Jessica Bell MPP, University–Rosedale

Government of Ontario

Auditor General’s Annual Report Investigates Surgeries, Land-Use Planning, Homelessness, and more

Published on December 2, 2021

Ontario’s Auditor General, Bonnie Lysyk, released her comprehensive 2021 Annual Report this week. The AG’s annual report investigates various government and government-regulated sectors in Ontario to assess if they are working well and providing value-for-money.

This year’s report has chapters on Ontario’s unsustainable land use planning practices, the Ontario Provincial Police force, Ontario’s programs to support businesses during the pandemic, oversight of the public colleges sector, and wait times for surgery. I have included a summary of her findings below.

As a member of the Committee on Public Accounts, it’s now my job to work with the Auditor General to investigate and address the issues raised in her annual report over the coming year. I welcome feedback, suggestions and advice from University Rosedale residents so I can do this job effectively and collaboratively.


Land-Use Planning in the Greater Golden Horseshoe

  • The sustainable growth goals of the provincial growth plan for the Greater Golden Horseshoe are not being met, and the government lacks effective processes to measure and ensure these goals are being met. As a result, too much sprawl-oriented development is occurring, resulting in farmland loss and higher infrastructure costs.
  • Minister’s Zoning Orders (MZOs) are disrupting municipal planning processes and undermining growth plan goals. These MZOs are enabling sprawl-oriented developments in areas lacking municipal services such as water and wastewater.
  • Infrastructure planning is driving sprawl-oriented development, contrary to the goals of growth planning. The Auditor General cites Highway 413 as an example.
  • The Ford government has accelerated the use of Minister’s Zoning Orders, many of which have disrupted municipal planning processes and undermined the goals of the growth plan. For example, 13 of 44 MZOs issued between March 2019 and March 2021 enable development in areas that may not have existing or planned municipal services such as water and wastewater, triggering large and unplanned municipal infrastructure costs.
  • The ministry cannot explain how it chooses which projects will get MZOs. This lack of transparency “opens the process to criticisms of conflict of interest and unfairness.” 17 of the 44 MZOs benefitted the same seven development companies or groups of companies.


Homelessness programs are inadequate, disorganized

  • Ontario does not have an overarching and coordinated homelessness strategy.
  • Municipalities do not track system-level supports for homeless individuals, and this is not collected if shelter staff do not collect it.
  • The Data the Province collects is insufficient to monitor and audit effectiveness of supports given by municipalities, including frontline services to homeless populations.
  • Neither the Ministry nor some municipalities have standards for shelters
  • The province’s lack of action to support people transitioning from correctional facilities, health-care facilities and the child welfare system is a contributing factor to the number of people who are homeless.
  • Ministry funding is outdated, based on old modeling and Statistics Canada data about housing need.


Public Colleges Oversight

  • Compared to other provinces, in 2018/19 Ontario spent the lowest per capita on college student funding.
  • The AG showed that between 2012/13 and 2020/21, domestic enrollments fell 15% while international enrolments grew 342%. Public colleges are increasingly relying on international student fees to remain financially viable.
  • In 2020/21, 68% of total tuition fee revenue came from international students, with international student enrolment representing 30% of total enrolment, The Ministry does not have a plan for the college sector to mitigate the risk of a high reliance on international students for financial sustainability and were it not for international student tuition partnership revenues, five of the six public colleges with private college partnerships would have incurred operating deficits in 2019/20.
  • Most public-private partnerships and programs have not been subject to quality assurance checks, the AG recommends more oversight is needed.
  • $62.4 million of COVID-19 funding was provided to colleges based on projected revenue decreases due to the pandemic, but two colleges that received funding actually saw an increase in revenue and annual surplus.
  • Finally, delays at the Ministry level have negatively impacted colleges’ ability to launch programs that are responsive to the job market in a timely manner.


COVID business support programs were poorly managed

  • There was a general lack of scrutiny and oversight with the government’s COVID support programs.
  • Around $210 million was paid to 14,500 ineligible recipients of Ontario’s Small Business Support Grant Program. Grant amounts were unreflective of revenue lost. Over 51,000 businesses were paid $939 million but their actual revenue loss was only $225 million.
  • The Property Tax and Energy Rebate program was underutilized; only $340 of $905 million was approved and sent to 31,000 businesses.
  • The Main Street PPE program was underutilized. There was no basis for setting a $1000 per business maximum, and only 18% of budget was actually paid out, about $11.6 million of $65 million
  • The Digital Main Street program worked well, and saved businesses $2.74 million.


Wait times for some surgeries are lengthening, harming people

  • Wait times for surgeries have gotten worse during the pandemic, and there is significant regional variation in wait times for outpatient surgeries.
  • There is no centralized mechanism for intake and referral, or provincial oversight over surgery providers to ensure that patients are properly informed of their right to receive the standard, publicly funded surgery options without paying out-of-pocket. The lack of coordination contributes to longer wait times. There is also inconsistent oversight of the different outpatient surgery providers.


Assisted living services are poorly regulated, inadequate

  • Ontario Health has no mechanism to confirm that clients receive the services they are eligible for and are sufficient to meet their needs. Only two of 14 LHINs required their agencies to report data related to client hospitalizations and long-term care admission. They do not present this data to the Ministry.
  • AG found that assisted living programs can offer a cost-effective means of keeping seniors in their homes and out of hospitals and long term care but the Ministry has not effectively leveraged these services to improve overall health system performance.
  • There is no requirement for agencies to report staff-to-patient ratios, rate of referral acceptance or frequency of missed visits. AG found that LHINs did not collect information about abuse and neglect by assisted living personnel, and did not take steps to ensure that complaints about services were resolved.


Cardiac disease and stroke treatment is not meeting targets

  • Provincial targets for optimal time to treat emergency cardiac and stroke procedures have not been met, increasing risk of permanent heart and brain damage for patients. Fewer than 60% of heart attack patients received emergency treatment within the target time in 2020/21.
  • In 2020/21 the Ministry stopped funding Heart & Stroke’s effective campaign to raise awareness among the public about the three key signs of stroke and the need to call 911.
  • If cardiac and stroke patients were transferred to more appropriate settings after surgery, instead of staying in hospital acute care, the health system could save $150 million.


COVID-19 PPE Supply

  • The province was not prepared to respond with sufficient PPE during the COVID-19 pandemic due to long standing issues that have persisted since the 2003 SARS outbreak. The provincial stockpile expired in 2017, when the Ford government began destroying the stockpile without establishing a process to replace it.
  • When the pandemic hit, the Ministry of Health did not have enough PPEs in the stockpile and ready for distribution as required under the Ontario Health Plan for an Influenza Pandemic.
  • When the pandemic hit, the province had no mechanism to report how many PPEs were available across the province. Many healthcare providers did not have the recommended 4-week emergency supply of PPE.
  • The Ontario Health Plan for Influenza Pandemic recommends all healthcare providers have an emergency 4-week supply of PPE, but the Ministry had no requirements in place to monitor and confirm these stockpiles were maintained.
  • The Minister of Health waited until April 1 to start reporting PPE supply levels, which limited the transparency about the distribution and use of scarce PPE supply.
  • The Ministry was not prepared to obtain, store, and distribute PPEs, and had to create a new PPE procurement process during the pandemic.


Ontario Cannabis Retail Corporation

  • There is a lack of oversight, transparency, reporting, and standardization which results in poor service quality for producers, retailers, and consumers.
  • Progressing “slowly” with its social responsibility mandate, and struggling to enforce age restrictions without feeding the illegal market.


Private Career Colleges Oversight

  • Almost 1,400 outdated programs, including paramedics and IT, are being delivered by private career colleges.
  • The Ministry does not examine the content delivered to students to verify that it is the program approved by the Ministry. The Ministry cannot confirm that students are receiving adequate education for employment from private career college programs.
  • The Ministry does not effectively administer, oversee and enforce the legislation and Ministry policies that are in place to protect the interests of existing and prospective students of private career colleges in Ontario