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.
Conservative
Pat Kelly Conservative Calgary Rocky Ridge, AB
You have a very specific target for base, wing and unit fitness. You talked about hiring 44 additional staff.
Have those additional staff—all 44—been hired?
LGen Lise Bourgon
I cannot guarantee that the 44 have been hired, but I know CFMWS has leaned forward and hired everyone they were asked to hire. They're a bit more flexible in their hiring procedures, given that they're not public employees. They're part of the NPF employees, the non-public funds employees.
I would say yes.
Conservative
Pat Kelly Conservative Calgary Rocky Ridge, AB
Okay.
How were they recruited, then? Can you say that again?
LGen Lise Bourgon
They're non-public fund employees. CFMWS has a construct different from that of public employers. I will not go into details, because it's very complicated and we won't have time.
Conservative
Liberal
The Chair Liberal John McKay
Thank you, Mr. Kelly.
Madam O'Connell, you have five minutes.
Jennifer, are you hearing me?
No, you're not.
I was thinking that Emmanuella asked a very key question and I thought it deserved an answer.
Liberal
Liberal
Emmanuella Lambropoulos Liberal Saint-Laurent, QC
I'll continue on the question of perinatal mental health.
I wonder whether you can tell me if there's anything being done. I don't know whether some members in the armed forces are having children and dealing with this as well. Is it something on your radar? Is it something you've been dealing with?
MGen Marc Bilodeau
We're currently in the process of hiring specialists—OB/GYNs—who will help us provide advice to build a better program there. They will advise us how to better manage, from a health care perspective, women in the perinatal period, and make sure we're preventing any potential injuries. We know that's a period prone to injuries, so we're working in partnership there. We hope to be able to build a better prevention program, and also a care program. We won't reinvent the wheel, though, because a lot of it has already been done, mainly by our colleagues in the U.S. and the U.K. That's why international collaboration is so important.
In February, we were lucky to host a symposium at the Canadian embassy in the U.S. We invited our partners from the Five Eyes community and tried to share what we're doing, respectively, from a women's health perspective. We agreed at that conference to keep working together to develop the clinical practice guidelines that will allow us to move together in improving women's health in the military.
LGen Lise Bourgon
On that aspect, and again from a physical fitness standpoint, emphasis is put on pre- and postpartum fitness at our gym, with experts. Pelvic floor therapy you are going to see across.... I believe it was in Petawawa that it was done for the first time. Mothers or parents with their newborn can go to the gym and have physical fitness developed for them. It's both prevention and recovery. There are very good initiatives going forward.
Liberal
Emmanuella Lambropoulos Liberal Saint-Laurent, QC
I'm happy to hear that.
I guess that's why we haven't heard it on the Department of National Defence side; we've heard it more from veterans who don't necessarily have that support and who.... It comes in later. That will be one of our recommendations going forward. Perhaps we'll look for a little more information on that.
I'll pass the floor to my colleague Mr. May.
Liberal
Bryan May Liberal Cambridge, ON
I know we've talked about some of the gaps in the system right now. I'm wondering whether you can take us through the process or the point at which—if there is a point—a person in care is handed off to a provincial health care system. I'm thinking about cancer treatments and things like that.
I'm wondering whether you can explain the level of health care that exists within the military and where there's that transition to public care.
MGen Marc Bilodeau
As General Malcolm described earlier, we're providing enhanced primary care in our clinics. In most of our clinics—the 37 we mentioned—we have a primary care team, which is usually led by a family physician. Many of them are augmented by physiotherapy and mental health. Those are our two main areas of focus from a health care perspective. In some of them, we have some diagnostic technology, such as X-rays and labs, but not in all of them. We need to outsource everything that goes beyond that, including specialty care and hospital care, because we don't have it in the military.
MGen Marc Bilodeau
We do not have MRIs. We have two deployable CT scanners, but we don't have MRIs in our clinics, so every time a member requires services beyond what we have, we do a referral. It's the same as in the civilian sector. It's a referral to a specific clinic or providers to receive the care they need.
Liberal
Bryan May Liberal Cambridge, ON
Is there any preferential treatment for CAF members in terms of those referrals, or are they going into a queue scenario?
MGen Marc Bilodeau
Officially, there's no preferential treatment, but if we have a special operational requirement that requires a member to have a knee arthroscopy, for example, in advance of others because we need them to deploy in six months, if we develop a good relationship locally, then we're usually able to negotiate that access.
We're trying to be careful with that. We know we're competing with all Canadians. We need to be careful in terms of how we're managing it. In some exceptional cases, I believe it's justifiable, since the security of our country depends on it.
Liberal
The Chair Liberal John McKay
Thank you, Mr. May.
Madame Normandin, go ahead, please, for two and a half minutes.
Bloc
Christine Normandin Bloc Saint-Jean, QC
Thank you very much.
I'd like to come back to the issue of mental health services. You spoke of the importance of making them more efficient. I'd like to hear your thoughts on the way to make that happen on the operational level.
For instance, when a person receiving mental health services is transferred, do they have to start the whole process over with a new professional or is there some kind of follow-up? I suppose that the bonds of trust people have with their mental health practitioner aren't the same as those people develop with a doctor who might treat a sprain, for example.
MGen Marc Bilodeau
Thank you, Mr. Chair.
Actually, the beauty of our system is that it involves the maintenance of pan-Canadian electronic health records. All of the information related to the care that's provided to patients is recorded in these files, which are accessible from anywhere. That way, when a member is transferred or temporarily assigned to another base for operational reasons, access to care is much easier.
As for the therapeutic bonds that exist with our members, I agree with you that it plays a major role not only in terms of the quality of care, but also in terms of the support we can offer our members.
Furthermore, the advantage of telemedicine is that it allows us to ensure follow-up with a professional even when a member moves around. That said, this only happens on occasion, since the majority of our members don't get transferred when they're very sick. It remains an option we can use when we need to, however.
We also occasionally authorize our members to travel to meet a health care professional. That only happens in exceptional circumstances since the majority of mental health care services can be provided through telemedicine.
Bloc
Christine Normandin Bloc Saint-Jean, QC
Can members' mental health issues be considered a good reason to avoid transferring them? Isn't it preferable to wait for their condition to stabilize and spare them from having to deal with the stress of being transferred?
MGen Marc Bilodeau
I completely agree with you on that. The advantage of our relationship with the chain of command is that we establish limits to employment and that we dialogue with the chain of command and the member to ensure that responsibilities are shared. The goal is to foster the necessary conditions to allow the member to recuperate. In some cases, it's a matter of recommending delaying the transfer so that care can be provided.
Liberal
The Chair Liberal John McKay
Thank you, Madame Normandin.
Ms. Mathyssen, go ahead, please, for two and a half minutes.