Every year, usually in December, an annual report from the provincial auditor general becomes public on the AG’s examination of government resources and administration. The annual report contains performance audits of various ministries and agencies, a report on the operation of the Environmental Bill of Rights and follow-up reviews of all the performance audits from the annual report published two years previously.
Sitting quietly in one of last year’s reports was a piece of information that caught the attention of a civil servant who immediately recognized the potentially catastrophic outcome of what she read.
The auditor general had detailed a plan by the Progressive Conservative government to gradually discontinue testing of private drinking water sources across Ontario.
The 2023 Annual Report, no different from previous annual reports, covered a wide swath of provincial activities. Twelve value-for-money audits ranged from health care-related matters to driver training and examination centres. With so much detail released in one fell swoop, not all of the audits garner public attention.
A review of media reports from shortly after the release of the annual report tended to focus on the Ford government’s decision to relocate the Ontario Science Centre to Ontario Place. By January, the media attention shifted to the AG’s audit on the state of the aggregate industry. It was not until early spring, more than four months after the release of the AG’s report, that attention centred on a couple of aspects contained in the audit of Public Health Ontario (PHO), an independent government agency for health protection and promotion.
PHO was established in 2007, as a result of the 2003 SARS outbreak. The agency is considered one of the “three pillars” of Ontario’s public health system, along with the 34 local public health units and the Ministry of Health. However, as the AG audit indicates, PHO is often ignored when the ministry develops policy decisions that impact public health.
The agency supports areas such as preventing and controlling infections and the spread of communicable diseases, improving environmental health and preventing chronic diseases.
The approximately 40-page audit contained ten recommendations, including clarifying the agency’s roles and responsibilities, improving procurement policies, and instituting metrics to measure client satisfaction and service quality.
PHO is also in charge of Ontario’s public health laboratories, spending the majority of its $222 million in annual funding operating the 11 lab testing sites located in Toronto, Hamilton, Kingston, London, Orillia, Ottawa, Peterborough, Sault Ste. Marie, Sudbury, Thunder Bay and Timmins.
The testing done by the laboratories informs public health surveillance, detects threats and outbreaks, and enables preventive action and therapeutic interventions. In addition to diagnostic and confirmatory tests, the PHO labs do complex testing referred by other providers such as hospitals and community laboratories.
During the 2022-23 time period of the AG’s audit, the PHO’s labs conducted 6.8 million tests for diseases such as HIV, syphilis, tuberculosis, influenza, West Nile virus and COVID-19.
The AG report revealed that despite the large volume of tests, many of them were done disproportionately among the 11 labs. During a five-year period from 2018 to 2023, the laboratories in Peterborough, Sault Ste. Marie and Sudbury transferred between 80 to 91 percent of the tests they received to other labs for analysis due to a lack of capacity and/or expertise in their own lab, while the laboratory in Toronto received more than 19 million tests from the other PHO labs.
PHO’s rationale for the high volume of transfers included “capacity issues, lack of expertise or sufficient volume to maintain competency of laboratory personnel in a specific test, lack of equipment to conduct certain tests or (lack of) efficiencies to achieve economies of scale.”
With that context, Recommendation 5 in the audit reads:
“[T]o more efficiently deliver public health laboratory services, we recommend that Public Health Ontario, in conjunction with the Ministry of Health, update and implement a plan within 12 months to streamline public health laboratory operations.”
The agency, given an opportunity to comment on recommendations, as per the AG’s normal practice, indicated that it accepted the recommendation, would work with the Ministry of Health “to update the plan to streamline and modernize the agency’s laboratory operations” and would communicate service delivery changes to stakeholders.
The AG report provided some history on “the plan.”
In 2017, at the request of the deputy minister of health, PHO developed “a joint modernization plan” collaboratively with ministry staff. A search of online PHO documents indicates the process was termed the Laboratory Modernization and Pressure Management Plan, which would have seen the closure of six labs in Hamilton, Kingston, Orillia, Peterborough, Sault Ste. Marie and Timmins.
The government committed to the plan in the 2019 provincial budget but the plan was put on hold due to the construction of the new London laboratory and the increased testing capacity required because of COVID-19. PHO had identified that $6 million in savings would be realized in the consolidation, which was confirmed by a 2020 consultant’s report, however the Ministry of Health, at the time of the AG’s audit, had not re-committed to the plan.
Preceding the recommendation on the efficient delivery of laboratory services was a more general recommendation that the Ministry of Health follow up annually with PHO on any outstanding recommendations, so that the organization could “more effectively plan its activities”.
The section on the implementation of outstanding recommendations noted the planned laboratory closures but also that the plan would see the removal of “20 tests and restricted eligibility for 12 additional tests, as well as the gradual discontinuation of private drinking water testing."
These AG recommendations may have been dutifully carried out by the Ministry of Health and PHO if not for the keen eye of a supervisor at the Ausable Bayfield Maitland Valley (ABMV) Source Protection Region in Exeter, Ont., who first noted the discontinuation of private drinking water testing.
These AG recommendations may have been dutifully carried out by the Ministry of Health and PHO if not for the keen eye of a supervis
The Clean Water Act is the legislative regime that ensures the protection of drinking water in Ontario. The province is apportioned into 19 multi-stakeholder source protection committees, with a mandate of coming up with local solutions to “ensure clean, safe and sustainable drinking water for Ontarians, by protecting sources of municipal drinking water such as lakes, rivers and well water,” as per Conservation Ontario, the non-profit association that represents Ontario’s 36 conservation authorities.
For the Ausable Bayfield Maitland Valley Source Protection Region, located in southwestern Ontario along the southeastern shore of Lake Huron, the implications of the elimination of private well testing could have serious ramifications. The region’s Source Protection Committee were apprised of the AG report, earlier this year, at their meeting on Jan. 31.
The ABMV Source Protection Committee estimated that about half of their region’s population is serviced by private wells. While the private wells do not technically fall under the Clean Water Act, which covers only municipal drinking water systems, the province encourages private well owners to sample their drinking water using the free microbial testing provided by the PHO laboratories.
The committee also pointed out that the elimination of the free testing was counter to the Ministry of Environment, Conservation and Parks, Source Protection Branch’s direction to Source Protection Regions to “deliver education and outreach to private well owners under the new Best Practices initiative.”
Any shift toward private testing raises the spectre of the Walkerton water crisis of May 2000, which saw seven persons die and approximately 2,000 of the town’s 4,800 residents ill from E. coli bacteria in the water supply. The subsequent provincial inquiry from Judge Dennis O’Connor identified the privatization of the municipal water supply as a contributing factor to the crisis.
Unlike the data provided in the AG report regarding the inefficiencies in the PHO laboratory system, there is no indication as to why private drinking water testing was being recommended for discontinuation, though one could conclude that the lack of cost recovery may be a factor.
When contacted by The Pointer regarding any publicly available documents related to the Laboratory Modernization and Pressure Management Plan and, specifically, the justification for discontinuing free private well testing, PHO media relations demurred from providing any background based on the fact that the plan “has not been approved by the government.”
The ABMV Source Protection Committee approved a motion, at their January meeting, requesting that the province not proceed with the recommended phase out of free private well testing in Ontario.
In the related correspondence that went out Feb. 26, addressed to the (then) Minister of Agriculture, Food and Rural Affairs Lisa Thompson, the chair of the ABMV Source Protection Committee made the argument that forcing private well owners to use commercial labs for their testing, at a fee, would disincentivize testing and increase the risk of people becoming ill. The letter also noted how the private drinking water test data maintained by the PHO is used by researchers “to publish evidence that helps support public health policy.”
The ABMV Source Committee’s motion was circulated to other Source Protection Committees, local health units and municipalities in their catchment area requesting support, with a copy to the Minister of Environment Conservation and Parks and the Minister of Health and Long-Term Care.
Around the same time as the efforts from Ausable Bayfield Maitland Valley, OPSEU (the Ontario Public Service Employees Union), which represents 180,000 members, recognized the potential job loss associated with the possible closure of laboratories. The union launched a petition calling for a stop to the closures and an increase in public health infrastructure investment. OPSEU argued that consolidation would increase travel time, compromising the integrity of samples, “causing further delays in getting results and putting patients and our communities at risk.”
After the AG’s Annual Report is tabled, it is referred to the Public Accounts Committee for review. The issue of the discontinuation of the private water testing had yet to generate more widespread attention. When the committee met on March 4, the topics of discussion were the Value-for-Money Audits of Tourism Support Programs and the Metropolitan Toronto and Ottawa Convention Centres, the review of government advertising and the special report on changes to the Greenbelt.
By April, however, most of the other 19 Source Protection Committees had sent letters in support of the ABMV Source Committee’s motion to the government. Niagara’s Source Protection Committee considered a report at their March 26 meeting.
The staff report commented that the AG recommendation on the discontinuation of private well testing was “concerning” and that a past study had identified the Niagara Peninsula as an area of elevated risk for E. coli contamination, based on private well water testing data.
A past study had identified the Niagara Peninsula as an area of elevated risk for E. coli contamination
A number of different chemicals can also enter into the private water supply, such as lead, nitrogen, phosphorus, sodium, copper, arsenic, cadmium, and fluoride. Testing ensures the levels of each of these, and other chemicals in the private drinking water supply are not above amounts considered safe for human health. Lead, for example, is commonly found at high levels in surface water near areas where residents use wells.
The Canadian government has established a “maximum acceptable concentration” of five micrograms per litre for total lead in drinking water.
Readings in parts of Niagara of surface water have shown levels above this threshold, however this does not mean private drinking water in the area would necessarily have unhealthy levels of lead.
From the staff report:
“[P]rivate drinking water systems have always been top of mind for many working in drinking water protection programs, including source protection. While private drinking water systems have always been the responsibility of the owners, it has always been helpful to point residents who have concerns about their drinking water to this free testing program that is available.”
In the letter supporting the ABMV Source Committee motion and asking the province to reconsider the AG recommendations, copied to Niagara’s municipal councils, Niagara Peninsula Source Protection Committee chair Bill Hodgson reiterated the negative impact the discontinuation of private well testing would have.
The Niagara committee, however, was not necessarily opposed to possible efficiencies in the reduction of laboratories, despite the potential closure of the Hamilton lab that serves Niagara:
“Efficiency may be gained by reducing the number of laboratories, another method of submitting private drinking water samples to remaining laboratories should be considered. For example, facilities that already send samples to provincial laboratories (hospitals, public health units) could be considered as drop-off points for private water samples thus making use of centrally coordinated courier services.”
The actions of the Niagara Peninsula Source Protection Committee prompted the three Niagara NDP MPPs to send a joint letter to Minister of Health Sylvia Jones calling on the government to maintain the “life-saving service” of private well testing.
With the issue of the discontinuation of free private water testing finally gaining attention more than four months after the release of the AG report, Minister Jones was forced to address the matter in the provincial legislature on April 16. While she stated, ”there is no one in the province of Ontario or in this legislature who believes that putting well water testing at risk is on the table,” she couched her language carefully in the present tense indicating that there were no changes in testing and that the ministry had not made any decisions about changes to the provincial well-water testing program.
Less than a week later, on questioning from MPP Jennie Stevens (St. Catharines), the minister was more emphatic: “My question is to the minister of health. Despite recent assurances that there have been no changes to water testing, communities like Niagara depend heavily on Public Health Ontario’s free drinking water testing. They need to know the minister is committed to keeping those labs open … Can the minister explain why the discontinuation is still under consideration when so many experts are telling you it’s a big mistake?”
Minister Jones: “Speaker, this is going to be the third time: To be clear, there are no changes, where the people of Ontario can get their well water tested for free in the province of Ontario.
“I grew up on well water, I know how important it is. There are many people in this chamber who understand the value and importance of why and when we test public well water in the province of Ontario.
“I want to remind the member opposite that this was actually a report that came out from an independent officer of the assembly, the auditor general. And the last time I checked, the auditor general does not impose and set policy on the people of Ontario. We do that. As a government, we have been very clear that there are no changes anticipated in well water testing.”
After a further question from MPP Stevens, bringing up the legacy of Walkerton, the minister responded: “We will continue to test the well water in the province of Ontario. We’ve had it for decades. I grew up with it. It is a system that many of us understand the value and importance of in rural Ontario because we lived it every single day. We’re going to continue that process.”
The minister gave no indication that the testing regime would remain free to the more than three million Ontarians on private wells, nonetheless, it appears to be status quo for now. In addition, there appears to be no movement to close any of the PHO’s 11 laboratory sites, no matter how inefficient they are.
At some point the proposal to discontinue private well testing would have certainly become apparent, but it could have occurred at a point where the government may have been too far along to change course.
The efforts of the Ausable Bayfield Maitland Valley Source Protection Region were duly noted by the Source Protection Manager at Conservation Ontario:
“[U]nder the leadership of Ausable Bayfield Maitland Valley Source Protection Region, many of the Source Protection Committees and local councils have been passing resolutions requesting that the government not phase out private water well testing, further to a recommendation found within an auditor general's report into Public Health Ontario. This issue was raised at the Conservation Ontario Council at our AGM. The province had previously refused to clarify whether they would be taking that step. Just recently, Health Minister Sylvia Jones stated that the province would continue to provide free well water testing. Congratulations to those involved in the efforts to make this happen.”
It is unclear how the auditor general will reconcile the recommendation to close PHO laboratories and cease private drinking water testing in its two-year follow up review of the value-for-money audit.
Dean Iorfida is a Local Journalism Initiative reporter based at The Pointer.
