Veterans Affairs Committee on Nov. 24th, 2009

[The Vice-Chair (Mr. Robert Oliphant (Don Valley West, Lib.)), Liberal, Rob Oliphant]

Good morning, and welcome.

My name is Rob Oliphant, and I am the vice-chair sitting in for David Sweet, who is the chair, until he arrives, which should be shortly.

I am now calling to order the Standing Committee on Veterans Affairs, meeting number 35.

We welcome our witnesses this morning. Thank you for coming to this committee.

We are undertaking a study on the new Veterans Charter. The study has been going on for a few weeks and we've been hearing witnesses. This is a continuation of that process.

We have three sets of witnesses today. I don't know whether you've spoken among yourselves about going in a particular order. If you haven't, I would suggest that we hear from the ANAF vet group first, then from the Canadian Association of Veterans in United Nations Peacekeeping, and then from the occupational therapists group. It will sometimes be a little bit awkward, in that you all won't be coming at the review of the Veterans Charter in the same way, but we have a standard practice here of hearing from all the witnesses first, about ten minutes from each group, and then we turn it over to the members of the committee to do questioning. We'll take that questioning for the next hour or so after that.

I'll call upon Mr. McCartney first.

[Lorne McCartney, Dominion Secretary-Treasurer, Army, Navy and Airforce Veterans in Canada]

Thank you, Mr. Chair and members of the Standing Committee on Veterans Affairs. It is an honour to be here today to discuss veterans issues as they relate to the new Veterans Charter.

I am here today representing our president, Mr. Gordon Marsh, and I am speaking on behalf of the executive and members of Canada’s oldest veterans organization, the Army, Navy and Air Force Veterans in Canada, abbreviated as ANAVETS. We were founded in Montreal in 1840 and Queen Victoria signed the charter for our first unit. At the present time, we have approximately 16,000 members across Canada, formed into 68 units under seven provincial commands. Our association has been involved in all aspects of creating the new Veterans Charter and continues to work at improving the many aspects of this very complex document.

As a veterans organization, one of our foremost concerns lies with military personnel who have been injured, either physically or psychologically, while engaged in their duty. We believe that when the Canadian government dispatches a military force overseas to further its international aims and objectives, our nation has an inherent obligation to provide the best possible care and support to those injured in the line of duty.

When we look at a soldier—I use that term in the general sense, referring to all members of the Canadian Forces—responding to the call to duty, we must go beyond the individual and consider the whole family unit. It is so often the spouse who must give up a career to follow his or her spouse through various postings and all too frequently is forced to raise a family alone while the member is absent from the home on military duties. Furthermore, when that soldier is wounded, the family also suffers. The immense burden of providing care to the injured person and the possibility of having to return to the workforce to sustain the family places stresses on everyone, the children included. These are complex issues. Each case has its own sad tale, and the Canadian government and all our citizens have an obligation to repay the debt that is owed to these families.

We believe that the wounded soldier and his or her family is entitled to such support that their quality of life should be, as near as possible, no worse off than had the injury never happened. In the new Veterans Charter and in the recommendations of the advisory group’s recent findings, there is a wide spectrum of services and payments designed to provide support and financial compensation to those injured while doing their duty. We feel that the charter contains inadequacies that must be corrected. Some of these items were discussed prior to the approval of the new Veterans Charter, and some were discovered later. In any event, promises were made that these items, which we called gaps, would be addressed once the act was approved. That was almost three years ago.

There are many areas I would like to touch on here, as we feel they may be misunderstood, and I will therefore help to clarify our position. The disability award is a lump-sum payment given to the injured person for pain and suffering only. This payment should not be considered as any sort of pension plan or wage or payment for the individual to fix up his or her home to accommodate his or her handicap. We generally support this award but feel its intent must be better explained.

As the charter now stands, the wounded soldier receives a pension based on a percentage of the pay for the rank he or she held at the time of injury. The majority of those wounded in military operations are at the lower range of their military potential. For example, had he or she been wounded as a private, he or she would have reasonably expected to have reached the rank of sergeant or warrant officer, and a lieutenant could have reasonably expected to become a major or higher. The injured service person should not be forced to raise a family through the trials and tribulations of life subsisting on a percentage of the pay entitlement at the lower end of any wage scale.

Had the soldier not been wounded in the service of Canada, he or she would have progressed to the full potential of his or her ability. Lost are the promotions that would have been forthcoming, and wage incentives will not be applied, nor will career satisfactions be garnered. As the family grows older, costs increase, thereby placing additional burdens on the family. Is it any wonder, then, that our military has not allowed many of our injured veterans to be released from the armed forces?

You will no doubt have seen what problems SISIP, an insurance-based remuneration system, is causing to providing appropriate compensations for our veterans. This should be addressed by either getting rid of SISIP or adjusting it to fit the requirement. Furthermore, our veterans lose the ability after release to have a pension plan similar to members that are in the military. This should be fixed as well.

We believe that the claims and benefits process is too complex and must be simplified. Better assistance must be made available to claimants to guide them through the maze of detail and to obtain their benefits.

In spite of these comments, ANAVETS is most appreciative of the sincerity and dedication of the staff of Veterans Affairs Canada. We thank them for their service to Canadian veterans. I also thank the members of this committee for allowing me to make this presentation on behalf of our association. We in ANAVETS are confident that you have the best interests of the men and women serving in the Canadian Forces in mind. We hope you will make every effort to ensure that those who have given so much will be treated with the respect and dignity that they have purchased with their blood.

Thank you.

[The Vice-Chair (Mr. Robert Oliphant), Liberal, Rob Oliphant]

Thank you. Merci beaucoup.

I love being on this committee, because I learn something after every witness.

Mr. Griffis.

[Ronald Griffis, National President, Canadian Association of Veterans in United Nations Peacekeeping]

Thank you, sir.

Mr. Chairman, honourable members of the Standing Committee on Veterans Affairs, veterans, and guests, it is indeed a privilege and honour to appear before this committee today. Thank you for inviting our association to this meeting.

May I take this opportunity to thank the Standing Committee on Veterans Affairs for all the work they have done on behalf of veterans and their families.

My name is Ron Griffis, the national president of the Canadian Association of Veterans in United Nations Peacekeeping. Our association was formed in 1989 and consists of 28 chapters located from coast to coast. All of our members are veterans of the Canadian Forces.

I am a member of the New Veterans Charter Advisory Group, the Gerontological Advisory Council, and the Veterans Affairs Canada client advisory committee located in Halifax, Nova Scotia. Our association has been associated with the construction of the new Veterans Charter since its beginning. The most recent report involving the new Veterans Charter was created under the guidance and direction of Chairwoman Muriel Westmorland of Hamilton, Ontario, and was received by Veterans Affairs Canada on October 1, 2009.

Three subcommittees had input into this document. They were, generally speaking, family, financial, and rehabilitation. I was involved in the family subcommittee, under subcommittee chairperson Colonel (Retired) Don Ethell. Our heading was “Strengthen Family Support Services". My copy of the report indicates there are a total of 16 recommendations in this new report. I would request that the recommendations not be prioritized but treated as a family of recommendations, with each carrying its own weight.

The new Veterans Charter has always carried the title of a living charter and should be updated on an ongoing basis. The gaps that have been identified in this report should be addressed as soon as possible. We appreciate that we are experiencing financial difficulties, but this should not be the reason we do not correct the identified problems now.

Military personnel and their families give of themselves freely on a continuing and regular basis. They subsequently become veterans. A very specific definition of a veteran is one who has completed basic military and trades training and has been honourably released. To ignore them now just creates problems that will surely surface in the future and cost more to treat and correct.

To do nothing is not acceptable. You have an excellent report at your fingertips, and I respectfully request that all recommendations be implemented as soon as possible. As military members, veterans, and their families enter the Veterans Affairs Canada system, they generally speaking encounter significant bureaucratic difficulties. I understand the office of the veterans ombudsman may be looking into this issue, and hopefully his report suggesting changes to the application for benefits will address this significant issue. It is imperative that Veterans Affairs Canada be afforded all and any assistance you may be able to provide them for a swift implementation of these recommendations.

I point out that since I arrived in this building at a quarter to eight this morning, we have lost six veterans. We lose veterans at the rate of one every 15 minutes on average. Last year, 15 newer veterans—not the traditional veterans from World War II and Korea—committed suicide. We keep losing veterans, and we cannot afford the cost in human lives that has taken place.

Thank you ever so much.

[The Vice-Chair (Mr. Robert Oliphant), Liberal, Rob Oliphant]

Thank you as well.

Mrs. Taylor.

[Dr. Elizabeth Taylor, President, Canadian Association of Occupational Therapists]

Good morning, Mr. Chair and members of the committee.

I'm Dr. Elizabeth Taylor, president of the Canadian Association of Occupational Therapists. I am an occupational therapist, academic, and psychologist. I work primarily in the mental health field in developing programs in the community for those who live with mental illness and their families. My experiences have given me a first-hand understanding of the issues facing the Canadian military.

Today with me is Dr. Claudia von Zweck, occupational therapist and executive director of CAOT.

I recently met a veteran on the streets of Edmonton. He was young, homeless, and addicted. But once trust was built he shared with me a story of life before war. As an occupational therapist, I recognized the symptoms of PSTD and realized he had fallen between the cracks of service--cracks that I'm sure this committee will address as part of your study of the Veterans Charter.

Veterans Affairs Canada, despite such issues mentioned above, are delivering quality services to our valued veterans under the existing terms of the new Veterans Charter. This charter, identified as a living document, is built on the same principles on which occupational therapy is based. These are the principles of wellness, personalized case management, rehabilitation, and finally job placements--best known to occupational therapists as return to work. All of these are critical elements in defining the professional skill sets of occupational therapy. We believe that as you study the strengths and weaknesses of the charter, the recommendations we put before you will enhance the work of VAC and support excellence in rehabilitation in a more cost-effective manner.

Occupational therapists are highly trained health professionals who work in hospitals, clinics, workplaces, homes, schools and communities. Occupation in our context relates not just to the job that someone would write on their annual tax form, but rather all aspects of daily living from personal care to work requirements. Occupational therapists find creative solutions to enable people to perform to their best abilities in their everyday tasks. In simple terms, when an injury, illness, disability, or other problem limits the ability of one to function within the environment that defines them, an occupational therapist can provide solutions to support the individual in ways that will enable them to re-engage in their daily activities--for example, to fully function in the career of their choice and maintain self-reliance.

Occupational therapists have been involved with the military community since the inception of the profession. Occupational therapists do more than provide direct service. Their holistic training gives them expertise in developing and supporting sustainable practices, managing caseloads, allocating resources, and demonstrating accountability to both the public and funders, all of which makes them an asset to Veterans Affairs Canada.

We continue to play a role in the care of veterans. However, we believe that our profession is being underutilized in the care of veterans, and the care of injured soldiers who, without proper management of their illnesses or injuries, will eventually join the ever-growing ranks of VAC. Occupational therapists promote the wellness of veterans by enhancing occupational performance, treating post-traumatic stress disorders, and reducing the number of Canadian soldiers discharged for medical reasons. They identify solutions for occupational performance that ensure resilience and full recovery. All of these are components listed in the charter.

One area that has provided concrete results is the return-to-work project developed by occupational therapist and reservist Major Chantal Bérubé at CFB Val Cartier. It has had a positive impact on the well-being of military members returning from deployments. Prior to her work there was a 10% return to active duty, whereas with the implementation of her program nearly 70% of injured soldiers returned to active duty within a short period. This significantly reduced the number of soldiers on disability and the numbers who would have transitioned to civilian life and then hopefully accessed the many services offered by VAC. We have other examples of how we can enhance the care of veterans, and we would be pleased to address these during our discussion.

In closing, we are concerned that the full potential of occupational therapy is underutilized. Therefore we suggest the following recommendations to you in your review of the charter. Occupational therapists could contribute more through (1) being included on all inter-professional assessment teams at VAC to ensure that the best and most cost-effective decisions and services are provided from the very beginning of treatment; and (2) more comprehensive return-to-work plans using occupational therapists in order to reduce the number of military transferred to civilian life and to the care of Veterans Affairs Canada.

Thank you for providing this opportunity to speak. We welcome your comments, questions, and concerns and we will provide any support we can in addressing them.

Thank you.

[The Vice-Chair (Mr. Robert Oliphant), Liberal, Rob Oliphant]

Thank you very much, Dr. Taylor.

Our round of questioning will begin with Ms. Sgro from the Liberal Party. You have seven minutes.

[Judy Sgro, Liberal, York West, ON]

Thank you all very much for being here today and for helping us with this important work on this review.

I don't know where to start. I have about five questions that I've written down here. I think I'm going to go to Mr. Griffis first.

Tell me a little bit more. You mentioned about the number of suicides. Aside from the number of veterans we are losing every 15 minutes, you mentioned specifically the issue of the number of veterans who are finding suicide as their avenue. Can you elaborate more on that? It's an area that I find very disturbing. Actually one of our colleagues has a motion to deal with that specific issue and to study it more thoroughly. Could you elaborate a bit on that issue, please?

[Ronald Griffis]

What happens is these people fall through the cracks. What happens is people recognize the difficulties, but until the veteran seeks help on his or her own, there is very little that his or her relatives and loved ones can do. It's one of those situations that develops. We try to intervene, but by the same token it's extremely difficult. Of course, the final criticism is that we are not able to help and the person commits suicide. It's a criticism of the system. We recognize the difficulties. We see the person indulging in substance abuse in his or her habits and things of that nature. We try to help and we can't help.

[Judy Sgro, Liberal, York West, ON]

I think you hear that a lot when it comes to individuals who commit suicide. It's a terrible thing that anybody would feel so desperate in their life that there's no out for them other than to commit suicide. But somehow it feels even worse when it's a veteran who feels that after what they've given, their only avenue is to take their own life.

[Ronald Griffis]

Take into consideration, also, that they're very young veterans--22, 23, or 24 years old. They have their whole lives ahead of them, their whole professional lives ahead of them. They're intelligent, they're well-meaning, but it ends in tragedy.

[Judy Sgro, Liberal, York West, ON]

Many of the young men who are coming back who you're referring to are clearly suffering from PTSD. Sometimes I think that maybe we should just automatically assume that for everybody returning from the experience, let's say, of Afghanistan today, I don't know how they'd not be suffering from PTSD. It would just seem automatic to me. Would we not be better off trying to just say we know our young soldiers are going to come home and they're going to be suffering from that, so we're immediately going to put them into some sort of program for a following year after coming back in order for them to receive the help, even if they don't think they need it, and package it in a way that's it's not help they're receiving, it's just part of the re-establishment of their life here?

[Ronald Griffis]

I think it would be extremely difficult on the Department of National Defence and Veterans Affairs Canada to establish a program with that in mind. To force somebody to take action is just not the Canadian way.

[Judy Sgro, Liberal, York West, ON]

Well, it's not the Canadian way to see our young soldiers who are suffering from all of this turn around and take their lives either.

[Ronald Griffis]

Yes.

[Judy Sgro, Liberal, York West, ON]

Mr. McCartney, you talked about the gaps currently in the system and the lump-sum payment. Could you elaborate a bit further on that whole issue of how we might do a better job of that?

[Lorne McCartney]

With respect to the lump-sum payment, the only reason I bring this up is that I hear people from time to time sort of saying, “Well, in the old days we used to have a pension and now we get a certain amount of money and we're supposed to live off of that”. It's given once at the beginning, and some people abuse the fact that they have that money and they may gamble it away or do silly things with it, that sort of thing.

I only mention that because everybody assumes this is the pension plan, but it is not the pension plan. This is just for pain and suffering, and not everybody gets the $265,000 or whatever it is. If it's a small item, they get a lot less money, and if it's major, they get more and more, and I believe if you die then your estate would get the $260,000, that sort of thing. I only mention that because this whole program has a number of ways of providing money to people who have to leave the service because of injury and that sort of thing.

And the other point that was mentioned just before is getting people back to work as soon as possible so that hopefully taxpayers' money won't be spent and the people who are back at work feel good about themselves and become fully functioning members of society again, as much as possible. But that wasn't the aspect I was mentioning.

What I'm really trying to say in this paper here is that it's not just that gap. The major gap, as I see it, is really how I put it: we have to treat those people as if they continued in their military career. What I mean there is that if you do go, you get pay raises and incentives as you go along, and at a certain point in time, of course, you can retire. Most people put in 35 years and the pension is a 70% average of the best seven years. But as well you have money coming in afterwards, a pension. Right now when the people get out they don't have a pension; so yes, they might get 75% of the salary when they get out, but that pension only goes for a certain length of time. At age 65, I believe, it stops, and people say, “Well, you should have put money into a pension plan”. The military pension plan, for those who stayed in it, has contributions from the government, so you go a lot further on a military pension plan than you would after you get out.

All I'm saying, and what my briefing is based on, is that we should be treating these people—these people should not be paying for this war themselves—as if they remained in the military and giving them what you would get, not be limited by things like SISIP, for example, and the way we approach these people.

[The Vice-Chair (Mr. Robert Oliphant), Liberal, Rob Oliphant]

Thank you, Ms. Sgro. That completes your seven minutes.

Monsieur André.

[Guy André, Bloc, Berthier—Maskinongé, QC]

Good morning.

Congratulations on your excellent presentations.

You discussed the problem of suicide among veterans and the military. In fact, I may introduce a motion today.

My questions will be different from Ms. Sgro's. From what I have read, it is difficult to assess the suicide rate among former military personnel, among veterans, because suicides are not always recorded as such in the Canadian Forces. I would like to hear your comments on that, Mr. McCartney.

Ms. Taylor, your first name is Elizabeth; you are not an actress by any chance, are you? If you are, I will ask for your autograph. I know that the actress is still alive, which is why I thought maybe...

I was very surprised to learn that occupational therapists are not part of the multidisciplinary teams. In the CLSCs in Quebec, there are always multidisciplinary and interdisciplinary teams, depending on the circumstances, for any home support and long-term care matters. They have occupational therapists, physiotherapists, social workers. I feel that occupational therapists play a very important role in home care and in other areas.

I thought I heard that, in the rest of Canada, you are not part of the multidisciplinary teams. Is that correct? Things are different in Quebec.

[Dr. Elizabeth Taylor]

Just to be very clear, we are part of the teams in providing, in many places, direct service.

One of our recommendations is that if we were to be part of the early planning stage and used more regularly at that point, some of the decisions might be different and some of the results might be different over time.

Very often, occupational therapists have been used just to provide the at-home direct support, but it's that planning stage and that global decision-making that happens right from the beginning when somebody becomes a veteran that very often we're not part of. I think our services could be better utilized at that point.

Let me give you an example. If somebody is significantly disabled, very often the decision might well be to support them or have them live in an institution. If an occupational therapist were involved in that initial planning period, the home might well be very effectively adapted, there would be fewer resources required, and that would be a significant cost saving.

Another quick example, one that was used--

[Guy André, Bloc, Berthier—Maskinongé, QC]

As I understand it, you are not part of the intervention plan. As far as the plan is concerned, you just follow orders. You are not an integral part of the plan.

[Dr. Elizabeth Taylor]

At this point, we're not technically part of the leadership team that does that overall planning. That's where I think the gap exists for our profession and for the veteran himself or herself.

[Guy André, Bloc, Berthier—Maskinongé, QC]

Why? Is it because the profession is not recognized in the rest of Canada? In the CLSCs in Quebec, it is my impression that occupational therapists are part of the intervention plan. I worked in that area. Are you telling me that the profession is less recognized in the rest of Canada? Is that the case?

[Gérard Asselin, Bloc, Manicouagan, QC]

Perhaps it is the case in the military.

[Dr. Elizabeth Taylor]

It's certainly recognized. I think it's the fact that there have been pockets of service across the country. Strategically, it's not as well identified.

Perhaps I'll have Dr. von Zweck talk about it from the national perspective.