TORONTO -- Children in Ontario undergoing CT scans have been unwittingly subjected to radiation doses equivalent to more than 4,000 X-rays, levels high enough to raise cancer fears, the province's Auditor-General says.
In his sweeping annual report yesterday, Jim McCarter said doctors have underestimated the effects of certain diagnostic imaging tests on patients, especially children, and have exposed them to levels of radiation that are believed to cause cancer.
A survey by his office found that 94 per cent of pediatricians who refer a patient for a CT scan were not aware of the effects of radiation exposure on a child's body. Studies have shown that, because children's organs are more sensitive, a single CT scan of a stomach is the equivalent of more than 4,000 X-rays.
The auditor not only put a magnifying glass on doctors' growing dependency on CT scans and other expensive procedures such as magnetic resonance imaging. He also used broad new powers recently given to his office to scrutinize numerous public-sector agencies for the first time, including the Ontario Health Insurance Plan, children's aid societies, school boards and the Crown corporations that keep the lights on.
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He found a litany of questionable spending practices, including those of Hydro One chief executive Tom Parkinson, who billed about $45,000 in business expenses on his secretary's corporate credit card, thus avoiding any scrutiny by the board of directors and the corporation's external auditors.
The Auditor-General also found an OHIP system riddled with problems, including indications that people not entitled to services are receiving free medical care. There were 12.9 million OHIP cards in circulation as of December, 2005, a number that exceeded the population by 305,000.
Health Minister George Smitherman said yesterday that the number of cards in circulation is now roughly equal to the province's population. However, other problems remain, including how easy it is to get away with defrauding OHIP. Since 1998, the Ministry of Health has referred 1,150 of its most serious cases to the Ontario Provincial Police, but it has recovered only $37,000 of $700,000 outstanding. OHIP's fraud branch has a backlog of 7,000 cases.
Three doctors put in claims for 800 patients totalling $58,000 after their licences to practise medicine had expired. Another doctor whose licence had been suspended received payments for 300 patients. Even three doctors who were dead managed to continue collecting OHIP payments.
Some of the Auditor-General's most damning findings -- on four of the province's largest children's aid societies -- were leaked last week. He found questionable spending on luxury cars, Caribbean vacations and a $4,600 annual gym membership, while at the same time case workers did not respond quickly enough to the situations of vulnerable children.
Mr. McCarter told reporters yesterday that the government needs to tighten its oversight of the province's 153 children's aid societies.
"We're concerned," he said. "How can you not be concerned?"
Mary Anne Chambers, Minister of Children and Youth Services, announced yesterday the creation of an accountability office to toughen enforcement and monitor the societies. "The wellbeing of children has to come first in every instance," she said.
The Auditor-General also found lax controls for documenting expenses.
At Ontario Power Generation, there were no receipts to support $6.5-million in expenses.
It was Mr. McCarter's probe of the use of CT scans that took him beyond how taxpayers' money was spent. Over the past 10 years, the number of CT scans in Ontario has jumped 200 per cent -- and he found that in 50 per cent of cases at two hospitals that perform pediatric CT scans, radiologists used inappropriate settings.
"No one should pretend that a report like this doesn't land with an exaggerated thud," Mr. Smitherman told reporters. "We take this issue very, very seriously.
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