2010 Paulatim Magazine - RAAMC Association

Some of these differences change over time presenting challenges to
each of us. Greater troop dispersion and improved lethality of weapons
in the modern battlefield implies we will need to apply greater tactical
understanding and more technical expertise to accurately support and
coordinate the health effort. Yet we focus on improving clinical improve
skills of our military health staff. To ensure health planning, military
health staff will need to have better contact with the whole Battle
Group. That is better communication, and manoeuvre and application of
military health skills.
Another constant challenge is the expectation that care for casualties
will be based on optimal, comparable civilian levels of medical care
creates a tension. The civilian sector faces fundamental change and
uncertainty greater than our own. Health accounts for a significant
proportion of government expenditure. History dictates expenditure on
health continually rises due to dependency and demand. In this
environment, earlier intervention and prevention has lead to shorter
periods of hospitalisation, better health, and longer life. This can only
work if health care assets are structured to achieve a common outcome,
even if they are in competition with each other.
Comparable levels of civilian care can be based on a military health
chain of care. This can be replicated within the ADF through adaptation
of the existing framework. A joint approach to health starts with
Prevention (physical conditioning, diet, environmental health and
health intelligence), where prevention fails emergency procedures
(casualty evacuation and medical regulation) stabilise life and deliver
the casualty to the most appropriate treatment facility. Treatment can
be provided to save life and promote functioning and assist healing
(role 1 – 3 medical support), prior to rehabilitation (physical
conditioning and ongoing support) and return to duty or discharge.
Every military health professional should be able to explain each to our
colleagues and prospective patients.
One way to minimise the tension and challenges is to reduce
unnecessary duplication of services. At present considerable expertise is
“tied up” in a few senior people, a lack of knowledge then emerges at
the tactical and operational health planning making determination of
strategic and future capability difficult. A step towards jointery has
occurred with ADF health refocussed under a central command with
regional delivery. This spoke and hub model of health care has
provided small well-coordinated health units responsible for the Land,
Air and Maritime Health delivery. We have generated an independent
chain of care for our patients providing a seamless transition of patient
management from point of injury overseas and returning to
comparable levels of treatment in Australia. Yet we cannot remove that
fact that health is an emotive issue resulting in a perception of military
health support being sub-optimal against civilian levels of care.
One way to reduce further tension is through the delivery of numerous
joint health projects. These are highlighted and summarised below:
• JP 2048 the amphibious ship brings larger joint health capability.
The Primary Casualty Reception Facility provides a that can grow
from a complement of 25 staff to a 75 staff facility with:
°
°
°
°
°
6 resuscitation bays, (TRIAGE area in the aircraft hangar);
2 operating facilities (each capable of housing up to 2
operating tables);
2 Intensive Care beds (ICU)
6 (8) HDU beds; and
36 LDU beds.
• JP 2060 has delivered Phase 1 and Phase 2 Deployable Health
Capability (DHC) for example replacing canvas with weather-haven
systems to remove duplication of single service solutions to deliver
a joint operational capability. Phase 3 will provide a three tiered
enhancement to our operational support including:
°
°
°
Health systems
Health Training systems
Health C4I
These two projects will present enhancements and combined health
optimisation however there are several projects including mobility
platforms such as the new Army Vehicle project (overlander), Land 400
(Armour replacement), enhanced tactical communications and Strategic
Reform that will provide overall optimisation of ADF Health.
8 8 P A U L AT I M – M A GAZINE O F T HE R OYA L A U S T R A L I A N A R M Y M E DICAL C O R P S – 2 0 1 0
I challenge each of you to think of military health as restrained,
conservative and inflexible. Please challenge yourself, as I believe often
that you are the only limiting factor and by improving your utility in
Military Health you improve the health of others.
In sum, the changing face of ADF Health services has several constants,
deployed health capability must provide comparable levels of civilian
care to our soldiers, and every health professional has the obligation
of understanding the differences of Defence health and be able to
utilise them. We live in exciting times, the difference will be the way
we apply it, as enhanced capability can be delivered and single service
barriers dropped by enhanced jointness.
By: MAJ Mike Treloar