Thank you.
Good afternoon, everyone, ladies and gentlemen, members of the Standing Committee on Health.
My name is Richard Valade. I am a doctor of chiropractic and the president of the Canadian Chiropractic Association. With me today I have Dr. Deborah Kopansky-Giles. She's a chiropractor on the staff of St. Michael's Hospital in Toronto. We thank you for the opportunity to be here today.
We in the chiropractic profession feel strongly that our services are not being properly utilized for the public good. Chiropractic has been rigorously evaluated by the scientific community so that we now have a solid body of evidence that chiropractic care is effective for neuromusculoskeletal disorders such as back pain, neck pain, and headaches. But it's not being used as much as it should be.
We are well aware that the delivery and administration of health care takes place primarily at the provincial and territorial levels. Provinces make decisions about what services their residents are offered. So we know that it's pointless to ask this committee to comment about decisions that are made provincially and territorially. Instead, we confine our remarks to those cases where federal resources are applied directly to health.
We feel that we can do much more to help people whose health services are paid directly from the federal purse. There are some obvious cases. First, the service provided to members of the Canadian Forces is inconsistent. Did you know that a soldier in Afghanistan cannot get any chiropractic care to relieve back or neck pain, but at the same time, back at home, members of his or her family have access to care for back and neck pain through the public service health care plan? It is regrettable that soldiers in the field do not have the choice of highly effective, non-invasive chiropractic care for their back and neck pain. Chiropractic is well established to provide prevention of injury and to relieve major and minor injury to muscles, nerves, and joints, and it is appropriate to those who serve in rocky, unpleasant, and harsh terrain. We feel there is much that we can do to make reasonable health services available in the places where our soldiers serve their country.
The chiropractic profession is represented by several officers currently serving in the Canadian Forces. Dr. Denis Tondreau and Dr. Lison Gagné both serve as active reservists. They are both fully prepared to offer their skills as doctors of chiropractic while on duty at no charge, and yet there is no precedent to allow them to do that. In the past, they have both used their skills to aid their colleagues in spite of there being no regulation to support their work in the forces. Dr. Tondreau served in Afghanistan in 2008 and was welcomed and supported by the medical chief of staff at the base for his chiropractic skills to treat his injured colleagues. However, he could not get his orders changed to reflect his service as a chiropractor. We think this type of situation needs to be rectified. In fact, we think that chiropractors should be in uniform and actively serving in the forces. However, it would be a step forward if service personnel even had reasonable access to chiropractic care, so they wouldn't be second-class citizens compared to their families in Canada.
Dr. Tondreau most recently was deployed to Sierra Leone in November 2008.
Dr. Gagné has been in the Canadian Reserve Force since 2007. During training, Dr. Gagné attempted to alleviate her colleagues' musculoskeletal ailments, an area in which chiropractic excels. However, she was met with hostility from her superior officer and was told not to use chiropractic skills to treat people, regardless of positive results. Most recently, Dr. Gagné trained in Mississippi in January 2009, and she awaits deployment overseas with hopes of utilizing her chiropractic skills for the benefit of her colleagues.
This system in the Department of National Defence is especially concerning when one looks at the RCMP, which has long recognized the value of chiropractic care. For some years, RCMP members have had 2.5 times as many acute care treatments available to them as the Canadian Forces makes available to its members at home here in Canada. The RCMP is currently exploring ways to improve and enhance services and rehabilitation for acute and chronic pain. The RCMP is considerably ahead of the forces in making comprehensive care available to their members.
In terms of Canada's use of chiropractic care, we are significantly behind the United States military. In the United States, the Department of Veterans Affairs calculates that the number one reason veterans seek care when returning from Iran and Afghanistan is lower back pain. In addition, over 20% of U.S. military treatment facilities employ doctors of chiropractic for treatment of military-related injuries.
Let us consider another example: our first nations aboriginal population. Canada's history in dealing with first nations is a blot on our reputation as a dignified and enlightened country. First nations people suffer many health problems, and in many cases their levels of diabetes are higher and their overall levels of health lower than they are in other Canadian populations.
What we see is a highly inconsistent approach to chiropractic services available to the first nations people. Services vary widely, depending on such factors as the province of residence, the particular nation or group they belong to, and the arrangements they have made. This is not the Canada that reflects the values of the Canada Health Act's national principles of portability, accessibility, universality, comprehensiveness, and public administration.
In contrast, as an example of successful first nations care, the Joe Sylvester clinic in Anishnawbe Health Toronto is a pro-service, multidisciplinary clinic that has been offering health care to Toronto urban aboriginal communities since 1996. Health care professionals available at the clinic include chiropractors, physicians, nurses, traditional native healers, and complementary and alternative health care providers.
In this unique setting, comprehensive, traditional, and conventional care is delivered in the spirit of true multidisciplinary cooperation. Dr. Kopansky-Giles has first-hand experience with this clinic.
Building on this example, we would like to see first nations people have equal access to qualified, comprehensive health care services.
Chiropractors are second to none in keeping people healthy and efficient at a very reasonable cost. Essentially, we believe federal populations should have equitable access to chiropractic without gatekeeping. People who have sore necks, sore backs, or headaches should get care right away, get back in action right away, and lose as little time as possible from work and family.
The chiropractic profession prides itself that patients have quick access to practitioners and quick access to treatment. We feel this is a healthier way for the population to stay alive, focused, and engaged. In the long run we feel that not allowing people to become debilitated is a much better way to have a healthy Canada.
We now turn to a very solid example of how care should be offered across the full spectrum of a federally serviced population. It is a wonderful case study of cooperation and efficient service that can serve as a beacon for the best use of health dollars.
St. Michael's Hospital in Toronto offers chiropractic services in one of Canada's first hospital-based chiropractic care clinics. This clinic incorporates the expertise of a health care team of chiropractors, medical doctors, and physiotherapists to deliver comprehensive, appropriate, and high-quality care.
The St. Michael's Hospital department of family and community medicines welcomed the clinic to the hospital in 2004. The initiative was made possible by the Ontario Ministry of Health and Long-Term Care's primary health care transition fund. This successful example of interprofessional collaboration has benefited the hospital, the staff, and, most importantly, the patients.
Because we regard this initiative so highly, we thought it best to send the practitioner who knows most about it to join us here today so that the committee members can explore the working of a program that runs so smoothly and so well.
This finishes my oral comments. Both Dr. Kopansky-Giles and I will be pleased to answer any questions you may have regarding any issue related to our profession's submission.
Thank you.