National Defence Committee on June 5th, 2008

[The Chair, Conservative, Rick Casson]

We'll call the meeting to order.

This is our 29th meeting, pursuant to Standing Order 108 on a motion adopted Tuesday, November 20, on the study of health services provided to Canadian Forces personnel, with an emphasis on post-traumatic stress disorder.

Today we have a very esteemed panel of witnesses before us.

Members, before we get started, I'd like to reserve a little time at the end of the meeting for some housekeeping duties, so if we could exhaust our questions early and get all the information out of these folks that they have, we'll move on. If we could just save a few minutes, 15 minutes or a half hour, that would be great.

You can each introduce yourselves, who you are and who you represent, and then we'll get into the questions. There are no opening statements by any of you.

[Commodore J. Bennett, Commander, Naval Reserve, Department of National Defence]

General Tabbernor will go first.

[Major-General D.C. Tabbernor, Chief, Reserves and Cadets, Department of National Defence]

Good afternoon, ladies and gentlemen.

My name is Major-General Dennis Tabbernor. I am chief of reserves and cadets. I am basically General Hillier's principal adviser on reserve issues.

I took over the position on the 20th May from Major General Herb Petras, who retired. The year before that I was in Afghanistan, in Kabul.

[Cmdre J. Bennett]

Good afternoon. Bonjour, tout le monde.

My name is Commodore Jennifer Bennett. I am the commander of naval reserves. I am a naval reservist. I've spent my entire military career as a primary reservist. In my civilian career, I'm the director of a school, so I have two simultaneous careers.

My position is somewhat different from my colleagues'. I am one of three formation commanders in the navy. There is a formation commander on each of the coasts, and I am a formation commander who reports directly to the Chief of Maritime Staff on naval reserve matters.

[The Chair, Conservative, Rick Casson]

Thank you.

[Brigadier-General G.J.P. O'Brien, Director General, Land Reserve, Department of National Defence]

Good afternoon.

My name is Brigadier-General Gary O'Brien. I am the chief of staff for Land Reserve. I am the senior army reserve adviser to the chief of the land staff. I am also the commander of the Canadian Rangers as a secondary duty, handling all of the reserve issues within the army.

My prime responsibilities, aside from managing the Canadian Rangers, are to provide advice and cover all the institutional issues within the army reserve for the chief of the land staff. I was in Afghanistan before Dennis, so I too am an Afghanistan veteran. I was responsible for running the ANP program for the coalition.

[The Chair, Conservative, Rick Casson]

Thank you.

[Brigadier-General E.B. Thuen, Director General, Air Reserve, Department of National Defence]

I'm Brigadier-General Eldren Thuen. I'm deputy commander of mission support at 1 Canadian Air Division, and I'm also the director general of the air reserve, here in Ottawa. I'm the senior reserve adviser for the chief of the air staff. I'm also the developer and implementer of reserve policy, in concert with my colleagues here today, and CMP for the air reserve.

[The Chair, Conservative, Rick Casson]

Thank you.

We have a schedule for who asks questions, when, and for how long. We'll get started with the official opposition.

[Joe McGuire, Liberal, Egmont, PE]

Thank you, Mr. Chair.

Maybe Major-General Tabbernor could explain to us the status of the reserves when it comes to their care after they come back from duty in Afghanistan or wherever.

We have heard from witnesses, especially early on in our hearings, that the reservists were not being treated the same as other soldiers. We understand that this has been corrected.

With respect to the follow-up for reservists when they return and go back to their regular jobs, what connections do you have with them? Are they out of sight, out of mind, or is there a system put in place to see how they are coping? A lot of times mental sicknesses don't click in till six months later or longer. What kind of system is set up for making sure that these people are coping properly?

On a recent trip to Afghanistan I was well taken care of in my hour of need by a reservist from Peel Regional Police, so I have a special interest in how they do when they get back here.

If you could elaborate on that, General, it would be appreciated.

[The Chair, Conservative, Rick Casson]

Go ahead, sir.

[MGen D.C. Tabbernor]

If you allow me, I will just talk generalities, and then I will ask General O'Brien to talk specifics, because most of the soldiers coming back belong to the army.

There is a process in place to prepare soldiers--and I use the term “soldiers” generically to include basically everybody leaving the country for overseas operations--which ensures that they are medically, administratively, and physically ready to go over, and that the training they get is adequate to meet the operation they're going into.

So whether they're going to a small UN peacekeeping mission in Africa or whether they are going into a more robust mission in Afghanistan, there is a process there to prepare the reservists to go overseas.

On the way out, the reservist follows the same process that his regular force counterpart follows to come out. In my case, we did a fairly comprehensive medical before I left theatre, and there are follow-up processes put in place that I have to follow once I am back in-country here, which will take place over the next number of months.

Therefore, my treatment is no different from that of my regular force counterparts. One of the issues that we may have with individuals--and it applies to both the regular forces and the reservists--is with those who are not necessarily in a unit that has gone overseas. For instance, there is the issue of an individual augmentee who has gone overseas and then come back to his unit, whether it's a reserve unit or a regular force unit, and how that individual is looked after and followed up on.

There is a process in place to deal with that as well, on both the administrative side and the medical side, to ensure that the individuals are looked after.

If a reservist has an issue, the medical world has a process in place to look after him or her. Eventually, if it is going to be a long-term issue, there is a hand-off process to hand off the soldier from the Department of National Defence to Veterans Affairs to ensure continuity of care.

I will let General O'Brien give you a bit more stuff specifically for the army side.

[The Chair, Conservative, Rick Casson]

Go ahead, General.

[BGen G.J.P. O'Brien]

It's very much as General Tabbernor has laid out. More specifically, once the reservist is coming out of theatre, he follows exactly the same decompression leave and returns with the unit he's deployed with.

Once he is returned, he's required to do a mandatory three half days' reintegration time with his unit, during which he'll do an initial medical. There will be follow-ups at three months and six months. The unit and the brigade force generation officers that are now in place are responsible for tracking and ensuring that this reservist receives the proper post-tour follow-up. It is tracked and measured by our chain of command in the army today.

[Joe McGuire, Liberal, Egmont, PE]

Thank you.

[Anthony Rota, Liberal, Nipissing—Timiskaming, ON]

I'll take on a couple questions as well.

For the reservists who come back, location is probably one of the biggest issues I have an affinity for, because I come from northern Ontario. I can see it there, where people put their heart on the line, they put their heart and soul into something, especially reservists, who are in a small community and who go into theatre and then come back.

We've seen it with the regular forces, with reservists who are not, as you mentioned, part of a unit. Is there any kind of funding or a special type of funding there to help them out once they go back to their community? If you come back to your unit, you're guaranteed a place or you have a position in the military, although that doesn't always happen, but for reservists who are going back and who have health problems, who's responsible for taking care of those individuals?

Do you have a plan in place? How does that work exactly?

[BGen G.J.P. O'Brien]

Absolutely. It has certainly been evolving, and it is getting better every day. But there is absolutely a plan in place. Once a reservist has returned, it is the responsibility of the reservist's unit itself to make sure he is getting the proper follow-up. If a problem is identified, he is handed over to the appropriate authorities within the casualty management system. He is treated and provided all those treatments in a centre as close to his home location as possible. But you are correct, it is most difficult for reservists who return to small units in rural Canada where they may live some 20 or 30 kilometres away from their home armoury.

They do share some responsibility for making sure they show up, but it is the unit's and the chain of command's responsibility to track them and to identify if there are issues. If there are issues, it is their responsibility to send them over to the casualty management system where the full spectrum--as is the case for the regular force--of benefits are applied to support the individual.

[Anthony Rota, Liberal, Nipissing—Timiskaming, ON]

Is the casualty management unit with the base? I'm going to take the examples of North Bay and Petawawa. Petawawa has a base unit that takes care of it, but it doesn't seem to be as well-advanced as Edmonton or Valcartier. They're close to major centres and have better access to large health units or health centres on the civilian side. Is there anything that helps a person in North Bay avoid two hours of travel to get to a unit that can give him service--so he can get civilian service, instead of a system that maybe isn't well-developed or as developed as some of the larger centres?

[BGen G.J.P. O'Brien]

You're absolutely correct. At this time there are 20 casualty management centres being set up across the country. Because the country is so large, we are victims of our geography. The reserve footprint is so broad. The initial centres are going into the regular force super-bases, so they won't service the reserve community totally. The additional centres will go into large metropolitan areas, centred around where the reserve communities are. The plan is to expand to cover all of the areas--to match them where practical--to provide those services for reservists.

[The Chair, Conservative, Rick Casson]

Thank you.

Thank you, Mr. Rota.

Mr. Bachand.

[Claude Bachand, Bloc, Saint-Jean, QC]

Thank you, Mr. Chair.

I will first direct my questions to you, general Tabbernor. You know we are studying health care, with an emphasis on post-traumatic stress disorder. I'd like to know if the cadets are covered if they are physically injured. I don't think that at their age, they would suffer of a post-traumatic stress disorder, because they haven't witnessed events which are very stressful.

But what happens to a cadet who breaks his leg? Is he dealt with by the military authorities or is he transferred to the public sector of the province? I would like you to tell me what the situation is.

[MGen D.C. Tabbernor]

There are two aspects to it. As you're aware, cadets do training in locations close to home during the school year, and some of them go away in the summer to cadet training centres. In the cadet training centres we have established medical facilities that provide initial care to cadets who may be injured while undergoing training. The intent is to ensure that the cadet is stabilized and, if the issue is serious, to quickly transfer them to a civilian facility that can provide more care.

The intent is to get them back into the provincial medical system as quickly as possible. To assist with the medical care for the cadets, each army, navy, and air cadet league has an insurance policy that covers cadets for medical concerns.

If a cadet is injured doing local training, we would then turn them over to the provincial medical facilities as quickly as possible, because in a lot of places where the cadets train there is no military facility. So the intent is to put them directly into the provincial care system as quickly as possible.

[Claude Bachand, Bloc, Saint-Jean, QC]

This is also the case, as far as I know, for soldiers who get injured while training or on a tour. Do you know how do the agreements between provinces work out? If a cadet gets injured while training or at a summer camp, you say that you will first stabilize his condition and you probably have facilities in the bases to do it. But after that, you transfer him as rapidly as possible in a hospital facility that is administered by Quebec or another province.

Do you continue to pay the costs or is that transferred to the provincial authorities?

[MGen D.C. Tabbernor]

I do not have a definitive answer to that question, sir.

[Claude Bachand, Bloc, Saint-Jean, QC]

Could you send that information to the clerk? I would appreciate that.

My next question is directed to the group of generals who are here today.

I'd like to know what you think about the report of the auditor general, which is highly critical of the health services offered to reservists.

I imagine you've had time to read the report. I'd like to hear your reactions to this report. Do you think that the auditor general went to far? Do you admit that the report is close to reality?