Finance Committee on Nov. 23rd, 2017

[Jennifer O'Connell, Liberal, Pickering—Uxbridge, ON]

Thank you, Mr. Chair.

While I appreciate Mr. Dusseault's motion, the minister was just here and spoke to the Auditor General's report. Mr. Dusseault had the opportunity and asked her and the commissioner questions specifically in regard to the Auditor General's report.

I know that many times when ministers appear before us, it never feels like we have enough time as individual members, but she did actually stay longer than was scheduled and made notice in advance to the committee that she was happy to talk about any of the issues, not just supplementary estimates. I feel we had the opportunity for questions and to have this conversation, and the minister remained here as long as everybody needed to have their turn and stick to the schedule.

I don't think there's an issue in the sense of the minister's being able to talk about this issue. She's spoken about it in the House and she spoke about it again here today. She spoke about it in her opening comments and was not waiting to just react to a question. I think she provided a lot of information to this committee and made herself very available to talk about any of the issues that the committee wanted to, which sometimes is more than we get in terms of the structure of the committee and sticking to the motion at hand.

I'm not opposed to the idea of the minister coming here and speaking about the Auditor General's report, but she just did. In fairness to the best interests of this committee's time, I feel that we had that opportunity, and the member did get to ask those specific questions as well.

[The Chair, Liberal, Wayne Easter]

I have on my list Mr. Poilievre and then Mr. Kmiec.

[Pierre Poilievre, Conservative, Carleton, ON]

I'm going to pass.

[Some hon. members]

Oh, oh!

[Pierre Poilievre, Conservative, Carleton, ON]

I'm sorry to disappoint you over there. I know you were anxiously awaiting my remarks.

[The Chair, Liberal, Wayne Easter]

Go ahead, Mr. Kmiec.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

I thank my colleague for ceding his turn.

Not everybody got a turn. I didn't get a chance to ask questions of the minister. The minister specifically came in here to speak about the supplementary estimates and, through her joyous willingness, to answer extra questions. She knew, since she had been put on notice by the chair, that there were going to be questions asked about more than just the supps, and that's why she was doing that.

I think that Mr. Dusseault's motion is perfectly reasonable. One of the fundamental things we do is review how government operates and what it does. It's more than reasonable to have the minister return here to spend a full hour or more to speak specifically to the issue with the call centres and how the service levels are awful.

The most interaction a person will have in Canada is in trying to pay his or her taxes. If most attempts to contact the CRA wind up without the connection even being made and then a third of the answers are incorrect, I think that's worthy of this committee's attention and a more extensive discussion, whereas today we had the supps, the DTC, and perhaps seven minutes on the call centres.

In some weeks this committee has met every single day except for Fridays, even during travel. I don't mind doing more work. I'm looking forward to the opportunity to have the specific people involved in administering the call centres explain to us what is going on, the technology, and the direction that was given. There's a lot more detail to discover in an interaction at the committee than there is through question period, because we can go into the details and we can have a back-and-forth.

Mr. Chair, I think this is a good motion proposed by my colleague from the New Democrats, and we should seriously consider it.

[The Chair, Liberal, Wayne Easter]

Mr. Kelly is next.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

I completely agree with Mr. Kmiec. The answers that we heard today were in many cases not satisfactory, and I would love to see the minister given an additional opportunity to elaborate further than the answers we got today.

[The Chair, Liberal, Wayne Easter]

With that, are we ready for the question?

[An hon. member]

I'd like a recorded vote.

[The Chair, Liberal, Wayne Easter]

(Motion negatived [See Minutes of Proceedings])

[The Chair, Liberal, Wayne Easter]

We're back to our original question list.

We're going to tighten it up to about four-minute rounds so we can get most people on.

Go ahead, Ms. O'Connell.

[Jennifer O'Connell, Liberal, Pickering—Uxbridge, ON]

Thank you, Mr. Chair.

Thank you all for being here.

Mr. Chair, I just want to make something clear. My frustration with some of the conversation around the disability tax credit should not be misunderstood. The chair, Mr. Fergus, and many of my colleagues have stated concerns that something has changed in terms of the administration or the communication, or that there is something going on. Even the commissioner acknowledged that they have to get to the bottom of where these concerns are coming from.

My frustration comes from the fact that prior to being a federal member, I spent a large part of my career fighting for persons with disabilities, and it really bothers me when I see the opposition fighting and using people with disabilities as a political pawn when they knew that making cuts to the CRA, cutting the disability advisory committee, cutting training.... What did they think would happen, Mr. Chair? Did they think service levels would be improved by making substantial cuts to the CRA and cutting nurses who could help the CRA administer some of these things? My frustration is from the fact that substantial cuts happened over the past decade, and now we're living with the ramifications.

Cuts were made so that technology couldn't be increased, and now we have to go through files manually to figure out where the problems are coming from. In this day and age, in this government, the CRA has to manually pull files to figure out the data. Perhaps, had the Conservatives made some investments and kept up with the times, we could have managed this in a way that made sure that the most vulnerable persons with disabilities, who fundamentally need this money and these resources, wouldn't have to be waiting for cases to be manually pulled so we could get to the appropriate solution.

With that preamble, Mr. Chair, I'll get to my questions in terms of technologies.

This is what we tend to be hearing about where there might be some level of difference. I say “difference” because we don't even have an answer for what's going on, although we know there was no policy change.

There seems to be some difference coming from this idea that technology has made the administration of type 1 diabetes in particular easier to manage, or that the therapy does not require those 14 hours. I guess my critical question is this: who in the CRA, or what level of the agency, determines at what point the technology correlates to a reduction in hours needed? You haven't had the disability advisory committee from 2006 until today. You didn't have them to consult with. The Conservatives also fired nurses who would advise at the CRA, so at what level did the discussion around technology...? Who made that decision? Who would make a decision like that, if that's ultimately the rationale?

It's not just with diabetes; it could be for anything in administering the disability tax credit.

[Frank Vermaeten]

These are complex questions in a complex decision-making process. We run a fairly large program here. As the commissioner said, we gave out $1.3 billion of benefits for 2016-17, so it is a very big program. We're processing a lot of applications. I think it was 265,000 last year.

Then there are various lines of impacts, and for each one there are tests to determine whether an individual would qualify. One needs to keep up to date with the medical technologies, because ultimately what you're seeing is after-treatment.

For example, if it involves vision, you have to ask what the impairment is after eye surgery. It's not about the condition before eye surgery. You absolutely need—

[Jennifer O'Connell, Liberal, Pickering—Uxbridge, ON]

I'm sorry. I don't mean to cut you off.

Is that a CRA manager who keeps updated on the technology?

[Frank Vermaeten]

Yes, it's a CRA manager, in consultation....

It would be at a manager level. It certainly wouldn't be made at my level. It would be managers and people trained in this. We have a staff of nurses at headquarters who are in constant communication with the medical community. They're doing research. We get doctors calling all the time, so the nurses very often will call doctors.

There's a constant feedback loop here in terms of the evolution of technology. It's not just, as you pointed out, on diabetes, but on a whole range of issues. We absolutely need to keep up to date on that, and that definitely impacts whether somebody will or will not be eligible, because it's done on a case-by-case basis.

[The Chair, Liberal, Wayne Easter]

Thank you both.

Go ahead, Mr. Kelly.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

Thank you, Mr. Chair.

The preamble to that last question just simply can't go without some reply.

Mr. Chair, and to our witnesses, a decision was made—seemingly, one would guess, at the ministerial level—to change how the disability tax credit is applied. We have a letter signed in the minister's own hand that states she believes that most type 1 diabetics do not meet the criteria. That's a policy decision. That has nothing to do with how many tax collectors the CRA employs. It doesn't have to do with cuts. It doesn't have to do with the number of employees when a minister makes a decision. It doesn't have to do with committees.

I would also note, and remind you for the record, that transfers to the CRA steadily increased throughout the last Parliament. I'm not sure what these cuts are to which Ms. O'Connell refers. The number of personnel employed by the CRA, I understand, peaked in about 2004 at 51,000 employees. It was cut during the final Parliament of the last Liberal government by 11,000 people.

None of this really matters. What matters is getting to a resolution over an issue that happened this past May, which is when, according to reports we've heard at this committee, the approval rate for type 1 diabetics appears to have gone from an 80% approval to an 80% rejection. The questions that have been asked around here are trying to get to the reason, because it simply appears that there was a change in language in the letters and questionnaires that go to medical personnel that asserts that most type 1 diabetics don't, in fact, qualify.

I cede the floor to you, Mr. Vermaeten. It would seem to be that simple—that this change in language in the form is what has resulted in this change from 80% approval to 80% rejection. We await the data, as specific as possible, to demonstrate where the approvals went and where they are now.

[Frank Vermaeten]

Maybe I can say two things.

First of all, yes, we are looking at this and doing a comparison of the last several years and post-May 2017, which you referred to. We are looking over time to see what's happened to acceptance rates, so certainly we'll look at that. It's going to take a little while because it is a manual process, and we don't store data by the underlying disease but about the impairment. That's what we look at.

The second thing I'll say is this is not a letter that indicates a policy change by the Minister of National Revenue. What's stated here is that there has been an evolution with respect to the therapy for diabetes. With devices like insulin pumps, it now takes less time to manage diabetes.

I absolutely stand behind this.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

If I may, type 1 diabetics have told both this committee and members of Parliament outside the committee that the technology, while it is incredible in the way that it can help sustain life and improve the quality of life for diabetics, is not simpler. We've heard this from type 1 diabetics who insist that while a pump is a wonderful advancement in technology, the pump and the necessity of performing tests for the pump to be used correctly do not necessarily correlate at all to a reduction in the time applied to therapy.

[The Chair, Liberal, Wayne Easter]

That'll conclude this round of questioning, but finish what you started.

[Frank Vermaeten]

I think you're going to get a range of views on that. Based on the information that I've received from our staff, my assessment is that there have been a lot of advances that do reduce the time it takes for some people to manage their diabetes. That's not for everybody, but it certainly does in some cases, and maybe in many cases.

We can argue back and forth that you've talked to some doctors and I'll say our staff has talked to many doctors, but that's part of the disability advisory committee. I think it's going to help provide advice on issues like that when you bring in professionals who are specialized in this area. I think that will be very helpful, because clearly it is a controversial issue, and I recognize that. We want to administer this in the very best way.

[The Chair, Liberal, Wayne Easter]

We'll be turning to Mr. Lauzon, who will have the last question.

[Stéphane Lauzon, Liberal, Argenteuil—La Petite-Nation, QC]

Thank you, Mr. Chair.

I will ask my question in French.

Mr. Vermaeten, we have talked at length about the changes that have been happening for a few months or weeks. We have often talked about technological advances. Technology comes with good things and creates businesses, but it sometimes causes job and service losses, such as the one that seems to to be included in the letter.

Specialized nurse practitioners have been hired to work on that, and the form has been simplified. The requests have been reviewed and updated, and, as a result, letters were sent out, indicating that the 14-hour treatment requirement per week was not going to be met.