Manitoba air ambulance contract broke tendering rules, lacked oversight: auditor

WINNIPEG – Manitoba’s auditor general says the government broke its own tendering rules and didn’t ensure it was getting value for money when it signed a $159-million air ambulance contract.

Carol Bellringer also says the province failed to establish proper monitoring of patient safety on the air ambulance fleet.

Bellringer says a 10-year contract signed in 2012 with the Shock Trauma Air Rescue Service, known as STARS, was never put out for public tender and was signed despite evidence the cost-per-mission would be up to 600 per cent more than in other provinces.

“Without the benefit of a tendering process, (Manitoba) Health could not demonstrate that they are achieving value for money, balancing price with economy, efficiency and effectiveness of the goods and services required,” Bellringer wrote in her annual report tabled in the legislature Wednesday.

Manitoba recently grounded STARS for three months after three critical instances where patients may have been deprived of oxygen. The non-profit agency, which has operated for years in Alberta and Saskatchewan, agreed to upgrade its equipment, increase training and work with a new oversight panel.

Bellringer said Manitoba didn’t adequately explore other options, such as expanding its own fleet of 24 air ambulances called Lifeflight, before it signed the contract in 2012. The government’s own analysis showed Lifeflight could have completed around 600 missions at a cost of $3 million, she said.

“The substantial cost difference should have prompted … further analysis to determine if budgeted numbers were reasonable,” Bellringer wrote. “We found no documented analysis or evidence explaining this significant cost difference. (Manitoba) Health could not demonstrate to us that it is receiving value for money.”

The air service was grounded after a woman died shortly after landing in Winnipeg for medical care in late November. Her death was later attributed to an underlying medical condition.

Last May, a two-year-old boy was left brain-damaged following a flight from Brandon to Winnipeg during which his breathing tube became dislodged. In February 2013, there was a case where a patient was not provided with sufficient oxygen.

Although concerns about the quality of patient care aboard the ambulances were raised, Bellringer said Manitoba Health doesn’t have an adequate way of monitoring the “patient care that STARS provides.”

“Such a process may have detected some quality of patient care concerns earlier.”

Bellringer recommends the province develop better ways to monitor STARS operations and ensure its insurance certificates are updated annually. The province has agreed to all recommendations.