Ontario paid for-profit clinics $4.1 billion as wait times rose, report says

Ontario paid for-profit surgical and medical imaging facilities $4.1 billion between 2017 and 2025, and median wait times increased for eight of 12 publicly funded priority procedures over the same period, according to a Canadian Centre for Policy Alternatives report released by CUPE National.

The report, titled Not adding up: Surgical and diagnostic privatization in Ontario, was written by CCPA senior researcher Andrew Longhurst. It analyzes data from 918 licensed private centres, called integrated community health services centres, and two private hospitals that offer publicly funded health services.

Provincial payments to for-profit facilities rose from $457 million in 2018 to $674 million by 2025, an increase of 48 per cent, according to the report. The report says the payments are a booming business funded exclusively by government.

Surgery volumes and funding growth

The report says the volume of surgeries performed in public hospitals increased by 10 per cent between 2017 and 2025, while the volume of surgeries in integrated community health services centres increased by 117 per cent over the same period.

Between 2022 and 2025, the average annual growth rate of public payments to for-profit surgical facilities was 22.8 per cent and to medical imaging was 10.7 per cent, according to the report. That is two to four times the 4.9 per cent average annual growth rate of public hospital funding over the same period.

The report also says public payments to for-profit facilities are not transparently reported. It says the Ontario Public Accounts report $84.7 million transferred to integrated community health services centres, while expenditure reporting obtained through freedom-of-information requests puts payments at $659 million, meaning Public Accounts under-reported payments by 778 per cent in 2024-25.

These for-profit facilities offering MRI and surgical services take in much more funding from the province than they pay out in value to Ontarians. And while the provincial government claims its subsidy of these private businesses will lead to shorter diagnostic and surgical wait times, the evidence shows the opposite is true.Andrew Longhurst, CCPA senior researcher

Wait times and extra-billing

Median wait times increased between 2017 and 2025 for eight of 12 publicly funded priority procedures, including MRI scans, cataract surgeries and all cancer surgeries, according to the report. The report says this challenges the Ontario government's claim that greater outsourcing reduces wait times.

The report says nearly one-third of unlawful extra-billing and user fee contraventions from 2023 to 2025 were related to cataracts and other eye procedures. It says 46 out of 147 contraventions were related to those procedures, a focus of surgical privatization.

The CCPA's research shows that privatization is driven by ideology rather than by evidence. We know that private delivery of hospital surgeries and diagnostics is more expensive, skews access to the wealthy and robs staff from the public system. Funding for the private surgical and diagnostic clinics should be cancelled in the interest of efficiency and equality, and the government should ensure the efficient use of our existing public hospital infrastructure.Michael Hurley, president of the Ontario Council of Hospital Unions, the hospital division of CUPE (OCHU-CUPE)

Longhurst said the province should stop privatizing surgeries and medical imaging, increase public hospital funding and service capacity, and act on the evidence to improve the public system. The report is available at policyalternatives.ca.