The National Treatment Monitoring Committee (NATMOC) was established in 1992 to monitor the integration or sale of the Repatriation General Hospitals and the operation of the Repatriation Private Patient Scheme (RPPS) in each state and territory. After approving the operation of the committee for an initial two-year period, the Repatriation Commission reviewed NATMOC’s role in May 1994 and, satisfied with its progress, approved an extension for a further two years. It approved further extensions in 1996, 1998, 2000 and 2002. In July 2004 NATMOC was further extended until 2006.
Enabling legislation
NATMOC is established under the Repatriation Private Patient Principles, which are determined under section 90A of the Veterans’ Entitlements Act 1986. The principles state that the Repatriation Commission will monitor access to, and quality of, hospital care arranged for the veteran community through a national treatment monitoring committee and treatment monitoring committees in each state and territory. NATMOC also has the same monitoring role under paragraph 13 of the schedule to the Seamens’ War Pensions and Allowances Regulations.
Membership
Membership of NATMOC is determined under RPPP No 13. Members are appointed for a two-year period but may resign at any time. The committee has two Australian Government officers and seven members who represent ex-service and associated organisations.
| Mr Mark Sullivan | President, Repatriation Commission-Australian Government representative and Chair-from 25 October 2005 |
| Mr Ken Douglas | Division Head Health, DVA-Australian Government representative |
| Mr Ted Richards | Returned & Services League of Australia-from 25 October 2005 |
| Mrs Norma Whitfield | War Widows’ Guild of Australia-from 25 October 2005 |
| Mr Colin Doust | Australian Veterans and Defence Services Council |
| Mr John 'Blue' Ryan OAM | Australian Federation of Totally & Permanently Incapacitated Ex-Servicemen and Women |
| Mr Simon Agnew | National Legacy Coordinating Council |
| Air Vice-Marshal John Paule AO DSO AFC (Retd) | Regular Defence Force Welfare Association |
| Mr Rob Cox OAM | Vietnam Veterans Association of Australia-to September 2005 |
| Mr Ron Coxon OAM | Vietnam Veterans Association of Australia-from 25 October 2005 |
Functions
During 2004–05, NATMOC continued to provide a forum for state treatment monitoring committees to raise issues best addressed at a national level. NATMOC received reports from state committees relating to the operation of the RPPS and wider health care issues for the veteran community.
Staff
The Department continued to provide secretariat services to the committees. Information about NATMOC can be obtained from the Branch Head Hospitals and Business Development.
Funding
NATMOC is financed from the DVA budget allocation. Although committee members receive no sitting fees, the Department covers the cost of travel and accommodation where members are required to attend interstate meetings.
| Travel expenses for three meetings | $14 585 |
| Accommodation for three meetings | $7 266 |
| Provisioning for meetings | $388 |
| Total | $22 239 |
NATMOC does not distribute funds or grants.
Meetings
Meetings were held on 22 July 2004 in Perth, 28 November 2004 in Brisbane and 8 April 2005 in Melbourne.
Activities and issues raised
The committee’s priorities during 2004–05 included:
- reviewing the minutes from state treatment monitoring committees;
- monitoring:
- mental health;
- the Defence/DVA Links Project;
- Military Compensation and Rehabilitation Service statistics;
- Centre for Military and Veterans’ Health;
- Australian Centre for Posttraumatic Mental Health;
- New prescriber feedback program – Veterans’ MATES;
- health contracting;
- health studies;
- the National Ex-Service Round Table on Aged Care; and
- telepsychiatry trial
- considering issues arising from the newly formed Australian Hearing Services Advisory Committee on which Air Vice-Marshal John Paule is a representative.
Mental health
Members continued to have a particular interest in mental health initiatives and noted the Repatriation Commission’s work to improve access to community-based mental health care options. The committee also was kept informed of the work being done by the Australian Centre for Posttraumatic Health and the establishment of the National Veterans Mental Health and Wellbeing Forum.
Defence/DVA Links Project
NATMOC has continued to show support for the Defence/DVA Links Project, which aims to improve services to Australian Defence Force members and veterans by identifying common business areas between the DVA and Defence and making better use of resources.
Military Compensation and Rehabilitation Service statistics
Throughout the year, the committee was updated on the Military Compensation and Rehabilitation Service output statistics and monitored facts and figures provided in respect to service in East Timor.
Centre for Military and Veterans’ Health
The work being done by the Centre for Military and Veterans’ Health, including the professional development of Defence health staff, “think-tank” activities, e-health initiatives and research on longitudinal health issues was strongly supported by the committee.
New prescriber feedback program – Veterans’ MATES
The members were informed of the launch of the new prescriber intervention and feedback program, Veterans’ MATES (Veterans’ Medicines Advice and Therapeutics Education Services). Strong interest was shown in this program, which will be provided in conjunction by the University of South Australia.
Health contracting
The committee was kept up-to-date on the provision and contracting arrangements of the following health services:
- Local Medical Officers;
- specialists;
- allied health;
- optical;
- alternative therapies;
- dental;
- Booked Car With Driver;
- Rehabilitation Appliances Program;
- public and private hospitals;
- Veterans’ Home Care; and
- community nursing.
Health studies
Members continued to monitor the progress of the following studies:
- Korean War Veterans’ Health Study;
- Study of Health Outcomes in Aircraft Maintenance Personnel;
- Nuclear Tests Participants Cancer Incidence and Mortality Study;
- Review of the expert panel into Special Air Service health concerns; and
- Vietnam Veterans’ Mortality and Cancer Incidence Study.
The members were also briefed on beryllium and depleted uranium issues.
National Ex-service Round Table on Aged Care
NATMOC continued to have a strong interest in aged care issues addressed by the National Ex-service Round Table on Aged Care.
Outlook for 2005–06
The committee will closely monitor the introduction of the new veteran partnering arrangements that will be implemented in metropolitan Perth and Brisbane in 2005–06.
New South Wales Treatment Monitoring Committee
Meetings held: 16 September 2004, 25 November 2004, 17 March 2005 and 9 June 2005.
| Mr Gary Collins | Deputy Commissioner, DVA - Australian Government representative and Chair |
| Mr Effie Cauchi | Acting Director, Health, DVA - Australian Government representative - to March 2005 |
| Ms Jennifer Collins | Director, Health, DVA - Australian Government representative - from April 2005 |
| Mr Don Rowe OAM | Returned & Services League of Australia |
| Lieutenant Colonel A "Bushy" Pembroke MC (Retd) | Regular Defence Force Welfare Association |
| Mr Barris Liptrott | Australian Veterans and Defence Services Council |
| Mr G (Les) Blok | Totally & Permanently Incapacitated Veterans’ Association of NSW Ltd |
| Mr Peter Maher | Vietnam Veterans’ Federation of Australia |
| Mr Harry Kirkman | Vietnam Veterans Association of Australia - to November 2004 |
| Mr Barry Billing | Vietnam Veterans Association of Australia - from November 2004 |
| Ms Catherine Katz | NSW Health Department |
| Mr Ken Duncan | Sydney Legacy |
| Mrs Audrey Blood | War Widows’ Guild of Australia |
Matters of significance
Major issues focused on during the year included:
- the operation and review of the Repatriation Private Patient Scheme;
- Concord Repatriation General Hospital;
- Lady Davidson Private Hospital;
- Veterans’ Home Care;
- Local Medical Officers and specialist medical services;
- mental health; and
- complaints monitoring.
Repatriation Private Patient Scheme
Committee members were provided with quarterly statistical reports showing admission data for public and private hospitals and day procedure centres in NSW. Only minor variations occurred during the year to the numbers of separations and occupied bed days in both public and private hospitals.
The committee discussed the role of the Veterans’ Liaison Officer (VLO) in private hospitals and was provided with a document clarifying the role of VLOs, and contact details of VLOs in NSW.
Concord Repatriation General Hospital
Members received regular updates from the Medical Director of Concord Hospital. Issues discussed included the ongoing development of the new mental health facility – the largest of its kind in Australia – and an increase in the number of senior medical staff in the emergency department. The hospital is also about to take delivery of a new Magnetic Resonance Imaging machine.
Concord Hospital continued to host a variety of commemorative events, including a commemorative service for VP Day, which was well attended.
The committee also was advised that the hospital is involved in a major study, funded by the National Health & Medical Research Council, into male health issues.
Lady Davidson Private Hospital
Lady Davidson Hospital continued to have high numbers of veteran patients (between 50 per cent and 56 per cent of all admissions). The average age of patients is high and there continues to be a strong focus on rehabilitation. The committee was informed that a patient satisfaction survey completed in 2004 showed high levels of satisfaction both with treatment in the hospital and with the associated discharge planning process.
Veterans’ Home Care
The committee was informed that additional funding of about 12 per cent was allocated to the Veterans’ Home Care (VHC) program in NSW following the Federal Budget. During the year there were no waiting lists for VHC services in any region of NSW and the average waiting time between assessment and approval was one to two weeks. There was a marked decline in complaints about VHC services in NSW during the course of the year.
The assessment process for VHC was discussed and committee members were provided with a paper explaining how the process works to ensure that services are targeted at veterans with low-level care needs.
Local Medical Officers and specialist medical services
The committee noted the increases in fees to both Local Medical Officers (LMOs) and medical specialists. No major issues were raised regarding access to LMO and specialist services during the year.
A request was made for clarification of DVA policy in relation to treatment for the eye condition macular degeneration. The committee was provided with a statement of the DVA policy.
Mental health
Committee members requested information about numbers of admissions for psychiatric services. Preliminary data suggested that about 6 per cent of separations and 4 per cent of occupied bed days were related to psychiatric conditions.
Access to psychiatric services in country areas also was discussed and DVA provided feedback on action being taken in relation to services in specific areas.
Complaints monitoring
Committee members received a report at each meeting listing the number complaints received during the preceding quarter and identifying the main categories into which they fell. The total number of complaints received in 2004–05 (151) was greatly reduced from the previous year’s number (412), largely due to the dramatic decline in complaints about VHC. This was attributed to the improvements in access to, and timeliness of, VHC services, due in part to the allocation of additional funding. All complaints were investigated and a response provided to the writer. The committee was satisfied with the action taken.
| Complaint category | 2003-04 | 2004-05 |
|---|---|---|
| Transport/travel | 53 | 41 |
| Hospitals | 28 | 9 |
| Rehabilitation Appliances Program/allied health | 80 | 40 |
| Doctors | 21 | 9 |
| Veterans’ Home Care | 215 | 46 |
| Other | 15 | 6 |
| Total | 412 | 151 |
Victoria Treatment Monitoring Committee
Meetings held: 7 September 2004, 30 November 2004 and 8 April 2005.
| Mr Bob Solly | Deputy Commissioner, DVA - Australian Government representative and Chair |
| Mr Mike O'Meara | Director, Health & Client Services, DVA - Australian Government representative |
| Mr Chris O'Gorman | Executive Director, Corporate Development, Austin Health |
| Ms Mignonne De Witt | DVA Contract Manager, Human Services |
| Sir Guy Boileau, Bt | Regular Defence Force Welfare Association |
| Mr Lloyd Saltmarsh | Naval Association of Australia |
| Mr Phil Davies | Australian Federation of Totally & Permanently Incapacitated Ex-Servicemen and Women - to 24 February 2005 |
| Mr John Vincent | Australian Federation of Totally & Permanently Incapacitated Ex-Servicemen and Women - from 31 March 2005 |
| Mr Reg McMaster | Vietnam Veterans Association of Australia |
| Dr Ian Goy | Melbourne Legacy |
| Dr Allan Beech | Melbourne Legacy |
| Mrs Marjorie Wilson | War Widows’ Guild of Australia |
| Mr John Johnson | Returned & Services League of Australia |
| Mr John Riches | Returned & Services League of Australia |
| Mr Brendan Lynch | Australian Veterans and Defence Services Council |
Observer: Mr Robert Winther, Veteran Liaison Officer, Austin Health.
Matters of significance
Major issues focused on during the year included:
- the Austin Health redevelopment;
- the Veterans’ Psychiatric Unit at the Austin campus; and
- aged care issues.
Austin Health redevelopment
The major redevelopment of the Austin Hospital progressed during the year. The upgraded facility on the Austin campus was officially opened in May and became operational in June 2005. Austin Health also commenced work on a Heidelberg Repatriation Site Development Master Plan and is believed to be in discussion with the Department of Human Services concerning re-development of the Heidelberg Repatriation Hospital campus.
Veterans’ Psychiatric Unit
A number of issues were brought to the committee’s attention regarding the Veterans’ Psychiatric Unit at the Austin campus, in particular the need for improvements to the buildings and infrastructure, the treatment of non-veterans in veterans’ mental health wards, and the age and gender mix of patients. These concerns were raised with the hospital and the Victorian Department of Human Services. They have noted the concerns and aim to achieve a long-term solution with the redevelopment of the Austin campus. Several interim initiatives also have been undertaken or are planned. These include introduction of a new meal regime in the wards, approval of expenditure on building maintenance work, and continuing efforts to achieve more appropriate segregation of patients.
Aged care issues
The committee received regular reports on the activities of the Victorian Ex-Service Round Table on Aged Care. The major issues discussed were:
- the position of younger veterans in residential care; and
- the need for ex-service groups to give a higher priority to aged care issues.
Mental health
The committee was kept informed on developments in DVA’s mental health policy; particularly the increased focus on community-based treatment. A report was presented to show how Victoria State Office is developing a service planning model to improve access for veterans to this type of treatment.
Health service trends
Presentations dealing with trends in a range of DVA health services were made at each meeting. The areas addressed were private hospitals, Veterans’ Home Care and pharmacy.
Information/discussion sessions
The following information/discussion sessions were conducted at meetings during the year:
- Towards Better Health for the Veteran Community;
- provider fees;
- DVA’s mental health strategy;
- DVA’s revised rehabilitation appliance arrangements;
- public hospital contract arrangements; and
- hearing services.
Complaints monitoring
During the year, 40 complaints were received and resolved. As in previous years, all issues were dealt with on a case-by-case basis, being forwarded to the relevant provider organisation for thorough investigation and report. The greatest area of complaint was hospital treatment, with the majority of these complaints focusing on the quality of clinical care and discharge planning issues.
| Complaint category | 2003-04 | 2004-05 |
|---|---|---|
| Hospital treatment | 18 | 26 |
| Veterans’ Home Care | 5 | 5 |
| Transport | 4 | 4 |
| Rehabilitation appliances | 0 | 2 |
| Specialist services | 1 | 2 |
| Pharmacy | 0 | 1 |
| Total | 28 | 40 |
Queensland Treatment Monitoring Committee
Meetings held: 25 November 2004 (joint meeting with NATMOC), 14 February 2005 and 23 June 2005 (an extraordinary meeting to discuss veteran partnering).
| Mr David Mackrell | Deputy Commissioner, DVA-Australian Government Representative and Chair |
| Mr Kevin Ross | Director, Health and Corporate Support, DVA-Australian Government Representative |
| Mrs Helen Hill | War Widows’ Guild of Australia |
| Mr Cyril Gilbert OAM | Returned & Services League of Australia, Queensland Branch |
| Retired Air Commodore Kevin Casey | Regular Defence Force Welfare Association |
| Mr Bob Baulch OAM | Returned & Services League of Australia (RSL), Western District Rural & Remote |
| Mr Malcolm Wheat | Vietnam Veterans Federation, Queensland Branch Inc |
| Mr Gordon Blake | Australian Veterans and Defence Services Council |
| Dr Peter Grant OBE RFD ED | Legacy Coordinating Council |
| Ms Julie Kissane | Veterans Health Services Unit, Queensland Department of Health-from 1 August 2004 |
| Mr John Custance | Australian Federation of Totally & Permanently Incapacitated Ex-Servicemen & Women, Queensland Branch Inc |
| Mr Terry Ward | South Eastern District RSL-from 1 August 2004 |
| Mr John Smith | Secretary, Vietnam Veterans Association of Australia, Queensland Branch-from 1 August 2004 |
Observers: Mr Alan Kinkade, CEO, Greenslopes Private Hospital; Mrs Veronica Kratzmann, War Widows’ Guild of Australia; Ms Serena Buckham, Queensland Department of Health; Mr Graham Fox, Limbless Soldiers Association, Queensland; Ms Libby Brown, Australian Federation of Totally & Permanently Incapacitated Ex-Servicemen & Women (Queensland Branch); Mrs Sonja Hellier, Australian Veterans & Defence Services Council Incorporated; Mr Brett Bullians, Vietnam Veterans Association of Australia (Queensland Branch).
Matters of Significance
Major issues focused on during the year included:
- re-appointment of members;
- Local Medical Officer and specialist services;
- veteran partnering;
- mental health;
- RPPS hospital separation data; and
- Rehabilitation Appliances Program.
Re-appointment of members
The members of the committee were advised that nominations from all organisations had been received and appointment/re-appointment of members was confirmed to 30 June 2006.
LMO and specialist services
Local Medical Officer and specialist service coverage and fees were discussed at both committee meetings and members were concerned to ensure that members of the veteran community had adequate access to care. An increase in pricing arrangements with LMOs and specialists took effect from 1 January 2005, and its impact on access to LMO and specialists was closely monitored by members.
Veteran partnering
Committee members were informed that hospital arrangements in the Brisbane metropolitan area would change with the conclusion of the current Greenslopes Private Hospital contract in January 2006. This will occur through the opening up of private hospital services to full veteran partnering in the Brisbane metropolitan area, which will provide improved access for veterans. An extraordinary meeting was held on 23 June 2005 to brief members on the proposed tender process. Committee members took an active interest in this matter and provided feedback on a number of related issues.
Mental health
Members were provided with information about a range of mental health projects, including:
- National Veterans Mental Health and Wellbeing Forum;
- mental health consultation paper;
- Pathways to Care;
- ageing and mental health;
- Alcohol Management Project;
- Project ASIST; and
- RSL Care Mental Health Rehabilitation Project.
RPPS hospital separation data
Members closely monitored the use of public and private hospitals by veterans and war widows/widowers in Queensland on a quarterly basis. Data in relation to the top 20 diagnostic relation groups as they affect veterans in hospital were reviewed. The data reflected the high usage by veterans in cataract surgery, mental health treatment, investigative colonoscopies and endoscopies and skin procedures. In categories with longer length of stay, high use areas were noted as circulatory, respiratory and treatment for heart failure.
Rehabilitation Appliances Program
Committee members were kept informed of progress with the Rehabilitation Appliances Program (RAP) reforms process. Following a national six-part tender process, new RAP supply arrangements are being progressively implemented. The committee took an active interest in the RAP progress and highlighted areas of interest/concern.
Information/discussion sessions
The following information/discussion sessions were conducted at meetings during the year:
- review of the NATMOC minutes;
- Greenslopes Private Hospital update;
- Magnetic Resonance Imaging machines; and
- Veterans’ MATES.
Complaints monitoring
During the year, 25 complaints were received concerning various aspects of hospital treatment. All issues were dealt with on a case-by-case basis, being forwarded to the relevant provider organisation for thorough investigation and report. For reporting purposes, these were categorised into nursing, discharge planning, specialist care, transport, doctor and other issues. Some complaints covered more than one category.
| Complaint category | 2003-04 | 2004-05 |
|---|---|---|
| Nursing | 11 | 5 |
| Discharge planning | 11 | 8 |
| Specialist | 3 | 3 |
| Communication | 21 | 16 |
| Transport | 1 | 2 |
| Doctor | 1 | 1 |
| Other (administrative/management issues) | 13 | 13 |
| Total | 61 | 48 |
South Australia Treatment Monitoring Committee
Meetings held: 23 July 2004, 27 October 2004, 11 March 2005 and 17 June 2005.
| Ms Pamela Blamey | Deputy Commissioner, DVA-Australian Government representative and Chair |
| Ms Kerrie Bowering | Assistant Director Health Services, DVA-Australian Government representative |
| Mr Allan Lambden-Stewart | A/g Manager, Hospital Contracts and Transport, DVA-Australian Government representative |
| Mr Max Farrell | Legacy Club of Adelaide-to 7 March 2005 |
| Mr Ron Zwar OAM | Australian Veterans and Defence Services Council |
| Mr Bill Schmitt AM | Ex-Prisoners of War Association |
| Mrs Kathleen Rhodes | War Widows’ Guild of Australia |
| Mr John Spencer | Returned & Services League of Australia |
| Mr Ian Condon | Regular Defence Force Welfare Association |
| Mr Ron Coxon OAM | Vietnam Veterans Association of Australia |
| Mr John Reeves | The Association of Totally & Permanently Incapacitated Ex-Servicemen and Women SA Branch Inc. |
| Mr Darren Renshaw | RGH, Daw Park |
| Ms Jenny Richter | Director, Financial Risk Management and Monitoring, South Australia Department of Health |
Matters of significance
Major issues focused on during the year included:
- South Australian Health and Community Services Ombudsman;
- Repatriation General Hospital Daw Park Financial Recovery Committee;
- changes to Repatriation General Hospital Daw Park outpatient day programs;
- update on mental health initiatives in South Australia;
- negotiation of new long-term arrangements for public hospital services for veterans; and
- public and private hospital utilisation.
South Australian Health and Community Services Ombudsman
The committee was advised that the South Australian Government had passed legislation for the creation of a Health and Community Services Ombudsman to commence on 1 July 2005.
Repatriation General Hospital Daw Park Financial Recovery Committee
Advice was provided by the South Australian Department of Health representative on the Financial Recovery Committee that had been established to assist RGH Daw Park in addressing its financial position.
Changes to Repatriation General Hospital Daw Park outpatient day programs
Following the development of outpatient protocols for group programs, the committee was provided with details of the changes to outpatient programs at RGH Daw Park. Consistent with the recommendations made in the DVA Mental Health Strategy, the new programs are more structured with a focus on meeting treatment outcomes through regular assessments. In addition to these changes a new Relapse Prevention Program was introduced, initially to provide a safety mechanism for veterans who have been discharged from the previous hospital-based programs to community-based services.
Update on mental health initiatives in South Australia
The committee was provided with a summary of the initiatives in place to meet the objectives of the DVA National Mental Health Strategy. Discussions included details of those programs that were being run locally in addition to National Office coordinated initiatives as well as an outline of the links that have been created with external organisations and providers to highlight and address veteran mental health issues.
Negotiation of new long-term arrangements for public hospital services for veterans
With the current 10-year arrangement between the Commonwealth of Australia and the South Australia Department of Health for the provision of public hospital services to veterans expiring on 30 June 2005, updates of the status of negotiations for a new long-term agreement were provided to the committee.
Public and private hospital utilisation
The committee continued to monitor the provision of services by public and private hospitals in South Australia. Major developments discussed included the successful contracting of day procedure centres and country private hospitals in South Australia, the annual price review for metropolitan Tier 1 and Tier 2 private hospitals, as well as the new long-term arrangements for public hospital services.
A report was presented to the committee detailing the utilisation of public and private services for the period 1998-99 through to 2003–04 covering aspects such as trends in numbers of separations and occupied bed days by various categories. The report provided statistics on many facets of hospital activity including public and private utilisation, separations by age cohort, average length of stay and reasons for admission in addition to treatment population projections. It was noted that during the past four years, the total number of separations in both public and private hospitals had remained stable, with only a marginal increase or decrease of less than 1 per cent during those periods. It also was noted that in 2003–04 there was a mix of 47 per cent separations in public hospitals and 53 per cent in private hospitals.
Complaints monitoring
A summary of each investigated and resolved complaint received from members of the veteran community, in relation to any public or private health service, is presented to the committee at each meeting for discussion. These summaries include brief details of the complaint and an outline of the outcome enabling discussion on any emerging trends or issues. During the year the committee reviewed some 51 complaints, 65 per cent of which fell into the hospital treatment and discharge planning categories.
| Complaint category | 2003-04 | 2004-05 |
|---|---|---|
| Policy and procedures | 0 | 2 |
| Available services | 1 | 3 |
| Discharge planning | 8 | 10 |
| Access | 4 | 9 |
| Transport | 4 | 1 |
| Hospital treatment | 20 | 23 |
| Other | 8 | 3 |
| Total | 45 | 51 |
Western Australia Treatment Monitoring Committee
Meetings held: 22 July 2004 (joint meeting with NATMOC), 4 November 2004, 10 March 2005 and 8 June.
| Mr Russell McLaughlan | Deputy Commissioner, DVA-Australian Government representative and Chair-to 29 July 2004 |
| Mr Arthur Edgar | Deputy Commissioner, DVA-Australian Government representative and Chair-from 29 July 2004 |
| Ms Marilyn West | Director Health, DVA-Australian Government representative |
| Mrs Hazel Donald | War Widows’ Guild of Australia |
| Mr Les Crowe | Vietnam Veterans Association of Australia |
| Mr Ross O'Connor | Returned & Services League of Australia |
| Mr Bill Dedman OAM | Regular Defence Force Welfare Association |
| Mrs Shirly Mooney | Australian Veterans and Defence Services Council |
| Mr Peter Eddy | Legacy |
| Group Captain Jean Harrison (Retd) | RAAF Association |
| Mr Mike Hoar | Naval Association of Australia |
| Mr Derek Phillips JP | Australian Federation of Totally & Permanently Incapacitated Ex-Servicemen and Women Inc |
| Mr R Giblett JP | Special Air Service Association-to 2 March 2005 |
| Mr M Krassovsky | Special Air Service Association-from 2 March 2005 |
| Ms Bing Rivera | WA Department of Health |
Observers: Mr Kevin Cass-Ryall, Executive Director, Hollywood Private Hospital, Mr John Parker, Assistant Director, Hospital and Medical Services, DVA, WA (to 10 August 2004) and Mr David Watson, Assistant Director, Hospital and Medical Services, DVA, WA (from 10 August 2004).
Matters of significance
Major issues focused on during the year included:
- increased level of departmental fees for specialists and Local Medical Officers;
- the continued decrease in the size of the treatment population in WA;
- the operation of Tier 1 and Tier 2 veteran partnering private hospital arrangements, commenced in late 2003, in metropolitan Perth;
- the planned commencement of a tender process for the introduction of comprehensive veteran partnering in the Perth metropolitan area, in the second half of 2005;
- the development of a proposal for a respiratory rehabilitation (Breathe) program at Hollywood Private Hospital;
- the continuing commitment of the T&PI Association in WA to the development of the Applied Suicide Intervention Skills Training (ASIST) program;
- the introduction of the Military Rehabilitation and Compensation Scheme from 1 July 2004;
- the purchase of Galliers and Kaleeya Private Hospitals by the WA Government; and
- the purchase of Rockingham Family Hospital by Ramsay Health Care, renamed Coastal Private Hospital.
Veteran partnering
Committee members took an active interest in Department plans to extend veteran partnering arrangements in outer metropolitan Perth. A special meeting was held on 8 June 2005 to brief members on the proposed tender process to improve private hospital access in Perth.
Operation of the Repatriation Private Patient Scheme
The committee noted a continued in decline in the size of the treatment population and at the end of 2004 there were 28 032 entitled card holders - 21 878 Gold Card holders and 6 154 White Card holders - down from 28 669 card holders at the end of 2003.
Under Repatriation Private Patient Scheme arrangements, 29 074 hospital admissions were provided for entitled veterans and war widows in WA, an increase on the 28 184 admissions in 2003. However, the number of medical and surgical services, including consultations, provided in 2004 decreased from 438 500 in 2003 to 421 893.
Hollywood Private Hospital provided 58.1 per cent of admissions during 2004 (57.3 per cent in 2003), while the public hospital share of admissions decreased from 30.8 per cent in 2003 to 26.4 per cent in 2004. Admissions to other facilities were 12 per cent of the total admissions in 2003, have risen in 2004 to just over 15 per cent (including Tier 1 private hospitals other than Hollywood and Tier 2 and 3 facilities).
Hollywood Private Hospital
During the year Hollywood Private Hospital reported:
- it had introduced new arrangements to assist identification of inpatients for hospital visitors that address concerns for patient privacy;
- it was reviewing future plans seeking to produce uniform accommodation standards throughout the hospital;
- the transfer of outpatient palliative care services to Silver Chain Nursing, while retaining inpatient palliative care services;
- the purchase of the Benchmark hospital group (which had no hospitals in WA) and the Rockingham Family Hospital by Ramsay Health Care;
- the on-site provision of MRI capacity, due to come into service later in 2005; and
- planning for 38 more beds and the re-opening of two operating theatres progressed.
Complaints monitoring
During the past 12 months 16 formal complaints were received and addressed, the same number as the previous year.
| Complaint category | 2003-04 | 2004-05 |
|---|---|---|
| Hospital treatment/facilities | 5 | 12 |
| Admission procedures | 1 | 1 |
| Access under the RPPS | 3 | 3 |
| Hospital transfers | 2 | 0 |
| Billing arrangements | 2 | 0 |
| Discharge procedures | 3 | 0 |
| Total | 16 | 16 |
Tasmania Treatment Monitoring Committee
Meetings held: 1 September 2004, 1 December 2004, 9 March 2005 and 1 June 2005.
| Mr Neil Bayles | Deputy Commissioner, DVA-Australian Government representative and Chair-to 1 October 2004 |
| Mr Kevin O'Sullivan | Deputy Commissioner, DVA-Australian Government representative and Chair-from 4 October 2004 |
| Ms Christina Shaw | Director, Health, DVA-Australian Government representative |
| Mrs Noeleen Lincoln OAM | Returned & Services League of Australia-to 7 March 2005 |
| Mr Anthony Scott OAM | Returned & Services League of Australia-from 25 May 2005 |
| Mrs Joan Cooper | War Widows’ Guild of Australia |
| Mr George Debnam | Australian Veterans and Defence Services Council |
| Mr Maxwell Muir | Australian Association of Totally and Permanently Incapacitated Ex Servicemen and Women |
| Mr Jack Brotherson | Hobart Legacy |
| Lt Col David Solomon (Retd) | Regular Defence Force Welfare Association |
| Mrs Anne Harper | Vietnam Veterans Association of Australia |
| Mr Norm Davie | Department of Health & Human Services |
| Mrs Fiona Cairns | Department of Health & Human Services |
Matters of significance
Major issues focused on during the year included:
- hospital contracts;
- withdrawal by certain specialists from DVA arrangements;
- increased state government funding for health; and
- the Alice Elliott Day Centre review.
Hospital contracts
The committee was advised of the following changes to hospital ownership:
- Calvary Health Care Tasmania (private) took over St Luke’s Private Hospital in May 2004;
- Mersey Community Hospital, a private and public hospital operated by Healthscope, which had a small number of private beds, became a public hospital in December 2004 and was renamed the Mersey Campus of the North West Regional Hospital; and
- Calvary Health Care Tasmania is due to take over St Vincent’s Private Hospital in July 2005.
Following the above changes, there will be only two operators of acute private hospitals in Tasmania – Calvary Health Care Tasmania and Healthscope.
Withdrawal by specialists from DVA arrangements
The committee was kept appraised on the specialists in Tasmania who had withdrawn from providing services in private hospitals despite the announcement in the Federal Budget of a 20 per cent fee increase for specialist procedures and a 15 per cent increase for consultations from 1 January 2005.
The greatest impact was in neurosurgery, urology and orthopaedic surgery. In particular, all three neurosurgeons in Tasmania withdrew from providing services in Tasmanian private hospitals. Where necessary, DVA staff assisted veterans and LMOs in finding the nearest suitable provider. While this was usually a provider in Tasmania, a small number of veterans travelled interstate to see a neurosurgeon.
Interim arrangements were put in place for veterans accessing private hospital accident and emergency departments and requiring immediate attention from a specialist in one of the above speciality categories.
Increased state government funding for health
The committee was informed that in September 2004 the Tasmanian State Government had announced a $75 million funding package to address priority issues facing the health sector, particularly in the provision of specialist services in the areas which veterans were experiencing difficulties. This included recruitment of additional specialists and nurses in Tasmanian public hospitals; $6 million for capital expenditure, including the replacement of old hospital beds and equipment; and the creation of a new 22-bed Transition Care Unit for non-acute patients waiting for nursing home beds at the Royal Hobart Hospital. Of this funding package, $21 million was earmarked for spending in the 2004–05 financial year.
Alice Elliott Day Centre review
In January 2004 DVA advised the committee of an undertaking to review the future management of the Alice Elliott Day Centre.
The review commenced early in 2004 and was undertaken by a senior DVA staff member under the direction of a steering committee of experts in the fields of health and aged care. A review reference group, made up primarily of representatives from ex-service organisations, also was formed, to act as a consultative forum to provide advice and opinion on the review as it progressed.
Following a number of meetings during 2004–05, the steering committee compiled a draft report, with its recommendation for the future of the centre. Further feedback is being sought on the report and recommendation from ESOs and other groups. Their comments will be provided to the Deputy Commissioner, and subsequently to the Repatriation Commission, for consideration.
Complaints monitoring
During 2004–05 there were seven complaints reported to the committee, all in relation to hospitals. Four complaints were about discharge planning, two about to access to private room accommodation, and one about the ordering of rehabilitation aids. These complaints were dealt with on a case-by-base basis and resolved satisfactorily.
| Complaint category | 2003-04 | 2004-05 |
|---|---|---|
| Hospitals | 4 | 7 |
| Reimbursement of travel expenses | 3 | 0 |
| Total | 7 | 7 |
Northern Territory Treatment Monitoring Committee
Meetings held: 30 November 2004 and 24 May 2005.
| Ms Pamela Blamey | Deputy Commissioner, DVA SA/NT-Australian Government representative and Chair |
| Ms Kerrie Bowering | Assistant Director Health Services, DVA SA/NT-Australian Government representative |
| Ms Sue Filipovich | DVA NT Regional Manager, Secretariat |
| Mr Ken Bourke | Totally & Permanently Incapacitated Ex-Servicemen and Women NT Branch. |
| Mr Jack Hamilton | Legacy NT |
| Mr Joe Lavery | Vietnam Veterans Association of Australia NT State Branch |
| Mr Eddie Josephs | Returned & Services League of Australia, Darwin Sub Branch |
| Ms Robyn Harrison | Patient Advocate, Royal Darwin Hospital |
| Mr Ian Pollock | Northern Territory Department of Health & Community Services |
| Dr Peter Beaumont | General Manager, Darwin Private Hospital |
| Mrs Nola Smith | NT Council of Ex-Servicewomen |
Matters of significance
Major issues that the committee focused on during the year included:
- access to services;
- NT aged care planning; and
- health promotion—Men’s Health Peer Education activities.
Access to services
The committee was provided with an overview of the arrangements for access to hospital services in Darwin consistent with the Departments’ veteran partnering arrangements. To support a greater awareness of hospital access arrangements, supplementary advice was prepared for Darwin veterans, in conjunction with promoting the relevant DVA fact sheets.
A presentation to the committee highlighted the discharge planning process in the public sector, and advised how veterans with complex needs could be supported for their transition home.
Access to dermatology services continued to be managed in conjunction with Local Medical Officers, surgeons, and specialists from Adelaide, with mental health services provided through LMOs and the Vietnam Veterans’ Counselling Service, available psychiatrists and hospital services, with travel interstate where clinically required.
NT aged care planning
The committee was given an overview of the demographics of the Northern Territory, noting that the territory has a relatively small population of 200 000 people with a younger age structure than the rest of Australia. There are also issues of isolation and difficulties providing equitable access to health care services in remote areas.
Members were briefed on the proposed NT allocations for the next three years for residential places, community aged care packages and extended aged care at home packages. The regional distribution of aged care places in the NT already exceeds the national benchmark particularly in the allocation of community aged care packages, but is consistent with the demand for services and their effectiveness in providing services in the rural and remote communities.
Health promotion—Men’s Health Peer Education activities
The health promotion program continued to build on its success, with updates of activities provided to the committee. Of particular interest was the development of a partnership between the Men’s Health Peer Educators and COTA National Seniors on the ‘Quality Use of Medicines’ presentations. There are now several NT Men’s Health Peer Educators and the NT Regional Manager is accredited to deliver ‘Quality Use of Medicines’ information sessions to the NT veteran community.
Complaints monitoring
DVA received two complaints during the year. Issues are managed on a case by case basis, and are forwarded to the relevant providers for investigation and report. One complaint received was in relation to transferring a DVA patient from the emergency department of the Tier 1 hospital to the Tier 2 hospital, with the second complaint was regarding hospital accommodation whilst an inpatient.
| Complaint category | 2003-04 | 2004-05 |
|---|---|---|
| Hospital services | 1 | 2 |
| Total | 1 | 2 |
Australian Capital Territory Treatment Monitoring Committee
Meetings held: 25 October 2004, 6 December 2004 and 14 March 2005. A meeting scheduled for 20 June 2005 was deferred until 28 July 2005 (joint meeting with NATMOC).
| Mr Gary Collins | Deputy Commissioner, DVA-Australian Government representative and Chair |
| Mr Effie Cauchi | Acting Director, Health, DVA-Australian Government representative-to March 2005 |
| Ms Jennifer Collins | Director, Health, DVA-Australian Government representative-from April 2005 |
| Mrs Colleen Thurgar AM | Returned & Services League of Australia |
| Mr Laurie Dillon | Returned & Services League of Australia |
| Mrs Margery Smyth OAM | War Widows’ Guild of Australia (ACT) |
| Mrs Gwendoline Henwood | War Widows’ Guild of Australia (ACT) |
| Mr Adrian Roberts | ACT Totally & Permanently Incapacitated Ex-Servicemen and Women Association Inc |
| Mr Mike Phoenix | Vietnam Veterans Association of Australia |
| Mr Peter McCann | Vietnam Veterans Association of Australia |
| Commander David Clinch (Retd) OBE | Regular Defence Force Welfare Association |
| Mrs Maelyn Wishart | Regular Defence Force Welfare Association |
| Mr Ian Gore | Canberra Legacy |
| Mrs Loraina Dorham OAM | Morshead Home for War Veterans and Community Citizens-to December 2004 |
| Ms Ann Atkinson | Australian Government Department of Health & Ageing-ACT Office |
| Ms Joan Scott | ACT Health |
Matters of significance
Major issues focused on during the year included:
- the operation of the Repatriation Private Patient Scheme;
- Veterans’ Home Care;
- Local Medical Officers and specialist medical services; and
- aged care issues in the ACT.
Repatriation Private Patient Scheme
Only small variations were noted in admission rates to public and private hospitals during the year. Committee members were informed that the agreement between ACT Health and DVA had been extended and that good progress was being made with negotiation of a new agreement. Agreements with two private hospitals were extended for a two-year period.
Veterans’ Home Care
The committee received updates on developments in the Veterans’ Home Care program, in particular the allocation of additional funding following the 2004–05 budget. Members were informed that satisfaction levels with VHC services were significantly higher than at the beginning of the previous reporting period and that there were no significant delays to assessments or service provision. The committee also discussed the process by which any complaints about VHC services were best addressed.
Local Medical Officers and specialist medical services
The committee took a particular interest in the development of an after-hours medical service to be based in the Canberra Hospital, under an arrangement between general practitioners and the ACT Government. The committee sought assurances concerning veteran access to this service under DVA payment arrangements and the ACT Government representative informed the committee that this issue was included in the contract negotiation process.
Aged care issues in the ACT
The committee also acts as the ACT Ex-Service Round Table on Aged Care. During the course of the year, the committee received regular reports on aged care issues in the ACT from representatives of the Australian Government Department of Health and Ageing and from ACT Health. Issues from the National Ex-Service Round Table on Aged Care also were reported to the committee by the ACT representative on NERTAC.
Other issues
Members of the committee sought clarification from DVA concerning the arrangements for the delivery of certain programs by the ACT office of the VVCS - Veterans and Veterans Families Counselling Service. DVA obtained this information and passed it on to committee members.
The committee also made an approach to NATMOC requesting that NATMOC consider supporting a study into the health problems of former submariners.
Complaints monitoring
At each meeting the committee received a report detailing letters of complaint received since the date of the last meeting. All of the matters were investigated by the NSW State Office and a response provided to the writer. The committee was satisfied with the action taken.
| Complaint category | 2003-04 | 2004-05 |
|---|---|---|
| Transport/travel | 2 | 0 |
| Rehabilitation Appliance Program/allied health | 3 | 1 |
| Medical | 4 | 1 |
| Veterans’ Home Care | 3 | 4 |
| Total | 12 | 6 |