Kirsty Duncan

[Questions Passed as Orders for Returns, November 3rd, 2010]

With respect to services offered to veterans in Canada: (a) how many full-time and part-time positions have been cut from Veterans Affairs Canada (VAC) between 2006 and 2010; (b) what is the number of uniformed professionals, public servants and contractors by region; (c) what is the overall cost of contract workers; (d) over the next five years, what plans does VAC have to cut back or expand (i) its operational budget, (ii) full-time, part-time or contract positions, (iii) programs or services offered; (e) since 2005, broken down by year, how many (i) Second World War veterans have passed away, (ii) Canadian Forces (CF) members became veterans, and how many of these veterans have families, (iii) new recruits have become CF members and how many of these new CF members have families; (f) how are the numbers in (e) expected to change over the next five years; (g) how many Veterans Affairs’ case managers and client service agents currently exist and specifically, (i) where are they located, (ii) what is the average number of clients they serve, (iii) what are the projected numbers of case managers and client service agents needed over the next five years, (iv) what specific preparations are being undertaken to meet these needs; (h) how many times has the "Veterans Charter" been altered, listing for each change (i) the date, (ii) the nature of the change, and (iii) the reason for the change; (i) how many veterans are living from (i) the Second World War, (ii) the Korean War, (iii) Afghanistan, (iv) Canada’s peace-keeping missions; (j) for each group listed in (i) how many veterans are (i) disabled, (ii) severely disabled, (iii) receiving the monthly disability payment, (iv) received the lump sum pay-out of up to $276,089; (k) for those who received the lump sum pay-out, how many veterans received (i) the maximum pay-out, (ii) the average pay-out; (l) how many veterans received a lump sum pay-out between (i) $0 and $25,999.99, (ii) $26,000 and $50,999.99, (iii) $51,000 and $75,999.99, (iv) $76,000 and $100,999.99, (v) $101,000 and $125,999.99, (vi) $126,000 and $150,999.99, (vii) $151,000 and $175,999.99, (viii) $176,000 and $200,999.99, (ix) $201,000 and $225,999.99, (x) $226,000 and $250,999.99, (xi) $251,000 and $275,000.00; (m) how is financial need measured; (n) how many veterans are currently receiving social assistance, and how do these statistics compare with those under the previous monthly disability program; (o) how often was the monthly payment increased and why; (p) how many veterans have lost their homes in the last five years; (q) what was the average payment for spouses and children prior to 2006, and how do these statistics compare with the new lump sum, specifically (i) how often is the lump sum increased, (ii) is there a portion of the latter payment for spouses and children; (r) what was the average disability pay-out under the system prior to 2006 particularly over a Second World War and Korean War Veteran’s lifetime (in today’s Canadian dollars), and how do these statistics compare with each category identified in (l) and the maximum lump sum pay-out of $276,089; (s) what specific actions are being taken to address the 31 per cent of veterans not satisfied with the lump sum payment as identified in the VAC survey released in June 2010; (t) how many veterans are currently appealing decisions regarding their disability pensions, and what is the average time taken to a final decision; (u) how many veterans have appealed a decision regarding their disability pension (i) once, (ii) twice, (iii) thrice, (iv) four times, (v) five times; (v) how many veterans’ complaints were reviewed by the Veterans Ombudsman during his tenure, up to and including September 20, 2010, broken down by complaints against (i) Veterans Affairs Canada services, (ii) Veterans Bill of Rights, (iii) the Veterans Review and Appeal Board, (iv) the Bureau of Pension Advocates; (w) in detail, what are all emerging and systemic issues related to programs and services provided or administered by Veterans Affairs Canada brought forward by the Ombudsman during his tenure up to and including September 20, 2010, including, but not limited to, physical and mental health issues, the replacement of pensions with lump-sum payments and disability stipends, and pension claw backs; (x) what are the details of all outreach activities to veterans or organizations that serve veterans across Canada during the national "Leave Nobody Behind" campaign launched by the Veterans Ombudsman, including the issues brought forward by veterans or organizations; and (y) what specific measures were used to evaluate the Veterans Ombudsman’s performance in the areas of (i) accountability, (ii) ethics (iii) training, (iv) governance and stakeholder engagement?

[Questions Passed as Orders for Returns, November 3rd, 2010]

With respect to chronic cerebrospinal venous insufficiency (CCSVI): (a) do the Canadian Institutes of Health Research (CIHR) or Health Canada recognize the Consensus Document of the International Union of Phlebology (IUP) on the diagnosis and treatment of venous malformations, in which CCSVI is recognized as venous truncular lesions obstructing the main outflow routes from the central nervous system; (b) does CIHR or Health Canada recognize the recommendations by the IUP expert panel for therapeutic interventions, including angioplasty, stenting, or open surgical repair of the lesions, in proven CCSVI cases; (c) did anyone from CIHR or Health Canada attend the July 26, 2010 CCSVI Professional Symposium and, if not, (i) was there a review of the findings of the Symposium, (ii) was the review included in the process for the August 26, 2010 meeting between CIHR and the Multiple Sclerosis Society of Canada (MSSC); (d) what were the terms of reference for the August 26, 2010 meeting between CIHR and the MSSC; (e) in detail, what were the steps taken in the review of the current state of CCSVI science for the August 26 meeting and, specifically, (i) were international experts outside of the United States consulted, (ii) what process was undertaken to ensure fair and unbiased reviewers, (iii) what check of reviewers’ backgrounds was undertaken regarding links to specific organizations, review panels and grants obtained, (iv) which, if any, of the reviewers had previously spoken for or against the CCSVI theory or liberation procedure, (v) were reviewers who had experience or expertise with CCSVI selected and, if not, why not, (vi) which, if any, of the reviewers declared a conflict of interest, (vii) what, if any, action was taken to address any identified conflict of interest; (f) did the Health Minister review the biographies of the committee members for the August 26 meeting (i) if not, why, (ii) if so, were any problems identified and any action taken; (g) what published papers were reviewed by panel members, broken down by (i) those that confirm venous malformations in Multiple Sclerosis (MS) patients, (ii) those that deny venous malformations in MS patients, (iii) those that neither confirm nor deny venous malformations in MS patients; (h) were international practitioners, such as those in Bulgaria, Italy, Kuwait and the United States, consulted to learn (i) how many liberation procedures they had undertaken, (ii) what, if any, improvements their patients experienced, particularly in relation to fatigue, "brain fog", motor skills, and Expanded Disability Status Score; (i) what were the details of the agenda for the August 26, 2010 meeting; (j) what will be the process for establishing the CCSVI working group, announced August 31, 2010, and (i) will it be an open or closed process, (ii) will it include CCSVI and liberation procedure experts from Canada, such as Dr. Sandy MacDonald, and around the world, (iii) who will Chair the group, (iv) how often will it meet, (v) how often will it report and to whom; (k) what are CIHR and Health Canada’s responses to the Society of Interventional Radiology’s September 2010 position statement, particularly its statement that it “strongly supports the urgent performance of high-quality clinical research to determine the safety and efficacy of interventional MS therapies, and is actively working to promote and expedite the completion of the needed studies”; (l) prior to the CIHR’s announcement on August 31, 2010 that pan-Canadian clinical trials on the liberation procedure would not go forward at this time, how many provinces or territories requested that the federal government undertake national clinical trials; (m) since the beginning of 2010, how many Canadians have travelled abroad for the liberation procedure and what, if any, tracking has CIHR or Health Canada undertaken regarding each patient’s procedure, progress and related expenses; (n) will Health Canada be undertaking a review of the liberation procedure at each location it is performed worldwide, including an examination of (i) the cost, (ii) the number of procedures performed, (iii) the data collected, (iv) the safety and efficacy of the procedure, (v) the follow-up, (vi) the ranking of the sites for Canadians wishing to pursue this treatment; (o) what consideration has CIHR or Health Canada given to how the August 31 recommendation not to proceed with national clinical trials will impact the number of Canadians travelling outside of Canada for the liberation procedure and what, if any, studies have been undertaken to address the possible impacts; (p) will CIHR or Health Canada undertake any studies relating to any challenges MS patients face on returning to Canada after receiving the liberation procedure abroad, including medical complications, the refusal of treatment by neurologists or practitioners and the refusal of care by long-term health facilities; (q) will the government grant the $10 million the MSSC has requested for research and, if so, when; (r) how much of the $16 million the government allocated to CIHR will be available for (i) MS research, (ii) CCSVI research; (s) will CIHR funds be made available to assist in the creation of a registry that collates data regarding the progress of MS patients who undergo the liberation procedure and, if so, (i) who will be involved in its development, (ii) what is the timeline for development and roll-out; and (t) what research is CIHR or Health Canada undertaking or funding regarding (i) an atlas of anatomical venous variations in the neck and chest, (ii) treatment for venous inflammation, iron storage and hydrocephaly, (iii) possible linkages among CCSVI, MS and other unidentified factors, (iv) treatment and follow-up protocols, (v) design of safe apparatuses and procedures to keep liberated veins open?

[Veterans, November 2nd, 2010]

Mr. Chair, more than 800 food hampers will be delivered to needy veterans and their families in Calgary alone this year. Homeless people do not have the documents needed to support their claims and this lack of documentation causes problems when they are in crisis and need immediate help, as supporting documentation is needed to qualify for help from Veterans Affairs Canada. This system puts homeless veterans at a real disadvantage.

Could the hon. member comment on whether a national strategy is needed to deal with homeless veterans?

[Veterans, November 2nd, 2010]

Mr. Chair, I appreciate the member's message that we must be there for our men and women.

Soon after the start of the Afghanistan and Iraq wars in 2002, researchers found that mild traumatic brain injury episodes were self-reported by 12% to 20% of American military members returned from deployment. Most patients who suffer from MTBI recover completely within three months. However, a small minority report persistent non-specific symptoms that can be disabling.

Blast weapons cause injury as a result of supersonic waves of intense air pressure and a variety of other mechanisms, including blunt force. Severe blast energy exposure can cause multiple injuries, including blast lung, ruptured tympanic membranes and transient cardio-respiratory effects. Evidence from animal research, case reports and clinical experience show that lower primary energy might cause isolated brain injury.

What action would the member ask the minister to take to address the issue of MTBI, particularly as there is a link with dementia.

[Veterans, November 2nd, 2010]

Madam Chair, I think we have to recognize there is criticism of the new veterans charter, enough to spark a day of protest. I really believe that there needs to be consultation across this country, and change.

As the parliamentary secretary said, we are proud to be there for them. So I must address the issue of agent orange. I have many questions.

I am wondering if the hon. member thinks the precautionary principle has been applied to the safety of the environment and the health and welfare of members of the Canadian Forces and the civilian population since the first spraying in 1956 up until the present.

I am wondering if he can comment on why only half the claims have been paid out and on the fairness of the date of the compensation. Currently only those who were still alive on February 6, 2006, are eligible to receive compensation for exposure to agent orange. Can he also comment on the fairness of eligible illnesses in relation to the United States? The Institute of Medicine is updated every two years. We have not included that information here in Canada. And can he comment on eligibility for veterans' health care benefits and on veterans' children with spina bifida and other birth defects?

Finally, what critical integrative analyses regarding agent orange, purple and white, such as longitudinal evaluation of cancer data, have been undertaken here in Canada and made available to the public?

Has the government, and this is really important, undertaken any studies to understand trans-generational effects?

[Veterans, November 2nd, 2010]

Mr. Chair, I would like to thank my colleague for his passionate and caring speech. He raises an excellent point about research.

There seems to be a delay in translating research at Veterans Affairs Canada. For example, in Canada the illnesses of those who are eligible for an Agent Orange payment are actually based on the Institute of Medicine report from 2004. In the U.S. that is updated every two years. There is a review of the science and the new science is added.

If we look at ALS, research showed that veterans were more at risk of developing ALS. Again, the government chose to ignore this information as late as this spring. The U.S. took action back in 2008. It was the Dyck family who fought so hard to get compensation here in Canada, with the veterans ombudsman.

Now we have new research looking at post-traumatic stress disorder, and we see there is an increased risk of our veterans developing dementia.

I am wondering if my hon. colleague could comment on the need to make sure we have up-to-date research.

[Veterans, November 2nd, 2010]

Mr. Chair, with regard to the new veterans charter, the focus of this debate is not to go into the past. It is about fixing things today. We appreciate that the minister took action in the fall. We appreciate any help that he brings to our veterans. We appreciate the investment and we are looking forward to seeing that bill and to ensuring it meets the needs of veterans.

[Veterans, November 2nd, 2010]

Mr. Chair, the hon. member raises an important issue, which is the issue of long-term care.

When members of the Canadian Forces go off to war and into harm's way, we have an obligation to look after them when they return and ensure they have the care and treatment they need. They should not be fighting another battle when they come home when they absolutely need that specialized care.

I will address the issues of operational stress injuries, anxiety, depression and PTSD. We need people who are experienced in those fields. What do we need to do immediately in order to take action on PTSD? Is it investments in awareness, outreach and suicide prevention? Is it hiring more mental health professionals? Is it improving care and treatment?

Once veterans have a diagnosis, we need to make it easier for them to get the support they need.

[Veterans, November 2nd, 2010]

Mr. Chair, it is a privilege to serve on the committee with the hon. member.

He raised the issue of long delays. Every day we hear of people waiting for answers on their claims. Right now we are dealing with a woman who has been denied her agent orange claim, although it is one of the accepted Institute of Medicine diseases that is recognized. We then went to Veterans Affairs Canada was actually put in two years ago. We were told by Veterans Affairs that she did not get it in quickly enough and her claim has been denied again. I now have the information to send to Veterans Affairs that her claim two years ago.

The delays are certainly an issue, as are the lump sum payments. Veterans Affairs' own survey showed that 31% of veterans do not think this meets their needs. We really need to look at this because we need to ensure that our veterans are able to live a good quality of life and in dignity.

The last question was regarding the veterans ombudsman. The member has done an excellent job of highlighting the issues that our veterans have been raising, such as agent orange and ALS. As recently as May of last year, the government was not taking action on ALS. It was not until the Dyck family, and my condolences to the Dyck family, had the courage to come forward and tell their story along with the veterans ombudsman that the government moved on this issue. I was actually at ALS Ontario's meeting on Saturday where Mr. Dyck was celebrated. My condolences again to the Dyck family.

ALS. agent orange, clawbacks and lump sum payments are some of the issues that the veterans ombudsman had the courage to raise.

[Veterans, November 2nd, 2010]

Mr. Chair, my earliest memories are of a Legion where my mom played in a pipe band. I liked to listen to the kindly older men while the band practised. I liked their stories. They would test me, “Do you know what that tune is? Do you remember what it stands for?” They were The Battle of the Somme, Black Bear, and Highland Laddie.

By the time I was five, I knew to stand for the colour guard, to take my woolly winter hat off as I entered the Legion, and why we wear a poppy. I found the word “veteran” hard, so my parents instead used the word “hero”. My whole life, veteran has been synonymous with hero.

Every summer we lined the streets of the Canadian National Exhibition for Warriors' Day. I remember the rows and rows of men and women who stretched from one side of Princes' Boulevard to the other, Legion after Legion, the 400 Squadron, the Toronto Scottish, waiting for my grandfather to march past and then my mother, and clapping until my hands were raw.

As a child, I was fascinated by the veterans' medals, and I asked my dad how anyone could have had medals that stretched from one side of his chest to the other. My father taught me that Canada owes our veterans. That is why we come to honour them each summer and that is why I must never forget them. He told me how his own father was not able to fight in the second world war, but that at the end of each week, how his father, a barber, prepared packages tied up in brown paper with string, to send to the boys from the neighbourhood. As a child, I saw my father cry only twice, but his eyes watered every time he told me about those packages.

As I grew older, my understanding of our veterans' gift to my parents' generation and to mine deepened, while the rows upon rows of veterans dwindled. Today Warriors' Day is a mere trickle of what it once was, with many veterans being driven in vans along the parade route. But the ranks of new veterans are growing. My hands are still raw and none of my family can manage a dry eye when the first Legion passes.

For 25 years, I had the honour and privilege of performing with the 48th Highlanders of Canada, Dileas Gu Brath, and had planned to do officer training with the navy if I had stayed in Canada for school. I have stayed on the bases as Esquimalt and at Valcartier, and was asked to teach new recruits at Borden. I would like to thank the 48th for the profound respect they taught me for military culture, history, and the sacred trust Canada has with its veterans, for the debt of gratitude we owe them, and always, that we will remember them.

I came to serve in Ottawa for two main reasons: to fight to end child hunger in Canada, and to fight for neurological disease, all because of what a veteran said when I was a child. He said that he went to war for my mom's generation, for my generation, and for those to come, that he did not go for his own. One hundred thousand never came home. Then he said the words that I have never forgotten, that have haunted me all my life: “What will you and your friends do for the next generations? We are entrusting you with the future we fought for”.

Let me begin by thanking all of our veterans, our World War II veterans, our Korean War veterans, our Canadian Forces veterans, and all our Canadian Forces and reserves. I thank them, I know each member of this House thanks them, and our country thanks them.

I was enormously proud to be appointed the veterans critic by our party. I take this new role to heart. I profoundly take my service to them, as they taught me service throughout my life, and I will do my utmost to honour them, their service to our country, and, most important, to work to restore the sacred trust Canada once had in them.

I will fight hard to bring attention to the issues they have raised with me such as agent orange, ALS, atomic war veterans, clawbacks, lump-sum payments, the new veterans charter, and privacy. I never would have believed, and Canadians would not have believed, that we would ever have had to fight for the privacy of our veterans. We assume that this is a given in our country. To name but a few issues, there is PTSD, the veterans' ombudsman's office, and Veterans Affairs.

It is disgraceful that in Canada we have let them down, and let them down on so many issues. Yet again they have had to be the heroes, to lead us to see the injustices, and to push us to begin to right the wrongs. I am sorry that they have come home only to fight other battles: for care, treatment, and something so basic as privacy.

While I may have come to Ottawa for two main reasons, I now have a third: the brave men and women who put their lives on the line for Canada in time of war and in time of peace. They are our country's heroes.

This week, Canadians across our country will begin to gather in places where it is impossible not to be moved by the sacrifice of our veterans. We shall remember the fallen, the battles that have defined generations. We shall remember our humanity in difficult circumstances, during peacekeeping missions. We shall remember the generations serving today. Many left as young men and women only to return as heroes, to take their place alongside previous generations for the courage they have shown and the sacrifices they have made.

However, our veterans deserve more than one day, one week, of remembrance. They have earned care when they need it, respect throughout their lives, and the necessary economic, familial, and social supports to return to civilian life, to adjust to a new life, or to age with dignity and grace. They do not want hollow words, with no action. They deserve leadership with real change, and they deserve what they engaged in so extraordinarily well themselves, namely, action.

Our veterans deserve significant changes to veterans affairs. I want to acknowledge the good work of the people there, though. I want to recognize the people who actually served in the military and who understand the culture. We need a change in the current philosophy, from the insurance policy climate of today to the sacred trust of the past, from helping a veteran only to the age of 65 to looking after a veteran to the end of his or her life, to reinstating the originally intended benefit of the doubt when dealing with veterans, to streamlining processes and procedures and ensuring that there are enough people to allow timely processing of claims.

There also needs to be an extensive review of the new veterans charter, in consultation with veterans across the country. We need to know what is working, what is not working, where the gaps are, and what needs to be changed.

Although the charter was intended to be a living document, the government has not made one change in four years.

We need to make real changes in compensation. This is one of the most criticized pieces, with 31% of veterans saying the lump-sum payment does not work for them.

Why does the government continue with something that is failing to help our veterans?

We must also ensure that VAC is properly prepared for when our men and women return in 2011. VAC cannot meet the demand of today's veterans, let alone the veterans of 2011. Where is the vision, the strategic plan, and the resources to ensure that the department is ready?

I profoundly thank Colonel Pat Stogran, veterans ombudsman, for his years as an officer in the service of our country and for his excellent and courageous service to our vets over the past three years.

Finally, I honour all our veterans, their families, the fallen, and those still serving. There is no commemoration, praise, or tribute that can truly match the enormity of their service and their sacrifice.