Veterans Affairs Committee on May 1st, 2017

[Bernard Butler]

Essentially, from a Veterans Affairs Canada perspective, we provide support for service-related disability. If an individual comes forward suffering from a mental health issue or another condition that's linked to service-related military sexual trauma, then that would be dealt with as any other benefit claim in our programming would.

[The Chair, Liberal, Neil Ellis]

Mrs. Lockhart, go ahead.

[Alaina Lockhart, Liberal, Fundy Royal, NB]

Thank you, Mr. Chair.

Thank you for joining us again, Mr. Butler.

I appreciate having both you and the ombudsman here today as we start this study. As you know, in the other studies that we have done, we've identified and worked with the officials to look at areas where we can improve. The intent here is to take a look internationally and see what lessons can be learned.

Your information today about context and all of the other differences between our system and those of some other countries has been really good to help us keep perspective. Having said that, are there areas where you think we should focus? Is it on service delivery that you think we should be focusing as we carry out this study, or are there other suggestions?

[Bernard Butler]

It's a bit of challenging question, obviously, but I do welcome it.

When you look at comparisons to other countries, quite frankly, I think it's quite fair to look at service delivery models as well as the suite of benefits. However, again, context will very much influence what you discover as you go through that exercise. The other consideration for you—and the ombudsman alluded to that earlier—is the fundamental issue of the purpose, the outcome. What are we trying to achieve through veterans programming?

From our perspective, I would suggest that we are very much concerned with a number of issues. One is easing transition. One is the wellness and re-establishment concepts that were introduced in the new Veterans Charter, and validated by this committee and other studies since as being foundational. The other is essentially that support for finding a new purpose, finding successful transition both for the veteran and the family members.

I think that from a committee point of view you probably want to have a sense of against what framework you will make your determination. Simple dollar-for-dollar comparisons are never helpful. What is our programming really out to achieve? I would argue that it's out to achieve support for veterans and their families to achieve a sense of wellness and successful re-establishment and transition to civilian life.

There's one more example I'll give to you to consider. In budget 2017, the education benefit was one that I think I heard about in this very room. We met with stakeholders on the day of the budget. Some of them described that educational benefit as being transformational and being a landmark benefit. When you get into dollar-to-dollar comparisons of benefits, the challenge is how you put a monetary value on a paid university education for a veteran who's transitioning out and wants to do something different with his or her life. Now they have the opportunity to take a four-year program if they so choose. How do you put a monetary value on that?

That goes, basically, to this concept of what you believe we're trying to achieve collectively as a government, the people of Canada, for Canada's veterans. Again, from our perspective, from my perspective, I would argue it's achieving a sense of well-being for those veterans and for their families. Financial security is part of that, but there's a whole range of other dimensions associated with the transition.

[Alaina Lockhart, Liberal, Fundy Royal, NB]

I actually think that's very interesting because we've heard that question posed in many different scenarios over the last year and a half. What does wellness mean? What is that outcome? The question's always posed, but we have a hard time getting to the answer.

You had mentioned a few things. Can you elaborate a bit more on that wellness? What is wellness? Is that part of our mission statement for VAC? Do we have that nailed down?

[Bernard Butler]

I think it's fair to say that, from a strategic perspective, it's where we and where our minister would like to go. At the end of the day veterans serve, they make an enormous contribution. Some of them serve for lesser or greater periods of time. Some of them come out with no challenges; others with many, and many complex challenges. For all of them, the end state should be the same; veterans and their families should feel that they have the supports in place to move from the military environment, to remove the uniform, and to transition into civilian life wherever that may be, and have that same sense of purpose that we all strive for. If you look at, essentially, the social determinants of health—financial security, education, health, and so on—those are the things that, I feel strongly, we should be enabling and supporting veterans to achieve as they move from a uniformed life into civilian life.

It's captured under one notion when I use that term “wellness”, but essentially, that's where we believe our programming should take us. That's why things like adequacy of the recognition benefit, the non-economic benefit, is so important. The adequacy of the income support benefits, the earnings loss benefit, the effectiveness of our rehabilitation programs, the caregiver recognition benefits—saying to a caregiver, your contribution is valued, and here is some financial recognition for that purpose—it all goes to that end state, from my point of view, of having a family make their contribution and then have support as they come out of service.

[Alaina Lockhart, Liberal, Fundy Royal, NB]

Thank you very much.

[The Chair, Liberal, Neil Ellis]

Thank you.

Mr. Eyolfson.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Thank you, Chair.

Thanks, Mr. Butler. Welcome back, it's always a pleasure.

We have a varied population of veterans, from the Second World War, to Korea, up to today's conflicts. There are very few left from the Second World War or Korea, but there are some. What would you say is the biggest challenge to Veterans Affairs in communicating what the benefits are to these different populations? There are veterans out there who just don't know what their benefits are and how to access them. What would you say are the biggest challenges to communicating this to all of them?

[Bernard Butler]

I suspect that there are a number of challenges. One, and the committee has certainly talked about it, is the complexity of the programming. I think that's one challenge. Another is recognizing the demographic spread of veterans. The 85-year-old veteran may not spend quite as much time on social media as the 20-year-old veteran, so he or she is not getting information necessarily from the Internet, although their caregivers, their daughters, and their sons may be getting it in that way.

The long and the short of it is that the challenge lies in ensuring that we're reaching out through as many mediums as we can, that we're simplifying the message, that veterans trust us to provide the care, compassion, and respect they deserve, and that they have access to benefits in an effective and expedited way. I think that's essentially the challenge we face.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

All right. Thank you.

We talked about PTSD. We talk about it a lot in this committee. One of the themes that comes up in both the armed forces and Veterans Affairs is that there are so many barriers regarding the stigma of it for highly functioning people who don't want to appear weak. It's not considered an injury in the same way that the loss of a leg is. How well would you say we are breaking down that stigma in veterans and having them seek care? Is this improving?

[Bernard Butler]

I think it is improving, evidenced by the fact that there's an increasing number of applications coming to Veterans Affairs for post-traumatic stress disorder and other conditions related to mental health. I think that our transition model is helping as well. We have been working on this model over the last few years with our colleagues in the Canadian Armed Forces and the Department of National Defence.

The model currently ensures that our case managers are working side by side on over 100 bases and wings, for example, in the IPSCs. They are working with members. The idea is to encourage them actively and openly to come forward and make a claim if they haven't. Some of that we can influence in Veterans Affairs. A lot of it has to be influenced within the military environment. I think all indications are that the military is very committed to trying to make that happen. I think we are making some headway and you're seeing it in the increased numbers.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Okay. Good.

This is always such a loaded question. We've said again and again how comparing jurisdictions is so difficult because of the different contexts. Can you make comparisons with the other jurisdictions you've looked at, based on how our efforts to reduce the stigma of PTSD compares with similar efforts in other jurisdictions, if not in a quantitative way, at least in a qualitative one? Would you say we're doing better, or are we in the middle of the curve? Where would you say we fall in the spectrum of different jurisdictions?

[Bernard Butler]

I'm glad you characterized it as a loaded question. What I would say to you is that, with the greatest respect, I would be very reluctant to compare different countries in terms of the success of the measures they have adopted. This is because of the unique social contexts that dominate this discussion.

I must say in fairness that's not something we've looked at from the point of view of destigmatizing. This would probably be more of an issue for the Canadian Forces, which may well be in a position to comment on comparisons along those lines.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Thank you.

To expand on a question that I was asking Mr. Parent in the last hour, I made reference to trying to find meaningful employment for veterans, particularly if it's non-combat roles in the armed forces. We've said how it used to be easier before there was the universality of service provision.

Has Veterans Affairs had any dialogue with the armed forces regarding any alterations to that policy to make sure that veterans can get meaningful employment?

[The Chair, Liberal, Neil Ellis]

I apologize. You'll have to make your answer short on that one, please.

[Bernard Butler]

Again, in terms of still-serving members, that's a question I think you'd be better to ask directly of the Canadian Armed Forces, in terms of how they deal with it internally.

However, from a Veterans Affairs perspective, I can tell you that this issue is key and really reflects, in large measure, budget 2017 and the new and improved career transition services program that we've adopted. That, we believe, will go quite a long way to helping those members who, for whatever reason, cannot remain in the Canadian Armed Forces and who transition out.

[The Chair, Liberal, Neil Ellis]

Thank you.

Ms. Wagantall.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Thank you very much, sir, for being here.

I've heard a lot today about standards, and that's so key to ensuring that what we're giving to our veterans is of high quality. You're dealing with the quality of the service to the veteran, and we want it to be the best it can be. Of course, we want the cost of that service to be the most reasonable it can be based on taxpayers being responsible for the funds we use.

You mentioned that you're working on standards for service dogs, which I think is commendable and very important. I have a daughter who trains dogs. I started looking into what's available in Canada right now as far as the standards for dogs, and it's all over the map, quite honestly. Alberta and B.C. are done through Assistance Dogs International, which is simply obedience training. The standards in Manitoba are through Manitoba Search and Rescue. It's under the department of health. In Nova Scotia, it's under the department of justice. We have to streamline this. We have an opportunity to set something up that would be really good, hopefully the first time around.

When it comes to those standards for our veterans, we are looking for service dogs who are not obedience-trained dogs. They have very specific roles to play. I know that they're coming out soon. I can hardly wait to see what we come up with. Is the focus on making sure, first of all, that they're service dogs? Secondly, I also see that you can be charged $30,000 for a service dog right now, and then there are others who are doing it through a different approach where the dog is free to the veteran.

How in the world do you come up with something, and will it be a standard that's set, or are we at the beginning stages of a voluntary commitment to those standards?

[Bernard Butler]

You obviously have given a lot of thought to this. Your questions are quite helpful, for sure.

From our point of view, I'll use the example of Seeing Eye dogs. Veterans Affairs programming has for many years been providing support to blind veterans for their service dogs. It is a well-established concept, and the standards for that are very well articulated. As we move into now, something that is really quite—

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

It's for PTSD-related.

[Bernard Butler]

Yes, it's very different as a concept.

We are at that point where, as we're waiting now for the work to be concluded on the standards issue, we will then look to see what they are recommending, what would be an acceptable national standard both for training of dogs, for acquisition of dogs, and so on. We'll look at that, and then, of course, the collateral point is the efficacy issue. Is this an effective therapy or an effective support to veterans with PTSD?

If the answer to that appears to be yes from the research that comes out, then obviously what we have to do—and we're already now starting to direct our minds to it—is to say, okay, what would that look like on the ground? What should Veterans Affairs programming do? Should it provide, as we do with CNIB service dogs, the vet bills and care of the service dog? Should it extend to acquisition of the service dog? There are all kinds of very complex issues that have to be looked at as the clarity emerges in terms of the standards and the efficacy.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

The acquisition should be the most reasonable cost back for the best product. Is that right?

[Bernard Butler]

I think it's fair to say, madam, that's right, because as you point out, all Veterans Affairs Canada does is administer these programs on behalf of the people of Canada. We always have to do it in a way that's effective, that's safe, that gets the best value for Canadians and for veterans. Those are all related considerations in the process.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Do I have time?