Veterans Affairs Committee on Feb. 7th, 2011

[The Chair, Conservative, Gary Schellenberger]

I'd like to call the meeting to order.

Welcome, everyone, to meeting number 37 of the Standing Committee on Veterans Affairs. Pursuant to Standing Order 108(2), we are studying combat stress and its consequences on the mental health of veterans and their families.

Today we welcome witnesses from the Office of the Veterans Ombudsman: Guy Parent, our new Veterans Ombudsman; and Charlie Cue, activing director, research and investigation.

Welcome, gentlemen.

Mr. Parent, you may begin your presentation.

[Guy Parent, Veterans Ombudsman, Chief Warrant Officer (Retired), Office of the Veterans Ombudsman]

Thank you.

Mr. Chair, members of the Committee, I would first like to thank you for your invitation to appear before the House of Commons Standing Committee on Veterans Affairs. This is my first appearance before a parliamentary committee and I am pleased to be participating in this discussion with you today.

With me is Colonel (retired) Charlie Cue, Director of the Research and Investigation Section and Special Advisor in my office.

You have invited me here today to discuss the work done by the Office of the Veterans Ombudsman in relation to combat stress and its consequences on the health of veterans and their families.

I would like to start by saying that I salute the work done on this issue by this committee and in fact by several other bodies. I hope that my views will be useful in your discussions.

Before going into the subject in hand, let me share with you how the Office of the Veterans Ombudsman operates under my leadership. We currently provide three main services to the veterans community. We provide information on the various programs and services available to veterans and their families through Veterans Affairs Canada and other groups serving the veterans community. We provide assistance and referrals to veterans who come to us, often as their last resort, after being bounced between organizations or after receiving conflicting advice. We also provide intervention. This can be as simple as an informal mediation between a veteran and a service provider on a single issue, or as complex as a full investigation of a systemic problem culminating in a formal report with recommendations.

To get back to the subject at hand, I would first like to say that I prefer to use the term "operational stress injuries", since it is a broader term than "combat stress". Many veterans who seek assistance from the Office of the Veterans Ombudsman are often dealing with issues relating to operational stress injuries, even if there is another reason for their call. That is why the Office has an interest in this issue.

Here are a couple of examples that represent different issues brought to our office by veterans and their families in relation to their dealings with Veterans Affairs Canada. Both cases show that Veterans Affairs Canada appears to be ill-prepared to deal with veterans in a crisis situation.

In the first case, a veteran was in receipt of psychiatric services from a physician located in Ottawa, although he was a resident of Montreal. Veterans Affairs Canada, recognizing the importance of the patient-physician relationship, agreed to reimburse the travel for this arrangement. However, the physician in question was posted to Trenton, and when the veteran found himself in a crisis situation and requested permission to travel to Trenton to see his physician, Veterans Affairs Canada refused his request. After three months, when the spouse of the veteran contacted Veterans Affairs Canada because the veteran had become suicidal, she was advised to contact 911. As a last resort, she contacted the Office of the Veterans Ombudsman, which began negotiating with Veterans Affairs Canada on her behalf. During the course of these negotiations, the Department of National Defence stepped forward, resolved the issue in a two-day period, and agreed to reimburse the veteran for his travel to Trenton.

In the second case, during the course of an in-depth transition interview, it was recognized that a veteran had significant mental health issues. Veterans Affairs Canada did not follow up with the veteran after he retired from the Canadian Forces. When his condition deteriorated, the veteran wound up in the criminal justice system and was incarcerated in a psychiatric institution. The family contacted the Office of the Veterans Ombudsman because they did not know where else to turn. We liaised with Veterans Affairs Canada, which eventually addressed the issue.

These two examples show the importance of responding quickly to the needs of veterans suffering from operational stress injuries, since their problems can deteriorate quickly.

That is why the Office of the Veterans Ombudsman will continue to be on guard and provide advice concerning services and programs offered to veterans dealing with operational stress injuries and the Department's transformation agenda. All of the measures designed to simplify and expedite the delivery of services will have a positive impact on veterans who have operational stress injuries.

The Office of the Veterans Ombudsman will work with the Department on mental health issues, and will challenge it from time to time, when we intervene on behalf of the veterans who seek our services. I would also like to point out that employees of the Office have received training so they are better able to help veterans in distress when they call. That information has been very useful.

Individual interventions, discussions with the Department in that regard and any systemic research we might undertake in future will be based on research and studies done by other organizations. That will avoid duplicating effort in this area.

There are a number of relevant areas that you may want to consider in your work, as these may have been overshadowed by more visible issues. Among other things, there are access to occupational stress injury clinics and transition challenges. Maybe I'll elaborate a little bit about these particular points.

In terms of access to occupational stress injury clinics, we are concerned that people in crisis don't have direct access to occupational stress injury clinics. There are challenges with transitions, going from a spectrum of care in the National Defence area to a spectrum of care by Veterans Affairs Canada. The difference between transitioning from medication and transitioning from a caregiver is an issue that needs to be looked at.

There is complex bureaucracy and red tape in processes at Veterans Affairs, which in fact are really worse for somebody suffering from mental injuries than for somebody suffering from physical injuries. Everything makes those more complex for them.

There is also how Veterans Affairs is dealing with new research that is available in different fields, recognizing some of the latest reports that make linkages between conditions of service and possible injuries. There is the national strategy on homeless veterans. There is awareness and access to programs and services for reservists in particular, and the lack of research on veterans in the criminal justice system. Previously we quoted an example about somebody who did end up in the justice system, but there is no way of tracking how many veterans are in fact there right now.

In 2011 I will continue to push forward on veterans issues by focusing on unfair practices and making realistic recommendations for change. This will benefit all veterans, including those with operational stress injuries.

To focus energies and to guide both me and the Office of the Veterans Ombudsman, I have chosen “One Veteran” as the 2011 theme. This will reinforce the idea that since sailors, soldiers, airmen, and airwomen, as well as members of the Royal Canadian Mounted Police, do not question where and when they must serve, for Veterans Affairs Canada and the Royal Canadian Mounted Police to determine the level of programs and services that will be provided based on the type of service rendered is an injustice of the first order.

To this end, I will be working closely with veterans advocacy groups to encourage them to consolidate their efforts to make the “One Veteran” principle a Veterans Affairs Canada reality, with the focus on service in general rather than on service “where and when”. I believe that the application of the “One Veteran” principle will simplify processes, lower costs, and result in better service to veterans.

In the coming months, based on the September 2009 report the office published entitled “Serve with Honour, Depart with Dignity”, I intend to pursue the recommendations already made to the minister regarding funeral and burial expenses. I will be putting forth recommendations on identified unfairness issues concerning the veterans independence program, and I will be taking a critical look at the Veterans Affairs transformation agenda.

I encourage you and your parliamentary colleagues to move to pass Bill C-55, an act to amend the Canadian Forces Members and Veterans Re-establishment and Compensation Act and the Pension Act. Although not comprehensive, the extra support that is offered is needed.

In conclusion, I want you to know that I focus on people and the effectiveness of outcomes rather than processes. We are seeing positive changes in the world of mental health at the Office of the Veterans Ombudsman. We will continue to provide an objective viewpoint as to whether or not these outcomes are successful.

Thank you, Mr. Chair.

[The Chair, Conservative, Gary Schellenberger]

Thank you, sir, for that.

Just to let people know, try to keep your questions short so that we can get the answers back. The ombudsman is only here until 4:30, so we want to make sure that we can get as many questions answered as we can.

We start off with Mr. Lamoureux, please.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Thank you, Mr. Chair.

In your concluding remarks you made reference to Bill C-55, and you're anxious to see that particular bill pass. I take it you're familiar with the content of the bill. If so, can you give any indication if there are things that should be included in that bill that could be possible amendments? Are there other things that vets are looking for?

[Guy Parent]

Yes.

We certainly agree with what is proposed in the present bill. Certainly it rectifies some of the deficiencies that have been identified to date in regard to income loss and EIA and PIA. It also looks at the base salary in terms of income loss. Any recommendations in reference to the lump sum award are also recognized as being needed. There's good improvement in that area.

Having said that, I think we're concerned, as are the veterans, that nothing can be really done until the bill itself is passed. That's why we're encouraging the committee to go ahead as soon as possible to encourage the passage of the bill.

As to if there is anything else that should be in there, maybe my colleague can speak to that.

[Charlie Cue, Acting Director, Research and Investigation, Office of the Veterans Ombudsman]

Yes.

The bill's actually just correcting the EIA/PIA. It's correcting a deficiency that was noted in the previous bill, and that's making a good correction for it. It's changing the name of the job placement program, and it's putting in some options for the lump sum. All those things.... It's not comprehensive, but there are minor changes.

They are the first changes to the bill, but from our office's perspective we don't see any problems with them. It's a small step forward. The minimum salary piece is actually not covered in the bill; it's actually covered under regulations. That can be changed outside of the bill if someone wanted to do that.

[Guy Parent]

The one concern we might have there about the base salary under the income lost is the fact that there is a difference between the regular force and the reservists. That's a bit of a concern. As we go back to the “one veteran” theme, it doesn't make any difference what was your status of service when you went to Afghanistan, for instance. You should be entitled to the same benefits, which would include compensation, the same salary base.

[The Chair, Conservative, Gary Schellenberger]

There's just one thing. I know Bill C-55 is coming up, but today we're here on operational stress and suicide. We would like to try to keep those questions as much as we can to that, please.

Go ahead. You still have two minutes.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Yes. Thank you.

You made reference to assistance by helping vets go to Veterans Affairs, and you cited a couple of examples. To what degree as the Veterans Ombudsman do you go to outside organizations, whether it's the Ontario Ministry of Health or Manitoba Health, to seek assistance that goes beyond the typical Veterans Affairs? Do you have reports that would provide that sort of information?

[Guy Parent]

In fact it's yes to both questions.

At the first level of intervention, which is the level of information provided, our front-line officers, our client service representatives, handle the calls. We do handle about 2,000 calls per year. These are people who are seeking information as to where to go and what to do. This is where they are directed—2,000 approximately per year—to the right programs. If a program is not available within Veterans Affairs Canada, they will certainly be directed to local, provincial, or community programs to access any of the needs that they have.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

You, more likely than anyone else, would be able to provide some sort of a guesstimate—if possible—of suicides. Can you give us any details in terms of what you would estimate it would be?

[Guy Parent]

I certainly can't give an estimate, because I think we have the same difficulty internally in the Office of the Veterans Ombudsman as DND and Veterans Affairs, and it is the problem of tracking. Given the fact that a lot of the veterans are self-identified also, it's almost impossible at this point and date to get a good assessment because of the tracking deficiencies.

The tracking overall from National Defence to Veterans Affairs and the transition would help us in determining that in the future.

[The Chair, Conservative, Gary Schellenberger]

Thank you very much.

Mr. André, please.

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

Welcome to our committee, Mr. Parent. I am very pleased to meet you. I think this is your first appearance here.

[Guy Parent]

Yes, but not my last.

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

Absolutely not, we hope.

Congratulations on your appointment on November 11. We are happy to have you here. Veterans need an ombudsman to advocate for them.

One issue relates to post-traumatic stress. When we studied the issue of people dealing with post-traumatic stress, a number of witnesses who testified talked to us about statistics. Some were discouraged by the fact that, as they said, from 70 to 90% of initial applications for services or a disability pension were rejected. There seems to be more receptiveness to second applications, 40 to 50% of which were accepted. It seems to have become a knee-jerk reaction for the Department of Veterans Affairs to reject an initial application. A number of witnesses pointed this out. Denis Beaudin, for example, testified to this.

The effect is to deter these people who are dealing with a very serious personal psychological problem. They have the impression they have to fight the Department of Veterans Affairs to have their disability recognized.

Should this situation be a priority for the Ombudsman's attention? Have you defined the situation clearly?

This is quite common. We hear many veterans complain about the fact that they have been denied disability status. This puts them in a truly precarious situation. These are very vulnerable people. Some of them get discouraged and wait years before claiming what they are owed.

You are probably familiar with the situation. I would like to hear what you have to say about it.

[Guy Parent]

In my presentation, I did not really go into detail about our future priorities, but I would say that our upcoming systemic review will address precisely these concerns.

Certainly the Department of Veterans Affairs does not distinguish between an individual's immediate and long-term needs. Particularly in cases involving psychological injuries, that causes huge problems. Consideration has to be given to immediate needs and long-term needs.

So we are starting a systemic review. In fact, we aren't starting it, we are almost at the report stage. We are studying the arbitration decision process, from the initial application to the appeal and review by the appeal board. We should have reports on this subject in the next 10 weeks.

We will probably submit our recommendations to the department and the Minister in the form of observations. If we see a need, there will be a public report. In any event, this is certainly one of the major subjects of concern we are also studying.

We are taking a very close look at the Department's transformation, since it is saying specifically that it wants to cut waiting time. That also raises concerns. We might ask whether they are simply going to change the method of calculating or whether they are going to introduce more efficient processes.

To sum up, our Office is investigating this at present.

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

Do you think this can be attributed to incompetence on the part of the people involved, who are not capable of assessing a person dealing with post-traumatic stress properly, or can it rather be attributed to a policy of the Department of Veterans Affairs to reject the initial application and accept it later?

[Guy Parent]

I wouldn't say incompetence, but there is certainly a lack of education and experience, given that this is a relatively new subject. It is not an easy subject, particularly when we're talking about post-traumatic stress. It calls for relatively specific experience.

While I won't say incompetence, I think there is certainly work to be done. The people who decide whether to accept or reject applications need to be prepared, so they are able to understand the circumstances in that kind of case.

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

Thank you.

[The Chair, Conservative, Gary Schellenberger]

Mr. Stoffer, please.

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

Thank you, Mr. Chairman.

Mr. Parent and Mr. Cue, thank you both very much for coming today. I really like the concept of the “one veteran” policy. I think everyone we speak to believes that a veteran is a veteran is a veteran and a spouse is a spouse is a spouse, etc.

But having said that, would you then be arguing for the hospitalization benefits that World War II and Korean overseas veterans get now under certain criteria, like Camp Hill, Ste. Anne's, etc.? Would you be arguing, then, that our modern day veterans, those who have served post-'53, should have access—someone like yourself, with over 37 years of service? If you had a disability of some kind and you required short- or long-term facility care, should that fall under the guise of benefits provided by the federal government?

[Guy Parent]

Well, the “one veteran” concept obviously is aiming towards that, certainly aiming for that in the future when programs are developed, whether it be something of the sort of the new Veterans Charter, that we don't distinguish between types of veterans and service where and when.

I know that, for instance, this is a concept that developed over years that was segregating, not so much after the First World War but more and more so after the Second World War, the Korean War, and the Gulf War, and that sort of thing. So now we've created a lot of little individual organizations, and a lot of programs and benefits are based on service where and when, and we want to get away from that.

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

Yes. One of the fears I have is that when the last World War II or Korean veteran dies, those hospital beds will be gone. They'll be turned over to the provinces and then you get in line with everybody else. I've always feared that, because we have a lot of veterans in their seventies now who require long-term or short-term care and they call upon the province to do that.

Another thing you said is you don't have a track of how many prisoners in our systems may be veterans. Wouldn't a letter from you to the federal corrections people, asking them to do a survey within their prison population to find out how many served their country, be helpful?

[Guy Parent]

I think it would be. I think you're right, it would be helpful. But I think we go back to the self-identification process. Are they willing?