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Raising the Bar: Creating a New Standard in Veterans Health Care
The State of Health Care for War Veterans and Service Men and Women
Report of the Subcommittee on Veterans Affairs of the Standing Senate Committee on Social Affairs, Science and Technology
Chair of the Subcommittee : The Honourable Orville H. Phillips
Deputy Chair : The Honourable Archibald Johnstone
February 1999
MEMBERSHIP
The Standing Senate Committee on Social Affairs, Science and Technology:
The Honourable Lowell Murray, P.C., Chair
The Honourable Peggy Butts, Deputy Chair
and
The Honourable Senators:
Cohen, Erminie Joy |
Lavoie-Roux, Thérèse |
*Ex Officio Members
Cathy Piccinin
Clerk of the Committee
The Subcommittee on Veterans Affairs:
The Honourable Orville H. Phillips, Chair
The Honourable Archibald Johnstone, Deputy Chair
and
The Honourable Senators:
Cohen, Erminie Joy |
*Lynch-Staunton, John |
*Ex Officio Members
Note : Former Senators Hon. Lorne Bonnell, Hon. Jean Forest and Hon. Duncan Jessiman also served on the Subcommittee during the course of this study.
Barbara Reynolds
Clerk of the Subcommittee
ORDERS OF REFERENCE
Extract from the Journals of the Senate of Wednesday, November 5, 1997:
The Honourable Senator Bonnell moved, seconded by the Honourable Senator Ferretti Barth:
That the Standing Senate Committee on Social Affairs, Science and Technology be authorized to examine and report on the state of health care in Canada concerning veterans of war and Canadian Service persons; that the study concern itself with the availability, quality and standards of health care available to those veterans and Service persons;
That the Committee have power to authorize television and radio broadcasting, as it deems appropriate, of any of its proceedings; and
That the Committee submit its report no later than June 30, 1998.
The question being put on the motion, it was adopted.
Paul C. Bélisle
Clerk of the Senate
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Extract from the Minutes of Proceedings of the Standing Senate Committee on Social Affairs, Science and Technology of November 25, 1997:
The Honourable Senator Bonnell moved, -
That the Subcommittee on Veterans Affairs examine and report on the state of health care in Canada concerning veterans of war and Canadian Service persons; that the study concern itself with the availability, quality and standards of health care available to those veterans and Service persons;
That the Subcommittee have power to authorize television and radio broadcasting, as it deems appropriate, of any of its proceedings; and
That the Subcommittee submit its report no later than June 30, 1998.
After debate,
The question being put on the motion, it was adopted.
Jill Anne Joseph
Clerk of the Committee
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Extract from the Journals of the Senate of June 16, 1998:
That, notwithstanding the Order of the Senate adopted on November 5, 1997, the Standing Senate Committee on Social Affairs, Science and Technology which was authorized to examine and report on the state of health care in Canada concerning veterans of war and Canadian Service persons, be empowered to submit its final report no later than December 30, 1998; and
That the Committee be permitted, notwithstanding usual practices, to deposit its report with the Clerk of the Senate, if the Senate is not then sitting; and that the report be deemed to have been tabled in the Chamber.
The question being put on the motion, it was adopted.
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Extract from the Journals of the Senate of Wednesday, December 9, 1998:
The Honourable Senator Phillips moved, seconded by the Honourable Senator DeWare:
That, notwithstanding the Order of the Senate adopted on November 5, 1997, the Standing Senate Committee on Social Affairs, Science and Technology which was authorized to examine and report on the state of health care in Canada concerning veterans of war and Canadian Service persons, be empowered to submit its final report no later than February 26, 1999; and
That the Committee be permitted, notwithstanding usual practices, to deposit its report with the Clerk of the Senate, if the Senate is not then sitting; and that the report be deemed to have been tabled in the Chamber.
The question being put on the motion, it was adopted.
Paul C. Bélisle
Clerk of the Senate
OPENING COMMENTS
Two years ago, as this Subcommittee finished a major report on the topic of pensions, we had to decide what issue we would focus on next. The decision was obvious: the state of health care for veterans and service persons in Canada.
The Subcommittee issued an interim report on this subject more than a year ago, and had its study of health care temporarily interrupted with another urgent study on issues surrounding the Canadian War Museum.
It should be recognized that the study represents the culmination of three years of work of the Subcommittee, on the issues of pensions, health care, and commemoration.
This report also represents an important first in co-operation between the Subcommittee and the Department of Veterans Affairs. The department provided Mr. John Walker to accompany the Subcommittee on its fact-finding missions. The Subcommittee cannot adequately express this gratitude, as this provided immediate solutions to some situations in facilities, and a new line of communication and understanding between the Subcommittee and department.
It should be recognized that the Subcommittee is coming to the end of a long journey, both with the tabling of this report and new legislation looming. The department has made great strides in its policies and standards, but it has further to go. Individuals like Deputy Minister David Nicholson should be commended for their leadership. It is the hope of the Subcommittee that the pace of the improvements in care and services being made available to veterans only increases, so that the many deserving men and women can obtain them before their passing.
Progress has been a theme not only of the Subcommittee's work over the past three years, but within this study as well. Senators were impressed to see the vast improvement in facilities and care at Sunnybrook Hospital since their first visit there more than a year ago.
If there is one message the Subcommittee would like to leave with the reader, the government, and those who work in veterans care, it is simply that by developing a national standard of care and adhering to it, we can better serve the men and women. These are the same men and women who served without question on foreign soil so many years ago.
I would be remiss in not thanking the many individuals who have assisted the Subcommittee in completing this report. I would like to thank my Deputy Chair, Senator Johnstone, who travelled with me to visit 70% of the veterans care beds in the country. As well, Grant Purves, from the Library of Parliament, Barbara Reynolds, our clerk, and Françoise Crepin, our administrative assistant, served the Subcommittee exceptionally. Thanks go also to Lloyd Lawless from my Senate office and Gerry Birt from the office of the Deputy Chair. There are too many witnesses, veterans, and health care professionals who provided such fair and honest testimony, to thank them individually: so I'll do so collectively here.
As this will mark my last report as Chair of the Subcommittee, with my retirement from the Senate looming, I would like to thank all of the individuals who assisted the work of the Subcommittee in years past.
This Subcommittee, and the Senate, leave an important legacy of reports for veterans. I only hope this work can continue in the Senate, and that others can build on the work that has been completed to better the quality of life of each and every Canadian veteran.
Orville H. Phillips
Chair
COMMENTS FROM DEPUTY CHAIR
It is my privilege, after more than five decades, to again be associated with the Honourable Orville Phillips. During the 1940’s, Senator Phillips and I attended Prince of Wales College in our native Prince Edward Island. While at PWC we spent two years in Air Cadets in the same squadron, including summer camp. During World War Two, as aircrew members, we again shared similar experiences having served in Bomber Command in the European Theatre of War. I am pleased that once again our paths have crossed, this time in the service of Canada’s veterans.
Among those who assisted us in making this report possible were the Honourable Fred Mifflin, Minister of Veterans Affairs for Canada, his Deputy Ministers and staff who co-operated fully with the Subcommittee, often at considerable expenditure of time and effort. We thank them most sincerely.
The fact that we are responding to problems and deficiencies found during our study of veterans facilities and are thereby making suggestions does not in any way imply that we found any lack of empathy or dedication by caregivers in the carrying out of their responsibilities. It takes a very special person to care for wartime veterans. We are, in fact, impressed with those who are charged with the often difficult and onerous duty of caring for the incapacitated and elderly at the many veterans facilities we visited across Canada.
Veterans are a group apart. Having volunteered their all, including life itself, they are a proud people not given to undue complaint, and they scorn to be importunate. They have earned the right of proper care within an environment which offers an acceptable quality of life.
Not to be forgotten is that, although elderly and occasionally incapacitated, the quality of life experienced by veterans is greatly enhanced when their rights are recognized and acted upon. Paramount among these is their right to dignity and their right to be consulted.
As veterans age their numbers dwindle with those remaining experiencing more not fewer needs. It is not too much to expect that we, as Canadians, will do all in our power to make their remaining years as comfortable and enjoyable as is humanly possible. It is my hope that this report will go a long way in achieving that end.
Archibald H. Johnstone, C.D.
Deputy Chair
The Mandate of the Subcommittee
A Note on Veterans of the Merchant Navy
The Organization of the Final Report
PART ONE - VISITS TO VETERANS HEALTH CARE CENTRES
The Lodge at Broadmead, Victoria, B.C.
George Derby Centre, Burnaby, B.C.
The Brock Farhni Pavilion, Vancouver, British Columbia
Colonel Belcher Veterans’ Care Centre, Calgary, Alberta
Deer Lodge, Winnipeg, Manitoba
Parkwood Hospital, London, Ontario
Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ontario
The Perley and Rideau Veterans’ Health Centre Ottawa, Ontario
Camp Hill Hospital Halifax, Nova Scotia
Ste Anne’s Hospital Ste Anne de Bellevue, Quebec
PART TWO - GENERAL ISSUES
1. Issues of Leadership and Government
A. Standards of Care
B. Standards of Institutional Care(a) Staff
(b) Food
(c) Veteran Safety Issues
(d) Implementation of a Standard of Institutional CareC. Standards of Care for the Independent Veteran
(a) The Veterans Independence Program
(b) Creative Housing Solutions2. Turning 4082 beds in 76 Institutions into a Network
3. Administrative Issues(a) Consultations
(b) Funding for Training
(c) Billing the Treatment Accounts Processing System (TAPS)
(d) Recognition of Volunteers
PART THREE - PENSIONS AND OTHER ISSUES
1. Pensions
2. Other IssuesA. War Veterans Allowance – Near Recipients
B. Veterans of Peacekeeping Missions3. Conclusion
APPENDIX 1 Witnesses and Individuals Met during the Course of this Study
APPENDIX 2 Recommendations from the First Report
APPENDIX 3 Message from the Department of Veterans Affairs
The Subcommittee recommends that Veterans Affairs Canada and other government departments and agencies, when referring to veterans, note that veterans of the Merchant Navy are included in the definition or figures given.
The Subcommittee recommends that Veterans Affairs Canada work with the management of the Lodge at Broadmead and local veterans organizations to build and equip a warm, sheltered outdoor area in which veterans can smoke without being exposed to the elements.
The Subcommittee recommends that Veterans Affairs Canada intervene with the provincial and Capital Health Board authorities to oppose any further increases in the workload of staff at the Lodge at Broadmead without a corresponding increase in staffing levels.
The Subcommittee recommends that Veterans Affairs strongly oppose any move to amalgamate the Lodge at Broadmead with the Capital Health Region.
The Subcommittee recommends that Veterans Affairs Canada urge the province of British Columbia and the Capital Health Region to support the expansion of the Lodge at Broadmead and that the department contract for as many additional veterans priority beds as possible.
The Subcommittee fully supports the initiative to develop a Veterans Health Care Centre and outreach program at the Lodge at Broadmead and urges Veterans Affairs Canada to fund and develop it as a model for the other regions.
The Subcommittee recommends that Veterans Affairs Canada offer to help establish and finance ongoing training in long-term care of the elderly for the staff of the George Derby Centre.
The Subcommittee recommends that Veterans Affairs Canada continue to assist the Board of the George Derby Centre in every way possible to become a multi-level facility.
The Subcommittee recommends that Veterans Affairs Canada take the initiative in ensuring that the department, veterans organizations and the management co-operate in re-decorating the Brock Fahrni Pavilion and in acquiring some new furniture. In particular, they should study the feasibility of transforming the second floor into an attractive main street and of developing a recreation and meeting hall large enough to seat at least 200 persons.
The Subcommittee recommends that the sprinkler system in the Brock Fahrni Pavilion be extended to cover the top two floors if this work has not already been done.
The Subcommittee recommends that Veterans Affairs Canada evaluate the night time staffing levels on the veterans’ wards at Brock Farhni Pavilion and have them increased if necessary.
The Subcommittee recommends that the Minister of Veterans Affairs intervene with the relevant ministers and officials of Alberta as soon as possible to win their support for an immediate decision to finance construction of a new facility for the Colonel Belcher Veterans’ Care Centre.
The Subcommittee recommends that Veterans Affairs Canada help design and implement an appropriate training program for staff at the Colonel Belcher Veterans’ Care Centre and that it provide additional funding for electric beds and for increased assistance from a social worker.
The Subcommittee recommends that Veterans Affairs Canada contribute to the costs of upgrading the bathing facilities in the veterans wing of Deer Lodge.
The Subcommittee recommends that Veterans Affairs Canada ensure immediate steps are taken to improve air quality in Deer Lodge and require that any solution chosen not prejudice the safety of veterans in an emergency.
The Subcommittee recommends that Veterans Affairs Canada intervene directly with the Province of Manitoba and the supplier of meals to insist that the latter improve the quality of the meals served veterans at Deer Lodge.
The Subcommittee recommends that Veterans Affairs Canada help Deer Lodge management train staff in techniques of handling re-thermalised meals.
The Subcommittee recommends that Veterans Affairs Canada and its local officials continue to help the management of Deer Lodge find and implement short-term ways of improving the quality of meals.
The Subcommittee recommends that Veterans Affairs Canada offer Parkwood Hospital assistance in making the dementia ward more homelike and functional.
The Subcommittee recommends that Veterans Affairs Canada strongly encourage the plan to change the service style from tray style to bulk dining room service in the Western Counties Wing of Parkwood Hospital. The same plan should also be considered for the Hospital itself.
The Subcommittee recommends that Veterans Affairs Canada work with the management and staff of Parkwood Hospital to provide more assistance at mealtimes and greater stability in the staff assigned to care for the individual veteran.
The Subcommittee recommends that Veterans Affairs Canada encourage Parkwood Hospital to proceed on an experimental basis with the idea of boarding out-of-town visitors with city spouses willing to offer accommodation.
The Subcommittee recommends that Veterans Affairs Canada ensure that the Sunnybrook and Women’s College Health Sciences Centre can complete the Behaviourable Care Unit and the modernization of Kilgour Wing without delay.
The Subcommittee recommends that Veterans Affairs Canada explore ways of providing veterans in Kilgour Wing of Sunnybrook and Women’s College Health Sciences Centre with the assistance of additional staff at suppertime.
The Subcommittee recommends that Veterans Affairs Canada meet regularly with the Board and Management of the Perley and Rideau Veterans’ Health Centre to review the latter’s plans to deal with the crisis brought about by the ongoing cuts to its funding. It further recommends that Veterans Affairs Canada offer to do everything possible to mitigate the impact of these cutbacks.
The Subcommittee recommends that Veterans Affairs Canada ensure that the money it has saved and will save through reduced per diem contributions to the operational costs of the Perley and Rideau Veterans’ Health Centre is returned to the Centre in ways that directly benefit veterans.
The Subcommittee recommends that Veterans Affairs Canada ensure that the Board and Management of the Perley and Rideau Veterans’ Health Centre are aware of and respect the responsibility of Veterans Affairs Canada to guarantee an appropriate level of care for veterans, regardless of provincial standards.
The Subcommittee recommends that Veterans Affairs Canada offer to finance and support the research of Camp Hill Hospital into improved out patient services and that it offer research and development funding for "hip pads" and other innovative devices.
The Subcommittee recommends that Veterans Affairs Canada and the management of Camp Hill Hospital review the Hospital’s evacuation plans.
The Subcommittee recommends that the Department indefinitely postpone the transfer of Ste Anne’s Hospital to the Province of Quebec, that the Department amend veterans legislation to permit the spouses of disabled veterans to occupy beds reserved for veterans, and that Ste Anne’s Hospital be gradually modernized to this end.
The Subcommittee recommends that Veterans Affairs Canada adopt the "quality of life" of a veteran as the guiding principle of departmental policy and spending decisions on veterans health care and that this principle underlie the standards of care adopted for veterans in institutions and for veterans living at home.
The Subcommittee recommends that Veterans Affairs Canada:
The Subcommittee recommends that Veterans Affairs Canada review the staffing levels of hospitals and residences under contract, and in the Veterans Affairs standards of institutional care establish levels of acceptable staffing that exceed minimum safety levels and offer veterans the comfort margin necessary to maintain a high quality of life.
The Subcommittee recommends that Veterans Affairs Canada review the staffing levels on veterans wards of chronic care hospitals and ensure that the standards of institutional care provide for additional staffing on these wards.
The Subcommittee recommends that Veterans Affairs Canada standards of institutional care ensure that in the event of layoffs, only the most junior staff on veterans wards are subject to bumping and that no staff with six months experience or more on dementia wards be subject to bumping unless by someone judged to have an equal degree of training and/or experience.
The Subcommittee recommends that Veterans Affairs Canada standards of institutional care specify that Veterans Affairs Canada, a veterans organization, or a charitable organization shall have the right to hire part-time staff to provide extra care for veterans, under such terms and conditions as the department or the organization shall decide.
The Subcommittee recommends that Veterans Affairs Canada encourage the on-site preparation of meals.
The Subcommittee recommends that Veterans Affairs Canada standards of institutional care establish a minimum standard of veteran satisfaction with the meals provided and that facilities meeting or exceeding this standard be rewarded with a premium equal to 10% of their per patient or per resident food expenses.
The Subcommittee recommends that wherever possible Veterans Affairs Canada supply veterans wards with commercial toasters.
The Subcommittee recommends that Veterans Affairs Canada study the steps Sunnybrook hospital has taken to improve the quality of meals and make this information available to all institutions with a re-thermalised food service.
The Subcommittee recommends that Veterans Affairs Canada encourage facilities to form "meal" clubs for veterans who are interested in food preparation and to encourage family and volunteers to reserve the small kitchens available to prepare special meals or treats for veterans. Veterans Affairs Canada should make a reasonable contribution to the equipment of the kitchens and pay for the food costs of these meal clubs.
The Subcommittee recommends that Veterans Affairs Canada standards of residential care include the requirement that facilities with more than one floor have a plan and the equipment necessary to carry out a vertical evacuation of the building with the staff available.
The Subcommittee recommends that Veterans Affairs Canada evaluate safety equipment that could be used to assist a limited number of staff carry out a successful vertical evacuation.
The Subcommittee recommends that the Veterans Affairs standards of residential care include a requirement that veterans have the equivalent of a Food and Travel Pass encoded with essential medical information, the Pass to accompany them during any evacuation of their ward.
The Subcommittee recommends that Veterans Affairs Canada adopt accreditation in good standing by the relevant national organization as a condition of placing veterans in a hospital or long-term care facility.
The Subcommittee recommends that a "Veterans’ Charter" be developed to set out the additional standards which must be met by the individual hospital or long-term care facility. The Subcommittee further recommends that the terms of this "Veterans’ Charter" be included in the agreement between Veterans Affairs Canada and the individual institution.
The Subcommittee recommends that Veterans Affairs Canada negotiate agreements with individual provinces to allow hospitals and long-term care facilities with more than 50 veterans a degree of autonomy from the regional health authority.
The Subcommittee recommends that Veterans Affairs Canada offer designated facilities building loans to carry out construction, expansion or modernization of veterans care beds on a priority basis.
The Subcommittee recommends that enhancing the quality of life of the independent veteran and his or her spouse become the guiding principle of the Veterans Independence Program rather than incidental to the cost advantages of reducing the need for institutional care.
The Subcommittee recommends that the Government of Canada take steps to extend some form of Veterans Independence Program benefits to those veterans with overseas service who are entitled to a veterans priority bed and are at risk of losing their independence.
The Subcommittee recommends that the Veterans Independence Program compensate a spouse or a family member for the cost of parking while making regular visits to an institutionalised veteran.
The Subcommittee recommends that Veterans Affairs Canada expand Veterans Independence Program benefits to cover the travel costs of out-of-town spouses who visit institutionalised veterans and, where necessary and desirable, to pay for the costs of overnight accommodation.
The Subcommittee recommends that Veterans Affairs Canada, as a millennium project, initiate a project to build at least two experimental "clusters" of housing for aged veterans and their spouses in regions of the country where waiting lists for veterans priority beds are already long and are expected to get longer.
The Subcommittee recommends that Veterans Affairs Canada compensate family doctors for consultations with the medical or nursing staff looking after a veteran in a hospital or long-term care facility, and for consultations with family members making treatment decisions on behalf of the veteran.
The Subcommittee recommends that Veterans Affairs Canada provide long-term care facilities with funding to upgrade the training of the nursing and care giving staff looking after veterans. This funding should include the costs of replacing staff taking courses;
The Subcommittee recommends that Veterans Affairs Canada develop an inventory of recommended training courses and materials on caring for the elderly and the very old, and related subjects; and,
The Subcommittee recommends that Veterans Affairs Canada, in consultation with the professional staff of Ste Anne’s Hospital, develop new training videos and training material as necessary.
The Subcommittee recommends that Veterans Affairs Canada revise the Treatment Accounts Processing System (TAPS) to simplify billing by institutions, and that all institutions be regularly briefed about what benefits can be billed.
The Subcommittee recommends that Veterans Affairs Canada and the Veterans Review and Appeal Board Canada form a committee to investigate the possibility of systemic discrimination in the pension adjudication process and that representatives of the veterans organizations be asked to participate in the study.
The Subcommittee recommends that once a condition is accepted as service related, its further deterioration or aggravation be attributed to the conditions of service, not to age.
The Subcommittee recommends that the final decision about the assessed level of disability to be granted a veteran or member or ex-member of the Canadian Forces be made by the District Medical Officer who has examined and interviewed the applicant, in consultation with the family doctor and/or specialist.
The Subcommittee will monitor implementation of Veterans Affairs Canada's promise to develop a standardized information and procedures manual for use in the field and a training module for pension officers.
The Subcommittee recommends that Veterans Affairs Canada authorize the Bureau of Pensions Advocates to hire sufficient staff to ensure that lawyers have the time to thoroughly prepare their cases for submission, and to thoroughly brief themselves about a case before presenting it to a review or appeal board.
The Subcommittee recommends that veterans organizations be represented on all review and appeal boards by a non-voting member of their choosing.
The Subcommittee recommends that recipients of the War Veterans Allowance be allowed to deduct from income for the purposes of determining eligibility for payments, the costs of prescription and non-prescription drugs, medical equipment and medical supplies recommended by a doctor to treat a medical condition.
The Subcommittee recommends that Veterans Affairs Canada pay a non-governmental organization to establish, operate and to advertise a toll-free counselling service for veterans of peacekeeping missions.
The Subcommittee recommends that Veterans Affairs Canada establish a toll-free counselling service to provide at home veterans and their care givers with advice, emotional and social support.
The Subcommittee recommends that the Standing Senate Committee on Social Affairs, Science and Technology follow up the present report by forming a task force to re-visit the institutions to evaluate progress in implementing these recommendations and to visit and report on the health care offered veterans in smaller communities. The Subcommittee recommends that the director of residential care of Veterans Affairs Canada be asked to accompany the task force on these visits and that the task force submit its report within one year.
The Mandate of the Subcommittee
The Subcommittee on Veterans Affairs received on 25 November 1997 the mandate to examine and report on the state of the health care provided Canadian war veterans and Service personnel following their discharge from military service. During the week of 15 December 1997, the Subcommittee heard from the Royal Canadian Legion and the National Council of Veteran Associations to draw on the experience of their service branches before visiting Sunnybrook hospital in Toronto, Ste Anne’s Hospital in Ste Anne de Bellevue, and Veterans Affairs Canada in Charlottetown. The pressure of other work forced the Subcommittee to interrupt this study and turn its attention to other matters. As a result, in March 1998 it tabled its First or interim Report, Long-term Care, Standards of Care and Federal-Provincial Relations. At this time, however, the Subcommittee had only been able to visit the two largest veterans health care centres. Many more facilities across the country have been visited since then.
The Subcommittee visited Ottawa’s Perley and Rideau Veterans’ Health Care Centre in early June before the Senate rose for the summer. In November the Subcommittee decided that it would be almost impossible to arrange for all of its members to participate in a tour of health care centres in the West and the Maritimes. This responsibility would be undertaken by a two-member task force consisting of the Chair of the Subcommittee, the Honourable Orville Phillips, and the Deputy Chair of the Subcommittee, the Honourable Archibald Johnstone. In November, December and January they visited veterans in nine residences located in British Columbia, Alberta, Manitoba, Ontario, and Nova Scotia. A planned trip to Newfoundland had to be cancelled due to an outbreak of influenza in the facility to be visited.
A Note on Veterans of the Merchant Navy
It should be noted that the veterans of the Merchant Navy have been fully integrated into the figures and estimates about veterans provided by Veterans Affairs Canada. However, this is not always noted where publications define "veteran" or "overseas veteran", nor is it footnoted when the number of veterans is given or estimated. Since veterans of the Merchant Navy were excluded from the definition until recently, it is important to draw attention to the fact that they now have the status of veteran.
1. The Subcommittee recommends that Veterans Affairs Canada and other government departments and agencies, when referring to veterans, note that veterans of the Merchant Navy are included in the definition or figures given.
Members of the fact-finding task force were pleased to find that some veterans’ residences included veterans of the Merchant Navy among their residents.
The Organization of the Final Report
The visits to individual hospitals and residences, and the formal and informal meetings with veterans, senior management and staff were the most important part of our study of the health care afforded veterans in priority beds. These visits gave rise to recommendations about specific health care facilities. As a result, the first part of the Final Report gives a brief account of the visit to each facility, the observations of our fact-finding task force, and, our specific recommendations, if any. Since Sunnybrook hospital was revisited, a note on this visit is included as is a progress report on the recommendations made in the First Report. Although Ste Anne’s Hospital was not re-visited, a revised version of the earlier observations is included: the visits to health care facilities across the country reinforced the belief that it has a critical and continuing role to play as a "centre of excellence", a factor which we wanted to be reflected in the Final Report.
The second part of the Final Report treats the general issues which arose from the visits to individual facilities, from the contacts with veterans organizations and from the two visits made to Charlottetown to meet with officials of Veterans Affairs Canada. These issues include developing communications among the management and staffs of the various veterans residences, standards of care, independent living at home and in specially-built homes, staffing and staff training, etc.
The last part of the Report is devoted to the adjudication of pensions by the Department and the Veterans Review and Appeal Board and to the other issues that have arisen during the discharge of the mandate of the Subcommittee.
