The provincial government could have saved taxpayers an estimated $90 million if it had acted sooner to increase the health system’s capacity to provide stem-cell transplants, the auditor general says.

In her annual report, released Wednesday, Bonnie Lysyk noted that the province was first alerted to the shortage of treatment capacity in 2009, but waited six years to approve capital projects to expand stem cell transplant projects.

Meantime, patients have faced long waits and many continue to travel to the United States for transplants where they are almost five times as expensive. As a result, patient outcomes have also been affected.

“Earlier planning could have mitigated many many of those difficulties,” Lysyk told a news conference after her report was tabled in the Legislature.

Read more:

Martin Regg Cohn: Auditor general Bonnie Lysyk could use a good editor

Auditor takes aim at Wynne’s government over spending, waste, lax oversight

Auditor general Bonnie Lysyk took aim at Premier Kathleen Wynne’s Liberals for using government money on advertising that "fosters a positive impression of the government party." Lysyk also questioned the government's financing structure for the Fair Hydro Plan.

Highlights from the Ontario auditor general’s 2017 annual report

Of 14 value-for-money audits conducted by her office, five focused on health care with findings reflecting the annual report’s central theme that the province needs to do more planning. In addition to cancer treatment services, the auditor looked at community health centres, lab services, public drug programs and public health.

The annual report revealed that in the last two years, 65 Ontario cancer patients have had to travel to the United States for stem cell transplants, each of which costs $660,000, compared to $128,000 on this side of the border.

It is estimated that another 106 patients will have to be treated in the United States over the next four years while the province continues to build its capacity to do more transplants.

Lysyk said that overall, most cancer patients’ needs are being met, but there are exceptions: “We believe Ontarians with cancer are generally receiving quality care in a timely manner. However, our audit identified areas where still more could be done to meet patient needs.”

Health Minister Eric Hoskins later told reporters that his government has increased funding for stem cell transplants by 600 per cent over the last five years, with $32 million being invested in capital infrastructure this year alone.

“There is always more work to be done,” he said.

Hoskins said Ontario’s cancer system is “one of the best in the world.” Compared to other provinces, Ontario has the best outcomes for patients with breast, prostate, lung and colorectal cancers, he added.

But PC health critic Jeff Yurek said it has taken tragic cases to hit the headlines for the government to get serious about the shortage of treatment capacity for patients needing stem cell transplants.

“They ignored that until unfortunately there were some high-profile cases of people dying while waiting to get the services they need,” he charged.

A Star investigation last year told of how 18-year-old Laura Hillier of Burlington died while waiting for a stem-cell transplant.

Loading... Loading... Loading... Loading... Loading... Loading...

The provincial auditor’s report pointed out that Ontario cancer patients are treated differently than those in British Columbia, Alberta, Saskatchewan and Manitoba when it comes to public coverage of costly drugs taken outside of hospitals. Adult Ontarians under the age of 65 are on the hook for those drugs.

Hoskins said the the majority of cancers occur in seniors and that their drugs are publicly covered. As well, as of Jan. 1, the cost of oral cancer drugs will be covered for those ages 24 and under as part of the government’s new OHIP+ Children and Youth Pharmacare program, he added.

NDP Leader Andrea Horwath said that Ontario needs a pharmacare program that is available to everyone, regardless of age.

The auditor’s report also cited these problems with cancer care: radiation treatment is not provided to enough patients; support services for patients experiencing side effects are inadequate; psychosocial services such as consultations with dieticians are inadequate; and waits for biopsy results are too long.

An audit of the province’s 75 community health centres (CHC) found that there is insufficient information to show whether they are cost effective.

In fact, the probe raised more questions than answers about the centres, which provide health services to vulnerable populations.

It found that 16 per cent of CHCs were responsible for more patients than their capacity, while about half of them served fewer than 80 per cent of their targeted number of patients.

On a weekly basis in 2016/17, each CHC doctor or nurse averaged 31 patient encounters, but some saw as few as 16 patients while others saw almost 60 patients.

“The ministry lacks the information it needs to make informed decisions on whether it should expand the CHC network or reallocate funding among existing CHCs,” the report said.

Ontario could have saved millions of dollars on lab tests if it had more promptly updated a nearly two-decades-old list of prices it pays private sector community laboratories for tests, according to the audit of that sector.

Ontario may be spending more than it needs to on generic prescription drugs, the auditor found.

“Generic drug prices in Ontario have dropped significantly in the last 10 years, but opportunities appear to still exist for the ministry to obtain further discounts on generic drugs,” Lysyk said.

The provincial government has no overarching chronic disease prevention strategy and does not know whether its 36 public health units are making headway in the fight against preventable chronic disease, the report notes.