ASPEN Medical Group provide health support for Australian Troops on operations

ASPEN Medical Group have a nice website outlining their provision of health support to our deployed forces.

It can be found here for East Timor and here for the Solomon Islands.

Providing civilian health support to armed troops on operations is clearly inappropriate and speaks volumes as to the lack of care by the senior leadership and the CDF of the ADF for Australian troops. Civilians are limited to working only in areas in which it is safe for them to do so.

The irony is that the civilian health support cannot provide health care when they most need to, at conflict sites. While Australian troops are taking injuries, civilian doctors and nurses who are not trained, armed or equipped for combat cannot be expected to enter a dangerous area to assess, treat and transport injured troops.

Uniformed Medical and Nursing Officers are trained, armed and equipped to provide health care in combat situations. It is a pity the ADF cannot address the toxic culture of discrimination directed towards their health professionals in order to retain their services.

Dr Julian Fidge

Ordered to shut down this blog!

My Commanding Officer, LTCOL Laureen Grimes, has ordered me to shut down this blog. Her letter to me can be found here .

I have elected not to oblige LTCOL Grimes, as I remain convinced that despite the tensions that might arise, the publication of these documents are overwhelmingly in the public interest. And the best way to prove their veracity is to publish the signed document where it is available.

I accept that officers who have behaved poorly are embarassed by the publication of the these documents. But I am motived by protecting Australia, Australian troops and improving the capability of the ADF. I have no idea what motivates senior officers of the ADF, but it seems to be mainly the vested interests of their colleagues, not the defence of Australia.

As I write, officers like LTCOL Grimes continue to discriminate against Specialist Service Officers - the doctors, dentists and nurses, and these officers leave the ADF. We are all very busy professionals, we don't have time to waste on fools and we won't be treated like dirt.

The end result of LTCOL Grimes' actions, and the actions of other senior officers of the ADF is that Australian troops are not able to be provided with appropriate health support. No ADFpersonnel deployed on operations anywhere in the world are supported by ADF health units, as there are simply not enough doctors, nurses and dentists left in the ADF!

I note also that despite having been suspended and investigated since December 2010 for essentially the same behaviour, Brigadier Robert Marsh, the Commander of 4th Brigade, has not yet charged me with anything. I strongly doubt that I am committing any offence against the Defence Force Discipline Act or any other law by publishing this blog, otherwise I am sure that 8 months later I would have been charged.

I am quietly confident that any judge would accept that I have exhausted all ADF avenues, including the Inspector General ADF and the Commonwealth Ombudsman without having my concerns properly investigated and that a blog like this is the least any responsible citizen would provide in an effort to promote improvement in the ADF.

The ADF would, of course, like to conceal their lack of leadership. I was hoping the new CDF would be more concerned about Australian troops and Australian interests than looking after his mates. Disappointingly, it appears to be business as usual.

Julian

Another failed court martial by the ADF

Below is the Notice of my directions hearing, where my court martial was vacated by the Judge Advocate.

Thank goodness someone has a clue in the Military Justice System. What was Colonel Cameron thinking when he convened a General Court Martial for insubordination?

As it turned out, 8 of the 12 charges were withdrawn, and the remaining 4 were changed anyway.

Your taxes at work...

The Australian Defence Force Investigative Service

You may remember this ADF version of the Keystone Cops from the recent ADFA Skypegate debacle, when the ADFIS "investigated" the cadets involved in broadcasting the intercourse between two ADFA cadets. Until it got away from the ADFIS, there was no case to answer, and it was the typical ADF response to these matters: the woman's behaviour was wrong and she was vilified by the hierarchy of the ADFA. In contrast, the boys who had committed several sins against a fellow officer cadet were simply told to get back to work.

As you know, ADFIS are clueless, and the boys were eventually charged with a number of offences.

Here is my personal experience with ADFIS:

After writing a formal and polite letter to Brigadier Michael Arnold he charged me with insubordination. He then set up a kangaroo court with one of his infantry commanders, Lieutenant Colonel Laidlow, who had the good sense not to proceed to hear the trial when I pointed out the complainent was his immediate superior. When I did eventually stand trial, an alternative CO tossed the whole thing out when he read the letter. His reasons were "There is nothing insubordinate, insulting or prejudicial to good discipline in the ADF in this letter".

But not ADFIS! This is what Warrant Officer Kealy-Bateman found:

The letter I wrote to Brigadier Arnold can be found here.

Meanwhile, Australian troops continue to have whatever health support anyone else can provide when Brigadier Arnold sends them overseas on operations.

How Brigadier Arnold stopped the investigation of my complaint of unacceptable behaviour in the ADF

When the ADF or the Minister for Defence says they are going to have an inquiry, most people would expect they would gather as much information as possible in order to make the best decision.

But what actually happens is that the Terms of Reference for an inquiry of usually limited so that nothing will be uncovered that reflects badly on Defence or the Minister for Defence.

For example, read through the TOR for my complaint. There are more things excluded than included.

As a result of poor leadership like this, the ADF is now unable to provide health support for any of our forces serving overseas. In Afghanistan, medical support was provided by the Dutch and now the US. In East Timor and the Solomon Islands, it is provided by a civilian group, ASPEN Medical Services.

Civilian health support is not as good as uniformed health support. And when the situation becomes unstable, the civilians must leave. Then the troops have no health support.

Terms of Reference of the ADF inquiry into my complaint of unacceptable behaviour.

2008 Redress of Grievance about Unacceptable Behaviour in the ADF

This is a slightly edited copy of the complaint I made about unacceptable behaviour in my unit, 4 Combat Service Support Battalion, in 2008.

Brigadier Arnold, then the  Commander of 4 Brigade, refused to investigate most of this complaint. See his Terms of Reference in a later blog entry to see how the ADF sweeps matters under the carpet.

2008 Redress of Grievance about Unacceptable Behaviour in Defence

Colonel Commandant A.P. Adams discriminates against Specialist Service Officers

I was told yesterday that the officer hearing the charges against me is Colonel Adams, the fellow who is in charge of one of the army training institutions that fosters discrimination and actively discriminates against Specialist Service Officers. I have been on course there and been interviewed by the senior instructors, including the commanding officer, for protesting about the behaviour of the General Service Officers towards their Specialist Service Officer colleagues.

Let me give you an example.

On my last course, these particularly dim GSOs asked me about the siting of field hospitals. Having worked in the Rwandan emergency in 1994/94 and Baragwaneth Hospital in South Africa, I have a strong working knowledge of this sort of question. So I told them what was required, and they dismissed my opinion because I "hadn't worked on brigade staff". I told them to get stuffed.

Their arrogance and ignorance became apparent to all shortly afterwards. These halfwits went on to present to our supervisor, on behalf of our group, without consultation with any of the subject matter experts (doctors or nurses), that they needed 834 (yes, eight hundred and thirty four) emergency medical teams for a medium sized operation in a relatively quite area. In fact, we only needed three.

Despite obvious proof that these GSOs were performing very poorly and not taking any notice of the subject matter experts in their group, I was interviewed by the Senior Instructor, a Major and then by the Chief Instructor, a Lieutenant Colonel, for arguing with these very sensitive GSOs. Both the SI and the CI failed to appreciate the dysfunctional environment of their school, and I was unfairly criticised in my course report.

Finally, ALTC and Colonel Adams have a policy of not using Specialist Service Officers as instructors, only General Service Officers. Obviously this is discriminatory. But more than that, it means that our officers are deliberately being trained by second-rate instructors. The Specialist Service Officers are, by virtue of their appointment, very highly educated and trained. I do not mean to infer that SSOs can teach everything, but to have a policy which excludes them means our army is not as well trained as it could be. We should always use our best instructors wherever and whenever possible, not deliberately exclude them!

Colonel Adams discriminates against Specialist Service Officer and fosters an environment in which we are undermined, belittled and harassed. His is obviously biased and cannot be impartial in a matter like this, where my complaints about discrimination against SSOs are being treated as insubordination.

This is merely futher abuse of the Military Justice System and another kangaroo court set up to stop me drawing attention to the lack of health support for our troops. I have no doubt Colonel Adams will find me guilty of everything, regardless of the evidence put to him, and that these proceedings will be used to discharge me from the ADF.

_________________________________________________________________________

Hello Sir,

FYI, the Superior Summary Authority (SUPSA) for the proceedings is COL A.P. Adams CSM, Commandant. Mailing address is:

Colonel A.P. Adams
Commandant
Army Logistics Training Centre
Gaza Ridge Barracks - South
MILPO
BANDIANA VIC 3694

Legal Representation: When you request approval to use a legal officer as your defending officer, I request you provide me with a copy of your request. To assist with the process please see attached and extract below from DLM:

Legal officers as defending officers
7.313 An accused person may wish to have a legal officer as a defending officer. In such circumstances, the accused person should be made aware that additional limitations will apply. Importantly, there is no entitlement to be represented by a legal officer at proceedings before a SUBSA. A legal officer may only appear as a defending officer before a CO or SUPSA if the requested officer is ‘reasonably available’ and leave is granted by the summary authority.295
7.314
Guidance on applications for legal representation and the factors that may be considered by a summary authority in deciding whether or not to grant leave for legal representation is provided above. [End extract]
Dates: The dates for the proceedings will be 30 Apr and 01 May 11.
Location: Simpson Barracks.
Further details: An instruction outlining key administrative, rations, accommodation details will be released in due course.

Sir, request you ack receipt of this email please.

Kind regards
RSM
______________________________________________________________________________

The Hon Warren Snowdon places his head firmly in the sand, while Australian troops go into combat without appropriate health support

Below is the letter I have just received from Warren Snowdon, the Minister for Defence Science and Personnel. The Minister has been advised that the Department of Defence has conducted a full assessment of my concerns and has found no evidence of harassment or discrimination directed towards me, or other Specialist Service Officers.

This is passing strange, as Defence has consistently refused to abide by their own directives and investigate any of my strongly expressed concerns about the treatment of SSOs since 2008. In fact, they have done everything they can to stop me exposing the critical shortage of Medical Officers they have created through their misbehaviour. So it is certainly not possible for Defence to be advising the Minister they have conducted a full assessment of this matter. This is simply more of a cover-up of serious misbehaviour amongst senior officers in Defence.

Apparently, my written concerns, expressed consistently over the past four years, don't constitute evidence. Nor does the fact that the ADF is unable to provide health support to any of our deployed forces, and much of our garrisoned forces, provide any evidence of a problem.

The Minister goes on to say he is confident that these matters have been appropriately considered, while Australian troops on operations receive inadequate health support from civilians or other countries.

In my opinion, the Minister Snowdon must be grossly negligent or completely incompetent if he thinks these matters have been appropriately considered. At the very least, there is overwhelming evidence of a critical shortage of Medical Officers that has crippled the ADF. For an independent view, see my post publishing the Defence Force Remuneration Tribunal's Reasons for Decision published earlier.

This letter nicely illustrates the whole problem, and how dysfunctional the senior leadership of the ADF has become: A Medical Officer (me) tries very hard to bring these facts to them and help them fix the problem. They charge me with insubordination, lie to the Australian Government, and rely on a dim Minister to accept their false reassurances.

Don't they know truth will out?
_________________________________________________________________________

Sedition and Mutiny in the ADF, or Incompetence?

Like Brigadier Michael Arnold, Brigadier Marsh has refused to investigate my concerns about the ADF's critical shortage of Health Professionals, despite my 4 page letter to him and written directives that he must do so. Apparently he doesn't care about Australian troops, either.

I have edited out names of innocents, as before.

___________________________________________________________

Brigadier Marsh, RFD

Commander 4 Brigade

Simpson Barracks

Victoria                                                                          6th December 2010

Dear Brigadier Marsh,

I write in response to LTCOL L.A. Grime's Notice to Show Cause why I should not be suspended from duty on suspicion of committing service offences.

In addition to responding to the notice, this document is also a complaint about harassment and discrimination against Specialist Service Officers by General Service Officers generally and discrimination against me specifically by General Service Officers because I am a Specialist Service Officer. I refer you to DI(G) PERS 35-3 Management and Reporting of Unacceptable Behaviour.

I have not sought advice about the notice as it was served upon me on Tuesday evening, giving me effectively three days (Wednesday, Thursday and Friday) to seek advice. I have not received one of the documents, an MP3 file, that LTCOL Grimes promised me. The time given for me to respond is manifestly unfair and in keeping with the bastardisation of Specialist Service Officers by General Service Officers that I have been complaining about for several years now.

Nevertheless, the notice is of the same extremely poor standard as previous attempts by LTCOL LA Grimes to harass me and I am confident that this will be as easy to dismiss as the kangaroo courts she organised in 2008 and 2009 and the court martial in September this year.

I will assume the missing document LTCOL Grimes has failed to supply is substantially about the same subject, that is the inability of the ADF to provide health support to Australian soldiers because of the inability of the ADF to retain doctors, nurses and dentists.

There are at least seven reasons why I cannot be reasonably suspended. I suspect if I had a reasonable amount of time or the opportunity to seek expert counsel, many more would come to light. But off the top of my head I can immediately think of the following. In no particular order, they are:

1. There is insufficient reason to suspend me;
2. There is no advantage gained by the ADF in suspending me;
3. There is considerable disadvantage to the ADF if I were to be suspended;
4. Suspending me will diminish morale amongst health personnel and other ADF members;
5. There is overwhelming evidence the Defence Force Discipline Act is being misused again as part of a general campaign of harassment of SSOs and myself specifically;
6. Supporting the actions of LTCOL LA Grimes will foster the current poor practice of ADF GSOs in resorting to the most extreme processes and punishments as their first or early action in dealing with situations that are better handled through inquiry, education and negotiation; and
7. Suspending me from duty is not in the interests of Australia or the ADF.

Firstly, It is clear from that the issuing of this notice that LTCOL Grimes does not understand the process she is initiating. She has written in her notice that I am being investigated, and the mere fact that I am being investigated may be reasonable grounds for suspension. This is nonsense. The investigation has not resulted in any charges being laid, nor will it. It is impossible for the ADF to prosecute me because I was not a defence member at the time the alleged offences took place.

Further, the issues discussed with the media are matters of public knowledge. Everything mentioned is well known to any interested observer of defence matters. It has been well known for a long time the ADF cannot retain SSOs. There was no utterance of confidential material.

In any event, it is not open to the ADF to pursue this matter.

The process initiated is only every used when it becomes clear there is a reasonable chance of success in a prosecution. This is usually signalled by a decision to lay charges. It is not the 19^th century, and the DFDA is not a plaything for struggling officers to use for personal vendettas.

Secondly, the ADF gains nothing by suspending me from duty. If the concern is that I will continue to voice my concerns to the Australian Parliament and press, suspension cannot prevent me from continuing to do so.

Thirdly, if I am suspended the ADF loses a critical individual asset. I enlisted in the ADF over thirty years ago, and have enormous experience working in countries all around the world. I am an experienced pharmacist, doctor and effective leader of health teams.

Fourth, morale amongst ADF health support personnel is already at an all-time low because of the extant situation you and your colleagues have created. ADF health support personnel are ignored and civilian contractors are given their jobs, or the health support is provided by allies. Suspending me from duty for trying to provide appropriate health support for members on operations will signal all observers that you disagree with the provision of appropriate health support to soldiers and further lower morale amongst all ADF members and health support personnel especially. My actions are strongly supported by every right-thinking soldier and officer.

Put more simply, I am trying to protect soldiers. You happily send them into hazardous operations without appropriate health support. No-one in their right mind would support your position, or act against mine. Suspending a Medical Officer for expressing concern about the current health situation is madness and will reinforce the current, unacceptable situation to the dismay of everyone affected by it.

Fifth, this notice continues a pattern of harassment carried out by LTCOL Grimes and her subordinates for the past two years. In some semblance of chronological order,

1. The captain OIC of Beersheba was replaced by a staff sergeant, over the heads of the three remaining captains who were all SSOs. This is bizarre and confusing for everyone, especially the SSGT and the soldiers who know a captain outranks a SSGT by a fair bit.
2. This year SSOs in 6^th Health Company, 4 CSSB were denigrated and undermined by the appointment of an engineering captain from outside the company and associated corps who has no association with health support as the second in command. This has continued the discrimination directed towards SSOs by failing to appoint, train or encourage any of the very competent Nursing or Medical Officers with 6^th Health Company.
3. LTCOL Grimes had me charged with insubordination for asking an ROG to be elevated to the Chief of Army, which is clearly an offence under Defence Force Regulations.

4. LTCOL Grimes instigated an investigation and adverse findings against me in my PAR, saying that I had carried out an unauthorised promotion of a new Nursing Officer, Lieutenant Nursing Officer, when he was in fact commissioned and appointed in the usual manner by a Major in Albury. All I did was congratulate him!
5. Immediately upon arrival the same LT was posted to a private's position in a Low Dependency Unit by our OC, without discussion. Again this is very demoralising and denigrating to everyone who is aware of this bizarre, destructive behaviour.
6. At the same time our OC said she was taking all of the Medical Officers out of their posted positions and teams and they would be working independently – which is a fairly good indication of how little she knows about our jobs, and how little she knows about how little she knows. I couldn't open the door to my practice without a receptionist and a nurse, and I often have another doctor, a practice manager and psychologist on site as well. Not to mention IT support, the bookkeeper and the other important team members I need to make a functional medical unit!

LTCOL Grime's behaviour is belligerent, bizarre and destructive of the fabric of the ADF. It displays hallmarks of psychopathic behaviour. It is most likely that the notice is so badly misconceived because it is wrongly motivated.

Sixth, if LTCOL Grimes was genuinely concerned about the ADF or members under her command or had any reasonable motivation for her actions she would have taken reasonable steps to gather information in order to make a good decision. I would have been interviewed about the precise nature of my concerns and asked why I had these concerns. Supporting her notice by suspending me will foster similar mismanagement and further poor decisions by your subordinates.

Seventh, suspending me from duty acknowledges publicly the ADF is discomforted by my concerns and adds credence and weight to them. If my concerns were unfounded, the matter would not be serious enough to attempt to silence me with the DFDA. It is not in the interests of Defence or Australia for my concerns to be supported or to be broadcast any more than is required to fix the problem. I acknowledge the futility of making this point – obviously if you had any regard for the interests of Defence or Australia, you would be more supportive of your SSOs, we would be able to provide health support for our troops and I wouldn't be so concerned about their welfare. I have included it for the other addressees.

Previous dealings in similar matters with your predecessor, Brigadier Michael Arnold, were handled in a particularly vile manner and I have no confidence you will behave any differently. Accordingly, I have elected to publish the Notice to Show Cause and my response to the Senate Standing Committee on Foreign Affairs, Defence and Trade, the Minister for Defence and the Shadow Minister for Defence. I believe the critical shortage of SSOs in the ADF to be a Proper Reason for this disclosure. I consider these two documents can aid understanding of the reasons Australia is unable to properly support deployed ADF personnel and may be unable to meet treaty obligations and so constitute Proper Instruments. In the absence of any reasonable response by anyone in the ADF or the IGADF, I consider these offices to be Proper Persons to whom to disclose this information.

Further, I consider it possible the misuse of the DFDA and Military Justice System by senior officers such as Brigadier Arnold, Brigadier McDade and LTCOL LA Grimes to be seditious. The Australian Parliament, through the Senate, has made it very clear the MJS is not to be misused, and have allocated millions of dollars of public funds in order to stop this kind of misuse. I consider this notice to be further misuse of the DFDA and to directly undermine the Australian Parliament.

It is possible the actions of some of these officers have seriously weakened the ADF and may constitute offences under the DFDA, including, but not limited to:

DFDA Sect 15G Imperilling the success of operations

             (1)  A person who is a defence member or a defence civilian is guilty of an offence if:
                     (a)  the person engages in any conduct; and
                     (b)  the conduct imperils the success of operations against the enemy.

DFDA Sect 20 Mutiny

"mutiny" means a combination between persons who are, or of whom at least 2 are, members of the Defence Force:
                     (a)  to overthrow lawful authority in the Defence Force or in an allied force; or
                     (b)  to resist such lawful authority in such a manner as to prejudice substantially the operational efficiency of the Defence Force or of, or of a part of, an allied force.

Defence Force Regulations Reg 92 (2)

A member is guilty of an offence if he or she causes another member to be victimised, penalised or prejudiced in any way for:
                (a)    making a complaint; or
               (b)    requesting the referral of a complaint.

It is clear from the above that you have a major problem with several of your middle and senior officers discriminating between SSOs and GSOs and harassing them. While your predecessor and the Chief of Army do not feel directives are binding upon them and have ignored my previously expressed concerns about discrimination and harassment of myself and other SSOs, I would take this opportunity to remind you that DI(G)PERS 35–3 Management and Reporting of Unacceptable Behaviour specifically states that an overarching principle of the ADF is that:

7b. Defence does not tolerate any forms of unacceptable behaviour, nor the mismanagement or disregard of complaints;

and specifically that:

7c. Commanders and managers are to take all reasonable measures to eliminate and prevent unacceptable behaviour and to manage complaints, including the appointment of a case manager;

My concerns are not trivial and are not confined to me. The conduct I refer to above has crippled the ADF, as you well know.

Yours sincerely,

Dr Julian Fidge BPharm, Grad Dip App Sc (Comp Sc), MBBS, FRACGP

Captain

Medical Officer

6^th Health Company

4 Combat Service Support Battalion

 

cc Senate Standing Committee on Foreign Affairs, Defence and Trade

Minister for Defence

Shadow Minister for Defence

____________________________________________________________

When questioned about why the ADF was not investigating, a spokesperson for Senator Snowdon, the Minister for Defence Science and Personnel and Veterans Affairs, wrote:

"On January 13, the Commander requested Dr Fidge provide  additional information by January 31 in order to proceed with the investigation, as Dr Fidge's letter of complaint does not contain sufficient detailed information to thoroughly consider his complaints."

Brigadier Marsh continues to mismanage my complaint, which obviously contained enough information to make enquiries, as at the date of ths post. I am happy to report that 6th Health Company has a new 2IC, whom I think is a Nursing Officer. I am happy to have forced Lieutenant Colonel Grimes to have reversed that appointment and awarded it to an appropriate officer.

The reason it is has never been open to the ADF to investigate or prosecute me is quite clear - I was not a defence member at the time. A defence member is defined in the Defence Force Discipline Act as:

________________________________________________________

"defence member" means:

                     (a)  a member of the Permanent Navy, the Regular Army or the Permanent Air Force; or

                     (b)  a member of the Reserves who:

                              (i)  is rendering continuous full‑time service; or

                             (ii)  is on duty or in uniform.

_________________________________________________________

And I was never on duty or in uniform when I wrote these letters or spoke to the press, far less rendering CFTS. But as the Senate found, many ADF officers don't think they are bound by the laws of this country.

I'll publish the Senate findings on the ADF's contempt of Parliament when I get time.

Cheers,

Julian

Medical Observer Article 21st February 2010

Military GP with a mission

21st Feb 2011

 

Melinda Ham reports on how Dr Julian Fidge’s whistleblowing caused a national controversy.

 

Being labelled a whistleblower has not deterred Dr Julian Fidge, a Wangaratta-based GP from country Victoria.

In fact, he regards it as a compliment and after being rebuffed by the Australian Defence Force (ADF), he is now taking his concerns to the Senate Standing Committee on Foreign Affairs, Defence and Trade.

Dr Fidge, a Reserve ADF medical officer in Melbourne with the rank of Captain, made national headlines recently when he claimed the ADF was critically short of medical personnel, including doctors, nurses and dentists, due to an entrenched culture of demeaning these professionals.

Talking to the press about these allegations has predictably landed Dr Fidge in hot water; the ADF has referred him to a psychologist and he has faced more than a dozen charges of insubordination. While the charges have all since been withdrawn, he remains suspended from the Reserves.

“I entered the military with my eyes wide open. I knew the army was a large organisation and very hierarchical, but I never expected this,” Dr Fidge says.

Citing a “deep ethos of public service and duty”, Dr Fidge joined the armed forces in 1980 as a reservist at age 16 and a student at Melbourne High School. He then served in the regular army from 1981 to 1985 as a signalman.

After completing a Bachelor of Pharmacy and then medical qualifications, Dr Fidge returned to the army as a reserve medical officer in 2005 in the 4th Combat Service Support Battalion in Melbourne.

He had his first taste of working overseas for the military with a stint in East Timor for four months in 2006, conducting aeromedical evacuations.

“Having a Black Hawk helicopter as your taxi was amazing and to be part of Australia’s effort to stabilise that country was fantastic,” he says.

At the same time though he saw firsthand that contract medical teams didn’t always have the best judgment. He recalls one incident where as the result of incorrect treatment, a soldier lost his hearing in one ear and had to be discharged from the army.

It’s been this experience of service and a continuing sense of duty that motivates Dr Fidge to pressure the joint ADF High Command for change for the good of the common soldier, he says.

“It’s not about me,” he says. “I have a pretty perfect life; a busy country practice, great friends.

I’ve got nothing to lose. I am doing this because of the effects on the soldiers who are receiving substandard care from contractors.

“We rely on contract medical teams because Australian medical officers are intimidated and harassed looking after their own troops and quit.”

Dr Fidge says he has numerous examples of this “toxic culture” compiled from current and past serving ADF medical officers, which he says mocks their years of training, experience and expertise. He cites incidents of sergeants over-riding decisions of medical officers over whether or not a sick soldier was fit for duty.

Dr Fidge’s allegations have been broadly dismissed by the Defence Department.

A spokesperson told MO there is “no evidence to suggest that there is a morale problem among ADF medical officers or that there are widespread concerns that medical officers are treated poorly”.

While admitting medical staff shortages, the department denies the issue is hindering the ADF’s ability to provide health support to current operations where they are using contractors instead.

Interestingly though, Dr Fidge’s recent complaints have coincided with several recent changes by the ADF, including the introduction of a new salary and career structure that recognises healthcare professionals’ specialist and post-graduate qualifications.

The Federal Government has also approved new programs to better the flexibility of medical officers’ career paths.

But Dr Fidge says these steps are still woefully inadequate and the ADF is just skirting around the real issue of transforming the culture and attitudes in the armed forces towards medical officers.

“I am going to continue pursuing the issues of healthcare to ADF personnel until I get what I want,” he says. “I’m strongly supported by my medical officer colleagues.”

ADF Provides Sub-Standard Medical Care to Deployed Troops

A copy of a letter I wrote on the 22nd of June 2007 for a soldier who lost his career, after questionable treatment by ASPEN Medical Services in East Timor.

______________________________________________________

To Whom It May Concern:

Re: Medical care by ASPEN Medical Services in East Timor late 2006.

I was the uniformed ADF Medical Officer on Operation Astute in Timor Leste from early October 2006 until mid February 2007. I was in charge of the helicopter aeromedical evacuation team, and my role was limited to the stabilisation and retrieval of sick and injured ADF personnel.

Nevertheless, when medics or soldiers were unhappy with the medical care provided by ASPEN Medical Services I was often approached to help resolve the issue. In the case of PTE X, the medic providing emergency care, CPL Robert Buttery, contacted me after the third or fourth episode of care by ASPEN Medical Services had failed to have any effect and PTE X's otitis externa continued to deteriorate.

I asked for PTE X to be sent back to Dili, where I took a brief history. I had some history from CPL Buttery already. Specifically, I was able to confirm from PTE X that despite diagnosing otitis externa, ASPEN Medical Services had failed to perform any ear toilet (cleaning) and had merely prescribed antibiotics and returned him to the field.

This unusual management of a common condition was always destined to fail, and indeed PTE X represented to ASPEN Medical Services. Again, his treatment was deficient and could never have been successful. He was again given antibiotics and returned to the field without having the affected ear cleaned.

I understand this happened a third time, with PTE X's condition worsening again in the interim. When he still failed to improve and reported to CPL Buttery, CPL Buttery contacted me and I asked for PTE X to be returned to Dili so I could advocate for him directly.

This did not turn out to be necessary, as ASPEN Medical Services finally realised they were unable to manage this common condition and made arrangements to return PTE X to Australia for management by an Ear, Nose and Throat specialist. However, by then it was too late and the repeated mismanagement and neglect of Jamie’s ear infection by ASPEN Medical Services had taken his hearing and vocation permanently.

There is no doubt in my mind that ASPEN Medical Services are responsible for Jamie’s hearing loss. Otitis externa is a common condition with a well established management regime which always responds well to appropriate management. Jamie’s ear infection should have both been better managed and referred earlier to an appropriate specialist.

This was one of several cases of mismanagement by ASPEN Medical Services that I personally witnessed in East Timor. I kept a record of these complaints as required of me and passed them to the Joint Operations Health Services Coordinator, Group Captain Amanda Dines. I did not receive feedback about the complaints I made or passed up my health chain of command.

I would be very comfortable testifying to the above. I also feel that any ENT specialist would point out that ear toileting (cleaning) is critical in the management of otitis externa, and that appropriate referral would have saved PTE X's hearing and career. This is a completely preventable tragedy caused by the neglect and mismanagement of PTE X’s ear infection by the doctors involved in his care.

Please contact me if I can be of any help.

Yours truly,

Dr Julian Fidge MBBS, BPharm, Grad Dip App Sc (Comp Sc)

_____________________________________________________

Instead of feedback and further inquiry about the medical care provided by ASPEN Medical Services from Joint Health Services, I was interviewed by the Battle Group Commander, Lieutenant Colonel Scott Goddard.

As an aside, I went to school with Scott, as I had done with the Joint Task Force Commander, Brigadier Mal Rerdon. Mal and Scott went straight to Duntroon. I thought I would learn a little more about the army before becoming an officer, despite being selected for officer training around the same time as them, and enlisted as a private soldier.

Scott instructed me that health complaints were to come to him. I don't know how Scott would decide what was poor service and what wasn't, as he had no medical training. And his orders were not in keeping with the health care directives of the army, so I don't know what he thought he was going to achieve.

In any event, I never heard anything back from Group Captain Dines or the Joint Health Services. I was forced to conclude the senior leadership of the ADF did not care about the medical services provided to the soldiers.

Could the ADF be any ruder?

I came across a copy of this letter from 2006. It is addressed to the Adjutant of 4 Combat Service Support Battalion, and shows just how stupidly the ADF treats Medical Officers. In his letter, this reasonably senior doctor, who is a critical individual assett to the ADF from the moment he accepts a commission, is asking why he is appointed at the same level as a doctor who has just finished his or her internship.

Another point arising from this letter is that the doctor writing it isn't too fussed, and his behaviour supports the view that health care professionals don't have unrealistic expectations about their treatment in the ADF.

But the letter does show how poorly the senior medical leadership functions - doctors like Major General Paul Alexander, for example, who has just been awarded an AO for his outstanding efforts in ADF health.
______________________________________________________

Dear Tim,

Can you please help or advise me how to progress the question of my rank.  My last payslip indicates I am a level 1 Captain.  All doctors join the Army as a Captain is what I was told when I was commissioned so I must've joined as a Level 1.

But I'm wondering how this is determined.  I have 16 years of experience since graduation and I got my specialist qualifications as an Emergency Physician in 1999.  Perhaps this wasn't appreciated when I joined up in 2004.  I did show them the documentation and I can do so again if I need to.  I certainly haven't given it any thought until a few recent comments made by others.  But it does seem odd to me that a doctor with 16 years of experience (nearly 7 of them as a specialist) would join the Army at exactly the same level as a newly graduated doctor fresh out of his first year as an intern.

The same sorts of issues will apply to Julian Fidge I reckon.

I think you mentioned having contacts in APA who would know about this and we started discussing this question with you on the weekend at which time you invited me to email you.  Are you able to enquire for me or at least point me in the right direction?

I can give you a little more information if its helpful - I graduated Monash Uni 1990, got my specialist qualifications with the Australasian College for Emergency Physicians in 1999.  I work in the Austin Hospital Emergency Department as one of their staff specialists (the Austin is a large tertiary teaching hospital in Melbourne).  I am MIMMS trained (Major Incident Medical Management and Support course) and have also done the MIMMS instructors course.  My interest area is disaster medicine and planning (including NBC events) and I help coordinate my hospital's planning and training for mass casualty events.  I don't know how much of this makes a difference but I figure you as the Adj might be interested anyway.  I've got a wife, 3 young kids, a house, blah blah etc. (I don't think you get higher rank for having a wife and 3 young kids - but you should).

Anyway, it was good to meet you on the weekend Tim.  I appreciated the little informal meeting you held and the interest you displayed.  I'd not seen that done before from the Adj.

Kind regards,
______________________________________________________

Don't forget the standard of care for an Australian soldier is to have a doctor trained in the emergency management of severe trauma flown to them when they are injured.

At the moment, our troops get a medic, because the senior leadership of the ADF either don't care about Australian troops, or are hopelessly incompetent. Either way, they need to be sacked, today.

Brigadier Michael Arnold ignores critical state of ADF health support

Below is an edited letter I wrote to Brigadier Michael Arnold, the Commander of 4th Brigade (Victoria) in 2008. It was in response to his unprofessional and incompetent determination with regard to my Redress of Grievance. I have withheld the names of innocent parties.
The ADF continues to lie to the Australian Goverment about this matter also: On the 19th of January 2011, a spokesperson for the Minister for Defence Science and Personnel and Veterans Affairs, The Hon. Warren Snowdon MP, said:

"Dr Fidge received a commitment from the Commander to continue to investigate the claims following the receipt of the additional information. Dr Fidge has not yet provided the additional information as requested."

Which is as good a way as any of avoiding the issue. I have, of course, provided all the necessary information and have done so since 2008. So I really don't have any options other than to publish the correspondence and let you judge for yourself if the ADF should be investigating.
__________________________________________________

Brigadier Michael Arnold
COMD 4 BDE

By facsimile

Thursday December 18th 2008

Dear Sir,

About a month ago you wrote to me with your decision about my grievances.

I am disappointed with your decision for several reasons, and do not accept it.

1. The ADF is unable to mount medical support for operations because of a lack of medical and nursing officers, even in such close proximity as the Solomon Islands and East Timor. The cost to the ADF of contracting medical support to ASPEN is at least ten times what it would cost to employ uniformed medical and nursing staff. Wounded soldiers have medics attending them instead of doctors, and the ADF is not able to satisfy the requirement of having wounded soldiers to doctors or vice versa within an hour of injury.
2. The ADF has a general problem with its behaviour towards medical officers. The unnecessary and preventable death of CAPT Paul Lawton is a demonstration of the attitude of GSOs towards MOs.
3. I have described a specific set of behaviours which comprise a subset of the general problems the ADF have with SSOs.
4. You chose to ignore my complaint, even though you have an obligation and the right to investigate my complaint. Your decision to not investigate all of my complaints was incorrect. Having been made aware of discrimination, harassment and bullying within your brigade by a Medical Officer, it was not and would never be open to you to ignore a serious complaint given to you in writing.
5. Not only did you fail to investigate, you actually failed to even acknowledge my written complaint of discrimination.
6. Of the two decisions you did make, one has not been implemented. I refer to your decision that I am entitled to a PAR for 2007. Your decision was ineffectual, and I have not received a PAR for 2007.
7. The other decision, that referring me for psychological assessment was appropriate, is incorrect. I have, some 4 months after the event, had some explanation for the referral. The referral was based, in part, on a WO2 Joanne Cripps (now a captain, I believe), complaining that I told her I was an MO and had made a decision about a patient of mine. The complaint, and the referral, are absurd. There was never any question that the CO has the power to do this. As a doctor, I also have this power. It was clearly an abuse of this power to refer me for psychological assessment without good reason. LTCOL Pollock's behaviour is not acceptable in Australia. I know this because I have been very well educated about this specific power, which I also have and am required to use reasonably and only as a last resort.
8. In addition to my previous expectations, I now expect CAPT Cripps to be charged with conduct to the prejudice of the ADF, as well as LTCOL Pollock and SGT Carmichael. Her complaint is obviously untrue and mischievous and has clearly caused me a great deal of trouble.
9. I insist on being treated in a similar manner to my peers. I also insist that my SSO colleagues are treated appropriately. Your decision reinforces the common bias against SSOs, that SSOs are not really officers, and that SSOs may be treated poorly. Your decision is unacceptable because it is discriminatory and undermines SSOs, specifically in this case CAPT Scalpel, CAPT Dentist and myself.

In summary, your decision was ineffectual, incorrect and not in the best interests of the ADF and Australia. It falls far below any acceptable standard of decision that could have been taken. Your opinion is not important to me personally, or professionally outside my service as a reserve officer, and I would not pursue this if there were not more important ramifications to your decision. But the ADF requires SSOs to conduct operations and I believe your decision adversely affects the capability of the ADF to mount operations.

I note during your investigation another SSO, CAPT Dentist, from 4 CSSB Wangaratta has gone inactive. As a dentist, CAPT Dentist was a critical individual asset to the ADF.

I trust you will forward this letter along with my original complaint as required.

If at any time you wish investigate further any of the matters I have raised I remain available to help you do this.

Yours truly,

 

Dr Julian Fidge

Captain

Medical Officer

4 CSSB

Beersheba Barracks

Wangaratta

___________________________________________________________

Brigadier Arnold continued to act appallingly, charging me with insubordination for not accepting his decision and setting up a kangaroo court in which he tried to have one of his infantry commanders hear his charges against me. More on Brigadier Arnold's kangaroo court later.

It may interest the reader that the next brigadier who reviewed my Redress of Grievance was able to organise my Performance Appraisal Review for 2007. I received it in November 2010, so it was, of course, completely useless. This next brigadier, in keeping with the attitudes, behaviour and general level of incompetence displayed by General Service Officers in the ADF didn't remedy this. It was more of a "Yes, we acknowledge we completely screwed you. But we don't give a toss about SSOs, so suck it up."

Actually, no, I don't think I will suck it up. Another young soldier died in Afghanistan today. My understanding is that a medic was sent in a helicopter to help.  That's not good enough for Australian soldiers.

The ADF's usual standard of care is a Medical Officer trained in the emergency management of severe trauma goes in the helicopter that attends. This is called Rotary Wing Areomedical Evactuation, and I am a trained RWAME Medical Officer with operational experience who has flown out to injured soldiers in East Timor.

At present, because of the incompetence of the senior leadership of the ADF, we don't have doctors, nurses and dentists where we need them. Parliamentry inquiries have continually criticised the conduct of ADF officers, who consistently fail to heed their political masters. The behaviour of the senior leadership of the ADF goes beyond mere incompetence and ignoring direction to active sedition at times.

It is past time the Australian Government stopped accepting such consistently poor performance from the ADF and started sacking the service chiefs and their incompetent colleagues.

Why Specialist Service Officers resign

I was just laughing at the difference between an ADF recruitment advertisement for Specialist Service Officers and what actually happens once we're recruited. There is really no encouragement to serve, which is why I guess most of the specialists resign.

Advertisement:
Employment as an officer in the RAAMC is diversified and interesting. As well as developing the management skills required to become an effective member of the health care team, RAAMC officers must be competent in tactics, operational and administrative staff work. The Corps seeks a special class of officer, one who can temper military zeal and excellence with compassion for their fellow soldier.

The aim of the Basic Officer Skills Module is to provide SSOs with the essential command, leadership and management skills required of an officer...  Trainees are instructed in command, leadership and management theory, service discipline law, communications, the Defence organisation, personnel administration, risk management, customs and traditions, and basic operations.

Reality:

When we arrived at the Royal Military College, Duntroon, we were continually reminded that we were "not core business" at the College. Senior trauma surgeons were made to sit through 20 hours of first aid training. I am not joking. This is how dysfunctional the senior leadership of the ADF has become.

Reality (from my "Agreed goals") 2008 given to me by my Officer Commanding:

• Provide medical advice
• Provide clinical training
• Maintain fitness and weapons competency

I may as well have stayed at my practice and seen a few more patients. So much for leadership, management and the challenges for which I actually accepted a commission.

But still, 2008 was better than 2010. In my 2010 "Agreed goals" my new Officer Commanding,  Major Kaylene Baird,  wanted me to:

• Conform with ASODs

ASODs is the Army Standing Orders for Dress. My OC thinks a suitable goal for an officer who has ten years experience in the Australian Army, operational experience and three degrees from three of the best universities in Australia is to dress myself properly.

That's not a joke. Her goal for me was to dress myself properly, something I have been doing for ten years. This is how disrespectfully we are treated by senior officers in the ADF.

History has made a different assessment of Medical Officers than this stupid, rude officer and her like-minded colleagues. The Victoria Cross has been won twice by only three people in history. Despite the fact that Medical Officers don't usually go anywhere near the fighting, two of the three double VC winners are Medical Officers. We are smart and brave, keen to serve, and this is how we are treated.

No wonder the specialists resign.

Skill shortage threatens defence - December 2010

Defence acknowledges their skills shortage is a national security problem. You'd think a senior ADF officer would be interested in my help with the Medical Officers, but they don't seem to think a national security problem warrants their attention: 

• Sean Parnell
• From: The Australian
• December 06, 2010 12:00AM

THE Australian Defence Force is maintaining its high operational tempo despite having so few personnel available in some key roles that at times there is a risk of "mission failure".
The global economic downturn has helped stabilise staffing -- so successfully that the ADF has a larger head count than its budget allows -- but there remain 20 "critical or perilous employment categories" across the services. Internal Defence briefings obtained by The Australian under freedom of information laws show this figure is down from 32 categories late last year, but still high enough to warrant attention.
The navy, according to a May briefing note, has 17 critical categories, the army has two critical categories, and the air force one.
Critical employment categories "severely limit the range of strategic and operational options available" and are elevated to a perilous rating if the shortages mean "the possibility of mission failure at the strategic or operational level has been raised".
A year ago, the navy had 20 critical categories -- of which three were perilous -- while the army had 11 critical categories and the air force one.
Defence is refusing to detail the personnel most in demand -- those under the most pressure due to the operational tempo -- saying it would threaten national security and defence preparedness.
Defence has been unable to clarify whether it still has employment categories deemed perilous, but shortages in the navy have restricted efforts in the past, and some air force specialists are known to be feeling the strain of repeated Afghanistan missions.
Defence no longer fears the mining boom will lure away personnel, however.
It has been running an Economic Resurgency Project, looking at the previous mining boom to predict any impact on recruitment and retention. A departmental spokesperson confirmed the boom was "not likely to have a significant impact on overall defence workforce outcomes".
Resources sector recruitment is forecast to peak this financial year, with growth slowing over the next five years.
ADF recruitment and retention outcomes remain strong, suggesting the pull from the resources sector has been limited.
"The ADF trains its workforce, with very few lateral entrants.
"Given many of the workforce pressures in the resources sector relate to skilled personnel, potential future impacts would most likely be" in retention of ADF specialist staff, and relatively less in recruitment.
A May briefing note for the Chiefs of Service Committee noted the improvement in critical categories but urged "caution in claiming victory". "It is likely that some of the pressures that resulted in these categories being critical still remain."


Link to article above

Retention of [ADF medical] staff is still a problem - from 2008

Journal of the Australian Defence Health Service,  Vol 9 June 2008

The Defence Health Services Directorate contains many historical artefacts, but none

more interesting than the series of portraits of the leaders of our health delivery teams

from their beginnings: Directors-General of individual Services, Heads (however

styled) of the combined Services Directorates, and Surgeons-General (Regular and

Reserve). A striking feature of these portraits is that the great majority of officers

depicted wear decorations or campaign ribbons attesting to their operational service.

Major General Sir Neville Howse’s Boer War Victoria Cross is the earliest, and Air

Vice Marshal Tony Austin’s Australian Active Service Medal (East Timor) the most

recent. Between them, those portrayed wear ribbons earned in World War I, World

War II, Korea, the Malayan Emergency/Indonesian Confrontation, Vietnam, Somalia,

Rwanda, both Gulf Wars, Timor L’Este, Bougainville and the Solomons. From

earliest days, our leaders have undertaken frontline service; indeed, this experience

undoubtedly has better fitted them for their eventual leadership roles.

Equally, the ranks of our future health services leaders are filled by medical,

nursing, environmental health and enlisted staff who have undertaken operational or

humanitarian deployments, often repeatedly and in numerous theatres. Our Reservists

are no less well represented, with several having undertaken 10 or more periods of

continuous full-time service in deployed health care facilities overseas. Defence

health staff have not been so operationally engaged since Australia’s withdrawal from

Vietnam more than 35 years ago. Currently serving or recently resigned health service

members have as much operational service as any group in the Australian Defence

Forces. Their pride in service and sense of mission accomplishment are palpable, and

reflected in the reorganisation of units and War Establishment postings of Reservists.

But all is not well, as the rate of resignations from the Permanent Forces remains

unacceptably high, particularly for medical staff. Recruitment rates remain

satisfactory, but where are our O4 and O5 officers, those who have completed one or

two overseas deployments and gained hard-won experience and expertise? Despite

Defence’s attempts to provide better and more satisfying career structures for

professional health staff, together with improved pay and conditions, it struggles to

retain experienced health staff — those ideally qualified to lead and mentor at unit

levels — beyond completion of their periods of return-of-service obligations.

Defence is simply unable to offer competitive packages in the market for professionals’ skills:

witness recent resignations by several experienced, well reported and potential starlevel

officers who immediately returned to work for Defence, as civilians, for better

pay and with security of tenure in desired locations. In these cases, at least Defence

has retained the expertise and experience of these former officers, but at what cost in

preparedness?

Thirty-four years ago, I responded to a survey designed to determine the factors that

led Defence medical staff to resign or continue serving, and 23 years ago I coauthored

a similar single-Service study of the same topic. Both resulting reports failed

to effect much change in Defence Health Services’ culture or the demographic of the

staff who serve there, mostly all too briefly. That is, the drivers of health staff

behaviour have not changed, nor has the problem of achieving optimal levels of

retention.

But other relevant factors have changed, and Defence may profitably exploit them.

In particular, these include increasing feminisation of the health workforce (especially

the medical component); greater interest in work–life balance throughout society,

including among Defence health care providers; Higher Education Contribution

Scheme debts incurred for university study; the rise of postgraduate medical degrees;

the often overwhelming civilian demand for services; and the

accelerating exit of Baby Boomer generation professionals from

full-time work, an attractive potential recruiting pool for lateral

recruitment endeavours.

While Defence cannot now survive without its civilian health

staff, “uniforms” are still preferable.

Group Captain Peter Wilkins

Editor, ADF Health

Outraged minister spills the beans on reality of Defence tactics

Nice to know I am not the only one being ignored:

• Ian McPhedran
• From: The Daily Telegraph           Link to article reproduced below
• February 18, 2011 12:00AM

STEPHEN Smith is the latest in a long line of Defence ministers who, despite warnings, have been shocked to find that vital information from military brass or senior officials is flawed or untrue.

Like earlier occupants of one of the Government's toughest jobs, Smith has vowed to clean up behaviour and implement a process of responsibility in the unwieldy 100,000-strong organisation. Apart from institutional resistance, Smith's biggest problem will be time.

Given the current volatile politics and Labor's parlous polling, he is unlikely to have the chance to effect change in what is at best a lumbering bureaucracy and at worst a closed shop.

Unlike his predecessors, Smith took the step this week of actually publishing some of the flawed advice and lies that he had been fed about the state of the navy's heavy lift ship HMAS Tobruk.

With both the amphibious lift ships HMAS Manoora and Kanimbla unable to put to sea, the Tobruk, a 40-year-old workhorse, was the last option available to the Government as Cyclone Yasi bore down on North Queensland.

In the event, the ship was not required to assist with the disaster, but that is hardly the point. Had she been required, she would have been unable to put to sea.

Smith had been told on January 28 that Tobruk was being maintained at 48 hours notice to move. On February 4 the navy assured him the ship had left its dock and was being prepared to return to 48 hours notice for sea.

By the time he delivered his stinging rebuke at the Australian Defence Magazine Congress in Canberra on February 15, this had still not occurred and Smith had clearly had enough.

Smith also released advice about the amphibious ships that he had been handed on February 9 by Defence Chief Angus Houston and Secretary Ian Watt.

It is an appalling document that not only sheets home the blame to the original 1994 decision to buy the rust-riddled vessels at a bargain price from the US Navy, but also reveals that they were purchased without logistics support packages. This is a recipe for the problems that have beset the ships - and their eventual demise.

"Efforts to remediate this shortcoming have, over the years, never properly succeeded through lack of resources or pressure to keep the ships running to meet emerging operational requirements," the advice says.
Unfortunately for Defence and the navy, no one bothered to tell their political masters until it was all too late.
This is typical of Defence culture, where many aspects of its business are run on the basis of "get it done until it can't be done and then we will think of something to tell the Government".

In the past ministers have been stunned by this approach, but have kept their frustrations under wraps. Stephen Smith is clearly not that way inclined and wants Australian taxpayers to have a clear understanding of where the blame really lies.

His next challenge will be doing something about it.
___________________________________________________

Indeed...  Perhaps the Minister should just sack every second general and hope some better officers are promoted. Surely it is not acceptable for the senior leadership of the ADF to make a practice of misleading the Australian Government?

Comments from others about ADF health support

Here are some links to some comments from other Medical Officers about the poor state of ADF health support:


MJAinsight article and comments 17 January 2011

Medical Observer article and comments 12 Nov 2010

Senator Evans just doesn't get it

Senator Evans must be really struggling with his duties to not be aware there is a critical problem in the ADF:


Senate Hansard - Defence misleads the Australian Government


In the final analysis, the ADF is unable to provide health support to any of our deployed forces, or even many of our garrisoned forces. It's not a matter of a "few vacancies".

An example of the nonsense Medical Officers have to put up with in the ADF

This is a slightly edited copy of a letter I sent to our Regimental Sergeant Major, the senior non-commissioned officer in our battalion. The RSM is responsible for discipline in the battalion. I also sent a copy of the letter to Captain Steve Lillis, the captain in charge at Wangaratta.

The letter was never answered, and the behaviours described in my letter continued and worsened in the battalion. A Dental Officer resigned shortly after these events, and my Commanding Officer, Lieutenant Colonel Michael Pollock, replaced Captain Lillis with a sergeant. Placing a sergeant in charge of the remaining three captains (two doctors and a dentist) was deeply insulting, and continues to this day.

And the ADF wonders why they don't have enough doctors, dentists and nurses!

The background to this letter is that a new recruit to 4th Combat Service Support Battalion had just had his twin babies die at birth, so he and his wife were very upset and he wasn't parading regularly. Our sergeant decided to discharge this very valuable soldier, and the soldier came to me as a Medical Officer to explain his wish to continue to serve and the reasons he had not been parading.

His explanation was compelling, and his discharge was not in any one's interest. I ordered the sergeant to leave the matter with me while I made enquiries as to how to manage the situation. Sergeant Carmichael ignored my orders and behaved in a very underhand manner.

____________________________________________________

RSM

4 CSSB

Maygar Barracks

By email

~10^th May 2007

RSM,

I had a 15 minute conversation with SGT Carmichael last night. CAPT Scalpel was present.

During our conversation, SGT Carmichael acknowledged that I had directed him to stop speaking with PTE Valuable about proceeding with his discharge. SGT Carmichael then admitted that he had failed to comply with my direction to abandon his conversation with PTE Valuable about discharge by waiting until I had left, and then resuming this conversation.

The reason SGT Carmichael gave for this was that both he and the Chief Clerk outrank me in matters of administration. The CC (Chief Clerk, a warrant officer several ranks below me) had asked him to give PTE Valuable his discharge papers, and my orders to the contrary were of no importance.

Clearly this is unacceptable, and I pressed him on this. His elucidation was that in matters of medicine he is happy to defer to me, but in all other matters he is not required to respect my rank.

SGT Carmichael then admitted he asked LCPL Z to enter my office and remove PTE Valuable’s discharge papers from my desk. He agreed he did not ask me if he could do this, and did not tell me he had done so despite ample opportunity the following week. LCPL Z did so, believing I had asked Sgt Carmichael to do so.

I explained to SGT Carmichael that we do not behave like this and that he was not under any circumstances to repeat this behaviour. I explained clearly to SGT Carmichael that when in the future he has concerns he is to raise those concerns with the officer concerned. I reassured SGT Carmichael that I respect and value his experience, and that I expect to be taught many things by him. But I explained to SGT Carmichael that he is not to undermine myself or any other officer by ignoring direction, and that his job as a sergeant is to advise myself and the other officers but respect our decisions and orders. His response was that he was carrying out the orders of the CC.

We then discussed the Chain of Command and I explained to SGT Carmichael that I am responsible to my Officer Commanding for the Health Company soldiers in the Northern Detachments. SGT Carmichael seemed disinterested in the COC, and I found his replies unsatisfactory. I reinforced the importance of the COC, honest behaviour and good communication by telling him that I considered these to be disciplinary matters.

SGT Carmichael then replied that he thought they were, also, and that he would be reporting to yourself and the CO about them. He seems to be confused about the COC, despite my clear directions. Moreover he seemed unwilling to accept my direction that matters of importance regarding Health Company soldiers in the Northern Detachments are to come through me. He did not accept that this serious matter was to be dealt with by myself or one of the other Health Company Officers.

At times during the conversation SGT Carmichael complained about my speaking bluntly to him in the presence of others. I acknowledged I am blunt. I asked him to help me with this in an appropriate manner.

We then had a long discussion about why my handling of the situation was a more correct way to proceed. CAPT Scalpel also tried to convince SGT Carmichael that this was a medical matter, and that the correct course of action was to gather information and involve our Officer Commanding. SGT Carmichael did not seem to be convinced, despite having two captains telling him this was so.

At the end of the conversation I was left with the impression that SGT Carmichael does not have much respect for the COC, specifically the Health Company COC. Alternatively, it may be that SGT Carmichael does not have much respect for SSOs.

Neither of these is acceptable, and I do not think that SGT Carmichael is suited to service in a CSSB. I am sure he functions reasonably in a regular or combat unit with General Service Officers whom he perceives as more competent than Specialist Service Officers. SGT Carmichael will need to adjust his behaviour considerably to work successfully in a CSSB. We need experienced sergeants, especially in Beersheba Barracks, but they must understand their job better than this and be able to function in this difficult position in the COC.

It is also critical that they communicate effectively with the officers they work with.

I foresaw that SGT Carmichael might complain about my handling of PTE Valuable, and so I asked CAPT Scalpel to speak with PTE Valuable last night in order to confirm the degree of correctness of my assessment of the situation and my actions following my assessment. You can be assured that my handling of PTE Valuable was conservative and correct. Please feel free to speak with CAPT Scalpel about any of the above. PTE Valuable now has a PM101 exempting him from parading and PT from September last year until April this year. He has a further PM101 which exempts him from PT and Fitness Assessments for three months. I presume any requirement to comply with a fitness assessment is overruled by my exemptions, which I have granted in discussion with the Senior Medical Officer of 4^th Brigade, LTCOL Jackson Harding.

I do not wish to make this a discipline matter at present. I assume that SGT Carmichael may have some preconceived notions which we need to dispel, and I would like to handle this through education and guidance.

Please speak firmly with SGT Carmichael and ensure he understands and will conform with the following:

1. Where there is a COC it is to be respected, informed and consulted for everything except trivial matters. For example, this matter of discharging a Health Company soldier from Wangaratta must come through myself or in my absence one of the other Health Company officers;

2. Regardless of an individual’s background, the rank structure is to respected and is to be seen to be respected;

3. I, and the other officers, outrank SGT Carmichael in all matters, not just health. Choosing when to comply and when not to is in particular is potentially a very dangerous practice which I will not further tolerate;

4. I, and the other officers, will decide when and how we will defer to his indubitable experience and advice, and that he is not to make these decisions for us; and

5. His work, experience and advice are highly valued, all the more so because we have very little effective SNCO input in the Northern Detachments.

I am certain both my OC and the CO will support these points, but please feel free to raise this matter with them and show them this letter if you wish.

I would like your advice on the matter and to hear or read your opinion after you have spoken with SGT Carmichael.

Please write to me if I can clarify or expand on any of the above.

Thank you,

Julian Fidge

Captain

Medical Officer

____________________________________________________

I was wrong, of course. The Commanding Officer, Lieutenant Colonel Michael Pollock, did not support these points and treated the Specialist Service Officers with disdain. He continued to undermine them, treating them like halfwits. An experienced Dental Officer resigned shortly afterwards.

PTE Valuable and his wife had another baby who is well and they are much happier. He continues to be a very good soldier who brings considerable skills to the Army.