Veterans Affairs Committee on Feb. 27th, 2020

[The Chair, Liberal, Bryan May]

Next is MP Lloyd, please, for five minutes.

[Dane Lloyd, Conservative, Sturgeon River—Parkland, AB]

Thank you, Mr. Chair.

Mr. Doiron, you said earlier in answer to my colleague Cathay Wagantall's question that not a single person has been cut off from the family mental health program. Can you clarify? Is that what you said?

[Michel Doiron]

I may have said it that way, but maybe I want to clarify that, because some people have been refused. We need to realize that we don't approve every condition. It has to be linked to the veteran, to the veteran's condition, and to help the veteran get better. It can't be in their own right. This is in the legislation. We may have a little flexibility on what that means, related to the veteran. We have refused some, and we will always refuse some.

[Dane Lloyd, Conservative, Sturgeon River—Parkland, AB]

I accept that. Were the cases which you did refuse previously approved, or was this for new applications for new care?

[Michel Doiron]

I would have to confirm that. I'm not 100% sure.

[Dane Lloyd, Conservative, Sturgeon River—Parkland, AB]

They might have been receiving care previously under Veterans Affairs, but then they ceased to receive...I think would be the definition of cut off.

[Michel Doiron]

It is possible, but we need to be clear. It may have been for a new condition that was not related to the previous condition. As an example, if you're going to marriage counselling with a veteran, we would support you with no issue, but you come back for another condition that may not be related to the veteran's issue. Although you were approved for that—I'm using marriage counselling but there are a few other ones—if you came back for that you may think and the individual may think they were cut off and why can't they continue doing it. This new condition is either not related to the veteran's condition or may be something in your own right, or may be in the right of your child, for example, a child who has autism.

[Dane Lloyd, Conservative, Sturgeon River—Parkland, AB]

In the definition of the purpose of the program, it's not necessarily to treat the family member. It's to treat the family member for the benefit of the veteran. If the family member is undergoing a great deal of mental stress because they have been cut off, maybe it is a new condition, but that creates stress for the veteran. Wouldn't you agree?

[Michel Doiron]

I would agree.

[Dane Lloyd, Conservative, Sturgeon River—Parkland, AB]

Then wouldn't it be necessary to continue the program in order to help benefit the veteran?

[Michel Doiron]

Not necessarily, because there is legislation that dictates how far I can go, and our resources for that are based on that legislation. My default is always care, compassion and respect. In service delivery, my colleague in policy sometimes gives me a hard time because I tend to want to push that as far as I can, because we need to remember that the people who work on the front line in service delivery deal with the veteran day in day out.

[Dane Lloyd, Conservative, Sturgeon River—Parkland, AB]

Yes. I'm sorry to cut you off. Thank you. I appreciate that clarification.

I have a quick question. Excluding the impact of the transfer of employees from Ste. Anne's Hospital in 2016-17, what were the reductions in front-line staff for Veterans Affairs? About 750 people were transferred to a provincial jurisdiction, which would indicate statistically that there was a huge reduction in Veterans Affairs officials, but excluding that impact, were there any reductions?

[Gen (Ret'd) Walter Natynczyk]

I would say that the number I was briefed on was in the order of 35%. Parking Ste. Anne's to the side, Charlottetown alone went from 2,000 to about 1,100 employees.

[Dane Lloyd, Conservative, Sturgeon River—Parkland, AB]

Are they front-line disability staff?

[Gen (Ret'd) Walter Natynczyk]

They are disability folks and some in corporate services. I would have to triage it all, but they were also in the field. There is a significant reduction concurrent with increasing demand and more veterans coming forward.

[Dane Lloyd, Conservative, Sturgeon River—Parkland, AB]

In what time period was that, sir?

[Gen (Ret'd) Walter Natynczyk]

That was from 2012 to 2014.

[Dane Lloyd, Conservative, Sturgeon River—Parkland, AB]

Thank you for the clarification.

The third question I want to ask is a little more general. There are other jurisdictions, Australia, United States and Great Britain, that have sent people to Afghanistan. What are we learning from these jurisdictions on how we can make our Veterans Affairs programs better?

[Gen (Ret'd) Walter Natynczyk]

Thanks very much for that question.

Again, my associates and I were at a Five Eyes veterans affairs conference with the Australians who hosted. This year it's with the Americans.

We are constantly looking for best practices across the board. The Australians benchmarked how the Five Eyes were doing. One of our allied countries said, “Please don't tell our veterans what Canada is doing.” Again, it will never be perfect.

[Dane Lloyd, Conservative, Sturgeon River—Parkland, AB]

What are some examples you could give?

[Gen (Ret'd) Walter Natynczyk]

The veterans independence program is an example. If you have an injury as a result of service and you're getting more and more frail, we will pay support to you to try to keep you at home. We know that you will be healthier at home longer before you have to go into a long-term care facility like the Perley and Rideau, the George Derby or Camp Hill. You will be healthier if you stay at home, so we're providing for nursing support in the home, the clinical beds, meals on wheels, landscaping and housecleaning. Our allies don't do that. They are coming to look at Canada to see what's going on.

We just had the Australians come to Charlottetown and say, “Tell us about the Bureau of Pensions Advocates.” The fact is that we're paying a platoon of lawyers to make sure that the veteran's entire circumstance is understood before we render the final decisions and appeals. We're the only outfit in the world with a Bureau of Pensions Advocates.

There are a lot of things like that. In fact, we can share with you the little chart that the Australians came up with. We are also looking at what they are doing. They have done things like, say an infantryman has done so many years in the infantry and has had so many jumps. Therefore, it's ankles, knees, hips, back, shoulders.... They are applying a presumptive model to that.

We're saying we want to do that. We're moving down that path.

[Dane Lloyd, Conservative, Sturgeon River—Parkland, AB]

Thank you.

[The Chair, Liberal, Bryan May]

Thank you very much.

MP Samson, please.

[Darrell Samson, Liberal, Sackville—Preston—Chezzetcook, NS]

Thank you for being here today. We appreciate it. I'm glad you came in a couple of days earlier, because it would have been challenging this morning or late last night. It's nice to see all of you here today.

Quickly on the comparison, Canada is seen as one of the most compassionate countries in the world to our service men and women. We did a comparative study here last year. I would invite members to read that, because that can be a good stepping stone to some further studies as we move forward.

The minister's mandate letter makes reference to addressing the backlog. We talk about automatic approvals.

Can you expand on that for members? That's an important theme that we should share with everyone today.

Thank you.

[Gen (Ret'd) Walter Natynczyk]

As we look at that terminology “automatic approvals”, it's almost a presumptive approach to injuries. It builds on what I mentioned a moment ago about what some of our allies are doing. We generally know that if someone has been in a certain trade doing a certain kind of deployment, they could have injuries as a result of their service.

When I was at Comox recently at 442 Squadron with Minister MacAulay, we were talking to about 20 search and rescue technicians. We asked about the probability of a search and rescue technician getting injured. The answer is 100%.

We look at the evidence model when we consider a disability claim to consider the circumstances of the service of the veteran. If they are, say, in the artillery, they might have a hearing issue and so on, so we're adapting the evidence model. Again, with the great work done by the entire team on a policy standpoint, a service delivery standpoint, right now we're approving 97% of all claims on post-traumatic stress disorder.

When we drill down on the 3% we're not approving, we find there was no diagnosis or there was a pre-existing condition prior to service in the Canadian Armed Forces, and in some cases the person never served in the armed forces. We're getting to a virtual 100% on the automatic approval. In fact, in all cases of mental health, we're approving 93%.

Back in 2014-15, we used to approve all musculoskeletal injuries in the 60th percentile. Jump in here if I'm off track. Because we've adapted the evidence model, we're now in the 80th percentile of approvals with regard to musculoskeletal injuries. It goes to this whole notion of moving down this path with regard to automatic approvals.

I'll turn it over to Michel Doiron and Rick Christopher.