Mahsi, Mr. Speaker. I would like to present the Standing Committee on Public Accounts' final report on the public review of Tabled Document 5-12(3), Report of the Auditor General of Canada on a Comprehensive Audit of the Department of Health.

At the request of the 11th Assembly, the Auditor General of Canada performed a comprehensive audit of the Department of Health in late 1991 and early 1992. The report was formally tabled in the Legislative Assembly on November 17, 1992, and was referred to the Standing Committee on Public Accounts for review.

The standing committee held public hearings in Yellowknife on January 6, 7 and 8, 1993. Subsequent public hearings were held in Rankin Inlet on January 25 and 26, and in Inuvik on January 27 and 28. Final public hearings and a public briefing by deputy ministers of various government departments were held on January 27 and 28, respectively. In addition, the standing committee has met on several occasions since November 1992 to consider written submissions and research material.

The Standing Committee on Public Accounts wishes to acknowledge the many organizations and individuals who provided input to the public review. The amount of interest and levels of public participation far exceeded expectations and should, perhaps, be considered indicative of the importance of the audit findings. The standing committee very much appreciates the thoughtful comments and extensive documentation provided by those who appeared as witnesses or prepared written submissions. All input was taken into careful consideration by Members of the standing committee.

As well, the Standing Committee on Public Accounts wishes to acknowledge the assistance of the Deputy Auditor General of Canada and his officials from the Edmonton regional office, who provided assistance during pre-review briefings and also appeared as witnesses during public hearings.

Based on its review of the Auditor General's report, the Standing Committee on Public Accounts is concerned about many aspects of the management of the Department of Health. Serious problems exist with respect to working relations with health and hospital boards, deficient information systems and human resource management.

At the base of all these weaknesses, however, there appears to be a single underlying fault. Presently, the Department of Health has an inadequate sense of direction, poorly defined priorities and no bench-marks against which to measure its progress toward defined goals. The Department of Health is in dire need of a well-developed, consensually-supported strategic plan.

The absence of planning impacts on almost every aspect of departmental operations. There is confusion about the roles and responsibilities of health and hospital boards, community expectations for aboriginal participation in health careers have not been met, departmental management is crippled by an array of uncoordinated and incompatible information systems, and the department seems mired in a "crisis-response" mode that precludes forward thinking.

Within this context, the Standing Committee on Public Accounts is of the opinion that the comprehensive audit presents a valuable framework for targeting areas for attention and improvement.

Yet, the standing committee found the nature of the management response to the report rather disconcerting, noting that the Department of Health provided little information about how it planned to implement even those recommendations with which it agreed. During public hearings, departmental officials made a point of questioning the methodology and context of the report, although they had not bothered to raise those considerations in their formal written response. The result was that the standing committee was left with some confusion about whether the findings and recommendations brought forward by the Auditor General would, in fact, become priority considerations of the department.

Members of the standing committee also became concerned with the manner in which information about certain aspects of the report was presented by some departmental officials during public hearings.

Accordingly, to date, the Standing Committee on Public Accounts has been disappointed in the quality and presentation of certain parts of the department's management response. The standing committee proposes to make a stern position on these matters so that its expectations are clear, not only to the Department of Health, but to the other government departments and agencies that will participate in future reviews of audit findings or public accounts.

In addition, the Standing Committee on Public Accounts is bringing forward extensive recommendations on matters identified by the Auditor General. In most cases, the standing committee's recommendations coincide with those of the Auditor General. Although there are some notable exceptions where differing viewpoints were received during public hearings.

With respect to the organizational structure of the health system, the Standing Committee on Public Accounts is concerned about the unacceptable state of role confusion and conflict which characterizes the department's working relationship with health and hospital boards across the Northwest Territories. The standing committee is of the opinion that much of the problem lies in the level of centralized control that has been exercised over the years since transfer, and it is hopeful that the process of establishing a "master memorandum of understanding" between the parties will help to clarify the management responsibilities of each one. In allowing more regional control over health facilities, programs and services, the standing committee recognizes that the department will need to review and possibly amend budget control directives.

During its review, the Standing Committee on Public Accounts explored the Auditor General's suggestion respecting structural changes that could improve efficiency within the Department of Health. As a result, the standing committee is proposing that certain financial management activities within the department should be consolidated within a single division.

In many ways, Mr. Speaker, the key challenge for the Department of Health will be to address its need for better planning for the future. The Auditor General has indicated that the department is caught up in the planning to plan posture. New approaches can be realized through the final completion of a small functional review of departmental structure and operations, revitalization of workload assessment initiatives and the development of a strategic plan.

The Standing Committee on Public Accounts also ...