Only 35% of recommendations made by the Auditor General in 2020 have been completed, according to a follow-up report issued Tuesday. The time frame for implementation is two years.
“In the case of 2020, this is one of the worst follow-up rates in almost two decades,” said Auditor General Kim Adair. “Although government has completed 92% of 2018 recommendations, momentum has slowed to 61% and 35% in completing 2019 and 2020 recommendations, respectively.”
Adair flagged two recommendations from the audit of the QEII New Generation Project – Halifax Infirmary Expansion and Bayers Lake Community Outpatient Centre. The AG’s 2023 follow-up report says:
As of October 14, 2022, the Department of Public Works and Nova Scotia Health have not implemented a contract management process nor completed work to make sure the master plan reflects hospital system end user needs. That recommendation remains important now that the government has changed course in its delivery of the project.
The ‘changed course’ refers to the fact the government is now negotiating with a single P3 entity to design, finance, build, and maintain a larger version of a new Halifax Infirmary at the Bell Road and Summer Street site. An earlier competitor, Ellis Don Construction, dropped out last June.
The new Infirmary is expected to be one of the largest hospital construction projects in the country. Details about when it will get started and how much it will cost have not been revealed to the public because the province continues to negotiate with the remaining P3 bidder, the Plenary PCL Healthcare consortium.
Yesterday, Public Works senior communications advisor Gary Andrea issued this statement in response to the AG’s concern expressed in her 2023 report:
The department has hired 6 employees to oversee contract management, a draft contract manual for the Bayers Lake Community Outpatient Clinic is under review and one will be created before the Halifax Infirmary project is finished. In addition, Build NS will ensure there are clear, documented agreements between all parties to the fundamental terms and conditions of all contracts. Build NS will also continue to work with Nova Scotia Health to maintain the responsibility of engaging end users throughout the design process.
Build Nova Scotia now appears to be in charge of the Infirmary portion of the QE2 redevelopment plan to replace the crumbling Victoria General hospital.
During a meeting of the Public Accounts Committee last week, David Benoit, the CEO of Build Nova Scotia, told MLAs he expects a contract will be signed in the spring of 2024 with Plenary PCL Healthcare.
That tentative date is more than a year later than what Adair was told in October 2022 about “the commercial close” of the Infirmary contract when she followed up on a 2020 recommendation about a process to oversee contracts.
Here’s what the Dept of Public Works said last October:
The Department of Public Works has approved and funded the hiring of a group of six full-time equivalent employees (FTEs) to oversee contract management. The Halifax Infirmary Expansion contract will be executed at commercial close scheduled for Winter 2022/2023. (Editor’s note: this has been changed to spring 2024) An associated project implementation plan has been drafted to govern the contract management plan through construction.
Meanwhile, in addition to its internal auditors, the government has hired the Deloitte accounting firm to evaluate whether the cost estimates put forward by its P3 partner will deliver value for money.
The deputy minister of Public Works, Peter Hackett, has said site preparation and geotechnical work on the new hospital is expected to begin this summer — $130 million to pay for consultants, architects, site prep, and overhead associated with developing the new Infirmary was allocated in the 2023-32 budget prior to the start of actual construction anticipated for the summer of 2024.
Last December, Premier Tim Houston announced the province would proceed with the Infirmary project after pausing for several months to ensure the new hospital included more beds and another Emergency department to care for a growing population. There will be a new cancer care centre in the complex. Site preparation work this summer will include moving sewer lines and power poles.
Houston said that the QE2 Regeneration Project would be broken into smaller packages to respond to “challenges” that include finding enough labour, materials, and project managers to phase in the construction of new healthcare facilities over many years.
In the Auditor General’s followup to recommendations made in 2020, Adair noted that since then, design changes made to the revamped Halifax Infirmary appear to have reduced the amount of space formerly allocated to two separate (but unnamed) hospital departments.
Recommendation 1.3 from 2020 reads:
The Department of Transportation and Infrastructure Renewal and the Nova Scotia Health Authority should ensure the master plan as well as any subsequent planning documents, including final design documents, reflect the details determined through the functional programming process. Departments within the hospital should be given the opportunity to review any significant changes from the functional programming and master planning processes with the appropriate oversight committee used to review and approve changes.
Since the Houston government was elected in the fall of 2021, Transportation and Infrastructure Renewal has been renamed Public Works. Here is part of Public Works’ response to Recommendation 1.3 filed in October 2022:
Department of Public Works (DPW) will continue to work with the Nova Scotia Health (NSH) to maintain the responsibility of engaging with end users throughout the design process. Both DPW and NSH have collaboratively built a process which values user input and enables transparency from the master planning stage through to the final functional program and building design.
The project team will continue to leverage this process to help ensure that the right product is provided upon completion of the Public Private Partnerships contracts.
Again, the forecasted date for completing a signed deal between the provincial government and Plenary PCL is the same as the “spring of 2024” answer provided to Public Accounts last week. Actual construction on the new Infirmary can’t begin until those documents have been signed.
Meanwhile, the Bayers Lake Community Outpatient Centre is substantially complete and Public Works spokesperson Gary Andrea said it will open to the public this fall.
An online petition signed by 2000 people in Clayton Park urging the adaptation of Bayers Lake to include an Urgent Treatment Centre was rejected by Health Minister Michelle Thompson as being too ambitious at this time.
Other projects under the QE2 Regeneration umbrella include a major expansion that will take place at the Dartmouth General Hospital as well as an expansion at the Cobequid Community Health Centre in Sackville.
Jails, bridges, contaminated sites
Adair also found that while the government has complied with 92% of recommendation made 5 years ago in 2018, there remain 2 important outstanding recommendations:
• The Department of Justice should complete a review of correctional facilities to ensure all correctional staff complete required training and re-certifications
• The Department of Communities, Culture, Tourism and Heritage should establish performance indicators, measure performance, and regularly evaluate grant programs
Some of the recommendations made in 2019 that have yet to be followed up include completing bridge inspections and formalizing the criteria to prioritize repairs to bridges in the central and western parts of the province.
Recommendation 1.2 made in July 2020 deals with contaminated sites:
The Province of Nova Scotia should have a complete inventory of known and potentially contaminated sites the Province is responsible for, including a process to monitor relevant information for decision making. Our 2020 audit found the Province did not have an adequate management information system in place to monitor contaminated sites… By not completing this recommendation, management may not have the appropriate information to make resourcing decisions, and to assess potential risks arising from future activities on the site.
Most of the identified contaminated sites are the result of mining. Asked by Adair to explain what followup has occurred, the response from Public Works as of October 2022 was:
Government has developed an interdepartmental advisory group (IAG) that reports known and potentially contaminated sites to the Deputy Minister Committee. The Deputy Minister Committee provides an oversight structure for awareness and inventory reporting… The IAG is developing policies and guidelines to complement Treasury Policy Board and Contaminated Sites Regulations. The estimated completion time is 2024.
So far, more than 68 contaminated sites have been identified across the province. Clean-up costs will be in the hundreds of millions of dollars.
It doesn’t matter what the Auditor General says or what blah, blah, blah Public Works puts out, two things are inevitable:
1. The P3 model will cost much more than planned, will pump provincial dollars into some private probers’ hands for 30 years in return for under paid Nova Scotians and poor service. In the end NS will be left with a mostly useless building and a huge bill.
2. Public Works will build what it wants without listening to those who have to deliver or receive the service, just as they do with schools, highways, etc.
Boondoggle extraordinaire that will ensure Nova Scotians remain poor and under serviced for another 50 years. And with an expensive, largely privatized health care system with too few doctors and nurses.