Proceedings of the Subcommittee on
Veterans Affairs
Issue 2 - Evidence
OTTAWA, Tuesday, December 16, 1997
The Subcommittee on Veterans Affairs of the Standing Senate Committee on Social Affairs, Science and Technology met this day at 4:01 p.m. to commence its study of the state of health care in Canada concerning veterans of war and Canadian Service persons.
Senator Orville H. Phillips (Chairman) in the Chair.
[English]
The Chairman: Honourable senators, we have a quorum and this afternoon we will be hearing from the major veterans organizations. We will rearrange our agenda to accommodate one of our Legion members who wants to get back to New Brunswick. Perhaps this preferential treatment is being afforded to him because he is a Maritimer. The National Council of Veterans Associations has kindly agreed to allow Mr. Annis to make his presentation first.
Mr. Ralph Annis, Vice-President and Chairman, Veterans Services and Legion Seniors Committees, The Royal Canadian Legion: Ladies and gentlemen, I do have to get back for my grandson's birthday party tomorrow.
The Royal Canadian Legion welcomes the opportunity to present its position on the state of veterans health care to the Senate subcommittee.
The Legion's concerns with health care, particularly long-term care facilities, go back a number of years. It is not our intention today to revisit this history, but rather to focus on where we are now, the problems we perceive, and to make some recommendations for future direction.
In the matter of veterans' health care, Legion provincial command representatives monitor the situation in each of their respective provinces. Where a situation can be handled locally, this is done by command representatives with regional or district Veterans Affairs Canada officials. At the same time, members of the Veterans Services Committee of the Whole report to me as their chairman with their concerns so that a national perspective can be taken.
For instance, the quality of the food at a New Brunswick facility may be something that can be addressed by the facility itself. If not, then provincial representatives from the Legion can deal with a district director and/or provincial health authorities. If communicated to the national level the complaint may be put together with complaints of a similar nature. For example, the trend towards rethermalization of food is a practice which is being widely adopted in order to cut costs, but it does not provide acceptable meals for those who are long-term residents of the facility.
On the October 23, 1997 the Dominion President wrote to the Honourable Fred Mifflin, PC, MP, Minister of Veterans Affairs. A copy of that letter is appended to our presentation. The Legion points out that the Transfer Agreements have given rise to difficulties, particularly in Ontario. A fundamental problem appears to be that the agreements, at the time they were executed, did not contemplate significant changes to health care reform at the provincial level as has occurred in recent years. Those responsible for health care in Veterans Affairs Canada now have 10 distinct jurisdictions to deal with. Although it may have been the intention to have federal standards as the common denominator, in practiFce this has been impossible to do.
At the Perley and Rideau Veterans' Health Centre in Ottawa, the Board of Directors was sufficiently concerned with the funding issues as to initiate a law suit against the provincial government. That action is still outstanding. Recently, the provincial command has sought the intervention of the Auditor General.
The Dominion President in his letter to the Minister, alludes to the recent tragic events in Sunnybrook Hospital in Toronto. While as yet we were not able to conclude what went wrong or why, there is concern that the overall framework governing the relationship among Veterans Affairs Canada, the Province of Ontario and the facility may have contributed to the overall situation.
Sainte-Anne-de-Bellevue is the only institution for which Veterans Affairs Canada retains direct control and responsibility. The department is in the process of affecting a transfer of this facility to the Province of Quebec. In our view, this is premature as Sainte-Anne's provides the last opportunity the department has to crystallize its standard of care for veterans which could then be used as a model for implementation across the country in facilities where provinces now have the ultimate control.
At a recent meeting with the Assistant Deputy Minister of Veterans Services of Veterans Affairs Canada, Dennis Wallace, it was agreed the department would provide its long-range strategic plan for health care to the Legion. Until the time of that offer, it was not apparent to us that there was a long-term departmental strategy to deal with the issues and, as of this date, we have not seen the plan, but look forward to commenting on it when we do.
I must apologize senators, we now have a copy of that plan and while we have not had a chance to study it in detail, we believe it is quite shallow and does need a lot of work.
The Dominion Secretary, Duane Daly was recently invited by Veterans Affairs Canada to sit on the VAC Gerontological Advisory Council. The purpose of that group is to provide expert advice and guidance to VAC on the development or adjustment of policies and programs to meet the needs of the aging veteran community. In this light, the Legion will emphasize issues that have been discussed in separate forums with various VAC officials.
The widows' proportionate issue, which the Legion presented to this committee at its last appearance on August 20, 1997, identifies one need where the Department of Veterans Affairs could include the veteran's spouse in an integrated and meaningful way. The minister has indicated support for the legislative changes required to provide a surviving spouse with the right to substantiate an increase in the assessment of a disability of the deceased veteran, regardless of the level at which that assessment was previously determined.
Given the departmental support for the concept, it would seem appropriate for this subcommittee to press for timely implementation of the required legislative amendments.
In our experience, veterans consider themselves and their spouses as a team when it comes to health care issues. Consequently, the lack of a consistent departmental philosophy towards the treatment of veteran's spouses is of concern. The Pension Act provides for a significant increase in the amount payable to the veteran as a result of having a dependent spouse. In addition, there is a survivor benefit to take care of the spouse's needs after the death of the veteran. In contrast, health care benefits are provided only to the veteran. These benefits may indirectly meet some of the needs of the spouses, but there is no recognition of the contribution of that spouse as part of the team beyond some softening by, for example, continuing the Attendance Allowance and Veterans Independence Program payments for one year following the death of the veteran. However, if the veteran enters a long-term care facility, the VIP is cut off immediately. This can lead to serious concerns and worry on the part of the veteran.
The department has recently completed a review of veterans' care needs, and a document dated October 17, 1997 gives a good background on the issues and makes key findings which have the potential to pave the way for a positive result in the future. This, together with the literature, Care Trends for Seniors, published in June of 1997, provides a starting point for positive gains in the future. On the negative side, there is the potential danger that the department is contemplating major changes to its programs in the way of reduction of benefits. The cutting off of allied veterans is a relatively recent example. If the proper focus is not maintained, some of the current benefits to clients under the existing, although admittedly complex system, could be lost. The department must be encouraged to provide more comprehensive and, perhaps, programs that are simpler to administer and that meet the needs of the aging veteran population.
In the area of long-term care facilities, the Royal Canadian Legion makes the following recommendations:
1. The department must publish a detailed federal standard of care for implementation in long-term care facilities that meets the needs of the veteran residents to the same degree, if not better, than was the case before the department surrendered its facilities to the provinces. It must be in readily understandable terms, such as hours of care per resident per day, and not in terms of the myriad of various provincial standards.
2. The Transfer Agreements must be reassessed and updated to enshrine VAC standards at a uniform level across the country so that veterans, wherever they are situated, receive the same comprehensive level of care.
3. The proposed transfer of Sainte-Anne-de-Bellevue must be halted or at the very least postponed until uniform federal standards are implemented at all of the existing facilities now under the control of the provinces.
4. The document, Review of Veterans Care Needs -- Background and Key Findings, should form the framework by which the department can:
(a) cope with the effects of provincial health care reform so that the health need of veterans is not diminished;
(b) modernize its health care delivery processes in order to keep current with health care delivery trends. Specifically, the department must adopt a multi-disciplinary team approach to assess and provide continuing care to the aging veteran population. Further, it must shift from institutional to community-based care. It is clear to the Royal Canadian Legion that this is what veterans and their families in the vast majority of cases want, and which would, in our view, meet the needs of, and provide the best quality of care possible to this very deserving segment of the Canadian population.
(c) recognize the need for caregiver support and respite care which, for the most part, is provided by female relatives of male veterans; and
(d) provide housing options as alternatives to institutionalization.
The department must re-examine its current system which determines which services will be provided based on gateways rather than needs. We have seen well-intentioned stretching of eligibility rules to meet needs in the current somewhat inflexible, complex, status-based system which is now used to determine benefits. Officials are to be commended for these initiatives, but the policy must be amended to ensure universal applicability.
The department must deliver on its undertaking to provide a client-centered approach to dealing with the clients.
In closing, I urge this subcommittee to press the government for immediate implementation of legislation to remedy the widow's proportionate pension situation as a timely signal of commitment to veterans and their spouses.
Senator Jessiman: What tragic event occurred at Sunnybrook Hospital in Toronto?
Mr. Jim Margerum, Chairman, Ontario Command Veterans Services Committee, The Royal Canadian Legion: At approximately seven o'clock a fire broke out and, in one particular room, two veteran residents died. In a room about 75 feet away, a lady resident died. Because of the building design, they were unable to extinguish the fire in time to avoid tragedy.
Approximately a week later a bed-ridden gentleman was thrown to the floor. His neck was broken and he was put back into his bed. He passed away. There is an inquiry into that incident. A safety audit of the facility has been conducted. Early in the New Year the coroner for the Province of Ontario will conduct an investigation or an inquiry.
Senator Jessiman: Will that inquiry deal with the fire as well as the circumstances surrounding the injury to the gentleman who broke his neck?
Mr. Margerum: I believe there are a myriad of lawsuits and legal problems, so we are in a difficult position to give full details of the incidents. However, there are two separate incidents. The Sunnybrook report deals only with the fire. It ignores the other incident. The VAC report on the incidents refers to the second incident. In that case the family members are quite irate, and we are having difficulty in dealing with them because of their allegations of a cover-up.
Senator Jessiman: Is there a difference from province to province in terms of the amount of money being spent on health care for veterans?
Mr. Jim Rycroft, Director, Service Bureau, The Royal Canadian Legion: We have noted that the primary complaints come from the Province of Ontario, which is not unexpected given the numbers. I cannot attribute level of care to dollars spent. In fact there seems to be a mind set or a philosophical approach which results in more being done with less money.
In our experience, Alberta provides a number of the standards by which others are measuring themselves. In the health care community, Alberta might be perceived as being slightly ahead in terms of defining and implementing standards, even though they probably spend less money per bed.
Senator Jessiman: Are veterans given some kind of priority treatment by reason of their being a veteran? My brother, who just passed away six months ago, was a veteran, and I do not think he was treated in any special way. However, that may be because he just did not apply for it.
Mr. Margerum: There are what they call, "veteran priority-access beds." A number of beds in different areas of the country are available for veterans who qualify according to certain conditions. As well, any overseas veteran can qualify for such a bed, but he must pay a board-and-lodging charge. A veteran who is hospitalized or put into a facility as a resident because of his war time injuries or related injuries pays no such charge. However, there is an allotment across Canada according to the province and according to the population of veterans in that province.
Senator Jessiman: Would one inquire at the Veterans Affairs office in any particular city to find out which facility is available to veterans?
Mr. Margerum: Yes. Further to your point on costs, not only is there a difference in the per diem rate across the country, but within Ontario there is a different per diem rate for the three contract facilities which are Perley and Rideau Veterans' Health Centre, Sunnybrook and Parkwood. They have different per diems and they have been established in different ways. I am referring to layout, staff requirements and things of that nature. These are based on national standards which I believe are erroneous. They should not be using them. They should use standards that fit the layout of the facility, that is, the number of rooms and the number of people in a room. They are using a national standard that does not adequately address the situation.
Senator Jessiman: Does a veteran who is not on a pension and who has a priority bed pay the same per diem as a non-veteran?
Mr. Margerum: They paid a maximum of $720 in the current year.
Senator Jessiman: What does that give them -- a semi-private room, for example?
Mr. Margerum: It depends on the facility. In Ottawa, all the rooms are single rooms. In Sunnybrook there are five and as many as six in a room. In Parkwood it varies from two to six.
Mr. Annis: Ontario has the largest hospitals available to us. In many other provinces we have access to very small hospitals which are scattered around the province. In New Brunswick, for example, we have as few as two beds in one old folks' manor. That is a good way to do it. We have 50 some beds in some hospitals. The amenities and so on vary from province to province and, in fact, even in areas within a province. Ontario has the biggest facilities, and they have run into the biggest problems. We want to have a national perspective and ensure that Veterans Affairs Canada establishes a high standard of care for veterans throughout Canada. This is not really up to scratch.
Mr. Margerum: When they first establish these particular centres, we had 20-year-old veterans coming home and they were cared for in the major centres in major cities. Now veterans are about 75 years old, on average, and they live in small communities across Canada. We have been asking for what they call floating, northern, or transitional beds which would be located in small communities where the need arises. In Ontario, we have been trying to encourage them to redistribute the beds across the province. We started that process in 1987 and, at that time, a report was prepared stating that they were waiting to put it into place. I also have a letter dated 1997 which contains the same story. In over 10 years, absolutely zero has been accomplished. It is a major concern that we must move a veteran from his home, hundreds of kilometres, and separate the spouse from her husband for the second time in their lives.
Senator Jessiman: When Veterans Affairs gave up the operation of some of these hospitals, was there not an agreement that veterans would be guaranteed a certain number of beds?
Mr. Margerum: Yes, there was such an agreement but, unfortunately, some of those beds have been closed and not reopened. In Sunnybrook they closed 44 beds for four and a half years on the contention that there was a shortage of nurses. Yet, during that time, the per-diem payments flowed into that hospital for those beds, was absorbed into the global budget, and was used for purposes other than looking after veterans.
Mr. Annis: Some provinces have been more successful than others in distributing these beds around the province so that veterans can be closer to their homes and families. Rather than close beds in, say, Sunnybrook those beds should be reallocated to Sault Ste. Marie, Kenora, or some other northern city.
Senator Jessiman: Do you find some provincial governments are easier to deal with?
Mr. Margerum: Yes, different provinces have a different outlook. My colleague from Saskatchewan told me they have a tremendous working relationship with their provincial government. You must bear in mind the requirement for operating these facilities is now a provincial responsibility as the federal government or VAC turned that responsibility over to each province, so it is important to have a good working relationship with each provincial government.
Veterans are being used as pawns in the argument surrounding the federal government cut-backs in transfer payments to the provinces. Two governments are fighting over whose pot payment for these beds should come out of, and that creates all kinds of problems for us. In Ontario, transfer agreements are not being updated because of the health care reconfiguration. They have not kept up to date. The money is there but, unfortunately, it is not being used.
Staff cut-backs are severe. In fact, the facility in Ottawa is considering a 62-employee cut-back. The Perley and Rideau Veterans' Health Centre may as well be closed if that is allowed to happen.
Mr. Annis: Different provinces have different standards. In the Atlantic region, the director general, recently retired, worked very closely with the Legions in all four Atlantic provinces, and they have been quite successful in distributing the beds around the Atlantic provinces.
The Chairman: Senator Bonnell wishes to table a report and he wants to ask a couple of questions.
Senator Bonnell:Before my part of the country was connected by the Confederation Bridge, Camp Hill Hospital in Halifax was strictly a veterans' hospital, but that is no longer the case. Most of the patients in that facility were senior citizens and the medical care was not as up-to-date as it should have been. Now rooms are set aside for veterans in the General Hospital. Do you know if the service for veterans is as good in the General Hospital in Halifax as it was in the Camp Hill Hospital?
Mr. Annis: The care in Nova Scotia is probably as good in the new facility as it was in Camp Hill. Nova Scotia has been successful in distributing their veterans to different facilities around the province. Having said that, I do know that health care for veterans across Canada does vary, and regrettably that depends on what priority it is given by provincial health authorities. Standards were more uniform when VAC was in charge.
Mr. Margerum: Facilities for veterans are now combined with community beds. We hear that veterans will get as good care as the resident in the community bed. That causes us some concern because, under legislation, veterans were to be provided with a particular level of care by the government in acknowledgement of their service to the country, and we are finding that that service is being reduced to conform with provincial standards. Consequently, veterans across the country are not receiving the level of care they should be receiving under the legislation.
The level of care has gone down. They are fed rethermalized food which is atrocious. Anyone who eats that food for three weeks would realize that rethermalization of food is very unsatisfactory.
Senator Cools: What is the rethermalization of food?
Mr. Margerum: The food is cooked at another facility, often in the U.S., and frozen in large plastic bags. Then it is shipped to the facility where it is thawed out and divided into plate-sized portions. The plates are then put on trays and the trays are placed on a special unit which is wheeled upstairs and plugged in overnight. This heats up the food and it is supposed to result in delicious food. However, the melting process usually results in about half a cup of water being on the plate of food. Alternatively, the food dries up and, three weeks ago, one gentleman broke two teeth biting into a slice of toast, and just last Friday he broke another tooth biting into a French fry.
Senator Bonnell: They were not PEI potatoes.
Senator Jessiman: Is this what is happening in the hospitals generally?
Mr. Margerum: I cannot speak for community beds, but I gather from friends who have been in hospital or who have family members who are in long-term care that there are many complaints about the food.
Senator Jessiman: Where is this?
Mr. Margerum: The Ottawa area and Ontario generally.
Mr. Annis: The toast that is given to the veterans in Saint John is made in Toronto. The bread is toasted, put in plastic bags, shipped frozen, and rethermalized.
Mr. Margerum: I have a piece of this toast that was served on the weekend. Some of the fellows to whom this is served do not have teeth, and the people who feed them dip it in coffee or tea to soften it.
The godsend is that, every three weeks, the veterans have a home-cooked breakfast in the ward. The staff have been excellent. At no time do I criticize the staff of the facilities.
The first step facilities took in reaction to funding cuts related to the food they served. The most basic enjoyment in life is a good meal. The largest number of complaints from the veterans in the facilities relates to the quality of the food.
Mr. Annis: When people go in to check the quality of food, they usually only sample one or two meals, and anyone can probably live with that. However, for the patient who is potentially there forever, then it is an entirely different kettle of fish.
Senator Jessiman: How many veterans' beds are there at Sunnybrook?
Mr. Margerum: There are 570, sir.
Senator Jessiman: Are they all for veterans?
Mr. Margerum: Yes.
Senator Jessiman: How does the food compare with that hospital and, say, the food served at Toronto General?
Mr. Margerum: I receive complaints. I gave a package to the clerk which includes two letters of complaint from Mrs. Johnson. In her first letter she complained that her husband was not being fed properly. It takes him about an hour to eat a meal and she found that, if she did not go there and feed him, he did not eat. She now hires someone to go to Sunnybrook to feed him. The nurse's report on her father said the he was eating well. However, when she made enquiries of a staff member, she was told that he did not eat. When she and the administration checked it out they found that, in fact, he had not eaten and the nurse's report was false. That is what people are facing.
Senator Jessiman: Do you have a certain number of beds in one facility in Ottawa?
Mr. Margerum: No, the beds are in different facilities.
Senator Jessiman: How many beds do you have, in total, in the building in which the veterans are located in Ottawa?
Mr. Margerum: There are 450 beds, of which 40 are still closed. There are 250 veterans' priority access beds.
Senator Jessiman: Are the other patients in that facility who are not vets getting the same kind of food?
Mr. Margerum: I would presume so. At one of the general meetings of family members of residents in the community beds there was a complaint about the food.
Senator Bonnell: Did you say that toast made in Ontario was being sent to New Brunswick?
Mr. Annis: The toast eaten in the Saint John veterans' facility comes from Toronto.
Senator Bonnell: That is probably how Ontario treats Atlantic Canada anyway. They think we are nothing but beggars, so they send us their old dried up toast. That does not apply only to the treatment of veterans, it is how all of us are treated.
Mr. Annis: I will agree with that.
Senator Bonnell: As to the treatment of the spouses of the veterans, as I understand it, many years ago -- and I happened to be chairman of the committee at the time -- we gave 100 per cent of the disability pension to the spouse if the veteran received 48 per cent or better. He only received 48 per cent, but his spouse received 100 per cent when he died.
Mr. Annis: We discussed that last year. She would get 100 per cent of her spouse's pension which is in fact 50 per cent of his pension. For example, if a veteran had a 100-per-cent pension, upon his death, his spouse would get 50 per cent of that which would be her 100 per cent. If he was receiving $2,000 a month, she would get $1,000 a month. When we speak of 100 per cent, we are referring to her 100 per cent.
Senator Bonnell: My understanding was that if a veteran got 48 per cent or better, his spouse would get 100 per cent, and if had been receiving anything less than that, she would only receive half. In other words, if the veteran was getting 20 per cent, she would get 10.
Mr. Annis: That is true. If the veteran was a 30-per-cent pensioner, she would get 15 per cent. The 48 per cent is the magic number, or it was until last year when we agreed to support it. Veterans Affairs has agreed to support it as well. The 48 per cent is the magic number which would give her 50 per cent of the overall pension, which for her would be a 100-per-cent pension. I hope I am not muddying the waters too much.
Senator Bonnell: We will straighten that matter out.
Mr. Rycroft: The full widow's pension is not 50 per cent of a veteran's pension. It is 75 per cent, if my understanding is correct. That is why to get over that magic 48 per cent is important because her survivor benefit is a full widow's pension which works out to 75 per cent of what the veteran was getting if he was a 100-per-cent pensioner.
Senator Bonnell: We will get the figures later on this week.
Although these widows did not serve overseas, there is no doubt that they supported their husbands. I know that, in some instances, the widow is a second wife who did not look after her husband throughout the length of his illness. What should the widow be entitled to receive? Should she, for example, be entitled to free drugs under Blue Cross? What do you want for that spouse?
Mr. Annis: We are not suggesting that the spouse should receive the equivalent of what her husband received. However, as yet, we do not have a figure. All we are saying is that, philosophically, in most cases -- and, admittedly, there are some who married last year -- the spouse has taken care of that veteran for 50 years. In fact, these spouses have done a lot of work for Veterans Affairs Canada and saved them money compared to what it would have cost them if the veteran had gone into a facility.
In taking care of the veteran over a 50-year period, we believe that the spouse has hurt her own health. As a caregiver of long-standing, that woman deserves some support.
Senator Bonnell: What do you call "long-standing" -- being married to the veteran for three years?
Mr. Annis: That is always a problem. There are such cases before the Veterans Review and Appeal Board. They used to be called "split" widows. That is, when a divorced veteran would marry someone else. The two widows would argue over who should receive the majority of his pension. There have been cases of involving three widows.
Senator Bonnell: Even four, I understand.
Mr. Annis: That may be so, but I am not familiar with those cases. Such cases go before the Veterans Review and Appeal Board which decides which widow will get the pension or part of it. They may split it 50/50 or 40/60. They listen to the lawyers' arguments on both sides and come up with what they believe is a fair decision on the veteran's remaining pension.
Senator Bonnell: Does The Royal Canadian Legion have a succinct recommendation to bring to this committee that we can fight for on your behalf? We must be able to express what The Royal Canadian Legion wants.
Mr. Annis: We will have a resolution to our national convention this coming June that will entail exactly what we are discussing.
Senator Bonnell: June, and even February, will be too late. Senator Phillips will be making a recommendation to the Parliament of Canada by February. Can you tell us what you will be discussing at the convention in June?
Mr. Annis: The widows proportionate pension is one thing the committee agreed on last year. We have had meetings since then with Veterans Affairs Canada, with the deputy minister, and they have agreed with us. However, it has not yet been drafted as proposed legislation. One of our strongest recommendation relates to the proportionate pension to those widows being in that legislation. We are working on that.
The other recommendation relates to caregivers who do not have a pension. This is the other side of the coin. That one will take a bit longer but, if you will support us in principle, we can put that suggestion to Veterans Affairs Canada.
Senator Bonnell: I would urge you to give our committee something in writing so that we can understand exactly principles you are relying on.
Mr. Rycroft: The principles are covered in the department's own paper which we have provided to the committee.
Senator Bonnell: Why have you chose to tell the department but not us?
Mr. Rycroft: We have told you. We gave you a copy of the report and told you that we supported it. What we have quoted in our recommendations comes from the department's internal study. That is a detailed plan. What we are looking for is support to have that implemented.
Senator Bonnell: Do they have a plan now?
Mr. Rycroft: There is a long way to go from planning to implementation. As with the widow's proportionate pension, it is one thing to say you support it, but it is another to have that implemented. It must be in the legislation.
Senator Bonnell: It must pass Parliament, including the Senate. May we have a copy of that?
Mr. Margerum: Yes.
The Chairman: My first question is based on your recommendation of a change from institutional to community-based care. I understand the desire of the veteran to be in his home town or village, but we are facing a very serious health problem in small towns and that is because doctors no longer want to practice in small towns. I cannot see geriatric care being provided in a small town which does not have a doctor in what we used to call the "village hospital." Most of those are now closed. How do you reconcile those problems with your recommendations?
Mr. Annis: Our recommendation is not that we do away totally with the larger units. We are suggesting that more and more we should be leaning towards involving those communities that have facilities. Many smaller communities have old folks' manors in which we could have reserved beds for our veterans. In fact we have done this on many occasions in some areas of Canada. I certainly would not suggest that we close Sunnybrook, Perley, Rideau or Colonel Belcher Hospital in Calgary without having the capability to handle all of our veterans. We do not mean to suggest that all the beds should be in small towns. However, we do suggest that we should be leaning in that direction so that these people can be a little closer to their families.
Mr. Margerum: In facilities in the small communities that could handle the requirement beds have been closed. However, there are chronic-care facilities or nursing homes where beds could be contracted and where they could provide the needed services, the minimum medical services. Our argument is: Why displace a veteran from a small northern town to, say, Ottawa when he could be at home where his spouse could see him on a daily basis?
As it is now, a veteran can be placed 40 miles away from Ottawa and if his wife does not drive she will not be able to visit her spouse. She ends up being is separated as she was during the war. Is that what we want? I think not. We want access to the person in residence by family members. Veterans should not have to move away from their homes if there is the ability to handle their requirements in a small community, and there definitely is that ability. We have an unwillingness on the part of VAC and the Ministry of Health to work together. They have told us, for 10 years, that they will address our concerns. In another 10 years there will no veterans left.
Is it their intention to save money by doing nothing until the veterans have all passed away, and solve the problem that way, or do they want to solve the problem while we still have veterans here today? Even today is too late. It should have been done 10 years ago. There are facilities available and the cost to put this in place can be found in the dollars they have now. They must distribute the funds properly and focus on the care of the resident, and not spend all their time and energy in political arguments about who will pay. Let us get the job done.
The Chairman: In community-based care, there is a tendency to hire organizations such as the VON or possibly two or three registered nurses who follow the patient at home. How do you, as those responsible for the veteran's health care recommendation within the Legion, feel home care is working? Do you have any suggestions for improvement?
Mr. Annis: It is working very well. The Veterans Independence Program which was instituted sometime ago, is working well. This enables the veteran to stay in his home and be taken care of by his or her spouse, other members of the family, or the VON. An attendance allowance is available to veterans who cannot afford the cost of having other people taking care of them. It is successful.
However, there often comes a time when veterans cannot be cared for at home and they must move into a facility where they will have continuous 24-hour a day care. That is when we must move them, hopefully, into a community based area where there is that capability. We are not suggesting that we provide such a facility in every town, but we are suggesting that, where the facilities already exist, we should reserve a room or two for veterans.
The Chairman: One aspect that concerns me is that the spouse may be looking after a veteran, 24-hours a day, seven days a week. That spouse is not getting any younger. I would like to see a program initiated where Veterans Affairs would take over complete home care for two weeks or a month perhaps twice a year to give that spouse a much needed rest.
Mr. Annis: Yes.
The Chairman: Do you think that is workable?
Mr. Margerum: They do have that program in some areas. They place the handicapped individual in a respite bed and then the caregiver can have a holiday.
The problem that exists with the VIP or forms of provincial care results from cut backs in funding. They are cutting back on care by the VON and others, and transitional periods do not exist. Consequently, a couple could be in dire straits and nobody would know about it because there is no reporting system to ensure they are all right.
There is a lady who attends the Rideau Veterans home every night to feed her husband. She uses a walker, weighs approximately 160 pounds, and has emphysema. She believes that if she does not feed him, he will not have a meal. That lady has been married to her husband since before the Second World War. She was separated during the Second World War. She goes home by bus every night. She has served her husband well, yet she has no income other than what she gets from his pension. She faces the problem of who will look after her. Should it be the responsibility of VAC or should it be the responsibility of the provincial government? That lady is in a difficult circumstance. If she must be institutionalized because of her condition, where will she go? Will she join her husband? In most cases that will not happen. Once again we are separating loved ones. I do not think that is what it was all about. We owe it to them to keep them together.
The Chairman: Do members of the Legion make an effort to visit the hospitalized or institutionalized veterans on a regular basis as opposed to occasionally touring the institutions?
Mr. Annis: Absolutely.
Mr. Margerum: Twice a week I go to the Rideau Veterans home. I talk to the fellows and get my ears burnt off with their complaints, concerns and praise. The Perley and Rideau do a great job in many areas. I do not want it to sound like they do not look after our veterans because that is not the case.
Every Wednesday we deliver fruit to the veterans in the facilities. Our various branches take turns. Volunteers assist in the feeding of veterans and act as porters who take the residents to different activities. We have a good corps of volunteers in Ottawa, and at Sunnybrook and Parkwood. These are not merely social visits. We play an active role in the running of these facilities. We provide funding and furniture, including T.Vs. Cable T.V. is being provided to all the residents in Ottawa by the local Legions. We play a strong and active role in the support of our veterans in the different facilities.
Mr. Annis: In most jurisdictions, the provincial command has a duty roster and the local branches will be requested to visit a facility on a regular basis. A group of Legion members, perhaps with the lady's auxiliary, will visit veterans. It is a tremendously successful program.
Senator Jessiman: Do the veterans approach The Royal Canadian Legion for assistance or do they go to Veterans Affairs. Since the Legion represents only some veterans, do those who not members have the same priority?
Mr. Annis: It does not matter to us: a veteran is a veteran.
Senator Jessiman: If a veteran wants to be admitted to a hospital where beds are set aside for veterans, are those beds allocated on the basis of who can afford to pay? Do you have a policy whereby you try to have those beds in at least semi-private wards?
Mr. Annis: That varies with the facility. In a nursing home, rarely are there more than two persons per room, and quite often it is only one. If it is a veterans' hospital, there could be several people in each room.
Senator Jessiman: Do you try to influence those in charge of this care?
Mr. Annis:That depends on various circumstances. The condition of the veteran is very important. If he is mobile then you can do things with him or her that you cannot do with someone who needs a wheelchair. I cannot give you a simple answer.
Senator Jessiman: What about home care? In various provinces a person can apply for home care whether that person is a veteran or not. Is priority given to veterans in this regard?
Mr. Margerum: No. That only applies when the veteran has qualified to receive VIP. They would have to apply to the local district health council which offers an amalgam of services, a one-stop shop, and they would be assessed and, if it was discovered that the applicant was a veteran he would be referred to Veterans Affairs Canada. VAC has counsellors who check up on individuals from time to time. Because they are in receipt of a pension, they are listed on the computer, so the counsellors are aware of who they are. Unfortunately, because of cost-cutting measures, some of that is slipping. Priority is being given to high-level-care cases as opposed to low-level-risk cases. We are concerned about that.
The decision to place them also must go through a district health council submission system and we do not believe that veterans are given the appropriate consideration and that they are sometimes overlooked.
For example, Sylvia Fisk who was the Director of Nursing at Sainte Anne-de-Bellevue Hospital who was told by an individual from the District Health Council that neither the Legion nor her MP would decide what facility she would enter. That lady passed away in a hospital never having been cared for in a veterans' facility. She was the head of nursing for 30 some years. There is a lot of slippage.
Senator Forest: My father served in the First World War and my husband served in the Second. My concern relates to benefits to veterans' spouses not being continued.
Mr. Annis: This subject was raised last year before this committee. We recommended then that widows be treated equally with their male counterparts. It was agreed by this committee and by Veterans Affairs Canada that the widows' proportionate pension would be put in place and included in the forthcoming omnibus bill to amend the legislation. We have not seen that draft legislation yet and I am worried that it might not be included. This is why we are strongly recommending that that proportionate pension be included and formalized in the amendments to the legislation.
Senator Forest: Are benefits to the widow included in the pension? Are there other areas where she would have received assistance while the veteran was living?
Mr. Annis: This is one of the areas that we would like to deal with further.
Mr. Rycroft: One of those benefits would be the Veterans Independence Program that helps keeps the veteran in his home. It is important that a spouse remain in the home as long as that spouse is capable of managing, perhaps with some help. Society must be able to provide an integrated approach. It only seems to make sense that, if Veterans Affairs is already tied in to the care of veterans and their spouses through disability pensions, through proportionate pensions for survivor's and so forth, that they take on the role with respect to spouses.
They seem to recognize it by acknowledging that respite care and other care is a necessity. We are saying that they should rationalize that process and then work to provide a solution that does not cut the widow off when her husband dies after a year, but continues as long as that person is capable of managing the home.
Senator Forest: We are recognizing that the home care program has not developed as well as it should.
Mr. Rycroft: That is a societal problem, in fact, it is usually a more cost-effective solution in any event, given that the taxpayer will pick up the tab in the end.
Mr. Margerum: When our provincial secretary was a counsellor or service officer for the Legion she went to the hospital where she met one of her clients who was just being discharged. He was walking to his home which was about six kilometres away from the hospital. She gave him a ride home and he invited her in. He opened the fridge and there was no food. He did not have any money in his pocket. Once VAC was contacted, they quickly provided assistance. This was a gentleman who was released from an acute care facility, and was left out in the cold. That is only one we know about. How many others in the community as well as veterans or spouses find themselves in the same boat? There is a serious anomaly in the provision and monitoring of home services. There is no capability of dealing with transitional periods. The Ministry of Health and Health Canada is failing to ensure that a person who is released is properly looked after.
The Chairman: Thank you very much, gentlemen, for your brief and for your informative answers. We hope you have a pleasant trip back to New Brunswick.
Mr. Margerum: If you would like this toast as an exhibit, you are welcome to it. The four envelopes that I gave to your secretary contain several letters of complaint. We have asked the Auditor General to do a forensic audit on Veterans Affairs and federal provincial transfer agreements because of the misuse of moneys. With the globalization of funding there is no audit trail. We listed some 20 points that should be looked at. I would urge you to examine that information. I would be pleased to provide any follow-up information.
I have seen your agenda and the list of people who will be appearing before you. One important element is missing. I would suggest that you hear from those people who are directly affected by this. I am prepared to assist you by taking a group to Perley and Rideau Veterans Health Centre where I can arrange a meeting with the residents and their spouses or those who are feeding these patients so that you can hear their complaints, their concerns and their plans for the facilities. That is critical information if you wish to judge the current status of hospital services.
The Chairman: We hope to do that in February. Honourable senators, we will now hear from the National Council of Veteran Associations in Canada. Mr. Chadderton, please proceed.
Mr. H.C. Chadderton, Chairman, National Council of Veteran Associations in Canada: I understand time is of the essence in these meetings. We did file a submission with the committee and, consequently, I do not intend to read that.
On the subject of continuing pensions for widows which was raised by Senator Bonnell, there are two groups who should be considered. First, if the pension received is 48 per cent or higher, it is considered that that veteran died from his pensionable condition, therefore, his widow would receive exactly the same pension as would a pensioner at the 100-per-cent rate.
Under the new legislation, which is now 11 years old, the proportionate pension, below 48 per cent, provides that when that pensioner dies, his widow will get one half of the proportionate rate.
I would like to follow up a suggestion made by Senator Bonnell. I will send to you by courier tomorrow an affidavit which I prepared for the Court of Appeal of Ontario which sets out the proposal the Legion members talked about. It deals with the fact that the full pension for a widow is still only 75 per cent of the full pension for a single male pensioner. This is a gender issue for the 1990s. It is an equality issue. It is something which should be looked at under the Charter of Rights and Freedoms. Inasmuch as your committee is pursuing that as well, I will send you a copy of my affidavit to the court which sets out all of the reasons why the caregiver, who has been a caregiver for at least 25 years, should not be left out in the cold.
Senator Jessiman: If the pensioner is in receipt of something less than 48 per cent, and he dies, will his wife get a proportionate part of that?
Mr. Chadderton: Yes.
Senator Jessiman: Is that 75 per cent?
Mr. Chadderton: No, it is 50 per cent. If he was a 20-per-cent pensioner, his wife will receive 10 per cent.
Senator Jessiman: If he is receiving 48 per cent or more, will she get 100 per cent of what he got?
Mr. Chadderton: No, she will gets the same pension as a pensioner at 100 per cent.
Senator Jessiman: Let us assume a pensioner gets 48 per cent and he dies. Will his widow receive 100 per cent?
Mr. Chadderton: Yes, she gets the maximum pension payable under the act.
Senator Jessiman: Would she get more than her husband was getting?
Mr. Chadderton: Yes, she would if his pension were, for example, 60 per cent.
Senator Jessiman: If it was 49 per cent, would she still get 100 per cent?
Mr. Chadderton: She would. That is an anomaly in the act and I can explain how that happened. It has been in place since 1939. In 1939, Parliament took the attitude that, if a man died and his pension was 48 per cent or more, there was no way to tell whether he died from his pensionable disability or not. Mr. Justice Woods of the Woods Committee, of which I happened to be the secretary many years ago, put it the best way it could be put. He said that a pensioner at 48 per cent, when he dies, is actually at 100 per cent if he died from his pensionable condition. That was the rationale for that.
There are very few pensioners in that group between 48 per cent and 60 per cent. The vast majority, the serious group of pensioners, are at 75 per cent or more.
The widow's pension, even for the 100-per-cent pensioner, is only $1,263. However, if the widow dies first, the veteran, at 100 per cent pension, will get $400 more than his wife would have received had she outlived him. That is why it is a gender or equality issue.
I will file that submission so you may have an opportunity to look at it.
We will reply later to some of the questions which your secretary submitted directly to us. Before we do that we want to use this opportunity to raise a specific matter in front of your committee and that is the number of studies that have been conducted by the Department of Veterans Affairs for the past seven or nine years. Believe it or not, 11 such studies have been conducted, and they all deal with gerontology and health care and issues as they pertain to veterans.
We have filed with you an introductory comment. This should be of some assistance in your discussions with the department.
In our documentation, we deal with veterans with overseas service who are not war disability pensioners. They are not "income qualified," but they have overseas service of one year or more. They number about 160,000. We call them the "phantom group" because most of these studies seem to be driven by Veterans Affairs Canada wondering what they will do about these 160,000 overseas veterans who have no benefits. They have no pension. They are not qualified for War Veterans Allowance because they have income. The question of what we will do with them seems to be taking up so much time at the Charlottetown end that the tendency, perhaps, is to overlook some of these other problems.
The next figures on this sheet are alarming. The total number of departmental or contract beds is 4,000 while we have this phantom group of 160,000 overseas veterans who are not clients of the department at the moment. All they are entitled to under the legislation is a bed, if one is available.
We made inquiries this morning and were told that all the contract beds are full. I have hear a waiting list for beds, as of this morning.
Senator Jessiman: Of veterans?
Mr. Chadderton: Yes.
Senator Jessiman: Could they be part of the phantom group?
Mr. Chadderton: They could be, but the majority are persons who are clients of the department, in other words, in receipt of War Veterans Allowance or that type of payment.
The waiting list at Sunnybrook is 27, and at the Perley and Rideau Veterans' Health Centre, it is 104. At Deer Lodge Hospital it is 94. The Brock Fahrni Pavilion in Vancouver has five on its waiting list; and the George Derby Centre has 23.
Senator Jessiman: How many beds, in total, does each hospital have?
Mr. Chadderton: I will have someone find that information right now. The point is that the Department of Veterans Affairs seems to be driven by doing studies -- in fact, they have done 13 different studies, some completed, some not -- to determine what they will do for the overseas veteran with one year's service. We call this the "phantom group" because the vast majority of these veterans will not require assistance from the Department of Veterans Affairs. They are not pensioners, they are not on WVA. If they must go into a hospital, they have good hospitals in Winnipeg, Saint John and Vancouver, as well as in other cities.
The only thing they are entitled to under legislation is a bed. If we only have 4,000 beds and there is a waiting list of well over 200 now, the situation is obviously off the rails somewhere along the line, and perhaps this subcommittee might want to look into that situation.
The Chairman: This phantom group is a forgotten group. I have run into a number of cases where the veteran has had a stroke, the spouse is unable to care for him, and the amount of money they have received was as little as $3.72 per month. They are left entirely on their own. We have overlooked this group. Veterans' organizations and this committee should carefully consider what is happening to this phantom group. They served overseas and they did what they were ordered to do, and now they have been left out in the cold.
Mr. Chadderton: If they are income qualified with overseas service, there is no problem. We are speaking about those people who had overseas service, came back, were rehabilitated, and have money and can pay for their own services. Because of this quirk in that an overseas veteran is entitled to nothing else but a bed, Veterans Affairs Canada has been completely preoccupied with the possibility of this great group of people descending upon the system. We do not believe that will happen. The resources of the department might better be used to look at other areas and decide whether there are other things that can be done. It is just ridiculous to think that this phantom group of 160,000 will, all of a sudden, descend upon the department.
In any event, the department has no way to do anything for them because they have no beds available.
How did this happen? Having dealt with veterans' issues for more than 50 years, I find it interesting how small issues are dealt with by way of legislation and are never get taken off the books. For example, in the 1930s Deer Lodge Hospital was built. Since they could not fill it with pensioned veterans or WVA veterans, they decided that, if a veteran in Winnipeg with overseas service wanted a bed in the departmental institution, he would be allowed to have a bed in that hospital. However, he would have to pay for it. That was the explanation for this entitlement. I suggest that somebody should consider whether it is still valid.
We have participated in all of these 13 studies. Departmental officials have been in our office time and time again and we constantly ask them what information they are looking for. They point out that there are all these overseas veterans who have entitlement to beds. Of course, our response is that they should build 28 more hospitals to meet the need. There are 160,000 veterans.
Senator Jessiman: I am familiar with Deer Lodge. I have friends who are part of that phantom group. They can afford to pay for beds in that institution, and that is a blessing because they have been unable to find a bed elsewhere. I have been told that the service was very good.
Mr. Chadderton: The waiting list now for Deer Lodge has 94 names on it. Some of these people could well be amputees with Alzheimer's disease, but they are not eligible for a bed. Although they have a pensioned condition, the amputation will not get them into the hospital.
Senator Jessiman: Some veterans in the phantom group have Alzheimer's and they have been admitted.
Mr. Chadderton: That is because they can afford it.
Should we be using the Veterans Affairs Canada budget to be looking after those people when, in fact, other cases need the funding? Some of those will be presented to you this afternoon by the Merchant Navy.
This has become a mission on the part of many people in Charlottetown. When you stop to ask them why they have this concern, they will tell you it is because there are 160,000 potential clients out there. I am not saying the cases you referred to should not be in Deer Lodge Hospital, but what if 160,000, all of a sudden, applied to Veterans Affairs? The facilities are just not there.
The Chairman: When was the matter of War Veterans Allowance and assistance last raised?
Mr. Chadderton: It is raised every year in accordance with the cost of living.
The Chairman: Am I correct in saying it was set a number of years ago but it increases by 1 or 2 per cent each year?
Mr. Chadderton: That is correct. Certainly the 33 organizations that I represent here have had no complaints about the income levels for War Veterans Allowance. They seem to be fair. They were set years ago, and they are increased yearly. There is no problem there at all.
When we were last before this committee we dealt with many issues, such as those related to prisoners of war, the Merchant Navy, and others. Those issues are still in front of your committee. Today I am responding to the letter from your secretary as to what we see are the problems with health care.
In the Legion's brief, Mr. Annis referred to the Gerontological Advisory Council. I am a member of that Council. At a meeting a few weeks ago we heard from probably seven experts in gerontology, doctors from all across Canada. One was Dr. Sherman from Manitoba, an acknowledged expert in this area.
At the outset of the meeting, they outlined their objectives. Those, they decided, were to advise the department on gerontology. These people work, hands-on, every day with this very problem of how to treat a person, not necessarily a veteran, who does not want to leave his home but who must, eventually, be hospitalized.
Forgetting about our phantom group and dealing only with our current demand, it is clear that there are not enough beds right now.
The department must consider whether they will sign for more contract beds. That costs money. If they are not willing to do that, then they better look to the community to provide those community beds for those people who are entitled to them.
There are 4,000 contract beds for the total number of overseas veterans or Canada service only veterans who can qualify, and those number over 200,000.
The only way to solve that problem is to make arrangements with the provinces and/or the communities, so that the veteran can get into nursing care programs. Of course, the gerontological experts would say that veterans cannot jump the queue. We would then remind them of the two pieces of veterans' legislation, the Pension Act and the War Veterans Allowance Act, both of which have built in an implied contract that veterans will be provided with long-term hospital care.
Senator Jessiman: Can the 160,000 overseas jump the queue?
Mr. Chadderton: No, that is our whole problem. For example take a man on War Veterans Allowance whose condition has been such that home care has allowed him to stay at home. However, when he needs a long-term care bed will he be allowed to jump the queue and get into a community bed in, say, Portage La Prairie? The answer is that that will not happen unless there is some input of federal money. That is understandable.
This is an area you could raise with the department. When health care workers, who are not employed by Veterans Affairs Canada, conduct a health assessment, they will take on the responsibility to try to find a bed, but they want a fee for service. If that fee for service could be paid by Veterans Affairs, then that could get the veteran ahead in the queue and into provincial or municipal facilities.
Senator Jessiman: They will need more beds.
Mr. Chadderton: They have the beds, sir. These beds are contract beds for DVA. There are thousands and thousands of beds which are not being paid for.
Senator Jessiman: The beds are there but not the money.
Mr. Chadderton: They will allow them in because DVA has a topping up procedure. DVA will provide the money to get them in. They will provide the money to pay for their care, if they are entitled. However, you cannot expect people who work for the province or a municipality to drop all their other cases and get those veterans into some kind of a facility. You cannot expect them to do that unless there is a fee for service involved.
Senator Jessiman: You currently have 250 waiting for these various facilities. Are you saying that there are beds in each province and, if the government were prepared to pay, these 250 could get a bed?
Mr. Chadderton: They would not have to pay for the bed, sir. I had a long talk with Dr. Shapiro who runs this program in Manitoba. She would be prepared to put a case worker on it, and clear the way to find a bed for that person. However, you cannot expect that Dr. Shapiro will allow one of her people do that unless there is a fee for service.
Senator Jessiman: Having paid for the service to get the person in, once they are in the bed, who pays?
Mr. Chadderton: The department, sir. It is a question of finding the bed.
Senator Jessiman: That need not be a high number because you would not need one person per veteran. Maybe one or two people could handle the situation for the 94 people.
Mr. Chadderton: These figures are flawed in the sense that these people think facilities are available and they have put their names on the mailing list. If we had a smoothly working system where the Province of Manitoba, for example, was working hand in glove with Veterans Affairs on behalf of the veteran, then I think the number might jump. That number would not scare us because that number reflects the scarcity of contract beds. If you want to open up community beds for veterans -- and there are hundreds of thousands of them -- the Department of Veterans Affairs must be prepared to pay a fee for service so that the provincial or municipal people will do the job.
Senator Jessiman: What does Veterans Affairs say about this?
Mr. Chadderton: This is one of the reasons I brought these studies to your attention. They are listed in my brief. Veterans Affairs Canada has been studying this thing to death for about 9 or 10 years and we have seen no results. Two weeks ago at this gerontological I heard these community health experts telling us that they have beds, but asking why they should allow a veteran to jump the queue. That is a reasonable question.
I am hoping the department will recognize that if they want to use these non-Veterans Affairs facilities, then there must be a fee for service. That would be one step towards solving the bed problem.
The other problem relates to aging and, in that respect, our Veterans Independence Program is excellent. However, although Veterans Affairs Canada pays for the services which are provided, the veteran must find the person who will, say, look after his grounds. That can be an onerous task for some of our aging veterans. The situation becomes increasingly difficult when the veteran needs specialized services, for example, a veteran with emphysema who needs the assistance of someone who will change his air pack. Veterans Affairs will pay for the service, but they will not provide the service.
There have been cuts in health care services across Canada. In most communities the VON or somebody else will come into the picture, but not only must they be paid, but also someone must seek out their services. The seeking out of the service is very difficult.
For example, at the Smith Falls regional health office they will find a nurse who will come in, but they will not turn themselves inside out simply because the patient is a veteran. If the department wants to improve their relations with these health care workers who are paid by a city, a municipality, or a province, then they must be prepared to put up some money. That money would be used to made beds available and for home care.
My staff and myself have been consulted on these studies. We could have written these reports before the study started. The reports always recognize that there are veterans out there with needs and that there is a way to meet those needs through the service providers, namely, the provincial health workers. However, there is no close working relationship between these two bodies.
In one of these studies, the department sent a young lady across Canada, and she prepared a very good report based on what information was available. However, she came up with no solutions as to how we could use beds in facilities for veterans. That is where the problem is.
I work closely with Veterans Affairs and I hate to criticize the department because it is doing an excellent job. However, they do seem to dwell on this figure of 160,000 overseas veterans who, in fact, are not clients. There is no bed for them anyway.
Veterans Affairs must be prepared to pay a fee for service. They must explain to provincial and municipal health workers the difference between a veteran and a civilian. They do not know. A senior provincial health worker in the Ontario government told me that our system is the same for everybody and that all needs will be met. That is fine in theory, but what we are dealing with is a group of veterans, who are 75 years old, and who have earned the right, either under the WVA or the Pension Act, to special consideration. It is the Department of Veterans Affairs or Veterans Affairs Canada's job to go out and ensure that that special consideration is carried out.
These health workers, who are practical people, do not dispute the situation once it is explained to them why a veteran has an extra entitlement. However, they must work within their budgets and they can only justify taking on five or so extra people if they have a fee for service.
I would like to answer the questions your committee sent us. Please turn to page 13 of our brief. The first question is:
Is a dollar spent on health care offering the same level of value in each and every province?
Veterans Affairs Canada does its best to even the score by what is called "topping up." However, I would be misleading your committee if I said that works totally because it does not. The have-not provinces cannot do the same job as the have provinces, even with topping up.
Your second question was:
What level of priority do veterans hold when dealing with provincial health systems?
We have already dealt with that.
Senator Cools: I was going to ask that.
Mr. Chadderton: The answer to that is no. The solution is: If Veterans Affairs Canada is willing to pay a fee for service then priority will be given to veterans. In today's world money counts.
Senator Cools: If I seem to be going in and out it is just that the Senate is still sitting. We are all doing double or triple duty.
When a veteran walks into a hospital, how is he treated? Does the hospital know that he has priority? How is that priority handled? Perhaps you can give us more insights into the interfacing of a veteran with provincial health care services.
Mr. Chadderton: There are two kinds of services. One applies to a veteran who is not a client of Veterans Affairs. He is not on War Veterans Allowance, he is not a pensioner. He walks in, produces his provincial health card, and he is treated the same as anybody else. He does not have any complaints.
The other services apply to the veteran who is a client because he is in receipt of War Veterans Allowance or they have a pensionable disability. That veteran does not get priority. That is a large part of this problem. He is entitled to some preference under federal legislation. He needs someone to recognize that and take him from number 30 on the waiting list up to number one by doing a health assessment report -- which Veterans Affairs does beautifully -- in order to be admitted immediately to long-term care.
As it stands now, he has no priority but we can "buy" him that. Perhaps that term should not be used, but that is what the budget of Veterans Affairs is for. It is to look after the affairs of the veteran, and to give him priority access to services over and above those available to him as a citizen.
The third question you asked was:
Are there equal levels of access to health services in each region and/or province across the country?
The answer to that question is no and, in that regard, I would urge you to study the waiting list. However, by "topping up" Veterans Affairs is trying to do a good job. The only way there would be an equal level of access is if Veterans Affairs paid a fee for service to the provinces. There is nothing clearer in this life than: If you do not pay for it, then you will not get it. That may be sad but it is true.
On the question of the level of care, Senator Phillips raised a question with the Legion to which I would like to respond. What was the situation prior to 1963 when the Department of Veterans Affairs agreed to give up its hospitals with the approval of the veterans groups? We all met. As a matter of fact, we were in the Prime Minister's office and we explained the situation to him. DVA could not continue to provide acute care because they could find the doctors who could provide that care. Contracts were signed, and as Mr. Margerum said, some of those contracts still exist, but the facilities do not because the beds have been closed because there were not enough nurses or some shortage of that nature.
In 1983 the system was sold for a mess of pottage. For example, a Manitoban veteran who could not get into a hospital in Flin Flon, could get into Deer Lodge, Queen Mary, Christie Street or Sunnybrook. It was a good system. However, that went down the drain, and it was supposed to be replaced by something just as good. Considering the average age of the veteran today, the system is not as good. DVA would have had to have more beds available. Certainly the system is not as good today. There are waiting lists and complaints. There are serious complaints about War Veterans Allowance recipients being unable to get home care when they need it, and then when they want a bed, there is a waiting list. Sometimes that waiting list is 27 days, even if you are on the priority list. That has happened at Sunnybrook.
Some priority beds are kept aside because those who run Veterans Affairs are not stupid. They do not want to see an article in The Toronto Star saying a veteran died on the door step.
Generally the waiting list situation is bad. I was hoping these reports would come up with a solution to that problem, but here we are, December, 1997 and the situation has not improved.
The fourth question you asked was:
Are veterans being placed in an equal or superior grade of facilities?
There are provincial health standards from province to province, and they vary, but the facilities for veterans are certainly equal and can qualify under the provincial standards.
The sixth question you asked was:
Are there developing health care trends or practices the department has not been able to address adequately due to a devolution of service industry?
That is very definitely the case because there have been health care cuts. This is hurting veterans as well as the rest of the population. I do not want this to be misunderstood. We represent veterans, that is our constituency, so we must speak on their behalf. Despite the health cuts and everything else, something still must be done. We still have veterans who served their country loyally. I believe they do have priority over and above the ordinary citizen.
Yes, there are trends and practices with devolution that are hurting the veterans.
The seventh question you asked was:
Has the change in service delivery been negatively affected by geopolitical issues or federal intergovernmental policy?
That is the same issue. The health cuts that have been made in all provinces have had the effect at the bottom line, that is, whether there will be a bed and whether there will be enough nurses. The aging of veterans has raised the question of whether there are enough services to go around. Can we provide a health expert to veterans? The veteran is suffering from those service cut-backs as well. The only way to overcome that is to have a fee for service.
The eighth question you asked was:
How are veterans affected by provincial cost cutting?
The same answer applies to that question.
The ninth question was:
Has there been a superior level of service delivery since the department privatized the Treatment Accounts Processing (TAPS) System?
No one could devise a better system. It works to perfection. The veteran can use his card at any druggist or through a 1-800 number. The immediately know what drugs he is entitled to. Formerly, a veteran in the City of Ottawa would have to go to NDMC where he would see a doctor and get a prescription. He would then wait to see a pharmacist. With luck, by two o'clock in the afternoon he would have his prescription. These trips were frequent. Most of us who have to renew a prescription know that once you have your TAPS card, all you have to do is call your druggist, and your prescription is renewed.
The eleventh question you asked was:
In what direction is the department moving in regard to outpatient care policies?
From reading these studies, it would appear that the department is moving in a positive direction. They recognize that there are needs out there. However, they are not doing enough to connect the needs to the providers. It is that simple.
The twelfth question was:
What provisions has the department made for spouses of veterans, particularly those who acted as caregivers, and their future health needs?
This is a tragedy. It is a black mark on the government and on maybe even veteran's organizations who may not have fought hard enough on this issue. When a veteran who has some Attendance Allowance and some Exceptional Incapacity Allowance dies, the family income drops from $3,300 to $1,200 a month. There is a one-year hiatus in that the pension is continued for a year. The Exceptional Incapacity Allowance is continued for a year, as is the Attendance Allowance. That gives the widow enough time to get over her mourning, and realize her standard of living must change. It is a terrible tragedy. If we are talking about the expenditure of money, there are not very many widows. They probably total 22,000 at the 100-per-cent rate.
Mr. Brian Forbes, Honorary Secretary General, National Council of Veteran Associations in Canada: There are actually less than that. There are probably 8,000.
Mr. Chadderton: These are caregivers, most of them 50 years in the saddle. They could not go out and get jobs because they looked after their veteran spouse all those years. One year after his death, she is cut off. Much can be done in that area. Certainly, the Veterans Independence Program should continue for her life if she is capable of living in the house.
Here is another inconsistency. What will happen if she cannot continue to live in a house and wants to move into a condominium? Your committee is aware of the fact that VIP will not be paid for groundskeeping if she is in the condominium, but yet it is part of the condominium fee. At the end of one year she must find new accommodation and move in with a son or take a cheap apartment somewhere because her income is reduced by at least half, and she is totally on her own.
How a government can say it is doing its job and not offer vital assistance to widows I do not know. Certainly, the widow's pension should be paid at the 100-per-cent rate as it is to the single veteran. You will receive those documents tomorrow.
In conclusion, clear across Canada, there is an understanding that veterans qualified by reason of disability or lack of income should be provided with access to a long-term care bed, where the need is medically justified. I have already pointed out to the committee how those beds can be found, not necessarily by welfare offices in DVA, but by welfare offices working with the health care workers in the community or the province.
Services must be available which would allow the veteran to age in place when his or her disabilities are such that he does not need to be institutionalized. Adequate home care must be made available until such time as long-term care is necessary.
I hope I have conveyed to this committee some of the real concerns we have.
The Chairman: We appreciate your forthright presentation.
You referred to the loss of the VIP when a widow moves into a condominium. VIP is more than a groundskeeping allowance. It is to defray the cost of running a home. I do not see why a widow would not be entitled to help in caring for a condominium with, perhaps, someone dropping in one or two days a week to assess whether she is eating properly and generally taking care of herself.
Mr. Chadderton: That was my mistake sir. If she moves into a condominium she will still be entitled to the homemaker service. However, she will not be entitled to the groundskeeping allowance in a condominium.
The Chairman: Thank you very much. We may find all our answers in Charlottetown. If not, we will have another meeting in February, and I hope we can call on you then.
The committee recessed.
Upon resuming at 6:50 p.m.
The Chairman: Honourable senators, we welcome Mr. Ian Inrig from The Army, Navy and Air Force Veterans in Canada, which is the oldest veterans' organization. I know the others contest that claim but I always enjoy telling them that, Mr. Inrig.
Some committee members are absent due to a retirement dinner being held for several senators, but we have read your brief. Please proceed.
Mr. Ian D. Inrig, Dominion Secretary-Treasurer, The Army, Navy and Air Force Veterans in Canada: Thank you, honourable senators, for the opportunity to appear here. As well, I thank the chairman for his generous remarks about the longevity of our association.
I understand that there is a need to conclude the hearing as soon as possible, so I suggest we go straight to the question portion. Our concerns are indicated in our written presentation and in our recommendations.
Senator Jessiman: Were you here during the other presentations?
Mr. Inrig: Yes, I was.
Senator Jessiman: Do you agree with the testimony that was given? Obviously, there is a waiting list throughout Canada. And then there is this phantom group who will pass on, as everyone does, but they may fall on veterans affairs. What is your recommendation? How do we get rid of these waiting lists? Is the answer found if the federal government agrees to pay a fee to find facilities? They say the beds are there. Do you agree?
Mr. Inrig: Yes. I agree with the comments of the Royal Canadian Legion and the National Council of Veterans Associations on this subject.
It was apparent to me when I was listening to your questions specifically, Senator Jessiman, that you may not have a copy of this document called, "A Data Consolidation of VAC Contract and Departmental Beds." It lists every contract and departmental bed in Canada, along with its location and its source of funding. This committee should have access to this information.
Senator Jessiman: I have not seen it.
The Chairman: I do not believe we have it, Mr. Inrig.
Senator Jessiman: Could we have copies of it?
The Chairman: I will invoke the parliamentary rule. Once you show a document, you must table it. Once you do that, we can photocopy it. Is that all right with you?
Mr. Inrig: That is perfectly fine with me, Mr. Chairman.
Going back to your question, Senator Jessiman, this document talks about contract beds and floating beds. In my brief, I mention that there are only 48 floating beds available in Canada. Why can the unused beds not be designated as floating beds so that they can be used in the communities where they are needed? If that were the case, the veteran's family need not endure long drives or long separations.
That is one of our points on availability of beds. We know it can be done. The beds are available in the various stocks. We have been given to understand that the provincial bureaucracies are not in favour of this because it imposes an administrative burden upon them. We have little patience with that.
Senator Jessiman: Do you find that, once you have contracted out, the service is about the same as it was before?
Mr. Inrig: I would say yes.
Senator Jessiman: Do you know anything more about the fire in Sunnybrook?
Mr. Inrig: My only knowledge of that is from the safety survey that was done for Sunnybrook. I presume you have copies of that.
Senator Jessiman: We will be seeing them tomorrow. You would not attribute that incident to the fact that it was not administered under VAC?
Mr. Inrig: Our concern with respect to the situation at Sunnybrook, and also the situation at the Perley and Rideau Veterans' Health Centre, is the lack of hands-on inspection or supervision, if you will, by Veterans Affairs Canada.
In their document, there is an action plan to which Mr. Chadderton referred. I do not know whether or not you have copies of that. I am prepared to show it to you and to have copies made for you, if necessary. They talk about an annual visit to a facility by a Veterans Affairs representative. We think that visits to these facilities should take place more frequently than on an annual basis. I would say four times a year, at a minimum, or once every two months.
Once you had that sort of involvement, the staff at the facility may start to look more closely at things like fire safety and other health concerns. Both the safety survey at Sunnybrook and the Perley report on the quality of care and selected services delivered to veterans by the Perley and Rideau Veterans' Health Centre are very good reports; they are thorough. They say, "We have a problem here and there," and so on.
However, unless those reports are acted upon and included in this long-term action plan of Veterans Affairs, the reports will gather dust, and we will continue to have problems in those two facilities specifically.
The Chairman: You mention the reports. I read those yesterday afternoon. My reaction to them is that they contain a lot of smoke and mirrors. They spoke about the improved smoking facilities for veterans and the safety of that. I thought they were trying to suggest that smoking was the cause of the fire, when I know entirely differently. It was not someone smoking in bed that caused the fire; it was a case of senile dementia. I am interested to know -- and I will be asking these questions tomorrow -- how often the fire marshal visited this facility, or other facilities, and what training the staff were given have in evacuating patients in case of a fire. I have not conveyed the idea of my questioning. Is there anything else that our group -- and I suppose I should have asked this of the others, but time does not always permit -- should be looking at? One thing that disturbed me was that we are checking the qualifications of people provided to us by the agency, yet the agency is not described. I do not know what the agency is. Do your people know any of those answers?
Mr. Inrig: We are no wiser than you, sir. I subscribe to your concerns and I certainly support them, when it comes to the inspection of plant and inspection of the common-sense things that we should be looking for to ensure fire safety.
The Chairman: When you say you are no wiser than I am, you remind me of my favourite story about Einstein, who was unable to read without his glasses. He was travelling on a train in the United States and he had left his glasses behind. He called the waiter over and said, "I cannot read the menu. Can you tell me what is on it?" The waiter looked at him and said, "No, sir, I am just as ignorant as you is." I guess we are both in the same boat, then. We will have to start pressing for those answers tomorrow.
Are there any specific questions that you feel should be asked in Sunnybrook tomorrow?
Mr. Inrig: I would pursue what you have already alluded to, the fire safety aspects, specifically with respect to the training and the qualifications of the staff. I would be examining the physical plant to see access routes, exit routes, things of that nature. I would be very much concerned about those things.
The Chairman: I would ask the same question of the Legion.
Mr. Margerum: There is one very important question on the central issue, and it is something that we have argued about over a number of years with the VAC. They have dementia patients there, harmless or genteel patients as I would call them. They put them in with psychogeriatric patients, who are violent and unpredictable. In both cases at Sunnybrook, the problem was with one of those patients. We understand, in the case of the patient who was thrown on the floor, that on the door of one of those four-bed rooms, there was a picture and/or a name of one of these psychogeriatric patients, which had not been taken down even though he was no longer a resident in that room. That gentleman went along and saw that picture or name plate, was confused, went in the room, found someone in his bed, took him out and threw him on the floor. That gentleman should not have been mixed in with the other patients. They should have had a special area for psychogeriatric patients. I think that is the terminology for those patients. I would ask them on what basis they mix these people together and why they are not separated, in view of the safety of the other people. That is a very critical question.
As to other questions, I agree with Mr. Inrig. You should look at the lay-out, the fire system, the number of times they do inspections. I think fire inspections are carried out once a year by the fire department. I also think they should not only have four inspections a year but that they should have random inspections. They should be able to walk in in the evening, overnight, or during the day, and see exactly what is happening. That would eliminate a lot of our problems there.
Senator Jessiman: You talk about the problems they had with the transfer to the facility at Perley and Rideau Veterans' Health Centre, and you have a lawsuit. What is it we have to watch out for there? Why is there the lawsuit? What happened?
Mr. Inrig: Again, my honourable comrade from the Royal Canadian Legion can give a better answer to that than I can because he is hands-on. It is my understanding that the terms of the transfer were, in part, erroneous. After the transfer took place, the province said, "We are going to do this," and the management of the Perley said that it was not in accordance with the terms of the transfer. Again, I will defer to Mr. Margerum on this.
Senator Jessiman: So it was a question of communication.
Mr. Margerum: One of the problems was that the Perley took over the Rideau Veterans' Home first, for a year, approximately, and then they transferred into the new facility. They had the same problem, a psychogeriatric resident in with the dementia patients. There was a Hong Kong veteran there, who is a little bit of an agitator because of his condition. He agitates people and he agitated this gentleman. The Hong Kong veteran is about five foot five, and the gentleman he decided to make remarks to is about six foot four and weighs about 240 pounds and he proceeded to punch him out. That was reported. The Minister of Veterans Affairs looked at the incident. The facility failed to report the incident in the prescribed time-frame. We took it up with the Minister of Veterans Affairs. He said he agreed with us, and that from now on, he will insist on having these things reported on time. Three months later, they moved into the new facility and the same thing occurred again, between the same two individuals, but there was an argument over where it occurred. It was not reported in the prescribed time-frame.
The spouse of the veteran was given one story. We went to the facility three days later to investigate the incident and the story had changed. That means one of two things: Either the person who called the spouse was not authorized to call but did and told her what happened, or the Perley staff did not report it. We had a similar incident, one where death could have resulted, so we reported that and brought our concerns to the VAC and others. They chose not to address it in a proper manner. As a result, these things happened at Sunnybrook. Until we address the serious situation of the mix of the veterans in there, there will continue to be incidents. If they do not address the problem, it is only a question of time until another incident occurs, sir.
Senator Jessiman: Is this what the lawsuit is about, one of the patients attacking another patient?
Mr. Margerum: That happened at Perley.
Senator Jessiman: Are they claiming that the province should have separated these people?
Mr. Margerum: The gerontology experts and those in that field say that you cannot mix these kinds of patients. However, because of cut-backs and because of closing beds, even though they have an allotment and have not opened all the available contract beds, they have decided to go the route of saving money rather than addressing the needs of our veterans, and they have mixed them.
The Chairman: I presume the Kilgour wing in Sunnybrook reports to the hospital administrator. I am not clear as to how they report to Veterans Affairs Canada. Do you have any knowledge of that, Mr. Inrig?
Mr. Inrig: No.
The Chairman: We should have clarified by what methods the reports are coming to Veterans Affairs Canada, whether they go through the administrator who does not want his administration criticized or whether they go directly to VAC.
Mr. Inrig: I agree.
The Chairman: With regard to the floating bed concept, I have heard many complaints that there is a long waiting list for admissions to institutions where, in many cases, the province has filled those beds. Let us take the case of a veteran who has been at home managing quite nicely and then has a stroke and must be transferred into an institution. However, the bed which is supposed to be reserved for a veteran is now occupied by a non-veteran without the province recognizing the fact that the federal government is responsible for the care of the veteran. They do not want to kick the non-veteran out. Of course, taking one patient out of a bed to make room for another is a problem. Do you have any suggestions as to how the priority of beds or the urgency of admission for veterans could be established?
Mr. Inrig: I would suggest that in a given facility if there were a prescribed number of contract beds and they were filled by a mix of both veterans and civilians, then the number that are filled by civilians should not be contract beds per se. That would then free up contract beds for the person in question.
The Chairman: I am thinking of two small hospitals in P.E.I. with which I am quite familiar. They complain that they do not have enough acute care beds and emergency beds, that patients end up in beds assigned for other purposes. I really cannot blame the doctors for that. The doctors do not want to say to a patient, "That bed is reserved for so and so, but it has been vacant for two weeks and we do not know when we will need it." How can that situation be met?
Mr. Inrig: I do not know the philosophical bent in which we are examining this, whether there are additional beds there or whether the facility has utilized all its beds. Assuming that it has utilized all of its beds, I would suggest that the object of the exercise is to get our veteran into a bed. If we have to put him 40 miles away until a bed in this facility becomes available, we put him there and then bring him back when this bed is available. I do not know if those things are explored by either the provincial authorities or by Veterans Affairs. It would seem to me that what is probably required more than anything else in this whole matter is a large measure of common sense, and I am not sure it is being applied.
The Chairman: I agree with you as to the common sense; I also agree that there are not enough hospital beds. This committee must hammer at that. We must have more beds.
Senator Jessiman: Were we not told that the beds themselves are there but that it is just the payment to service the beds that is in question? The physical beds are in the hospital. Am I correct in that?
Mr. Inrig: In some cases, yes, but not necessarily in all cases. I think we are talking at this point about a facility where beds are not available. The problem then for this committee is how to get them available as opposed to opening up those beds that are already there but are not being used.
Mr. Margerum: There are 250 beds in the Rideau Veterans' Home. There are actually 255 veterans there; five are in community beds.
Senator Jessiman: There are 250 beds available?
Mr. Margerum: There are 255 veterans in there. Five veterans are using community beds, bearing in mind that a veteran is still a resident of the province and is therefore entitled to the same treatment as a community resident. Veterans Affairs in the Ottawa district will place a veteran outside of Ottawa, in Embrun, for example, on the understanding that as soon as a bed open up at the Rideau Veterans' Home -- unfortunately, usually as a result of the death of another veteran -- that veteran will then be moved. If there is an excess of beds in the contract facility, community residents will be put in those beds. However, the attrition rate is high so it is not long before a veteran on priority one would be in there.
Taking away acute care beds in hospitals takes away the facilities of acute care requirement residents. We are recommending that they go either to nursing homes or to long-term care homes -- that is, facilities that have a good reputation and meet the requirements for minimum care -- and sign a contract for beds there. This would alleviate the situation. We do not support building huge hospitals when you take into account the time-frame left for our veterans.
There is definitely a provision to construct extra wings to existing nursing homes or, for instance, to take over five beds. For example, a hospital on Montreal Road in Ottawa cares for patients who have dementia or Alzheimer's disease. An entire floor of that hospital is empty. Those 40 beds could be taken by a lot of the people who are on our waiting list, yet they remain empty. Why is that happening? A contractual arrangement could be made with Veterans Affairs Canada and with the Province of Ontario. They should stop arguing amongst themselves. We could fill those beds and then let the two governments argue over who will pay. The beds are available. These provisions are not insurmountable; the bureaucrats just have to get their acts together.
Senator Jessiman: You were talking about this centre of excellence. You said that from the limited information you have received so far you would not support it. Is that correct?
Mr. Inrig: I would not support it?
Senator Jessiman: Yes. You say that you do not have council's report or the gerontological advisory report yet. However, in your report you say that you are advising the council about your lack of support.
Mr. Inrig: That is correct.
Senator Jessiman: Do you have any idea what the other advisory council will recommend?
Mr. Inrig: No. The advisory council held its initial meeting in October and then broke into subcommittees. The subcommittee that Mr. Chadderton was talking about met in Toronto. I am a member of that council, too. It concerned itself with housing.
The Subcommittee on the Centre of Excellence will meet in Victoria but they have not met as yet. I spoke to the chairman of that council. I am submitting a brief to them concerning our lack of support. I am doing that because, as Mr. Chadderton said, Veterans Affairs Canada has produced 11 studies over the last half dozen years. In fact, they are constantly coming up with studies and giving us copies to read. We do not see any point in having a national research organization because we are afraid that it will be set up with money that should go elsewhere for veterans' benefits. That is our prime concern. They already have a research staff member in their organization. His function is to do research, and so on. We do not see what Veterans Affairs Canada can achieve other than the grandiose title of a centre of excellence for its research area. They seem to be researching well, what with all the studies they have produced thus far.
Senator Jessiman: In other words, the money could be used better elsewhere?
Mr. Inrig: Yes.
The Chairman: In your conclusion, you say that monitoring should take place more frequently than on an annual basis. You suggested every four months; is that right?
Mr. Inrig: I would say at least four times a year, which would be every three months, possibly every two months.
The Chairman: In other words, it should operate as banks do? That is to say, when the inspectors show up, no one knows about it ahead of time?
Mr. Inrig: Exactly.
The Chairman: Do you think that the ceiling for those veterans who need assistance is high enough? That is to say, is the income ceiling high enough? I am beginning to wonder if it should not be raised.
I have received many complaints about people being a few dollars over the ceiling. Initially, they received a monthly assistance, but their spouse may have qualified for the Canada Pension Plan. When that small amount is finally given to them, they lose everything. That is grossly unfair.
Mr. Inrig: I suggest that the ceiling could be raised. A thorough review of the ceiling is in order. I would recommend that to this committee.
The Chairman: With regard to the cost curtailment, is it a budgetary measure or is it hurting veterans? If so, how are they being affected?
Mr. Inrig: We have one example where the veterans were actually hurt. That occurred in 1995. We had been told by the deputy minister that any benefits enshrined in legislation could not be touched. We were subsequently advised by staff members of Veterans Affairs Canada that they would reduce the travel benefits, for veterans who seek treatment, from an average of 25 cents a kilometre to 10 cents a kilometre. We said, "You cannot do this because it is enshrined in the regulations, which are part of the legislation." They said, "Well, we are terribly sorry."
I have a letter here written by a Veterans Affairs Canada staff member who stated that he was sorry but that the department had to make up the reduction in this cost curtailment as part of the reduction in funding by Treasury Board.
What made us particularly angry was that the change was made by Order in Council. It occurred in late August or early September of 1995, when the House of Commons and the Senate were not in session. Neither the House of Commons nor the Senate was given an opportunity to debate this change or to examine it. We felt that that was a betrayal of what the deputy minister had told us and that they were making this group of veterans pay twice. We have a very real irritation for this cost curtailment.
Senator Jessiman: When did that take effect?
Mr. Inrig: In September of 1995.
The Chairman: Yes. If I recall correctly, we were debating some amendments and the minister came back here and assured our committee that no veteran would receive less than he had been receiving. The mileage was then cut back and taxi fares were eliminated in certain areas.
Mr. Inrig: That is correct.
The Chairman: In so doing, damage was done to veterans, many of whom cannot use public transportation. It was their view that everyone could use public transportation.
Are there any other sections of your brief that you would like to emphasize, Mr. Inrig?
Mr. Inrig: I wish to emphasize what Mr. Chadderton said, namely, that the benefits of the VIP program which are bestowed upon the person entitled to receive VIP -- that is, housecleaning, groundskeeping, and things of that nature -- should be extended to the veteran's widow indefinitely. As long as she has the residence, she should receive those benefits. They should not be cut off after one year. We should like to see that continue.
The Chairman: You share the view of both the NVCA and the Royal Canadian Legion that the widows should receive fair treatment in the pension allocation.
Mr. Inrig: Yes, definitely.
The Chairman: Thank you very much, sir, for your appearance here this evening.
Our next witnesses are representatives of the Merchant Navy Coalition for Equality. Please proceed.
Mr. Gordon Olmstead, National Chairman, Merchant Navy Coalition for Equality: Honourable senators, it is almost 10 years since I first testified before Senator Marshall's committee, years of struggle in which your committee has made a difference in reducing considerable odds and providing advice and support. We thank you for that.
Ms Muriel MacDonald, Executive Director, Merchant Navy Coalition for Equality: As Mr. Olmstead stated, this committee is on record in its support for our cause. In January 1991, Senator Marshall's report "It's Almost Too Late" preceded and, I feel, influenced a Commons committee report on the merchant navy. In October 1994, your comprehensive report on all veterans, "Keeping Faith: Into the Future," summed up our concerns. We thank you for your hard work.
On the doorstep of 1998, we look back at your 1991 report and say that it is too late for Canada's wartime merchant navy. After more than 50 years, about three-quarters of the merchant navy war veterans have died, but we still hold faith that this Senate subcommittee and its recommendations will support our cause for justice for the health of the few remaining merchant navy veterans.
The coalition met with Veterans Affairs Canada Deputy Minister David Nicholson and his staff on May 7 and May 8 of this year. As a result, no-cost amending legislation is being drafted to fully include the merchant navy under the means-tested War Veterans Allowance Act. The result of that will be to reinstate Canada's wartime merchant navy as a war service and its veterans as war veterans. The result will be emotional healing and symbolic significance, especially for bereaved families.
Compensation for lost benefits, such as health benefits and lost opportunities, was on the May agenda but not discussed. On October 7, there was another meeting with the department to discuss compensation. The department is at this date non-committal.
After more than a half century, merchant navy war veterans have been without the benefits and services granted to their military comrades. Now, under the War Veterans Allowance Act, they face means-tested benefits and services, which benefits and services have eroded over the years as the department has had to meet cost-cutting and downsizing directives. In fact, the erosion of health care is systemic in the general population. The state of health care for Canadian veterans cannot be made without reference to legislation for medicare and its impact on the general population, and within that population on veterans, and within that minority the merchant navy war veterans.
It is not this committee's mandate to review the Canada Health and Social Transfer Act, but the fallout from legislation as it impacts on the health care of veterans is inevitable and cannot be ignored. That is only to say that the federal government has lost its authority to enforce national health care standards when the 50-50 cost-sharing system was replaced in 1977 with block funding and unconditional transfer of tax points.
Over the years, the federal government has reduced the yearly rate of transfer payments to the provinces, capped them and then put a freeze on them, replaced them with the Established Programs Financing Act, which was meant for health and post-secondary education, and the Canada Assistance Plan for welfare programs. They scrapped that and replaced it with the Canada Health and Social Transfer Act in 1996.
The provinces have gained more tax points, the federal government correspondingly less, and the federal transfer payments are less each year. The provinces are free to spend however they wish. They have to choose between raising taxes -- an unpopular move -- or cutting services.
Since 1986, the federal government has cut $35 billion from health care. The result has been to download to the provinces and from the provinces to some municipalities as provinces are increasingly unable to carry the extra freight. Some provinces have shifted the cost of health care to families and employees, opening the door to private insurers. Hospitals and hospital emergency departments are closing. There are long waiting lists for beds. We have heard all about this.
Some hospitals are partnering with the private sector to set up for-profit entities, like St. Joseph's in London, Ontario, which has partnered with Dynacare in a for-profit "rehab" joint venture. Toronto Hospital has partnered with MDS Inc. to develop and sell automated lab services. Both these companies have partnered with regional health authorities in Alberta and Saskatchewan. Hospitals are also outsourcing food, laundry, medical records and other vital components of their operations.
In this way, Colleen Fuller writes:
...public dollars sluice into shareholders' and investors' pockets.
Hospitals are big with investment counsellors.
Another piece of legislation that impacts on medicare is the 1992 Patent Amendment Act, which is now being amended. Seniors, including veterans, are among the biggest users of prescription and over-the-counter drugs. Many seniors are paying user fees on medications and seeing their deductions on provincial drug plans rise regularly. Many are going without.
In its February 1997 brief to the House of Commons, the National Pensioners and Seniors Citizens Federation noted that prescription drugs accounted for 15 per cent, along with doctors' fees at 15 per cent, of total health care costs in 1995. These costs are second only to the cost of running hospitals.
The prognosis for the future care of the disabled, poor and ill veterans is in doubt; for the merchant navy war veterans, it is critical. About 2,500 of 12,000 remain. Their average age, if alive, is 77, and for prisoners of war, 87. The average life expectancy of Canadian males is less than 76.
In the total veteran population, VAC reported in 1996-97 that 220,000 received direct benefits. Of those receiving benefits, the number of merchant navy war veterans is unknown. The department has not programmed its computers to distinguish merchant navy applications by service, although that is one of the qualifiers when applying for entitlement. Therefore, they do not know how many merchant navy war veterans are receiving benefits. Perhaps Veterans Affairs Canada should call on the computer experts in their knowledge economy partnership for assistance.
Some veterans are having to join the long waiting lists for beds in hospitals with designated veterans' beds. In 1994, I noted before a Senate committee that veterans needing level 1 nursing care were no longer being accepted in chronic care facilities. There was a waiting list for those needing level 2 care -- one-and-a-half to two-and-a-half hours daily nursing care; that is, feeding, bathing and toileting with visiting medical and psychiatric supervision. Today, nothing has changed.
It is too late for Merchant Navy war veterans who are at the end of the line. This October, only by deputy minister intervention was a Merchant Navy war veteran admitted to the Perley and Rideau Veterans' Health Centre.
I have not heard Veterans Affairs Canada's benefits redesign project mentioned today. Considering the disintegrating health care system, it should come as no surprise that VAC has contracted the nuts and bolts of structuring and delivering its core responsibilities of disability pensions, economic support, and health care programs to EDS Canada Ltd., an American information technology firm. Veterans Affairs calls this a cost-effective business solution. As briefly described in the department's "Performance Report -- (Improved Reporting to Parliament Pilot Document) -- For the Period Ending March 31, 1997," tabled in the House of Commons on November 6, EDS Canada Ltd. will integrate public non-profit and private for-profit delivery of benefits and services in liaison with Treasury Board, Public Works and Government Service Canada, and the Income Security Branch of Human Resources Development Canada. The project started in April 1993 with full implementation expected by June 2000.
I have that report and wish to table it for the consideration of your committee.
Apart from possibly compromising the five principles of the Canada Health Act -- universality, accessibility, comprehensive coverage, portability between jurisdictions, and non-profit public administration -- the coalition asks this committee, on behalf of Merchant Navy war veterans and all veterans, to request from Veterans Affairs Canada certain information to assist you in your study in preparation for your report. I have 12 questions. As the time is late, I will not go through them all. The main questions concern transparency and accountability. In addition, who has access to this information? How much is EDS Canada Ltd. receiving for this contract? What are the terms and mandate of the prime contractor and subcontractors? Another important point is, as this is a major Crown project, what level of profit-loss margins are set?
Apparently a pilot study is now being carried out at five district offices. I would like to know how many district offices will finally be involved. How long is the current Veterans Affairs Canada staff guaranteed employment and at what levels?
For veterans in long-term care, Veterans Affairs' safety audit at Sunnybrook reflects the general decline due to underfunding and understaffing. A similar audit at Perley and Rideau Veterans' Health Centre makes clear that, without the marginal help of volunteers and wives, some patients would not be fed, washed or have their clothes changed.
Veterans Affairs Canada is in an untenable position. The federal government has been looking for ways to provide services for less money. In addition to following directives of contracting out, partnering and privatizing, Veterans Affairs has to try to patch over the patchwork of uneven provincial services in a disintegrating medicare system.
After their December 12, 1997 meeting, the Prime Minister and the provincial ministers announced that they will work out a new framework for delivering social programs, including medicare. There is disagreement, however, on how to build this framework. Merchant Navy war veterans cannot wait.
In the interim of waiting for new federal-provincial rules for medicare, is EDS the answer to questions of how national guidelines and standards for veterans' care will be maintained and monitored? The levels of care are unclear. These and accountability were not given in the department's client-centred service delivery model, nor in their inconclusive action plan for institutional long-term care.
Veterans Affairs field staff face a daunting task of having to scramble to find health service in local, regional and provincial agencies, or by leveraging through those available from the department. The rationale for handling these problems is given in their philosophical shift from program-centred to client-centred. Most disturbing for ageing veterans requiring long-term care in the client-centred approach is the directive requiring "the client's direct involvement in self-care and planning decisions." There is no mention of providing for veterans with dementia, Alzheimer's or other disorders, who cannot make their own decisions.
Health care is a provincial responsibility but the provinces did not send the veterans to war. Health care of veterans is a federal responsibility. The federal government is abrogating its responsibility.
Canada's wartime Merchant Navy paid a debt it did not owe. Canada owes a debt it did not pay. Veterans Affairs Canada cannot be held responsible for the collapse of national health and social programs. They are responsible for abrogating their obligations to Merchant Navy war veterans. The restrictive legislation of 1992, Bill C-84, the Merchant Navy Veteran and Civilian War-Related Benefits Act, does not provide equal access to income-tested benefits and disability pensions given the military. Merchant Navy applicants must run a maze of 40 exemptions to win. Merchant Navy war veterans are not recognized for war service; nor is all their war service time, training or the injuries and death which occurred during training, service, and in theatres of war.
Veterans Affairs acknowledges the inequities of Bill C-84 in the pending no-cost legislation to include Merchant Navy war veterans under the means-tested War Veterans Allowance Act. This, at last, has symbolic significance for their recognition and reinstatement as the fourth arm of the armed services.
On a practical level, the eroding of health care generally and other benefits in war veterans' allowances do not meet the escalating cost of living and the ability to pay for basic necessities. Other evidence of the inequities of the 1992 legislation to provide the department's advertised "equal access to equal benefits" is the balance remaining in the fund allocated for catch-up. The fund ran out only a few months ago with Veterans Affairs estimating an untapped balance of between $70 million and $80 million.
It is too late for Canada's Merchant Navy war veterans. After more than a half century, about three-quarters of the original 12,000 have died. By the year 2000, approximately 2,100 or less, including Newfoundland survivors, may be alive.
In World War II, the first priority of the allies was keeping the lifelines open. British Prime Minister Winston Churchill acknowledge that had the Merchant Marine failed all would be lost. It must be remembered that Canada's wartime Merchant Navy, proportionately, suffered the highest losses, one in eight. Now at the end of life, Canada's Merchant Navy veterans are still being bypassed by other priorities, as they were in the post-war period.
Therefore, the coalition respectfully requests the Senate subcommittee to recommend to the appropriate departments that Canada's Merchant Navy war veterans receive a public apology and compensation for the bias, mistreatment and neglect they suffered during the war and post-war periods. To compensate for the lost opportunities and the discrimination in excluding them from benefits accorded their military comrades, a tax-free lump-sum payment of $20,000 should be paid to Merchant Navy war veterans and $40,000 to Merchant Navy prisoners of war who, on average, were incarcerated for 15 months but only have 36 months recognized. The $70 million to $80 million untapped balance could pay for this, or an income-tax-free life. During World War II, the Merchant Navy was the only service to pay income tax. The compensation would not replace, eliminate, modify or impinge upon whatever benefits some might now be receiving. These would continue. There are precedents. The government rightly paid compensation for the forced relocation in World War II of Japanese Canadians and the unjustified relocation of the Inuit in 1953.
Mr. Olmstead: I will deal with the background and Merchant Navy veterans who were prisoners of war.
In 1942, Geneva brokered a multilateral agreement among the western Axis powers and the Allies that merchant navy internees would be treated as prisoners of war. External Affairs ratified the agreement for Canada. Canada treated Axis merchant navy internees as prisoners of war, but Canadian merchant navy prisoners of war were denied that status on repatriation.
Canadian merchant navy prisoners of war were denied academic education, most POW benefits and all preferences in employment and rehabilitation. There was no provision for medical assessment on repatriation. Some were advised that they could not expect employment after four years as idle POWs; others that the jobs were reserved for "real veterans."
Disabled merchant seamen, including merchant navy prisoners of war, were not eligible for benefits or rehabilitation except for the Veterans' Land Act. Disabilities pensions were awarded only if the disability was due to enemy action. In 1992, disability pensions were extended to "during service" and a restrictive definition of service on a high seas voyage.
When the war ended, manning pools were ordered to destroy their records, including medical records. That destruction continues to make medical claims difficult.
In 1949, Transport extended the scope of vocational training from marine-only to general. Training was restricted to those under 30 years of age. Some 89 per cent of Canadian merchant navy prisoners of war were eliminated on that barrier alone. With 8,000 of the war's 12,000 merchant seamen severed from marine employment, Transport extended courses to 282, or 3.5 per cent.
At the end of 1948, Hal Banks and the Seafarers International Union had been brought in with the complicity of the federal government. In July 1963, after almost a year of investigation, the Industrial Inquiry Commission on the Disruption of Shipping, headed by Justice T.G. Norris, issued a report. The report was a scathing indictment of Hal Banks, his methods and his associates. Justice Norris called the result "industrial death." Perhaps that is a health consideration.
Seamen were robbed of employment at sea and branded as "unemployable Communists" ashore. Their treatment was brutal. A favourite persuasion was to spread a seaman's legs across a raised curb and jump on them to break them. Brutality was not restricted to the seamen. Even captains were attacked for as little reason as to delay a ship.
In 1964, Banks fled to the U.S. as a fugitive from Canadian justice. Many seamen had been reduced to unemployment and poverty. In the four decades of the Cold War, Canadian merchant seamen who had maintained their loyalty through the war had their living and their prospects destroyed.
In 1971, POW compensation was introduced for military prisoners only who had been held for at least one year by the Japanese.
In 1976, the federal government introduced time-based POW compensation where the time-based increments ended at 30 months. The compensation was extended to civilians including seamen.
On December 17, 1987, Bill C-100 received Royal Assent, among other items. It amended POW legislation to its present form. The time-based increments equate roughly to 5 per cent for each six months of incarceration but ended at 30 months. The 30- to 36-month period was designed to accommodate the Dieppe prisoners at approximately 33 months. There was no recognition of long-term prisoners like the primarily four-year prisoners of the merchant navy.
On the November 8, 1990, the Honourable G. Merrithew, then Minister of Veterans Affairs, in speaking of merchant seamen stated:
...the Royal Canadian Legion, the Army, Navy, Air Force Association, and the National Council of Veterans Associations, along with members of our department and members of the portfolio, which would include the Pension Commission, Bureau of Pension Advocates and the Veterans Appeal Board would put this thing to a major study with all groups present to see if anything can be done and if we can reach a meeting of minds on this particularly thorny issue.
The minister announced to the Commons standing committee that it was set up as a topic for discussion on October 24, 1990.
The parties named to this study, to the total exclusion of merchant navy representation, spent a year in reinforcing their mutual misconceptions. The veterans organizations had represented the merchant navy in the past -- to their detriment as described in the Senate report, "It's Almost Too Late," of January 1991 -- and were eager to continue to do so.
On June 17, 1992, Bill C-84 was considered in the Senate Committee of the Whole. Minister of Veterans Affairs Merrithew testified that:
Bill C-84 says, in effect, that the Merchant Navy was the fourth arm of the service... should they have been called by the manning pool to report for service, we want to include the trip from their home to that service, including, of course, from the time they were either hurt or sunk or were signed off, until they got home.
The first statement was not honoured and the second was legislated against. The old act covered service with its implications of health protection through repatriation. The amended act does not.
Senator Bonnell posed the questions that led to those answers.
In a program overview, Veterans Affairs announced that Bill C-84 was, in addition to the above:
...limiting future eligibility for Allied veterans to those who were domiciled in Canada at the time of enlistment... No existing Allied recipients who live in Canada will be affected by this change.
Obviously, if you have never had a chance to apply until after Bill C-84 was passed, you were cut off. This had the appearance of a preemptive strike against Allied merchant seamen. Who else is left who has never had a chance? It was also a breach of faith with the many experienced seamen from overseas who were contracted to serve on Canadian ships.
Allied merchant seamen, some whom were prisoners of the Japanese, with ten years' residence and citizenship, deserve access to the same benefits as a variety of other nationals in the military or resistance movements. They, too, suffered a higher rate of losses than the military.
Secretary of State MacAulay testified to the Standing Committee on National Defence and Veterans Affairs on March 10, 1994, that:
Second, merchant navy prisoners of war receive exactly the same compensation, on the same basis, under the same legislation as military prisoners of war.
In a brief dated March 18, 1988, Veterans Affairs Canada advised that year's subcommittee that the time-based compensation:
...was an attempt to compensate former POWs to some degree for the indignities, maltreatment, malnutrition and permanent scars which resulted from their imprisonment by the enemy...
The compensation is defined as time-based compensation but the last increment occurs at 30 months. It looks after the majority of military prisoners.
Over 85 per cent of merchant navy prisoners were held over 48 months. Once again, we have equal legislation, unequal treatment. The increment of approximately 5 per cent for six months' incarceration, which provides 25 per cent for 30-month prisoners, provides the same 25 per cent for 48-month prisoners.
The issue is health-related by Veterans Affairs and we reaffirm our request that Veterans Affairs increment time-based compensation by 5 per cent for each six-month period beyond 30 months.
Finally, Veterans Affairs own figures specify that in the surviving Merchant Navy approximately 70 per cent meet the means test versus 30 per cent for the military. It is too late to rectify their "means test" poverty but not too late to provide more than palliative care with a means test.
We are concerned that the health care agreements with the provinces are being eroded by provincial changes. What provision is Veterans Affairs making to maintain Veterans Affairs' standards?
In The Ottawa Citizen's "Brown's Beat" of December 11, Mr. Brown noted that 1,487 people in the Ottawa-Carleton area are on the waiting list for long-term care. On December 15, CBO reported a four-month wait for home care. Where does that leave the veterans or anyone else for that matter?
We recommend that the time-based POW compensation be extended beyond the 30-month increment by increments of 5 per cent for each six-month increment. See Table 1 for comparison proposals and Annex A for cost estimates. Your researchers may be interested in those documents.
We also recommend that legislation preventing allied Merchant Navy veterans from joining long-term allied resistance and military veteran beneficiaries be amended to permit their entry.
We also recommend that Minister of Veterans Affairs Merrithew's testimony that Bill C-84 says in effect that the Merchant Navy was the fourth arm of the services be put into effect by Veterans Affairs and that the fourth arm of the services be recognized by the government on Remembrance Day as the other services are recognized by the Chief of Defence Staff.
Mr. Thomas H. Brooks, Company of Master Mariners of Canada, Merchant Navy Coalition for Equality: Mr. Chairman, all our colleagues are getting older and their ability to understand their benefits is increasingly impaired. Presently, the merchant service is legislated under the Merchant Navy Veteran and Civilian War-related Benefits Act with cross-references to the War Veterans Allowance Act for its health and other benefits. When Mr. Michael Clegg from the legislative council on May 22, 1996 was reviewing the MN&CA for the purpose of enhancing the merchant service veterans' access to benefits, he stated that the legislation is so complicated, one really has to be a specialist to know where to make changes. We must ask the question: If a legal expert cannot understand the legislation without first being a specialist, how are our ageing veterans and their ageing families supposed to understand their veterans' health benefits?
The coalition recommends to the subcommittee that it support the request of the merchant service veterans to incorporate them directly into the War Veterans Allowance Act and eliminate the need for complicated cross-references.
The next recommendation was touched on very briefly by Ms MacDonald. The ongoing discussions between the coalition and Veterans Affairs Canada will focus on ensuring that more of the Merchant Navy service time is recognized as qualifying service, and that disabilities and illnesses that occurred during that time are recognized, and that the veteran is granted benefits accordingly.
The legislation does not recognize disabilities or illnesses that occurred under certain conditions, and I have made a list of 14 items, which I will not read.
The coalition recommends to the subcommittee that it support amendments to the War Veterans Allowance Act which will include the above service time as recognized qualifying service so that if a merchant service veteran became sick or disabled during that time, he or she will have equal access to equal benefits as their military service colleagues.
In the military services, there were always teams of specialists who travelled around the world informing military veterans of their rights to post-war benefits. They were advised on discharge and they were given travel and living costs to see a professional counsellor if they had problems. The merchant service never got any of that. We wonder how much information was given to the merchant service because there were many benefits that they did not receive. Out of 12,000 merchant seafarers at the end of the war who should have received a war service bonus, only 6,780 received it. They collected $212 each, which today would be worth about $2,120. Why did so many of these veterans not receive this bonus?
The coalition wishes never to see a repeat of lost benefits because of a lack of timely advice. The coalition recommends to the subcommittee that it support a publicity campaign by Veterans Affairs Canada to reach as many merchant service veterans as possible who may not know about their entitlement to health and other benefits.
In conclusion, the merchant service veterans are concerned about the recent and proposed changes in the funding and administration of health care and in the downsizing of departments that provide health services and benefits to veterans. The coalition encourages the subcommittee to make every effort to ensure that these services and benefits are not reduced for our ageing and vulnerable veterans.
The coalition thanks you for your kind invitation to present its views on the availability, quality and standards of health care for merchant service veterans.
The coalition is now prepared to answer any of your questions.
The Chairman: Ms MacDonald, on page 4, with regard to hospitals, you say that veterans needing level one nursing care were no longer being accepted in chronic care facilities.
Has there been any improvement in that situation since 1994?
Ms MacDonald: No. I called Veterans Affairs Canada and there has not been any improvement. It still stands the same, senator.
The Chairman: Other witnesses this afternoon told us that a veteran is still entitled to the same health care benefits as other people. Do you find that merchant seamen are having any more difficulty in getting health care than the ordinary non-veteran?
Ms MacDonald: Yes, some of them are. For instance, we had a member whose brother was also a merchant seaman. Our member was trying to get his brother into a hospital bed in Alberta, and he could not. He finally ended up in the Salvation Army and that is where he died.
Senator Jessiman: He was a merchant seaman?
Ms MacDonald: Yes.
The Chairman: I am not clear, Ms MacDonald. What type of bed was he attempting to gain admission to?
Ms MacDonald: It was an ordinary hospital bed.
The Chairman: You referred to the Auditor General's report for 1996. I reviewed that yesterday afternoon. Have you noticed any improvement since the Auditor General's report of a year ago? As a matter of fact, has Veterans Affairs attempted to contact any of the merchant seamen's organizations in regards to the Auditor General's report?
Ms MacDonald: No, sir.
Senator Jessiman: Are none of the other facilities available to the merchant navy?
Ms MacDonald: As I mentioned, with Mr. Nicholson's intervention, we managed to get one person into the Perley and Rideau Veterans' Health Centre.
Senator Jessiman: What about Sunnybrook in Toronto?
Ms MacDonald: I do not know. We are a very small organization.
Senator Jessiman: We will have to inquire. I would like to know whether you are being discriminated against. They do give some kind of priority to some veterans, but there is still a waiting list of 250.
Mr. Olmstead: The problem is qualifying for the service. Once you qualify, you go on the same basis as anyone else.
Senator Jessiman: They said that if you were a veteran and had been overseas, even if you are not qualified for a payment of any kind, you still get priority to a bed if you will pay for it, as I understood it. When you say "qualify," do you mean qualifying for a bed or qualifying for some kind of assistance?
Mr. Olmstead: Qualifying as a merchant seaman, as a merchant navy veteran, that is the basic problem. Once you overcome that barrier, you are on the same basis as other veterans.
Senator Jessiman: How many have been able to do that?
Mr. Olmstead: I do not know. I think there were about 10 in Sainte Anne's.
Senator Jessiman: Of the whole Merchant navy, of the original 12,000?
Ms MacDonald: There are only 2,500 left.
Senator Jessiman: How many have qualified as veterans?
Ms MacDonald: They are still under a civilian act, and there are 40 exemptions. As I said, this is like a maze through which they must run. Many just do not do it.
Senator Jessiman: Do you have any statistics as to how many of the 2,500 are considered veterans?
Ms MacDonald: We have asked Veterans Affairs for that, but they are not on the computer.
The Chairman: I can recall from your past appearances, Ms MacDonald, that you were having difficulty establishing the sea time. I think Mr. Olmstead in his evidence this evening said that the records were ordered destroyed in many cases. Are you still having problems establishing that seamen spent so much time at sea in an area which qualifies for consideration?
Ms MacDonald: Yes. We have had examples of people who have spent time on life-boats and in life-rafts, and their applications for disability were turned down.
The Chairman: On page 7 of your brief, you mention merchant navy prisoners of war who, on average, were incarcerated for 50 months. Is that figure correct?
Mr. Olmstead: It is over four years, and it is mainly because the Germans, in the winter of 1940-41, roamed the oceans fairly freely. They had merchant raiders, and the merchant raiders picked up prisoners. The submarines did not.
The Chairman: I see. That explains it. I found that figure rather confusing. They were taken prisoners by the merchant raiders rather than submarines.
Mr. Olmstead: The submarines would take perhaps the captain and one other person, but they did not have the accommodation. The Japanese slaughtered all the merchant seamen who survived the sinking.
The Chairman: In your conclusion, you mention eliminating the need for complicated cross-references. I like that idea, but I have one question. How would you establish that the individual was a merchant seaman and was entitled to the designation merchant navy veteran?
Mr. Olmstead: We have had a part in revising the legislation. If that goes forward, we think that will do it.
The Chairman: I was impressed by the statement that those of us who served in the three regular armed forces received an explanation of our benefits, while your people did not. I am happy to support your third recommendation. I do not know whether, under the fourth recommendation, you would get very much support for $20,000 tax-free for all merchant service veterans, but I think it would be interesting to see how the Hong Kong veterans come out and perhaps make a comparison with that. That would be a fair comparison, would it?
Mr. Olmstead: What the Hong Kong veterans and Mr. Chadderton are trying to do is very commendable. We would like to know that merchant seamen who spent their three or so years in Japan are also covered.
The Chairman: Yes. That is the point I was trying to make, Mr. Olmstead. The treatment should be the same for both groups.
Mr. Olmstead: Yes.
The Chairman: We thank you for your appearance this evening. It was interesting to hear from you again. While we are making progress slowly, we face the same problems with you as we do with many of the other veterans -- that is, age is catching up with us. We hope that we can further assist your cause when we are meeting with the officials in Charlottetown.
The committee adjourned.