Public Accounts committee  Thank you. Chair. There are several elements in that. Perhaps first to your question of whether it is robust enough, I'd make several points. One is that we have not audited the action plan. Just to put the caveat right up front, we haven't had a chance to sort of look behind the kind of progress that the agency is claiming in order to see what's actually been done.

Public Accounts committee  Mr. Chairman, thank you for this opportunity to present the results of our audit on surveillance of infectious diseases at the Public Health Agency of Canada, published in our May 2008 report. With me today, as you've noted, is Louise Dubé, principal responsible for audits of the Public Health Agency of Canada.

Public Accounts committee  Thank you, Chair. I'll be brief. Thank you for that question. We've talked a lot about the types of transfers that are unconditional. This is an example where there were quite a few conditions. The accountability framework that was put in place in 2008 had a number of different aspects, and very much the kind of thing that was put in place is typical of that portion of transfers where there are conditions.

Health committee  Well, it was a study for the very reason that essentially we asked ourselves a question: what kind of value-added could the legislative auditor add to our clients around this table and throughout Parliament? And our conclusion was that there was a lot of confusion about these transfers.

Health committee  On that question, the reason we didn't do an audit is that essentially all the judgmental elements here are judgments about policy, and so much of that is the result of all the federal-provincial negotiations that have been described here.

Health committee  Yes, thank you, Chair. Thank you very much for this opportunity to come here and talk about our work. This is what we live for, and this is why we do all this work. The other thought I had to leave with your committee is in terms of what next steps might be. As I mentioned before, as the auditors we monitor annually what kind of action is done by departments, satisfactory or unsatisfactory.

Health committee  Thank you, Madam Chair. I think it's difficult to say if it's more or less. It's different. The accountability is very much different, and as we describe in the study, the mechanism is essentially a trust. It's essentially an unconditional one in that there are some administrative things the provinces need to do, but once the money leaves the federal coffers, it essentially goes without any conditions.

Health committee  Thank you, Madam Chair. Just by way of a little bit of information, we do monitor on an annual basis how well departments are doing on our recommendations. I'll turn to Health Canada specifically in a moment, but in general what we find—it's one of our performance indicators and we publish it in our own departmental performance report—is that, by and large, departments do listen to what we have to say.

Health committee  Madam Chair, to clarify, we're really talking about two different chapters that we are presenting here. One is a study, which is the description of how the federal transfers work in general. The second part, which is very much an audit, is the piece where we have the comments about the health indicator reports.

Health committee  I got that part of it too.

Health committee  Thank you, Madam Chair. I'll be brief. There are really two levels, I would say, where activity has to go on. First of all, Health Canada really needs to get together with all of the other players here. You mentioned the CIHI, the PHAC, and Statistics Canada. When you look at what's been published, there's clearly an opportunity to make some low-hanging fruit, as I would characterize it.

Health committee  Yes, Ontario is one of the provincial auditors general working with us.

Health committee  Yes. Thank you, Madam Chair. This is such a great opportunity that I can't let it pass by. As we speak, we're in the midst of doing an audit on electronic health records for this fall. It's an interesting one too, because we're working in collaboration jointly with six of the provincial auditors general who are looking at how electronic health records are being rolled out in their respective provinces.

Health committee  Yes, thank you, Chair. There are several things. One is that, like any good auditor, we would reserve judgment until we can see it--we're from Missouri. Nonetheless, I think that in listening to what Health Canada has said it has done as part of 2008, there's certainly much more change there than we saw in any of the previous editions, and their conclusion was that each of the previous three editions was largely just a repetition of the one that preceded it, with relatively little creativity, relatively little sense of trying to continuously improve.

Health committee  Madam Chair, absolutely. We have had discussions through the years. We've been involved in this production for some years, in each of the editions, in different ways. We have those ongoing dialogues. As auditors, when we do that we're very careful to maintain our independence, for the simple and very important reason that if we were so involved with working with Health Canada or any other departments that we were no longer objective, then we really couldn't do our audit job later on.