Result at a Glance - Evaluation of Health Canada’s First Nations Health Facilities Program 2010-2011 to 2014-2015

Health Canada’s Health Facilities Program (HFP)

  • The purpose of the evaluation was to assess the relevance and performance of HFP for the period of 2010/11 to 2014/15.
  • The HFP funds eligible First Nations for the construction, acquisition, leasing, expansion and/or renovation of health facilities. These activities are intended to provide First Nations communities with the space required to safely and efficiently deliver health care services.

What the evaluation found

  • The program is relevant. There are ongoing challenges in First Nations communities including the increasing costs of maintenance and construction and changes in types and amounts of health services and programming delivered.
  • There has been a gap between the need and the resources available for health facilities. Regional involvement has helped prioritize areas of greatest need and risk.  
  • There is variation in the technical and administrative capacity of First Nations recipients.
  • Due to a number of gaps in program data collection, the overall safety of the health facilities could not be assessed.
  • There are impediments to the program’s access to accurate information. Regions have developed various information systems to meet immediate needs.
  • The policy of auditing the facilities every five years was met for 75% of facilities. There is variability in how audits and inspections were conducted which restricted comparison and roll-up of findings.
  • The 83 audits and inspections examined identified 1,900 issues of which approximately 30% were defined as critical (6% priority one: a significant threat requiring immediate action; 24% priority two: a substantial concern requiring action without delay). Examples of critical issues included missing carbon monoxide detectors, no plans for emergency environmental events and roofing repairs.
  • The evaluation concluded that the audit findings indicate some level of safety and security within the facilities as no facilities have been closed.
  • HFP has implemented design and delivery efficiencies such as coordinating with other departments/ jurisdictions and considering functionality when planning facilities.

Recommendations and responses

1. Health Canada should work with First Nations communities to ensure that FNIHB’s policy on the frequency of audits and inspections is implemented as intended and that deficiencies related to the health and safety requirements or building codes are systematically tracked and prioritized in the annual capital plans, both regionally and nationally.

Response: Health Canada will track and report on the frequency of audits/inspections as per the FNIHB policy. Tracking results will be presented for 2015-16 and 2016-17. Capital recommendations will be included in the Long Term Capital Plan (LTCP) effective 2017-18, based upon the available capital budget.

2. Health Canada should replace its existing management information system for the HFP with one that can provide program-level analyses of activities, outputs and outcomes that can also be accurately linked to expenditure data.

Response: FNIHB will continue to work through the departmental Investment Planning process for an appropriate replacement system, while also recognizing the need to work within the Health Canada – Shared Services Canada priority list. In the interim, FNIHB will continue to implement mitigation measures to ensure business processes can be followed and information of value is collected. 

3.  Health Canada should increase the level of consistency across regions with respect to a core set of standards related to facility audits and inspections, while continuing to allow for regional flexibility. 

Response: Health Canada will develop a core standard to improve the ability to compare and roll-up findings and recommendations.

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