TORONTO, Dec. 4, 2019 /CNW/ - Most of the value-for-money audits in the 2019 Annual Report relate to programs aimed at protecting the health, safety and well-being of Ontarians, Auditor General Bonnie Lysyk said today after the Report was tabled in the Legislative Assembly.
Lysyk added, however, that there is also a new volume on the Environment, the result of her Office assuming some of the responsibilities of the former Office of the Environmental Commissioner of Ontario last April.
As well, there is a third volume containing audit reports on corrections and the courts system in Ontario.
Volume 4 reports on follow-ups to recommendations of earlier reports, as well as on previous recommendations of the Standing Committee on Public Accounts.
Nine of the 13 value-for-money (VFM) audits in Volume 1 relate directly to the health, well-being and/or safety of Ontarians (we have provided individual news releases for each of them). They are:
Acute-Care-Hospital Patient Safety and Drug Administration: The audit found that of the 1 million people discharged each year by Ontario hospitals, about 67,000 were harmed during their treatment. In addition, two health agencies identified 15 preventable patient-safety events that should never happen (called "never-events") that could cause serious harm or death—for example, a foreign object left in a patient after surgery. The Report says that since 2015, 10 out of the 15 never-events have occurred a total of 214 times at six of the 13 hospitals that auditors reviewed.
Addictions Treatment Programs: Wait times for addictions treatment, hospital visits for opioid-related emergencies, and addiction death rates all continued to rise despite increased provincial spending, the Report found. In particular, the province spent about $134 million on its Opioid Strategy between August 2017 and March 2019, but opioid-related deaths, emergency-room visits and hospitalizations continued to increase. Auditors noted that the number of opioid-related deaths grew to more than four a day in 2018, up from over two a day in 2016.
Chronic-Kidney-Disease Management: Funding for most chronic-kidney-disease services in Ontario has not been reviewed or adjusted for years, and does not reflect the actual costs of providing services to patients, the audit found. In addition, the Report identified a lack of co-ordination between the Ministry of Health and two other government health agencies that made it difficult to plan, monitor, and evaluate services provided to patients. In 2018/19, the province spent about $662 million on chronic-kidney-disease services, and about $20 million to fund 700 kidney transplants.
Commercial Vehicle Safety and Enforcement: Ontario has had higher fatality and injury rates for commercial vehicles than Canada as a whole and the U.S. in most of the years between 2008 and 2017. Yet the audit found that between 2014 and 2018, the number of provincial inspections of commercial vehicles decreased by 22%. More than half of Ontario's 60,000 carriers have not had any of their commercial vehicles inspected by the province in the last two years, including many at the highest risk of future collisions.
Food and Nutrition in Long-Term-Care Homes: The audit concluded that food provided to the 77,000 people living in Ontario's 626 long-term-care homes does not always meet established standards for nutritional value or quality. The audit found that residents generally received sufficient protein in their diets but were also given too much sugar and not enough fibre.
Food Safety Inspection Program: The probability of a mass foodborne-illness outbreak in Ontario appears low but food-safety systems could be improved by identifying better ways to deal with pesticide residues in produce, accuracy of food-labelling in provincial food-processing plants, the licensing of fish processors and inconsistencies in public disclosure of food premises inspection results.
The food-safety risk for a small-scale incident could be higher. In Ontario, foodborne illnesses account for 70 deaths a year and 6,600 hospitalizations. The audit found that Public Health Units are responsible to investigate complaints of foodborne illnesses at food premises on a timely basis: two days from receipt of a complaint is considered a best practice, but inspection reports from five Units between 2016 and 2018 found that all five failed to meet the two-day window in 20% of cases.
Health and Safety in the Workplace: The audit found that in the last six years, many companies in Ontario have been cited repeatedly for the same or similar occupational health or safety hazards to workers. Although Ontario's injury rate causing lost time at work has been the lowest in Canada since 2009, the number of injuries in this province's industrial sector rose 21% in the past five years, and 29% in Ontario's health-care sector over the same period. As well, comprehensive inspections had been completed for only 23 of more than 550 mines as of July 2019.
Office of the Chief Coroner and Ontario Forensic Pathology Service: Gaps in quality reviews of work done by coroners and pathologists, along with unethical behaviour by some coroners, may have contributed to low-quality death investigations in Ontario, the Report concludes. Auditors found instances of coroners, who are physicians with medical practices, performing death investigations on people who had been their patients just days before they died, which is a conflict of interest. The audit also found that not enough quality reviews were being performed into how pathologists do their work.
Ontario Disability Support Program: The cost of the Ontario Disability Support Program (ODSP) has increased by about 75% in the past 10 years, from $3.1 billion to about $5.4 billion, but the government never investigated to find out why. ODSP provided benefits to more than 510,000 individuals, comprising recipients and their qualifying family members, in 2018/19. The Report noted that since 2008/09, the average monthly number of ODSP cases—a single individual or a family unit—has increased by 50%; in contrast, the population in Ontario has increased by just 12% over the same period.
The four remaining VFMs are:
Ontario Financing Authority: The Ontario Financing Authority (OFA) was effective in its investing operations and assessing short-term risks, but it has the opportunity to save millions for the province by assessing how much to hold in liquid reserves (cash and short-term debt); issuing more debt through auctions; and having public government bodies, such as hospitals and universities, borrow through it to lower interest costs.
Oversight of Time-Limited Discretionary Grants: Provincial government ministries paid out about $3.9 billion in discretionary grants during 2018/19 to third parties to pay for activities that benefit the public and help achieve public policy objectives. However, the government was not always in a position to determine whether the grants in fact fulfill their public policy goals. As well, legislators do not have a breakdown by ministry of discretionary grant programs to better inform them on how provincial funds will be spent.
Provincial Support to Sustain the Horseracing Industry: Ontario's horse-racing industry has received about $500 million in government funding over the past five years, but remains lacking in public transparency and accountability. Only one of the 15 racetracks posts its financial statements on its website, and there is no public reporting by racetracks of key performance indicators, including gross wagering, wagering commissions, purses paid, and the number of people currently working in the industry.
Technology Systems (IT) and Cybersecurity at Ontario Lottery and Gaming Corporation: The Ontario Lottery and Gaming Corporation (OLG) could do more to better protect its IT systems, the audit found. OLG accounts for just under half of the province's yearly revenue from its business enterprises. The Report says OLG does not review for cybersecurity weaknesses any software source code; nor did it proactively conduct security testing for its lottery and Internet gaming (iGaming) lines of business to identify possible vulnerabilities.
In addition to value-for-money audits, Volume 1 contains a chapter on the Auditor General's Review of Government Advertising, carried out under the authority of the Government Advertising Act, 2004. The Auditor General notes that the provincial government spent $16.39 million on advertising in the 2018/2019 fiscal year—the lowest amount since the Auditor General began reviewing government advertising in 2005 and well below 2017/18 spending of $62.6 million. The report says just one advertising submission violated the Government Advertising Act, 2004—preliminary versions of eight Ministry of the Attorney General multilingual television ads failed to include a statement saying the ads were paid for by the government of Ontario. The ads were resubmitted and passed the Auditor General's review.
Volume 2—Reports on the Environment
Volume 2 contains three chapters, the first of which is an overview of environmental challenges affecting air; water; land, resources and waste; nature and wildlife; and climate change. It recommends the province publicly report its progress on further developing and implementing its Environment Plan.
The second chapter addresses compliance by prescribed government ministries with the Environmental Bill of Rights, 1993 (Act). We found a number of areas where certain ministries did not fully comply with the Act or follow best practices.
The third chapter examines Ontario's plan to reduce greenhouse gas emissions, and concludes that the plan's measures and targets are not yet supported by sound evidence.
Volume 3—Reports on Correctional Services and Court Operations
Volume 3 contains four justice-related value-for-money audits. Lysyk noted that the work of her auditors was at times blocked by the refusal of judges and staff in the Ministry of the Attorney General to supply information needed to do a complete examination.
The audit on Adult Correctional Institutions found that Ontario's 25 correctional institutions are not equipped to deal with the two fastest-growing categories of inmates: those in remand (held without bail while awaiting trial) and those diagnosed with or suspected of mental illness.
Auditors examined Court Operations and reported that the backlog of criminal cases noted in previous audits of Court Services in 2003 and 2008 continues to grow. Between 2014/15 and 2018/19, the number of criminal cases awaiting resolution increased by 27% to about 114,000 cases. In addition, Ontario courtrooms operated only 2.8 hours on an average business day, well below the Ministry's optimal average of 4.5 hours.
The Auditor General's review of the Criminal Court System found that the backlog of criminal cases noted in previous audits in 2003 and 2008 continues to grow—between 2014/15 and 2018/19, the number of criminal cases awaiting resolution increased by 27% to about 114,000 cases.
An audit of Family Court Services found that, as of July 2019, about one-quarter of the 5,249 child protection cases awaiting resolution had been pending for more than 18 months, and some for more than three years. However, because of the limitations placed on the audit, neither the Ministry nor the Auditor General was able to determine how many of these cases were subject to the timelines required under the Child, Youth and Family Services Act, 2017.
Volume 4—Follow-Up Report on Audit Recommendations
The Auditor General's value-for-money audit reports typically recommendations designed to improve performance. Recommendations are a critical part of audit reports, and their implementation is important to drive positive improvements in the cost-effective delivery of programs and services for Ontarians.
Volume 4 contains 16 follow-up reports from the value-for-money audits published in the 2017 Annual Report. Consistent with previous years, progress has been made in two years toward implementing 69%, of recommended actions (66% in 2018). The report also found that 32% had been fully implemented (35% in 2018).
Read the report at www.auditor.on.ca
The Office of the Auditor General is an independent Office of the Legislative Assembly that conducts value-for-money and financial audits of the provincial government, its ministries and agencies. We also audit organizations in the broader public sector that receive provincial funding. Our vision is to deliver exceptional value and assurance to members of the Legislative Assembly, the Standing Committee on Public Accounts, and all Ontarians through high-quality work that promotes accountability, value for money and effective governance in the Ontario public sector.
SOURCE Office of the Auditor General of Ontario
For further information: Bonnie Lysyk, Auditor General, (416) 327-1326