Veterans Affairs Committee on May 31st, 2007

[The Chair, Conservative, Rob Anders]

Thank you.

Now we'll go to Mr. Gaudet, from the Bloc, for five minutes.

[Roger Gaudet, Bloc, Montcalm, QC]

Than you, Mr. Chairman.

Good day, Ms. Pringle. You may find my question amusing, but in your opinion, would it be a good idea if veterans lived close to military bases?

When I was attending the seminary run by the fathers of the Very Blessed Sacrament, each seminarian had morning chores. In all, 150 students attended this private school. There was only one custodian on staff and each student had daily chores to perform. The seminary did not employ any outside staff. All work was done by the students.

Do you think it would be a good idea to house veterans on a permanent basis in either temporary or permanent housing built by the government for forces members? Would that make for a better quality of life for veterans? And here, I am not just talking about veterans, but about nurses and other personnel along with their families. Veterans could then discuss their experiences with younger CF members. I am not sure whether this would be a good idea. What do you think?

[Dr. Dorothy Pringle]

I think it has a number of problems. The young soldiers who are serving in Afghanistan and the ones who are killed...so we become very aware of each of these individuals.... You hear that this person is originally from Nova Scotia but they're based in Petawawa, or they're from Ontario but they're based in Edmonton. I have no military experience of my own; I've not been involved with the armed forces. So I think it might be a nice idea for those veterans who choose to remain close to the bases, where they received their deployment, but I think we have to honour the fact that they have the right to live anywhere. And for many of them, they would want to move back closer to their families, I would expect, or for jobs. They need to be able to go wherever the jobs are and finish out their working lives in those communities.

It's not likely, if they have lived for 20 years in Sudbury after leaving the military, where they might have been based in New Brunswick, that they would want to move back to New Brunswick for that, except for some folks whose family might be there or because they've maintained close links. So I think it may be attractive for some folks, but I think for a lot of veterans, it would not meet their needs.

[Roger Gaudet, Bloc, Montcalm, QC]

Thank you.

[The Chair, Conservative, Rob Anders]

Thank you, Mr. Gaudet.

Now we have Mr. Shipley.

[Bev Shipley, Conservative, Lambton—Kent—Middlesex, ON]

Thank you, Dr. Pringle, for joining us today. When you're talking of Keeping the Promise, you talk very much about poor health in later years. In fact, poor health in later years is not inevitable, and you talked a bit here about health promotion. Last night, as many of us will talk about for a long time, many talked about how important it was for education.

In terms of education, they were talking certainly about themselves and understanding it better, but mostly about their supporting families and caregivers—not the professional people. In fact, I had some sense that some professional people clearly don't understand PTSD or some of those affected diseases that come following trauma.

You talked earlier about realistic ideas. One of the things they talked about, which struck me, is why there hasn't been a book written by those who have been affected by PTSD, so that it's basically one of those peer things. Many of those folks were affected with their families. Their families still don't get it; they still don't understand it. And I think it's hard sometimes for a family member to understand when it's coming from that individual rather than coming from someone extended from the family or outside of the family.

Do you have any comments on that?

[Dr. Dorothy Pringle]

I appreciate what the individuals were telling you. I have a master's degree in psychiatric nursing, and I've worked in that area for a long time. I think mental illness, regardless of the form it takes, whether it's a schizophrenic kind of disorder or a PTSD disorder, is very difficult for the public and for family members to relate to and to try to get a handle on. So I think these veterans are experiencing what folks with mental health difficulties have always experienced.

I think anything that can be done to help families, the community, and actually health care providers—who are not experts in this area, but who really appreciate the nature of what is being experienced—would be helpful. I think a book would be great.

[Bev Shipley, Conservative, Lambton—Kent—Middlesex, ON]

You've targeted that. Could you help us help them in terms of how that would get organized? Who would be best for them? Who would be the ones they could go to? Who are the ones we could go to? Who would be the best service provider for that?

[Dr. Dorothy Pringle]

Who would be the best service provider around the book?

[Bev Shipley, Conservative, Lambton—Kent—Middlesex, ON]

To get one going—

[Dr. Dorothy Pringle]

I'm talking off the top of my head now, but I wonder about one of the veterans organizations. It would either come from Veterans Affairs, in terms of their communications department—that's a possibility—or I can see the Royal Canadian Legion taking this on as a national initiative. Do they do that type of thing?

There may be a variety of ways of getting that accomplished. It is a great idea.

[Bev Shipley, Conservative, Lambton—Kent—Middlesex, ON]

It struck me as something that was actually needed for the general public, for the families. That would likely be an important step.

The other thing you talked about was fitness. Although we may not be in the category of being the best in fitness, it's important in later years, and through our lives.

You talked about it being better to be integrated. Is it better to be integrated into groups than trying to do things on your own? One of the things we hear is that when you come back after a trauma, people tend to seclude themselves. They tend to not want to be out, and yet as we will hear, once they pass through a time when they can get over a barrier and get out, it is better for them, even though they still have trauma effects hitting them.

I wonder if you have some comments about how we can understand the best way to get them into physical fitness, whether on an individual basis with personal trainers, or is it better in some cases to have them integrated into some sort of slow plan, so that they are with their peers? Part of this seems to be physical fitness, but it's also being able to talk to your peers.

[Dr. Dorothy Pringle]

It depends on the individual. The research shows that when individuals get into a program in which they are expected to take up a physical activity on their own, they don't maintain it. Their participation goes on longer and with better effect if they have support and contact by somebody and by telephone.

One of the programs that we're seriously looking at is an individual home-based physical activity program, supplemented by weekly contact—in our case by that early intervention specialist.

For those individuals who are not willing or interested in participating in a group, that program is probably the better one for them. They could also graduate from that program, because once they are feeling better—very frequently they don't feel up to getting out to groups—they may then be willing to join a group, but it will have to be a graduated kind of effort. Other people enjoy and get a lot out of group activity, and it's as much if not more the social side of things as it is the exercise. So if you can get people into group exercises that we know are useful and effective for them, that's more sustaining over the long term.

It is not a “one program fits all”. Each of these individuals has to be assessed, and it has to be determined with that individual and the caregiver, because we see this as equally important for the caregiver.

It may be that some caregivers would get involved, and then eventually the vets would get involved.

[Bev Shipley, Conservative, Lambton—Kent—Middlesex, ON]

Again, thank you very much for your comments.

[The Chair, Conservative, Rob Anders]

Thank you, Mr. Shipley.

Now, on to Mr. Valley, with the Liberals, for five minutes.

[Roger Valley, Liberal, Kenora, ON]

Thank you, Mr. Chairman.

Thank you, Doctor.

I believe the report came out six months ago in November. Can you remind us of what the next steps are, because we've heard over and over again that we need to get to a needs-based system? So would the first step we take be that?

When we heard from other witnesses, there were meetings planned in the future for your group. Can you tell us what the immediate future is?

[Dr. Dorothy Pringle]

We're meeting the first week of July in Charlottetown, and that's where the two groups, the health promotion committee and the assessment committee, are both reporting.

Our report came out, and by the time it was translated and got to Veterans Affairs for their work it was probably late summer. They have been working on it. They came back to us asking for assistance in terms of developing the implementation plans.

I think the needs-based one is moving ahead, and that's why the assessment committee has been investigating and making recommendations around the particular—I'm going to use the word—“instrument”, or the assessment tool that needs to be put in place in order to move us to needs-based. Our health promotion committee will be making its initial recommendations in July about where we should start in moving the health promotion side forward and redefining the roles of the care coordinator to expand them.

I can't give you a date when the changes will actually take place, but I've been at an awful lot of meetings this spring. We met with folks from Treasury Board as they began to work on the financial side of things. We're very hopeful that this is going to begin to be implemented maybe later this year, or certainly early next year at the latest.

Our council meets twice a year. This year we had an additional meeting because we were working on implementing Keeping the Promise.

[Roger Valley, Liberal, Kenora, ON]

Thank you, Doctor, and thank you for your dedication.

You used a term earlier that I hadn't thought of. You said that Veterans Affairs is a gap filler between the provincial systems. Sometimes, as we heard last night, there's more gap than filler. We all know of the shortages of some of the health care professionals across Canada, of all health care workers, and that must impact some of what you're trying to do for veterans.

We know there's been less and less of a federal presence in the ridings and in the communities. We've moved to local contracts for providing services in rural areas and local contracts with provincial hospitals. Does your group think these are complex enough, or is it something we need to expand on with the provinces? Recently in the media we've seen issues where some of the survivors, or veterans, or their families have issues with some of the provincial health care systems.

[Dr. Dorothy Pringle]

I think we're all subject to the limitations of our provincial health care systems. There are excellent aspects of these systems but also limitations. I think there are definitely gaps at this point in time.

I'd say home care may be one of the least well-developed sides of our health care systems across the country. We don't have sufficient budgets in there; we don't have sufficient nurses, physical therapists, homemakers, personal support workers, and that kind of thing. That affects the services to vets. That's where Veterans Affairs steps in and increases the amount of homemaking and increases the amount of personal care. It usually does not have to increase the amount of professional services, but if that's necessary, they will do that.

Everybody is limited by the availability of professional workers. We do not have enough physiotherapists, and we particularly don't have enough care programs in the home. I think that is an issue. It's recognized, and I think whenever it can be solved by contracting with private sources, for physio or whatever, that's done, but that doesn't always work. It is a limitation that affects all of us.

[Roger Valley, Liberal, Kenora, ON]

Thank you, Doctor.

I serve a rural riding, one of the larger ridings in Canada, and I thank you for your dedication. I've heard you say several times that the focus is on the large urban centres because your services are there, but it's sometimes the veterans who are out in the rural areas who, while we don't forget them, have a much greater difficulty receiving some of those services.

Thank you.

[Dr. Dorothy Pringle]

Yes, I agree.

[The Chair, Conservative, Rob Anders]

Thank you, Mr. Valley.

Now we'll go to Mr. Sweet with the Conservative Party for five minutes.

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

Thank you, Mr. Chair.

Thank you, Doctor, for all your good work and your answers to our questions today.

I recently had a veteran come into my office. I can only speculate that his age was close to 80. He had been exposed to asbestos and was not receiving services from Veterans Affairs. Fortunately, after one appeal, he was able to get services. Of course, subsequently, he was able to enroll in the VIP program. This will ensure that his wife gets these VIP services, but he was totally unaware of that.

One of the things I really liked about the last two witnesses from your council...one of the recommendations you're making is for a proactive solicitation for veterans services. Is that correct?

[Dr. Dorothy Pringle]

Yes, absolutely.

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

What role is this early intervention specialist going to play in that? I'm just trying to get a handle on it. What kind of person is this early intervention specialist going to be? What kinds of credentials do they have? Is this going to be a jack of all trades, or is this someone who's going to be a registered nurse?