Veterans Affairs Committee on April 29th, 2010

[Dr. Victor Marshall]

You're absolutely right. It is a huge issue. I think that problem is part of the reason there is an interest in expanding home care services rather than nursing home care.

Thirteen years ago, when we established the council, the veterans organizations' representatives on the council were, as the academics would put it, wedded to the bed. They had legislative authority for so many contract beds, so many nursing beds, and so many hospital beds. The council was reluctant in the first year or two to actually see the department move to expand home care service because they were afraid the money would be shifted away from these valued beds.

The gerontological experts on the committee were successful--I know we were--in getting across the idea that, actually, while there will always be some people who will need nursing home care, people like to stay in their own homes as much as possible. Even for demented people with Alzheimer's disease, for example, there are as many of them being nicely taken care of at home as there are...

It doesn't necessarily mean institutionalization in a nursing home. Others on our committee are much more expert on long-term care. In fact, we had Canada's leading experts on long-term care on the Gerontological Advisory Council. François Béland is one and Dr. Shapiro, from Manitoba, is another.

I think it's easier to sort of organize and contract for home delivered long-term care services in the rural areas than the alternative, which is to bring people to larger centres, to nursing homes. We no longer have a situation of every little town having its own nursing home. So if you want to keep people closer to home, community-based services will help, in part, to solve that problem.

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

I still have time, don't I, given that my friend the chair cut me off earlier.

As I said, the situation is different in the city. In terms of home support services for veterans in more remote rural areas, do you think that cooperation, collaboration with public health institutions in the regions is being maximized? Could arrangements not be made to work more with partners in the public health network, to sign more agreements to deliver these services to veterans in rural communities? What more could be done?

[Dr. Victor Marshall]

I would recommend that, but I have to say I'm a little handicapped because I've been living in the United States for 13 years, where it would be harder to do than I anticipate it would be to do in Canada. I know there are huge provincial differences in nursing home care, as I understand, across Canada as well. So I don't really have the detailed knowledge to say. It's just my hunch that it could be done.

Also, the Legion, for example, has played a very important role with respect to the monitoring of nursing homes, working in collaboration with Veterans Affairs Canada. They have played a very important role. And a program like that might be expandable to do the monitoring because it's the quality control that is the issue, isn't it? It's one of the big issues, at least, if you're doing something spread out over a large area.

[The Chair, Conservative, David Sweet]

Thank you, Mr. Marshall.

Thank you, Monsieur André.

Now we will move on to Mr. Stoffer for five minutes.

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

Thank you, Mr. Chairman.

And, sir, thank you very much for coming today.

We have, from Suzanne Tining, the deputy minister, copies of the four reports that your group has done over the years. What we don't have is a written response to those recommendations.

I'm just a bit confused here. We had Mr. Allard, of the Legion, who is part of your organization, indicate to us when he was here that there has been no written response to the recommendations. The witness after him, the following day, said that you don't get one, that you talk to them, you discuss your recommendations, but there is no written response to your recommendations.

When we do a report from this committee, we send it to the minister. Within a certain allotted time they give us a written response to our recommendations and to our basic analysis of what we've heard. I'm wondering, you've been here since the beginning, have you ever insisted on, or has your group ever asked for, a written response to your recommendations? You've said that, like Darragh Mogan, they're very receptive to your recommendations. But we really don't know that unless they put it in writing to say what they think of your analysis and your recommendations.

So have you ever asked for written recommendations to your reports? If not, why not? I'm just a bit confused as to why you wouldn't insist on or you wouldn't receive a written response to your very worthwhile recommendations.

[Dr. Victor Marshall]

We have not ever requested it. And I don't remember--it's been 13 years--anyone on the council ever suggesting that we get a written response to specific recommendations we made.

I have, in a sense, requested a response from the minister, but all I get is the “we do a lot for veterans” kind of reply. This is, again, not from the current minister, who is newly appointed, but I've had letters like that.

So why haven't we done it? We have felt that the relationship is good, ongoing, and more like a dialogue we have with these people.

When we have our council meetings there are always other members of the department there as well, besides Darragh and Ken Miller. And Brian Ferguson is there when he can be as well. So I think we've just felt that it's more like an ongoing dialogue. We give this advice, it appears in fairly detailed minutes, but we have not really felt the need to do that because we've trusted--and maybe it's misguided, although I don't think so--that they are doing their best to follow our advice and that they like our advice. They certainly tell us that orally, and in the minutes of virtually every meeting we have there is an expression from Brian Ferguson, the senior ADM, and from Darragh Mogan. That's in the minutes of the meeting, saying how valuable they find our advice.

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

Now, sir, your organization does this on behalf of veterans and their families. When I say veterans, I assume you're also including RCMP--

[Dr. Victor Marshall]

Yes.

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

Although I don't see that in here. So I assume you're including RCMP veterans in that same dialogue.

[Dr. Victor Marshall]

We were established just for the traditional veterans, and the RCMP wasn't in that picture. But we adopted this mantra--and I don't know whether it was the Royal Canadian Legion that started it or whatever--but a veteran is a veteran is a veteran, and the Mounties would come in there as well.

In later years, with the activity going on with the new Veterans Charter advisory group meetings and so forth, and a lot of cross-membership and representation, we do talk about these issues. We've always had reports since that exercise has been going on. Muriel Westmorland would come and report, and of course Don Ethell was sitting on both committees, so we were very well apprised.

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

Okay.

You do this on behalf of veterans, so you speak with veterans, you speak with their families, you do the consultations, you make a recommendation, and you send it off to the department. I assume veterans receive copies of your reports. I'll just take page 16 of your 14th December SNAG of 2007, just out of the blue--

[Dr. Victor Marshall]

SNAG, you say?

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

Yes.

[The Chair, Conservative, David Sweet]

Just a moment, Mr. Stoffer.

I think everybody needs to remember that the special needs advisory group, the new Veterans Charter advisory group, and the Gerontological Advisory Council are three different organizations. Mr. Marshall is representing the Gerontological Advisory Council.

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

Understandable, but my premise, sir, is that they do this work on behalf of veterans. They speak to veterans.

Veterans would probably get copies of your report. But how does a veteran know that the government has responded to these recommendations? All they get is what you've said, but they don't have anything corresponding to what the department has said. For example, Veterans needs to provide support to the caregiver who may also be the spouse, who in many instances could be raising young children. That means if there's a disabled veteran under the new Veterans Charter and his wife is providing the support for him, your recommendation is that VAC should provide support to her.

How do we know the government has responded to this? The veteran doesn't know what the government's official answer is to your question. That's my problem, and I'm trying to close the loop here, and I say it with great respect. You do this great work on behalf of veterans, but the veteran doesn't know what the government's response is to your recommendations.

[The Chair, Conservative, David Sweet]

Hang on just for a moment, Mr. Marshall. I gave some latitude at the time because of my other intervention, but you are over time.

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

Sorry. That's right.

[The Chair, Conservative, David Sweet]

Just for the record, again, SNAG is not Mr. Marshall's report--

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

Understandable. I just grabbed the first one out of this material here.

[The Chair, Conservative, David Sweet]

He can comment on it.

[Dr. Victor Marshall]

That was SNAG, but in fact we've said the same thing in the Gerontological Advisory Council as well. So the thought certainly applies, and there actually have been some legislative changes in that area with extending the...oh, I forget the name now, there are so many acronyms. When the veteran dies and if they're on VIP, for example, that benefit used to end after one year. We strongly advised, urged, that it be extended, and it has been extended, not as far as we would have liked, but there have been some results.

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

Thank you, sir.

[The Chair, Conservative, David Sweet]

Thank you, Mr. Marshall. I was just trying to keep the testimony straight.

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

Yes, understandable. Thank you.

[The Chair, Conservative, David Sweet]

Now on to Mr. Storseth for seven minutes.