Mr. Speaker, I am pleased to rise in my place today to respond to the motion of the hon. member for Edmonton East regarding national standards for veterans health care.
The motion calls for maintenance and special needs provisions that would be based upon national standards. These standards would be agreed upon by all provinces before health care responsibilities for veterans were to be devolved to any province for any portion of care.
The government's experience to date is that there has been no problem in the quality of care that could not be solved through its relationship and its agreements with the contract facilities and the provinces. If situations arise where action is required we should let the existing system work, rather than begin the long process of working with the provinces to create a national system.
I am not saying that the system cannot be improved. There is room to do that. Veterans Affairs Canada has 75 contract facilities across the country. The department encourages all of its contract facilities to be accredited. Veterans Affairs Canada also recognizes and respects provincial standards of care and, to provide assurance that the level of care is meeting the health needs of veterans, works with the provinces on quality assurance issues. The department also monitors its own set of 10 outcome areas in its contract and community facilities.
This is the way to improve the system, through the agencies and authorities now in place and through the effective partnership that has evolved with the provinces in the delivery of health care to veterans. That is why we should continue to allow the work that is already under way to be refined and improved upon in the best interests of Canada's veterans.
The problem with the motion is that it involves complex issues and proposes a very simplistic solution. No one who has watched the evolution of health care across the country would say that there are simple solutions, especially when these matters involve both federal and provincial jurisdictions and both the private and public sectors.
In resolving these complex issues there are several constants of which Canadians can be assured. One constant is the good work and continued interest of veterans organizations. They have monitored the provision of health care for veterans very closely over the years. I can assure the House that if the health care delivery system somehow fails to meet the needs of our veterans, these organizations let us know it. They are very forthright in their views and they enable the health care system in this country to respond.
Another constant is the emphasis that Canadians, as a whole, place on ensuring that our veterans receive treatment commensurate with the gratitude we feel as a nation; our gratitude for the sacrifices of those who served their country so well in our fights for freedom and democracy.
A third constant is the importance that the Parliament of Canada places on making sure that veterans receive appropriate health care. Today's debate on the motion of the hon. member is one example. Another is the report done by the subcommittee of the other place, entitled “Raising the Bar: Creating a New Standard in Veterans Health Care”. This report provided input for a new residential care strategy by the Government of Canada.
Finally, a fourth constant in dealing with the complex issue of health care for veterans is the work of Veterans Affairs Canada. I will talk about the services the department provides in a moment.
First, I would like to emphasize that when it comes to actual delivery of the health care services there are many different forces at work. For example, within the health care system there is a shift toward primary health care that emphasizes early identification of problems or potential problems and taking a holistic approach to human health.
The results are a growing emphasis on home care. Veterans Affairs Canada has been at the forefront of this movement with its veterans independence program, VIP. This program was first put in place in the early 1980s and has evolved to meet the changing needs of veterans. Through VIP, clients are offered choices for services based on their needs. The idea is to permit them to remain at home or in their communities as long as possible. This program has been called one of the most comprehensive and advanced home care programs in the world and it may well set the standard for the delivery of health care services in the 21st century.
Another important shift in health care delivery in Canada is the aging of our veterans. This is one of the areas where Veterans Affairs Canada is making a significant contribution, not only to the health of veterans, but to our understanding of the ways to respond to the aging population. The department has been recognized internationally for its work in research and care giving. The department has been involved in a number of research projects and helps the government to make informed decisions on ways to ensure that the health system meets the changing needs of all Canadians.
Another change in the provision of health care in Canada is the shift throughout the country from a clinical model of delivering health to a residential model. Clinical care utilizes nurses as the primary provider of patient care. In a residential model the nurses and other health care professionals serve as team leaders and most of the direct care to the patients is provided by health care aides who are part of these teams. Veterans Affairs Canada, through its review of veterans care needs project team, has determined that this emphasis on residential care is in keeping with the principal needs of veterans. Clinical care is still available for veterans and it is maintained in the larger residential care facilities.
The motion of the hon. member for Edmonton East proposes national standards for residential care facilities agreed upon by the provinces. But given this complex and changing environment, I do not believe that agreeing on a set of standards is realistic. The environment is changing too quickly. We know that reaching agreements with the provinces takes time. By the time an agreement is reached the environment can change so much that the terms of the agreement are no longer applicable.
Moreover, the needs of Canada's veterans are becoming more urgent as these veterans get older. We need to act quickly to address veterans' needs, not wait to reach an agreement with the provinces. I believe that the federal government has taken a more effective course in using the processes now at our disposal to promote a high standard of health care in these facilities.
One of the most important aspects of the process now in place is the vigilance of veterans organizations. Where they have perceived that health care delivery has fallen below a standard they feel should apply to veterans, they have spoken out and the federal government has responded. For that reason, we have a process in place today which helps to ensure that veterans receive good care in these facilities. The process involves an annual review of long term care facilities. Staff of Veterans Affairs Canada, usually the area councillors and district office nurses, visit contract and community facilities. They speak to the veterans on a confidential basis. They ask questions designed to determine whether the needs of our veterans are being met.
The questions they ask involve 10 specific areas of health care that research has shown to be the most important for our veterans. Those 10 areas are: safety and security, food quality, access to clinical services, access to specialized services, medication regime, access to spiritual guidance, socialization and recreation, activation and ambulation, personal care, and sanitation.
This is an extensive list. It is a comprehensive list of the key issues that would likely be negotiated with the provinces if we were to try to establish a national standard for veterans health care. It is a list of key health care deliverables that are already being applied across the country, not as a result of an agreement with the provinces, but through the persuasion of Veterans Affairs Canada.
The hon. member has good intentions with this motion. He wants to ensure that veterans can receive quality health care at long term residence facilities, but it would mean a more complex round of negotiations with the provinces. It would become more difficult, not easier, to make any changes necessary to improve the health care provided to veterans. Such negotiations would delay the real changes that can be made now to improve residential care for veterans. There are already initiatives in place that will deliver the results we all desire, that is, quality health care for our veterans.