Auditor general highlights several concerns with province’s ambulance service20 October 2020
FREDERICTON (GNB) – The auditor general’s latest report tabled today in the legislative assembly highlights several areas of concern for ambulance services in New Brunswick. The report focuses on the relationship between the Department of Health and EM/ANB Inc., the crown entity licensed to operate the $110 million-a-year province-wide ambulance service.
Since 2007, management of the provincial ambulance service has been contracted to the private sector, Medavie Health Services New Brunswick. The audit found the contract was poorly structured, allowing for questionable payments for paramedic vacancies, excessive use of response time exemptions and ambiguous performance measures.
“Paramedic shortages created over $8 million in surplus payments to Medavie Health Services New Brunswick, providing a disincentive to address low staffing levels,” said Auditor General Kim Adair-MacPherson. She said this is troublesome because the department has allowed unrestricted cost savings to be awarded as surplus payments to Medavie Health Services New Brunswick.
The audit also found the legislative framework and governance structure does not provide sufficient oversight of ambulance services due to numerous inherent conflicts and requires significant improvement. Issues include legislation with unclear mandate, complex management relationship, board composition lacking independence, and a contract which compromises the board’s influence over its CEO.
The contract allowed excessive use of full deployment exemptions, which overstated 911 response time performance results. The audit showed exemptions were allowed where the real issue was distance, out-of-service ambulances and driver error. These exemptions were offered in addition to the 10 per cent allowance already built into the 90 per cent performance expectation.
The report also found that combining rural and urban communities to measure response times reduced the emphasis on achieving performance expectations in rural or remote areas.
“Following contract renegotiations in 2017, performance-based payments introduced a bias towards achieving high performance in areas of greater population. The performance measures put rural and remote communities at a disadvantage. Even though 19 of 67 communities fell below performance standards, it did not reduce performance-based payments to Medavie Health Services New Brunswick,” said Adair-MacPherson.
The auditor general made 20 recommendations for the Department of Health and EM/ANB Inc. regarding the governance and management of the ambulance service contract with Medavie Health Services New Brunswick. The recommendations include changes to legislation, board by-laws and various contract provisions with Medavie Health Services New Brunswick to address the many findings.
The full report is available online.20-10-20