Thank you, Mr. Chairman.
Thank you, ladies and gentlemen, for inviting me to testify before this committee, which is looking at the issue of health care and services provided to veterans, particularly at this time, given the new Charter and its repercussions on the services provided to new veterans.
I am using the term "new veterans" or "new generation of veterans", to refer essentially to those from the modern or post-modern era, meaning after the end of the Cold War; these veterans are different from those who fought in the Second World War, the First World War and the Korean War. We also necessarily include in this group those who served between the Korean War and the end of the Cold War.
This new generation of veterans is growing and will continue to grow in coming years. So, it is extremely relevant to look at what we are doing for them and to see how we can act proactively in order to meet their needs.
I previously testified in front of the Senate committee in 2003 on a similar subject, and when I was associate deputy minister of human resources, or, at the time, personnel, I testified in front of SCONDVA, which is now scinder into these two committees. So I'm very happy to be back here today.
Very rapidly and succinctly, if I may, I think the first aspect I would like to introduce is one of the era in which we find ourselves; that is to say, what is happening now and what has happened over the last 15 or 16 years, since, essentially, the Gulf War, where we have seen a whole bunch of countries imploding and we've seen the UN launched into a whole series of different missions, and also countries, through coalitions, operating outside of the UN in a number of these missions. This new era of very complex and often ambiguous missions is not something that's going to end in the next couple of years. We are essentially in a new era, and we are at the start of a new era, contrary to the old era that really ended with the end of the Cold War.
In the old era, we were in what is known as classic warfare, attrition warfare, warfare of, essentially, armies against armies. Apart from our American colleagues, who lived the experience extensively with Vietnam, the whole concept was of professional armies facing professional armies, fighting it out with all the modern equipment, mostly in a Eurocentric sort of context.
This is not at all what has gone on since then, and it is not going to be the context of conflict into the future either. We will see a continuum of these very complex, very ambiguous, and very difficult missions as we continue to see countries imploding around the world, countries attempting to move towards democracy and human rights and good governance and rule of law, where we will continue to see massive abuses of human rights by extremism in various countries. We will also see the vulnerability of the developed world in regard to elements such as terrorism and even potentially the risks of nuclear devices.
Essentially, the era in which we find ourselves is an era in which those who serve in uniform—as those who serve in foreign affairs, those who serve on the humanitarian side, the RCMP and civilian police—will continue to serve in missions that are just not black and white. They are just not “good guy, bad guy”. They will have intrinsically complex dilemmas in how we solve, how we participate, how we use force in these missions.
We will continue to see those in the field facing complex ethical, moral, and legal dilemmas as they try to apply force or not apply force, as they try to integrate the use of force with the other two Ds, which are diplomacy and development, as we bring comprehensive, all-encompassing solutions to these conflicts.
So, ladies and gentlemen, the era of the blue beret with short pants and a baseball bat, chapter 6 peacekeeping, is over. The possibility of all-out central European massive use of armour, classic warfare in a World War III context, is also not there. In fact, the only two times we've seen it in the last 15 years were in the first Gulf War and when the American-led coalition went into Iraq the second time in 2003. Apart from that, they have been in all of these very complicated scenarios in which you don't face a classic enemy; you face, in fact, totally un-classic contexts.
This leaves me with the first point I wish to raise. In the back of the minds of those who are serving in the field, there is always this sense of a little bit of insecurity because we don't have all the tools, all the doctrines, all the training, all the tactics, all the equipment, and all the organizations that we used to have in classic warfare, well defined, well structured. We are still doing on-the-job training. There is still “ad hocery”, there are still new lessons being learned, and there is still a lot of crisis management going on.
For example, the context of the PRT in Afghanistan is not the be-all and end-all; it's a trial. It's a new way of doing business in which you are trying to resolve conflict. You are not fighting a war or peacekeeping; you are in conflict resolution. So that in itself creates a good setting for stress or at least potential trauma in those who are serving there. They don't have that same warm, fuzzy feeling we used to have in the Cold War, when we were both serving in Germany and knew exactly where we were going, who the enemy was, and what to use to sort them out. So that is a baseline.
One, this era is not ending. We are in this for some decades to come, and it will continue to be complex and more demanding. Two, we do not have all the fundamental conceptual bases and doctrines we used to have to say we're sending everybody in with exactly the right tools to do exactly the right job, because we're still learning it. Remember that in classic warfare it took us centuries to build humanitarian law, the law of armed combat, let alone the different conventions of the 20th century. So we are on new and complex ground.
The second dimension is that PTSD is not a disease or a mental health problem; it is an injury of the brain that is physically affected. Some of our grey cells get fried. Some of the circuitry gets screwed up and doesn't come back. It is not a psychological state that leads you to a mental health definition; it is a psychological fracture. It's a trauma that was brought upon something and it broke.
So, we are dealing with an operational injury and not a mental health problem. In this context, the urgency of responding to the needs of individuals with such injuries is the same as that for individuals who have lost a limb or been hit by gunfire, shelling or an exploding landmine, where the results are visible. There is no difference between the urgency of caring for a post-traumatic stress injury—the faster we react the better the results are—and the urgency of responding to the visible physiological need of a person with a broken limb.
That is why when we started this whole exercise in 1997, between Veterans Affairs and me, it went on two planes. One plane was within Defence, creating the quality of life program, and David was my private secretary and principal staff officer at the time when I was associate ADM(Mat) and we launched SCONDVA. It was with a gentleman called Richardson, I believe, who was an MP and the vice-chair, whom I went to see and said, “We are dying out there. We have soldiers killing themselves. We have families destroying themselves. We have individuals who are becoming totally operationally ineffective. We need to look at quality of life.” If you remember, that was the time of all the budget cuts and the impacts thereof. So SCONDVA took on quality of life and brought about massive changes within DND, and budget allotments to meet that requirement.
The second tranche of that was linking up with a chap called Dennis Wallace, who was at the time an ADM in operations at VAC, and we seconded a general into Veterans Affairs Canada, which we should have continued to keep doing. This one-star general was integrated into the whole process of modernization of Veterans Affairs to meet the needs of the new generation of veterans and was instrumental in assisting in building the Canadian Forces advisory committees, which Dr. Neary ultimately chaired, that produced the report that ultimately helped VAC produce the new veterans charter. Now we even have a bill of rights for veterans, which at the time we called a social contract between the military and the Canadian people.
So it took until 2006, only nine years--only nine years. However, we didn't close the shop during the nine years. We were not able to close down for inventory, keep the troops at home, sort out the processes, and then send them back in. On the contrary, the Canadian government has continued an incredible tempo of use of forces, as we tried to build a system that we had totally completely lost due to nearly 45 years of peacetime.
So we now have a system, but we have, however, a bunch of casualties out there who have not been responded to one way or another. We have not got the Gulf War veterans. We don't have the Agent Orange veterans. We have people out there still with pending scenarios that are in the hands of lawyers. Instead, they should be in the hands of politicians to take the decisions, to give them compensation, and to end it.
One of the principal reasons...on this aspect of those who have fallen through the cracks as we've modernized is the fact that they undermine the morale of those who are serving. What you do not need, and what certainly will have a terrible effect, is if the veterans, when they come back from fighting, or in whatever context they serve overseas, have to fight another fight to live decently back home. That undermines their morale, because they're always looking behind themselves, saying, “How is my family going to be handled? How will I be handled?”
In 1998, we had a young corporal come back, 22 years old, from Bosnia. He had been blown up by a mine. He lost a leg and his back was all blown to pieces. He was in the hospital. I went to meet him—I was a three-star at the time—at our hospital here in Ottawa. His wife was there and they had a young child. This guy had been injured less than a week. The first question he had for me was, “How is my family going to survive?” That's a question they should never have to ask, because we should be pumping that stuff to them.
So, ladies and gentlemen, my second point is that from this injury we have also seen a number of people, through the process of building a capability, which we have now, falling through the cracks. They will undermine the morale of those serving, because if they are not responded to they will continuously have the feeling that once you are injured, you will have to come back and prove, prove, prove, and fight your way through a process to be treated decently.
That is a negative effect on the operational effectiveness of the Canadian Forces, and it has an enormous effect on their sustainment, because the families turn around and say, “Why do you want to stay in an outfit like that? They've destroyed you. We pick up the pieces and we're abandoned.”
So it is also important for the sustainment of the Canadian Forces that those with experience who come back, who may or may not have certain injuries, feel that they are supported, and their families feel they are supported. We have to clean up the mess of those who have fallen through the cracks, as we build this extraordinary capability that we now have with the new charter.
I will rapidly address a number of specific subjects, if I may. I want to start with the reservists.
I serve as the honourary colonel for a regiment. Last Saturday, I met with the families of 17 soldiers from my regiment in Lévis who will be leaving for Afghanistan in August. I talked with the families; my wife was with us. I am President of the Centre de la famille Valcartier foundation, and my wife sits on the board of directors. Reservists are not getting sufficient support. The problem is that, if they're injured, particularly when it is a post-traumatic stress injury, they are scattered throughout the region and it is very difficult to bring them together and ensure treatment. It takes specific resources to treat them and to ensure that reservists, who are absolutely essential to the Canadian armed forces today, receive adequate care.
The Canadian Forces' establishment has been cut so much that we are forced to rely on reservists. Without them, the Canadian armed forces would have no operational capacity. But a double standard still exists. It is more difficult to provide care to reservists because they do not live on the major bases, they are scattered all over. Because this is a more complex problem, we need to find a more complex solution and a solution to ensure that these young people, who give a year of their lives to military service and who then return to the country—sometimes they do it twice—and their families receive exactly the same treatment as regular armed forces members. The blood that flows through the veins of reservists wounded overseas is exactly the same as the blood that flows in the veins of regular soldiers. When shots are being fired, they're not asked whether they are reservists or regular members. We are asking them to serve. The system should reflect equal treatment.
If more resources are needed to solve the problem we have in relation to reservists, then we need to organize our resources accordingly. There is a serious problem with services for reservists throughout the country.
The second point concerns Ste. Anne's Hospital. There have been, over the years, rumours that the hospital is being handed over to the Quebec government, or that we're closing it down or fiddling with it or modifying it, and so on.
The experience of our colleagues in the United States and in the U.K., in particular--and we've seen it in France, Belgium, and Holland--is that you need one place, at a minimum, that has the depth of knowledge and the experience of things military. We need, of course, the specialists who know how to treat a whole variety of ailments, from old age to whatever. Of course, you need that clinical side. But you need an institution that understands the culture and understands the dimensions of the military world. It is a different world. They work under a different premise than society. They follow, of course, the values and ethics of Canadian society, but they live within a context. Their jargon is even different from the normal population's. So you absolutely must ensure that Ste. Anne's remains with VAC.
Second, because of the prevalent nature of injuries that are not from bullets and bombs and mines and so on--the dominant, prevalent injury is operational stress or post-traumatic stress disorder--Ste. Anne's has to start dedicating a significant part of its assets to becoming a military PTSD institute in this country and internationally. We can't just treat. We must do some serious research to prevent the scale of injury to future individuals who are committed. So they have to learn, and they have to do trials, they have to test, they have to do research, and they have to do development. And they have to teach those who are working in the ten clinics the VAC now has, the five National Defence clinics that are out there, and, God knows, every other Tom, Dick, and Harry who is sort of contracted to help us. You must have a core capability that is not just treating today's problem; it is looking at how we reduce the impact of this injury in the future.
We do it on the physical side. I mean, the treatment we do now compared to the treatment for people in the trenches during World War I at Vimy Ridge is like day and night. Those of you who know M*A*S*H and watched the MASH 4077 know that was an invention that came in during the Korean War, and it reduced casualties immensely. It was amplified significantly in the Vietnam War. It is now a process by which we don't lose people on the scale we used to, because we took the physical problems and we analyzed them and we asked how to solve them.
Well, ladies and gentlemen, you have to do the same thing with the injuries between the two ears, and you need an institute that does that. Ste. Anne's has to shift a ward, a wing, floors--God knows what--to commit itself to reducing the impact of this injury on future veterans, future members of the forces, who will continue to be committed. That is the mandate.
Third, OSISS, the operational stress injury social support people, are those 400 veterans who are helping other veterans across the country. May I state that they have to be integrated within the process. They have to be inside those ten VAC clinics. They have to be inside those five Defence clinics. They have to be inside the different VAC offices on the bases and so on, because they will provide the depth of knowledge of the jargon and what these people are talking about, first of all, which clinicians don't automatically have. But second, they are an essential tool in the recuperation and stabilization of those veterans who are injured with PTSD.
You need professional therapy. You more often than not need pills. I take nine a day. I've been in therapy for eight years. And you need, between those sessions, a bosom buddy. You need someone who is prepared to sit there for four hours and listen to you talk. Families can't handle it. The impact is too strong. My family has still not read my book. Families can't handle it. Uncles and aunts or something, maybe; a friend, possibly. You need another vet to sit there and listen and be available between the official sessions to continue the process of it.
And you know what? I learned that from the Legion. First of all, it was absolutely essential for my still being alive today that I had a bosom buddy, but I learned it from the Legion. I learned it from the Legion when I was a kid, seven or eight or nine or ten years old, when I used to go there on Saturdays with my father. I watched my father sit around those tables, little arborite tables, chock-a-block full of beer. There would be five or six or seven of them there, and they would either be laughing their heads off or every now and again there would be one crying his heart out. But that evening, after his session with his buddies, the family could live decently without stress.
You absolutely must take that capability that was created by a lieutenant-colonel who served with me, Stéphane Grenier, inside DND and move it into the mainstream of services provided by those institutions.
Quickly, if I may, last but not least are the families.
I want to tell you a little story. When I came back from Rwanda, after having spent one year there, nearly four months of which at war, my mother-in-law told me that she could have never survived the Second World War if she had had to go through what my family did. Why? Because during the Second World War, when my father-in-law commanded his regiment in Italy, and later in Holland and Belgium, the family got very little information. Furthermore, information was censured. The entire country was caught up in the war.
Today, the country is at peace. However, the Canadian armed forces have been involved in conflicts since the Gulf war. We have been going to war for nearly 15 years. The plumber who lives on one side of the street and the public servant on the other side of the street are not at war. However, the families of soldiers are subjected to the realities of war. Our families experience our missions with us because of the media. They are always there and want to be the first to report who was injured, killed or taken hostage. The families are stressed and profoundly affected.
A system that takes care only of the individual and does not integrate care for spouses and children—I have two of my children who were affected—is a system that is far from perfect. The individual may receive all the assistance needed, but once back at home, he faces an extremely complex situation.
So, we need to find solutions in cooperation with the provinces to provide services to children and spouses who remain at home. We saw this in Petawawa; it's only a small example of what families are experiencing when soldiers return home.
We can invest a fortune to help individuals, but if we don't help their families, we will not achieve the desired objective. In closing, I want to remind you that the Charter is bringing us into the modern era, because it refers to the individual and the family. We must apply the Charter, and this is where we run into shortcomings.
Ladies and gentlemen, you have been very patient with me. I want to thank you very much for your invitation.
I am prepared to answer any questions.
