CONTENTS
Standing Committee on Public Accounts
THIRTIETH
LEGISLATURE
of
the
Legislative Assembly of Saskatchewan
STANDING
COMMITTEE ON
Hansard Verbatim Report
No.
5 — Thursday, January 23, 2025
[The
committee met at 08:31.]
Chair
Wotherspoon: — Okay, folks, we’ll convene the
Standing Committee on Public Accounts. My name is Trent Wotherspoon. I’m the
MLA [Member of the Legislative Assembly] for Regina Mount Royal and Chair of
the Public Accounts. I’ll briefly introduce the members of the committee:
Deputy Chair Wilson, MLA Chan, MLA Crassweller, Minister Harrison, MLA Gordon,
MLA Pratchler.
I’d like to introduce and welcome as
well the leadership of our Provincial Comptroller’s office: Provincial
Comptroller Chris Bayda and assistant provincial comptroller Jane Borland.
I’d like to welcome and introduce our
Provincial Auditor, Tara Clemett, and her team of officials that are here
today. She’ll be introducing her officials with each of the various chapters
that we engage in.
We have the following documents to
table: PAC 20‑30, Ministry of Government Relations: Responses to
questions raised at the January 21, 2025 meeting; PAC 21‑30, Western
Development Museum: Responses to questions raised at January 21, 2025 meeting.
Environment
Chair
Wotherspoon: — Okay, the first entity we’re going
to be focused on here today is the Ministry of Environment. I want to thank
Deputy Minister France and his leadership, his officials that are with him here
today for joining us, and for all those that have been involved in the work
that we’re going to discuss here today and all those involved in the work that
connects with your important ministry.
Deputy Minister France, I’d invite you
to briefly introduce the officials that have joined you here today. You can
refrain from getting into the comments on the chapters at this point. I’ll turn
it over to the auditor, and then I’ll come back your way for that.
Kevin France: — That’s great. Well
good morning, everyone. And thank you, Mr. Chair and committee members. Here
with me today, Kevin Murphy, assistant deputy minister of the resource
management division; Wes Kotyk, assistant deputy minister of the environmental
protection division. Behind me to my right is Rebecca Gibbons, assistant deputy
minister of the corporate services and policy division; and finally Aaron
Wirth, executive director of the climate resilience branch. Thank you, Mr.
Chair.
Chair
Wotherspoon: — Well thank you, and thank you to
your team of officials that have joined us here today. I’m going to turn it
over now to the Provincial Auditor. She’s going to focus on, I believe, chapter
11. And actually most of these chapters we’ll be focusing on independently, or
all of them independently, and the final chapter we have has some new
recommendations in it. But I’ll turn it over to the auditor.
Tara
Clemett: —
So thank you, Mr. Chair, Deputy Chair, committee members, and officials. With
me today is Mr. Jason Shaw, and he’s the deputy provincial auditor that is
responsible for the audits of the Ministry of Environment. Behind me, Ms.
Michelle Lindenbach, the liaison with this committee. So I’m sure you’ve seen
her face over the past few days. And then we also have Ms. Nicole Dressler, and
she’s a principal in our office and would have been involved in some of the
audits we’re reviewing today.
The first presentation, the order that
we have is such that we will look at, there’s five separate presentations. The
first four are all follow-up audits. So that will provide a progress update
basically on the progress the ministry has made with regards to recommendations
that this committee has already agreed to and that our office has made.
The last presentation is a new
performance audit. And it is around basically the ministry’s processes to
regulate industrial emitters, and it does contain three new audit
recommendations for this committee’s consideration.
I do want to thank the deputy minister
and his officials for the co-operation that was extended to us during the
course of our work. With that, I’ll turn it over to Jason.
Jason Shaw:
— Thank you. The Ministry of Environment regulates waste management and
enforces landfill and transfer station compliance. It regulated about 140
landfills in 2021. Chapter 11 of our 2022 report volume 1, starting on page
155, reports the results of the progress made on the recommendations we
initially made in our 2013 audit of the Ministry of Environment’s processes to
regulate landfills.
We made nine recommendations. This
committee agreed with the recommendations in April 2014. By January 2020 the
ministry implemented or fully addressed seven recommendations. By December 2021
the ministry implemented the two remaining recommendations.
The ministry developed and updated
guidance documents for landfills and transfer stations, as well as drafted
codes of practice it expected to include in legislation by December 2021.
Having standardized guides encourages operators to build, operate, and close
landfills by the same set of standards.
The ministry also completed, at least
annually, inspections of landfills it classified as high risk. As of December
31st, 2021 we found ministry staff completed annual inspections for 12 of the
16 high-risk landfills. For the remaining four uninspected high-risk landfills,
staff documented rationale for why an annual inspection was not completed.
Annual inspections confirm whether landfills operate in compliance with
permanent requirements and the law, which enhances environmental and public
safety.
This concludes my presentation. Thank
you. I will pause for the committee’s consideration.
Chair
Wotherspoon: — Okay. Thanks so much for the
follow-up on this important audit. Of course, I think the original chapter, the
original report came out in 2013, and the recommendations were concurred in by
this committee in 2014. Thanks as well for some of the actions we’ve heard and
that we’ll hear more about that have caused implementation.
I’ll kick it over to DM [deputy
minister] France for brief remarks, and then we’ll open it up for questions.
Kevin France:
— Thank you, Mr. Chair. And to begin I would like to thank Ms. Clemett for her
work and her team’s efforts. The Ministry of Environment values the
recommendations provided by the Provincial Auditor’s office and the vital role
in helping the ministry improve our operations. We appreciate your ongoing
support and collaboration.
The Provincial Auditor’s 2013 report on
regulating landfills issued nine recommendations to the ministry. In December
of 2021 the ministry implemented the last two remaining recommendations as
reported in the 2022 volume 1 of the Provincial Auditor’s report. With that, we
have fully implemented all the recommendations.
As recommended, the ministry adopted
guidance on landfills from the Environmental Code as an operating practice. We
developed and published new guidance documents for landfills, including the
Saskatchewan solid waste management strategy. We updated our waste disposal
grounds guidance documents and developed a new one for composting in June of
2020.
The second recommendation is for the
ministry to perform landfill inspections in accordance with its established
frequency requirements. Beginning in 2020 the ministry has established its
risk-based inspection program and, as discussed, landfills classified as high
are inspected annually.
Mr. Chair, I’m going to stop there for
any questions from the committee.
Chair
Wotherspoon: — All right. Thanks so much, and
thanks to all those involved in implementing those recommendations, of course.
I’ll open it up now to see if there is
questions from committee members. MLA Pratchler.
Joan Pratchler: — I see that the
number of operating landfills has decreased from 500 in 2015 to 139 in 2021.
How many are there currently?
Wes Kotyk:
— There are currently 111 operating waste management facilities.
Joan Pratchler: — Thank you. Could
one say that Saskatchewan’s waste generation is still trending downward?
Wes Kotyk:
— Yes, we can say that. The information that we’ve been collecting shows the
trend is going downwards and getting closer to our targets in our solid waste
management strategy.
Joan Pratchler: — Okay, thank you.
Chair
Wotherspoon: — MLA Gordon.
Hugh Gordon: — Could you speak to
inspections of the landfills themselves? How many environmental protection
officers are there, and how often are they conducting inspections?
Wes Kotyk:
— Thank you for that question. We’ve had a bit of a change in how we operate
that program. We used to have five dedicated EPOs [environmental protection
officer] that that was their sole purpose, was to regulate and inspect
landfills. We have now redesigned the branch so that we have 23 EPOs who have a
shared portfolio of landfills plus mining and industrial facilities. So they
have a shared responsibility. So all 23 EPOs will have some landfills in their
portfolio to inspect, and they’ll also have some mining and industrial
facilities.
Hugh Gordon: — Can you just speak to the types of
infractions that are found and what enforcement measures the ministry has taken
or typically taken?
Wes Kotyk:
— Typical infractions that we encounter are things like inadequate cover on the
waste, windblown litter and debris, maybe the gate’s not locked, and security
and things like that. So those are typical infractions. And what we find is
when those are identified at an inspection, we give them opportunity to address
it. And then we’ll follow up to ensure that they have done that within a
reasonable time frame.
Hugh Gordon: — How has your experience been with that? Has
that been sufficient?
Wes Kotyk:
— Yes. For most landfills, it has been. Some sometimes take a little bit more
encouragement, but you know, typically they are complying in a good time frame
for us.
Hugh Gordon: — Thank you. That’s
all my questions.
Chair
Wotherspoon: — Thank you. Any other questions on
this chapter? Not seeing any, I’d welcome a motion at this time to conclude
consideration of chapter 11. Moved by Minister Harrison. All agreed?
Some
Hon. Members: — Agreed.
Chair
Wotherspoon: — Okay, that’s carried. I’ll turn it
back over to the Provincial Auditor to focus in on a chapter focused on
something very important in this province: our wonderful fisheries and lakes
and rivers and fish stocks. So I’ll kick it over to the Provincial Auditor.
Jason
Shaw: — Thank you.
The Ministry of the Environment is responsible for managing freshwater fish
populations in a sustainable manner. It monitors fish populations to detect the
changes resulting from harvest, environmental conditions, and stocking. In
Saskatchewan an estimated 50,000 waterbodies contain fish, with the majority in
the northern half of the province.
Chapter 16 of
our 2022 report volume 2, starting on page 183, reports the results of the progress
made on the recommendations we initially made in 2019 of the Ministry of the
Environment’s processes to manage fish populations in a sustainable manner. We
made nine recommendations. By July 2022 the ministry implemented seven
recommendations, and we determined one recommendation was no longer relevant.
Therefore, at July 2022, one recommendation remained outstanding three years
after our original audit.
As outlined in
section 3.1 of the chapter, the ministry prepared a procedures manual for staff
to provide guidance on standardized, science-based field data collection and
reporting on fish populations and their health. We reviewed the draft
procedures manual and found it contained reasonable guidance for all
significant processes. Using consistent, appropriate approaches to sample fish
from one waterbody to the next and to analyze results helps ensure
comparability of results and consistent analysis.
The ministry
also developed a new ranking system to rank waterbodies and set how frequently
it would assess waterbodies, based on ranking as summarized in section 3.2. The
ministry’s new ranking system prioritizes lakes based on the type of fish in
the lake; the usage of the lake, such as if the lake is used for commercial
fishing; and environmental factors. The ranking determines how frequently the
ministry assesses the health of the fish population in the waterbody.
This
risk-based approach to prioritizing waterbodies aligns with good practice. The
ministry overall assessed the highest priority waterbodies consistent with set
intervals. For example, we found the ministry assessed eight of the nine
highest priority waterbodies consistent with its expected frequency. One was
delayed due to the COVID pandemic.
[08:45]
Indicated in
section 3.3 of the chapter, the ministry improved its waterbody assessment
reporting. We assessed five waterbody assessment reports from 2020 and 2021 and
found each report contained sufficient detail and followed the ministry’s new
reporting expectations, such as sampling decisions used. Completing waterbody
assessments consistent with risk-based frequencies helps ensure the ministry
collects sufficient information to detect changes in fish populations or fish
health within a waterbody, which enables it to take timely action to avoid
potentially irreversible declines in overall fish population and health of key
fish species.
The recommendation to create specific
management plans for key high-risk fish species and/or high-risk waterbodies
remains outstanding, as noted in section 3.4 on page 188. While the ministry
created fish management plans for three of the nine high-usage waterbodies as
part of its waterbody assessment process, we found these plans did not set
population sustainability targets.
We expected the fish management plans to
compare fish population data to set sustainability targets, and where necessary
would plan specific actions to manage fish populations. For example if the
ministry identified a concern, it may intervene by restricting the size of fish
caught that can be kept. Not having clear fish population sustainability
targets increases the risk that the ministry does not take appropriate action
to maintain the fish populations in high-usage waterbodies.
As outlined in section 3.5, the ministry
improved timeliness of completing waterbody assessment reports by setting
targets such as drafting reports by the end of the fiscal year the assessment
occurred. We reviewed five waterbody assessment reports from 2020 and 2021 and
found the ministry prepared four of five reports within targeted timelines. The
fifth report tested was still in draft seven months after the targeted
completion date. Completing timely waterbody assessments enables the ministry
to appropriately respond to significant changes in the health of fish
populations.
We found the ministry considered
receiving additional information from commercial fishers, but determined the
additional information would be burdensome on commercial fishers and not
practical. We also found other jurisdictions were not using this practice
either, and therefore we considered this recommendation implemented.
Finally section 3.7 notes the ministry
reviewed its 2010 fisheries management plan in 2022 and determined it completed
all action items. For four of the items completed since our original audit, we
found the ministry had sufficient evidence to support its completion status.
Thus we considered the ministry had implemented our recommendation about
determining resources necessary to complete its 2010 plan. Also as the 2010
plan actions were complete, the ministry no longer needed to develop a strategy
to assess effectiveness of the 2010 plan, so we considered this recommendation
no longer relevant.
Thank you and that concludes my
presentation.
Chair
Wotherspoon: — Thanks again for the presentation
and the focus of the chapter. I’m going to turn it over to Deputy Minister
France for brief remarks. Of course this has been considered before us as a
committee before. We’ve concurred in these recommendations. So a bit of a brief
update, and then we’ll open it up for questions.
Kevin France:
— Thanks again, Mr. Chair. The Provincial Auditor’s 2019 report on sustainable
fish population management identified nine recommendations. By July of 2022 the
ministry has fully implemented seven of the recommendations and one that is no
longer relevant based on the Provincial Auditor’s assessment.
The final remaining recommendation — to
create specific management plans for key high-risk fish species in high-usage
waterbodies — was identified as partially implemented in the Provincial
Auditor’s 2022 volume 2 report. Since then the ministry considers this last
recommendation fully implemented.
This past year the ministry created
lake-specific management plan templates. The templates incorporate sustainable
targets identified in the management plans. Through conversations with the
auditor’s office, they’ve indicated that these templates satisfy the intent of
their recommendation.
And as such I’ll stop there for any
questions, Mr. Chair.
Chair
Wotherspoon: — Okay, thanks so much. And I should
have maybe done it a little while ago, but I’ll table PAC 22‑30, the
Ministry of Environment: Status update, dated January 23rd, 2025. And that
relates to each of these chapters. Thanks to all those that were involved in
that work.
I’ll open it up now to committee members
for questions. MLA Pratchler.
Joan Pratchler: — Just one quick question on that last one.
That took awhile to implement. What were some of the challenges in getting that
moving forward to finally implement?
Kevin Murphy:
— Hello. Kevin Murphy, assistant deputy minister for resource management with
Environment. One of the things that challenges us in terms of setting targets
for our fish species is of course that they are in individual lakes. And none
of our lakes are exactly the same as our other lakes. So if you think about
even the circumstance with Lake Diefenbaker versus Last Mountain Lake. Last
Mountain Lake is a relatively natural lake with just a control structure on it;
Diefenbaker is a dammed reservoir and behaves very differently in terms of its
capacity to create productivity for fish species.
So we had been using a system of
managing by species in zones — relatively, sort of the angling zones of the
province, three zones — and found that that was inadequate in terms of being
able to actually set some of those targets. We’re now looking, because we’re
focused mainly on the recreational fishery with our regulatory structure, we’re
now looking at these lake-specific templates. And the time to develop those,
look at targeting work with other jurisdictions both in United States and
Canada to look at things that were mentioned by the auditor like slot limits
which give you a sense of how to manage the breeding population effectively of
those fisheries.
So it took our fishery team some time to
change that management regime and structure. A lot of the previous targets for
overall population productivity had been based on the commercial fishery, and
it’s not particularly valid in terms of managing the recreational fishery.
Joan Pratchler: — Thank you.
Chair
Wotherspoon: — MLA Gordon.
Hugh Gordon: — Can you just tell
the committee a little bit about how you’ve modernized your management reports?
What was added to better clarify sustainable targets and fisheries’ management
objectives?
Kevin Murphy:
— Thanks for the question. We have made changes in our lake management
templates to specify the exact type of index netting that we’re expecting the
staff to do, the kind of data that they need to collect on a regular basis from
each of those lakes to correspond to information that we’re also able to
collect from the recreational fishery, and in part from the commercial fishery,
to look at things like age structures, year class, general health and condition
of the population, some parameters that previously we weren’t necessarily
recording each time.
Our index netting system was based on
using gillnets that are effectively a broader span of sizes than are used in
the commercial fishery in the past. And we would record numbers of animals,
lengths, weights, etc., that were hitting those. Things like health condition,
whether they’re spawning, disease presence, those weren’t necessarily being
recorded every time. And some of the overall, sort of, span of lengths of the
animals that include forage base, things like that, also weren’t being
recorded.
Now it’s a more comprehensive data
template that allows us to build a better picture of what’s happening in the
lake and provide that guidance to our team, and do so with, sort of, set gear
types that aren’t different from region to region or biologist to biologist.
Hugh Gordon: — Okay, that’s all
for my questions. Thank you.
Chair
Wotherspoon: — Any further questions?
Could you give us just a little bit of a
glimpse into what one of these assessments would look like on one of these
priority lakes. You have the nine different waterbodies that are priority level
1 lakes, and it identifies that Last Mountain Lake was a lake that’s recently
been assessed, I believe. Could you just provide to us the information you’re
able to at a bit of a high level, what’s being measured and what the state of
the lake is with respect to Last Mountain.
Kevin Murphy: — Thanks. The team
will first gather information that we have both historically about the
waterbody, comprehensive information about water quality and sort of overall
regime management for that waterbody from our colleagues in Water Security as
they’re responsible for a lot of that material.
Any of the previous indices or stock
assessment reports, the methodologies we’d used there to prepare them to be
able to know whether or not they’ve got comparable data sets or they have to do
some work to be able to build that with all of the activities that I mentioned
in my previous response.
So they will, you know, typically we’ve
got a team, comprises biologists, technicians, usually some summer students
that accompany us out onto the waterbody. They will be doing things like
setting the index nets. So on a daily basis go out, set those nets. There’s a
prescribed period that they have to be in the waterbody catching. Usually
that’s, you know, several hours. Then they go out, pull the net again, process
the fish. They’re taking rough measurements for, say, total length of the
animal, weights, things like that as they’re processing that catch.
If there is anything else that they’re
doing in terms of additional work for the forage base, they usually go and do
that kind of fishing later using things like seine nets onshore, etc. And that,
you know, usually it’s a period of two to three weeks that they’re actually
working on the waterbody. Also weather dependent obviously. Last Mountain not
particularly conducive to work when it’s windy. So you know, we consider the
safety of our teams as they’re going out.
And each waterbody they’ll have to stage
whether they’ve got appropriate boat launches, how much gas, all of that kind
of stuff that they have to do. That information is then taken back and included
with any information that we have from doing things like what we call creel
census. So if there’s been a survey of catch rates, overall success by anglers
in the area, we typically try and conduct something like that.
There’s some roadside inspection work
that we’ll do in conjunction with compliance and field services staff, which
basically interviews individual anglers coming and going from an area. And on
occasion we’ll send out mail-in surveys, things like that as well to get a
sense of that relative sort of catch rate and which species are being focused
and concentrated on.
Unfortunately I have not seen the final
report for Last Mountain Lake yet so I can’t state what the status of the lake
is currently. I know that it’s been relatively stable in terms of its fishery
for the last number of years, but we’ll have to wait for the final reports to
be brought forward.
Chair
Wotherspoon: — No, thanks so much. I appreciate all
of that. And I was looking as well for a bit of some of the general trends or
the current state of that waterbody. These reports, these assessments, these
aren’t made public or they are made public?
Kevin Murphy:
— They will be made public, absolutely. Yes.
Chair
Wotherspoon: — Wonderful. Like the management of
these fisheries . . . You know, this is a wonderful asset, natural
asset, we have in this province, right? And it’s incredibly important to many
traditional users, many for sustenance but many, many sport fishers and for
tourism. And you know, I think we have unsurpassed fishing assets across this
province.
And I’m an avid fisher myself; I know
Last Mountain real well. So I wasn’t just looking for advice on where to go on
Saturday to sit on a pail, but I will be out there this weekend as will many
other people as well on lakes across this province. And you know, I want to
commend you all for the work you’re doing to manage the health of these very
important fisheries. So thank you for that.
I don’t have any further questions
myself at this point. I know the previous provincial comptroller, you know, he
was a big fisher too, Terry Paton. Good comptroller and awesome fisher and
hunter as well, so he’d care about this as well.
Any other questions from committee
members at this point? Not seeing any, I’d welcome a motion to conclude
consideration of chapter 16. Moved by MLA Crassweller. All agreed?
Some
Hon. Members: — Agreed.
Chair
Wotherspoon: — Okay. That’s carried.
Moving right along, we’ll shift our
attention to chapter 11.
Jason Shaw:
— Thank you. The Ministry of Environment is responsible for preventing the
introduction or spread of aquatic invasive species in Saskatchewan. Aquatic
invasive species are non-native animals such as zebra or quagga mussels or
plants that usually spread through the water and from one waterbody to another
by attaching to watercrafts, trailers, and related aquatic equipment. They pose
a serious threat to lakes and waterways in Canada and can cause serious damage.
[09:00]
Chapter 11 of our 2023 report volume 1,
starting on page 145, reports results on the progress made on the
recommendations we initially made in our 2016 audit about the Ministry of
Environment’s processes to prevent the entry and spread of aquatic invasive
species other than aquatic invasive plants in Saskatchewan.
We made five recommendations. By August
2020 the ministry implemented three recommendations. We are pleased to find by
March 2023 the ministry implemented the remaining two recommendations. The
ministry established adequate measures to evaluate the effectiveness of its
aquatic invasive species public education and awareness activities.
The ministry’s measures to evaluate the
success of its education and awareness activities included assessing
non-compliance rates, social media metrics, and data collected from its
watercraft inspection surveys. For example we found watercraft owners’ awareness
of aquatic invasive species increased from 93 per cent in 2020 to 96 per cent
in 2022. Having adequate processes for measuring results helps the ministry
evaluate the effectiveness of its education and awareness efforts related to
aquatic invasive species.
Also the ministry approved and tested a
rapid response plan to mitigate the spread of aquatic invasive species in the
province by March 2023. The plan includes reporting, response roles and
responsibilities, and processes for activating the response management plan. We
found the ministry’s plan was appropriately designed to mitigate the spread of
aquatic invasive species.
The ministry appropriately used the plan
and incident command system to assist in responding to an incident in 2021
where moss ball products sold in Saskatchewan contained zebra mussels. An
approved and tested rapid response plan aids in responding to the detection of
aquatic invasive species in a formal and timely manner.
This concludes my presentation. Thank
you. And I’ll pause for the committee’s consideration.
Chair
Wotherspoon: — Thank you, thank you very much. I’m
going to turn it over to Deputy Minister France for brief remarks, then we’ll
go from there.
Kevin France:
— Thank you, Mr. Chair. The Provincial Auditor’s 2016 report on preventing the
entry and spread of aquatic invasive species in Saskatchewan identified five
recommendations.
On the recommendation to measure the
effectiveness of public education and awareness campaigns, the ministry
conducted a provincial survey and we are using the results to guide future
education and awareness initiatives.
On the recommendation to complete and
test a formal rapid response plan to mitigate the spread of aquatic invasive
species, the ministry formally tested its approved rapid response plan in
January 2021 and documented its effectiveness. In January of 2024 we conducted
a tabletop exercise to further test and refine the province’s response plan. We
will continue to test and update the plan annually.
By March of 2023 the ministry
implemented the last two remaining recommendations as reported in the 2023
volume 1 follow-up report. And with that, the ministry has fully implemented
all the recommendations on aquatic invasive species prevention.
I’ll pause again for any questions.
Chair
Wotherspoon: — Okay, thanks so much. I’m going to
open it up to the committee for questions. MLA Gordon.
Hugh Gordon: — Can you tell the
committee a little bit about the types of aquatic invasive species? I guess the
extent, the number of them, and how they pose a serious threat to lakes and
waterways.
Kevin Murphy:
— Thanks for that question. I actually don’t know a strict number of aquatic
invasive species to provide to you because the number grows. The channels of
entry are typically, you know, transportation systems, recreational systems.
There is sort of a myriad of ways that aquatic invasive species could enter the
province.
Some of the main types of aquatic
invasive species include things like the mussels that the auditor’s report
referenced. We have things like various kinds of small fish species — tubenose
goby in the Great Lakes system — animals, you know, like that. Things like
spiny waterflea, which is a kind of a crustacean, a very small almost
shrimp-like organism that can come in in the same livewells and things like
that as the zebra mussels can. And then ranging to, you know, various kinds of
viri or small, you know, pathogens that can come in on even anglers’ boots. The
felt pad on the bottom of a flyfisher’s boots can contain whirling disease, as
an example.
So the points of entry can be border
crossings, airports, and any of our roadways. The real challenge for us is to
figure out what kinds of basic vectors there are and what sort of the life
histories of these aquatic invasive species are, and then go by likelihood to
pose risk. So our inspection right now is mainly focused on the sort of
external or livewell-carried types of organisms and doing an inspection there.
The other thing that we look at is what
typically kinds of activities can be taken or undertaken to ensure that we’ve
either killed or prevented the pathogen from entering. This is why the
concentration on things like the clean, drain, dry program. If you have had a
watercraft or a container that has been kept clean, drained, dried, it
typically will kill virtually any of the kinds of organisms that pose a threat
and a risk.
The threat and the risk ecologically,
typically either supplantation of our native species. They’re taking over
spawning grounds, they’re predators, or they’re outgrowing and outcompeting for
food base.
For things like the mussels, there’s
also an extreme risk to our industry and overall sort of recreational quality
of waters. The animals infest almost any surface. They cause beaches to be very
difficult for people to even walk into. They clog water intake, so everything
from your municipal water supplies through to intakes for power generation
facilities. In Ontario, they’re finding they have to send commercial divers
down to clean out the pipes on a fairly regular basis. It can cost hundreds of
thousands of dollars for a facility like that to maintain their water intake.
So there’s a broad span of impacts that
these kinds of organisms can have. And damage just to the fishery by outcompeting
some of our native fishes. You can see things like carp in a number of our
waterbodies. They’re actually an invasive; they’ve been here since the 1950s.
They’ve eventually, you know, essentially established, but they do outcompete
some of our native species like the bigmouth buffalo for forage and for
spawning ground. So there’s a wide variety of impacts. But again, focusing on
some of those pathways and some of the easy things that people can do to
effectively prevent the spread of the animals.
Hugh Gordon: — Just out of
curiosity on that, can you tell us if goldfish are becoming an issue in the
province as an invasive species, as it is I think becoming a problem in places
like British Columbia and perhaps elsewhere?
Kevin Murphy:
— There’s a number of carp species, which goldfish are one of them, that are
listed in our Act as potential. We have detected, I think there was one in a
stormwater detention facility found in the province, maybe two instances of
that. It’s typically the aquarium trade and then people releasing them.
We don’t think that goldfish in
particular are a particular risk to our fisheries or our major waterbodies, but
certainly in small contained systems like a stormwater detention facility or
someone’s trout pond they could be problematic. And they are listed, and we do
undertake inspection and work for that — education and awareness about not
releasing your pets into the wild. Absolutely. Yeah, that’s part of our
campaign.
Hugh Gordon: — Thank you.
Chair
Wotherspoon: — MLA Pratchler.
Joan Pratchler: — The cost is quite
significant, I see here in Alberta’s numbers and Ontario’s numbers and by some
of the things you’ve just mentioned. Do we have ballpark on the economic impact
to the commercial fishing, and how much does it cost to manage, and make sure
that these things are done well?
Kevin Murphy:
— So I’m happy to report that at present we remain free of these aquatic
invasive species. As an example, for the mussels species we have had no
confirmed reports of the animals actually entering our waters. And we do
actually undertake testing both with physical sampling — have they established
— and with genetic markers throughout over 20 of our key waterbodies in the
province every year. So far, no establishment of these organisms.
Just for our direct aquatic invasive
species program, right now we’re at $2.991 million being spent overall.
That’s staff, equipment like the decontamination trailers, and all of the work
that’s done around education and awareness just for that program.
I’m also happy to say that in terms of
the potential impact on our commercial fishery, that we don’t think is a major
risk for us at present, particularly for these. Most of our commercial fishery
is in our northern cold waters, and they’re not particularly suitable as homes
for these kinds of mussels, the most likely ones that are the current major
risk for the province. Mostly it’s a concern with our recreational fishery and
with things like our infrastructure, the water intakes, all of those things which
are mostly in the south of the province. And that’s why we’re spending these
dollars to prevent that incursion, and have been successful to date.
Joan Pratchler: — Prevention
matters?
Kevin Murphy:
— Yes, and that’s why we focus on that. Absolutely. Far better to prevent than
to be undertaking some of the work to try and poison the animals and remove
them from a waterbody, and may not even be successful based on the type of
waterbody and size, etc. So prevention is key. Absolutely. Countries like New
Zealand have also confirmed that.
Joan Pratchler: — Thank you.
Kevin Murphy:
— Thank you.
Chair
Wotherspoon: — MLA Gordon.
Hugh Gordon: — I wonder if you
could speak to the ministry’s rapid response plan as well, briefly.
Kevin Murphy:
— The rapid response plan was developed in partnership with federal officials,
with officials from rural municipalities and resort villages. And when we
undertake the tabletop exercises we engage all of those stakeholder groups.
There’s a national meeting going to be occurring within the next couple of
months where we will run another tabletop exercise with our partners.
The rapid response plan consists of
ensuring that we have appropriate identification, and then bringing in the
groups that are needed for whatever waterbody. That may be local authorities
from resort villages, things like that, to look at closing down boat launches,
undertaking inspections, then determining the spread of the risk, whether or
not it’s through the entire waterbody or localized to a particular marina or
boat launch.
And then based on that understanding,
looking at our response plan dynamics. Does it involve simply cleaning and
removing equipment that’s contaminated in one specific area? Or does it involve
some level of control using things like a phosphorus Lake Winnipeg was looking
at for their waterbody? To begin looking at a bay or is it an entire lake. If
it’s a small enough lake, that’s applicable. If it’s not then it’s quarantine
and containment and not allowing further movement out of that waterbody, and
continuing to basically hold that waterbody in quarantine if it’s not possible
to actually remove the animals from that area.
So the tabletop exercise posits what
. . . You know, is it one boat or is it things like the moss balls
coming in? Is it a number of different locations? How do we conduct the
response? And there’s a series of procedures that have been established, like I
say, both from a national and provincial perspective that allow us to walk
through that.
Hugh Gordon:
— Thank you.
Chair
Wotherspoon: — Thanks again for all the work on
this front. We’ve discussed it in the past. I mean it’s a remarkable thing when
you think about all the waterbodies in our neighbouring provinces or
jurisdictions, I think, all have presence of quagga or zebra mussels within
them — I believe Manitoba; south of the border, North Dakota, I believe
Montana; and then into Alberta.
So it’s a remarkable thing that we’ve
been able to maintain our waterbodies free, to the extent that we know, of
these invasive species. And it’s really disturbing when you talk about some of
the impacts, right, if all of a sudden you have some of these waterbodies or
watersheds contaminated. So we really commend you and challenge you to continue
to take this work on in a serious way because certainly, as you say, the
prevention is critical because some of the responses afterwards are rather
catastrophic for some of the fisheries.
[09:15]
Could you speak just at a high level, or
in a specific way, about what the biggest risks are right now to our watershed,
as far as the invasive species entering into our . . . You’ve talked
about release of things, like pets, that shouldn’t be happening we know very
well. You have a good campaign that I think you need to keep going with to let
people know that if you’re on Facebook Marketplace or anywhere else, and you
haul a boat over the border from the south of us or next door in Manitoba, that
there’s a fairly straightforward and simple process but one that’s invaluable
to make sure that you’re protecting the watershed.
What other measures or what other
factors are a risk for these watersheds?
Kevin France:
— Maybe I’ll start at a higher level, Mr. Chair, and I’ll turn it back to
Kevin. You know, I think . . . And we’ve touched on the importance of
prevention and awareness, and you know, I think to everyone’s point, we want to
make sure we don’t end up in a situation like Ontario or some of our
neighbours. Just to clarify actually, Alberta right now is zebra mussel-free,
but they’re prioritizing this work because they obviously see the threat.
At a high level, you know, we’re focused
on . . . We have awareness around 23 specific aquatic invasive
species publicly available on our website, just to educate, you know, the
population. Whether it’s fishing, recreational, or otherwise, you know, we’re
really focused on . . . We understand the importance but we’re also
focused on the economic impact. And so there’s a recreational perspective.
There’s a commercial fishery.
Knowing and understanding other
jurisdictions, and as Kevin’s pointed out, whether it’s Ontario and power
generation, once you have it, especially with mussels or quagga, it’s almost
impossible to eradicate, and therefore you’re managing. And the costs of that
become, you know, extreme.
And so you think about the focus and the
expansion of irrigation in this province. If we have the introduction of a
zebra mussel that starts to impact the intakes, that impedes the ability to
actually utilize that water to increase our production. And so you know, the
numbers are extreme in terms of the millions of dollars that would be impacted,
and that’s why we place such a prioritization on prevention and monitoring, as
well as awareness. Anything else you want to add?
Kevin Murphy:
— Certainly. Yeah, and apologize if I gave the impression that Alberta had the
zebra or quagga mussel. They’re mainly looking at things like whirling disease
right now in their salmonid populations.
In terms of the risk, I just wanted to
add what the deputy minister spoke to. There are two areas that we’re sort of
focusing on right now. First of all, we realize with vessel traffic that a lot
of recreational users, not anglers but folks who are using things like Jet
Skis, wakeboards, even kayakers in one circumstance earlier this year
. . . So growing that awareness campaign to the broad boating, and
sort of, watercraft or even just water toy-using groups to make them aware that
they’re also possibly a vector.
And also working with the federal
government with the airports. We have a really good connection to border
services on our American border; they are outstanding in collaborative work
with us. But bringing in the traffic that’s coming from overseas through the
airports. The referenced previous moss ball circumstance was coming from Europe
and was through the airports. So growing that awareness around that route of
ingress for us.
Those are the two that we’re focused on
right now that are sort of being considered to be outstanding risk areas.
Chair
Wotherspoon: — No, I appreciate that as well, as
well as sort of the broader perspective of watercraft. So you’ve got a group
that goes out to Manitoba to paddle, takes their canoes, comes back to
Saskatchewan the next weekend. What should they be doing with their
watercrafts, with their canoes?
Kevin Murphy:
— So that one is very much follow that “clean, drain, dry.” Quite frankly the
kayaker had clearly left their boat in the water for a period of time because
there were actually adults on the hull, which confuses me as to how you could
do that. But basically if you remove the watercraft, drain it and let it dry.
So for a canoeist, putting it on the roof of your vehicle and transporting it
back over that several hours and then leaving it for the next day before
putting it in another waterbody will have satisfied the conditions and the
expectations.
Chair
Wotherspoon: — No, thanks again. Thanks for the
very important work on this front. I hope we continue to talk about prevention
for many, many, many years and not about, you know, the responses to invasive
species within our own waterbodies. You mentioned the carp. So we have some
carp that are native to Saskatchewan, is that right? Like the . . .
No. So you talked about the bigmouth buffalo. That’s not a carp then?
Kevin Murphy:
— It’s a kind of sucker, sort of, actually.
Chair
Wotherspoon: — Sucker, right.
Kevin Murphy:
— Yeah. It’s part of the sucker family. There are no native carp species. They
are all Eurasian. So the one common carp that we do have actually came up
through the United States. It was introduced, I believe, in the 1950s from
Europe as sort of a food fish in the Louisiana area and areas like that. But we
have no native carp species. They’re all actually sucker species. They look
very similar.
Chair
Wotherspoon: — Okay. No, thanks for that. Now that
we’ve got you here . . . I promise to stop here soon. So then the
common carp. A few years back we had a really hot, dry summer. I don’t know if
that was a factor, but we ended up having large numbers of common carp which
were dying and floating on, say, Last Mountain as an example, but throughout
the Wascana watershed as well, down Wascana Creek. There were a few different
reports and articles that focused on them.
Can you provide us what the Ministry of
Environment’s take on that situation was?
Kevin Murphy:
— Typically when we see loss of fish in the summertime, it is usually low-oxygen
condition. And one of the ways that we confirm that is, is it skewed towards
larger bodied fish? A larger animal needs more oxygen and has less capacity to
draw that oxygen. And even a carp that can mouth-breathe some air into its swim
bladder and use that for oxygen, the larger they are, the more difficult that
is in warm water conditions.
There can also be occasionally some
algal blooms that put toxicity in the water. They’re typically associated with
that heat. And then curiously, sometimes, it’s a thunderstorm and a lightning
strike that’s killed the animals, and we look for broken backs in those
circumstances.
That particular one, the prevalence of
it, the heat conditions, it was low-oxygen conditions in the waterbodies. And
they’re a shallow-water species, so they suffer very quickly from low oxygen in
waterbodies.
Chair
Wotherspoon: — And then from a perspective of the
fishery, they’re an invasive species then? They’re not native to the fishery?
It was predominantly common carp that died that summer, right? And they were
large fish, as you’ve said, and you’ve identified why that would be the case.
And I guess that’s your large breeding stock as well. So from the ministry’s
perspective, I mean, other than it was unpleasant — the odour and large rotting
fish — did that cull a little bit of the population of the common carp then and
some of the breeding stock?
Kevin Murphy:
— Yes, absolutely. And as you say, other than for the unpleasantness and, you
know, potential for localized disease spread, not problematic from a population
perspective. If anything, beneficial for our other fish species.
Chair
Wotherspoon: — Thanks for that information. Any
other questions on this chapter? Not seeing any. I’d welcome a motion to
conclude chapter 11. Moved by MLA Chan. All agreed?
Some
Hon. Members: — Agreed.
Chair
Wotherspoon: — That’s great. Okay. I’ll pass it
back to the Provincial Auditor to focus on chapter 19.
Jason Shaw:
— Thank you. Saskatchewan produced the third-highest waste per capita in Canada
in 2020. Recycling helps repurpose materials that would otherwise end up in
landfills. Waste not diverted from a landfill potentially leads to greater risk
of water pollution, soil contamination, greenhouse gas emissions, and negative
human health impacts. The Ministry of Environment regulates eight waste
diversion recycling programs designed to divert various types of solid waste
from landfills.
Chapter 19 of our 2023 report volume 2,
starting on page 173, reports the results of the progress of implementing the
recommendations we initially made in our 2020 audit about the Ministry of
Environment’s processes to regulate waste diversion through recycling. We made
five recommendations. By August 2023 the ministry started implementing the five
recommendations, but further work was needed.
The ministry partially implemented the
two recommendations on page 175. The first, where we recommended the ministry
set written standard definitions for key information it requires operators for
waste division programs to report, and secondly for the ministry to require the
use of material-specific targets to assist in determining whether waste
diversion programs contribute to the achievement of the provincial waste
reduction goal.
The ministry defined the key terms and
calculations for waste collection, waste diversion, and waste recycling for one
of its eight recycling programs, the household packaging and paper program. The
ministry also revised and included these updated definitions in its regulations
for household packaging. We found the new rate definitions and calculations
documented in these regulations aligned with good practice. Defining these
terms and ensuring all waste program operators use them consistently is
important to ensure the ministry receives accurate and sufficient information
from program operators to make decisions.
The new household packaging and paper
regulations include improved reporting requirements requiring program operators
to set and report annually on both aggregate and material-specific targets.
However at August 2023, regulated recycling programs, including household
packaging and paper, had not set material-specific targets. The ministry
expects to receive the first reporting from packaging and paper program using
the new targets, definitions, and calculations in June 2025.
The ministry had a schedule for
reviewing and updating all eight recycling programs with the latest review
occurring in about 2026. Given the long planned time frame to review all
program operators, we encouraged the ministry to leverage policy or other methods
to expedite these changes. This improved reporting would better allow the
ministry to monitor progress and adjust strategies sooner, if necessary, to
ensure it achieves its 2030 target to reduce waste generated per person by 30
per cent from 2014.
The ministry partially implemented the
first recommendation on page 178 where we recommended the ministry obtain a
more robust understanding of the composition of waste entering Saskatchewan
landfills. By 2023 the ministry started to identify actions needed to further
develop understanding of waste composition. For example, in 2021 the ministry
started sending questionnaires to the municipalities operating landfills. This,
along with municipal composition studies, provides additional information about
waste composition.
The ministry partially implemented the
second recommendation on page 178 where we recommended the ministry analyze the
reasonability of program information reported by regulated waste diversion
recycling programs. The ministry had not yet assessed the reasonability of
information reported by its waste diversion recycling programs, as it had not
started collecting information based on revised definitions and
material-specific targets.
In 2022 the ministry began compiling
data from program operators and reports from the last five years to obtain a
better understanding of the trends within individual recycling programs. The
ministry was still assessing how it may cost-effectively verify waste-related
information provided by recycling program operators. Self-reported information
from recycling program operators may not always be reliable and accurate.
Independent verification of information provides the ministry with assurance
about the reliability of information it uses to monitor the programs.
The ministry partially implemented the
recommendation on page 179 where we recommended the ministry periodically
report to senior management on the rate of waste diversion through regulated
recycling programs. The ministry began in 2022 reporting quarterly to senior
management about its progress toward its solid waste management strategy.
However until it begins collecting
improved information, previously discussed, it is unable to report on waste
diversion rates through recycling programs. Without regular reporting of waste
diversion through recycling programs, such as using consistent definitions and
material-specific targets, senior management may not have adequate information
to assess the effectiveness of regulated recycling programs consistently.
Thank you, and this concludes my
presentation.
Chair
Wotherspoon: — Thank you very much for the
follow-up and the work on this front. I’ll turn it over to DM France for brief
remarks. Then we’ll open it up for questions.
Kevin France: — Thank you, Mr.
Chair. The Provincial Auditor’s 2020 report on regulating waste diversion
through recycling identified five recommendations. In the follow-up report in
2023 the auditor considers all five recommendations at least partially
implemented. The ministry agrees with the findings of the auditor’s report, and
we are working towards full implementation of all the recommendations.
In the 2023 follow-up audit, the fifth
recommendation was for the ministry to periodically report to senior management
on their rate of waste diversion through regulated recycling programs. In
response the ministry has provided annual reporting to senior management on the
performance of recycling programs in the province.
With the remainder of the
recommendations we will continue to prioritize this work over this fiscal to
work towards full implementation.
I will pause there for any questions.
Chair
Wotherspoon: — Okay, thanks so much. I’ll open it
up to members for questions. MLA Pratchler.
[09:30]
Joan Pratchler: — Thank you.
According to the status update the ministry is using information collected
through the program to identify new opportunities to improve waste diversion
and enhance current programs and initiatives. Can you speak to any of the data
that has already been collected so far and what opportunities have been
identified to improve waste diversion.
Wes Kotyk:
— All right. Thank you for that question. One of the things that we do is we do
an . . . We have a solid waste management strategy and we do annual
updates on that. And in the latest update it shows, based on the information
that we’ve collected from the various mechanisms through reporting, through
working with our regulated programs we identify what the trends are on the
waste diversion, where some of the initiatives are that we’re undertaking,
things like developing co-chapters for things like transfer stations, and one
under development for composting.
So I think, you know, we look at where
can we get, you know, the biggest bang for our buck. And I think things like
the composting co-chapter, I think what we’ll see is once that’s further
implemented and adopted by municipalities, I think that we will see a
significant reduction in waste going to landfills, because currently that’s one
of the biggest waste items that are going there.
And some of the larger centres, Regina
and Saskatoon, already have established programs — the green bin program with
that material — and it’s easy to calculate and get those reports on what those
diversion rates are for those. You know, I think what we need to see is once we
have it more widespread throughout the province, we’ll see better uptake for
that as well.
Joan Pratchler: — Thank you.
Chair
Wotherspoon: — MLA Gordon.
Hugh Gordon: — I’ve seen the auditor’s report that the
environmental assessment and stewardship branch employs 16 staff and noted that at
the time of the report there were four vacancies. Can you provide an update on
the staffing of those positions and whether they’ve been filled?
Wes Kotyk:
— Yes. So the environmental assessment and stewardship branch basically has two
program responsibilities. One is on the waste stewardship side that manages and
oversees all of the recycling programs and initiatives that we have. The other
side is managing our environmental assessment review process for large
developments that come into the province. We still have two vacancies within
the branch. One is on the waste stewardship side and one is on the
environmental assessment side.
Joan Pratchler: — What’s the
ministry’s relationship with municipalities? I see that in the update the
ministry started sending, you know, questionnaires out to the municipalities in
2021 and 2023. What has the response been so far, and are municipalities
responding to these surveys? How’s the engagement going there?
Wes Kotyk:
— Generally we have a good relationship with municipalities. We also, you know,
engage regularly with SUMA [Saskatchewan Urban Municipalities Association] and
SARM [Saskatchewan Association of Rural Municipalities], the associations that
represent the municipalities, and they will partner with us on a lot of these
initiatives to help encourage communities to participate in these surveys and
in their responses.
I apologize I don’t have an actual
number of what the return rates are on some of those surveys. I think we likely
report on that in the annual update report, but I just don’t have those numbers
at my fingertips right now. But generally the uptake is good and sometimes
we’ll send reminders and look at different ways to get that information. We can
always get some of that information as well from our regulated municipalities,
the ones that still have operating landfills. That number is, because of the number
of landfills is drastically reduced, it is a bit more manageable and a compact
number of facilities that we need to engage with for that information.
Joan Pratchler: — But generally
overall would you . . . You know, as I go around the province and see
communities, there are some that are just gung-ho about recycling. That’s been
established now in the general psyche of the province that recycling is where
we’re going in reducing waste. Would you be able to comment on that?
Wes Kotyk:
— Yeah, that’s a great observation, and yes, municipalities quite often are
ahead of the province on taking initiative on their own. They see first-hand
what they can do and what the implications are, and quite often what drives
their programs is they see, you know, they want to extend the life of their
existing landfill and their facilities so they’re quite keen on wanting to
remove waste from their landfills. And yeah, there are a number of
municipalities throughout the province that you see are out front of all the
others and are actually driving some of these initiatives.
Joan Pratchler: — Thank you.
Chair
Wotherspoon: — Any further questions, committee
members? Okay, not seeing any, I’d welcome a motion that we conclude
consideration of chapter 19 at this point. MLA Chan. All agreed?
Some
Hon. Members: — Agreed.
Chair
Wotherspoon: — That’s carried. We’ll move along now
to the last chapter actually for the Ministry of Environment here this morning
on our agenda, chapter 3. There’s some new recommendations in this one here, so
I’ll turn it over to the Provincial Auditor.
Jason Shaw:
— Thank you. The Ministry of Environment is responsible for managing and
protecting Saskatchewan’s environment for the well-being of the province and
its people. One of the initiatives the ministry manages is an output-based
performance standards program that began in 2019 to regulate industrial
emitters to reduce greenhouse gas emissions intensity. Emitters who join the
program are exempt from the federal carbon pricing system.
The program regulated 154 industrial
emitters in 2023. Industrial emitters regulated by this program, such as from
the oil and gas or potash or steel industries, accounted for about 16 per cent
of Saskatchewan’s total greenhouse gas emissions in 2021. Emissions intensity
means the emissions per unit of production. Nearly half of regulated emitters
exceeded their permitted emissions intensity limit for 2019 and 2020.
Under the program, industrial emitters
exceeding annual facility-specific emissions intensity limits must pay a levy
to the ministry intended to fund technologies to reduce emissions intensities.
Levies from industry are accounted for in the Saskatchewan Technology Fund.
Emitters that reduce emissions intensity below limits earn credits that can be
sold or saved for future use.
Chapter 3 of our 2024 report volume 1
starting on page 45 reports the result of our audit of whether the Ministry of
Environment had effective processes for the period ended December 31st, 2023 to
regulate industrial emitters to reduce greenhouse gas emissions intensity. The
audit did not examine the ministry’s processes to fund technologies that
mitigate, sequester, or capture greenhouse gas emissions at industrial
facilities as the ministry did not approve any funding applications by December
31st, 2023.
We concluded the ministry has effective
processes except in the areas of our recommendations to regulate industrial
emitters to reduce greenhouse gas emissions intensity.
We made three new recommendations for
the committee’s consideration. On page 52 we recommended the Ministry of
Environment use sufficient measures to publicly report on the effectiveness of
its output-based performance standards program. The ministry had two measures
specific to the OBPS [output-based performance standards] program at December
2023. These were to increase the number of facilities registered in the OBPS
program and to increase the amount of emissions covered under the OBPS program.
Both measures focus on program participation as reflected by the quantity and
the size of industrial emitter facilities registered in the program. These
measures are output based rather than achievement oriented, such as reducing
emissions intensity, and do not support an effective assessment of the program.
In addition these measures lacked adequate targets.
Without sufficient measures the ministry
cannot effectively assess and publicly report on the performance of its OBPS
program toward economic and environmental goals of the government and report on
what is important to the public.
On page 53 we recommend the Ministry of
Environment implement a robust data management system to efficiently obtain,
track, and analyze sufficient greenhouse gas emissions data reported by
industrial emitters.
We found the ministry manually input
limited data in a spreadsheet, such as the total emissions of emitters
registered in the OBPS program. For example, it did not track emissions and
units produced by product type. This process did not efficiently support
detailed trend analysis, and increased the risk of manual input errors or
unauthorized changes to data. While we did not identify any input errors or
concerns during our testing, using a more sophisticated data management system
can help the ministry identify data inaccuracies and improve analysis to
identify potential issues.
In addition, we found the ministry
combined actual and baseline data in its spreadsheet used to track actual
emissions for the year. The ministry used baseline data as a proxy where actual
results were not yet available. Such estimation methods do not provide accurate
provincial emissions data for emitters. Clear explanations would be needed to
provide for these data inconsistencies to support effective decision making.
At December 2023, the ministry was
developing an IT [information technology] system to allow efficient tracking of
all information collected from emitters, which will support more robust
analysis and reporting. Without an adequate data management system, the
ministry cannot efficiently obtain, track, and analyze greenhouse gas emissions
data reported by industrial emitters to determine whether the OBPS program is
achieving the desired results.
On page 60 we recommended the Ministry
of Environment document staff guidance for evaluating concerns identified in
third-party verifier reports about industrial emitter returns. As part of its
review of emissions returns, ministry staff confirmed that emitters use
appropriate accredited companies called third-party verifiers to verify and
issue an opinion on the accuracy of emissions returns. This is important as
emissions returns are complex and may require various methods to quantify and
estimate emissions.
Of the 480 verification opinions on
emitter returns up to December 31st, 2023, 56 were qualified and four were
adverse. The ministry followed up to confirm. The concerns reported did not
result in a significant deficiency that would impact levies due or performance
credits earned or required revised returns with reissued positive opinions for
all adverse opinions. Of the 16 facilities we tested, eight had qualified
opinions. The ministry appropriately followed up with these facilities to
obtain further details and assess the significance of reported concerns.
We found the ministry did not have
documented processes that outlined the steps staff would take when third-party
verifiers report concerns. While ministry staff addressed the concerns reported
to December 31st, 2023, more complex concerns may arise in future years where
staff may need further guidance. For example, staff may need further guidance
on questions to ask emitters for common types of concerns, when to escalate a
concern to the supervisor, or methods to resolve disagreements.
Not having written guidance for staff to
follow when third-party verifiers report concerns with information submitted by
emitters may lead to inappropriate or inconsistent follow-up or compliance
action for emitter returns, increasing the risk the ministry may not collect
all levies owed or treat all emitters fairly.
Thank you, and this concludes my
presentation.
Chair
Wotherspoon: — Okay, thank you. Thanks very much
for that presentation. For the thousands of folks that are watching at home and
committee members, just a reminder, this is a new report from the 2024 report.
So this isn’t a follow-up report like the others that we have. So we have new
recommendations as well.
I’ll kick it over to the deputy minister
for remarks, and then we’ll open it up for questions.
Kevin France: — Thank you, Mr. Chair. The ministry
recently received the Provincial Auditor’s 2024 report on regulating industrial
emitters. The audit report found that the ministry has effective processes and
procedures. This includes setting appropriate requirements for regulated
emitters, monitoring their compliance, and reporting emissions and testing
results under the output-based performance standards program, known as the OBPS
program. These recommendations are new; however I’m pleased to report that
we’ve made meaningful progress on all three identified in the auditor’s report.
The first recommendation is for the
ministry to use sufficient measures to publicly report on the effectiveness of
the province’s OBPS program. On that point, the ministry updated the OBPS
performance measures now that we have sufficient program data for a trend
analysis. We will continue to identify new performance metrics as the OBPS
program matures and additional data becomes available. We consider this
recommendation fully implemented.
The second recommendation is to
implement a robust data management system. The ministry has been developing and
refining an OBPS database since 2019. The OBPS data management system is
already partially operational and the ministry expects it to be fully
operational by the end of this fiscal year, with all data uploaded to the
system by the end of this month.
[9:45]
The third recommendation is to enhance
staff guidance for industrial emitter returns. The ministry has added a check
box to its existing comprehensive OBPS review checklist to confirm that
reviewers should follow up on concerns identified by third-party verifiers. We
consider this last recommendation fully implemented.
With that I’ll pause now for any
questions from the committee. Thank you, Mr. Chair.
Chair
Wotherspoon: — Okay, thanks so much for some of the
actions on this front and the report. I’ll open it up to committee members. MLA
Gordon.
Hugh Gordon: — The auditor notes
in her report that nearly half of the regulated emitters exceeded their
permitted limit for 2019 and 2020. Can you provide the committee with an
update? Are half the emitters still exceeding that permitted limit? And if you
could provide specifics for ’21, ’22, ’23, or ’24 that would be great.
Aaron Wirth:
— Hi, it’s Aaron Wirth, the executive director of the climate resilience branch
in the Saskatchewan Ministry of Environment. Thanks for the question. So it’s
remained about the same, around 50 per cent. And that’s really just indicative
of the various compliance options we have in the OBPS program.
So really there’s three. It’s a flexible
program and we’re sort of agnostic on which options regulated emitters use to
fulfill their compliance obligations. So they can either generate and retire a
performance credit, carbon credit; they can buy or retire one; they can pay
into the Saskatchewan Technology Fund to fulfill their compliance at the rate
for that year, the carbon tax rate for that year; or they can reduce some of
their emissions intensity; or they can do a combination of those three things and
reduce their emissions intensity, buy and use some performance credits, and/or
pay into the tech fund.
So that number isn’t really indicative
of anything other than to say that there’s, I’d say, balance in the program in
terms of the supply and demand of . . . likely the supply and demand
of credits.
It suggests to me that, you know, some
regulated emitters are choosing to reduce their emissions intensity and likely
earning credits as a result of it, and others are choosing other compliance
options and then are therefore buying credits from those that are reducing
their emissions intensity, incentivizing more people to reduce their emissions
to earn credits. So I suggest that anything, you know, as long as it’s not sort
of a 90/10 split, probably within the range of 50/50 or anything that isn’t
90/10 is probably pretty appropriate.
Chair
Wotherspoon: — MLA Pratchler.
Joan Pratchler: — Can you tell the
committee a bit more about the OBPS data management system, the IT system in
particular? In the development, was it in-house development or was it
outsourced? How did that come to be?
Aaron Wirth:
— Yeah, thanks for the question. So it’s something that’s been in development
since 2019 and we’ve been continuing to kind of build on it. And that’s been
the result of changes to the provincial program, changes to the federal carbon
pricing benchmark, and expansion of the program, things of that nature. So
we’re continuing to sort of build on it and, you know, now we’re able to sort
of operationalize it. It is something that we partnered with ISM on, but we
used mostly in-house emissions engineers and coders to work with us and ISM to
do that. So it’s been very successful.
As was mentioned, we’re looking forward
to uploading all the data. I think there’s 23 million data points. And so
that’s going to help us with some of the trend analysis the auditor had
identified, so we’re really excited about that. So that will go live and be
fully operational by the end of the fiscal year and provide some really
significant opportunities in terms of trend analysis and informing policy.
Joan Pratchler: — What type of data
will this management system collect? And do you have a sense already of some of
the trends that the ministry will be able to analyze through that system?
Aaron Wirth:
— Yeah, so the main data is really emissions data from the various regulated
facilities and their production data. And that’s how we calculate their
emissions intensity, which is their emissions per unit of product. So that’s
the main stuff, and it’s broken down into a number of different categories.
But really that’s going to allow us to
also serialize carbon credits as well, for those that are earning carbon
credits within our program, and make sure that the database is housing those
serialized credits and then retiring them as appropriate. It’s going to allow
us to do trend analysis and be able to report on regulated emissions,
compliance owed, credits awarded, compliance broken out by fulfillment method,
so use of credits as I mentioned, credit status. It’s going to allow us to
better, and through the use of a dashboard that we’re building, to talk about
emissions intensity of the program, which is a very positive story.
You mentioned where some of the trends
we’re seeing, we’re seeing a pretty significant emissions intensity reduction.
We’ve achieved a 3.5 per cent emissions intensity reduction. The federal
benchmark has only required us to achieve a 2.33 per cent reduction. So we’re
3.5. We’ve been required to reduce by 2.33, so we’re overachieving, which I
think is really positive. And we are seeing . . . It’s going to allow
us to better calculate the carbon tax savings to industry.
Really the OBPS program, it’s really
designed as a tax-sheltering program for emissions-intensive and trade-exposed
sectors in Saskatchewan. That’s how the federal government has set it up and
how their program operates. It’s how every other program operates. And so we’re
able to pull numbers like the most recent one suggesting that we saved industry
$1.7 billion from 2019 to 2022, which again is the purpose of the program,
to allow those industries who are trade exposed to reduce their emissions and
not be fully exposed by the federal carbon tax. So those are some of the things
that we’re going to be able to pull out of it.
Joan Pratchler: — And so when we
talk about emissions, were we talking about air pollution, other hard
emissions? What kinds of . . .
Aaron Wirth:
— So our program deals specifically with atmospheric emissions, yeah,
greenhouse gas emissions, whereas other colleagues would be dealing with air
emissions.
Joan Pratchler: — Is the OBPS
reducing emissions intensity?
Aaron Wirth:
— Yes, by 3.5 per cent. Above the 2.33 per cent we’re required to.
Joan Pratchler: — And you said it
was saving industrial emitters money, 1.7 million? Did I write that down
correctly?
Aaron Wirth:
— It’s 1.7 billion between 2019 to 2022. We’re forecasting . . .
Based on reductions of between 1 and 3 per cent per year of emissions
intensity, we’re predicting if the program continues to exist and the federal
benchmark continues to exist, a $14 billion savings to industry.
Joan Pratchler: — And over what
period of time? Sorry, I missed that.
Aaron Wirth:
— Yeah, good question. 14 billion cumulative to 2030.
Joan Pratchler: — From 2019?
Aaron Wirth:
— From 2019, correct. Yes.
Chair
Wotherspoon: — MLA Gordon.
Hugh Gordon: — The auditor
recommended that this information be publicly reported on. So will all this
data that you were just referring to, will that be available in the annual
report?
Aaron Wirth:
— It will all be made public starting this year, in actually just a few weeks.
I don’t think we’ve decided exactly how we’re going to do that. We’ll be
reporting it to the federal government. They are likely to make it public.
We’ll likely probably put it on our website. It’s been a pretty good repository
for the public to access and regulated emitters to access. So yes, it will all
be made public.
Hugh Gordon: — Thank you.
Chair
Wotherspoon: — MLA Pratchler.
Joan Pratchler: — Can you update the
committee on the number of industrial emitters currently? I noted that it grew
from 80 in 2019 to 154 in 2023, and over the last year. What would you say the
number is totally?
Aaron Wirth:
— I don’t have the exact number in front of me, but it is starting to plateau.
It’s probably another dozen I would say. And that’s because, you know, the big
increases were in the formative years of the program as we were sort of
educating and raising awareness about the eligibility for emissions-intensive
and trade-exposed companies. And since we’ve added 17 new electricity
facilities, largely from SaskPower, we’ve seen a substantial increase that way.
So we’re probably in the kind of 170 to
kind of 180 range, and probably that will taper off a little bit. But you know,
as new companies enter the province or maybe companies that we haven’t really
been introduced to learn about the program, we could see a few more. But we’ve
probably hit the main cohort of large, regulated emitters.
Joan Pratchler: — Thank you. Could
you tell us how many projects have been funded through the technology fund to
date? And could you table a full list of those projects and how much each
project received to date?
Aaron Wirth:
— So 13 projects were funded for the first-ever intake. That was last year, and
that was $25 million. Actually the projects are available on the news
release as a backgrounder attachment, and it details the exact amounts to the
companies and the nature of those projects.
Joan Pratchler: — Thank you.
Chair
Wotherspoon: — Any further questions, committee
members? So we’ve got implementation on two of the recommendations here
already, right. And then the other one, you’ve laid out some of the actions
that you’re taking. And in fact implementation on that one you’re expecting by
April 2025. So thanks for sharing all of that.
Any further questions with respect to
this new chapter and new recommendations? Not seeing any, I would welcome a
motion . . . I believe it’s recommendations 1 and 3 that
implementation has occurred, so I’d welcome a motion that we concur and note
compliance with recommendations 1 and 3. Do we have a mover? Moved by Minister
Harrison. All agreed?
Some
Hon. Members: — Agreed.
Chair
Wotherspoon: — That’s carried. And with respect to
recommendation 2, I’d welcome a motion that we concur and note progress. MLA
Crassweller moves. All agreed?
Some
Hon. Members: — Agreed.
Chair
Wotherspoon: — All right. That’s agreed. Okay. Well
that gets us to the end of our morning with the Ministry of Environment. I want
to thank DM France and all the leadership, all the officials that are here
today. I want to thank as well all those that are working through the ministry
and that are connected to the work here today as well. So thanks for your time.
MLA Gordon.
Hugh Gordon: — Yeah. I’d also
like to note the hard work you guys apparently have been putting in. The level
of professionalism you’ve displayed here today is quite noteworthy. I want to
thank you for being so well prepared in answering our questions and for being
so knowledgeable. This is an important area of our economy as well as our
environment, and the two go together. And hopefully your progress in these
areas will continue to provide a positive pathway for the province. Thank you
very much.
Chair
Wotherspoon: — Hey, good words there, MLA Gordon. I
know we’d all support those words, so thank you very much. Yeah, I would offer
you a chance for a final remark if you have one, DM France.
And you know, if you have some advice
out of the extensive knowledge you have on the fishery about where I should
locate on Last Mountain Lake on Saturday afternoon and, kind of, how deep and
what lures you’d suggest, do that privately because I don’t want anyone else to
know.
Kevin France:
— Probably don’t want those on the record.
Chair
Wotherspoon: — That’s right, yeah.
Kevin France:
— No, thank you. And thank you, Mr. Chair, and thank you to the committee.
Appreciate the comments. You know, I truly am honoured and blessed to have a
team with me, to your point, very knowledgeable and dedicated to this file and
the importance that the Ministry of Environment plays both for our economy as
well as our well-being in this province.
So again, thank you to the committee for
your time today and allowing for us to provide you with an update on the
ministry’s progress on the auditor and recommendations. And again I extend my
appreciation to the auditor’s office as well. We are truly proud of the
progress we’ve made to date and commit to addressing each of the remaining
recommendations. Thank you.
Chair
Wotherspoon: — Okay, thank you very much. We will
have a very brief recess, maybe just a few minutes, and we’ll get the
Saskatchewan Cancer Agency in here probably a little bit earlier than planned.
So thank you once again. Brief recess here as a committee.
[The
committee recessed for a period of time.]
Saskatchewan Cancer Agency
Chair
Wotherspoon: — Okay, we will reconvene our meeting
here this morning, the Standing Committee on Public Accounts. We’re going to
turn our attention to the Saskatchewan Cancer Agency. I want to welcome once
again here today Deputy Minister Smith, the DM of Health, along with all of the
officials that have joined us here today and all the leadership from the
Saskatchewan Cancer Agency.
I’ll ask DM Smith to briefly introduce
all the officials that have joined us here today. And then I’ll turn it over to
the auditor to put some focus onto the chapters, and then come back to the DM
and officials for some remarks. So go ahead, DM Smith.
Tracey Smith:
— Thank you, Mr. Chair. It’s good to be back today. And good morning to the
entire committee. First I’ll just start again by extending a thank you to the
Provincial Auditor, Tara, and her team for the audits that we’re about to
discuss throughout the course of this morning.
So maybe I’ll just turn and go right
into introductions. We’re joined today by staff from the Ministry of Health and
the Saskatchewan Cancer Agency to address any follow-up questions related to
the reports that we’re about to discuss. From the ministry today I’ve got
Norman O’Neill, assistant deputy minister; Ingrid Kirby, assistant deputy
minister; and Ryan Dobson, our director of operations and internal audit.
And with us today as well are: from the
Saskatchewan Cancer Agency we’ve got Deb Bulych, who is the president and CEO
[chief executive officer]; Braden Giblett, the chief financial officer; Ron
Dufresne, the vice-president of corporate services; Karen Efthimiou,
vice-president — apologies, Karen, if I messed that up — Darryl Boehm, the
director of oncology pharmacy services and care services; Jillian Fensom,
provincial manager of drug strategy and value in care services; and David Tran,
the director of population health.
The Ministry of Health, along with our
health system partners, have made significant progress on the recommendations
from the Provincial Auditor. Work is ongoing to fully implement any remaining
recommendations from previous reports. We recognize that there is still work to
be done, and we are committed to continuing this progress. The ongoing efforts
will build on today’s review and discussion.
Our ministry and health partners share
the same objective as the Provincial Auditor and her team: to improve health
care services for all Saskatchewan residents. The health care system remains
fully committed to strengthening services and implementing the efficiencies
identified by the Provincial Auditor and her team. Thank you.
Chair
Wotherspoon: — Well thank you very much, DM Smith,
and thanks again to all the leadership with the Sask Cancer Agency and the
Ministry of Health that have joined us here today, and to all those others that
have been involved in the work we’re going to be discussing here today.
Just a reminder to officials, if you’re
not seated at the front table with the DM and you’re coming up to speak, just
introduce yourself. Just provide your name before you speak so we can have it
properly recorded in Hansard.
And at this time I’d table PAC 23‑30,
the Saskatchewan Cancer Agency: Status update, dated January 23rd, 2025. I’d
like to thank all those that have been involved in the work that’s reflected in
that document as well. At this point I’ll turn it over to the Provincial
Auditor. I think they’re going to focus on the first two chapters that are on
the agenda there together and the new recommendations that come from them,
recommendations 10 and 25.
Tara
Clemett: —
So thank you, Mr. Chair, Deputy Chair, committee members, and officials. With
me today to the left is Mr. Jason Wandy, and he’s the deputy provincial auditor
that is responsible for the audits at the Saskatchewan Cancer Agency. Just
behind us is Ms. Michelle Lindenbach, and she’s the liaison with this committee
as well.
Jason’s going to present the chapters
for the committee in the order that they do appear on the agenda. It will
result in three presentations. He will pause after each presentation for the
committee’s discussion and consideration. The first presentation is about
managing the supply of cancer drugs, and it does include five new audit
recommendations for this committee’s consideration. The last two presentations
are follow-up audits that include the status update on outstanding
recommendations that we made and this committee has agreed to.
[10:15]
I do want to thank the CEO and her staff
at the Cancer Agency for the co-operation that was extended to us during the
course of our work. With that I’ll turn it over to Jason.
Jason Wandy:
— Thank you, Tara. Chapter 10 of our 2022 report volume 2 reports the results
of our audit of the Saskatchewan Cancer Agency’s processes for the 12‑month
period ended June 30th, 2022 to manage its supply of cancer drugs. We concluded
the agency had effective processes, other than the areas reflected in the five
new recommendations for the committee’s consideration.
Chapter 25 of our 2024 report volume 2
reports the results of our first follow-up on this audit, where we found the
agency implemented all five recommendations two years after the original audit.
Cancer is the leading cause of death in
Canada and poses an enormous burden on both the health of Canadians and on the
Canadian health care system. The Saskatchewan Cancer Agency is responsible for
delivering effective and sustainable research, education, prevention, early
detection, treatment, and supportive care programs for the control of cancer in
Saskatchewan. It provides cancer drug treatments to more than 10,000 patients
each year.
The agency maintains a list of approved
cancer drugs for cancer patients in Saskatchewan through its drug formulary and
administers most cancer treatments at its two main centres, the Allan Blair
Cancer Centre in Regina and the Saskatoon Cancer Centre. At September 2024 the
agency had over 200 approved cancer drugs on its list.
The agency uses three main methods for
acquiring its cancer drugs. It primarily purchases drugs through contracts
negotiated by the pan-Canadian Pharmaceutical Alliance, or the PCPA, along with
purchasing drugs through contracts directly negotiated by the agency itself and
through contracts established by Health Shared Services Saskatchewan’s
involvement with a national group-purchasing organization. In 2023‑24 the
agency purchased over $175 million of cancer drugs.
The agency implemented our first
recommendation on pages 105 and 239 of our 2022 and 2024 reports volume 2
respectively. We recommended the Saskatchewan Cancer Agency formally document
its processes for updating the approved list of cancer drugs that is its
formulary available to treat cancer patients. Our initial audit found the
agency regularly reviewed and updated its cancer drug formulary, but the
process to do so was not formally documented.
The agency makes its drugs and
therapeutics committee responsible for the oversight and management of the
cancer drug formulary. Each month the committee reviews new drug
recommendations from the PCPA. Once a PCPA letter of intent for a new cancer
drug is in place, the agency submits a request for approval of the drug in its
quarterly drug-funding submission to the Ministry of Health. Upon receiving
ministry approval, the agency adds the new cancer drug or indication to its
approved drug formulary.
The committee also reviews and approves
requests from physicians for changes to drug eligibility requirements set out
in the drug formulary. In addition, if the agency continues to see multiple
requests for a particular exception, the committee also considers adding those
particular exceptions to the formulary.
While we found the agency’s processes to
modify its cancer drug formulary aligned with good practice, it had not
formally documented its processes. Our 2024 follow-up audit found the agency
implemented this recommendation by documenting its process for updating the
cancer drug formulary within the terms of reference for its drugs and
therapeutics committee.
We tested a sample of three drug
formulary changes and found the agency met the documentation and approval
requirements outlined in the terms of reference. A documented process for
updating its cancer drug formulary helps those involved in the process be aware
of and fully understand the process and desired results. This may also reduce
the risk of delays in cancer drug availability for treating patients.
The agency implemented our second
recommendation on pages 106 and 240 of our 2022 and 2024 reports volume 2
respectively. We recommended the Saskatchewan Cancer Agency establish a time
frame for making decisions on physician requests for exception cancer drugs.
Our initial audit found the agency had a
formalized process to approve exception drug requests but did not have an
established time frame for deciding on requests. The agency maintains a
case-by-case review program for exception drug requests on an individual
patient basis. The program is intended for a small group of patients with rare
types of cancer. The program requires physicians to apply for an exception drug
by completing an electronic form that includes information and evidence to
support the request. The agency evaluates all applications to either approve or
deny the requests.
We found the agency had not established
a time frame, such as within one week, for making decisions on physician
requests. Our testing of exception drug requests found two cases where the
agency’s decision was not timely. It took 9 and 64 days, respectively, for the
agency to decide to deny the requests.
Pages 108 and 109 of our 2022 report and
2024 report volume 2 include our third and fourth recommendations. We
recommended the Saskatchewan Cancer Agency set out in writing relevant factors
it expects staff to consider when deciding to purchase cancer drugs directly
rather than using group-purchasing methods. Additionally, we recommended the
Saskatchewan Cancer Agency document its rationale and seek approval when
purchasing cancer drugs using the single- or sole-source purchasing methods.
The agency purchases the majority of its cancer drugs using group-purchasing
methods, though it directly purchased over $15 million of cancer drugs in
2023‑24 using tenders or single- or sole-sourcing methods.
Our initial audit found the agency’s
contract management policy did not consider certain factors, such as pricing or
clinical reasons that staff should consider when deciding to purchase cancer
drugs directly and not use group purchasing. The decision to negotiate
contracts directly rather than participate in group purchasing is an important
purchasing decision, as group purchasing enables the agency to realize benefits
of nationally negotiated prices for cancer drugs.
Additionally, we found the agency’s
contract management policy did not set requirements on what staff must consider
and document when using the single- or sole-source purchasing methods. We
tested 17 such purchases. While management was able to provide reasonable
verbal rationale for each purchase, we found the agency did not document its
rationale or seek approval from management independent from oncology pharmacy
services for using these purchasing methods. Our 2024 follow-up audit found the
agency implemented both of these recommendations.
Tara
Clemett: —
We found the agency approved a document in January 2024 outlining each drug
acquisition pathway, including factors for staff to consider when purchasing
cancer drugs directly. Examples of factors included the clinical needs of the
specific patient population, availability of generic drugs, supply
interruptions, and the quantity of cancer drugs needed. We tested one tender
and one sole-source cancer drug purchase and found staff appropriately
documented the factors supporting the decisions to purchase directly, and
senior management approved those decisions. Maintaining documented rationale
and approval for cancer drug purchases helps the agency facilitate a fair and
equitable procurement process and obtain best value when making purchasing decisions.
The agency implemented our fifth and
final recommendation on pages 110 and 241 of our 2022 report and 2024 reports
volume 2 respectively. We recommend the Saskatchewan Cancer Agency formally
document when and who completed potential supplier evaluations when tendering
for cancer drug purchases.
Our initial audit found the agency used
an evaluation matrix to score each bid received on a tender with members of the
agency’s pharmacy team completing the evaluations and providing an overall
score for each proposal. However testing found the agency didn’t record who was
involved in the evaluation process and have them sign off on the completed
evaluation.
Our 2024 audit follow-up found the
agency implemented this recommendation by preparing a work standard for
evaluating and awarding tenders to potential suppliers, including requirements
for all evaluation committee members to declare their independence. Additionally
the agency now requires all members to sign an award submission form
documenting the evaluation committee’s final award decision.
We tested one tender for cancer drugs
and found the agency formally documented when and who completed evaluations of
the potential suppliers, including having all the evaluation committee members
declare their independence. Maintaining adequate evidence to support an
independent supplier evaluation and award decision prepares the agency to
defend against potential conflict-of-interest allegations and challenges to the
tendering process and the award decision.
With that I will now pause for the
committee’s consideration.
Chair
Wotherspoon: — Okay, thanks again for the focus of
these chapters and the presentations. Thanks for the actions that have been
detailed here to implement these recommendations.
This committee has left the deputy
provincial auditor speechless once again here today. We wish him well.
We’ll turn it over to Deputy Minister
Smith to make a brief remark and then we’ll open it up for questions.
Tracey Smith:
— Thanks, Mr. Chair. And I will remark on all of the recommendations that were
touched on.
The recommendation regarding
Saskatchewan Cancer Agency formally document its processes for updating the
approved list of cancer drugs available to treat cancer patients is considered
as fully implemented as noted. The Saskatchewan Cancer Agency documented its
process for updating the cancer drug formulary within the terms of reference
for its drugs and therapeutics committee in August of 2024. The terms of
reference clearly establishes the frequency for updating the formulary at least
annually or when it adds new cancer drugs to the list.
The
terms of reference also includes documentation and approval requirements for
various types of formulary changes, including recommendations for new drugs
from a national drug expert review committee requiring provincial consideration
of drug funding and implementation, requests for new treatments not reviewed by
a national drug expert review committee, adding a historical standard of care
to the drug formulary, updated clinical criteria and/or treatments reflecting
current clinical practice, and removal of existing treatments from the drug
formulary that no longer reflect clinical practice.
The
recommendation regarding the Saskatchewan Cancer Agency establishing a time
frame for making decisions on physician requests for exception cancer drugs is
considered as fully implemented. The Saskatchewan Cancer Agency maintains a
case-by-case review program for exception drug requests. This program is
intended for a small group of patients with rare types of cancer. The
Saskatchewan Cancer Agency’s case-by-case review program policy outlines a
standardized and transparent process for agency staff to follow when physicians
request the use of cancer medications outside of the agency’s approved
formulary. In March of 2023 the agency updated its policy to include a target
to approve or deny exception drug requests within five business days.
The
recommendation regarding the Saskatchewan Cancer Agency setting out relevant
factors when deciding to purchase cancer drugs directly, rather than using
group-purchasing methods and document its rationale and seek approval when
purchasing cancer drugs using the single or sole-source purchasing methods, are
considered as fully implemented. The Saskatchewan Cancer Agency documented and
considered relevant factors before approving the purchase of cancer drugs
directly through tendering or single sole-sourcing rather than using group-purchasing
methods.
The
agency documents the rationale when choosing a particular drug acquisition
pathway, including factors for staff to consider when purchasing cancer drugs
directly. Factors include clinical needs of the specific patient population,
for example, patient intolerance to a certain drug; availability of marketed
generic drugs; supply interruptions; financial considerations, including impact
on associated costs of cancer drugs based on existing utilization patterns;
quantity of cancer drugs needed; and manufacturer declines to participate in
group purchasing.
The
recommendation regarding the Saskatchewan Cancer Agency formally documenting
when and who completed potential supplier evaluations when tendering for cancer
drug purchases is considered as fully implemented.
[10:30]
The agency maintains documentation of
when and who completed potential supplier evaluations when tendering for cancer
drug purchases. The agency uses an evaluation matrix to score each bid received
for a tender. Members of the agency’s pharmacy team complete the evaluations
and provide an overall score for each proposal.
In May of 2023 the agency prepared a
work standard for evaluating and awarding tenders to potential suppliers,
including requirements for all evaluation committee members to declare they are
independent. Additionally, the agency requires all members to sign an award
submission form documenting the evaluation committee’s final award decision.
That concludes my comments.
Chair
Wotherspoon: — Thanks very much for the
presentation and the work on this front. I’ll open it up now to committee
members. MLA Gordon.
Hugh Gordon: — You touch on some
of the relevant factors that have to be considered before approving purchases
of cancer drugs directly or through tendering or single sole-sourcing, as
mentioned I believe on page 241 of the 2024 report. I was just wondering though
if you could tell us what type of staff are involved in that process.
Darryl Boehm: — Hi, I’m Darryl
Boehm. I’m the director of pharmacy for the Saskatchewan Cancer Agency. So I
think the question was how many, or what type of staff are involved in making
the decisions for purchasing directly. It’s primarily the senior management of
the pharmacy department — so the director of pharmacy, our provincial manager
of drug strategy and value, and we have a provincial manager of oncology drug
programs. We do have purchasers that would weigh in on the decision, but the
final decision would be made by our senior management team. And then as noted
in the auditor report, we do seek management approval independent of pharmacy,
so our executive leadership team.
Hugh Gordon: — And I was also
wondering if you could provide the committee with an update on the full-time
employees of the Saskatchewan Cancer Agency. Are there any positions vacant?
And if you could tell us which ones.
Darryl Boehm: — Just to clarify, do you mean across the
entire agency or within the pharmacy department specifically?
Hugh Gordon: — Well I guess, to the deputy minister, if
you could just discuss it for the agency.
Tracey Smith: — For the agency?
Hugh Gordon: — Yeah.
Tracey Smith: — Okay, just give us one moment. Thank you.
Deb Bulych:
— Good morning. Deb Bulych, president and CEO of the Saskatchewan Cancer
Agency. As of December 31st, we have 918 FTEs [full-time equivalent] and our
currency vacancy rate for the Cancer Agency is 5.67 per cent.
Hugh Gordon: — Are you able to
identify which of those positions that are vacant . . . What are
those positions?
Deb Bulych:
— I think we can give you some idea. I’ll just confer.
Hugh Gordon: — Fair enough.
Deb Bulych:
— Give me just one minute.
Ron Dufresne:
— Good morning. My name is Ron Dufresne, vice-president, corporate services at
Saskatchewan Cancer Agency. To your specific question about number of
vacancies, we have a number of vacancies, or number of classifications rather,
in the organization.
Hugh Gordon: — Thank you.
Chair
Wotherspoon: — MLA Pratchler.
Joan Pratchler: — In terms of
physician requests, can you explain to the committee how a physician makes a
request for exception cancer drugs and the process that that request takes
before it’s approved or denied?
Darryl Boehm:
— Yeah, Darryl Boehm again. Thank you for the question. Physicians make
requests. We have an electronic form. It’s received by our pharmacy department
who gathers background information. It summarizes the request, which would
include evidence, the specifics of the particular patient, if there’s
individual circumstances that a patient needs an alternate therapy. It’s then
considered by the Chair of the disease site group — so that’s a physician that
specializes in particular cancers, so like breast cancer, lung cancer — and
myself as the director of pharmacy.
So together we evaluate that and make a
joint decision. And that decision is then documented in the patient’s
electronic health record, and the physician requesting the alternate treatment
is notified.
Joan Pratchler: — How often would
you say those medications would be denied or requests denied?
Darryl Boehm:
— I’m just going to . . . I have the exact number in my binder; I
didn’t bring it up. From April 1st of 2024 to January 15th of this year 83 per
cent of the requests were approved.
Joan Pratchler: — And what would be
some reasons that they may be denied?
Darryl Boehm:
— Particular reasons they may be denied may be a lack of evidence. It may be a
request that would be for a particular medication that’s already being
considered through a national process, which we follow, and wait for that
process to play out. So those could be two particular examples of why they may
not be approved.
Joan Pratchler: — And would any of
those denials cause patient outcomes less desirable?
Darryl Boehm:
— Well it’s hard to say. It would depend on the individual circumstances of the
case. Sometimes there’s alternate treatments available. So it would really have
to be, you know, on a case-by-case basis. It would be very difficult to say,
you know. That’s the best I think I can answer on that one.
Joan Pratchler: — So bureaucracy
could hinder therapy?
Darryl Boehm:
— I suppose it’s a possibility. Again it depends what alternative treatments
would be available. It depends on the specific nature of the case, the type of
the cancer, the stage of the cancer. Without any sort of details it’s difficult
to answer that.
Joan Pratchler: — Thank you.
Chair
Wotherspoon: — No further questions on your end?
Any further questions on these chapters? Okay, thanks very much. Not seeing any
further questions, we have the five recommendations, right, and we have
implementation on all of them that’s been noted. So I’d welcome a motion that
with respect to chapter 10 that we concur and note compliance with respect to
recommendations 1 through 5. Do we have a mover? Moved by Minister Harrison.
All agreed?
Some
Hon. Members: — Agreed.
Chair
Wotherspoon: — Okay, that’s carried. We will turn
our attention to chapter 17, and I’ll turn it back over to the Provincial
Auditor’s office.
Jason Wandy:
— The Saskatchewan Cancer Agency is responsible for providing services with
respect to prevention and screening of individuals for cancers, including
breast cancer. One in eight women in Saskatchewan will develop breast cancer in
their lifetime. Through the screening program for breast cancer the agency
informs women when they are due for their next mammogram and suggests women
over 50 years of age have a mammogram every two years. Starting January 1st of
2025 breast screening eligibility ages will be lowered as part of a phased
approach over the following 18 months to include women over 40 years of age.
Chapter 17 of our 2023 report volume 1
reports the results of our fourth follow-up audit of management’s actions on
the last remaining recommendation. We first reported in our 2016 audit about
the agency’s processes to deliver its systematic population-based screening
program for breast cancer. By November 2022 we found the agency implemented the
last remaining recommendation. We found it periodically reports key performance
information on the screening program for breast cancer, including the interval cancer
rate, to senior management and the board timely. The interval cancer rate is
the number of invasive breast cancers found after a normal or benign
mammography screening episode within one and two years of the screen date.
The agency also continued to provide
other key performance information such as the participation rate and retention
rate. The participation rate is the percentage of women who have a screening
mammogram within a 30‑month period as a proportion of the target
population. The retention rate is the estimated percentage of women aged 50 to
69 years who returned for a screening within 30 months of their initial screen.
Timely reporting of all key quality indicators provides relevant information
for decision making by the agency.
I’ll now pause for the committee’s
consideration.
Chair
Wotherspoon: — Okay, thank you. Thank you very much
for the important follow-up on this front. I’ll turn it over to Deputy Minister
Smith, and then we’ll go from there.
Tracey Smith:
— Thanks, Mr. Chair. The Saskatchewan Cancer Agency has established cascading
metrics for the breast screening program which are updated quarterly and
readily accessible to management and executive leadership. These metrics
include participation, retention, and interval cancer rates, providing critical
insights into the program’s performance.
By streamlining reporting processes, the
Saskatchewan Cancer Agency ensures timely availability of key information,
supporting evidence-based decision making and enabling leadership to monitor
trends and address program areas requiring attention.
That concludes my comments.
Chair
Wotherspoon: — Okay, I’ll open it up now to
committee members. And for anyone that’s observing the proceedings, of course,
we’ve considered this report and this recommendation in the past. We’ve
concurred in it and we have implementation now noted by the ministry. Opening
it up for questions. MLA Pratchler.
Joan Pratchler: — Just an overall
general question. What happened in the last few years that necessitated longer
wait times for just regular mammograms and that people had to go out of
province? What would be the factors that were involved in that?
[10:45]
Tracey Smith:
— Thank you for the question. So before I turn it over to Deb, just to you
know, again just to acknowledge your question just around some of the wait
times and what’s happened over the course of the last number of years. And I
know Deb, you know, Deb will touch on some of the impacts of the pandemic
obviously.
But just a general comment I would say
is that, you know, in the time that I’ve been in this role in working with Deb
and the team, the Cancer Agency has made really significant progress across a
lot of areas. I know we’re really focused on screening right now in terms of
the audit, but Deb’s going to touch on a little bit more in terms of their
approach to health human resources during this time and just some of the
changes that they’ve made at the Cancer Agency to be able to speed up
processes, reduce wait times, and ensure that patients are getting timely care.
So I’m going to turn it to Deb to fill in some of that.
Deb Bulych:
— Thank you, Deputy Minister Smith. As Tracey was saying, certainly the
pandemic had the greatest impact on screening for breast cancer. During the
pandemic we had stopped screening for a period of time. And then certainly
restart-up proves challenging with some HR [human resources] shortages of MRTs
[medical radiation technologist], mammo techs. That proved very challenging.
However I am proud to say that, working collaboratively with our SHA
[Saskatchewan Health Authority] partners and ministry, we’ve increased training
seats for MRTs with the hope that that will help greatly.
There’s always internal things that we
can look at as well, and we shortened a mammography appointment time from 15
minutes down to 10 minutes to better utilize our MRTs that we have, and that
has proved to be greatly beneficial. Evening clinics as well proving beneficial
in many areas for clients as well as staff, and certainly the second
mammography bus that will help as well in terms of this.
I want to clarify though that we haven’t
sent anyone out of province for mammography. Those are people who needed
biopsy. So just to be clear on that.
Another really good news story is that
we’re caught up in most of our breast screening sites. Our longest wait right
now is currently in Regina, and we’re booking into November ’25. So it’s down
to a few months, thank goodness. So a lot of great work between our team and
our SHA colleagues as well as the ministry.
And just also to let you know some other
good news in terms of reducing the age, we’d heard a lot about how this could
potentially impact our system. The ministry had provided extra staff for us to
manage this workload. And as I said in terms of the wait-list and the workload
that’s happening out in those sites, it’s being managed very well so far.
Joan Pratchler: — What are some of
the trends that you’re currently seeing with the interval cancer rate?
Deb Bulych:
— Sorry, say that again.
Joan Pratchler: — What are some of
the trends that you are seeing with the interval cancer rate?
Deb Bulych:
— Okay. All right. Sorry, took a minute. So we follow the national process with
CPAC [Canadian Partnership Against Cancer] for reporting interval rates. What
was holding me up a little bit is the latest we have are our 2022, and I was
questioning that. However it makes complete sense. It’s a two-year cycle, so we
would have had them the end of ’24.
And David is just pulling them up, so if
you could just bear with me. What we do know is that we’re hitting the targets.
He is just looking for some exact data. Or if you would like, we could just get
that to you.
Joan Pratchler: — I think that would
be fine too. Could you do that in a month? That’s what our last . . .
Yesterday was a month. We agreed to that.
Deb Bulych:
— Well the good news is we know we’re hitting the targets.
Joan Pratchler: — Yeah, thank you.
Deb Bulych:
— But because of the two-year cycle I was questioning them a little bit, but it
makes sense. It is a two-year reporting cycle.
Joan Pratchler: — Perfect, thank
you. So we’re lowering the screening age, right? So that’s going to put a
little bit more, you know, pressure on the ability to, you know, make plans to
deliver that in a timely way. What’s the process for contacting all those new
people that may not be on a regular, you know, basis waiting for that letter in
the mail?
Karen Efthimiou:
— Hi. I’m Karen Efthimiou. I’m the VP [vice-president] of population health,
quality and research.
So with lowering the age, that age is
actually self-referral. So women assess their risk, and they can have those
conversations with their physician. If they feel that screening is right for
them, they call the program and then we can book them in. We have had extra
staff which has managed our call volume. So January 1st was when we first
decreased the age to 47 to 50. We have experienced high call volumes, but we’ve
been able to manage it within the program because of the extra staffing. That
might be all that I can add for you right now. If you have another question
. . .
Joan Pratchler: — So if it’s
self-referral, many people don’t have access to a physician. Is there going to
be general communications or some kind of, you know, marketing campaign to
raise awareness for those that may not access a physician?
Karen
Efthimiou: — I have to
check. I’ll be right back.
[11:00]
Okay, with self-referral, patients do
not need a physician to self-refer. They can call our clinic and then we’ll
book them. We’ll send them the results. If there is an abnormal result, we have
a nurse navigator that will work with them to try and get them a physician or a
nurse practitioner to help navigate them through the system.
Joan Pratchler: — Okay, and so how
will the general public know that they can self-refer?
Karen
Efthimiou: — It’s in
our marketing campaign that we provide. So we do provide instructions; it’s on
our website as well. Again when we lower the age from, I think it’s 44 to 47,
we’ll be doing the same thing. We’ll be creating that media awareness,
promotional campaigns to let people know that as well.
Joan Pratchler: — Perfect. So when we decrease the age we’re
going to be increasing demand. So I’m wondering, you know, there’s the rural,
the two mobile units, or that’s what I understand. How else will rural be able
to access? Will that be enough support to run that? And secondly, what about in
the North? How will we meet that demand in the North?
Deb Bulych:
— Hi. So I think it’s important to note that because we’re a provincial cancer
agency we really do have a provincial focus. So in terms of breast screening
overall and prevention, we have a fairly robust prevention program that we
utilize alongside of our screening programs. They’re now an amalgamated
department within the division, which is very helpful to us. We have great
partnerships with the communities that we will be going to. We have 42 remote
sites that the mammo-bus will be going to. The most northern is La Loche.
So while we’re doing the work of the
mammography screening, there’s also a lot of prevention work that’s happening
as well in partnership with these communities to understand their needs. So
with the lowering of the screening age there’s also a lot of education, but
participation from the communities in terms of what their needs are. We listen
to that and we do implement in our programs and services. So that’s why there’s
42 remote sites now being attended by the mammography bus.
Joan Pratchler: — Okay, thank you.
Chair
Wotherspoon: — MLA Gordon.
Hugh Gordon: — The announced
breast health centre in Regina, I was wondering if you could provide an update
of the progress of the health centre. Have staff been hired? And what
diagnostic equipment has been purchased to date?
Tracey Smith:
— Thank you for the question. So just to provide a brief update, construction
of the breast health centre in Regina is currently under way, and we are on
track to be in a position to open within the next few months, in the coming
months. In terms of staff, two nurse practitioner, nurse navigator positions
have been hired. I don’t have an update on the rest of the complement of staff,
but I can say that the Saskatchewan Health Authority is in the process of
hiring for the remainder of those positions. And that’s well under way, but I
don’t have sort of the specific grid of the positions with us here today.
And equipment, similar. I don’t have the
itemized list of equipment that is going to be going into the new facility, but
I can confirm that all of the equipment has been ordered. And again it’s all
sort of working towards being on track to open within the next few months.
Hugh Gordon: — Thank you for
that.
Joan Pratchler: — Would you be able
to provide us with how many people are currently on the wait-list for
mammograms and biopsies? And is that different between Saskatoon and Regina, or
is it just a provincial number? I’m not sure.
[11:15]
Tracey Smith:
— Thanks for the question. Deb is going to provide a little bit more
information around the mammographies. We’re looking up just more generally on
biopsies to see if we can get a little bit more information. But in the
meantime, I’ll turn to Deb.
Deb Bulych:
— Okay, so we have eight mammography sites plus mobile. And at this moment, I
can say that for six of the actual sites we do not have anyone without an
appointment, so there aren’t people on the wait-list waiting. However for two
of the sites, due to the way that they schedule the mammographies — they do it
in terms of weeks not months — and so there are people waiting. However I don’t
have the most up-to-date numbers. But I can say that six of the eight
stationary sites do not currently have a wait-list.
Chair
Wotherspoon: — Do you have the numbers, even if you
don’t have the most up to date, that could be provided? What numbers do you
have?
Deb Bulych:
— The numbers that we have are just their overall wait-lists, but they include
things like other diagnostic imaging and whatnot. I think it would be a bit too
muddled for me to give full numbers because we’re not sure specifically which
are mammographies versus other tests, if that makes sense. It’s the way that
they do their scheduling for that service.
Tracey Smith:
— I’ll just say, just because I don’t think the agency has sort of the numbers
that you’re looking for today, we can take that back and see what we have in
terms of more updates and be able to provide that through to the committee, if
that works for everyone?
Chair
Wotherspoon: — Sounds good. And just looking, does
that satisfy the member in getting that information supplied back to the
committee?
Joan Pratchler: — I think so, yeah.
Chair
Wotherspoon: — Okay.
Joan Pratchler: — Because there’s a
delay sometimes, and is that a wait-list or is it just it takes that long to
get through those appointments? Is an appointment equal to a delay or a
wait-list? Yeah, I think we just need to parse that out to make sure that we’re
answering those questions.
Tracey Smith:
— And that’s what the team was talking about is just, you know, understanding
the different points in time. Because I think that’s important to the overall
picture when we’re providing the information back, just making sure we
understand, that everybody’s talking about the same points in time.
Joan Pratchler: — Sure. And you
could include that with the trunk of things that are coming back. Great.
Chair
Wotherspoon: — And maybe just, as Chair, thanks so
much for committing to get that information back to the committee. Sort of 30
days, one month, is that reasonable? Yeah. And then that gets supplied through
the committee Clerk, and then it’s available to all of us as members. Thank you
very much.
Joan Pratchler: — So just to make
sure I asked it properly, wait-list for mammograms, wait-list for biopsies.
Does that make sense?
Deb Bulych:
— Right, and I spoke to just mammograms.
Joan Pratchler: — Okay, yeah. Thank
you. Are women in Saskatchewan still travelling outside of the province for any
breast health diagnostics?
Tracey Smith:
— Thanks for the question. Ingrid’s going to come up and provide some
information.
Ingrid Kirby:
— Good morning. Ingrid Kirby, assistant deputy minister. So yes, we are
continuing to send patients to Calgary for breast biopsies. We continue to work
with the Health Authority to try to minimize the number of patients who have to
travel out of province. They’ve made great strides in redirecting patients.
Most of the challenges have been in Regina. So patients from Regina have also
been travelling to Saskatoon and Moose Jaw, which are a little bit closer than
Calgary, for those biopsies.
Joan Pratchler: — And could you give
a number?
Ingrid Kirby:
— For in-province redirections or for out-of-province?
Joan Pratchler: — How many go out of
the province for any kind of diagnostics?
Ingrid Kirby:
— Thank you. So far to date 457 women have received a biopsy in Calgary.
Joan Pratchler: — And that date
range was back as far as?
Ingrid Kirby:
— I’d have to check, sorry.
Tracey Smith:
— Mr. Chair, just while Ingrid is just getting confirmation just of the dates,
I guess, that you’re looking back to. But I thought just in terms of just, you
know, more broadly to your question around this program in particular, just
really want to reinforce that — as we’ve heard this morning even just with the
start of the first questions — in terms of cancer care, cancer waits, you know,
between the Saskatchewan Cancer Agency, the Health Authority, Ministry of
Health, obviously this has been a high priority for government as a whole.
All of the agencies have been working
together to either, you know, shorten wait times, make things more accessible
for patients, quicker, when they need the care that they need to get.
I would stress with this one as well,
again, I know in a lot of my conversations with other jurisdictions, you know,
access to cancer care, timelines, it’s an issue that we’re all facing and all
really needing to really work together and think really hard about what are
different options, possibilities to be able to improve access to cancer care
services.
You know, while Ingrid’s getting I think
the date around, you know, the number of patients that have been sent out of
province in the time frame, again just to reinforce that that’s really intended
to be a short-term scenario while we continue to make improvements in
Saskatchewan and really ensure that we’ve got the resources here. But in the
interim, you know, we need to look at other options to ensure that women have
access to the care that they need when they need it.
So with that, I’m just going to turn to
Ingrid to see if she has the dates that we can confirm for you and if there’s
anything else, Ingrid, that you want to, any other context that would be
helpful for the committee. Thank you.
Ingrid Kirby: — For sure. So we
started that initiative in December of 2023, so it’s just been just over a
year. And as Tracey noted, there’s been a lot of progress done in the province
to try to stabilize and ensure that patients are getting care as close to home
as they can.
Joan Pratchler: — Thank you. That’s
all I have.
Chair
Wotherspoon: — Any further questions over here?
MLAs, any other questions at this point? Not seeing any I’d welcome a motion to
conclude consideration of chapter 17. Moved by MLA Crassweller. All agreed?
Some
Hon. Members: — Agreed.
Chair
Wotherspoon: — That’s carried. And now we’ll turn
our attention to the last chapter with the Saskatchewan Cancer Agency on our
agenda here today, and I’ll turn it back to the auditor.
Tara
Clemett: —
The Saskatchewan Cancer Agency is responsible for providing services with
respect to prevention and screening of individuals for cancers, including
colorectal cancer. In collaboration with the Saskatchewan Health Authority, the
agency delivers a population-based screening program for colorectal cancer.
Through the screening program the agency
provides at-home fecal immunochemical test kits, also referred to as FIT kits,
to participants who are between the ages of 50 and 74 with a valid Saskatchewan
health services card and do not already have a colorectal cancer diagnosis. It
asks participants to return completed tests via mail or a drop-in location
where kits are then sent to the Saskatchewan Health Authority for processing at
the Roy Romanow Provincial Laboratory.
[11:30]
The
agency didn’t implement the recommendation on page 207 where we recommended the
Saskatchewan Cancer Agency analyze if its promotion strategies help increase
participation in its screening program for colorectal cancer.
The Canadian Partnership Against Cancer
notes First Nations, Inuit, and Métis; those living in rural and remote
communities; and those living in northern regions of provinces are among the
people at a higher rate and risk of developing cancer, including colorectal
cancer, as they are generally underserved in health care.
From November 2021 to March 2023 the
agency held 16 events to promote colorectal cancer screening, including five
events targeted at Indigenous and immigrant populations, who are generally
under-screened populations in Saskatchewan. However we found the agency did not
conduct an analysis to determine whether these events raised awareness or
increased participation in the screening program.
We found the participation rate of
individuals over 50 years of age in the agency’s colorectal screening program
continued to decrease over the past five years to about 41 per cent, which is
below Canada’s national benchmark of 60 per cent. We also found the
participation rates in northern Saskatchewan and those residents in the
colorectal screening program remain the lowest and continue to decrease.
Focusing promotional strategies on
under-screened areas to raise awareness and educate eligible target groups
should lead to increased program participation rates. Analysis of the
promotional events will help to determine whether these events achieve the
desired outcomes.
The agency partially implemented the
recommendation on page 208 where we recommended the Saskatchewan Cancer Agency
work with the Saskatchewan Health Authority to reduce the time patients wait
for colonoscopies, with the aim to provide these services within the nationally
accepted benchmark for colorectal screening programs.
The Canadian Partnership Against Cancer
has a benchmark of booking 90 per cent of follow-up colonoscopies within 60
days of a patient’s receipt of an abnormal screening result from a FIT kit.
From screening program invitations sent from January to October 2022, we found
almost 2,400 patients had an abnormal result from a completed FIT kit, with 559
of those patients having a follow-up colonoscopy by December 31st, 2022.
On an overall basis, 66 per cent had a
follow-up colonoscopy completed within 60 days of the abnormal FIT result,
falling short of the target of 90 per cent. Additionally, we continued to find
the average wait time for an abnormal result to a colonoscopy continued to be
over 60 days for patients in regions of the province where non-navigated
booking process existed. Under this type of booking process, the responsibility
for referring patients for a colonoscopy relies solely with the patient’s
primary care provider.
We found that the agency began working
with the Saskatchewan Health Authority to reduce patients’ wait times for
colonoscopies by proposing plans to have the agency book colonoscopies for all
patients with abnormal screening results. Without a consistent approach for
booking colonoscopies, patients who are non-navigated through the agency’s
screening program often were waiting longer for colonoscopies. Delays in
receiving colonoscopies could result in delays in colorectal cancer diagnosis
and required treatment.
The agency partially implemented the
recommendation on page 210 where we recommended the Saskatchewan Cancer Agency
work with the Saskatchewan Health Authority to determine a time frame or a
benchmark for providing patients and health care providers with pathology
results related to the screening for colorectal cancer.
In January 2023 the agency and the
Authority met to determine an appropriate turnaround target time frame for
pathology results. Both agreed to a target of 95 per cent within 14 days for
all locations. At May 2023 the target was under review by the Authority’s lab
medicine and atomic pathology provincial discipline committee, so it had yet to
be finalized.
From January to October 2022, our
analysis found 559 patients with colorectal screening program had
colonoscopies, with 433 of these patients having biopsies taken. We found the
average pathology wait time, so the receipt of the biopsy results, was 16.4 days,
with the longest time frame though being 37 days.
Having benchmarks for expected time
frames to give pathology results from colonoscopies to patients and primary
care service providers would help the agency and the Authority assess wait
times. Timely receipt of pathology results assists in determining and providing
appropriate and prompt treatment and reduces the risk of the cancer growing or
spreading.
The agency partially implemented the
three recommendations on page 211. We recommended the Saskatchewan Cancer
Agency align its quality indicators it regularly uses on the screening program
for colorectal cancer with nationally accepted indicators.
We also recommended the Saskatchewan
Cancer Agency report on the results of key quality indicators for its screening
program for colorectal cancer and the agency periodically include analysis of
the key quality indicators for its screening program for colorectal cancer in
its report to senior management and the board.
The Canadian Partnership Against Cancer
has set 10 national quality indicators for colorectal cancer screening
programs. The agency developed the indicators or reasonable proxy to monitor 7
of the 10 national quality indicators and plan to develop indicators for
another two.
At the time of our follow-up audit the
agency only reported the screening program participation rates to senior
management and the board twice a year. Management indicated the agency was
determining what other indicators to report to senior management and the board
and how often. Expected to do so by December 2023.
Our review of participation rates for
November 2022 and February 2023 found that, while the reports included timely
information, the reports didn’t include trend analysis or reasons why the
program did not achieve the national participation rate benchmark of 60 per
cent along with management’s actions or the plans to improve participation
rates.
Reporting on key performance indicators
for colorectal screening that are consistent with good practice can provide
senior management and the board with pertinent information for decision making.
Written, detailed analysis would help the agency understand its progress and
identify opportunities for improvement.
With that I will now pause for the
committee’s consideration.
Chair
Wotherspoon: — Thank you. Thanks very much for the
focus of this chapter and the follow-up here. All these recommendations of
course have come to this table. They’re part of the 2020 report. And thanks as
well to the ministry and the Sask Cancer Agency for the actions that have been
taken on this front. I’ll kick it over to Deputy Minister Smith for remarks and
we’ll go from there.
Tracey Smith:
— Thanks, Mr. Chair. To enhance participation in the screening program for
colorectal cancer, the Saskatchewan Cancer Agency undertook a series of
strategic initiatives.
First, the prevention and screening
departments were amalgamated in September of 2021 to integrate screening
closing with outreach and health promotion efforts. Recognizing the importance
of data in driving decision making and business intelligence, a specialist was
hired in July of 2022 to support evaluation and data analysis.
An outreach and engagement framework was
developed in September of 2023 incorporating evaluation components to ensure
strategies are effective, such as tracking tools and metrics from events. For
instance, the Saskatchewan Cancer Agency ran a province-wide colorectal cancer
promotional campaign in 2023 aimed at increasing screening participation and
awareness. The campaign’s effectiveness was evaluated using key metrics
including 1.8 million impressions, which surpasses the 1 million
goal; 7,100 web page clicks, which exceeded the 4,000 targets; and an 800 per
cent increase in audience reached compared to 2020 efforts.
Additional efforts included attending
community events to foster relationships and promote screening while leveraging
direct communications such as letters from the medical advisor to surgeons and
family physicians to encourage participation. Targeted outreach strategies,
such as understanding non-participation amongst the 50‑ to 54‑year-old
age group and redesigning promotional materials, were also initiated.
The Saskatchewan Cancer Agency has
prioritized reducing colonoscopy wait times by establishing a screening program
for colorectal cancer quality improvement committee in July of 2022 and
participating in the ministry-led provincial endoscopy committee since January
of 2022. Through these efforts a comprehensive endoscopy strategy was
developed. Reporting tools were introduced in January of 2023 to monitor wait
times quarterly, and a provincial navigation framework was created in August of
2023 to guide the expansion of navigation services.
To address resource gaps, the program
hired additional nurse navigators and engaged quality improvement consultants
to provide dedicated support. Expanding navigation services across the province
has become a key priority, focusing on establishing a provincial navigation
model and ensure seamless support from a positive fecal immunochemical test
result to colonoscopy. And navigated regions securing dedicated spots in
endoscopy units for FIT positive patients has contributed to achieving the
national benchmark of 60 days from an abnormal result to colonoscopy.
The Saskatchewan Cancer Agency informed
the Saskatchewan Health Authority of this audit recommendation back in 2020,
and has since taken several steps to establish benchmarks for pathology
results. Meetings with lab and pathology representatives began in January of
2023 to explore collaboration opportunities. A reporting tool was developed by
the business intelligence specialist to track pathology result timelines with
quarterly updates initiated in December of 2023.
The Saskatchewan Health Authority and
the Saskatchewan Cancer Agency have agreed on a target benchmark for pathology
result wait times, which is 95th percentile of patients, within 14 days. This
benchmark has been implemented by the Saskatchewan Health Authority in December
of 2024. Reports have been shared with the lab quality improvement committee to
identify improvement areas, while ongoing collaboration with Saskatchewan
Health Authority aims to establish a high-level plan for operational incorporation
guided by equality improvement framework.
To enhance transparency and decision
making, the Cancer Agency incorporated trending data into its reports in
September of 2022 and integrated historical data in January of 2023. This
foundation supported the development of a standardized reporting framework,
which was approved by leadership and the board in late 2023. Collaborative
efforts with the epidemiology and performance measurement department led to the
inclusion of additional metrics in the reports, ensuring comprehensive
information is shared with leadership. Standardized dashboards have been
created, providing access to performance indicators for population health
managers and leadership.
To improve the timeliness of reporting
on key quality indicators, the Saskatchewan Cancer Agency completed the backlog
of colonoscopy data entry in June of 2023, ensuring accurate and up-to-date
records. The agency expanded its analytics capacity by integrating business
intelligence across the department and streamlining processes. A standardized
reporting framework was developed in fall of 2023, enabling efficient exchange
of performance indicators to population health managers and leadership. This
framework allows access to data, enhancing decision making and operational
efficiency.
And finally, the Saskatchewan Cancer
Agency assessed national quality indicators for colorectal cancer screening and
aligned its reporting with benchmark standards. These indicators have been
embedded into internal reporting frameworks, ensuring the informed decision
making and strategic planning processes. To enhance reporting capabilities, the
Saskatchewan Cancer Agency hired a business intelligence specialist, as I’ve
noted earlier, and is using that to inform the dashboards. Again these are the
tools that the agency is using to be able to make good decisions,
evidence-based decisions, and really have a line of sight into those key
metrics.
That concludes my comments. Thank you.
Chair
Wotherspoon: — Thanks for the comments. Thanks for
the actions on this front as well to implement these recommendations. Looking
to committee members that may have questions. MLA Gordon.
Hugh Gordon: — I see some of the
actions that the agency’s taking to increase participation in the screening
program, which is alarmingly low. Can you speak to some of these actions in
more detail? So for example, what type of outreach and health promotion is the
agency doing, and what are some of the challenges in promoting your efforts?
[11:45]
Tracey Smith:
— Thanks for the question. Deb is going to come up and answer the questions.
Deb Bulych:
— So I think the first thing, I think I just need to provide some reassurance
that that 60 per cent national benchmark is a national benchmark that no
province is currently meeting. And Saskatchewan, the last data that we had in
terms of colorectal participation, we are the highest participation rate in
Canada. I’m not saying that that is great because of course we would love
. . . we aspire to the 60 per cent. But I thought I would just
provide some reassurance that it’s not that Saskatchewan is lagging behind
Canada. We’re actually leading with some of the work that we’re doing. But no
one in Canada is meeting that benchmark yet unfortunately.
Specific to your question though around
outreach, health promotion, and challenges, just to give you some examples,
we’ve conducted multiple community events where we set up a booth. We get
invited to communities. We set up a booth. We provide a lot of education on all
of our screening programs and on the cancer agency itself. We track the numbers
of participants and questions. We get back to communities with answers. It’s
really a lot of community collaboration, participation, and engagement to
promote the screening programs.
One important thing to highlight is we
work very closely with many First Nations and Métis organizations, especially
communities. A great example of us taking some feedback in our partnership with
them and then changing our services to try and increase collaboration and
participation rates, we’ve recently changed our names from . . .
removing the word “cancer” essentially, so breast check program, colon check
program.
The reason we did that is we heard from
our First Nations and Métis partners that word is just something terrifying. It
doesn’t exist in their language, and that . . . We took their
feedback. We actually changed the names of our program. So that’s an example of
things that we’re doing to try and keep increasing our participation rates
through real feedback from our communities. We’ve also had multiple First
Nations and Métis education sessions again out in community about all of our
services but really targeting prevention and screening.
One of the challenges — and I know it’s
really difficult; I struggle with this myself — that number’s always going to
move very slowly because it is so multi-faceted. But we do believe
. . . And we now have data that is stratified where we can target
certain areas. And I do believe Deputy Minister Smith mentioned the 50 or 54
area, the age group where we can target some strategies specifically to them
through our communications and through our education. So we do have that data
now that really stratifies it and allows us to target in that way. So we’re
doing multiple things, but that challenge is again the rates move slowly and
are very multi-faceted.
Hugh Gordon: — Just wondering if
you could also discuss, you know, the types of outreach your agency is doing
with health care providers.
Deb Bulych:
— So thanks for the question. Just want to make sure I don’t miss anything. So
multiple educational venues for health care providers. Our medical advisor for
each of our screening programs provides education at specific conferences for
medical professionals. We have educational materials specifically packaged for
all of the screening programs that are out to primary care, so in general
practitioners’ offices, family physician clinics, that type of thing. And we
also present to new physicians through the SIPPA [Saskatchewan international
physician practice assessment] program as well.
Hugh Gordon: — Thank you for
that. I was also wondering, I see you’ve hired a business intelligence
specialist to support evaluation and data analysis. And I just was wondering if
since that hiring, if there are any trends that that person’s been able to
identify for you that are helpful anyways.
Deb Bulych:
— Thanks. Thanks again for the question. A few things. I’ll just give a few
examples of trending that we have seen from the business intelligence
specialist. I mentioned the age 50 to 54. It was the business intelligence
specialist’s analysis that showed us that was an area we needed to target, so
that was one example.
Through his work we’re also able to do
geographical mapping of participation rates, so potentially targeting separate
communities. We’re able to provide report cards to the endoscopists throughout
the province so that they can compare their average to the provincial average.
And he also attends the screening quality improvement committees. So if there
are trends identified through his work, they’re discussed there in a quality
improvement fashion.
Hugh Gordon: —
Thank you for that.
Joan Pratchler: — I was wondering
if you might be able to tell the current wait times for colonoscopies in
Saskatchewan, Regina, Saskatoon, rural, and the North.
Deb Bulych: — So are research results okay?
Joan Pratchler: — Sorry, the air’s dry in here.
Deb Bulych: — You guys have been talking a lot in here.
Joan Pratchler: — I know. So can you provide, you know, the
wait times for colonoscopies for Saskatchewan in general, and then the two
large cities, Regina, Saskatoon, rural, and northern?
[12:00]
Tracey Smith:
— Thanks for the question. So just to clarify, colonoscopy, endoscopy
procedures, those are procedures that are provided through the Saskatchewan
Health Authority. And so, Deb’s team . . . We don’t have that
information here with us today, but what I could suggest again is that’s
something that — similar to the last question — we could commit to bring some
of that information back to the committee through that process.
Joan Pratchler: — Okay. And are you
thinking within the next month in the package.
Tracey Smith:
— It would be in the same, yes. It would be within that package.
Joan Pratchler: — Perfect. Okay. And
one other question I have, can you speak to the role of nurse navigators and
what they do? And also are those positions still filled? You know, are there
vacancies? Do you need more? Just to let me know a little more about that, that
would be helpful.
Chair
Wotherspoon: — Thanks again for that undertaking to
get that information back. And if we could have that supplied within that same
time frame, sort of the one month or sooner, through the Clerk.
Deb Bulych:
— Thanks again for the question. So we currently have six positions filled. One
is a vacancy due to retirement. We’ve not had any problem filling these
positions though, so we don’t anticipate that that’ll be an issue for us.
So what they do really is when a person
has an abnormal FIT, something comes back in the result, they will contact the
person, go over the result of the abnormal FIT, explain it to them, and then
help educate them, counsel them, and prepare them for the procedure. And then
they will actually book the appointment for them.
Joan Pratchler: — And do they do
follow up as well, or does it just kind of end at the procedure there for their
services?
Deb Bulych:
— It ends at the test. So, yeah.
Joan Pratchler: — That’s all the
questions that I have.
Chair
Wotherspoon: — Thank you. Looking to committee
members that may have other questions at this point. Not seeing any at this
point.
I guess we don’t have new
recommendations here. We have the implementation with respect to the
recommendations that are before us. So again, just thank you to all those that
have made that happen. And I would welcome a motion to conclude consideration
of chapter 23. Do I have a mover? Minister Harrison. All agreed?
Some
Hon. Members: — Agreed.
Chair
Wotherspoon: — That’s carried. I think we’ve
reached the conclusion of our time, our agenda with the Ministry of Health and
the Saskatchewan Cancer Agency. I want to thank Deputy Minister Smith and
president and CEO Bulych for their time here today, along with all of the
officials that have joined us, and all those that have been involved in this
very important work, and all those that are working tirelessly within these
respective organizations across the province to provide the health care that
Saskatchewan people count on. So thank you very much.
Any final words for us, Deputy Minister
Smith? We spent a fair amount of time together the last couple days. Thanks for
your work on this front.
Tracey Smith:
— Thanks, Mr. Chair. And again it has been a good couple of days. I think we’ve
covered a lot of ground. There were a lot of programs and services where there
were recommendations.
And I think, when I sort of reflect back
on the last couple of days, I know we had the SHA here yesterday, and today we
had the Cancer Agency. But I think you would have seen some themes where the
need to work collaboratively and that the relationship between the agencies
again as a health sector, every single day that is what we are working to do,
is to ensure that in all of it that we’re focused on the patient and on the
citizens that we provide care to. So I really was reflecting on that throughout
the course of the last couple of days, absolutely.
I do want to thank again the committee
for the questions, and I want to thank Tara and her team again for the audits
and the approach to the audits. We really appreciate what you do working with
our respective teams pretty much every single day.
And finally to Deb’s team, again thanks
to Deb for being here today along with the team and answering some questions on
some really important topics. And again, thanks to the ministry team for all of
the efforts in pulling this all together and getting us ready to be able to
talk about these really, really important items. So just thank you and have a
good rest of your deliberations.
Chair
Wotherspoon: — Thank you again. Members, I’ll just
hold you for . . . So thank you very much. And maybe just to the
Provincial Auditor at this point, there’s been a full few days of meetings.
Thanks to you and your entire team for all the work — your resource to this
committee, your incredible leadership in ensuring accountability and
performance, and the follow-ups that happen on all of the audits as well. So
thank you to you as well.
Now just one last item here that we’ve
chatted through here briefly with the Deputy Chair. Just looking to see we’ve
circulated the procedures manual for Public Accounts.
And, Health, you don’t need to stick
around for this stuff at all, unless maybe we can turn the tables and you can
have questions for us. You’d probably love that.
But we’ve got this procedures manual,
and from time to time it gets updated to make some little bits of improvements.
But the Clerk has done a bit of a scan on this front and brought forward some
minor updates that I can speak to here in a minute. Just looking for the
indulgence of the committee; you’re good with us taking a look at this?
Hon. Daryl Harrison: — Mr. Chair, could I
get the item added to the agenda?
Chair
Wotherspoon: — I guess I would . . .
Yeah, so I’ll do that more formally. We can’t add it to the agenda, but we can
add it to the agenda in this way. So looking to the committee members to add
this consideration to the agenda at this point. All agreed?
Some
Hon. Members: — Agreed.
Chair
Wotherspoon: — All right. Good. Pretty
straightforward. I think the changes here, majority of changes are minor
revisions, updates to branch names, rule numbers in the rules and procedures,
committee process changes, and document titles that are referenced in the manual.
Each of you have a copy here as well.
The most substantive change is simply to
clarify the wording on the status updates we receive and those requirements.
Currently the manual states that any recommendations that have already been
implemented don’t need to be included in the status updates. Sometimes status
updates look incomplete because they could be missing these recommendations.
Also I think they then get presented to
us in a bit of an inconsistent way. You’ll notice the last couple of days most
entities provided the implemented recommendations. So it’s just sort of having
a standard process here around what’s expected. Ministry staff often ask for
clarification on this section, we understand, through the Clerk’s office.
So the recommended changes would remove
wording that states implemented recommendations don’t need to be included. That
way committee members can have a fuller picture of all the outstanding
recommendations, especially if an entire chapter only has implemented
recommendations. And we’re not looking for a bunch of extra detail here; it’s
simply the statement that they’ve implemented that recommendation and it’s
recorded out.
So I guess at this point, like do
committee members have any questions on these revisions? Not seeing any. If
members are in agreement with changes, then I’d ask a member to move a motion.
Deputy Chair Wilson.
Sean Wilson: — I move the motion:
That the Standing
Committee on Public Accounts procedures manual be adopted as revised.
Chair
Wotherspoon: — Moved by Deputy Chair Wilson. All
agreed?
Some
Hon. Members: — Agreed.
Chair
Wotherspoon: — Okay, that’s carried. Okay, that
takes care of business. Thanks to all of you for all your work. These have been
some fairly full and long days. Thanks for being engaged in good ways. At this
point I’d welcome a motion of adjournment. Moved by MLA Crassweller. All
agreed?
Some
Hon. Members: — Agreed.
Chair
Wotherspoon: — That’s carried. This committee
stands adjourned to the call of the Chair.
[The committee adjourned at 12:11.]
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