Veterans Affairs Committee on March 22nd, 2021

[Dr. Heather MacKinnon]

Yes, you certainly do.

If you do a medical, you can charge VA for that, but you don't get paid by Veterans Affairs for anything really.

This is an issue too because the civilian side of it doesn't recognize you for what you're doing, and they make it quite hard on you. At one point, they all thought that I should have been billing Veterans Affairs for everything I did.

When I see a patient, the responsibility belongs to the Nova Scotia Health Authority, it doesn't belong to Veterans Affairs, so this is a problem some of the doctors run into.

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

Okay, thank you so much.

Retired Lieutenant Gerry White, you mentioned something that intrigues me because I'm aware of this in other cases. A patient needs a certain treatment, and they're just not getting that access from VAC, so the doctor goes ahead and tries things, does things, and finds results that work, and then it isn't recognized; they're not listened to.

I can say this specifically in regard to mefloquine and brainstem injuries. There are methods of dealing with this in amazing ways, and yet VAC is not responsive.

[The Chair, Liberal, Bryan May]

I'm afraid that's time, but I'll let Gerry give a quick answer.

[Gerry White]

Fortunately, I took doxycycline instead of mefloquine, but you just keep banging on the door until they answer.

I would like to address one of Tracy's comments. I am also a justice of the peace in and for the province of Nova Scotia, and I currently have several military and a couple of mounted police on the docket so that I can marry them before they turn 60, so that their spouses can get benefits. I don't know how you spell “pathetic”, but that's got to be right up there with it.

That should answer a plethora of questions.

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

Thank you.

[The Chair, Liberal, Bryan May]

Now, it's over to MP Samson for five minutes, please.

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

Thank you, Chair.

I can't thank all five of you enough for your presentations today. With the presentations and the feedback we're receiving, it will be extremely helpful for our committee to put a report in place that will help veterans. I just can't say enough. To each and every one of you, thank you very much for that information.

As you know, the population of Nova Scotia has the highest ratio of active and retired military in the country. Sometimes people forget that, but we have very high numbers. In my riding of Sackville—Preston—Chezzetcook, it's the highest yet. We have here today what I call team Canada, or team Nova Scotia, I should say. We have Dr. MacKinnon, Mr. White and Dr. Whelan, all three very important individuals, to support the veterans in our communities. How they help each other is just amazing. I know the connections between Heather in her work as a doctor supporting.... I can't say enough about you, Heather. Every time I listen to you, I'm just amazed by the things that you're doing. Mr. White and the support that you're giving, 24/7.... I think of the support that individuals but also VETS Canada provide. Dr. Whelan, the research is so important, and there's a link between all of you for that research, and that's why I think we're able to find some solutions as we move forward.

Dr. Whelan, very quickly, you talked about 40% of the veterans being invested in their treatments while 60% are not. Why is the number who are not invested so high and what can we do to change that?

[Dr. John Whelan]

Among the 60%, it would come down to the circumstances of their release from the military. If they're disgruntled about their release, if they want to stay in uniform and they still have a military code, they really don't want to move into civilian life and accept that they have problems and have to change some of their behaviours at home. They'll start and stop their therapy sessions, they may disappear for a while if they hear something they don't particularly like. We may invite their partners in and sometimes they don't want their partners involved. They're ambivalent. “I think I need it, I think I want it”—but then they disappear and they may show up again.

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

What can we do to change that?

[Dr. John Whelan]

I think, stepping back, that we need to debrief people before they leave the military culture, so they're not leaving angry, ashamed and feeling like a failure. That just continues and continues, and we're left trying to undo those effects.

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

That's a very good point.

Mr. White, you spoke about Peter Stoffer. I can't say enough about Peter Stoffer and his work as an advocate. He and I have been friends for a long time, and even today, we are working together to support veterans and their families. It's so important and I appreciate that comment.

I have two quick questions for you, and of course for Dr. MacKinnon, about the new programs that are out, the caregiver recognition benefit and the veteran and family well-being fund. How are they being received on the ground and what can we do to improve them?

We'll start with you, Mr. White, and then go to Dr. MacKinnon. Please be very quick because we're short on time.

[Gerry White]

Most people probably do not realize that those programs exist. I learned about them much after the fact. Simply getting the news that those programs are out there, getting your staff and your constituency staff to publish it in the quarterlies you put out to constituents, that is what is needed. Most veterans have no idea of the assistance available to them until they see that somebody else got it. The question is always, “How do I get that?” We say, “Well, go see Dr. MacKinnon, she'll be able to help you out.”

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

Thank you.

Dr. MacKinnon, quickly.

[Dr. Heather MacKinnon]

That's about it. Usually I don't know exactly who qualifies or why, I mean, it's not—

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

What can we do to improve it, Dr. MacKinnon?

[Dr. Heather MacKinnon]

You need to publicize it more. Send it out to veterans. Send it out to all people. Make it big and public, because they don't know. I'm using it for dying patients at the moment, but get it out. That's the big thing.

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

Thank you.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

Thank you, Mr. Chair.

Mr. White responded sharply to my last question about wait times.

Ms. Evanshen, you were about to speak and respond to my comments, but we ran out of time. Would you like to speak now?

Our discussion concerned telephone wait times, which are very long, over an hour.

[Tracy Lee Evanshen]

Thank you.

No doubt, thank goodness for phones with speakers, because we will just put it on the table and go about our business. We have been on the phone, and I'm not lying, for half a day. When we finally get through to somebody an hour and a half later and then they say, oh, let me just put you on hold, then another person picks up the phone and we have to start all over again. Then we're put on hold again, and then we're disconnected somehow. That just sends Kevin right over the edge. It's not even, let's just call back and do it all over again. We have to wait days before he can come back down and we can even attempt that. We get nowhere fast—hurry up and wait.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

I have another question for you, Ms. Evanshen.

If I were to say that we needed to stop injecting money sporadically and ultimately find more beneficial solutions that help us provide the resources needed to keep veterans and their spouses from distancing themselves from their families, what would be your solutions?

The problem is very real, and your presentation is excellent evidence of this reality.

How can we take action? Should we provide money or move human resources? What do you think?

How can we ensure that our veterans' family caregivers, such as you, can properly support their spouses?

[The Chair, Liberal, Bryan May]

That's time, but I'll allow for a brief answer, please.

[Tracy Lee Evanshen]

Thank you.

I think a case manager would be helpful. Kevin had a case manager. Then they said that we didn't need them anymore and we were dropped. We have nobody taking care of us, and then we're just bounced around.

More money, yes. More case managers, yes. More help. More empathy—not sympathy, empathy.

[The Chair, Liberal, Bryan May]

Thank you.

We have MP Blaney for two and a half minutes, please.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Thank you, Mr. Chair.

Mr. Bruyea, perhaps I will come to you.

You said in your testimony that veterans and their family caregivers are treated separately, like they're two different things and not related at all. You talked about things like not supporting children or dependants appropriately.

Could you speak a little bit about what those gaps are and what would be the next step? I know we've had witness testimony about the systems being put together a long time ago and that they don't apply anymore in the world that we live in.

What fundamentally do you think needs to be available for those dependants and caregivers?

[Sean Bruyea]

Thank you, Ms. Blaney. That's an excellent question.

If we take bits and pieces of what everyone has said here today, I think we really need to include a multidisciplinary approach. Mental health research has shown that veterans, especially with severe chronic illnesses, do not get better or progress in their lives unless they have a multidisciplinary approach.

The same would apply for those family members. The members have to be involved in that case management plan. We need to strip all the work and paperwork that case managers have to do so they're freed up to find those practitioners.

For instance, in the United States context, veterans can go to a hospital that offers all the multidisciplinary facilities that can address the veteran. What I would like to suggest is in Canada we don't have that one-stop facility. A case manager has to prove each individual practitioner for that team. Then, the burden is upon us, the other veterans, or the family members, to try to get that team to talk to one another. We can be much more creative about this. We can start working in a team management context.

Veterans Affairs in the United States has 24-hour-a-day mental health care. We can do the same in Canada if we start training and educating practitioners, bringing them into the Veterans Affairs' fold, and offering these services to the families, to the children, and to the veteran, of course.