Government Operations Committee on Dec. 7th, 2023

[David Prest]

Canada Life provided the Government of Canada with an integrated schedule of all of its deliverables. As we were approaching the July 1 date, there were a number of lower-priority items that the government was willing to defer until after the date in order for Canada Life to focus on some of the more important deliverables—for example, privacy and security concerns, making sure that those were in place to safeguard the health information of plan members. Another example is ensuring that plan members were properly communicated with. Those types of core deliverables were really the focus of Canada Life leading up to the July 1 date.

[Parm Bains, Liberal, Steveston—Richmond East, BC]

Okay.

There's been discussion at committee about whether there's value for money for Canadians.

What did you do to ensure that Canadians would get value from this $514-million contract?

[Marie-Chantal Girard]

From a contract perspective, it was retendered with the most accurate and up-to-date standards and criteria.

From a plan design perspective, when we started this negotiation with bargaining agents and the NAFR, the retirees, it was clear that having had the same administrator for many years, the best practices in the industry.... The contract had not been retendered, and there were some improvements needed in the administration and the efficiencies, such the fraud detection. The technology had evolved so much. We needed to see and introduce better administrative practices. That's what we did. That's what mandatory generic substitution is. We were the only ones lagging behind in not having that, for example.

[The Chair, Conservative, Kelly McCauley]

Thank you very much, Mr. Bains.

Ms. Vignola, you have six minutes.

[Julie Vignola, Bloc, Beauport—Limoilou, QC]

Thank you, Mr. Chair.

Thank you to the witnesses for being here.

Ms. Royds, who besides Canada Life bid on the contract to administer the PSHCP?

[Mollie Royds]

I'm afraid that I'm not able to disclose the names of the other bidders. That is information that we have to hold confidential.

[Julie Vignola, Bloc, Beauport—Limoilou, QC]

When exactly did the transition period start, and when does it end?

[Mollie Royds]

The transition period began on July 1 and will last until January. A six-month period of transition was anticipated under the contract.

[Julie Vignola, Bloc, Beauport—Limoilou, QC]

What exactly is the 18‑month period you mentioned in your opening statement for? When did it start?

[Mollie Royds]

Perhaps I will turn to my colleague Madame Archambault to go through the phases, including the timing associated with the 18 months. I don't have the exact dates.

Do you have the exact date of the start of the 18 months?

[Pascale Archambault, Acting Director General, Business and Technology Solutions Sector, Department of Public Works and Government Services]

Thank you.

The contract was set up in early November 2021.

The purpose of the start-up phase was for Canada Life to take the necessary steps to prepare to administer the plan, getting the website ready, setting up the claims process, hiring staff, finding office space and so forth. The company did not process any claims during that period.

[Julie Vignola, Bloc, Beauport—Limoilou, QC]

Do you know how many French-speaking staff were hired?

[Pascale Archambault]

I, myself, do not know.

[Marie-Chantal Girard]

Canada Life representatives are appearing after us, so that's a question you could ask them.

The number of staff has changed throughout the period. Canada Life doubled its workforce.

We know the service quality is the same in French as it is in English.

[Julie Vignola, Bloc, Beauport—Limoilou, QC]

Let's just say, from the emails people are sending me directly, I'm not so sure.

As part of the modernization effort, are the people who administer the plan trained to take into account the recommendations of professional associations or the Institut national d'excellence en santé et en services sociaux, say? Are they trained solely to apply the rules?

[Marie-Chantal Girard]

Again, I think the Canada Life representatives appearing before the committee next will be able to give you a more detailed answer.

I can tell you, however, that they are trained to answer eligibility questions for all the benefits. They have access to written scenarios with recommended answers. As we all know, health care is very complex, so there may be specific situations where claims staff need to consult with health professionals to better understand the claim. In those cases, neither employees of the government—so the employer—nor employees of Canada Life—the plan administrator—would ever take the place of a medical professional. They do not make those kinds of determinations. Doctors do.

[Julie Vignola, Bloc, Beauport—Limoilou, QC]

I don't know which doctors Canada Life is getting its advice from, because in some cases, people who need life-sustaining medication are being asked to take the generic version, even though it causes so many side effects that it jeopardizes their health.

Instead of understanding their situation, the plan administrator is asking people to provide even more documentation. Meanwhile, they aren't getting the medication they need to survive. They are being asked to make a choice: either submit the paperwork to prove that they genuinely need the brand-name drug, not the generic, to survive, or take the generic drug, which has the same effect as taking nothing at all, in other words, death.

Do you understand that?

[Marie-Chantal Girard]

I understand perfectly.

If I can have at least a minute to respond to your second question about substituting generic drugs for brand-name drugs, I can give you a more thorough answer.

I want to reiterate that mandatory generic drug substitution is an industry best practice. Generic drugs are approved by Health Canada and are suitable for most people.

That said, mandatory substitution will not come into effect until January 1, 2024. Again, we built in a transition period to inform plan members and give them time to consult a doctor or nurse practitioner about taking a generic drug. If they cannot take the generic drug, a form must be completed by the doctor or nurse, and that form is now one page shorter. As soon as the attending physician provides a medical reason, the individual will be exempted from the requirement.

[Julie Vignola, Bloc, Beauport—Limoilou, QC]

In the meantime, the person is still waiting for their medication.

[Marie-Chantal Girard]

We now have priority claims processing. If you give me the details of the person's case and their life or health is in jeopardy, their claim can be dealt with on a priority basis.

[Julie Vignola, Bloc, Beauport—Limoilou, QC]

Basically, you are guaranteeing me that, as of December 1, people are no longer waiting months for a decision on their claim. I have here names of people who submitted claims on October 22 and were told that Canada Life was still processing claims from September 15.

Are you guaranteeing me that no one will be told that kind of thing going forward?

[Marie-Chantal Girard]

I—

[The Chair, Conservative, Kelly McCauley]

I'm afraid that I have to cut you off there because we're past our time. Perhaps in the next round....

Mr. Johns, please go ahead.

[Gord Johns, NDP, Courtenay—Alberni, BC]

First we had Phoenix, under which employees couldn't get paid for work they had done. Now we have federal government employees.... These are people who have dedicated their lives to serve their fellow Canadians. They've had an absolute nightmare accessing their benefits.

The trust that public servants have in their employer, which is the Government of Canada, is evaporating. It's costing talent. You talked about this as being a really important tool for attracting workers. By extension, all Canadians benefit from this talent. It needs to be fixed.

When we look at all of the constituent stories that you're hearing around the table today, it's just a reminder of how necessary a pharmacare plan is for all Canadians. This is just public servants. Imagine Canadians who can't access any medicine. It is critical that we move forward with the pharmacare plan so that nobody is left without getting their medication in this situation.

To start, my question to you is this: What compensation can we expect for public servants and retirees who have suffered or paid interest out of pocket because of Canada Life's inability to process benefits in a timely way?

[Marie-Chantal Girard]

I'll let my colleagues speak about what they're doing to make sure that taxpayers' money is well managed.

Now, with regard to compensation, as regrettable as this has been—we're not denying that—I can assure you that every person who is owed money based on the plan parameters and the admissibility has been or will be made whole. They are being reimbursed everything that was due to them according to the plan. It might take longer, but they will get their reimbursement. We understand now that Canada Life is treating the requests much faster.