Global consulting firm McKinsey was awarded a $1.6 million contract to advise on the province's pandemic response structure after it cold-called the premier's office, the long-term care commission has heard.

The commission has been completing some of the final interviews of its tenure, drilling into the details of issues that contributed to the spread of COVID-19 through Ontario's long-term care homes. That includes the province's decision-making structure, which has been tweaked and shifted many times over the past year.

John Callaghan, co-lead counsel for the commission, led an interview of two high-ranking bureaucrats about the command structure: Alison Blair, associate deputy minister for pandemic response and recovery with the Ministry of Health, and Jill Vienneau, assistant deputy minister for the central coordination table secretariat in Cabinet Office.

The commission's questions come after the province's auditor general released a report highly critical of the province's "slow and reactive" pandemic response, alleging public health advice had been sidelined in the "cumbersome" command table structure, which she said had been created by a consultant — McKinsey and Company — in a $1.6 million sole-sourced contract.

One of Callaghan's questions was if the contract was a result of a cold-call to the premier's office.

Vienneau said that was true. The consultants had also sent some documents and some research to senior officials in government and the consultants ultimately worked with Cabinet Secretary Steven Davidson and the premier's chief of staff, James Wallace, on their review, who also co-chaired the central command table that was struck.

In February, when the novel coronavirus was becoming a clear threat, the province created a health command table to lead the pandemic response. After sitting in on the province's highest level meetings, McKinsey advised Ontario to build on that, including a broader perspective, and create additional tables.

Other advice was to delegate power down to the lowest appropriate level so decisions could be made quickly, to ensure meetings end with clear next steps, to have "a clear line of sight on decisions with a bias to action," and to ensure there is a "challenge role" at meetings, referring to asking tough questions.

McKinsey also worked with the Ontario Digital Service on creating a dashboard of pandemic data, said Vienneau.

By April 24, the company had completed work on the pandemic response structure. According to the auditor general, the company was paid an additional $3.2 million to assist with the province's COVID-19 recovery planning and the reopening strategy for education.

However, there were changes to the command structure after McKinsey's involvement. In October, the Health Command Table was renamed the Health Coordination Table and tasked with providing advice to a new Joint Minister Pandemic Response Leadership Table, led by the minister of health and the minister of long-term care. That stemmed from a review of the command structure by deputy minister of health Helen Angus, who also suggested that more external advice be included and that the other advisory tables be given more public visibility.

(Above, the response structure is seen before the shift to the health co-ordination table.)

The structure was also modified to include Chief Coroner Dr. Dirk Huyer's role as outbreak coordinator and the formation of the vaccine task force in late 2020.

The complex structures were being created and changed as they were leading the pandemic response, with Vienneau likening that to keeping the bus running while being on the bus.

"I must say when I look at the diagrams, I think of the London underground," quipped Callaghan, referring to the complex organizational charts that had prompted many questions from the commission. "I think you needed to get that guy to do a schematic of your tables."

The commission stopped taking submissions from members of the public at the end of January. It has made plans to interview the ministers of health and long-term care, as well as their deputy ministers and the chief medical officer of health.

The commissioners' complaints over the government's slow release of documents have continued and some of it was captured in the transcript of the interview on the pandemic response structure.

Callaghan said at the outset the commission believed it hadn't yet received all of the relevant documentation on the subject, as it was missing documents from Vienneau, as well as the "political emails" from the premier's chief of staff and some that may include the cabinet secretary.

"This is a very, very difficult process, but we're the ones that have to report," said lead commissioner Frank Marrocco. "And if we don't get the documents that we need in time to do the interviews properly, that obstructs our process and makes it, I think, unnecessarily difficult."

The commissioners had asked for the deadline for their final report to be moved back from the end of April to the end of December because of the document delay, but were rebuffed by LTC Minister Merrilee Fullerton.

McKinsey won sole-source pandemic contract after premier’s office cold call: Commission testimony

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