Outsourcing surgeries and imaging to private for-profit clinics has not resulted in a drop in wait times for most procedures, according to a new study released Monday.
The study relied on publicly available information and data obtained through four Freedom of Information requests. It found that since Ontario has started outsourcing more key procedures, wait times for these medical imaging services and surgeries are actually going up.
“Since the provincial government has prioritized for-profit surgical and diagnostic delivery over the expansion of public sector capacity and improvement, wait times are generally increasing in Ontario,” Andrew Longhurst, the study’s author, wrote.
According to the Canadian Institute for Health Information, median wait times for eight of 12 priority procedures increased between 2017 and 2025. These procedures and imaging include ones outsourced to private clinics, such as cataract surgeries and MRI scans.
For cataract surgeries, which the report identified as one of the “key procedures” that was subject to privatization, median wait times increased from 67 days in 2017 to 68 days in 2025, according to the report.
“This trend challenges the government’s rationale that greater outsourcing of cataract surgeries would significantly reduce wait times,” the report’s author notes.
For MRI scans, the report states, wait times increased from 35 days in 2017 to 47 days in 2025, representing a 35 per cent increase.
CT scans wait times, according to the report, remained unchanged at six days.
“However, wait times for the 90th percentile of patients increased by 95 per cent for MRI and 231 per cent for CT scans, which raises concerns that patients beyond the 50th percentile are waiting increasingly long times,” the report read.
“In other words, it is not only median wait times that matter. The increasingly long waits for many patients beyond the middle of the wait-time distribution is a red flag for health system performance.”
While a “relatively small share of total day surgeries” are outsourced to these for-profit facilities, known as Integrated Community Health Services Centres (ICHSC), the report states that the volume of publicly funded procedures and medical imaging services increased by about 117 per cent between 2017 and 2024-25.
In 2024-25, about $674 million went to for-profit surgical and medical imaging in Ontario, an increase of 48 per cent from 2017-18, the study found.
There are 918 ICHSCs in the province, up from about 902 in Ontario in 2023. Most services provided at these centres include medical imaging, such as diagnostic ultrasounds. The Ministry of Health has contracted eight clinics to perform plastic surgeries, six to perform eye surgeries, and seven to carry out CT and MRI scans.
Don Mills Surgical Unit and Shouldice Hospital, two private hospitals, perform multiple surgical procedures and hernia repairs.
The report states that across Canada, outsourced surgeries and medical imaging are “consistently found to be more expensive” than the same surgeries performed at public hospitals.
The report states that cataract surgeries performed at Don Mills Surgical Unit were “more than twice as expensive” as those performed in public hospitals, while knee arthroscopies were “two to three times more expensive.”
Reducing surgical backlogs
In a statement, Lily Barnes, a spokesperson for Ontario Health Minister Sylvia Jones, called claims made in the report “misguided.”
“Ontario is proud to have one of the largest publicly funded health-care systems in the world, with some of the shortest wait times for critical surgeries in the country, and our government continues to provide record funding, investing over $101 billion in health care this year alone,” she said, adding that this number represents a 64 per cent increase from 2018.
“For the third year in a row, we have increased hospital funding by a record four per cent, bringing the total increase to over 50 per cent since 2018. This historic funding has directly supported hospitals in reducing surgical backlogs, resulting in a 4,260 per cent increase in publicly funded same-day hip surgeries and a 5,840 per cent increase in same-day knee surgeries”
She added that the province has taken “bold action” to expand publicly funded procedures to community surgical diagnostic centres in an effort to “connect more people to life-changing procedures sooner.”
“Our expansion has resulted in 32,000 more people each year receiving cataract procedures, 1.2 million more people being connected to MRI or CT scans per year, and 20,000 additional joint surgeries per year,” the statement continued.
“Our government will continue to deliver more connected, convenient care in every corner of the province, always ensuring that people are accessing the health care they need with their OHIP card, never their credit card.”
The report says that surgical and diagnostic privatization is becoming “more deeply entrenched in Ontario’s health care system” since the 2023 passage of Bill 60, dubbed the Your Health Act, legislation that enabled private clinics to conduct more OHIP-covered surgeries to reduce the province’s surgical backlog.
“The growth of this for-profit industry—benefitting from substantial public funding—comes as public hospitals face funding austerity,” the report states, adding that Ontario’s Financial Accountability Office (FAO) estimates that just to maintain current service levels, $6.4 billion in new health care spending is required in 2026-27. The 2026 budget 2026 adds $3.4 billion in additional spending, leaving the system short by $3 billion in this fiscal year, the report notes.
“Costs in the hospital sector have been increasing by about six per cent per year due to population growth, aging, and inflation, according to the Ontario Hospital Association,” the report states.
“However, the Ontario budget plans for total health care funding to increase by 3.5 per cent in 2026-27 and 2.3 per cent in 2027-28.42 These increases are insufficient to address the health care needs of the population.”
In recommendations made in the report, Longhurst suggests the Ontario government provide more funding to hospitals, implement centralized waiting lists, look at physician payment reforms that enable “team-based care,” while staffing existing public operating rooms that sit idle days, evenings, and weekends.
“Rather than doubling down on privatization, the Ontario government would be wise to focus on policy strategies grounded in proven evidence and experience, both in Canada and internationally,” he wrote.
“Although some of these public system improvement initiatives exist in certain parts of the province and among certain surgical specialties, the provincial government does not have a clear plan to scale up and spread public sector innovations provincewide.”
