Toronto 
Ontario has significantly expanded the use of for-profit clinics for surgeries and medical imaging, but a new study says the shift has not delivered the shorter waits used to support the policy.
The Canadian Centre for Policy Alternatives (CCPA) examined Ontario’s health-care outsourcing using four Freedom of Information requests, government data and existing research. Its findings cover a period in which the province increased public funding for privately delivered procedures, particularly following the passage of Bill 60, the Your Health Act, in 2023.
The central finding concerns wait times. Between 2017 and 2025, median waits increased for eight of 12 priority procedures examined by the report.
The 12 priority procedures examined were MRI scans, CT scans, bladder cancer surgery, breast cancer surgery, colorectal cancer surgery, lung cancer surgery, prostate cancer surgery, cataract surgery, hip fracture repair, coronary artery bypass graft (CABG) surgery, hip replacement and knee replacement.
Wait times increased for MRIs, cataracts and every cancer surgery examined
Median wait times increased for eight of the 12. Those increases were recorded for MRI scans, all five cancer surgeries, cataract surgery and hip fracture repair. CT and CABG waits were unchanged, while median waits declined for hip and knee replacements.
The report argues this challenges the rationale that expanding outsourced care will reduce waits in Ontario’s health system.
Cataract spending increased sharply, but waits did not improve
Cataract surgery provides one of the report’s clearest examples. Public payments to integrated community health services centres, or ICHSCs, for ophthalmology increased 185 per cent between 2017-18 and 2024-25. Despite that increase, the report found cataract surgery wait times did not improve.
For-profit surgery volumes more than doubled
Surgeries performed at ICHSCs increased from 16,873 in 2017-18 to 36,653 in 2024-25, a 117 per cent increase. Public hospital day surgeries grew from about 1.26 million to 1.39 million during the same period, an increase of 10 per cent. Still, outsourced procedures accounted for only three per cent of Ontario day surgeries in 2024-25.
Public spending on for-profit facilities reached $674 million
Ontario paid for-profit surgical and medical imaging facilities $674 million in 2024-25, up 48 per cent from $457 million in 2017-18. These facilities received $4.1 billion cumulatively over eight years. Medical imaging represented $621.8 million of the latest annual total.
The report says some privately delivered procedures cost more
The CCPA cites research finding cataract surgeries at Don Mills Surgical Unit cost more than twice as much as procedures performed in public hospitals. Privately delivered knee arthroscopies were two to three times as expensive.
CCPA wants Ontario to change direction
The report recommends stopping further privatization of surgeries and medical imaging, increasing public hospital funding and capacity, and pursuing improvements within the public system.
“If the privatization of surgeries and diagnostic procedures was sound health care policy, then the evidence would support this direction,” the report concludes. “But it does not.”
Report: Not adding up: Surgical and diagnostic privatization in Ontario
