What's worse, the untendered, 10-year contract with STARS -- Bellinger says it will cost taxpayers almost $160 million during that period -- is the tip of the iceberg in a government procurement program in which many contracts are awarded without a bidding process.
"It wasn't as though contracts were awarded with no thought to it," Bellringer said Wednesday. "It's just that it didn't comply with the way it's been set out."
The 443-page report is the largest single auditor general's report submitted to the legislature and Bellringer's last, as she retires at the end of the month. The province has yet to find her replacement.
The report covers more than a dozen areas in which the government and its various operations -- at least those audited -- were found wanting in how money is spent and in accountability.
However, the most damning criticism focused on how the STARS air ambulance became a full-time service during the October 2011 election campaign. It comes two weeks after STARS was allowed to fly in emergency cases following a three-week suspension. The province grounded the service because of concerns over patient safety following the death of a woman after a flight.
The report found besides not complying with public tendering principles, contract information was not initially made available to the public as set out in legislation. It also found the province's value-for-money analysis for STARS was weak in that costs per mission were likely to be 231 per cent to 618 per cent higher than other EMS programs.
"(Manitoba) Health did not conduct a detailed needs assessment to determine all the requirements," Bellringer said in the report. "Instead, it relied on STARS as the main source to define program-delivery needs."
The report also found in five cases, flight manifests were incomplete, four in which STARS ignored stand-down directions, four instances in which a STARS referral emergency physician could not be reached to consult on a patient-care matter and an unspecified number of cases in which the helicopter landed when it was not authorized.
Health Minister Erin Selby said the government accepts each of Bellinger's recommendations and it will be the work of a new clinical oversight committee, under University of Manitoba dean of medicine Dr. Brian Postl, to address the concerns highlighted by the auditor general and in an independent review into patient care and air medical crew training.
"A helicopter service is just part of a modern EMS service," Selby said. "It's saved the lives of many Manitobans."
Opposition health critic Myrna Driedger said Bellinger's report on STARS is a "scathing indictment of gross mismanagement by the NDP government."
Driedger said most loathsome was how the NDP used STARS to curry votes in the 2011 election. "I think the NDP were in such a rush to get this helicopter before the election that they didn't do proper scrutiny, they didn't do proper due diligence," Driedger said.