Thank you, Bill.
I'm Adam Luckhurst. I'm a senior executive within the Department of Veterans' Affairs in Australia. As the high commissioner said, I'm very lucky to be on an exchange program with Veterans Affairs Canada for the next 18 months or so.
I've only been in Canada for about five weeks, so I'm rapidly learning about your country, and it's certainly a great place to be.
I've got a broad background in veterans affairs issues. The key areas I've been involved in are areas around rehabilitation policy, looking at our linkages with our defence force, our research program, and also management of some of our health services, particularly our hospital program.
I thought I'd give you a general overview of the way our department works and touch briefly on a couple of issues that I understand you're interested in; namely, around mental health and also transition for our younger defence force members. Following this, obviously I'd be happy to answer any questions you may have.
I would, however, like to stress that I have a broad knowledge of the veterans affairs system in Australia, but it is a very big program, it has a very considerable budget, and I may not be able to give you all the levels of detail you may wish. I'd be happy to provide that later if need be.
If I could talk about what the Veterans' Affairs portfolio looks like in Australia, primary within it is what we call our Repatriation Commission, which comprises three members: a president, who is also the secretary or the head of the Department of Veterans' Affairs; a deputy president; and a community representative, who is nominated by ex-service organizations.
The Repatriation Commission is essentially responsible for setting policies and making decisions under our Veterans’ Entitlements Act, which I'll come to in a moment. And that really, on a day-to-day basis, means it's the decision-maker for the granting of pensions and our provision of health care and those sorts of things. But obviously many of those decisions are delegated on a day-to-day basis to officers of the department.
We also have a Military Rehabilitation and Compensation Commission, which is very similar to our Repatriation Commission. It is comprised of the same three members and it also has a broader group of representation, which includes representatives from Defence, and they are administering our Military Rehabilitation and Compensation Act, which is in place for veterans who served after July 1, 2004.
We also have a Veterans' Review Board, which is responsible for reviewing decisions of the department particularly relating to entitlements--was a claim accepted?--or assessment, which is really about what level of pension is deemed to be payable.
We also have a Repatriation Medical Authority, and it's responsible for determining statements of principle in relation to medical or scientific evidence connecting injuries, diseases, or death with the circumstances of a veteran's service.
We also have the Office of Australian War Graves--I think Bill has given you a good picture of the nature of our war graves--and they're obviously responsible for managing our war graves and other commemorative activities as well. They are also responsible for publishing and maintaining nominal rolls of participants in previous conflicts.
We also have a couple of smaller bodies: the Specialist Medical Review Council, which is responsible for reviewing statements of principle established by the Repatriation Medical Authority; and the Veterans’ Children Education Board, which oversees the programs we administer relating to children's education as dependants.
Within the portfolio we also have the Australian War Memorial, which is our war museum. It is not just a museum; it also collects a lot of the historical records about people's service in various conflicts.
As I've alluded to, a number of different pieces of legislation outline the way our repatriation system works in Australia. Primary to this is the Veterans’ Entitlements Act, and that essentially provides for services for those who undertook missions up until June 30, 2004.
Three key services are provided under that act.
The first is the granting of disability pensions and income support to those who have war-caused disabilities.
The second is the provision of a comprehensive range of health care treatment services. Under these arrangements, veterans have access to health care services at no cost, and that includes hospital care, and that's within Australia's public and private systems; medical practitioners, primarily medical specialists and general practitioners; pharmaceutical items; and allied health treatments, such as dental, optometry, physiotherapy, podiatry, occupational therapy, and the like. We have a veterans home care program, similar to your VIP, which provides domestic assistance, personal care, home maintenance, and respite care. We provide aids and appliances, hearing services, transport, and also residential age care.
The third part of the act really provides for looking after the dependants of veterans, particularly war widows.
The second key piece of legislation is our Military Rehabilitation and Compensation Act, which came into force in 2004, and it really is very similar to our Veterans' Entitlements Act in its broad thrust. The key difference between the legislation is a significantly enhanced focus on linkages with the defence department and in particular the provision of rehabilitation.
The rehabilitation program is really aiming as far as possible to restore ability and function as close as possible to where the individual was before the injury occurred. And obviously in line with good practice, the program is required to cover medical, vocational, and psycho-social rehabilitation.
MRCA also provides serving or former Australian Defence Force members with payments when they are incapacitated by accepted conditions. These payments are based on their Australian Defence Force salaries and allowances. Reservists can have their payments based on their civilian and military earnings.
Compensation is then provided in cases where permanent impairment has been shown, and compensation can be paid in either a tax-free periodic payment, a tax-free lump sum, or a combination of the two. Funds are provided to enable the member to receive financial advice to determine which option is most appropriate to their circumstances. MRCA similarly provides for widows and dependants as well.
There is a range of other pieces of legislation but two I'll just mention very briefly. One is the Safety, Rehabilitation and Compensation Act, which provides for rehabilitation and compensation for Australian Defence Force personnel injured up until June 30, 2004, but not in a period of wartime. And also, the Australian Participants in British Nuclear Tests (Treatment) Act 2006, which provides for non-liability cancer treatment for those who participated in the British nuclear tests in Australia.
I'd now like to provide some information on the funding levels and numbers of clients.
Total proposed expenditure for 2008-09 for the veterans affairs portfolio is $11.6 billion Australian. The service provided by the department under the various pieces of legislation is split into four main outcomes: the provision of income, support, and compensation payments, for which the total is around $6.3 billion Australian in 2008-09; provision of health care services, for which funding is about $4.9 billion Australian this financial year; the provision of commemorative services to recognize the service and sacrifice of men and women, with funding for 2008-09 being $45 million Australian; and the provision of advice and information about benefits entitlements, and services, and funding in that area will total about $58 million Australian in 2008-09.
At December 2007, the Department of Veterans' Affairs had approximately 423,000 clients. Of these, over 137,000 have some level of accepted disability that has warranted the granting of a full or partial disability pension.
The department provides treatment cards to those who are eligible to receive one. Over 235,000 have a gold card, which entitles veterans to receive treatment for all conditions they have, regardless of cause. Approximately 52,000 have white cards, which enable them to receive treatment at no cost, but relates to war-caused disabilities only. We also provide orange repatriation cards to a small number of allied war veterans, including some Canadians—I think there are around 30 or so, so it's quite a small number indeed. The cards are provided to entitled veterans from World War II and enable the individual to receive a pharmaceutical allowance of $5.80 Australian per fortnight and pharmaceutical items at a subsidized cost of $5 Australian each.
Some allied veterans may also be eligible to receive a service pension from the Australian government. I believe there are a small number of Canadian allied veterans who receive the service pension in Australia as well.
I understand from the secretariat that there are a number of areas you are interested in. I would therefore like to briefly cover two of these, the first being services and supports to those with mental health conditions.
DVA has in place a comprehensive range of services and programs to meet the health care needs of those with a mental health condition. At January 2008, 52,227 veterans had an accepted disability in the area of mental health. This represents approximately 18% of those who are eligible for treatment under DVA's health care system. Almost 140,000 DVA clients receive some form of treatment for mental health conditions. So for those other people to whom we would be providing services outside of their war-caused disabilities, there is a considerable number of services being provided there.
We have a number of avenues for the provision of treatment. DVA operates the veterans and veterans families counselling service. It's a specialized confidential service that provides nationwide counselling and support to Australian veterans, peacekeepers, their families, and eligible Australian Defence Force personnel. The veterans and veterans families counselling service operates out of 15 offices throughout the country and has also established a network of approximately 500 private practitioners to assist veterans in regional, rural, and outer metropolitan areas.
Services available from the veterans and veterans families counselling service include counselling for individuals, couples, and families; clinical case management; crisis counselling, including after hours telephone support; educational and treatment group programs; lifestyle programs, such as heart health; the Stepping Out program for transitioning Australian Defence Force members; referral; and information and education.
Separate from the veterans and veterans families counselling service, individuals can access other health care providers, such as specialists, general practitioners, psychologists, and social workers, under the DVA health care system using their treatment card.
The department has also developed a range of education programs aimed at promoting an understanding of mental health conditions and how to get information, help, and assistance. The At Ease initiative is a suite of communication products developed for the veteran community about mental health and well-being issues. It encourages veterans to recognize possible signs, take appropriate action, and assume more responsibility for their own health and well-being. The At Ease branding will be used in all communications to veterans and health care providers and provides a focus on keeping your mind at ease, with the tag line of “Recognise, Act, Maintain”. The key elements of the At Ease initiative at the moment include a dedicated At Ease website, a 24-hour hotline, an information booklet for veterans, a range of fact sheets, resources for families and caregivers, and information for health care practitioners.
For a number of years, DVA has also operated the Right Mix program. This initiative was developed to reduce alcohol-related harm, to assist veterans to understand their alcohol use, and to provide avenues for information and further assistance.
The government has also recently established the mental health life cycle project, which is aimed at achieving a range of outcomes, including enhanced psychological resilience among serving personnel, better early intervention on mental health surveillance, successful transition from defence to civilian life for Australian Defence Force members and their families, effective rehabilitation support, and timely access to mental health treatment.
The first elements of the package are commencing in 2008-09. There needs to be an establishment of a transition management project and family support trial. That's occurring in Townsville, on the Queensland north coast--a study into the barriers to successful rehabilitation and an examination of treatment options for hard-to-engage clients. Work is now under way, in conjunction with the Department of Defence, which we're working with on this project, to finalize the details of those three projects.
The department also provides core funding to the Australian Centre for Posttraumatic Mental Health, which is an academic centre operating within the University of Melbourne, to continue its important work in developing further understanding of effective treatment strategies for a range of mental health conditions affecting war veterans and others.
The Minister for Veterans' Affairs and the Minister for Defence Science and Personnel recently announced a review of mental health care in the ADF and beyond.
The review will seek to assess existing mental health programs and support across the Australian Defence Force, in the Department of Veterans' Affairs, and advise on their effectiveness, gaps in services, and challenges in delivery. It would also examine and advise on transition processes between the Australian Defence Force and DVA. It is expected that a report will be provided to ministers by mid-December 2008.
The second key area I'll focus on relates to how the department and the Department of Defence are working together to improve both linkages and transition support.
DVA and the Department of Defence have a defence links program, which is in place to ensure close working relationships and to enable the improvement of support to veterans by both agencies. Some of the key areas of work today have tackled a range of different areas, and they include rehabilitation.
Under the Military Rehabilitation and Compensation Act, Defence has the prime responsibility for rehabilitation programs while an individual is a member of the services. DVA has the responsibility after discharge. So DVA and Defence are working closer together to ensure exchange of information and ideas, to maximize outcomes from rehabilitation for individuals.
Work is also under way to ensure that appropriate systems and linkages are in place to manage the shift from one agency's responsibilities to another when an individual accessing rehabilitation programs discharges.
We are also looking at transition management. A key area of focus for both departments is working on strategies to improve transition, and in particular close attention is being made to those being medically discharged, so that all claims and other issues are addressed prior to the point of discharge, wherever possible.
DVA already operates transition management services for those being medically discharged on behalf of the Department of Defence. They assist members sort through the range of issues they may have at transition and help them work out appropriate options for dealing with them.
A range of information products have also been jointly produced, and two pilot projects aimed at establishing improved processes between agencies concerning transition support have been established. The department, through the veterans and veterans family counselling services has also established the Stepping Out program, which is aimed at assisting defence force members considering transition to civilian life to understand some of the issues that may arise for them and how they can seek information and support to deal with them.
We're also working together in the area of health care. Close working relationships in the area of health care are also in place. This, in particular, covers areas of mental health, but we're also looking at preventative health care programs, such as hearing loss. There is a web-based program that's been put in place between the two departments in those areas.
We've also placed considerable attention on the area of records management between the two organizations. In particular, DVA now has access to some defence IT systems, which enable us to gather information about an individual's service, but we've also put in place streamlined arrangements for the management of paper-based records, which most of their decisions are still based on. This work has been very successful, and we've significantly reduced, as a result of it, the processing time for clients, for personnel.
Finally, there's also a close cooperation in the area of research in defence. DVA has established jointly a Centre for Military and Veterans' Health, an academic centre based at the University of Queensland. One of the key bits of work for that centre is undertaking some research, looking at some of our personnel who have been on more recent deployments, both in the Middle East and in Australia's near north.
I hope this has been of some assistance to you, and I'm happy to answer any questions you may have.