The Ontario government plans to significantly expand publicly funded surgeries and diagnostic procedures performed in for-profit facilities.
In May 2023, the government passed new legislation (Bill 60) which will encourage the growth of this for-profit sector and expand the types of surgical and diagnostic procedures allowed to be performed outside of hospitals. Drawing on Freedom of Information requests, financial and statistical analysis, and a review of the research literature and policy experience, this report evaluates the government’s policy direction.
The government’s stated rationale for increasing the use of for-profit care is to increase capacity and reduce wait times. However, expanding the for-profit sector is unlikely to do either: capacity depends on the availability of qualified staff, which is unchanged by the addition of profit.
This report recommends that the provincial government rethink its plans for the significant expansion of for-profit surgical and diagnostic delivery and, instead, refocus efforts on public system improvement based on the research evidence and policy experience in Canada and internationally. Effective, evidence-based policy strategies include single-entry and team-based referral models, improving and maximizing public operating room capacity, increasing access to seniors’ home and community care to alleviate hospital overcrowding, and reducing the overuse of diagnostic tests and surgeries. As well, public health interventions to reduce the spread of COVID-19 would help reduce strain on hospitals, and in turn, help prevent cancelled surgeries, backlogs, and longer wait times.