Good morning ladies and gentlemen and thank you for the opportunity to address the committee.
I will begin by providing you a brief summary from the Canadian Forces perspective of issues surrounding health personnel and collaborative care that I understand are of interest to the committee.
The Canadian Forces are very much really a separate health care jurisdiction in Canada. While the most tertiary and high-level care within Canada is obtained through civilian jurisdictions, the CF has its own deployed tertiary care and its own training establishment, dental service, public and occupational health agency, pharmaceutical supply system, and research organization, as well as other services. It also maintains nationally unique capabilities necessary to support military operations. Except in very specific authorized circumstances, the military health service is only mandated and resourced to provide care to CF members, but pursues every opportunity to enhance the provision of provincial or territorial care to the families of CF members.
The Canadian Forces Health Services experienced severe personnel shortages in the 1990s that seriously affected our ability to support military operations. To address this and other gaps, the Rx2000 project was initiated in January 2000. One of its many components was an Attraction and Retention Initiative to address health personnel gaps.
Our attraction and retention model and strategy had been expected to close some of these gaps, particularly for physicians, which was the first group we targeted. As of January, our total effective strength for uniformed medical officers has been met, and our intake requirement is satisfied up to 2017. These successes are mainly due to competitive recruiting incentives, compensation scales, continuing medical education opportunities, and employment opportunities in other work environments.
The successful physician model has been applied to other distressed professions with varying success.
Pharmacists remain a challenge due to shortages in the civilian sector, where salaries are high and the CF is not competitive. Forecasts indicate that most of our distressed occupations will achieve their Preferred Manning Levels within five years if our funding model remains at its current level.
Given the investment required to recruit health care professionals, we try very hard to retain them once they are enrolled. We use a number of incentives, such as professional development programs, maintenance-of-competency programs, incentive allowances, professional advancement opportunities, and so on.
The importance of recruiting and retaining enough health professionals is only expected to increase as the implementation of the Canada First defence strategy progresses. Since it takes many years to educate and train health professionals, their attraction and retention must remain the subject of constant effort and vigilance.
The CFHS also employs many civilian health professionals. Our ability to recruit and retain them is constrained by disparities between market forces and public service employment incentives.
This has resulted in some staffing gaps and has necessitated a reliance on expensive contracted services. We therefore support efforts to enhance Public Service recruitment and retention.
With the exclusion of the CF members from the Canada Health Act, very much like the RCMP, civilian health care providers and provincial and territorial health authorities may also charge out-of-province, and sometimes non-Canadian, resident rates for health care services to CF members, ranging from approximately 130% to 200% of provincial rates. We would therefore support initiatives to standardize and minimize such cost differentials.
With respect to collaborative health care, the primary care renewal initiative was designed to provide high-quality patient-focused care through collaborative practice, strong continuity of care, and a standardized approach across CF health services, while remaining adaptable to ever-changing CF operational needs.
At the core of our model, our care delivery unit is composed of several types of clinicians supported by a variety of support and population health staff. They work closely together through means such as case conferences to deliver optimal evidence-based care based on best practices and are supported by a variety of mental health centres and clinical and population health specialists. Our lessons learned in all aspects of health care are available to any interested departments. We collaborate closely with many departments, such as Veterans Affairs Canada for the transition of care to CF members leaving the armed forces, VAC and the RCMP for the provision of mental health services, the Public Health Agency of Canada for national public health threats, provincial and territorial authorities for the provision of tertiary care, and many health institutions for health research and clinical training.
We're committed to assisting the federal health care partnership and departments interested in our CF health information system, which is very popular for our clinicians. It would permit controlled electronic access to patient records and link health facilities across Canada and locations outside Canada, such as in Europe and in Afghanistan.
Thank you again for your interest in the health of CF members and for the opportunity to appear before you today. I'd be pleased to answer any questions.
Thank you.