Veterans Affairs committee  It is important to realize that it's not just deployments into combat zones that cause operational stress injuries. They can result from humanitarian assistance and disaster-response activities. We have found that exposure to dead people and disastrous situations can be as difficult for people to deal with as actual combat experience is.

Veterans Affairs committee  Whether everybody is up to date all the time is a difficult question.

Veterans Affairs committee  It's required, yes.

Veterans Affairs committee  The JPSU isn't within my realm, really. I do have case managers who work within the JPSUs to help coordinate the health care of the patients who are in the JPSU. There is no health care delivered within the JPSU as such. The construct of the JPSU is really there to provide all the other kinds of supports necessary for the members and their families, looking at how they need to prepare for transition, looking at their financial arrangements, all those types of things.

Veterans Affairs committee  With the periodic health assessment, there is a questionnaire screen that the individual goes through. It's every five years before 40 years of age, and every two years after age 40. Then they sit down with a physician, or a physician assistant or nurse practitioner, and they go through the answers to the questionnaire.

Veterans Affairs committee  I'll start with the last question first. It is usually remote locations. We have had a challenge recently to fill our psychiatrist position in Shilo, Manitoba. We had some difficulty finding psychiatrists to go to Cold Lake, Alberta. In those situations, for example with Shilo, we used the Veterans Affairs Canada OSI clinic in Winnipeg to provide members with psychiatric service.

Veterans Affairs committee  Are we doing them during service?

Veterans Affairs committee  As soon as a soldier asks us to transfer the file, we'll start the process to transfer the file to Veterans Affairs Canada.

Veterans Affairs committee  We do a mental health screening for anybody who is recruited as they are coming into the forces. Then, with each periodic health assessment, there is a small section that does a screen for mental illness. Members under forty years of age have a periodic health assessment every five years; when they're over forty years of age, they have one every two years.

Veterans Affairs committee  Our road to mental readiness program, which I referred to in my opening comments, is all about educating members of the Canadian Armed Forces and members of the chain of command about how to recognize when their soldiers or their battle buddies may be having difficulty with mental illness.

Veterans Affairs committee  I'm not aware that we're tracking those conversations.

Veterans Affairs committee  The medical records of the Canadian Armed Forces personnel are in fact transferred over to Veterans Affairs Canada when we receive the request from Veterans Affairs Canada, and that includes any of the diagnoses we've made prior to their transition to Veterans Affairs Canada. I am not in a position to comment on Veterans Affairs Canada's policy with respect to responding to the information that they ask for from those veterans.

Veterans Affairs committee  There has been an issue with respect to the timeline to transition the files. About two years ago we were at six to eight months, I believe, to transition a file. We put resources in place about two years ago to increase the number of people reviewing files to transition to Veteran Affairs Canada, and we're down to several weeks to two months, maybe, for transition of files.

Veterans Affairs committee  Members can sign informed consent for us to release the document, but it still doesn't remove my responsibility to review the file entirely for any third party information and to make sure that there is no third party information in the file when I transfer it to Veteran Affairs Canada.

Veterans Affairs committee  Mr. Chairman, and members of the House Standing Committee on Veterans Affairs, as surgeon general, I am responsible for the delivery of health services, the provision of deployable health services capabilities to support operations, and the provision of health advice to the Canadian Armed Forces.