PACP Committee Report

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GOVERNMENT RESPONSE TO THE 1^st REPORT OF THE STANDING

COMMITTEE ON PUBLIC ACCOUNTS

MILITARY HEALTH CARE – NATIONAL DEFENCE

Recommendation 1: That the Department of National Defence provide the Public Accounts Committee with a detailed progress report by 31 October 2008 on the implementation of its plan to address deficiencies identified by the Office of the Auditor General in its audit on Military Health Care.

The Government accepts this recommendation, with the necessary revision to the timeline. The Government has developed an action plan intended to address the recommendations contained in the Auditor General’s report on military health care. This action plan was presented to the Public Accounts Committee on 31 January 2008. An updated action plan was provided to the Auditor General in spring 2009. DND intends to provide the Committee with a copy of this updated action plan, which includes details on progress to date, by the end of June 2009. Progress towards achievement of these recommendations will be provided to the Auditor General on a regular basis. Copies of these reports will be provided to the Committee as they become available.

Recommendation 2: That the Department of National Defence provide information in its annual Departmental Performance Report on the aggregate costs of the military health care system, as well as the number of physicians, nurses, pharmacists, medical technicians, and physician’s assistants employed in that system.

The Government accepts this recommendation. DND will report this information in the Fiscal Year 2009/10 Departmental Performance Report. In future years, DND will also look for other ways to make this information available to the public.

Recommendation 3: That the Department of National Defence conduct a comprehensive survey by 30 June 2009 of the state of mental health of CF members and the quality of mental health care services they and their families receive, with a special emphasis on those returning from overseas operations.

The Government accepts the intent of this recommendation and has already been working towards its implementation. Two surveys are currently underway as a part of a regular program to determine areas of personnel support in need of updating. The first survey, Canadian Forces Health and Lifestyle Information Survey (2008), will help determine the state of mental health in the CF, as well as develop a picture of the overall health and fitness of CF personnel. The survey contains significant emphasis on mental health issues including questions on depression, mental distress, post traumatic stress disorder and suicide. In addition there is a large section on the utilization of mental health services and patient satisfaction. The survey is sent to a random selection of CF members and will be compared to previous surveys. The survey was sent out in three cycles to take into account seasonal variations in factors such as physical activity. The first cycle was sent out in the fall of 2008. While the results of all three phases will not be ready to analyze until fall 2009, preliminary mental health results could be available by July 2009. The second survey (entitled Your Say) measures the attitudes of CF personnel and their families towards the CF and its quality of life programs. The next version of the survey will be sent to CF members in June 2009 and will contain questions to measure the availability of mental health resources for CF members and their families. Capturing the views of those returning from overseas operations is particularly important to ensuring the CF health system meets the needs of members. In addition to the two surveys, on completion of lengthy deployments, CF members receive briefings on mental health issues and have an opportunity to discuss, in private, any personal concerns with a mental health provider, including concerns related to the availability of services. Ninety to 180 days after returning to Canada, members are required to complete a detailed health questionnaire and an in-depth interview with a mental health professional to discuss any outstanding issues.

Recommendation 4: That National Defence report in its annual Departmental Performance Report on the status and implementation of the Canadian Forces Health Information System, including whether the system is on budget and on time.

Recommendation 5: That National Defence confirm in its annual performance report that all physicians, nurses, dentists and pharmacists are licensed to practice and that all medical technicians and physician assistants are certified. National Defence should also confirm the number of practitioners who take advantage of the Maintenance of Clinical Skills program.

Recommendation 6: That National Defence develop a governance framework for its military health care system that involves senior leadership, health care providers, and Canadian Forces members using the system.

The Government accepts this recommendation. The CF is continually seeking new ways to involve members in the administration of programs. The CF will review the current CF Health System governance structure to identify possible areas for improvement, with a particular focus on the need for user and healthcare provider input. The CF has begun to address the Committee’s concerns with the military health care governance system. For example, the Spectrum of Care Committee is now chaired by the Assistant Chief Military Personnel and reports to the Chief of the Defence Staff. This committee is responsible for determining the medical procedures and benefits to be made available to CF personnel. It is made up of senior leaders from Canada Command, Canadian Expeditionary Forces Command, and Canadian Special Operations Forces Command, as well as health services providers and senior leaders from Military Personnel Command. CF members in the system are represented on the Committee by their senior officers. Their views are also communicated to the Committee through the results of the Canadian Forces Health and Lifestyle Information Survey and the Your Say survey. As a result of the Spectrum of Care Committee’s membership, and by raising the approval level to the Chief of the Defence Staff, the CF can now ensure that the medical system reacts to the needs of its senior leadership in implementation of Government policies and directions.