Public Accounts Committee on Oct. 29th, 2026

[Karen Hogan]

I think AI could help with the volume of data that's there, but it will always take a human in order to be able to really make a determination. It is about finding the right balance between leveraging technology, because of the volume, but also making sure you have the intelligence of the analysts in order to be able to determine whether things are suspicious. These are bad actors. They're not making it easy for you to identify. You do need a human in this process no matter what.

[The Chair, Conservative, John Williamson]

Thank you.

That is your time, Ms. Yip.

Mr. Blanchette‑Joncas, you have the floor for two and a half minutes.

[Maxime Blanchette-Joncas, Bloc, Rimouski-Neigette—Mitis—Matapédia—Les Basques, QC]

I would like to return to an important program: the Canadian dental care plan. I can tell you that many people in my constituency have phoned me because it was not easy. I understand that anything new requires us to adapt, but many people have told me that their application for enrolment was refused, sometimes for unclear reasons. Yet, according to them and according to the criteria, they were entitled to it.

Your audit mentions that people were refused even though they were eligible for the plan. Now that your audit has been carried out, are you able to say whether the people concerned have managed to have their cases reviewed?

[Karen Hogan]

I cannot provide you with such specific details, but we are passing on our findings to the Department of Health. Following up on people who were refused cover by the scheme despite being eligible is very much part of the department's responsibilities.

[Maxime Blanchette-Joncas, Bloc, Rimouski-Neigette—Mitis—Matapédia—Les Basques, QC]

It appears that there is a problem, firstly, with eligibility for the program and, secondly, with obtaining responses from Sun Life, the private company to which the government has awarded the contract.

Your audit states that, in 2025, only 16% of applications for prior authorization had been processed within the stipulated three-day time frame. That is only 16%.

Do you think that failing to meet the standard three times out of four may have delayed people's treatment?

[Karen Hogan]

It depends. Ninety-seven per cent of services do not require prior authorization. So what you're saying really applies to those services for which authorization must be obtained. In my view, if a service standard has been established, it should be adhered to. In 2026, there was an improvement for around half of the requests. Once again, it really is up to the Department of Health to work with its provider to improve the service.

[Maxime Blanchette-Joncas, Bloc, Rimouski-Neigette—Mitis—Matapédia—Les Basques, QC]

Can you explain, in your audit, why we are unable to meet the standard half the time?

[Karen Hogan]

Actually, I haven't really checked what Sun Life does on a day-to-day basis. We are checking how Health Canada carries out its monitoring. We have found that Health Canada monitors the decisions taken, and these decisions comply with its criteria in most cases. However, I cannot explain why there is a delay in the provider's responses.

[The Chair, Conservative, John Williamson]

Thank you very much.

Ms. Dancho, go ahead for five minutes, please.

[Raquel Dancho, Conservative, Kildonan—St. Paul, MB]

Thank you, Mr. Chair.

I reviewed your report on the Public Health Agency, Ms. Hogan. I saw it as a bit of a post-mortem of the federal government's management, at least in part, of the COVID-19 pandemic. As you're aware and as you outlined in your report, the Public Health Agency of Canada's national emergency strategic stockpile maintains the stockpile of medical supplies for public health emergencies, like pandemics. That's my understanding. It also works in conjunction with provincial stockpiles.

Your report gives what I would say is a resounding failing grade to the government's performance regarding emergency medical supplies during the COVID-19 pandemic. To summarize what you wrote, there is a significant and persistent weakness in the management of national emergency strategic stockpiles. You said that there are “gaps in its understanding of the types and quantities of medical supplies it needed” to respond to future public health emergencies. You also said that the Public Health Agency lacked “a strategy to manage excess and expired inventory” and in fact “wrote off” over 300 million dollars' worth of medical supplies that had expired or been damaged. Further, you said that the agency did not address “known deficiencies” in stockpile warehouses, including over 20 million dollars' worth of pharmaceuticals it had to throw out largely, from what I read, because of a cold storage problem they'd known about, as you outlined, for several years.

Finally, in your 2021 report on the procurement of PPE, you found that there were long-standing problems in stockpile management at the time. You outlined in this report that, since then, 14 actions have been set forth by the Public Health Agency, but only five have been implemented. There have been five small actions taken since the 2019 COVID-19 pandemic. That is my read.

From your reading of this, those five actions were not the most important actions that needed to be taken. Is that correct?

[Karen Hogan]

You did an excellent job of summarizing it. Thank you.

I think those five actions were some of the easier ones to accomplish. Some of the more complex ones, like ironing out information-sharing agreements with the provinces and territories, haven't yet been done. That one is so essential, whether it be for medical information, as we saw during the COVID-19 pandemic, or.... It's about knowing what the provinces and territories have in their stockpiles so Canada can be aware. The federal stockpile is supposed to supplement that. The federal stockpile plays a critical role when it comes to pharmaceuticals. There are certain things that only the federal stockpile has. It's important to have that awareness and collaboration among all levels of government so there can be a better Canadian response.

[Raquel Dancho, Conservative, Kildonan—St. Paul, MB]

There's a clear mandate for the national emergency strategic stockpile, as you outlined, to ensure that the country is prepared, whether it's for a natural disaster or a pandemic, but also for national security threats like a chemical, biological, radiological or nuclear attack.

I see you are nodding your head.

To confirm, there is not a single government agency, including, notably, the one you outlined, that can give an accurate account of what medical supplies we have or how prepared we are in case of a major global conflict on Canadian soil or another COVID-19 pandemic, for example. There is no central database in Canada.

[Karen Hogan]

If you are looking Canada-wide, no. The federal government could tell you about its stockpile, and every province and territory could tell you about theirs.

That's why we think it's a key action that needs to be addressed. It's so the awareness is there.

[Raquel Dancho, Conservative, Kildonan—St. Paul, MB]

I would go even further than the report. I feel this is a national security emergency, if you look at it from a 30,000-foot level. Ultimately, our elected government is responsible and charged with safeguarding the health and safety of Canadians. The Public Health Agency is supposed to do that work on its behalf.

Despite the serious and persistent issues you clearly outlined, I wasn't able to find in your report or anywhere else a clear ministerial or prime ministerial directive during or since the COVID-19 pandemic to address this—not from the current Prime Minister, Prime Minister Trudeau or any health or public safety minister. I could not find a single elected Liberal in charge throughout the last number of years who has mandated and overseen the significant improvements that are needed.

In short, is it correct to say that Canada has remained woefully unprepared in terms of our emergency preparedness capacity regarding medical supplies since the COVID-19 pandemic? Would you agree that we are unprepared if that happens again?

[Karen Hogan]

I think we all lived through the pandemic in 2020 and 2021 and saw the public service rise to the challenge and help support a Canadian response.

It's my expectation, based on all the years of findings, that my office has given them recommendations going back to H1N1 and SARS, and they're not acting on those. Therefore, I would tell you that there are significant weaknesses in how they manage this stockpile. The country is not as well prepared as it should be for a next emergency, and that's why they need to do the basics. Get your needs done, and buy what you need to make sure that your stockpile is as equipped as it should be.

[The Chair, Conservative, John Williamson]

Thank you, Ms. Dancho.

Up next we have Mr. Osborne, please, for five minutes.

[Tom Osborne, Liberal, Cape Spear—Mount Pearl—Paradise, NL]

Thank you. I have a couple of questions for the Auditor General.

You talked about 81 requests from provinces for part of that stockpile. Can you tell us how many of those 81 requests the Public Health Agency actually fulfilled?

[Karen Hogan]

The 81 requests were received over the two-year period we audited, and all 81 were responded to.

They are different types of requests. Some were to respond to emergencies, such as wildfires or flooding, to supplement what the provinces and territories had in their stockpiles. Others were preventative for major events. There's equipment that is sent, for example, for the G7. Responding to the day-to-day is one thing, but the national emergency strategic stockpile should be prepared for something of the magnitude that we all lived through in 2020 and 2021, and that's where it's falling short, in being prepared for something of that size again.

[Tom Osborne, Liberal, Cape Spear—Mount Pearl—Paradise, NL]

I appreciate that.

Your study ended on March 31. With regard to the actions that you identified had not been achieved by the Public Health Agency, has there been any communication with it since to determine what may have been done since March 31 in terms of the scope of your assessment?

[Karen Hogan]

We ended our audit period in March 2026, but if you look at the back of our audit, you'll see that we actually date our audit report. That would have been the last day that we had a conversation. I can tell you on this one that, personally, I had many conversations with the deputy minister, so it is very recent. They also have an obligation to tell us all of the things that are still happening after March 31, and we have an obligation as an auditor to consider if it's important enough to adjust what we've said. Anything we think is critical will have been factored into this so far.

[Tom Osborne, Liberal, Cape Spear—Mount Pearl—Paradise, NL]

What changes have taken place between March 31 and today?

[Karen Hogan]

I don't think there were any big, subsequent events after March 31 that we needed to include here. I do know that they are working very hard on their needs assessments and scenarios because that's the starting point, but we haven't seen anything new be completed. Therefore, we didn't feel it was necessary to update our assessments. In some cases it's only half of the supplies, and in some cases it's 20%, so we didn't feel the need to update that.

[Tom Osborne, Liberal, Cape Spear—Mount Pearl—Paradise, NL]

In terms of the dental plan, we, as members of Parliament, get calls from folks who have applied, were approved and subsequently found out they had coverage elsewhere. It created some issues.

I know the government announced some upgrades, new pre-eligibility verification and so on, recently. Will that address some of the issues that you've identified?

[Karen Hogan]

I'm not sure that I'm aware of some of the pre-eligibility changes that have been announced, so I apologize. I think improving communication is definitely something we had as a finding, and it's communication with oral health providers, who are really the main conduit, day-to-day, with plan members. We also found that it wasn't always clearly communicated to plan members that they may not get dental service free of charge. Given the way the system works, every Canadian in the plan might actually still have something to pay.

There's always an opportunity for improvement, and I think one of the key areas here to improve is communication.

[Tom Osborne, Liberal, Cape Spear—Mount Pearl—Paradise, NL]

Overall, in your assessment of the dental plan, what has the impact been for Canadians in general? Has it been a positive program for Canadians?