Evidence of meeting #19 for National Defence in the 39th Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was medical.
A recording is available from Parliament.
Bloc
Claude Bachand Bloc Saint-Jean, QC
Is there a threat assessment? If we are considering sending a patrol to a place that we know is very dangerous, do we make sure that, before we send them into that theatre, that helicopters are available in case something happens?
LGen Michel Gauthier
Absolutely. Medical evacuation capability is part of the checklist as the operation is being planned. There is a series of other important capabilities in support of an operation. As for threat assessment and management, the commander of the tactical group would decide to proceed with or without those resources, according to the threat level. I assure you that this is always part of the planning process.
NDP
Dawn Black NDP New Westminster—Coquitlam, BC
Thank you very much, Mr. Chairman.
I also welcome you both to our committee. It's nice to see you again.
A report was released today by the DND/CF ombudsman—ombudsperson, I suppose—into the medical treatment for reservists. I'm sure you've had a chance to go through it. It was really very scathing I think in its observations and some of its conclusions as well. In reading the report, it was pretty clear that there's not a significant level of tracking going on with the care with respect to reservists.
I want to ask you why there would be this gap in services between what a reserve soldier would receive and what a regular forces soldier would receive. I don't understand why it would be this way. Part of the report said, for instance, that for the loss of a limb, a reservist may get 40% entitlement compared to what a regular soldier might get.
I'm sure you've read the report. There were some very troubling kinds of conclusions and statements made with the report.
I just want to ask you why there would be this different level of medical services to reservists. Clearly, it's gone on a long time. What's the basis for it? How did it come to be this way? And what's going to be done to correct it?
LGen Michel Gauthier
Both of us are squarely focused on operations outside the country and health care support to operations outside the country. The issue you've just referred to actually has to do with treatment and entitlements back in Canada as opposed to in our theatres of operation, so it's not really something I have the expertise to comment on at all, unfortunately.
I assume Colonel Bernier will have the same comment.
Col Jean-Robert Bernier
I would have to defer to others. It's a Veterans Affairs issue, in some ways, as far as entitlement--
Dawn Black NDP New Westminster—Coquitlam, BC
No, it wasn't. It was medical care and tracking of the medical health of reservists when they return.
Col Jean-Robert Bernier
Those kinds of things, such as benefits, some elements within DND, are under the purview of elements of the chief of military personnel outside the health services completely, and other elements are not operations.
I can say, however, that all reservists--because we know it's harder for us to follow up on them after deployment--specifically get an interview with a medical officer before returning out of the theatre at the end of the deployment. They also, policy-wise, are required to undergo the same six-month post-deployment enhanced screening. Their entitlements for care are the same as for regular force members for injuries they suffered as a result of military service.
One of the problems you'll note in the ombudsman's report is that there's been inconsistency of application and incomplete application--that kind of thing. There are many reasons why it's been that way historically, but one of them is that there's a point when a reservist reverts back to part-time service, as a class A reservist, when the mandate for his health care is the provincial government's, so there's an element of stepping into another jurisdiction's mandate and prerogative.
I can assure you that the armed forces will be taking it very seriously. I know this has been an issue that's been discussed internally for some time over the years.
NDP
Dawn Black NDP New Westminster—Coquitlam, BC
Clearly, when more and more reservists are being sent now to Afghanistan--the proportion is going up compared to other missions--it's something that absolutely must.... I think Canadians will be horrified when they read this report. I was.
I mean, really, a soldier is a soldier. I'm not part of the military, so I don't understand why there'd be a difference in the culture. I take what you said, that you're responsible for treatment while they're on the mission, but I would certainly urge anybody who has any influence to fix this. It seems totally unfair.
LGen Michel Gauthier
I have absolutely no doubt that CDS, the chief of military personnel, and the Surgeon General will all receive the ombudsman's report with great interest. For our purposes--being focused overseas--what we can say is there's absolutely no difference between how a reservist and a regular force soldier is supported, cared for, and looked after. They're all soldiers deployed.
NDP
Dawn Black NDP New Westminster—Coquitlam, BC
While they're on mission, yes.
The other question I have follows up on Mr. Bachand's question. He asked about injuries at forward operating bases. I want to ask you specifically about operational stress injuries and post-traumatic stress disorder at forward operating bases. How is that dealt with? Have you had to return soldiers from a forward operating base because of operational stress injuries? How would that process work without contravening any of the information you don't want to contravene?
Col Jean-Robert Bernier
Physician assistants at forward operating bases, or other medical people--including medical officers or medical technicians--have training and can identify individuals who are having problems. Individuals can also approach a chaplain, if there is one, or their chain of command. There are peer counsellors who are trained, non-medical people who have specific training in helping to identify and support individuals who are suffering normal stress reactions after a traumatic incident.
At any point, should one of those individuals need to be, or want to be, seen at a higher level--or it's determined by any of the health care providers that they should be--then they can be referred for further assessment by a medical officer or by the mental health people. Either while they're at the forward operating base or once their subunit rotates out of it and they're back in Kandahar, they can be assessed at any time. They can access things directly. They don't have to be referred by a medical officer; they can go directly to the social worker or directly to any of the mental health professionals.
NDP
Dawn Black NDP New Westminster—Coquitlam, BC
Has anybody had to leave a forward operating base because of an OSI?
Col Jean-Robert Bernier
I don't know the answer to that question. People have had to be extracted in the middle of a...but that's something--
LGen Michel Gauthier
This is not something that would naturally get reported up the chain back to Ottawa on a regular basis nor even be kept track of. I can tell you I am aware of situations where that has occurred.
Conservative
The Chair Conservative Rick Casson
Yes, that's it. When you ask good questions and get good answers, time flies.
Mr. Hawn, and then we'll go back over to the official opposition.
Conservative
Laurie Hawn Conservative Edmonton Centre, AB
Thank you, Chair, and thank you both for being here.
Just as a bit of a point of clarification and information on Ms. Black's first question, the department has already actioned some of the recommendations from the ombudsman's report, and there is a proposal before Treasury Board to standardize the compensation, regular and reserve. Where that is in terms of the timeframe, I don't know, but they have taken some action in that area. It is ongoing.
General, I want to ask you a question. This relates back to Mr. Bachand's question.
Can you describe our level of cooperation, mutual support, and attitude between allies in moments of duress—i.e., an attack, injuries, and so on—and tell us whether they think of themselves as Americans, Canadians, Brits, Dutch, or just us? Can you comment on that?
LGen Michel Gauthier
The thought brings a smile to my face because I've seen some of this during visits overseas, especially when it comes to lives being at stake. The attitude, the working environment, the spirit inside the Role 3 facility, for instance, where there aren't just Canadians but other nations that are involved, in the teams that come together, whether they are American helicopters, British helicopters, Dutch helicopters, or whatever it might be, is that they are over there to support mission accomplishment and they are over there collectively to support soldiers. There is absolutely nothing more important than providing that support to individual soldiers.
There is no bureaucracy. There are no walls or international barriers that would say we are not going to provide that support because this is ours and we don't want to share it—absolutely not—especially in cases where life and limb are at stake.
Conservative
Laurie Hawn Conservative Edmonton Centre, AB
You two are more on the staff side, obviously, at the moment. I know operators hate to hear that. With a lot of things going on, with actions that are on the field, how have you found the flow of information from commanders in the field up through commander of CEFCOM as the force employer? Up to the force generators out there and getting back down to the field, is the flow of information effective and timely, and are there things you are looking at to make improvements there?