Health committee  The outcome measure, as you know, is a sort of holy grail of the health care sector. Outcome is very difficult to manage. We're going to have a better handle on it as soon as the last phase of our health electronic system is implemented. Then we'll be able to extract data to see whether or not we're making a big difference in hypertension, diabetes, and so on.

Health committee  Pre-deployment, everybody is screened to make sure they're both physically and mentally stable to be able to deploy. At every deployment there is a pre-deployment screening that includes a psychological screening.

Health committee  That would be a very difficult task. There would be an enormous increase. I would guarantee that. You just have to look at the U.S. TRICARE system. It is an absolutely enormous task.

Health committee  The physician assistant model started in the military in Canada. It's been in existence for over 40 years. It was a requirement that came strictly out of necessity. You could never send doctors everywhere. Ships have a small number of people. We couldn't send doctors there, and of course many of the army units are very far forward.

Health committee  I want to be clear when I say efficiency is going to go down with the collaborative model. That just means that you cannot churn through patients as fast. That doesn't mean you are providing good care. From an efficiency perspective, we just had our health care budget completely analyzed by government consulting services, and we actually came out per capita, per unit of service, actually more cost efficient than the civilian health care sector using the CIHI data.

Health committee  On the first issue about clinical psychologists, you're right that we do not have them, but we hire them as civilians. One reason is that the requirement to be in uniform is absolutely required for deployment. Because we have psychiatrists, mental health nurses, social workers, and padres on deployment, the unique acute care requirement of psychologists is lacking in the operational theatre.

Health committee  No. Number one, if somebody has some kind of illness, whether it's physical or mental, we have--

Health committee  My budget, the health service budget, is a corporate budget controlled by the senior leadership.

Health committee  The collaborative care model obviously is very in vogue today, and you hear about the PCR, primary care reform, basically everywhere you go in the health care sector. The collaboration in the military is nothing new. It's been in existence for much longer than it existed in the civilian system.

Health committee  Should I go first? You've identified a very clear issue in the transition from the military to the civilian sector. Obviously, as I stated in my opening comment, my mandate as the Surgeon General ceases the moment you no longer wear the uniform, so that becomes partly a Veterans Affairs issue, but the member then re-enters the civilian health care system.

Health committee  I would like to answer you in French, but this is official testimony. So with your permission, I will answer in English, to be sure that what I say is clear and exact. I very much appreciate that question. Obviously for that very specific reason, the Canadian Forces have their own military health care system.

Health committee  Good morning ladies and gentlemen and thank you for the opportunity to address the committee. I will begin by providing you a brief summary from the Canadian Forces perspective of issues surrounding health personnel and collaborative care that I understand are of interest to the committee.