Denise Hanrahan, Auditor General
P.O. Box 8700
St. John’s, Newfoundland and Labrador
December 13, 2023
Dear Ms. Hanrahan,
I am writing to request that you conduct a performance audit of the Newfoundland and Labrador Health Service (NLHS) and its predecessors, the Regional Health Authorities and the Newfoundland and Labrador Centre for Health Information.
Specifically, I ask that you investigate their use of contracts with third parties for the provision of services, to determine whether the NLHS and its predecessors:
a) Spent responsibly on such contracts;
b) Whether the arrangements agreed to were cost-effective; and
c) Whether contracted services could have reasonably been provided in-house by government departments or Crown corporations.
My concern regarding the use of private contractors by the NLHS and its predecessors comes from a number of revelations in the media. In April, it was reported that the provincial government had signed nearly $100 million in contracts with agencies providing travel nurses. Another article presented estimates by the Department of Health and Community Services, showing that the use of travel nurses to cover gaps in service would cost the province $18.4 million per year, compared with $4.1 million had they employed nurses already in the public system. Just this week, CBC News also reported that the NLHS spent over $2.5 million to house travel nurses between January 1 and August 31 of this year.
In the latest re-organization of healthcare delivery, the provincial government announced its intention to move toward and integrated air and road ambulance system. While the NDP has called for private and community ambulances to be integrated under a public system, I fear that the decision to contract out its management, as well as air service, will result in higher costs to the taxpayer and a deterioration in service. Moreover, I wonder why government lacks the in-house capacity to oversee such a transition or manage the integrated system once it is in operation.
Given the enormous strains that our healthcare system is currently facing, I am concerned that government is rushing to fill the gaps without a coherent plan. In doing so, government could be spending more than necessary and opening up the public system to creeping privatization that will ultimately erode its effectiveness and universality.
MHA for Labrador West