An Anonymous Letter Sparked An Audit At B.C. First Nations Health Authority

Auditors found several issues regarding senior management at Canada's unique body for delivering First Nations health services.

A federal audit sparked by an anonymous letter has revealed problems of secrecy, conflict of interest, and workplace misconduct at the First Nations Health Authority in British Columbia.

Adrian Wyld / The Canadian Press

The Authority is the first of its kind in Canada. It is a First Nations-run body that took over the job of providing health services to First Nations from the federal government.

But an anonymous letter to the Auditor General of Canada's office extensively alleged issues of misconduct, problems with hiring senior positions, and manager conflicts of interest.

The office launched an audit in response. Auditors found that salaries of senior managers were not disclosed publicly. Amounts spent on professional service contracts, hospitality, and travel were also not disclosed.

Auditors also found that "considerable variations" in expenses were paid to senior managers without documentation.

"It is our opinion that such disclosure would constitute an important element of transparency and maintaining public confidence in the organization," wrote Auditor General Michael Ferguson in his audit released Tuesday.

Auditors also looked at whether the most qualified candidates were hired as managers. They reviewed 14 hires and found only "limited" evidence that the most qualified candidates were hired.

In only three of 14 positions was there a public posting or rationale for why the job was not publicly posted. Background checks were only performed in three of 14 hirings, and in only eight of 14 was there evidence the successful candidate had the required qualifications.

Auditor General of Canada's report

Auditors did say that some growing pains are inevitable when setting up an organization so quickly. The Authority grew from 50 employees to over 500 in just a few years. It serves over 200 First Nations, 40 of which are in remote communities.

For the most part, auditors did not investigate the claims in the letter but rather how the Authority reacted to the claims. Results were mixed.

In response to allegations of "several incidents" of workplace misconduct, senior officials asked managers if they knew of the incidents. None of them brought anything forward.

Auditors found that this was not sufficient, and that misconduct complaints need to be investigated and documented.

The Authority was found to have properly handled a complaint of conflict of interest.

Senior officials and the board of directors acknowledged there was one conflict of interest. The board sent letters to the individuals involved that outlined conditions for managing the conflict.

Auditor General of Canada's report

After almost 10 years of talks, the Authority was created in 2013 and took control of designing and delivering health programs to First Nations in the province. The idea was to improve services while enhancing First Nations involvement in decisions.

First Nations in British Columbia have much poorer health outcomes than the wider population. Youth suicide rates are four times higher than in the general population. The infant mortality rate is twice as high and life expectancy is significantly lower.

Ottawa committed to providing the Authority $4.7 billion over 10 years to deliver programs previously handled by Health Canada.

Auditors found that it is too soon to say whether the Authority is improving the health of First Nations people, but did call its creation an important milestone.