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.
Liberal
The Chair Liberal John McKay
Yes, save it for next time. There are going to be plenty of rounds. We have these folks for two hours, so we can go back to it.
Madam Lambropoulos, you have five minutes, please.
Liberal
Emmanuella Lambropoulos Liberal Saint-Laurent, QC
Thank you, Mr. Chair.
Thank you to our witnesses for being here with us today.
This was a study that I put forward, and the main reason I put it forward is that when I sat on the veterans affairs committee several years back, there were clear concerns that I had that have been raised here already. However, I do want to push a little bit and see if there's more information that we can gather here today.
At the time, officials from Veterans Affairs were saying that they're very limited in terms of the information they receive about these veterans' medical histories within the forces. It was very much up to the veteran to go and seek help. There wasn't anybody reaching out to them. There wasn't a database of people who should be checked on every couple of years. It was very much up to the veteran to reach out for help.
Clearly, there's a lot of work that needs to be done there. One of the recommendations that we made in that study, which only went to Veterans Affairs—it did not go to National Defence—was to have a consent form signed to allow their medical information to be transferred to Veterans Affairs when they're signing other forms as they are being released.
First off, I would like to know if you think that would make a difference and if you think that could be a recommendation that we have in this committee for this particular study that would go to National Defence.
Second, I know that you've been speaking, Monsieur Bouchard, about a recent program, a transition program. I'm wondering if you can explain a little bit further. Specifically, what in the last couple of years has been done in order to merge these two departments together in order to better offer services to our people?
LGen Lise Bourgon
I think that the CAF transition group—and I'll give the floor back to Commodore Bouchard—was really a jewel of the SSE in 2017 by providing that transition in one place. All the services are being provided, and then we are integrated with Veterans Affairs Canada for our members.
Dan, I'll give you the floor again.
Cmdre Daniel Bouchard
The intent of the transition group and the various transition centres across Canada—there are 32 of them—is also to centrally provide these services to not only our ill and injured but all the regular force members transitioning out. We're focusing on the families.
Retention is always key. We're trying to retain our folks as much as possible and we're trying to transition them to another career within the Canadian Armed Forces. However, when a decision is made to release from the military, then for that continuous care, a transition adviser is provided to the member and their family, and the adviser oversees a transition plan. They oversee a five-step process for what we call the military to civilian transition. There is the decision to transition and then their understanding of it. They have a plan, and it's monitored, and there's some training provided to them. Then there's a support continuum. By having Veterans Affairs Canada embedded with us at the transition centres, we can ensure that continuity of care.
As of this summer, 75% of our transition centres will be established. We will be at our full operational capability by April 2024, and we expect to have the full spectrum available at all of the transition centres.
LGen Lise Bourgon
I may add that when we look at the full spectrum, we see it is the full spectrum. It's financial. It's insurance. It's VAC. It's medical. It's physical fitness. It's the entire spectrum. It's for our members and also for their families to ensure that they're fully ready to transition.
I've been wearing this uniform for 36 years, so the day I decide to release from the military, I lose my identity—let's be honest. How do we empower our people and their families to do that gracefully if they're ready to transition to a civilian life or to veteran life now?
Liberal
Emmanuella Lambropoulos Liberal Saint-Laurent, QC
Thank you.
Just to be clear, would you recommend that a consent form be signed upon release in order for the information to be transferred to Veterans Affairs so that it can have the information necessary when someone shows up?
MGen Marc Bilodeau
This is already happening. That's the process by which the medical file is being released to either the member or somebody whom they choose that they want it to be released to, whether it's a family physician or a psychiatrist or whatever.
This is the process. The challenge in that process is that we need to go from an electronic system and print it out or put it on a memory stick and transfer it back to the civilian system, which is going to require a full printout and re-scanning. The process is not smooth. It's not only us at our level, but we're definitely trying to ease that.
The beauty is that within the transition groups, we have nurse case managers that are ours, who work for the CAF, who are responsible for ensuring a smooth medical transition for members who have been identified as having medical issues at the time of release. The challenge we have is that if a member does not disclose that issue at release and later develops a health issue, then there's potentially an access issue there, which I know VAC is working on, but we're potentially losing those. I think that with the new transition program that Commodore Bouchard is working on, we're going to catch more of those people, but that's still a challenge, in my view.
Liberal
The Chair Liberal John McKay
+ Thank you for that, Madam Lambropoulos.
Madame Normandin, you have two and a half minutes.
Bloc
Christine Normandin Bloc Saint-Jean, QC
Thank you very much, Mr. Chair.
I'd like to return to the subject of telemedicine, which came up earlier.
My understanding is that the Maple telemedicine service is mainly for families of serving members. The services are mainly provided by civilian physicians, because medical officers aren't part of the program.
Has anyone considered the possibility of setting up a similar telemedicine service? In other words, could medical officers provide services to members transitioning out of the forces, for example? These members are likely to have greater trust in medical officers than civilian physicians.
Is this option being considered?
LGen Lise Bourgon
Mr. Chair, I thank the member for the question.
The Maple service has two components. On the one hand, it provides services to military families who just moved to a new province and don't yet have access to health care. These services are provided through Canadian Forces Morale and Welfare Services.
On the other, Maple also provides services to veterans, those members who were released from the Canadian Armed Forces. Veterans who move to a new province and don't yet have access to health care can use the Maple service.
I'd now like to yield the floor to Major-General Bilodeau, who will be able to tell you all about the practice of telemedicine on the military side.
MGen Marc Bilodeau
Thank you, Mr. Chair.
The fact is that we've always used telemedicine. In the past, services were mainly provided over the phone. Military members could call a doctor to get a prescription renewed, for example. Of course, when the pandemic hit, we had to quickly find new ways to apply technology to telemedicine, among other things through the use of video conference.
The things that were implemented were implemented because we didn't have any other choice. We acted out of necessity, especially in the first few months of the pandemic, when everything was closed. We understood that was the only way for us to keep seeing our patients and giving them the care they need.
The challenge involves the fact that our current telemedicine system isn't fully integrated with our electronic health records system. It's a real problem, mainly in terms of coordination and logistics. These problems should be resolved within a few years, with the modernization of our various systems.
That said, telemedicine certainly has added value, because some of our members are deployed in places where there are no military clinics nearby. Telemedicine also allows us to provide greater support to our members deployed abroad, for instance when they need to consult a specialist. A lot of issues can be resolved through video conference. In-person consultations aren't always needed. The same can be said for most mental health issues.
Telemedicine allows us to provide our members with more specialized care. There's no doubt that telemedicine adds a lot of value—
Liberal
The Chair Liberal John McKay
Thank you, Madame Normandin.
You have two and a half minutes, Ms. Mathyssen.
NDP
Lindsay Mathyssen NDP London—Fanshawe, ON
On the working group and the duty to report, in terms of what the medical practitioners deal with, what is the progress of that working group to date?
LGen Lise Bourgon
The working group on the duty to report is continuing to work with the recommendation from Justice Arbour. This is a lead, and it is being led by the chief of professional conduct and culture with JAG, the judge advocate general, but on the health service side, I think it's important to remember that there's a difference on the duty to report.
I'll give the floor to General Bilodeau.
MGen Marc Bilodeau
We, as licensed health care providers, have an obligation to protect the confidentiality of the information that is disclosed to us within a clinical encounter, so we don't apply that duty to report for health care providers, because if I were to do that in reporting something—an incident—against the member's consent, I could lose my licence, and I probably would.
None of our licensed health care providers do it, despite the policy. We can't adhere to the policy, because we'd all end up without a job. For us it's an non-issue, and we've already provided direction against that policy to protect our health care professionals from that perspective.
LGen Lise Bourgon
Because of their duty, they have that exception on that duty to report. We're still working on the actual policy, but in actual day-to-day business, they're exempted.
NDP
Lindsay Mathyssen NDP London—Fanshawe, ON
The CDS actually mentioned switching over to a “duty to respond”. I don't know if you wanted to add to that as well, but what is the deadline for that working group to actually report back on the duty to report?
LGen Lise Bourgon
They're working very hard on this and trying to deliver as soon as possible with all of Justice Arbour's recommendations. I'm not privy to the actual deadline and when it's going to happen. I'm sorry.
LGen Lise Bourgon
That's all part of that same file. They're working on the way forward to try to come up with a solution and put it into our policy and regulations.
Conservative
Cheryl Gallant Conservative Renfrew—Nipissing—Pembroke, ON
Thank you, Mr. Chairman.
It was reported to me that last week there were three suicides on Base Petawawa. Would you please tell the committee what number of mental health workers are currently available to members at Garrison Petawawa?