Ontario’s auditor general finds COVID-19 vaccine waste, uncoordinated bookings
Ontario’s auditor general says the province wasted 38 percent of COVID-19 vaccine doses between February and June because it overestimated demand for boosters, and its annual report also finds the province has a disorganized booking system and adult vaccinations are not fully track.
Auditor General Bonnie Lysyk says in her report today that the total wastage of COVID-19 vaccines in the county is nine percent, or 3.4 million doses.
She says about half of those could have been avoided with better demand forecasting.
You can read a summary of the 2022 Annual Report of the Accountant General here.
Lysyk says wastage rates varied quite a bit between public health units, with a private company wasting 57 percent of its supply between May 2021 and May 2022, but the county has not determined the causes.
She also identified problems with the vaccine appointment booking system, as the county has created its own portal, but about half of public health departments use their own portal, while some hospitals, pharmacies and private companies also use their own methods.
“Multiple booking systems also encouraged Ontarios to ‘buy vaccines’ by registering for multiple appointments to try and get the fastest appointment or a specific vaccine brand,” Lysyk wrote in the report.
“The continued absence of a centralized booking system (as of August 2022) increases the likelihood of unnecessary waste in the future, as such no-show arrangements could lead to more wasted doses of vaccine.”
Multiple bookings led to about 227,000 no-shows in 2021 in the provincial booking system alone, the auditor found, likely contributing to vaccine wastage.
The lack of a centralized booking system also led to inconsistent checks and controls to ensure that when bookings were opened up to certain groups, such as health care workers or the immunocompromised, only those who qualified actually made appointments, Lysyk found.
GPs underutilized in vaccine rollout: AG
GPs were underutilized in vaccine rollouts, Lysyk found, noting that the fee structure discouraged them from administering injections in their own offices.
Doctors were paid between $170 and $220 an hour by the government to work at vaccination sites operated by a public health unit or a hospital, while doctors were paid just $13 per dose to vaccinate in their own offices. Also, Lysyk found that clinicians were paid much higher rates to administer injections than nurses, who were paid between $32 and $49 per hour, and pharmacists, who were paid between $30 and $57 per hour.
The Department of Health conducted a study of procedures and effectiveness at nine mass immunization clinics between the summer of 2021 and December of that year and completed the study in July, Lysyk wrote, but did not share the results with public health units to help them plan for the roll-out of the bivalent vaccines this fall.
Also, the auditor says that despite the Department of Health saying in 2014 that it was going to expand a system used to track student vaccinations to track vaccine data for all Ontario residents, that has not happened.
Lysyk found that contracts for goods and services related to COVID-19 were timely given the urgency of the pandemic, but better coordination could have reduced some costs.
About $18.7 million was paid to private companies for underutilized mobile COVID-19 testing, the auditor found.
“Sellers received a guaranteed minimum daily payment to cover overhead costs, even if a minimum number of COVID-19 tests were not performed,” Lysyk wrote in the report.
One supplier charged its guaranteed minimum daily payment of $8,255 whether zero tests or 250 tests were performed in a day, the report said.
The audit identified 105 cases, worth $800,000, in which merchants received their guaranteed minimum daily payment despite not testing anyone that day.
Lysyk’s report for 2022 includes a total of 15 audits.
Auto insurance premiums up since 2017
Her office also found that average auto insurance premiums in the county increased 14 percent from 2017 to 2021 to $1,642.
Ontario has the highest auto insurance premiums for private passengers in Canada, despite having one of the lowest rates of car accident injuries.
“Despite several reports over the past decade that have made recommendations to improve the auto insurance framework for private passenger vehicles in Ontario and reduce premium costs, the (regulator) and the Treasury Department have not improved the framework enough to provide Ontario residents with a cheaper auto insurance for passenger cars,” Lysyk wrote.
For example, Lysyk said Ontario could follow the example of British Columbia and Saskatchewan and introduce a mandatory certification regime for auto repair businesses to protect against fraud.
A 2017 government-commissioned report called Ontario’s auto insurance system “one of the least effective insurance systems in Canada”, recommending several changes, including adopting a “care not cash” approach, exploring better ways to care for people who have been catastrophically injured, and make contingency costs of attorneys more transparent.
Little action has been taken so far based on the report’s recommendations, Lysyk wrote.
The former Liberal government commissioned the 2017 report at a time when it came under fire for promising, but failing, to cut car insurance rates significantly. The Liberals had pledged in 2013 to cut tariffs by an average of 15 per cent by 2015, but then Prime Minister Kathleen Wynne later admitted it was a “stretch goal”.
In the first quarter of 2018, not long before the Liberals were roundly defeated by the Progressive Conservatives in the election, the average rate drop was about 3.3 percent since 2013.
Lysyk also found that auto insurance rates vary so much across the province that the exact same person driving the same car would pay $1,200 a year in London, Ontario, but $3,350 a year in Brampton.
The government directed the Financial Services Regulatory Authority of Ontario to begin reviewing that framework earlier this year.