Jessica Bell MPP, University–Rosedale

Government of Ontario

2023 Auditor General Report Highlights

Published on December 12, 2023

Recently the Auditor General provided his annual report. Below is a summary of key reports. 

Science Centres  

  • “The recent relocation decision was not fully informed and based on preliminary and incomplete costing information and had proceeded without full consultation from key stakeholders or a clear plan for the existing site.”  
  • The business case justifying the relocation of the Ontario Science Centre to Ontario Place excluded several costs and failed to consult important stakeholders, suggesting it was rigged to reach a pre-determined conclusion.  
  • 90% of the claimed savings comes from the lower costs of operating a much-smaller OSC with less exhibition space, and never even studied the impacts of longer drives on attendance from Ontario students and families 
  • Nearly half of surveyed science teachers say they will be less likely to go to the relocated OSC 
  • Although the government expects the relocated OSC will be more inconvenient for students and suburban residents due to the longer distances, it hopes to attract more tourists. 
  • The business case excluded the costs of parking. The relocation has been driven by the need to justify the costs of Therme’s parking garage 
  • With proper investment, including the completion of long-delayed capital repairs, the existing Ontario Science Centre can once again deliver the quality educational and cultural programming that made it an iconic destination of generations of students, families and tourists. 

Emergency Departments  

  • Between July 2022- June 2023, there were 203 unplanned ER closures involving 23 hospitals. Prior to 2019/20 unplanned closures were very rare. There would have been 400 more ER closures if the government did not renew the Locum Program until March 2024, under pressure from the public.  
  • Patients are waiting to see a doctor has increased to more than 2 hours over the last two years. Patients who need to be hospitalized for inpatient treatment are waiting more than 24 hours. The average wait time for a bed is 13 hours, a significant increase over the last 10 years.  
  • Staffing shortages and the lack of primary care doctors are driving overcrowding in emergency rooms. 
  • Strains in the system and long wait times at emergency departments resulted worse outcomes; delayed or missed diagnoses, leading to repeat visits from patients with worsening health 
  • “Our audit concluded that the Ministry of Health and Ontario Health, in conjunction with hospitals, do not have fully effective systems and processes to oversee the delivery of care at emergency departments, or to manage resources efficiently, to help ensure emergency care that is timely and meets all patient needs.” 

Northern Hospitals: Patient-Centred Care 

  • Health inequity persists in Northern Ontario due to a lack of commitment from the government and Ontario Health. There were 10 temporary closures of obstetrics departments in Northern Ontario, three stayed closed for over a year. Ontario Health does not track or monitor the closure of these services which allows health inequities to persist for Northern women and nonbinary people. 
  • Northern Ontario hospitals are much more reliant on agency staff. Reliance on agency staff is 25 times higher than before Ford took office.  
  • In 2018, Health Quality Ontario developed the Northern Ontario Health Equity Strategy in 2018, but after five years this has not been done because, according to Ontario Health, the Ministry did not approve the required funding. 
  • “The Ministry did not have a dedicated healthcare strategy that addresses all the north region’s unique challenges; this is critical for improving access to health care for Northern Ontario patients and for supporting hospitals in the delivery of services.” 
  • Northern Health Travel Grant mileage rate has not been updated in 2007 and the Ministry has not measured the extent to which the program covers the actual cost to patients to access care away from home   
  • Mileage rate is still at 41 cents per km, Canada Revenue Agency says it should be 68 cents per km (current milage rates for business travel)   
  • 330 ALC patients in northern hospitals waiting for LTC or home care. Between 2018/19 - 2022/23, ALC patients in northern Ontario hospitals grew from 24-34% while the rest of Ontario grew from 10-22%.  

Public Health Ontario 

  • Public Health Ontario has been unable to meet several of its legislated responsibilities under the Ontario Agency for Health Protection and Promotion Act 
  • Public Health Ontario (PHO) struggles with inefficiencies at its labs and poor coordination of public health research. Challenged to effectively protect and improve the health of Ontarians, surveillance of diseases, detection of health threats, etc.  
  • The audit found that PHO was not taking the lead in performing or coordinating testing for the surveillance of some diseases, such as latent tuberculosis and wastewater testing for the detection of COVID-19.  
  • PHO was not consulted about key public health decisions, including increasing Ontarians’ access to alcohol and gambling 
  • Three of 11 PHO lab sites perform tests on only 9 to 20 per cent of samples and specimens they receive and transfer the rest to other sites. 
  • Since 2019/20, PHO has received limited increases in base funding, and some base funding has been replaced by one-time annual funding, which is not guaranteed from year to year. Base funding has still not returned to pre-pandemic levels. The lack of consistent funding puts the continuation of the advisory committee for public health emergencies at risk  

Long-Term Care Homes: Delivery of Resident-Centred Care 

  • Changing demographics in long-term care homes. Residents have more complex health needs than they have historically  
  • Only 57 ethnocultural homes in Ontario (out of 626 homes). The median wait time for these homes is up to five years, 8x longer than for other homes 
  • There is a high vacancy and turnover rates compromise quality of care; homes are reliant on agency staff to fill the gap  
  • AG estimates a quarter of the homes in the province still provide fewer hours of direct care to residents than the provincial targets, according to the Fixing Long-Term Act 
  • With the province’s plan to build 30k new LTC homes by 2028, the staffing issue will only get worse if there is not direct action taken  
  • Pay inequity between LTC homes and other healthcare settings contributes to high vacancy and turnover rates 
  • Implementation of More Beds Better Care Act, 2022 has not been transparent to the public 

Report Summaries  

Operation of Environmental Bill of Rights  

  • The Ministry of Municipal Affairs and Housing violated the Environmental Bill of Rights (EBR) when passing Bill 23 and its Greenbelt changes 
  • The Ministry of Natural Resources and Forestry also violated the EBR when it failed to consult on its repeal of the Duffin's Rouge Agricultural Preserve Act, when it failed to note any of the serious environmental risks to its changes to the wetland classification system, and when it falsely claimed the environmental impacts of its decision to gut the powers of conservation authorities would be “neutral,” despite knowing the changes would bring significant risks 
  • The Environment Ministry had the worst report card of all ministries when it came to meeting its obligations under the EBR 
  • The Environment Ministry has ignored past AG recommendations concerning the EBR 
  • AG: “When municipalities, organizations and individuals take the time to comment on proposals, they expect and deserve that the ministry will give their thoughts, suggestions and expertise due consideration before making its final decision. This is each Ontarian’s right under the EBR Act. But in these consultations, the government did not fulfill its obligations to the people of Ontario” 

Driver Training and Examination  

  • The sector is plagued with issues of a lack of oversight and assessment, rarely requires drivers with repeat suspensions to take retraining courses, and other issues that increase collision rates amongst those impacted   
  • Despite repeated failures over 10 years to deliver on performance targets, the Ministry awarded a new contract to the same company to continue delivering driver examination services in Ontario. Services offered by Plenary/Serco experienced numerous performance failures over the 10-year contract that began in 2013. Issues weren't addressed even after the Ministry attempted to hold them accountable. Despite repeated concerns, the Ministry awarded a new contract to Plenary without competition. The Ministry did not start work on procuring this contract until 2021, and subsequently determined it didn’t have enough time for an open competition. 
  • There’s a lack of oversight of driving schools/instructors. Many driving students might be given specific “route training” to practice the specific course of their driving exam, which could hamper the ability of an examiner to assess the student’s driving skills 
  • The Ministry rarely requires drivers with repeat driving suspensions to take retraining courses. The fatal collision rate for drivers with two or more suspensions in the previous year had a fatal collision rate that is six times higher than the general population.  

Aggregate Resource Mgmt.  

  • The government is not adequately enforcing the rules for aggregate pits and quarries, including rehabilitation of sites   
  • The lack of inspection and enforcement resources has led to a lack of widespread compliance with extraction limits at aggregate pit and quarry sites 

 York University Operations and Capital 

  • York is financially sustainable, but its increasing dependence on revenue from international students, capital expansion projects and deferred maintenance backlog warrant monitoring  
  • In 2023, international students accounted for 18% of York’s total enrolment, but almost half of its revenue. Students from India and China represented 57% of all international students enrolled at York. Presents a challenge, particularly because at the time of the audit there were political tensions with India, and India suspended visa services. 

Convention Centres 

  • The convention centres are too focused on profit generation. Quote: “Government-operated convention centres are generally meant to be drivers of positive economic impact in their communities, and it is important they stay focused on this goal.” 
  • Since 2018 the two centres have lost out on the opportunity to host 97 events (19 events at MTCC), that would have driven an estimated $52 Million in economic activity to their regions because they were outbid. The Auditor General attributes this to the centres being too focused on profit, and a lack of oversight by the Ministry 
  • Ministry has not acted on a plan to redevelop the Metro Toronto Convention Centre 
  • “Ministry Has No Strategy to Help the Convention Centre Industry Recover [post-pandemic]” and AG contrasts this with the approach of BC and Quebec 

Tourism Support Programs 

  • Ministry, “does not have an effective long-term strategic plan for supporting and growing tourism in the province’ 
  • The Auditor General found Ministry does not provide needed support in a timely way, leading to arts, music, and culture festivals event cancellations, impacting local economies  

Travel Industry Council of Ontario  

  • The Travel Industry Council of Ontario (TICO), the regulator, created in 1997, hasn’t changed much even though the industry has 
  • Administering the $1M Travel Industry Compensation Fund, used to compensate travel consumers, may outweigh benefit to consumers