National Defence Committee on June 17th, 2008

[The Chair, Conservative, Rick Casson]

I call the meeting to order.

Today we've reached our 33rd meeting in our study on health services provided to Canadian Forces personnel, with an emphasis on post-traumatic stress disorder.

As it could be our last meeting before the summer break, it's an honour to have General Rick Hillier before us today.

Welcome, sir. It's always a pleasure to have you here. Thank you for taking the time to come.

On behalf of the committee, I'd like to thank you for all your hard work on behalf of our brave men and women serving in the Canadian Forces. In your years as CDS, you've been active in addressing the issues of mental health within the forces. So, again, we look forward to hearing your comments.

Before I hand it over to you for your comments, I have a note from John Cannis, who is the vice-chair of this committee. He's recovering from surgery and could not be here today. He called to extend his best wishes to you, Mr. Hillier, and wanted to thank you for your tremendous service to our country and to our men and women in uniform. He wishes you good health and much success in future endeavours.

Sir, you are familiar, I believe, with being before this committee and you know the drill. We will give you an opportunity for comments, and then we'll have a round of questioning. I understand you have an hour for us today, which will give each party a chance to ask a question or two.

The floor is yours, sir, and thank you very much for appearing.

[General Rick Hillier, Chief of the Defence Staff, Department of National Defence]

Mr. Casson, ladies and gentlemen, thank you.

First of all, let me say that I'm glad to appear before the committee today.

As CDS, one of my most important responsibilities is to ensure that we have a Canadian Forces that cares holistically for our men and women. That care includes making sure we have the right leadership at every level, that we have the right equipment when we ask those men and women to do a job for us, that they are appropriately trained, that they have the right benefits to compensate them for the job they do for us, that they are physically prepared for the jobs they have to do, and that they are looked after, prepared, sustained, and supported medically and dentally, and certainly that includes their mental health. It is a responsibility that I take seriously and that I know the leadership of the Canadian Forces also takes seriously. It wouldn't even require me on top of them to make sure they do, because they do.

I appreciate and welcome the committee's interest in this regard. We welcome your leadership in this specific field, because I believe the Canadian Forces have gone through some tough times. We almost broke the Canadian Forces, as a country, and within that, we almost broke the medical system. Therefore, much of what we have been doing for a long period now is simply trying to recover, to get out of that deficit and get us to a solid base where we can do our job in the way that we want to do it.

Thank you for your continued support to the men and women of the Canadian Forces.

To better appreciate where we are—and I know you've been through much of it with respect to our health care generally and mental health care specifically—I think it's key to understand where we have been.

With the end of the Cold War, the anticipated peace dividend led to our downsizing, including the CF health systems and health services, exactly as our commitments operationally worldwide in intense operations skyrocketed, with operations in Croatia, Bosnia, Macedonia, Somalia, Rwanda, Cyprus, and others. We now continue to see, perhaps in increasing numbers, casualties from those operations who for the first time have felt confident enough to come forward.

The result was a dramatic reduction of military health care capacity, retaining only those services deemed necessary for future operations. A decision was taken to downsize in-garrison care in Canada and leverage the civilian health care system; a decision that ultimately did not serve the needs of a modern day fighting force.

We closed in-patient capabilities in Ottawa, Valcartier, Halifax, Esquimalt, and Germany, all with in-patient psychiatric capacity. In-patient addiction rehabilitation services were closed in Valcartier, Kingston, Winnipeg, Esquimalt, and of course Germany, as we did the pullout from there.

At the same time, the civilian health care sector was under severe financial pressures. It could not easily accommodate the additional Canadian Forces patients with unique occupational requirements.

By the late 1990s we knew, and it was confirmed by a chief review services report, that our military health care system was in trouble. We had almost destroyed it. As a result, we launched a health care project entitled “Rx2000”.

Rx2000 was our health care reform initiative—and I know you've heard about it—which would touch every aspect of health care delivery in Canada and on operations abroad. We addressed a host of issues with Rx2000: primary care; mental health services; health protection and promotion; attraction, retention, and training of health care personnel, which was a major challenge; and other issues such as electronic health records.

Part of Rx2000 included a comprehensive review of mental health best practices using an evidence-based approach. This led to a multidisciplinary mental health care delivery model, since validated by a third-party evaluator and the OAG.

Redeveloping lost capabilities is difficult and it takes a long time. We know when we lose unique capabilities it will require years, and for us, sometimes decades, to regrow that. I think there are lessons there for the future.

Rx2000 started to correct many of the deficiencies we identified in the late 1990s but did not address all of the current realities. It truly was a survival mode.

What has transpired since then?

The Canadian Forces have continued to adopt a proactive stance in addressing the health needs resulting from contemporary conflict. Further enhancements are being made to the Canadian Forces health care system. We are hiring more health care providers at clinics across Canada to further enhance the primary care provided there. We are expanding the case manager program to better support members with complex health care issues and we are expanding our mental health services.

By the end of this fiscal year we will have hired an additional 218 mental health professionals--psychiatrists, psychologists, social workers, mental health nurses, pastoral counsellors, and addiction counsellors, just to name some of them. Our CF team will have almost 450 mental health professionals.

The Canadian Forces mental health team uses an interdisciplinary model that involves comprehensive and holistic mental health assessment and tailored treatment that meets the individual's unique needs.

Where problems result in treatment not being available in the CF in a timely manner, personnel are referred to the outside civilian health care providers.

It is important to recognize that the Canadian Forces are unique in their use of civilian mental health providers.

The CF funds appropriate and necessary care without the member incurring payment charges.

The treatment can be as long as necessary, provided that the therapy is evidence-based and follows best practice guidelines.

This approach is at the leading edge of mental health care in Canada. We also realize that the social environment can enable care and recovery from mental health problems in the way it addresses the stigma that has been too often associated with mental health issues.

We've all been there. We realize what a challenge it was. The result was a program of social support for members and families: the operational stress injury social support program, launched in 2001. With some success, this program has grown into a robust partnership--we believe a strong partnership--between us and Veterans Affairs Canada, with 40 employees and some 120 volunteers across the country. We've assisted more than 3,500 clients, including more than 100 families. It offers one-on-one support, peer support groups for serving military personnel, veterans, and families, and social support to bereaved families.

This innovative program has been enhanced by a new educational campaign for our people, our men and women. This campaign was developed by a group, including veterans who have recovered from mental health problems, clinicians, the U.S. Marine Corps, and Canadian academia, and it will help us increase general awareness of mental health, provide information on how operational stress can affect individuals, their peers, their subordinates, and those around them, and teach CF personnel what they can do to assist those with mental health issues.

Our goal is to provide our men and women who serve our country in uniform the tools to recognize early signs of mental health challenges and issues and to take positive action. This educational campaign has been expanded to CF families to also help them, help them support their loved ones and help them deal better with the effects of mental health problems suffered by those who serve. Family members of mental health sufferers will be involved in this initiative, and they are actually in town this week to help develop the curriculum.

Alignment of these initiatives will be ensured through a variety of things. First of all, there will be an arm's-length mental health services advisory committee, a joint initiative between us and Veterans Affairs Canada. Again, it is led by an experienced champion for OSI sufferers, Colonel (Retired) Don Ethell, who is an aggressive champion. I think you've already had the opportunity to talk to him. We will draw on a wide group of mental health experts through that committee.

We have re-established the Canadian Forces operational stress injury steering committee, which is a forum for our senior leadership, including me, to help discuss better ways to support those who have suffered an operational stress injury. I've never been a believer in committees, and I was part of the original operational stress injury steering committee. I actually think we can get some more value from it by having our leaders focus on it.

Establishing our special advisor to the chief of military personnel, Lieutenant-Colonel Grenier, who has himself suffered an operational stress injury, has been key to the initiatives already launched, and he, with his team, will build on the successes already achieved.

Let me just tell you something. I was in Bridgewater, Nova Scotia, just a month ago, I think it was, for a rally in red. I had the opportunity to talk to Mr. Jim Davis, who lost his boy in Afghanistan a year and a half ago, I believe it was. Mr. Davis, speaking with his knowledge of many of the other families who have lost their sons or daughters in Afghanistan, was full of nothing but praise for this officer here and the leadership and support he has provided to those families in their darkest hours and darkest days.

Notwithstanding these major advancements in clinical and non-clinical health care, we have many challenges. All of us know that.

Bases like Petawawa and Gagetown that have sent large segments of their communities on deployments continue to have their mental health services stretched. Part of the challenge is the geographic location of the bases and the resulting difficulty in finding, attracting and retaining necessary skill sets in local areas. This challenge is common to most rural communities in Canada. To address this, the Canadian Forces will leverage their neighbouring regional mental health centres in areas such as Ottawa and Halifax.

The Canadian Forces health care system as a whole is strong, but I do believe we have actually just recovered from a deficit. We think we have a solid base on which to build the kind of health care system that we believe is absolutely necessary, and we are working hard to improve it every day. We remain confident in our overall health care system, but we still work hard to improve it.

While no system is perfect, patient satisfaction, and the surveys that come from them, consistently show that the health care system is meeting the vast majority of patient needs. We'd like to have it perfect. It's not, but we work hard to try to make it that way. We, the leaders, are fully aware of the impact that mental health and operational stress injuries have on our members and their families. We actively support our mental health care initiatives and provide leadership that we believe is right and fundamental for those people. All of these efforts will need both the support and the funding of the Government of Canada for years to come, because the effects of mental health injuries are sometimes felt decades after the initial diagnosis. I think our men and women deserve that, and they certainly need that kind of leadership from you.

Thank you very much. I'm prepared to take your questions, Mr. Chair.

[The Chair, Conservative, Rick Casson]

Thank you, sir.

We'll open up the opening round with seven-minute spots.

We'll start with Mr. Wilfert.

[Bryon Wilfert, Liberal, Richmond Hill, ON]

Thank you, Mr. Chairman.

Thank you, General Hillier, for being here.

As the official opposition, we certainly want to thank you and congratulate you for your tremendous work over the years. I know there was some rumour about your wanting to maybe coach the Toronto Maple Leafs. I did see you down at the Gardens one time with about 300 soldiers. When you were on the Gardens' ice, you had a standing ovation longer than the Leafs, which is probably not hard to do—

[Voices]

Oh, oh!

[Bryon Wilfert, Liberal, Richmond Hill, ON]

—and the Ottawa Senators. It's usually the politicians who are used to being on thin ice, but I have to say that the support you received was very, very impressive.

Since you were appointed in 2005, I have to say there has been a wonderful transformation of the forces. I know the job isn't easy, but the fact that you and your wife, in particular, have gone across this country and have seen families—and we've certainly heard of this—speaks very well for you. So thank you very much.

[Gen Rick Hillier]

Sir, thank you for saying that.

[Bryon Wilfert, Liberal, Richmond Hill, ON]

I want to ask you a couple of questions.

We are, sir, looking at recommendations. We know, and we've seen in the United States, the fact that the more tours of duty people have, the more mental health issues tend to increase. We've seen in the United States where they have been prescribing.... Maybe you can enlighten us on that. Is it the common practice of the Canadian military to prescribe certain drugs for combat-related fatigue or combat-related stress in the field?

Secondly, do you think it would be useful for us to see another survey of the forces personnel with regard to the kinds of services that are being provided—the last one, I believe, was in 2002—in order to make sure we can provide the right services as we move forward?

Finally, do you have any specific recommendations that you could make to this committee? In particular, if you had a wish list of one, what would be the one thing you think we should be trying to provide to ensure that the people in the field, who put their lives on the line on a daily basis, will have the support they need, and particularly for their families when they return?

[Gen Rick Hillier]

I'd be delighted to answer those questions.

We do not use drugs in the field to combat fatigue or to keep people awake 24, 36, or 48 hours. That is not our policy. There are many implications when you do that kind of thing, and most of these implications we're not comfortable with. One of them is that you always have a fall-off when the effect of the drug wears off, and that may be the time when alertness is most desperately needed. We do not use drugs. We do not enhance the performance of our soldiers. We do not keep them awake and allow them to remain more alert for longer periods of time by using drugs.

We use a variety of mechanisms to train people, make them physically robust, provide them the right balance of surge and relaxation. Sometimes they're driven pretty hard because the tempo of operations demands it. We always say that rule one in operations is that the enemy has a vote. We do not use drugs to ensure that people stay awake or can serve for longer periods of time.

I'm not sure whether an audit would serve a useful purpose right now. I've been through the procedure several times over the past years and months. In 2002, we had the audit you referred to. We took the recommendations from that audit, and we are in the process of implementing them. We are now changing fundamentally all the things we're doing across the country in providing services. What we need is one or two years to give some of those things an opportunity to take hold. Then we could do an audit of where we are at that stage. So I would suggest that the summer of 2010 or thereabouts would be a better date to look at this. That would be my first-blush impression.

Sorry, was there a third question that I didn't answer?

[Bryon Wilfert, Liberal, Richmond Hill, ON]

There was the audit, and I thank you for the information with regard to drugs.

Is there something you would say would be a priority? I know we went through a major deficit. In 2005 your responsibility was to start to modernize the forces. We are in a better financial situation at present. What would you suggest we were lacking that we could respond to now?

[Gen Rick Hillier]

I thought your third question was going to be whether my Toronto Maple Leafs watch was still working. But like the team, it hasn't told time very well for about 41 years, and it's a major challenge.

I don't think there's one single thing, but it all comes to one single thing. This is something I believe in very fervently: being valued is worth its weight in gold, and being valued means actions, not just words. Excuse my language, but we have a little slogan in the army: “Bullshit walks and action talks”.

That's so true for our men and women when they're out doing something. When you're on that dirty, dusty, dangerous trail in Kandahar, and you're 12,000 kilometres away from home, and it's 51 degrees centigrade, and you're carrying 80 or 85 pounds, and somebody is shooting at you, you can be forgiven for thinking you're in this all alone, all by yourself, and nobody cares.

“Being valued” means taking action to ensure that our young people, whether they're wearing the army, navy, or air force uniform, understand that they're connected to Canada every single second. They need to understand that they have the right leadership in place, that they've had the opportunity with the dollars given to them to be able to receive the right training in a comprehensive and intelligent manner—and we're getting a lot better at this, though we haven't always done it smartly in the past—that they have absolutely the right equipment, and that when conditions change we can react quickly and get that equipment to them. They need to believe that Canadians see what they're doing, appreciate it, and show their support for it. “Being valued” is worth its weight in gold.

If we can take actions that practically show that value in a variety of ways, then that means more than anything else. Our people have to be prepared to take risks. They have to be competent and know they're taking risks for noble reasons. Knowing that they're sustained by our nation allows people to deal with an awful lot. Increasing funding would help us to deal with some of the challenges of support, sustainment, and recovery from mental health injuries, operational stress injuries, and post-traumatic stress disorders. Those kinds of things are practical demonstrations of what actually allow people to believe fundamentally that they are valued. I think that counts for more than anything else. That's not just one thing. It is “action, not words”.

[The Chair, Conservative, Rick Casson]

Thank you.

Mr. Bachand.

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

Thank you, Mr. Chair.

I too would like to welcome General Hillier and thank him for his services to the Canadian Forces. When he came to Saint-Jean a few years ago to see his son receive his degree, he invited me to go running with him. As we are about the same age and as I was training at the time, I thought I would be able to keep up. Regrettably, after a few minutes, I realized that, not only was he ahead of me, he also had the legs of a man of 20. In a small way, that shows what General Hillier has been able to accomplish and gives an idea of the great respect he inspires in the men and women he commands. Each time I saw him with them, I saw what charisma means. I will end by saying that the Bloc Québécois has a great deal of admiration for what you have done. I wish you a very happy retirement.

In your presentation, you talked a lot about treatment, about the fact that people with wounds or post-traumatic stress have access to services on their return. I must acknowledge that, for several years, the Canadian Forces have taken health issues seriously, especially post-traumatic stress disorder. It is true that more and more effort is being put into helping these people get back on their feet. Can we talk a little about prevention?

It has been explained to me that attempts are made to train as close as possible to the theatre of operations. I have been to several of these places, and I understand, I think, that there is nothing worse for a battle-ready soldier, trained for action, to see atrocities being committed while having to obey orders to do nothing. Everyone was talking about Srebrenitza when I was in Bosnia during rotation 9. That was then, now we have to deal with the present.

Questions were asked in the House of Commons today about alleged sexual assaults committed by members of the Afghan army. There are reports that our officers and soldiers are witnessing these assaults and that the officers are issuing orders not to report them.

You are going to retire soon and I would like your opinion. I would also like to hear you guarantee that you have ordered all the officers presently in the theatre of operations not to demand that situations of that kind be kept secret and that nothing be done. They cannot give orders like that. Can you be absolutely clear that that is the case?

I am pleased that you are here with us this afternoon. We are finally able to meet the person responsible for the Canadian Forces. This responsibility rests with you and I can only hope that the problem will be resolved.

[Gen Rick Hillier]

Sir, thank you for the question. Let me walk through a couple of points.

First, we went through a terrible time in the former Republic of Yugoslavia, in the Balkans, when under the mission mandate and the rules of engagement and the legal constraints we had soldiers standing around and watching what was equivalent to ethnic cleansing. All of us know about that. That was a terrible time, and it was more difficult for soldiers to come home feeling satisfied, which is a key part of staying healthy from a mission like that than almost anything else you would do in your life.

Secondly, when our soldiers, sailors, airmen and airwomen-- because they are all there and sometimes we forget the last three pieces—when they go abroad for us, as they are now in Kandahar, in Afghanistan, they go with the very best values our country holds near and dear to our hearts. They walk them, they live them on a daily basis here, and we expect them to.

Thirdly, we're not the inspector general for the Afghan national security forces, so we don't go in and pry into all their details. But to the essence of what you said, sir, let me simply say that if we are in Afghanistan, we're there to help the people of Afghanistan. Yes, we're there to work and help build the Afghan national security forces very directly. If we witness any kind of serious abuse—I'm trying to think of exactly the words to say—of individuals, I expect that my soldiers, sailors, and airmen and airwomen are going to immediately alert their chain of command, and that chain of command, with those soldiers, is going to take action to stop any kind of serious abuse.

Just in case there is any doubt of that, I have reconfirmed that direction down through the entire chain of command into Kandahar province to make sure the CDS's intent and our expectations as a nation are absolutely clear to all and sundry, and they are. If there is any serious abuse of Afghans, and I think we've had some good examples in the past year.... I know there was a young sergeant, for example, who was caught on TV cameras, saying, “You know, I'm concerned that if these people are handed over to the Afghan national security forces, who were there at the time, they may be beaten, injured or killed, and we're not going to do that; we're not going to let them go over.”

That's the kind of behaviour we expect. That's the kind we're going to reinforce through our chain of command. That's what Canadian soldiers give us all the time. We will do an investigation to see if there is any witnessing of anything that's occurred in the past and see if we've not done that kind of thing, but I guarantee what you said, my CDS guidance and direction down the chain of command is absolutely, unequivocally clear.

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

So you issued the order that any action of that kind be condemned. Just to finish, then, can you tell me if you can circumvent the orders of the government? Can we have the document you mentioned, or is it classified? When did you react and give those orders? Was it recently?

[The Chair, Conservative, Rick Casson]

General, before you respond, we are dealing with the quality of life in the forces here, so keep that in mind. I think questioners should keep that in mind as well. So if your response could be framed in that—

[Gen Rick Hillier]

Sir, what I would say is this. I'm not going to talk about when I specifically did it. It's very clear to my chain of command.

We do this because we believe that's one of the things our young men and women in uniform have to be absolutely clear about, that we have the moral high ground. Our values are such that we do not stand by if we're witnessing somebody being seriously abused. We're not going to stand by. Not only do they have the authority to get engaged and stop it or help stop it, but we expect them to. That's exactly what we want to do, because there is a correlation, sir, to the kind of effect a mission like Afghanistan will have on people, and we don't want any ambiguity whatsoever.

We're not the inspector general, as I've said, of the Afghan forces. Police forces and army forces come from around Afghanistan, so we're not investigating their units all the time. If we witness something, we're going to get involved. I want the chain of command alerted. I want people to get involved and stop it, and then we'll refer it to the Afghan authorities to sort out the longer-term part to go with it. But I don't want any ambiguity on that whatsoever.

[The Chair, Conservative, Rick Casson]

Thank you very much.

Ms. Black.

[Dawn Black, NDP, New Westminster—Coquitlam, BC]

Thank you very much, Mr. Chair.

Welcome to the committee once again.

Also, on behalf of my party, I wish you well in your future endeavours and in the choices you decide to make as you leave the Canadian Forces.

We've had a lot of testimony before this committee, some of which has been in camera. The testimony we heard in camera was very troubling testimony about mental health services and the lack of timely diagnosis or the lack of treatment that Canadian Forces members and their families felt they had a basic right to expect. The testimony was very striking in that the story each of the people who testified in camera told was almost identical. And there were several of them who told of their experiences.

At the same time, we've heard from people of higher rank within the military who clearly are committed to trying to treat mental health issues properly and effectively. They want to do that. But there seems to be this gap between what we're hearing from the upper echelons of the Canadian military and what we've heard from soldiers, not all of whom have been soldiers who returned from Afghanistan. Some were soldiers from our time in Bosnia. We even heard testimony about veterans from the Second World War who many, many decades later started to show symptoms of post-traumatic stress disorder.

My question to you is about this gap in perception and the gap between the testimony we heard from the individual soldiers and their families, who felt they didn't receive timely attention to their mental health issues, and the reports and testimony we heard about the desire in the higher levels of the military to ensure that they will. There is definitely this gap in the testimony we heard, and I'd ask you to address that.

[Gen Rick Hillier]

Well, I would say that the gap has been eternal. You mentioned World War II and even, obviously, when we had veterans alive, World War I, right up to the former Yugoslavia.

I am actually surprised that we had any treatment program for people who came out of Bosnia, Croatia, Somalia, and places like that. As we were quadrupling the operations we were conducting worldwide, we were dismantling the medical system and getting rid of all those kinds of things because of the pressures under which we came. So I'm absolutely amazed that we had any kind of treatment, and I know it wasn't very good.

We have done a lot of work since then. But as I said earlier, we're just coming out of a deficit. Actually, I think we've just gotten ourselves back to a level playing field, and it's going to take some more months and years to get and build the kind of medical system that can actually look after all the people and their physical injuries and wounds and mental injuries and wounds.

We have made some progress. From five years ago to two years ago to even six months ago, the progress has been dramatic. It'll be better six months from now than it is right now. I think a telling point is that we're actually getting veterans from those earlier campaigns now coming forward, because the stigma has been removed somewhat. They have confidence that they'll get treatment and will usually get the right treatment.

But that doesn't sort of cover the fact that we still have significant challenges. We don't have enough of the right people in the right places. In an organization of 87,000 people, you're still going to have people who view it this way as opposed to people who view it that way. And not all will have the same positive outlook that an injury is an injury is an injury, whether it's physical or mental. We work every single day to change that.

It's a slow process. But I think it has been an almost miraculous change in the last two or three years to be able to come to grips with a significant number of injuries and the larger number of mental health injuries or operational stress injuries or post-traumatic stress. I think the change has been dramatic, and we just want to keep building on that.

Every single day we are clearer in terms of how we want to approach it. We get better policies in place, and policies are important, because they allow the universal treatment of folks. Then we actually get all the pieces coming together in places like Edmonton, and in places like Petawawa and Gagetown, particularly. We know we've had some very unique challenges in those last two places.

So I don't make any apologies, Madam. We've done a massive amount of work. We've had great satisfaction, for the most part.

There are still people who have not been seen quickly enough. We perhaps have not helped identify quickly enough that they have a challenge, or perhaps we didn't recognize that. I don't ever say for a moment that there's not some guilt on all of us. All I can say is that the leadership is committed. We've put the resources into it. We really have. And this man here on my left has been doing that on our behalf and on behalf of the people there.

We still struggle, though, as you know, getting the right kind of experts in place and getting them to a place like Petawawa. I mean, I love Petawawa. Having done three tours there, I'd live the rest of my life there. But not everyone who has the kind of specialty we need wants to go to Petawawa or to Gagetown. So we still struggle somewhat with all these things.

[Dawn Black, NDP, New Westminster—Coquitlam, BC]

That was in the testimony we heard, that the services are uneven across the country.

The other issue I wanted to raise was the issue of the ombudsman's report, which was really a very dramatic and in many ways condemning report on the treatment, oftentimes, of reserve soldiers. At a time when the Canadian Forces are relying in larger numbers on members of the reserve, I'd like to ask you what steps have been taken so far to address the concerns the ombudsman raised in the report.

I also want to know whether the whole issue of compensation has been levelled out between the reserves and the regular force, because in that report they made mention of a different level of compensation for a lost limb in the reserves than there was in the regular forces. There was some really troubling documentation about reservists returning from Afghanistan wounded and going home to the community they may live in, so they're not within the unit and able to access medical services on the base.

[Gen Rick Hillier]

I'd be delighted to talk to that. Of all the unique challenges we have, the reserves are actually a little greater challenge.

You all understand; you bring people back and if they want to go back to their home communities, sometimes it is difficult to maintain that contact and communication with them. We've taken a whole variety of measures--very practical, pragmatic measures. If an injured soldier comes home from Afghanistan, he or she will remain on full-time service until they have made the complete recovery that we and they are happy with. So they would remain part of our unit, and we keep them on full-time service as long as they want to be.

Whether they stay at home or they're with the unit, we work with the individual, and in that way we can provide them with the direct medical care for an operational stress injury or other kind of mental injury, or a physical injury.

That's a key one right there, because we used to have the policy that you came back home and I think it was 30 days' leave, and then you went back to being a class A reservist of 35 days a year. That is a huge change in and of itself.

We've put in place a variety of smaller programs, like link nursing, where we have a nurse who actually has responsibility for maintaining contact with those reservists no matter where they go.

We have put an emphasis on the chain of command of reserve units across the country. When they receive back to their units those young soldiers who they helped select and helped prepare and who they corresponded and communicated with when they were on the mission, they have a responsibility to then follow that young soldier, that young Sergeant Grenier or Corporal Hillier, and work with them over the next days and months. Mental health injuries sometimes don't come to the fore until five, six, seven, ten months down the road.

So we've taken a variety of measures to do that, including addressing what was a perceived financial discrepancy between a regular force soldier and a reservist.

[The Chair, Conservative, Rick Casson]

We might have to come back to that. We're out of time for that.

[Gen Rick Hillier]

We've taken that one on, yes, we have. What we want is a soldier treated as a soldier.

[The Chair, Conservative, Rick Casson]

Very good. Thank you.

Mr. Hawn.