DVA LogoAnnual Report 2005-2006

Strategic issues

The Repatriation Commission’s strategic priorities during 2005-06 and into the future have been shaped by the significant demographic changes taking place in the veteran community. The number of older veterans is declining, but many older veterans and war widows/widowers are becoming frail, resulting in increased demand for a range of health services, as well as preventive health and home care services to assist them to continue to live independently at home for as long as possible.

At the same time, the Commission is responsible for  a smaller but increasing number of younger veterans with very different needs, including rehabilitation, treatment and support for physical, emotional and mental health conditions. The challenge for the Commission and for DVA is to maintain the services needed by older members of the veteran community, while ensuring that the needs and expectations of younger veterans and their families are clearly understood and met.

Commission activity

 During 2005-06, the Repatriation Commission considered 127 submissions and held 15 formal meetings.

Matters considered included:

In 2005-06, the Commission focused on equity of outcomes and ensuring that service levels are maintained or improved in a time of significant demographic changes in the veteran community. Improvements in service provision were achieved in a number of areas.

Community nursing

In November 2005, the Department released a national Request for Tender (RFT) for the provision of community nursing services to eligible veterans and war widows/widowers from 1 May 2006 to 30 June 2008. The tender process resulted in the establishment of a new panel of community nursing providers across Australia under a Deed of Standing Offer on 1 May 2006. The new contractual arrangement will continue until 30 June 2008.

Many providers previously contracted to the Department successfully participated in the tender process, as well as a number of providers that are new to the Department. The establishment of this new panel of providers ensures the continuation of this important in-home nursing service for veterans and war widows/widowers. The community nursing program plays an important role in assisting veterans and war widows/widowers to remain living in their own homes for as long as possible and preventing inappropriate or premature admittance to hospital or residential care.

Veterans’ Home Care

In 2006, the Veterans’ Home Care program celebrated five years of providing services to the veteran community. More than 125 000 veterans and war widows/widowers have been assessed for services and more than 10 million hours of service have been provided during that period. 

However, the Veterans’ Home Care client group is ageing and becoming frailer and, as a result, demanding higher levels of service from the program. In addition, the number of war widows is increasing and demanding a change in the mix of services as well as additional services to address issues such as social support and social isolation.

The program is not structured to cater to these higher level needs in the longer term. A major independent review of Veterans’ Home Care is planned for 2007, to identify any changes necessary to ensure that the program continues to meet veterans’ needs as they age and become more frail.

Hospital services

As a result of a nationwide private hospital Request for Tender process conducted in the first half of 2006 on behalf of the Repatriation Commission and the MRCC, the number of Tier 1 hospitals was doubled to 241 facilities. This greatly increases the choices available to veterans and their treating specialists and will lead to improved local access to hospital care.

Repatriation transport

In June 2006, the Minister for Veterans’ Affairs announced reforms to the Department’s Repatriation Transport Scheme. The reforms aim to simplify and expand arrangements for Booked Car with Driver services to assist eligible persons to attend medical treatment. The service was made available to all eligible persons aged 80 and over and removed the need for them to obtain medical certification for this service. The approved treatment destinations for this service were also expanded.

Care coordination

Two care coordination pilots, approved by the Commission, commenced in NSW and Queensland during the year to trial different models of providing coordinated health care to veterans. A third pilot planned for Victoria did not proceed.

The NSW pilot uses a 24-hour tele-health service and the Queensland pilot involves the provision of a health assessment and care planning by general practitioners (GPs) and coordination of services provided by dedicated Service Coordinators. This pilot uses an Electronic Health Record system that enables the collection and secure electronic transfer of documents between the GP and other health care providers. An on-going evaluation of each pilot will provide valuable information on aspects of the care coordination models, such as costs of care, quality of life and satisfaction of veterans, general practitioners and the Department. The evaluation is expected to be completed by the end of 2006-07.

Health research

The Repatriation Commission continues to oversee health studies undertaken by the Department. This year has seen the completion and release of the Australian Participants in British Nuclear Tests in Australia: Mortality and Cancer Incidence study.  The first three volumes of a series of four reports on the Vietnam Veterans mortality and cancer incidence studies have also been endorsed by the Commission.

This year has seen a strengthening of collaboration with the Department of Defence and Centre for Military and Veterans’ Health. Significant progress has been made regarding studies of three recent ADF deployments; East Timor (InterFET), Solomon Islands and Bougainville. Other collaborations include the establishment of a steering committee into the development of clinical practice guidelines for post-deployment ill-health and development of e-health projects.

Commemorations

The national Salute to Veterans in Canberra on 13-15 August 2005 to mark the 60th anniversary of Victory in the Pacific and the end of World War II.

The Commissioner chairs the committee overseeing the Government’s Saluting Their Service grants program and chaired a national committee established to oversee the planning for commemoration of the service of Vietnam veterans and the 40th anniversary of the Battle of Long Tan in August 2006.

Commission members were also involved in a number of commemorative missions during the year, including to Hawaii, Papua New Guinea, Singapore and Hellfire Pass to mark the 60th anniversary of the end of World War II and to El Alamein to rededicate the 9th Australian Division Memorial. 

Consultation

In 2005-06, members of the Repatriation Commission continued to build on the close relationship with ex-service organisations by attending major ex-service organisation conferences and congresses. The Repatriation Commission also sought the views of the veteran community through a number of consultative forums. These forums are also used by the Department in meeting its obligations to consult persons who may be affected by proposed legislation and to give them an opportunity to comment.

Defence/DVA Links

In October 2005, Commissioners discussed with Defence proposals to move the Defence/DVA Links program into a new phase, with increased operational focus to better reflect current activities. As a result, the Defence/DVA Links Project Review Board was re-formed as the Defence/DVA Links Steering Committee, with working groups established to address issues of joint interest. 

The first working groups are addressing the transition processes for ADF members moving from military to civilian life and the sharing of electronic data sources such as PMKeyS, the Defence personnel database. Moves were also initiated to form a single Defence/DVA Health Consultative Forum, replacing the Defence/DVA Medical Advisory Panel and its working groups on health research and mental health.

Other practical issues being addressed are the improvement and promotion of the services provided by the Department to ADF members including those on bases, improving the Department’s knowledge of ADF structures and the military lifestyle, and trialling joint OH&S promotional activities in areas where there is shared interest in reducing compensable risks. A joint Defence/DVA protocol has been agreed for managing major incidents and high profile cases.