Evidence of meeting #25 for National Defence in the 39th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was back.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

M. F. Kavanagh  Commander of Canadian Forces Health Services Group and Director General of Health Services, Department of National Defence
Hilary Jaeger  Canadian Forces Surgeon General, Department of National Defence

4:50 p.m.

Commander of Canadian Forces Health Services Group and Director General of Health Services, Department of National Defence

Cmdre M. F. Kavanagh

The health care expenditure in this country runs about $3,000 a head, so it would be 3,000 times however many dependants there are.

4:50 p.m.

Conservative

Laurie Hawn Conservative Edmonton Centre, AB

Plus the infrastructure, plus the personnel.

4:50 p.m.

Commander of Canadian Forces Health Services Group and Director General of Health Services, Department of National Defence

Cmdre M. F. Kavanagh

Plus the infrastructure, plus the personnel, yes.

4:50 p.m.

Conservative

Laurie Hawn Conservative Edmonton Centre, AB

What I'm getting at is that it's really very unrealistic to suggest that the Canadian Forces would ever be in a position to provide medical care for dependants.

4:50 p.m.

Commander of Canadian Forces Health Services Group and Director General of Health Services, Department of National Defence

Cmdre M. F. Kavanagh

Anything's possible.

There's another part to it. Our American allies do this, and yes, as Dr. Bennett will tell you, as a family practitioner, it broadens your practice of medicine. We experienced that in Germany. But it does have a downside on the military piece as well. There's another pressure. On top of providing the operational readiness care we do at home now—the pre- and post-deployment—and what we do overseas, now you're adding another demand on the organization, but you can't leave the families without that person. So it would just increase the pressure and increase the stresses of meeting the deployment requirements.

4:50 p.m.

Conservative

The Chair Conservative Rick Casson

The last spot in the second round goes to the official opposition. Pass?

Then we start the third round by going back to official opposition, and then back over to the government.

Laurie, if you have something more that you want to go on with, you have some time here.

4:50 p.m.

Conservative

Laurie Hawn Conservative Edmonton Centre, AB

How about something feel-good?

Commodore, you and I were at an event in Edmonton not long ago, and the aim was to raise money for something called Fisher House. Can you tell us a little bit about what Fisher House is?

4:55 p.m.

Commander of Canadian Forces Health Services Group and Director General of Health Services, Department of National Defence

Cmdre M. F. Kavanagh

I had the opportunity to visit Kandahar in May, and also Landstuhl, Germany, so I've seen the facilities in both places. The surgeon general will be going in the new year.

At the beginning of the evacuation chain, our facility in Kandahar may be a plywood hospital, but I can tell you that it's providing absolutely first-rate care. They are doing amazing things there. Likewise, there's the evacuation chain the Americans provide for us. There are flying intensive care units. That's what's in the back of those airplanes. And when they get to Landstuhl they're also provided with superb care. If the patient is in Landstuhl long enough or is serious enough—and mainly it's long because they're serious enough—we bring the families over to Landstuhl.

Fisher House is like Ronald McDonald House, if you are familiar with that in Canada. They provide a place to stay, give them the support they need, and make sure they get something to eat. It's on an American base, so it's culturally friendly, which decreases the stress on the members, particularly if they're coming from this country, have never been to Germany, don't speak the language, and don't understand the culture. And it's within walking distance of the hospital. Our personnel are treated exactly the same as the American people who use this facility, and they provide the creature comforts and help look after them.

There's a whole series of these on various U.S. bases. They were originally started by a man and wife named Fisher. They were wealthy Americans who started this as part of their charity work. They subsequently passed away, but they left an endowment that keeps these houses going, and the network is actually expanding. But now the money is raised through fundraising.

My old unit in Edmonton, 1 Field Ambulance—I was the commanding officer under General Cox—

4:55 p.m.

Conservative

The Chair Conservative Rick Casson

This General Cox?

4:55 p.m.

Commander of Canadian Forces Health Services Group and Director General of Health Services, Department of National Defence

Cmdre M. F. Kavanagh

That General Cox.

4:55 p.m.

Conservative

Laurie Hawn Conservative Edmonton Centre, AB

I told you it was feel-good.

4:55 p.m.

Commander of Canadian Forces Health Services Group and Director General of Health Services, Department of National Defence

Cmdre M. F. Kavanagh

Master Corporal Franklin, who you've also seen, is a solider in that unit, a medic, and the unit took it upon themselves to have a fundraising event to raise some money for this. I was told the other day that the unofficial total is $80,000 that they've raised for that organization. The Chief of Defence Staff, along with a few of the casualties and their families, are going to go back early next month sometime to award the money to the organization and also to give commendations to Fisher House and the Landstuhl Regional Medical Center.

4:55 p.m.

Conservative

The Chair Conservative Rick Casson

Thank you.

Mr. Bachand.

4:55 p.m.

Bloc

Claude Bachand Bloc Saint-Jean, QC

Thank you, Mr. Chairman.

You would probably be the best person to answer my question, Ms. Jaeger. I see that you are in charge of liaison for discussions with other NATO countries. I imagine that you examine treatment protocols and so forth before developing policies. What is of particular interest to me is the relationship between you, the Department of National Defence, and the Department of Veterans Affairs. I am thinking in particular of those soldiers who find themselves withdrawn from active service. Some soldiers have to leave the armed forces because of physical or mental health problems. As I understand it, the Department of National Defence ceases to have anything to do with these soldiers from the moment that they are withdrawn. Their files are handed over to the Department of Veterans Affairs.

4:55 p.m.

Canadian Forces Surgeon General, Department of National Defence

BGen Hilary Jaeger

That is correct, but the process begins before the soldier is withdrawn from service.

We operate on a case-by-case basis. We have a case management system for people who suffer from chronic physical or mental health problems. As soon as it becomes apparent that the person cannot remain in the Canadian Forces, our case management officers begin discussions with the Department of Veterans Affairs to organize follow-up and ensure that the veteran understands all the benefits to which he is entitled. The process begins at least six months before the member leaves the Canadian Forces, and sometimes as early as a year or a year and a half prior to discharge.

4:55 p.m.

Bloc

Claude Bachand Bloc Saint-Jean, QC

Fine. I understand that the process begins a year before the soldier is discharged. Nevertheless, am I right in thinking that, from the moment the Canadian Forces sign the discharge, your legal responsibility ends and the matter is passed over to Veterans Affairs. Is that correct?

5 p.m.

Canadian Forces Surgeon General, Department of National Defence

BGen Hilary Jaeger

That is correct, but we run a joint mental health care project with the Department of Veterans Affairs.

I'll speak in English again for clarity's sake and so that I don't sound too disjointed.

The project seeks to create a system of clinics across the country, some of which are run by the Canadian Forces and some of which are run by Veterans Affairs Canada. Regardless of whether they're currently serving members or Veterans Affairs Canada clients--or, for that matter, members of the RCMP or retired members of the RCMP--they all have access to these clinics, to whichever one is best placed to meet their needs. If a member of the CF retired but stayed in Ottawa, where we run the clinic, they would continue to come to the same clinic. If they retire and move to Montreal, they have the Ste. Anne's Hospital; they will have their care through Ste. Anne's Hospital.

5 p.m.

Bloc

Claude Bachand Bloc Saint-Jean, QC

Yes, but the joint project with the Department of Veterans Affairs is only for those suffering from mental illness. What happens to those who have a permanent physical disability that precludes them from returning to the armed forces? Are they solely the responsibility of Veterans Affairs?

5 p.m.

Canadian Forces Surgeon General, Department of National Defence

BGen Hilary Jaeger

After they have been discharged, yes.

5 p.m.

Bloc

Claude Bachand Bloc Saint-Jean, QC

That is the situation after they have been discharged.

Why did you pay particular attention to mental health care? We often hear complaints of poor treatment at the hands of Veterans Affairs by members of the Canadian Forces who have been discharged due to physical disability. The department does not take care of them. From a jurisdictional point of view, although they are the responsibility of the Department of Veterans Affairs, it is often provincial institutions that provide care for them. The provinces are left to deal with the problems.

Would it not be possible to set up a committee on physical disability, similar to the one that deals with mental health care issues?

5 p.m.

Canadian Forces Surgeon General, Department of National Defence

BGen Hilary Jaeger

We chose to focus on mental health issues because continuity of care is very important in such cases.

5 p.m.

Bloc

Claude Bachand Bloc Saint-Jean, QC

Yes, it is a real problem.

5 p.m.

Canadian Forces Surgeon General, Department of National Defence

BGen Hilary Jaeger

It is preferable that the same institutions continue to provide care to these people after they have been discharged.

Thus far, nobody has asked us to do anything on the other matters to which you refer.

From a point of view of jurisdiction, at the moment we have no responsibility remaining after the member is retired. They leave with a provincial health care card. Perhaps depending on why they leave, they leave as entitled people under Veterans Affairs Canada and the primary responsibility for what happens to them shifts from us first to the provincial health care system, but frequently there is supplementary health care or payment from Veterans Affairs Canada.

5 p.m.

Conservative

The Chair Conservative Rick Casson

Thank you.

Mr. Blaney is next.

5 p.m.

Conservative

Steven Blaney Conservative Lévis—Bellechasse, QC

A lot of questions have already been asked and I will try to ensure that mine are not redundant.

I would just like you to clarify something for me. Where exactly is Fisher House located?