Health Committee on March 23rd, 2010

[Joyce Murray, Liberal, Vancouver Quadra, BC]

One of the things this group has been studying includes the international medical graduates as a potential resource to help with shortages. Has there been any identification of this as an opportunity? I understand you're saying that it's the professionals in the community, but it seems to me that there is a responsibility to support the members in a way such that, if there is an absence in the community, it's not acceptable to just say that the community doesn't have those professionals. That's where the organization would fill in some gaps.

[The Chair, Conservative, Joy Smith]

Your time is up, Ms. Murray.

Could someone make a comment?

[Insp Rich Boughen]

I didn't want to leave you with the impression that we leave our membership hanging in isolated communities. When issues are identified, we can either get the assistance they need at another location, or at times transfer them out of the community to a location that's better suited for them, for treatment, or because of the community itself.

[The Chair, Conservative, Joy Smith]

Thank you.

We'll now go to Monsieur Malo.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Thank you, Madam Chair.

I would like to thank the witnesses for their presentation.

Going by the very touching testimony given by Ms. Smith and all of the testimony heard, I would say, essentially, that the client groups who are affected by your organizations are special and unique by virtue of their functions and the work they do. In particular, I am thinking of the Department of Veterans Affairs where they work both with a somewhat aging clientele, I'm thinking of veterans of the Second World War and the Korean War, and now with a much younger clientele, thinking of veterans of the Gulf War or more recent conflicts.

As a result, health services have to adapt to these two types of very special client groups. I am wondering whether, to respond to this type of clientele, there have to be tailored services, health professionals who are more specifically familiar with this type of clientele. Is that necessary?

[The Chair, Conservative, Joy Smith]

Who would like to take on that answer?

Mr. Brown.

[S/Sgt Murray Brown]

If I may, sir—and I hope I have captured your question correctly—from a point of view of being able to take on these unique services, in fact we haven't. We're floundering in that area. I'm a bit jealous to hear some of the successes on the military achievements medically. When you look at the specialty required, you have to remember that in our service delivery--we are in many places--that even the health services stations or the nurses stations have been closed out. We are all there is in many of those jurisdictions.

As Superintendent Boughen indicates, we have to move them out. The difficulty, though, with not providing that circle of care is that we move them out and then we move them back in with no follow-up or continuation. Granted, now we can do this by video conference. But if you're sick, it doesn't give you much confidence that your medical practitioner is somewhere else in Canada while you're stuck in the community that is sometimes fuelling the difficulty you're having. In our organization—and the commissioner doesn't like me speaking for him, so I will keep his request in mind—we don't, in that context.

I hope I have answered your question. If I haven't, I apologize.

[The Chair, Conservative, Joy Smith]

Mr. Boughen, did you want to respond?

[Insp Rich Boughen]

The part of the question that I think you hit on that is so important is that there is a tremendous diversity of experiences. Several years ago the military came upon the term OSI, meaning operational stress injury. We've adapted that because it works for us. Without being military, I don't want to float into a jurisdiction that I'm not versed in, but the experiences of the military in their everyday work are much different from ours. When the military deploy, they are in it for a period of time. They're deployed into a zone, and it might be for six months or three months or a year, depending.

For the policing experience I'll be RCMP-specific, but I think it touches on all policing throughout the world, or in Canada for sure. Every time we put on a uniform, we are at work, so coming across tragic events--car accidents, homicides, child abuse--is a daily occurrence. We have just begun learning in the recent past that those things take their toll. We are learning about things such as secondary trauma, which is viewing things or hearing about things that you can do nothing about. It's the unfixable suffering, the deep pain that we as police officers encounter every day. We're just recognizing that although it might not meet the definition in the DSM of what post-traumatic stress disorder is, the symptoms and symptomatologies are very similar. There is sleep disorder; there is substance abuse; there is anxiety, depression, mood swings, and a whole bunch of behavioural changes.

One of our challenges is finding health care professionals who get that. Quite frankly, I don't think there are a whole lot of what are called trauma psychologists. We are very fortunate in our organization to have Staff Sergeant Jeff Morley, who is in E Division. I work with him, and he is an unusual person in that he is also a registered counselling psychologist. He understands that. We've taken some strides in dealing with the prevention of these types of injuries, and at some point, should it please the committee, I can talk about them.

[The Chair, Conservative, Joy Smith]

Mr. Jung, I believe you want to make some comment.

[Cmdre H.W. Jung]

I would like to answer you in French, but this is official testimony. So with your permission, I will answer in English, to be sure that what I say is clear and exact.

I very much appreciate that question. Obviously for that very specific reason, the Canadian Forces have their own military health care system. It's not just doctors; we have a complete health care system that is more or less self-sufficient. We have uniformed doctors, uniformed nurses, pharmacists, psychiatrists, and so forth, who provide that very specific health care requirement while knowing and living in and experiencing the same environment that our patients undergo. We understand what they're going through and we deploy with them in that environment.

Obviously we also have civilians working in our system to make sure that when we take our military members out of their base, there's some continuity. Military members, because they're military, do get posted just like any other military members. They get deployed. Therefore to ensure the continuity of care, we have a mixture of military personnel and civilians in our health care facilities, but the majority of the occupational health care and the understanding of the context where the health care issues arise are provided by occupational clinicians, as we call them.

[The Chair, Conservative, Joy Smith]

Thank you very much.

We'll now go to Mr. Stoffer.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Thank you, Madam Chair. It's indeed an honour and a pleasure to be on the health committee. I think this is my first time in twelve and a half years.

First of all, Mrs. Smith, our condolences on the loss of your husband. To the RCMP folks, our condolences again on the loss of those two great men in Haiti. To Mr. Jung, our condolences again on the loss of that soldier in Edmonton last week.

All of you have a very tough job, just as tough as it is for the family members behind you who allow men and women to serve our country in a capacity that is unknown to most of us because you see things, hear things, and do things that we only hear about in the media.

I have a couple of basic questions. Mr. Tousignant, you're aware of the VIP program that the military have, correct? Do you believe, sir, that the RCMP should now be included under the veterans independence program?

[C/Supt Alain Tousignant]

I know there's some work being done. We're working on the VIP program, but I'll defer to Inspector Boughen for the specifics as to where we're at with that development.

[Insp Rich Boughen]

I'm sorry, could you repeat?

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

The veterans independence program is a program that's quite successful with our military. Unfortunately, in my view it's not extended to enough of them, but that's a debatable point. The fact is that for those who do receive it, it's an excellent program. It's administered under VAC. A lot of the RCMP concerns were administered under VAC. For similarities of the concern that Mr. Brown had issued, do you believe, sir, that it's now time for the RCMP and their families to be allowed the services under VIP?

[Insp Rich Boughen]

We have done a tremendous amount of work over the last several years in forwarding information to government to set out our position as an organization. Right now that's before the commissioner and the minister. We work diligently to try to put into place the regulations that are required to be able to offer certain benefits that are commensurate with the military.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Are you then saying, sir, that there's a proposal on the table, and it just needs a nod and a wink by somebody to make it happen?

[Insp Rich Boughen]

I'm not sure about the nod and the wink, but I know there is documentation that our minister has been briefed on. It's with our commissioner as well.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Sir, do you yourself believe, though, that it should be a good program for RCMP members and their families?

I know I'm putting you on the spot. If you're not permitted to answer, that's fine.

[Insp Rich Boughen]

In terms of those kinds of benefits that you're talking about, what we've striven for in preparing the documentation is to make the regular member population equal with the rest of Canadians who are afforded similar types of benefits.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Mr. Brown or Mrs. Smith, do you think it's time now for the RCMP to be under the Canadian health care act, or should it be kept the way it is now?

[The Chair, Conservative, Joy Smith]

Go ahead, Mr. Brown.

[S/Sgt Murray Brown]

Mr. Stoffer, I know it's being looked at in different capacities as we speak, but I'm not really privy to the legal work and the consequences in order to answer it.

We are looking at some issues now of being able to have medical cards in certain divisions. For instance, as I mentioned, in Nova Scotia I cannot have an MSI card. My family has them, but in many of the provinces in Canada we do not have them. As we speak, we are running a pilot in Alberta to look at facilitating it.

For me the issue is not really whether we're in or we're out; the issue is that we need the services to allow us to function and be treated like most other Canadians when it comes to health care. I think it's a short way to answer your question, but technically and legally I don't want to touch it.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

That's the thing.

Commodore Jung, you're correct. If you go to the Stad in Halifax, for example, they provide excellent medical care for the serving members. The problem, of course, is that when serving members leave and become veterans, they no longer have access to the Stad. They go into the general system, and that's a problem. Many people in the provincial system don't understand post-traumatic stress disorder. In fact, I would advise this committee--and I'll give the name to the chair later--of Lieutenant Colonel Dr. Heather McKennitt, who gets tremendous numbers of referrals from regular doctors because she understands what it's like to wear the boots, as they say, whereas most provincial doctors do not. That's one of the problems we have. I'd like your comments on that.

Mrs. Smith, to give you the final word, can you make one recommendation that may prevent another RCMP officer from looking at no other excuse but suicide? I know there are many, but which one do you think would be most helpful to help the next person down the line?