Shocking errors in auditor general’s report on B.C.’s secure supply test

Opinion: Three years into B.C.’s safer drug supply program, government is just beginning to address big problems

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VICTORIA — As BC approaches the third anniversary of the Safer Drug Supply program, a report from the auditor general arrives to explain why New Democrats are having trouble building support for the experiment.

“We found deficiencies in key areas,” said Auditor General Michael Pickup’s Tuesday report on the management of safer supply by the Health and Mental Health and Addictions ministries.

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“Specifically, ministries did not develop or implement strategies to address prominent barriers to implementation, and did not effectively report publicly on performance of the prescribed safer supply.

“For these reasons we conclude that ministries did not effectively monitor the initial province-wide implementation of the prescribed safer supply.”

Some of the rulings were shocking, given recent controversies over the distribution of safer drugs as substitutes for illicit toxic supplies.

Take, for example, the problem of diversion, when prescription and safer-supplied medications are diverted to the illicit market.

The New Democrats dismissed recent RCMP reports of significant diversions in Prince George, Campbell River and elsewhere.

The auditor general found the government has failed to control diversion, according to those on the front line of the safer supply program.

“Health system partners and some health authorities believe that communication from ministries on prescribed safer supply, specifically diversion, has been weak,” Pickup wrote.

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The Ministry of Mental Health and Addictions “has developed a reinforced monitoring plan on diversion, however they have not publicly reported that this work is underway.”

Furthermore, “there is no communication plan for ministries to publicly report the results.”

Even when the government has collected information, the auditor general found that it has been reluctant to make it public.

“There is an internal dashboard on safer prescribed supplies available to ministry staff and partners (e.g. epidemiologists from regional health authorities) with statistics for prescribers of safer prescribed supplies and customers of safer prescribed supplies” , informs.

“The ministries intended for the dashboard to be public in September 2022, but this did not occur during the audit period.”

It hasn’t happened since then either. The audit covered the first two years of the safer supply program, until June 30, 2023.

The government, responding to the auditor general’s report this week, admitted that the work is just beginning.

Pickup found that the government is overly reliant on incomplete and outdated fact sheets on the performance of the safer supply programme.

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“The current level of public reporting from ministries is insufficient to keep health system partners and the public informed about whether prescribed safer provision is achieving intended outcomes effectively and efficiently,” Pickup concluded.

He and his staff also documented major failures in the management and delivery of safer supply.

The two ministries have failed to make “significant progress on some of the most challenging barriers, such as access in rural and remote communities.

“Ministries have documented issues, including programmatic, legal, and medical practice barriers, but have not assigned responsibility for the vast majority of specific steps to address them.”

Those within the system also informed the auditor general and his staff about the lack of progress in engaging key players in delivering safer supply medicines.

“Safer prescription delivery depends on prescribers, and prescriber hesitancy has been a major barrier across the province,” the report says.

“We found that health authorities want ministries to be proactive and facilitate more coordinated planning to build support for rollout across the province.”

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But the auditor general and his staff “found no action plan” to extend safer supply across the province, including rural, remote and Indigenous communities.

“Until these challenges are resolved, it is unlikely that services will be fully implemented.”

The delay could be a matter of life and death for those who need drugs in safer supply.

“Up to 225,000 people in British Columbia may be at risk of death from the supply of toxic drugs, but fewer than 5,000 of them access a safer prescribed supply,” according to the auditor general.

“As the drug supply has become more toxic, the need for barrier-free access to a safer prescription supply has become more pressing. “People continue to die in increasing numbers across the province and at high rates in rural and remote areas.”

The auditor general also criticized the implementation of related overdose prevention programs and supervised consumption sites.

“We conclude that the ministries did not guarantee the effective implementation throughout the province of overdose prevention and supervised consumption services by health authorities,” he concluded.

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Responding to these doubly damning findings on Tuesday, Premier David Eby said the government has accepted all of the auditor general’s recommendations and will begin implementing them.

He missed the most important point of the report about safer supply.

“While the program is novel and in a relatively early stage of implementation, the barriers are known and significant,” the auditor general wrote. “They must be addressed from the beginning. We discovered that no substantial work had been started in this regard.”

Nearly three years later, the New Democrats are just getting started on what needed to be done all along.

But rest assured, they have an endless supply of press releases claiming they’ve made great progress.

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