is beneficial legislation irrespective across the board, but the decision to apply section 7 (2) to all of those people who are defined as being included in one of the tiers enables facilitated access into the compensation scheme.

Senator MARK BISHOP —Got you.

Mr Douglas —The normal 60 per cent figure that tends to be used is one that is associated with conditions claimed. These figures we have given you relate to people who have claimed. The number of conditions they have claimed will be higher than the 500.

Senator MARK BISHOP —Yes.

Mr Douglas —I do not believe that we have given you the figures on conditions claimed.

Senator MARK BISHOP —I take that point. I might return to that Mr Douglas, because that will give a different set of figures. Taking the two sets of figures, roughly 500 disability claims admitted out of somewhere in the ballpark of 1,200 or 1,300 workers in the program over the relevant time is something in the order of 40 per cent of the work force ending up on disability claims. Is that normal or abnormal with your exposure to vets and defence industries, Mr Killesteyn?

Mr Killesteyn —I would find that very difficult to pass judgement on because, first, you are talking about a benchmark figure of 1,200 or 1300 where that figure jumps around; and, secondly, I am talking about the benchmark of the number of people who have actually claimed—that is, those people who have reached a view that the conditions that they are experiencing are associated with their fuel tank maintenance work. To establish a benchmark against a potential 1,200 or 1300 or whatever is not a fair indicator of whether the 40 per cent rate is common or not. That benchmark is somewhat illusory, I think.

Senator MARK BISHOP —Why do you say it is illusory if 500 workers exposed in a program out of 1,200 or 1,300, give or take, say, 10 per cent, are then years afterwards admitted for various disability pensions? Why is it illusory?

Mr Killesteyn —Because I have no way of suggesting how I contrast deseal-reseal work with any other type of work within defence.

Senator MARK BISHOP —All right.

Mr Killesteyn —I could give you a figure. We have 17,000 compensation claims a year. If I take 17,000 compensation claims out of the total number of people who are serving, that is essentially another similar measure that you are suggesting. Again, I do not know whether that is good, bad or indifferent. The contrast you are asking me to make is a difficult one to draw any conclusions from.

Senator MARK BISHOP —It may well be a meaningless conclusion. I understand where you are going. Have you or your officers in your experience over the years noticed such a high proportion of workers in the defence industries being accepted for disability claims? I accept your point, but 500 out of 1,200, or 40 per cent of workers, strikes me as objectively a very high proportion. There is a lot of experience here at the table. Have you identified such a high figure in other areas?

Mr Douglas —I think the difficulty is that people have service outside of their deseal-reseal experience.

Senator MARK BISHOP —Yes.

Mr Douglas —Some 30 years down the track, the numbers we are giving you represent their claims against total service issues. Some of these people may have even had operational service experience.

Senator MARK BISHOP —Yes.

Mr Douglas —Therefore, they have issues arising from other factors of service. It is a very difficult benchmark to form a judgement about.

Senator MARK BISHOP —Right. But that 500 who have been admitted for disability claims relates to disability of whatever degree suffered from exposure in the deseal-reseal program.

Mr Douglas —No, these are people who have claims accepted under either piece of legislation.

Senator MARK BISHOP —Yes, relating to—

Mr Douglas —Including at least one condition related to deseal-reseal.

Mr Killesteyn —Of itself, the contention that you are putting that this particular work has perhaps driven conditions at a higher rate is acceptable. I would not necessarily disagree with that. But I find it a bit difficult to draw a distinction between this work and other work and claims generally across board.

CHAIR —Listening to the evidence, this is somewhat confusing to me at the moment. We have had evidence in the past about difficulty of establishing a direct causal link between the exposure and particular illnesses and the fact that the range of symptoms and conditions is apparently unconnected and diverse. However, as we have just heard from researchers with the SHOAMP, the incidence is high enough to come to a conclusion that something is happening here. Which aspects of the legislation have enabled you to determine that such a high percentage of workers engaged in the F111 deseal-reseal program had a causal link? I assume you had to determine that somewhere along the line. It seems a bit counter-intuitive to a lot of other evidence we have heard.

Ms Spiers —It is actually all in how the schemes operate. That is why you will see a higher rate of success under the Safety, Rehabilitation and Compensation Act. It is because of the way the section 7(2) determination operates contrasted to the Veterans’ Entitlements Act, which has statements of principle based on sound medical and scientific evidence.

CHAIR —Give me the quick idiot’s guide to that difference.

Mr Killesteyn —This is compensation 101.

CHAIR —Good.

Ms Spiers —You will have two pieces of paper in front of you. One is headed ‘Processing of veterans’ entitlements claims’ and one is headed ‘Processing SRCA claims’. I will take you very quickly through the VEA claims process. It is very high level, so I am using concepts here. I am happy to expand on any particular issue you might have.

As Mr Douglas mentioned before, there are four key elements you need once you are looking at a claim. Under the Veterans’ Entitlements Act, they have to be a veteran or a defence force member. I am not talking specifically about the deseal-reseal group. This is genetically how the act operates. They have to have eligible service. The key on eligible service is that it determines the ability of a person to claim under that particular act. If you want me to I can expand on that.

CHAIR —They are date specific?

Ms Spiers —Yes, they are date specific. The other key bit about eligible service is that the standard of proof that is applied to your claim is dependent on the nature of your service. I will speak very generically here. If you have war or war-like service, you will have the more generous standard of proof, which is that the commission has to be satisfied beyond reasonable doubt that the claim cannot succeed. If you have just peacetime service or defence service—if I can use those concepts—then the more common balance of probabilities or reasonable satisfaction concept of proof is applied. That is the key in terms of eligible service. You then have the claimed injury disease and you need a diagnosis. Both acts operate with the concept of needing a diagnosis for the condition.

Under the VEA, you then have to apply the relevant statement of principle. You will see that I have mentioned in the sidebar that they are prepared by the Repatriation Medical Authority. The authority has five eminent specialists in the field of examining medical and scientific evidence and looking at causal connections with service. We have statistics provided by the RMA that 94 per cent of all the conditions claimed are covered by a statement of principle. You can see that it covers the field.

There are always two statements of principle for each condition. I mentioned the fact that there were those two standards of proof. You will get the two statements of principle, and the one for beyond reasonable doubt has a more generous view on what factors need to be satisfied to have that condition accepted as service related. The statement of principle has the causal link. You have to satisfy one of those factors to succeed with a claim under the VEA.

I will come back to the situation where there is no SOP in the use of section 180A. I want to continue through the process. If someone can satisfy a factor within the statement of principle relevant to the condition they have claimed then we determine the condition to be war caused or defence caused, depending on their type of service. We must then immediately assess a rate of pension payable as a result of accepting that condition. You will see I have mentioned the Guide to the assessment of veterans’ rates of pension (GARP) and the lifestyle questionnaire. We look at a combination of the social impact of that condition, self-reported, and also the physical impact of that condition to determine a rate of disability pension.

You will see that we pay 10 per cent to 100 per cent of the general rate. I have given those ranges of fortnightly pension in the sidebar. If we determine that the rate of pension will be 70per cent or greater, we are obliged to consider the above general rate payments. You have heard of the TPI and the special rate. They are earnings-related pensions. We have to consider that as part of the decision-making process.

As a consequence of making those decisions, we then issue person with a DVA health care card. It will depend on the level of impairment they have as to whether they get one specific to the condition they have—that is, a white card—or a more general card that covers all conditions, which is the gold card. Obviously the gold card is the one that regardless of whether the condition is war caused you can go to the doctor and get treated using the card. I think the committee would be aware of the significance of the gold card. There is also access to health and related care services. We have mentioned just three of programs: veterans’ home care, the rehabilitation appliances program and counselling.

Not directly related to what I have just mentioned, but depending on the nature of the person’s service, they might also be entitled to claim a service pension. They obviously have to satisfy an income and assets test. If they are applying for an aged service pension they must obviously satisfy the age requirement. If it is invalidity pension then they are unable to work. That is the simplest way I can put to you how this works.

CHAIR —You have done well.

Ms Spiers —I will go back to a case where you do not have a statement of principle. As I said, six per cent of those claimed conditions do not. They are ones where either the Repatriation Medical Authority has not established a statement of principle or it is such a rare condition that the medical evidence means that the authority is not in a position to form a statement of principle. We then go back to the old section 120 of the legislation, which provides that the commission has to be satisfied—let us assume that this person has service that gets the highest standard approved—beyond reasonable doubt that the condition is not related to service. It would rely on independent medical evidence from the person’s treating doctor, or perhaps specialist-level evidence. You can see given the numbers that those cases are very rare and for rare medical conditions as a rule that is in effect how it operates.

I can talk about section 180A in the context of this or I can talk broadly about how SRCA operates. I do not know which way the committee would wish me to go.

CHAIR —Why not run us through SRCA very quickly.

Ms Spiers —Okay. You will see it is a slightly different arrangement. You do have the concept of defence force member and you need defence service. You have to have a claim condition and a diagnosis. Once again, you need something that satisfies the ISCD classification. The requirement then is to look at determining liability. The legislation requires us to determine the liability to accept the condition as being service related if there is a significant contribution of service in developing that condition, and it must a material contribution. There is case law to support what that means.

To assist the commission delegates who make these decisions, you will see that we have mentioned as a sidebar the Military Rehabilitation Compensation Commission, which is the policy arm responsible for defence claims under the SRCA legislation. The policy arm has agreed to the use of statements of principle that do not appear in the Safety, Rehabilitation and Compensation Act, but only where it will result in a positive outcome for a claim under SRCA.

If there is a statement of principle, for instance, ischemic heart disease, and the medical evidence that you would normally gather for the particular SRCA claim is not working, but you can look at the factor and see that the individual can satisfy it in the statement of principle then the policy says accept the claim. You have satisfied the significant contribution element of it. So it is a supportive element. But that is using the different schemes’ causal instruments for the purposes of establishing causation under the SRCA legislation.

Section 7(2) is in the Safety, Rehabilitation and Compensation Act. We have heard quite a bit of discussion today and on other days about what it is. It is a determination that can set a list of conditions, injuries, diseases and particular work environments and say that if you are in this sort of work environment and you have this sort of condition then you have satisfied the significant contribution test and you do not have to get a medical opinion to satisfy that. You have your diagnosis and service, tick, liability is accepted. That is how section 7 (2) operates.

I will now deal with what immediately hangs off a liability determination. You will see that I have mentioned ‘severely injured’. That is an automatic entitlement. It is for extreme cases with extreme injuries. But the liability decision operates quite separately then to what can happen after that. You can see we have quite deliberately drawn it as three elements: permanent impairment, rehabilitation and treatment, and incapacity payment to age 65. That is quite different from the Veterans’ Entitlements Act. Once you start a claim, we accept liability and pension or health care follows as a matter of course.

Here you have permanent impairment. That looks at the potential for a lump sum. It is the non-economic loss, it is based on the level of impairment and it is non-taxable. It is for the inconvenience of the impairment and you have rehabilitation and treatment. There are vocational, living skills and aids and appliances elements under rehabilitation.

In terms of treatment, there is not a health card under SRCA. It is the reasonable cost of treatment paid for the accepted injury only. The nice little comparison here is that you may have a truckload of conditions accepted under the SRCA legislation and you will be accepted for treatment costs for each of those. You might have a similar person who has entitlements under the Veterans’ Entitlements Act and, because they have had this cumulative bunch of conditions accepted, they are entitled to a gold card. It is not just their accepted conditions that are covered, it is all of their health care. That is quite a distinction between the two schemes.

To the right you will see there are the incapacity payments to age 65. If there is a loss of income as a result of the incapacity, then it is periodic payments. It is economic based and cuts out at age 65. What can flow from that also is access to related care, being household or attended care. As you can see, the schemes operate quite differently.

I will apply some of the knowledge of the particular group we are dealing with. Many of the group have entitlements under both acts, and they are not mutually exclusive. A claimant can claim the same condition under both acts. As you can see, they will not follow the same path. If they are successful under both acts then we use the provisions of compensation offsetting to adjust for the fact that they have been previously compensated under the former act. That is a different discussion that I could entertain you with if you wish.

CHAIR —Going back to my earlier question, under what provisions will most of the people who have been processed who have this raft of difficult to attribute causal relationship be compensated?

Ms Spiers —They will satisfy the SRCA rate. With the exception of the pure contractors, all of the defence force members have coverage under the Safety, Rehabilitation and Compensation Act but not all of them have coverage under the Veterans’ Entitlements Act. That is why that act has some attraction.

CHAIR —Just to tidy up our paperwork, we will take these documents as exhibits. It is resolved. Thank you.

Mr ROBERT —Mr Killesteyn, previously when you were here you indicated that the total cost to the commonwealth so far was about $67.0 million, which tended to break down into the SHOAMP study at $5.3 million, the interim health care program better health program at $1.9 million, the ex gratia payments at about $22 million and $38.1 million in compensation. You indicated in your opening statement that you are working on the whole-of-life costs that we asked for. We accept that. Is the $67.9 million figure still correct, or has that changed?

Mr Killesteyn —It might have varied marginally with a number of additional compensation cases. I think we have processed the last of all the ex gratia claims now, so it has probably moved up marginally. But I do not think I would say it has doubled or anything like that.

Mr Douglas —It will continue to increase for those people, for example, in receipt of incapacity payments and for those people who may not have accepted a lump sum.

Mr ROBERT —They are the whole-of-life costs. But the $67.9 million is in accounting terms the cash that the commonwealth has paid out.

Mr Killesteyn —So far.

Mr Douglas —Thus far.

Mr Killesteyn —And it can only escalate.

Mr ROBERT —Of course.

Mr Killesteyn —With the exception of the ex gratia payments at this point, because all of those decisions have now been made.

Mr ROBERT —And you are coming back to the committee with respect to what will be the total cost over time.

Mr Killesteyn —Which will move as a consequence now of the compensation decisions.

Mr ROBERT —Of course.

Mr Killesteyn —But I suspect that it will be very significant.

Mr ROBERT —This is a gypsy question. Does the department know the average cost of a gold card per annum? What does a gold card cost the commonwealth per annum?

Mr Killesteyn —It is $16,000.

Mr ROBERT —What does a white card cost the commonwealth?

Mr Killesteyn —We have a little statistics card. Perhaps we should all have it at our disposal. It is one of those things you keep in your wallet. This time it did not work.

Mr ROBERT —You have a statistics card in your wallet?

Mr Douglas —Yes.

Mr Killesteyn —I apologise, it is not $16,000. The estimated average gold card cost for 2006-07 is $14,500. This is at March 2008. For a white card, it is $1,400.

Senator MARK BISHOP —Ms Spiers, I presume it was you who provided a fairly detailed response on the discussion we had last time about section 180A of the VEA. Thank you for that. I now understand where the department is coming from. Could you also take on notice and provide to the committee the relevant extracts from the explanatory memorandum and the minister’s second reading speech so that I can go back to the original source material? I do not think you provided the results.

Ms Spiers —If it will assist the committee, I actually have those with me.

Senator MARK BISHOP —That would be useful. I refer to the parts you rely upon in coming to your construction of that section of the act. Secondly, can you explain to me now why the Repatriation Commission’s interpretation of section 180A of the act is to take the same approach to ex gratia payments as it does to the application of the SOPs by the RMA? I ask that because I would have thought, prima facie, that if there is an ex gratia mechanism in the act to give a benefit to a worker, a group of workers or a class of workers in exceptional circumstances, the exceptional circumstances will, by their nature, vary over time. It is indeed a safety valve. Why is it limited to the link between the outcome and medical science or medical causation? Why is the same process applied in both sections?

Ms Spiers —I think I can clarify the issue for you now. The ex gratia scheme is not covered in the legislation; it is an administrative scheme. So the rules that have been explained in this forum and others have been the government’s policy in terms of how the administrative scheme would operate.

Senator MARK BISHOP —Right.

Ms Spiers —Section 180A of the legislation deals with what the Repatriation Commission is allowed to do. The words in the section are clear in terms of when it can operate, but it is still at the discretion of the Repatriation Commission. It is in keeping with the legislation to allow the commission to exercise its discretion to use section 180A determinations where it considers appropriate, once it has met those conditions precedent. That is, that there is either a statement of principle in place from the Repatriation Medical Authority or the authority has declared that it will not make a statement of principle and that the Repatriation Commission considers, given the existing statements of principle, that the claims cannot succeed. Then at its discretion, if it has evidence before it that allows it to look at a particular group for acceptance of any particular condition—that is, injuries or diseases—it can do a section 180A determination.

I will clarify the operation of section 180A. If the Repatriation Commission were minded to do section 180A determinations, it would have to do determinations, not a single one. It would be for every condition it wished to cover for a particular group. It is the range of those health conditions mentioned in the SHOAMP report.

Senator MARK BISHOP —Right.

Ms Spiers —I do not think it is in conflict because one is an administrative scheme and one operates under the legislative banner of the Veterans’ Entitlements Act. But it is a subsequent discretion.

Senator MARK BISHOP —Right. With regard to section 180A in the VEA, you have determined the policy in terms of its application and you derive that, you say, from the act. What is this administrative scheme you are referring to?

Ms Spiers —You mentioned the ex gratia scheme.

Senator MARK BISHOP —Yes.

Ms Spiers —That is an administrative scheme; it is not covered by the Veterans’ Entitlements Act or the Safety, Rehabilitation and Compensation Act.

Senator MARK BISHOP —What is the section 180A? How do you refer to that?

Ms Spiers —It is a legislative provision within the act resulting in legislative instruments. However, it is still at the discretion of the body that determines those instruments, and that has been the Repatriation Commission.

Mr Killesteyn —Section 180A is entirely related to the issue of determining compensation. The ex gratia scheme has absolutely nothing to do with compensation; it relates to the work circumstances. The ex gratia scheme is an executive scheme determined by the rules and policies laid down by the former government. That is what has been applied. The rules are taken, we look at the evidence in terms of a person’s involvement in the programs against the rules, and we administer that in the absence of legislation. It is an executive scheme and we are guided simply by the decision of cabinet.

Section 180A is really about whether there can be a way of, again, giving facilitated access for people in terms of their claims for compensation in a similar way to the section 7(2) determination under SRCA. That is why the issue keeps being raised. People are looking to make claims under the Veterans’ Entitlements Act rather than the Safety, Rehabilitation and Compensation Act, generally because they have believe the Veterans’ Entitlements Act is more generous than SRCA. They are therefore looking for exactly the same facilitated access as far as their compensation claims are concerned.

Senator MARK BISHOP —All right.

Mr Killesteyn —We do not believe that that makes sense, because all the workers have eligibility under the Safety, Rehabilitation and Compensation Act. The section 7(2) determination has already been established. However, it is a question of whether more people should be given access to section 7(2) —that is, more than those who are currently defined in terms of the three tier definitions. I guess that is the issue that defence would particularly have a view about whether that needs to be expanded

Senator MARK BISHOP —Thank you. Indeed, you submit that section 180A of the VEA is part of a legislative scheme that has limited application in particular circumstances. Indeed, there is no legislative provision in the act for an ex gratia payment.

Mr Killesteyn —That is correct. Indeed, the advice in relation to the use of section 180A from all of our legal advisers, including external legal advice from Attorney-Generals, is that there still needs to be scientific evidence about the conditions and the causes of those conditions before you can execute a determination under section 180A. The advice I have is that it would be difficult in the circumstances that we are currently facing with the deseal-reseal workers.

Senator MARK BISHOP —Thank you Mr Killesteyn and Ms Spiers. That has helped me a lot.

Mr ROBERT —I refer to ex gratia payments. The SHOAMP study professors indicated that the cause of the issue, whilst not a single factor, is best described as an environment cocktail of solvents, closed spaces, heat and the time and intensity. This led to the government’s decision to have the ex gratia payments for time in the tanks for the four programs. Air Vice Marshal Brown and Mr Killesteyn, was that also your view? Was that the reason why government went there?

Air Vice Marshal Brown —I would have trouble answering that question because I was not around at the time when those sorts of determinations were made. I think that was why government went down that path. In my view it is still a flawed approach to the problem.

Mr ROBERT —What would defence rather have seen in that respect? Did it have a view?

Air Vice Marshal Brown —I think at the time there was a view about trying to grab everybody who had some sort of disease or sickness as a result of that. From that point of view probably a more targeted approach would have been better. The problem is that when you put together an ex gratia payment like that you have to try to put a boundary around it. I think that is where we have run into difficulty with that scheme.

Mr ROBERT —Mr Killesteyn, do you have anything else to add in that respect? I am assuming that government went there because of those four things in the SHOAMP, especially that time intensity. The SHOAMP guys were saying that the longer the time the higher the rate of illness. It showed a direct link.

Mr Killesteyn —Hindsight is a wonderful thing, as you well know, Mr Robert.

Mr ROBERT —It is a perfect thing.

Mr Killesteyn —I think there was an element that there was much more potential clarity around the people who were involved in the formal programs than there was around those who were involved in the informal fuel maintenance work. To that extent it was a useful place to start once a decision had been made to provide an ex gratia payment. That was a useful place to start to determine who would be eligible for that payment. Hindsight tells us that it appears that others were involved in fuel tank maintenance work who did work of a similar nature.

I think that is where the whole issue is now vested. I guess that defence would have a particular view about who those people are and whether they should now be part of the tier definition for access to section 7(2)(i) of the Safety, Rehabilitation and Compensation Act, or whether it needs to be extended to an ex gratia payment. But that is a difficult judgement.

Mr ROBERT —In the pick and patch program is it reasonable to say that we have?

Air Vice Marshal Brown —There were guys in squadrons 482, 1 and 6 who spent considerable time in the tanks doing pick and patch work. I think the F111 was a unique aeroplane. Fuel tank leaks were a problem throughout its service. You had the four formal programs and you could identify people that were involved in those four formal programs. At the squadrons there would have been people who worked inside the tanks, but they would have also done other work. They might have rigged flaps, done ramp servicing, and things like that. The whole time they were in the squadron was not spent inside the tanks.

Mr ROBERT —Of course.

Air Vice Marshal Brown —But they certainly would have spent a week, two weeks, or some period doing that. It is very difficult to identify that group of people.

CHAIR —Under the SRCA provisions what is the qualifying service or years of service?

Ms Spiers —It is straightforward. Basically, with the exception of those contractors that were not employed by the Defence Force, anyone that worked on the F111 program, because of the nature of their defence service, would be picked up by the Safety, Rehabilitation and Compensation Act.

CHAIR —Is that in section 5?

Ms Spiers —Serving member, or former serving member.

CHAIR —I turn for a few moments to the ex gratia scheme. The submissions we received from the departments at the earlier public hearing in Canberra, and again today, reiterate that there was no connection between entitlement to ex gratia payment and questions of health—exposure to things that would create health problems. That has certainly been the basis upon which I have been functioning during the course of this inquiry.

The definition of those who qualify for tier 1 and tier 2 payments has a range of folk undertaking very different activities. How was that put together? For example, on what basis was it determined that 30 days working on the reseal-deseal program was equal to 30 days working as a boiler or plant attendant?

Dr Gardner —I can answer some of that. You may recall from my initial evidence on 21 July that I said there was zero relation between health and outcome, et cetera. This morning, Professor Brown mentioned in his evidence that in general there is an exposure matrix in measuring health outcomes and that it usually relates both to time and to intensity of exposure. What he did not say was that in relation to the SHOAMP study, apart from the rough estimates of time, and self-reported estimates of time, during various jobs there were no actual measurements, in most cases, of days of work, and certainly no actual measurements of personal dosimetry with exposure, breathing zones, skin absorption, urinary excretion, et cetera. So they are very ‘soft’.

It is important to mention that there may be a misunderstanding, which Mr Robert picked up on. Of the conditions that appeared to be related to time of exposure and/or intensity of exposure, these were almost exclusively the self-reported symptoms. There was no evidence relating to things objectively measured by Dr X at Health Services Australia—things that could be related—nor was there a link to the cancers. The other problem here—again we had a long discussion over a period of many years while the SHOAMP study was being developed and reported on by the researchers—is whether those findings are significant. I said previously that I believed them to be of borderline statistical significance, but today they have said that they believe they are significant.

There are a couple of things that they did not bring out, that is, that there are some internationally accepted criteria that have been around for about 30 years known as the Bradford Hill criteria that determine whether things are likely to be real. A couple of the conditions that were not mentioned today relate to whether there is other evidence to support a particular finding and also whether the finding has biological plausibility. In other words, is this likely to be possible? Again I point to the fact that there were problems relating to the SHOAMP outcomes. For example, some bowel cancers were found. There is zero evidence in the literature relating to solvent exposures and bowel cancer.

I do not doubt that people had bowel cancer—that was a confirmed diagnosis—but I am at a loss to explain how that relates to occupational exposures. There are other important things to understand. I believe, even today, having been involved almost from day one in the SHOAMP program and subsequent programs, that there is nothing that relates to exposure that we can find from the statistically valid outcomes in the SHOAMP study other than the self-reported neurological and neuropsychiatric problems. I do not doubt that they are real but we have no way of independently confirming time or intensity.

Mr ROBERT —Can I challenge that for a second, Dr Gardner?

Dr Gardner —Yes.

Mr ROBERT —Just going back to what Professor Attia said, he agreed that statistically it was not significant, but he said that it was clinically significant. He also said that in the cancer study there was a 40 per cent increase in the exposure group than the control group, which was a confirmed medical diagnosis, and that the control group’s cancer study was exactly the same as the general population, except apparently they were a little healthier, so there was a 30 per cent decrease in mortality. Would that not be at odds with what you just said?

Dr Gardner —Unfortunately, this comes back to the fact that I believe both of us are correct.

Mr ROBERT —Of course, clearly.

Dr Gardner —The reason for that is that what he said is not incorrect. It is important to understand that there are a small number of cancers, which he did mention. In fact, of those cancers, and I mentioned bowel cancer—

Mr ROBERT —Twenty-seven in the group of 900.

Dr Gardner —That is a remarkably small number. I would have expected a lot more than that. The other problem is that with some of these cancers, for example, the bowel cancers, from my 30 years in this field I am aware of no other industry studies to do with solvents and working in chemicals that would relate to that.

Mr ROBERT —What are the odds of getting a 40 per cent increase—albeit 27 of the 900—and getting similar numbers in the control groups at two different bases? They were exactly the same as the general population. Statistically, at a maths level, the odds of that happening are somewhat remote.

Dr Gardner —No. In fact he acknowledged—and you may wish to follow it up with him—that this is at the five per cent statistical level. In other words, when you do these studies you have to say, ‘What is the likely chance of this arising just by chance?’ Unfortunately, in this study the figures came out right on that border of the five per cent statistical significance level. So, yes, you would go maybe tick-flick of a coin, or maybe not.

Mr ROBERT —He also acknowledged, Dr Gardner, that that five per cent is an arbitrary level. If there were an assumption that there had been other cancers and deaths, or people that had not been picked up by putting their hands in the air, the rate of cancers would have increased or gone up.

Dr Gardner —Absolutely. I fully acknowledge that. That is one of the reasons why I believe it is very important at a future time to keep looking at cancer incidence mortality studies to ensure that the denominator number is known.

Mr ROBERT —Do you support his contention when he said it is not statistically significant but it is clinically significant?

Dr Gardner —I would like to sit on the fence on that because—

Mr ROBERT —Wouldn’t we all?

Dr Gardner —For example, in relation to melanoma, there were increased cases of melanoma. Apart from exposure to the sun before the age of 16 and latitude issues, for example, at Amberley, I am aware of no other issues where there is clear statistical evidence in relation to occupational exposure and melanoma.

Mr ROBERT —The issue the committee has is that you obviously are the number one guy in the Air Force who wants to sit on the fence. I respect that as the fence can be pleasant at times. The SHOAMP guys are calling it clinically significant. How should the committee treat the range of medical opinion that has been put before it today?

Dr Gardner —The SHOAMP report addresses this issue. As I said, this was robustly discussed in its development, including by the Scientific Advisory Committee and by the consultative forum. I acknowledge that the SHOAMP investigators think it is significant. I think it is on the cusp, but I am prepared to accept that this needs to be followed further. Some of the recommendations that we have made in our submission today suggest that it should be followed up.

Mr ROBERT —Thank you.

CHAIR —I suspect that we will explore a number of issues after lunch. I go back to my earlier question about how we got to the definition of who gets what under the ex gratia payment system. How was a determination made that working for 30 days in the fuselage was the same payment, for ex gratia purposes, as working for 30 days with the incinerator, for example?

Mr Killesteyn —Chair, I am not sure whether I can give you a definitive answer to that. This is one of those areas of judgment that was made at the time that the rule had been put together. Essentially, I think we have discussed before in previous evidence that the 30 days had some precedent—if I can use that word without being too strong on it—in relation to chemical exposure as a consequence of service in Vietnam. This payment recognised a unique working environment and it drew a distinction between those who were involved in that work in an intensive way verses those who had some lesser level of involvement. Conclusions were drawn, lines were drawn, and a 30-day rule popped out. I suspect that it could have been less than that and it could have been more than that; it just depended at the time. Unfortunately, I cannot give you more on that.

CHAIR —Assuming that there was some logic in its creation, and that is a pretty brave assumption, it was also then said that there was a 60-day exposure for people involved in pick and patch. Is that meant to tell us that they were there for half the length of time, that it was half as uncomfortable, or what?

Wing Cmdr Sanders —I was part of the team that helped to put this together. You drew an inference that 30 days was significant. We had to put a boundary around particular activities. The inference that 60 days was half the effort and half the effect is incorrect; it was a means of putting a boundary around it.

CHAIR —This is what worries me. In the answer you just gave you referred to half the effect.

Wing Cmdr Sanders —That was in response to—

CHAIR —I may have misinterpreted what you meant by ‘effect’. If by ‘effect’ you meant the effect of being in that environment and being exposed to something, that opens up confusion, or it is part of the ongoing confusion. Part of our task is to try to make some sense of this ex gratia payment. It has been the core of a lot of angst amongst people, and I think understandably so. I am trying to get a grasp on how it came to be created and whether any methodology, logic, or rationale underpinned it. I look at that from the premise that these payments have nothing to do with exposure to dangerous chemicals, health implications or anything of the sort. We know that to be the case because it has been paid to people who have not even submitted a claim for any health impairment.

So, clearly, there is no connection with health. If it is to do with an environment that is unpleasant or difficult I am trying to comprehend that rationale if that is what it is about. If that is not what it is about then set me straight. For example, 30 days gets you $40,000, which is better than $1,000 a day. That is a pretty decent allowance; not too many people get an allowance of $1,000 a day for working in a hardship environment. That is one level of rationale. Leaving aside the ratio of money I am trying to figure out how it was put together, why some people are in, why some people are out, why some people get $40,000 and why others get $10,000. If you are there for 30 days at the furnace you get $40,000, but if you are there for 30 days doing pick and patch you get $10,000.

Mr ROBERT —None if you are pick and patch.

CHAIR —I might have given a bad example. Nothing appears to me to give me an answer. Where is the underlying threat of logic or rationale in that?

Dr Gardner —I answer that partially to reinforce what Mr Killesteyn said, that is, that this is an administrative solution because no clear information came from the SHOAMP study that related time, dose or anything to outcomes. I think the SHOAMP people alluded to that in their evidence. Nearly all the health outcome studies have some relation to dose and response. In other words the more the dose the more the response. This was a proxy in the absence of valid environmental and personal monitoring samples. It is reasonable in general to say that the more exposure the more likely the outcome and, therefore, you have had more in the way of bad working conditions.

CHAIR —That would make some sense to me if the payment was to be linked to health outcomes, health exposure, or health threat, but it is not.

Dr Gardner —It is not.

CHAIR —It is not, which to me makes that answer hard to reconcile.

Mr Killesteyn —We may all be accused of ex post commercialisation or something. Another way of looking at this is that the 30-day rule is a relatively low benchmark. One of the objectives was that once a decision had been made in principle to pay an ex gratia payment associated with the working environment that should avoid a situation where those people who have only a casual association with the work should not get the payment. The payment should go to those who are more intensively engaged in that work.

CHAIR —Was this constructed with any regard whatsoever to the stated reason that it was for a unique work environment and it was not health-related? I do not know who created this document. I assume that the list was finally ticked off by the cabinet of the day. Do we have any information? Can you give us any information about the parameters, the guidance for those who created that classification of who is in tier 1 and who is in tier 2?

Wing Cmdr Sanders —The decision that we were given was that there was to be a lump sum payment. We then had to set about trying to put a boundary on who would be the recipients. The recipients would be those who had been most greatly affected by their working conditions, hence the potential exposure.

Senator MARK BISHOP —Who gave you that decision?

Wing Cmdr Sanders —It was a government decision.

Senator MARK BISHOP —It was a cabinet decision. Cabinet made a decision and you then had to fix an administrative arrangement to give effect to that cabinet decision.

Wing Cmdr Sanders —That is what it amounts to, yes.

Senator MARK BISHOP —A political decision was made to have a solution, and you were instructed to have an administrative solution to give effect to it?

Wing Cmdr Sanders —I do not have an opinion on the motives, but I can say that this was the consequence.

CHAIR —That explains the process. Whether or not logic is running through it is another question. I guess we sorted out the process. I want to clear up one matter that was raised earlier in evidence talking about this point. One of the people at the table made a point about the ex gratia payment and said that firemen were getting a payment. At the time I said that, with people from DVA and Defence behind, no doubt they could shed light on how that came to be. Now is the time to shed light on it.

Mr Killesteyn —In the questions that were taken on notice we included some explanation of the firemen. I can go through that now.

CHAIR —If you could do so quickly, yes.

Mr Killesteyn —This is the situation. In a number of cases I think the department made an error in accepting that a person was eligible for an ex gratia payment. On our assessment, after a 100 per cent quality check of all the 1,215 decisions, we came to the view that three errors were made, two of which were firemen and there was one other error. Essentially, the basis for the firemen was that at the time we started making the decisions we had advice that particular individuals were involved in activities as defined under tier 1, I think it was. We were subsequently advised that they were there simply on a training program, which would not have involved them in doing the incinerator work. So it was a question not of the rules themselves but rather of the information we had about the activities of those two individuals.

Chair, can I take a moment to clarify something in Senator Bishop’s question relating to that decision? I want to ensure that the committee is not left with the impression that the detail of the tier definitions was made up by the administration or the departments—defence and/or DVA. There was a decision in principle to provide an ex gratia payment and then, as has been given in evidence, some rules were designed that they were effectively signed off by government. It was not something that the administration or the Department of Defence and DVA made up and then applied; it was signed off by government.

Senator MARK BISHOP —Cabinet made a decision in principle and, as part of that decision-making process, did it endorse or determine a set of guidelines?

Mr Killesteyn —We were given the task of providing options about how the ex gratia payment would apply. That was put to government and government ultimately made the decisions on who would be eligible for the ex gratia payment under the various definitions.

Senator MARK BISHOP —So you made it. Cabinet made a decision that an ex gratia payment would be made and the departments were asked to provide options on how that could be administered and determined. You gave cabinet or government a set of options and they made a decision on which option from the options that the two departments provided?

Mr Killesteyn —Yes.

CHAIR —Thank you for that. We might adjourn for lunch now.

Proceedings suspended from 12.36 pm to 1.32 pm

CHAIR —We will resume the hearing. Before lunch we were exploring a couple of things relating to the ex gratia payment. I go back to some of the questions associated with the ex gratia payment and refer to pick and pay folk. What do we know about their access to the ex gratia payment? How many have applied for the ex gratia payment, how many have received either tier 1 or tier 2, and how many have been rejected? What is the standard of proof that is used?

Mr Killesteyn —Referring to the number of claims that we got, I said this morning that we had 1,215 claims. As I understand it, 489 of those claims were refused. While I cannot give you a precise answer, our view is that more than 90 per cent of the claims that were refused would have been involved in—if I can just make it clear—the informal pick and patch activities as distinct from those pick and patch activities that were defined as part of the formal program.

CHAIR —Could you elaborate on that a bit?

Mr Killesteyn —I think there was a description in tier 1 that used the term ‘pick and patch’. There is also a generic description that people use to describe those who were outside the formal programs, particularly those who were in squadrons 482, 1 and 6, as involved in pick and patch activities. I guess that that group of pick and patch workers are the ones who are concerned about whether further benefits should be extended to them.

CHAIR —How did that other group fail to meet the tests?

Mr Killesteyn —Because they were not involved in the formal programs.

CHAIR —What constituted the formal programs?

Mr Killesteyn —I turn to my colleagues in defence—the four formal programs.

CHAIR —What was the pick and patch formal program? What constituted your access to that as opposed to informally doing pick and patch?

Air Vice Marshal Brown —There was always a section called the reseal-deseal section. If you were posted to that section and you were involved in pick and patch you came in underneath the tier 1 definitions.

CHAIR —And that goes back to 1973?

Air Vice Marshal Brown —Yes.

Mr Killesteyn —I think this is another area of confusion in terminology, in language, about which we have to be careful.

Air Vice Marshal Brown —In between the formal programs aeroplanes would be sent down to the reseal-deseal section to have some work done on them.

CHAIR —It seems from the evidence that enough people have come forward to say that they were involved in pick and patch work and that they have been denied access. It now seems that roughly 90 per cent of the 489 who were refused fit that category. How do you distinguish between the two? The pick and patch work was being done as the aircraft had to be serviced. I assume defence does not dispute that the work was carried out? The planes would not have flown if it were not carried out. The nature of the planes is that if you did not do the work they would not get off the ground.

Air Vice Marshal Brown —That is right. In reality there was no real difference between the pick and patch work done at squadrons 1, 6 and 482 and what was done in the reseal-deseal section.

CHAIR —The delineation that has been made in the past might be convenient from a paperwork perspective, but on the ground it could not be said that there is much to distinguish it?

Air Vice Marshal Brown —No, I do not believe that there is.

Mr Killesteyn —The delineation I make is for clarification. Of the 489 people who were refused, greater than 90 per cent of those cases were pick and patch activities not involved in the formal programs—in other words, those people who were more than likely posted to squadrons 482, 1 and 6. I think that is where there is a lot of concern.

Air Vice Marshal Brown —I suppose you could make one delineation. If you were down at that reseal-deseal section all you did was pick and patch, whereas if you were part of 1, 6 and 482 squadrons you did other maintenance activities.

CHAIR —That is understood, but in relation to reaching a threshold at 10 days, 30 days, 60 days, or whatever the threshold might be, it is conceivable that you would be in the unofficial pick and patch activity, you would accumulate that many days, but you would be excluded. They would fit into the category that we just identified as being the 90 per cent of those 489 unsuccessful applicants for ex gratia payment? Is that correct?

Mr Killesteyn —That would be my understanding.

CHAIR —Thank you. When we took evidence in Brisbane on the ex gratia payment, a couple of witnesses said at various meetings that had been held that they had been led to believe that a substantial amount of money was coming their way. I specifically recall evidence that at one such meeting the then Chief of the Air Force advised people to get financial advisers. That was interpreted by a number of people there—they did not put a figure on it but I would say that they were probably thinking about six-digit figures—and that created an expectation that clearly was not fulfilled, or probably was never likely to be fulfilled. Could you give the committee any advice about whether information of that kind was provided?

Air Vice Marshal Brown —I will hand over to Wing Commander Bill Sanders. He was at all those meetings so he can probably give you some information.

Wing Cmdr Sanders —I was at that meeting. The one you are referring to was in December 2004 when the CDF went to Amberley to explain what the government decision had been. It was a private and closed meeting. People who were there were there only by invitation. During the meeting people started to ask questions about when they could expect the payment and how much, and people started to speculate on the amount. There were some pretty wild guesses as to what it might be.

At the time the CDF said, ‘Before you make any decisions about what you are going to do with whatever it is that you get, get some financial advice.’ His motives, from memory, were to dampen down speculation and no more. People drew an inference from that that the amount was going to be quite substantial. The advice was followed up soon after by the support group which put out a sheet of advice that said, amongst other things, ‘Without knowing the amount of money, get some financial advice as to what you are going to do.’

CHAIR —Looking again at the groups that are identified for tier 1 and tier 2, for example, if you were not involved in any tank entry but your usual place of work was the rag hangar, you qualify for the ex gratia payment. I am trying to reconcile how that measures up on the hardship and convenience type scale with spending days inside the F111 in the unofficial pick and patch. The former group qualifies for the ex gratia payment but the latter group does not. I have great difficulty comprehending any fair basis for coming to that conclusion. Could you shed any light on that?

Air Vice Marshal Brown —I think you have to commence where it all started. I am only giving an explanation as the inquiry was about the formal deseal-reseal programs. I think that is how a lot of the compensation, or the basis for it, started to grow. I will hand over to Bill. He can probably give you a better explanation about why that related to the rag hangar.

Wing Cmdr Sanders —A number of people were included as a means of being inclusive. Fire fighters were another group of people and incinerator operators were another group. It was a case of being inclusive and offering that as an option to government. It was part of the options that we offered up.

CHAIR —Another way of interpreting ‘inclusive’, is erring on the side of generosity in those cases. I do not know whether that is quite the right way of putting it.

Wing Cmdr Sanders —I do not believe it was generosity. Possibly it was generosity, but it was to try to cover all the groups that had been involved to the same degree.

CHAIR —People in the unofficial pick and pay were excluded from the ex gratia payment. I assume that because they were excluded from ex gratia payment they also missed out on access to section 7(2) SRCA support?

Mr Killesteyn —I cannot answer that question.

CHAIR —It is probably an issue for DVA.

Mr Killesteyn —That is correct. If you are not part of one of the four formal programs you do not get access to any of the tiers, including tier three, which does not provide you with an ex gratia payment but which gives you section 7(2) access.

CHAIR —That helps to put the finger on some of the causes of angst. Apart from that group of pick and pay folk who were not part of the official group, and whom I suspect constituted a large number of individuals who have provided submissions to the committee, are you aware of other similar groups whose circumstances have prevented them gaining access either to the ex gratia payment or to the section 7(2) SRCA provisions? Earlier mention was made, for example, of those who had passed away before the date. We are fully conversant with that. Are you aware of any other identifiable groups?

Mr Killesteyn —I do not mean to be confusing in this instance but it is the description—the label that we are giving these groups of people. One label is pick and patch, another label, which may be a little easier to deal with, is people who were posted to squadrons 482, 1 and 6. In those postings people would have been involved in pick and patch activities as well as a range of other activities. You would have had submissions from those individuals, for example, the photographer. Broadly speaking, we think we are talking about 2,300 people in squadrons 482, 1 and 6.

CHAIR —Did you say 2,300?

Mr Killesteyn —Yes. 2,300.

CHAIR —What are the records for those people like? Do we know?

Mr Killesteyn —Let me just clarify. The photographer was not in squadrons 482, 1 and 6. The large majority of people—or 99.7 per cent of the group that we are talking about—would have been in squadrons 482, 1 and 6. The photographer would be representative of the dribs and drabs of others in the original question that you posed.

Mr ROBERT —Having said that, not all those 2,300 would have done pick and patch.

Mr Killesteyn —That is exactly right, yes.

Mr ROBERT —That is part of the difficulty.

CHAIR —What is the state of the records in respect of that?

Air Vice Marshal Brown —Let me clarify the records for you as I think there is a bit of a wrong impression. If any maintenance was done to an F111, if you had gone inside a tank and done any sort of repair on an E-500, which is the record of maintenance for that aeroplane, you would have put your name there to show that you had done it and a supervisor would have signed it. The problem we have is that under the legislation those records were required to be kept for about only seven years, so they were all destroyed. That detailed record keeping is no longer available to us because of the length of the program. From about 1990 we were a little lucky in that there was a decision to keep F111 maintenance records until the present time. The real problem is that you do not have that detailed knowledge of who worked on the aeroplanes.

CHAIR —Where records have not been available but claims have been approved, either for ex gratia payment, health support and so on, what test has been applied to satisfy DVA?

Mr Killesteyn —It is the balance of probabilities. As we explained in our submission, we have tried to tier the evidence that would be used to make a decision. It starts from evidence of records, if they were available, through to corroborating evidence from people who may have been involved in musterings, right through the lower level to statutory declarations. So you build up that profile. At the end of the day, when you have collected that evidence, you make a decision on the balance of probabilities.

CHAIR —Is there a requirement that somebody is able to attest to your presence when the person doing the certification is known by record to have been there, or is it adequate just to have a couple of statutory declarations from people who say, ‘I was there and I know that this person was also there with me’ when neither of them have separate identifiable documentation of their involvement in the program? I am trying to get some idea of the minimum threshold.

Mr Douglas —You have to look at each case on its merits. In essence, the generic description that Mr Killesteyn has given is correct. You start with the service record from defence, which may indicate that a person was posted to a particular unit at a particular time, and relate it to the claim that that person would be making. To the extent that that confirms or establishes a link between the condition being claimed and the service being rendered, clearly you grow in confidence with the level of granularity that is available in the evidence. To the extent that you do not yet satisfy it, you look at each case on its merits and spread your wings to gather additional evidence.

CHAIR —Spread your wings a bit for us now and give us an example. If the records show that you are in Darwin at the relevant time and you claim to have been in the program, obviously that is the end of the game?

Mr Douglas —Correct.

CHAIR —I am talking about records not absolutely confirming your involvement in the program.

Mr Douglas —You might go to something like a statutory declaration which is perhaps supported by a statutory declaration from a colleague, a mate, who was posted at the same unit at the same time. You might interview a number of people to determine whether or not the claims being made by the individual agree with the claims that that individual is making. It really is horses for courses. You might look for photographic evidence. Somebody might have kept souvenirs of particular events or occasions and produced them. It is a matter of going as broadly as you can, bearing in mind, at the end of the day, the high standard of proof on the part of the commission.

Mr Killesteyn —Included in our submission are two case studies. I can go through those now with you if you wish. I refer, for example, to case number 1:

During the Board of Inquiry (BOI), Claimant A submitted a BOI [Board of Inquiry] statement regarding his claimed involvement in a program. He had no supporting documentary evidence whatsoever. Due to the specific nature of detailed information in his BOI [Board of Inquiry] statement the F-111 Lump Sum Payment Team contacted Claimant A in order to seek more information, and suggested that he obtain a statutory declaration that supported his claimed activities from the supervisor who he had stated he had worked with in the program. The subsequent receipt of a supporting statutory declaration from this supervisor, as well as information obtained from other supervisors by the Lump Sum Payment Team, was considered to be of sufficient strength to have his claimed approved.

The second example I have is as follows:

During the process of investigating an unrelated ex-gratia claim, further information was received concerning the nature and depth of participation of Claimant B in the 2nd F-111 Fuselage Fuel Tank Deseal/Reseal Program. This verbal information came from proven reliable sources who were supervisors in the 2nd Fuselage Deseal/Reseal Program.

These are two examples of where we were looking for supportive evidence from alternative sources. As I said in my opening remarks, a statutory declaration of itself from a claimant provided a line of inquiry but of itself it did not necessarily represent a determining piece of evidence.

CHAIR —Thank you.

Mr Douglas —The concept is similar to a proof of identity issue. You are establishing primary and secondary evidence.

CHAIR —Thank you. Mr Killesteyn, in your opening remarks you might have been referring to a case that I am about to mention, which was evidence given in Brisbane involving a RAAF employee who was in hospital on suicide watch who had put in for a claim. The evidence given to us was that the letter advising of the failure of his application was delivered to him in hospital whilst he was there on suicide watch. I am not sure whether that is the case to which you were referring in your opening remarks. For the record, to be clear about this, can you shed some light on what happened?

Mr Killesteyn —It was the case that I was referring to in my opening remarks. A decision had been made that the individual was not eligible. Given his mental state, the question arose as to the best means of informing this individual. We took advice from the treating psychiatrist as well as the Veterans and Veterans Family Counselling Service about the best way in which to advise the individual. The advice that was given to us was that this should not be done simply by sending a letter; it should be done in an environment in which his reaction to the news, which was bad news, could be monitored and managed.

On the basis of that advice we did so while he was in hospital under the treatment of the psychiatrist. Before that action was taken the decision was carefully considered by senior levels within the department. As I suggested in my opening remarks, the alternative of simply sending a letter would have been even more insensitive, given the individual’s mental state.

Ms Spiers —In order to assist the committee we have cases, not necessarily deseal-reseal cases, where we became aware of a person’s mental health. We often release information via their doctor or, in this case, when they are in a supported environment. It is a practice we adopt when the circumstances dictate, and only on expert medical opinion.

Mr Killesteyn —Such as yours?

Ms Spiers —Yes.

CHAIR —I think it is fair to say that the process caused substantial distress to the former RAAF member and his wife. It might be argued that they could have suffered even greater distress had it been provided in a different way or at a different time. Perhaps none of us will ever know the answer to that. Given the distress that it clearly caused—I heard what you said about the advice that was taken—I think DVA would be well advised to review its practices in that respect and look at a range of other options and timings. It struck me that the timing could barely have been worse.

In a sense, the acknowledgement that it would produce or was likely to produce an adverse reaction that required medical attention should have rung alarm bells that another way or another time would have had merit. I certainly do not propose to try to pass judgement as it is not something that this committee or I are competent to do. In fairness to the family and because of the clear distress that they suffered I think it would be a wise thing for the DVA to review those practices. That is a bit of gratuitous advice from the Chair.

Mr ROBERT —Mr Killesteyn, you said earlier that 500 of the 626 claims had been finalised. Of those 500 can you outline how many received a white or gold card? You reeled off a whole swag of numbers, for example, 60 were TPI, et cetera. Do you have those numbers to hand?

Mr Killesteyn —We will take that question on notice so that we can give you precise figures. Generally, you can take it that war widows would have got a gold card, so that is five; and 67 were granted TPI status, if I can use that terminology, so they would have got a gold card.

Mr Douglas —A maximum of only 378 could be getting a card of any kind because that is the number of people who are receiving benefits under the VEA.

Mr Killesteyn —A maximum of 378. We will take that question on notice. Broadly, the gold card and the white card attach to the status.

Mr ROBERT —That will be great. My next question is to the Air Force. You said that there were approximately 2,300 personnel in squadrons 482, 6 and 1. However, we noted that not all of them would have been doing pick and patch work, especially from 1973 to whenever that pick and patch work stopped. Do you any idea of how many people might be involved? I understand that it is a subjective question.

Air Vice Marshal Brown —I think there would have been more than 2,300 in those squadrons over that time. The predominant trade that got inside the tank were airframe fitters or ATECHs, and that is what the figure is based on. We had a look at the records to determine how many airframe fitters or ATECHs we had in those squadrons. Having said that, only a percentage of those ATECHs were probably involved in pick and patch activities or fuel tank repair. Again, that would be a fair body of work to try to—

Mr ROBERT —You think there were about 2,300 airframe fitters and ATECHs between 1973 and 1990?

Air Vice Marshal Brown —Yes, that is the information we have.

Mr ROBERT —I suggest it would be almost impossible to find out from the records base what number went into the tanks.

Air Vice Marshal Brown —From the records that we have at the moment, yes.

CHAIR —I wish to ask about private contractors. Can we define how many there were and what tasks they performed?

Air Vice Marshal Brown —We have that information in our questions on notice. If you give me a second I will get to it.

CHAIR —I apologise; I have that here as well.

Air Vice Marshal Brown —We had a total of 48 civilian contractors. Sorry, they were the ones who were involved in the SHOAMP study. If you go to question No. 2 and to the responses that we have provided you will find a breakdown of programs 1 and 2—the wooden tank and spray seals.

CHAIR —Thank you. Is there a reason for the distinction between former RAAFs and contractors, and civilian contractors?

Air Vice Marshal Brown —Former RAAFs have entitlements under the DVA legislation, whereas civilian contractors do not. That is the reason for the break up. Former RAAFs basically have the same entitlements that serving members have. They are entitled under the DVA legislation, whereas purely civilian contractors do not have that mechanism.

CHAIR —That is in the four formal deseal-reseal programs. Were any civilian contractors involved in the informal pick and patch?

Air Vice Marshal Brown —I do not believe there were because that was done out of squadron resources. We did not have any contractors involved with squadrons 1, 6 and 482.

CHAIR —Are we looking at only at nine individuals?

Air Vice Marshal Brown —That is what I believe.

CHAIR —Do you know how many of them have lodged claims of one sort or another?

Mr Killesteyn —I can give you ex gratia claims, if that is what you are after.

CHAIR —Any claims?

Mr Killesteyn —We have had 77 tier 1 successful claims.

CHAIR —Sorry, just in relation to civilians?

Mr Killesteyn —Yes, ex gratia civilian contractors.

CHAIR —Now I am confused. I thought we were talking about nine people.

Air Vice Marshal Brown —We have broken up civilian contractors, former RAAF verses purely civilians, so you have the entire number.

CHAIR —All right.

Mr Killesteyn —Including former RAAF.

Air Vice Marshal Brown —Including former RAAF.

CHAIR —Referring to the group that does not have access to veterans affairs, presumably it would have recourse to the Queensland workers compensation system?

Ms Spiers —Correct.

CHAIR —Referring to those people, do we have any knowledge of the claims that they have made?

Wing Cmdr Sanders —It has been some years but we work closely with Queensland WorkCover to assist them with this particular group of people. As to numbers, I would have to take that question on notice and contact them. We have not been talking to them for quite some time.

CHAIR —Okay.

Mr Lysewycz —On the previous occasion, on 21 July, reference was made to two claims by private contractors which have been settled. We have four current claims by private contractors that we are defending in the Supreme Court of Queensland—six in total. At this stage we have sought information from the solicitors representing them to establish how they wish to proceed. We are just awaiting details on that.

CHAIR —That is four outstanding common law actions?

Mr Lysewycz —By private contractors. That is four of the 31 that we mentioned before.

CHAIR —Sorry, what was your last point?

Mr Lysewycz —There are 31 common law actions in Queensland.

CHAIR —And four of them are from civilians?

Mr Lysewycz —That is right.

CHAIR —Four of the outstanding ones are from civilians. One of the things that was mentioned at that first hearing was a desire to try to find a way of dealing with those claims more expeditiously, or in a less formal and legal sense. Am I right about that? Eyebrows are being raised. Did I walk away with the wrong impression?

Mr Lysewycz —We are doing more than trying.

CHAIR —Thank you.

Mr Lysewycz —We are well advanced.

CHAIR —That is good. Given that desire, I was going to ask whether procedures are already in place, or whether you have views about procedures or mechanisms that the committee might consider recommending to parliament and to government, that would facilitate a resolution of those matters, where that is able to be done. Obviously it takes two to tango. If people want to exercise their full rights in the courts they are entitled to do so. Is there a process in which you are currently engaged, or a way of handling these issues that you think is worthy of consideration?

Mr Lysewycz —I do not think there is anything that we would like to suggest be recommended to government as a way ahead or, if you like, a template for the future. One of the advantages of approaching the current cases as we are is that we are able to tailor the approach to the individual and to the firm of solicitors representing that individual and come up with a process that is amenable to progressing the claim to a point where we can formally mediate it. Each of them comes from a different point in time, different employment circumstances and different sets of medical conditions. We are accommodating all that.

We are at the stage where, with the agreement of solicitors representing these claimants, we have six at a stage where we expect to be in a position to start negotiations at the end of November. Basically, it is a paste program. Pre-litigation there is such a degree of exchange of information between parties around the table that we should have sufficient information to evaluate each claim, put a value on it and resolve it.

That is emerging to be a fairly standard approach that we are adopting within defence in litigious claims. Currently that draws its inspiration from the Attorney-General’s drive to have the Commonwealth appearing less often in courts. As a last resort we might have to go to a hearing, but that will be very much a last resort.

CHAIR —Thank you.

Dr Gardner —Can I comment briefly, not from a common law perspective but from a workers compensation-occupational medicine perspective. Reinforcing what Wing Commander Sanders said earlier, in the early days there were significant issues with the workers compensation system in Queensland, in that the sole exclusive access of a relatively small number of civilian contractors was through that workers compensation system in Queensland. The statutory authority there was not particularly interested, in that this was a small number of their 70,000 plus claims each year. They had no experience in it; they had no specialist staff; and they did not know what to do. In particular, under their legislation there were some time things.

When the claim was accepted there were time limits to have it resolved. It was all very difficult. In fact, the Chief of Air Force at the time made a call to encourage them to be more flexible. But again, because the numbers were small, it was a difficult issue. I suggest that while that is not part of our formal submission the committee might think this issue could come up again, not just in relation to defence but also in relation to any Commonwealth employer where civilian contractors are subject to state law. There must be a system that recognises and treats all people equitably and fairly. Relying on the state system is not necessarily the right way to go.

CHAIR —Do you think claimants have encountered difficulties in the state system over and above the difficulties that we have been talking about in the federal system?

Dr Gardner —Yes, absolutely. They had significant issues because the system had no experience of how to cope with this. Because they were waiting and WorkCover in Queensland did the right thing, basically they made a decision to the effect that if someone lodged a claim but asked them not to determine it they would put it on hold. In that way they got around the two-year limit. When that was done the expectation was, as it was in the Commonwealth system, that the SHOAMP study would provide a way forward. Of course, it did not.

Ms Spiers —I wish to comment on schemes that were in operation that informed people that when the government proposal had been settled and announced, members of the Department of Veterans Affairs would meet with Queensland WorkCover and explain how the scheme would operate. We offered any assistance we could and expert knowledge if they got any claims. That offer was made very early on.

CHAIR —Do those civilian contractors have access to the ex gratia payment?

Ms Spiers —Yes.

CHAIR —Thank you. Your submission makes reference to possible areas of future health study. I thought we might try to explore that a little. I have in the back of my mind somewhere that the SHOAMP report—I could be wrong about this—was about a $6.5 million exercise. Sometimes I wonder whether we would not be better off just dealing with the concerns rather than spending money on these other things. That said, if there is an ongoing benefit for other employees, or it is a substantial issue anyway, it makes some sense. The issue of partners which was raised earlier today was mentioned by some of the families in evidence in Brisbane. Do defence or veterans affairs have a view about the need for and desirability of further examination of impacts on family?

Dr Gardner —Chair, I can address your questions. In preparation for today’s sessions and at the request of the deputy chief we put together a list of options of possible future health-related activities. Our submission recommends three of those. One would be that, at a time that is agreed—and probably in the next few years—there should be a further repeat of the statistical mortality and cancer incidence study. Two were done as part of the SHOAMP program.

Subsequent to that, Veterans’ Affairs commissioned an updated report, which will be called the third cancer mortality incidence study. Currently it is being finalised in draft form and it is expected to be released later this year. The interim report basically shows the same results as the second cancer and mortality incidence study. However, if this is further repeated in another five to 10 years time with larger numbers of people and a longer period for exposure, there may be statistically significant figures, although at the moment the study still shows borderline statistical significance.

Mr ROBERT —Could I jump in quickly, Dr Gardner. You said that this third study, though not released, points to statistically not significant. However, does it point to clinically significant as did the SHOAMP study?

Dr Gardner —Thank you, Mr Robert. I have seen this draft report only very briefly and I have seen it only in summary form. Basically, it shows the same numbers and the same cancer. Again, it would come down to a matter of interpretation. We have not become aware of large masses of people who have diseases.

Mr ROBERT —If the numbers were exactly the same, Professor Attia’s comment of ‘clinically significant’ could not hold true?

Dr Gardner —It could hold true. In fact, I mentioned this in my testimony back on 21 July. One of the problems is that some people in the latter programs were working on deseal-reseal programs up until a year before the SHOAMP study started. Therefore, if they are going to get sick—and we hope that they do not but if they are—they do not have to get sick or to show up in the statistics.

Mr ROBERT —I interrupted you. You were talking about the first of your three recommendations.

Dr Gardner —The first recommendation is on pages 13 and 14 of our report. The second one is to address the issue that the chair raised earlier relating to psychological health issues. A study was commissioned by the Air Force through Professor Leonie Coxon at Murdoch University in Western Australia to look at the psychological health, mostly of women, who were caring for chronically invalided spouses. The numbers were small; it was a very select group; and basically it came up with fairly predictable findings. That is, that people who look after chronically disabled and/or depressed spouses tend themselves to have higher rates of a whole range of psychological ill health indicators.

Mr ROBERT —Does that compare also with a non-military group?

Dr Gardner —In the study that Leonie Coxon did there was reference to external examples. But there is an exact comparison and there were no non-military people in her group.

Mr ROBERT —Granted, but did she do a literature review as part of the study?

Dr Gardner —Yes, she did an extensive literature review. It is summarised in the back of the report, which has been attached to our submission on questions on notice. The third thing—we again mentioned this in passing on 21 July and it has been alluded to today—is that there is a growing body of evidence, not just in the Air Force but also in a whole range of other occupations, that some people are genetically sensitive to chemicals and processes at levels that are safe for the vast majority of employees. We believe that this area is worth exploring. In discussion with DVA that would be looked at. Some preliminary work has been done in this area but it must be looked at, properly evaluated and expanded. This area could have significant benefits for the whole Australian population and not just for defence.

Mr Killesteyn —Mr Robert, if it would help, we can provide you with the penultimate draft of the third cancer incidence and mortality study prior to its formal publication and release.

Mr ROBERT —That will be good, although from the committee’s point of view I think Dr Gardner made the point that the third study shows almost identical results to the second and first studies. We will take that as read. That would be great.

CHAIR —If it happens to identify any markedly different outcomes we would want to know that before we concluded our findings. If we are talking about conclusions that are basically along the same lines it does not materially alter what we are on about. There might be some matters that we want to pursue with you in writing—issues to clarify arising out of today’s transcript. You will be provided with a copy of the transcript of the evidence for any adjustments that are required to be made.

Today we have managed to address a number of issues that had been left hanging from both the earlier session in Canberra and arising out of evidence that we took in Brisbane. I take this opportunity to thank both departments for the cooperative approach that has been adopted today and for their willingness to explore potential alternatives. I think that is a good and healthy thing.

I understand that the recommendations you have provided to the committee are not formal positions that have the endorsement of ministers, government or the like, but they will assist the committee in looking at potential ways forward. I am grateful for your cooperation in that.

Subcommittee adjourned at 2.18 pm