The members of the standing committee expect departments to have clear plans based on blue-chip information, to be explicit in how they intend to implement those plans, and to report back on the results of changes and initiatives in a concise and informative way. For a number of years, the Department of Health and Social Services has been unable to provide quality information in both financial and program areas to the standing and special committees of the Assembly.
Over the past two years, there has been a slight improvement in the development and reporting of some general statistical information on health. However, adequate information necessary to make accurate and informed decisions about programs and expenditures continues to be unavailable or of poor quality. The department has consistently failed to demonstrate that issues were in hand and that there was a comprehensive approach based on top quality data.
Two issues were raised during the business plan review that, in the view of committee members, indicated that the department remains in a perpetual planning phase, unable to move forward on the hard realities facing the health and social service system.
The first issue was a contract to review health care sustainability being sole-sourced to a southern contractor with no tender process. The committee sees this as essentially a review of the governance system deciding which facets of the health care system the boards or the department control.
Members of the standing committee were concerned that not only was the contract for the review of health care sustainability sole-sourced, but that the chosen contractor was from outside the Northwest Territories. Members are always concerned when a contract of this size, $300,000, is awarded to a southern contractor. The concern is even greater when no other northern or southern contractors had the opportunity to participate in a competitive bidding process.
The results of the review on the sustainability of health care may now be in question because of the closed way in which the contractor was selected, and the resulting speculation at the board and other levels about why the decision was made. There is a concern that if the department hand-picked the contractor, they perhaps also hand-picked the results of the review.
The committee's second issue was the addition of two new senior manager positions, an associate deputy minister and an assistant deputy minister for population health and clinical services.
Members of the committee noted that they had been pushing for the department to increase its ability to monitor the clinical side of health care. It is hoped that the appointment of an assistant deputy minister for population health and clinical services is a first step in improving monitoring.
While the department did attempt to explain the need for the two new senior management positions, no explanation was provided why this was not identified as a critical need in October during the business plan review. Yet, members noted that the senior staff were appointed and in place by January.
The department indicated that there are emerging pressures on the system caused by the boards' deficits, and that the department is dissatisfied with the quality of information that they were able to provide over the last two years. It was also revealed that this led to the department being unable to provide the quality of advice, analysis and support necessary for decision-makers to make informed decisions. The department said this contributes to a growing sense that the system is out of control and the department believes that there is little it could do to make the necessary changes to sustain the viability of the health care system in the absence of quality information.
Committee members were told that the department required short-term senior management help to oversee operational and payroll audits for boards in difficulty, and to coordinate what is hoped to be the final review of the health care system for quite some time.
The standing committee agrees with the department that there are serious problems, both operationally and with the quality of information and resultant decision making. There was a suggestion that the latest governance review and the addition of the two senior manager positions would make the difference. Committee members sincerely hope this is the case and that the next business plan will see a department which is proactively dealing with the important issues that are part of its mandate.
Now that there is a shared understanding of the challenges facing the department and health and social services system, the standing committee is prepared to work with the Minister and department to address the problems to improve the situation.