Oral Health Programs for First Nations and Inuit—Health Canada

Opening Statement to the Standing Committee on Health

Oral Health Programs for First Nations and Inuit—Health Canada

(Report 4—2017 Fall Reports of the Auditor General of Canada)

28 November 2017

Michael Ferguson, Chartered Professional AccountantCPA, Chartered AccountantCA
Fellow Chartered Professional AccountantFCPA, Fellow Chartered AccountantFCA (New Brunswick)
Auditor General of Canada

Mr. Chair, thank you for this opportunity to present the results of our audit on oral health programs for First Nations and Inuit. I would like to remind the Committee that we have done other reports in the health area, one of them on the access to health services for remote First Nations communities, which we presented to Parliament in the spring of 2015. Joining me at the table are Casey Thomas and Joe Martire, the principals who were responsible for the audits.

In our audit on oral health programs, we focused on whether Health Canada knew if the programs had a positive effect on the oral health of Inuit and First Nations people. These programs are important because they provide access to a range of medically necessary dental services.

We concluded that while Health Canada provided access to these important services, it could not demonstrate how much they helped to maintain and improve the overall oral health of Inuit and First Nations people.

Even though the Department knew that the oral health of these populations was significantly worse than other Canadians’, it did not focus on closing the gap. Also, the Department had not finalized a strategic approach to help improve the poor oral health outcomes.

We found that Health Canada did know that its $5 million Children’s Oral Health Initiative, which is focused on prevention, improved the oral health of some First Nations and Inuit children. However, the Department’s data shows that fewer children are now enrolled and fewer services are provided under the initiative than in previous years. Health Canada does not know why this is the case, making it difficult to address the situation.

We also found that there were administrative weaknesses in the Department’s management of its Non-Insured Health Benefits Program. The Department’s service standards for making decisions on pre-approvals and complex appeals were not clear. Also, Health Canada did not always inform its clients and service providers promptly about some of the changes it made to the services it paid for.

This matters because delayed or unclear communication about what services are available can affect clients’ access to the oral health services they need.

We also found that in the 2 regions we examined, Health Canada was slow to take action to address human resource challenges. Without action, these challenges could eventually affect service delivery.

We made 6 recommendations, including that Health Canada should finalize and implement a strategic approach to improve the oral health for Inuit and First Nations people, and that it should develop a concrete plan to determine how much of a difference its programs are making to the oral health of Inuit and First Nations people.

Health Canada agreed with our recommendations and committed to take corrective action.

Mr. Chair, this concludes my opening remarks. We would be pleased to answer any questions the Committee may have.