Opening Statement to the Standing Committee on Public Accounts – Oral Health Programs for First Nations and Inuit—Health Canada
22 March 2018
Michael Ferguson, Chartered Professional AccountantCPA, Chartered AccountantCA
Fellow Chartered Professional AccountantFCPA, Fellow Chartered AccountantFCA (New Brunswick)
Auditor General of Canada
Mr. Chair, thank you for this opportunity to present the results of our audit on oral health programs for First Nations and Inuit. Joining me at the table is Jo Ann Schwartz, the auditor who was responsible for the audit.
In our audit of Health Canada’s oral health programs, we focused on whether the Department knew if its two programs, the Non-Insured Health Benefits Program and the Children’s Oral Health Initiative, had a positive effect on the oral health of Inuit and First Nations people. These programs are important because they provide access to a range of medically necessary dental services.
We concluded that while Health Canada provided access to these important services, it could not demonstrate how much the services contributed to their objective to maintain and improve the overall oral health of Inuit and First Nations people.
Even though the Department knew that the oral health of these populations was significantly worse than that of other Canadians, it did not focus on closing the gap. Also, the Department had not finalized a strategic approach to help improve the poor oral health outcomes in the populations it served.
We found that Health Canada knew that its $5 million Children’s Oral Health Initiative, which is focused on prevention, improved the oral health of some First Nations and Inuit children. However, the Department’s data showed that fewer children were enrolled and fewer services were provided under the initiative than in previous years. Health Canada did not know why this was the case, making it difficult to address the situation.
We also found that there were administrative weaknesses in the Department’s management of its Non-Insured Health Benefits Program. The Department’s service standards for making decisions on pre-approvals and complex appeals were not clear. Also, Health Canada did not always inform its clients and service providers promptly about some of the changes it made to the services it paid for.
This matters because delayed or unclear communication about what services are available can affect clients’ access to the oral health services they need.
We also found that in the two regions we examined, Health Canada was slow to take action to address human resource challenges. If unaddressed, these challenges could eventually affect service delivery.
We made six recommendations, including that Health Canada should finalize and implement a strategic approach to improve the oral health of Inuit and First Nations people, an effort it began in 2010. We also recommended that it should develop a concrete plan to determine how much of a difference its programs are making to the oral health of Inuit and First Nations people.
Health Canada agreed with our recommendations and committed to take corrective action.
Now that these oral health programs are the responsibility of Indigenous Services Canada, we understand that it intends to fulfill the commitment made by Health Canada.
Mr. Chair, this concludes my opening remarks. We would be pleased to answer any questions the Committee may have.