Veterans Affairs Committee on Nov. 2nd, 2017

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

Thank you.

It's nice to see you again. Thank you again for coming.

I'm at a disadvantage in that at least four of the questions that I came up with have been asked by other people, so I'm crafting new ones.

One of the things we talked about is that we need a Canadian-made solution, but we also need to look at best practices. You mentioned Australia being geographically and societally very similar. Can you think of any specific elements—things they're doing very well, in terms of their veterans affairs—that we can take an example from to use in Canada?

[Guy Parent]

Yes. I've mentioned two already. One was the fact that once you've served in the Australian Defence Force, even for one day, you become a client under the mental health care system for the rest of your life, which is a very important aspect.

The other is that there are records and information that are shared with veterans affairs right from the time an individual joins the forces, so they become clients. Everybody who serves in the Australian Armed Forces is a client of Australian veterans affairs. They do that right from the start. It goes back to what we talked about before, that we have the My VAC account now, which is useful for all serving members. Those things are important.

[Sharon Squire]

Building on that, for the Australian model Guy just described, the idea is that once that cohort is through, they will not have to make an application because it will be paperless. Once they have been injured and need something, veterans affairs already knows. There's no application necessary when they leave, as they have all the information. There's no application necessary for that veteran. That's where they're trying to head with their huge transformation.

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

Can you think of any barriers to establishing that in Canada?

[Guy Parent]

No. If the VAC account were introduced for recruits as soon as they joined the forces, then the link would be there.

An important point that goes back to a culture issue is what my colleague mentioned before. We now have to encourage serving members to be their own promoter of wellness, as it were. They need to record what they do, where they've been, and every time they have treatment. Instead of relying on a third agency to do that, we need to change the culture of the serving members, so they say, okay, I'm responsible for my future as well. If we have that in the future—if we have a link between two departments and the people are actually conscious that they have a responsibility—then I think we're heading in the right direction.

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

Thank you.

As a happy coincidence, just like your predecessor from an hour ago, you made a comment that segues into my next question. You talked about medical records, and I made an earlier comment about how we have the two different systems.

We know that there have been many difficulties with transferring records from CAF to the different civilian agencies or to the different provincial systems. Many provinces haven't gone paperless. I worked in the emergency department of a major teaching hospital where we still used paper charts. For long-term patients, they would be seven volumes thick—in the 21st century.

Right now, is the ability to transfer medical records from CAF to the different civilian health agencies improving across the country?

[Guy Parent]

It is improving, because of the digitized system. Where we face difficulty is with the tracking down when somebody has been out of the forces for a few years. Some are paper records. Others are microfiche. Some are digitized. This is one of the issues we are faced with on the medical side.

One of the things that have improved is that.... At one point in time, the interpretation of an injury or illness was different on the DND side and on the VAC side. They used different language. Now, at least, they have harmonized that and they use the same language, which makes it helpful for application and that sort of thing.

The other challenge on the medical side was with medication. For instance, the compendium of drugs for DND was different from that of Veterans Affairs Canada, so in the transition there was always a problem for the individual switching to a medication available on the Veterans Affairs Canada side.

Moving forward, these things are improving.

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

Yes.

I can tell you that there are also interprovincial barriers for medical records. Where I worked, the hospital could certainly pull up a computer record of every prescription that this patient had had in the last six months, but only in Manitoba. If the patient came from Ontario or Alberta, we had no idea what they had been taking. That seems to be another barrier. The provincial systems aren't talking to each other.

[The Chair, Liberal, Neil Ellis]

Thank you.

Mrs. Wagantall, you have five minutes.

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

Thank you.

Thank you so much for being here.

I want to focus on your conversation about outcomes and communication. You say, “Without clearly defined outcomes, we cannot measure success and we cannot communicate effectively with our veterans. If we could focus on specific outcomes, then we can focus the support on what the veteran actually needs, and we can communicate clearly the types of programs available. From the veterans' perspective, this makes the system easier to...understand.”

Basically, you say that we need to clearly define outcomes, including outcomes on how services are provided and what we are actually trying to provide and measure for veterans. In talking about those things, this impacts every other part of the conversation completely, yet it doesn't seem to be something that has been focused on.

You've done a number of reports. Do you have any idea how many?

[Guy Parent]

Do you mean on this particular subject?

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

Reporting on concerns for veterans...?

[Guy Parent]

There would be 30-some, so far.

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

Great.

There are 11 reports from Mr. Walbourne, and a number of reports from us. There are reports everywhere, but never has this been dealt with, to define who we are and why we are here. Really, that has to come from our veterans. We talk about “communicating effectively to veterans”. We actually need to hear from them, as much as possible, before we try to communicate to them.

Apparently, we are about to begin another study dealing with trying to identify the impediments to transition. I've heard a lot of those discussed already. Would we not be wiser, at this point, to find a way to come up with very concise answers to what outcomes we need to clearly define and how we are going to define outcomes for how service is provided, so that we can move on? As long as that isn't defined, it's like you say, we're shooting at the target but never reaching the bull's eye.

How do we do that? How do we come up with those outcomes?

[Guy Parent]

Certainly, I agree that one of the best ways to get there is through consultation with our veterans. They are the ones who can best advise on what their needs are, but it is also important to recognize that now, with the ministerial advisory committee, there is a very strong consultation process in place and people are able to identify what their needs are.

On the business about successful transition, in fact we are releasing a report in the next few days that has to do with the determinants of a successful transition. I think it's important because the key factors in there are everything we are talking about right now. One of the things that are very important is that people must take control of their transition, and then they must be financially supported throughout. They shouldn't have any financial difficulties to achieve a transition.

Again, it goes back to what the financial goal is.

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

I understand that. If those goals aren't clearly defined for them, how are they supposed to navigate that? It should be clear. When these individuals sign up and say, “Yes, I'm 100% expendable”, they should know exactly what those outcomes would be.

I just heard you mention that it needs to be more the responsibility of the armed forces members to keep track of their visits when they go to the hospital. That's all done through the Canadian Armed Forces. Their care is through the Canadian Armed Forces. Why is that not all there for them?

[Guy Parent]

Not necessarily. Some people do see physicians and caregivers outside of the system sometimes. Again, we go back to the universality of service and not wanting to divulge some of their injuries or illnesses. They might make use of the provincial facilities for care.

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

Not wanting to divulge means we have a culture problem.

[Guy Parent]

That's exactly what the universality of service has led to—the fact that now people would not divulge the full extent of their injuries because they would not meet the universality of service standard.

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

The sad thing about this is that, when you sign up, there should be a note somewhere, “You may not want to divulge everything, so make sure you keep track of all your appointments.” That just shows a clear problem.

[Guy Parent]

It's a different culture.

Again, I'll go back to the outcomes. Another example is these vocational rehabilitation programs. There are two available now—one on the DND side, and one on the Veterans Affairs Canada side. We can't tell you which one is best, because there is no outcome that has ever been measured. We know that many people have been through, but nobody has ever....

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

Who is nobody, and how do we get those outcomes measured?

[Guy Parent]

It was one of the recommendations of this committee, in the previous report, that the vocational programs be reviewed. That has never been done.

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

We should, as a committee, possibly study what we would recommend as the way to approach getting those outcomes and what those outcomes should be, based on testimony.

[The Chair, Liberal, Neil Ellis]

Thank you.

Mr. Samson, you have five minutes.