Social Policy in Ontario

But there’s often not enough doctors to call for help, because the province is allowing specialists trained here at a cost of $780,000 apiece to flee for work elsewhere while rural areas remain short of physicians, rookie auditor general Bonnie Lysyk said Tuesday.

In her first annual report, Lysyk also took aim at Service Ontario for slow customer service, “generous” taxpayer-funded pensions, overtime and rampant nepotism at Ontario Power Generation, cottagers living on the cheap in provincial parks, and a lack of fire alarm systems in shelters for abused women, to name a few transgressions.

Despite a quadrupling in autism funding since the Liberals took power in 2003, “there are still more children with autism (1,748) waiting for government-funded services than there are children receiving them,” Lysyk wrote, noting the number of diagnoses is on the rise and echoing conclusions in the Star’s Autism Project last fall.

Late diagnosis of autism and long wait lists mean too many children don’t get “intensive behaviour intervention” or IBI therapy until age seven, while research shows children who start it by age four have more success.

But some families of children with the disorder are getting more help than others, Lysyk found, calling for a provincial strategy to deal with autism treatment.

The government has reimbursed about 60 families $21 million for IBI treatment outside regular programs since 2006 — at least twice the amount available for children in those programs.

“This practice of special treatment continues while others are on a wait list for services,” Lysyk said, noting the legislature passed a motion last spring to work on a developmental services strategy, including autism.

She blamed the ministry and school boards for not “effectively” monitoring the Liberal government’s health schools strategy.

“Even if food choices at cafeterias appear to be healthier than before, none of the school boards that were visited had reviewed the food and drinks sold . . . to ensure they met the School Food and Beverage Policy’s specific nutrition standards.”

In high schools, the plan to push healthy eating is looking sickly, Lysyk suggested in another section of a 444-page report.

Cafeteria sales dropped sharply after the Ministry of Education brought in its new policy on serving healthier foods — between 25 per cent and 45 per cent at three school boards surveyed at a time when almost one in three children are overweight and 12 per cent are obese.

“Many high-school students prefer to eat at fast-food restaurants rather than at their school cafeterias now that those cafeterias are offering healthier food choices,” Lysyk concluded.

The auditor found menu items sampled at some schools far exceeded standards for fat and sodium and that schools have “no formal monitoring strategy” to ensure pupils in Grades 1 to 8 get 20 minutes of daily physical activity during school hours.

Also on the health front, the auditor found an alarming brain and cash drain, which could cause a political headache for Premier Kathleen Wynne with an election expected next year.

Lysyk’s analysis showed one-third of surgeons — from general surgeons to orthopaedists, neurosurgeons, cardiac surgeons and pediatric surgeons — leave the province after years of specialty training that cost Ontario taxpayers an average of $780,000 per doctor.

It’s not only a blow to the provincial pocketbook because the departures are resulting in “often lengthy waiting lists for the very surgical services they’ve been trained to perform,” she said of the departing specialists.

For example, wait times are as long as 326 days for forefoot surgery following a specialist’s assessment and 263 days for cervical disc operations.

She also found only five per cent of Ontario doctors work in rural areas, which are home to 14 per cent of the population, and a program that subsidizes hospitals to get Ontario nursing graduates into full-time jobs results in less than half being offered permanent positions.

When it comes to getting patients to hospitals, the audit found ambulances in just over half of 42 municipalities surveyed responded to their emergency calls within 15 minutes last year.

A problem is that the Ministry of Health does not set targets for response times other than for the most “time-sensitive” patients who are choking or suffering cardiac arrest.

In another blow to Northern Ontario, she also upbraided the minority Liberal government for lowballing the cost of plans to privatize the money-losing Ontario Northland Transportation Commission.

It was billed as a plan to save $265.9 million over three years but could cost taxpayers as much as $820 million excluding an environmental cleanup costs.

“The government made the divestment announcement before doing a comprehensive business-case analysis,” said Lysyk, who earlier this fall issued a report that revealed the cost of the government’s cancellations of two power plants before the 2011 election could balloon to $1.1 billion, four times the initial estimate.

In terms of other government snafus, the Service Ontario system for renewing drivers’ licences, health cards and the like is well behind forecasts to do 60 per cent of its business online by now because it lacks an “effective strategy.”

Only 30 per cent of transactions are done by consumers online, meaning the government is missing out on “significant” savings that could be used to offset often long lineups at Service Ontario offices.

The target time of 15 minutes in line is often “far exceeded” and none of the seven Service Ontario operated under contract met service standards for answering calls.

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