A review of the financial practices of a northern Manitoba regional health authority has raised concerns over whether the province is providing sufficient oversight into health-executive spending.
The Finance Department audited the financial practices of the Nor-Man Regional Health Authority last year as part of a greater review of the RHA's operations. The department's report, a copy of which was obtained by the Free Press, raised questions about expense claims by the region's former chief executive officer and other executives. It concluded the RHA needed to improve its travel-expense policies.
"We were unable to review details of the (chief executive officer's) 2009/10 expense claims due to the overall lack of documentation," provincial investigators said in their audit completed last June.
They said the region's former health boss, Drew Lockhart, often supported travel-expense claims with copies of his personal credit card statements on which charges for hotels and airfare were highlighted.
To support meal claims, he submitted credit card slips for the total dollar amount. The slips did not name whose meals were being expensed or any other details often required by employers.
Lockhart resigned last May shortly before a separate operational review of the RHA was published. It capped months of turmoil in the vast northern health authority, which includes Flin Flon and The Pas.
Among the public complaints that sparked the review were long waits to see doctors, substandard care, poor board oversight and allegations of nepotism within the RHA. Lockhart's wife was at one point the RHA's director of planning, research and development.
The operations report, conducted by a panel led by Reg Toews, former chief executive officer of South Eastman Health, made 44 recommendations, all of which the government promised to implement. Included among them was firing Lockhart, who by then had resigned.
"I think that this report is a glaring example of government failure to properly provide oversight over health-care spending," Conservative health critic Myrna Driedger said Wednesday. "When the government doesn't have its eye on the ball, I think the system is open to financial abuse."
In its budget last Tuesday, the government announced it would rationalize Manitoba's 11 regional health authorities, reducing their number to five. The province has also introduced enabling legislation to cap RHA executive salaries and require health-authority CEOs to post their expenses online.
The government was motivated, in part, to carry out some of the proposed reforms by the Nor-Man audit, Health Minister Theresa Oswald said Wednesday. "Nor-Man, and what we saw there, did contribute to our decision-making, absolutely," she said.
Doug Lauvstad, Nor-Man's board chairman, said Wednesday his RHA had accepted and implemented all the recommendations the government made for improving its accounting procedures. "We know that policies needed to be tightened up and certain actions taken to ensure that appropriate approvals were done and in the right order," he said.
Lockhart was succeeded as CEO by Helga Bryant, whom Oswald said has done an "exemplary job" since being appointed last year.
But Bryant's future is in doubt. Under the province's amalgamation plan, Nor-Man will merge with the Burntwood Regional Health Authority next month.
The province hopes to save $10 million over the next three years through its RHA rationalization plan.
larry.kusch@freepress.mb.ca
Among the issues raised in the report:
CEO expense claims were submitted and reimbursed without an itemized chronological expense listing.
The CEO claimed a total of $1,100 in unsupported vehicle expenses in claims between April and June 2010 without detailing vehicle mileage.
The CEO, his spouse, two other senior managers, five board members and "a relative of a board member" spent $915.21 ($91.52 each) on a dinner at an "upscale" restaurant.
The CEO's claimed meal expenses were often more than double the per-diem reimbursement rate used in the region by other senior managers. "Contributing to the higher expenses was the amount spent on tips, averaging over 25 per cent," the report said.
The CEO "inappropriately claimed and received approval for reimbursement" of a family YMCA membership to the Winnipeg Y costing $1,058.
Questionable accounting policies flagged:
Credit card slips and personal credit card statements were accepted to support claims for restaurant meals and even airfare.
Nor-Man's travel policy failed to require written pre-authorization for out-of-region travel.
The RHA's policy required receipts for hotel and rail travel expenses but was silent about requiring receipts for air travel, taxis and meal expenses incurred on RHA business.
-- source: Internal audit report on Nor-Man Regional Health Authority, June 2011
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