Veterans Affairs Committee on May 1st, 2023

[Blake Richards, Conservative, Banff—Airdrie, AB]

Can they actually apply, or is it just awareness?

[Col Lisa Noonan]

They can apply for some of the benefits, but I think that's probably a better question for VAC when they come.

[The Chair, Liberal, Emmanuel Dubourg]

Thank you, Colonel Noonan. I'll stop right here.

Mrs. Romanado, you have the floor for the next five minutes.

[Sherry Romanado, Liberal, Longueuil—Charles-LeMoyne, QC]

Thank you very much, Mr. Chair.

I am pleased to be with you today.

I have to say that the last time I was in the veterans affairs committee I was PS for Veterans Affairs. Since that time, my platoon has grown. Not only are my two sons still serving, but I have a daughter-in-law who's also serving. As I said, the force generator in me is continuing.

One of the questions I have is following up on Mr. Desilets. We talked a little bit about prevention in terms of modified equipment. Female serving members were allowed as of 1989 to take on combat roles. We're talking over 30 years ago, and yet we're hearing that we still do not have the proper equipment for women soldiers, for instance the Kevlar vest or the backpack. I went and visited a QM. I put the backpack on. It's too long for me, so it rubs on the back of my lower back. Obviously, I'm not a serving member so wearing it for half an hour is one thing, but carrying around an 80-pound pack on your back that is not adequately made for the frame of a female.... I'm sure the two colonels here know exactly what I'm talking about.

What is it going to take for the Canadian Armed Forces to be able to equip women in the military with the proper equipment so that they can prevent injuries? If we're hearing that musculoskeletal injuries are happening more predominantly in female military members, what can we be doing to help you make sure you have the necessary equipment in the military adapted for women we want to recruit and retain?

[Col Lisa Noonan]

I think, Colonel Wright, with some of the work she's doing and some of the extension of the musculoskeletal work perhaps could respond to that.

[Col Helen Wright]

Thank you.

It is not an area that I am specifically working in, but I absolutely acknowledge that there is work to be done there. I think the good news here is that the system now widely acknowledges that there is work to be done in this domain, and it's already started.

Now, finding the solutions is not an overnight endeavour, unfortunately, but I do know that the work is already under way. As I said as I started the answer, even more importantly, because it is generally acknowledged that this gap needs to be filled, I really am optimistic that the pendulum is swinging in that direction and that the work will be done.

Unfortunately, the solutions aren't always straightforward. That's the problem. We can often find the things that don't fit, but it isn't necessarily that easy to find how to address it.

[Sherry Romanado, Liberal, Longueuil—Charles-LeMoyne, QC]

Thank you for that. I'm sure that this committee will probably put forth recommendations in terms of getting this addressed once and for all.

In my previous life when I was a PS, we had heard about the transition and that no military member should transition out into the civilian world without a family doctor. We all know the health care situation across Canada. If we have a serving member who is transitioning out, it's great that we provide the information regarding the benefits that are available to them. However, if it's a medical release and they need to have the diagnosis, that means they need to have a medical doctor. They need to have a specialist, and so on.

Are the Canadian Armed Forces working with provincial counterparts in helping military members find health care professionals before they release? They need to have those diagnoses in place prior to being able to get the services from Veterans Affairs. They actually need to make sure they have a medical doctor. I know that's something that—depending on where they move after they leave the forces—might be an issue. Could you elaborate on what we're doing in that regard?

[Col Lisa Noonan]

Thank you very much. Maybe I can start, Mr. Chair, and then hand over to Colonel Wright.

I co-chair the seamless transition task force, STTF, with a VAC counterpart at my level, and the higher-level committee is the joint steering committee that the CMP co-chairs with Steven Harris.

For the STTF, we're working on a telehealth initiative for ill and injured members. It started in January 2022 and it's ongoing for another couple of years. For the ill and injured members in particular, it's very important that they have continuity of care as they search for a family doctor, and the telehealth initiative fills that gap. It's co-funded by VAC and Canadian Forces Morale and Welfare Services. It really is providing that bridge to the longer-term care. It is a trial right now. We're continuing to discuss with health services and VAC what the longer-term option will be, if it's this or if something else provides that bridge.

We're also looking for non-medically releasing and whether that is something that's going to be required in the future as well. Those discussions are also ongoing.

Colonel Wright, I'm not sure if you wanted to add to that from a health services perspective.

[Col Helen Wright]

Thank you.

I will add to that with respect to ill and injured patients. I don't want to suggest that the continuity of care is more important for them. It's important for everyone, of course, but we are trying much harder now to anticipate early—when we're aware that the member is going to release—and to find and integrate them into their civilian health care even before they have left the CAF, so that the turnover can be slow and gradual. They can start seeing their new providers while they're still in the CAF, so that we really are bridging that gap.

Now, that happens more often for the more significantly ill and injured. We are not at the point of being able to make those kinds of transitions for the non-injured members. That's where the bridging techniques that Colonel Noonan just mentioned will be important.

[The Chair, Liberal, Emmanuel Dubourg]

Thank you very much.

Mr. Desilets, you now have the floor for two and a half minutes.

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

Thank you, Mr. Chair.

Mr. Beck, you said earlier that the suicide rate among women was fairly low.

Did I understand that correctly?

[Capt(N) Iain Beck]

Yes. I can tell you that we see about zero to two suicides per year in our female population. The problem with trying to analyze is that you're basically going to breach privacy by having such a small number.

In order to come up with an analysis of a statistical comparison with the Canadian general population, we needed to aggregate data over the last 15 to 20 years. This is a report that's not published yet that we will be putting out shortly, which is comparing our suicide rate in our female population to the Canadian general population.

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

Okay.

I am not questioning what you are saying, but the ombudsman's report listed three studies—in 2010, 2014, and 2020, respectively. The ombudsman concludes that, for women veterans, the risk of suicide is 80% to 90% higher than for women in civilian society.

What is your response to that?

[Capt(N) Iain Beck]

I can't explain that. I don't see that kind of data, so I'm not sure where that's coming from. I know you mentioned three different reports.

We don't see that in our statistics.

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

This comes from the Office of the Veterans Ombudsman.

Ms. Noonan, the Office of the Veterans Ombudsman found that female veterans' pay was 17% to 22% lower than male veterans' pay in the three years after they left the military.

Can you explain that?

[Col Lisa Noonan]

I think this is where we absolutely need more research to determine exactly what is at the root of that difference. There could be several reasons behind it.

It could be that when women release from the CAF, because they're predominantly in support occupations while they're in the CAF, they go out in civilian life and do that same occupation and the salary could be lower. They are perhaps paid less depending on the occupation.

It could be that they're going back to school in greater numbers than male veterans and therefore there's a dip in their salary for a period of time while they retrain. It's unknown at this point.

I think, as mentioned before, that's where we need the research. It's to see what's at the root of some of these differences that have been released in various reports in the past and what programs are needed to address those gaps.

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

Thank you, Ms. Noonan.

[The Chair, Liberal, Emmanuel Dubourg]

Thank you, Mr. Desilets.

Ms. Blaney, the floor is now yours for two and a half minutes.

Please go ahead.

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

Thank you so much, Mr. Chair. I appreciate that.

I'm going to come back to Colonel Wright.

I think I'm going to ask that you send a response to the committee because I don't think you'll have all of this at your fingertips.

Could you send the committee information on the current training and requirements that are in place to ensure that military doctors are up to date on how to take care of all common women's health issues that could take place on deployment in operational settings?

For example, what training do they get on menstruation suppression, dysfunctional uterine bleeding management, sexual assault documentation and management, IUD complications, breast cyst management, menopause management and counselling around military-specific occupational and environmental reproductive hazards?

Could you look into that and get back to the committee?

[Col Helen Wright]

Certainly, although I would just like to make a comment there.

Our providers are trained in the civilian system to the same standards as Canadian clinicians and with the same ongoing continuing medical education requirements, etc. Also, we are working now on additional education products for our providers to refresh their memories if it's been a while since they've done those things, but certainly, yes, we can give you a more fulsome answer.

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

Thank you.

I think the challenge I'm having is that I hear what you're saying, but what I'm hearing from women veterans is that when they have these things happen and they go to VAC, VAC is saying that they don't have information from CAF to validate their experience. What I'm trying to figure out is, where is the breakdown in communication?

My next question also goes to you. On this one, I'm asking for an actual response.

I'm just curious. Data collection is something that we've heard a lot of concerns about. I'm wondering if the CAF is keeping records of infertility rates, pregnancy loss rates or any kind of anomaly rates of offspring. I'm just trying to figure that out, because it seems to me that there's not as much documentation. After 30 years, we should be able to figure out some sort of semi-balance of medical illnesses and injuries that happen to women specifically in this area. I'm just wondering if that's being tracked at all.

I understand that it's hard to study—I heard Captain Beck talk about the small component of women who are serving—but we can't ignore this, because we're hearing too many stories on the other side. I'm just trying to figure out what we are tracking and how it is being useful to make sure that women get the health care they need while they're serving and then on the other side when they're veterans.

[Col Helen Wright]

That is exactly the kind of work that we want to spend more time focusing on in the future. We do have the data. We are the care provider for these folks and so we have their medical records. If they are seeing a specialist outside the CAF, of course the records come from those specialist providers back to us. We have an electronic health record, which has in it the kinds of information you mentioned.

Pulling it out to do the kind of analysis you mentioned, though, is time-consuming, but it is exactly the kind of research we are planning on doing or in augmenting what has been done. We're hiring more epidemiologists to work specifically in women's health. An epidemiologist is the kind of person who would do things like draw that information out of the health record and then start looking at the population-wide patterns.

[The Chair, Liberal, Emmanuel Dubourg]

Thank you very much.

Now we go to Mrs. Cathay Wagantall for five minutes, please.

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

Thank you so much, Chair.

I appreciate all of you being here.

Most of my questions I believe will go to you, Colonel Noonan.

I'm so excited to see this sentence: “Together, the CAF and VAC developed the new Military-Civilian Transition process to ensure a seamless, personalized, and standardized process across all Transition Centers.”

I've been on this committee since November 2015 and the term “seamless transition” has been there forever. I know that we went through a pilot project, so I'm assuming that we are now into actually providing the service. Yes?

[Col Lisa Noonan]

That's correct, yes.