Part 1

Functions and powers

The Repatriation Commission was established on 1 July 1920 by proclamation of the Australian Soldiers’ Repatriation Act 1920. When this Act and several other related Acts were replaced in 1986 by the Veterans’ Entitlements Act 1986 (VEA), the Repatriation Commission was retained.

Under section 180 of the VEA, the functions of the Repatriation Commission are:

• to grant pensions and other benefits and provide treatment for veterans, their dependants and other eligible persons;
• to advise the Minister on the operation of the VEA; and
• generally to administer the VEA, subject to the control of the Minister.

The VEA also gives the Repatriation Commission the power to take necessary actions in connection with the performance of its functions, duties and powers (section 181). The responsible Minister under the VEA is the Minister for Veterans’ Affairs. The Minister does not have any powers to direct the Repatriation Commission beyond the power to approve various actions of the Repatriation Commission. These powers are detailed under the Freedom of Information statement at Appendix C.

The Repatriation Commission currently provides services to almost half a million veterans and members of the Australian Defence Force (ADF), their partners, widows/widowers and children.

Structure

The Repatriation Commission has three full-time members appointed by the Governor-General:

• the President, Mr Mark Sullivan, was appointed from 2 December 2004 until 25 October 2008. He replaced Dr Neil Johnston AO who retired on 30 September 2004;
• the Deputy President, Mr Ian Campbell, was appointed for a three-year term from 1 January 2000 and was re-appointed for a further three-year term to 31 December 2005¹; and
• the Services member (generally known as the Repatriation Commissioner) Rear Admiral Simon Harrington AM RAN (Retd). The third member of the Repatriation Commission is chosen from lists of names of persons submitted to the Minister by ex-service organisations. Rear Admiral Harrington was appointed on 25 August 2003 for a three year term to 24 August 2006.

The Repatriation Commission members are also part-time members of the Military Rehabilitation and Compensation Commission (MRCC) with the President serving as Chair of the MRCC and Secretary of the Department of Veterans’ Affairs (DVA). This results in a high level of cohesion between the two commissions and the Department and interconnects them with a high level of administrative and fiscal accountability.

1. Mr Campbell resigned on 2 July 2005. Mr Edward Killesteyn PSM has been appointed as Deputy President for a three-year term from 15 August 2005.

Administration of the VEA

The Repatriation Commission is vested with broad powers to enable it to carry out its functions, duties and powers under the VEA. It also has specific powers to enter into contracts, deal with real or personal property, undertake building works and engage individuals and organisations to perform services.

In relation to claims for pensions, benefits and treatment under the VEA, the Repatriation Commission is the decision-maker. It has responsibility for deciding and reviewing individuals’ entitlements to pensions, benefits and treatment in accordance with the VEA. Although the Commission has no staff of its own, it is able (by sub-section 213(1) of the VEA) to delegate its powers. In practice, these delegates are staff of DVA.

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Relationship with the Department

The Repatriation Commission is responsible for the general administration of the VEA, while the Department provides administrative support to the Commission. The responsibilities of both bodies are therefore inextricably linked and the Repatriation Commission has a vital interest in the activities of the Department and in the assessment of the appropriateness, effectiveness and efficiency of departmental programs.

The Repatriation Commission delegates many of its powers to the Department. It takes an active interest in the administrative arrangements of the Department, including the administration of major programs and the progress and outcome of all major reviews, including Australian National Audit Office efficiency audits.

The Repatriation Commission would like to thank the staff of the Department for their achievements throughout the year, and their continued dedication to achieving excellence in service delivery.

Commission activity

During 2004–05, the Repatriation Commission considered 158 submissions and held 18 formal meetings. Matters considered by the Repatriation Commission included:

• health studies;
• ambulance and community nursing services;
• income support policy and processing issues;
• transport arrangements including the Booked Car With Driver service;
• research proposals;
• hospital re-contracting;
• ongoing improvements to health services, particularly under the Rehabilitation Appliances Program;
• Health Insurance Commission/DVA Services Agreement;
• legal appeals; and
• review of VEA Treatment Principles.

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Strategic issues

The Repatriation Commission is working closely with the Military Rehabilitation and Compensation Commission to ensure that the needs of serving and ex-service personnel and their dependants will be addressed and that there is consistency in policy development. Mental health treatment and rehabilitation services for veterans are priorities for the Commission, as is the continued provision of quality medical and hospital services. To aid in the future treatment and care of veterans, the Commission continues to oversee health studies undertaken by the Department. In 2004-05 the Commission was involved in the commemoration of significant wartime anniversaries, and will be involved in commemorating more of these in 2005-06. The Commission continues to maintain and develop strong relationships with ex-service organisations and with the Department of Defence, particularly through attending conferences of major ex-service organisations, and overseeing the Defence/DVA Links project.

Mental health

The Repatriation Commission received responses from the veteran community and health industry on the consultation paper Improving access to community-based mental health care options for veterans. All respondents broadly endorsed the paper and expressed a desire to be involved in the process of implementing the recommendations.

The priority for mental health in the coming year will be to implement the outcomes of the consultation paper, and to better integrate and coordinate hospital and community based services, including primary health care. This will complement initiatives being undertaken within the Department to improve rehabilitation services and better inform veterans about recovery and return to work options.

Improving delivery of health services

The Repatriation Commission recognises that health contracting is a significant part of its business and is working to ensure that purchasing and contracting practices evolve as the scale and profile of the veteran population changes.

The Commission considered care coordination as a possible model for providing improved health services to veterans, particularly those with complex health care needs. The Commission supported the implementation of three care coordination pilots aimed at identifying the most effective model for veterans. The pilots are expected to commence on 1 October 2005 and run for a period of twelve months. The outcomes of the pilots will provide information on the benefits and health outcomes for veterans who participate in a care coordination program.

The Commission has asked the Department to ensure that the care coordination pilots are undertaken to the highest ethical and procedural standards. This will involve an independent evaluation to determine the effectiveness of the pilots to generate improved quality of life for veterans and economic savings for the Government.

Hospital services

The number of private hospital separations, or completed episodes of care, continues to increase, despite the slow decline in the treatment population. With the increasingly advanced age profile of the World War II veteran population, private hospital admissions continue to shift gradually from surgical to medical. Overall, the average number of days in hospital remains steady with some reduction in surgical length of stays being offset by an increase in the length of medical episodes.

The number of public hospital separations remains steady; likewise the average length of stay. As the treatment population ages, there is a shift from acute surgical hospital services to low medical acuity and rehabilitation hospital services. DVA is working with state and territory governments to ensure that veterans have access to these lower medical acuity and rehabilitation hospital services allowing better transition to home.

In early 2006, the long-term contracts with Greenslopes Private Hospital and Hollywood Private Hospital for the provision of private hospital services to veterans will come to an end. A major priority for 2005-06 for hospitals is the conduct of tender processes in Perth and Brisbane to move these areas to arrangements that are consistent with those applying in other states. During the same period, tender processes will also be carried out to implement a second round of veteran partnering private hospital arrangements in non-metropolitan Queensland, Tasmania, South Australia and Victoria. In addition, the Department is currently working with state and territory governments to finalise a new round of long-term agreements for the provision of public hospital services.

Access to health services for Repatriation Health Card holders

The availability of health services for Repatriation Health Card holders in some regional and remote localities has been an ongoing matter of concern for the Commission. However, the Commission is of the view that the availability of health services for the veteran community in these areas reflects the limited availability of health services generally to the community at large. The limited availability of healthcare professionals outside major metropolitan centres is a structural workforce issue which affects veterans in the same way as the general community. To address this issue, the Commission has in place the Repatriation Transport Scheme which provides transport, accommodation and meal allowances for veterans needing to travel to access healthcare services not available in their local region. Additionally, during 2004-05 the Commission implemented fee increases for specialists and Local Medical Officers from 1 January 2005. The 2005-06 Budget also provided an increase in remuneration for anaesthetists, dentists and a range of allied health providers, which will take effect from 1 July 2005.

Department’s management information system

The priority for the Department’s health management information system for 2005-06 will be the development of an integrated client-centric data view of health services used by DVA entitled veterans, war widows and widowers and dependants. This will complement current program specific views to provide an overall picture of the person’s service usage.

Health studies

This year saw the completion of the Korean War Veterans’ Health Study and the Study of Health Outcomes in Aircraft Maintenance Personnel (SHOAMP). The Department also made significant progress towards the completion of the Nuclear Tests Participants Cancer Incidence and Mortality Study and the Vietnam Veterans’ Mortality and Cancer Incidence Study. The Department’s research, as a result of the Korean War Veterans’ Health Study, is of international interest and will add significantly to the body of international literature. A statement of work for an occupational hygiene survey of the Oberon Class submarines also was undertaken by the Centre for Military and Veterans’ Health (CMVH).

The establishment of the CMVH has given DVA greater flexibility in the way that it organises its health research. The Department of Defence and DVA will continue to collaborate with the CMVH regarding prospective studies of more recent ADF overseas deployments. Of particular interest is the development of a pilot longitudinal health review on ADF personnel deployed to East Timor (InterFET).

Commemoration

The Commission continued its active involvement in the Government’s Saluting Their Service commemorations program. There were a number of significant anniversaries in 2005. To mark the 90th anniversary of the Gallipoli landings, the Minister for Veterans’ Affairs, the President and the Commissioner, together with the leaders of 10 national ex-service organisations, attended Anzac Day services at Gallipoli. The Commissioner led a commemorative mission of World War II veterans to France and the United Kingdom in May 2005 for the 60th anniversary of Victory in Europe. In June 2005, the Minister led a commemorative mission of 11 veterans, together with the Deputy President and the Commissioner, to Borneo to commemorate the 60th anniversary of the 1945 landings at Tarakan, Balikpapan, Labuan and Brunei.

Commission members are closely involved in the planning of, and will take part in, commemorative missions proposed for September 2005 to Hawaii to mark the 60th anniversary of the Japanese surrender and to Papua New Guinea to commemorate the 60th anniversary of the final battles there and the subsequent surrender of Japanese forces.

The Commissioner and the Vice Chief of the Defence Force were overseeing the planning of the Salute to Veterans to be held in Canberra on 13-15 August. This planning is being carried out by a committee comprising representatives from the Departments of Veterans’ Affairs, Defence and the Prime Minister and Cabinet, the Australian War Memorial, ACT Government, National Capital Authority, Returned & Services League and other organisations.

Relationship with ex-service organisations

The Repatriation Commission continued to build on its close relationship with ex-service organisations. A sound relationship with ex-service organisations is crucial to ensuring that the Commission’s policies and services enhance the health and well-being of veterans.

During the year, members of the Commission attended major ex-service organisation conferences and congresses and sought the views of the veteran community through a number of consultative forums.

Relationship with Department of Defence

The Defence/DVA Links project remains a priority for the Repatriation Commission. The project continues to map out the long-term course for the Department within the broader Defence portfolio. The Defence/DVA Links Project Review Board continues to be a conduit for key joint Defence/DVA activities. This includes the areas of health, records management and transition management for ADF personnel leaving the services.

Several successful DVA/Defence partnerships flowing on from the 2001 F-111 Deseal/Reseal Board of Inquiry have continued into 2004-2005. These have included the Study of Health Outcomes in Aircraft Maintenance Personnel (SHOAMP) and the F-111 Deseal/Reseal Health Care Scheme. In addition, the Government response to the SHOAMP has provided further opportunities for collaboration between the departments as arrangements to implement the response are finalised.

Delivery of services

The Commission recognises that the declining World War II population will result in a reduction in the Department’s workload and resources in the coming years. The challenge for the Department will be to maintain services to the veteran community, using more effective methods to meet the changing needs of the veteran community, including for younger veterans and to make better use of technology. The Commission is carefully monitoring the Department’s internal Review of Service Delivery Arrangements to ensure services to the veteran community will be maintained.

The Commission is also carefully monitoring the Department’s quality assurance processes, so that it can continue to be assured that the decisions of its delegates are of the highest quality.

Veterans’ Children Education Scheme

As required under the Veterans’ Children Education Scheme (VCES), each Veterans’ Children Education Board has provided a report to the Repatriation Commission.

The VCES provides support services and financial assistance to children of certain deceased or severely incapacitated veterans or members of the ADF. Under the scheme, children have access to educational guidance and counselling to help them achieve their full potential. Benefits, including education allowances and other forms of assistance such as additional tuition, special financial assistance, rent assistance and fares allowance, are available at all three levels of education (primary, secondary and tertiary).

The total number of children benefiting from the VCES as at 30 June 2005 was 4 803. This represents an overall decrease in student numbers of 6.14 per cent from the previous year. While the number of students in secondary and tertiary education decreased, the number of primary students held steady.