National Defence Committee on April 28th, 2023

[The Chair, Liberal, John McKay]

You have 15 seconds.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

All right. Well, I won't get an answer even if I squeeze in a question.

[The Chair, Liberal, John McKay]

Thank you, Mr. Kelly, for that generous allocation of time.

Mr. Sousa, you have five minutes.

[Charles Sousa, Liberal, Mississauga—Lakeshore, ON]

Thank you for being here and enlightening us on some of the challenges you face.

Some time ago, my uncle was a young doctor in the navy, and it was seen as a practicum for him. He ended up going back as a civilian into pathology and forensics. It seemed to be sort of a launching pad in order to get the big opportunities that existed.

I understand the challenges, and you explained to us the concerns, which we all share. Given the great demand with respect to mental health that is now coming upon us, how are you attracting people to become doctors, nurses and practitioners in the military?

[LGen Lise Bourgon]

In military service for the entirety of the CAF members, that purpose to serve in meaningful employment needs to be in every new applicant. Why people join after that depends on their respective situations.

I'll turn the floor over to General Bilodeau, who might have a better perspective of the medical side.

[MGen Marc Bilodeau]

Thank you, Mr. Chair.

We are hiring in 19 different health care occupations—

[Charles Sousa, Liberal, Mississauga—Lakeshore, ON]

I can't hear.

I'm sorry. Go ahead.

[MGen Marc Bilodeau]

We're hiring in 19 different health care occupations. Obviously, we need to have a targeted approach for each of those. They are not trained in the same types of schools. They're not trained in the same environment or in the same locations in the country. We're trying to have a very targeted approach for each.

For example, for physicians, we're putting advertisements in medical journals. We're going to med schools to do presentations on what it is to be a military doctor. Usually, we bring somebody in uniform to talk to the med students as well, so that they understand the environment, the conditions, the benefits and everything we offer them as an exciting career.

We're also doing this through a network of specialist recruiters who are specialized in recruiting health care professionals. There are people working full time for us in different areas of the country where the main focus is really to recruit health care professionals on our behalf.

Obviously, we're recruiting a lot of people, but a lot of people are leaving after their obligatory service because they've decided to do something else with their lives, so retention becomes a challenge for us. We need to do better from a retention perspective and try to make sure that we keep them excited while they're serving so that they are willing to serve. We need to create that sense of identity, as well, that General Bourgon was talking about, and that sense of purpose.

[Charles Sousa, Liberal, Mississauga—Lakeshore, ON]

Because it's a unique group that you have, is it also used as a test? You know how they try.... In terms of sharing and doing research, is the membership called upon at times to be used in that regard, so that they can have a more controlled group to monitor? It's done willingly, obviously.

[MGen Marc Bilodeau]

Yes. There's a bit of research happening in our organization, if that's the question. Some of our professionals are interested and are doing research.

I fund a health research program. That is allocated in my budget. We have a captive population that is easier to study, I would say, than the rest of the population. I would say it's not the majority of our people who are interested in research, certainly not early on in their career, but we definitely have a platform for our people when they're interested.

[LGen Lise Bourgon]

We get a lot of our medical practitioners through internal transfers within CAF. They join in an occupation; then they fall in love with the CAF way of life and they apply to become doctors or nurses, and they join. We're seeing a lot of internal transfers.

None of us is doing this for the money. The financial security has to be there, but it's that purpose and that desire to serve. That's who we want to go and connect with. That's our challenge.

[Charles Sousa, Liberal, Mississauga—Lakeshore, ON]

Thank you very much.

[The Chair, Liberal, John McKay]

You have a little less than a minute.

[Charles Sousa, Liberal, Mississauga—Lakeshore, ON]

That's even better.

On the challenges that you've associated with accessing health care, I suspect that in some remote areas, it's very difficult for you to share civilian resources in whatever country you may be in.

How do you deploy some of that? You need to station people there for a long period of time in order to have a substantial or a strong base of medicine and support for those members.

[BGen Scott Malcolm]

Thanks for the question.

Basically, an analysis is done of what the local resources are. We have two permanent standing clinics, one in Geilenkirchen and one at SHAPE, that are able to provide some support to folks in Europe.

When it comes to specific deployments, the assessment is made of what's available locally and what other allied resources there are, and we develop a medical plan in order to ensure that we have continuous support for our folks. Ultimately, if there's a big issue, they are transferred back to Canada.

[The Chair, Liberal, John McKay]

Thank you, Mr. Sousa.

You have two and a half minutes, Madame Normandin.

[Christine Normandin, Bloc, Saint-Jean, QC]

Thank you very much,

I'd like your opinion on the possibility of a partnership between the Canadian Forces Leadership and Recruit School in Saint‑Jean‑sur‑Richelieu and the city's community sector.

The Centre de crise et de prévention du suicide du Haut‑Richelieu‑Rouville provides recruits with a room reserved and paid for by the armed forces. It's a real win-win. The centre offers specialized services and it can remove recruits from a crisis situation.

Are such partnerships being considered in other areas? I know some people from the suicide prevention centre will be appearing before the committee later, but I'd like to know if, broadly speaking, this is something you're considering.

[MGen Marc Bilodeau]

Thank you for the question.

There are a number of community partnerships right across the country. At the local level, we encourage a lot of our clinics to show leadership in that regard. They can enter into partnerships to improve the services they provide to our members. These kinds of relationships are critical to ensuring proper follow-up of medical records.

There are certain services that our military clinics don't provide, and so we need to purchase these services from the provinces and the various community organizations. It's a beneficial arrangement in that we enter into a contract with an insurer, namely Medavie Blue Cross, which facilitates payment of all the health care services our members need. These partnerships only get better with time, and they allow us to have our needs met and to lead our members back to health so that they can keep doing their job.

[Christine Normandin, Bloc, Saint-Jean, QC]

Who's responsible for liaising with these service providers or for making sure the service exists? Is it the community organizations who reach out to the Canadian Forces and offer their services?

[MGen Marc Bilodeau]

It happens in different ways. Sometimes, our own teams who work in local clinics show initiative and establish partnerships. As surgeon general, I also get offers sent to me, which I refer to my subordinates. I'd also mention the civilian partnerships that already exist at my level. We're striving to encourage our local teams to build these kinds of relationships, as they ultimately allow us to improve the services we provide our members.

Brigadier-General Malcolm, do you have anything to add?

[The Chair, Liberal, John McKay]

We're out of time.

You see? General Malcolm is catching on.

You have two and a half minutes, Ms. Mathyssen.

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

I want to follow up.

On one of my questions, you referred to provisions provided by OSISS in terms of mental health, but that isn't actually applicable to sexual trauma and the service's sexualized trauma experience within the military. I noted that it's referred to the SMSRC. However, in terms of that transition, when members ideally are served by SMSRC, that doesn't happen for veterans, so how do you manage that transition for people who are experiencing sexualized trauma?

[LGen Lise Bourgon]

I'm not sure that I can answer all of your questions here, because that's outside my field, outside my wide responsibilities. That one is not in there, but in relation to military sexual trauma and the work that is being done by OSISS, the organization that Commodore Bouchard...that great network is being replicated for MST survivors. This is being led by the SMRC, of course, but based on the development of OSISS. They're kind of replicating the same system. Because it's working so well for operational stress injuries, the MST network and survivors will be developing that same system.

I can't answer more than this because that is a responsibility of the SMRC to provide, but I know that OSISS is being used as the tool to provide that MST support to our survivors.

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

Is that information something you can get to this committee in terms of timelines that will show that progress, or the plans for it?

[LGen Lise Bourgon]

We can take this back as a question for the SMS...SM....