As a result of their deliberations committees may make recommendations which they include in their reports for the consideration of the House of Commons or the Government. Recommendations related to this study are listed below.

Recommendation 1

That the Government of Canada commit to making Canada an international leader in the research, diagnosis and on-going treatment of mental or physical injuries caused by military service, such that service members and veterans are fully supported, both during and after their service.

Recommendation 2

That the Government of Canada explore options to reform the current model of CAF healthcare funding, wherein provincial health agencies are often charging CAF members higher than normal service fees to get the medical treatment they require.

Recommendation 3

That the Government of Canada work with industry to expedite the approval of new technologies and modalities of treatments for the Canadian Armed Forces.

Recommendation 4

That the Government of Canada establish a consistent and overarching definition for operational stress injury, military sexual trauma and morale injury that can be used by health care and policy makers, particularly as a shared definition for program eligibility with the Canadian Armed Forces and Veteran Affairs Canada.

Recommendation 5

That the Government of Canada invest greater resources and funds into the research of health and mental health outcomes and impacts of CAF service on women to create necessary health and mental health resources, particularly surrounding fertility, menopause, perinatal challenges and menstrual suppression.

Recommendation 6

That the Government of Canada work with the Canadian Armed Forces to revise the process for booking appointments to reduce wait times for mental health and specialist health treatments.

Recommendation 7

That the Government of Canada explore options for expanding all on-base health services to the families of service members.

Recommendation 8

That the Government of Canada provide greater funding to the Military Family Resource Centres.

Recommendation 9

That the Government of Canada take active measures to ensure that service members who need it are connected to a family physician and relevant specialists upon their discharge to ensure continuity of care.

Recommendation 10

That the Government of Canada create a more efficient process for transferring health records between federal and provincial jurisdictions by working with Seamless Canada to modernize its use of technology and high security storage of data.

Recommendation 11

That the Government of Canada ensure that a determination of injury applicable to service from a CAF doctor or specialist be deemed sufficient for the purposes of Veterans Affairs Canada and that the veteran not require additional screening to access treatment, benefits, or supports.

Recommendation 12

That the Government of Canada work to ensure all relevant health resources are available for CAF members transitioning to VAC the moment they are discharged from the military.

Recommendation 13

That the Government of Canada give the Canadian Armed Forces the ability to retain medically released members until such time as all the benefits and services from the Canadian Armed Forces, Veterans Affairs Canada, and Service Income Security Insurance Plan have been confirmed and put in place.

Recommendation 14

That the Government of Canada collaborate with the relevant provincial and territorial licensing bodies to allow for the priority licensing of doctors from NATO allied countries that wish to join the Canadian Armed Forces.

Recommendation 15

That the Government of Canada work with the Canadian Armed Forces to ensure competitive health care wages and employment for CAF members, contractors and public sector employees.

Recommendation 16

That the Government of Canada retrain service personnel who have been injured, whenever possible, rather than release them for not meeting the universality of service doctrine.

Recommendation 17

That the Government of Canada undertake a comprehensive and comparative review of the health and transitioning services of allied nations to learn and potentially adopt practices that can benefit the quality of care both serving and retired members of the Canadian Armed Forces can receive.

Recommendation 18

That the Government of Canada, particularly the Department of National Defence and the Canadian Armed Forces, begin a consultation process with expert military medical practitioners, social workers, psychologists, and former members of the Canadian Armed Forces, to establish a nationwide data base of these critical professionals to ensure outgoing members have a seamless transition to health services when they leave the CAF.

Recommendation 19

That the Government of Canada prioritize efforts to reduce the wait times for CAF members, who are being medically discharged, to have their injury attributed to service in the forces.

Recommendation 20

That the Government of Canada increase its efforts to replace the aging medical infrastructure in the Canadian Armed Forces and the Department of National Defence.

Recommendation 21

That the Government of Canada move to implement a digital medical record system to replace the existing and antiquated health record-keeping system used by the Canadian Armed Forces and the Department of National Defence, where the medical information of members of the Canadian Armed Forces is readily accessible to employees from Veterans Affairs Canada, military medical personnel, and civilian medical practitioners, for the purpose of facilitating access to medical records across the entities, for the calculation of medical entitlements and for a seamless transition upon release from the CAF.

Recommendation 22

That the Government of Canada immediately implement the following recommendations, made by the Ombudsman’s Office, and already accepted by the Government of Canada, in the reports Canadian Rangers: A Systemic Investigation of the Factors That Impact Healthcare Entitlements and Related Benefits of the Rangers, and A Systemic Review of the Compensation Options for Ill and Injured Reservists:

• “That the Department of National Defence and the Canadian Armed Forces eliminate ambiguity and inconsistency in language in the policy framework for Reservists, with a focus on health care entitlements, as soon as possible.”
• “That the Department of National Defence and the Canadian Armed Forces ensure compliance with the existing illness and injury reporting process so that Canadian Rangers are not inadvertently barred from accessing their health care entitlements and related benefits.”
• “That the Department of National Defence and the Canadian Armed Forces ensure the delivery of health care to Canadian Rangers to which they are entitled by: engaging with Canadian Rangers with the view of identifying the barriers to their access to Canadian Armed Forces health care, and their health care needs within their social and cultural contexts; and identifying and implementing a service deliver y model for Canadian Armed Forces health care that is responsive to the identified needs of the Canadian Rangers.”
• “That the Department of National Defence and the Canadian Armed Forces take concrete steps to ensure Canadian Rangers have a clear understanding of the importance of reporting injuries, and to improve their knowledge and awareness of the health care entitlements and related benefits available to them by:
  • .... Amalgamating information on Canadian Ranger health care entitlements and related benefits;
  • .... distributing this information to Canadian Rangers in various languages and formats as necessary, by fall 2018;
  • .... and ensuring that this information is integrated into formal and any other relevant training offered to the Canadian Rangers, by fall 2018.”
• “The Department of National Defence and the Canadian Armed Forces improve the governance and administration of the Reserve Force Compensation process by: a) Creating a functional authority who is accountable for the Reserve Force Compensation process, and who can reinforce the applicable policies and directives in place; b) Amending Canadian Forces Military Personnel Instructions 20/04 to provide clarity and consistency in the cessation of service due to service-related injuries and illnesses; c) Streamlining the Reserve Force Compensation process by: i) Standardizing and simplifying forms; and ii) Ensuring that units forward claims directly to the Director Casualty Support Management for adjudication, within 30 days of the time the application was commenced; and d) creating a Defence Administrative Order and Directive to codify the Reserve Force Compensation process, including service standards or a performance measurement strategy to validate the effectiveness of the entire process.”
• “That the Department of National Defence and the Canadian Armed Forces take concrete steps to improve the knowledge and awareness of the compensation options available to ill and injured Reservists by: a) Making any relevant documents, policies, procedures and forms easily accessible on the internet and on the Defence Information Network; b) committing the resources required for the development and implementation of a communications plan, including i) activities, ii) products, iii) timelines, and iii) metrics to reach and inform Reservists about available compensation options; and c) formalizing training on Reserve Force Compensation and the Government Employees Compensation Act, and defining the roles and responsibilities for all Reservists and their leadership within these processes.”.

Recommendation 23

That the Government of Canada immediately implement the following recommendation, made by the Ombudsman’s Office, and already accepted by the Government of Canada, in the report Part-Time Soldiers with Full-Time Injuries: A Systemic Review of Canada’s Primary Reserve Force and Operational Stress Injuries:

• “That the Department of National Defence and the Canadian Armed Forces improve the clarity and administration of Reservists’ entitlement and eligibility for health care, periodic health assessments and future Reserve employment by: a) Completing the revision of Queen’s Regulations and Orders, Chapter 34—“Medical Services,” that has been under review since 2009, to clearly identify all entitlements to care for all Reservists; b) incorporating the requirement for Reservists to undergo routine periodic health assessments (or to have their medical readiness determined) into the revised Queen’s Regulations and Orders Chapter 34—“Medical Services” (along with associated policies and directives). Once this requirement is codified, ensure that the appropriate resources are in place to guarantee Reserve medical readiness; c) confirming in Canadian Forces Military Personnel Instruction 20/04 that Reservists whose Medical Employment Limitations so allow may be eligible to obtain new employment despite the existence of a temporary medical category.”
• “That the Department of National Defence and the Canadian Armed Forces take measurable steps to improve the knowledge and awareness of the entitlements available to all Reservists, especially those who may be ill and injured, by: a) Making any relevant documents, policies, procedures and forms easily accessible on the internet and on the Defence Information Network, and ensuring this information remains current; b) committing the resources required for the development and implementation of a communications plan. This would include activities, products, timelines and metrics to reach and inform Reservists; c) ensuring that training on entitlement to health care (currently provided by the Field Ambulance Medical Link Teams) is effective and mandatorily provided to Reserve units; and d) ensuring that Reserve units have the appropriate number of training days to provide mandatory training to their members, and that such training is completed.”.

Recommendation 24

That the Government of Canada, consistent with the best practices of the health insurance industry and for the prevention of chronic conditions, remove the requirement that Canadian Armed Forces members must obtain a physician’s referral to access chiropractic treatments that can be claimed through insurance. Moreover, the Government should increase the annual amount that can be claimed for such treatments.

Recommendation 25

That the Government of Canada evaluate and test the suitability of uniforms, equipment and other gear for Canadian Armed Forces women on a continual basis. Moreover, when conducting such evaluations, the Government should apply a gender-based analysis plus lens to ensure that Canadian Armed Forces women can carry out their duties safely and comfortably.

Recommendation 26

That the Government of Canada provide Canadian Armed Forces members with full access to reproductive care, including fertility preservation and treatment benefits.

Recommendation 27

That the Government of Canada establish standards designed to ensure that the medical assets and resources available to Canadian Armed Force women while they are deployed meet their needs, regardless of where they are serving, and integrate women’s health education into pre-deployment training.

Recommendation 28

That the Government of Canada, in collaboration with relevant stakeholders, take immediate steps to eliminate the stigma concerning mental health services for Canadian Armed Forces members and military families, including by amending Section 98 of the National Defence Act to remove the criminalization of self-harm for Canadian Armed Forces members.

Recommendation 29

That the Government of Canada increase awareness, among Canadian Armed Forces members, about the physical and mental health benefits, services and supports that they can receive during and following their release from the Canadian Armed Forces.

Recommendation 30

That the Government of Canada, respecting provincial and territorial jurisdictions and in cooperation with relevant stakeholders, ensure that mental health and other care providers at operational stress injury clinics have adequate training to provide treatments and programming that are tailored to situations involving military sexual trauma. As well, the Government should design and implement a mental health training program for Canadian Armed Forces members that focuses on responding to the disclosure of sexual assault.

Recommendation 31

That the Government of Canada work with provincial and territorial governments, as well as relevant other stakeholders, to ensure that all Canadian military family members have access to mental health services and supports that are both adequate and tailored to their needs.

Recommendation 32

That the Government of Canada, in collaboration with provincial and territorial governments, expedite its efforts to increase the availability of—and secure access to—affordable child care and family physicians for military families.

Recommendation 33

That the Government of Canada reaffirm the importance of spiritual and religious care for CAF members and their families and adopt a policy of inclusion in the Chaplain Services that ensures all CAF members are able to receive pastoral care in all religions, faiths, and spiritualities, and furthermore that Chaplains from all religions and faiths are welcome in the Chaplain Services and are protected by the Charter of Rights & Freedoms.