Veterans Affairs Committee on Dec. 10th, 2009

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

But you couldn't enforce those guarantees, in my view. Bilingual services could deteriorate and there's nothing the federal government could do after it was transferred. I think that's pretty clear, and talk about writing guarantees into an agreement I think is more symbolic than anything, to be honest. I think that the minute it's transferred, you lose that control. I think that's something the government should think about and maybe develop some sort of system for making the guarantees firm and enforceable.

Thank you. I'll pass my—

[The Chair, Conservative, David Sweet]

Actually, that's the time, but do you want to comment on the last statement of Mr. Scarpaleggia?

[Brian Ferguson]

No, I'll just take that as a statement.

[The Chair, Conservative, David Sweet]

Thank you, Mr. Ferguson.

Now on to Monsieur André, pour cinq minutes.

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

Good morning, Mr. Ferguson.

I will continue in the same vein as my colleague. First of all, I would like to ask you what are the issues relating to the transfer of Ste. Anne to the Government of Quebec in terms of providing quality care to patients.

Let me explain. Ste. Anne's Hospital provides a framework, specifically for nurses in the care provided to veterans. In my opinion, there is a higher level of oversight than what you would find in the CHSLDs (residential and long-term care centres) which exist throughout Quebec.

According to your objectives, you must provide the same quality of care to veterans. How will you do this under the new structure?

[Brian Ferguson]

Thank you for that question.

I'll ask Darragh to comment. We've made these types of arrangements in all the previous transfers, so Darragh might just want to speak briefly about how that has been accomplished.

[Darragh Mogan]

What happened in previous agreements is where we require a different or a higher organization of care, we arrange for that, and if it's above the provincial standard of care, we pay for it. So that's certainly a possibility. That has happened in previous transfers.

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

At Ste. Anne's Hospital, there are far more nurses than nursing assistants. So, there is far more specialized care than what you would find in other similar institutions.

From that perspective, I'd like to ask you a question. If long-term care beds were to be offered to people on the West Island of Montreal, and it is a need, we'll admit, how would you establish the boundaries for these services? Would the civilian population have the same services as veterans? How would this work?

[Brian Ferguson]

I'll ask Madame Gravel to elaborate, but essentially if we do that—and I underline “if” because it's still a discussion item—it would be an arrangement where we would reflect the needs that Quebec has in services provided, the beds they would use. So we would attempt for the civilians to provide services that would be requested by the Government of Québec.

Rachel, did you have anything you wanted to add?

[Rachel Corneille Gravel]

Yes, I have maybe just one comment.

Mr. André, one of the reasons why there are more nurses at Ste. Anne's Hospital is because it is a subacute care hospital and therefore [Editor's Note—Technical Difficulties] to care for residents having a more serious condition at Ste. Anne [Editor's Note—Technical Difficulties] in acute care hospitals.

As an example, nurses are able to oversee IVs in hospital. It substantially reduces the cost of transfers to other institutions. Based on the agreement we are considering with [Editor's Note—Inaudible], if they are interested in having programs that require certain types of care at Ste. Anne, the fact that we have nurses is a definite asset. These are things that we will have to look into. We will have to correctly assess our needs and see what they are prepared to take over [Editor's Note—Technical difficulties] from Ste. Anne's Hospital.

[The Chair, Conservative, David Sweet]

Madame Gravel, the translators are just having a little bit of difficulty. The sound was cutting out, so you might want to speak into the phone a little bit clearer if possible.

[Rachel Corneille Gravel]

Do you want me to repeat it? I could repeat it in English. Can you hear me well?

[The Chair, Conservative, David Sweet]

Monsieur André, would you like the answer repeated?

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

Perhaps for the others, if need be, but I am fine. I lost a few words—

[The Chair, Conservative, David Sweet]

Okay, Madame Gravel.

[Rachel Corneille Gravel]

I apologize for that. Maybe I'll speak a little slower.

[The Chair, Conservative, David Sweet]

You're loud and clear now.

[Rachel Corneille Gravel]

Thank you.

[The Chair, Conservative, David Sweet]

Do you want to repeat your answer?

[Rachel Corneille Gravel]

Yes. I apologize.

I was saying that Ste. Anne is a sub-acute-care hospital. We're not like the traditional long-term-care institutions. That's the main reason why we have nurses and we don't have auxiliaries. That situation presents a lot of transfers to acute-care institutions. We have doctors 24 hours a day, so if the condition of the patient deteriorates we have the capacity at Ste. Anne to keep the veteran here and take care of him, unless the condition worsens so much that we need to transfer him.

With Quebec, we will have to look at these options. For instance, if they want a very specific program or different programs at Ste. Anne, where sub-acute care needs to be provided to their clientele, they will definitely need nurses. We have the capacity to provide that service. We need to look at their needs and the type of service and level of service they're willing to buy from us.

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

I fully understood what she said. Quality services are offered to very frail individuals, veterans, along with close monitoring. Also, there is another client base in the civilian population.

If the civilian population were to share the same environment as veterans, would we continue to offer the same types of services to both veterans and civilians, acute care? Also, where do the discussions with the Government of Quebec stand on this point?

[Brian Ferguson]

Thank you for the question.

The discussions haven't reached that stage, but we know we will have to cover those points. In the way it's been handled, there are a number of successful institutions across Canada—for example, The Lodge at Broadmead--where there are civilians and veterans in the hospital and they intermingle quite well. We pay for the difference in the cost of increased services that Mr. Mogan mentioned. It seems to work very well.

That's one of the reasons we suggested that it might be useful for committee members to not only see Ste. Anne, but also visit some of these facilities to see how they've worked out in practice. It's the expertise of the department in having arranged those kinds of settlements in the past that we hope to bring to bear in this instance and make sure those guarantees are there.

[The Chair, Conservative, David Sweet]

Thank you, Monsieur André.

Mr. Stoffer is next, for five minutes.

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

Thank you, Mr. Chairman.

Just to make it very clear, when the department talks about overseas veterans they mean World War Two and Korean veterans. Right now we have a lot of overseas veterans from Bosnia and the Middle East, but they don't qualify for those beds. Is that correct?

[Brian Ferguson]

I can ask Darragh to elaborate, but if their injuries are so severe that they need institutionalization, they can be considered veterans for the purposes of long-term care facilities.

Is that correct, Darragh?