Evidence of meeting #58 for National Defence in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was services.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Lise Bourgon  Acting Chief of Military Personnel and Acting Commander Military Personnel Command, Canadian Armed Forces, Department of National Defence
Daniel Bouchard  Commander, Canadian Armed Forces Transition Group, Canadian Armed Forces, Department of National Defence
Scott Malcolm  Commander, Canadian Forces Health Services Group, Canadian Armed Forces, Department of National Defence
Marc Bilodeau  Surgeon General, Canadian Armed Forces, Department of National Defence
Clerk of the Committee  Mr. Andrew Wilson

8:45 a.m.

Liberal

The Chair Liberal John McKay

I call the meeting to order.

We have quorum and we have our witnesses in place.

We are about to commence a study on the military health system and provision of health and transition services under the Canadian Forces Health Services Group, based upon a motion taken earlier to study this matter. This is our first meeting.

I want to welcome the panel. I see three unfamiliar faces and one familiar face.

Maybe I can turn to Lieutenant-General Lise Bourgon and ask her to introduce her colleagues and—whether it's her or someone else—to please give an opening five-minute statement.

8:45 a.m.

Lieutenant-General Lise Bourgon Acting Chief of Military Personnel and Acting Commander Military Personnel Command, Canadian Armed Forces, Department of National Defence

Thank you very much, Mr. Chair.

Good morning everyone.

I guess I come here too often, since you know me.

8:45 a.m.

Liberal

The Chair Liberal John McKay

You're a veteran.

8:45 a.m.

LGen Lise Bourgon

As you know, I'm Lieutenant-General Lise Bourgon. I'm the acting chief of military personnel and commander of military personnel command.

First this morning, I would like to acknowledge that we are gathered on the traditional unceded territory of the Anishinabe people.

As Acting Chief of Military Personnel, I am responsible for recruitment, training, retention, education, career management, policy, pay and benefits, health services, military career transition, morale and welfare programs, and a host of other corporate and personnel support services. It is a very broad mandate.

I am joined here today by three of my senior commanders.

First, to my right, is Major-General Marc Bilodeau, the surgeon general, who is the medical adviser to the chief of the defence staff and to the Minister of National Defence. He's also the functional authority for the professional and technical aspects of the medical and the dental care to our members.

I'm also joined by Brigadier-General Scott Malcolm, commander of the health services division, whose responsibility it is to deliver health care to CAF personnel to ensure their readiness and enable CAF operational success through the provision of agile health service capabilities around the world.

To my left is Commodore Daniel Bouchard, Commander of the Canadian Armed Forces Transition Group that provides military career transition services to serving or retired members, including active, retired, healthy, ill and injured members, and families of deceased members.

I would like to thank the committee for its interest in better understanding our military health system, the provision of health services and the transition support to our members. These are indeed important topics, because, first and foremost, we have a duty to take care of our people who put service before self.

Unlike any other institution, the provision of health care to our members is the responsibility of the CAF, and not the province or territory where they reside.

Together, all of us here today are focused on providing the required supports and services to our members through all aspects of their military careers, whether they are healthy, ill or injured, transitioning to civilian status or deployed on operations.

Our priority is the long-term health and wellness of our military members and the provision of high-standard and quality health care to the full diversity of the CAF. This is achieved primarily through the Canadian Forces Health Services Group, which is responsible for the care and well-being of about 64,000 regular forces members as well as our reserve forces members on operations or in full-time service.

Canadian Forces Health Services, or CFHS, is a key enabler to our military missions around the world through pre-hospital, primary, surgical and specialized care.

Here at home, CFHS provides health services through 37 primary care clinics across the country, and 31 of those offer specialized in-house mental health care. The multidisciplinary teams of mental health care providers include social workers, mental health nurses, psychologists, psychiatrists, addiction counsellors and mental health chaplains.

The CAF’s mental health program has been recognized by our NATO allies and civilian organizations for its robust approach to mental health care, stigma reduction initiatives, and mental health research, training and awareness programs.

For example, the road to mental readiness program, launched in 2007, helps promote mental resilience and improves mental health awareness.

We also have a special program called “Resilience Plus” created specifically for military college students.

Given the unique nature of our jobs, sometimes our members become significantly ill and injured. Whether their injury is physical or mental, they may require enhanced support through a return-to-work program or to transition within the CAF or, sadly, to post-military life.

That is one of the reasons why Canada’s 2017 defence policy Strong, Secure, Engaged directed us to create the CAF Transition Group. In close collaboration with Veterans Affairs Canada and other valued partners, we now have 32 transition centres at bases and wings across Canada.

CAF Transition Group staff work to offer the best possible service and support to all CAF personnel and their families to prepare for and, at the appropriate time, complete a seamless and successful transition to civilian life.

It is important to note that transition does not automatically mean leaving the forces. CAF TG—transition group—offers services and programs to support, first and foremost, the return to duty of our members, whether that is by reintegrating them into their home units or helping them transfer their skills and experience to new career paths within the CAF, such as through occupational transfer.

8:50 a.m.

Liberal

The Chair Liberal John McKay

General Bourgon, are we close to the end?

8:50 a.m.

LGen Lise Bourgon

I am almost done.

We know we have more work to do to continue to provide quality service to our members. That is also why we are working to improve the spectrum of care that we provide and how it is provided, especially on service and support for women and diverse members.

I think that budget 2022 announced $144 million over five years to expand the CAF health services and physical fitness program to be more responsive to women and gender-diverse members.

We are also taking concrete steps to make our health resources and services more inclusive. For example, we have reviewed our transgender care program to make it more inclusive and comprehensive for our members.

We also continue to work with our women members to offer person-partnered care and to identify gaps and needs in order to act on them.

Whether our personnel are on the road to recovery, rehabilitation, returning to duty in the CAF or transitioning to civilian life, we are committed to assisting them in their journey.

Thank you once again for this opportunity to appear before you today. We welcome questioning from committee members.

Thank you.

8:50 a.m.

Liberal

The Chair Liberal John McKay

Thank you, General Bourgon. It's not even nine o'clock and already I've cut a general off.

With that, we'll start with Mr. Bezan.

8:50 a.m.

Conservative

James Bezan Conservative Selkirk—Interlake—Eastman, MB

Thank you, Mr. Chair.

I want to welcome our witnesses to committee.

General Bourgon, it's good to see you back.

You mentioned the JPSU, which we had stood up as part of the road to mental readiness program to help them with that transition.

JPSU no longer exists. There is a new format. Can you explain, for those who are medically releasing for either visible or invisible injury, how we handle them specifically?

8:55 a.m.

LGen Lise Bourgon

Yes. Mr. Chair, thank you very much for the question.

I will give the floor to Commodore Bouchard, whose job it is to be the leader of the CAF transition group.

8:55 a.m.

Commodore Daniel Bouchard Commander, Canadian Armed Forces Transition Group, Canadian Armed Forces, Department of National Defence

Thank you very much, Mr. Chair.

The JPSU, as you said, was stood up in 2009 to assist our ill and injured in their transition and their support. In 2017, we stood up “Strong, Secure, Engaged”, recognizing the requirement to increase the support to our members who are transitioning. In 2018 my organization, the Canadian Armed Forces transition group, was stood up in order to provide that support.

We have developed a process for military to civilian transition. All regular force—and soon reserve force members—will be transitioning through our organization to civilian life.

Our primary focus also is on retention. As General Bourgon was saying, we have stood up 32 transition centres in nine regions to support the process of transition.

8:55 a.m.

Conservative

James Bezan Conservative Selkirk—Interlake—Eastman, MB

They don't have to report in like they used to under JPSU to be part of a unit. They aren't required to parade or be on exercises or training or anything—

8:55 a.m.

Cmdre Daniel Bouchard

That is correct. They are employed in accordance with their military employment limitations. Some can continue on with some parts of work, and the idea is to reintegrate them as best we can into the—

8:55 a.m.

Conservative

James Bezan Conservative Selkirk—Interlake—Eastman, MB

Release happens when everything has been assessed. Do you hand them off to Veterans Affairs with pensions in place as well, or do they still have to wait sometimes months and years, especially our reservists, before they receive a pension or any of their disability benefits?

8:55 a.m.

Cmdre Daniel Bouchard

With our new process at the TC, it's a holistic approach, and we have Veterans Affairs Canada embedded with us to better support our members as they transition. Our ill and injured are supported by a service coordinator, who provides them with a personalized approach across the services that they require, and we ensure that the services will transition with them if they are releasing from the Canadian Armed Forces.

8:55 a.m.

Conservative

James Bezan Conservative Selkirk—Interlake—Eastman, MB

I'm going to switch gears a little bit here.

When we are deploying our troops to places like Latvia, Kuwait, Poland or the U.K. right now, do we provide our own medical teams to accompany them or do we rely on allies to provide their medical care?

8:55 a.m.

LGen Lise Bourgon

The answer depends, but mostly we have our own integral medical resources.

General Malcolm, you may want to add to this.

8:55 a.m.

Brigadier-General Scott Malcolm Commander, Canadian Forces Health Services Group, Canadian Armed Forces, Department of National Defence

Mr. Chair, thank you very much for the question.

As it stands right now, in terms of support to operations Impact, Reassurance, Unifier and Projection, all of the medical personnel deployed there are providing supporting medical care to our troops on the ground. It's only in our other operations that they are there as trainers.

8:55 a.m.

Conservative

James Bezan Conservative Selkirk—Interlake—Eastman, MB

In Poland, where do our guys go for medical attention if they get a sprained ankle in theatre? They're out there training—

8:55 a.m.

BGen Scott Malcolm

We do have internal—

8:55 a.m.

Conservative

James Bezan Conservative Selkirk—Interlake—Eastman, MB

What level is it? Is it a medic? Is it a doctor or a nurse?

8:55 a.m.

BGen Scott Malcolm

Our trainers right now are typically med techs and medical aides, who are all capable of dealing with basic medical issues that our folks are going to run into.

8:55 a.m.

Conservative

James Bezan Conservative Selkirk—Interlake—Eastman, MB

If somebody had operational stress injury while serving abroad, what process comes into play then?

8:55 a.m.

BGen Scott Malcolm

If they've faced a traumatic event or a stressful event, in that case the first assessment is always with our med tech or the next available provider. If it's outside their scope to deal with it, then it would be referred higher. If there's no one in the immediate area to support them, they can be referred either to local civilian care or, if necessary, repatriated back to Canada, or if they are in theatre, to one of our locations like Geilenkirchen where we have a clinic.

8:55 a.m.

Conservative

James Bezan Conservative Selkirk—Interlake—Eastman, MB

Okay.

We know that recruitment has been an issue and that we don't have all of the troops we need, whether it's soldiers, sailors or aircrew. How has the recruitment crisis affected health services?

8:55 a.m.

LGen Lise Bourgon

Thank you, Mr. Chair. That's a really good question.

As you're all tracking, from a chief of military personnel standpoint, recruitment, retention and training modernizations are my number one priorities. All are important, and indeed the medical side has suffered in the same way on the recruitment side and the retention.

I will pass the floor to General Bilodeau, who might be able to talk about specific recruitment and retention efforts targeting—