"… we provide care locally, and that’s what people want… that’s a big change"
Dr Graeme Killer AO - Principal Medical Adviser
As DVA’s Principal Medical Adviser, Dr Graeme Killer, has seen many changes in the provision of health care to Australia’s veteran community in his 21 years with the Department.
When asked how DVA is serving its clients differently from when he joined the Department, Dr Killer responded that the move from a model of hospital-based care to one of community-based care was the most significant change. When almost 300 000 veterans returned from the First World War, government owned and operated Repatriation General Hospitals were established to provide for their care, with clients travelling to the nearest for treatment.
"Time caught up with this system," said Dr Killer. Economic pressures and an ageing veteran population eventually strained the Repatriation General Hospitals to their limit. Importantly, the availability of health services in non-metropolitan areas had continued to improve and it no longer made sense for elderly clients to travel several hours for treatment that could be provided locally. So DVA transitioned from being a healthcare provider to being one of Australia’s largest purchasers of health services. "This has been one of DVA’s biggest successes," said Dr Killer. ‘Community-based care means DVA beneficiaries can access most healthcare in their local area, in a familiar environment, close to the support of their families.’
According to Dr Killer, DVA is serving clients better by recognising the different cohorts and sub-cohorts of clients, and targeting programs and initiatives accordingly. Many veterans are living longer and with more chronic conditions that require the involvement of several specialists.
One initiative to address this is the Veterans’ Medicines Advice and Therapeutics Education Services (MATES), aimed at improving the use of medicines in the veteran community. It draws on DVA’s database of clients’ GP, specialist and hospital visits and medications prescribed. Clients’ GPs can access this information as well as up-to-date education modules on topics relevant to veterans’ health care. This program, recognised by the World Health Organization and the US Food and Drug Administration, has produced better outcomes by assisting medical practitioners to prescribe better and fewer drugs.
"My work with veterans is the most wonderful period of my life. I’m proud of my contribution to the health of DVA’s clients, and I’m passionate about continuing to improve health and rehabilitation outcomes for the growing cohort of younger veterans injured in contemporary conflicts. We need a change in the way they think about their injuries, we need them to think about … getting better, it’s all about rehabilitation."
For Dr Killer, the ongoing challenge is to improve the rehabilitation options for contemporary veterans, to minimise their disabilities, and to maximise their potential to find meaningful employment after life in the defence force.