I call this meeting to order and once again welcome Ms. Vignola, who is joining us in place of her colleague.
Welcome to meeting number 35 of the Standing Committee on Public Accounts. The committee is meeting in public today for the first hour, which will be televised, and will move in camera for the second hour to discuss committee business.
Pursuant to Standing Order 108(3)(g), the committee is meeting today to receive a briefing from the Auditor General concerning the reports that were tabled in the House on Thursday, May 26, 2021, which were referred to this committee.
Today's meeting is taking place in a hybrid format pursuant to the House order of January 25, 2021. Therefore, members may be attending in person in the room or remotely, by using the Zoom application. It would appear that we are all attending virtually today.
On that note, interpretation services are available for this meeting. You have the choice, at the bottom of your screen, of either “Floor”, “English” or “French”. Before speaking, click on the microphone icon to activate your own mike. When you are done speaking, please put your mike on mute to minimize any interference. When speaking, please speak slowly and clearly. Unless there are exceptional circumstances, the use of headsets with a boom microphone is mandatory for everyone participating remotely.
Again, should any technical challenges arise, please do advise the chair. Note that we may need to suspend for a few minutes in that case, as we want to ensure all members are able to fully participate.
I'd now like to welcome our witnesses.
Joining us today from the Office of the Auditor General are Karen Hogan, Auditor General of Canada; Glenn Wheeler, principal; and Jean Goulet, principal.
I will turn the floor over to Ms. Hogan.
Thank you, Madam Chair.
I am pleased to discuss our audit reports, which were tabled in the House of Commons on May 26.
I am accompanied by Jean Goulet and Glenn Wheeler, the principals who were responsible for the audits.
The first of the audit reports considers how the government acquired protective and medical equipment during the pandemic. The second looks at how Indigenous Services Canada provided the protective equipment and health care workers that indigenous communities and organizations needed to respond to COVID-19.
Both audits showed that there were issues in planning and stockpile management before the pandemic. For example, in our audit on procuring personal protective equipment and medical devices, we found that before the pandemic, the Public Health Agency of Canada had not addressed long-standing and known issues with the systems and practices used to manage and operate the national emergency strategic stockpile.
The Agency knew of these issues because they had been raised in audits and reviews going back more than a decade. As a result, the Public Health Agency of Canada was not as prepared as it should have been to deal with the surge in requests for equipment from the provinces and territories triggered by the COVID-19 pandemic.
In our other audit, we found that Indigenous Services Canada had not followed its own approach to procure sufficient equipment. As a result, it did not have enough of some types of protective equipment in its stockpile when the pandemic broke out.
However, both these audits also showed agility and responsiveness.
Overall, the Public Health Agency of Canada, Health Canada and Public Services and Procurement Canada helped address the needs of provincial and territorial governments for personal protective equipment and medical devices. Indigenous Services Canada did the same for indigenous communities and organizations. Faced with a crisis, these organizations worked around their outstanding issues with the management and oversight of the emergency equipment stockpiles and adapted their activities.
For example, during the pandemic, the Public Health Agency of Canada improved how it assessed needs and allocated equipment to help meet the demand for personal protective equipment and medical devices from the provinces and territories. It also outsourced much of the warehousing and logistical support needed to deal with the exceptional volume of purchased equipment.
Similarly, Health Canada reacted to the increased demand created by the pandemic by modifying its management of license applications from suppliers for personal protective equipment and medical devices.
Public Services and Procurement Canada also made adjustments by accepting some risks to facilitate the quick purchase of large quantities of equipment in a highly competitive market where supply was not always keeping pace with demand.
If the departments had not adapted their approaches to the circumstances, it is likely that the government would not have been able to acquire the volume of equipment that was needed.
Indigenous Services Canada also adapted quickly to respond to the pandemic and relied on the national emergency strategic stockpile to fill pre-existing shortages of items in its own stockpile, such as gloves and hand sanitizers.
The department supplied indigenous communities and organizations when provinces and territories were unable to provide them with personal protective equipment. The department also expanded access to its stockpile beyond those directly supporting the delivery of health services to include police officers and people in communities who were sick with COVID-19 or caring for sick family members.
Indigenous Services Canada also streamlined its processes for hiring nurses in remote or isolated First Nations communities and made its contract nurses and paramedics available to all indigenous communities to respond to additional health care needs due to COVID-19. While the department took steps to increase capacity, the number of requests for extra nurses and paramedics also increased. As a result, the department was unable to meet more than half of the 963 requests for extra nurses and paramedics that it received between March 2020 and March 2021.
Our audits of the government's pandemic response continue to show that when the people who make up the federal public service are faced with a crisis, they are able to rally and focus on serving the needs of Canadians.
However, these audits also show that issues forgotten or left unaddressed have a way of coming back, typically at the worst possible time.
Canada was not as well prepared to face the pandemic as it would have been if the stockpile of emergency equipment had been better managed and if a long-term solution had been put in place for health care workers, such as nurses, in indigenous communities.
If there is one overall lesson to learn from this pandemic, it is that government departments need to take action to resolve long-standing issues and to see the value in being better prepared for a rainy day.
Madam Chair, this concludes my opening remarks. We are pleased to answer questions.
Thank you very much, Ms. Hogan.
Colleagues, before I turn to the questioning, I have received the speaking order we normally follow during our meetings. However, in the past we have taken an approach whereby we open it up to those who have questions and perhaps get the opportunity to have a three-minute round. I look to you for your guidance. As I said, I have the speaking order. We would have enough time for the first four rounds of questions, according to the speaking order.
Is it the will of the committee to follow a speaking order this morning? I'm seeing yes.
We will follow our speaking order then, starting with Mr. Berthold for six minutes.
Thank you very much, Madam Chair.
Good morning and welcome, Ms. Hogan. My thanks to you and to the members of your staff for joining us again.
Ms. Hogan, I will focus on some of the things you said in your presentation. You said that the Public Health Agency of Canada was definitely aware of the issues, as they had previously been raised in audits and reviews over the past decade. The same is true for Indigenous Services Canada.
Don't you think you had a unique opportunity to demonstrate the importance of the reports of the various auditors general over the years, and the negative effects that are generated when agencies, departments and services do not follow those recommendations? It seems to me that you either did not make that point in the report you presented, or that you did so timidly.
I would really like you to provide us with this information. I think it's very important.
Ms. Hogan, you'll understand that our mandate at the Standing Committee on Public Accounts is to study your reports and recommendations. It is really starting to get my back up, to see that long-standing requests and recommendations are being given so little consideration.
As I mentioned at the outset, when it comes to exceptional situations, public servants are indeed exceptional in their ability to react. However, why is this capacity not as evident when there is no crisis? Always waiting until there is a crisis to react has created problematic situations.
So I would like to get this information on the government's response to requests as quickly as possible.
Ms. Hogan, I don't know if you intend to go any further, but I could have said the same thing about Indigenous Services Canada.
I think it's important to illustrate that your recommendations are helpful. The current situation clearly shows the need for departments to follow some, if not all, of your recommendations.
I'll try to answer that by talking about some of the long-standing issues in the two reports.
I'll start with the first audit. In it, we looked at the Public Health Agency of Canada's management of the national emergency strategic stockpile and its response to the pandemic going forward. There were a few things I would highlight.
One would be making an assessment of a standard or basic level of certain types of equipment to be maintained in the stockpile to deal with a health crisis in the future. Another is fixing the IT system that supports that stockpile. We saw many weaknesses in not being able to track expiry dates and issues in even identifying what was in the stockpile. It's really about taking the time to do all of that in between crises instead of doing it in reactive mode and really not fixing those long-standing issues and just finding a better response in the context of the current environment.
That would be that first report.
If I turn to the Indigenous Services Canada report, I would highlight the fact that there have been long-standing difficulties in trying to secure skilled health care workers in indigenous communities. A solution needs to be found there, because the pandemic just made a bad situation worse.
Thank you, Madam Chair.
Ms. Hogan, Canada has warehouses built to store equipment should the provinces and territories need it. A few weeks before the pandemic began, thousands of apparently expired masks were thrown away.
To your knowledge, does Canada have a schedule or system for tracking equipment, as any company does if they don't want to throw their money out the window or into the landfill?
In its procurement strategy, has Canada found ways to ensure that, in the future, it won't be dependent on foreign countries to meet its needs?
You raise one of the shortcomings we found in our audit, that the electronic inventory management system for the national emergency strategic stockpile was not effective. The government could not track the expiry dates of certain equipment stored in the Reserve Force and was therefore unable to act if necessary.
We recommend that the government put in place a comprehensive process to better manage the reserves, and that requires technology that provides data to make good decisions. We could not find out why the government did what it did, but we know that there was some very important data missing.
We found that, during the pandemic, the government tried to use Canadian suppliers, but that there was a lack of personal protective equipment suppliers in Canada. We didn't really look at how the government had expanded that market. As I mentioned on the day I tabled my report, this is something I will look into in the future, as it will help us determine whether Canada has positioned itself well and is better prepared for a future crisis by ensuring that we have Canadian suppliers.
I'm certainly happy, and I know the residents of Hamilton Centre are happy, that we're having this discussion about the national emergency strategic stockpile. It's something that I've been on for quite some time, both at this committee and at the government operations committee.
I want to pick up where Ms. Yip left off with some really good questions about post-SARS. Everything I know about this tells me that we've known a pandemic was a possibility, so we created an organization called the national emergency strategic stockpile, yet we've heard testimony today that the planning was driven by short-term thinking with possible implications in and around the budget.
Through you, Madam Chair, to Ms. Hogan, whose short-term thinking? Who would have been responsible to make the decisions and the recommendations to put forward to the minister, and likely cabinet, that resulted in the shuttering of three out of our nine national emergency strategic stockpiles?
Thank you, Ms. Hogan, and thank you for your continued excellent work.
As you might have suspected, based on the earlier questioning, I'm going to continue where Matthew Green left off. I think I know the answers, but I want it clarified on the record. I'm going to ask about N95 masks specifically, because it is a representative case, and it was particularly important during this crisis, as you said.
As of January 1, 2020, did the government know how many N95 masks it had?
Thank you, Madam Chair.
Thank you to Ms. Hogan and Mr. Goulet for being here to answer our questions today.
I was interested in a couple of areas. One was on nurses and paramedics and the hiring of staff for Indigenous Services Canada. In paragraph 11.55 in your report, you mention 77 nurses had been hired for the 51 remote communities prior to the pandemic and that 147 additional nurses and paramedics had been hired during COVID. It seems to me that we would be in really tough shape if we hadn't started hiring for remote communities before the pandemic hit.
I know retention is a problem. My wife and I have friends who had gone up to one of the remote nations to work in education. She did about a year of service there and then didn't renew her contract.
Turnover is part of it. I'm wondering how many of the 77 who were hired prior to the pandemic were still in place and whether we've got a net new hire there. I also know that in our community, the local long-term care facilities had a lot of trouble hiring during COVID. People were getting scooped by the hospital, where they got more money or different hours. Some of the long-term care facilities really had trouble keeping staff.
Did you look at turnover in your audit?
I will eventually turn to Glenn Wheeler and see if he can add something about net new hires.
What I can say is that the streamlining process Indigenous Services Canada applied during the pandemic to increase the number of nurses they could hire for those 51 remote communities where they're responsible for delivering health services was really effective. That's why we recommended they consider whether that should be a process going forward.
You're absolutely right that attraction and retention is a very long-standing issue in those communities. It's driven partially by a national shortage of nurses—as you've mentioned and alluded to, and as we saw, the pandemic made that worse—but also by the challenging nature of the work. Often the nursing stations are run by one or two individuals who have to deal with a complete host of issues along the spectrum of medical responses needed. Then there's the ever-present inadequate housing issue that we see in some of the remote and isolated communities, such that retention is complicated.
I don't know, Glen, if there's anything that you wanted to add about turnover and staffing.
There are several options to better manage the reserve in the future.
During our audit, there was some management of the reserve. Subsequently, there seems to have been less of a focus on it, and more of a focus on bulk procurement and seeking third-party support for inventory management because of the volume. There really hasn't been any attempt to address the existing gaps. All we're seeing are reactive behaviours.
It is hard to say whether a system like the one you are suggesting should be used, but it is an analysis the government should do to be better prepared. Indeed, the use of local suppliers would allow for a more timely response.
Madam Chair, I think the members of this committee would agree that there have been startling revelations today, in particular the understanding that in 2019 this department, public health, threw out two million masks in Regina.
We know there were requests coming out of the province for 3.2 million masks, and yet the government was only able to respond with a little over 100,000 critical N95 masks for a disease that is respiratory and airborne in nature from February all the way until August, in the height of the first wave.
I heard talks of audit committees, systems that would have been set up for quality control. I'm going to go back to the original question. Who was responsible for these decisions, and who was responsible for the audits and the oversight?
I'm going to pass it over to my colleague Mr. Berthold, but before I do, I want to tell you that one of the reasons that I focused on this aspect is that someone who's close to me, a health care professional, who was working in an Ontario hospital, was asked to reuse N95s on the front line during COVID. This has very serious consequences, and we can never ever let this happen again.
It's over to you, Mr. Berthold.
Ms. Hogan, I want to go back to what I said earlier about the importance of this report and the need to highlight failures, in a long-term perspective.
We were able to see that the machine could react in the short term and adapt, but it still took three months to get there. During those three months, public health authorities advised Canadians not to wear masks because they were not available. This had disastrous consequences for the health of Canadians. The Public Health Agency of Canada must recognize its share of responsibility for not following your recommendations.
Ms. Hogan, you saw that only 4% of the masks requested had been delivered. That is simply unacceptable. How can you send a clear message to the Public Health Agency of Canada and the departments so that we don't have this kind of failure in the future?
Thank you, Chair. You were saving me for last.
Good morning, everyone.
To the Auditor General, these reports were issued on May 26, to much scrutiny.
I want to first thank you and your team for the great work that you're doing. I want to refer to your opening remarks in paragraphs 6, 7 and 8, where you talk about the agility and responsiveness of the individuals who work for the federal government in the various departments.
I would like you and your team members to elaborate, please, on these two words of “agility and responsiveness”, because we faced a once-in-a-100-years pandemic and it required the muster of resources from across the federal government, from the Canada Revenue Agency to the various departments to PSPC. We see the vaccines that have arrived in Canada. We see Canadians being vaccinated, and for a statistical fact, almost 73% of the residents of the region I live in have actually received their first dose, so great work's being done by all levels of government, and there's lots of co-operation.
Going back to these two words of “agility and responsiveness”, can you comment on that, Auditor General, please?
Good morning to you, of course.
Thank you. I'll try to do it quickly and cover both reports, if I may.
With regard to the Public Health Agency of Canada and Public Services and Procurement Canada with Health Canada, the agility and responsiveness that we saw there I would outline in four ways.
There was a long-term national supply and demand model that was developed in order to determine the needs across the country. That model was then used to help inform bulk procurement and make it more accurate. We saw the Public Health Agency of Canada move to bulk procurement, which was led by Public Services and Procurement Canada. They took on some additional risk, but they were able to secure large amounts of equipment in a very competitive market where supply was often not keeping up with demand.
The third thing we saw was that the Public Health Agency of Canada outsourced a great deal of its warehousing and logistics in order to deal with this massive amount of volume, and they did that in a temporary way, because it is just surge capacity.
Finally, after the issues about managing who had what in which stockpile provincially and territorially, we saw the provinces and territories collaborate with the federal government on a scarce resource allocation strategy. There was the issue of deciding how would they equitably distribute what was received across the provinces and territories when the purchases were just not meeting the demand. All of that was evolving and continued to improve throughout the pandemic.
With regard to to Indigenous Services Canada, the responsiveness we saw there was that they were actually able to meet all of the personal protective equipment requests from indigenous communities. They too developed a tool—a calculator—to figure out how much every community might need, and they streamlined processes and increased the pipeline of workers. While it didn't meet the surge, they still were able to increase how many health care workers were in communities.