Health Canada has come before this committee for years acknowledging the vacuum of knowledge about where federal health transfers are used but pleading that it can't hold other jurisdictions responsible. What is disturbing about the lack of monitoring and surveillance is not whether or not the recipients are accountable per se, but that Health Canada doesn't appear to think it's worth its while to find out as much as possible about how federal transfer money is being spent. So when you consider that about $24-plus billion dollars are in play, ignorance is not bliss.
Now, why doesn't Health Canada follow its transfers to see if they're being used effectively, whatever the accountability is?