New report shows for-profit clinics performing surgery to worsen wait times and staffing shortages

A new report suggests the Ford government's Bill 60, which will allow more OHIP-covered surgeries to take place at private, for-profit clinics, will actually increase surgical wait times. Tina Yazdani reports.

By Tina Yazdani and Meredith Bond

A new report shows Ontario’s move to allow private health clinics to perform surgical procedures covered by OHIP will worsen wait times and public sector staffing shortages.

The health care reform bill passed in May of 2023 expanded cataract surgeries and diagnostic imaging and testing while the government will create an entirely new system to perform hip and knee replacement surgeries. The bill was introduced as a way to cut down on wait times and increase capacity

However, the report from the Canadian Centre for Policy Alternatives said it’s unlikely to do either of those things as capacity depends on the availability of staff, which will remain unchanged.

“Ontario does not lack the physical space and equipment to improve wait times for surgeries and medical imaging, what we see is we lack the necessary staff to be able to do the work,” said Andrew Longhurst, the author of the report and a health policy researcher.

While Ontario has had increasing wait times for some of these procedures, the province has some of the best wait time performances in the country and this has been because they have not allowed the for-profit sector to “destabilize public hospital staffing.”

In Alberta, where wait times are some of the worst in the country, the government’s focus on for-profit delivery of health care diverted resources from public hospitals.

“To be clear, wait times remain too long for Ontario patients but the sensible approach is to properly fund and improve the public system, not destabilize it,” Longhurst added. “What we tend to see when you are competing for the same limited pool of healthcare professionals is you’re going to be robbing the public hospitals of the workforce they need already in short supply and you’re going to see longer waits.”

“It really indicates that the threat we talked about, the threat of U.S.-style healthcare, the threat is real and we’re starting to see that interest in a very real way,” said Longhurst.

Ontario’s Attorney General estimates 34 per cent of hospitals in the province have unused operating room capacity. The report recommends taking advantage of that unused space instead of moving surgeries outside of hospitals by staffing them.

Health Minister Sylvia Jones said they are working on doing both, staffing and expanding capacity.

“We will continue to do both because we really want to make sure people who are sitting on wait lists right now get an opportunity in communities as quickly as possible.”

When asked about the report’s findings that this would worsen staff shortages, Jones did not respond.

Opposition leader Marit Stiles said she believes this was never about reducing wait times.

“This has only and will only ever be about this government’s commitment to padding the pockets of shareholders of these private corporations.”

The government stresses that the procedures will remain covered under OHIP, but the report has highlighted a lack of oversight which raises concerns about upselling and the quality of care.

“For-profit facility ownership also introduces financial conflict of interest in medical decision-making, which can lead to upselling self-referrals and clinically unnecessary procedures issues,” said Longhurst. “We also see generally that care delivered on a for-profit basis increases risks to patient safety and care quality as corporations find ways to reduce costs.”

Longhurst added this will also increase costs for taxpayers as for-profit delivery costs more.

“Researchers through FOI discovered that those same procedures in private for-profit facilities were more than two times the price than performing them publicly. But that was only discovered through freedom of information. So again, it just speaks to the fact that for taxpayers, it’s not providing good value,” said Longhurst.

The report also found that public payments to for-profit facilities are not accurately and completely accounted for in Ontario’s public account.

It found that in 2021-2022, the provincial government underreported payments by 720 per cent. The public accounts reported $68.5 million had been sent to independent health facilities, but based on expenditures obtained by Freedom of Information requests, the payments actually totalled $474.1 million.

“The data are not being reported in a consistent way. And I think the big issue here is being able to understand what’s actually happening is a challenge and I think again, the public interest is not being served when this information is not made available in a timely and public manner with proactive disclosure,” said Longhurst. “It is all shrouded in secrecy. And I think that’s one of the issues.”

Longhurst explained there is ample evidence to suggest it’s not more efficient, but if the province does follow through transparency is going to be very important.

“If they are going to continue to proceed with this, let’s see all of the financial reporting. Let’s see the transfer payment agreements, make those publicly available. Let us know the per unit cost per procedure that you are paying them … I think fully understanding the cost to the taxpayer is going to be really important.”

Top Stories

Top Stories

Most Watched Today