Australia, Commonwealth of
Sarah Edith Sharkey
Department of Defence
Campbell Park Offices
Canberra ACT 2600
Basic Task of the Military Medical Service
The mission of the Australian Defence Force’s Joint Health Command is to provide a joint health effect to enable Australian Defence Force capability and provide care for our people. Through the delivery of reliable, resilient, affordable and best-practice health services, Joint Health Command enables a healthy, ready, and supported Force from enlistment through to transition from the Australian Defence Force. In addition, it partners with the Navy, Army and Air Force to ensure that the Australian Defence Force’s deployable health force is equipped and skilled to provide health care in the deployed setting. Joint Health Command is part of Joint Capabilities Group which delivers joint capabilities to improve the Australian Defence Force’s warfighting effectiveness.
Joint Health Command is responsible for:
· The provision of health advice to Commanders at all levels
· Developing health policy and programs
· Delivery of garrison health services to the ADF through a network of facilities in Australia and overseas
· Coordination of the joint health capability domain
· Coordination of health research
· Capability coordination of health materiel.
The Commander Joint Health commands Joint Health Command and its subordinate units.
The Commander Joint Health is Defence’s principal advisor for high-level integration and coordination of health services within Defence.
The Commander Joint Health is responsible for:
- efficient and effective delivery of agreed health services and functions including the provision of garrison health and health-related support services to enable Defence preparedness
- joint capability coordination for the Australian Defence Force’s joint health capability domain including health materiel, health workforce and health preparedness.
The Commander Joint Health is also be designated Surgeon General Australian Defence Force. The Surgeon General Australian Defence Forces exercises technical authority through:
- developing and managing Australian Defence Force joint health doctrine and health policy. This includes health manuals, health directives and bulletins and Australian defence doctrinal publications
- regulation, governance and strategic reporting across the Defence Health domain to assure the quality of health service delivery by complying with applicable policy and technical direction
- participating in, developing and managing health agreements, arrangements and relationships with international military partners, Australian Government bodies and non-government organisations.
The Surgeon General Australian Defence Forces is also the authoritative source of strategic health advice. Health staff within Joint Operations Command and the single Service environmental Commands are responsible for deployable health capabilities.
Military Health Facilities
Joint Health Command manages 59 health facilities commanded by eight Joint Health Units located in Australia and overseas. The Joint Health Units report to Garrison Health Branch within Headquarters Joint Health Command. Garrison Health Branch coordinates the delivery of a comprehensive range of health services to Australian Defence Force personnel within Australia in order to support operational capability. Services provided to personnel on base include primary health care, preventative health care, diagnostic testing, pharmaceutical supply, physiotherapy services, dental services, mental health and psychology services. Services such as specialist medical care, tertiary level inpatient services within the local civilian hospital healthcare network, and rehabilitation services including specialised case management, are provided off base to ADF personnel usually within the local area.
The Australian Defence Force’s current contract with an external health provider continues to deliver a suite of health service packages to Australian Defence Force personnel in the garrison environment, including:
· Contracted health professionals in support of on-base services
· Pathology, Imaging and Radiology services via a national provider network
· Optical services via a national provider
· A 24-hour Health Hotline Service
Access to off-base specialist and allied health services via a national provider network.
Institutes and Training Units
The Australian Defence Force has four training units operated by the single Services. These are:
· Australian Defence Force Dental School
· Royal Australian Navy Medical School
· Army School of Health
· Health Operational Conversion Unit
These training units provide crucial training to Australian Defence Force members, ranging from initial employment training through to specialist health training. The training units equip service personnel with the necessary skills, knowledge and practical experience to perform their medical role in the unique military environment.
Submarine and Underwater Medicine Unit – Royal Australian Navy
The main function of this unit is to give expert advice on diving and submarine medicine to the ADF. The unit provides emergency decompression for diving accident victims and provides the emergency medical system required in the event of a submarine accident. The unit also supports the emergency treatment of civilians suffering from diving illnesses.
ADF Malaria and Infectious Diseases Institute – Joint Health Command
The primary role of the Australian Defence Force Malaria and Infectious Diseases Institute is to research infectious diseases pertinent to the Australian Defence Force in areas of operation and to investigate measures to prevent catastrophic mission failure due to infectious diseases. Areas of research include prevention and treatment of vector-borne disease through pharmacological agents or physical means.
Institute of Aviation Medicine – Royal Australian Air Force
The Royal Australian Air Force (RAAF) Institute of Aviation Medicine at RAAF Base Edinburgh is formally commanded by the Air Force. The unit is staffed by a mixture of uniformed and civilian personnel with diverse skills in Aviation Medicine, Human Factors, and Aeronautical Life Support. The Institute enhances the effectiveness and safety of Australian Defence Force aviation through research into aviation medicine and the provision of aviation medicine training to clinicians and aircrew.
Australian Defence Force Centre for Mental Health – Joint Health Command
The Australian Defence Force Centre for Mental Health is a centre of excellence in military mental health providing leadership, best practice and innovation. The Australian Defence Force Centre for Mental Healthis staffed by a multidisciplinary and integrated military and civilian clinical team who provide tertiary level consultancy services, develop and trial mental health programs and support the training and development needs of the Defence mental health workforce.
Medical Service Personnel
Joint Health Command has an integrated clinical workforce of approximately 2,000 personnel comprising uniformed, public servant and contracted employees. Together, this workforce delivers care to approximately 80,000 entitled persons serving in permanent and reserve positions as well as attached members of partner militaries and entitled civilians. Annually our clinicians record more than 1 million consultations, order more than 350,000 imaging and pathology tests and refer out to 110,000 external specialist episodes.
Our combined care approach and singular electronic health record facilitates connected and informed decision-making. It also facilitates health and business intelligence and supports improved processes through an evidence-based examination of care and financial records associated with the delivery of care.
Operational health support to deployed forces is delivered by the single Services through Joint Operations Command. Australian Defence Force uniformed health services personnel work in both garrison and the deployed space.
All aspects of operational (field) health support to Australian Defence Force operations remain the responsibility of the individual single Services – Navy, Army and Air Force. The single Services are responsible to the Chief of the Defence Force to raise, train and sustain deployable health capability including personnel and equipment. Deployable health capabilities are then assigned to, and commanded by, Joint Operations Command for specific operational missions and exercises.
The Royal Australian Navy has Role 1 health support organic within all its ships. It has the capacity to deliver Role 2 and Role 2 Enhanced capabilities through a small number of appropriately equipped ships within the fleet. This capability is currently provided through the Bay Class Landing Ship Dock HMAS Choules and the Canberra Class (Landing Helicopter Dock) Amphibious Assault Ships HMAS Canberra and Adelaide.
The Australian Army divides it deployable health capability into two broad categories; Close Health Support and General Health Support. The majority of the Army's permanent force health personnel are divided between two units. The Close Health Battalion provides the Army's point of injury through to Role 1 care, and can be reinforced to provide a non-surgical Role 2 capability. The 2nd General Health Battalion provides the Army's deployable Role 2 Light Manoeuvre and Role 2 Enhanced capabilities.
The 3rd Health Support Battalion is a geographically dispersed unit that raises, trains and sustains Army reserve specialist medical, nursing and allied health capability to support the Close and General Health Battalions. The 2nd Division also contains significant Army Reserve health sub-units that can provide an additional point of injury, evacuation and Role 1 asset along with specialist health personnel to reinforce the Role 2 Light Manoeuvre and Role 2 Enhanced capabilities to the Division. Additionally, the Army provides forward Aeromedical Evacuation through task allocated rotary-wing assets utilising the MRH-90 Taipan and CH-47 Chinook aircraft. The 1st Psychology Unit provides operational psychology support to the Land environment including mental health assets.
The Royal Australian Air Force operational health capability is managed by its Health Services Wing consisting of an operational training unit, two Expeditionary Health Squadrons that can generate a deployable health capability up to Role 2 Enhanced and an Aeromedical Evacuation Squadron that provides a tactical and strategic Aeromedical Evacuation capability as part of the Australian Defence Force Aeromedical Evacuation System. Tactical and strategic Aeromedical Evacuation is performed utilising a variety of fixed wing platforms including C-17 Globemaster, C-130J Hercules and C-27J Spartan aircraft.
Since 1999, the Australian Defence Force has deployed on over 100 operations. Globally, the Australian Defence Force has made significant contributions to coalition campaigns in Afghanistan and Iraq. Regionally, ADF personnel have operated in significant numbers in Timor Leste, the Solomon Islands and Bougainville. Domestically, the ADF has been involved in border protection operations and counter-terrorism activities. ADF personnel have also contributed to humanitarian assistance and disaster relief operations in the Philippines, Pakistan, Indonesia the Solomon Islands, and Fiji as well as undertaking humanitarian assistance and disaster relief activities in Australia caused by fire, flood and cyclone.
The Australian Defence Force is often called upon to contribute highly specialised, niche medical capabilities, tailored to meet its obligations as part of a multinational force. Australian Defence Force Medical personnel are currently supporting operations in the Australian Defence Force contribution to the international effort to combat the terrorist threat in Iraq and as part of the NATO mission in Afghanistan.
The Australian Defence Force uses civilian services and facilities extensively, appreciating that civilian and military expertise and experience can enhance each others’ operations. The far-reaching coverage required across the Australian continent presents operational challenges for the Australian Defence Force and timely support depends on the close relationship that exists between the Australian Defence Force and civilian health systems.