CF Medical Service in rapid decline

By Col (Ret) E. Peter Green, MD

The Annual General Meeting of the Defence Medical Association was held recently in Ottawa. The Canadian Forces Director General of Health Services (DGHS) and the Surgeon General both addressed us. They largely confirmed the tremendous strains the CF medical services were experiencing.

The DGHS commenced by emphasising that a medical service is people-based, and that without the right people with the right qualifications and training, no military medical service can survive. Unfortunately, she said, there continue to be significant problems with recruitment in all the clinical occupations. 

Treasury Board has partially helped with more money for signing bonuses and increased salary, but this has met with very limited success. Whatever money has been found is too little, and coming too late.

It was made clear by the DGHS that the self worth of military members was falling, and retention was plummeting. To fill the gaps, more civilians are being hired, but they cost more and do less. Each position filled by a civilian on contract, costs more but with fewer responsibilities; it becomes yet another grain of sand under already sore feet.

Other combat service support areas in the CF have also moved to contract out what is seen as low priority tasks, and the DGHS reported that like the CFMS, they have discovered that the military ethos has been damaged, flexibility diminished.

The Surgeon General spoke about the move away of the medical services from the commands, and how this was proving very upsetting to commanders. He cited the brigade commander from Petawawa who visited NDMC the week before. The brigade commander, while speaking to one of the courses being run there, said, "You are moving away from us and we don't like it."

Some shortcomings cited were that occupational health information is missing to commanding officers and that there is a breakdown of trust between the commanding officer and medical officer. Both Air and Navy units have safety concerns, while the Army wants more interaction to improve relationships on every level. 

One of the problems is a shortage of uniformed medical officers (80 per cent of captains eligible for release walked last year). As a result of this shortage, the few remaining medical officers in uniform are not happy; they get the "dirty and distasteful" jobs from the civilian physicians and can only react to crises. 

The Surgeon General told me that it is proving very difficult to persuade serving physicians to take promotion because of the increased workload and hassle. They choose to leave instead. He stated that the uniformed staff sense they are becoming "guests" in their own Base hospital. 

Unfortunately, I believe that what we were hearing was close to a death rattle for a uniformed medical service. Career progression and training are being sacrificed to immediate operational needs and the requirement to do something, anything, to persuade those few still in, to stay in.

What started as corrective action to improve garrison health care will end in destroying the operational abilities of the CFMS; something built up over many years, now destroyed in only a short few.

Both an immediate and mass influx of uniformed medical staff is needed to improve the quality of career and life. Without this infusion, the capacity of the CFMS, and hence the CF, to operate outside home bases will diminish and ultimately disappear. _

Col Peter Green was a delegate to the Defence Medical Association meeting.

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