Veterans Affairs Committee on June 7th, 2017

[The Chair, Liberal, Neil Ellis]

I call the meeting to order.

We will continue our comparative study of services to veterans in other jurisdictions. We have in front of us today the Department of Veterans' Affairs from Australia.

Good morning—or good evening in Canada—and thank you for appearing.

There won't be opening statements, so I will give the analyst the floor for a couple of minutes. Then we'll flip into questions.

[Jean-Rodrigue Paré, Committee Researcher]

Good morning.

I want to give members a general overview of how the system works in Australia.

I will probably say something wrong. So you can correct me later on.

The system generally works in a very similar fashion to the Canadian system. The main difference is in how the permanent impairment compensation is paid in Australia. Since 2006 in Canada it's been paid as a lump sum, based on the level of disability, up to 100%. It's a lump sum of up to $360,000 now. Australia, at about the same time, decided to continue with a monthly life pension—I believe it's actually paid twice a month—but veterans can decide to have that monthly payment turned into a lump sum. The maximum amount is around $1,500 a month.

If I'm wrong on that, please correct me later.

The advantage of that is that the amount of the lump sum, if the veteran elects to be paid the lump sum, takes into account the age of the veteran at the time of disability. If a veteran is injured at age 30 or earlier, the amount will be the same, but then the amount of the lump sum will be a little lower as the veteran ages. That's the general idea.

Again, you can correct me if I've said something wrong.

Most of the other elements of the system are the same. One distinction, though, is that Australia sent a significant contingent to Vietnam. As we know from our travel to the U.S., that population of veterans might have some specific issues concerning mental health that did not appear in other contingents. That would be an issue to inquire about. The contingent was about 8,000, if my information is right.

They have a similar rehabilitation program for physical and mental health problems, as well as vocational rehab. Something that Australia has and that doesn't exist in Canada is housing aids. They have subsidized loans, depending on the condition, age, and other criteria. They also have their Veterans and Veterans Families Counselling Service, which is very similar to the phone line that Veterans Affairs Canada administers here.

I won't go into the details of all of that, but you have a general idea. The main thing is that the system is very similar to the Canadian system. The difference is the payment of the monthly pensions. That is very specific to Australia.

Thank you.

[The Chair, Liberal, Neil Ellis]

Thank you.

Deputy Secretary and Chief Operating Officer Liz Cosson will make a few opening remarks, and then we'll flip into questions.

Thank you to all, and welcome.

Go ahead, Liz.

[Liz Cosson, Deputy Secretary and Chief Operating Officer, Department of Veterans' Affairs Australia]

Thank you, Mr. Chair.

My name is Liz Cosson. I'm the deputy secretary and chief operating officer. I have a team here that is very happy to take questions from the committee.

By way of a brief introduction, as a department, we are approximately 2,000 people who are spread across Australia in delivering our services and support to our veteran community. I'll give you some statistics in relation to that community shortly. Also, as part of the department, we have a Repatriation Commission and a military rehabilitation and compensation commission. Joining me is the deputy president of the Repatriation Commission.

We work collaboratively to look at how we can best serve our veterans and the broader community. We have around 300,000 clients, and 174,000 of those are veterans with an average age of about 65. We have about 154,000 clients who are dependants of an average age of about 79. Of those, 120 are widows of World War I veterans.

Our numbers are reducing. We see them reducing to about 240,000 by 2020, but what we as a department are identifying is that the younger veterans, our new veterans, are presenting with quite complex claims, and they require a different approach in managing their circumstances.

We have a budget of just under $12 billion Australian. About $6 billion of that goes to compensation and support, as outlined. About $5 billion goes to health and well-being. We also have a commemorations program of about $66 million.

Over the last couple of years, and in a dedicated effort in the past 12 months, what we have been doing is listening to our veteran community to identify how we can change our programs to improve our service and best serve our younger veterans, because we are hearing from them that they are not as satisfied as our older cohort of veterans. We've been working in collaboration with the Department of Defence to look at what our future operating model will be. Ms. Pope, who is with me, is leading that transformation.

Among the key things we are hearing is that we need to change from just focusing on claims to improving the transition from service into the community, and to moving a lot of our ADF members from a life of being dependent on the ADF community to a life of independence. We also have heard that a few of our veterans have not been happy with our claims processing times and the way they have to approach the department. We have been placing a lot of effort on our time taken to process, and in the budget we received just over $13 million to support us in improving the processing activities.

What we've also heard about is the importance of families. You referenced our Veterans and Veterans Families Counselling Service. We also receive funding in the budget to extend the eligibility of our veterans counselling services to pick up more broadly the family members.

You mentioned our commitment to Vietnam. We had about 60,000, including our nurses, who deployed to Vietnam, but unfortunately we only know one in three of those veterans, and from recent conflicts, we only know one in five. Our efforts are really focused on how we can connect to those veterans and that broader community where they do have eligibility for our support and services.

In addition to what I've mentioned and your interest today, I'll conclude my opening. That was just by way of introduction on what we're doing as a department. I'm very happy to open it up to questions from the committee.

[The Chair, Liberal, Neil Ellis]

Before we start, maybe we could just take a minute and get a quick introduction by each member of your staff, and then maybe we'll have some questions. I see that you have legal staff and some others there. Could we just go around?

[Liz Cosson]

Carolyn.

[Carolyn Spiers, Principal Legal Advisor, Department of Veterans' Affairs Australia]

I'm Carolyn Spiers, the principal legal advisor.

[The Chair, Liberal, Neil Ellis]

Thank you.

[Kate Pope, First Assistant Secretary, Transformation Division, Department of Veterans' Affairs Australia]

I'm Kate Pope, first assistant secretary of the transformation division.

[Craig Orme, Deputy President, Department of Veterans' Affairs Australia]

I'm Craig Orme, the deputy president of the Repatriation Commission that Liz mentioned.

[Lisa Foreman, First Assistant Secretary, Rehabilitation and Support Division, Department of Veterans' Affairs Australia]

I'm Lisa Foreman, first assistant secretary of the rehabilitation and support division.

[Veronica Hancock, Acting First Assistant Secretary, Health and Community Services Division, Department of Veterans' Affairs Australia]

I'm Veronica Hancock, assistant secretary of the policy branch in the health and community services division.

[Colonel Stephanie Hodson, National Manager, Veterans and Veterans Families Counselling Service, Department of Veterans' Affairs Australia]

I'm Dr. Stephanie Hodson, national manager of our Veterans and Veterans Families Counselling Service.

[The Chair, Liberal, Neil Ellis]

Excellent. We have a wide range of knowledge here.

We'll start with Ms. Wagantall.

You have six minutes.

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

First of all, thank you so much for being part of this with us this evening. I've been very excited about this opportunity to study what other countries are doing. It's interesting that regardless of the number of veterans involved and the scenarios we've been in, transition and mental health seem to be significant issues all over the world.

I just want to draw attention to an issue that I think Australia has been doing a wonderful job on. In an article in The Guardian on June 2, 2017, the Australian Minister for Veterans' Affairs, Dan Tehan, spoke about the progressive outreach services that his office is providing to veterans exposed to the malaria drug, mefloquine, who are potentially experiencing side effects or are concerned about what these side effects are.

He was quoted as saying:

Over the past year defence has had direct contact with more than 250 concerned individuals about the use of [mefloquine] and has provided information on the trials, how to request individual medical records, and the mechanisms in place through which to seek help.

I just want you to know that our veterans in Canada are very encouraged by these moves you are making, which they see as being very proactive. As we also have veterans who have been exposed to mefloquine, can you advise us how these rollouts have gone about and whether there are other veterans services being considered in this area?

[Veronica Hancock]

This is Veronica Hancock, from the health and community services division.

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

Hi, Veronica.

[Veronica Hancock]

In Australia, for our defence forces, mefloquine has been used only as a third-line drug for malaria resistance. The the majority of our forces who are serving in malaria-prone areas are actually receiving other drugs. The numbers involved in Australia who have had mefloquine are very small.

For us, reaching out to individuals is quite feasible. Most of that activity is done by the Australian Defence Force as opposed to the Department of Veterans' Affairs, but we actually have a collaborative effort in place at the moment. That's the work that Minister Tehan referred to in his media release, as part of which we ran a workshop in a city called Townsville, in the far north of Queensland, where a number of the people who are most concerned about the administration of mefloquine currently live, to provide information about the services and the supports available for people who have concerns about their mental or physical health, whether as a result of their exposure to mefloquine or from other causes.

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

I appreciate that, and your outreach is, I'm sure, much appreciated by those individuals. As you said, it's not a large number, but there is a concern there and you're meeting that need.

I also noted that the Australian Department of Defence has set up a mefloquine web page to further educate soldiers and veterans on mefloquine toxicity. How has this effort been received? Can you tell what kind of action it is receiving?

[Veronica Hancock]

I'm not sure how many page views, for example, that information has had. As you noted, it's administered by our colleagues in the Department of Defence, but we do get informal feedback from people that the information provided there is helpful in addressing some of their concerns, and we certainly direct people. We don't have competing information on our website. We refer people who are looking for information to the ADF site.

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

Okay, so there is co-operation there between Veterans' Affairs and the Department of Defence.

[Veronica Hancock]

Yes, definitely.

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

How much time do I have?

[The Chair, Liberal, Neil Ellis]

You have two minutes.

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

Okay. I'll try to do this quickly.

This is an issue that is very important to our veterans, so I want to just carry on a little bit with it. The Guardian article also quotes Professor Jane Quinn, a pharmaceuticals researcher at Charles Sturt University. It reads:

Originally from the UK, Quinn's husband, Major Cameron Quinn, was an officer in the British army and was given mefloquine during a training exercise in Kenya in 2001.

He suffered depression and nightmares immediately after taking the drug,...and he eventually took his own life in 2006.

I am sure you're familiar with those reactions.

Professor Quinn now works with military veterans exposed to antimalarial drugs, including mefloquine, to study neuropsychiatric conditions that arise from taking the drugs. She said that while the number of personnel given mefloquine today is minimal, that has not historically been the case—and this is what we're experiencing in Canada, as well—particularly for those individuals taking part in clinical trials in the 1990s.

She goes on to state the need for a study to:

evaluate and untangle all the different things that might be causing these symptoms and ascertain what is being caused by the drug and what is being caused by...other factors that can impact an individual over their lifetime.

With the proactive work you guys have already been doing in this area, we really feel there is a need for an independent study, and since we have the same concerns, do you think there would be scope for an international collaboration with the Canadian government and Canadian veterans to deal with this issue that's clearly something that's on the forefront with our allies?