Federal medical fund buys saws, steamer

POSTED AT 2:41 AM EDT    Monday, June 10 By LISA PRIEST From Monday's Globe and Mail

Money from a billion-dollar federal fund, established to purchase crucial diagnostic and treatment machines across Canada, was used to purchase such items as woodworking saws, sewing machines, a laundry truck and a steamer cooker.

While patients in many parts of the country endure long waits for access to the medical machines, some of the federal money has been used by the provinces to buy the saws and other non-medical equipment for hospitals and other medical facilities, a Globe and Mail investigation has found.

And an economist commissioned by the Canadian Medical Association to track spending from the fund says almost half — $468.8-million — has yet to be accounted for. A draft report from the economist, to be released in a few weeks, suggests that some of the money may not even have gone to hospitals or been spent on any type of health care.

Until now there have been only a few public reports of misuse of the equipment fund. The first were in April, when The Globe and Mail reported that New Brunswick bought lawn tractors, ice makers and floor scrubbers with money from the fund.

Since then, The Globe has pieced together a more comprehensive national picture through documents obtained under federal and provincial access-to-information laws, and from other sources.

Among the findings:

In Newfoundland, bulk food transfer carts, a laundry truck, steamer cooker, photocopiers and a hot-and-cold meal delivery system were purchased with some of the federal money. Yet patients continue to face waits of up to nine months for access to the province's only magnetic resonance imager, one of the oldest in Canada.

The Alberta Mental Health Board bought woodworking saws, sewing machines, a projection screen, radio and camera equipment. It said any questionable purchases were informally reviewed with the federal Finance Ministry, something ministry spokesman Jean-Michel Catta denies.

One floor-scrubber and three ice machines were purchased with the federal money in Saskatchewan. Yet it has taken casino profits to replace a 22-year-old fluoroscopy machine and a 14-year-old portable arm used for X-ray machines in Prince Albert.

Though Manitoba has had access to its $37.3-million share of the money since October, 2000, only $2.84-million of it has actually been spent. However, the government said the remaining money has been earmarked for diagnostic and treatment machines.

British Columbia used some of its $132.2-million share of federal money to purchase a washing machine, two hot-water tanks and bedside tables. It also purchased 15 new and replacement computerized tomography scanners and 11 MRI machines.

The fund was established in September, 2000, "to enable the provinces and territories to immediately purchase and install medical equipment for diagnostic services and treatment," as a Liberal government summary has put it.The money was distributed to provincial governments, who promised to account publicly for the ways it was used. But no formal accountability measures were put in place.

Farah Mohamed, spokeswoman for federal Health Minister Anne McLellan, said it is up to the provinces and territories to report to their constituents what purchases are made and that the fund is used appropriately. "We know from some of the reporting that very important purchases have been made, and I don't think people should lose sight of that," she said.

Though half of the federal money did go toward the purchase of MRIs, CT scanners, neonatal incubators and other hospital machines, what was purchased with the rest remains somewhat of a mystery. "Clearly, unless the federal government or the provinces/territories can demonstrate where the monies were spent, we can only conclude that the remainder of the funds have been used elsewhere, whether it be in health or in other non-health expenditures," says the report by the medical association's economist.

André Lalonde, executive vice-president of the Society of Obstetricians and Gynecologists of Canada, said: "We've received virtually none of the money from this fund." Sewing machines, while important, should come out of hospital operating costs, not a high-tech diagnostic and medical equipment fund designed to reduce lengthy waiting lists, he said. "It's a poor choice when we know how hard we fought to get the highly technical equipment to hospitals," Dr. Lalonde said.

The fund was established in the fall of 2000, after provincial governments, hospitals and doctors complained that decade-long cuts to the health-care system had taken their toll. The money was allotted according to provincial population; in exchange the provinces were to provide a public accounting of how the $1-billion was spent. That $1-billion was supposed to be in addition to annual equipment spending by provinces and territories, which the report CMA says averaged $755-million a year from 1992 to 1999.

Months after the federal fund was established, radiologists and other doctors were troubled. They complained that press releases put out by provincial governments announcing new equipment purchases didn't match serial numbers on medical machines and sales reports. "There has been no accountability by the provincial governments," said Normand Laberge, chief executive officer of the Montreal-based Canadian Association of Radiologists. "The federal government needs to say, 'That's it. Enough is enough.' "

A coalition of medical specialist associations, among them cardiologists, orthopedic surgeons, oncologists and others, is being formed. It will press Ottawa to create a mechanism to ensure provinces spend any future medical-equipment money on its intended purpose, he said.

Mr. Laberge said New Brunswick's purchase of lawn tractors, ice makers and floor scrubbers was an inappropriate use of the fund. Don Richardson, a spokesman for New Brunswick Health Minister Elvy Robichaud, said "a fair chunk of money" did go toward diagnostic purchases.

In Alberta, Health and Wellness spokesman David Dear defended the purchases made for mental-health purposes out of the province's $97.7-million share. "We stand by our list because we are sure we followed this thing scrupulously," Mr. Dear said, adding that many major diagnostic and treatment machines were purchased as well. "I would be very surprised if there was any concern on the federal government's part for what's on that list."

Dinah Gray, the Alberta Mental Health Board's acting director of communications, said the tools have a therapeutic purpose for psychiatric patients. Woodworking saws have been used to make furniture, picture frames and children's toys. The sewing machine helps patients with symptom relief and self-esteem, in addition to helping them acquire new skills, she said.

In Saskatchewan, Peter Mayne, spokesman for Saskatchewan Health, said ice machines make ice chips, which are given to patients to keep them hydrated when they are not permitted liquids. He stressed that the bulk of the province's $33.3-million in federal funds was spent on diagnostic and medical equipment.

In Newfoundland, $17.4-million in federal equipment money was pooled with millions in provincial money, then distributed to health boards, said Diane Keough, communications director for the Department of Health and Community Services.

Though the money primarily went to purchase CT scanners, general X-ray machines, mammography units and nuclear-medicine equipment, she said the $90,000 laundry truck is hospital equipment too. "It's equipment the board identified that they needed," she said in a telephone interview from St. John's.

Jill Wheaton, food operations co-ordinator at Lakeside Homes in Gander, Nfld., said the $19,000 steamer cooker makes all the meals for the 110 residents in the seniors home. "It's a replacement of the one we had in the early eighties. We've been using the same one for years and years," said Ms. Wheaton. "It's what we use to cook our vegetables and our meats."

Quebec has not yet spent its $100-million, which the province has said will be used to purchase radiology equipment.

Ontario has spent its allotment of $379.9-million, largely on medical equipment such as ultrasound and X-ray devices.

Information requested from Nova Scotia was incomplete. That province provided data on $14.9-million that was used to purchase diagnostic equipment but did not include an accounting of what remained from its $30.6-million allotment.

Prince Edward Island received $4.5-million. The province wrote to Allan Rock, then health minister, suggesting it would use the money to purchase MRI services and expand its cancer treatment centre.

Nunavut was alloted $900,000, the Yukon $1-million and the Northwest Territories $1.4-million. How that money was spent is not known.

While Peter Collingwood, clinical chief of diagnostic imaging for the Health Care Corp. of St. John's, acknowledged a steamer cooker is important, he said the fund was meant for high-tech equipment purchases. "It's frustrating not being able to access that source," he said, adding that patients wait up to nine months for the province's only MRI. Three new MRI scanners are needed, he said.

In Manitoba, where only $2.84-million of $37.3-million of the fund had actually been spent, patients continue to face long waits for diagnostic services, said Myrna Dreidger, that province's Progressive Conservative health critic. "Our waiting lists for diagnostic tests have gone up," she said in a telephone interview from Winnipeg.

Pat Hosang, executive director of urban regional support services for Manitoba Health, said while that most of the money hasn't yet been spent, it will be — on medical equipment. In the meantime, Mr. Laberge of the radiologists' association said, patients continue to wait. "Patients are waiting for access to high technology, not sewing machines," he said.

Economic Straits