THE HON. WARREN SNOWDON MP
Minister for Defence Science and Personnel
Friday, 17 October 2008
OPENING OF THE SEVENTEENTH ANNUAL
CONFERENCE OF THE AUSTRALIAN MILITARY
MEDICINE ASSOCIATION, WREST POINT
CONVENTION CENTRE, HOBART 0930 FRIDAY 17
OCTOBER 2008
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SPEAKER: THE HON. WARREN SNOWDON MP
Good morning,
It is my great honour to help open this annual conference of the Australian
Military Medicine Association….here on the lands of the traditional custodians,
the Nuenonne and the Paredarerme people…
It is with great respect I visit their lands today…
And it is with respect too that I acknowledge the president of the Australian
Military Medicine Association (AMMA), Dr Russell Schedlich.
The Patron of AMMA, the Surgeon General Defence Health Reserves, Rear
Admiral Graeme Shirtley.
The ADF’s own Commander Joint Health, Major General Paul Alexander
And Dr Tyler Smith from the Naval Health Center, San Diego who is the
Principal Investigator of the US Millennium Cohort Study.
Being asked to open this conference is indeed an honour…
an honour but also an opportunity to say, at the very outset of what I am sure
will be a fascinating few days, that this Government is committed, wholly
committed, to meeting the health needs of our Defence Force personnel.
In particular this morning I would like to make mention of the work we are
doing, and the work that needs to be done, in mental health care for our
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sailors, soldiers and airforce personnel, but first let me say how gratifying it is
to see such a large number of delegates at this conference.
The benefits which can accrue from such gatherings and the sharing of
knowledge between such a wide range of health professionals can only
improve the health care we provide to military personnel.
It is particularly gratifying that Dr Tyler Smith will give us the benefit of the US
experience of the Millennium Cohort Study.
Collecting, managing, accessing and analysing the data that the Australian
Defence Force collects, to obtain insight into military health is still something
we struggle with.
What I can tell you however is that we have sent a total of 22 833 personnel to
the Middle East Area of Operations (MEAO) from the start of operations in
2003 to 31 August 2008.
That is, 22 833 people, which represents 37,370 separate deployments.
And of those 22 833 people, 340 have subsequently been medically
discharged, or 1.5 per cent.
The most common conditions leading to discharge include mental health (133
personnel) and musculoskeletal conditions (120).
Of the 133 personnel medically discharged for mental health conditions, 86
were directly or possibly attributable to their MEAO service.
This comprises 0.38 per cent of those deployed to the MEAO.
To be a member of the Australian Defence Force is no easy thing…we
choose the most dedicated, the best, the fittest men and women…
And as an initial statistic on how we are selecting, training and caring for our
men and women in Iraq and Afghanistan…I think it’s a good starting point …
But of course as we all know, and as any veteran will tell you, ill health can
take time to appear.
And so the Australian Defence Forces is also running a series of studies as
part of the Deployment Health Surveillance Program.
This work, done independently by the Centre for Military and Veterans Health
is investigating the health outcomes of recent operational deployments to the
Solomon Islands, Bougainville and East Timor, as well as to the Middle East
Area of Operations.
Already the first results are in - looking at the comparative health of ADF
personnel deployed to the Solomons between July 2003 and December 2005.
and while even here, we’re only talking a couple of years since deployment,
and so it is still very soon to draw conclusions, at least so far there seems to
be no significant differences between the health of Solomon veterans and
non-deployed personnel.
But there will be more on that topic from the experts during the course of this
conference…
And certainly the opportunity to compare our experience, statistics and
research with those of our close American allies is very welcome.
AMMA itself was established in the immediate aftermath of Gulf War 1 in
1991.
And over the 17 years of its existence there have been major changes to not
only the ADF but also the Australian Defence Force Health Services as they
respond to the international environment and the associated increase in
operational tempo.
From a time when few in the Australian Defence Force had seen operational
service… over the life of AMMA there have been deployments the length and
breadth of the African continent, South East Asia, the South West Pacific and
the Middle East.
It is an impressive list, and it naturally places stress on our people…
And just as they adjust to meet these challenges, so too must the support we
offer our Defence men and women also adapt and respond to the multiple
deployments and changing nature of conflict…
There is a distinguished history of medical advances being directly linked to
conflict.
The Thomas splint was invented in the nineteenth century for the treatment of
TB of the knee.
Its introduction to the battlefields of Flanders for the immobilisation of serious
leg fractures prior to evacuation, reduced the fatality rate for such wounds
from 80 per cent in 1916 to 8 per cent by 1918. It is still in use today.
Our trans Tasman cousins are rightfully proud of the exploits of Sir Archibald
McIndoe from Dunedin who developed many of the techniques for treating,
reconstructing and rehabilitating the badly burnt aircrew during the Second
World War while working at the Royal Victoria Hospital at East Grinstead in
UK.
His patients formed the Guinea Pig Club, a tribute to the ground-breaking
nature of his techniques.
Again, as a result of operations in the Middle East and Afghanistan we are
seeing advances in the treatment of severe trauma.
The development of Combat Body Armour and the extensive use of
Improvised Explosive Devices are resulting in changes in the patterns of
wounds and so also changes to treatment and the techniques and equipment
being employed in surgical centres throughout operational areas.
I have no doubt that over the next few days here, new techniques in the
management of severe trauma developed in the combat hospitals in Iraq and
Afghanistan will be passed on throughout the international medical fraternity
to the benefit of the wider civilian community.
Certainly ADF heath care – but also our training; our leadership; our policies must be continually reviewed as our role changes and kept to best practice,
and conferences such as this assist with understanding and responding to the
needs of our personnel…
It is a forum to listen; to discuss and develop ideas…
and I am especially interested to see there is significant emphasis in the
program not only on environmental and operational health threats, but also on
the mental health consequences of deployments.
This Government is determined to ensure that high quality mental health
support is available to ADF personnel and the ex-service community.
And I mention the ex-service community deliberately….because we
acknowledge the need to do better at transitioning care out of the services
and into the civilian community….
To that end the Government is seeking to build and reinforce a
comprehensive spectrum of mental health services for both former and
serving ADF members.
We need to ensure that all our personnel receive appropriate mental heath
care from the moment they undertaken initial training through to their veteran
and retirement years.
As many of you would be aware Defence and Veterans’ Affairs have jointly
sponsored a review of mental health services which is being conducted by
Associate Professor David Dunt of the University of Melbourne.
Professor Dunt is travelling widely to a variety of Defence establishments
gathering the information which he requires.
I understand that he has been very well received wherever he has visited, with
large numbers of Defence personnel of all ranks very keen to speak to him
and pass on their views of the mental health services provided by Defence.
And that so many are willing to share their stories is wonderful news alone because of course one of the key issues confronting the ADF is the stigma
associated with mental illness.
Indeed I think, trained as our men and women are to be capable and resilient,
even admitting to yourself that there is a problem, can be a hurdle.
And then there is a very real sense that to suffer a mental injury is not as,
normal, or as treatable, indeed as recoverable, as suffering a physical injury.
So perception is a big problem.
We have made progress in recent years on this front but we still have a lot of
work to do to – and for the ADF leadership to make it very clear that to be the
best soldier, the best sailor, and best airman or woman you have to be fit –
and that means getting care if you’re unwell.
And education and awareness is one aspect, indeed a key theme, being
addressed by the Mental Health Strategy.
The ADF Health Services have developed the Strategy over the past six years
with specialist input from centres of excellence such as the Australian Centre
for Posttraumatic Mental Health.
It is an impressive program and is amongst the best in the world but I already
know it is undermined by a critical lack of skilled health personnel
We have many incredible, hard working medical staff working for us, serving
the nation – and many too, who are reservists, delivering health to the
frontline.
We thank them for their service. But we need more.
And how such shortages is truly affecting implementation of the Strategy is
something I’m sure will surface in Professor Dunt’s report.
And of course, Defence is not alone in this.
You more than most will be acutely aware that there are national and
international shortages of health professionals.
This Government is working to address these national shortages.
A few weeks ago (29 September) the Prime Minister announced additional
funding would be made available to take the number of Commonwealth
supported nursing university places to 1094, including 130 openings for
specialist mental health nurses.
But obviously the ADF too must focus on the recruitment and retention of
skilled personnel, including health personnel.
And as a major retention initiative, the Government is committed to
progressively extending free health care to ADF dependent spouses and
children, targeting regional and remote locations in particular.
A small-scale trial will be implemented next year for the families posted to
Singelton in NSW, Pilbara in WA, East Sale in Vic, Cairns in QLD and
Katherine in the NT.
And today I would also like to announce the expansion of that trial to Darwin in
the Northern Territory, Townsville in Queensland and Pukapunyal in Victoria.
The experience in these locations will inform the progressive delivery of basic
health care to ADF families across the country.
Please believe me when I say, this Government is committed to keeping our
Defence Force fit – and not just fit for operations, but fit as members of their
families and their communities.
Our security and liberty come at a price – and the Government has a duty to
honour and serve our ADF personnel as they honour and serve their nation.
I realise the health challenge before us, but ladies and gentlemen, with your
help, I believe we are equal to it.
Thankyou again for the opportunity to speak today and I wish you all the best
for the conference.
Media contacts:
Kate Sieper (Warren Snowdon):
Defence Media Liaison:
02 6277 7620 or 0488 484 689
02 6265 3343 or 0408 498 664