Veterans Affairs Committee on Dec. 10th, 2009

[The Chair, Conservative, David Sweet]

Bonjour, mesdames et messieurs.

I want to welcome you to the 38th meeting of the Standing Committee on Veterans Affairs. We have one witness with us here in person, Brian Ferguson, and we have two on the line, Darragh Mogan and Rachel Gravel.

Prior to going to the witnesses--and Mr. Ferguson has already informed me that he has the only opening statement, and Mr. Ferguson also needs to catch a flight--let me make a suggestion, because there was some concern expressed to me that we ran out of time last time. We have two motions before us, and I think Madam Sgro also wanted to talk about some modification to her motion. So my suggestion would be that we hear our first set of witnesses from 9:00 to 9:50, and then we go to business from 9:50 to 10:10, and then we'll hear our second set of witnesses. Then we won't have to be concerned about running out of time for business.

Does that meet with the approval of the committee?

[Some hon. members]

Agreed.

[The Chair, Conservative, David Sweet]

All right, then without any further ado, we'll get right to our witnesses who are before us right now.

I just want to check to make sure. Madam Gravel, Mr. Mogan, are you online?

[Rachel Corneille Gravel, Executive Director, Ste. Anne's Hospital, Department of Veterans Affairs]

Yes, I am. It's Rachel Corneille Gravel here in Ste. Anne's.

[Darragh Mogan, Director General, Policy and Research, Department of Veterans Affairs]

And Darragh Mogan from Charlottetown.

[The Chair, Conservative, David Sweet]

Very good.

Now that we know we're connected technologically, I will let Mr. Ferguson go ahead with his opening remarks.

[Brian Ferguson, Senior Assistant Deputy Minister, Policy, Programs and Partnerships, Department of Veterans Affairs]

Thank you, Mr. Chair and committee members. It is my pleasure to appear before you today with, via telephone, Darragh Mogan, director general of policy and research at Veterans Affairs, and Rachel Corneille Gravel, executive director of Ste. Anne's Hospital.

We are here today to provide an update on the future of the hospital.

A deck with background has been provided to you with further information on Ste. Anne's itself and on the history of previous transfers by Veterans Affairs Canada of veterans facilities. I'm not going to go through it in detail; it is provided for your information. I will have opening remarks and cover some of the content that is in the deck.

First of all I would like to give the committee an update on discussions regarding a potential transfer.

Last July the Department of Veterans Affairs and the Quebec government Health Department exchanged letters of interest as to discussions on a potential transfer. A first meeting was held at the end of September and led to preliminary discussions on the matter. A follow-up meeting was held mid-November and another will take place in January.

We are committed to keeping veterans, their families, and key stakeholders informed. We have established a link on our website to provide easy public access for up-to-date information. We have met and will continue to meet with national bargaining representatives and local unions.

The Government of Canada has a very long and proud history of providing facility-based health care and long-term care services and benefits to Canada's veterans. In the early 1960s the department had 18 hospitals. At that time the delivery of health care became a provincial responsibility and we saw the inauguration of universal hospital insurance.

Given these changes, the 1963 Glassco commission recommended to government that departmental hospitals be transferred to the provinces. VAC began transferring its facilities to the provinces in which they were located. The last such transfer was the Saskatoon Veterans Home in 1996.

Ste. Anne's Hospital is the last federal hospital to be administered by Veterans Affairs Canada. Its role as a leader in the field of care and support for military staff dates back to 1917 when it was founded by the Invalid Soldiers Commission, to care for wounded World War I veterans.

The building of Ste. Anne's Hospital was then part of a national initiative started in 1915 due to the lack of capacity in the provinces, because of improper infrastructure, to meet the needs of wounded soldiers upon their return from the front. The first buildings were built quickly and without any major investment, to meet the immediate need in beds. They were torn down in 1970 and replaced by a modern 13-storey building.

The hospital has a reputation for excellence in several clinical fields and is nationally known for its high quality of care and services offered in both official languages. It has developed a unique expertise that is perfectly adapted to the complex clinical needs of traditional veterans. For younger generations of veterans, the hospital provides mental health care and services accessible throughout the country thanks to a coordinated national network of operational stress injury clinics. The area of research is growing at Ste. Anne's, and a research affiliation with McGill University has recently been formalized.

We have made two attempts in the past decade to transfer Ste. Anne's. We are optimistic that it will work this time, because the province's need for long-term care aligns well with the availability of beds at Ste. Anne's. After the last attempt to transfer Ste. Anne's in 2001, the Government of Canada recognized the needs at Ste. Anne's and allocated $114 million over time to modernize the physical plant and infrastructure. The renovations at Ste. Anne's have been undertaken to eliminate all health and safety risks for residents and employees, to provide veterans with an environment adapted to their changing needs, and to bring the hospital in line with provincial standards. The modernization is mainly complete, and the facility is now able to house 446 residents, all with their own private room and adjoining bathroom.

In all previous transfers of VAC facilities the department has put in place guarantees to maintain priority access for veterans, to maintain the high quality of care for veterans, to retain the high quality of personnel, and to guarantee care in the official language of the patient's choice, where required. The care of veterans in these facilities has been integrated into the department's overall long-term care strategy. Veterans Affairs ensures these guarantees are met through monitoring to ensure that all facilities remain accredited through the national hospital accrediting process, ongoing monitoring at the facilities by VAC personnel, enforcement of the obligations set out in the negotiated agreements to transfer, and monitoring and analysis of provincial compliance monitoring data. In addition, to ensure the guarantees meet the needs of VAC clients, we measure client satisfaction through ongoing client surveys. Our most recent national survey showed client satisfaction rates of 97%.

I know the committee has expressed its intention in the past to visit Ste. Anne's. We would welcome such a visit. In addition, the committee may wish to consider visiting previously transferred facilities to see how such transfers have worked.

Admission of eligible veterans to Ste. Anne's has peaked and projections show it will decline steadily over the next ten years. The average age of clients admitted to Ste. Anne's is 87. The department's demographic projections show the supply of beds will begin to exceed veteran demand by 2010 and that by 2015-16 there will be more empty beds than resident veterans. Maintaining the quality of care and services at Ste. Anne's involves maintaining a critical mass of residents. To ensure the potential of the facility is maximized and that full advantage is taken of the government's investment in modernizing the hospital, its ability to use vacant beds is a key issue. Any discussions about the hospital's future have as their first priority to ensure that our veterans at Ste. Anne's continue to receive the quality care they have earned and deserve.

Transferring Ste. Anne's to the Province of Quebec would maintain and maximize the hospital's expertise in geriatrics and psycho-geriatrics and increase bed availability for other Canadians in need. Currently there are needs for long-term care beds in the provincial health region where Ste. Anne's is located. Any future transfer agreement would require that veterans continue to have priority access to quality of care and services, that the interests of hospital employees are protected, and that official languages guarantees are respected, as was the case in the government's previous successful transfers.

If a transfer agreement were to be signed, it would have to be approved by both orders of government before it could be implemented. To give you an idea of expected timelines, I would point out that previous transfers have taken between three and five years to be finalized. The Government of Canada has undertaken to duly inform the public, internally and externally, during the entire process.

Thank you very much.

[The Chair, Conservative, David Sweet]

Thank you, Mr. Ferguson.

Now we'll go on to questions. We have less than 40 minutes, so we'll begin with five minutes for questioners. That will still leave a number of people short, but at least it will still give a lot of time for most.

Mr. Scarpaleggia, for five minutes.

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

Thank you, Mr. Chair.

I would appreciate fairly succinct answers, Mr. Ferguson, given the limited time.

Who has priority access to the hospital right now?

[Brian Ferguson]

It should be veterans who have overseas service or who were injured in the service of Canada. I'll ask Mr. Mogan to elaborate on whether there are any further eligibilities that I missed there.

Darragh.

[Darragh Mogan]

That summarizes it quite well, Brian.

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

I think that's a very incomplete answer, because it's a little bit more complicated than that, based on what I've been told. For example, Canadian citizens who fought for Allied forces overseas do not enjoy the same eligibility as a Canadian citizen who fought for Canada overseas. Is that correct?

[Brian Ferguson]

They have their own specific eligibility, and I'll ask Darragh to elaborate.

Darragh.

[Darragh Mogan]

Allied veterans, as of a change in 2003, have access to the beds in Ste. Anne's Hospital if the care that they need is not available in their community.

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

There are two levels here of veterans, really. If you fought for the Canadian Forces, you have immediate eligibility. If you're a Canadian citizen and you fought for the Allied forces, you can go but only after your condition in a community health facility deteriorates to a certain point. What would the harm be in levelling the playing field and just giving Canadian citizens who fought for the Allied forces overseas the same eligibility?

It seems to me that there are empty floors at Ste Anne's at the moment. There is apparently no waiting list. What's the harm in allowing these veterans the same access, since they fought in the same war, they're Canadian citizens, and they've paid their taxes? There are probably not that many of them, as well. I know that there are a few cases in my community where Allied forces vets are fighting to get into the hospital, and they're coming up against a brick wall.

What would the harm be? I can't imagine that it would cause too much stress on the hospital's facilities. As I say, the numbers are very small.

[Brian Ferguson]

I'll ask Darragh and Rachel both to comment, if I may, Mr. Chair.

Darragh will comment from the point of view of the Allied veterans, and Rachel on the situation of the beds in the hospital.

[Darragh Mogan]

Certainly eligibility changes are a policy issue to be addressed by government.

I should correct one thing, an impression that may be there. In order to be eligible for care at Ste. Anne's, you have to have served overseas. For instance, in the Second World War, fully half of the force did not serve overseas, the Canada service veterans.

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

I understand that completely. I'm talking about people who served overseas, either for the Canadian Forces or for the Allied forces.

[Darragh Mogan]

I understand it, but I want to correct that for the other members who may not understand it. The point is that a change in the eligibility would have to be a change in government policy.

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

I understand. So it's incumbent upon the minister to make that change if he cares to do so.

My next question has to do with--

[Brian Ferguson]

Sir, could I ask Rachel Gravel, if I may--

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

It's been answered. My question has been answered, thank you.

There is a glaring need for chronic beds in the West Island of Montreal. How soon would it be possible to enter into a rental agreement with, say, the Lakeshore General Hospital, which is the community hospital there in the West Island, to rent beds on some of those empty floors? Hopefully we wouldn't have to wait three to five years for an agreement between the province and the federal government. Could we not start renting beds as soon as possible, without transferring control?

[Brian Ferguson]

That is a possibility, sir, and we are still, as I said, in exploratory discussions with Quebec and looking at their needs and our needs. We're looking at that possibility.

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

I must tell you very honestly that this news of a potential transfer is causing enormous stress among aged veterans in my community. I meet them all the time, and they're very worried. They're worried not only about the standards of care, but they're worried about access to bilingual services.

If there were a transfer, how could guarantees be put in place that veterans would continue to receive care in either official language? Once it's gone from the federal government's hands, the federal government has no levers of control over that. Maybe you could enlighten me on how we could guarantee bilingual services after a transfer.

[Brian Ferguson]

Certainly that would be part of the negotiated arrangement. Should we proceed to formal negotiations and get to that stage, we would be ensuring that in the negotiated arrangement those guarantees would be in place.