Dear Sir
I read with great interest a most commendable paper by LTCOL Kerry Clifford on Defence Health Service or Health Advice Agency: “An alternative reality to the Stevens Review” in Vol 16 Number 3
What is refreshing is that the alternatives brought up were in fact debated by the Committee in South Australia that then provided a submission to the “Stevens Review”. To have a single separate service which is similar to South Africa was one view. The second was to embed within one service which is the US Marines model and the third was to evolve what we have, which has hitherto occurred.
The implicit aim of Defence Health is to provide the medical resources to enable the ADF to be operational. To that end the success story in Australia has been the part time Force (which is not in Reserve) which has enabled professionals to maintain their skills in their clinical practices and teaching hospitals and then deliver as required, which may be under threatening and arduous conditions. Commercial enterprises may have a role but in general principle mercenary forces will only perform when the pay is good and the threat level is low. Those driven by National interest, wearing the uniform, will do, and have done, a great deal more than that.
The continued challenge is to develop that the partnership of the full and part time Medical Force drawing on the success story of the last 105 years. It is evolving and it is working but given the expanding knowledge and technology in medicine the specific challenge is how to manage, recruit, retain and career progress the part time Force with due regard to all the other competing Civilian interests. Whatever system we utilise this needs continued enormous effort in this regard.
Yours sincerely
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