The Importance of Partners

Thank you for having me here tonight.

I want to talk about a group that I believe outperforms DVA in providing for Veterans.

That is, I want to talk about the importance of Veterans’ partners.

One of the greatest lessons I have learnt over my last year as Shadow Minister for Veterans’ Affairs is the importance of a veteran’s family, especially their partner in providing veterans with love, support and care.

Firstly, partners of veterans contribute in the area of compensation and income for the veteran. It is a sad fact that when veterans return from conflict they are often unable to participate in the workforce to a level that they could have if it was not for their service.

In these cases partners work long and hard to compensate the veteran for income that they could have been earning. Often this means that the partner has had to sacrifice their original career ambitions and aims for this purpose.

Secondly, a partner will provide the veteran with the greatest recognition he or she can receive. A veteran can march in as many services as he wishes. He can have memorials erected in commemoration of his service. But I am sure that none of this means more to a veteran than their own partner’s recognition of their sacrifice.

Perhaps the greatest way a partner contributes to a veterans’ health is through the provision of health care.

This is clearest in the case of partners who are carers. The role of a carer is a selfless role, and one that requires a massive commitment of blood, sweat and tears.

Carers have to forgo a place in the workforce. They are prevented from achieving income freedom, disadvantaged by not being able to accumulate their own superannuation or savings.

They often have their social lives cut dramatically. No longer do they have the free time or energy to pursue those activities that may have given them pleasure and relaxation.

It takes a special person to be this selfless.

Carers make a great contribution to our society, by caring for their loved ones, who may otherwise be taken out of the community.

Carers provide us with so much and deserve more recognition for their efforts.

I believe that we must be doing more to understand the role that partners of veterans play so that we can provide appropriate resources to help them where we can.

The Children of Vietnam Veterans Health Study

I am aware that there are many issues that have a large impact on partners of veterans, many of which need to be addressed. However due to the limited time available to me tonight I can not touch on them all. Tonight I want to focus on the proposed Children of Vietnam Veterans’ Health Study.

I want to outline my thoughts tonight on where we are currently and also outline some ideas about where I believe we should be.

Firstly, I would like to congratulate the Minister on his announcement that he will be forming a new Advisory Panel on Intergenerational Effects. I would like to congratulate Professor Elizabeth Waters as being appointed chair of this panel and I am sure she will do an excellent job. This is a positive step in the right direction.

At the last election this government promised that it would conduct a feasibility study to determine if a study into the health of children of Vietnam veterans could be conducted, and if it would be worthwhile.

The Veterans’ community had been pushing the government on this issue. They Veterans community accepted the government’s position with good faith.

The government has finally, after a prolonged period, released the findings of the feasibility study.

I want to talk about the feasibility study’s findings.

When the Minister received the findings of the feasibility study he also received two letters attached to this study.

The first letter was addressed to Mark Sullivan, the Secretary of the Department of Veterans’ Affairs, and was from Professor Alexander McFarlane writing on behalf of the Scientific Advisory Committee.

Professor McFarlane made the findings of the study very clear when he wrote that:

The Committee has found that a study into the health of children of Vietnam veterans is feasible. In addition the Committee is of the view that there would be substantial merit in such a study.

The Committee’s preferred option, and the option we see as most feasible, would be a study design comparing the children of Army Vietnam veterans with the children of Vietnam war era Army personnel who did not serve in Vietnam. The brothers and sisters of these groups of Army soldiers, who have children, would also be included in this design. This option would examine the impact of Vietnam on the health of children as well as answer the question of whether the health of the children of Vietnam veterans is different from a general community sample where the father had not served in the military.

A decision to proceed with this study and the commitment of resources for the study is a matter for Government, and goes beyond the terms of reference of this Committee.

The second letter was from the Repatriation Commissioner, Rear Admiral Simon Harrington who also served as the Chair of the Consultative Forum. In this letter Rear Admiral Harrington also makes clear the findings of the study. He writes

The Forum, comprising of members of the Vietnam veteran communities as well as a son and daughter of Vietnam veterans, supports the Committee’s conclusion that a health study is feasible and reinforce the benefits of undertaking a pilot study.

The consensus of the Forum was that a study, if pursued successfully, would provide Government with authoritative and specific information about the health impact that Vietnam service has had on the sons and daughters of Vietnam veterans. This information would be of value if the government considers designing innovative and targeted policy responses to address potential health issues that may be identified in a health study.

The report itself states that

The SAC has identified that a study of the children of Vietnam veterans is feasible, and have selected a preferred study design that would provide a way to assess evidence for differences in the mental and physical health of children of Vietnam veterans compared to children from the general community and children of other Australian Defence Force personnel who did not serve in Vietnam.

I apologise for the long series of quotes, especially to those who have already read the report, but I feel it is very important that we are clear on what the feasibility study said and what it recommended.

It is clear that the advice that the Minister received on this issue was that:

1. A study was feasible and very worthwhile; and

2. A pilot study should be completed.

What was also clear and what has been understood in the veterans’ community is that real results could have been achieved in a lot less than 7 years.

The question therefore is why has the Minister chosen to respond to these findings in the way he has.

The Minister has appointed the Centre for Military and Veterans’ Health to undertake further research on the feasibility of the study. They have been appointed to develop, in the Minister’s words, a research protocol.

They have not been appointed to implement a pilot study.

They have not been appointed to conduct a study.

This leads to the question of why the Minister chose to ignore the advice given.

Firstly, the Minister points to the fact that the feasibility study outlines a number of issues that could impact on the success of future research. These are the issues I assume will be addressed within the research protocols.

My concern is that the feasibility study examined these issues. Their findings address many of these issues.

There is no doubt that the study did find that some of the issue will need to be resolved.

However, nowhere in the study is it recommended that these issues need to be resolved by undertaking further research into protocols. Instead the study recommended that:

A pilot study would allow detailed exploration of the various study designs to determine a scientifically robust design and the associated costs. Undertaking a pilot study will also allow for the assessment of potential recruitment and response rates and the testing of the standardised measurement instrument available to health and wellbeing outcomes.

I have two questions that come from this.

Firstly, why did the Minister ignore the advice of his own independent study?

Secondly, why did the Minister feel that another lengthy study was required on this topic when the feasibility study has examined many of these issues and at no place does it recommend the action he has taken?

Another reason I have heard from the Minister is that he is concerned that the study is proposing to sample only Army personnel and not Airforce and Navy personnel.

Again the feasibility study addresses these issues when it says

The SAC extensively discussed whether the comparison groups should include fathers from all three Australian Defence Force service arms and decided to include only Army veterans in the study design for scientific and logistic reasons. The logistic reasons include that there are larger numbers of Army enlisted veterans, a list of Army veterans who did not go to Vietnam is already available for a comparison group, and the consistency in the nature and length of deployment in Vietnam. The costs and the resources required in undertaking a health study incorporating all service arms would increase considerably.

These seem like very sensible reasons to me. The study also makes it clear that non-Army personnel do not have to fear missing out under the proposed format. The study clearly states

While the decision to study the Army was for methodological reasons, this does not negate the potential relevance of these findings to RAAF and RAN veterans’ children. In deciding upon this option, it is important to acknowledge that there were many similarities in the nature of service between some RAAF, RAN and Army personnel.

The study has therefore addressed this issue so I can not understand why the Minister sees this as an impediment to commencing a study.

So again I have to ask why is the Minister ignoring these findings?

To my mind the findings are clear the study is feasible and a pilot study would help work through the technical issues.

And again, I stress that there are options, real options, that won’t take anything like 7 years.

The Minister instead has made the decision to engage in further work on research protocols, which he predicts will be finished by the end of 2007.

I can not help but be cynical that the results will be available at the end of 2007 when an election is to be held before that time.

I also question why so long is needed just for the development of protocols. Surely some of these issues can be worked through in a much shorter time.

Instead what we have is a very credible and sensible feasibility study that has led to the Minister calling for a further feasibility study.

This is an issue that is very important because of what we already know.

We already know that children of Vietnam veterans have three times the suicide rate of the general community.

We know that this rate worsened from the 1980s to the 1990s.

We should therefore be acting on this now, not in the future, not after the next election, but now.

We knew this in 1999.

While the government has introduced a small number of initiatives related to this fact, these initiatives have largely been reactive and passive.

This Minister has for example introduced an expansion in the Long Tan Bursary Scheme and also approved a continuation of free access for children over the age of 35 to the Vietnam Veterans Counselling Service.

These were welcomed by me as worthwhile decisions.

However, the question we need to ask is: is this enough? Can’t more be done now?

The programs and assistance offered by this government require the individual or the family to come to the government or health providers to seek assistance.

It is my understanding however that due to the nature of the issue, namely mental health and suicide, these sorts of measures while necessary and welcome, are limited in their impact.

Under this government there have been limited programs or measures that promote an outreach to the veteran community generally to raise awareness of mental health issues and signs.

The government needs to be less reactive in this area and much more proactive.

One measure that I believe should be looked at very closely is providing Program ASIST with increased funding and administrative support.

ASIST stands for Applied Intervention Skills Training and is a workshop conducted by LivingWorks Australia, under the auspices of Lifeline Australia.

ASIST workshops aim to equip participants with the skills needed to play an effective suicide intervention role. The emphasis is on suicide first aid and helping a person at risk to stay safe and find professional support.

The ASIST program is well run by the National Coordinator Derek Philips, however Derek recognising the need and importance of suicide intervention programs has been running a campaign to have the Department provide the program with greater support and exposure.

The thing that I like about this program is it teaches prevention strategies and does not rely on reactive strategies. It is about promoting awareness throughout this community, the veterans and their familles that will contribute to a solution for this very serious and disturbing problem.

I think the Minister should be looking into this and giving this serious consideration. I definitely think there is scope to bring the ASIST program and its associated courses under the umbrella of health services offered by the Department.

This isn’t the only thing I think we should be doing but it would be a good start and it is something that the Minister can do right now.

Another practical measure that should be taken is for a review of communication strategies within the Department.

The programs that are currently running and support that is available within the Department are often of a high quality. They are often of a high quality yet they are often woefully underutilised.

The Minister needs to ensure that the information is getting out there.

Two pertinent examples here are the Vietnam Veterans Counselling Service and the Vietnam Veterans’ Children Support Program. These are two very worthwhile programs that I fear are being under utilised.

I think that one of the problems is that often information about these programs is only provided to people who already are diagnosed with a problem. We need to be getting this information out into the community to as many sources as possible so that people can start to recognise and spot problems, and if they do, they can be aware of the support that is available to them.

This is about being proactive and raising awareness rather than reacting.

An example of an initiative that I think could have been done better was the government’s provision of a free PTSD booklet to all Veterans diagnosed with PTSD. This was welcomed by Labor but again the problem is it did not go far enough. Providing already diagnosed sufferers of PTSD with an information booklet does not help those veterans who are yet to be diagnosed. A free booklet should have been made available to the whole veteran community and their families.

I was also glad to hear the Minister say recently that the Department is working on a strategy to raise awareness among GPs of the specific health issues that may be faced by veterans and their families.

These are just some of the practical measures that I would ask the Minister to implement now. We should not be waiting until the end of 2007. These are measures that address the problems that we already know exist and therefore we have no excuse to wait. And we should be identifying other initiatives that can be implemented now.

Given what we already know this is the least we can do for the families of those who have served this country so well.