moved that the fourth report of the Standing Committee on National Defence presented on Thursday, June 12, 2014, be concurred in.

Mr. Speaker, it is my pleasure to bring this matter before the House today. This is the fourth report of the Standing Committee on National Defence, issued a year ago now. It is an ongoing situation with respect to the care and treatment of Canada's ill and injured military personnel and their families.

This report was a result of two years of study into the situation involving military veterans and soldiers who have been serving the country. We had a spike in serious injuries of soldiers in the period we were in Afghanistan. We had 12 years of participation in that war in Afghanistan, an unprecedented length of time for Canadian Forces to be serving, with multiple deployments of Canadian soldiers in a very dangerous situation.

We had an extraordinary experience. I do not think we were prepared for the consequences of soldiers being deployed for this long, this far away, or for the consequences to them.

The report made quite a few findings, one of which I think we are all very pleased with, which was that the response of the military medical personnel with respect to physical injuries and trauma, although they were obviously serious and tragic for the individuals involved, was very rapid, high level, and well-recognized for its professionalism; in fact, not only professionalism but an advanced state of ability to deal with traumatic injuries, of which we unfortunately had very many.

In terms of the provision of assistance to those who were injured in the course of the Afghanistan conflict, there was a high degree of responsiveness. In fact, the Canadian Forces medical team was recognized internationally for its efforts with high praise and awards.

The area that caused the most concern for the committee, and for returning soldiers and their families, was the consequences of the mental injuries people suffered, which have now been widely and universally recognized as post traumatic stress disorder, PTSD.

Back in the 1990s, I was involved in representing a large number of victims of sexual assault as children. I recall learning an awful lot about PTSD but also being told at the time by an American military psychiatrist that there was no such thing as PTSD. That was what was believed to be the case, but he did not in fact believe in that.

I found it quite surprising, but it is worth noting that acceptance of the situation with PTSD is not something that has been around forever, particularly within military circles.

In Canada, we took a while to recognize the extent and state of the situation. We have very little in the way of statistics on it. Studies that were done of the needs of mental health professionals and health professionals within the Canadian Forces were based on projections done in the Statistics Canada study in 2002. Those were the figures upon which we were relying.

The study was repeated in 2013, but by the time we prepared the report, the results had not been made public. We were operating with information that was available at the time. We know that there had been, within the Canadian Armed Forces, very little in the way of support for independent research. Internal research was being done. Unlike other forces, like those of the United States and the U.K., there has not been widespread support for independent research on military and veterans' health, injuries, and treatment. That has changed, but it has only changed in recent years.

I see a couple of my colleagues from the defence committee opposite. We heard evidence from Dr. Alice Aiken of the Canadian Institute for Military and Veterans Health Research which was established recently at Queen's University with support from some 25 universities across the country. CIMVHR is an independent institute made up of 25 Canadian universities undertaking research into the needs of Canadian military personnel, veterans and military families.

Dr. Aiken told the committee that in terms of funding and sustainability for independent research we actually did not have any. That has changed. There was a recommendation by our committee in our dissenting report that Canada contribute to a significant and independent research fund that would allow CIMVHR, through its partner institutions, to undertake self-directed research into the health issues affecting CAF personnel, veterans and their families. That was actually done. There was a recommendation made not for this year's budget, but last year's, to have the support of the $5 million fund which was contributed to CIMVHR from the last federal budget and was matched by the True Patriot Love Foundation. There is now a significant fund that is available for research across the country.

In fact, last week I attended a seminar at Memorial University in my riding of St. John's East. Researchers and those interested in military and veterans' health were gathered together to talk about ideas for research projects that are necessary to advance the cause of Canadian soldiers' and veterans' health issues.

We talked about PTSD and the need for more professionals to deal with that. The whole issue of the families of soldiers who are also affected by the fact that their spouse has PTSD became something that we were focused on during the committee's study, because while we did have a program and the military is directly responsible for the health care of soldiers, the issue of families arose with respect to jurisdiction. It was stated quite specifically that the military and the federal government do not have responsibility for the health care of families of military personnel for constitutional reasons, because health is a provincial matter.

The consequences of that for our military families was that a soldier who had been suffering from PTSD would return home and be in the community with their spouse and family, suffering from PTSD and the consequences of that PTSD were not known to the family. The family was experiencing them. In fact, there is significant evidence to support the fact that spouses themselves would suffer from PTSD as a result of the soldier's experiencing PTSD. That was something that was brought home to the committee by witnesses, by family members, by discussions with soldiers in nearby businesses, for example, in Petawawa. We were told by some of these individuals that despite much effort, it was very difficult for spouses to get any access to treatment or counselling, or even some education to understand what was happening to their soldier spouse.

That was very debilitating. It caused serious problems within families, serious problems within marriages, and a situation of people suffering from PTSD not being able to actually advance and help to solve their problems.

There is another thing we found out with respect to the support for families in this whole area where there is no direct responsibility for the health care needs of families. People are moving across the country. We know the situation in the military. They can be posted every two years. They go to a different community. These are families with children. There are quite a lot of young children in the families of Canadian Forces members. The figure that was given to me last week was that there are some 68,000 children of Canadian military personnel. These families with children are moving across the country. The first thing families have to do when they arrive in a new community is find a family doctor. That is one thing that is absolutely necessary for the health and well-being of individuals.

What happens in these situations, particularly in some of the rural and remote areas where military bases are located in this country, is there is significant pressure on the local medical system. There is a lack of quick access to family doctors particularly when there are special needs children, those who may have learning disabilities or other types of needs that need assessment. There are long waiting lists. The problems multiply as families move around.

One of the things that is absolutely necessary and has not been resolved is how we deal with military families' health needs when they are being moved across the country. Often, in the case of PTSD, they are dealing with a family consequence, not simply an individual soldier's consequence. How do we do that, I suppose, without trampling on the jurisdictional situation that exists?

There are ways of doing it. It can be done. When the military moves families from place to place, the infrastructure of a city, of a town, of a location, is often affected by the presence of the military. Let us face it. There are traffic needs, needs for transportation, bridges, housing, and all of that, and the military can influence those decisions. It can also provide support for clinics so that in an area where the military operates, money could be provided to ensure that an area is attractive to medical personnel so that they can go there and have access perhaps to a clinic that is already built and available that would provide for the needs of the local community as well as the military families. Some incentives could be offered. There are ways that the military, the Department of National Defence, can be proactive in ensuring that the opportunity for health care for the military families is present.

I know it has instituted programs now to involve spouses through the military family support centres and through programs that have been established. Recognizing that the health of the soldiers depends upon the health of the family, it is able to extend counselling and more services. We would like to hear an update from the government on how far along that is.

I know there is a need for more research in this field. There are a lot of different types of professionals, whether they be health professionals, social workers, researchers from a whole bunch of different academic disciplines, involved in this. I want to commend the work of Dr. Aiken,, who has done a tremendous amount in a very short time to promote the notion of independent research throughout the country. It has been pretty much in the last five years that this work has been done. It is a tremendous effort by Dr. Aiken and her team, with the support of True Patriot Love, which has come on board and is working very closely with her and the institute to build support across the country.

I know there were members from all sides of the House who promoted this idea. They received a very strong welcome from me and my colleague, the member for Vancouver East, who was our health critic at the time and was very interested in the work that was being done. We fully supported that work. It is one area where we would like to hear more.

Another area that kept coming up again and again had to do with the transition for people who were in the military and were going to be medically discharged for one reason for another, but were being pushed out of the military prior to receiving their 10 years of service that would qualify them for a pension. We heard excruciating testimony from individuals.

In particular, I remember Corporal Glen Kirkland from Manitoba who testified before our committee. He said that he was about to be medically discharged, but he was not ready to go. There was a large debate in this House about it. In fact, he was told by the then minister of defence that this would not happen to him. He did not accept that, because he believed that if he was being made an exception, the rule would still be there that people would be discharged before they had reached the opportunity to get the security of a pension.

A whole series of recommendations came out of this dilemma, that the military was looking for ways to separate from individuals who were not going to be able to fully meet the universality of service requirement and were about to be discharged prior to getting a full pension and income security.

This was the biggest fear of many people to even come forward to get treatment for PTSD, that it would be a career ender and would result in having no income security. They would not be able to stay in the military; they did not meet the universality of service requirement, and they would end up in a situation separated from their career with no prospects for the future. This was something that was very prevalent. It also prevented people from getting the treatment they needed to try to overcome the PTSD they were suffering.

These are some of the issues that the committee had to deal with. We put forward a number of serious recommendations. One recommendation followed from comments by the former ombudsman, Pierre Daigle, who talked about universality of service.

Universality of service means that anybody in the military has to be ready to deploy at any time for expeditionary operations within the domain of the Canadian Armed Forces. He said that there was a need to modernize that and modify it to the extent to allow people who may have certain disabilities as a result of PTSD or physical disabilities to be reintegrated into the force. We have some very prominent examples of how that has worked. There should be some modification to allow individuals to stay in the military even though they may not be able to be fully deployed in a battle situation.

These are some of the issues. There was a lot of work put into the report and a lot of recommendations. I think it is time we had a report on how these recommendations have actually been implemented, what progress has been made, and what are the steps forward on matters like universality of service and ensuring that people are able to transition with their health needs met from being a serving member to being a veteran.

Jack Harris

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