Evidence of meeting #7 for National Defence in the 43rd Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was quebec.
A recording is available from Parliament.
Conservative
James Bezan Conservative Selkirk—Interlake—Eastman, MB
Thank you, Madam Chair.
I want to thank our witnesses for appearing. I want to thank Colonel Malcolm and Major Martin, our military members who are with us.
Major Martin, I particularly thank you for your testimony at the Ontario long-term care commission. I think it was brutally honest. It really gave everyone a clear picture of the unfortunate events that unfolded and that you and your team were sent in to clean up.
To start, I have a couple of quick questions for you, Colonel Malcolm. If we were in an operation like Afghanistan and had so many of our medical personnel deployed in managing role 3 hospitals in forward-operating bases, would we have been able to handle the domestic response that was required during the first wave of COVID-19?
Conservative
James Bezan Conservative Selkirk—Interlake—Eastman, MB
But that's exactly what I mean. It's about the number of medical personnel deployed at our role 3s in forward-operating bases throughout Afghanistan. If we had all those people deployed, how would we manage a pandemic like we're experiencing right now?
Col Scott Malcolm
In order to tackle this very complex problem in the spring, we took a very different approach to it. We looked at it through a very needs-based health workforce planning lens. We looked at managing individuals and individual professions in this regard. We had to make some very deliberate decisions.
Certainly, in the face of a large-scale deployed operation like Afghanistan, more challenging decisions would have been made to manage the needs of a larger deployed force and balance those with domestic requirements.
Conservative
James Bezan Conservative Selkirk—Interlake—Eastman, MB
Thank you.
Will medical health services be required to participate in the rollout of the COVID-19 vaccine, especially now that General Fortin has been appointed as the leader on the distribution of COVID-19 vaccines?
Col Scott Malcolm
As of right now, the additional roles of the Canadian Armed Forces and specifically Canadian Forces health services remain to be determined, though I will note that in the omnibus RFA that was developed as part of Operation Laser, one of the planning contingencies included in it is a role for the Canadian Armed Forces in mass vaccinations. That's factored into the planning, but it remains yet to be determined whether or not we will be required in that regard.
Conservative
James Bezan Conservative Selkirk—Interlake—Eastman, MB
In preparation, as part of your training and readiness with the Canadian Armed Forces and through your health services group, are you right now training members of the Canadian Armed Forces to actually administrate vaccines across the country?
Col Scott Malcolm
For a number of our clinicians, the administration of a vaccine is a standard part of their training. The vast majority of those folks, be they medical technicians or nurses or physicians, are currently administering influenza vaccinations to our troops across the country.
Conservative
James Bezan Conservative Selkirk—Interlake—Eastman, MB
I understand that the Canadian Armed Forces have been discussing their participation in the distribution of COVID-19 vaccines for some time as part of Operation Laser.
Colonel Malcolm, have you any idea how many members of the medical health services group will be required to help in this section of Operation Laser in the distribution of COVID-19 vaccines?
Col Scott Malcolm
As the military continues to gain a greater understanding of the needs the Public Health Agency and perhaps the provinces and territories may have with respect to the rollout, the role that Canadian Forces health services may play remains yet undetermined, noting that we have provided a pharmacist and a health care planner as part of that initial planning team.
Conservative
James Bezan Conservative Selkirk—Interlake—Eastman, MB
In this planning process, when would the Canadian Armed Forces, under the leadership of General Fortin, have a solid plan in place that could be explained to Canadians from coast to coast to coast, so that they understand how the vaccines are going to be distributed, what role the Canadian Armed Forces would be playing, how we get to vulnerable populations and how we innoculate those who are living in rural, remote and northern communities?
Col Scott Malcolm
Madam Chair, that would be a question better placed to Major-General Fortin and the Public Health Agency of Canada. I'm not privy to the details and where things stand on that plan at this time.
Liberal
Liberal
Yvan Baker Liberal Etobicoke Centre, ON
Thank you, Madam Chair. I would like to ask my first question to Professor Estabrooks.
Professor, it's good to see you again. I have about five minutes, so I'm going to try to split my time between you and Mr. Hébert, if possible. If we could keep it within two minutes, I'd be grateful, just so that I have a chance to ask him a question as well.
Professor, do you believe that it is important, in light of what the Canadian Armed Forces discovered and revealed as far as some of the practices and conditions in our long-term care homes are concerned, that national standards for long-term care be established? If so, why?
Professor, University of Alberta, As an Individual
Yes, I do, for some of the reasons articulated earlier. There is a patchwork of what can be expected across the country. It would raise educational standards. It would probably raise care hours and our understanding of the kinds of mixes provided. At the minimum it would reassure and would help the public understand that there's a national interest and a common understanding of what you could expect when you get old and need long-term care.
Not everybody is going to need long-term care when they get old. Dementia is the main driver of admission to long-term care. Those people whose needs overwhelm the family and the community in home care do need long-term care. For them, it's the right place to be if it's done properly.
Right now I think Canadians are afraid—I know they are—to go into a nursing home. The pandemic has exacerbated it. There's no sense, I believe, in the country that this is a national effort in the same way, even though it's still a bit of a patchwork, that health care is. Long-term care is not health care. It's a combination of social and health care. There's no real sense of cohesiveness that I can see in terms of what you get to expect when you get old and need that kind of care.
Liberal
Yvan Baker Liberal Etobicoke Centre, ON
Thank you very much. I'll switch to Mr. Hébert now.
Dr. Hébert, it's a pleasure to meet you virtually. Thank you for being with us today.
My question is the same one I just asked Dr. Estabrooks regarding national standards for long-term care facilities.
In the Speech from the Throne, the government announced that it will work with the provinces to establish these national standards. Do you agree that this is important and a good way of improving conditions in long-term care facilities?
As an Individual
Thank you very much for the question.
I agree because, in every other field of medicine, we have standards, either Canadian or international, for treating diabetes, Alzheimer's disease, obesity and heart disease. These standards must be based on the best scientific evidence available and, because Canada's provinces have relatively similar health care systems, it makes sense to bring the provinces together to benefit from their respective experiences and expertise.
It's also worth noting that Quebec's health services are accredited by Accreditation Canada, which also have national standards and has applied these standards in Quebec for decades. So, it's normal to rely on not only Canadian standards, but also international standards, to ensure Quebec and Canada have the highest possible standards in the world when caring for elderly people in institutions.
Liberal
Yvan Baker Liberal Etobicoke Centre, ON
We have about 45 seconds. Briefly, what were some of the most horrific or difficult conditions you or your personnel observed in your service in long-term care, and what could be done about them?
Maj Karoline Martin
Certainly the report answers much of that, but I think for the clinicians it was actually seeing patients dying alone or not having their family with them. That was very challenging for all of the clinicians involved.
Liberal
Bloc
Alexis Brunelle-Duceppe Bloc Lac-Saint-Jean, QC
Thank you, Madam Chair.
Dr. Hébert, you spoke about national standards. Does Quebec's department of health and social services currently implement strategies for mental health and elder care? Has the department always done so?
As an Individual
Yes. The Quebec government has mental health care and elder care strategies. What I have bemoaned for a very long time is that these elder care strategies have been a low priority and the result has been much more carnage in Quebec than in the other provinces and other industrialized countries. This is due to many years of neglecting this part of the system.
Bloc
Alexis Brunelle-Duceppe Bloc Lac-Saint-Jean, QC
So, Quebec has elder care strategies. You said that was music to your ears. In other words, the federal government, which has no hospitals, or maybe one or two, is in a better position to overrule the people on the ground.
Is that correct?
