SUB-COMMITTEE ON THE STATUS OF PERSONS WITH DISABILITIES OF THE STANDING COMMITTEE ON HUMAN RESOURCES DEVELOPMENT AND THE STATUS OF PERSONS WITH DISABILITIES

SOUS-COMITÉ SUR LA CONDITION DES PERSONNES HANDICAPÉES DU COMITÉ PERMANENT DES RESSOURCES HUMAINES ET DE LA CONDITION DES PERSONNES HANDICAPÉES

EVIDENCE

[Recorded by Electronic Apparatus]

Tuesday, June 8, 1999

• 1538

[English]

The Chair (Ms. Carolyn Bennett (St. Paul's, Lib.)): I call the meeting to order.

We welcome, from the Office of the Commissioner of Review Tribunals, the commissioner, Peter Smith; Margaret McGrath, the deputy commissioner; Tina Head, the senior counsel; and Chantal Favreau, counsel. Welcome.

Mr. Peter Smith (Commissioner, Office of the Commissioner of Review Tribunals, Canada Pension Plan/Old Age Security): We will proceed with the opening statement, Madam Chair.

The Chair: That would be great.

Mr. Peter Smith: It's about 12 minutes long, but as a former university lecturer I was trained to talk in 40-minute periods, so you may want to be vigilant and tell me to cool it at the appropriate time.

I am happy to be here with my three colleagues. Mrs. McGrath has been with the OCRT since its inception in 1991 and has been reappointed twice, I think it's fair to say. Ms. Head has been our senior counsel,

[Translation]

Our senior counsel,

[English]

for about three years. She performs really general counsel duties and a number of other related duties in the policy analysis and related areas, as well as those you would assume would be performed by a senior counsel. Madam Favreau is our avocat, our lawyer, working directly with Tina. Chantal plays an enormous role—all of my colleagues play enormous roles—with us in the area of the review, vetting, and doing what you might call quality review of the decisions of our tribunals across the country.

• 1540

Honourable members may not know that today we are making a bit of history, as this is our first appearance before a committee since our creation in December 1991. So we should mark that just very quickly and briefly.

I'm certain honourable members are aware that our having not appeared before a standing or subcommittee of the House in the past does not indicate a lack of interest in the work of review tribunals by members of Parliament. We're fully aware that CPP disability appeals are currently a very important source of dossiers and constituency casework. Many MPs' staff assist constituents in preparing appeals, and some assistants appear as appellant representatives at our hearings.

The Office of the Commissioner of Review Tribunals, OCRT/BCTR—I'll try not to use too many more acronyms after that—is an independent, quasi-judicial tribunal. We are the second of three levels of appeal under the Canada Pension Plan and the final level of appeal under the Old Age Security Act.

The Ottawa-based office is comprised of a full-time commissioner and a deputy—Ms. McGraw and myself—a staff of about 84 located in the National Capital Region, and 300 part-time panel members across the country. Neither the commissioner nor the Ottawa staff has the authority under the CPP legislation to hear or decide appeals. This responsibility is given to review tribunals composed of three persons chosen by the commissioner from a panel of 300. The act requires that every tribunal be chaired by a lawyer, and in disability cases one of the members must be a medical doctor or a qualified health professional.

When we were established, the expectation was that there would be about 1,800 appeals per year. That number was exceeded in the first full year of operations, the fiscal year 1992-93, and it has increased exponentially every year thereafter until last year. In 1997-98 we received 10,977 appeals, an increase of 441% since our first year of operations.

As you might imagine, this has created a number of administrative challenges, which have been identified in the annual reports provided to honourable members and the staff of your subcommittee. Last fiscal year we set a record for total hearings of 9,607. We expect this year to exceed this total by the end of the fiscal year, averaging 900 hearings a month, for total hearings held of 10,800.

[Translation]

But such numbers do not tell the whole story. Most important above all is the human dimension. Like the honorable members who deal daily with these people in their constituencies, we at the OCRT are aware that each of these appeals represents a person with a significant health concerns who is also likely to be experiencing personal and financial hardship, most often of a severe nature.

[English]

We know it is still difficult in our communities for a person with disabilities to identify and obtain access to the income, health, and social supports appropriate to their circumstances. Under the current system at CPP, in most cases it's not until the review tribunal level of appeal that a person who has applied for disability benefits has an opportunity to meet face to face with a decision-maker and tell their story. By this point in their lives, as some of you know, and we know rather well, some appellants are angry, frustrated, and exhausted. Understandably, this can be part of the dynamic of the review tribunal hearing.

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Knowing these general circumstances, our challenge is to provide a hearing that is informal, fair, and compassionate and to make decisions consistent with the evidence and the legislative criteria for disability benefits. It's not an easy task that is faced by our panel members.

In the remainder of this short statement, I'll try to provide an executive summary of some facts and issues relevant to review tribunals and the OCRT's role as the second level of appeal. I'll list these relatively quickly and give our perspective on each, without going into detail on the rationale for our perspective. I hope this will be productive, as it will lend itself to questions and answers closer to the needs and concerns of members of the subcommittee.

I'll then close with a bit of data, which you have a handout on, that summarizes our operations and indicates our performance, I hope, in some small way as an organization.

First, we are an independent administrative tribunal mandated by section 82 of the Canada Pension Plan Act. We are thus substantially different from, for example, a program developed and delivered by a government department, in that a ministry does not answer for us to Parliament, in conformity with the doctrine of ministerial accountability.

Indeed, our tribunals are called upon to adjudicate decisions taken by those responsible for a program of HRDC, the income security programs branch. There is an administrative line from the commissioner to the minister of HRDC, but this does not mean the minister answers to Parliament for us in any way similar to his or her reporting, for example, on that program and branch of the department. The minister, in fact, plays no role at all in our day-to-day operations, unlike a program of the department and the minister's role in respect of programs of the department.

There is some confusion in this area—may I just say as an aside—because of the language that has built up in the administration of the Canada Pension Plan and the appeal system, where, for example, the official from income security programs branch, who is called the minister's representative, attends the tribunal. I can understand how some appellants would think the minister himself or herself was actually directly involved. Of course, people are acting under delegated legislation of the minister.

So there's possibly an occasional communication difficulty posed here. The impression is left that possibly, in the current instance, Mr. Pettigrew is actually making decisions. In fact, I'm told he does not see any specific case references in correspondence or the daily flow.

[Translation]

Second, in their primary role of rendering decisions, our panels are as independent of us in the Office of the Commissioner as we are of the ISP Branch of the department. Each panel on each appeal has its own independence, and the OCRT cannot overturn their decisions.

[English]

Third, the commissioner does have the primary duty, by statute, of commissioning, composing, or creating each panel and ensuring the appellant and other parties to the appeal are informed of and prepared for the hearing.

We are thus the manager of the second level of the appeal process, with responsibilities that extend to training and in-service professional development of tribunal members. But as honourable members I'm certain know, the office of the commissioner does not appoint panel members. That is the responsibility of the governor in council.

Fourth, and in partial response to the question posed at your subcommittee's meeting of March 4, the commissioner does not have statutory powers to discipline panel members or otherwise to call them to a formal accounting for their actions and behaviour during hearings. Discipline of federal appointees is entrusted primarily to the governor in council, where it is customary to proceed on a case-by-case basis, with advice often tendered by the privy council office, the ethics counsellor, or others in the federal system.

Sixth, and also partly in response to the comments by Miss Grey at the March 4 meeting of this subcommittee to the effect that aggressive questioning by our tribunal members was reported to her as reducing some appellants to tears, I am obliged, by the facts I have, to report to you that we have heard this complaint very infrequently.

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In terms of formal complaints, only about 30 are received each year by us, and most have not dealt with this matter of the style, tone, or approach of questioning. Most of them actually deal with the substance of the tribunal's denial decisions, as you might imagine, and where the appellant is not pleased, to say the least, in many cases.

On the other hand, several advocacy organizations and a group of Toronto community legal aid clinic lawyers have recently expressed concern to us about questions asked by panel members in some of our hearings. This feedback, together with the comments of the members of this committee, have led us to conclude that problems of perception and possibly of practice have arisen from a very small number of our hearings, and this is very troubling to us.

Consequently, and my seventh summary point here, Mrs. McGrath and I, on April 19, sent a package to all our panel members, including excerpts from your March 4 meeting and a draft practice note entitled, “Treatment of the Parties During Hearings”. This package was provided a little while ago to your clerk, and some of you may have seen it.

We plan to issue a final version of the practice note after assessing our panel members' rather extensive response about this thing so far. It's taking us quite a time to respond in kind to our panel members' very conscientious response to this.

Suffice it to say, today I would like to quote two paragraphs from Mrs. McGrath's and my message accompanying the draft practice note and so on to our panel members, where it says:

Our mission statement puts service to the parties at the forefront of our mandate, and expresses our commitment to treat them equally, fairly, and with understanding, respect and dignity. And, frankly, we are proud of our record or achievement and have great confidence in the deep commitment of all of us—Panel Members, Commissioner, Deputy Commissioner and OCRT/BCTR staff alike—to our mission statement.

[Translation]

We are all aware of the complex factors at play at a review tribunal hearing, and of the myriad vulnerabilities and disadvantages experienced by appellants as they make their way through the CPP decision-making process. These combine to create expectations that are sometimes impossible to satisfy. However, we also recognize that the perception of fairness is central to our work and is a standard by which we are judged.

[English]

Eighth, and on the important question of delays in our part of the appeal process, here is our perspective in a nutshell.

Currently, it takes about 6.7 months, on average, for us to receive and process an appeal and hold a hearing. We're making efforts to reduce these throughput times, recognizing that some of this time is mandated by a statute governing our operations.

Honourable members may realize how an instant and very quick turnaround is not always in the interests of our disability appellants.

Finally, Madam Chair, may I just draw your attention to the data, which I believe you have all received a copy of.

The Chair: I don't think we have the data, Peter.

Mr. Peter Smith: We have extras if you wish. It was separate, not an attachment. Mr. Scott was saying he didn't get it.

Frankly, some of this material we could not aggregate until very recently in terms of our computer appeals management system. It was first designed to do the basics of the logistics of coping with this enormous increase in the number of hearings, but it's just in the last year that our staff have been able to take time from that, having achieved that part of the program design. They are now able to give us some performance indicators and management information.

I'm grateful to Ms. Head, as part of her general counsel duties, for helping to prepare this for the committee.

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Very briefly, the first graph on page 1 shows you the growth in appeals, cresting last fiscal year. We quite honestly do not know whether the slight downward dip in total appeals received is a trend as yet. Early indications this year suggest about the same level or slightly below last year's level on appeals received, but we don't know that yet.

The pie chart on page 2, and I'm sure this is not news to you, indicates the degree to which we, as a result of the appeals received, are very much in the business of appeals in respect of disability. The disability benefits of the Canada Pension Plan are an overwhelming preoccupation.

Page 3 shows a little bit of good news in the sense of a steady increase in our productivity, if we could even call it that, in an area of social decision-making. I sometimes wonder whether we should be using these private sector bits of language, but it seems to be the norm today.

Our productivity, measured in total hearings held, from the first year's lowest to last year's record of 9,706...the good news, I submit, is the dip in the top line. It is holding out on the promise that we will continue to have success in reducing what might be called an inventory of cases in process but not heard.

On page 4, I hope there is also a bit of good news; certainly, in our tentative judgment it is. It demonstrates that last year, for the first time since the first full year of operation in 1992-93, we were able to hold about the same number of hearings as the number of appeals received in the system. I'm sure you appreciate the fact that if we continue to perform that well, we will even out and reduce the throughput times and serve people in a more timely and better fashion.

The remaining four graphics are the kinds of tables that will be in our next annual report, which we hope to produce by the end of the summer. Page 5 gives you a run-down of these four remaining graphics in respect of the last fiscal year's full year of operation.

On page 5, you may wonder about this figure of 2,005 for reversals and withdrawals. It's not in a legal sense that we can call them settled; they are the result of offers to settle. After the appeal has been received by us, but before the hearing, the department in many cases offers, in effect, to settle the appeal. More technically, it's called a “reversal”, because the department, under a minister's reconsideration, had previously decided to continue the denial that was originally the decision at the initial phase. That's a relatively large number, and it's an interesting number.

On page 6, the pie chart indicates the degree to which Ontario is the source of the majority of our appeals, followed not too closely, as you can tell, by B.C., Alberta, and Nova Scotia. We do not have the capacity to analyse such trends more fully than that, but of course it has something to do with the structure of the economy across the country and different levels of economic development and so on.

Page 7 reports our basic numbers for last year. We can say that the allowed and dismissed percentages—23.6% were allowed and 69.7% were dismissed—are quite consistent with the historical pattern over the years of operation of the OCRT.

• 1600

Finally, we thought you'd appreciate the breakdown of our panel members from last year's data. For us, the somewhat satisfying major demographic characteristic was that 44.6% of our panel members across the country were women.

We have to do better among lawyers. We need more women lawyers, but these two are busy.

I look forward to your questions.

The Chair: Thank you very much.

My immediate question is, how many people would have a disability?

Mr. Peter Smith: How many of our staff?

The Chair: Panel members.

Mr. Peter Smith: We know some. We have not done a statistical profile. Mrs. McGrath can give us an idea.

Ms. Margaret McGrath (Deputy Commissioner, Office of the Commissioner of Review Tribunals, Canada Pension Plan/Old Age Security): We have a few who are disabled, Madam Chair.

The Chair: We will begin our questioning with Miss Grey.

Overall, I would love you to be thinking about if we're going to make this system work better, what your overall recommendations would be, because it seems to be fraught with some frustration. I have a big concern that you as the head of this don't seem to have control in terms of the way it's set up, in terms of who actually you're stuck with and how you evaluate them and their reappointment.

Mr. Peter Smith: It is a difficult calculation. I don't know whether stuck with...I wouldn't say stuck with. Frankly, I've been in this post only six months. Generally speaking, as a relative newcomer, I've been very impressed by the kinds of people who have come through the process.

Let me pose the question this way. If the essence of the legal process of appeal is the independence of each tribunal, each panel of three, per case, and if they are not to be interfered with and thus they provide natural justice and so on, Mrs. McGrath shouldn't have the powers of discipline because—

The Chair: Out of your presentation, the IRB has a real performance appraisal that actually does influence whether or not somebody gets reappointed. Is there that procedure for you? Miss Grey has complained that somebody was actually abusive to one of the appellants. Are you asked whether that person should be reappointed?

Mr. Peter Smith: We are not necessarily systematically asked, but if we were to offer a view, it would be very carefully listened to. We have, I gather, consistently been asked, and I have in just a couple of instances since I've been commissioner...

You mentioned the IRB procedure. Generally speaking, it's fair to say that in a number of areas the IRB is very advanced among the ministry of tribunals in Ottawa in the federal system. In a number of areas, we are looking to emulate some of their procedures. They got there first.

The Chair: Does that need a change in the law, or is that something you can do internally?

Mr. Peter Smith: May I ask Ms. Head as our specialist in potential areas of reform for her view on that?

Ms. Tina Head (Senior Counsel, Office of the Commissioner of Review Tribunals, Canada Pension Plan/Old Age Security): The commissioner could undertake a system of evaluation of our panel members without requiring an amendment to the CPP legislation. It's a question of resolving organizational culture issues, of practicalities.

For example, we have 306 members at the moment. We're anticipating having as many as perhaps 331 or 333 members who are all part-time, whose appointments generally average about three years. To put into place a formal or even informal evaluation mechanism for all 333 members who have rotating, ongoing appointments requires some creativity and a focus on the bare essentials.

The Chair: Okay, thank you.

Miss Grey.

Miss Deborah Grey (Edmonton North, Ref.): Thanks, Carolyn.

I'll just follow along that same vein and say thank you for coming. I appreciate all of you being here.

Towards the end of your comments, Peter—it's on the chart here that Tina just referred to as well—you said you're aiming for 333 members. This is a part-time position and it's a three-year appointment. How many days a year would they sit on a panel, for instance?

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Mr. Peter Smith: It varies completely, Miss Grey. It's volume. In parts of Metropolitan Toronto, it would be three weeks a month for about half the year. In other provinces and in less metropolitan centres, it would be once every two months. These are groupings of hearings—Tuesday, Wednesday, Thursday, three hearings a day, so a total of nine.

Miss Deborah Grey: Okay.

Mr. Peter Smith: It is a key point, actually, if one wants to get into it, that these are all part-time. So translating the successful performance appraisal system of the IRB to an exclusively part-time operation raises some questions.

I'm sorry, I may not have answered Miss Grey's question fully.

Miss Deborah Grey: I think my next point is to say if there are no absolutes, no evaluation mechanisms... You're accountable to somebody.

Mr. Peter Smith: No formal ones.

Miss Deborah Grey: I suppose.

Mr. Peter Smith: We do have a complaints procedure, which is quite simple, and if you want me to sketch it I will.

Miss Deborah Grey: Yes, but who does the complaining? The appellant? So the complaint always has to come from—

Mr. Peter Smith: It's any party, but generally speaking, the appellants. But I have to say maybe more appellants should complain in the form of writing a letter than have, because I'm pretty sure that 30 people a year out of a total of 9,000...

Miss Deborah Grey: It's pretty slim. I bet each one of us would swear up and down we've had those 30 people in our own offices.

The Chair: We know those people.

Mr. Peter Smith: I don't know whether an administrative tribunal should be in the business of promoting complaints to itself, but certainly appellants and other parties... We've even had one complaint recently from a minister's representative about the behaviour of a chair, for example. We have to honour every complaint from parties. But in regard to the question, we don't click in the complaints procedure if it is someone else acting on behalf of...unless that person is a recognized representative of the appellant, for example.

Miss Deborah Grey: Regarding the fact that these people are all independent, obviously there's some training given to them about what they are looking for and what some of the criteria are. You say in Ontario there are 138 of them. In my province of Alberta there are 23.

If you were to correlate that... You say there's no way you can correlate that, really, because of the volume, or because of this or that. Could it be—and I don't want to be cynical—that somebody says there's a panel that we can kind of get by? Do they have any bottom line or any top line of where they can go with this? Or do they say, well, this is a case where we're going to award as much as we can, or they're parsimonious so they say no, you don't get it? There have to be some mechanisms in place whereby you say, wait a minute here, these are some of the common denominators we're going after.

Mr. Peter Smith: We do indeed have some mechanisms in terms of in-service professional development. This year, for example, we will be doing three national workshops. One of the goals of the workshops is the natural goal for an administrative tribunal, which requires a judicial body to provide consistency in decision-making.

The Chair: Is the workshop compulsory?

Mr. Peter Smith: It is compulsory for those members we invite.

Miss Deborah Grey: If you're going to be consistent, don't you think you'd have to do it across the whole gamut?

Mr. Peter Smith: We of course do that at the original training level.

Miss Deborah Grey: Once.

Mr. Peter Smith: It's intensive, but you're right, it's just once.

Miss Deborah Grey: I'm a school teacher. If I got set loose just once, saying, go at her, Deb, it's all yours for the next however long because you have your permanent teaching certificate now, I would think I was pretty well on easy street.

Mr. Peter Smith: As a former teacher myself, though, I realize the possible salutary effects of the peer group, if you will, the checking of one member by two others. There's a good deal to be said for that kind of collegiality, especially when you're dealing with legal and health professionals, who are accustomed to the self-regulation and peer assessment model. Maybe that saves us sometimes.

May I ask any of my colleagues if they would like to add anything on this very important point of training and retraining?

Ms. Margaret McGrath: We talked about orientation sessions. We start with an orientation session, and it's a very intensive three days, orienting newly appointed members to the legislation.

Once they're out working and they are constituted as members of the tribunal in a particular area, there's a dialogue that goes on continuously between that tribunal and our office. We are available almost from 6.30 a.m. until 8 p.m.

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Mr. Peter Smith: It's a hotline.

Ms. Margaret McGrath: It's a question of the learning curve being long, and at the initial orientation session we don't expect that we can cover very much.

The dialogue that goes on is over the phone and it's often by practice notes; it's the decisions when they come in. We have an opportunity then to discuss, and some will phone and ask, is this the sort of thing we should be writing? So there's no end to the training. It's going on constantly.

Miss Deborah Grey: Okay. Let me jump one step farther and say, to whom are you accountable? You said you're completely independent; you're not under the minister's—

Mr. Peter Smith: No, I didn't say completely.

Miss Deborah Grey: Okay, excuse me, then. You're not subject to ministerial accountability.

Mr. Peter Smith: I think it's fair to say that no one, not even the Auditor General, is completely autonomous in the Canadian system.

Miss Deborah Grey: That's my point, Peter.

Mr. Peter Smith: It's a question of degree.

Miss Deborah Grey: To whom are you accountable?

Mr. Peter Smith: In a very direct sense, Ms. McGrath and I are appointed by the governor in council on the recommendation of the Minister for Human Resources Development Canada, and there is an anomaly, actually, compared with most other people in this kind of work; the statute requires the minister to set the salary. So that's a relatively clear and important power.

Miss Deborah Grey: To whom are you responsible and accountable?

Mr. Peter Smith: Ultimately to the governor in council, I would argue.

Ms. Margaret McGrath: You can go farther and say to Parliament, which created us in 1992. We are responsible to Parliament.

Miss Deborah Grey: Yes. You can appreciate that the buck has to stop somewhere. In your remarks you brought particular attention to the fact that you are not under ministerial responsibility.

Mr. Peter Smith: In the same sense as, for example, officials of the department are, there is an administrative reporting relationship, as well as, if you will, the appointive part of it.

If you would like to continue to pursue this, I would ask Ms. Head to shed further light on to whom we are responsible.

Miss Deborah Grey: We all need to be accountable to someone, and I'm sure that you folks like to have that chain of command clear in your heads.

Tina.

Ms. Tina Head: I think Peter has actually already covered it. In the administrative sense, he's accountable to the minister, who in turn is responsible to Parliament for the performance of the office, and ultimately, as appointees of the governor in council, the commissioner and the deputy are accountable to the governor in council.

Miss Deborah Grey: If you folks could change something about the CPP disability scheme right now, what would it be?

Mr. Peter Smith: The current policy?

Miss Deborah Grey: Yes.

Mr. Peter Smith: You're asking members of an administrative tribunal to comment on policy?

Miss Deborah Grey: I sure am.

Mr. Peter Smith: I know, and you're pursuing it rather directly and effectively.

I would address first—and Mrs. McGrath may also want to give you some views—that in our own mandate it really is proper for us to comment, generally speaking, although I think there is a residual right of the commissioner and/or the deputy commissioner to comment on policy anywhere, in our annual report or whatever, but we won't all agree with this.

Miss Deborah Grey: We want to stick with the CPP disability problem, Peter. That's all we want to do.

Mr. Peter Smith: I understand.

Miss Deborah Grey: We just want to fix it.

Mr. Peter Smith: If there were to be one change of direct relevance to the quality of service to appellants that we provide, it would be in the area of earlier parts of the process specifying fully and in detail to the appellant the reasons for denial, which at a general level—I have many years of volunteer service in the human rights area—I think would be a fuller provision of the basic human rights of the clients of the system.

I know that is an area that is currently being studied by the department; indeed, a pilot project is underway in a couple of provinces on this general area. But that would arm, if you will, our appellants in a fuller sense, because in the current process, the hearing itself, the first step, aside from our chairs introducing the hearing, and so on, is usually the tabling of what is called the minister's argument document, but that's just the beginning of the hearing. The appellant hasn't had access in terms of information, in letter or otherwise, until that point as to the precise or more detailed reasons for the earlier denials.

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It may have to be implemented gradually if it is implemented at all, but I think that would be a very important change directly affecting our part of the process, and it's certainly our prerogative to talk about our part of the process.

Miss Deborah Grey: That's what I was asking. Thank you for—

Mr. Peter Smith: Mrs. McGrath, might want to expand on that.

Ms. Margaret McGrath: As the commissioner said in his opening statement, we are the first people an appellant will see in this whole process. We are the first body they can tell their story to, and often our panel members have to focus on the actual issue of the disability appeal. Sometimes they're not well informed because of lack of information and often, as Mr. Smith just said, the denial letter just says, you have been denied the benefit. It could go a long way to saying why. But some of the work our tribunal members do is that they have to go back and deal with this at a hearing.

If I had a magic wand, I'd like appellants to know early on that they have a contact with people, to discuss the merit of an appeal, and what are the criteria necessary in order to meet the eligibility requirements, which are very stringent and have become more so recently.

So if there was contact early on at that level, at the initials, I think it would make our work a little bit easier and perhaps reduce the number of appeals we do get.

The Chair: Thank you.

Miss Deborah Grey: Can I ask one more quick question? You say they work part-time three weeks a month for half a year in Toronto. Do they all get the same salary, a yearly salary, or is it so much an hour or a day?

Mr. Peter Smith: There is a per diem, which is a little higher for the lawyers because they are given the additional chair duties and the primary responsibility for recording the reasons for the decision, and actually writing the decision.

Miss Deborah Grey: How much are those per diems?

Mr. Peter Smith: It is $325 for the general members and the medical members, which as you might appreciate is quite low for a medical professional, and $450 for the lawyer/chairs.

Miss Deborah Grey: Great, thanks.

Mr. Peter Smith: So it's very much on a per diem basis, plus relevant expenses. And it's only the day of the hearing; it's not case preparation, as Tina has pointed out, which is very important.

Miss Deborah Grey: How do you maintain that kind of part-time job and say to somebody else, shucks, I'm busy here. You must have some pretty understanding employers or people with case practices. If I were the lawyer or the doctor, do I just say, sorry, I can't see you today because I'm sitting? Is that how they deal with it?

Ms. Margaret McGrath: We give them a lot of lead time, at least a month. We make up our rosters three and four months in advance. We know where we're going to be going, and we also ask our members to keep us apprised of their commitments and their agendas. It's a job for one person actually in our office.

Miss Deborah Grey: Do you sit in on the hearings ever?

Ms. Margaret McGrath: Not very often, unfortunately.

Miss Deborah Grey: Would you like to?

Ms. Margaret McGrath: I'd love to, but we have to deal with those decisions once they come into our office. When you have 1,000 a month, you don't get a chance to roam the country very much.

Mr. Peter Smith: We should have mentioned in the earlier discussion, in terms of checking inappropriate behaviour, that when we have time, monitoring and going out on the road and meeting in small groups and so on is wise. Ms. McGrath has had some time to do that. Madame Favreau has had this year...but generally speaking, we're in an operational context of each month delivering.

Miss Deborah Grey: Good, thank you.

[Translation]

The Chair: Ms. Dalphond-Guiral.

Ms. Madeleine Dalphond-Guiral (Laval Centre, BQ): To what do you attribute the truly remarkable increase in the number of appeals filed between 1992 and 1999? What could possibly explain this increase?

[English]

Mr. Peter Smith: I think the practices of some provincial governments—although I can't say that we as the OCRT have analysed this, Madame; we don't have time to do that and it's not part of our mandate to do it. But it's certainly reasonably clear to us that some provincial governments have, maybe increasingly, adopted the general operating procedure for some of their disability social services clients, possibly—I don't know—workers' compensation clients, that they should apply to CPP disability.

I'm told that some indeed have studied the practices of private insurance companies recently, in the last two or three years. We haven't analysed this, so I don't have direct evidence, but I'm told that there are some corporate practices that are basically leading to an insistence by the private insurance companies that their disability policy-holders apply to the CPP.

The Chair: And appeal.

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Mr. Peter Smith: And appeal. My guess is those are two areas resulting in the large growth, the exponential growth.

[Translation]

Ms. Madeleine Dalphond-Guiral: According to your chart, there are only 12 panel members in Quebec. Therefore, I have to conclude that there are very few appeals filed in Quebec and that the ones filed originate with employees of companies tied to the federal government. That would explain this figure. In Quebec, we have the Régie des rentes which performs the same functions.

Have you compared to the two systems? What have you found? It seems to me that a very large number of appeals are rejected. Do we see a similar pattern in Quebec? Are the reasons given for rejecting the appeals similar or quite different?

[English]

Mr. Peter Smith: I'm happy to say that Madame Favreau has just recently done a study of comparison—

[Translation]

Ms. Madeleine Dalphond-Guiral: I saw it on his face. It was almost as if the question had been prepared in advance.

Some members: Oh! Oh!

Ms. Chantal Favreau (Legal Counsel, Office of the Commissioner of Review Tribunals, Canada Pension Plan/Old Age Security): There are some differences. Allow me to answer that question in French.

Ms. Madeleine Dalphond-Guiral: That's fine with me.

Ms. Chantal Favreau: I thought it would be.

There are some differences in terms of the appeals system. I don't have the exact figures for Quebec, but I do know that under the CPP, there are three levels of appeals or decision-making, namely the minister, the Review Tribunal and the Pension Appeals Board.

In Quebec, decisions are rendered by the Régie des rentes. These decisions are subject to review and can be brought before the administrative tribunal. This system was implemented on April 1, 1998. Therefore, Quebec has one less level of appeal.

Under the CPP, decisions are generally rendered by licensed nurses, whereas in Quebec, they are made by doctors. As I understand it, 15 doctors are currently employed on a full-time basis with the Régie.

Another fairly notable difference between the two systems is in the definition of the "substantially gainful". Quebec's Régie des rentes specifies an amount, whereas the CPP does not. Again, boils down to a matter of interpretation.

Filing deadlines are also different. Under the CPP, the deadline is 90 days at all levels of appeal, whereas in Quebec, people have one year to request a review by the Régie des rentes, and subsequently, 60 days to appeal this decision to an administrative tribunal.

There are also jurisdictional differences. We administer the Pension Act and the Old Age Security Act, whereas the Régie des rentes oversees four different pieces of legislation.

Another distinction can be drawn on the basis of age. Under the Régie des rentes, a person 60 years of age and over undergoes a somewhat different test to determine his level of disability then does a younger person. An assessment is done on the basis of his actual job, not on the basis of any job, as is done under the CPP. Unfortunately, I don't have the figures showing the number of applications, but I've been told that last year, Quebec's Regie des rentes received 6,500 applications. I'm not certain what percentage of these applications were directly tied to requests for disability benefits, but my impression is that the percentages are similar for both systems.

Ms. Madeleine Dalphond-Guiral: What are the grounds for rejecting an appeal? I would think that people applying for disability benefits have been advised by their doctor or employer to do so.

Ms. Chantal Favreau: Appellants often tell us that their doctor has determined that they are unable to work for a particular reason, either because they suffer from an illness, from back problems or from some other ailment. However, medical reports rarely comment specifically on the person's ability to work. The test that we administer is not designed to evaluate the illness as such, but rather a person's ability to be gainfully employed. That's where we encounter the biggest problem.

Appeals can be rejected for two reasons. Firstly some people fail to meet the eligibility criteria in terms of CPP contributions; secondly, some people do not satisfy the criteria for a severe, prolonged disability. People seem to have some difficulty understanding that decisions are really tied to a person's ability to work, and not to his ability to continue doing the same work as before or to the fact that he is having problems. Every single person with heart problems will not necessarily received disability benefits. Our job is to determine if the illness is preventing that individual from working. The problem we often encounter with medical reports is that they are not clear on whether the person in question is able to be gainfully employed.

• 1625

Ms. Madeleine Dalphond-Guiral: Have you considered ways of enhancing health-care professionals' understanding of the system? There must be significant costs associated with handling these appeals, not to mention the anguish and worries experienced by workers awaiting a decision. Have you considered any kind of continuing education for them?

Ms. Chantal Favreau: Certainly there are steps that we could take. Currently, we are focusing on providing better information to appellants at the start of the appeals process. Appellants should be aware of whether they meet the criteria in terms of CPP contributions as well as a number of other conditions. The more information they have, including information as to why their application for disability benefits was initially rejected, the better able they will be, from the outset of the process, to decide whether it is advisable or not to continue with the appeals process. They will also know if there is anything more they need or if any information is missing.

We believe it's very important to involve the appellant in the decision-making process and to provide him with the facts he needs to make well-informed decisions. We could even be in touch with doctors to let them know what kind of information we need. Our regulations clearly stipulate the kind of data we need to get from doctors. We want facts relating to the diagnosis, proof of the disability, a description of the treatment administered and an assessment. Often, all of this information is not contained in the medical reports. When that happens, we refer them to a particular provision in the legislation and direct them to answer these questions so that we can have a better overall idea of the appellant's physical or mental state.

Ms. Madeleine Dalphond-Guiral: Thank you.

Ms. Chantal Favreau: You're welcome.

[English]

Mr. Peter Smith: May I just add briefly, Madam Chair, that I believe the income security programs branch has been working on a plan to engage the Canadian medical community more specifically on these questions of definition and so on of disability under the CPP. There have been plans discussed by my predecessor, Mr. Stuart, that we would play a role, somewhat like I believe Chantal referred to, in possibly a modest advertising campaign in medical journals on some of these matters. But we have as yet not done so.

Take that as a representation.

The Chair: Mark.

Mr. Mark Muise (West Nova, PC): Thank you, Madam Chair. Thank you to our guests. I think it's very important to note that we saw a lot of problems with the CPP, and it's important that the review tribunal be here to understand what we're faced with and probably get a more first-hand feeling for what people in the community are faced with.

There are few things that upset me or cause me to be... I'm not going to be as firm as I would want to be on this issue, because this is a very serious issue that puts people, Canadians, through a whole lot of difficulty and in my opinion through a process that doesn't need to be as difficult.

I'd like to make a suggestion. The question was asked why there was the huge increase from let's say 1993-94 to 1999. One point that I think was missed that should probably be there is the fact that the federal government or CPP is saying, we don't want to pay for these things so we're going to shut it down. It's sending the people to a different level. It's putting an inordinate amount of work on your shoulders. The costs don't go down. If anything, they go up because the tribunal has a lot more expense. In many cases, you have to repay these people with interest. The system puts Canadians through a process that is very frustrating and in the end doesn't accomplish a whole lot except spend a lot of Canadians' dollars that could be put to better use, namely to the people who would qualify.

• 1630

Ms. McGrath, I really liked your comment about putting the people who come to the appeal process in touch with a human being who could explain the situation, because one of the jobs we're faced with in our office is explaining the system. Once they are refused, we have to sit down with them, or explain on the phone about the definition that Chantal just mentioned, about severe and prolonged, how it has to prevent any work, etc., and go through the steps that are required. In my opinion, that should not be our job. It should be the job of either CPP or the review tribunal. So that creates a problem.

The other concern that we're told about is the attitude of panel members. I think that's something the review tribunal should address very directly and should do immediately. If there is training but the problem is ongoing, there should be more training. Yes, you have a large number of people, and yes, there's not enough time, but we owe it to the people we work for. I make a strong recommendation that it should be addressed.

You touched on another issue and wondered why there weren't more complaints. People are financially, emotionally, physically, and health-wise drained. First, they are drained when they apply. They're further drained by the appeal process. Why the heck are they going to make a complaint? That's the reason. So I take it as my responsibility to make a general complaint today. And please don't see this as me sending this bad piece of information to you, but it has to come out. I think we owe it to the people we all ultimately work for to address.

Peter mentioned that the minister doesn't get involved when it reaches the appeal process. If we look at page 5, at the reversals, he might not get directly involved in the appeal process, at the appeal itself, but be it through intervention from us or additional information given to the minister, he in fact does do reversals. In a sense, when he sees it's getting closer to the ultimate decision, he does make a reversal. So what you said was true to the letter, but in fact there's more to it than that. When he sees it's getting closer, why put these people through that? Why go through the expense? Why put Canadian taxpayers through that expense?

There's more, Madam Chairman, but I think I've had my say for now.

The Chair: Hopefully, we might get around to you again, Mark.

Hon. Andy Scott (Fredericton, Lib.): Thank you very much. In recognition of the fact that this is your first appearance, I hope we haven't disappointed you.

I'm curious about the numbers of people. The complaints we get have to do with the difference in definitions. It's not your fault or your problem specifically, but you can appreciate people who are involved in a lot of this. It's just the government. Probably, it's workers' compensation, it's disability tax credits, it's CPP disability; somehow I'm disabled over here and I'm not disabled over there. It's a very difficult thing, and we get a lot of that—I presume we all do.

I understand the difference, in terms of what it is that each of these particular programs is designed to identify, and so on, so I understand the distinctions. Having said that, are there any efforts or is there any collaboration in the context of how we come up with these definitions? That would be one question.

• 1635

The other major complaint we get is just the time it takes and so on, and it occurs to me that one of the problems in the time it takes is the number of people who actually go through the system, who take the time and incur the cost Mark has referred to, and who are there out of desperation more than out of disability. There are people who go through this and are turned down and they appeal, and after having gone through all of this, they haven't gotten anything. Some will acknowledge to me that they really don't think they're disabled as much as they just can't work. They used to do something that physically they're no longer able to do. I think they understand that the definition is not about that, but they don't have anyplace else to go.

So, consequently, this would be one of the questions that would arise. I know this is a policy issue and it's really not your responsibility to even think about these things, but, hey, you only get one chance every decade, so we'll let you have a go at it. If we in another committee or in the whole committee were to look at the problems faced by older workers, I would have to assume that the absence of a comprehensive program for older workers has a huge impact on the volume and therefore the time it takes for the people who actually are deserving of a disability treatment to get it. So you can inform the committee's work on older workers as to the need to deal with that problem in a way that solves your problems as well as ours.

Mr. Peter Smith: Certainly, Madam Chair, Mr. Scott is correct in that quasi-judicial tribunals don't too often stray into the area of prescriptive policy.

On the first question of policy collaboration on definitions and related matters, I think he's correct that it doesn't fall within our turf. I think Mr. Rabinovitch informed you and we are aware, from what we've been told by the branch, that there is a considerable stakeholders' exercise going on. In fact, we've just looked at a document that is to be one of the base documents in discussions across the disability-providing community, if you will, or sector. But that is more naturally led by the department than by us.

I must say that we should possibly be taking the time ourselves, and I've asked Ms. Head in particular, in addition to all her other duties, if she couldn't expand a little bit our outreach and networking among at least those stakeholders most directly relevant to our part of the process.

On the time delays and so on and the program for older workers, do my colleagues have anything they would like to respond to—

Mr. Andy Scott: Maybe I can make the question more precise.

Mr. Peter Smith: Yes.

Mr. Andy Scott: I've seen 50% as a sort of ballpark figure in terms of people who appeal and who at the end of the process are or are not successful. Wasn't the number about that?

Mr. Peter Smith: Mr. Rabinovitch's numbers, which we have not verified, suggest that 9% of those who initially apply for CPP disability begin the process with us, and a percent of that group proceeds to the PAB. So his basic submission to you, I believe—and we do not have the capacity to analyse the whole thing—is that 91% are dealt with at the first two levels. I believe that's correct.

Mr. Andy Scott: I think it's more a question of at some point in the process there was a 50-50 delineation, and I don't remember where it was.

I think you can probably help me get by the numbers I don't know. What I'm really trying to get to is that there are a number of people who would seek CPP disability right from the beginning. There are a number of people who don't get it and don't bother to appeal. There's a whole bunch of things. What I'm arguing or suggesting is that a lot of that is desperation-driven rather than disability-driven.

As the desperation continues to exist, those people go through the system. I think you could almost tell from the very beginning that there's very little likelihood they are going to end up with this, but they don't have anyplace else to go. Some of them, as you noted, are there at the request of third-party insurers. I know in the province of New Brunswick they are there at the request of income assistance. In order to qualify for income assistance, it's on the record in our province that they have to demonstrate that they have been turned down by CPP disability. Consequently, the system has taken a number of people.

• 1640

If there were a program for older workers that relieved the pressure, what would it say? That's what I'm trying to get to.

Mr. Peter Smith: In the process as we see it—

Mr. Andy Scott: What does it cost to go through this whole system and in the end be turned down? If there were something else more appropriate for these people to do, in addition to the savings in terms of the problems we have with time, it also, I suggest, would save the exercise of having to go through this whole thing driven by desperation. Does anybody have any idea what it costs to go through the system?

Mr. Peter Smith: I regret to say that I don't believe we have, but I think there would be considerable merit in exploring the concepts you've introduced, Mr. Scott. Just thinking out loud, given the goal of lack of information that Ms. McGrath and I have identified, at the very least a concentrated program for older workers would maybe level it a bit more for these Canadians. But in terms of the costing of it, I'm not—

Mr. Andy Scott: My interest is not necessarily driven by some sense that it's overly costly. My interest is driven by the fact that it takes a long time, and part of the reason it takes a long time is that there are people in the system who perhaps might not be there if there were something else they could do or another program they could pursue. But in its absence they have no choice but to try to get a disability pension.

This is on the grounds we are all very familiar with, which are: “I used to work in the woods; I can't do it any more. I'm not educated enough to do something else, and therefore I must qualify for disability because I'm too disabled to work in the woods.” That doesn't meet your criteria, but it certainly meets that of all of my constituents. Consequently, if there were a program for older workers to deal with that person, you wouldn't see them, and the people who need disability wouldn't have to wait in that line.

Mr. Peter Smith: They would be receiving faster service.

Mr. Andy Scott: Yes.

Mr. Peter Smith: I can certainly see that outcome.

The Chair: In the black and whiteness of what you're allowed to do within the legislation, I have had a big interest in partial pensions, which isn't part of your mandate, but there seem to be lots of conditions where that would seem like the kind and fair thing to do. There are people recovering from cancer who can't possibly do a full day's work, but they get turned down because they don't meet the criteria. We don't have any good tools for fatigue. We don't have any good tools for preserving one's immune system, where people just instinctively know that if they go flat out, they get sick. I wouldn't want to be in your position and actually be on these panels of people who have to make black and white decisions about things that rarely are black and white. So I have an interest in how we could free this up to be fairer for the people who just won't fit this very strict criteria.

Just in terms of that concern, as a physician who has filled out these forms for a long time and who has helped people with appeals, I had this sneaking suspicion that the people who had the money to appeal were quite often from the third party side and that there were a whole bunch of people who would take huge coaching and encouragement from me to appeal, because they weren't sort of sophisticated people.

I think this is what we were trying to ask Mr. Rabinovitch. If 67% are turned down the first time and then we lose a whole bunch who don't appeal, are we actually looking at these people who aren't appealing in a sort of exit interview to find out why they didn't appeal? Did they not think they deserved it? Did they not think their disabilities were severe and prolonged, or could they just not stomach the idea of getting a lawyer and doing all the stuff it would take? I keep thinking that maybe the people who come to you sometimes aren't the ones who need you.

• 1645

The other question we asked, in the original form... I've talked to experienced panel members who say, when they start seeing those letters copied to the whole world—to the insurance companies and all of these people—they know it's a third-party vehicle. Would we not be better to just put a tick-off box at the top of the form saying “Did somebody ask you to apply?” For the less experienced panel members, would that give them a little bit of a leg up that this was just one that would be sent along, as Mr. Scott has said, and waste all of the resources?

These people didn't qualify from the beginning, and we waste all this money on an appeal process that would have been better spent on somebody who actually deserved it, but maybe didn't have enough sophistication to appeal. I guess I'm worrying that we sometimes aren't getting to the people we need.

Mr. Peter Smith: These are enormously important questions, and I think both Ms. McGrath and Ms. Head would like to make some comments first.

Ms. Margaret McGrath: I'd like to add, Madam Chair, that we do extensive counselling in our office before they go before a tribunal. Our clients have a 1-800 line for four months. We walk them through the whole process and they have information that will detail exactly what is to happen, step by step.

At the other end, once the decision is made, we have quality decisions that are issued. Often they will touch on the sensitive areas Mr. Scott just talked about. It is a frustrating process. We see that in the quality of the reasons, and the tribunal will agonize over the fact that this person doesn't meet the eligibility requirements. We just wish that were there at the front end, not at the time of the tribunal.

The Chair: In the continuing education of physicians, there's something a bit insulting about signing a form that says you think somebody qualifies and then finding out you're wrong.

Doctors learn through case histories and case examples, so are there certain ones that should be part of continuing medical education, in terms of learning about disability, that you could actually put out there that say even though this person has had three different cancers and this and that, they actually don't meet the criteria? That's one I remember fighting for. Is that a departmental thing that should happen?

Mr. Peter Smith: I would think that might be both. I certainly wouldn't rule out that area as a review tribunal project, in terms of professional development of professionals. Are there cases that help? I know what you mean, in terms of the case orientation of medical education, as well as legal education, of course.

The Chair: Maybe I just have to do this venting. Quite often the GP is the person who knows this person best. You get some rather obnoxious orthopedic surgeon as the expert witness, who doesn't really have a clue about rehab or the natural progress of an illness, or whatever. Because he has a few more letters after his name, he will end up giving the absolute death blow to this person's appeal because he'll say something like, “If it didn't appear within three days”—or whatever—“of the accident, then it isn't related to the accident”, which is absolutely incorrect. But because an orthopedic surgeon has said it, this person doesn't have a chance.

Even in educating the panel members on the appropriate role of various specialists, the rehab doctor or GP is a far better witness when it comes to disability than some of these high-powered specialists. Is that part of the orientation?

• 1650

Mr. Peter Smith: The agenda is getting longer as we listen, but Ms. Head may want to comment on the cases side of it and the professional education side.

Ms. Tina Head: Just on this last point, what you're saying reinforces, from our point of view, the importance of having an in-person hearing with the review tribunal, because their job isn't to just review written medical reports. They need to take into account the whole sum of the evidence, including what's brought to the table by the person who's disabled, what they say about their daily life, what they say about how their condition affects their relationships and their social interactions—their whole fibre and being. We train our tribunalists to evaluate all of that evidence. It's not just a question of a written medical report.

But coming back to the question of the medical reports, it's also not the case that specialists will always trump a family physician or a general practitioner in appropriate cases. It is something we emphasize has to be approached on a case-by-case basis. A tribunal will prefer what a general practitioner has to say because they do know the person far more intimately than somebody who's seen them once for a quick five-, twenty- or thirty-minute visit.

However, there are occasions when a specialist is best qualified to talk about whether there's precise scientific basis for a particular aspect of their condition. That will carry its appropriate weight in a hearing. But we do our very best in our training to remind our panel members that they really have to take a look at the whole ensemble of the evidence. It's the person you're dealing with, and it's not a question of whose doctor trumps whom.

The Chair: The tool we quite often recommend—I think we mentioned it before—is a day in the life kind of diary that somebody applying would bring—or an appellant. Is that something that could become a regular tool, or is it included in the normal line of questioning because it is an in-person kind of hearing?

Ms. Tina Head: Actually that's the genesis for a lot of the questioning by our panel members that sometimes causes the reactions we've talked about. Sometimes that kind of questioning can feel very intrusive and can touch on very intimate parts of your being. When you're sitting in front of three perfect strangers who are asking for that kind of detail about your life and you've been through a lot of processes, it can be interpreted in a way that the question wasn't necessarily intended.

I can also say myself, from having reviewed countless of our decisions, that it's frequently a matter of evidence that the person comes to the hearing with a diary in hand, and the tribunal does rely quite heavily on that information. It's important.

The Chair: Thank you.

Mr. Peter Smith: On this question of specialists and GPs, is there any jurisprudence we might think of right now, Chantal? I'm putting you on the spot, but it does follow. Do any particular cases come to mind that might be part of continuing medical education, for example?

Ms. Chantal Favreau: There are cases from the Pension Appeals Board that deal with that same issue. As Tina mentioned, there's no fast rule as to whether or not the specialist or generalist will overrule what's preferable. It's just on a case-by-case basis. That information is available to panel members as well as appellants.

The Chair: Is there a breakdown in terms of the rapid advance of technology and the rapid ability for a different kind of accommodation to be possible? Are there certain conditions that maybe once were compensable that now...whether it's blindness or...

Mr. Peter Smith: Less disabling, you mean, given medical technology.

The Chair: Are there conditions that are now less disabling just because of the ability of technology to help these people? Is there an accommodation period where somebody could actually... I think it's the permanence or “severe and prolonged”... But with a certain amount of time, somebody could actually now learn how to deal with it differently.

Mr. Peter Smith: This is a difficult area that I think arises in other areas of medical science. At what point is there consensus in the health-scientific community? At least, that seems to lie behind a bit of the thinking about disability appeal decision-making. Lying behind that is, at what time is there consensus on certain conditions?

• 1655

The Chair: So is there a breakdown that you would have of how many hepatitis C, how many this, how many that?

Mr. Peter Smith: Do you mean of our cases?

The Chair: Yes, by diagnosis.

Mr. Peter Smith: We do not have the capability in our appeals management system at the moment to get that kind of information.

It is something that could be secondary analysis, I suppose. In other words, what have been the grant and dismissal results—

The Chair: But whereas there might have been lots of them for a while, now there may be a lot fewer. I was just wondering if you would watch trends in terms of what actually... And of course, with the very controversial things like fibromyalgia and chronic fatigue, if there were those kinds of numbers to show some of the people who don't qualify that a certain number of people have qualified, with that same diagnosis, it would make them feel less discriminated against.

Mr. Peter Smith: Tina has a comment.

Ms. Tina Head: In part, your questions take us back to the point that the current criteria for disability really is based on your capacity to work, not on your having a particular condition. It's the job of a tribunal in each case to take a look at the individual and see how a particular condition affects their particular capacity to work and what access they might have themselves to resources in the community that might assist them to get back to work. We have no capacity to generalize or draw trends from that information. Really, it is ultimately the job of a review tribunal to look at that one individual, give them their full attention, and assess whether for that particular individual the resources, the supports, and the skills are there to get them up and out to work regularly, regardless of their condition.

The Chair: Has whether they've applied to CPP or whether they have a CPP disability ever been part of a health survey from Statistics Canada?

Mr. Peter Smith: Not that I'm aware of.

Ms. Tina Head: Not that I'm aware of, but I haven't seen the health survey questions for quite some time.

The Chair: Yes. There haven't been any for a decade. But in the next survey, would that be helpful?

Mr. Peter Smith: Yes, the one that I gather you have discussed at earlier meetings of this subcommittee. Indeed, resources are being put to it, and so on. I think it would be very valuable, because we're dealing with numbers that are quite significant when you consider 60,000, 70,000, or 55,000 applicants a year. We're dealing with an “n” in statistical terms that is quite significant.

The Chair: Mr. Muise.

Mr. Mark Muise: I'd like to make this comment because I think it's important—and this is my point of view. I hope you don't see us here just to make your life miserable. We have to deal with this on an ongoing basis, and I think because it's your first visit here and because you are maybe somewhat isolated just by the sheer amount of work you have to do, that's why you're hearing these things. We want to make the process better, as you, I'm sure, want to do. So what you're hearing today is not just us venting—that really helps—but we're transferring to you what we're hearing on the street.

I hope we have impressed on you how serious an issue it is, but that we want to work with you as well.

Mr. Peter Smith: I very much appreciate the constructive orientation of your earlier remarks and these. We do feel a bit isolated. We are not the front-liners, as you can tell. We're the managers of the system. But a number of our conversations with our panel members have the same subject matter that you, Mr. Scott, and others have presented here.

These are people who are very sensitive, generally speaking, to the circumstances of the appellants, so I think we are tous dans le même cul-de-sac at some level. But we have certain constraints as an administrative tribunal.

• 1700

Mr. Mark Muise: I think as managers it's your responsibility to make sure those panel members are as humane, fair, and gentle as possible, because we're not dealing here with people who deal with administrative matters on a daily basis. You sitting at this tribunal can be very comfortable, because you deal with this type of thing. But these people, as we said, are drained, are sometimes very nervous, are not in great shape in many ways, and they're having a lot of difficulty.

Mr. Peter Smith: We continue to insist that it be as informal a process and as non-court-like a process as possible whilst maintaining some order in the hearing room.

Mr. Mark Muise: Yes.

Mr. Peter Smith: We have rejected earlier plans and ideas that, for example, our hearings would be held in courtrooms across the country. That's out of the question because of the additional intimidation of the courtrooms. There's an example. When you look at it as a first suggestion, it's a logical thing to think that there are some empty courtrooms, so go and... That's not very appellant friendly, to say the least.

Mr. Mark Muise: I've seen myself spending half an hour on the phone with a constituent who has been rejected, just going through the process that they need to go through, for example, how to prepare, to bring someone who is perhaps not as emotional as they are, to have their doctor... And even if they must pay—and I think they should be paid—ask details such as what you do, what you take, what it does, what it affects, and how it affects your day-to-day operations.

Mr. Peter Smith: Just to follow up on a comment that Mrs. McGrath made earlier, we have three 1-800 client-line operators, and they are very busy.

Mr. Mark Muise: They are probably intimidated by that as well.

The Chair: Mr. Scott, I think, had one last question.

Mr. Andy Scott: What is the nature of the medical members of the panel? What is their background? I assume there are no orthopedic surgeons.

Mr. Peter Smith: I think that's a safe assumption. There is a regulation made under the Canada Pension Plan that has a very long list—I'm not sure of how many—including—

Mr. Andy Scott: Generally, they would be nurses or...

Mr. Peter Smith: The centre of gravity is RNs and other experienced nurses, I would say.

Ms. Margaret McGrath: And a few medical doctors.

Mr. Peter Smith: It's difficult to get MDs, GPs especially.

The Chair: You could pay their overhead for $300—

Mr. Peter Smith: No, quite frankly, it is not close to a respectable per diem, some might argue, for MDs. But those we have, we value, and they have become coaches and assisted others across the system. In terms of the centre of gravity as it stands now, the majority of our members are senior nurses, senior experienced nurses, and they're very valuable too.

Mr. Andy Scott: You've broken this down by province, but they travel outside the province.

Ms. Margaret McGrath: Yes, they do, but initially they're here in their own regions. That's the whole basis of the appointment process. They are appointed for a region. That region could be fairly large. I don't know if that answers your question, Mr. Scott.

Mr. Andy Scott: It does. There is a certain efficiency if you have good people. They could go to Nova Scotia, New Brunswick, or wherever. The idea that they would have to be restricted... I didn't think they were, and I don't think they are.

Ms. Margaret McGrath: They're not restricted, no.

The Chair: Thank you very much for coming. I think there needs to be a place where people like yourselves, who are the court of highest authority on some of these things, actually re-engage in the policy process, and I would hope that you actually do know secretly what's not working. I hope that we, as a committee, will try to figure out how we can make sure that all of the people in your position are consulted, and I hope you will make the call to Statistics Canada to help them make sure that some of their questions are helpful to you. We thank you so much for coming. I think you have quite a challenge. Thank you very much.

Mr. Peter Smith: Thank you for a very valuable session.

Mr. Andy Scott: Brown envelopes are available on the way out.

Mr. Peter Smith: As well as destinations for late-night rendezvous.

The Chair: Thank you very much.

[Editor's Note: Proceedings continue in camera]