Australian Defence Force: Injuries

Senator Chris Evans asked the Minister Representing the Minister Assisting the Minister for Defence, upon notice, on 16 May 2002:

1. (a) How many injuries were there in each of the services in the past 3 years; (b) for each year since 1998, how many individuals in the Navy, Army and Air Force were injured (separately for each service, and for permanent personnel and reserves); and (c) can these figures be broken down into the types of injury (for example, muscular strain, fractured bone, ligament damage, tropical diseases contracted).
2. For each of the injury types identified in (1): (a) what is the average length of rehabilitation (using approximate figures based upon standard medical advice for treating the type of injury, if there are no statistics on actual rehabilitation periods experienced by Australian Defence Force (ADF) personnel); and (b) for how many days on average is a servicemen or woman with that type of injury unable to engage in military training, and/or perform their regular job.
3. How many personnel in each year since 1998 separated from the ADF indicating injury as the sole or main reason for separation (please list separately voluntary and involuntary separations).
4. What is the system within Defence for recording injuries in the ADF (for instance, who is responsible for reporting injuries to an individual in a unit to what level in the chain of command, is there an administrative area responsible for collecting health and injury records of personnel, etc).
5. For each year from 1998, how many injuries immediately or ultimately led to members being classed as Totally and Permanently Incapacitated.
6. Has there been analysis done of the costs to Defence of injuries, both in terms of actual medical costs and costs involved in a member being unable to perform their regular duties for a period of time.
7. (a) How often is such an analysis conducted; (b) when was it last done; and (c) can a copy of the most recent analysis be provided; if there is no such document, can a 2-3 page summary of ADF performance in this area over the past few years be provided, including trends and issues of concern.
8. With reference to page 327 of the Defence Annual Report 2000-01 which states that a report was commissioned to look into the management reporting requirements needed by senior executives, commanders and managers from the Defcare system: (a) what changes were recommended in the report; and (b) what are the outcomes.
9. With reference to page 329 of the Defence Annual Report 2000-01 which notes that certain organisational changes left personnel uncertain as to who should report and when: (a) were these changes within Defence or Comcare; and (b) what was the nature of these changes.
10. For each year from 1998 onwards can the following information be provided: (a) the workers' compensation premiums paid to cover the costs of injuries sustained in the ADF; (b) how much was spent in the ADF on occupational health and safety training and education and other injury prevention initiatives; (c) how many personnel were receiving ongoing compensation payments as a result of an injury sustained in the ADF (indicating the total amount paid to these people); and (d) how much in total was paid by Defence to people in the form of compensation for injuries sustained in the ADF.

Senator Hill - The answer to the honourable senator's question is as follows:

1. 1. Injuries recorded in each of the Services in the past three years are as follows:

      	Army	Navy	Air Force	Unknown*
      1999	5425	1899	925	99
      2000	3914	1352	987	48
      2001	4555	1846	1457	30

      * "Unknown" is where an employee's service has not been recorded.
   2. In compiling data on the number of individuals injured, an injured individual is recorded once per service per employment type (permanent or Reserve) for the calendar year in question, that is, if an employee is injured more than once in the year in question, but is in the same service for all injuries and also falls into the same employment type for all injuries, then that employee is counted only once. However, if an employee, for example, is injured twice in the year and is in the Navy for the first injury and then transfers to the Army and is injured the second time, then that employee will be counted twice - once under Navy and once under Army.
      
      Consequently, totals cannot be automatically summed across the services or employment types to give an ADF total, as the total may not equal the sum of the areas due to individuals being represented in more than one area during the time periods given.

      		Army	Navy	Air Force	Unknown*
      1998	Permanent personnel	3404	1884	741	65
      	Reserves	897	6	33	7
      1999	Permanent personnel	4513	1592	821	91
      	Reserves	203	3	9	0
      2000	Permanent personnel	3235	1192	899	44
      	Reserves	146	2	11	1
      2001	Permanent personnel	3911	1637	1257	30
      	Reserves	158	4	7	0
      2002 (to 29 May)	Permanent personnel	733	297	246	2
      	Reserves	51	1	2	0

      * "Unknown" is where an employee's service has not been recorded.
   3. A breakdown of the injuries figures provided at (1)(a) by injury nature is provided below.

      Injury Nature	Army 1999	Army 2000	Army 2001
      Burns	42	44	48
      Contusion with intact skin surface and crushing injury excluding those with fracture	92	83	116
      Diseases of the circulatory system	54	142	23
      Diseases of the digestive system	37	10	14
      Diseases of the musculoskeletal system and connective tissue	253	270	308
      Diseases of the nervous system and sense organs	123	453	111
      Diseases of the respiratory system	236	21	20
      Diseases of the skin and subcutaneous tissue	8	6	3
      Dislocation	76	82	73
      Effects of weather, exposure, air pressure and other external causes, not elsewhere classified	32	29	41
      Foreign body on external eye, in ear or nose or in respiratory, digestive or reproductive systems	52	59	84
      Fracture of vertebral column with or without mention of spinal cord lesion	3	3	4
      Fractures	282	276	349
      Infectious and parasitic diseases	28	50	25
      Injuries to nerves and spinal cord without evidence of spinal bone injury	0	3	0
      Internal injury of chest, abdomen and pelvis	3	1	3
      Intracranial injury, including concussion	28	31	25
      Mental disorders	19	17	27
      Multiple injuries (where no principal injury can be identified)	6	1	2
      Neoplasms (cancers and benign tumours)	1	1	2
      Open wound not involving traumatic amputation	160	200	228
      Other and unspecified injuries	124	196	616
      Other diseases	146	79	36
      Poisoning and toxic effects of substances	1685	394	1010
      Sprains and strains of joints and adjacent muscles	1574	1145	1091
      Superficial injury	273	278	215
      Traumatic amputation including enucleation of eye (loss of eyeball)	3	1	2
      Unknown (nature of injury not recorded)	85	39	79

      
      

      Injury Nature	Navy 1999	Navy 2000	Navy 2001
      Burns	67	66	60
      Contusion with intact skin surface and crushing injury excluding those with fracture	70	62	88
      Diseases of the circulatory system	7	43	4
      Diseases of the digestive system	11	2	2
      Diseases of the musculoskeletal system and connective tissue	116	92	90
      Diseases of the nervous system and sense organs	5	5	8
      Diseases of the respiratory system	26	13	11
      Diseases of the skin and subcutaneous tissue	2	3	1
      Dislocation	30	25	24
      Effects of weather, exposure, air pressure and other external causes, not elsewhere classified	11	11	13
      Foreign body on external eye, in ear or nose or in respiratory, digestive or reproductive systems	111	72	29
      Fracture of vertebral column with or without mention of spinal cord lesion	2	2	0
      Fractures	115	75	70
      Infectious and parasitic diseases	4	1	1
      Injuries to nerves and spinal cord without evidence of spinal bone injury	1	0	0
      Internal injury of chest, abdomen and pelvis	5	2	1
      Intracranial injury, including concussion	19	10	9
      Mental disorders	11	26	27
      Multiple injuries (where no principal injury can be identified)	2	0	0
      Neoplasms (cancers and benign tumours)	2	0	0
      Open wound not involving traumatic amputation	175	161	166
      Other and unspecified injuries	43	51	167
      Other diseases	40	24	33
      Poisoning and toxic effects of substances	101	111	564
      Sprains and strains of joints and adjacent muscles	663	322	340
      Superficial injury	230	156	107
      Traumatic amputation including enucleation of eye (loss of eyeball)	1	0	5
      Unknown (nature of injury not recorded)	29	17	26

      
      

      Injury Nature	Air Force 1999	Air Force 2000	Air Force 2001
      Burns	18	24	30
      Contusion with intact skin surface and crushing injury excluding those with fracture	27	32	51
      Diseases of the circulatory system	3	20	1
      Diseases of the digestive system	0	4	1
      Diseases of the musculoskeletal system and connective tissue	55	72	77
      Diseases of the nervous system and sense organs	8	12	11
      Diseases of the respiratory system	3	30	8
      Diseases of the skin and subcutaneous tissue	0	1	0
      Dislocation	18	14	32
      Effects of weather, exposure, air pressure and other external causes, not elsewhere classified	6	3	9
      Foreign body on external eye, in ear or nose or in respiratory, digestive or reproductive systems	20	20	23
      Fracture of vertebral column with or without mention of spinal cord lesion	1	0	0
      Fractures	70	70	89
      Infectious and parasitic diseases	5	4	3
      Injuries to nerves and spinal cord without evidence of spinal bone injury	0	0	0
      Internal injury of chest, abdomen and pelvis	0	1	2
      Intracranial injury, including concussion	8	5	6
      Mental disorders	4	6	13
      Multiple injuries (where no principal injury can be identified)	0	1	0
      Neoplasms (cancers and benign tumours)	1	1	2
      Open wound not involving traumatic amputation	52	76	121
      Other and unspecified injuries	28	59	154
      Other diseases	8	15	15
      Poisoning and toxic effects of substances	78	183	297
      Sprains and strains of joints and adjacent muscles	380	242	383
      Superficial injury	113	78	93
      Traumatic amputation including enucleation of eye (loss of eyeball)	3	0	1
      Unknown (nature of injury not recorded)	16	14	35

2. The information sought in the honourable senator's question is not readily available. To provide a complete response would require considerable time and resources and, in the interest of efficient utilisation of departmental resources, I am not prepared to authorise the expenditure of resources and effort to provide the information requested. However, similar statistical information is available in the ADF Health Status Report 2000, but it does not cover each year since 1998.
3. The information sought in the honourable senator's question is not readily available. To provide a complete response would require considerable time and resources and, in the interest of efficient utilisation of departmental resources, I am not prepared to authorise the expenditure of resources and effort to provide the information requested.
4. The Defence Safety Management Agency (DSMA) records all reported injuries to Defence military and civilian personnel. The form AC563 Incident and Fatality Report is completed by the injured person, including ADF members, civilians, cadets, contractors and visitors. This includes information on witnesses to the incident. It is then sighted and signed by the relevant supervisor, forwarded to the relevant Commanding Officer, then to DSMA and, where appropriate, Comcare, Comcover or the Australian Radiation Protection and Nuclear Safety Agency.
5. The Department of Veterans' Affairs provides compensation under:
   • the Veterans' Entitlements Act 1986; and
   • the Safety, Rehabilitation and Compensation Act 1988 and provisions within the Defence Act 1903, administered by the Military Compensation and Rehabilitation Service.
   
   The term 'Totally and Permanently Incapacitated' is used uniquely to refer to the special rate of disability pension that may be granted under the Veterans' Entitlements Act 1986.
   
   A date of injury is not stored on the Department of Veterans' Affairs computer systems, as this is not necessary for the administration of pensions under the Veterans' Entitlements Act 1986. It is not possible, therefore, to provide a count of the number of grants of pension at the special rate that have resulted from injuries suffered since 1998.
   
   Under the Defence Act 1903, where a member is severely injured, an additional amount of compensation is payable. This is called a Severe Injury Adjustment and is payable to those who sustain an injury which results in a whole person impairment of 80 percent or more. One payment has been made for an injury sustained in 1999 and one for an injury sustained in 2001.
6. Yes.
7. 1. Analysis of the total cost of injuries to Defence is carried out biennially as part of the ADF Health Status Report. The first report was completed in 2000. I have forwarded a copy separately to your office. The second report is due towards the end of this year.
   2. The most recent analysis was carried out in September/October 2001 as part of a report entitled Ex Ante Cost-Effectiveness Analysis of the Defence Injury Prevention Program implemented within the ADF.
   3. Yes. I have forwarded a copy separately to your office. Table 2 of the report lists the information requested.
8. The report referred to is the Review of the Defcare Computer System – Occupational Health and Safety and Rehabilitation Information in the Australian Defence Force by Susanne Tepe, PhD and David Nield from SHE Pacific.
   1. The report recommendations were divided into three groupings and can be described as:
      1. those designed to enhance the Defcare computer system capability:
         • design of a standard suite of reports for users to obtain their own data and enable benchmarking across Defence;
         • revision of the incident reporting system to include an in-built action management analysis facility and risk assessments. This will enable incident alerts to trigger other injury and incident information from other databases eg Report of Defective and Unsatisfactory Material; and
         • development of interfaces with PMKEYS, HEALTHKEYS, other incident reporting systems and balanced scorecard/management reporting.
      2. those designed to make the Defcare system easier to use:
         • design and implementation of an easy to use incident alert facility for inclusion on DSMA and Defence web sites;
         • making sure the Defcare database is deployable for units on deployment and ships at sea; and
         • reviewing the way Defcare windows/text are presented through consultation with users outside the occupational health and safety (OHS) community in Defence.
      3. recommendations that address the Defence OHS management systems, training and corporate governance:
         • the establishment by Defence of a clear set of OHS standards, with procedures on how to achieve the standards;
         • the adoption by Defence of a consistent process for incident investigation and reporting;
         • the establishment of a task force to implement a consistent approach to the continuum of risk assessments, so that risk assessments become standards in Defence;
         • inclusion in the balanced scorecard of a measure of injury as an indicator of human resource capability and safety performance, as well as a measure that indicates compliance with OHS regulations;
         • introduction of accountability for individual managers/officers for the safety performance of their people, with the performance measurements system including a safety measure in each person's performance objectives;
         • a number of training recommendations aimed at ensuring safety was appropriately covered within Defence;
         • making sure a consistent approach is taken to assigning safety advisers to unit/base/ship etc;
         • recognising that there is a need for expert advice, in particular requests for advice on the safe use of chemicals;
         • enhancing an organisational culture that supports and encourages reporting of incidents, ensuring reporting is disconnected from punitive measures; and
         • increasing the awareness of Defcare throughout Defence.
   2. The outcomes are:
      1. The Defcare system is in the process of adopting and implementing the recommendations of (a)(i) enhancing the system and (a)(ii) making Defcare easier to use; and
      2. A Safety Governance Project has been established to address points raised in the recommendations at (a)(iii). The Defence Committee provided direction at their November 2001 meeting in relation to a safety management system for Defence and specific safety performance requirements.
9. 1. and b. The changes referred to on page 329 of the Defence Annual Report 2000-01 are a result of the restructure of Defence into 14 Groups during the Defence Reform Program. The restructure caused uncertainty in relation to whom incident reports should be forwarded to within Defence. This issue has now been addressed and all reports are forwarded, through the chain of command, to the DSMA for input into the incident and injury database, Defcare.
10. 1. Unlike civilian compensation, there is no insurance arrangement for workers' compensation costs for the ADF. Funding of the benefits arising from compensable injuries for the ADF remains a Defence responsibility. Defence does not pay a premium, instead, the benefits are met on a pay-as-you-go basis. In other words, the scheme is unfunded.
       
       Prior to 1 July 1999, the cost of military compensation was a below the line item. Defence is now required to carry its unfunded liabilities on its balance sheet. The unfunded liability, which is calculated by the Australian Government Actuary each year, is the estimated present value of future claims payments for all injuries sustained as at the valuation date.
    2. The total spent on ADF OHS training and education by the DSMA for 2000-01 was $394,556. This amount has been increasing by 20% per annum since 1998.
       
       Additional expenditure was incurred by individual Defence Groups and the Service Training Commands. Although it would be possible to extract this, it would be too time consuming and costly to collate this data.
    3. 1998-99: 1,213 personnel; 1999-2000: 1351 personnel; 2000-01: 1450 personnel.
    4. 1998-99: $110.3m; 1999-2000: $116.9m; 2000-01: $122.5m.

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