AG report found two Hamilton neighbourhoods excluded from 'hot spot' vaccine strategy
Doctors were paid five times more than nurses to give COVID-19 vaccine injections, the auditor general says in an annual report that found booster shots wasted, hot spots" missed, and slams Premier Doug Ford for ignoring" his own experts to plow ahead with Highway 413.
The going rate for doctors putting needles in arms was between $170 to $220 per hour, compared with $32 to $49 for nurses and $30 to $57 for pharmacists, Bonnie Lysyk said Wednesday, raising questions about the wide range of pay" for performing the same task at public health and hospital clinics.
There was a significant gap in the rate paid between doctors and nurses and there were different rates paid depending on where the vaccinations were given," the 1,000-page report noted.
The finding comes a day after an Ontario Superior Court justice struck down the Ford government's Bill 124 wage restraint legislation, which limited nurses and other public sector workers to annual pay increases of one per cent and has been blamed for an exodus of workers from a health-care system strained by the pandemic.
Lysyk also delved into procurements of COVID-19 supplies and found them generally in line with proper procedures despite the haste required in a public health emergency, but said a mix of decentralized and unco-ordinated" vaccine booking portals contributed to confusion while a strategy of concentrating shots in COVID hot spots" missed eight vulnerable communities.
She found the Ontario Lottery and Gaming Corporation needs to do more to clamp down on potential money laundering in casinos.
As first revealed by the Star, Lysyk contacted mystery shoppers" for a sting operation at four unnamed Ontario casinos to test anti-money laundering measure.
While two of her agents were caught by casino security, others were able to launder" money by buying thousands of dollars in chips, playing a few games, then cashing them out for cheques.
On highways, the audit found the Transportation Ministry deferred six projects in 2019 that had already been given the green light and instead funnelled the money to four highway projects as directed by the minister's office - even though these projects were ranked as a lower priority by the ministry's technical and engineering staff."
They then added on Highway 413, a proposed 60-kilometre freeway from Milton to Vaughan, and the Bradford Bypass, both widely opposed by environmentalists but cornerstones of Ford's re-election plan.
About $158 million earmarked for two highway project in northern Ontario was reallocated to other projects in southern Ontario.
Direction from the minister's office was inconsistent with the recommendations of the ministry's subject-matter experts who indicated that they would not have recommended those four projects at that time, and did not have a specific time frame for when they would have recommended them," the auditor said of plans to widen Highway 401 in Tilbury and work on Highway 3 in nearby Essex and on Highway 17 through Kenora and Arnprior, west of Ottawa.
Those four projects were rated by ministry staff as either medium or low priority and these four highway projected priorities were communicated to the ministry by government officials primarily through meetings, rather than emails or letters. This left an incomplete record of how these decisions were made, by whom, and why."
Highway 413 was identified as high priority but kept on the back burner as it requires a federal environmental assessment before moving ahead.
If approved, the Highway 413 project would become the largest highway project in the infrastructure plan," the report says.
On the pandemic, the audit found Ontario had wasted at least 3.4 million COVID-19 vaccine doses as of June 30, 2022.
About half of this wastage could have been prevented with better forecasting of the doses required," the report concluded.
While the province wasted about nine per cent of the vaccines received from the federal government from December 2020 to June 2022, the wastage was 38 per cent between February and June 2022 when demand for boosters was much lower than the province anticipated."
As of mid-August, 82 per cent of Ontarians age five and over had been given two doses of COVID vaccine - a rate that ranks the province eighth in the country, the report said.
Health Minister Sylvia Jones said she disagrees with Lysyk on some of her findings critical of a vaccine rollout.
We have done an incredible job," Jones told MPPs in the legislature's daily question period. I will not apologize for our vaccine rollout. We have a lot to be proud of."
New Democrat MPP France Gelinas (Nickel Belt), her party's health critic, called it sloppy and unco-ordinated."
The hot spot" vaccination strategy, aimed at concentrating doses in the most vulnerable communities of multi-generational families and essential workers with higher rates of COVID, did not always work as planned, the report found.
The Ministry of Health did not apply their chosen method of selection consistently across all postal code regions. This resulted in eight lower-risk neighbourhoods receiving vaccines ahead of high-risk neighbourhoods, and nine higher-risk neighbourhoods being excluded from the hot spot strategy."
The nine neighbourhoods were in Kent County, Windsor, Niagara Falls, King City, Peel, eastern York region, Milton, and two neighbourhoods in Hamilton. Neighbourhoods ranked lower risk but included were in Ottawa, Windsor, and York Region.
Differing vaccine booking systems for the province, some of Ontario's 34 regional health units, pharmacies and hospitals led to confusion and unfairness, the audit found.
Ontarians with access to better technology and more time often booked multiple appointments, resulting in many wasted no-show' appointments," the report said.
The lack of a central registry for vaccinations of all provincial residents limits the ability to adapt to new outbreaks of emerging diseases," the report added.
While a 2014 audit prompted the ministry of health to promise an expansion of its Panorama vaccination-tracking system for school-age children, that effort remained incomplete" by 2020 despite $170 million to upgrade it in the previous decade, Lysyk noted.
Instead, the ministry built a brand-new system - COVaxON - at a cost of over $144 million to meet the need," the report said.
While to some degree, it was understandable that the province did not have a perfect system at the onset of the vaccination program, rectifying the weaknesses we have identified in this report is important to help Ontario become better equipped and prepared to deal with potential surges in demand for the COVID-19 vaccine and to address future disease outbreaks."
Lysyk faults the ministries of health and education for not co-ordinating on locations for mobile COVID-19 testing services to better meet demand," resulting on the spending of $18.7 million on underutilized" facilities.
The two ministries separately signed mobile testing contracts with private companies.
Vendors were paid a guaranteed minimum daily payment to cover overhead costs even if a minimum number of COVID-19 tests were not performed, ranging from $991 to $8,255 per site. For example, one vendor charged the Education Ministry its guaranteed minimum daily payment of $8,255 whether zero tests or 250 tests were performed in a day."
On COVID vaccinations, there were 21,237 adverse events" reported, or 63.2 per 100,00 doses, with 94 per cent classified as nonserious" such as pain at the injection site, rashes and fever. Another 1,118 were considered serious, including 27 deaths.
Kristin Rushowy is a Toronto-based reporter covering Ontario politics for the Star. Follow her on Twitter: @krushowy
Rob Ferguson is a Toronto-based reporter covering Ontario politics for the Star. Follow him on Twitter: @robferguson1