Veterans Affairs Committee on May 31st, 2007

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Thank you, Mr. Chairman.

I first want to say that in my ten years as a member of Parliament, last night was the best committee I ever attended in terms of the meeting. I thought you, Mr. Chairman, did an outstanding job. It's a pretty sensitive thing to cut people off who want to talk, but I thought you did it extremely well, and my hat's off to you. I thought yesterday was very uplifting. I wasn't sad at all. It was actually quite a remarkable thing to witness. So that one's in the memory bank for a while.

Madam, thank you very much for your presentation. I have only two questions for you.

When you make the recommendations to government, do you put any fiscal parameters around them? Do you advise government how much it may cost them and, if not, why not?

Second question: do you compare the work or the studies you do with other countries that we are allies with, for example, the United States, Holland, Britain, New Zealand or Australia, in terms of how they treat their aging veterans and their families as well?

The last question for you is this. When a veteran passes on and their spouse is left behind, do you feel there's not all of a sudden a disconnect from that individual? I ask this because we all hear from family members whose veteran has passed on, and it's very difficult for them to approach the government or the department in any way to try to achieve services they may require.

Thank you.

[Dr. Dorothy Pringle]

The council itself does not do the work on the fiscal side of the recommendations. We don't have the expertise to do that. But the staff of Veterans Affairs does do that and does assess what it would cost, and they've been doing that on the recommendations for Keeping the Promise.

We're told on the council about what kinds of aids would then be required to put into place the recommendations, and we push back and say you have to do better than that in terms of getting these programs in place. But we don't do the fiscal analysis itself.

We try to be realistic around what's possible. We're not recommending a personal trainer for every veteran in order to achieve a higher level of physical activity. But we do believe it is possible to put in place and give access to physical activity programs that meet the needs of individual veterans.

We do look at what is available in other countries and what they make available to their veterans. I'd say we have looked at the Australian situation, perhaps, more than the U.S. I don't believe the U.S. is doing anything particularly on the health promotion side of things.

In the Australian situation--and now I'm talking about the Keeping the Promise working group--we had the benefit of a staff person who was on exchange from Australia, and he worked in the veterans affairs directorate in Australia. He was a very knowledgeable individual. Again, he had firsthand knowledge of what was going on in Australia, and he was one of the staff people who worked with our Keeping the Promise working group. So we had good access to that.

We relied a lot on the research done in Australia on the long-term effects of deployment on the health of Korean War veterans. We were very influenced by that research.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

What about the last question regarding the spouses of veterans who have passed on?

[Dr. Dorothy Pringle]

I know this came up earlier. The Gerontological Advisory Council did recommend to Veterans Affairs that the services available to veterans through the VIP program had to be made available to their family caregivers and that these services had to remain not only for a year following the veteran's death but for the remaining lives of these caregivers. I believe that is being put into place now.

We're absolutely in agreement that the caregivers should receive the same consideration and access to services as the veteran.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Thank you.

[The Chair, Conservative, Rob Anders]

Thank you, Mr. Stoffer.

We'll go over to Mrs. Hinton and the Conservative Party.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

Good morning, Dr. Pringle.

[Dr. Dorothy Pringle]

Good morning.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

I've listened very carefully to some of the comments you have been making today and with great interest. It's obvious to me that you're leaning very much toward the exercise and prevention side of things, which I happen to think is a good way to go.

In terms of what we're able to do for veterans now and what you'd like to see changed, I have asked the same question of every witness we've had on this particular issue. If you could personally change one aspect of the system as it is now, what would it be? That's the first question.

I have a couple of comments. It's interesting how people who hear the same information perceive that information. You said that 60% of people are not involved with Veterans Affairs right now, and what you meant was that they're not in a long-term care facility. I actually think that's good news, not bad news, although I want to make certain that the 60% who don't need that care now have access to it.

One other comment I wanted to make is that the average age of a Canadian veteran is 36. We've got a few years left here to try to do the things you're speaking about, which is to make people more flexible and in better physical condition so that hopefully they don't have all those issues to deal with when they become 80 or 85 years old.

Would you mind answering that first question: if you could change one aspect of the system as it is now, what would it be?

[Dr. Dorothy Pringle]

I've got to stick with the health promotion theme. I think VIP works very well. I think there are some wrinkles in the sense that people need more assistance in linking to services—that is, they need help in getting the person to shovel the snow, etc.—but even that's getting better across the country. I think VIP is working well.

I think the long-term care is working better because of moving beyond just the designated veterans beds in veterans facilities. Going to the community beds has made a big difference. Our recommendation is that we need to make access to retirement homes and assisted living easier, which will improve that whole residential side even more.

I think there's been a huge gap in Veterans Affairs on the health promotion side. We've been waiting until veterans got into difficulty before we really admitted them into the service end of the system; we provided help to them after they were frail and after they could no longer do things. We don't know how long they were in difficulty before they contacted Veterans Affairs. I think if we can link to as many veterans as we can find in this country, get through to them on the health promotion side, and work with them, we'll have a better chance of either eliminating or delaying some negative health consequences and we will have better attachment. We can get them VIP services earlier, if that's necessary, and they won't have to get sick before we start working with them.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

We're certainly in agreement on that one as well. If I'm hearing you correctly, the only aspect of the current system that you would change is that you would like to see Veterans Affairs, the department itself, become more proactive in making sure our aging veterans are kept in better physical condition than they are today, for example, and you think that will make a significant difference to the well-being of our veterans, because—

[Dr. Dorothy Pringle]

Let me clarify. You asked me for the thing I would change most. That's what I would change most. I think there are other areas that we need to improve, and giving access to assisted living is one of them. For me, I think we would get the biggest impact if we began working with veterans immediately upon their leaving the forces, stayed in touch with them over their lifespan, and made available to them health promotion strategies, activities, and links into programs. We should be able do that from the time they leave the forces.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

That's helpful. Thank you very much.

As a gerontology committee member, you deal almost exclusively with senior veterans. I would imagine you would have very little exposure to the younger veterans. Is that a correct assumption?

[Dr. Dorothy Pringle]

That's true.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

Do you think there would be any benefit to your committee members interviewing and speaking to some of the younger veterans, in a proactive manner, once again, so that you're preparing them and yourselves for the future?

[Dr. Dorothy Pringle]

We have a little access to the younger veterans through the membership of the Gerontological Advisory Council of the representatives of veterans organizations. They're younger and they represent a variety of experiences. But it's not extensive contact.

I think there would be value in having a better feel for the 35-year-old veteran. I think the average age of the Canadian Forces veteran is actually 56, not 36—at least that's the information I have.

But for veterans of the 1970s, 1980s, and 1990s and people who are leaving the forces now, I think we would be able to take into account those experiences when thinking about the programs that will be needed over the next decade.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

Thank you very much for your input. I appreciate your testimony today.

[The Chair, Conservative, Rob Anders]

Thank you very much, Mrs. Hinton.

We'll now go to Mr. St. Denis of the Liberal Party for five minutes.

[Brent St. Denis, Liberal, Algoma—Manitoulin—Kapuskasing, ON]

Thank you, Mr. Chair.

Thank you, Dr. Pringle, for joining us today.

Elliot Lake was mentioned. I'm the member of Parliament for the riding that includes Elliot Lake. You're right that thousands of Canadians have moved there. As we're being broadcast around the world on the web, more are invited to join us in Elliot Lake.

I want to add to my colleagues' comments in thanking the chair, the clerk, and the researcher for facilitating last night's excellent meeting.

Dr. Pringle, I think one of the challenges for our older veterans and the new and emerging veterans as they retire—one of the things they face to varying degrees—is the issue of red tape. It's not only the paperwork. It's the effect of the paperwork on their health. If the health issue is in the nature of a mental injury, I would say it has a more exaggerated impact versus an injury that is physical. But in either case, it would have a negative impact.

In your work, do you deal at all with ancillary issues such as processing veterans into and through the gateway and through the system? What's the impact on their general health and the frustration levels they may feel?

[Dr. Dorothy Pringle]

We're aware of this, and we are made aware of it by the representatives of veterans organizations on our advisory council. I think it is a problem in our current system, and it's largely driven by all of the different eligibility criteria. It means that people who need some kind of contact don't get it, because they can't pass the first barrier of getting into the system or they don't meet an eligibility criterion.

I think on our recommendation that we work on needs-based access and we contact every veteran, if we can, and connect them to Veterans Affairs, whether they need services or not, they may very well need assistance in navigating the health care system.

We're proposing in Keeping the Promise that for the early intervention specialist it would be part of that individual's role. If this person is part of the caseload that she or he is working with, they need to identify whether or not there are health promotion programs that this individual would benefit from and would be interested in participating in.

They also need to help the person navigate the system, get through the red tape, and complete forms. But I expect there would be far fewer forms if we had a needs-based system as opposed to eligibility criteria.

[Brent St. Denis, Liberal, Algoma—Manitoulin—Kapuskasing, ON]

Thank you, Dr. Pringle.

There's a word that comes to mind. You said the word “navigator” was not generally accepted by the veterans.

One job I had when I was younger was an “expediter” in a factory. An expediter is somebody who goes and find the parts that the assembly line is waiting for, because they're somewhere in the factory. In the same vein, I think these folks need an expediter to make sure they get into the system as they need to be and are processed efficiently and fairly.

[Dr. Dorothy Pringle]

That's a great name. I think it's a great title.

[Brent St. Denis, Liberal, Algoma—Manitoulin—Kapuskasing, ON]

Related to the red tape, from your experience, how would you describe the attitude of the military, whether it's DND or Veterans Affairs, or the government in general, historically, towards injured veterans? Are they seen as being still part of the military family and we have to do our best, or are they seen as a drain on the system, especially those with mental injuries, where it's not visible, and are maybe even seen, sadly, as pariahs—or they feel that way, a lot of them, anyway? How would you describe the general philosophical approach to those who have left the military, particularly those who are injured in some way?

[Dr. Dorothy Pringle]

First of all, I have limited exposure to this. We don't have contact with DND.

I will say that I have not encountered negative views at all from the Veterans Affairs staff, and we work with a lot of staff, both in Charlottetown and people across the country. Staff come to our Gerontological Advisory Council meetings and participate in discussions, so we get exposure to that.

The thing is, when the veteran is coming to Veterans Affairs now, I think the injuries that are clearly linked to war services have been identified and those people are in the system. It is long-term possible complications of wartime service that are surfacing now. It's these older veterans, where it's not an amputation; it's not an obvious injury. It's a consequence of either deployment or military service, like arthritis. The research is fairly recent still on linking the long-term effects of military service to old age health problems.

That's the group that we see, and I think we have a good feel for them. I can't really speak with any knowledge or authority on the experiences of young injured veterans.

[Brent St. Denis, Liberal, Algoma—Manitoulin—Kapuskasing, ON]

Thank you, Dr. Pringle.