Public Accounts Committee on Jan. 31st, 2008

[MGen Walter Semianiw]

You don't pay me to be a bureaucrat, right?

[Brian Fitzpatrick, Conservative, Prince Albert, SK]

I would like to deal with performance measurements. There seems to be a lot of emphasis on getting performance measurements in place. It's my observation that the provincial systems we have in Canada have a long way to go to get uniform performance measurements in place across the country, and it's a work in progress.

Many of the provinces seem to be very reluctant to get with it and to provide that sort of data. They probably have a whole host of reasons why they would be taking those positions, but it seems to me, if I'm hearing you folks correctly, you do have the data. Maybe you're a little bit behind in having this produced on as frequent a basis as people might want, but you do have access to the data to know what kind of service the men and women who serve in the military are receiving. Am I correct in that assumption?

[MGen Walter Semianiw]

Yes.

[Brian Fitzpatrick, Conservative, Prince Albert, SK]

Okay. Thank you very much.

I want to deal with wait times, which I think are crucial to any health care delivery, especially in your operations. If somebody in the military saw a general physician in the armed services and required the treatment of a specialist, how long do you think it would take--if you can give us some sort of guidance--before that service person would actually gain access to the specialist and start receiving the required treatment?

[BGen Hilary Jaeger]

The answer of course varies a little bit by geography and by the specific specialty you're looking for, and of course in urgent situations, in emergency situations, waiting time isn't an issue.

We tend to do a little better than the civilian sector, largely because where we have enough volume we have Calian contracted physicians for that specialty who come to that base on a schedule, perhaps every Friday or every other Monday, and you get seen in that kind of delay.

We are looking at a month or less for most specialties, very few go out longer than that.

[Brian Fitzpatrick, Conservative, Prince Albert, SK]

That's very interesting, because the only organization that I know, for the last ten or so years, that has tried to track waiting times in this country has been the Fraser Institute people. They issue their list for provinces every year.

In my home province of Saskatchewan, the average wait time that I saw last time, from the time you see a general physician to receiving your first treatment, is something like 27 weeks, which is close to seven months, which I find appalling and unsatisfactory. If my car broke down and the mechanic told me to bring it back in seven months, I'd be a little bit dismayed. But you're saying you feel that your wait time average might be in the realm of a month. That's far better than what we have in the Saskatchewan system.

Speaking of mental health as well, even though it's not an area for the federal government, I've encountered many people in my riding who have people in their families who have serious mental health problems. It's more a provincial area, but I have tried to look at this problem a bit, and I find that in the provincial system in Saskatchewan, there is a real major shortage of mental health services for people who have mental health problems. If somebody has a mental health problem in their family, I'm sure if we surveyed them we wouldn't like the kindsof responses we'd get back on that sort of thing.

Some people have tried to conjure up that there's some really systematic, major problem in the way we're dealing with mental health in the military. You mentioned one psychiatrist for 2,000 people over in Afghanistan. I think there might be one or two for my entire riding, and that's 73,000 people. How do you think your mental health services do stack up, compared to the provincial systems?

[The Chair, Liberal, Shawn Murphy]

Thank you very much.

[BGen Hilary Jaeger]

I'd refer the committee to Senator Kirby's recent report when he was chair of the Standing Senate Committee on Social Affairs, Science and Technology, Out of the Shadows at Last, which made the splash about mental health.

Compared to the services available to the average Canadian, I believe we do very well, but you raise a challenge that in fact comes into play with us every day as we try to fully implement our mental health reform.

We have resources to hire people. We have the authority to spend the money. The money is waiting there. Where are the health care providers?

It's a very, very competitive market out there, and there are not a lot of health care providers. When we do find the right people, they tend to like working with us a lot, and they tend to become very loyal and very dedicated to what they do. But it is a hard job to find them, and it is a harder job to entice them to work in some of our more peripheral areas.

[MGen Walter Semianiw]

And to be fair, it's not just a national issue, it's an international issue. Internationally, the number of mental health care providers are in short supply around the world. So we're competing with not only the internal-to-Canada challenge, but also the international challenge.

Again, to reaffirm what General Jaeger said, it's not an issue of us not having enough money to do it; it's an issue of finding people who are qualified to do it and then hoping they want to go where we want them to go, which becomes, for me and for her in uniform, an unlimited liability issue to serve this nation.

[The Chair, Liberal, Shawn Murphy]

Thank you very much.

Monsieur Lussier.

[Marcel Lussier, Bloc, Brossard—La Prairie, QC]

Thank you, Mr. Chairman.

Ms. Fraser, mention was made of a survey conducted in 2002. Many things have happened in Afghanistan since 2002.

Do you think the sampling used for the survey was representative of our CF members? Are we talking about a regional survey? Have you commented at all about this?

[Sheila Fraser]

Mr. Chairman, as we noted in the report, this survey was carried out by Statistics Canada. Judging from our experience with Statistics Canada, I would have to say that these surveys were carefully conducted and that their findings are very good. However, as we also indicated in the report, the specific focus of the survey was mental health services. On the heels of this survey, medical services launched a series of initiatives to improve services in this area. These initiatives are listed in the report.

[Marcel Lussier, Bloc, Brossard—La Prairie, QC]

So then, steps were taken to begin compiling data on satisfaction levels.

Brigadier General Jaeger, are their plans in the works to provide mental health services to returning soldiers in February 2009?

[BGen Hilary Jaeger]

We will follow the same procedure that we have followed for other rotations, namely third-location decompression in Cyprus. At that point in time, members are informed of all the services available to them. Mandatory screening which occurs four to six months after the soldiers are rotated out and which is designed to identify CF members at risk is very important to us. That is why all CF members—it is never exactly 100%, but that is our goal— who have been deployed are required to undergo a detailed screening.

I am well-acquainted with the Chief Medical Officer at CFB Valcartier. She is well aware of the importance of monitoring these individuals closely and she takes the appropriate action.

[MGen Walter Semianiw]

The Veterans Affairs' team is already on the base, and that is very important for this program.

[Marcel Lussier, Bloc, Brossard—La Prairie, QC]

My colleague Mr. Holland raised one very specific issue. We need some statistics, since parliamentarians will be making some decisions in the coming months.

I would like to make a formal request. Firstly, is it possible to single out from the figures presented to us, the medical costs associated with the mission to Afghanistan? Right now, the figures are all rolled into the same budget.

Secondly, do you have any statistics for us on the number of military members who have been injured to date to Afghanistan? The newspapers report the number of fatalities. Could you tell us how many soldiers have been injured and are currently being treated by medical personnel? Overall, how many cases of mental illness have been diagnosed every year since our mission to Afghanistan began?

It is critical for us to have these figures. Could you get them to us? We are not interested in surveys on the satisfaction of CF members, even though these are important in terms of doing overall evaluations. We would like some statistics on the number of casualties in Afghanistan. This type of request is in line with the notion of transparency that the Prime Minister has promised. Therefore, it is important that you provide us with these figures.

[MGen Walter Semianiw]

We can do that for you.

[Marcel Lussier, Bloc, Brossard—La Prairie, QC]

When?

[BGen Hilary Jaeger]

It will take us two or three months.

[The Chair, Liberal, Shawn Murphy]

Thank you very much, Mr. Lussier.

[Jean-Yves Laforest, Bloc, Saint-Maurice—Champlain, QC]

Mr. Lussier has just made a specific request and we've been told that this information will be forwarded to us. That means the public accounts committee should be getting some figures. At least that I what I understood.

Thank you very much.

[The Chair, Liberal, Shawn Murphy]

Let's firm this up. The information will be tabled with the clerk of the Standing Committee on Public Accounts. What timeframe are we talking about?

[MGen Walter Semianiw]

It is three months, to be specific,

and the information will relate to the situation in Afghanistan.

[The Chair, Liberal, Shawn Murphy]

It will be within three months, and that will be tabled with the clerk in both official languages.

[MGen Walter Semianiw]

Yes, it will be in both official languages.

It will be tabled in both official languages.