National Defence Committee on May 12th, 2023

[Bryan May, Liberal, Cambridge, ON]

Do you have a sense of the timeline for that report?

[Gregory Lick]

The minister will probably receive it within a couple of weeks.

[Bryan May, Liberal, Cambridge, ON]

Colonel Jardine, I want to shift gears a bit. We often hear that the CAF has predominantly been a male institution—this is historic—and, as a result, the services and supports around health and well-being have been designed around men. This would apply, of course, to veteran supports as well.

To you, Colonel, what are some of the gaps that emerge out of this for women and gender-diverse members and veterans?

[Col (Ret'd) Nishika Jardine]

We did a study, a literature review—last year, I believe it was—in which we found a number of significant differences between how service affects men and how service affects women. There are a number of gaps and impacts. If we have time, I would invite my colleague Mr. Schippers to give you a taste of some of that.

We know that service impacts women differently in many ways. As for Veterans Affairs as well, you're quite right; the support, benefits and services were designed with men in mind. It was the default, the norm.

What we know today is that the table of disabilities is being reviewed through a gender-based analysis lens. We look forward to seeing what those changes are going to be. We haven't seen them yet.

We did a report on sexual dysfunction. For example, one of the questions on the medical questionnaire for men given by VAC when they go to see the doctor with this questionnaire is around erectile dysfunction or sexual dysfunction, but on the women's questionnaire, there is no such question, yet we know that women also experience sexual dysfunction. There are those kinds of gaps.

I'll leave it to you. If you would like to hear more about specific examples, I'll let you make the decision to hear from Mr. Schippers.

[Bryan May, Liberal, Cambridge, ON]

He has about 30 seconds.

Go ahead, Mr. Schippers.

[Duane Schippers, Deputy Veterans Ombud, Office of the Veterans Ombudsman]

Women are two to three times more likely to medically release than men veterans, 45% due to mental health and 43% due to musculoskeletal issues. Compared to women in the Canadian general population, they're more likely to have PTSD. They are at an 80% to 90% higher risk of suicide than men. Men veterans have a 40% higher risk of suicide than men in the Canadian general population. Women who release as non-commissioned members, the non-officer category, are three times more likely to die by suicide than women who release as officers.

There are some serious income issues, as well.

[The Chair, Liberal, John McKay]

Unfortunately, we'll have to leave the answer there. Mr. May didn't leave you with a lot of time. It's blindingly obvious to people who can count.

Ms. Normandin, you have the floor for six minutes.

[Christine Normandin, Bloc, Saint-Jean, QC]

Thank you very much.

I thank both witnesses.

I would like to start with you, Mr. Lick. According to one of your recommendations, you said that a member of the Forces should never be medically released without all required resources in place. The government accepted that recommendation. Although it claimed to have implemented it, based on the calls you received, you saw that this was not the case.

My question has two parts. Here's the first:

Do you find it problematic that, in a certain sense, the government is correcting the homework we give it? Do you think someone else outside government should see if the recommendation was actually implemented?

[Gregory Lick]

I will answer in English, because of the technical nature of the question.

Yes, our recommendation still stands. It was accepted by the government. All benefits and services should be in place before they are medically released.

They are not there yet. Part of the issue, as we talked about earlier, is the fact that in some cases the service attribution is not being done in an efficient manner. We talked about that already. Adjudications, therefore, are slow. There is a tremendous backlog in that regard.

As I said in my opening remarks, there are many people in VAC who want to do the right thing. It's absolutely true. I actually hear it all the time. At the same time, they're stifled, or shackled, by the process issues. There are many of them. I encourage the committee to explore those more than anything.

With respect to your question around whether it should be an outside agency of some sort, I don't believe so. In that regard, in terms of service attribution and making sure that happens quickly, the best people to do it are the people who are treating you and have knowledge of your environment within CAF health services. That aspect, I think, is probably best done by the CAF, as we've already recommended.

In terms of the services and supports for everybody, VAC is well positioned to do that. I wouldn't want to hand it to another insurance agency. I don't think that's the right thing either. VAC is probably best positioned to do that. It just needs better processes to do that.

[Christine Normandin, Bloc, Saint-Jean, QC]

My question had more to do with assessing the implementation of your recommendations. When you make a recommendation and the government accepts it, but you get the impression it is not being followed, should an external party evaluate the recommendation's implementation?

[Gregory Lick]

This becomes then the issue of who is best positioned to have oversight over different departments. In this case, it's the Canadian Armed Forces and the Department of National Defence. I think we are well positioned to provide that oversight.

Are there better means of doing that? I've already talked very publicly about the need for independence in that regard. It's making sure the department responds in a timely manner to our report recommendations, which I'm not seeing right now, even though it has generally accepted them in the end.

As I come near to the end of my term, with another year left, I become more and more frustrated at not seeing action. Even all of you as committee members are facing the same thing. You've made recommendations. The department officials say, “They've been implemented, or we're in the process of implementing them.” Well, people are suffering as a result of that, and that's not right.

[Christine Normandin, Bloc, Saint-Jean, QC]

Regarding what you just said, based on the calls you received, you've seen that the recommendation wasn't really implemented. Do you have access to enough information sources to analyze whether recommendations were actually implemented?

Are there other information sources you should be able to access to better follow up on your own recommendations?

[Gregory Lick]

We have access to all the information required to follow up on our recommendations.

That's the reason we have progress reports. One of the differences I always talk about with my audiences is the difference between us and the Auditor General. The Auditor General does the same types of reports for various departments, but what happens to them after that? How does it progress?

We put all of our progress reports on our website. They're accessible to everyone. They show—according to our assessment, not the department's assessment—whether there's progress on the recommendations or not.

That is incredibly powerful. It doesn't always get the action as quickly as we would like. It's a means of getting more action. We also see a tremendous amount of benefit from doing that. It provides you as committee members, and all of the public, with heat, light and transparency on what is being done or not being done.

[Christine Normandin, Bloc, Saint-Jean, QC]

I will immediately say what my next question will be, which will be for both of you.

Has a veteran ever left the armed forces voluntarily and after their departure, it turns out they had an undiagnosed mental health problem? With a diagnosis, they could have been released for medical reasons.

That's the subject I'll raise during the next round of questions.

[The Chair, Liberal, John McKay]

Thank you, Ms. Normandin.

That's a good question. She has another two and a half minutes coming to her, so she can get an answer then.

Before I call on Ms. Blaney, Mr. Schippers, when I interrupted you on Mr. May's question, you were in the middle of some—I thought—very interesting statistics which, as far as I know, have not been made available to the committee. I wonder whether that set of statistics could be tabled with the committee after we're finished.

Is that acceptable?

[Duane Schippers]

Certainly, Mr. Chairman.

[The Chair, Liberal, John McKay]

Okay. Thank you.

Madam Blaney, welcome to the committee. We're very nice here, by the way.

[Rachel Blaney, NDP, North Island—Powell River, BC]

It's very good to be here, Chair.

I want to thank the witnesses so much for their important testimony today.

I'm going to come to Colonel Jardine first. It's very good to see you.

In 2021, your office published an investigative report entitled “Peer Support for Veterans who have Experienced Military Sexual Trauma”. You found that there is a gap in access to peer support for veterans and MST survivors. You recommended the government provide a funded peer-support program that meets the needs of veterans who have experienced MST, and publish the GBA+ for the establishment of the program.

I'm wondering if you could update the committee on the progress that has been made with regard to this recommendation.

[Col (Ret'd) Nishika Jardine]

Through the chair, thank you. It's lovely to see you again as well.

First of all, our recommendations were accepted. We understand that a program has been in development and is in the process of being implemented. I don't know exactly where they are with it, but I understand it's in implementation.

With respect to the GBA+, this is something that we ask for in almost every report we do and every recommendation we make. We have yet to see those.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Thank you for that.

I'm going to come back to Mr. Lick. It's very interesting. You talked about how service attribution being decided through legal mechanisms incentivizes rejection and leads to members falling through the cracks. That really concerns me. When we look at the system, between the CAF and VAC, we're seeing too many people falling through the cracks.

For Canada to ask people to provide service to us in that profound way and to let them fall through the cracks, I think, is a significant failure that we should all be responsible for and all take action on.

In 2016, your predecessor published a report entitled “Determining Service Attribution for Medically Releasing Members”. Its recommendations were rejected by the then minister of national defence.

I'm wondering if you can speak to why service attribution needs to be as close to the injury or illness as possible, and the principles behind this recommendation.

[Gregory Lick]

That is a recommendation we still strongly believe in, as I've already talked about. For me, it makes common sense that the people who have the best knowledge of the environment in which you're working—and, possibly in this case, getting injured, whether that's a mental injury or whether it's a physical injury—are best able to determine that the mental or physical injury that occurred was as a result of that work environment. This came from a number of people within the department too.

One issue raised as to the reason it was rejected was the ethical issue of the treating doctor doing the service attribution at the same time. That's an issue of process. That can be resolved within the organization. A person or a medical professional who has the knowledge of the work environment is best able, I think. It just makes common sense. I can't say it any other way.

In that regard, though, it in fact then allows the service attribution to be done more quickly. Giving it over, transferring files—there's a lot of documentation back and forth over to VAC—and then making an adjudication slows the process down. What we want to ensure is that the services, benefits and supports those people need are in place as soon as that injury occurs. People who are transitioning need those services and supports as quickly as possible. That service attribution piece, if we can do it more quickly, will be good for the people who are transitioning, so that they don't fall through the cracks.

I will say, though, that one thing we will do if people come to us as they're transitioning is this. When there are medical issues, we will intervene sooner. When we intervene, we get tremendous co-operation from the CAF. A lot of times, those transitions are stopped. We make sure that everything that can be done is done before they are released.

In actual fact, when we intervene on a medical issue, we get tremendous co-operation from CAF in that regard.

[Rachel Blaney, NDP, North Island—Powell River, BC]

My next question is for both of you.

I know that both of your offices have called for legislation to instate independent ombuds offices that report directly to Parliament and have expanded investigative powers.

When it comes to resolving the deeper issues in health services, transition and benefits, how could this legislation protect CAF members and veterans?

I'll start with you, Mr. Lick.

[Gregory Lick]

I've talked about this quite often, and so have my predecessor and every one of the predecessors before that. I always ask a question like, “Okay, why is it going to be greener on the other side of the fence?” In that regard, I have three main issues.

One is that I feel we can serve our constituents better in that regard. It provides more accountability for Parliament to provide oversight of a military institution. I think that's a good thing. That's what Parliament is all about—to provide oversight of, in this case, the military and all the forces.

However, the main one I see as the greatest benefit is compelling the department to respond in a timely manner and holding it accountable for the recommendations we make. That is the one area—as I've said lately and over the last number of years since I started—in which we're seeing the responses get slower and slower. Yes, they may have been accepted in the end, but we're left to see whether they're going to accept them or not, and what they are going to do about them.

In fact, the department works on it very quickly, but we're seeing slower and slower responses, and that's not a good thing for—

[The Chair, Liberal, John McKay]

Unfortunately, we're going to have to leave the answer there.

Colleagues, we have 25 minutes' worth of questions and a little more than 15 minutes. I'm going to have to chop everybody's time by a minute.

With that, Mr. Kelly, you have four minutes.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

Thank you.

It is extraordinarily frustrating when questions are asked, answers are provided through recommendations, then recommendations are ignored. I feel as if we're asking the questions that have been answered already in reports to Parliament.

You referred to health care for the families of serving members as a matter of “national security”. I think that was well put. We are in a crisis of recruitment, and this is a factor in retaining personnel. One of the recommendations made to Parliament in the Veterans Affairs report of 2017 was this: “That the Canadian Armed Forces further integrate family members into their mental health and suicide prevention programs.”

Has that happened with the Canadian Forces?