This was a very large and complex inquiry with terms of
reference which could easily have taken multiple reports to cover. Rather than
produce a number of reports, the committee has sought to table this report as
soon as possible. The clear message to the committee was that immediate as well
as longer term action is required to address suicide by veterans.
The committee appreciates that not everyone has the time to
read this report cover to cover and provides this executive summary to give an
overview of the key issues from the evidence and highlight key recommendations.
Recommendations are categorised into short, medium and long term.
Short term
Streamlining administration
The need to streamline the administrative practices of DVA was
the overwhelming concern of the majority of submissions to the inquiry. The
importance of improvements in this area is also recognised in the committee's
longer term recommendations. Recent improvements through DVA's 'Veteran Centric
Reform' program have highlighted the potential for further reform of
administrative processes which can be rapidly achieved. The committee has
recommended that the government continue to support and fund the 'Veteran
Centric Reform' program in DVA (see Chapter 5).
At the same time as pursuing the 'Veteran Centric Reform'
program, the committee has recommended the government continue to fund
measures to reduce the backlog of claims and increase case coordination staff
to assist clients with complex needs. To facilitate further assessment and
improvement of administrative practices, the committee has recommended that
the Australian National Audit Office commence a performance audit of the
'Efficiency of veterans' service delivery by the Department of Veterans'
Affairs' as soon as possible (see Chapter 5).
Staff training
The committee was concerned to hear that some clients felt they
had not been treated with respect by DVA officers. The committee acknowledges the
difficulties of interacting with clients who are very frustrated with the
processes and may be experiencing mental health issues. The committee would
therefore like to ensure that relevant DVA staff interacting with clients have
appropriate and up-to-date training. To this end the committee has
recommended that DVA review its training to ensure that staff have an
understanding of: military service; the health issues of veterans; have appropriate
skills to deal with mental health conditions; and training regarding
interpreting medical assessment reports (see Chapter 5).
Improving engagement
The committee appreciates the diverse nature of the veteran
community and that it provides a challenge for DVA to ensure appropriate
engagement. Older veterans are generally not reliant on online resources but
contemporary veterans expect them. The committee believes there is scope for
DVA to enhance its digital communication through social media to reach younger
veterans. This would assist with referring clients to the most appropriate
resources. The committee has recommended DVA expand its online engagement
through social media (see Chapter 5).
Targeted programs based on new
research
The committee commends recent research in this area, such as
the AIHW findings concerning veterans at-risk of suicide, and believes more can
be done to respond to new research findings. The committee considers better use
of this research identifying 'at-risk' cohorts in the ADF and veteran community
to target proactive support programs is needed. Research findings such as those
by the AIHW should be used to develop new targeted suicide prevention and
veteran support programs. The committee has recommended that the government develop
and implement targeted suicide prevention programs based on the new research.
The committee also recommended that the government expand the DVA Reconnects
project to proactively contact veterans in at-risk groups (see Chapter 3).
Increasing access to the mental health community
The committee heard about a lack of experience in treating
veteran specific issues within the wider mental health community. The committee
considers that enhancements to online resources and training programs could assist
with this issue. The committee has recommended that the government enhance
the provision of veteran-specific online training programs (See Chapter 3).
Further, mental health professionals highlighted discrepancies between the
fees paid by Defence and DVA as a barrier to veterans accessing support.
The committee has recommended that Defence and DVA align their arrangements
for the provision of professional mental health care (see Chapter 3).
Addressing issues in transition
Appropriate support is essential to assist ADF members
transition to civilian life. Significant reform in this area is occurring. The
committee has recommended the Transition Taskforce examine and address gaps in
support to veterans, barriers to employment and any disincentives for veterans
undertaking work and study. Vulnerable ADF personnel can fall through the
cracks of support in the transition process. The committee has recommended a
two-track transition process be established with intensive support for veterans
who will need it. Furthermore, the committee has recommended all transitioning ADF
members should be provided with a DVA White Card to facilitate access to
non-liability health care, serve as veteran identification and as a platform for
data collection (see Chapter 6).
Accessing the benefits of
alternative therapies
The committee heard from veterans with mental health conditions
who felt alternative therapies had significantly improve their conditions. The
committee accepts that the evidence base is developing in relation to many
alternative therapies but several are being provided through ESOs and other
groups. The committee believes there is scope to expand the reshape the
existing programs to take account of the benefits of these therapies. The
committee has recommended that the government expand the Veterans and Community
Grants program to support the provision of alternative therapies to veterans
with mental health conditions. The committee also recommended that DVA
consult ex-service organisations and the veteran community about ways to reform
the Veterans and Community Grants program to support the provision of
alternative therapies.
In particular, the committee perceived value in developing an evidence
base in Australia for supporting the use of complementary treatments, such as
the effectiveness of companion and assistance animals. The committee has
recommended funding for a trial program that would provide assistance animals
for veterans with Post Traumatic Stress Disorder (PTSD) stemming from their
military service in order to gather research (see Chapter 7).
Medium term
National suicide register
A clear message from the evidence was the wish for an
on-going register of veteran suicide. The committee agrees that there should be
a national register. The committee has recommended that the government
establish a national veteran suicide register to be maintained by the Australian
Institute of Health and Welfare (see Chapter 3).
Research
The committee was very concerned by accounts of negative
interactions with DVA. It is logical that veterans who were satisfied with
their experiences were less likely to be interested in the inquiry.
Nonetheless, the committee believes a key contention by many witnesses, that
the claims process is a key stressor and contributing factor to suicide by some
veterans should be looked at closely. The committee has recommended that the
government commission an independent study into the mental health impacts of the
claims processes. Results from this study would feed into medium and longer
term recommendations to address administrative issues described below (see
Chapter 3).
Medical assessment
Many veterans told the committee that they were unhappy with
their experiences in medico-legal firms and being required to attend multiple
appointments. The committee supports efforts by DVA, Defence and CSC to
implement a single medical assessment process. However the committee has recommended
that DVA reassess its use of medico-legal firms to ensure the assessments are
appropriate for conditions of veterans, particularly mental health conditions
(see Chapter 5).
Further supporting veteran employment
Gaining meaningful employment one of the most important components
of success for veterans in their post service lives. However, those
transitioning from the ADF can struggle to connect with employers and employers
can be unsure about transferrable skills. The committee has recommended the
Career Transition Assistance Scheme include an option for veterans to undertake
a period of work experience with an outside employer. The valued skills and
experience of ADF members means they are often well suited to other public
sector careers. The committee has recommended that the Australian Public
Service Commission conduct a review into mechanisms to further support veteran
employment in the Australian Public Service and the public sector (see
Chapter 6).
Support for partners
A supportive and inclusive approach to the families of veterans
in the transition process is vital to ensuring the long-term well-being of
veterans. However, a consistent theme from the evidence received was that there
was a lack of support for the partners of veterans who have mental health
conditions or have acquired severe disabilities arising from their service. The
committee has recommended that the Department of Veterans' Affairs review the
support for partners of veterans to identify further avenues to support. This
review should include services such as information and advice, counselling,
peer support and options for family respite care to support partners (see
Chapter 6).
Navigating support
There are a complex range of services available for veterans
and the committee heard that people struggle to navigate them. The committee
was attracted to the idea of a single point of information that can operate to
link veterans with local services and support. The committee believes that the
Veterans and Veterans Families Counselling Service is the most appropriate organisation
to take on this role as it is trusted in the defence community and received
praise for the services it offers. The committee recommended that the
government provide funding to support the Veterans and Veterans Families
Counselling Service to create and maintain a public database of services
available to veterans and to provide an information service to assist veterans
and families connect appropriate services (see Chapter 7).
Veteran's Review Board
The committee was concerned that the practice of preventing
veterans bringing their lawyer to the VRB is appropriate in all cases. A number
of examples were provided where vulnerable veterans felt underrepresented or
were unable to fairly engage with VRB proceedings. The committee accepts that
this practice has been maintained in order to allow the VRB to be an open and
non-adversarial forum for veterans to seek review of decisions. The committee
also acknowledges the genuine efforts that the VRB makes to support veterans in
its proceedings.
However, given the long-term future of veterans is in the
balance, and the structural barriers involved in making an appeal to the AAT,
veterans should be able to achieve the fairest hearing possible. The
committee has recommended an independent review of the representation of
veterans before the VRB (see Chapter 7). This review should assess whether
the rights of vulnerable veterans are being adequately protected and whether
further support mechanisms for veterans appearing before the Veterans' Review Board
are required.
Longer term
Addressing legal and administrative
complexity
The burden of legislative complexity and administrative
hurdles impacts veterans when they are seeking support at a vulnerable period
in their lives. The complexity of the legislative framework was a key theme
from the evidence received. While arguably the most important issue during the
inquiry, the committee recognises there is no quick fix.
Some previous reviews have examined at this issue but
ultimately recommended that a single piece of legislation not be pursued. This assumption
that a single piece of legislation cannot easily be achieved, has resulted in ad
hoc measures intended to simplify the system. While any simplification is
welcome, the fundamental complexity in the system has remained.
The committee agrees with witnesses that the current framework
is complex and confusing and contributes to the frustration felt by veterans
and ex-service personnel in dealing with DVA. There are two aspects: the legal
complexity which has resulted in administrative complexity.
Other jurisdictions have simpler legislative frameworks for
veterans. While the committee acknowledges steps being taken by DVA to streamline
some aspects of their processes the committee anticipates that simplifying the
legislative framework would result in efficiencies for all, including flowing
through to the time taken to process claims. The committee has recommended
that the government ask the Productivity Commission to review the legislative
framework and administrative processes with the objective of simplifying the
system. In particular, this review should examine the utilisation of Statements
of Principle in the determination of compensation claims. The review should be
completed within 18 months and be tabled in the Parliament (see Chapters 4
and 5)
The committee recognises the ICT issues with multiple
systems adding to the complexity and the lack of investment in efficient ICT.
The committee reaffirmed its recommendation from the inquiry into the mental
health of ADF serving personnel[1]
that DVA be adequately funded to achieve full digitisation of its records and
modernisation of its systems by 2020, including the introduction of a single
coherent system to process and manage claims.
Advocacy
The committee commends the excellent work of advocates in
assisting veterans make claims. Volunteer and ESO supported advocates will
continue to be required to assist the vast majority of veterans to make claims.
However, the decreasing numbers of advocates will put pressure on the current
system. The committee is also concerned about DVA being responsible for the
training of advocates who will then argue against the decisions of DVA officers
on behalf of veterans. The committee is recommending the establishment of a
Bureau of Veterans' Advocates (BVA) institutionally modelled on the Bureau
of Pensions Advocates in Canada. This would consist of a section of legally
trained public servants with a mission to independently assist and advocate for
veterans in making claims. The BVA will supplement and support the current
system of volunteer advocates. Where necessary, the BVA will be allocated a
budget to commission legal aid to assist veterans make appeals. The BVA will
also take over responsibility for grants to ESOs regarding advocacy, training
and accreditation of volunteer advocates and insurance issues (see Chapter 7).
Finally, the committee acknowledges that there is
substantial support being committed by the Australian Government and
considerable work being undertaken by DVA to transform the client experience
for veterans. It is encouraging that DVA's reform agenda appears to be moving in
the same direction as the recommendations suggested by many submitters. The
areas highlighted in the Budget 2017-18 for the ADF and DVA also respond to
several of the concerns raised during the inquiry. Nevertheless the pace of
reform has been slow and needs to be increased. The committee hopes that the
recommendations in this report will contribution to this reform.
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