NDDN Committee Report

The CFHS is among the best of its kind in the world. Particularly on battlefields like those in Afghanistan, our wounded soldiers, sailors, airmen and airwomen are provided with the most dedicated, professional and effective medical treatment Canada can provide. The Canadian Forces also sponsors important social support programs for military families.

As effective as current Canadian Forces health care and social support programs are, there is room for improvement. Concern has been expressed over the ability of the Canadian Forces to meet the growing needs of soldiers injured, both physically and psychologically, in combat in Afghanistan and elsewhere.

The Committee found three over-arching issues that seemed to be at the root of much that is troubling the Canadian Forces health care system.

First, the Committee heard evidence that attitudes toward mental health issues in the Canadian Forces remain largely negative. Such attitudes exist far beyond the Canadian Forces and can be found throughout Canadian society. Worse still, the stigma experienced by people with mental illness can be more destructive than the illness itself.[2]

We think the Canadian Forces can lead by example in the field of appropriate attitudes toward mental health. Proper attitudes lead to positive practices that treat psychological injuries with the same relative urgency and respect given to physical injuries. Once any injury is inflicted, there is no time to waste. The Committee suggests that, as an example to all Canadians, the Canadian Forces initiate and embed a modern, enlightened view of mental health issues that is scrupulously adhered to by all ranks.

This is the one major step that allows effective improvement in all other areas.

Second, there is a problematic policy-implementation gap. For every senior officer or departmental official who told us of initiatives being taken to improve military health care generally and mental health diagnosis and treatment in particular, we heard at least one junior rank who told us the system was not working for them.

Based on evidence heard, the Committee thinks the main difficulty resides in front-line clinics that are under-resourced and with case managers who are over-worked.
Well-meaning health care providers are being ‘burned out’. Somehow, in the midst of such strain, the Canadian Forces must find a way to deliver consistent quality and continuity of care.

We recognize however, the inherent challenges involved when resources are in short supply. This is the third principal issue we discovered. There is a chronic shortage of professional health care providers in Canada.[3] When Canadian Forces patients are referred to civilian health practitioners for treatment, they compete for already limited access to care with the existing civilian patient population. Waiting for treatment can be even longer in areas of the country, such as many isolated or rural regions, where there is already a severe shortage of resident medical professionals. As well, Canadian Forces health services compete, just like any other employer, with provinces and established medical institutions for the talents of graduating medical students. A study by the Federal Healthcare Partnership (FHP) noted that the shortage of physicians is reaching “crisis proportions”.[4]

The main issue here is recognition of the fact that the shortage of medical professionals is not only a Canadian Forces problem and therefore cannot be solved simply by providing more money and directing the Canadian Forces to recruit more healthcare providers. What is needed here is a whole-of-government approach to mobilize, deploy and sustain sufficient medical health professionals to meet the growing needs of injured Canadian Forces personnel and their families.

From these over-arching issues flow a number of consequential challenges that we have identified and addressed at the individual, family, Canadian Forces, Department of national Defence and government levels.

All the challenges identified by the Committee are solvable. It will take teamwork.