1998 - 1999 Department of Veteran's Affairs

| Return to Contents |

National Treatment Monitoring Committee

Subsidiary Bodies

Background

The Repatriation Commission established the National Treatment Monitoring Committee (NATMOC) to monitor the integration or sale of the repatriation institutions and the operation of the Repatriation Private Patient Scheme (RPPS) in each state and territory.
Representatives of key ex-service organisations (ESOs) and the Department of Veterans' Affairs (DVA) make up the committee. NATMOC held its inaugural meeting on 19 March 1992 but was not formally established until the Repatriation Private Patient Principles (RPPPs) came into operation on 1 July 1992.
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 was extended again in 1996 and in 1998 until 30 June 2000.
Enabling legislation

NATMOC is established under the Repatriation Private Patient Principles (RPPPs) which are determined under section 90A of the Veterans' Entitlements Act 1986. The RPPPs state that the Repatriation Commission will monitor the access to, and quality of, hospital care arranged for the veteran community through a national treatment monitoring committee and a treatment monitoring committee (TMC) in each state, the Australian Capital Territory and the Northern Territory. NATMOC also has the same monitoring role under paragraph 13 of the schedule to the Seamen's War Pensions and Allowances Regulations.
The Repatriation Commission has the power to determine or amend the RPPPs and is responsible for the ultimate direction of the committee. The RPPPs are subject to effective parliamentary scrutiny through the mechanism of a disallowable instrument.
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 Commonwealth officers and seven members who represent ex-service and associated organisations:

Dr Neil Johnston President, Repatriation Commission – Commonwealth representative and Chair

Mr Geoff Stonehouse Division Head, DVA Health Care & Services – Commonwealth representative

Mr G 'Rusty' Priest Returned & Services League

Mrs Eileen Watt War Widows' Guild – until 31 October 1998

Mrs June Healy War Widows' Guild – from 1 November 1998

Mr John Jeppesen RFD Australian Veterans and Defence Services Council

Mr Bill Weir Australian Federation of Totally & Permanently Incapacitated Ex-Servicemen and Women

Mr Simon Agnew Legacy Coordinating Council

Air Vice-Marshal John Paule
DSO AFC (Retd) Regular Defence Force Welfare Association

Mr Rob Cox Vietnam Veterans' Association of Australia

Expiry of current membership

The current periods of appointment began on 1 July 1998 and will expire on 30 June 2000.
Powers and functions

Following the integration or sale of the repatriation general hospitals (RGHs), NATMOC, together with the TMCs, monitor the standard of health care and the range of health services available to veterans, war widows/widowers and dependants throughout Australia.
During 1998-99, NATMOC continued to provide a forum for TMCs to deal with issues best dealt with on a national level. NATMOC received reports from TMCs, DVA and state health departments on aspects relating to the operation of the Repatriation Private Patient Scheme (RPPS) and the wider health care issues for the veteran community.
Staff

DVA continued to provide secretariat services to the committees. Information about NATMOC can be obtained from the Branch Head, Health Services on (02) 6289 6181.
Funding

NATMOC was financed from DVA budget allocation. Although committee members received no sitting fees, DVA covered the cost of travel and accommodation where members were required to attend interstate meetings. They were:

NATMOC expenses for 1998-99
$

Travel expenses for three meetings
12 703

Accommodation for three meetings
4 549

Provisioning for meetings
440

TOTAL
17 692

NATMOC does not distribute funds or grants.
Meetings

Meetings were held on 13 August in Brisbane, on 12 November in Adelaide and on March 25 in Canberra.
Activities and issues raised

The committee's main activities during 1998-99 included:

reviewing the minutes from TMCs;
monitoring the renegotiation of public hospital agreements;
monitoring negotiations with private hospitals;
monitoring medication management initiatives undertaken by DVA;
monitoring the development program of Daw Park Repatriation General Hospital;
monitoring the progress of the National Ex-Service Round Table on Aged Care;
consideration of reports and briefing papers from DVA on issues affecting a wide range of health care services for the veteran community; and
representation on the new Australian Hearing Services Advisory Committee.

Repatriation Private Patient Scheme

The committee acknowledged DVA's commitment to working with treatment monitoring committees to ensure the scheme works in the best interests of veterans, war widows/widowers and dependants.
Concord Repatriation General Hospital – New South Wales

In the last year, financial support from the Repatriation Commission enabled Concord RGH to implement a series of initiatives to improve the care provided to veterans and war widows/widowers, and to emphasise the links between the hospital and the veteran community.
The special services introduced through this initiative were:

the appointment of a veterans' and war widows'/widowers' liaison service;
a psychiatric day care centre;
a centre for neurodegenerative disorder management;
a centre for tertiary prostate cancer and urology;
a centre for degenerative joint disease management; and
commemorative activities including the establishment of a hospital museum and the commissioning of the hospital's history.

Lady Davidson Private Hospital – New South Wales

In a year affected by ongoing building work, there was an encouraging growth in occupancy rates at Lady Davidson Private Hospital for some months and a consistently high proportion of veteran patients. Members were kept informed of the refurbishment program which included the addition of a hydrotherapy pool. With the addition of three new wards and a range of other new facilities, a consistent growth in hospital activities in 1999-2000 is expected.
Repatriation General Hospital Daw Park – South Australia

Changes in planning since the integration of RGH Daw Park into the SA health system in March 1995 and veterans' easier access to private hospitals have necessitated a review of the role and function of the hospital.
Members were briefed on two options for RGH Daw Park which were jointly announced on 25 March 1999 by the Minister for Veterans' Affairs and the Minister for Human Services. The first option was that RGH Daw Park would continue to provide the current range of services, with other services continuing to be developed. The second option involved some scaling back of acute services for the hospital to become a specialist facility with a focus on areas such as rehabilitation, hospice care and psychiatric care.
On 29 June, the Minister for Veterans' Affairs and the Minister for Human Services jointly announced that veterans will continue to have access to the full range of medical and surgical services at the hospital to be maintained at current levels for 21 months within a five-year funding agreement. As well, DVA will now progress Tier 1 contracts with private hospitals to ensure improved access and choice for veterans.
Austin & Repatriation Medical Centre – Victoria

The committee was briefed on the progress of the redevelopment of the Austin and Repatriation Medical Centre (A&RMC). Consortia bids for the redevelopment were short listed to two groups – The Sisters of Charity Healthcare, and a joint bid from Ramsey Health Care of Australia/Mayne Nickless and the Inner and Eastern Healthcare Network. A brief is being prepared outlining the services that will be required from the successful tenderer.
Plans for the hospital caused a degree of concern within the veteran community, particularly the adequacy of the A&RMC budget, the continuation of fully-funded treatment for veterans, and consultation with the veteran community on the redevelopment process.
Greenslopes Private Hospital – Queensland

Members were briefed on the developments at Greenslopes Private Hospital. A new renal unit, a coronary care unit and a new 30 bed sub-acute unit were opened. The sub-acute unit, the Florence Syer (a survivor of the Vyner Brooke that sank off Banka Island in World War II) Unit, will help veterans who are waiting for nursing home placement, on transfer for palliative care, or in need of convalescent care. Pre-admission clinics are being expanded, the admissions area relocated and renovated together with several floors of the multi-storey building (acute ward).
Hollywood Private Hospital – Western Australia

Redevelopment at Hollywood Private Hospital progressed well. The hospital's accreditation was renewed. Main achievements included the opening of the new catheterisation laboratories, a coronary care unit, an after-hours chest pain clinic and the Hollywood Specialists' Medical Centre. The new Day Procedure/Gastroenterology Unit received its first patients in April. Approval was granted for a further 50 beds to be established in refurbished older wards at the hospital later in 1999, and two new operating theatres are being planned.
Repatriation Centre Hobart – Tasmania

The former repatriation general hospital site has been renamed the Repatriation Centre and houses a range of aged care services, 12 palliative care beds, a number of other State Government organisations and some non-government organisations. All in-patient services, except for the palliative care beds, are now based at the Royal Hobart Hospital. The veteran community expressed little concern about the transfer of these services.
Throughout the year the committee was briefed by the department on the following matters:

Renegotiation of public hospital agreements (Medicare agreements) – following provision in the Budget of some $750 million ($150 million per annum over five years) to DVA to purchase hospital services for entitled veterans on a full-cost basis.
Negotiations with private hospitals – NATMOC provided a valuable forum for discussing specific arrangements for the provision of services under consideration with private hospitals.
Community nursing reforms – an independent review of the schedule of fees will be completed by August 1999.
Medication management initiatives are designed to reduce medication misadventures, improve wellbeing, keep veterans in their own homes and avoid preventable admissions to hospitals. The initiatives include: the Prescriber Intervention and Feedback Program; private hospital medication reviews; nursing home training; community-based medication reviews; and the Rural and Remote medication initiative in which DVA has contracted the Remote and Isolated Pharmacists Association of Australia (RIPAA) to administer the accreditation of pharmacists to conduct medication reviews of veterans on referral from a doctor.
Repatriation Pharmaceutical Benefits Scheme – with particular emphasis on monitoring the use of hypnosedatives and reviews of RPBS topical anti-fungal and dermatological preparations.
Optometrical services – members took a keen interest in the developments in the tender process for a national supplier of visual aids to veterans and war widows/ widowers. When it became apparent the proposal could not guarantee a wide network of participating optometrists and optical dispensers, tender negotiations were terminated in August at which time NATMOC members were advised that DVA remained committed to improving its Optical Supplies Program.

Further consultations with the optical industry on alternative ways of improving the program began in 1999 and feedback from the industry is assisting DVA to develop a framework for an improved program. Important components of the framework will be:
- the establishment of a DVA advisory group on optometric services and supplies. Representatives from the veteran community will join the group during the assessment of frames for inclusion in the new DVA range;
- a comprehensive review and update of the range of spectacle frames and lenses; and an updated pricing schedule issued to all DVA contracted optometrists and optical dispensers in January. The pricing schedule was produced in a new booklet format containing, for the first time, information for providers. The additional information covered gold and white health care cards, veteran entitlement to optical services, DVA's administrative arrangements, payment advice and DVA contract numbers.

DVA will submit the framework to the Repatriation Commission for consideration in the new financial year.

Vietnam Veterans' Morbidity (Health) Study – the report on female veterans and the validation process on male veterans and their families were covered.
Korean Veterans' Mortality Study will determine the reasons for the deaths of Korean veterans and compare the rates for each reason with the rates in the general community.
Hearing services – a member of the committee, Simon Agnew, continued as the veterans' representative on the Hearing Services Advisory Committee. Monitoring veteran access to hearing services will continue and the committee will also monitor the impact of new arrangements for the management of replacement hearing aids to be introduced by OHS on 1 July 1999.
Discharge planning – 3 700 revised Discharge Planners' Resource Kits circulated in early 1998 were well received. As a result of the survey 160 additional kits were distributed;
National Ex-Service Round Table on Aged Care – representatives from the major ex-service organisations attended a 'round table' at Parliament House in June 1998, to consider the value and benefits of developing a national strategy on aged care for the veteran community. The National Ex-Service Round Table on Aged Care (NERTAC) was inaugurated. NATMOC and the TMCs were seen as appropriate avenues for circulating information on aged care issues. NATMOC will continue to take a keen interest in the issues addressed by the Round Table and to facilitate an exchange of information to and from the veteran community on aged care issues.
Health care planning for local medical officers – DVA's promotion of home care was introduced in 1996 as part of the Memorandum of Understanding between DVA and the Australian Medical Association. This fee-for-service model of general practitioner assessment and planning aims to assist local medical officers promote better care for veterans with complex health needs (see Health Program page 75). Over 6 500 care plans have been completed and DVA is carrying out an evaluation to ascertain the comprehensive care needs of its veterans and war widows/ widowers with complex health conditions and the effectiveness of health care plans in improving their care.

Back to top

Subsidiary Bodies

New South Wales Treatment Monitoring Committee

Meetings held: 3 September, 10 December, 11 March. An out-of-session meeting was held on 17 May with the Australian National Audit Office on the performance audit of DVA's organisation of the provision of health services to veterans.
Membership to 30 June 1999

Mrs Felicity Barr DVA Deputy Commissioner – Chair

Ms Janet Anderson DVA Director, Health Care and Services

Mr G "Rusty" Priest Returned & Services League of Australia

Mrs Beryl Page
War Widows' Guild of Australia

Mr John Jeppesen RFD Australian Veterans and Defence Services Council

Mr G (Les) Blok Totally & Permanently Incapacitated Veterans Association

Lt Col A "Bushy" Pembroke MC
(Retd) Regular Defence Force Welfare Association

Mr J A Stanton Sydney Legacy

Mr Ray Bennett Vietnam Veterans' Federation of Australia

Ms Catherine Katz NSW Health Department

Matters of significance

The committee focused on a number of major issues including the:

operation and review of the Repatriation Private Patient Scheme (RPPS) and the promotion of health care plans;
Vietnam Veterans Morbidity (Health) Study;
the effects of the extension of the Gold Health Care Card;
Community Nursing.

Repatriation Private Patient Scheme (RPPS)

The committee monitored the use of public and private hospitals by veterans and war widows/widowers in NSW, noting the increased use of private hospitals. It was briefed on the implementation of the RPPS review recommendations including the negotiation of an extension of the current agreement with NSW Health, reassessment of private hospital arrangements to streamline access, and the implementation of more effective communication strategies with providers and the veteran community.
It received updates on the promotion of health care plans and the targeting of those veterans with complex care needs. The committee supported the use of health care plans as part of a coordinated approach to veteran health care.
The chief executive officers of both Concord RGH and Lady Davidson Private Hospital attended committee meetings and reported on developments at each hospital. Concord appointed a veteran liaison officer and introduced a number of special veterans' services including commemorative activities, and a psychiatric day care centre with funding of $995 000 provided by the Repatriation Commission under arrangements with NSW State Health. There was a steady increase in veteran occupancy at Lady Davidson Private Hospital which undertook a refurbishment program including the addition of a hydrotherapy pool.
The committee continued to stress the importance of access to hospital and medical services for the veteran community in rural and remote areas and encouraged the work of the NSW state office in extending health services, particularly the post traumatic stress disorder programs and the rural psychiatric services, in these areas.
Community nursing reforms

The committee was briefed on consolidation of the new community nursing arrangements and noted that new providers continued to be interested in contracting for services. DVA's work with NSW Area Health Services to contract their publicly-funded community nursing services was also covered. Changes had elicited very few complaints from veterans and war widows/widowers and the service remained of a high standard.
Vietnam Veterans Morbidity Study

Regular updates on the progress by the Australian Institute of Health and Welfare in validating the findings of Volume 1 of the Vietnam Veterans Morbidity (Health) Study were provided as was a briefing on the findings of Volume 2 of the study which related to female veterans.
Extension of the gold card

Approximately 11 000 members of the veteran community in NSW received a Gold Health Care Card under this initiative. Of these, about 6 500 had previously held white cards and nearly 4 500 had not had a treatment card before.
Contentious Issues

The major contentious issues aired at the meetings related to delays in transport services, delays in veteran reimbursement, and the provision of care in public and private hospitals. The committee was satisfied that in all cases action was taken by DVA to investigate, resolve, and where appropriate, put in place mechanisms to prevent a recurrence of any problems.
Australian Capital Territory Treatment Monitoring Committee

Meetings held: 28 September, 14 December, 25 March, and 21 June. An Aged Care forum was held on 16 November to review aged care issues in the ACT and to discuss the incorporation of aged care into the terms of reference of the ACT TMC.
Membership to 30 June 1999

Mrs Felicity Barr DVA Deputy Commissioner – Chair

Ms Janet Anderson DVA Director, Health Care & Services, NSW

Mrs Colleen Thurgar Returned & Services League of Australia

Mr Geoff Johnson Returned & Services League of Australia – from 1 December 1998

Mrs Marge Gilmore War Widows' Guild of Australia

Mrs Margery Smyth War Widows' Guild of Australia – from 23 July 1998

Mrs Lolita Steingrube War Widows' Guild of Australia – from 1 December 1998

Brigadier Alf Garland (RL) Totally & Permanently Incapacitated Ex-Servicemen and Women Association of the ACT

Mr Stuart Weller Vietnam Veterans' Association of Australia, ACT. Mr Weller was represented by Mr Peter Mazengarb until 31 December 1998, and thereafter by Mr Mike Phoenix

Major General John Whitelaw Australian Veterans and Defence Services Council

Mr R (Jock) Scott Regular Defence Force Welfare Association

Commander David Clinch Regular Defence Welfare Association – from 1 December 1998

Mr Simon Agnew
Canberra Legacy

Mr Alan Sharpe Canberra Legacy – from 1 December 1998

Ms Dene Nash ACT Department of Health & Community Care

Mr Len Waugh Department of Health and Aged Care – from 26 October 1998

Matters of significance

The committee focused on a number of major issues including:

the operation and review of the Repatriation Private Patient Scheme;
the expansion of the committee's terms of reference to include matters about aged care;
Vietnam Veterans' Morbidity Study;
community nursing; and
the role of the Office of Hearing Services (OHS) in providing services to the veteran community.

Repatriation Private Patient Scheme

Key issues during the year included the provision of post traumatic stress disorder seminars for providers and progress in the negotiation of an agreement with the ACT Department of Health and Community Care to provide veteran health services based on partnering principles, ie the health provider/hospital and DVA working together in close partnership to provide the best outcome for the veteran community. The National Capital Private Hospital which opened in August 1998 had been contracted to DVA as a Tier 2 hospital (ie. a private hospital that provides services to veterans).
Expansion of terms of reference to include aged care

A forum on aged care and its importance to veterans in the ACT was held in November.
New terms of reference for the TMC were agreed and the committee was expanded to incorporate aged care representatives from ex-service organisations. A representative from the Commonwealth Department of Health and Aged Care was invited to become a member of the committee also. The first key task was the development of a communication strategy to ensure the veteran community was fully informed of the aged care services available and the means of accessing them. The strategy included avenues for veteran feedback on the quality of services.
Community nursing reforms

The progress of the community nursing reforms in the ACT was monitored throughout the year and it was shown that the changes had been implemented successfully.
Vietnam Veterans Morbidity Study

The Vietnam Veterans Morbidity (Health) Study was a standing agenda item.
Office of Hearing Services

The veterans' representative on the Hearing Advisory Committee, was Simon Agnew a member of the TMC, who reported on OHS service delivery.
Contentious Issues

Contentious issues and any emerging trends were considered at each meeting. Issues covered a range of subjects and no major categories or trends were apparent. The committee was satisfied with the action taken by DVA to investigate, resolve and, where appropriate, put in place mechanisms to prevent recurrence of problems.
Victoria Treatment Monitoring Committee

Meetings held: 30 June; 1 September; 10 November; 9 February, 20 April.
Membership to 30 June 1999

Mr Brian Flynn DVA Deputy Commissioner – Chair

Mr Wally Hacking Returned & Services League of Australia

Dr Sol Rose Returned & Services League of Australia

Mrs Eileen Watt War Widows' Guild of Australia

Mr Bruce Coleman Australian Veterans and Defence Services Council

Mr Gordon Taylor Totally & Permanently Disabled Soldiers' Assn.

Dr Allan Beech Melbourne Legacy

Dr Alan Tait Legacy (Country)

Mr Ian Wall Regular Defence Force Welfare Association

Mr Brendan Lynch Vietnam Veterans' Association of Australia

Mr Edward Wightman Naval Association of Victoria

Maree Bowman Director, Health, Community & Staff Services, DVA

Mrs Sue Harvey Executive Director, Nursing & Patient Support, Austin &Repatriation Medical Centre

Mr Peter Lewis Department of Human Services

Retiring members

Mr Geoff Trevor-Hunt Vietnam Veterans' Association of Australia

Mr Fred Cullen Returned & Services League

Dr Ronald Benson Melbourne Legacy

Dr William Adam Executive Director, Clinical Services, Austin & Repatriation Medical Centre

Ms Veronica Spillane Department of Human Services

Matters of Significance

During the year the committee focussed on the following major issues:

the redevelopment of the Austin & Repatriation Medical Centre;
Commonwealth/State Hospital Services arrangements;
veteran partnering arrangements with private hospitals;
delivery of post traumatic stress disorder programs; and
progress of the removal of prior approval.

Redevelopment of Austin & Repatriation Medical Centre

The committee had regular briefings by representatives of the state's Infrastructure Investment Unit on the redevelopment of the centre. Tenders have been called and two groups, short listed – one from the Sisters of Charity Healthcare, and the other a joint bid, comprising Ramsay Healthcare, Health Care of Australia/Mayne Nickless, and the Inner and Eastern Healthcare Network.
The Infrastructure Investment Unit is preparing a brief which will specify the services required of the successful tenderer. The committee has sought to ensure that the brief is based on consultation with all relevant departments at the hospital. It is concerned that the new hospital will adequately address the future needs of both the veteran and the wider community.
Commonwealth-State Hospital services arrangement

The funding arrangements negotiated under the six-year agreement with the Department of Human Services for public hospital care of veterans and war widows/ widowers in Victoria has been finalised. The arrangements enable full-cost recovery by hospitals, with a generous premium for treating veterans. This has prompted a number of public hospitals to approach the ex-service organisations for advice on how to attract "business" from the veteran community.
Veteran partnering

The committee was a valuable source of consultation following the Repatriation Commission's decision to introduce veteran partnering into arrangements with Victorian private hospitals.
After consultation with the hospital industry, tenders were called for at the beginning of June. It is anticipated that hospitals gaining Tier 1 status, ie, ability to admit an entitled veteran without the necessity of obtaining prior financial authorisation from DVA, will be announced in August.
Post Traumatic Stress Disorder

The committee played a key role in setting up a post traumatic stress disorder (PTSD) program in Mildura. Members received reports on further rural mental health initiatives (eg Warrnambool), and endorsed the signing of a contract with the Albert Road Clinic, Albert Road, South Melbourne, the first private PTSD provider in Victoria.
Removal of prior approval

The committee endorsed the removal of the requirement to obtain prior departmental approval for allied health treatment, aids and appliances.
Queensland Treatment Monitoring Committee

Meetings held: 13 August, 30 November, 29 March, 28 June.
Membership to 30 June 1999

Mr Gary Collins DVA Deputy Commissioner – Chair

Mr Kevin Ross DVA Director Health Care & Services

Mr Cyril Gilbert Returned & Services League

Mr Bob Taylor Returned & Services League – until 2 March 1999

Mr William Mason Returned & Services League

Mrs Marjory Brown War Widows' Guild of Australia

Dr Peter Grant Brisbane Legacy

Mr Kevin Casey (Retd) Regular Defence Force Welfare Association

Mr Fred Cottrell Australian Veterans and Defence Services Council

Mr John Smith Vietnam Veterans' Association of Australia

Mr Val Kleem Totally & Permanently Disabled Soldiers' Association of Australia

Mrs Wendy Pilkington Queensland Department of Health

Observers: Mrs Rose Kleem, Mrs Elizabeth Jones, Mr Jack Lemon and Mr Patrick Jackson
Matters of Significance

Major issues which the committee focused on during the year included:

the gold card extension – over 2 500 Queensland veterans who previously had no DVA entitlement to a Gold Health Care Card were identified and received a booklet of information detailing the range of treatment services available;
the extension and development of new and existing services at Greenslopes Private Hospital;
the continuing contractual arrangements with private hospitals and day surgeries, and the monitoring of quality care as part of the contract;
effective discharge planning and clinically appropriate lengths of stay;
the signing of the agreement with Queensland Health, reflecting a change in funding arrangements for DVA patients who choose to be admitted as private patients in a public hospital;
the provision of hearing services via the Office of Hearing Services; and
the launch of HomeFront – over 500 calls were received from Queensland veterans since the service began in January.

Greenslopes Private Hospital

Mr Robert Glynn, general manager of Greenslopes Private Hospital, attended the TMC meetings throughout the year and provided the committee with updates on hospital developments. Upgraded facilities included a new renal unit, a coronary care unit and a new 30 bed sub-acute unit – the Florence Syer (a survivor of the Vyner Brook that sank off Banka Island) Unit. This was opened on 6 June and will cater for veterans who no longer require acute care but who are waiting for nursing home placement, who need convalescent care, or who are waiting to transfer to palliative care. Pre-admission clinics are also being expanded. There was a major refurbishment program which included relocation of the admissions area and renovations including several floors of the multi-storey building (the acute ward).
Mr Glynn also reported on the progress of negotiations with Queensland Health about the possible co-location of a new private hospital with Princess Alexandra Hospital. Mr Glynn also reported on visiting specialist arrangements at Greenslopes.
Discharge planning

Because the committee had expressed some concerns about the perceived lack of discharge planning by some hospitals, they were briefed about the proactive approach undertaken by DVA state office. This included visits to a number of contracted facilities and the development and distribution of resource material (a wall chart and amendments to the discharge planning kit) which reflect current Queensland arrangements. Positive feedback was received from all hospitals visited.
Complaints monitoring

Twenty five complaints were received during the year on aspects of hospital treatment. These were categorised and all complaints were dealt with on a case-by-case basis with some issues addressed through the hospital contracting process. Some complaints covered more than one category:

Category of Complaint
Number of complaints

Nursing
8

Discharge planning
4

Specialist
7

Communication
9

Other
8

All complaints were forwarded to the relevant hospital for investigation and a report forwarded to DVA state office within the required time frame. The level of complaints was considered very low in proportion to the increasing number of admissions.
South Australia Treatment Monitoring Committee

Meetings: 25 September, 12 November, 15 February, 29 March, 25 June.
Membership to 30 June 1999

Mrs Pamela Blamey DVA Deputy Commissioner – Chair

Mr Geoff Banks DVA Director, Health & Community Services

Mr Max Farrell Legacy

Mr Ron Zwar Australian Veterans and Defence Services Council

Mr Bill Schmitt Ex-Prisoners of War Association Inc

Mrs Kathleen Rhodes War Widows' Guild

Mr John Spencer Returned & Services League

Cdr Robin Pennock Regular Defence Force Welfare Association

Mrs Coral Farrelly Council of Ex-Servicewomen's Association (SA) Inc

Dr Michael Jelly RFD Department of Human Services – until 8 February 1999

Professor Brendon Kearney Department of Human Services – from 8 February 1999

Mr Kerry Bromilow Association of Totally & Permanently Incapacitated Ex-Servicemen and Women (SA Branch) Inc – until 26 March 1999

Mr Barry Vincent Association of Totally & Permanently Incapacitated Ex-Servicemen and Women (SA Branch) Inc – from 26 March 1999

Mr Ron Coxon Vietnam Veterans' Association of Australia

Matters of significance

A major focus was the future role of the Repatriation General Hospital (RGH) Daw Park in the context of DVA seeking to develop a new agreement with the State Government on the funding of public hospital services for veterans and war widows/widowers. The recommendation from the Repatriation Private Patient Scheme review to give veterans easier access to contracted private hospitals gave further impetus to the need to review the role of the hospital.
As noted above, an options paper was issued in March. Under one option, Daw Park would provide the current range of services, with other services continuing to be developed with veteran access to private hospital continuing under present arrangements, whereby prior approval is required for veterans to be admitted to private hospitals. The second option involved scaling back acute services so the hospital became a specialist facility, focussing on areas such as rehabilitation, hospice care and psychiatric care. This option would include easier access for veterans to contracted private hospitals for those acute services no longer available at Daw Park.
An extra-ordinary meeting of the committee was held on 29 March to discuss the options paper. On 29 June the decision was made that Daw Park would continue to provide veterans with the full range of services. The decision follows a five-year agreement between the State and Federal Governments, under which federal funding for Daw Park will remain at its present level for 21 months from 1 July 1999. Veterans are now assured of receiving treatment they require at a hospital which has specialised in veterans' care for many years. During the consultation, the veteran community expressed a wish to access other public or private hospitals which might be more convenient to them. DVA will now progress Tier 1 contracts with private hospitals to ensure improved access and choice for veterans. Veterans already have access to public hospitals in South Australia.
Complaints

Ninety six complaints were received the during the year. Most were hospital-related and included treatment, accident and emergency attendances, discharge planning and waiting times. Complaints continue to be dealt with case-by-case. The sources of these complaints were:
Hospitals

Category of Complaint
No. of complaints

In-patient
51

Accident and emergency
21

Discharge planning
13

Hygiene
4

Outpatients
7

Facilities
1

Other Services

Category of Complaint
No. of complaints

Repatriation appliances
2

Transport
5

Oxygen
1

Podiatry
1

Security
2

Contentious Issues

Contentious issues covered a range of subjects and no major categories or trends were apparent. The committee was satisfied that action was taken by DVA to investigate, resolve and, where appropriate, put in place mechanisms to prevent recurrence of problems.
A new feature of meetings this year was a regular rural and remote report provided through representatives of the Returned and Services League, Legacy and the Vietnam Veterans' Association. Issues such as the under-supply of general practitioners in the Riverland, support for widows/widowers in country areas, and the adequacy of respite care services for carers of old people suffering from dementia in Yorke Peninsula, were widely debated with follow up reports provided by DVA.
Western Australia Treatment Monitoring Committee

Meetings held: 2 September, 17 March
Membership to 30 June 1999

Mr Jim Dalton DVA Deputy Commissioner – Chair

Mr Russell McLaughlan DVA Director, Health Care and Services

Mr Ken Bladen Returned & Services League

Mrs Fran Aggiss War Widows' Guild

Air Commodore Sam Dallywater Australian Veterans and Defence Services Council

Mr Bill Dedman Regular Defence Force Welfare Association

Mr Rob Cox Vietnam Veterans' Association of Australia

Mr Arthur Greaves Totally & Permanently Incapacitated Association

Mr Peter Eddy Perth Legacy

Mr Arthur Robinson Ex-POWs Association

Mr Laurie Sullivan Royal Australian Air Force Association

Mr Theo Bushe-Jones Naval Association

Ms Ros Franck Health Department – until 2 November 1998

Ms Paola Morellini Health Department – from 2 November 1998

Others attending meetings were: Mr Kevin Cass-Ryall, Executive Director, Hollywood Private Hospital and Mr Bob Wright, DVA Contract Manager.
Matters of Significance

The committee considered the following major issues :

the extension of the Gold Health Care Card to World War II veterans of the Australian Defence Forces aged over 70;
monitoring the progress of the work of the National Ex-Service Organisation Aged Care Round Table;
the continued redevelopment of Hollywood Private Hospital;
negotiation of DVA contract arrangements with the WA Health Department;
changes to DVA's optometrical services;
the launch and impact of DVA's Service Charter; and
participation in the accreditation process of Hollywood Private Hospital's post traumatic stress disorder program.

Operation of the Repatriation Private Patient Scheme

The Repatriation Private Patient Scheme (RPPS) performed very effectively during the year in providing quality care to veterans and war widows/widowers. The scheme delivered 346 000 professional medical and surgical services to the veteran community in the 1998 calendar year. Also, there were more than 21 700 hospital admissions and an occupancy of almost 117 000 hospital bed days.
During the 1998 calendar year, about 73 per cent of people receiving hospital care under the RPPS attended Hollywood Private Hospital, 26 per cent attended public hospitals and 1.4 per cent attended other private hospitals. Comparable figures in the previous financial year were respectively 71 per cent, 28 per cent and 0.6 per cent.
Veteran community feedback

Committee members and departmental staff received a consistently high level of positive feedback about the hospital care being provided to veterans and war widows/ widowers. Again there was again a significant number of compliments and commendations from both individual veterans and war widows/widowers as well as through ex-service organisations and general consultative forums.
During the 1998 calendar year, 26 complaints were received. This represents an approximate ratio of one complaint per 834 hospital admissions or one complaint for each 4 500 hospital bed days utilised. Following analysis and discussion by the committee no systemic problems were identified and those matters that did arise were the subject of timely resolution.
Hollywood Private Hospital

The committee noted the following progress over the year:

the renewal of the hospital's accreditation;
the opening of new catheterisation laboratories, a coronary care unit and an after-hours chest pain clinic;
the Hollywood Specialists' Medical Centre was opened in November;
the new Day Procedure/Gastroenterology Unit accepted its first patients in April;
the relocation of the pathology facilities in December;
Health Department approval for a further 50 beds to be established in refurbished older wards scheduled to be available later in 1999; and
the advanced planning for two new operating theatres.

The committee was enthusiastic in its support of this ongoing work. It acknowledged the dedication and leadership in the transition and rebuilding of the former RGH Hollywood by Mr Roger Snell, former executive director of Hollywood Private Hospital and welcomed Mr Kevin Cass-Ryall, the hospital's new executive director.
Tasmania Treatment Monitoring Committee

Meetings held: 26 August, 18 November, 17 February, 19 May.
Membership to 30 June 1999

Mrs Kay Grimsley DVA Deputy Commissioner – Chair until December 1998

Mr Roger Winzenberg DVA Deputy Commissioner – Chair from February 1999

Ms Christina Shaw DVA Director, Health Care and Services

Mr Wally Sutherland Returned & Services League

Mrs Joan Cooper War Widows' Guild

Mr George Debnam Australian Veterans and Defence Services Council

Mr Peter Sutcliffe Totally & Permanently Disabled Soldiers Association

Mr Jack Brotherson Hobart Legacy

Col Jim Macbride Regular Defence Force Welfare Association

Mrs Ann Harper Vietnam Veterans' Association of Australia

Mr Norm Davie Department of Health and Human Services

Ms Melanie Allen Department of Health and Human Services

Matters of Significance

The Repatriation Centre (former Repatriation General Hospital)

The former repatriation general hospital site, now known as the Repatriation Centre, houses a range of aged care services, 12 palliative care beds (Whittle Ward), a number of other State Government organisations and some non-government organisations. Apart from the palliative care beds, all in-patient services are now based at the Royal Hobart Hospital. The transfer of these services from the repatriation hospital went smoothly, with little concern from the veteran community. Representatives from the state Department of Health and Human Services provided brief reports on developments at the Repatriation Centre at each of the TMC meetings.
Private hospital co-location with Royal Hobart Hospital

Following a tendering process, the Department of Health and Human Services signed an agreement to have a private hospital co-located at the Royal Hobart Hospital site. Australian Health Care (AHC), the successful tenderer, began refurbishment of the Queen Alexandra wing of the Royal Hobart Hospital in February, with a planned opening date of November 1999. Services and equipment will be shared between the public and private hospitals.
Dialysis Unit for the North West Coast

For many years, North West Coast residents have had to travel to Launceston up to three times per week for hospital-based dialysis treatment. There were several veterans in this group and ex-service organisations requested the State Government to provide the necessary facilities in the area. In February, the State Government announced that a dialysis unit would be based at the Northwest Public Hospital in Burnie and would be operational from July 1999.
Veteran Community Information Service

In November, the Launceston RSL sub-branch with assistance from DVA staff, established a community information service for veterans admitted to the Launceston General Hospital (LGH). As part of this service, the Launceston RSL makes arrangements for veterans in hospital to be visited by their peers, and provides and/or arranges support services for them. Office space at the hospital is made available on three days a week to help in the provision of this service.
Discharge Planners Network

DVA convened the first meeting of the Discharge Planners Network in February. Discharge planners from most hospitals around the state attended, as well as representatives from the Division of General Practice, community nursing and the Brain Foundation. The group believes there is value in meeting on a regular basis to discuss issues, problems and resolutions. The group was joined at the second meeting in June by representatives from CareWorks (Coordinated Care Trials). Minutes were provided to TMC members.
Complaints monitoring

DVA received some 12 written complaints about treatment. A summary of the complaints and follow-up action by DVA was provided to the TMC. Each complaint was quite different, so no trend was identified.
Information Sharing

The committee continued to be a useful avenue for briefing ex-service organisation representatives on initiatives in DVA Health Care and Services – a number of staff attended each meeting. Guest speakers at meetings included:

David Swan, Chief Executive Officer, Calvary Hospital;
Lorraine Hill, DVA Discharge Planning Coordinator, Calvary Hospital;
Dr James Cretan, Director Medical Services, St Helens Hospital;
Neil Beer, Chief Executive Officer, St Helens Hospital (who is also project manager, Hobart Private Hospital); and
Kate Ryan, project manager of the Care Management Project (improved discharge planning for elderly frail patients), Royal Hobart Hospital.

Northern Territory Treatment Monitoring Committee

Meetings held: 18 November, 20 May
Membership to 30 June 1999

Mrs Pam Blamey DVA Deputy Commissioner – Chair

Mr Michael Barrett Returned & Services League

Mr Kenneth James Totally & Permanently Incapacitated Soldiers Association

Mr Garry Casey Vietnam Veterans' Association of Australia

Mr Leon Eddy Legacy Club of the Northern Territory

Mr Ray Anderson Regular Defence Force Welfare Association

Ms Robyn Harrison Territory Health Services

Ms Janice Wheldon Darwin Private Hospital

Mr Tony Wyles Regional Manager, DVA, Darwin

Matters of significance

Northern Territory health agreement

A six-year agreement, effective from 1 July 1999, has been signed between DVA and the Territory Health Services. Under the agreement, DVA will pay for services for eligible veterans and war widows/widowers in Northern Territory government hospitals, on a full cost-recovery basis.
Provision of Repatriation Appliances Program

During the year, the supplier of appliances under the Rehabilitation Appliances Program was declared bankrupt. Two other organisations stepped in to assist until a permanent arrangement was in place. Although no contracts have been signed with these two organisations, there have been no major problems with the provision of appliances.
Complaints Monitoring

There were few complaints discussed by the committee during the year. Corrective action, where necessary, was advised.
Back to top

| Return to Contents |

Dr Neil Johnston	President, Repatriation Commission – Commonwealth representative and Chair
Mr Geoff Stonehouse	Division Head, DVA Health Care & Services – Commonwealth representative
Mr G 'Rusty' Priest	Returned & Services League
Mrs Eileen Watt	War Widows' Guild – until 31 October 1998
Mrs June Healy	War Widows' Guild – from 1 November 1998
Mr John Jeppesen RFD	Australian Veterans and Defence Services Council
Mr Bill Weir	Australian Federation of Totally & Permanently Incapacitated Ex-Servicemen and Women
Mr Simon Agnew	Legacy Coordinating Council
Air Vice-Marshal John Paule DSO AFC (Retd)	Regular Defence Force Welfare Association
Mr Rob Cox	Vietnam Veterans' Association of Australia

NATMOC expenses for 1998-99	$
Travel expenses for three meetings	12 703
Accommodation for three meetings	4 549
Provisioning for meetings	440
TOTAL	17 692

Mrs Felicity Barr	DVA Deputy Commissioner – Chair
Ms Janet Anderson	DVA Director, Health Care and Services
Mr G "Rusty" Priest	Returned & Services League of Australia
Mrs Beryl Page	War Widows' Guild of Australia
Mr John Jeppesen RFD	Australian Veterans and Defence Services Council
Mr G (Les) Blok	Totally & Permanently Incapacitated Veterans Association
Lt Col A "Bushy" Pembroke MC (Retd)	Regular Defence Force Welfare Association
Mr J A Stanton	Sydney Legacy
Mr Ray Bennett	Vietnam Veterans' Federation of Australia
Ms Catherine Katz	NSW Health Department

Mr Brian Flynn	DVA Deputy Commissioner – Chair
Mr Wally Hacking	Returned & Services League of Australia
Dr Sol Rose	Returned & Services League of Australia
Mrs Eileen Watt	War Widows' Guild of Australia
Mr Bruce Coleman	Australian Veterans and Defence Services Council
Mr Gordon Taylor	Totally & Permanently Disabled Soldiers' Assn.
Dr Allan Beech	Melbourne Legacy
Dr Alan Tait	Legacy (Country)
Mr Ian Wall	Regular Defence Force Welfare Association
Mr Brendan Lynch	Vietnam Veterans' Association of Australia
Mr Edward Wightman	Naval Association of Victoria
Maree Bowman	Director, Health, Community & Staff Services, DVA
Mrs Sue Harvey	Executive Director, Nursing & Patient Support, Austin &Repatriation Medical Centre
Mr Peter Lewis	Department of Human Services

Mr Geoff Trevor-Hunt	Vietnam Veterans' Association of Australia
Mr Fred Cullen	Returned & Services League
Dr Ronald Benson	Melbourne Legacy
Dr William Adam	Executive Director, Clinical Services, Austin & Repatriation Medical Centre
Ms Veronica Spillane	Department of Human Services

Mr Gary Collins	DVA Deputy Commissioner – Chair
Mr Kevin Ross	DVA Director Health Care & Services
Mr Cyril Gilbert	Returned & Services League
Mr Bob Taylor	Returned & Services League – until 2 March 1999
Mr William Mason	Returned & Services League
Mrs Marjory Brown	War Widows' Guild of Australia
Dr Peter Grant	Brisbane Legacy
Mr Kevin Casey (Retd)	Regular Defence Force Welfare Association
Mr Fred Cottrell	Australian Veterans and Defence Services Council
Mr John Smith	Vietnam Veterans' Association of Australia
Mr Val Kleem	Totally & Permanently Disabled Soldiers' Association of Australia
Mrs Wendy Pilkington	Queensland Department of Health

Category of Complaint	Number of complaints
Nursing	8
Discharge planning	4
Specialist	7
Communication	9
Other	8

Mrs Pamela Blamey	DVA Deputy Commissioner – Chair
Mr Geoff Banks	DVA Director, Health & Community Services
Mr Max Farrell	Legacy
Mr Ron Zwar	Australian Veterans and Defence Services Council
Mr Bill Schmitt	Ex-Prisoners of War Association Inc
Mrs Kathleen Rhodes	War Widows' Guild
Mr John Spencer	Returned & Services League
Cdr Robin Pennock	Regular Defence Force Welfare Association
Mrs Coral Farrelly	Council of Ex-Servicewomen's Association (SA) Inc
Dr Michael Jelly RFD	Department of Human Services – until 8 February 1999
Professor Brendon Kearney	Department of Human Services – from 8 February 1999
Mr Kerry Bromilow	Association of Totally & Permanently Incapacitated Ex-Servicemen and Women (SA Branch) Inc – until 26 March 1999
Mr Barry Vincent	Association of Totally & Permanently Incapacitated Ex-Servicemen and Women (SA Branch) Inc – from 26 March 1999
Mr Ron Coxon	Vietnam Veterans' Association of Australia

Category of Complaint	No. of complaints
In-patient	51
Accident and emergency	21
Discharge planning	13
Hygiene	4
Outpatients	7
Facilities	1

Category of Complaint	No. of complaints
Repatriation appliances	2
Transport	5
Oxygen	1
Podiatry	1
Security	2

Mr Jim Dalton	DVA Deputy Commissioner – Chair
Mr Russell McLaughlan	DVA Director, Health Care and Services
Mr Ken Bladen	Returned & Services League
Mrs Fran Aggiss	War Widows' Guild
Air Commodore Sam Dallywater	Australian Veterans and Defence Services Council
Mr Bill Dedman	Regular Defence Force Welfare Association
Mr Rob Cox	Vietnam Veterans' Association of Australia
Mr Arthur Greaves	Totally & Permanently Incapacitated Association
Mr Peter Eddy	Perth Legacy
Mr Arthur Robinson	Ex-POWs Association
Mr Laurie Sullivan	Royal Australian Air Force Association
Mr Theo Bushe-Jones	Naval Association
Ms Ros Franck	Health Department – until 2 November 1998
Ms Paola Morellini	Health Department – from 2 November 1998

Mrs Kay Grimsley	DVA Deputy Commissioner – Chair until December 1998
Mr Roger Winzenberg	DVA Deputy Commissioner – Chair from February 1999
Ms Christina Shaw	DVA Director, Health Care and Services
Mr Wally Sutherland	Returned & Services League
Mrs Joan Cooper	War Widows' Guild
Mr George Debnam	Australian Veterans and Defence Services Council
Mr Peter Sutcliffe	Totally & Permanently Disabled Soldiers Association
Mr Jack Brotherson	Hobart Legacy
Col Jim Macbride	Regular Defence Force Welfare Association
Mrs Ann Harper	Vietnam Veterans' Association of Australia
Mr Norm Davie	Department of Health and Human Services
Ms Melanie Allen	Department of Health and Human Services

Mrs Pam Blamey	DVA Deputy Commissioner – Chair
Mr Michael Barrett	Returned & Services League
Mr Kenneth James	Totally & Permanently Incapacitated Soldiers Association
Mr Garry Casey	Vietnam Veterans' Association of Australia
Mr Leon Eddy	Legacy Club of the Northern Territory
Mr Ray Anderson	Regular Defence Force Welfare Association
Ms Robyn Harrison	Territory Health Services
Ms Janice Wheldon	Darwin Private Hospital
Mr Tony Wyles	Regional Manager, DVA, Darwin