Submission to the Productivity Commission

Concerning:

Efficiency of veterans service delivery by the Department of Veterans’ Affairs

Private submission

Author: Mr David Watts BMedRadSc

Current Chair of the Australian Gulf War Veterans Association

Former member of the Royal Australian Navy 1986-1995 (9 years)

Active Service Persian Gulf War 1990-1991

Introduction

I wasn’t going to make a contribution to this review as I’ve made two similar submissions to the Senate (who gagged me and made my submission confidential) and the ANAO (who didn’t acknowledge they’d accepted my submission) and so I thought why bother. Thinking part of the problem was that I had openly named many Commonwealth Public Servants that I believed had done wrong, I have taken this opportunity to make the same claims I did in my previous submissions only this time I’ve changed the names to obscure the identity of the individuals involved in the hope that the Productivity Commission will publish this input so that the plethora of failings of DVA and its sister agencies are bought into the light. I have attached a submission document with this which I class as confidential however it includes the names and references to which this review can test many of my claims.

In my own case I have experienced firsthand of how detrimental to my own health dealing with the Department of Veterans Affairs can be. A number of times during the process I was very strongly contemplating suicide due to how DVA was treating me at the time (circa 1997-98). If I can just say, I think one thing is completely lost on DVA, for me just like so many others that have felt and experienced these dark times, I was not in a good place health with mobility and mental health issues when I first sought help from the Department.

In my case, I could hardly walk due to service accepted injuries and I was unemployed directly because of this. In fact I was sacked from civilian employment because my then employers work cover insurer told that employer they could not insure me because of my defence injuries, I personally read the letter. I had no

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income to support myself and no fall back, I’d only recently left the military and was very much on my own.

I had been a taxpayer all my working life, right up until the point where my Defence injuries put me out of the workforce, I and as I imagine expect every other taxpayer out there, believed that the taxes that we pay that make their way to DVA are used to help our injured and sick veterans (not that I had ever expected nor wanted to be forced to rely upon such help). However truth be told the reality of reaching the level of support we might expect is so contrary to the propaganda endlessly churned out by DVA that I understand why so many younger veterans do take their lives. I think it is lost on DVA that after the stress of war exposures the stress reaction for many of us subconsciously becomes a battle between life and death.

Apparently I am lucky, I have so far survived the process but I live in pain, constant unrelenting pain and I don’t seem to be free from the type of thoughts one has when they just want that pain to end. I have been significantly impacted in every area of my life because of my injuries. My relationships have suffered, my earning power was destroyed during what should have been the period of my life where I bought a home and set myself up for my future and even with the Department now covering most of my health care costs, my health is continually deteriorating at a constant near predictable pace.

I have been a veterans’ advocate in a voluntary capacity for close to twenty years in so much as my health has allowed me to deal with the matters at hand at any given time. In my experience I am genuinely at a loss to be able to put a finger on just one problem within the Department of Veterans Affairs because the problems are so widespread and systemic and encompass Defence Health/ Medical Hierarchy and the Repatriation Medical Authority that I am now of the belief that a formal inquiry is warranted and people should be made accountable for their actions.

1. The reasons why Australian veterans are committing suicide at such high rates.

In my opinion the Department of Veterans Affairs is largely responsible for the elevated suicide rates in younger Australian veterans but so too is the legislature. Ask any advocate, the Department is behaving in an overtly adversarial manner toward veterans claims, some might say they always have but more recently they have been given an enabler to do so by the introduction of the Military Compensation Rehabilitation Act of 2004 (MCRA).

MCRA is the most adversarial piece of legislation to befall our diggers and it is a slight on the major players in the Ex-Service Community that demonstrated such apathy and complacency to allow it to pass with so little contention. The predecessor to MCRA, the Veterans Entitlements Act (1986) was defined by the High Court as a piece of beneficial legislation. MCRA sidestepped that legal protection.

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In my opinion this is why the Department sought to end the reign of the VEA and introduce a new Act, the Department was fed up with losing in court every time it tried to cancel the blank cheques written to veterans by politicians, the blank cheque about how the nation will look after you if you are injured. From this veteran’s perspective DVA has nothing but contempt for veterans and I shall elaborate further on that within this submission.

I think there is one big thing being lost on nearly everyone involved in veteran mental health, including DVA’s so called in house mental health experts is so obvious that I am a little perplexed as to how it has not been addressed. Modern veterans are returning to society with much the same mental health issues as their predecessors of earlier conflicts however the modern veterans are returning to an inherently high stress society that is far more stressful than times experienced by veterans of earlier times.

Our whole society has grown more stressful. The pressures to find work, pay bills, provide for one self and family are endless. Following past conflicts, veterans maimed, visibly injured and otherwise could often find work when returning from war. Many found public service employment within state and federal departments but such programs are an exception these days. For veterans forced into the private sector I’ve experienced firsthand how work cover insurers don’t want employers employing veterans injured during service.

I have not had the resources to examine the hypothesis that life is more stressful now compared to the years following World War 2 but I think through life experience I can safely state that times have changed and not necessarily for the better in so far as individuals stress exposure is concerned. Perhaps this should be examined academically however I suggest the increase in veteran suicides may well be mirrored by an increase in the incidences of suicides in the general population over similar periods.

While life stressors might be greater now it is critical that we don’t focus on this aspect but rather on how this added stress can and obviously does impact on veteran health. This point mustn’t be utilized to deflect on the seriousness of the issue but used as a tool to illustrate the increased risk of suicide to veterans returning to ever increasing stressful societies.

What happens when a veteran with mental health issues experiences a stressful episode is that the veteran suffers by default, a subconscious reaction to the stress trigger, which is best described as a life and death stress response. It is not that the actual situation that is life of death but the psychological mechanism that allows most people to process the stress in a rational manner is dysfunctional in the effected veteran who without any conscious control of the reaction reverts to a default abnormal response which could be due to the underlying psychological changes following intense fear and subsequent fight or flight responses from the earlier event.

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That is not to say the veteran is abnormal, they have undergone change because of an abnormal event(s) that now persist and have a prolonged impact on their life. These people are now acting in a normal manner for someone that has experienced a life changing abnormal event(s).

My suggestions would be, as a priority, that the Department of Veterans Affairs must recognize the impact that stress has on a veterans health and immediately drop the adversarial approach. If that means that the best mechanism for dealing with veterans claims reverts to use of the VEA over MCRA then this should be examined as a matter of urgency.

Also given that many approach DVA when their injuries prevent them from employment DVA needs to have the ability to expeditiously give the injured veteran a temporary income whilst their claim is being resolved. The faster the Department can then assess the claim means the less time between retraining and placing the veteran into other meaningful employment (if this is deemed appropriate) the better for all concerned. Additionally with the difficulties injured veterans experience in finding meaningful employment and purpose in their lives there needs to be a whole of government approach to finding these men and women priority employment within the government sector.

2. The Repatriation Medical Authority.

The concept behind the Repatriation Medical Authority (RMA) is on face value a sound idea however in practice the administration of the Authority has been anything but independent. The following points are of significant concern and merit further investigation.

From my experience the RMA does not act within the legislated provisions, nor intent of the Veterans Entitlements Act and I think it has been some time if ever, that the RMA have complied with the spirit of the VEA. This is no particular reflection on the current expert members of the Authority but many past indiscretions can and should land at the feet of some current and former Authority members.

One thing that seems to have escaped the RMA is that it has never been empowered by the Act, to dismiss the expert opinions, works or published peer reviewed scientific material of experts other than themselves with greater experience in different areas than the members of the Authority, yet time and again the Authority has done just this. The nature of the VEA, being a beneficial Act, has empowered the RMA to use its discretion to create instruments based upon their clinical judgement but never has the Authority been granted the legislative power to refute the medical scientific works of experts in their field.

My experience with the RMA process is in relation to past RMA investigations into Gulf War Syndrome/ Gulf War Illness. I have found how the RMA have deceived the veteran community into believing the Authority is an independent entity from DVA.

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The Authority members only meet for a few days every other month, most of the “investigation” work is performed by a team of Commonwealth Public Servants (many with @dva.gov.au email addresses) whom are otherwise known as the RMA Secretariat and whose job it is to collate briefs for the consideration of the five expert members.

On a personal note it has taken me many years to read all of the available scientific literature pertaining to Gulf War Illness a subject that is continually evolving as science better understands how the condition impacts the sufferers. What is expected of the RMA is that the independent expert members make a decision on the available scientific data. Unfortunately the RMA members put their faith blindly into the briefs prepared by the RMA Secretariat and it is the many problems I have identified in this process that makes me question the entire process. I would go so far as to say the behaviour I have so far uncovered leads me to believe the problems are systemic, have existed for years and perhaps adversely affect hundreds of legal instruments.

In the first RMA investigation into Gulf War Syndrome, the then Principle Medical Officer [RMA Dr1] was privately involved in a doctoral thesis project for her own academic benefit, on the mental health of Australia’s Gulf War Veterans and was doing so under the direct supervision of DVA’s then mental health advisor/ contractor to DVA [Professor 2].

The brief delivered to the “independent” expert members of the RMA by [RMA Dr1’s] team was heavily biased towards a mental health aetiology and outcomes in Gulf War veteran health. The brief argued against the expert medical and scientific opinions of international experts whom had been actively involved in far greater direct research on Gulf War veteran health and did so utilizing nothing but a self-confessed academic bias and hokum psychological hypothesis.

If the RMA investigation led to an outcome that disputed [RMA Dr1’s] private research then her work would have been in question, conversely if the RMA investigation supported [RMA Dr1’s] thesis she would personally gain from the legislated confirmation of her output. There is no other way to put this other than that [RMA Dr1] had a clear conflict of interest and should have never been concurrently involved in the two GW investigations, nor should staff that she hired or oversaw in her previous tenure as PMO.

One of the early indication I had that the RMA Secretariat were acting outside the scope of the Act was in reading the bibliography of the resources the RMA were relying upon to make their decisions. The VEA specifically states what evidence is defined to be considered as sound medical scientific evidence and that is largely material published in medical scientific journals. One item I uncovered in these bibliographies was a reference to a book called “Hysteries” written by a feminist fashion author that went on to cover topics like alien abductions and chronic fatigue syndrome and with a mention on Gulf War Syndrome. It is clear that the RMA

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Secretariat were out fishing for anything they could find to support their shallow thinking.

Applicants seeking RMA investigation for Statements of Principles are told to provide sound medical scientific evidence to support the case for investigation. A more thorough examination of the RMA bibliography resources found a clear bias in the theme of sources sought that heavily favoured mental health references even after [RMA Dr1] left as PMO but was still working as a part time researcher within the Secretariat after leaving her permanent position to start a family. Another source of concern was a number of references used by DVA’s contractor [Monash] in its published research on Australian GW veterans’ health, these specifically related to epidemiology practices that one would not be as applicable to the specifics of exposures etc that the RMA should be contemplating to include in the “factors” determined to associated disease with the veterans service.

In the case of the GWS investigations, the RMA took one side of a scientific aetiology hypothesis and actively fought against another equally if not more valid scientific hypothesis in the aetiology of the illness affecting around one third of both Australian and international coalition Gulf War veterans. The legislation does not give the RMA the power to cherry pick what evidence it uses to determine Veterans legal instruments! I have previously named [RMA Dr1] however it is unfair to lay the blame entirely at her feet as the past Head of the Authority [RMA Professor 3] should have been well aware of the private academic interests and pursuits of his Secretariat’s PMO ( the Agencies principal investigator) given that she was under the direct academic supervision of DVA’s own contractor [Professor 2]. Additionally I am of the belief that the general direction of Secretariat investigations is also the remit of the Head of the Authority.

With respect to the classification of or definition of disease, the RMA decided to refuse the creation of a Statement of Principles for Gulf War Illness/ Syndrome on the grounds that it did not meet the criteria of a disease as defined by the Act. When I sought clarification behind the decision the Repatriation Medical Authority was overtly obstructive and refused access to all FOI requests for correspondence between the Australian Government Solicitor and themselves in relation to the definition. The RMA have proven time and again that they are an unwilling participant in the FOI process as evidenced by the number of occasions that we have had cause to seek assistance from OAIC.

A colleague later sought access to the same definition via the FOI process with the RMA and what followed was an abuse of the FOI process. My colleague received an unsolicited telephone call from the RMA’s very own long standing legal representative from the Australian Government Solicitor one [Mr Massive Haemorrhoid] who used the words to the effect that he wanted to see if the recipient would fall to the ground frothing at the mouth at the prospect of dropping the FOI request in return for him having a Special Counsel create a legal document

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explaining what definition of disease the RMA was using. Now this seems to me to be a significant abuse of the FOI process by this individual.

The judicial system had long ago determined, before the creation of the RMA, that the definition of disease was, simplistically put, that the veteran needed medical/ health treatment. In our case, with a cohort incidence in the 26-29% of Chronic Multi-symptom Illness (also known as Gulf War Illness by the Institute of Medicine [IoM]) the RMA referenced numerous IoM reports to attempt to refute GWI but when the IoM finally acknowledged it and confirmed the condition as GWI the RMA were at pains to ignore the IoM. The RMA under what we suspect is DVA pressure are resisting legitimate scientific evidence and refuse to allow a theatre of war specific disease instrument to be created. The RMA have also seemed to be at pains to selectively sidestep legal definitions and do the bidding of DVA.

During the most recent RMA GWS investigation, and after I actually realized that the Secretariat was adversely influencing the Authority members, I took the bold step to provide my submission directly to the expert members via their institutional and academic contacts. After doing so we were able to see the RMA create an instrument for Chronic Multi-system Illness, this term is the US VA approved term for Gulf War Illness indicating the independence of the system can work when the biased influence of the RMA Secretariat are removed from the process.

We know this position of not creating a conflict or theatre specific instrument, is the position of the Repatriation Commission who have made it abundantly clear that they objected to such a measure in the DVA Deputy Commissioner’s letter to the RMA. But we have also found this mentality in documents obtained by FOI concerning DVA’s international (Ministerial) interactions with their international counterparts, one such presentation by DVA’s [Psychologist 4] made the silly argument that Shell Shock, Agent Orange, PTSD, Gulf War Illness etc were all examples of the same condition and were labelling of conflict specific conditions that DVA wanted to avoid at all costs (five minutes on PubMed would have disproved the entire premise but I digress).

By any measure it seems that both the RMA and Repatriation Commission have objections to diseases being associated with regions however this is at odds with internationally medically accepted norms. Ross River Fever, originated in the Ross River catchment. Japanese encephalitis and West Nile virus are further examples of a long list of conditions associated with regions. The international medical community will ask sufferers of travel movements if patients present with symptoms of regionally contracted disease or illness yet DVA and the RMA do not. They are out of step with international medical practice and are on the face of it completely if not also criminally obstructive in the clinical management of veteran health.

DVA are transfixed on a mentality that veterans are attracted to disease labels and will seek out compensation for conditions the Department publicly refute the existence of. Should we ask if this mindset comes from the bonuses being paid to

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public servants? Let’s look at DVA’s mishandling of veteran health studies, I will focus on both Gulf War health studies as I have a thorough understanding of the issues in point.

After veteran pressure, DVA reluctantly established health a study to look at the health outcomes in the 1991 Gulf War cohort. What DVA then did was contract a research group and established behind closed doors, the scope of these investigations. Much could be said of this but what best sums up DVA’s approach was that at the time it established the first study (2000) the pattern of adverse health symptoms being seen in international Gulf War veteran cohorts was well known. In fact the current CDC model for GWS/GWI is based upon the 1997 Iowa Persian Gulf Veteran Study, yet DVA refused to utilize a case definition in the Australian study to establish whether Australian veterans were suffering the same issues as allied Gulf War veterans.

What DVA did was establish a set of terms for the health study that essentially looked for nothing. By in large aside from the actual physical investigations much of the data collected in the study was from multiple choice questionnaires that were used internationally to mainly detect mental illnesses. Nothing wrong with that given veteran exposures to mental stress however the 1991 Gulf War was probably the most toxic battlefield of the 20th Century.

One of the toxic elements, DVA seem to be at pain to ignore, is the exposure of our forces to a Nerve Agent Pre-Treatment drug. The drug pyridostigmine bromide was administered on mass, to veterans of the 1991 conflict and this drug is cited by numerous international researchers as a probable cause in Gulf War Illness. If DVA and the Repatriation Commission were acting in the spirit of the VEA then the Repatriation Commission would have used its legislated power to create an instrument to enable public funding of the health care Gulf War veterans require, just as they did for Vietnam veterans agent orange exposure. However DVA have fought this at every opportunity and in doing so have openly defied the beneficial status of the Act.

The mass exposure of Australian Gulf forces bears examination because the TGA import permits specifically state that Defence “could not guarantee the safety or efficacy of this drug”. In fact the drug is from the same family of chemicals as the chemical weapons and organophosphate toxins that troops were potentially going to be exposed to. Also of note the drug is a neurotoxic agent and did not have Australian approval to be used in the circumstances that it was, in other words it was unapproved untested and those taking the drug had no indication of that. There were no internet connections for them to check and the packet the drug came in stated “take only when ordered by your Commanding Officer”, this is something service men and women generally do without question in time of war!

This family of drugs is also potentially more toxic to individuals due to individual genetic variation. An enzyme in the body known as paraoxnase controlled by the

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PON1 gene is what the body relies upon to clean organophosphate like toxins from the body but through genetic variations people have different levels of the enzyme. This explains why some veterans are sick and others are not. To date neither Defence nor DVA have offered any screening of veterans exposed to this neurotoxic agent.

The aforementioned paragraphs should ring alarm bells. Defence knew many months before it ordered the troops to take these drugs that they could not guarantee the safety of the drug yet the troops were never told of this. This is a clear breach of the human rights of these men and women. What isn’t widely known is that senior Defence Medical Officers involved in the medical countermeasures given to Gulf War veterans were and are now working within DVA. One [DVA Dr 5] and another Defence’s representation [DoD Dr 6] and were directly involved in the Gulf War health study.

[DVA Dr 5] was on the staff of the ADF Surgeon General that issued the controversial drugs to veterans of the Gulf War, by most ethical standards of governance [DVA Dr 5] would be seen to have a conflict of interest however DVA do not appear to see that as anything that should preclude an individual from any decision making processes. We later learned that [DoD Dr 6] (so named for his sleeping during health study meetings) was in fact involved in the importation of said controversial drugs as we found when we got the TGA import permits, not that he ever provided any such details to the health study.

[DVA Dr 5] has also made a submission to this review and low and behold he wants more funding for veteran health research. Unfortunately his motivation appears to be more aimed at keeping DVA in control of policy based on cherry picked study outcomes. With respect to the Gulf War health studies, not a single recommendation from those studies have been implemented by DVA fifteen years after the first study was delivered.

Combined with the Mefloquine issue, the actions of our senior Defence medical hierarchy makes me call into question their ethical behaviour. What should not be lost is that senior uniformed and civilian medical officers transferring to DVA from Defence have a history that potentially includes directing sick veterans to take untested drugs on their advice or approval and we see those same people now making decisions on the compensation and health care of veterans they may have adversely impacted. The current DVA Top DVA Medical Officer [DVA Dr 7] is another such individual whom has already displayed open hostility toward veterans questioning their exposure to the drug Mefloquine. By any standard I cannot see how former Defence medical hierarchy can transfer to DVA without some potential for significant conflicts of interest and this is something that needs to be addressed. The cover up club needs to emptied.

These are but a few incidences where our armed forces have been treated as guinea pigs without their informed consent and this act itself brings to mind questions

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of criminal behaviour. On this point I reflect on history and ponder the fact didn’t the WW2 allied command try and convict Nazi doctors for experimenting on human subjects whom had no choice but to do as they were told.

It is the same ethical dilemma here, troops are now this day as then were and are in no the position to refuse orders to take neurotoxic drugs prescribed by senior Defence medical officers, some of whom now work at the Department of Veterans Affairs. It is fair and reasonable to ask if it is appropriate that former military medical officers be employed by DVA? While there is no evidence that I can present that these people are actively working to cover the mistakes of their and their colleagues past the potential exists through the fact that a conflict of interest exists and this must be addressed as a matter of urgency.

Continuing with matters related to the Gulf War health studies, DVA have been obstructive in releasing information pertaining to the health studies. Via FOI, we have twice sought access to the data collected in the health studies in order to perform our own analysis of the data. On the first occasion we sought the de-identified data set of the first health study (2000-03) so that we might use a case definition of GWS/ GWI to look for patterns of illness within the Australian cohort. DVA refused our request as did their contractor. It is important to note that the contractor in this instant has become so intertwined with DVA that they appear to have favourite status with the Department and neither is happy to allow academic scrutiny of this work.

On the second occasion we sought access to Gulf veteran health study data it was when we learned that the so called independent research contractor was made to submit draft copies of their research to DVA and DVA would then go out and make changes to the research before the reports were made public. Now this practice was hidden from the veteran organizations involved in the process and the Department has refused our FOI requests for the draft research papers. Our aim was to find the changes because the data we were able to extract from tables within the reports did not substantiate the headlines and results made in the executive summary. This is another example of the Department behaving disgracefully. Interference in research like we’ve seen here is something akin to the manipulation of science made by big tobacco not the behaviour the public expect of a taxpayer funded department.

Jobs for the boys, corruption or something else?

Another issue(s) I feel I must address with relation to the 2000-03 Gulf War health Study pertains to the blurred lines between DVA, Defence doctors and DVA’s health research contractors. My review of those involved found much to raise my eyebrows.

When the former head of Compensation [DVA bureaucrat 8] retired and left the position as Chair of the Consultative Committee, he was replaced by another crony [Defence Dr 9] (formerly of the tropical health studies unit “hint Malaria drugs”) who was previously Defence’s representative on the committee. He was joining the team, as mentioned earlier, the senior DVA doctor [DVA Dr 5] who was as stated earlier,

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on the staff (if not Chief of Staff) of the ADF Surgeon General that implemented the medical countermeasures program for the Gulf War and a host of other senior former military medical officers now making sure the study amounted to naught.

If the review were to seek out the minutes of the committee meetings for the first study it will see that [DVA Dr 5] stated the veterans in the veteran cohort of the study, were exposed to the range of medical countermeasures including anthrax vaccinations yet [Defence Dr 9] was at pains to claim most veterans were not.

Related or not I will let others be the judge but upon [the Defence Dr 9] retirement from the army, he was appointed to head the Centre for Military and Veterans Health, a body which received a number of multimillion dollar DVA veteran health research contracts. I don’t have any evidence that the [Defence Dr 9] did wrong, however the fact is that it could be argued that he appears to have been rewarded with a prestigious position with a then, newly formed institute, receiving considerable public funds from DVA relating to veteran research. This might be entirely innocent but equally it may raise questions about due process within the sphere of DVA and Defence influence on research into veteran health.

The contractors for this study also seemed to enjoy a more than close relationship with DVA with the lead investigator [Monash Professor 10], a member of the editorial board of the Australian Military Medical Associations journal alongside DVA’s Medical Officer [DVA Dr 11]. Both the [Monash Professor 10] and [DVA Dr 11] travelled to the United States together (we presume, we had to presume as they destroyed the travel document we learned after an FOI request) to a special little Gulf War Conference where much was made of trying to play down the scientific research on US Gulf War veterans by a leading US GW researcher. At this point early on in GW research, the leading US GW researcher was privately funded and clear from VA interference in the direction of their work.

That leading US GW researcher and others (free of VA interference) were and continue to be of the scientific opinion that the ill health of Gulf War veterans was due to toxic exposures. However what we have found from the committee minutes of DVA’s Scientific Advisory Committee (for the 2000-03 study) [Monash Professor 10] and [DVA Dr 11] attempted to dismiss the leading US GW researcher’s work describing his team as some obscure doctor in Texas. We found this rather derogative knowing this researcher was formerly an esteemed researcher at the CDC. This belittling opinion was seemingly shared by the RMA but not the wider international research community. This points more to collaboration between DVA, their friendly contractor and the RMA and does much to question the independence of the Authority.

3. Departmental Complaints Processes.

Over the course of my involvement in veterans’ advocacy I have had cause to make several concerns known to the Department both via correspondence to the

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Department and correspondence to the office of the Minister. Both methods are ostensibly fruitless and so often fraught with frustration.

The Department doesn’t deal well with criticism, not one bit. Responses rarely address the matters raised and when attempts are made to address the topic or issue the responses from the Department and those provided to the Minister are full of more twists and spin than a tropical cyclone.

I gave up writing to the Repatriation Commission a long time ago over serious failings associated with Gulf War veteran health research. The Department doesn’t want to know about our problems with their handling more to the point, mishandling of our health research. The reason I gave up was because the then Deputy Commissioner [DVA bureaucrat 13] decided to take an obstructive stance to our complaints. I raised valid scientific concerns over connected to a multimillion dollar health research but [DVA bureaucrat 13] at first side stepped the concerns deflecting them to the contractor who was the source of the concern and when I wasn’t able to get a satisfactory response from the contractor, [DVA bureaucrat 13] refused to answer any more questions pertaining to the matter.

[DVA bureaucrat 13] adopted a response policy that he was of the view that the matter had been raised and addressed and I was told he would not respond unless we provided new information or concerns. Now from the aforementioned points I’ve raised it is reasonable to say that I had some very valid concerns. Not one of these concerns was addressed to my satisfaction. Now I say my satisfaction but let me be clear I’m not setting unrealistic standards, I am simply seeking the truth in veteran health reporting and that public servants act in accordance with the Public Service Act.

The Department is unaccepting of criticism and if I can borrow a term I read elsewhere, DVA run a fortress DVA mentality. They contract an army of media hawks searching for negative headlines, letters to the editor and the like and do their best to gloss over or downplay or spin away any and all criticism of the Department. It is as if the reputation of DVA is their sole focus and veterans’ needs are a very distant low priority, we know to be true from a recent document to surface from DVA that their staff needs are more important than those of Australia’s veterans.

One of the main problems I have, outside of the many points I’ve already raised, is the lack of a clear independent complaints pathway. As and end user of the services of this Department I have come to the conclusion that senior/ National management is the problem and this for me means veterans need an external point of contact for all complaints. Serious issues are being by a management that will do everything it can to protect the image of the department. Veteran complaints are all too often ignored and we need a more direct pathway to resolve matters external to DVA influence.

4. Veteran health research

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(PLEASE FOR THE LOVE OF GOD, TAKE CONTROL OF THIS AWAY FROM DVA)

My experience with the Gulf War research programs has shown me that DVA cannot be trusted to handle veteran health research. The simple fact is that this is fox in the hen house stuff. The DVA budget should fund veteran health research however DVA should have no say in the direction of the research. I point to the review toward the CDMRP model (link here) http://cdmrp.army.mil/gwirp/default as a model to strive for in Australian veteran health research.

The Department of Veterans Affairs does not listen to the concerns of stake holders and certainly does not address issues nor back down when stake holders raise legitimate objections to Department initiatives. DVA established the scope of the investigation of both the Gulf War veteran health studies with the most vague (look for nothing find nothing) health outcome criteria, there was no attempt to investigate a case definition of illness known to be effecting international Gulf War veteran populations.

DVA establish advisory or consultative committees into veteran research in name only. The actively seek to keep out veterans with the knowledge and skills to see through their research trickery. They have the consultative process purely to say they had one but stakeholder input is quashed by committees heavily loaded with numerous government representatives and those of their contracted research agents that vastly outnumber veteran representation. And the minutes made for all such meetings come several months after the meeting and more often than not do not include controversial topics raised at the previous meeting and anything that is included is worded in such a way as to spin the outcome to be neutral or positive toward the Department.

The books are cooked at every turn with DVA! And at that I must say this permeates everything about them. From minutes that simply do not reflect any negative comments towards the Departments of handling of anything to you name it. I heard DVA described as having a Castle Mentality, it meant they were out to protect the Keep at all costs. They have a small army of media watch firms on the payroll scanning media high and low looking for veteran complaints and when identified there are letters going back to the news sources with rebuttals from the Ministers Office.

One can only guess if the Minister’s ever hear of the media complaints by veterans nor if they even authorize such responses but it would be my educated guess that it would be a cold day in hell before they tell the Minister a shard of the truth behind any such story, this is systemic department wide case of Yes Minister. I have formed the opinion long ago that this Department is long overdue a cultural enema.

DVA also established the cohort groups in the Gulf War health studies and they did so with no thought to look at sub group analysis of the different units involved who

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were exposed to different things during different phases of the conflict. One problem that this created was to categorize a large number of people into one group despite different exposures, the scientific effect was to dumb down the risk factors of disease or illness for those exposed to toxic battlefield hazards.

Some might suggest that this was not deliberate however given the number of “medical professionals” at DVA involved in the design of these studies I would have to call it deliberate. In fact I’d go so far as to say that DVA intentionally manipulate input factors and data to suit DVA policy, written or otherwise. DVA often stack committees with more DVA and contractor research staff to outnumber stake holders but also of late I have been made aware of DVA trying to control who ESO’s are sending along to participate in such committees. It seems DVA are looking for the individual who for lack of formal education in the health disciplines doesn’t know better, or who won’t ask the hard questions and say no when the interests of the people they represent are being challenged. I’m sorry to say that but from my perspective there are those in the ESO community who are quite happy to go along to these committees for nothing more than the free sandwiches DVA puts on.

DVA have had plenty of practice manipulating veteran research. They know if they ask certain questions or focus research with standard international mental health multiple choice questionnaires then the chances are that they will get a mental health based outcome so they can downplay more hazardous exposures that veterans may have faced during certain deployments.

I’ve mentioned elsewhere that DVA make contracted researchers provide them with draft copies of research then the Department makes changes as it sees fit passes the report back to the contractor to sign and essentially sells the process as an independent report to both government and the wider community. This practice alone should rule DVA ineligible from the control public monies in relation to veteran health research. In fact what this process needs is greater veteran oversight and this is happening in the United States with demonstrable good outcomes for veteran health research.

As a final example of the problems rooted in this department let me marry together an example of a complaint concerning research and DVA’s failed response to the complaint. During the First Gulf War health study, the Monash research team made a claim that the chemical weapons alarms on Australian ships were only activated due to exercise and false alarms. Monash cited their source for this information as the ships log of a warship tied up alongside in Australia during the conflict phase of the war. DVA’s response to this was to suggest we discuss the matter with Monash who acknowledge an issue but failed on all fronts to correct the record.

As it stands this example was the catalyst that led me to believe that this institute had very little comprehension of the Gulf War and even less on Australian military experiences during the conflict. The fact is that this statement and numerous other factually incorrect statements remain on the record despite my protests to DVA. DVA

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have zero interest in factual honest veteran health or experience reporting and it is this and other examples that [Mr Second Clown] refused to address unless we provided “new” information. The original issue was never addressed and the Department is now playing ostrich.

5. Defence Medical Hierarchy

I and a great many other serving men and women in the ADF have been poisoned by Defence medical officers. I’m greatly concerned about the ethical behaviour of the senior command of the Australian Defence Forces medical command. Through my own experiences and with knowledge of the widespread trial of Mefloquine on Australian Defence personnel in Bouganville and Timor, I think it is time to shine the light on what I believe is unethical medical experimentation on Australian servicemen and women by senior medical officers.

Following World War 2 victorious Allied powers prosecuted Nazi German medical officers for experimenting on prisoners during the conflict. The trials in Nuremburg led to the international community establishing basic human rights standards in medical research and Australia as part of the international community ratified this convention. One of the core concepts of protection of human rights in medical research gave participants the right to be fully informed and that participation be voluntary and based on being given information about the potential for side effects.

What I have uncovered in relation to the Gulf War medical exposures is that the Department of Defence medical officers whom imported the drugs knew, before these untested drugs were imported into Australia, that they could not offer any “guarantee of safety or efficacy” yet at no point was this information provided to the forces compelled to people ordered to take the drugs. I have copies of the TGA import permits which confirms this, yet as someone order to take these drugs I have my testimony that I was never told of any potential side effects nor that Defence could not guarantee the safety of the drug.

We have seen a similar episode of deception be that intentional or by omission, with our troops exposed to mefloquine. No informed consent, although I’m sure those administering the trial are claiming otherwise but the deeper concern I have over drug trials on our forces concerns the fact that we have senior officers asking subordinate members of the Defence force to take drugs that may not be in the interest of the person taking or being made to take the drug.

The dynamics of the relationship in these circumstances mean that subordinates asked to take drugs by senior officers feel compelled to do so out of fear of repercussion if they fail to do so. In the past we have seen Defence threaten personnel with non-deployment if they do not take these drugs often classed “medical countermeasures”. To be refused deployment is to impair the career of the individual and most unwillingly give away potential long term health consequences in order to safeguard their career.

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The relationship between any senior military medical officer and the average junior member of the defence force compelled to take experimental drugs is not the same as one would see in civilian medical testing. There is almost an underlying compulsion on subordinates within Defence to do as their senior officers ask, it is part of the culture and not something that should change. What should change is that Defence must stop experimenting on serving members and Senior Defence Medical Officers should be kept away from compensation bodies such as DVA where their past employment and behaviour may influence the outcomes delivered to veterans of the force exposed to senior medical officers activities.

6. Conclusion

The Department of Veterans Affairs are failing the veteran community, especially the younger veterans. The failings of the Department permeate nearly every aspect of their dealings with Australia’s veteran community. The Department does not listen to the concerns of veterans and all too often refuses point blank to entertain the possibility that there could be a legitimate problem. For some time I have been saying to other veterans dealing with this Department that DVA is in dire need of a cultural enema, they lack empathy with their veteran clients and I feel this is largely due to the fact that so few veterans work within the Department. The Department is quick to suggest to some of our sickest veterans that they find employment but is very slow to offer those same people employment opportunities.

Given the significant failings in oversight by DVA, the control of the scope and direction of all veteran health research is something that should be taken from DVA and given over to the oversight of appropriately panel composed of appropriately qualified veteran representatives. The Department should have limited involvement in veteran research by way of recommending or not certain research and for the funding of the same. Final say should be made at the discretion of the Minister taking into consideration the recommendations of the veteran health research panel, the scientific validity and need of the research in managing the longer term health of veteran the population(s) and to a lesser extent the opinion of the Department.

The investigation arm of the RMA Secretariat is not functioning in accordance with Act. This function should be removed from the RMA and placed beyond the influence of DVA. Again I suggest an oversight from appropriately qualified veteran representatives with future investigative briefs to be prepared by an approved and accredited tertiary or medical research institute with no prior history of DVA/ Defence influence on a contractual basis subject to satisfactory performance.

For me, former Defence medical officers have a clear conflict of interest taking employment with the Department of Veterans Affairs. Senior Medical Officers that have held positions that could have influenced or implemented policy that has negatively impacted the health of Defence members have a potential conflict of interest working in an area that deals with compensation for said Defence members.

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In my opinion the potential for a conflict of interest is enough to raise questions over due process.

Defence recently released an internal report on an investigation into the trial of the drug Mefloquine on defence members. Unsurprisingly when Defence investigates Defence (as is the case when DVA investigates DVA) neither seem capable of finding fault in their own processes and activities, there must be some awfully lumpy rugs in both departments Canberra offices.

Aside from the problems with internal complaints previously stated there is a fundamental disparity in relationship between senior military medical officers and subordinates asked to participate in drug trials. That subordinate members are asked to participate in drug trials (that often further the career of the instigator of the trial), presents a serious ethical problem for Defence and raise questions over the sanctity of the individual service man and woman’s basic human rights.

I strongly recommend that the Senate move to have Defence medical officers prohibited from conducting drug trials on serving members and that should Defence require such information, that it source that information from an external party. Furthermore given that considerable numbers of veterans, servicemen and women have already been exposed to toxic and or neurotoxic drugs in the course of their employment, I suggest that DVA immediately move to provide extensive non liability medical coverage to those persons via a Gold repatriation health care card.

Thank you for your time and consideration of these matters. For the record, whilst I have included my personal experiences, I’ve done so to explain and justify my input. I believe I have tried to be as objective and professional as I possibly could during my assessment of everything I have commented on. I am able to substantiate my claims but have omitted such detail for ease of submission. If required, I am prepared to make an oral submission to the review team should the need arise.

Yours faithfully,

David Watts BMedRadSc

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