Public Accounts Committee on Feb. 25th, 2015

[Alain Giguère, NDP, Marc-Aurèle-Fortin, QC]

Thank you.

If I understand correctly, you have analyzed the situation to determine whether waiting times had an effect on morbidity, and you concluded that this was not the case.

[BGen Jean-Robert Bernier]

For each suicide, a psychiatrist and a general practitioner conduct an in-depth analysis. However, in no case did the timeliness of care or the waiting time have an impact on the suicide. These were either individuals who were not receiving treatment because they hadn't asked for it, or people who were receiving good care, as is often the case in the general public.

[Alain Giguère, NDP, Marc-Aurèle-Fortin, QC]

My next question is for Mr. Doiron.

In sections 3.10 and 3.2, the report deals with delays of favourable decisions with respect to applications for disability benefits. In 20% of cases, individuals must wait more than a year, which is a major delay. For the remaining 80% of cases, who receive their disability benefits within a one year time frame, there may be a wait of 11 months, which is an enormous delay.

Could this situation contribute to crime, self-harm, or spousal violence? Among the individuals who have applied for this disability benefit, how many are now homeless?

[Michel D. Doiron]

Our analysis does not go that far, but I agree with you that one year is too long of a wait. That's why we are trying to implement procedures that ensure that appropriate care is available much faster. These are individuals who are waiting a year before receiving psychological care. However, studies show that there could be long-term impacts. Furthermore, recovery can take longer.

With respect to your question, I don't have specific data available.

[Alain Giguère, NDP, Marc-Aurèle-Fortin, QC]

The department...

[The Chair, NDP, David Christopherson]

Sorry monsieur, time has expired.

Moving over to Mr. Albas, you have the floor sir.

[Dan Albas, Conservative, Okanagan—Coquihalla, BC]

Thank you, Mr. Chair, and thank you to all of the officials here today. Certainly this is an important topic, and I do appreciate what you do for our veterans.

First of all, let me start with the Auditor General's department.

Assistant auditor general, there was a mental health action plan that was put forward by the government as a response the very day that the Auditor General tabled this report, “Mental Health Services for Veterans”.

Have you viewed the action plan? Have you made a comparison with your recommendations? Does the action plan substantially meet the vast majority of the recommendations?

[Jerome Berthelette]

We appreciate the fact that the department has put the action plan in place. However, we'll make no comment on the action plan until such time as we have conducted an audit and followed up on the action plan in that manner.

[Dan Albas, Conservative, Okanagan—Coquihalla, BC]

Okay, but does the action plan seem to address areas of the recommendations that were raised in your report?

[Jerome Berthelette]

We do our work on the basis of audits.

[Dan Albas, Conservative, Okanagan—Coquihalla, BC]

Sure. I just wanted to see if that is something...because the government, obviously, has spent a fair bit of time to make sure it's a complete list. We have a copy of it here today.

Changing gears, I'd like to talk to some of the other officials from DND, as well as from Veterans Affairs.

We recently conducted a study on transnational crime. One of the unique aspects of the report that came out of that was the impact the Privacy Act can sometimes have on process.

Sometimes, there are things within the government's ability to control. Sometimes there are limitations on government put in place by the Privacy Act for very good reasons, but which may cause, you know, unintended consequences. Mr. Hayes has raised the point that, sometimes, we could look at simplifying some of the forms that Veterans Affairs uses to get these applications done sooner.

Could you please speak to the Privacy Act, and whether or not that could sometimes provide a challenge in getting files and histories from DND, and what kinds of constraints that puts on your ability to process these files quickly?

[Michel D. Doiron]

Thank you for the question.

I'm not sure that I would quantify the Privacy Act as a detriment to the service. I'd be careful saying that because it's there for a reason as you've highlighted, sir. But we have seen that in the exchange of information between DND and VAC, we have to comply with the Privacy Act. When we do, it does create additional challenges to getting the information, especially when reviewing the personal file of a veteran where there's some good recent, third party information. We have to comply.

The Privacy Act says you can only share for the reason that you've taken the information. Therefore, we do need releases and we do need permission to share that information. It therefore adds, I don't want to say a delay, but it does add a step in the process where my partners at CAF have to redact a file prior to providing it to Veterans Affairs to process a disability claim, or anything else that we may do with the file.

We work with it. We comply with the Privacy Act. We feel very strongly that it's important, but it does sometimes cause us some additional steps in the process.

[Dan Albas, Conservative, Okanagan—Coquihalla, BC]

Chair, maybe I should clarify. I don't view the Privacy Act as being detrimental, but it does have an impact, I think, on the overall process. There are certain things that we can control, and there are certain things that we can make more efficient.

I do know that the Brigadier-General had mentioned business practices, and always being open to being innovative, and making it more and more efficient. That being said, this is not just a typical business enterprise. There are limitations enshrined in law, such as the Privacy Act.

Brigadier-General, is there anything that you'd like to add or comment?

[BGen Jean-Robert Bernier]

Just that the protection of the confidentiality of the health information of our troops is critical, vital ground for us.

If our troops, especially those with sensitive conditions like mental health conditions have the slightest concern that we are not strictly protecting their confidentiality, and completely complying with all elements of the Privacy Act strictly, then we run the risk of those people suffering from mental health conditions, who are already vulnerable, not presenting for care and their conditions getting worse and worse until, in some cases, they'll commit suicide.

Strict compliance with the Privacy Act is absolutely critical for us. But it does pose some delay because we necessarily have to have the consent and we necessarily have to do the severances for any third party information. Often with psycho-social or mental health issues there are third parties involved in the notes, in the files, that have to be extracted before they can be legally and ethically transferred to another authority that serves a different government purpose, in the interest of the individual.

[Dan Albas, Conservative, Okanagan—Coquihalla, BC]

Okay. Thank you very much.

[The Chair, NDP, David Christopherson]

Okay. Moving over we now go to Mr. Valeriote. Welcome, you're not a regular member of the committee, but we're glad to have you here today, sir. You now have the floor.

[Frank Valeriote, Liberal, Guelph, ON]

Thank you, Chair.

Thanks, everyone, for appearing before us.

Mr. Doiron, I'm going to speak directly to you.

It's nice for certain members to bring forward the successes, or partial successes or efforts on behalf of VAC, but I have to highlight the failures, sir, just so you know.

We've had $1.13 billion in cuts retracted from Veterans Affairs that must have put some pressure on Veterans Affairs Canada in providing the services it needs. We closed nine Veterans Affairs offices, and there's been a huge impact and a huge response by the Canadian public, particularly veterans. We know from the Auditor General's report that over 15,000 applied for those benefits and we know that 24% were denied, and of that about a third appealed.

I think about how difficult it is for somebody to come out from under the cloud or the shadow of mental illness and come forward and actually seek help. Of those who appealed, 65% were successful. I think about the ones who gave up, who didn't appeal. Not just as an MP but as a person, I automatically think, my God, there must be a culture of denial at the veterans appeal board, at any level there, and not a culture of “give these people the benefit of the doubt”, those who were prepared to and do put their lives on the line and who suffer the ultimate liability.

I'm concerned, Mr. Doiron, that we are not responding.

Last year we presented a report—and Mr. Hayes was on the committee—to the then Minister of Veterans Affairs who accepted everything but virtually did nothing.

My first question is this. You said 50% of the 168 who died by suicide were not self-identified. Can you tell me if any of the 50% who were not in treatment were any of the ones who were denied treatment but had applied? Before you answer you could give some thought to this, Mr. Doiron. It says the Auditor General recommended VAC “work with the Veterans Review and Appeal Board to identify whether reasons for successful reviews...indicate a need to modify the application process.”

I'd like to hear from you about that and I want to know what's happening now, not what you will do, because we've been hearing a lot of “wills” but not a “now”.

You can go first, Brigadier General.

[BGen Jean-Robert Bernier]

While still serving in uniform, the short answer is no. We drag people in and we do everything we can. We have multiple mechanisms across the armed forces to bring people into care—

[Frank Valeriote, Liberal, Guelph, ON]

Sorry to interrupt.

I understand but I'm talking about the veterans who had taken their own lives.

[BGen Jean-Robert Bernier]

We don't treat veterans.

[Frank Valeriote, Liberal, Guelph, ON]

Mr. Doiron, can you give me that answer, then?

Of those who died, of the 168, how many had sought benefits and were denied? You don't know. Do you keep track?

[Michel D. Doiron]

No, they were Canadian Armed Forces; they were not veterans.

[Dr. Cyd Courchesne, Director General of Health Professionals and National Medical Officer, Department of Veterans Affairs]

Those were military members.

[Frank Valeriote, Liberal, Guelph, ON]

So there's no.... I'm talking about the veterans who died by suicide.

[Dr. Cyd Courchesne]

But the number you're quoting is not the veterans. It's the serving military members.