Veterans Affairs Committee on April 24th, 2007

[Maj Chantal Descôteaux]

No.

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

No?

[Margaret Ramsay]

It's not a Canadian Forces issue. We don't give them the pensions. It's Veterans Affairs who grant—

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

Oh, Veterans Affairs grants them first? Okay.

[Margaret Ramsay]

—the pensions to the serving member.

[Maj Chantal Descôteaux]

We keep telling our chain of command that this is not a good thing, so I'm happy to tell it to you today, but the member applies to VAC.

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

To VAC first? Okay. Jesus—

[Marc-André Dufour]

But they use the clinical file we prepare at National Defence. Therefore, in determining pension amounts, they are using material prepared in relation to treatment contained in medical files. That movement is completely—

[Maj Chantal Descôteaux]

And before, they would use that material—

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

So there's no recommendation on your part?

[Maj Chantal Descôteaux]

Recommendation?

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

Is there a recommendation for this on your part, or not?

[Maj Chantal Descôteaux]

Yes, that's the one I gave you. We should not be allowed to apply for a pension until we're close to release. That's the recommendation.

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

I was very pleased to see that you're actively recruiting mental health professionals for the reserves as well. I think that's a very beneficial program.

With the increase in the number of reserves entering theatre in Afghanistan.... Your response to my colleague's question was that when the members are going back to their base, they have access to the professionals on the base. What about the reservists who go back to their own communities? What type of services do they have access to? Do you do contracting with professionals?

[Maj Chantal Descôteaux]

Reservists coming back will have a screening by us, the supporting base, but they go back to their downtown area very quickly. I recommend we don't let them go back downtown, that they stay with us and work for another year, so we can have them close by. They're getting paid and we're there, we can support them. We can screen them better. They stay in a group. They can vent with people, not be somewhere where nobody understands what's going on with them.

That's our first recommendation. The second one is that if they're sick, they should come back to let's say Valcartier, to be assessed. That's what they should be doing. We assess them. We give the diagnosis and then we set up care near their home. But unfortunately, the way it's working out with VAC—that's another thing—is that sometimes they will not come back to us. They're still reservists, but they will go downtown. They will get a phony diagnosis, an incorrect diagnosis made by someone downtown who is not used to this.

Let's say they get an incorrect diagnosis of PTSD and not the proper care for what they have, which is really an adjustment disorder with a personality disorder. Then we're stuck in a bit of a fight with the patient. Patients come back to us and say they should have a medical release because of the diagnosis they were given downtown, and here's what we should be doing. We get into a fight.

It's not well set up. They should come back to us. They should not be allowed to go on pension yet. We give the diagnosis. We treat them as best we can and then we set up their care downtown and VAC takes over. That's another point where we have problems with reservists.

The other thing with reservists is it's not clear, to me anyway—

[Marc-André Dufour]

For me too.

[Maj Chantal Descôteaux]

For many base surgeons, how do you deal with reservists? What level of care are they allowed, depending on their contracts? I guess the ombudsman is doing something, because they have come to our base. It's an issue. It's not clear in our laws, if you will, so I'm trying to give the best care I can to all those who come to us, but the most difficult patients are those who have personality disorders and are playing the system a little bit. These patients present a challenge.

Then you have those who are really sick and don't know they should come to us to get proper care. So we're doing our best. What's good is that we give them all the necessary information before they're deployed, so they know when they return, they should come to us. I'm not sure it's the same throughout Canada, but we're trying.

[Margaret Ramsay]

We do a four-month post-deployment screening as well, and all the reservists are called in for that medical and mental health screening.

[Maj Chantal Descôteaux]

But if they are reservists, sometimes they don't come.

[Margaret Ramsay]

It's not easy to contact them sometimes. We have them for the year. But we definitely have noticed that reservists are demanding a lot more service. In Newfoundland, we're putting in extra resources already. In St. John's, we've just added psychology. We have a full-time social worker in Gander, mainly because of reservists coming back. We realize there's more need on the base, and they are coming to the base for care.

[Maj Chantal Descôteaux]

And the quality of care given to these areas is even more important to look after and to supervise, as Marc-André was saying.

It's very difficult to treat PTSD patients. It's sometimes easier for a family physician to say if they want sick leave, here it is, take that pill, and for psychologists to say they feel sorry you. That's not how we are supposed to deal with that.

So we have created a bunch of people who think they are worthless, not able to work any more. They just want to say they have not been treated well, etc. This is not the way it's supposed to be. People can get better and can be active again in society. It's an issue. We need to look at how care is given everywhere and we need to be able to supervise that as much as we can, with people like Pascale Brillon and Stéphane Guay.

[Margaret Ramsay]

We don't even talk about returning to work. We talk about “remaining at work” when you're sick and get treated, because we know when people are off work, the longer they're off, the less likelihood there is they're going to get better and return to work. So we're really trying to promote that.

[Maj Chantal Descôteaux]

And I think we're getting there. We have the return to work program in most of the clinics, but this mentality is not there in the civilian sector. A lot of doctors find it so easy to just say sick leave, sick leave, sick leave. It's very difficult to practise medicine the right way and to tell someone you think it's time they went back to work, because if they don't, they'll be in their basement drinking and taking pills and thinking they're worthless.

[The Chair, Conservative, Rob Anders]

Thank you very much.

Now we'll go over to Mr. Sweet for five minutes.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

Thank you, Mr. Chair.

Ms. Ramsay, you had mentioned a 2002 study that was done. Do you know what the sampling size was for that from the military?