The complex, convoluted network that is ORNGE

By MPP Toby Barrett

The scandal surrounding ORNGE air ambulance has been in the headlines and the talk around many coffee shops as of late. As a member of the Public Accounts Committee, I’ve had an opportunity to examine this situation up close through both Auditor General Jim McCarter’s report and testimony before the committee.

It is unfortunate that Government members used stall tactics during committee last week to grind proceedings to a virtual standstill moments before key witnesses like former Minister of Health George Smitherman and other government officials were about to testify. Those we were able to hear from underlined the need to dig deeper.

Indeed the report, and testimony before our committee, describe a lack of oversight and control going back to the inception of ORNGE.

It was in 2005, that the Ministry of Health and Long Term Care announced it was appointing a not-for-profit Ontario Air Ambulance Corporation – soon to be renamed ‘ORNGE’. Up until that time, the Ministry had contracted with private operators.

However, the Auditor’s report identified $700 million in government funding going out the door to ORNGE with no follow up since it was established.

ORNGE’s first priority must be to ensure the safe and timely transport of patients needing air ambulance services. To that end, in 2006, the Ministry committed to set and monitor standards to ensure that the “end result will be improved care, improved access to service, increasing effectiveness and efficiency of the delivery of service, and the assurance of greater fiscal and medical accountability.”

But the report paints a different picture.

For instance, while funding to ORNGE for air ambulance services had increased more than 20 per cent since 2006/07, the number of patients actually decreased by six per cent. Meantime on land, ORNGE received $65 million to perform inter-facility land ambulance transfers, projected to number 20,000 annually. “However, ORNGE is currently providing only about 15 per cent of the projected transfer.”

While the Ministry of Health continued to dole out cash, oblivious to its use, ORNGE board and management, “created a network of for-profit and not-for-profit subsidiaries and other companies with which ORNGE has entered into complex financial arrangements to deliver air ambulance services.”

ORNGE’s corporate head office is one of many examples of the convoluted arrangements officials utilized. As the Auditor pointed out, ORNGE used $15 million in funding borrowed through a bond issue to purchase the building that houses its corporate head office. ORNGE then entered into a complex arrangement with other entities it created to sell the building and lease it back to itself.

McCarter calculates that, “Over the first five years of the 25-year lease, this amounts to ORNGE paying $2 million more than it should pay.”

ORNGE has borrowed almost $300 million to finance, among other things, the purchase of 12 new helicopters, 10 new airplanes, and 11 used helicopters.

Meanwhile, the Minister of Health argues she should not be fired, because “We fired the CEO…We fired the board.” However, in front of the committee her deputy minister admitted that, “The board agreed to resign on their own volition.”

The Minister has a responsibility to ensure that services are being provided cost-effectively, meeting the needs of the public and our health-care system – those responsibilities are clearly not being met.

I look forward to digging deeper in the coming weeks of committee deliberations on ORNGE.