Proceedings of the Subcommittee on
Veterans Affairs
Issue 11 - Evidence
OTTAWA, Tuesday, June 9, 1998
The Subcommittee on Veterans Affairs of the Standing Senate Committee on Social Affairs, Science and Technology met this day at 5:45 p.m. to continue 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, when we were conducting our study on health care last fall, we did not have time to visit the Perley and Rideau Veterans' Health Centre, even though we had received an invitation to do so. Since then, a problem has arisen as a result of litigation between that health centre and the provincial government. This evening, we will meet with two of the veterans' groups that have a specific interest in Perley and Rideau Veterans' Health Centre.
Our first group this evening is the National Council of Veteran Associations in Canada. I do not think I need introduce the witnesses since both Mr. Chadderton and Mr. Forbes are well-known to this committee.
Welcome. Please proceed with your brief.
Mr. H.C. Chadderton, Chairman, National Council of Veteran Associations in Canada: Honourable senators, this issue has been with us for some time. It is only within the last few weeks that it has become public. The presentation I am making today concerns the Perley and Rideau Veterans' Health Centre. I would make it clear that, although a court case is pending, we are dealing only at the moment with the action, or lack of action, on the part of Department of Veterans Affairs in regard to the sustaining grant for the Perley home.
The main player in the transfer agreement was, of course, the federal government in the name of the Department of Veterans Affairs. Although you heard some of this information the other day, the province received about $35 million in actual cash in this transfer. They received another $9 million from the Perley, including the community. In addition to that -- and this is not often talked about -- the province received the entirety of what was known as the Rideau Veterans Hospital. The tax-roll authorities in Ottawa informed me today that no recent assessment of these buildings had been done because the buildings are condemned. However, they did tell me that it is worth at least $12 million. The Department of Veterans Affairs' stake in the Perley-Rideau is at least $35 million in hard cash, plus what was known as the Rideau Veterans Hospital which is assessed at $12 million plus.
Coming right to the bottom line, it looks as if all that veterans will receive out of all of this hard cash and property is about 250 substandard beds, if things continue as they are now. As I see it, the Department of Veterans Affairs cannot allow the province, unilaterally, to opt out. Moreover, the Auditor General, in our view, will insist that the Department of Veterans Affairs monitor these and other contracts. We have been in touch with the Auditor General's office and they have assured us that that is one of their responsibilities.
The Department of Veterans Affairs has a particular responsibility in this matter in connection with the transfer agreement.It is difficult to explain, but I believe we understand it. For the first five-year period, the Department of Veterans Affairs will pay a rate for 175 veteran beds according to the applicable schedule of benefits established by Ontario. However, about a year ago when the changes occurred and these former "hospitals" became "charitable institutions," everything began to fall apart. The Department of Veterans Affairs automatically reduced its commitment to the Ontario charitable institution rate.
To give you some solid figures, at Sunnybrook in Toronto, or at Parkwood in London, the Ontario government is presently paying a per-diem rate for management and administrative costs of about $230 per day, per bed. What is being paid now for beds in the Perley and Rideau Veterans' Health Centre is about $170 a day.
I would refer to the blue sheet which I distributed to give you the essential facts. The decision by the Government of Ontario is contrary to the transfer agreement with Department of Veterans Affairs. When the transfer agreement went through, veterans lost 50 beds in the National Defence Medical Centre and, of course, they lost the Rideau. The board of the Perley-Rideau is now taking legal action against the Government of Ontario for breach of contract. The last time I was before this committee, Mr. Chairman, I was unable to give you that information because the matter was before the courts.
In January, Madam Justice Bell of the Ontario Court, General Division, stopped the proceedings. She noted that the Department of Veterans Affairs was the main player, had put most money in, and asked where they were. Consequently, legal papers were served on the Department of Veterans Affairs because she felt they should be supporting the application from the Perley which, in fact, was asking the court to find that the transfer agreement had been violated.
The Department of Veterans Affairs refused to become involved prior to the court case, and the Perley retained Mr. John Connolly of the legal firm of Lang Michener. The province then brought a motion to dismiss the claim and Mr. Connolly brought a cross motion for a summary judgment.
Honourable senators, there is some urgency about this because the case will come up again in court at the end of June. If the court considers that the Department of Veterans Affairs is doing nothing to protect the interests of veterans, doing nothing to protect the money they have put into this, we are afraid the court might find that there is not as much to this claim as there should be. In other words, it is essential, in my mind, that the Department of Veterans Affairs join in this claim. To date, they have refused to do that, as you will see from the letter in my file dated March 17 which states:
...the action is solely an issue between the Perley Hospital and the Ontario government.
I started out in this whole affair in 1945 when I was a patient in what was known as the Veterans' Hospital, which was really two hospitals located on the grounds of what was then the Ottawa Civic Hospital. We gave that up because, when the National Defence Medical Centre was built, 50 beds were allocated to veterans. The Rideau Veterans' Home on Smyth Road, which has now been all but condemned, took the remaining veterans. In 1945, we gave up a temporary hospital situation.
There was then much agitation to build a new veterans' hospital. Promises were made which were never kept. However, they did decide to build the Perley and Rideau Veterans' Health Centre. The Perley, which has been a hospital in Ottawa since the 1800s, was a long-term-care institution. It joined with the Rideau Veterans' Home to form the new institution. They built a beautiful new institution on Russell Road, but the service will cause the problem.
How did all of this happen? I am criticizing any level of government, but it happened when the Ontario government delisted the Perley-Rideau from a hospital to a charitable institution. That was a way of cutting down on the management costs. However, the Perley-Rideau must be run. If it were run in the same as Parkwood or Sunnybrook we could expect that the rate would be $230 per bed, the Parkwood and the Sunnybrook rates. However, once the delisting went through, of course, the Ontario government said they would reduce that rate to about $180 a day. The Department of Veterans Affairs let veterans down by agreeing to that rate, which was the rate for charitable institutions.
The result is that morale at the Perley-Rideau is very low, but it is much more serious than that. The DVA arrangement to "top up," as they call it, runs out in the year 2000. From then on, the seven-year reduction that the Ontario government is committed to pay will, by the year 2003, be down to about $97 per day, per bed, which is lower than the welfare rate. Certainly, if we look at it, the tripartite agreement involving the Ontario government, the Perley and the Department of Veterans Affairs, has been broken unilaterally by the Ontario government.
In my view, the long-term and even the short-term situation on veterans is drastic. We are suggesting that this committee should make an immediate recommendation to the Department of Veterans Affairs that, notwithstanding a letter from the Department of Justice of March 27, the Department of Veterans Affairs should remind the Department of Justice that it is not running the Department of Veterans Affairs. There was a commitment from the Department of Veterans Affairs that there would be a rate consistent with an adequate level of long-term care. That is the issue before you.
I will repeat the dates so that they are fresh in your minds. This whole scenatio started in 1945 when veterans came home from overseas to this Ottawa catchment area where there was a veterans' hospital attached to the Ottawa Civic Hospital. There was very good surgical and other care for veterans.
In 1960, the Civic Hospital went down the drain, and veterans were brought into the National Defence Medical Centre or the Rideau Veterans Hospital. In 1988, contracts were drafted with the Ontario government for the construction of the Perley and Rideau Veterans' Health Centre. I was at that time a member of the Rideau Foundation, and my colleague Mr. Forbes was a member of the board of the Perley-Rideau. We were involved in all of these negotiations.
In 1994, construction began. In 1995, the hospital opened to great fanfare. We had some complaints, but we felt that this would work out. However, in 1996 came the big shock. Unilaterally, the Deputy Minister of Health for the Province of Ontario said that the Perley and Rideau was being delisted from a hospital to a charitable institution. From then on, the amount of money the Department of Veterans Affairs was putting into the pot was insufficient to provide adequate care. It was the amount normally paid not to a hospital but to an institution under the Charitable Institutions Act.
I mentioned the $37.75-million funding from the federal government. The Ontario government, which has unilaterally slashed this agreement, put up the magnificent sum of $19.5 million. That is all. The Perley contributed $9.75 million.
Over the seven-year period, instead of the $31 million the Perley and Rideau would get if it were still a hospital, it will only receive $14.5 million. The per-diem per-bed rate will be reduced from $167 to $94.02 by 2003.
The effect of this delisting represents a financial bonanza for the federal government. I do not think there is any other way to describe it. If they had stuck to the spirit of the agreement, which was to ensure that the Ontario government provided enough money for adequate care, then there would not be a rate of $167. The rate would be closer to the Parkwood or Sunnybrook rates, which is $230 per diem per bed.
I wish to talk about the level of care, something this committee has been looking at for a number of years. The standard of care set out in the contractual obligations was intended to be the same level of care available at the Perley and the National Defence Medical Centre. It cannot be, not at a rate of $178 per day.
I want to be clear that we are not suggesting that this committee should attempt to intervene in the legal action. The National Council of Veteran Associations may yet have to do that. Presently, we are considering doing that in connection with Sunnybrook.
At the moment, the window of opportunity for this committee is to grasp hold of this issue, find out what it is, and perhaps get evidence from the Department of Veterans Affairs. If the situation is as I explained, then I think this committee should immediately say to the Department of Veterans Affairs that they cannot do this because they are supposed to be the protector of veterans' interests. You must convey to them that, by allowing the Ontario government arbitrarily to slash the rate down to that applicable to charitable institutions, and by refusing to take part in the court action, they are leaving the Perley-Rideau out to dangle.
We have no crystal ball, but it stands to reason that if Madam Justice Bell revisits this issue -- and she has already served papers on the Department of Veterans Affairs and been told by the Department of Justice that the Department of Veterans Affairs considers it a matter solely between the Perley and the Ontario government -- she must find against the Perley and Rideau Veterans' Health Centre because the Department of Veterans Affairs is the major player which is avoiding the issue.
Along with colleagues in other veterans' organization, the National Council of Veteran Associations has the interests of veterans at heart. Veterans Affairs, acting on behalf of war veterans, has made a substantial investment of government moneys in this institution, over $35 million, plus whatever the old Rideau Veterans' Home was worth, which is at least $12 million. Some of the veterans' organizations themselves have made substantial contributions to the Perley-Rideau. I mentioned $75,000 from the War Amputations of Canada which went to the Perley and Rideau foundation. We feel we have standing to suggest to this committee that some action should be taken.
I assume the brief has been with you and that most if not all of you have had an opportunity to read it. I will turn directly to my recommendations on page 7 of my brief.
We recommend that the Department of Veterans Affairs be required to provide an immediate explanation to the subcommittee regarding its failure to support veterans' interests in regard to the change of status for the Perley and Rideau Health Centre. In other words, I do not think we can stand by and let the Department of Justice write a letter on behalf of the DVA saying, "We are not interested. This is a case for the Perley and Rideau and the Ontario government."
Our second recommendation is that the Department of Veterans Affairs be requested to join with the board of trustees of the Perley-Rideau in the court proceedings to enforce the memorandum of intent and other agreements. It is not too late for that. I made some inquiries today. Although the case is coming up, presumably at the end of June, if the Department of Veterans Affairs and the Department of Justice were to change their minds and decide to become part of this action, then I would assume that the court would allow a further stay of proceedings to give the Department of Justice and the Department of Veterans Affairs time to be examined and time to come forward in support.
Our third recommendation is that the Department of Veterans Affairs, in the interim, should negotiate a per-diem rate with the Perley and Rideau which would permit provision of the same standard of care to entitled veterans as is consistent with other institutions. Perhaps it was very fortuitous, but in the transfer agreement, there is language which states that this rate can be examined at least once a year and that it is entirely possible under the transfer agreement for Veterans Affairs to determine that $178 per day is inadequate. In the interim, the Department of Veterans Affairs could top that up to the rate for Sunnybrook and, hopefully, to the rate for Sainte-Anne's Hospital, which is $250 per day. However, if we allow this situation to continue, where the Perley-Rideau will have to operate on a declining budget, which at the moment is $172 a day, and within five years it will reach $94 a day, we will end up with a very inadequate -- and I do not want this term would be misunderstood -- "welfare" rate type of care for veterans.
Finally, the Department of Veterans Affairs should take immediate steps to provide the necessary benchmarks for an acceptable standard of care consistent with the needs of veteran patients.
I was pleased to see your committee's recommendation not to dispose of Ste Anne's Hospital. As long as that hospital exists, we do have a standard. In terms of dollars right now, that standard is roughly $250 per day.
I make no apologies for bringing this new issue to the committee. We only received the information that we needed when we knew the board of trustees of the Perley and Rideau Veterans' Health Centre were going to bring this to your attention. I was asked to have lunch with them, and I did. You can understand what happened. Their claim is against the Ontario government, which is where it must stay, but our interest is to bring the DVA into this on behalf of the Perley and Rideau and to fight for the interests of veterans.
The Chairman: You said that you anticipated that the court would be resuming its hearings on the litigation between the Perley and Rideau Veterans' Health Centre and the provincial government on June 30.
Mr. Chadderton: Yes.
The Chairman: No specific date has been set for that yet, has it?
Mr. Chadderton: I would ask Mr. Forbes to answer that because he has been in constant communication with the solicitor for the Perley-Rideau Veterans' Health Centre.
Mr. Brian Forbes, Honorary Secretary General, National Council of Veteran Associations in Canada: Two motions have been brought forward which are interim measures in the court proceeding. The solicitors for the Perley have taken the position that this is such a clear case that they have asked the court for a summary judgment. The evidence is so self-evident that there should be a breech found against the Ministry of Health. In response, the government lawyers for the province of Ontario have brought a motion to dismiss.
Those motions were first heard in January. Mr. Chadderton referred to the fact that the judge of the day, Madam Justice Bell, thought the missing party, namely, the Department of Veterans Affairs, should be brought into the action and notified of the concern of the court. The matter was then adjourned to June 30. The motion to which I referred will be heard on June 30. There is some urgency, given the present date, but the anticipation of all legal counsel is that this issue may go to trial later. These motions, which are diametrically different, will be heard by Madam Justice Bell and, at that stage, the Department of Veterans Affairs will not be present. Mr. Chadderton's conclusion is that that is unacceptable.
Mr. Chadderton: Mr. John Connelly, the solicitor from Lang Michener who is acting for the Perley has expressed an opinion -- and that is all it could be -- that, if the Department of Veterans Affairs does not join in this action, it will be extremely difficult for him to get a summary judgment. Furthermore, if he cannot get that, it will be extremely difficult for him, down the line, to act in the interests of one party. It is difficult to understand why the Department of Veterans Affairs, the government department that has put up all the money and made all the promises, is now opting out and saying that this is a matter between the Perley and the Ontario government.
The Chairman: Do you have any knowledge of the means by which the Perley and Rideau Veterans' Health Centre could raise the funds necessary for litigation if the matter came to trial?
Mr. Chadderton: For six years, I was on the foundation of the Perley and Rideau Veterans' Health Centre. In six years, we raised a little over $2 million. It was difficult going. However, in speaking to the Chief Executive Officer, Mr. Fougère, I believe they have taken the attitude at the Perley and Rideau that either they follow along the court proceedings -- including a trial, if necessary -- or they will have to close. The money is not there.
What is the effect of all of this? The effect is that veterans need special care. They suffer, for example, from incontinence and have psychiatric problems. They run a program for those who are alcoholics. These are all special veterans' programs which would have to be financed, but representatives of the Perley and Rideau have told us -- and I assume that they also told you this -- that they cannot afford to continue to run these special programs for veterans if their funding from the Ontario government is based on this charitable institution rate. That is already beginning to happen. In the last figures I saw, they had already laid off 70 members of staff. That figure may be even higher now.
Mr. Forbes: You have touched on a very sensitive issue with regard to the board of trustees of the Perley, of which I was a member for six years. The costs of this legal action are and will be substantial. They are having difficulty with their budgets now, given the slashing that has occurred. They are eating into funds that should be applied to the administration of the hospital. It is a bit like David and Goliath in that the board of trustees of the Perley and Rideau Veterans' Health Centre are taking on the province of Ontario while the Department of Veterans Affairs, the other member of this tripartite agreement, is sitting on the sidelines. It has already been noted at the court hearing by Madam Justice Bell that this does not seem to be correct.
The Chairman: Even if they did win, appeals by the province could carry this on to the year 2003, when there might not be too many World War II veterans left.
Mr. Chadderton: This is correct. That is why we suggested in our submission that, as an interim measure and to honour its commitment, the Department of Veterans Affairs take a look at the transfer agreement and say that, until such time as a settlement is reached one way or the other between the Perley and Rideau Veterans' Health Centre and the Ontario government, the Department of Veterans affairs will follow its commitment to ensure that the level of care for veterans is an adequate one. That would mean they would have to increase the amount from $167 to somewhere near the Parkwood rate or the Sunnybrook rate, which is $230 per day.
Senator Johnstone: Last Thursday morning, when we toured the Perley and Rideau Veterans' Health Centre, I got rather sentimental. I fell behind most of the time because I wanted to talk to our veterans. I studied the photographs of these young RCAF officers, what they looked like then and what they look like now. It brought back many memories.
What is the average age of the veterans at the Perley and Rideau Veterans' Health Centre?
Mr. Chadderton: Approximately 75 to 76.
Senator Johnstone: That young?
Mr. Chadderton: Yes.
Senator Johnstone: I am 73, so that does not seem old.
Mr. Chadderton: It may be higher. I am giving you the average age of World War II veterans. Under the VIP, the department attempts to keep these people in their own homes. However, eventually they require institutional care. The average age may be higher. It could certainly be somewhere between ages 75 and 80.
Senator Johnstone: We were told, and I think I understood properly, that a veteran breaks down, on average, about five years earlier in life than the average citizen.
Mr. Chadderton: Yes.
Senator Johnstone: You are faced with these people needing more care, not less care; but instead having more money to do that, you have less money.
Mr. Chadderton: Yes.
Senator Johnstone: Our visit was a very moving experience and I was sorry when it ended. The question now is: What is the next step?
The Chairman: I should point out to the committee that Senator Andreychuk has had considerable legal experience. She was formerly a Crown prosecutor and a judge. She will discuss the legal aspects of the case with you.
Senator Andreychuk: You are talking about a tripartite agreement. Was it two agreements or one agreement? Were there three parties to one agreement, or were there two separate agreements?
Mr. Chadderton: There were several agreements. The parties were, on the one hand, the Ontario government and, on the other hand, the Perley-Rideau and the Department of Veterans Affairs. The Department of National Defence was involved, too, because there were 50 veterans in the National Defence Medical Centre. There really are two parties.
Senator Andreychuk: Were there two agreements?
Mr. Chadderton: Originally, there was a memorandum of intent and then a transfer agreement. I use the word "agreements" because the documents were amended from time to time. However, what we are really talking about, so we do not become confused, is the transfer agreement as amended.
Senator Andreychuk: I understand the Department of Veterans Affairs has a responsibility to the veterans. It seems to me it does not matter what mechanism was employed to deliver that. Whether it was through the Ontario government, through its own structures or through a charity, it has an obligation.
From what I am hearing, I do not feel that your only avenue is through the courts. Your avenue should be directly to the Department of Veterans Affairs, emphasizing that you have a responsibility to these veterans. If circumstances change, you still have a responsibility to the veterans. There must be a reasonable standard of care. Should we not be negotiating now with the department, irrespective of when that case is heard?
Mr. Chadderton: Yes.
Senator Andreychuk: You could go the legal route, which may or may not be satisfactory, but there is an accountability route through the federal government which should be explored immediately. An undertaking has been made which should be respected, no matter what circumstances change. Have you approached the minister?
Mr. Chadderton: Yes. We have had voluminous correspondence with the deputy minister who has said that he is in the hands of the Department of Justice on this. As a result, the letter of March 17, which is in my brief, refers in the letterhead to the Department of Justice Legal Services, Veterans Affairs Canada, and it is signed by Peter D. Clark, counsel. That ends it. In other words, the deputy minister has said to us that it is out of his hands. If the Department of Veterans Affairs wanted to attempt to "sue" -- if we can use that term -- the Ontario government, then the Department of Veterans Affairs would have to get the approval of the Department of Justice. That approval has not been forthcoming.
Having said that, I am more than a little disappointed that the Department of Veterans Affairs has not taken a much stronger stand with the Justice Department and insisted on honouring the commitment. The transfer agreement is clear; it is in black and white. However, the Department of Justice, according to the deputy minister, has said that they will not become involved. Their letter of March 17 ended it. That is why we felt we had to come to this committee. Where else can we go?
Senator Andreychuk: It seems to me that it is again more of a political issue. Surely the Department of Justice is rendering a legal opinion to the ministry. The ministry is not bound to accept that opinion any more than you are bound by your lawyers. Who gives whom the instructions? That is the issue. Would it not be fair to ask the Minister of Veterans Affairs whether he is in charge of the conduct of his department or whether it the legal department of the Ministry of Justice?
There are cases to indicate that they are giving an opinion and that they are not usurping the authority of the individual ministers.
Mr. Chadderton: That is correct. It is very difficult for us to understand, speaking on behalf of the some 350 organizations under the national council, that the Department of Veterans Affairs is not in there fighting as hard as they can along with the Perley-Rideau. What we have here is a breach of contract. That is my opinion, and it is certainly the opinion of our lawyer, and it is the opinion of the lawyers on behalf of the Perley-Rideau.
Senator Andreychuk: I wanted to separate that because lawyers are paid to have opinions on all sides. The court will ultimately decide. That is a legal track to determine whether there has been a breach of contract. Assuming there has been no breach of contract, that does not end the issue because, first and foremost, that is how we got into this, by our responsibility to veterans.
Mr. Chadderton: You are quite right.
Senator Andreychuk: A political will must be brought to bear almost more than the legal question.
Mr. Chadderton: The door has been slammed in our faces. We have taken it to the deputy minister. People from the War Amps and the Legion have worked to get this agreement through, only to find that, one year after it was in operation, the Ontario government unilaterally said that we were delisted.
We have gone back to the deputy minister. He has said that he is bound by a decision of the Department of Justice. That is set out in the letter from Peter Clark.
The Chairman: Is it your opinion, Senator Andreychuk, that the deputy minister or the Minister of Veterans Affairs is not necessarily bound by the opinion expressed by the Department of Justice?
Senator Andreychuk: That is why governments always take outside opinions on certain cases, as well as inside opinions. It is because it is an opinion. I do not see where they are bound by it.
I can see where the department would say that they do not intend to get into a fight over a contract. That may be another value judgment, but I do not think that relieves them of their responsibility toward veterans.
If they do not want to pursue it in court, that is their choice, but how will they give a standard of care to these veterans for whom they are responsible? They must come up with another innovative way. They cannot avoid their responsibilities.
It is a political question which goes back to the fundamental acts and responsibilities of the government to protect and look after veterans to meet to a standard of reasonable care. The only defence that can come back is to say that $93 is reasonable care. They would be foolish to do that if there are guidelines in place. They must prove that a reasonable standard of care with $93 is being achieved. That is the issue. They have discretion as to how they accomplish their end, but the end must be accomplished.
Mr. Chadderton: The transfer agreement, in our opinion, provides for what we call a "topping-up."
Mr. Forbes has been in touch with the lawyer for the Perley and Rideau Veterans' Health Centre, and was on the board when all of this was happening. He has something to add.
Mr. Forbes: Senator, you have made a very insightful point. If Veterans Affairs deems it appropriate to opt out of this legal action -- and we think it is damnable that they have decided not to take the Ministry of Health of the Province of Ontario to court for breach of agreement -- there are consequences. They are a party to the transfer agreement. They have been a party to every agreement that has been entered into between these three parties from day one. Their obligation to the veteran community remains. If they wish to be the sole funder of appropriate care, as you so aptly put it, so be it. If they decide not to pressure the Ontario government to maintain the standard that should exist under the transfer agreement, then I believe that Veterans Affairs should be holding the bag politically and, perhaps, legally.
This becomes a serious issue in that in the year 2000 the Department of Veterans Affairs is theoretically supposed to be out of this transfer agreement. I agree with your conclusion. They cannot opt out if they do not require that the standard be maintained post year 2000. I think your committee is seized with a rather interesting issue.
The Chairman: It is my understanding that Perley and Rideau became a hospital by provincial Order in Council. Is that correct?
Mr. Forbes: Yes, under the Public Hospitals Act.
The Chairman: I am not familiar with how a hospital is removed from the listing. Can you give us any information on that?
Mr. Forbes: I think it might be classified as arbitrary and unilateral. This came out of left field in 1996 when, as Mr. Chadderton said, the Deputy Minister of Health in Ontario delisted this hospital under the Public Hospitals Act and put it under the Charitable Institutions Act; a remarkable legislative event.
Mr. Chadderton: I have read all the correspondence. There was very brief correspondence from an official of the Department of Health in Ontario who said that the hospital was going to be delisted. The people from Perley said that they could not do that. The next correspondence said, "You are delisted."
I saw no legal reference or Order in Council. It was a decision made under the reduction of services that the Ontario government is handing down to various hospitals. I do not think anyone could have been more surprised than we were when we saw that the Perley and Rideau was losing its status as a hospital to become a charitable institution. We have not been able to find out how the rate for a charitable institution is set, but we have been told that within seven years it will be $95.
The Chairman: The veterans in the Perley-Rideau are now left in a charitable institution, which is completely against the act and established policy since the end of World War I. This is the only case I know of where veterans have been placed in a charitable institution, and I think it is very important to reverse this decision for that reason.
Senator Andreychuk has given some legal suggestions. She spoke of political will. I will give some political advice to the board of Perley and Rideau Veterans' Health Centre and point out that, under the agreement, the Department of Veterans Affairs gets certain space to carry out its function within the hospital. Most important, they get two parking spaces. I think they have put up a bigger fight about the two parking spaces than they will about the reduction in veterans' care.
Mr. Chadderton: The lawyer's brief lists the services that understand will no longer be provided. They are: alcohol-related behaviour management; behaviour management generally; concentrated care; convalescent care; geriatric psychiatry; geriatric rehabilitation; respite care; and incontinence problems. All of those services will no longer be available. According to the complaints we are receiving from veterans and dependants of veterans who are residents of that institution, those services are starting to disappear now.
The Chairman: You mentioned the necessity for action by this committee. I think, rather, that it must be by the entire Senate. Right now, of course, there is a push to adjourn for the summer recess, but the committee will probably give consideration to raising this matter in the Senate chamber and trying to get a commitment before the end of June, if not before adjournment, that the Leader of the Government in the Senate or the Minister of Veterans Affairs will contact the committee in writing.
I do not think we will have the opportunity to have a full-scale debate on it, but we will try something of that nature.
Thank you very much for your brief and your suggestions.
We now have with us representatives of the Royal Canadian Legion. The first witness will be Mr. Jim Rycroft, Director, Service Bureau. Mr. Rycroft has attended a number of meetings of this subcommittee and needs no further introduction.
Mr. Jim Rycroft, Director, Service Bureau, Royal Canadian Legion: I will simply highlight a few of the areas covered in the brief. I am accompanied this evening by Mr. Jim Margerum, chairman of the Ontario Command Veterans Services Committee; Mr. Jim Mayes, District "G" Veterans Services Chairman; and Ms Helen Allard, President of Branch 462 of the Royal Canadian Legion and chair of their Veterans Services Committee.
To echo the comments by the National Council, the Legion has asked the Minister of Veterans Affairs to exercise leadership with respect to the obligations under the transfer agreements, not only with respect to the Perley and Rideau Veterans' Health Centre, but the other facilities that have been transferred as well.
This evening our focus will be on Perley and Rideau Veterans' Health Centre. The response to that exhortation to exercise leadership has simply been words from the Director General of Health Care that the Department of Veterans Affairs will be doing its best to maintain standards. We would have asked them to specify what standards they meant by that.
This emphasizes how important it is not to transfer Sainte-Anne's, as Mr. Chadderton said, until Veterans Affairs Canada demonstrates in an existing situation with a transferred facility, such as the Perley-Rideau, that it can show leadership to maintain the demonstrated federal standard. Sainte-Anne's simply cannot disappear from the playing field if we are to have a place which demonstrates that standard.
My comrade Jim Margerum will illustrate, by way of clear examples, what happens when the transfer agreement is not honoured. You will see a number of very specific instances where it has a direct effect on those residents in the Perley and Rideau facility, their relatives, and those to whom the Department of Veterans Affairs is obliged to provide the service.
Mr. Jim Margerum, Chairman, Ontario Command Veterans Services Committee, The Royal Canadian Legion: Honourable senators, it is a pleasure for Ontario Command to have this opportunity to address some very important issues concerning the level of care, the quality of life, and the safety and security of residents in contract beds and facilities in Ontario and, in particular, those at the Perley and Rideau Veterans' Health Centre.
Since the transfer of responsibility for the care of veterans to the Province of Ontario and to the PRVHC, managed by Perley Hospital Incorporated, there has been a noticeable decline in the level of care, the quality of life of veterans, and the services provided. The initiatives we have put forward to solve the problems have been frustrated. It appears that the three parties to the transfer agreement are unwilling or do not have the capacity to ensure that veterans will continue to have the high level of care they previously enjoyed. This has forced us to take the unprecedented action of requesting the Auditor General of Canada and the provincial auditor to conduct comprehensive audits on the transfer agreement.
We will now address the main issues and problems which have resulted in numerous complaints from veteran residents, spouses or family members, concerned staff, veterans' organizations, and many volunteers.
The standards surrounding the food provided attracts many complaints. Prior to the transfer, residents were assured that the quality of the food and the amount served would continue to be the same as that described in Appendix 1, item 6. In fact, for the first three months at PRVHC, residents were served meals cooked and prepared on the premises. Then disaster struck and the rethermalized food system was implemented. The food is described as bland, tasteless, mushy, too hot, too cold and by other terms I cannot repeat.
An example of this can be found at Rideau 1 South. The staff is required to feed 16 residents, five of whom are confined to their rooms. It takes about an hour and a half to two hours to complete the feeding. The last persons fed have cold porridge, cold coffee, cold tea and any other foods meant to be served hot.
Other problems with food in the system are addressed in the Ministry of Health inspection report, Appendix 2, December 16, 1997, and in the VAC report on quality of care and selected services delivered to veterans at PRVHC, audit report dated April 10, 1997.
In our opinion, the only solution is to scrap the rethermalized food system and return to home cooked meals prepared and cooked on the premises. Our veterans certainly deserve this improvement to their quality of life.
Prior to continuing with the report on care, I would like to read a letter which I received on Sunday, June 7, written by a lady and signed by 21 residents or family members who provide care to their spouses in the facility.
It states:
Dear Sirs,
We are the spouses and family friends of the veterans at Perley & Rideau Veterans' Health Centre. We desperately need your help for our poor vets.
In some sections, from 3 p.m. on we have only one nurse to run the two sections. We hardly see the nurses because they are too busy with too much to do$ And so are the health workers.
Oh, yes, they get fed, dressed and get fast baths, but they have no time for anything else and are put back in their wheelchairs. The staff are all overworked and very tired and they are doing the best they can. The staff have no time to spend with them. It is only work, work, and more work. Our men are getting so restless, they get into fights, disagreements, and they get into serious arguments.
Why are our vets getting so slim? Why are we seeing so many ambulances come and go? Why have there been so many accidents lately? Why are so many dying? It is because we are so short of staff. The poor old men gave the best years of their lives for us, our country. And, oh yes, dear sirs, for you and your families too. When is all that cruelty going to stop? When there are no veterans left?
Shame on us, shame on our government for neglecting those poor men and ladies like that.
Oh sure, there is no money, you can't do anything, but is it not funny that there is money to increase your wages? Why are some of us now visiting our spouses twice a day?
Why are their fingernails and toenails not getting the same care as before?
Where is all the money that DVA and the Legion has put in there? Why is it impossible to get volunteers to help our vets? Some of us are not very healthy; others are getting on with age. It would be such a big help to have volunteers to take our men in their wheelchairs for fresh air, play music, watch TV.
Dear Sirs, do you realize that many, many of our men have not been outside yet with the beautiful weather that we have been getting? Why were those beautiful courtyards built?
Please let's open our hearts and give the rest of our old vets beautiful memories of their last years.
Please help, help, help.
It is signed by one of the spouses and 21 others. I have two more letters signed by a number of people. Unfortunately, I have not yet received them. I think you will see that they parallel what we are complaining about in terms of care.
Care is fast becoming the source of major complaints as a result of staff cuts and an increase in the use of agency staff unfamiliar with the care and needs of veteran residents. There is a notable increase in the aggressive and agitation levels of some residents, as reported by their spouses who are very concerned. Please look at Appendix 3 for a typical complaint.
I should like now to enumerate other examples of decline in the care and services provided. It is claimed that some residents of Rideau 1 North and Rideau 1 South have never been outside in the courtyard for a long period due to lack of staff and that the courtyards are empty 95 per cent of the time.
The fenced-in area at the north of Rideau Wing was to be an outside exercise walking space. It has never been developed due to lack of funds. It seems to indicate a warehousing of the residents and is one of the causes of the aggressive, agitated levels observed by spouses and volunteers.
A spouse has been informed that a husband will have to give up the use of an electric bed to another resident who is deemed to have a higher need. VAC or the Ministry of Health should be providing another bed, not taking one away from another resident who also requires it.
Complaints have been made that diapers are not always changed during the afternoon due to reduced staff.
Spouses and staff members have stated that agency personnel are not provided with written instructions and are unaware or not familiar with the needs and care that residents require. Residents in Rideau 2 North and South have indicated the same problem and they state the problem is worse on the weekend.
It appears that some spouses and family members are afraid to complain and be branded as troublemakers. They have asked me to arrange a meeting with the legion and members of the Senate subcommittee who are willing to attend. They wish to describe, first-hand, their complaints and concerns regarding the deterioration in the level of care and services provided. I would be pleased to organize or facilitate such a meeting at your convenience.
We believe that the decline in the level of care, the quality of life, and the erosion of services can be attributed to the following causes. First, clause 60 of the transfer agreement executed March 25, 1992, requires that the parties conduct a review of said agreement within five years. There was no review conducted within the five-year period, which is a clear violation of the agreement and which has contributed to some of the problems.
There is no national standard of care established for veterans, and the level of care varies from province to province and, in fact, from facility to facility. National standards for staffing are for optimum conditions and do not meet the needs of all facilities due to the physical layout and the size of the facility.
The PRVHC must be made to realize that they are responsible to provide the level of care and services as legislated federally and according to veteran health care regulations and VAC programs. VAC must provide the additional funding needed where additional community bed funding provisions fall short.
In 1996, the provincial Minister of Health promised to amend the provincial regulations to enshrine these veterans' rights but has not done so and, therefore, has betrayed the veterans. The VAC nursing audit on quality of care at PRVHC stated that VAC nursing wished to signal PRVHC management and departmental officials that further reduction to the existing staff ratios for physical therapy, occupational therapy, nursing and recreology and that this could have a detrimental effect on patient care. The Chief Executive Officer of the PRVHC stated that that institution did not meet the minimum standard of care in these areas.
It certainly appears that the VAC does not read their own reports or implement their recommendations. At the PRVHC liaison committee meeting, it was indicated that the VAC could not provide more funding than the per diem paid by the province.
The VAC is obliged to provide a level of care consistent with VAC federal regulations. Not only are they abandoning their responsibilities, we believe they have betrayed the veterans.
The Rideau Veterans Home Transfer Agreement, executed March 25, 1992, has never been enforced totally or complied with and has, in our opinion, been violated by all parties. It is a frustrated agreement that must be revisited and revised to ensure veterans will be cared for and provided the quality of life they justly deserve and were promised by Canada. We will not allow our veterans to be betrayed.
We strongly recommend that all veteran contract beds be housed in the Rideau residence, which is 130 beds, and the balance of 120 beds in the Ottawa residence. This will allow for more effective control, monitoring and auditing of veterans' care by VAC and others. The staff can be assigned and instructed to provide the level of care and special services to which veterans are entitled, and this will reduce staff turnover. This will be less strenuous on our ageing volunteers and will greatly assist them in providing comfort and service sponsored by veterans' organizations. It is our opinion that there must be an ombudsman to resolve complaints independent of the three parties to the transfer agreement.
In conclusion, I will be pleased to answer any questions about our presentation.
Senator Andreychuk: We have been told the Ontario government unilaterally did some things that have caused problems but, from your report, it appears that it goes deeper than that. The transfer agreement was not complied with. Why you would not want to join the Department of Veterans Affairs as a co-defendant as opposed to a co-plaintiff?
Mr. Margerum: I was also on the board of directors of the Perley and Rideau Veterans' Health Centre. At the same time, I was chairman of the Rideau veterans housing review committee struck by Dominion, an Ontario command, to review the situation surrounding the lack of a proper facility to look after our veterans for the last years of their lives.
I did not last too long on the board because I spoke up for veterans and was accused of conflict of interest. I resigned as a member. I resigned at the same time as the vice-chairman of the board who did not believe the transfer agreement would adequately protect the rights of the Perley and Rideau Veterans' Health Centre both financially and because of the language.
They did not believe the commitments by the provincial government and/or the federal government were suitable. I shared that view. I also felt that it did not have enough Ts crossed and Is dotted to ensure the safety, security of life, and quality of life for veterans.
There were two agreements, the first of which was a temporary agreement that Perley was responsible for looking after the veterans at the Rideau Veterans' Home prior to the move into the new facility. There was a transition period. Then there was the master agreement.
The second question dealt with care. The definitions are clear that "care" means a service delivered to meet a long-term health need as established under the health care system of the Province of Ontario which is the equivalent of a type-two or type-three health care need for "intermediate" care or "chronic" care as those terms are defined in the Veterans Health Care Regulations.
Everyone knew what was required, but the VAC in their wisdom are backing out. You can see the details of that in Appendix 5.
The VAC pointed out that there was difficulty in maintaining the level of care because of cut-backs, through no fault of the hospital; they could not afford to keep the necessary staff. This was their own department writing a report critical of what was going on as a result of provincial cut-backs.
At a liaison meeting on March 18, it was asked where we go from that point. Mr. Greg Fougère reported that the Ontario Court General Division would be approached for a date to have the case heard. Mr. Power confirmed that the hospital would win the case and would return to its original per diem of $187. He also stated that, if the judge were to decide that Ontario was correct, the facility would undergo seven years of reduction to the per diem as per the case-mix index.
Mr. Fougère stated that the per diem could be topped up by the federal government for veterans care as it is for municipal long-term care facilities. Mr. Power stated that the federal government's legal advice had been it could not provide more funding than the per diem paid by the province. That may have been their legal advice, but it is not their moral right, nor is it their right to deny veterans what is guaranteed to them by the people of Canada. When veterans came back from war, they were given a mandate by the federal government that the VAC would be empowered to look after their care. They are now leaning on a clause in the contract.
The government picks and chooses the clauses they wish to put into operation and, in the meantime, that leaves our veterans as pawns. They are being used by everyone in the fight to resolve the situation. The facility cannot simply provide the care because they do not have the funding necessary to supplement the staff requirements.
Senator Johnstone: The uniform worn by these gentlemen is one I know very well and wear myself. I wish them every success.
Senator Phillips and I have known each other for a long time. We were in the same school when we were boys. We joined up for service within months of each other. We both flew with bomber command. We know what you are talking about. You have our understanding and sympathies. We have a few ideas of what we may be able to do. We discussed it after coming back from visiting the Perley and Rideau Veterans' Health Centre. Senator Phillips hosted me for lunch, during which we had a serious discussion about this matter. Do not feel you will be leaving here without our support.
Mr. Margerum: I would draw your attention to another concern which will demonstrate how veterans have been used. Back in 1988 the Government of Ontario and the Sunnybrook Hospital closed 44 beds because they said they could not hire sufficient nursing staff to maintain the beds and it would be closed for approximately three months. Four and one-half years later we went to a meeting with the Deputy Minister of Veterans Affairs, with provincial officials, legion people, and officials from the Province of Ontario when it was discovered that, for four and one-half years, the province had not cut the funding. They got the funding for 44 beds even though they were not occupied. On top of that, Veterans Affairs Canada provided top-up, or co-payment, of approximately $1 million for two and one-half years before the Auditor General caught them and cut it off. That amounted to approximately $15 million that was not used for its rightful purpose.
I will read for you the comments attributed to the provincial official in the minutes of a meeting held on December 8, 1993:
Mr. Thompson noted that prior to 1993/94, the MOH has not reduced Sunnybrook's budget; they have just not funded Sunnybrook at the level that its costs have increased. In 1993/94 there has been an absolute reduction due to the Social Contract. Mr. Thompson also noted that Sunnybrook receives a global budget and is free to allocate its funds as it sees fit.
What I am trying to point out is that Veterans' Affairs Canada provide funding, as does the province, and there is no absolute guarantee that it is being used for veterans. I have strong concerns that it is a waste of taxpayers' money and a disservice to the veterans when the money is not used for its intended purpose.
The Chairman: I would like to turn to paragraph 7 in your brief, which is on page 6, where you recommend contract beds be housed in the Rideau Residence and the balance in the Ottawa Residence. Senator Johnstone and I visited Perley-Rideau last Thursday, but I must say I am not clear as to what you mean by the "Rideau Residence" and the "Ottawa Residence." Could you elaborate on that for me, please?
Mr. Margerum: Yes. There are three wings to the facility and there are 450 beds within the facility. One hundred thirty beds are for the Rideau Veterans' Wing, or Rideau residents, and it is occupied, 100 per cent, by veterans. The remainder of the veterans are scattered throughout the hospital. That makes it very difficult to monitor and to audit the care, and to provide programs to a nucleus of people who are together. Veterans sometimes do not get the benefits of organizations that provide volunteer services.
We have seniors, former veterans, who are volunteers there. You saw the building, so you know its length. To porter two residents from Rideau Veterans down to the auditorium is quite a task.
We have some problems with the volunteer system at the Perley, but that is gradually being resolved. We are forever being told that the veterans' beds are the same as community beds, that veterans should get the same care, or that they do get it, but we take a different view different.
That facility was put together to do two things: One, to take over the responsibility from the Province of Ontario to look after veterans; and, two, to look after community residents. Eventually, as veterans departed the scene, it would become a community care facility. Hopefully there will be no more wars which will result in more veterans. We understand the rationale in saving the funding.
However, it presents a problem because we have legislation specifying that veterans deserve special care because of the trauma they suffered. We now see them having problems with their fingernails and toenails. A podiatrist is not available to them. A good number of them have diabetes and we are now seeing amputations. Spouses are afraid to speak up because they feel that they will be called "troublemakers." We have a prime example in Sunnybrook with Debra Johnson, in the information they gave you at the last hearing. She is targeted as a troublemaker. The VAC people are being targeted as troublemakers because they are there too often.
What right do we have to ensure that proper care for veterans is being provided? The Perley has made great strides in reducing the difficulties between veterans groups such as ourselves, and last year we contributed $60,000 for the care of the veterans. We paid for all television cable hook-up to improve their quality of life. Unfortunately, because of staffing, we cannot concentrate our veterans in one area. Since they cannot go outside, they are staying in their rooms and, if their spouses or family members do not come and take them out, that is where they spend their day, in their rooms. Their housing is becoming, as some people tell me, like "incarceration." That is their word.
If we can concentrate our veterans in the Ottawa Wing and Rideau Wing, it will be much easier for us. The staff can then be instructed in the care of veterans and in the special benefits and programs they have available to them. There will be less turnover of staff. As it is now, many veterans say they never know who will be caring for them from day to day; bearing in mind they get bathed and that they become uncomfortable when the staff changes too often. Their average age, by the way, is 78 to 79. Their average life expectancy is about three and one-half years. We have how many years left to look after our veterans?
If VAC will not initiate action and take seriously their responsibility for looking after our veterans, if they will not help the Perley-Rideau resolve the financial problems with the Province of Ontario, what will happen to our veterans?
Appendix 4 is an example of what has happened in the past. A few years ago, when the NDP were in power in the Province of Ontario, we had hearings on Bill 101. They said that they would transfer the Perley and Rideau to a long-term care facility under the Charitable Institution Act. Nobody believed it would happen. When the government changed, we went to the PCs and we raised the fact that, if they rolled them over to the province, the benefits provided by VAC would be lost, and they agreed with us. They had their legal people write up two amendments to Bill 101, and any other legislation that was involved with the care of veterans. Essentially, these two amendments guarantee that the veterans have a place in the facility and the province is responsible for it. They are responsible for the community rate and any additions are the responsibility of VAC.
The Minister of Health of the day assured us that would happen. The premier of the province assured us that he would look into the matter, however, we have had great difficulty in arranging meetings with him. He has declined our requests to meet with him. The new Minister of Health has not met with us on the matter. We want to be assured that the standard of care meets the requirements of our veterans according to Veterans Affairs Canada regulations.
As to the question of dollars, there is only one taxpayer. However, any top-up or added payment would come from federal sources, and it would be fair. Appendix 5 contains the notation that: "...the Federal government's legal advice had been that it could not provide more funding than the per diem paid by the Province."
Where are the rules? Where is the law? On what basis do they have the audacity to make such a statement when it is very clear that Veterans Affairs Canada was set up to look after veterans and to ensure that the care as provided under the regulations would be delivered?
They saw fit in 1968 to transfer all facilities to the provinces, as they felt they had no business in the management of hospitals. However, these Mickey Mouse agreements have been just that. They do not stand up. They did not look after the needs for our veterans, and that is why we are in trouble.
We took the unprecedented action of going to the Auditor General to ask him to review the matter and to determine if what they are being billed for is being delivered. VAC has simply not done their job. They have a motherhood statement saying VAC and Canadian veterans have the greatest legislation in the world and the greatest programs. They preach that, and I agree that they do have those things. However, delivery has gone downhill, and unfortunately it is at the end -- when they need help the most. On top of that, the caregivers, their spouses, are now being forced to suffer again as they did during war time. We must not allow that to continue. They must address it now, not tomorrow because that would be too late.
The Chairman: When making my rounds with the group, we dropped in on a few patients, and I see the signature of the wife of one of them on the letter to which you referred. This particular patient had Alzheimer's. If he was home, DVA, under VIP, would be providing certain care for him. I asked what sort of difference VIP was making with regard to the money being paid to the attendant she was paying to stay with her husband in the home. Is there any reason why DVA should discontinue the attendant's allowance and other benefits when a patient enters a centre such as Perley and Rideau?
Mr. Rycroft: It is my understanding that they do not cease attendant allowances. VIP is ceased, but not the allowance.
The Chairman: Perhaps this lady did not understand my question, but she left me with the impression there was no help being given to them.
Mr. Rycroft: I would want to confirm it, but my understanding is that the attendant's allowance is continued. VIP was continued for three months. Due to a recent policy change that will be one year once a veteran enters an institution. It is my understanding that the attendant's allowance does continue while the veteran is institutionalized.
The Chairman: Have you checked to see how many people in the home would be entitled to this assistance and how many of them are getting it? Is there any quick way this can be done? I think it is very important that we have that information.
Mr. Margerum: I would estimate that 60 per cent or 65 per cent of them would be entitled to some form of allowances or provisions based on the fact that they are able to get electric wheel chairs and other things. Our VAC hands-on staff do a great job.
My quarrel is with the "island," even though I realize you are from the island. My quarrel is with the management of VAC. When we bring problems to our local counsellors, they deal with them very quickly. I am not an expert in the day-to-day operations, so I do not know all the details involved in the attendant's allowance per se. You must remember that many people just do not understand what they are entitled to, and they do not ask. If we see someone has a problem, we ask them if they are on a pension and so forth, and then we phone our service officers and they handle it. We do not try to play doctor. We give it to the people who are qualified to handle the particular situation.
Senator Johnstone: Mr. Chairman, the word "volunteer" has come up from time to time. To what degree must you depend on volunteers, and are they subject to burn-out?
Mr. Margerum: We lost many of our volunteers for two reasons. When we first integrated the facilities, we had a few difficulties with the management of the facility. We had volunteers of 30 to 35 years of age looking after veterans, and they just packed it in.
Some of the new provisions respecting the reconfiguration of health care in Ontario affected some of our provisions, but our volunteer system was very strong. It is weak now because of ageing, and because of the attitude that has prevailed. As a quick example, I would mention the noon-hour feeding. I do not believe you gentlemen were there when the feeding took place. In Rideau 1 South, there are four people to feed the 16 residents from 11:30 to 1:00 p.m. but in that time period, two of the staff members go to lunch. If there are no spouses or volunteers feeding the residents, it takes much longer. Sometimes their meals are untouched.
The volunteer system is very important. If we had a mechanism to restructure the system, with people putting aside their differences and deciding to look after our veterans no matter what, we could probably come up with what we used to have, which was a good volunteer system. However, because of the indifference that prevails with VAC and with the Province of Ontario, people have lost interest. Unfortunately it is the veteran in the facility who is suffering.
The Chairman: During our visit, it was pointed out that about 12 patients need special help being fed at breakfast time. It often starts at 8:00 and does not finish until 10:30, and by that time the food is cold and that much more distasteful. That is because of the reduction of staff and only two people are available to do the feeding.
At Perley-Rideau and Sunnybrook, where the staff has been reduced as a result of cutbacks, is there any reason why DVA cannot provide the staff? You mentioned Sunnybrook got so much as a global budget. It is obvious that the veterans in these wings require so many more staff than patients in other wings. Surely they could provide more staff and not use cut-backs as an excuse for being understaffed. It would only require a few additional members of staff
Mr. Margerum: Presently, they provide an additional staff member because of the problem we had with a Hong Kong prisoner of war who was assaulted twice by an individual. They put an extra person on duty in that particular wing, paid for by VAC.
I would remind you that this is their residence. It is not a prison. It is not a hospital. It is a residential facility providing medical care for the residents.
Presently, VAC provides care to someone who is at home, such as my brother, who is a Korean veteran. He receives VIP. When he came out of the hospital, he was visited by people who were paid by VAC. If VAC genuinely wants to look after veterans and fulfil their commitment, they could do so tomorrow. They only have to look at the legislation and they will find a way to do it. If the bill is too high, then legal people can fight it out later on. They certainly can provide services under different provisions. Perhaps they will have to take a more lenient interpretation of the regulations, but they certainly can do it. Counselors must go in, assess the problem, and provide the needed service immediately. That is the quickest way to handle it. Other legal battles can be fought out in the courts. Our priority is to look after the residents now and ensure that they have adequate care and that their needs for special services can be met, even on an interim basis, until the legal position is resolved.
The Chairman: Going back to the VIP, I will have staff contact Mr. Fougère to see if he can provide us with further information. In the meantime, if your organization and NCVA can provide us with any information on that, it would be greatly appreciated.
I have a feeling there may be some people in these facilities who might not realize that they are entitled to that allowance. This is probably a case of a lack of communication rather than intent.
Are there any further questions?
Senator Johnstone: We are very pleased that you came here tonight. We will certainly try to be of help.
The Chairman: Thank you very much for your presentation.
The committee adjourned.