Ask someone in government or the health sector about the Ornge scandal, and you'll get a lot of eye-rolling. With its bizarre schemes to leverage public dollars for private profit, Ontario's air-ambulance service spiralled so extraordinarily out of control that it's largely seen as an outlier.
But just because Ornge was an extreme case doesn't mean there's nothing to learn from it. With a committee of MPPs set to resume its investigation on Wednesday, here are a few things the government should have learned already about what to do differently in future, to better defend public dollars and trust.
Draw clear lines between public and private
At the core of the scandal is a blurring of lines between for-profit and not-for-profit operations. That led to Ornge making a big commitment to a manufacturing contract – then accepting a private consulting contract from the manufacturer. It also allowed former CEO Chris Mazza to keep his exorbitant salary away from public view, even though public dollars went toward it.
There's nothing inherently wrong with public-private partnerships; many have worked out well for Ontario. But when a fledgling company is pledging to run parallel public and private operations – in Ornge's case, accepting $150-million annually to serve the public health system, while also trying to build a private client base – there need to be firewalls.
Get serious about corporate governance
Ornge's board of directors has been accused of not looking closely enough at what came before it. But it's hardly unique for directors – particularly those who sit on multiple boards – to be unengaged in day-to-day operations, and unwilling or unable to ask necessary questions.
In future, government should make sure that its companies, agencies or partners have people in place to hold executive leadership accountable. One option, a health-policy veteran suggests, is to put a senior public official – a deputy minister, for instance – on the board. That way, if nothing else, the government will have eyes and ears at the table if things go off the rails.
Be realistic about political accountability
It's no great mystery why Health Minister Deb Matthews and top officials in the Premier's office overlooked early warnings about Ornge. They have enough headaches already; they weren't looking for another one involving a relatively small dollar figure, at a company most people had never heard of, involving complaints that would have taken weeks to sort through.
That's an explanation, but not an excuse. In fact, it's a consequence of too few people being entrusted to make key decisions. If the highest officials can't be expected to keep tabs on every file – and, realistically, they can't – then they need to delegate.
A related question, unlikely to be answered any time soon, is whether one minister should really be in charge of nearly half of government spending.
Crack down on unregistered lobbying
"I never lobbied," former Liberal Party of Canada president Alf Apps said before committee recently, moments after acknowledging he had called a senior government official to inquire about setting up a meeting with Ornge executives.
It's well known around government that there are senior Liberals who trade on their influence with the government while passing themselves off as consultants or legal counsel, avoiding the scrutiny that comes with registering to lobby. Whether Mr. Apps fits that description is open to interpretation. But he at least helped reignite the question of what a lobbyist is exactly.
Beware of fast-talking people with all the answers
Former health minister George Smitherman, who had a thirst for change but little appetite for details, was especially susceptible to a sales pitch like the one he got from Dr. Mazza. But as they try to flatten health-spending increases, while maintaining or improving on the current level of service, governments could still fall into that trap.
Some risk and experimentation are healthy, and the pendulum shouldn't swing too far the other way. But if you've seen the "Monorail" episode of The Simpsons, you know the danger of someone slick selling you something that sounds too good to be true.
Adam Radwanski