Very subtle ways, yes.
Evidence of meeting #73 for National Defence in the 41st Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was military.
A recording is available from Parliament.
Evidence of meeting #73 for National Defence in the 41st Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was military.
A recording is available from Parliament.
4:05 p.m.
Liberal
John McKay Liberal Scarborough—Guildwood, ON
You said that Canada is doing better with its stigma than anybody else is, and yet in your personal case, I guess because of your rank, the stigmatization was quite subtle in its own way.
4:05 p.m.
Liberal
John McKay Liberal Scarborough—Guildwood, ON
I guess it's an unfair question to ask, but I'll ask it anyway. Do you think the military treatment of your kind of diagnosis is different from what it would be outside the military?
4:05 p.m.
As an Individual
I will say that I believe it's better in the military than it would be outside the military, and that's a good thing, because we have an institutional obligation and a moral obligation to develop expertise at that level. That is why, when I was advocating for more clinics and more treatment programs, for in-patient programs, some people were saying, “Well, you don't understand, Grenier, what we need to do is just refer them to the civilian health care system.” I thought that no, that's abdication, that we need to create that expertise.
On cancer, as an example, I can completely understand that the military surgeon general should probably not develop a robust capacity to deal with cancer, because there are outstanding civilian capacities across Canada. However, for this form of injury, which is literally caused by service, if we don't develop that expertise, then who will?
Therefore, I think we're there. I don't know, but I'm pretty sure that our military psychiatry is up there, and that's a good thing.
4:10 p.m.
Liberal
John McKay Liberal Scarborough—Guildwood, ON
Yes. Actually, that leads me to a question. I didn't understand your comment. You said we should call in people who have left military practice for the military, and I didn't quite understand—
4:10 p.m.
Liberal
John McKay Liberal Scarborough—Guildwood, ON
Left medical practice for the military? Do you mean that they leave their practice behind and go into the military? Is that what you're saying?
4:10 p.m.
As an Individual
No. I'll rephrase that. Civilian doctors will get hired across Canada into medical clinics to augment the uniformed presence there. In psychiatry, you'll have psychiatrists who work in a military clinic and see military patients. They maintain an affiliation with the large hospital in their city or a clinical practice in their civilian life, and they develop an expertise and work within our medical system.
The people I was referring to and who would be interesting to invite to this committee are those who chose to leave. There are many who chose to leave because they were having a hard time, perhaps, in dealing with the fact that they were being paid more to see fewer patients, and they felt it was wrong, that it was simply wrong.
4:10 p.m.
Liberal
John McKay Liberal Scarborough—Guildwood, ON
They were being paid more in the military to see fewer patients—
4:10 p.m.
Liberal
4:10 p.m.
As an Individual
That's correct, so quoting the inefficiencies, perhaps, of the military system, and how it is developed and built, and how efficient it could perhaps be.... Now, I'm not saying that we should encourage the surgeon general to create a factory of treating soldiers, but when psychiatrists have openly shared with me the notion that they just couldn't put their hand on their heart and feel good about making all that money to see three patients in a day and to spend half the day twiddling their thumbs when the lineup, the waiting list, was six months long....
4:10 p.m.
Liberal
John McKay Liberal Scarborough—Guildwood, ON
Okay.
Now, I will turn to another thing you said that I thought was interesting. Actually, there were a number of interesting things, but I only have seven minutes and I'm down to about five, or two, or whatever I'm down to now.
You didn't seem to be happy with the process of your being released. You're a lieutenant-colonel. You're well known, and you have good contacts. Whatever shortfalls there are, you can probably succeed in rearranging, so that the treatment isn't as onerous as it would be for an enlisted corporal. Could you expand on that thought? That's a pretty serious issue.
4:10 p.m.
As an Individual
The only motivation that I've always had in doing what I managed to do in the last 12 years of my career was the motivation to think that if it's bad for me, imagine what it's like for the privates and corporals. That was my motivation for everything I ever tried to do or achieve, and yet again, when I was released 13 years after starting to work on all these systemic problems, the very issues that were present 12 years ago, such as the lack of transition services between DND advising Veterans Affairs that Grenier is taking these pills and please make sure that the coverage is right and I went to the pharmacy and all of a sudden I had to pay out of my pocket. That is not the issue. I had the $180 to get my pills, and I didn't go without. But what if you are somebody with a low income who doesn't have a job and who has to find $180? What happens to these soldiers or veterans? Well, they go without, and when you stop medication, that's not a good thing.
An issue that existed 12 years ago, which I along with so many others thought was over, unbeknownst to me, it happened to me. Again, the question is, if it happened to Grenier, it must be happening to someone else.
4:10 p.m.
Conservative
The Chair Conservative James Bezan
Mr. McKay, your time has expired.
Mr. Strahl, we're going to the five-minute round with you. The committee needs to keep the comments as concise as possible in the five-minute rounds so people have a chance to get in their questions.
4:10 p.m.
Conservative
Mark Strahl Conservative Chilliwack—Fraser Canyon, BC
Thank you, Mr. Chair, and thank you, Colonel Grenier, for your passion for an issue that obviously we continue to have some issues with.
Maybe we'll get to finish up with Mr. McKay's questions. To use a football analogy, it sounds as if the hand-off was fumbled between DND and Veterans Affairs. Maybe you can describe to me how the system is supposed to work. You said transitional services, so is there an organization or individuals who are theoretically supposed to do this? Where was the failure in the system? Was it in the process, or was it a matter of falling through the cracks?
As a committee that's hopefully going to make some recommendations, I'm trying to figure out what needs to change so people like you and people in much lower ranks than yours don't experience this problem.
4:15 p.m.
As an Individual
I've been known not to invent stuff when I don't know. I'm not sure. But what the committee should be aware of, and this is an issue for the committee to look into because my information may be outdated, is that National Defence and Veterans Affairs Canada may still have two inventories of approved medication for psychiatric conditions. Part of what probably happened to me is that DND and Veterans Affairs still haven't agreed as to if this medication is covered at DND and Veterans Affairs. I believe it was approved at DND and it wasn't approved at Veterans Affairs. One has to ask, why is that? If it's good for Grenier when he's in uniform, why is it all of a sudden bad for Grenier?
In the world of psychiatry, that is probably a very small example of the dissonance in the whole mental health system, not only in the military and Veterans Affairs, but across Canada. If this were a committee that looked at mental health in general, you would discover this throughout. Not that DND doesn't need to get its act together, but the entire process is very systemic.
4:15 p.m.
Conservative
4:15 p.m.
Conservative
Mark Strahl Conservative Chilliwack—Fraser Canyon, BC
—yes, need to talk, or if they had some seamless transition, it would be those two.
You also talked about remustering problems, recognizing of course that the military needs everyone to deploy, that a certain standard has to be met. Using the example of someone in the infantry who can no longer be around explosives, how could you see them being remustered in a way that would still allow them to meet that basic requirement? They meet the physical standards and meet all the other standards that we require of people who are in the military, but they couldn't deploy into active combat. Can you explain what you were talking about?
4:15 p.m.
As an Individual
I'm not sure if the committee is familiar with employment limitations. When medical practitioners provide the leadership and the decision-makers for people's careers with information to help guide that decision-making process, no diagnosis is necessarily shared. No medical information is shared, but employment limitations are shared with the chain of command. The employment limitations normally are very clear, non-medical articulation of what the individual can and cannot do in the military. Of course, medical doctors write these things, and of course these doctors are people who are familiar with the medical company, the organization.
One case comes to mind. Several years ago we were reviewing the file of an armoured master corporal in Petawawa. The head of casualty support management and I are with the unit that releases military members, that has the authority to say, “We need to release the person, or do we have the authority to retain him? Yes, we do, but we're not sure what to do with the person.” The employment limitation in this master corporal's file was, as I recall, word for word, “can no longer serve in the armour core”. That was it. That was the employment limitation written in black and white by a medical doctor who is in uniform. To me, it clearly opens up the potential for suitability testing for another trade. Despite these very clear limitations, the occupational transfer was denied and the person was kicked out of the military.
For a case that is as clear as that, and they are not all like that, mind you, but when they are clear, these are the soldiers who should be given an opportunity.
4:15 p.m.
Conservative
The Chair Conservative James Bezan
You were right on the money at five minutes.
Mr. Larose, go ahead.
4:20 p.m.
NDP
Jean-François Larose NDP Repentigny, QC
Thank you, Mr. Chair.
I want to thank our witness for joining us today.
Mr. Grenier, I applaud you for all the energy you have invested in this matter. What you had to say has been very insightful. I could actually ask you 40 questions, but we will stay within the 5-minute period allotted to me.
When I was in the reserve, some of my instructors had been to Bosnia. They were amazing instructors. Those sergeants were living with physical and mental injuries. I realized that during training. I saw some of them cry. I understood that this was a culture—and I see that the situation has not changed much—where everything was hidden. People would not talk about their difficulties and had to hold on to that pain. Not much was offered in terms of support. So some progress has been made, and that's a good thing.
A couple of minutes ago, you talked about incentives. I thought that was interesting. Can talking about your need for support be a problem? You talked about two issues. First, the physical aspect and the mental aspect are kept separate. Second, if someone reports their injuries and undergoes an assessment, they are likely to lose their job. Have I understood that correctly?
We have only five minutes, and I know that my other question could require more answers. What could be done to improve things in the area of incentives, given this specific culture?