Mr. Chair, members of the committee, thank you for this opportunity to appear once again, this time to address the Auditor General's report on military health care. I am sorry I am not mentally agile enough to have incorporated any more details about some of those excellent questions in my opening remarks, but I am sure many of them will be brought out during the question period.
I am accompanied by Lieutenant-Colonel Joel Fillion, our senior staff officer for mental health. In this role, Joel is responsible for the coordination of many aspects of mental health care within the Canadian Forces health services, including analysis, policy, and program development; training; and resource allocation, to name a few. And to cut through all those words, he is the guy who has to implement the mental health initiative under Project Rx2000, so he's the guy who is beating the bushes trying to find those extra mental health providers for places like Petawawa and Valcartier. It's not an easy job.
First of all, the Department of National Defence fully accepts the recommendations outlined in the Auditor General's report. We believe that the report provides a fair and balanced assessment of the sate of our military health care system, which is continuing its transition through a massive reform process.
Madam Fraser is clearly positive in her comments in a number of areas in this report and, in particular, she notes that previous concerns about accessibility and continuity of care have been addressed, that a high percentage of CF members are satisfied with the health care they receive, and that the new model for mental health care is considered a best practice approach.
Various initiatives undertaken in the CF health services reform, such as multidisciplinary collaborative practice and electronic health records, are advocated practices from the 2002 Kirby report entitled The Health of Canadians--The Federal Role and in the 2002 Romanow report entitled Building on Values: The Future of Health Care in Canada. These practices continue to be advocated today by the Health Council of Canada.
Rx2000 and the Canadian Forces health information system represent very significant reforms, and although work remains to fully implement these initiatives, I am confident many of the changes being put in place will serve us well in addressing the Auditor General's recommendations.
As you know, the report itself contains eight recommendations centred on the four key themes of governance, cost of the CF health system, performance management, and credentialing of health care providers. We have a general action plan with expected outcomes and dates for addressing each recommendation. I will focus my remarks today on some specific actions taken to date, which I believe will be of particular interest to this committee.
Prior to the release of the Auditor General's report, the determination of which medical and dental services treatments and items would be provided at public expense to entitled persons fell heavily on the shoulders of health care providers, notably me, sitting in front of you.
Subsequent to the report, and after a review of the terms of reference for the spectrum of care committee, which makes health care entitlement determinations, the Chief of Military Personnel sought and received approval to raise the level of oversight of this committee to the Armed Forces Council, the senior leadership of the Canadian Forces. Having the Armed Forces Council make decisions about CF members' health care entitlements will now better enable the CF health services system to determine whether costs incurred are indeed related, as the Auditor General noted they should be, to patient requirements and operational needs.
The inaugural meeting of this elevated spectrum of care committee took place on February 4 this year. We are continuing to improve our ability to analyze and isolate cost data, although the CF health information system, when fully implemented in 2011, will provide the true conduit for greater cost data generation and decision-making support.
A number of recommendations in the Auditor General's report involve selecting system performance indicators, setting standards of care, and measuring activities against these standards and indicators. A new CF health services performance measurement advisory group was instituted in January this year and has begun to develop a performance measurement framework to define applicable performance indicators and to set benchmarks for these indicators. The list of indicators chosen will be in keeping with the pan-Canadian primary health care and population health indicators, which were recently developed by the Canadian Institute for Health Information.
It is worthwhile noting that CF health services will be among the organizations taking a lead in institutionalizing these practices in a multidisciplinary primary care setting. Data collection in relation to certain mental health indicators has been included in the CF health and lifestyle survey set to take place later this year.
Periodic health examinations, which currently take place every five years but will be accelerated to every two years, have recently been modified to capture more mental health and deployment-related health data. This data will feed into performance indicators as the performance measurement framework unfolds.
For deployments, the initial CF theatre trauma registry, which led to evidence-based modifications to pre-hospital medical training and protocols, has now been replaced with the U.S. joint theatre trauma system, which encompasses a far broader range of data fields and quality indicators. This system also includes a complete quality assurance and improvement framework to stimulate the production and updating of clinical practices based on objective data analysis.
In addition, progress includes the development of a CF Health Services Group Quality Improvement program and a chart audit and peer review process, which is being piloted at three bases starting next month. Further refinement and system-wide application will ensue following this effort. As has already been done, CF Health Services is also continuing to measure aspects of quality through mechanisms such as patient satisfaction surveys, survey reports from the Canadian Council on Health Services Accreditation, and internal assessments such as Staff Assistance Visits, or, in other words, inspections.
On the issue of credentialing of health care providers, a national credentialing cell was recently recreated and has achieved licensure verification for 100% of physicians and dentists, 96.7% of pharmacists—that's a very nice detail, but it means that one pharmacist hasn't answered the mail yet—and 79.9% of nurses. A new CF credentialing policy is set for release in the near future.
I am confident that we have made considerable progress, and I take extreme pride in being able to state that we can demonstrate trauma mortality rates in Afghanistan that are as good as those of any other nation working in that part of the world, and indeed as good as those of any leading trauma centre in Canada.
The mission of the Canadian Forces health services group is to provide full spectrum, high-quality health services to Canada's fighting forces wherever they serve. I am confident that our mission is being met, and we are working diligently to objectively demonstrate this.
This completes my introductory remarks. I thank you for your interest in the CF Health Services and for the opportunity to appear before this committee, and I look forward, with Lieutenant-Colonel Fillion, to addressing any questions you have.