Proceedings of the Subcommittee on
Veterans Affairs
Issue 2 - Evidence (evening meeting)
OTTAWA, Wednesday, November 28, 2001
The Subcommittee on Veterans Affairs of the Standing Senate Committee on National Security and Defence met this day at 5:47 p.m. to examine and report on the health care provided to veterans of war and of peacekeeping missions; the implementation of the recommendations made in its previous reports on such matters; and the terms of service, post-discharge benefits and health care of members of the regular and reserve forces as well as members of the RCMP and of civilians who have served in close support of uniformed peacekeepers.
Senator Jack Wiebe (Deputy Chairman) in the Chair.
[English]
The Deputy Chairman: This is the Subcommittee on Veterans Affairs of the Standing Senate Committee on Defence and Security. The name subcommittee means that the members on this committee are basically members of the National Security and Defence Committee of the Senate. The Senate committee has asked this subcommittee to examine some of the concerns of veterans affairs in Canada, especially as they relate to the report that the Senate made to the Department of Veterans Affairs a number of years ago, to determine how many of the recommendations contained in the Senate report have been adopted and carried through.
We have two presenters tonight from the Merchant Navy Coalition for Equality and from the National Council of Veterans Associations in Canada. I would like to begin by calling on Muriel MacDonald from the Merchant Navy Coalition for Equality to make the first presentation.
Ms Muriel MacDonald, Executive Director, Merchant Navy Coalition for Equality: Honourable senators, thank you for allowing me to speak to you today. I would like to introduce to you George Henderson, who is the chairman of the Merchant Navy Coalition for Equality. He was elected in May of this year. He is also president of the Canadian Merchant Mariner Association.
I will introduce Foster Griezic, Professor of Canadian History, Carleton University. He is the coalition's unpaid advisor and consultant. For the past 14 years, he has been rescuing Canada's forgotten wartime merchant navy history from misconception. He restored pride and recognition for merchant navy veterans.
In 1999, the coalition succeeded in changing legislation to include wartime merchant seamen under federal war acts. After 60 years, they have equal access with all veterans to reduced health care.
It is ironic that at their time of life, pre-conditioned by the wartime experience, their health care is at the crossroads where the illness of old age meets the crisis in medicare. Veterans Affairs, as the "third level of government" has no legal control over the decentralized, unregulated health systems of ten provinces and three territories. Health care for the general public and veterans is blurred. More veterans, because of age, are dependent upon medicare, and provincial extended care services.
Honourable senators, your subcommittee on veterans affairs does not report to the Standing Senate Committee on Social Affairs, Science and Technology. However, since December 1999, that committee has had the mandate to examine the status of Canada's health care system and the role played by the federal government in providing health care to Canadians. Health care constitutes a very real world for Canada's aged veterans and injured veterans who have returned from global conflicts who are also long-time tax-paying citizens. However, there is a fundamental roadblock as they attempt to present their case for fair and just treatment for health care, and it begins here.
The committee, led by Senator Michael Kirby, has close ties to the for-profit health care industry. He serves on a number of boards, including the one that overturned health measures introduced by Canada and other countries. Because of his vested interest in the following corporations, which creates an obvious conflict of interest, I am asking that Senator Michael Kirby step down from the standing Senate committee reviewing health care.
Senator Kirby is a director of Extendicare. In 1993, Extendicare deferred over $34.2 million in corporate taxes.
The Deputy Chairman: If I could interject, Senator Kirby is not a member of this committee, nor does this committee report to Senator Kirby's committee. I would have to rule any comments in regard to or with reflection on Senator Kirby as not acceptable. If you have a concern with Senator Kirby, it would best be addressed to him and/or the committee he chairs.
Ms MacDonald: I understand that he is not a member of this committee. Last year, in the last parliamentary session, he did sit on this Subcommittee on Veterans Affairs, and I have a recommendation at the end that includes recommendations that this subcommittee can make to the Standing Senate Committee on Defence and Security and to Veterans Affairs because medicare is in such a crisis.
The Deputy Chairman: The Senate Subcommittee on Veterans Affairs reports to the National Defence and Security Committee, which in turn, reports to the Senate of Canada. We do not have jurisdiction or responsibility to report to any other committee. For that reason, if you wish the Health Committee to hear that, I would suggest that you make that presentation to Senator Kirby.
I understand that there are some who have expressed the view that you express in your brief. However, I wish to point out that, as a result of some of the concerns that have been expressed to Mr. Kirby, he has made representation to Mr. Wilson, the Ethics Councillor, and I understand that you had an opportunity to examine his correspondence and their correspondence. We could provide that to you tonight, but the Ethics Councillor has said clearly that Senator Kirby does not have a conflict of interest.
If I may, I will read the senator's statements in the Senate as of Tuesday, November 27:
I received Mr. Wilson's opinion last week. Its final paragraph reads as follows:
No doubt the Committee's work, when finished, will have an important impact on the public debate about the Canadian health care system. But the report will not be binding on the federal government and, therefore, I do not find that you are in a conflict of interest.
This committee would like to hear some of the concerns that you have about the health care system, and we then, in turn, can make those recommendations to the Senate, at which time we will have an opportunity in the chamber to debate this.
Senator Kenny: I have been reading this document. This is a privileged forum where things are being said about Mr. Kirby, which I believe these people should say elsewhere, in a public forum, where Senator Kirby has recourse to the courts. This is absolutely inappropriate to be putting this forward in this manner.
Ms MacDonald: The information that you object to is from InfoGlobe's Report on Business database. That is public knowledge, I think. Everyone has recourse to the Infoglobe database. However, if you people do not want to think outside the box, to use that terrible cliché, that is fine.
Senator Forrestall: Slow down, Ms MacDonald. Do not accuse me or be level charges like that because I have plenty of things to do with my time this evening, as I do most days. If you have an axe to grind with Michael Kirby, then grind it with him. Do not grind him through us. You are saying that I am as bad as he is, in your mind. I do not think he has done anything wrong, and he made a statement, in any event, as the chair has suggested. This is the wrong venue. We are not the people you should talk to.
Ms MacDonald: I know people who have tried to get to speak before Senator Kirby's committee but have not had any success. For instance, the Canadian coalition on health care has not been able to make it. There was a good health care forum not too long ago, in 1995, 1997. I guess that was just tabled.
In any case, the merchant navy people want what most Canadians want, which is a restored medicare. They want primary care, which they cannot get. They want access to hospitals. They want convalescent care. They want long-term care. They want affordable drugs. I can refer you to page 6.
Among the coalition's recommendations is that the Senate focus on policy amendments that would improve national domestic health care and on existing trade rules.
One such area is prescription drugs. On average, prescription drugs cost Canadians over $1,000 a year. That is higher for seniors and aged veterans. Many do without medication. After Prime Minister Mulroney brought in Bill C-91 giving drug manufacturers a twenty-year patent protection, the cost of prescription drugs in Canada rose by 93 per cent from 1987 to 1996. I quote Matthew Sanger, from Reckless Abandon: Canada, the GATS and the Future of Health Care:
Since then the U.S. challenged Canada's system of compulsory licensing, arguing that prior to 1989 patent protection by pharmaceutical drugs was inconsistent with Canada's obligations under the Trade-Related Aspects of Intellectual Property Rights Agreement, TRIPS.Mr. Sanger said:
In September 2000 the WTO Appellate Body upheld an earlier panel ruling, which required Canada to increase the protection for patents for 20 years from the date of filing a patent application. Generic drug manufacturers warned that extending the term for these patents could cost Canadian consumers as much as $200 million in higher drug prices. Canada has not yet indicated whether it will extend protection for the patents in question, or face trade retaliation.I would like to go back to my original document that I gave to the clerk of the committee. I will discuss the problems that merchant seamen are having.
Ontario is Canada's largest populated and wealthiest province. It is an example of private for-profit over public health care. It foreshadows the kind of health care aged veterans can expect nationwide when medicare is gone.
What kind of health care will an elderly veteran or an injured veteran returning from endless rotational duties in global conflicts get? In the 1990s war against the deficit, National Defence Medical Centre, NDMC was severely downsized and patient care was compromised. It was learned through Access to Information that the military hospital was forced to close its operating room in 1998 because bacteria growth was making patients sick. It was reported in February 2001 how the military rents an operating room and five beds at the Ottawa Hospital's civic campus.
I have to tell you my father, who was 91 years old and flew in the Royal Flying Corps in World War I, died at the NDMC in 1992.
Starting in 1996, the Ontario government made huge cuts to health care, and that teaching hospital is one of the nine hospitals in Ottawa restructured under Premier Mike Harris. It has long waiting lists, overcrowded emergencies, a lack of beds, cancellations and reduction of services. According to Mohammed Adam's special report in the Ottawa Citizen, October 29, 2001, the other hospitals "are critically underfunded and lurching from crisis to crisis."
In Canada's capital, what are needy veteran's chances for long-term care? He or she must join another long waiting list. As a matter of fact, in the middle of this month, it was reported over 1,500 people were waiting for beds. If accepted, they should not leave home without bringing a relative or friend to take up the slack.
The Perley-Rideau Veterans' Health Centre was downgraded from a hospital to a charitable institution in 1996 by the Ontario government. It lost more than half of its $31.5 million annual provincial funding, 300 full-time jobs were cut and all the basic nursing care was eliminated. The same year, according to the Ontario Health Coalition media release of September 14, 2001:
...the province quietly removed two regulations that set minimum standards for staffing in facilities. One regulation insured that all patients had a minimum of 2.25 hours of care a day. The other forced facilities to have a minimum of one Registered Nurse on staff 24 hours per day, seven days per week. There are no legislated minimum standards any more.The Perley-Rideau is well examined in the Senate subcommittee.
What can people do? There is the Ottawa-Carleton Community Care Access Centre. It acts now as a transferral group. Its therapy alone went up $830,000 more every year than by public health staff. The Ontario government refuses to pay the extra bill. On November 8, 2001, the government announced in future it would appoint all boards to Ontario community care access centres. This will end community-based non-profit inter-agency cooperation. Paul Leduc Browne stated in "From Sacred Cow to Chopped Liver: Medicare in Ontario Savaged by Funding Cuts, Privatization," CCPA Monitor, September 2001:
In the drive to reduce expenditures and cut taxes, the Ontario government destroyed thousands of health care jobs and drove many health care workers out of their professions and out of the province...A comparison of public and private spending on health care in Ontario shows that expenditures have increased much more quickly in the private than in the public sector. Between 1980 and 1999, public expenditures on health care increased by 135 per cent - but private expenditures shot up by 333 per cent.If you consider Alberta, Premier Ralph Klein has taken privatization further. As you know, reliable non-self-interest reports in the U.S. and worldwide have documented that private sector involvement in health care does not improve the health care system.
I might also add that in 1999, the Auditor General of Canada, who reports to Parliament, flagged lack of accountability. He said Parliament cannot readily determine the extent to which each province and territory has satisfied the criteria and conditions of the Canada Health Act.
The crisis in medicare did not happen overnight but was done step by step in secrecy, without public knowledge or consultation. Over the years, various governments have changed the legislation, capped, frozen and ratcheted back provincial transfer payments below growth in the economy and substituted tax points as part of federal payment.
I refer to the monograph of former Liberal health minister, Monique Bégin, entitled, "The Future of Medicare: Recovering the Canada Health Act," which she presented at the Justice Emmett Hall's 2nd Memorial Lecture in August 1999. She states she is not sure that "- we can reopen the Canada Health Act...for fear of losing it all together. The opposition forces at play against medicare, although small, focused interest groups, still are, in my opinion, that dangerous."
It was reported briefly in the Senate's interim report, "The Health of Canadians - The Federal Role, Volume One - The Story So Far," where Ms Bégin is quoted as having suggested:
...that new legislation similar to the Canada Health Act be established to govern the use of new federal transfers. The new Act could include additional conditions, such as accountability and sustainability.The conditions Ms Bégin suggested in a new associated act could enforce public administration, now a dead letter in the five principles of the Canada Health Act. Of the five principles, public administration is crucial to the other four principles.
In her monograph, Ms Bégin was critical of the formal endorsement by the federal government on May 17, 1996, of the 12 provincial principles underlying the Alberta health care system.
Canadians do not know the extent of growth of the private health care business. In her monograph, Ms Bégin cited that the media had reported over 1,000 private clinics in Ontario alone and that taxpayers need to know why there exists such a trend, where it is taking us, and what are the rules applying here.
There is much talk of using premiums, user fees and higher taxes to save medicare. Aged veterans on fixed incomes cannot afford such measures. Will this mean further dispossession for veterans under a third level of government? I pointed out that Veterans Affairs, as a third level of government, has no control. It has been well pointed out by the Auditor General and others.
It is time the current unfair federal tax system is restructured and the abuses eliminated. There are a number of tax loopholes enjoyed by corporations and wealthy individuals, who never stop campaigning for lower taxes.
In 1995, the number of corporations paying no income tax whatsoever was 90,415. Statistics Canada reported that the combined profits of these corporations in 1995 was $18.5 billion. Two internal Revenue Canada reports obtained by Canadian Press under access to information revealed most business firms pay low tax no tax. Based on July/August CCPA Monitor information, it was stated that:
Almost two-thirds of all business firms in Canada with annual revenues of less than $15 million - as many as 716,000 of them - paid not a dime of federal income tax between 1995 and 1998. Neither did as many as 41 giant corporations with annual revenues of more than$250 million.
Among the big corporation subsidiary companies, 40 per cent of them - about 2,664 in all - were also completely tax-free.
One of the studies looked at federal taxes paid by Canada's banks and other financial institutions between 1996 and 1998. It found that in 1998 the total amount they paid in taxes to Ottawa dropped by an "astounding" $1.6 billion - a decline of 44 per cent
The sharp drop in tax revenue from the banks was attributed in the report to "aggressive tax planning" made possible by the "complexity of financial products, institutions and transactions."Honourable senators, I am not a tax expert, but it is not unreasonable that, for example, corporations making over $1 million in profit, paying little or no tax, could make an annual dedicated contribution of 1 per cent to health care, or they could contribute the amount of interest on deferred taxes granted by the federal government.
Veterans remember life without medicare and they remember life with medicare. Veterans from the First World War advocated for social justice. It was veterans from the Second World War who took up their cause of enlightened self-interest - a collective approach to social programs. All Canadians benefitted. I will quote from Mel Hurtig's book, The Betrayal of Canada:
When the federal government had a strong influence over the provincial administration of health care with all provinces participating, there was a notable improvement in the health of Canadians.Dr. Marc Baltzan, a past president of the Canadian Medical Association, summed up the situation as follows:
In a decade, 1974 to 1987, the annual chance of dying from illness and accident has fallen 2.5 per cent. The result is a massive life saving: 45,000 Canadians live who otherwise would be dead. This equals all the Canadian servicemen killed in the Second World War.He attributed the decline in death rates with the widespread introduction of major advances in clinical medicine with preventive medicine making a lesser contribution.
Morbidity reduction is another avenue. Implanted lenses, replaced hips and knees, angina relieved and so on, reduce the chance of death and improve the quality of life.Honourable senators, can we do any less for our veterans today and in the future? I will be happy to take any questions.
The Deputy Chairman: Thank you. I would like to use the chairman's prerogative to begin the questions.
The partners in the coalition of the Merchant Navy Coalition for Equality have about 2,000 members. Have you any idea of how many other merchant seaman veterans there are who do not belong to the coalition?
Ms MacDonald: That is like asking the Legion how many veterans do not belong to the Legion. I really cannot answer that.
The Deputy Chairman: The reason I ask that is the veterans of the merchant navy tend to be somewhat older than the equivalent uniformed veterans, and as a result, the need is probably there more for beds, nursing homes and chronic care institutions. Do you have any idea of approximately what percentage of the members of the coalition are now in nursing homes or in chronic care institutions?
Ms MacDonald: Professor Griezic can answer that because he has been consulting with Veterans Affairs on that.
Mr. Foster Griezic, Consultant, Merchant Navy Coalition for Equality: There is a real problem with the numbers that are available to us. We can simply go through the numbers that we come in contact with. If I can allude to the question that you asked earlier in relation to how many others outside the actual organization are around, I have always said that there are at least double or more outside the organization, which would be a comparable situation for the Legion concerning veterans in that organization.
The problem is that Veterans Affairs Canada does not have complete statistics either, and only in going through the last process of the legislation and the compensation did it find a number of additional people who were merchant seamen, in other words, veterans who would fit into the designation and qualifications that were established by VAC.
The real problem, as has been admitted by the individuals looking after health care for the veterans, is they simply do not know, and there is no simple concrete statistic that can be provided.
One of the problems goes back historically to the attitude toward merchant navy veterans. They have always been wrongly designated as civilians, which we all are. Even with the changes that were made in the legislation in 1992, they were in a halfway house as "almost veterans." They were still designated as civilians. Not until March 1999 did they get official designation as veterans. Even after that, Veterans Affairs Canada was sending out letters to civilians, and not veterans, with reference specifically to that.
It becomes difficult for us to say precisely how many there are, when Veterans Afffairs Canada does not know. All we can do is count how many we have in our organizations and others who are known about outside of the organization. I cannot be more precise.
The Deputy Chairman: That is understandable, but of the 2,000 that you have as members, I imagine that your organization advises them as to what is available, what is not available, what benefits are provided by the department, and which ones are not and so on.
Do you have an idea of those 2,000 who are under your care, if I can use that term, who are in nursing homes or chronic care institutions, or is that 2,000 figure pulled out of the sky?
Mr. Griezic: No, it is not. The difficulty is saying that they are under our care. As an association, we work freely. Unlike the Legion, which has paid organizers and so on, we do not have payment. This is done freely. I have been doing this for 15 years. It has cost me a great deal of money, but there was an injustice that had to be corrected. That has been done.
We do have a service officer, as an example, who goes into St. Anne's, Hospital and it is documented by the former Deputy Minister of Veterans Affairs that we had to get in touch with the deputy minister to get a merchant navy veteran into St. Anne's. We had to approach him to get the merchant navy veteran into the hospital to get the care he needed because they were referring to him as a civilian. That was corrected.
In 1998, for the very first time, I met a POW who is in our organization. I actually introduced him to our organization and he subsequently joined. It is an interesting story and I was going to make reference to him. He is now deceased, unfortunately. He received nothing from the government for all those years. There was not a penny from the government. I told Veterans Affairs Canada about him and within three weeks it started paying. At this point, he was in a home, and the family had to pay for that themselves. He died in 1999, the year after I met him.
That is the real problem. We, as an organization, simply try to bring them together, make them aware of what is happening - there is a quarterly that goes out to them - and tell them what is available and how they should go about doing things.
There is a further problem, even in this regard. I can point to cases specifically where merchant seamen want nothing to do with the government, as simple as that. Ever since 1945, any time they made any sort of attempt to have a dialogue to find out what was happening and what they could get access to - I could show you correspondence as well because I made photocopies from the archives; it does not matter whether it is from C.D. Howe and you can go up the line - these individuals could not get access to the benefits that their military comrades received after the war. They become frustrated. They gave up. They do not want to get anything. A black woman, now in Vancouver, who should have received compensation said, "I do not want anything to do with it," and there is nothing I can say to her. Perhaps you can, but I cannot because she does not believe that anything will be done for her. I do not know how you can change that mentality.
The Deputy Chairman: That is difficult to do.
Going back to the idea of the coalition, you mentioned that both of you are volunteering your time to work for the coalition, and your coalition is comprised of four organizations. Is one the Canadian Merchant Navy Veterans Association?
Mr. Griezic: No, it is the Merchant Mariner Association.
The Deputy Chairman: Is another the Canadian Merchant Navy Association?
Mr. Griezic: Yes, that is correct.
The Deputy Chairman: Is one the Canadian Merchant Navy Prisoners of War Association?
Mr. Griezic: That is correct.
The Deputy Chairman: Is another the Company of Master Mariners of Canada?
Mr. Griezic: It withdrew once we got both the compensation and the legislation.
The Deputy Chairman: Do any of these organizations or associations have paid staff?
Mr. Griezic: No, not that I am aware of.
The Deputy Chairman: You say that there is a difficulty for the Department of Veteran Affairs to be able to identify who is a civilian and who is or was a merchant mariner.
Mr. Griezic: That is correct, a member of the merchant marine.
The Deputy Chairman: How can that identity best be obtained?
Mr. Griezic: It is a simple process, and I can make a suggestion. It has to start with the Department of Transport. Prior to 1995, all records on merchant navy personnel were kept by the Department of Transport. At that point, Veterans Affairs Canada took over and transferred all those records to Charlottetown. There are original copies still available in the National Archives. It has records. It has copies of those records now, fully. There is no reason for not knowing how many there are.
There is a problem, however, in the definition of what constitutes merchant navy veterans, based on their activities and whether they sailed, during the war, in dangerous waters. We have always contended all waters were dangerous waters. Fishermen do not fit that category. It has been a problem to get Veterans Affairs Canada to closely examine the records to find out who its members are. I am simply saying that Veterans Affairs is responsible for them, rather than our organization because, with respect to these individuals, as Ms MacDonald has pointed out, it was the prerogative of the federal government. They were under the responsibility of the federal government during the war just as the military personnel were. They were under the Judge Advocate General of the navy. They were totally under admiralty orders when they sailed. They were told on what ships to sail, whether they were Canadian or not. It was a situation where the federal government had responsibility for them and the records that are there then transferred over to the federal government. It should have spent time on it.
You and I both know that there has been a problem with financing and the government has only recently balanced the budget and had the funds for doing things like this. We have advised the government that it must have personnel to examine those records, find out where the merchant marines are and who they are.
I can tell you again about the number of individuals that I found who were prisoners of war. I do not get paid for this. I am not with the federal government, and I have no family members involved in this. We have a situation where it is incumbent upon the federal government to find out where these people are. We certainly do our part to try and tell the government where merchant mariners are. I can cite specific examples where I have pointed the government to individuals and said, "Help these people as best you can. They are POWs." There are those who were not POWs but simply sailed on ships.
The Deputy Chairman: Is there a definition within the Department of Veteran Affairs as to what constitutes a merchant navy veteran?
Mr. Griezic: There is a definition, legislatively, by Bill C-61, which was passed on March 26, 1999. The policy practice has modified that. With the policy practices that were introduced once the payments were agreed to in the year 2000, there were some modifications to that definition, but basic definitions have been in place since 1999.
The Deputy Chairman: Is your association happy with that definition?
Mr. Griezic: Yes, we are, because we helped draft the legislation. For the first time, merchant navy personnel were involved in the legislation. It happened in 1997 when the offer was first made by the government for us to discuss the process of establishing legislation that would give merchant seamen equality with their military comrades. We applaud that greatly, because it is a giant step to finally recognize that. The government basically acknowledged, by not having done it previously, that there was historical discrimination practiced against merchant seamen.
Senator Forrestall: Having gone to sea for a number of years on oil tankers, people might think I know something about the sea. I know something about the men and women who sail on vessels. My son is a master mariner, and I was in the engine room of a number of oil tankers over a long period of time for that old Canadian company, Imperial Oil. That goes back to the 1940s and 1950s.
This is a fight in which I have quietly been engaged for 36 years. I knew thousands of men and women. There is only a handful left. In talking to veterans, you hear different reactions. I know merchant mariners who enjoy the full benefits of the description "veteran" and the benefits that flow under that. However, I know many more, as you have indicated, Ms MacDonald, who simply do not.
I ask explicitly: What services do these men and women require? It would help if the committee understood what is available, what they are getting, and could separate that from the question of what has to be done to give them easy access to benefits. I always liked George Hees' attitude: "For God's sake, if there is a doubt, give it to them." We solved a lot of problems in that short period of time. More problems were solved than were created. Could you help me with what is required?
Ms MacDonald: Their average age is 81 and the average age of POWs is 91. I have to go back and say that the line between health care for veterans as set out by Veterans Affairs -
Senator Forrestall: Can we deal with them one at a time? Health care in the Province of Nova Scotia and most other provinces -
Ms MacDonald: I do not know what it is in Nova Scotia.
Senator Forrestall: It is universal, as it is in all the other provinces, to the best of my knowledge.
Ms MacDonald: What I have read from the Canadian Centre for Policy Alternatives is that medicare is in crisis across the provinces. There is no accessibility. There is no universality flowing from one province to another any more. In Ontario, there is even difficulty getting into hospitals in Ottawa.
The line between health care for veterans and health care for the general public is blurred. What people of that age need is primary care because, as one veteran told me, "When you get old, your parts wear out." The family doctors of some veterans have died. However, veterans need primary care and access to hospital care when they need it. There are just more waiting lines. They need convalescent care, but there is no longer convalescent care. At one time Veterans Affairs used to have priority beds in public hospitals; that is gone.
They need long-term care, but in a regulated way. There have been a lot of horror stories about warehousing people in some of these long-term care areas. The Perley-Rideau Centre is an example. I have mentioned in my brief how the Legion has done much for them. However, you really must have a relative with you to take up the slack.
My late husband was a merchant seaman. In 1979, he had cancer and was in the Ottawa Civic Hospital. The provincial health minister at the time was Dennis Timbrell. Public hospitals could not have the mini malls that they have now to make a little extra money. All they could do was show was a few artworks.
You should have seen what was going on in the cancer ward. There were people crying night and day. The nurses were understaffed. Wives and relatives brought in fresh linen. I was fortunate enough to be able to pay for service and for nurses at night. Night is the worst time for patients in a hospital. That was 1979.
Senator Forrestall: Veterans need access to long-term health care, including palliative care and active medical treatment.
Ms MacDonald: We really must re-establish the five principles of the Canada Health Act. We must return to the 50:50 situation where the provinces paid 50 per cent and the federals paid 50 per cent. We need new financing. I hear that some people have advocated 25 per cent payable by the federal government. I would like to have some kind of bridge financing. That is why I suggested in my brief, for those making over $1 million per year, that there be some sort of a dedicated health tax on deferred taxes, some percentage figure as bridge funding.
Senator Forrestall: This is the first, the primary care area.
Mr. Griezic: With primary care, at least from the information that has been provided to me by Veterans Affairs Canada, there is the whole problem of long-term care, whether it is level 2, 3 or 4, then it is nursing care and then it is chronic care. You have the list of this. The major problem is that, as you know, there is only one hospital for veterans in Canada at this point. That is St. Anne's Hospital in Quebec.
Senator Forrestall: What happened to Camp Hill Hospital?
Mr. Griezic: Camp Hill Hospital provides for veterans, but it is no longer run by Veterans Affairs Canada.
Senator Forrestall: It has not been for a large number of years, you are right, but it does have a distinctive wing.
Mr. Griezic: That is correct, but to get that distinct wing -
Senator Forrestall: To stay with that for a moment, does not each province have a basic facility that dedicates part of its capacity to veterans?
Mr. Griezic: Some provinces are supposed to have these specific areas and they are supposed to be prioritized. There is no question of that at all. That does not necessarily happen, simply because of the availability of beds and everything else. If the beds are already taken, patients are not thrown out.
As an example, I have had difficulty finding out precisely, from the B.C. government, who is, in fact, there. Veterans Affairs Canada has admitted to me that it does not really know. It has a "guestimate."
We are in a bit of a bind as we try to discover for ourselves what is available for these people and where we can recommend to them. You then have to get a counsellor involved.That is a super thing, because counsellors can provide whatever advice is there that coincides with what Charlottetown is saying, whereas we cannot do that. It becomes very difficult.
I have a full list, provided by Veterans Affairs Canada, of the hospitals that are supposed to be providing access. Some of the centres are supposed to have one bed for veterans. How will we find that one centre when someone needs to be put in a bed? Will veterans travel all around Vancouver to find out where that one bed might be available? How will they know? That becomes a real dilemma for them.
There is concern about access to pharmaceuticals when veterans need drugs, if they do not have the Veterans Affairs card. Many of them are concerned because the cost of the pharmaceuticals is simply skyrocketing. Many of them are more concerned about that than about getting into a hospital because of the cost of drugs that they need.
Senator Forrestall: It is fair to say that there has been a changing attitude on the part of our government over the last several years. It has been slow and painful, but at least some measures have been taken, including the recognition that many of them were owed moneys. That has resulted in more seamen feeling a little more kindly towards their government than was the situation over many years.
What is next? You are putting emphasis on medical care. What about some of the other benefits that extend to veterans that are now denied because merchant mariners are not true veterans? What about all those Canadians who served on board Her Majesty the Queen's ships elsewhere? What about all those Canadians who served on that great fleet of American tankers and victory vessels? Have they been identified? Do we know their whereabouts?
I remember, over the years, small groups of people who got together because they identified as Canadians who went to sea, not necessarily under a Canadian flag, but who nevertheless served at sea. We found ways of identifying veterans in this type of situation. What about those people?
Ms MacDonald: In 1999 the legislation was changed. The various types are all included. They are all included in the War Veterans Allowance Act and some war legislation. Finally, in 1999, they were included under war legislation. They have the benefits that are covered under that legislation.
Senator Forrestall: What are those benefits?
Ms MacDonald: There is a war veteran allowance, which is assistance. Mr. Griezic should speak on the problem of getting disability pensions for merchant navy prisoners of war who were there about 15 months on average. The allowance stops at 36 months, which is ridiculous. Their pension stops. Mr. Griezic can better speak on that issue than I. That battle is ongoing.
Mr. Griezic: Basically, those who sailed on Norwegian ships or American liberty ships are included in the compensation and in the legislation. Ms MacDonald alluded to the real problem, which is that the benefits that were available after the war had been dramatically emasculated so that these people are getting access to benefits that have been cut down dramatically. It is not the best situation, but it is better than nothing for them to actually have access. Including those people is something that we have fought for strenuously.
Similarly, in relation to the individuals who were POWs, it does not make any sense at all. We have the Legion supporting us now and we have been fighting for this since 1988 and earlier. The push really began in 1988, when it became a question of how do you take away a pension from an individual who was a POW for 50 months? Suddenly, for some reason, the government said, "Oops, we will pay you only for 30 months of incarceration." What happens to the other 20 months for those who were incarcerated for 50 months. We must recognize that.
The government is at least talking about that issue specifically. As I said, fortunately, we have the Legion supporting us because it has members who are in that category as well. However, the merchant navy has the greater proportion of long-term POWs. They are cut off at 30 months and lose that additional 20 months. That is grossly unfair.
Senator Forrestall: They never had access to the Veterans Land Act benefits.
Mr. Griezic: That is right. As well, they never had access to the veterans' insurance, veterans' business loans and those sorts of things.
Senator Forrestall: Were they compensated for that exclusion?
Mr. Griezic: They have just recently been compensated. That was included in the ex gratia payment.
The Deputy Chairman: For my own information, how much was that payment?
Mr. Griezic: Do you want a breakdown? For the POWs, it was $24,000.
The Deputy Chairman: Are you saying that the highest level of compensation was $24,000?
Mr. Griezic: Yes, but you had to be a POW to get that.
The Deputy Chairman: I want to revisit something that we talked about before, but it is evident that there is a problem in identifying who is a merchant navy veteran. You made the suggestion that it is the responsibility of the department to undertake that. Do you have any suggestions to make as to how the department would go about identifying who would qualify as a merchant navy veteran?
Ms MacDonald: I do not think there has been any problem. When the compensation package was made known, many merchant seamen and women came out of the woodwork from all over the country. Bill C-61 identified who is a merchant navy war veteran.
The Deputy Chairman: I was under the impression that you had no idea how many merchant navy veterans there might be above and beyond your 2,000 members.
Mr. Griezic: There is no exact number. I am sorry if that was the impression. There is no precise number as to how many there are. As Ms MacDonald mentioned concerning the compensation, money does weird and wonderful things. There were all kinds of people who did not qualify at all who were outside of the bailiwick. There are other people who should have applied and did not, but certainly, we now have a much better idea as to how many there actually are. It is still not precise.
The Deputy Chairman: Are we aware of those who should have applied but did not apply? Is the department aware of who those people are, and if not, how do we go about making the department aware?
Mr. Griezic: The department is extending the deadline for applications.
Senator Forrestall: There were so many of them.
Mr. Griezic: We find these people and ask, "Did you put in an application?" They say, "Well, no, we did not, because we did not think we were going to get anything." You may have someone who was in hospital and did not know what to do about it. You say, "Send it in anyhow." The department is considering those applications.
At this point, the department is reviewing approximately 750. I cannot tell you precisely how many. Another problem we have is that the government will give us different statistics, partly because of their own certitude about the numbers. It gave me statistics a day before a specific meeting, and refuted them the next day. I was quoting statistics that the department gave me on the Monday, and on Tuesday, it said, "These are not correct. Another 13 should be in there." When I phoned the source in Charlottetown the following day to ask what was going on - it happened that I knew the fellow from university - he said that even the statistics that were given in the meeting were incorrect.
What are we supposed to do? It becomes a difficult situation for us to establish how many there are, what they are doing, and how we can access and help them.
The Deputy Chairman: I imagine that figure changes. It must be difficult to give you a precise number because, as you say, some who should have applied have not applied, and because the time is extended, new ones will be added. Because of their age, from 81 to 91, unfortunately some will pass away. I can understand that difficulty. Do you feel confident that the system is there to ensure that the identification of those who qualify will eventually take place?
Mr. Griezic: All we ask is that the department consult with us. Prior to 1997 no consultation took place. We had meetings. There was no recognition of the organization by the department, which created a tremendous hiatus where we tried to work on something and the department worked on its own and it basically tried to exclude the merchant navy.
One of the greatest victories for the merchant seamen was on March 1999 when the Dominion Legion Command finally agreed to support the merchant navy to become veterans and to get compensation. It had always said that it supported merchant marines, but I documented that, in fact, it had not. Since then, we have been working together. We had one meeting with the Legion in 1994, and it was because of a Parliamentary committee that it agreed to have the meeting because I insisted that the politicians use their position to get the Legion to meet with us. Ms MacDonald, unfortunately, was dealing with cancer at that point and was not able to attend. They said after that that there was no need to meet again with the merchant navy organization. We taped that whole thing.
The Deputy Chairman: In other words, it did not offer you a paid organizer to help.
Mr. Griezic: No.
The Deputy Chairman: You mentioned some of the health care concerns and problems that you feel are evident throughout Canada. Are you satisfied that the same level of nursing or chronic care is available to the veteran as is available to all Canadians?
Ms MacDonald: Did you say, "as is available to all Canadians?"
The Deputy Chairman: Let us consider, for example, myself. I am not a veteran. If I had go into an extended care home, would I be treated worse or better than a veteran?
Ms MacDonald: If it is a for-profit private home, you would be treated the same - but bring a relative with you, or somebody to take up the slack for you.
The Deputy Chairman: There is uncertainty, but I would like to have an idea as to what length of time a veteran must wait when a need arises for availability for a bed. I imagine the statistics that we should use are those that apply to the medicare system right across the country. Is that a fair guess?
Ms MacDonald: That is a fair guess, yes.
Mr. Griezic: It is not much better because some of them will have to wait longer. It is really a "catch as catch can" situation for them. They are supposed to be given priority. They are supposed to be, and I stress that. That does not always happen, and that is admitted by the provincial governments and by Veterans Affairs Canada. That should not happen.
The Deputy Chairman: We have spent the majority of our time talking about health issues as they relate to veterans, and that is important when you are of the age that our veterans are today. Health care is certainly number one. Are there any other areas that are not related to health that we should examine in terms of the needs or the requirements of veterans, other than health? Have they been treated the same as other veterans who were not merchant navy veterans?
Mr. Griezic: They have since 1999. There has been an attempt by the department to give them the same treatment. That has only happened because we have consistently confronted it with the need to treat merchant seamen in that fashion. There are suggestions that can be made, which are pertinent to the point you have raised.
I mentioned one particular family, but there are other spouses who have lost their husbands within the past year or two. Most are in their 80s. I suggest that the committee consider recommending to the department that those spouses have access to the full care that their veteran husband would have received. I suggest that for a number of reasons. The spouse, as you know, does not have the financial backing that a male has. The widow could need glasses or hearing aids. There are two cases in B.C. where I know specifically that assistance is required for new hearing aids, but these people are not assisted with that at all.
You and I both know that, frequently, the women end up in the same age bracket. They need home care. They need someone to come in and help them with their homes. They can depend on family, but I do not think they should have to. They have been with their spouses, their husbands, now deceased, perhaps for 50 years. Suddenly they are left alone, and they have to do the cleaning themselves in their houses. Why should it not be open to them to have someone come and shovel the snow, if they are here in Ontario, or do the housecleaning or whatever they need, or help with the rains if they are in Vancouver, to assist those people to have a better life? They will not last much longer. The cost is negligible because of the small numbers involved.
The Deputy Chairman: Are you advocating that on behalf of all veterans' spouses, or just merchant navy spouses? Is that a treatment that is now afforded to other veterans?
Mr. Griezic: No, it is not. As we have done for the military veterans who were long-term POWs, because there will excess left over from the compensation of approximately $6 million to $8 million, we have suggested that the money that is left over be used to provide for the full-time based compensation, which would include the military veterans. Our organization has recommended to the department that it do that. It will only cost the department approximately $3 million to do this. That money is there for the merchant seamen. We have been fighting that cause for some time. The department has admitted that it is possible, because of what happened on September 11, it is now afraid of other costs coming into play. That does not make sense to me. That money is there; it can be used positively, so why not use it?
We ask this committee, if it can, to recommend to the department that it provide for that extra funding, with full-time based compensation, for all personnel. As I have said, the Legion supports it, as does the national POW association. That should happen.
The Deputy Chairman: Thank you for the time you took to spend here tonight. You have made some excellent points.
Could I have a motion that the material that was presented to us tonight, on behalf of the Merchant Navy coalition, be filed as an exhibit with the committee?
Senator Kenny: I am uncomfortable with the statement, chair, so I have difficulty with filing that with the committee.
Mr. Griezic: I would like to know specifically what is objected to. I know what the differences are, and I have no problem with that. What specifically creates the split for not accepting it?
The Deputy Chairman: We will adjourn for five minutes and I will be more than willing to discuss that with you.
I will now welcome witnesses from the National Council of Veterans Associations in Canada. We have someone who appeared before our committee earlier in the year and, at that time, we mentioned that if he thought of anything afterwards we would welcome him back. That is Mr. Clifford Chadderton.
Welcome to our committee once again.
Mr. Clifford Chadderton, Chairman, National Council of Veterans Associations in Canada: Mr. Chairman, I have filed with the committee a brief that I do not intend to read, and neither will I make any comment on that brief. It was produced at a recent annual general meeting of the 39 veterans organizations for whom I speak today.
The impression I received was that the committee really wanted to talk about issues arising out of the committee report, "Raising the Bar: Creating a New Standard in Veterans Health Care." There is only one main issue, and that is, of course, long-term health care. It is an issue that we have discussed before the Senate subcommittee on a number of occasions.
I am very conscious of the discussions going on in the media at present regarding long-term health care, and I am also conscious of the fact that this is partly a provincial responsibility. I intend to direct my remarks, however, at what I consider to be the federal responsibility in this regard and get right to the issue, to provide senators with whatever time you might want to take for questions. I draw your attention to this document. These figures are up to date as two days ago.
On page 2, we have listed the major institutions where veterans are provided with long-term care. This was the figure that I gave to the committee the last time I appeared, about a year ago. We expressed serious concerns about long waiting lists for veterans who have entitlement under either the departmental health regulations or under the Canadian Pension Commission.
On page 1 the situation is described as it exists today. I draw your attention to the fact that a year ago the waiting list figure for the major institutions was at 677. The waiting list, as of this week, has risen to 814, which is the clearest indication I can give to your committee that somewhere along the line a battle is being lost.
I am not here to point fingers, but there are a number of provisions under which entitled veterans can and should be provided with long-term care beds. The first category would include those who require this for a pensioned condition, such as a gunshot wound illness and that type of thing. The second group would be those who are entitled by reason of income qualification. In other words, what we call war veterans allowance is provided for people who, for various reasons, are unable to subsist on their own income.
There is a third category, and I would pay great respect to the government for having developed it, called "Near WVA." I get smiles when I hear that, but some people with an accumulation of very small industrial pensions, war veterans allowances and old age security pensions are below the poverty line. Consequently, Veterans Affairs can admit them as a third group to long-term care beds. The fourth group is the overseas veterans, who are entitled to long-term care beds provided they can meet certain income qualifications.
The dimensions of the problem have not changed. I refer to the report of the Auditor General of Canada, who has said that there are approximately 50,000 to 60,000 veterans who are in any one of these four categories. The bed space for which Veterans Affairs Canada has what they call a "priority access" is somewhere close to 9,200. Therefore, we are quite a long way from being ready and able to provide long-term care for the people for whom this Parliament has passed legislation.
We have attempted, over the years, to develop some form of remedy for this. The remedy is quite clear. We have been in touch with almost all of the provincial governments, with the exception of Quebec, which has not been a requirement because there is no real problem in the Province of Quebec. However, we have been in touch with provincial governments that are responsible for long-term health needs and they are all operating, in one way or another, under long-term agreements with Veterans Affairs Canada that have ceiling limits.
How could we go about solving this? If the agreements between Veterans Affairs Canada and the various provinces were renegotiated, it would open the way for the provision of long-term care beds for entitled veterans in what is known as "community hospitals." With regard to a budget item, it is important for the committee to know that no new legislation is required to provide extra beds within the orbit of each province. The health care regulations provide that, if an entitled veteran goes into a long-term care bed in an institution that is under provincial control, the Department of Veterans Affairs budget provides that it can pay $150 per day over and above what the province provides for these beds.
Provided that beds are available - and that would be a problem to be decided with the provinces - it is a simple matter of mathematics. If we consider Halifax as an example, there are 130 veterans on the waiting list in Halifax - 114 for Camp Hill Hospital, which is well known to all of us, and 11 for the Soldiers' Memorial Hospital in Yarmouth. What can we do to provide beds for those 130 people?
At the moment, under the legislation and the contracts that have been signed by Veterans Affairs and the province, the number of beds that can be made available, where Veterans Affairs would pay the additional $150, has a ceiling to it. That ceiling is artificial. I am certain, because we have spoken recently, that the director of the hospital in Yarmouth would be very pleased to set aside a priority access bed for a veteran - I do not mean to put him into the bed, I just mean to put him at the top of waiting list. The hospital would be quite prepared to do that if $150 of the cost for the veteran's "incarceration," if I can use that term, would be provided under federal legislation.
However, the bureaucrats and perhaps the political masters of the department have said, "No, we will put these various ceilings in each of these provinces." With regard to priority access beds, there would be a requirement for Veterans Affairs to renegotiate the agreements with the provinces - perhaps by taking away the limits altogether, I do not know. However, at least the number of beds that could be made available on a priority access basis for entitled war veterans must be increased.
Frankly, I am puzzled by the fact that there is any problem at all. I have been involved in Parliamentary committees for many years. Senator Kenny may remember my association with Mr. Gordon Blair, which goes back about 30 years. I am puzzled by the fact that some of these beds are empty. I am puzzled by the fact that we have 814 entitled veterans. Could I ask Jean McMillan what the average waiting time is? I think it would be important to know that.
Ms Jean McMillan, Assistant Director, National Service Bureau, National Council of Veterans Associations in Canada: The average waiting time in many facilities can be up to two years, which is very intimidating for our veterans and their families.
Mr. Chadderton: It would not be less than 30 days in most cases. Here we have the problem of 814 entitled veterans who have medical certification that they require beds. In many cases, the beds are available but the province is asking, "Why should we give the veteran a priority over and above the non-veteran?" The only reason the province may want to do this is that the federal government has access to funding of $160 a day. We all know that funding for long-term care - it is in the media today - has been a real problem for us.
What we are suggesting is that the veterans are being denied access to long-term beds that are available because of the agreements between Veterans Affairs Canada and the various provincial departments of health. If that is a problem, I would be very surprised. I have talked to many provincial health officials in my travels - and I will be seeing some in Alberta next week - who say, "The big problem is funding," and I say, "But it is not for veterans' beds." You could put a veteran into a bed in Swift Current and, instead of getting $185 a day from the Saskatchewan government, you would get that amount plus another $150 per day from the federal government. That is the number one conundrum that I would say is facing us.
I should explain to you that I have put this problem to both the former Deputy Minister, Mr. David Nicholson, and to the present Deputy Minister, Admiral Larry Murray. We have also placed it before what is called the Gerontological Advisory Committee, which is a committee in Veterans Affairs, but so far we have not seen anybody prepared to move on it.
The Deputy Chairman: Thank you very much, Mr. Chadderton.
Senator Forrestall: If I could ask for a quick clarification: you mentioned the Soldiers' Memorial Hospital in Yarmouth, Nova Scotia, but are you sure it is not in Middleton?
Mr. Chadderton: Yes, you are quite right, the hospital in Yarmouth is the one I was speaking of. Was your figure for the Soldiers' Memorial Hospital?
Ms McMillan: Yes.
Mr. Chadderton: I am sorry. That was my error. I stand corrected.
The Deputy Chairman: I will start with a question of clarification. There is only one veterans hospital in Canada - in Quebec - that is being run by the Department of Veterans Affairs. The arrangements for veterans' beds are made with provincial governments in provincial hospitals.
Mr. Chadderton: That is correct.
The Deputy Chairman: Say, for example, that the Department of Veterans Affairs makes an agreement with the government of Saskatchewan that 150 beds would be made available to veterans. If one of those beds becomes vacant, then would a veteran who was halfway down the list be automatically brought up to the top of the list to go into that bed?
Mr. Chadderton: That would not happen at the moment.
The Deputy Chairman: If there are 150 designated veterans beds, and there are veterans waiting but not none of them is at the top of the list, would someone who is not a veteran then occupy a veteran designated bed?
Mr. Chadderton: Yes, that is correct. For example, in Regina, the waiting list at Wascana Hospital for the designated veterans beds is 23 veterans, as of this week.
The Deputy Chairman: Do you have any idea how many in the designated veterans beds are not veterans?
Mr. Chadderton: There are 23 veterans waiting, and there are approximately 160 designated veterans beds in Wascana. Deer Lodge Hospital is another example.
The Deputy Chairman: I am surprised by the answer and it bothers me. For example, if there are 100 designated beds in Wascana, I can understand if a bed becomes available and there is not a veteran waiting for it, that it will be filled by a non-veteran. However, if there is a designated veteran's bed and there is a veteran on the waiting list below someone who is not a veteran, I would think that the veteran would automatically have access to that bed. Is that the way it works?
Mr. Chadderton: That is quite correct. In Wascana, there are 23 veterans on that waiting list for that empty bed.
The Deputy Chairman: The fact that there is an empty bed means that a veteran, if on the waiting list, will get that bed.
Mr. Chadderton: No. In the first place, there are no empty beds. They are always full.
The Deputy Chairman: Not necessarily. If a bed is vacated because the patient has died, there is an empty bed. We have agreed that there will be 100 designated beds for veterans and there are now 99 veterans in that hospital, in 99 beds. However, there are 10 veterans on the waiting list and above those 10 veterans are another two non-veterans. When that veteran's bed becomes vacant, does the person at the top of the list fill the bed, or does the first veteran on the list fill that bed?
Mr. Chadderton: If it is a priority access bed, there could be 10 people who are non-veterans and another 10 who are veterans. The non-veterans will wait and the top person on the veteran's waiting list, which is 23 for Wascana right now, will be taken off that list and provided with the bed.
The Deputy Chairman: Suppose there are three veterans on the waiting list and there are 10 non-veterans ahead of them, in priority. If there are 10 empty beds - and there are only 90 veterans in the 100 designated beds - does that mean a non-veteran can move into those designated beds? Is that correct?
Mr. Chadderton: Yes, because part of the agreements signed between Veterans Affairs Canada and the institutions provided that if there were empty beds, they could be filled by non-veterans. However, if a vacancy occurred, and there were veterans on the waiting list, then the veteran would take that empty bed.
The reason for that is quite simple: You do not want to deny a long-term care bed to a civilian simply because there was no veteran available to fill it.
The Deputy Chairman: If there is a veteran available to fill that bed, and there happens to be a civilian on the list above that veteran, the veteran still gets the bed.
Mr. Chadderton: Yes, that is correct.
Senator Forrestall: That would be simply because there are other hospitals beds dedicated to the non-veteran, to which the veteran would not necessarily have access.
Senator Kenny: Mr. Chadderton, it is good to see you again. I would like to ask a couple of questions to put things in context.
What percentage are we talking about in terms of total number of veterans who are in long-term beds, as compared to the waiting list?
Mr. Chadderton: We have about 92 veterans in two kinds of departmental beds, some of which were designated as being part of a former institution, or a new institution that has been built, such as the Perley-Rideau Veterans' Health Centre in Ottawa. There are other designated beds, for example in the Ottawa region catchment area, such as in Smith's Falls. The total would be in the order of 150 beds in the Perley and Rideau and perhaps another 150 in the region, with five of those beds being in Smiths Falls and so on.
Senator Kenny: Let me rephrase the question. In Canada, as of the date of drawing up this list, there were 814 veterans waiting for beds.
Mr. Chadderton: That is correct.
Senator Kenny: How many veterans were there actually in beds on the same date?
Mr. Chadderton: There were 9,200 veterans in beds.
Senator Kenny: In terms of growth, does the rate stay fairly consistent, or does it fluctuate from day-to-day or month-to-month?
Mr. Chadderton: I am glad you asked that question. Five years ago, we brought to your attention the issue of the phantom veteran. We know he exists, but we have no record of him. However, he served in World War II. He is back in Canada now. There is no doubt that, if he continues to live, he will require a long-term care bed and so, that is how this nebulous figure of 50,000 from the Auditor General came down the pipe.
We do not really know how many there are, but I think I would answer your question this way: We told this committee four years ago that there is a crisis hanging over our heads. It is not here now because we are able to find ways and means of finding beds for veterans or of giving them the veteran's independence allowance so that they can remain in their own homes. However, we pointed out that situation will not continue. The crisis will only get worse. That is why we bring these two figures to the attention of the committee today. It has worsened, from 677 to 814 in one year.
Senator Kenny: You must be psychic, Mr. Chadderton, because you are answering my third question. My second question was: Between last year and this year, has the change been relatively straight-line, or is there a significant variation from day-to-day or month-to-month?
Mr. Chadderton: It is from month-to-month, according to the records. It is a significant figure when the waiting list number provided by Veterans Affairs Canada was 677 and today it is 814.
Senator Kenny: I am asking if it went from 677 to 814 and then down to 700 again? Does it jump around?
Mr. Chadderton: No, not at all. There may be peaks and valleys, but it is in an upward climb.
Senator Kenny: In terms of the demographics of this group - and I think you were about to answer this a moment ago - how predictable is the upcoming demand? Is there a bubble involved? One would assume that, at some point, we would see it tapering down as opposed to increasing. However, there might have to be a bubble first before we see that tapering down.
How good a grip do we have on the demographics and what will be the demand?
Mr. Chadderton: Veterans Affairs has a good grip on it because its statistical records are now of such calibre that with a fair degree of certainty it could say that if the figure was 600 a year ago and it has climbed to 814, by this time next year it will be at least 1,000 and maybe more. It is very simple for Veterans Affairs to divine that figure because the average age of the veteran of whom we speak is 81. Naturally, the only solution for diseases that accompany aging is long-term care beds or death. That is why we have been trying to tell the Department of Veterans Affairs not to wait until this problem reaches crisis proportion.
I will go back in history briefly. This did happen with regard to applications for war disability pensions. Former members of this committee saw the crisis developing. As a result of that, with the assistance of reports from this committee, the department developed what is known as "pension reform." It cut the time down from three years to eight months to get a pension through. We are considering the same situation here.
I am not talking about pensions, I am talking about a solution to the problem, which is long-term care beds. In my opinion - and I will not mince words - I believe that the Department of Veterans Affairs has studied this to death. It has considered the issue and the reports are available. It has had a gerontological advisory committee from which, incidentally, all the veterans' organizations resigned just today. In so doing, the veterans' organizations decided that they could not depend on a bunch of academics to tell them what is the problem.
The problem is there and the district offices know the problem. I would think that the time has come for Veterans Affairs to examine the real results of its "bed studies," as it calls them, and then examine the figures and claim that it does not have a solution. The solution is there. If the provinces did not have the beds I would say there is no solution, but we know that, although the provinces do not have thousands of beds and certain provinces institutions have been closed, beds are available but they are being denied to the veterans by reason of a contract that has an artificial ceiling.
Senator Kenny: I am still on context questions, Mr. Chadderton. I know that the province has designated veterans as being especially deserving, but can you give us assistance in comparing the waiting lists for non-veterans for long-term care beds?
Mr. Chadderton: No, I cannot. I can simply say that where an institution was built partly with provincial funding and partly with federal funding - I can quote two examples: Broadmead, which is near Victoria, British Columbia, and the Perley-Rideau Veterans' Health Centre in Ottawa - the agreement that was drawn up between the Department of Veterans Affairs and the provinces provided that certain beds would be priority access beds for veterans and the rest would be available to the community.
Senator Kenny: Quebec is different. Can you tell us why?
Mr. Chadderton: Yes. I have been watching this carefully. Veterans Affairs had the political will and probably reasons to get out of the hospital business. That goes back to 1953. The one hospital that was retained was St. Anne's Hospital, near Montreal. That was retained because Veterans Affairs could not come to an agreement with the Province of Quebec as to what improvements would be made, et cetera. Consequently, just recently, the federal government has agreed to build an extra wing.
The reason there have been no problems in Quebec is that Veterans Affairs has retained St. Anne's Hospital and, therefore, it is a veterans' hospital. If there is a waiting list, the Veterans Affairs people will go to the community and ask if veterans would rather stay at Saint Anne de Beaupré or be moved into St. Anne's Hospital. In most cases they will choose St. Anne's Hospital. In some cases they may take a community hospital because in the Province of Quebec the Department of Veterans Affairs has the ability to absorb a large number of veterans. I believe Quebec has 2,600 beds.
In Toronto we have the George Hees Wing and Kilgour Wing, which are part of Sunnybrook & Women's. They are operating, but the problem is that the agreement under which the old Sunnybrook Hospital was turned over to the University of Toronto for management provided that there would only be a certain number of beds available for veterans. The university wanted to develop Sunnybrook as a teaching hospital, not as a long-term care institution. That is why we have waiting lists in Toronto. Some people say Sunnybrook Hospital is there and it is huge, but it is also a huge catchment area. I believe we have a waiting list for Sunnybrook also.
Senator Kenny: If I understood your earlier testimony, the system is working correctly inasmuch as when a bed becomes vacant, a veteran can jump the queue and move into the bed if it is a designated bed.
Mr. Chadderton: Absolutely.
Senator Kenny: Where the system is not working properly, in your view, is that while there is $150 per day federal incentive, the Department of Veterans Affairs, for reasons unknown to you, is not making that money available to the provinces in sufficient quantities. It has arbitrarily, in a way not contemplated by the legislation, capped the amount of money that it will pay to each province.
Mr. Chadderton: I have just one slight correction, Senator Kenny. It has capped the number of beds that will be designated as priority access beds in community hospitals. That amounts to the same thing. The other problem is that if a province suddenly declared that, for example, in the Smiths Falls Hospital instead of 12 beds there will be 24 beds allowed, then the district office of the Department of Veterans Affairs could put another 12 veterans in that hospital.
Senator Kenny: I am not an expert in hospital economics, but if the hospital in Smiths Falls is able to collect an extra $150 from the federal government on top of whatever it gets from Queen's Park, does it not almost become a profit centre, and would it not be in the interests of that hospital in Smiths Falls to add beds on its own?
Mr. Chadderton: Whether it would be profitable to add beds, if you mean bricks and mortar, I do not know. However, I do know that hospital managers are operating on tight budgets these days. If they get $200 from Queen's Park for a bed, but for having a veteran in that bed they could get $350 in total, it stands to reason that the hospital manager would be happy. It also stands to reason that the people in charge of the financing at the province level will also be pleased. It would mean that there are extra beds that are filled where the hospital is getting an extra $150 per day.
That is why I said, Mr. Chairman, that this is a quandary. I do not pretend to understand it because it is a matter of changing the agreement between the province and the federals and allowing for more beds to be priority access beds, which would allow DVA to put some of our 814 veterans into those beds.
Senator Forrestall: First, to make a correction: it is never a matter of a veteran jumping the queue. The veteran is simply moving into something to which he is entitled.
Mr. Chadderton: That was bad wording on my part.
Senator Kenny: No, it was my bad wording.
Senator Forrestall: I just wanted to correct the record. I do not want people to think that veterans jump the queue.
We know that last year there were some 9,000 people on the waiting lists spread over those four categories who are looking for places. They are all eligible and sooner or later we must deal with them. I am interested in when the upward curve hits the top and starts to come down.
Since the Halifax Herald started flagging veterans' deaths in Nova Scotia, the interest in veterans affairs has soared enormously. I have had dozens and dozens of calls and letters. I do not know whether other major newspapers do that, but it certainly indicates how quickly we are losing our veterans.
I am interested in when the upward curve hits the top and starts to come down. When will we hit that plateau? At present the number is 814. Do you think that in five years it will go to 4,000, 5,000 or 6,000?
Mr. Chadderton: The quick answer is: That will not be too far off, say two to three years. If my memory serves me correctly, the estimates in the report by the Auditor General were based on actuarial studies. That is the only factor you have because, in the first place, these people were all physically fit. They do not fit into the normal pattern of aging for people who did not, on enlisting, go through a medical procedure that indicated they were all right to put on a uniform.
It will probably be three to four years. There have been three studies on this, and I have taken the average of the three studies. I have also taken the figures that the Auditor General's representatives presented to Mr. Forbes and me when we had a meeting one time. I hesitate to use the word "crisis," but I estimate that we are three years away from a serious crisis when the average age of the veteran reaches 85.
Senator Forrestall: Would that crisis last another two to three years? My understanding of the study was that we would begin to see the crisis - it has been a long time since we examined that - and once we hit the plateau, we might expect it to continue for another two to three years.
Mr. Chadderton: Yes, it will continue until 2010.
Senator Forrestall: It would be 2010 before the curve started to come down. It would continue coming down until it started engaging the Korean veterans, peacekeeping veterans and so on. During the crisis period, how many more beds do you think we may need?
Mr. Chadderton: I believe my paper projected close to 10,000.
Senator Forrestall: Is that new beds?
Mr. Chadderton: That is not newly built beds, but new beds.
Senator Forrestall: That is available beds.
Mr. Chadderton: Yes. If I could add that if I am going to make a mistake in something as serious as this, I would rather make the error on the side of caution. It may only be 6,000. On the other hand, it is not as if we are building new billets. The beds will be there and they will be used, but we will be giving a priority to veterans. That is why we are before the committee.
Senator Forrestall: What about those who attend these people, such as caregivers, doctors, nurses and technicians that do X-rays and take blood? We are coming into a jam already and in two to three years we will be hitting a crisis. How many new doctors will we need? Have you had a chance to consider that? I do not recall any studies, but I am sure this aspect has been examined. Can you enlighten us on that point?
Mr. Chadderton: Of course. That is why provincial health authorities have said to us during discussions:
If Veterans Affairs is going to come along and ask us to provide another 2,500 beds in the Province of British Columbia, please do not expect us to do that with a flick of the wrist, we have to increase our training potential for caregivers.While sitting on the Gerontological Advisory Committee I learned a lesson, which is that we do not necessarily need very highly skilled people. We need people who are properly motivated to be caregivers.
You have put your finger on it. I may have given the impression - as a matter of fact, I did - that maybe a stroke of the pen would solve the problem. A stroke of the pen, meaning a new agreement between Veterans Affairs and the provinces, would open the way. The provinces would have some lead time because they must train more people.
We have had the situation in this country where beds have been closed because there was not properly trained staff. I know that our confreres in the Royal Canadian Legion, when they were before you, were very concerned about the level of care. That is why I have not touched upon it. This committee is well versed in that.
As a matter of fact, part of this committee made a trip across Canada and observed this. You do not cure the problem of the level of care in a minute or two. What I am saying, Senator Forrestall, is that nobody will move with this artificial ceiling. I am convinced of that.
I have seen no movement in the four years since we first put our big report before Senator Phillip's committee that went into "Raising the Bar: Creating a New Standard in Veterans Health Care," which went into Veterans Affairs for study. The only movement we have seen, to be fair, was when Mr. George Baker was the minister and he attended the convention of the Royal Canadian Legion in Halifax a year and a half ago. He said, "We are going to provide another 2,600 beds." I think that requires qualification. That did not mean another 2,600 beds would be built. It meant exactly what I was suggesting to this committee: that Veterans Affairs was willing to sign an agreement with the Province of Nova Scotia that there would be another 2,600 priority access beds for veterans. It was put to me that we were on the right track.
Senator Forrestall: That is 2,600 in that part of the world.
Mr. Chadderton: Yes, although I do not think it was specified.
Senator Forrestall: Senator Johnson, before he left, was wont to - and did - take me aside on many occasions to talk to me about housing. He was using that as a generic term for accommodation, of course. One of the last things that he said to me was: "For heaven's sake, do not let the work that Senator Phillips and I have started end. Keep it going."
I think we are targeting it, but we are not a rough group at all. We have intentions to do something about it, because the lessons are there. Senator Phillips and Senator Johnson and others who participated, through to Mr. Lawless, have left us with quite a set of instructions and directions. I am sorry that our chair is not here because he would have been working from that document.
In any event, that is the first part. In addition to caregivers who do not necessarily have palliative care training, what are we to do about palliative beds? How do we separate that kind of bed, or should we? Should we leave veterans with their colleagues? What should we do?
Mr. Chadderton: I believe that, when it reaches the stage of palliative care, it is a problem that we can safely leave in the hands of the institution providing care because that includes various levels of care to the level we are talking about now, which is long-term care.
The next level is palliative care. What normally happens there depends on the institution. It may send the patient to a hospital where he can be cared for with additional pain relief and facilities to help him in his final days.
I want to keep this very simple. I want to say that we are really talking here about long-term care beds. What happens next? He may be there seven days or he may be there seventy days and then he is gone, but this is quite a problem.
Let me add one other thing. I was at Broadmead in Victoria just a week before Senator Phillips was there. I recognized immediately the approach that the administrators were going to take and it was this: Would it not be wonderful if we had nice gardens here for these people to come out in the sunshine and if we had all of these extras that go along with expensive long-term care beds? I think, Senator Forrestall, that is probably not a realistic dream.
If you know Sunnybrook Hospital well, as I do, there is a garden where people can go in their wheelchairs, but that is it and that is all they will do. A hospital like Deer Lodge is completely surrounded by buildings. It is very nice but you will not make a Broadmead out of it. Broadmead is the cream of the crop.
I would hope that the need is very apparent: The need is a bed with a decent caregiver and a decent level of care. I am not suggesting that the level of care is satisfactory, by any means, but I am suggesting that if you do not have a bed at all then you are not getting anywhere near solving the problem, sir.
Senator Forrestall: I hesitate to get into any other areas. We were just talking with some people who expressed concerns about merchant mariners. Do you feel comfortable that those folks, for example, might be included on your waiting list? If I were to go down through those lists, would I find a merchant seaman or two, who are there because they are veterans?
Mr. Chadderton: No. It would be an inconsequential number, sir. Once they attained the status of veteran, they went into the figuring that Veterans Affairs was doing. They certainly could be included here on waiting lists, but they are veterans. I do not think there is any specific problem that affects any one specific group of veterans, except those of female gender.
Senator Forrestall: Is that right?
Mr. Chadderton: Yes, sir. I spent some time with the Nursing Sisters' Association of Canada in Charlottetown two and a half years ago on this very problem. A long-term care bed in an ordinary institution that you might find in a small town might be satisfactory for the "tough, old veteran" type of guy, but women have very special requirements as they get older. They have various problems that do not afflict those of us of the male gender and those must be looked after.
The nursing sisters feel that you could put a veteran in a ward where there were six other veterans and not only would you not be creating a problem, you would be solving one. You would be providing solidarity and bonding.
Percentage-wise, we have few female veterans. Those are nursing sisters, members of the Overseas Red Cross Corps and the St. John Ambulance members. This group is not large in number, but this topic was number one at the Nursing Sisters' Association meeting in Halifax. They said: "Do not think that you will just throw us into a ward and we will be happy." I do not find any difficulty in explaining this, but I think it is something we all understand.
Senator Forrestall: Yes, we understand.
Mr. Chadderton: I can understand. My father was in a veterans hospital, but I would never want to see my mother in the same circumstances, sir.
Senator Forrestall: Would this be true of the WACS and the WRENS?
Mr. Chadderton: Yes, it would be. I do not have figures on them. They do not have an association, as do the Nursing Sisters Association and the Red Cross Corps (Overseas detachment). I have a pretty good grasp on how they feel about these problems. It would have to be worked into the numbers.
Again, maybe I am being too critical of the institutions. Deer Lodge is in Winnipeg, which is my home. I was there two weeks ago and it is doing marvellously on addressing special needs. If a veteran and his wife are in care, the institution will try to get them into the same room. They do that type of thing.
You do not have to be any kind of mental giant to realize that long-term care for those of female gender requires a little extra. Maybe it is training. Maybe that is what the provinces are getting at. Perhaps they can take a group of rough, tough females and train them to be caregivers to these veterans. Institutions can move the guys around and move the bedpans around, but female veterans do not want to be exposed to that. They want something a little bit better. I would be remiss in my duties if I did not explain that to the committee. I have had a close association with them, particularly through the Nursing Sisters' Association.
The Deputy Chairman: Mr. Chadderton, we promised we would only keep you here for half an hour. We have now kept you here for over an hour. You have given us a tremendous amount of food for thought. Thank you for taking the time to be here.
Before we adjourn, we have a little matter of business. Is it agreed that the material submitted by the National Council of Veterans Associations in Canada be filed as an exhibit?
Hon. Senators: Agreed.
Mr. Chadderton: May I add one thing? I have been appearing before parliamentary committees for many, many years. I wish to publicly repeat this statement: The work that has been done by this Subcommittee on Veterans Affairs has furthered the cause of solving veterans' problems and legislation. It has even provided veterans with new feelings of pride in their country. The reports that this committee has produced, Mr. Chairman - I am not just saying this because it is the thing to say - are gems. People often refer to the report "Raising the Bar" and the reports from Senator Marshall's committee. As an advocate, I would crawl here on my hands and knees. I believe sincerely that this committee can make a difference, whereas the committee in the other House is often taken up with affairs such as national defence. We need that, but this committee has always given me a feeling that veterans are a priority.
The Deputy Chairman: Thank you. I hope we can raise the bar a few more notches.
The committee adjourned.