Canadian troops get better care overseas: report

[RHFC_piper]

I know this was posted in The Sandbox and Areas Reports Thread August 2008, but I wanted to comment on it directly... so here it is again.

Posted with all the usual caveats.

Canadian troops get better care overseas: report
Article Link

Updated Wed. Aug. 13 2008 9:11 AM ET

CTV.ca News Staff

Inconsistent care across the country means wounded Canadian soldiers returning from overseas may not be getting the most effective care, according to a senate report.

The senate committee on national security and defence finds that care for soldiers on the ground at Kandahar Air Field and at transitional facilities such as the one in Landstuhl, Germany is exceptional. There is, however, a greater challenge with the long term care that is needed from the Canadian health care system once soldiers return home.

Here's the part that intrigues me;

Reservists face greatest challenge

Kenny said the soldiers who face the toughest challenge are reservists, as they must often cope with rehabilitation without the support of their regiment.

He said regiments are like family and look after each other very well, but the very mobile nature of reservists poses a challenge.

"Some injuries (which are) more of a psychological or mental nature might manifest themselves six months later or eight months later, and your regimental family is too far from you to help, and that was a great concern that we had."

As much as I hate to say it; this article is 100% accurate.
The Hospitals in Kandahar (from what I remember of it) and Germany were amazing in terms of care, so much so that when they asked us (the wounded in Germany) where we wanted to go to recover once we got back to Canada (Ottawa or Toronto) I asked if I could stay in Germany... Once I got to Sunnybrook I wished they would have let me.

Since being home, getting care for injuries, both physical and psychological, has been an uphill battle.  Even now after almost 2 years of being home I'm fighting almost daily for simple things like Physiotherapy, Massage Therapy (don't get any ideas, deep tissue massage is about as comfortable as being run over by an HLVW, but it eases the spasms around the wounds.), anxiety care and medication.  It has come to the point where I have to get the senior most levels of my home unit involved, directly, with medical staff to push for things as basic as a medical appointment for extension of contract...  Needless to say, this is very frustrating.

The article mentions "the Regimental Family" and how reservists are "disconnected" from it; well, I'm sure there are people in my home unit who would feel a little slighted by this as they're really trying to keep that connection strong.  But, I believe what the article is referring to is the Regimental bond PRes members make with the Regiments they deploy with.  As much as I am a Fusilier, I have shed more blood and tears with the RCR, which somehow makes them more my family.  Don't get me wrong, as I've said, I'm still a Fusilier at heart, but that bond of blood is strong.  And because of this, I do feel "disconnected" from my Regimental Family...

I'm not going to say it's harder for the Reserve members, 'cause I really don't think it is.  We have strong civilian communities to support us, as well as the ability to "get away" from the military mindset when we need a break, and we don't have to travel far to get away since we're not surrounded by a base or a military community.  As well, from discussing this very issue with fellow soldiers from tour, also injured in the same incident, who are Ref F; the Reservists are getting much better, though less frequent, attention since we're more "unique" in our community.  For example; in my Regiment, there have only been 2 soldiers wounded since WW2 and I'm one of them... With in my Brigade there is only a handful of wounded reservists... Because of these facts, we're given a lot of special attention from all levels.  It's not always timely, or efficient, but when we bitch people of much greater tactical importance tend to listen.  From my discussions with my Reg Force counterparts, I have ascertained that this is not the case when recovering on base; when a big R corporal complains that the care they're getting (or not getting) is insufficient, they're but one in a sea of many... A number, not a name.  And they're not unique in their community; everyone on base knows, or is related to, or works with someone who has been injured.
So, really, who has it worse? The Reservist; who gets excellent treatment by both civilian and military medical facilities, when they get medical attention, which is always an up hill fight... or the Regular Force member; who receives regular medical care, but sometimes not enough, or slips through the cracks due to the volume of other injured Reg F members.  I think it's a tough call.

Anyway, I just wanted to vent some frustrations.

 

[canuck101]

I was on the DND website and found this article: http://www.forces.gc.ca/site/community/MapleLeaf/article_e.asp?id=4018

Lets hope they can get this open soon.

 

[-Marauder-]

Piper - very insightful.  Very.

 

[RHFC_piper]

I was on the DND website and found this article: http://www.forces.gc.ca/site/community/MapleLeaf/article_e.asp?id=4018

Lets hope they can get this open soon.

As much as I think this new CF hospital is great for the big R soldiers, it really won't change much for the PRes members... It's still fairly far away from the majority of PRes members.  As well, not all injured Reg F members want to recover in the same place; most would prefer to be near family, so it's not always an issue of quality in service, but access to quality service. 

By the time injured soldiers get back to Canada, they've already been treated for their major injuries (in most, but not all cases), so they don't really need a specialized hospital as much as they need post-surgical care such as physiotherapy and regular check-ups, both of which can be done locally.
Example; when I came back to Canada, I spent 2 weeks in Sunnybrook, where they performed no major surgery and completed no major tests or scans which couldn't be done elsewhere; they just changed bandages and administered medication... which could have been done somewhere else, somewhere closer to my family, Like St. Mary's hospital in my home town.  Only after enduring the hell that was Sunnybrook for 2 weeks and complaining to anyone who would listen did I get moved to St. Mary's.
The reason for the delay was that Sunnybrook is a "specialized" hospital which could better deal with my injuries... Funny that... St. Mary's has all the same "specialists" for my case, as Sunnybrook; such as the Ultrasound technician or the wound care specialist...  Kinda seemed pointless to have me "recover" almost 2 hours away from my Fiance (now wife) and 3 hours away from my parents...

Even after I was out of the hospital, I was (and still am) receiving care in London, which is roughly an hour and change away... which can be a bit of a hassle, but I'd hate to have to think what it would be like if they expected me to drive to Ottawa (6 hours away) for care which can be administered in my home town.
And this isn't just the case for PRes members; there are a lot of Reg F members who would prefer to recover from major injuries closer to home... which may not be Toronto or Ottawa.

Don't get me wrong; I think there have been major changed in the right direction when it comes to care of the wounded, but things could always be better.
Sometimes, dealing with being injured can be much more stressful that the actual event which caused the injury...  Especially when you couple the physical and psychological care headaches with dealing with military bureaucracy...  There have been quite a few days where I've been looking for an alternative to CF employment, just so I can get the hell away from the stress...  and I'm not even doing anything incredibly stressful in the CF (recruiting has it's days, but...).  I spend more time dealing with personal admin that anything else military, and that can be very stressful on its own.

Anyway, as stated, the system is getting better... slowly but surely... It just has to be expanded to include care outside of military facilities with greater co-operation with civilian medical care.  Any soldier, injured in combat or otherwise, should be able to receive any type of care from any medical facility in Canada without having to jump through any hoops... they should simply have to show up, show ID and be attended to without question... and the bill goes to DND to deal with.  (of course, this is within reason.)

That's just my take on it all.

 

[stegner]

Should the federal government in partnership with the provinces look to creating some small military hospitals in areas with large bases?  These hospitals could be open to civilians so the CF medical folks could get practice with civilians on their own turf, rather than being attached to a civilian hospital.  This would also help fund the hospitals.  Is the idea too crazy.

 

[RHFC_piper]

Should the federal government in partnership with the provinces look to creating some small military hospitals in areas with large bases?  These hospitals could be open to civilians so the CF medical folks could get practice with civilians on their own turf, rather than being attached to a civilian hospital.   This would also help fund the hospitals.  Is the idea too crazy.

It would probably be better the other way around; Military wings in Civilian hospitals.  The facilities are already there and are usually undermanned anyway.  And as you stated; it would help to keep CF med staff current.

Besides, most bases have hospitals; even limited ones... and usually have ties to civilian hospitals close by.  It's the outreach to troops in areas with limited or no military facilities... like the Reserves or Reg F members out side of bases.

 

[stegner]

It would probably be better the other way around; Military wings in Civilian hospitals.  The facilities are already there and are usually undermanned anyway.  And as you stated; it would help to keep CF med staff current.

Besides, most bases have hospitals; even limited ones... and usually have ties to civilian hospitals close by.  It's the outreach to troops in areas with limited or no military facilities... like the Reserves or Reg F members out side of bases.

Ahh gotcha.  That makes sense. 

 

[daftandbarmy]

This issue is a big deal in the UK right now too.

There used to be military hospitals in the UK, but they were closed due to a lack of wounded to treat (thanks God) and funding cuts. A type of Peace Dividend if you like. Now that they, like us, are back in the 'shootin' wars' there's a big movement to re-open them. Some obviously don't think that this is a good idea, and some military doctors I know are critical of 'military only' facilities because it's difficult to make sure the staff have the latest and greatest training etc. There's far more OJT for medical personnel on the NHS wards than you'll ever get in a military facility just due to the sheer numbers involved.

Anyways, they've started a petition. I'm not much of a petition guy, but it will give you a flavour of what they're trying to do.

“We the undersigned petition the Prime Minister to Create a dedicated Military & Veterans Hospital within the UK.”

Just some background, 2 Para alone have on this tour (April 2008) sent back over 50 casualties to the UK and many cannot be accommodated so when all of the casualties from other battle groups are added to the figure, how is ONE ward in an NHS hospital going to cope? It cannot cope, the individual troops are sent home to recover relying on NHS visiting services which themselves are over committed. A lot more than 5000 names are needed for this petition and quite cynically, Downing Street has put a time limit of one month for this to be achieved (closing date 19th August). Do what you can. Please copy the link below to confirm your signature on the petition at the bottom of this email'

“We the undersigned petition the Prime Minister to Create a dedicated Military & Veterans Hospital within the UK.”

http://petitions.pm.gov.uk/Wounded/

The petition was created by Denzil Connick (For those who don’t know him he was injured in the Falklands Campaign) and reads: 'We the undersigned petition the Prime Minister to Create a dedicated Military & Veterans Hospital within the UK.'You will then have to enter your details then click on the reply from No 10 to count.

 

[Greymatters]

It would probably be better the other way around; Military wings in Civilian hospitals.  The facilities are already there and are usually undermanned anyway.  And as you stated; it would help to keep CF med staff current.

Besides, most bases have hospitals; even limited ones... and usually have ties to civilian hospitals close by.   It's the outreach to troops in areas with limited or no military facilities... like the Reserves or Reg F members out side of bases.

Theoretically, a good idea.  Practically, it might be a bad idea.  The anti-war protesters would use it as a focal point for their activities and rallies, as would every other goup with a beef about the military, or Canada's work overseas... 

 

[RHFC_piper]

Theoretically, a good idea.  Practically, it might be a bad idea.  The anti-war protesters would use it as a focal point for their activities and rallies, as would every other goup with a beef about the military, or Canada's work overseas... 

I can see it being swung may ways by everyone;
Soldiers in hospitals "militarizing" the health care system. Would this really be a bad thing? maybe more would get done.
or
Civilian doctors and nurses helping our military medical professionals treat the soldiers and their families. Setting ground work for situations where the CF needs to aid civil power.  Even having civilian doctors teach Medics how to treat civilians for the event of aiding other countries during natural disasters.  This would also be a good way for military doctors to train civilian doctors who wish to work abroad in places like Afghanistan (we have a lot of civilian doctors there.)

I see a lot of benefits which would, in my mind, counter any negatives.

besides, there's also the argument, which is pointed out in the article, of "why aren't we caring for the troops more."  Which is the logical counter to any "anti-military" protest.  Basically eluding to them protesting the care and well being of our troops.

If we constantly looked at the "what if's" and didn't do things because of what may happen, nothing would get done.  It's good to weigh the odds, but you can never please everyone, so it's always better to do what is the most beneficial. 
The way I see it is; Military doctors and nurses in Civilian hospitals = more doctors and nurses in hospitals... hard to argue against that one.

 

[Greymatters]

Good points.  Mine was not to say 'here's why we shouldn't', but rather pointing out a big negative that should be considered and overcome...

 

[Blackadder1916]

Theoretically, a good idea.  Practically, it might be a bad idea.  The anti-war protesters would use it as a focal point for their activities and rallies, as would every other goup with a beef about the military, or Canada's work overseas... 

I can see it being swung may ways by everyone;
Soldiers in hospitals "militarizing" the health care system. Would this really be a bad thing? maybe more would get done.
or
Civilian doctors and nurses helping our military medical professionals treat the soldiers and their families. Setting ground work for situations where the CF needs to aid civil power.  Even having civilian doctors teach Medics how to treat civilians for the event of aiding other countries during natural disasters.  This would also be a good way for military doctors to train civilian doctors who wish to work abroad in places like Afghanistan (we have a lot of civilian doctors there.)
(. . . )
The way I see it is; Military doctors and nurses in Civilian hospitals = more doctors and nurses in hospitals... hard to argue against that one.

The use of civilian hospitals to provide basic (tertiary) health services to the military (including intergrating CF medical units in civilian hospitals) and as a means of maintaining skills competency for military medical personnel is already the way business is done. 

http://www.forces.gc.ca/health/news_pubs/hs_factsheets/engraph/sheet-10_e.asp?Lev1=4&Lev2=9&Lev3=11

CFHS Partners
To fulfil its mandate of providing comprehensive health care to Canadian Forces (CF) members, the Canadian Forces Health Services (CFHS) rely heavily on a wide variety of civilian health care agencies. Through strategic alliances, Memoranda of Understanding (MOU), local arrangements, and a general spirit of cooperation and good will, the CFHS have integrated itself into the mainstream of the Canadian health system.

(click on the link above to view a list of outside hospitals and other agencies that are used by the CFHS)

It has always been difficult (especially since intro of Medicare and Unification)) to have the critical mass of miltary patients that justifies dedicated military in-patient/specialized medical facilities.  Even when we had facilities that provided comprehensive dependent health care services (CFE and Cold Lake), we still had to refer out for many of the specialist requirements.  Though it has been several years since I left the CF, I don't imagine that has changed very much, even in light of increased casualties from Afghanistan.  I recall one staff study (from the 80s) that, based on military demographics and ultiization rates, determined a single military hospital (similar to or smaller than the then NDMC) was necessary.  Of course that would have to assume that that all military units/personnel were located within a reasonable vicinity.

While it may seem that having the military in civilian hospitals may 'militarize' those institutions to their betterment, my take would be that it would more likely 'civilianize' the military pers.  Again, critical mass; there have been examples of that happening (CFH Oromocto).  However, medical cross-pollination is not a bad thing.  In fact, it is a lot better now than it was back in the 70s and 80s.  From anecdotal evidence only, it appears that a number of the Canadian civilian physicians and surgeons going to Afghanistan under CF contract do so to gain trauma experience.

 

[Greymatters]

The use of civilian hospitals to provide basic (tertiary) health services to the military (including intergrating CF medical units in civilian hospitals) and as a means of maintaining skills competency for military medical personnel is already the way business is done. 

Where do we have military staff at civi hospitals?  Hmmm, you might want to PM that answer to me in light of my earlier paranoia...

 

[Blackadder1916]

Where do we have military staff at civi hospitals?  Hmmm, you might want to PM that answer to me in light of my earlier paranoia...

See reply #1 above for one example and here's a link to an article from October 2001 for another.  This is nothing new nor hidden from view.

 

[Greymatters]

Ya learns sumtin new every day!  Sounds like it is working very well...

 

[medicineman]

Vancouver General Hospital is home to CF Trauma Training Centre (West) - did a rotation there on my PA course.  Hell, with the exception of 2 weeks in Gagetown, all my rotations for my PA course were done in civilian facilities.  One of the hospitals in Ottawa has military staff as well but can't for the life of me remember which one - there was a ward at the Civic but think they went somewhere else.

MM 

 

[stegner]

One of the hospitals in Ottawa has military staff as well but can't for the life of me remember which one - there was a ward at the Civic but think they went somewhere else.

Is it Monfort?

 

[medicineman]

I believe that you are correct.

Thanks for that.

MM

 

[PMedMoe]

Nope, they haven't moved to the Montfort...........yet.    They're still at the Civic.

 

[medicineman]

Silly me - I stand corrected.  Again.  ;D

MM